July 18, 2006

New models for sexuality education

Chulalongkorn University's Master of Science in Human Sexuality
and Teenpath focus on sexuality - not sex - in new curricula

Story by ORATIP NIMKANNON

Is it ever too early to study sex education in schools? In a society where teen pregnancies, abortions, sexual harassment, and sexually transmitted diseases remain a problem, it is no longer a question of whether or not we need sex education in schools. Rather, the question is at what age do we start to teach it in public schools?

"Most people tend to think of sexuality education as something that happens between the sheets, but that's only 10 percent of it."
Dr Sompoch

In the 2005 Durex Global Sex Survey, more than a quarter of 6,843 Thai correspondents said sex education should start at the age of 12. According to the same survey, nearly 25 percent of the correspondents first received sex education at the age of 15, and more than 20 percent did not receive it until they were 17 years old.

Sex vs sexuality

A similar Durex Global Sex Survey revealed in 2002 that the main focus of sex education in Thai schools is on the anatomy of human sexuality - the sexual organs, the reproductive system, and sexually transmitted diseases. This complies with the traditionally narrow concept of "sex education", not to be confused with the broader term of "sexuality education", which includes - but is not limited to - the wider panorama of sexual topics, such as, sexual development, bonding, mother-to-child and male-to-female relationships, pre-natal and postpartum care, contraception, gender roles, sexual orientation, etc. Traditionally, the Thai sex education programme taught very little about sex and almost nothing about sexuality.

The Basic Education Curriculum of 2001 incorporates sexuality education into the broader health and physical education. The current theory is to introduce basic concepts of human sexuality and the differences between male and female roles at the primary school level, before ultimately advancing into the broader areas just mentioned.

Notwithstanding the 2001 statute, sexuality education in schools has not been very successful. "The limitation is that teachers themselves don't know [a great deal] about sexuality education because they have not studied the subject before," says Waranuch Chinvarasopak, a programme officer at Programme for Appropriate Technology in Health (Path), an international, non-profit organisation that has fostered and promoted public health issues in Thailand for more than 20 years. "Sex is also a taboo subject in [Thai] society, which makes the teacher's job even more difficult," she adds.

Teaching methods

In 2003, Path launched a five-year project called "Teenpath," in collaboration with the Ministry of Education and the Ministry of Public Health. Teenpath aims to give educators the proper skills to teach students about sexuality. Three years after the launch, more than 500 schools and vocational institutions all over the country are participating in the project.

"Teenpath adopts a child-centred learning approach, in which teachers start by asking what the students would like to know - the myths and misinformation they've heard - and then explain these issues as the students raise them," says Waranuch. As they do so, she adds, teachers will start to listen more, and talk less. "They may soon realise that they know very little about sexuality, compared to what their students already know."

In addition, the training also discusses the teachers' attitudes toward sexuality and how those attitudes can influence the way they educate students. Teachers, Waranuch adds, often teach students a moralistic or personal view of what they believe sexuality should be, instead of unbiased facts about human sexuality.

Most importantly, sexuality education is not just about sexual intercourse. Rather, Teenpath's curriculum is designed to discuss sexuality education in terms of long-term human sexual development, sexual orientation, relationships, personal and negotiation skills, sexual behaviour, sexual health, and how all these dovetail with society and cultural mores.

These complex and interrelated topics, Waranuch says, cannot be taught only once a year or sporadically because as students mature from year to year, both their physical developments and social skills change. Sexuality education must, therefore, parallel these changes, which makes the comprehensive curriculum necessary throughout the 12 years of basic education.

Whether or not it is appropriate to introduce sexuality education to students as young as Prathom 1 depends on what parents and teachers think the goals of sexuality education are - or should be.

"If sexuality education means knowing one's own body and oneself, then smaller children do need to know it because this is the basis for teaching them to respect each other and each other's body," she says. By showing respect to each other, younger students also learn not to mock each other's physical appearance, race or skin colour, for example. The key message at this point is about diversity in human bodies and figures. From this starting point, teachers can branch out and teach basic knowledge about gender roles.

