Introduction: Tips and Strategies for Sexuality Educators and Advocates for Sexuality Education
Comprehensive sexuality education is increasingly viewed as a crucial component of any young person’s formal education as well as a public health necessity. Over one billion people—nearly one-fifth of the world’s population—are adolescents between the ages of 10 and 19. Many are already sexually active, whether married or not, and are vulnerable to sexually transmitted infections, HIV/AIDS, unplanned pregnancy, botched abortion, and sexual coercion or violence.

At the International Conference on Population and Development (ICPD) held in Cairo in 1994, representatives of 179 countries agreed that adolescents have a right to information regarding their reproductive and sexual health. The compelling need for high-quality information and services has been reaffirmed at subsequent conferences, including the United Nations Special Session on Children, held in New York in 2002. Comprehensive sexuality education could have a dramatic impact on curbing the AIDS epidemic, decreasing the number of unwanted pregnancies and resulting complications, and empowering girls and women to exercise their right to sexual and reproductive self-determination.

Given this increased support, many comprehensive sexuality education programs and curricula are being developed, and much has been learned about effective teaching approaches. Unfortunately, however, some of the most creative teaching materials are not easily accessible in many parts of the world. This resource manual provides a handpicked selection of some of the best English-language sexuality education materials currently available. The lesson plans address key issues; use creative,
interactive, learner-centered teaching strategies; and are adaptable to diverse cultural settings. They are also progressive. They address gender issues, challenge discriminatory attitudes and behaviors, and present sexuality as a positive part of life rather than something to be feared and shrouded in taboos.

The lesson plans reprinted here are appropriate for 10- to 19-year-olds and are classroom ready. They are meant to serve as a source of ideas, examples, and inspiration for educators developing their own sexuality education curricula. Depending on the cultural context, level of community support, and students’ level of knowledge and experience, some lesson plans may need considerable adaptation to be relevant and effective. Listed at the end of the book are references to additional recommended lesson plans that are either available online or can be ordered for a fee.

Guiding Principles
The lesson plans for this manual were selected based on the following principles:
Sexuality is an integral part of human life, which everyone has the right to
experience positively.

• All people have the right to determine their own sexual behavior and reproduction, and the responsibility to behave safely and with respect for the rights of others.
• All people, including children and adolescents, have a right to receive unbiased
  information about sexuality.
• Discrimination based on sex, race, ethnicity, nationality, class, religion, sexual orientation, age, or ability is wrong and should not be tolerated.
• Sexual violence, coercion, harassment, and exploitation violate human rights
  and are not acceptable.
• Effective sexuality education presents a positive, accurate, and comprehensive view of human sexuality, respects and empowers participants, and is age-appropriate.
• Comprehensive sexuality education enables adolescents to experience their sexuality safely, appropriately, and responsibly, now and in the future.
• Sexuality education should be taught by persons who are well trained, comfortable with the subject matter, and committed to these principles.

Why is Comprehensive Sexuality Education Necessary?
Young people need relevant information before they become sexually active in order to protect their health and rights and those of others. Comprehensive sexuality education recognizes that sexuality is not just about sexual intercourse. It encompasses a broad range of human experiences that are central to who we are as human beings, including human development, emotions and relationships, sexual health, sexual behavior, and sexual violence. In addition to providing accurate information, comprehensive sexuality education encourages students to explore their own values and develop the communications skills and self-respect necessary for a positive and healthy sex life.

In most places, discussion of sexuality is taboo. But regardless of the silence surrounding the topic, sexuality permeates life in every culture, and taboos only serve to heighten curiosity and reinforce ignorance. They do not foster healthy and responsible behavior. Comprehensive sexuality education aims to replace silence and shame with information and skills. By bringing sexuality into the open, young people are more likely to make wise, realistic, and informed decisions based on principles of human rights and gender equality. Given the potential risks inherent in sexual activity, we owe it to young people to help them safeguard their own futures.

