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Sex Education Based on Abstinence? There’s a Real Absence of Evidence

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Sex education has long occupied an ideological fault line in American life. Religious conservatives worry that teaching teenagers about birth control will encourage premarital sex. Liberals argue that failing to teach about it ensures more unwanted pregnancies and sexually transmitted diseases. So it was a welcome development when, a few years ago, Congress began to shift funding for sex education to focus on evidence-based outcomes, letting effectiveness determine which programs would get money.

But a recent move by the Trump administration seems set to undo this progress.

Federal support for abstinence-until-marriage programs had increased sharply under the administration of George W. Bush, and focus on it continued at a state and local level after he left office. From 2000 until 2014, the percentage of schools that required education in human sexuality fell to 48 percent from 67 percent. By 2014, half of middle schools and more than three-quarters of high schools were focusing on abstinence. Only a quarter of middle schools and three-fifths of high schools taught about birth control. In 1995, 81 percent of boys and 87 percent of girls reported learning of birth control in school.

Sex education focused on an abstinence-only approach fails in a number of ways.

First, it’s increasingly impractical. Trying to persuade people to remain abstinent until they are married is only getting harder because of social trends. The median age of Americans when they first have sex in the United States is now just under 18 years for women and just over 18 years for men. The median age of first marriage is much higher, at 26.5 years for women and 29.8 for men. This gap has increased significantly over time, and with it the prevalence of premarital sex.

Second, the evidence isn’t there that abstinence-only education affects outcomes. In 2007, a number of studies reviewed the efficacy of sexual education. The first was a systematic review conducted by the National Campaign to Prevent Teen and Unplanned Pregnancy. It found no good evidence to support the idea that such programs delayed the age of first sexual intercourse or reduced the number of partners an adolescent might have.

The second was a Cochrane meta-analysis that looked at studies of 13 abstinence-only programs together and found that they showed no effect on these factors, or on the use of protection like condoms. A third was published by Mathematica, a nonpartisan research organization, and it, too, found that abstinence programs had no effect on sexual abstinence for youth.

In 2010, Congress created the Teen Pregnancy Prevention Program, with a mandate to fund age-appropriate and evidence-based programs. Communities could apply for funding to put in only approved evidence-based teen pregnancy prevention programs, or evaluate promising and innovative new approaches. The government chose Mathematica to determine independently which programs were evidence-based, and the list is updated with new and evolving data.

Of the many programs some groups promote as being abstinence-based, Mathematica has confirmed four as having evidence of being successful. Healthy Futures and Positive Potential had one study each showing mixed results in reducing sexual activity. Heritage Keepers and Promoting Health Among Teens (PHAT) had one study each showing positive results in reducing sexual activity.

But it’s important to note that there’s no evidence to support that these abstinence-based programs influence other important metrics: the number of sexual partners an adolescent might have, the use of contraceptives, the chance of contracting a sexually transmitted infection or even becoming pregnant. There are many more comprehensive programs (beyond the abstinence-only approach) on the Teen Pregnancy Prevention Program’s list that have been shown to affect these other aspects of sexual health.

Since the program began, the teenage birthrate has dropped more than 40 percent. It’s at a record low in the United States, and it has declined faster since then than in any other comparable period. Many believe that increased use of effective contraception is the primary reason for this decline; contraception, of course, is not part of abstinence-only education.

There have been further reviews since 2007. In 2012, the Centers for Disease Control and Prevention conducted two meta-analyses: one on 23 abstinence programs and the other on 66 comprehensive sexual education programs. The comprehensive programs reduced sexual activity, the number of sex partners, the frequency of unprotected sexual activity, and sexually transmitted infections. They also increased the use of protection (condoms and/or hormonal contraception). The review of abstinence programs showed a reduction only in sexual activity, but the findings were inconsistent and that significance disappeared when you looked at the stronger study designs (randomized controlled trials).

