Comprehensive Sex Education as Sexual Violence/Abuse Prevention? – Some Findings.

I. Comprehensive Sex Education Reduces the Risk of Sexual Violence

Comprehensive sex education (CSE) is a model of sex education that focuses on the most current evidence-based findings on sexual development, health, and safety (WHO, 2023). It is often contrasted to models of sex education based on moral values. In the United States, this value-based sex education is most often known as “abstinence only until marriage” (AOUM) sex education, which teaches students that sex is only proper within the (typically heterosexual) marriage (Santelli, et al. 2017). These models are not mutually exclusive, for instance, AOUM does not necessarily reject scientific consensus entirely, nor is CSE always value-free, and there is a spectrum between both positions (Kramer, 2019). However, it has been reasonably demonstrated that sex education that focuses primarily on the facts, such as the preventative benefits of contraceptives, is associated with more positive outcomes for youth such as increased condom use, as well as fewer STDs and unplanned pregnancies (McCaffree & Matlack, 2001; Kirby, 2008; Goldfarb & Lieberman, 2021).

Though less often considered, many have also argued that CSE reduces risk of victimization by sexual violence and sexual abuse. Regarding sexual violence, it has been observed that having received CSE before college was positively associated with a reduced risk of penetrative sexual assault amongst college-aged women. Specifically, according to Santelli et al. (2018), learning both refusal skills and methods of birth control was associated with a 10% decreased risk of sexual violence amongst women. Meanwhile, abstinence-only education, which was defined as receiving education on refusal skills alone, was not associated with a reduced risk of sexual violence. Additionally, according to Zou (2021), receiving birth control instruction was associated with an 11% reduced risk of sexual violence.

This seems to suggest that certain aspects of comprehensive sex education, even if they do not directly relate to sexual violence, still have preventative qualities in that regard. This is further supported by Senn et al. (2011), who found that a sexual assault resistence program enhanced with descriptions of positive sexuality had superior outcome in several areas—including risk detection and willingness to initiate sexual activity—than the basic program.

Comparing by state, Herman (2020) took the five states with the highest rape rate and the five with the lowest, and examined the sex education policies in each of them. She found an emergent pattern, wherein states with the higher rates of rape such as Alaska, Michigan, and Arkansas have a history of enacting lax standards of sex education for each school district, and stressing abstinence. On the other hand, the five states with the lowest rape rates, such as New Jersey, Connecticut, and Maryland, were found to have much clearer guidelines on sex education and incorporated more scientific insights into their curriculum. Herman concedes that this does not prove the existence of a casual relationship, but she points out that other possible variables affecting rape rates such as male-to-female ratio, urbanization, or racial demographics, cannot explain these discrepancies. Herman’s analysis offers some reason to believe that the benefits of CSE in preventing sexual violence extend beyond the individual level, and may have cultural implications.

II. European Sex Education Results in Lower Rates of Child Sexual Abuse

Sexual exploitation of minors, or child sexual abuse (CSA), may also be reduced by comprehensive sex education. Case-controlled studies on this are difficult to come by, though international data can reveal some broad trends. According to a meta-analysis by Finkelhor (1994), here is a breakdown of the CSA rates in the United States and five European countries:

CSA rates per nation	Girls %	Boys %
United States	27	16
Switzerland	9	3
Sweden	9	3
Norway	19	9
Great Britain	12	8
France	8	5

Pereda and colleagues (2009) conducted a follow-up meta-analysis that demonstrated similar results across these countries. This suggests that Europe, specifically Western and Northern Europe, has significantly lower rates of CSA than the United States. Many of the European countries have also expressed a much greater openness towards sex, and have enacted much more comprehensive sex education policies (Weaver, et al. 2005; Bell 2009; Jones, 2021).

For example, sex education in France is known for its openness, and encourages students and teachers to engage in dialogue, while outside the schools family planning clinics openly cater to youths (ibid). In fact, in 2016, researcher Odile Fillod created a 3-D model clitoris for students to interact with, as many French feminists have been bringing attention to the erasure of the clitoris and its role in women’s pleasure (Stutzer, 2016; Theobald, 2016).

In Switzerland, sex education begins in kindergarten, and teachers are heavily encouraged to provide the addresses of sexual and reproductive health services (IPPF & BZgA, 2018). In one particularly illustrative example of Switzerland’s forthrightness, in 2011, an elementary school in Basel began offering “sex boxes” which contained plush toy penises and vaginas, and gave students the opportunity to massage one another with warm sandbags to help them practice closeness and intimacy (Menzie, 2011; Stoeffel, 2014).

Sweden, meanwhile, is a world leader in sex education, first establishing it in 1942. Then it was abstinence only, but at the time any sex education in primary and secondary schools was an innovation. Starting as early as 1977, Sweden took the steps to modernize its sex education through discussion of birth control and STDs. Today sex education in Sweden is overseen by the Swedish Association for Sexuality Education (RFSU) which visits schools to verify that the curriculum taught is accurate, and fights to make sex education mandatory for teachers, in order to ensure students are getting the best information (RFSU, 2015; Haight, n/d).

