Sexual education models in the EU

J.V. Lazarus

WHO, Denmark

Employing an ecological approach, two countries in the EU are reviewed, to illustrate how sexuality education is much more than school-based education. In Lithuania, a changing economic and social environment coupled with a strong Catholic Church has resulted in a small but vocal opposition to sex education in schools. In Denmark, sex education has been a part of the primary school curriculum for over 30 years, but the quality varies greatly and the entire structure of sex ed is currently under revision. In both countries, the broader context of key stakeholders such as parents, religious leaders, politicians and the mass media has impacted greatly on school-based sex education be it on teaching materials and curricula, international involvement or on who provides sex ed.

Ecological models, which attribute a crucial role to the social and physical environment in determining a population’s level and distribution of health and the consequent importance of structural interventions that work by altering the context within which health is produced and reproduced should be considered when studying sex education and the desired impact on sexual and reproductive health. However, ecological approaches have been slow to impact public health practice with regard to risk behaviours and related interventions. Often, researchers and policy-makers have failed to acknowledge the importance of the contextual environment in which sex education programmes are implemented. The dominant model has been to help young people cope with risk environments by changing their attitudes and behaviours, be it by for example promoting sexual abstinence or the use of contraception, first and foremost the male condom. This model fails to adequately address how environmental factors may influence attitudes and behaviour or how certain behaviours, e.g. alcohol consumption or the use of other drugs, may in part be responses to environmental conditions.

Looking ahead, addressing professional and ideological opposition to sex education - even in countries considered to be fully functioning democracies - will be one important step towards improving sex education, be this education an integrated part of life-skills education at schools or part of youth-friendly health services, the health promotion activities of a family doctor or qualified advice given by a parent.