This year, researchers published a systematic review of systematic reviews (there have been so many), summarizing 224 randomized controlled trials. They found that comprehensive sex education improved knowledge, attitudes, behaviors and outcomes. Abstinence-only programs did not.

Considering all this accumulating evidence, it was an unexpected setback when the Trump administration recently canceled funding for 81 projects that are part of the Teen Pregnancy Prevention Program, saying grants would end in June 2018, two years early — a decision made without consulting Congress.

Those 81 projects showed promise and could provide us with more data. It’s likely that all the work spent investigating what is effective and what isn’t will be lost. The money already invested would be wasted as well.

The move is bad news in other ways, too. The program represented a shift in thinking by the federal government, away from an ideological approach and toward an evidence-based one but allowing for a variety of methods — even abstinence-only — to coexist.

The Society of Adolescent Health and Medicine has just released an updated evidence report and position paper on this topic. It argues that many universally accepted documents, as well as international human rights treaties, “provide that all people have the right to ‘seek, receive and impart information and ideas of all kinds,’ including information about their health.” The society argues that access to sexual health information “is a basic human right and is essential to realizing the human right to the highest attainable standard of health.” It says that abstinence-only-until-marriage education is unethical.

Instead of debating over the curriculum of sexual education, we should be looking at the outcomes. What’s important are further decreases in teenage pregnancy and in sexually transmitted infections. We’d also like to see adolescents making more responsible decisions about their sexual health and their sexual behavior.

Abstinence as a goal is more important than abstinence as a teaching point. By the metrics listed above, comprehensive sexual health programs are more effective.

Whether for ethical reasons, for evidence-based reasons or for practical ones, continuing to demand that adolescents be taught solely abstinence-until-marriage seems like an ideologically driven mission that will fail to accomplish its goals.

Complete Article HERE!

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‘I’m 62 and my sex life is more important now than ever’

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‘I don’t believe I shouldn’t have a sex life just because I haven’t met ‘the one’’

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Sex is just as important for women after 50: that’s what the European Court of Human Rights made clear when it ruled that the judges who reduced a 50-year-old woman’s compensation for a botched gynaecological operation had discriminated against her.

Maria Morais, who is Portuguese and has two children, sought compensation on the grounds that she was unable to continue a normal sex life, but the judges in the original case had argued that the importance of sex declines for women as they get older.

The European Court of Human Rights found that this constituted sexual discrimination, and that the judges had “ignored the physical and psychological importance of sexuality for women’s self-fulfilment and other dimensions of women’s sexuality”.

Sex doesn’t stop at a certain age

In popular culture, portrayals of relationships among older people are becoming more common, implying a greater acknowledgement of older women’s sexuality

In popular culture, portrayals of relationships among older people are becoming more common, implying a greater acknowledgement of older women’s sexuality. The film It’s Complicated (2009) starred Meryl Streep (inset), whose character has an affair with her ex, played by Alec Baldwin, decades after their divorce. This year, Hampstead saw Diane Keaton as a widow falling in love with a man living wild on Hampstead Heath, played by Brendan Gleeson.

Data backs up her case, too. In 2014, a Saga survey of 9,685 people aged over 50 found three-fifths are sexually active and 23 per cent are having sex once a week.

Research released by the Longevity Centre in 2016 showed that 60 per cent of men and 37 per cent of women aged over 65 had sexual activity in the past year.

Caitlin (not her real name), 62, needs no court ruling or Hollywood film to tell her that her sex life is important. She has been in a number of monogamous relationships, but is now having intimate relationships with more than one man.

Having an active sex life makes me feel alive. There’s a deliciousness about it.

I’m single and I have sex regularly, but I’ve been celibate in an earlier relationship when my partner lost interest. I have also been a mistress, where I discovered the thrill of coming to terms with my non-vanilla side. I feel more in touch with my sexuality now than I ever have done.

