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Effecting a Sexual Behavior Modification among Adolescent Children
- Rajan R Patil (15 July 2005)
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BMJ bias against abstinence
- Trevor Gordon Stammers (16 July 2005)
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Teen sex-education no more a taboo
- Urban JA D'Souza (22 July 2005)
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Rajan R Patil, Epidemiologist UN House-II, Orissa 751009 India
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Sex education to children is one of the highly debated subjects with regards to the content, means and its expected end. Opinions are varied on the appropriate treatment warranted by this subject in terms of biomedical or socio-cultural paradigm. Being a health professional, I was frequently called upon to handle a class on sex education. Very often such sex education is inappropriately equated to educating children about human reproductive system. My personal interest in the subject of Human sexuality began while dealing with the issue with rehabilitated adolescent children. I discovered that they were least interested in the anatomy of genital organs or details of the reproductive system, or process of fertilization or menstruation. I observed that the group I was handling was obsessed with the idea of sex. They were obsessed with abstractness of sex. The mere utterance of the world “sex” was scintillating to them. Hence innovation in the approach to the subject was necessitated. Undisputedly, the subject of ‘sexuality’ is one of the most stigmatized and the most misunderstood topics of all the issues concerned to the human behavior. Part of the reason being, absence of culture of discourse on the issues related to sexuality in an open, frank and informed discussion over the subject. Consequently subject of sexuality is fret with myths and misconceptions. I decided to change my approach in handling this very sensitive. Would like to share a very process oriented methodology, which generally I adopt to handle the subject while exploring this sensitive issue with the children. The following step-by-step approach was found to be very helpful to set the stage for discussing human sexuality with adolescent children. 1. Funnel approach: This approach is generally adopted in behavioral studies while handling sensitive issues. In this process discussion is initiated from a larger and wider topic and gradually narrowed down to the topic of interest. e.g., start with identifying different parts of motor bike, Tree etc 2. Activity Based Learning: Sexuality being very sensitive issue it is important that ice should be broken before taking up such issue. Activity based discussed are often found to be useful in forging a rapport within the group and also with the facilitator. So once the group is gelling together in parts identification as above, the facilitator could lead them to human body mapping. Very often there is hesitation in indicating genital organs. At this stage discussion is on sexuality is initiated by asking participants the reasons for hesitation or shyness in when it comes to sexual parts or topic 3. Thinking Man’s TV. To begin the discussion on sexuality, the facilitators writes the word SEX in large fonts on the board and ask the participants to close eyes for two minutes and observe various visuals that come to their mind and types feelings they experience. 4. Free listing : Facilitator requests the participants to spell out the visuals and the they experienced and lists it on the board. 5. Simulation: In this stage a hypothetical real life conflict situation is enacted through a role plays e.g., reaction of the family members on learning of their child’s teenage pregnancy etc. 6. Discussion and Wrap up: The role play generally end with the discussion. Care should be taken by the facilitator to not to be judgmental, but rather help the participants go through the process of critical thinking and informed decision making processes as illustrated in ‘Life Skills’ approach. I have tried this step-by-step approach with at least three different street children groups and two general groups. Would feel greatly encouraged to receive your feedback after similar trial in your respective setting. regards, Rajan R Patil : email <rajanpatil@yahoo.com> Competing interests: None declared |
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Trevor Gordon Stammers, Hon Senior Tutor in General Practice, St George's, University of London SW17 0RE
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The tradition in BMJ journalism of always putting a negative spin on anything to do with abstinence education is powerfully illustrated by Hopkins Tanne's news item.(1) She states that 'the federal Department of Health and Human Services in June showed that abstinence programmes...did not decrease teenagers' sexual activity, pregnancy, or infection with sexually transmitted diseases'. Of course it didn't; the report was an interim one about younger children, some only in the 3rd grade. In fact the report plainly states that it 'does not examine behavioural outcomes due to the short duration of the follow-up period and the young ages of the program participants.'(2) and that 'the success of the programs in promoting abstinence, as well as in reducing risks of pregnancy and sexually transmitted diseases cannot be fully determined without data that measures behaviours in the older teenage years'. (2) This appropriate data is not even gathered, yet once again abstinence is dismissed, not on the basis of any evidence, but by prejudiced and innaccurate reporting. Such spin, even if subsequently corrected, has already done the damage I can only assume Tanne intended. A correction would none the less be a start towards a more balanced approach. 1. Teenagers need sex education, not just abstinence advice Janice Hopkins Tanne BMJ 2005:129, doi:10.1136/bmj.331.7509.129-c 2. http://aspe.hhs.gov/hsp/05/abstinence/report.pdf. pages xx and xxxiv Competing interests: Trevor Stammers is a trustee of Challenge Teams UK - a charity providing abstinence-based school sex education programmes |
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Urban JA D'Souza, Associate Professor School of Medicine, University Malaysia Sabah, 88999, Kota kinabalu, Malaysia
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With the booming spread of HIV throughout the World, a sex education program in high schools and colleges (adolescent children) is the urgent need of this hour. Promoting abstinence among teenagers may be not as simple as preaching1. American Academy of Pediatrics recommendation on teenage children’s counseling on sexual behavior and postponing sexual activity is definitely a positive move. The impact of counseling has to be well studied and in the Western world it may definitely have a greater positive impact. In the Asian region, sex still remains a taboo, open discussion and sharing of information and knowledge regarded as an immoral practice. Even though, every responsible adult citizens, including, parents, teachers, policy makers and government think that, open discussions are ethically and morally improper. Educated parents are still resistant to impart healthy knowledge and practice of sex with their adolescent children. Most of the teenagers sought their peer groups as the sole responsible guides to inform them about their sexuality and most of the time, may be driven to the wrong practices. As AIDS is spreading like fire in every part of the World, educating teenagers is an urgent need before HIV makes it way through among the innocent teen children. References 1. Tanne JH. Teenagers need sex education, not just abstinence advice. BMJ 2005;331:129. Competing interests: None declared |
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