Let’s talk about sex: gender norms and sexual health in English schools

Abstract

The sexual health of young people in England is an urgent public health concern. Teenage pregnancy rates have declined but remain the highest in Western Europe and are associated with health, social and economic problems, even after adjusting for pre-existing disadvantage. Rates of sexually transmissible infections (STIs) remain high. If undiagnosed, these have important consequences for later fertility and health. Sexual violence against women and girls is a major sexual health concern and a growing body of evidence suggests sexual harassment and assault, female genital mutilation and rape are common experiences had by women and girls in England. 1,2While interventions to address young people's sexual health have focussed on knowledge, skills and contraception access, amazingly none in the UK has explicitly addressed the effects of the social hierarchies of gender and gendered behavioural ideals that shape young people's sexual expectations, attitudes and behaviour. The lack of attention to gender is a persistent gap in health research, practice and policy.Research suggests a link between rigid and inequitable gender norms and negative sexual health in terms of partner violence, teenage pregnancy and STIs.3-8 Gendered power imbalances in sexual relationships may constrain young women's ability to negotiate safe and pleasurable sex. A US cross-sectional study showed that women with high levels of power in their intimate relationships were five-fold as likely as women with low levels to report consistent condom use, after controlling for sociodemographic and psychosocial variables. This study estimated that over half of the lack of consistent condom use among women can be attributed to low sexual relationship power.9 Another cross-sectional study of 5913 adolescents aged 14-18 years in 20 secondary schools in Bolivia and six secondary schools in Ecuador showed that sexually active adolescents who consider gender equality important report higher use of contraceptives, are more likely to describe their last sexual intercourse as a positive experience and consider it easier to talk with their partner about sexuality compared with sexually experienced adolescents who are less positively inclined towards gender equality.3 These correlations were consistent for boys and girls. Non-sexually active adolescent boys and girls who consider gender equality to be important are also more likely to: (i) think that sexual intercourse is a positive experience; (ii) consider it less necessary to have sexual intercourse to maintain a relationship; and (iii) find it easier to communicate with their girlfriend/ boyfriend compared with sexually non-active adolescents who consider gender equality less important.3 Furthermore, findings from 10 studies in Latin America, Asia and Africa found significant associations between support for inequitable gender norms and increased risk of partner violence and unprotected sex. 6,7 Qualitative research suggests that pervasive norms about how males and females are supposed to behave can affect sex...

A peer-led intervention to promote sexual health in secondary schools: the STASH feasibility study

“…Schools provide a major context for social development 22 and are ideally placed to challenge unhealthy and inequitable norms underpinning sexual risk behaviours. 23 For interventions attempting to diffuse change through social networks, schools provide a 'captive audience' and naturally occurring friendship groups. 24 School-based interventions tend to comprise one or both of: l sexual health education and training to improve knowledge, exploring emotions and sexual norms, developing sexual negotiation skills and self-efficacy, and making informed choices 3,25 l providing access to sexual health services either in or out of school, including condoms or access to other forms of contraception (e.g.…”

“…These values drew on the literature, policy and stakeholder consultations. Foremost among these were aims to address negative gender norms, 23,79 to take a broadly 'sex-positive' rather than risk-focused approach and to draw on a rights-based discourse of sexual health. 80 A rights-based approach was familiar to students and teachers from the current Scottish curriculum.…”

Dokumentarische Forschung zu schulischem Unterricht. Relationierungen und Perspektiven

“…The authors emphasize that gender is an ongoing activity achieved through daily interactions, rather than a fixed category. School-based sexuality education is recognized as a crucial program for adolescents to gain knowledge on gender equality (Jamal et al 2015). Holistic sexual education, in particular, has been shown to promote understanding of gender equity (Goldfarb & Lieberman 2021).…”

An exploratory investigation of the perspectives of educated parents on the gender roles and stereotypes in child and adolescent sexuality

“…The stereotypes and social roles of the patriarchal model are detrimental, not only in the aforementioned effects on sexuality but also because they lead to a dichotomous way of thinking about many other issues. When hierarchies are formed from these dichotomous categories, discrimination, violence, exclusion, and violation of rights can occur (Endendijk et al, 2017;Jamal et al, 2015;Khan & Hamid, 2020). With the flourishing of feminist movements seeking justice, equality and changes in the roles and stereotypes of gender, health and education programs emerged that promote the rights of women in all areas of life.…”