The Sexuality Information and Education Council of the United States (SIECUS) has developed guidelines for providing comprehensive sexuality education. These guidelines, which are available at www.siecus.org/school/sex_ed/guidelines, have been adopted by several countries, including Nigeria and India. As excerpted from the guidelines, sexuality education seeks the following behavioral outcomes:

Life Behaviors of a Sexually Healthy Adult
A sexually healthy adult will:

Human Development

• Appreciate one’s own body
• Seek further information about reproduction as needed
• Affirm that human development includes sexual development, which may or
  may not include reproduction or genital sexual experience
• Interact with both genders in respectful and appropriate ways
• Affirm one’s own sexual orientation and respect the sexual orientation of others

Relationships

• View family as a valuable source of support
• Express love and intimacy in appropriate ways
• Develop and maintain meaningful relationships
• Avoid exploitative or manipulative relationships
• Make informed choices about family options and relationships
• Exhibit skills that enhance personal relationships
• Understand how cultural heritage affects ideas about family, interpersonal relationships, and ethics

Personal Skills

• Identify and live according to one’s values
• Take responsibility for one’s own behavior
• Practice effective decision making
• Communicate effectively with family, peers, and partners

Sexual Behavior

• Enjoy and express one’s sexuality throughout life
• Express one’s sexuality in ways congruent with one’s values
• Enjoy sexual feelings without necessarily acting on them
• Discriminate between life-enhancing sexual behaviors and those that are
  harmful to self and/or others
• Express one’s sexuality while respecting the rights of others
• Seek new information to enhance one’s sexuality
• Engage in sexual relationships that are consensual, nonexploitative, honest, pleasurable, and protected against disease and unintended pregnancy

Sexual Health

• Use contraception effectively to avoid unintended pregnancy
• Prevent sexual abuse
• Act consistently with one’s own values in dealing with an unintended pregnancy
• Seek early prenatal care
• Avoid contracting or transmitting a sexually transmitted infection, including HIV
• Practice health-promoting behaviors, such as regular check-ups, breast and testicular self-exams, and early identification of potential problems

Society and Culture

• Demonstrate respect for people with different sexual values
• Exercise democratic responsibility to influence legislation dealing with sexual issues
• Assess the impact of family, cultural, religious, media, and societal messages on one’s thoughts, feelings, values, and behaviors related to sexuality
• Promote the rights of all people to accurate sexuality information
• Avoid behaviors that exhibit prejudice and bigotry
• Reject stereotypes about the sexuality of diverse populations
• Educate others about sexuality

Getting Community Support Before You Start
Parents, families, and communities hold common misconceptions about sexuality education. They believe that children and adolescents are too young to learn about sexuality and that if they do, they will want to have sex earlier. Neither is true, but addressing such misconceptions is essential for a program’s success and longevity.

Assess the level of resistance. Your first step in addressing community fears and building support is to assess the actual degree of resistance among parents and community leaders before you begin. It is easy to overestimate. Hold preliminary meetings with community leaders and parents and listen to their fears. Most parents want to help their children with these difficult issues but are either too embarrassed or ill-informed to do so. Many are grateful for these programs and will be supportive, especially once they are assured that sexuality education is helpful to young people—now and in the future—and part of the solution to existing social problems.

Build a network of supporters. Get support from respected community leaders, parents, and school administrators, and ask them to work with you to gain support from their peers and constituents. Offer to provide educational sessions. Identify ways to keep your network engaged in your work and maintain their support. Network with other sexuality educators within your community and beyond it, and work to support and encourage one another.

Form a small advisory committee of various constituents in your community. Involve a range of interested parties, such as parents, teachers, administrators, community leaders, traditional leaders, health care providers, religious leaders, elected officials, and adolescents both in and out of school. Be certain that at least some members of the advisory committee are strongly supportive of your program. Then you will be in a better position to address opponents’ concerns from within.

Educate adults about the reality of adolescents’ lives. Present community leaders and parents with facts about adolescents in your community and the issues they face. These may include rates of teen pregnancy, early or forced marriages, abusive dating relationships, HIV/AIDS and other sexually transmitted infections, and abortion complications. Also present evidence, if you have it, of how sexuality education made a positive change in someone’s life or in a community. Tell true stories of adolescents who have faced problems and their thoughts about how sexuality education could have helped them. You may also want to invite young people to speak about the importance of sexuality education or have them write short essays to adults. In a forum, divide adults into small groups; then have them analyze the problems facing young people and brainstorm solutions. You might also have them think back to their own adolescence, how they felt, their fears and mistakes, what they wish they had known during that period. Have them write down such thoughts, and then ask them to make a list of what they would like their children to know.

