Comprehensive Sexuality Education interactive report

Comprehensive Sexuality Education

Comprehensive Sexuality Education

There are more young people in the world than ever before.

there are 1.8 million young people, the majority becoms sexually active at 15 years

Sexuality is a fundamental aspect of human life.

Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.

there are 1.8 million young people, the majority becoms sexually active at 15 years

Gender Equality, Sexual Rights, Empowerment

CSE promotes the fundamental principles of a young person’s right to education about their bodies, relationships and sexuality. And the full range of information, skills and values to make informed decisions about their health and sexuality.

CSE promotes gender equality and the prevention of violence against women and girls.

CSE promotes gender equality and the prevention of violence against women and girls. It can increase confidence, and when young people feel empowered, they can choose when and who they have sex with.

However, they don't always have accurate information about their sexual and reproductive health or their right to access services.

Lesbian, gay, bisexual, transgender, intersex, queer and questioning (LGBTIQQ) people are especially marginalized, as are many young people who have survived sexual violence and rape.

When LGBTIQQ issues taught positively CSE can challenge the rise in violent homophobia and transphobia globally.

Growing up intersex in Uganda

“My name is Kisaakye. As any growing child I expected bodily changes such as growing breasts and menstruation; but these things didn’t happen to me. I waited and waited, and still nothing. I began to wonder whether I was a boy or a girl. I decided to ask my aunt about it. She said “Yes we know, but we decided to keep quiet. Just try to live like a normal child.” But it wasn’t easy for me. I did not understand who I was. My grandmother said I was bewitched.

Secondary school was very miserable for me. Many of the students would wonder whether I was a girl or boy. I dropped out of school, stayed home and did house work.

My turning point was when I saw a helpline advertised on TV. I contacted them and I received counselling and a hospital referral. Finally, I met people who encouraged me and introduced me to other people who had similar experiences to me, and also linked me to RHU.

At RHU, I could share my personal experience with other young people. They also contributed to building my self-esteem and widening my understanding of sexuality issues. I now feel empowered and I can speak about it freely through the Youth Action Movement (YAM). I am very grateful that they are going to support me to do what I have longed to do in life - a course in computer studies.

CSE in preventing and addressing SGBV

In Palestine sexual violence against women, especially within the family, is common. Women's virginity is linked to the honour of their family, and will face threats of death for dishonouring their family.

Mariam needed help to get out of a coerced “relationship”, fearing for her life if her relatives find out.

“In the beginning my nephew wanted to kiss me. “I resisted. But then he started touching my body. It became a relationship between lovers. To “preserve” virginity, it was always anal sex.
“I knew it was wrong. But who I should talk to? If my brother found out he would have beaten me - killed me.”

At the PFPPA's clinics, social workers give awareness sessions on sexual violence in the waiting rooms, hoping to catch the attention of women there for other reasons who are hiding the fact they have been abused. It was this kind of session that proved vital for Mariam.

“When my sister was pregnant I went with her to the PFPPA clinic,” she remembers. “The social worker there, Ruba, started speaking about sexual violence. When my sister went in with the doctor, I went to Ruba's office and told her I needed help; I cried.” Mariam kept visiting Ruba, and ended things with her nephew.

“What happened to me is not rare. It would have been impossible for me to approach a relative and tell them what was going on; I was too frightened. And nobody would have believed me over a man.
“I've found there are other women of my age who've had similar experiences to me but women are frightened to speak about it.
“Before, I despised myself. Now I feel powerful. I leave the house, I meet people. I feel I'm responsible for myself, that I have to protect myself, and that I need to help others if they need me. Everyone's telling me 'you've changed, you're stronger'.”

Through its association with religious and community leaders, the PFPPA seeks to persuade the public of the importance of talking openly about sexual health and relationships, and dispel the idea that sexuality education for young people goes against the teachings of Islam.

Starting Early

CSE with 11-14 year olds is critical.
It prepares them to take informed decisions and with ‘setting the stage’ for future sexual health attitudes and behaviours.

Increasingly young people are looking online for information and find inaccurate misinformation about sexual and reproductive health and sexuality.
This highlights the need for accurate, well-communicated CSE material in all countries.

Challenging discrimination and early marriage in Nepal

The lack of sexuality education in Nepal contributes to discrimination perpetrated towards women and girls, including, early and forced marriage.

Family Planning Association of Nepal (FPAN) is boosting comprehensive sexuality education both at schools and outside of school settings to reach marginalized young people. FPAN stay open on Saturdays and help pupils form committees to educate their peers on sexual and repoductive health information, including young people who don't attend school.

“We get to learn what we couldn't learn anywhere else – like about menstruation,” says Puja, 15. “I didn't know anything about it when I first got my period. I didn't know what was happening to me. I was so scared when I saw the blood. I thought I was going to die. I was too ashamed to show my mother.”