As students reach puberty, sexuality education must delve more seriously into the myths and reality of sexuality, based on the several examines given above. At this age, students begin to experience love and romantic relationships, which make them more susceptible to undesirable consequences, such as teen pregnancy and sexually transmitted diseases.

" 'No' means 'no'."

"Teaching students how to make a decision and appreciate its consequences is very important in sexuality education," Waranuch says. "It's not only about safe sex, but also consent. It's never too early to learn the meaning and application of the maxim: " 'No' means 'no'." Students need to know their own feelings and what they really want, rather than, for example, a young female agreeing to have sex because she is afraid that her boyfriend will choose another partner."

At Kanchanaburi province's Bo Ploy community, for example, students often rendezvous and leave school prematurely in order to get married. The students' parents also support this idea, says Nongree Prachanimit School's deputy director Suntaree Rungnarai. The school is home to more than 700 Mathayom students.

"Students and parents have very little understanding of the subject of sexuality. And when students need counseling, we are unable to provide it," she says. The school had hoped to change this scenario by joining Teenpath in 2005.

Led by 29 homeroom and counseling teachers who have previously participated in Teenpath's teacher training programme, the school allocates at least one hour each week for extra-curricula activities and discussions on sexuality topics.

The ministry's curriculum, Ajarn Suntaree says, touches very broadly on the topic of sexuality education. Lower secondary students, she adds, are keen to learn about physical and biological changes to their bodies and how to handle relationships with the opposite sex; while upper secondary students are more concerned about dating. In supplementing the ministry's curriculum, the school turns to Teenpath, which discusses specific sexuality issues that are more relevant to what students are curious to know.

Professional training

In addition to the Teenpath project, Chula has taken a step further in the professional training of sexuality education experts through its Master of Science programme in Human Sexuality. Dr Nikorn Dusitsin, director of the Centre for Research and Sexuality Development at Chula's Institute of Health Research, established the programme in 2001. Based on his experience as an obstetrician, Dr Nikorn acknowledges that people have a very limited understanding of sexuality.

"We know that many social problems we have right now are related to sexuality," Dr Nikorn says. "But we don't have any experts or institutions that specifically investigate the subject," he adds. The lack of experts explains why people continue to misunderstand sex and why teen pregnancies, abortions, sexually transmitted disease, and sexual harassment continue to plague Thai society.

"Thai people, I think, are still unclear about gender roles, meaning that women don't know how to treat men, and men also don't know how to treat women," says Dr Sompoch Iamsupasit, dean at Chula's Faculty of Psychology and ex-chair of the programme. "That explains, in part, why we have so many rape cases," he adds.

The Chula programme

Chula's master's programme is a collaboration among the Faculty of Psychology, Faculty of Medicine, the Institute of Health Research, and the Graduate School. It investigates sexuality in three main aspects: physical, social, and psychological. Students study the biological bases of human sexuality, sexual behaviour, perspectives on human sexuality, research methodology, and relationship counseling as core courses. The electives cover topics from socio-cultural and legal issues in human sexuality to practical psychotherapy and research methodology in epidemiology.

"Most people tend to think of sexuality education as something that happens between the sheets, but that's only 10 percent of it," says Dr Sompoch. After a year of preparation, the first academic year started in 2002, with 14 pioneering students. This number decreased to around 6-7 in the following two academic years. This is because courses are conducted during the day, as a full-time programme, and require students to invest many hours into research. Dr Sompoch, however, hopes that this number will increase to about 20 or 30 students per academic year.

Based on the sexuality education module, developed by the Institute of Health Research, graduate students conduct teacher training programmes in more than 40 schools. The module touches on seven key areas in sexuality education, namely sexual development, sexual health, gender roles, sexually transmitted diseases, self-esteem, abnormal sexual behaviour, social and cultural influences, and media analysis.

Similar to Teenpath, the module aims to create a better understanding among teachers regarding sexuality education, and also to equip them with the necessary knowledge and skills to lead classroom activities and discussions.

The programme selects two teachers from each school to undergo a 15-day intensive training course, which is divided into sexuality counseling workshops and teaching materials workshops. After these 15 days, the students and educators from Chula monitor the teachers' progress by conducting 18 sessions of supervised training.

