The pathways by which gender norms drive adolescent sexual experience and health are easy to imagine. Anthony coerces a girl at a party to have sex, in order to satisfy his buddies’ questions about his heterosexuality. Jessica has unwanted sex because she’s afraid her boyfriend will become violent again if she refuses. Sofía becomes pregnant to “save” her boyfriend, who can exit the gang if he becomes a father.
The argument for sex education in schools is a familiar one. First: Abstinence-only programs have been rigorously evaluated, and they don’t work. Second: Young people have a right to information to protect their health. Third: Comprehensive sex ed delays sex and promotes the use of contraception and condoms among those teens having sex, thereby reducing the rates of unintended pregnancy and sexually transmitted infections (STIs), including HIV. Fourth: We know what content must be included in a sex ed curriculum for it to work.
The first two claims are unassailably accurate. The third and fourth are on more wobbly ground.
The disconcerting truth is that while curricula that teach “comprehensive sex ed” easily outperform those that preach abstinence only, they still often fall short. When sex ed curricula are evaluated according to learners’ actual health outcomes (that is, their rates of pregnancy or STIs), the majority fail. The bottom line is that sometimes sex ed does work—demonstrating actual positive health outcomes—but most researchers agree that what makes that happen has been poorly understood. Indeed, researchers note the difficulty of identifying key characteristics that are consistent across studies.
A recent study from the Population Council contributes powerful evidence to the policy debate—and suggests an urgent need for a new approach to adolescent sexuality education. The study, conducted by one of us, found that a key to improving effectiveness of sex ed programs is for curricula to address issues of gender norms and power dynamics.
These results are stunning in their magnitude. Programs that engage young people in thinking critically about gender and power are almost five times more effective at reducing rates of unintended pregnancy and/or STIs than programs that do not. The review found that “gender/empowerment” programs generally succeed: 80 percent reduced learners’ pregnancy and/or STI rates. Programs that ignored gender and power typically failed: only 17 percent were effective. The two approaches have nearly opposite outcomes.
The hypothesis for this study rested on strong evidence: In study after study, young people who adhere to conservative attitudes about gender norms, or who report unequal power in their intimate relationships, have worse reproductive health than their peers. This means they have earlier sex, more partners, earlier pregnancy and/or higher rates of STIs.
How do the effective programs move beyond facts and role-playing how to say no to promote critical thinking about gender and power? They give young people, including kids like the fictional Anthony, Jessica and Sofía, opportunities to reflect in-depth about how gender and power dynamics operate in their own lives. They do this through activities like discussion, journal-writing and poetry.
A paradigm shift in sex ed is much needed, and some changes are promising. Several nonprofit organizations have released guidelines for developing sex ed curricula that place gender and power at their heart. It’s All One Curriculum, for example, was created by the Population Council in collaboration with six other nongovernmental organizations. It is a free, downloadable resource available in several languages that provides content and sample activities for placing gender and rights at the center of sexuality and HIV curricula. Globally, the United Nations Population Fund is championing the gender-focused and rights-based approach. Federal and state policy and funding guidelines in the U.S. need to catch up.
A gender/power lens also has implications for teaching very young adolescents, those ages 10 to 14. Puberty is often defined by pressures to conform to conventional gender roles, as well as by experiences of bullying, eating disorders, sexual harassment and first sexual intercourse. Moreover, bullying in late elementary school is a predictor of dating violence by eighth grade. While isolated interventions aimed at these outcomes can help, all of these behaviors have roots in gender and power norms.
An example of one integrated approach is Population Council’s iMatter program, adopted by a number of school districts for grades 4 through 6. Rather than teaching about intercourse or STIs, iMatter focuses on topics like puberty, gender, body image and fairness/rights (including bullying and sexual abuse). The theory is that strengthening belief in equality and human rights among puberty-age kids best positions them to develop safe and healthy intimate relationships later on—it also enables them to apply what they learn in sex ed classes in middle and high school. Further research into such approaches for this younger age group is needed.
Proponents of comprehensive sex education will continue to face objections by those who categorically oppose such programs. We need sex education, but we can and must do better. From now on, no program can claim to be “comprehensive” or “evidence-based” unless it addresses gender and power in meaningful ways.
Photos via Shutterstock; Population Council