As a peer educator, Puja spreads knowledge to empower other girls. “When girls have their period they have to stay in a separate area of the home, or to sleep outside. I know now that menstruation is not a punishment from the gods. We can give that information to others so they don't discriminate against their daughters when they get their period."

The educators go into schools and also work with groups of girls who are out of education, who are seen as most at risk of having unsafe sexual relations or facing violence.

Parents were initially concerned. “They told us that if we gave sex education to their children, they would have sex at a young age,” says Manju Rarajuli, 21. “But soon they saw the positive effect on their children and also that they were benefiting themselves."

Empowering people with disabilities

The Reproductive and Family Health Association of Fiji (RFHAF) partner with the Ministry of Education of Fiji and the Fiji Western Disability Association to provide CSE to young people with disabilities. It enables them to make informed decisions about their sexual and reproductive health and rights.

They teach about boundaries and encourage young people to tell their problems to someone they trust.

Thanks to what she learned, Malisa, a 12-year-old with a hearing impairment, escaped sexual violence. “One day, I was in a cab on my way back home from school. Instead of taking me back home, the cab driver took me to a deserted house and left me there alone. I asked myself why someone would take to a deserted area. From what I learned in RFHAF, I knew that something wasn't right. I remembered what I learned during my session”.

I escaped and ran to the highway. I flagged down a passing taxi, and asked the driver to take me to the police station. Writing on a piece of paper, I asked the police to find my teacher so that I could tell her what happened to me. I have never been so scared in my life and I am thankful to my teacher and the volunteer educator from RFHAF for teaching the steps to take.

Thanks to RFHAF for giving me CSE. It saved my life and I am certain it will save a lot of other people with disabilities in such situations.”

Sexual Pleasure and confindence

SEX-POSITIVE APPROACHES strive to achieve ideal experiences, rather than solely working to prevent negative experiences.

Encouraging discussions among young people about desire, sexual pleasure and confidence is empowering and actually increases their confidence to ask questions.

Drama puts the ‘sexy’ back into safer sex in Venezuela

Venezuela has one of the highest teenage pregnancy rates in Latin America yet sexuality education in schools is not mandatory.

Dangerous misconceptions about pregnancy and abortion abound: teenagers think that if they've done it once and not got pregnant, they won't ever get pregnant, and maternity hospitals see about 40 unsafe abortion-related admissions a day.

Plafam teamed up with an acclaimed improvisational theatre company in Caracas, to speak frankly and humorously about sexuality while also busting myths. They tell the audience that sexuality should be about fun and pleasure.

Actors improvise three or four sketches, sometimes including songs and music. “We wanted something different that would have an impact on young people specifically,” says the sexologist Michela Guarente. "Through the improvisation we really get them laughing, - it's a great moment to sneak in the information they really need, not just about sexuality, but also about building a life plan.

"We talk about how to make sexual acts pleasurable but also safe. Like masturbation is something you can do with your partner that's really safe and pleasurable, where you can establish this really intimate connection'.

Valeria, 22, says “Teaching sex education through arts is a wonderful idea – because the arts move you. Sexuality is about fun and pleasure,” she says. “It's not just about preventing STIs and unwanted pregnancies. It's about how to fall in love, how you relate to other people. It's about dreaming about a better future for yourself.”

Macedonia: Sexuality Education for Young People with Learning Disabilities ..and Their Parents

One misconception about people with learning disabilities is that sexuality is not, or should not, be an issue for them - that they simply should not have sex.

Lara, 27, has behavioural problems and learning disabilities. Every day she travels alone on the bus. It’s an important mark of independence – but one that means she must know how to keep herself safe.

What does she feel about the sexuality education sessions? “I feel good about them and I find them useful,” she says. “ If someone wants to force us we can push them to protect ourselves, to defend ourselves. And some things that you can do at home only, and when you’re alone but not in public places.” Lara says she had a boyfriend once, and would like one again – if she can find one. “I need to behave appropriately, not be aggressive with him, and use a condom,” she says.

Lara’s father, Branislav, says, “At the beginning I thought it was a strange to discuss, but now I accept that it needs to be talked about openly here in the centre with the young people - particularly about sexual abuse, but also about their sexual lives.”
“I’m from the old school; I don’t discuss these things with my daughter. My parents didn’t discuss these issues with me. It’s difficult for us to have an open forum for discussion, so it’s better to do it in the centre. We need to keep in mind that sexual abuse is very high among people with learning disabilities. Lara has started discussing these things openly now."

Reaching marginalized youth
in informal settings

School-based CSE doesn’t always respond to the needs of a diverse youth population, particularly girls, 10-14 years olds, young people of colour and disabled young people.

Restrictive laws regulate young people’s sexual identity and behaviour. This has a disproportionately negative impact on lesbian, gay, bisexual, transgender, intersex, queer and questioning (LGBTIQQ) youth, marginalizing them from access to services.

Globally, the number of school enrolments in schools is falling. CSE delivered in non-formal settings has the potential to reach vulnerable and marginalized youth populations who are not in school.