Sex is not the be all and end all. While I’m passionate about sex for those who want it, I’m also very aware that other people can get satisfaction from other things. But I think if one has the desire, sex is such a fabulous, life-enforcing thing at any age. It’s just a marvellous sensation.

Being 62 doesn’t mean I have to settle

I talk openly about my sex life with my close friends; it’s a running joke with them about what my neighbours would make of me.

I’m not hankering for my ‘one and only’. If I met them, that would be delightful. But I don’t believe I shouldn’t have a sex life just because I haven’t met ‘the one’. You can have good enough relationships that are absolutely fine without being the big thing. I don’t like compromising – just because I’m 62, it doesn’t mean I have to settle.

It would be fabulous to meet somebody who ticks all of the boxes, but I don’t feel I’m missing out because I haven’t got that. Having a sense of adventure and not knowing who I may meet is great fun.

I wanted to be open minded about sex

‘I was stood in the college library and thought, ‘I’m going to go and masturbate’

I grew up in a village South Wales and lost my virginity aged 18 to the man I thought I was going to marry. It was a huge thing because I was still a practising Catholic and it was not the done thing to have sex at school.

At that age, I wanted to be open minded about sex. I enjoyed it. I loved the power of being able to turn a man on, But with everything around you [at that age] you have a patriarchal version of sexuality. The whole thing of ‘what is sexy’ comes from the images you see.

I never masturbated as a teenager – I think I was quite proud that I didn’t. Then I got into this relationship and started to think there must be more to sex than this. When I was 19, I was stood in the college library and thought, ‘I’m going to go and masturbate.’ And I went back to my room and I did!

I began exploring my sexuality in my forties

‘I set myself a goal of being able to use a computer.’

I’ve always had sexual fantasies about spanking, which meant I had a life time of growing up with these suppressed fantasies that I thought were sort of dangerous.

I began exploring my sexuality in my forties when I posted adverts in a magazine. I met someone I thought I was going to be with for the rest of my life when he responded to my advert.

He already knew that I had these fantasies from reading my advert. Our sex life was completely vanilla but fantastic and very active until about six years in, when he developed an illness and went off sex. He seemed almost relieved of the burden.

I cared about him and so I put up with it and set myself a couple of personal goals. One was to learn to use a computer properly. Another was to start creative writing – I had always wanted to write erotica.

Things changed with this exploration of female sexuality and fantasies. I realised I wasn’t going to bring the world crashing down because I have sexual fantasies.

Age 56, I started advertising for lovers

‘I discovered this community out there with the same interest.’

Writing erotica was fun and I was curious to find out if what worked for me sexually worked for other people. I discovered this community out there with the same interest and it brought me back to life.

I started communicating with a man online. We discovered we were both in sexless relationships. I had never been unfaithful and took monogamy very seriously but I was getting to the point where I couldn’t continue like this. I told my partner I was going to struggle to stay faithful if our relationship remained non-sexual.

Suddenly, we had a fantastic sex life again. But it only lasted a fortnight.I told my partner again that I would not be able to be faithful in a sexless marriage and he left me. The man I was talking to online became my lover.

I began putting adverts out online to meet other people and started having other sexual partners. I was 56 at this time.

Sex has to be intimate

We have the rituals you have as a couple; going out together, watching TV, going on holidays

For me, there has to be a level of intimacy in sexual encounters. I met a couple of guys where there was a coldness and that is just not right for me. But there can be a level of intimacy without love.

There’s a chap I’ve been seeing for a few years and we’re very comfortable with each other. We have the rituals you have as a couple; going out together, watching TV, going on holidays.

I see other people because the time we have together is limited and I want more. The ages of the people I see varies; I recently stopped seeing someone who was five years older. The oldest chap I was seeing was about 69. But I’ve also had relationships with people in their thirties and forties.

I’ve now moved back to the village where I grew up. I’m part of the Women’s Institutes and I’ve done relatively serious things work wise. It’s just nice that there is this other part of you that is private, such fun and so life-enhancing.

