As interested groups argue about a sexual health strategy for Scotland, is there a danger of overlooking the most important constituents of all, young people themselves? Raymond Ross reports on an education programme that encourages pupils to discuss the issues openly
At the end of last month there was a brouhaha in the press over the Scottish Executive's sexual health strategy. Consultation on the draft report ended on February 27 and just a few days before, the Health Minister, Malcolm Chisholm, encouraged the public to take part in the debate.
"Our aim is that a strategy will emerge which will pave the way for improved sexual wellbeing for this and future generations founded on the pillars of self-respect, respect for others, and strong, respectful relationships," said Mr Chisholm.
An extension would be given to those who still wanted to have their say on Enhancing Sexual Wellbeing in Scotland: a Sexual Health and Relationships Strategy.
A heated debate followed in the newspapers about the rise in sexually-transmitted infections and teenage pregnancies (Scottish figures are among the highest in Europe). Executive proposals to extend sexual health projects in the Lothians across Scotland were denounced by the Archbishop of Glasgow, the Most Rev Mario Conti, and guidelines for teachers (already available in the Lothians) were criticised for encouraging the use of condoms and morning-after pills.
Joan Forrest, a senior lecturer in social studies education at Strathclyde university, was an adviser to the working group on the McCabe Report (2000), which recommended a national strategy on sexual and relationships education (SRE). She believes that sexual health education is in a better state than scare headlines might suggest, though provision is still variable across Scotland.
She argues for much more pupil involvement and believes children often feel they are living in a different society from the adults who are trying to impose upon them.
"The crux is that in sexual and relationships education at the moment there is not enough credibility given to what the young people feel their needs are," she says.
"Should SRE be decided wholly by adults? By adults who are not fully aware of the pressures on young people today?
"Schools should be asking the pupils to assess what their needs are, certainly from S2 onwards," she says.
In her response to the Executive's sexual health strategy, Ms Forrest writes: "The school section, in particular, lacks recognition of the contribution that young people themselves can and should make to their development.
"There is no emphasis on young people as critical and independent thinkers and the importance of encouraging that.
"Programmes should foster ownership, empowerment and involvement, as suggested for community-based activities and programmes. We talk about informed choices with alcohol and drugs but not with sexual activity."
She also believes that pupils should be given much greater leeway in class discussions: "SRE classes should provide the opportunity for young people to think about sexuality."
Teachers must have good training, she says, because this can be mischievously misinterpreted by outside bodies. They also need to be reassured that the materials they are working with are conducive to getting young people to think about the issues of good sexual health.
"It's not about giving information solely. That's the easy bit. It's getting them to think for themselves that can be problematic because you don't know where that discussion will lead.
"What are their values? You have to let them explore. You have to be realistic and let them talk about the issues, or they'll talk about them elsewhere. Schools, after all, are about preparing young people for society. "
Dr Daniel Wight, a senior researcher at the Medical Research Council's social and public health sciences unit at Glasgow university, is one of the team behind the delivery and evaluation of the SHARE (Sexual Health and Relationships: Safe, Happy and Responsible) programme, which the Executive recommends should be built into a revised education programme.
He believes that putting the pupils at the centre of SRE involves more than giving them information and allowing explorative discussion. "It is about the delivery of skills-based sex education, about the development of negotiating skills," he says.
Dr Wight believes that sexual health education is in a good state, developing in quality and consistency across Scotland. However, he feels the development of pupils' negotiating skills in how far they want to go in a relationship should be more central.
"Developing negotiating skills means being able to establish with a potential partner how far you want to go," he says. "Most S3-S4 pupils have kissed, fondled or petted but have not generally gone as far as intercourse.
"However, they don't generally talk about these things between themselves as partners, and most sex education doesn't deal with it at all.
"It's difficult to develop these skills through SRE. We tried role-playing but no one liked that. So SHARE developed an interactive video which sets a scene, moves to a party and eventually ends in a row because the boy wants to go further than the girl.
"The teacher can stop the video at certain points to discuss what the pupils think; and the video shows both good practice and bad practice outcomes, the moral being that the better you communicate the more success you will have.
"SHARE materials are about developing skills to avoid going further than you want, or if you are happy to go further there are skills in introducing condom use.
"It's about harm reduction, about avoiding sexual interaction you are not comfortable with and about emphasising responsibilities in a relationship," he says.
Currie High in Edinburgh was one of the first schools in Scotland to pilot the SHARE project in 1995 and all six guidance staff are trained to use the programme.
"SHARE materials are the best there are on the market and the teacher training involved is invaluable," says Harriet Martin, the principal teacher of guidance.
She believes there should be a national sexual health strategy and does not think SRE is in any kind of mess, but does see a need for appropriate teacher training.
"You have to let pupils discuss what concerns them and be comfortable with it," she says.
"I can't say pupil consultation andor pupil involvement in SRE has been a conscious policy in our school but we have had pupils review personal and social education materials on drugs and advise us on them. They also bring new ideas of their own to staff. I don't see why this couldn't be extended to SRE.
"We have senior pupils acting as peer supporters for all year groups, and pupils can leave anonymous suggestions in my pigeonhole for matters they want discussed in personal and social education classes, including SRE. We slip these into class discussions as a matter of course," she explains.
Currie High's sexual health education programme is fully developed but regularly reviewed and updated.
It places a strong emphasis on making informed decisions, on rights and responsibilities in relationships, on negotiating skills, on sexually transmitted diseases and HIVAids and, when suitable, on condom skills. It makes a lot of use of video and visual material but only limited use of visiting experts, though this may change.
Mrs Martin believes the next generation will benefit from the SHARE approach because the present young generation will have learned to talk to each other about sexual relationship matters and to talk to their children as they grow up.
"These negotiating skills are as fundamental as they are transferable to areas such as deciding whether or not to take alcohol or drugs.
"It's about young people learning to be comfortable with their own decisions, about empowering them, allowing them to be in charge of their own lives."
THE SHARE PROGRAMME
The SHARE programme involves:
* 20-sessions of teacher-delivered curriculum for 13-15-year-olds;
* active learning throughout;
* emphasis on the development of sexual negotiation and condom handling skills;
* focusing on improving the quality of sexual relationships and reducing incidents of unsafe sex and unwanted pregnancies; and
* a five-day training course for those delivering the programme.
For further information contact the Medical Research Council's social and public health sciences Unit, Glasgow university, tel: 0141 357 3949 www.msoc-mrc.gla.ac.uk