Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial
BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7351.1430 (Published 15 June 2002) Cite this as: BMJ 2002;324:1430All rapid responses
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Sex education dose not work,it says so in the BMJ,said a rather smug
community Paediatrician. I was therefor intrested to read the whole
article for myself. My role
this year to promote and support the other school nurses in Airedale PCT
advance the devlopment of a spiriling sex and realationships education
across all our primary and secondary schools. Iam aslo a family planning
nurse and on several occassions have heard the A Pause Programme developed
in Exeter University heralded as the only sex eduction programme proven to
reduce the age of first intercourse. Is this not so?
Even if the limited package of education mentioned in the article were
freely available to all schools it would be as nieve to think that it
would reduce the pregnancy rate in isolation. After all 15 lessons on
healthy eating would not reduce coronary heart disease.Fortunately school
nurses are aware of the need to adopt a multy faceted approach in our area
we encourage parents to talk to their children in an open and supportive
way, we work with the Health for MemTeam to promote shared responsiblity
in relationships education in school.The most intersting finding in this
research for me would be the cofirmation of my own observation that family
coposition and parental monitoring are signficant factors in teen
pregnacy.The difficlty is finding the solution.
Competing interests: No competing interests
It seems to me that there is a vast difference between the following
statements:
1. "Sex education does not work."
2. "One particular specially-designed sex education program doesn't work
any better than the sex education we were already doing."
People are going to sensationalize and distort the results of this
study if that distinction isn't made clear. The story-header on your front
page poses a question ("Does sex education work?") that is not answered by
the authors.
Amy Cavender, M.Ed.
Competing interests: No competing interests
How long will sex education continue to rely on the
false promise of adult-led information sessions?
Providing opportunities for peers to be trained and
supervised to offer peer-based sex education is the key
to respectful sexuality practices, reducing unintended
pregnancies, increasing condom use, and reducing the
transmission of disease. For more information on how
this works, visit our non-commercial site at
<www.peer.ca/peer.html>
Competing interests: No competing interests
I totally agree with the response by Violet j. Willis.
1. The stress should be on that sex education starts at home.
2. Use of graphics increases the curiosity and need for
experimentation in young adults.Hence the need to change the entire
strategy and curriculum for sex education. The parents should be involved,
not only to see the vidio tape of the film their children will be shown
but to actively participate according to the changing needs and
understanding of the adolescents.
Competing interests: No competing interests
If the goal of sex education is reducing sexually transmitted
diseases and unwed pregnancy, it is a major disaster, but if as my
research suggests the goal is to promote the sexual revolution and get
kids to have sex with kids, it has been a monumental success.
Dale O'Leary
Competing interests: No competing interests
Most kind of education does not work!
Why single out sex education?
Competing interests: No competing interests
It is of no surprise to me regarding your outcome for the study of
sex education and teen pregnancy.
I think detailed and graphic sex education classes actually arouse
curiosity of teenagers with regard to sex. That curiosity coupled with
the current lack of discipline (i.e. parents wanting to be buddies with
their children) and parent innatention due to dual careers which leads to
teens being home alone for long periods of time during the afternoon leads
to sexual experimentation.
Teens as young as 13 are now becoming sexually active. This coupled
with a teenage brain that is not mature and cannot make adult decisions
(in the US you can't smoke until you are 18 and cannot drink until the age
of 21) creates a culture of reckless behavior sexually and a maturity
level not ready to handle all the strong emotional response of "caring"
stable relationships that sexuality should foster between two people.
Instead teens begin a cycle of multiple transient sexual excounters with
no lasting emotional ties between partners. This causes emotional pain
and perpetuates the problem by the individual seeking out more sex to fill
the emotional void - riskier behavior that usually ends in a unwanted teen
pregnancy.
The solutions to the problem of teen pregnancy is very simple, but
hard for clinicians and politicians to swallow.
1. Shame must be brought back by parents and guardians of teenagers.
For generations, this was the number one cultural response to a unwanted
teen pregnancy.
2. Parents must get involved with their childrens lives. I just
can't believe that a few hours per night and maybe the family gets
together on the weekends - know what their teens do and who the child's
friends are. Tax breaks for parents who decide to have one breadwinner in
the family is much better than dual career households. At least one
parent is home to monitor the teens life and be there for them when they
come home from school.
3. End graphic sex education in schools. Teens should be tought the
biology around sex including contraception use but any other education or
issues regarding sex should be taught by the parents of the child.
4. If a teens do get pregnant encourage adoption as a solution. The
child will be raised by stable, loving parents who want the child and can
provide a better life than an immature 13-18 year old. If the adoption
option fails, strongly encourage marriage between the couple who concieve
a child and finally if this fails, legally make sure the mother indicates
who the father is so the child can be financially supported later when the
father gets a job.
Hope the above helps for future studies.
Violet J. Willis
Competing interests: No competing interests
Additional strategy required for sex education
Dear Sir,
It is almost 20 years since Victoria Gillick attempted to force doctors to
obtain parental consent before treating children. Her legacy in fact was
to totally remove any parental role in the provision of contraception for
youngsters.
We now have the highest teenage pregnancy rate in Europe and second
highest in the world. Government led attempts to curb this have focused on
endless teenage initiatives, providing ready access to free contraception
and advice.1. The latest announcement of free condoms available through
schools is yet another variation on the same theme and will surely
contribute insignificantly.2. In a Nottingham study, many teenagers who
became pregnant had sought contraceptive services in the preceding twelve
months. 3. Hence, contraceptive failure is as significant a factor as
simple access to contraception.
Over the last generation, there has been a major sea change in
parental attitude, with a whole generation of parents who are now tolerant
of sex on TV, jokes about drugs and the concept of teenagers experimenting
with sex. They represent a huge and currently untapped resource that could
help in guiding teenagers about contraception.
Parents are informed that their child is having sex education in
school, but are not actively invited to partake of this process. Parents
would benefit from knowing that talking about sex does not encourage
teenagers to experiment at an earlier age. It is likely that youngsters
that use contraception will do so more effectively if parents are aware of
this fact. Teenagers will benefit from knowing their own parent’s specific
view on their personal use of contraception, rather than a general
discussion of the birds and the bees. Many teenagers might be relieved to
find their parents open minded and sensible, underneath the British ‘stiff
upper lip’ exterior, if only both parties were better able to communicate
their views.
Setting out a programme to help parents clearly convey their views and,
hopefully, to give their teenager parental permission to use
contraception, (and possibly practical help in obtaining it) may sound non
- PC and rather old fashioned, but at least it merits piloting and could
be an additional strategy to those currently planned.
1. Wight D, Raab G, Henderson M, et al. Limits of teacher delivered
sex education: interim behavioural outcomes from randomised trial. BMJ
2002; 324:1430-3
2. Kirby D, Resnick MD, Downes B, et al. The effects of school-based
health clinics in St Paul on school-wide birthrates. Fam Plan Perspect
1993; 25:12-16.
3. Churchill D, Allen J, Pringle M, et al. Consultation patterns and
provision of contraception in general practice before teenage pregnancy:
case control study. BMJ 2000; 321:486-9.
Dr Rachel Pryke. General practitioner and family planning doctor.
Winyates Health Centre, Winyates, Redditch. Worcs. B98 0NR.
Email drpryke@inglewood.fsnet.co.uk
No competing interests.
Competing interests: No competing interests