According to UNESCO there are 111 million new cases of sexually transmitted diseases among people ages 10 to 24 globally each year. In addition, 4.4 million women age 15 to 19 seek abortions each year. As part of their on-going programme to try to improve this situation, and with a strong focus on trying to reduce HIV transmission, UNESCO is in the process of formulating Sex and Relationship Education guidelines that they hope will make the task of helping the world’s young people to make informed decisions. A welcome and much needed contribution? Sadly, not everyone thinks so.
As a doctor and the mother of four teenagers teaching young people how to avoid making harmful decisions seems like an admirable idea to me and, moreover, one where the insight from an expert and multi-disciplinary panel would be advisable. And yet, and I suspect to the surprise of few, concerns have already been raised in some quarters that these guidelines might somehow corrupt the world’s youth.
For an outline of this view see the September 3rd issue of Time.
http://www.time.com/time/health/article/0,8599,1920024,00.html
It is not however my intention to put forward arguments either for or against the UNESCO project. Instead I’d like to consider whether or not a medical humanities perspective, informing into the way in which the responses of various interest groups are understood and engaged with, might be of value. In order to do so I’ll begin by detailing the considerable expertise of the existing panel. My brief summary does not do justice to their many achievements but does suggest the different insights they bring to this important issue.
Peter Aggleton is a professor of education known for his analytic work on the cultural aspects of sexuality and has global experience researching the social aspects of HIV‐related prevention, treatment and care.
Arvin Bhana is a sociologist whose primary interest is in developing interventions that influence risky and health promoting behaviour of young people by engaging with young people, families, schools, and the wider community.
Doug Kirby is a scientist whose has systematic reviews have identified important common characteristics of effective sexuality education and HIV education programs.
Elliot Marseille is an economist whose focus is on the economics of HIV prevention and treatment in developing countries.
Elizabeth Mataka is the United Nations Secretary‐General’s Special Envoy for AIDS in Africa and a social worker by training. She has pioneered peer education in Zambia through the facilitation of the formation of over 2,000 school/community based Anti‐AIDS Clubs.
Sara Seims is a population scientist with expertise in international reproductive health issues, including teen pregnancy, and behavioural research in the areas of HIV/AIDS.
Alice Welbourn is a social development adviser, writer, trainer and activist in participatory approaches to gender, sexual and reproductive health. She was diagnosed HIV positive in 1992.
Jimmy Whitworth is responsible for the Wellcome Trust’s strategy and policy for developing scientific portfolios for research in low and middle income countries. He is a physician by training, specialising in infectious diseases, epidemiology and public health.
Even these much shortened bios give a good indication of the expertise and calibre of the individuals developing the guidelines. Clearly these people have an enormous wealth of expertise to bring to this important task. They know about the ravages that HIV/AIDS continues to inflict on so many young lives, they know about the options available to young people that, were they but to make use of them, could reduce the damage inflicted on them by unwanted pregnancies and sexually transmitted diseases, and they know, importantly, what works and doesn’t work in sexuality education.
So is there anything missing? Or rather are their any other perspectives that might usefully be enjoined to help those who see the UNESCO programme as a corrupting force to change their minds and thereby to help ensure that as many young people as possible can make informed choices about sexual behaviour.
Coming at this from a medical humanities perspective, I find myself wondering how the perspective of a literary scholar, drawing on the AIDS literature, on literature about the sexuality of young people and about relationships between the generations, might have shaped the way in which the UNESCO programme would have been conceived and then promoted globally. Or to what extent an anthropological perspective on the ownership of sexual knowledge and the understanding in different cultures of the relationship between sexual innocence and moral worth might offer insights into possible ways to bridge the gap between those for and against sex education. I’d also like to hear from historians about how and why sex and sex education remains and indeed increasingly is becoming such a controversial topic in certain parts of the world and in certain groups within different societies. Has it always been this way and, if not, how and be what route did we get where we are. And I’d like a specialist in film and media studies to explain what, and to what effect, young people are accessing formal and informal sex education via the internet, films, and on-line communities and the implications this has-for good or for bad-on the impact that UNESCO can hope to make.
I’m not, I hope, altogether naive. I realise that there will always be some minds, on both sides, that are determined to remain closed. I’m just saying that as well as the insights of educators, sociologists, economists, public health physicians and field workers this important issue would benefit from some of the perspectives that the arts and humanities have to offer on why and how people create meaning in their lives and why, in this instance, sex and the way in which information about it is imparted to young people has come to mean such different things to different people. Because at the end of the day, no matter how good the guidelines, there remains an uncomfortable and perilous gap between logic and intuition in the sex education debate. Medical humanities has, I’d like to suggest, a modest contribution to make to bridging it.
For an analysis of why seemingly intelligent and logical people, faced with the same set of facts, can sometimes reach diametrically opposed conclusions read:
Kirklin D. Minding the gap between logic and intuition: an interpretative approach to ethical analysis
http://jme.bmj.com/cgi/content/full/33/7/386
To read about the UNESCO project in detail go to:
http://portal.unesco.org/en/ev.php-URL_ID=42114&URL_DO=DO_TOPIC&URL_SECTION=201.html