Wake up and smell the condoms: An Analysis of Sex Education Programs in the United States, the Netherlands, Sweden, Australia, France, and Germany

The ultimate goal of Dutch sex education is to instill a sense of responsibility in youth regarding sexual activity and empower them to make good decisions and set their own sexual boundaries (Ferguson et al., 2008).

Youth in Sweden also fair significantly better on many measures of sexual health than youth in the United States. Sweden has a teen birth rate of 7 per 1000, which is lower than the US, France, Canada, and Great Britain (Darroch, Singh, & Frost, 2001). The rate teens who neglected to use contraception at most recent intercourse was only 7% in Sweden, compared to 20% in the US (Darroch et al., 2001). Sweden also has a lower teenage abortion rate than the US: 17.2 per 1000 in Sweden versus 29.2 per 1000 in the US (Singh & Darroch, 1999).

Sex education has been mandatory for all students in Sweden since 1955 (Lottes, 2002). Sex education in preschool years has been mandatory since 1956 (McConaghy, 1979). All teachers are trained in sex education as part of their teacher training (McConaghy, 1979). Swedish sex education focuses on providing honest answers to student questions (McConaghy, 1979). The ethical principles of Swedish sex education are below, as quoted from the Swedish National Board of Education:

1.     “Nobody is entitled to treat another human being simply as a means of self gratification.”

2.     “Mental pressure and physical force are always a violation of individual liberty.”

3.     “Sexuality forming a part of a personal relationship has more to offer than casual sex and is therefore worth aspiring to. This, it will be observed, does not imply any moral castigation of persons dependent on casual sexual relations during periods of their lives.”

4.     “Sexual fidelity towards a person with whom one has a personal relationship is a duty.” (Lottes, 2002)

Overall, Sweden supports an open and liberal approach to sex education encouraging responsibility and respect towards others. In addition to their sex education programs, Sweden supports the sexual health of their youth with a network of free clinics run by midwives, gynecologists, and social health workers that provide free abortion without parental consent and access to cheap oral contraceptives.

Australia is the third country I will focus on that fairs significantly better than the US on many measures of adolescent sexual health. The birth rate for teens ages 15-19 in Australia is 40.5 per 1000, significantly less than the rate for US teens (112.4 per 1000)1 (Weaver et al., 2005). Australian teens ages 15-19 have an abortion rate of 3.9 per 1000, compared to 30.2 per 1000 for US teens. Ninety percent of Australian males and ninety-five percent of Australian females report having used contraception at first intercourse (Weaver et al., 2005) . It is clear that Australian teens tend to make healthier choices regarding sexual activity than American teens.

Recognizing the health risks for teens who do not receive adequate sex education, in 1988 the Australian government called for a sex education program that was “‘honest, explicit, and comprehensive’ and ‘realistic in its assumptions about the attitudes, skills and behaviors of young people’” (Peppard, 2008). In 1999 the government published Talking Sexual Health, encouraging a sex education model that emphasized how social constructions of gender and power affect young people in regard to sexuality and emphasizing sexual diversity. Talking Sexual Health was endorsed by all Australian states and territories (Peppard, 2008). Talking Sexual Health endorses a sex education curriculum that includes units about drugs, sex, and health, knowledge and action, addressing diversity, and exploring power dimensions in sexual relationships (Australian Research Centre in Sex, Health and Society, 1999). Australians implement sex education programs that use a whole school approach, accept young people as sexual beings, provide students with skills to control and enjoy their sexuality, cater to the sexual diversity of all students, and provide appropriate and comprehensive curricula pertaining to personal decisions and behaviors, sexual health, diversity, and social justice (Weaver et al., 2005) . Overall, Australia takes a comprehensive approach to sex education with a strong emphasis on diversity that I haven’t seen in my research of any other country. Unfortunately, I could not find information on public health policies that supplement sex education in Australia.

Next, I will examine sex education and sexual health policies in France. Youth in France fair well on most measures of sexual health. The teen birth rate in France is 22 per 1000 (compared to 122.4 per 1000 in the US) and the teen abortion rate is 13.2 per 1000 (compared to 30.2 per 1000 in the US) (Weaver et al., 2005) . The French gonorrhea rate is 74 times less than that of the US and the Chlamydia rate is 20 times less (Weaver et al., 2005) . Twice as many women in the US begin having sexual intercourse before age 15 than in France (14% and 7%, respectively) (Darroch et al., 2001).  French women also have fewer sexual partners than American women, with only 13% of women ages 18-19 having more than two sexual partners in the past year compared to 49% of their US counterparts (Darroch et al., 2001). Only 12% of French women reported neglecting birth control at their most recent intercourse; 20% of US women did (Darroch et al., 2001).

All French schools are required to provide sex education. In 1996, the federal government mandated that students ages 12-14 spend at least two hours in sex education classes. Parents may exempt children from sex education classes in schools, but all students over age 13 must attend mandatory 20 to 40 hours of sex education workshops over a four year period (Weaver et al., 2005) . French sex education often starts with questions raised by students and is led by student interest. Curricula focus on biological sexual maturation, reproduction, STD prevention, and contraception (Weaver et al., 2005) . Biology teachers cover the biological aspects of development, including reproductive anatomy, and often invite community specialists to speak to students on more expansive topics (Berne & Huberman, 1999) . Schools, the media, and community organizations all work together to encourage and enable healthy sexual behavior among youth (Berne & Huberman, 1999) .