To graduates from the human sexuality programme, this type of field research has helped them to both realise how prevalent misinformation about sexuality is and how they can help to alleviate this misunderstanding. "There's not much difference in the way students in Bangkok and students in rural areas perceive sexuality, because they have access to the same type of cultural, historical, traditional and media information," says Surangrat Kongsri, a graduate. "So, these students usually have the same misconceptions about sexuality. Male students, for example, seem to be overly concerned about the size of their genitalia."

Besides teaching and teachers' training, graduates from the master's programme in human sexuality can also enter careers in healthcare and counseling. Some students who hold an undergraduate degree in healthcare, says Dr Somepoch, usually return to their work in hospitals or clinics. Legal experts and lawyers will also find this programme useful, he adds.

With combining efforts from both academic institutions and non-profit organisations, sexuality education in schools will become more relevant to teens' lives. This is not to say that the job weighs solely upon teachers and academic institutions. Rather, parents and society each have a role to play in promoting a friendly environment in which children can grow up, simply by maintaining an open mind and providing ways for children to communicate their problems.

"We can all hope that our children will grow up safe and sound. But in the end, the lives they choose to live may not be what we expect. If this is the case, we need to respect their decision," says Waranuch.

For more information on Teenpath, visit www.teenpath.net or call Path at 02-653-7563-5. For more information on the work of Path, visit http://www.path.org/ . For information on the Master of Science Programme in Human Sexuality, visit www.ihr.chula.ac.th or call 02-218-8145, 02-218-8152-3.

Selected poll results, spotlight on Thailand
More than 317,000 people from 41 countries took part in the world's largest ever survey on sexual attitudes and behaviour. The research confirmed that Greece is officially the sexiest country with the Greeks having sex 138 times a year - well above the global average of 103; Croatia (134) Serbia and Montenegro (128) come a close second and third; and Thailand came in at 97 times per year.
Almost half of all adults surveyed said they were happy with their sex lives although men are the least satisfied with how often they have sex. The survey also revealed the global average age for first time sex is 17.3 and the trend is for people to lose their virginity earlier, with 16-20 year olds becoming sexually active by 16.3 years of age.
Most people believe sex education should start at 11.7 years. Thais, according to the survey, should start sexuality education at 12.1 years. In contrast, Chileans believe it should start at 10.7 years. Virtually all those surveyed believe children of 16 and under should receive sex education and more than a third believe governments should invest in sex education in schools. Almost half of all adults globally admit to having had unprotected sex without knowing their partner's sexual history, despite more than one in 10 admitting to having had a sexually transmitted infection (STI).
Just over a third (35 percent) say they were 16 or under when they lost their virginity.
Young people continue to have sex at an earlier age than previous generations: while the 25-34 year-olds lost their virginity at 17.9, the 21-24 year olds were 17.5 and 16-20 year olds were just 16.3
Women are sexually active earlier than men - at 17.2 compared with 17.5
People in India are the oldest to lose their virginity (19.8) followed by the Vietnamese (19.6), Indonesians (19.1), Malaysians (19), and Thais (18).
Globally, people have had an average number of nine sexual partners. Indians have had the fewest sexual partners (3) compared with the Chinese (3.1), the Vietnamese (3.2) those from Hong Kong (3.7), and Thailand (10.6).
Source: http://www.durex.com/cm/gss2005results.asp

What governments should do
More than a third (34 percent) of people globally believe that governments should invest in sex education in schools. At least 53 percent of Thais, according to the survey, believe that the government should invest in sex education in school; only two percent of Thais were not concerned with sex education.
One fifth (20 percent) of all adults want to see governments funding free contraception, with another 20 percent wanting to see money go towards finding either a vaccine or cure for HIV/AIDS.
Those aged 45-55 placed most importance on investment in sex education (48 percent), whereas the 16-20 year olds were the age group that placed the most importance on free contraception (26 percent).
The countries that would most like to see an investment made in sex education are Vietnam (69 percent), Turkey (57 percent) and Greece (56 percent).
More Icelanders than any other nationality want to see government funding for free contraception (48 percent), while the Indonesians are most likely to call for awareness of abstinence before marriage (22 percent).
Source: http://www.durex.com/cm/gss2005results.asp

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