Complete Article HERE!

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Young entrepreneurs launch a handy online guide to all things sex

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A team of millennial entrepreneurs have pulled together a ‘BuzzFeed of sex ed’. About time too.

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Fumble describes itself as a ‘handy guide to sex’ (pun intended). It offers curious teens social content like blogs, videos, games, galleries and quizzes.

The team behind Fumble say it responds to the lack of engaging digital platforms for good quality sex and relationships content for young people. They work with Brook, a leading sexual health charity, to make sure all the content is top notch.

It sets out to answer all the questions on sex, relationships, identity and bodies that young people are asking the internet during puberty, and is aimed at anyone under 20 (boys and girls alike).

The Fumble gang say their lightbulb moment for the project came from being some of the first to grow up with the internet, and being very aware of the challenges that poses for young people.

They explain that nearly every teen as young as 14 has accessed online porn, according to the NSPCC, and many teenagers say they’re using this content (at least in part) because they’re not getting answers to questions about sex, relationship and intimacy elsewhere.

Young people definitely need a hand: a whopping half of teen girls don’t know what’s happening when they first start their period and teachers describe sexting as fast becoming an ‘epidemic’ on primary school playgrounds.

‘Young people turn to the internet with questions, and the internet responds with a whole load of unhealthy content,’ co-founder Emily Burt explains.

‘We want to redress the balance, and offer an alternative (and excellent) voice in the digital landscape.’

The site launched a few months ago and it’s pulling in thousands of pageviews.

The team is currently running a crowdfunder to get the project up and running properly, and keen supporters of the idea have donated over two grand already.

Fumble is running a social campaign alongside, asking people to share any horror stories from their sex and relationships education (SRE) in school, along with the hashtag #WhyIFumble.

Fancy a Fumble? Seems like a great idea.

Complete Article HERE!

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Fun sex is healthy sex

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Why isn’t that on the curriculum?

by Lucia O’sullivan

Damn—we forgot to teach our kids how to have fun sex.

Most news covers the sex lives of young people in terms of hookups, raunch culture, booty calls and friends with benefits. You might think that young people have it all figured out, equating sex with full-on, self-indulgent party time.

Despite my decades as a researcher studying their intimate lives, I too assumed that the first years of consensual partnered sex were pleasurable for most, but got progressively worse over time. How else to explain the high rates of reported by adults? I was wrong.

Our research at the University of New Brunswick shows that young people (16 to 21 years) have rates of sexual problems comparable to those of adults. This is not just a matter of learning to control ejaculation timing or how best to have an orgasm. Their sex lives often start out poorly and show no improvement over time. Practice, experience and experimentation only help so much.

This project came to be after a former colleague at my university’s health centre told me that many complained of pain from vulvar fissures (essentially tearing) from intercourse. The standard of care is to offer lubricant, but she began to ask: Were you aroused? Was this sex you wanted? They would look at her blankly. They had been having sex without interest, arousal or desire. This type of tearing increases a young woman’s risk of STIs, but also alerted my colleague to a more deep-seated issue: Was sex wanted, fun and pleasurable?

What emerged from our first study was verified in our larger study: Low desire and satisfaction were the most common problems among followed by erectile problems. Trouble reaching orgasm, low satisfaction and pain were most common among young women.

Was this a select group? No. Overall, 79 per cent of young men and 84 per cent of young women (16-21 years old) reported one or more persistent and distressing problems in sexual functioning over a two-year period.

Parents focus on disaster

Despite what you might think from their over-exposed social media bodies, today’s youth start sex later and have fewer partners than their parents’ (and often their grandparents’) generation did. A recent U.S. national survey found that young people have sex less often than previous generations.