Attitudes toward the sexual behavior/expression of minors in European schools is also notably more lax, even towards prepubescent children. In 2017, Norway released a national framework plan for kindergartens (Rammeplan for Barnehagen) which states that staff must help children “becoming familiar with and confident in their own bodies,” “support children’s identity development and positive self-esteem,” and that “[children’s] wonder and exploration must be met with recognition” (Lehn, 2023). In interviews with 18 Norwegian Kindergarten teachers on their reactions to children’s classroom sexual behavior such as masturbation, results revealed that while there were general feelings of embarrassment and discomfort on the subject, these feelings were more related to how their responses would be interpreted by other staff members. As for the children themselves, there was broad support for the idea that such behavior was not evidence of pathology or abuse, and that open and accepting conversations on child sexuality should be promoted (ibid).

III. Does Comprehensive Sex Education in the U.S. Produce Less Child Sexual Abuse?

Implementing another state-by-state comparison, here is a breakdown of the CSA rates in each state along with their sex education policies based on data from the “Sexuality Information and Education Council of the United States” (SIECUS, 2022). SIECUS offers the most extensive information on sex education policy for all fifty states, and documents which states are required to stress abstinence and which mandate instruction about HIV and other STDs. It also reveals which states do not require (or require only limited) information on contraceptives, and which states require expansive information on contraceptives (i.e., covering the various types, instructions on proper use, benefits, etc.).

States that are required to stress abstinence, and that offer limited or no information on contraceptives will be coded as AOUM states. States required to only cover abstinence (as one option) and that provide expansive information on contraceptives will be coded as CSE states. While the dividing line between CSE and AOUM cannot be limited to these two factors, this corresponds to the findings of Santelli et al. (2018) and Zou (2021) that suggest that refusal skills and birth control instructions were associated with a reduced rate of sexual violence whereas refusal skills alone were not. Does this more comprehensive approach also impact the rate of CSA?

Using data on CSA rates based on a 2021 Children’s Bureau report, here are the rates of CSA per 1,000 children in the AOUM states: Alabama (1.91), Arkansas (2.53), Delaware (1.05), Florida (0.60), Georgia (0.29), Idaho (0.49), Indiana (1.61), Kentucky (0.82), Louisiana (0.31), Michigan (0.64), Mississippi (1.76), New York (0.53), Ohio (1.67), Oklahoma (0.78), Pennsylvania (0.79), South Carolina (0.71), Tennessee (1.54), Texas (1.01), Utah (1.41), Washington (0.31), Wisconsin (0.80). Altogether, this averages 1.03 incidents of child sex abuse per 1,000 children in these states.

Meanwhile, the CSA rates in the CSE states are as follows: California (0.44), Colorado (0.95), Connecticut (0.54), Hawaii (0.24), Illinois (1.53), Maine (1.20), Maryland (1.52), Missouri (0.97), New Jersey (0.30), New Mexico (0.46), North Carolina (0.47), Oregon (1.11), Rhode Island (0.63). Altogether, this averages 0.80 incidents of CSA per 1,000 children in these states, which is 0.23 incidents less.

Looking at it another way, HealthGrove has analyzed data on sex education by the CDC and ranked 44 states from best to worst. The top five best states in sex education are New York, which has a CSA rate of 0.53 per 1,000 children, followed by New Jersey (0.30), Wisconsin (0.80), New Hampshire (0.31), and Rhode Island (0.63), with an average of 0.51. The five worst states in sex education, along with their rates of CSA, are Alaska (1.61), South Dakota (0.37), Tennessee (1.54), Alabama (1.91), and Nebraska (0.46), with an average of 1.18 [1].

IV. Conclusion

While CSE is touted as one of the most effective ways to increase condom use and reduce the rates of STDs and unplanned pregnancies amongst youths, it may also have the effect of reducing the risk of sexual violence and abuse. Although most children in the U.S. are given instructions on how to avoid sexual abuse, and many middle and high schools have programs that teach (specifically girls) on the dangers of sexual assault, CSE is based on a much broader view of positive youth sexuality. Sex education that teaches students only how to avoid sexual risks without also teaching teaching ways to safely have sex fails to recognize the possibility of positive youth sexuality, and this can put kids and teens at risk of sexual violence or abuse.

For instance, AOUM sex education is often based on shame—portraying the decision to have sex as a moral failure (Norwick, 2016). The belief that abstinence is the only responsible decision can make it difficult for young people to recognize when their rights are being violated, especially if they have been made to believe that they have forfeited their right to safety by engaging in sex (Clonan‐Roy, 2020). Comprehensive sex education, on the other hand, sends the message that not only can youths have safe sex, but they have the right to demand that any sex be safe and consensual.

Notes

[1] Arizona occupied the 44th spot, though it did not submit its data in time for the 2021 Child Maltreatment report.

References

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