It can also be a way to reinforce knowledge for young people who are in school, so that they receive sexuality education both within and outside their school. Outside, CSE is delivered through innovative, cutting-edge learning styles. In countries where CSE isn't delivered in schools, non-formal settings provide the only opportunity for CSE.

In Kenya there's a growing generation of young people who are disproportionately affected by HIV. These adolescents were born with HIV and/or have lost one or both parents. Coupled with the poverty brought on by these circumstances, they have many unmet health, educational, economic and social needs.

FHOK address these challenges to improve the quality of life of adolescents (aged 10–19 years) living with or affected by HIV in Kenya.

A key role has been played by the youth mentors, specially trained members of the community who work with youth in school and those not in school. The mentors work as access points for information and training on life planning skills, sexual and reproductive health, HIV and, if required, facilitate confidential referrals to the clinic. Many of the youth mentors are looked up to as role models.
Some of the older adolescent youth mentees have been trained to become youth mentors. Emmanuel, a 19-year-old living with HIV, says:

"This has saved a generation. From the opportunities provided, I am able to take care of my three siblings. I struggled through high school with a lot of difficulties, having to stay away from school because of opportunistic infections. I have now gained control of my life. All l can say is FHOK saved my family and me from starvation, life as a school drop-out, a life on the streets!"

Twenty years old and already mother of three, Irene is a sex worker in the Philippines.

She left her hometown when she was pregnant, fearing that her father would find out that she was no longer a virgin. During the pregnancy her partner abandoned her. She struggled to find other work due to her limited education. As a sex worker, her estimated monthly earnings is P15,000 (US$300).

Irene’s first access to reproductive health services was when she received free condoms from the Family Planning Organization of the Philippines (FPOP) during their outreach activities in 2012. A year later Irene participated in FPOP’s peer education training on adolescent reproductive health. It targeted young girls in sex work, many of them were illiterate. Since the training Irene, who was pregnant at the time, had actively taken steps to seek the health services offered by FPOP, including obstetric and gynaecological care Weeks after her pregnancy, Irene came back to the clinic to get injectable contraception, but the clinic staff assessed found that she had contracted a Sexually Transmitted Infection (STI) from unsafe sex. She was given an emergency contraception and both she and her partner were given free STI treatment. Both of them fully recovered from their conditions.

Although Irene continues sex work, Irene participated in FPOP’s peer education and team building session where many of its activities were related to reproductive health, and she now knows the importance of having information and access to reproductive health services and is grateful that she can rely on FPOP for youth friendly care without discrimination.

CSE in schools

All children and young people should access information that is scientifically accurate, non-judgemental, inclusive and gender sensitive. It must include the development of key life skills and the opportunity to explore attitudes and values.

Evolving capacity is about individual development and autonomy - the way that each young person gradually develops the ability to take full responsibility for her or his own actions and decisions. This happens at different paces for each individual.

Schools are an important place to reach large numbers of young people with high quality CSE. However, across the world, CSE is often not delivered in schools, and where it is, the quality is often poor.

Trained and qualified teachers are needed to deliver high quality CSE to young people in schools. Too often, sexuality education is not comprehensive and teachers may have their own bias and do not always cover topics that may be viewed as more controversial. Topics are taught too late after young people have already experienced puberty or menstruation or initiated sexual activity.

CSE content must be culturally relevant and adapted to meet the needs of young people. It is important that within the school environment, CSE is taught in a way that makes young people feel comfortable and safe.

Effective school programmes have often established close links with local SRH services to facilitate access to contraception and testing for sexually transmitted infections.Services should include prevention of adolescent pregnancy, care for pregnant adolescents, HIV prevention, testing, counselling, treatment and care, vaccination against HPV and safe abortion care.

There are differences across and within communities, contexts and age groups about young people’s knowledge, beliefs, attitudes and skills as they relate to sexual behaviour and risk-taking. That is why initiatives should engage communities and embed programming within the local context. It is important to gain support from parents, families and other key community members by familiarizing them with the content of their young people’s learning and equipping parents with skills to communicate more openly about sexuality with their children.

“My name is José Gabriel and I’m nine years old; I am studying at San Luis school in Tarija Bolivia.
Two years ago my teacher Rosita started talking about sexuality education or, as we call it, the CIES course. At first I was embarrassed, but we started talking with cartoons, puzzles and games. I enjoyed it, because I understood what she was teaching me. My teacher explained to me how my body works and how to clean it. She also told me that I have a penis and girls have a vagina. Now, I teach the same things to my little brothers when they ask.

Before, saying those words was bad. I could not talk about sex because my dad got angry and told me that children should not talk about such things. Now, after my dad and my mum had lessons with my teacher, we talk about sex and stuff. It isn’t bad to talk about sex anymore; my dad also speaks with my brothers and my sisters.

That makes me happy.

Age-appropriate sexuality education delivered by CIES Bolivia