Did years of calamity programming in the form of “good touch/bad touch,” “no means no,” and “your condom or mine” take a toll? Perhaps that was intended as so much of our programming is designed to convince young people of the blame, pain and shame that awaits them in their sexual lives. If we really believe that young people are not supposed to be having sex (that it should just be reserved for adults in their reproductive years and no others, thank you), it might as well be unpleasant, dissatisfying or painful when young people have sex, right?

Young people are over-stressed, over-pampered and over-diagnosed. They are also under-resourced for dealing with challenges in their sexual lives. This is how a bad sex life evolves.

Parents make efforts to talk to their children about sex and believe they get their messages across. Yet, their children typically report that parents fail to communicate about topics important to them, such as jealousy, heartbreak, horniness and lack of horniness. Parents’ messages are usually unidirectional lectures that emphasize avoiding, delaying and preventing. Young people dismiss these talks, especially in light of media portrayals of sex as transformative and rapturous.

Sex in Canada’s schools

Canada’s schools deliver fairly progressive sex education across the provinces. But they do not resemble the comprehensive approaches offered in countries such as The Netherlands and Switzerland. Those countries have teen pregnancy rates as low as 0.29 per cent of girls aged 15 to 19. Canada’s rate is 1.41 per cent, far higher than many European countries (such as Italy, Greece, France and Germany) but consistently lower than the United States. Thankfully.

These rates are a general metric of youth sexual health and key differences in the socialization and education of young people. They reflect the extent to which we are willing to provide a range of sexual information and skills to young people. More progressive countries reinforce messages that sex can be a positive part of our intimate lives, our sense of self, our adventures and connection. Young people in those countries have healthier and happier sexual lives. They know how to enjoy sex while preventing infections and unwanted pregnancy.

Many countries, including Canada, are swayed by a vocal minority who strongly believe that teaching young people about the positive components of sexuality will prompt unhealthy outcomes, despite all evidence to the contrary. When parents and educators fail you, and peers lack credibility, where else are you to turn?

Porn – lessons in freak

Enter porn. Young people turn to porn to find out how things work, but what they learn is not especially helpful. Porn provides lessons in exaggerated performance, dominance and self-indulgence. The relationships are superficial and detached. Producers rely heavily on shock value and “freak” to maximize viewer arousal, distorting our understanding of what is typical or common among our peers.

Of course young people turn to porn to find out how sex happens. It’s free, easily accessible and, for the most part, private. One young man in our interviews said, “I learned a lot about what goes where, all the varieties from porn, but it’s pretty intimidating. And, I mean, they don’t look like they’re loving it, really loving it.”

Our research makes painfully clear how few messages young people have learned about how to have fun, pleasurable, satisfying sex. They may seem self-indulgent to you, but then nobody took on the task of saying, “Sex should be fun, enjoyable and a way to connect. Let’s talk about how it all works.”

Fun sex as safe sex

Did anyone teach you these lessons? A friend and esteemed fellow researcher told me that he learned how sex worked by viewing his dad’s porn magazines. The only problem was that in his first sexual encounter he did not realize that there was movement involved.

Without a platform of positive communication with our youth about sexuality, and specifically about how sex unfolds and can brighten life and improve health and well-being, there is no room for them to address new challenges in the sexual realm. The World Health Organization’s alarming report of the rise of antibiotic resistant gonorrhea, for instance, will sound like another dire warning from an endless stream. Nobody is consistently motivated by threats.

We must talk to young people about how to have fun sex. This will help to offset the chances that struggling with problems in their sexual lives now will develop sexual dysfunctions and relationship strain that distress so many adults. These lessons will arm them with the information and skills required to keep them safe and to seek effective solutions when problems emerge. Best of all, they will be healthier and happier now and as adults as a result.

Complete Article HERE!

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What it’s like to be a male sexual surrogate

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The Sessions looked at the work of sexual surrogates

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For most adults, sex is an activity that can bring joy, frustration, contentment or disappointment – the full range of human responses. But for a few people, the very thought of sexual contact with another human being causes such anxiety that they can never get close to the act.

