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Behavioral Health Brief: Advocating for Earlier, Better Sex Education
By Lindsey Getz
Social Work Today
Vol. 19 No. 3 P. 6

The #MeToo movement has been effective in bringing issues surrounding sexual violence to the public eye. But many say that the underwhelming legislative response to the movement leaves room for so much more work to be done. In terms of where to go from here, it’s been argued that the best next step just may be better sex education—something that should start earlier than most may realize.

When people think of sex ed, an awkward conversation with a parent or other caregiver about the so-called “birds and the bees” or a mandatory middle school health class that taught only the basics about reproduction may be memories that come to mind. But sex ed advocates say that a significant opportunity is missed when conversations surrounding one’s body start too late or fail to miss important talking points. By the time children receive the “talk,” they’ve already formed foundational concepts about their body and their rights—as well as the bodies and rights of others.

Sex educator Nicole Cushman, MPH, executive director of Answer at Rutgers University (a national organization that provides access to sex ed) and advisor to AMAZE (a sex ed video series), says that the foundational building blocks for sex education start very early in childhood with a lot of the messages children receive in their home or caregiving settings.

“Actions such as teaching children the proper names for body parts including genitals, teaching them how to interact with peers, and communicating consent in regard to their body and unwanted touching—even if it’s a hug—all help lay the foundation for future understanding,” Cushman says.

Debra Hauser, MPH, president of Advocates for Youth, a DC-based nonprofit organization and advocacy group dedicated to sex ed, and also an advisor to AMAZE, says that these concepts—such as asking to borrow a crayon but respecting the other child’s right to say no—are the beginning of consent education. Similarly, with bodily autonomy, as awkward as it may be for parents, if a child wants to refuse a hug from a relative, sex educators say it’s important to teach children they have a right to their own bodily boundaries. They are allowed to say no.

“Another early elementary school lesson that serves as a building block for future relationships is the concept of what makes a person a good friend,” Hauser says. “Talking to children about how friends make them feel is the beginning of helping children understand healthy vs. unhealthy relationships. Later, this can transition into talking about choosing a good partner—and what that looks like.”

Relationship Communication
Hauser says that there is a misperception that sex ed at the elementary school level is explicitly about sex—when it’s clearly more about foundational concepts that will support future sex education.

But what’s taught at that later date also has much room for improvement. Currently, only about one-half of U.S. states mandate any form of sex ed, with two teaching abstinence-only and nine requiring instruction on consent.

Moving into a space where sex ed is taught early and thoroughly is critical when it comes to sexual violence prevention. Meaningful sex ed includes teaching skills for establishing boundaries, consent, and forming healthy relationships. In fact, a recent study from Columbia University found that undergraduate women who received this type of sex ed before college were half as likely to have been assaulted, even after accounting for gender, income, race/ethnicity, and other factors. Meanwhile, students who received abstinence-only sex ed before college were not shown to have significantly reduced experiences of campus sexual assault.

“We’ve made a lot of progress and sex ed is no longer just a plumbing lesson in most places—but there’s still a long way to go,” Cushman says. “We are moving into an era of consent education that goes well beyond just talking about preventing unintended pregnancies or STDs but starts opening the door to dialogue about healthy relationships—something that is absolutely key to sexual violence prevention.”

Cushman says that a good sex education curriculum should focus on the characteristics of a healthy relationship including decision-making, communication, negotiation, and boundaries. Young people also need to learn what might indicate that a relationship is unhealthy and one they should move on from.

“These conversations apply not only to romantic relationships but also to peer relationships, health care provider relationships, teacher relationships, and family relationships,” Cushman says. “Being able to clearly communicate feelings and boundaries in regard to one’s body is a lifelong skill.”

An Emotional Component
By moving sex ed away from being a conversation solely about logistics and discussing the important relational concepts related to it, Hauser says that the vital “emotional components of sex ed are brought to light.” And this is something that young people need—and crave. She says that one of the common topics that continually comes up on AMAZE are questions young people have about relationships such as how to handle rejection and whether something they are going through is “normal.”

“There’s a huge emotional and mental health component that needs to be addressed with sex ed,” Hauser says. “We already know from the [Centers for Disease Control and Prevention] that the suicide rate has risen among all groups—but it is disproportionately high among LGBTQ youth. They often feel different, and many have experienced bullying and harassment at home or at school. These young people, like all young people, need to be accepted and loved. This is, of course, the very task of adolescence—to experience relationships that teach you about what you want in your future.”

Hauser says that young people who do not feel accepted or loved and those who are stigmatized, bullied, or mistreated often internalize these negative feelings and may consequently take greater risks around sexual health than they would have otherwise taken. Hauser says, for example, that bisexual and lesbian young women are twice as likely to experience teenage pregnancy than their heterosexual peers, while those who experience childhood sexual abuse are also at elevated risk—facts that may be explained by recent research tying childhood maltreatment (including bullying, abuse, or being rejected by one’s family) to increased sexual risk-taking behaviors associated with early pregnancy.

Hauser says, “This is where the mental health component of sex ed is so vital.”

Technology: Friend or Foe?
Since technology touches almost every area of our lives these days, it’s not surprising that it’s also having an impact on sex ed. This can be both good and bad. Research shows that being exposed to pornography at a young age can have negative effects on the development of beliefs and expectations relating to sex and relationships. But technology can also be a very valuable tool in helping teach young people about healthy sexual relationships and ideations.

“Technology can be a powerful tool for kids who have questions or are looking for more information about their body or what they’re going through,” Hauser says.

Young people are using technology at high rates, and they’re likely going to turn to it whether that’s under the guidance of a parent or not. That’s why Hauser says that instead of shying away from technology, educators and caregivers should really find ways to tap into it and use it as an ally.

“That’s what we’re trying to do with AMAZE and the resources available to young people who have a lot of questions,” Hauser says. “We’re meeting kids where they’re at—and for most of them, that’s online and utilizing technology.”

The Social Worker Role
As sex ed continues to evolve to better serve young people, both Hauser and Cushman believe that social workers can play a critical role.

“I think social workers are highly skilled at navigating what is often seen as a sensitive subject, such as topics relating to sex ed,” Cushman says. “I think that the more voices we have contributing to this conversation, the more it would increase educators’ comfort and confidence in teaching sex ed. It has been traditionally uncomfortable for some, but we need to make it more natural and commonplace to talk about.”

Cushman says she believes that the vast majority of parents—and educators—are on board, but the voices of opposition, though a minority group, tend to be loud. That’s why the more professional voices out there that are supporting this messaging, the better.

“Social workers play a big role in the attempt to normalize and help promote the acceptance of sex ed,” Hauser says. “This is primarily a local issue with school boards and parents coming head to head to make these decisions. Social workers who feel compelled can be an incredibly important voice in their local communities and can help showcase how sex ed—particularly in elementary schools where it is so incredibly critical but often overlooked—can help promote healthy transitions into adulthood.”

— Lindsey Getz is a Royersford, PA–based freelance writer.