For them, psychosexual therapy is usually a good choice. And in a few cases, this can involve a particular form of therapy: use of a sexual surrogate.

Sexual surrogates are trained and professional stand-in partners for men and women who have severe problems getting to an intimate/sexual relationship. Normally, the client will be undergoing counselling with a psychosexual therapist, and then, in parallel with that, will have ‘bodywork’ sessions with a surrogate partner.

Andy, 50, is a psychosexual therapist who also worked as a surrogate for a number of years. Clients tend to be aged from their mid-thirties to around fifty and most came to him through word of mouth. “Some people have never experienced sexual intimacy,” he explains. “I had one client who had never gone beyond kissing.” Others have experienced abuse and have negative connotations around sex or have physiological problems.

“I would usually do between six and ten monthly sessions of three hours each. The first sessions would be about getting comfortable being in a room with a man. So I will say, ‘So you’re in a room with a man, how does that feel for you?’ And perhaps it reminds them of being a teenager so we’ll talk about what that teenage part of them needs – to be more confident, say.”

Although the sessions would build towards penetrative sex, it would be a long way down the line. But some clients want to take things too quickly, he says. “If they want to rush into sexual intimacy or penetration then I’ll slow them down and ask them where that comes from. Most of them do need to slow down because they’re rushing into what they think is the goal of sex.”

After a few sessions, Andy would bring touch into the sessions. “I would ask them what sort of touch they would want to receive. And they might like to receive some sort of massage, fully clothed or partly unclothed. Sometimes we would sit opposite each other on the sofa and find out what happens in her system if one of us leans closer. Does she get excited? Does she want to run away? Does she want to reach out and have more contact?”

Once the client was comfortable with touching, nudity would be introduced. “I might do an undressing process where I would invite them to take off one piece of clothing and each time to name a limiting belief that stops them really enjoying and celebrating their body and allowing pleasure in it. ‘One thing that stops me is my belief that I’m unattractive and my bum’s too big.’ They would take off that piece of clothing and that belief. Then I would offer feedback about what I see, so, ‘Your breasts feel very sensual and feminine to me’.”

Sexual surrogacy has been operating in Britain for a few decades, introduced from America, where it was also the subject of the Oscar-nominated film The Sessions, based on the true story of partially paralysed polio survivor Mark O’Brien and Cheryl Cohen-Greene, the surrogate he worked with to overcome his problems.

While most surrogates are female working with male clients, there are a handful of male surrogates in Britain who work with female clients. Male surrogates tend to be mid-thirties and older.

For many men, being hired to act as an intimate partner for a woman they barely know would be a strange situation. So how did Andy feel during these sessions? “Sometimes it was quite challenging, sometimes engaging, sometimes arousing,” he recalls. “And client reactions were very varied too. Some would feel ashamed, sometimes emotional or physical discomfort. Or they would feel excitement and confidence. It was moment to moment – it’s like how you feel in a relationship, you feel many things.

“It’s an interesting line to walk. There are many clients that I have worked with who I really liked and I enjoyed the work with them both sexually and emotionally but I’m also aware that I’m not there to be in a relationship with them.”

He is glad he did the job but it did cause him difficulties, not least in relationships with his own partners, whom he always made aware of his work. “I supported many women through a very challenging and sometimes life-changing process,” he says. “But I found that ultimately it took too great a toll – energetically, physically and emotionally. I was putting myself in situations of intimacy with a client that I wouldn’t necessarily have chosen. And I found that draining. I would sometimes ask, ‘Why did I do that to myself?'”

Overall he believes they key to sexual surrogacy involves being realistic about what will come of it.

“I think surrogacy is to be entered into with as much self-awareness as the client can muster,” he says. “While it can point them in the right direction, it’s not the answer. Ultimately, they have to find confidence within themselves. It can be a step on that journey.”

Complete Article HERE!

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