Use research to support the need for your work. Find existing research about adolescents’ knowledge, attitudes, and behaviors that shows the need for your work. If none exists, consider doing research to show the need. Qualitative interviews can be a useful source of information. Present research findings in a format that is easily understood by community members, such as a fact sheet. Consider providing information from national or international studies about the impact of sexuality education. For example, the World Health Organization issued a report in 1993 entitled “Does Sex Education Lead to Earlier or Increased Sexual Activity in Youth?” It reported on the outcomes of 47 sexuality education programs. In 25 cases, the programs neither increased nor decreased sexual activity or rates of pregnancy and disease, in 3 cases (including an abstinence-only program) sexual behavior increased, and in 17 cases, the programs actually delayed sexual activity and reduced unplanned pregnancies and sexually transmitted infections. You can also download a 1997 UN report on HIV/AIDS entitled “Impact of HIV and Sexual Health Education on the Sexual Behavior of Young People: A Review Update,” available at www.unaids.org.

When You are Ready to Start
Do a pilot program first to see how it is received. A pilot is simply a test-run to measure the effectiveness of materials, identify potential problem areas, and gauge participant and community reactions before a project is done on a larger scale. Pilot programs can be done in many different ways. For example, if you are introducing sexuality education into a school or school system, you could start by teaching only one class or grade level in a school or by teaching a course in the community before starting in the schools. During the pilot, educators should be actively observing and recording feedback.

Get the support and approval of the participants’ parents. Involve them in the program and encourage and promote parent-child communication. Inform parents of the program in writing and allow them to decide whether they want their child to participate. Invite them to an orientation session to let them know what will be taught, the rationale, and the core values of the program. Ask for their support and approval. Consider providing some parent-education sessions.

Get the official support and approval of the institution or organization in which you are working. You may need to provide some sexuality education sessions for organizational leaders so that they also understand what you want to do.
Address and defuse problems if they arise. Answer questions and concerns directly and carefully, but do not make major changes to your program values, goals, or content because of the opposition of a few individuals. Maintain communication with your advisory committee, network of supporters, and parents throughout the program, and call on them for assistance in handling resistance.

Designing a Course
Assess your learners’ needs and interests. Find out what they already know; talk with other teachers, youth leaders, and health care providers, and ask adolescents directly what they think they want to learn. Use any existing data on adolescents’ knowledge, attitudes, and practices regarding sexuality.

Establish course values. See, for example, the principles listed earlier. Course values will serve as the basis for determining the content and enable you to guide your participants’ thinking and behavior throughout the course. They should be introduced and discussed during the first session. They are also useful for explaining the course rationale to parents.

Develop clear and specific learner objectives. Objectives should state what the participants should know or be able to do by the end of the course or session. This is useful for determining what you need to teach, the types of methods you will use, and how you will assess the students’ learning.

Outline a draft schedule for the course. Think carefully about the flow of the content. What is a logical sequence and organization of the material you intend to cover? What do the participants need to learn first so that they can understand other topics? How can you build their understanding and link lessons to one another to reinforce learning?

Balance what you want to achieve with the time available to you for teaching. Determine whether you should reduce the number of topics or the amount of time you will spend on some. Sometimes even dealing with topics briefly can have an important impact on your participants if you can provide a learning experience that is clear and gets to the core of the topic.

Develop lesson plans. These should include learning objectives, key messages, and methods. Effective lessons should build upon and, where possible, connect to previous lessons. For every topic, make sure that your participants have an opportunity to work with, analyze, or think about new information or experiences; reflect on their feelings; practice using skills; and apply or visualize applying what they have learned. If you decide to use activities from the lesson plans included here, make sure that you spend the time required to adapt them carefully. Some may require considerable preparation or research. Adapt any ideas to suit your particular objectives and participants. Make sure that the materials you use reflect typical ideas or possible circumstances in your community and are suitable for the cultural backgrounds of your participants. Note that if you are teaching in a language other than English, you will need to
think carefully about how to translate the terms used in talking about sexuality.

Plan for assessment. Determine what your participants have learned and how close you’ve come to reaching your own goals. This should be done informally during and at the end of each lesson as well as periodically during a course. Traditionally, it is done through testing, a method that you can use if it is appropriate to the context in which you are teaching. There are many other less formal and less stressful ways to quickly assess what your participants have learned and what they are focusing on. For instance, periodically pass out small slips of paper and ask participants to write down one important thing they learned, one thing they still do not understand, and what questions they still have about the topic.

The Ideal Lesson, Workshop, or Curriculum
The ideal sexuality lesson, series of lessons, curriculum or workshop is composed of
sequential learning activities that work together to accomplish the following goals:

• Introduce key concepts
• Continually reassess learner needs, interests, attitudes, knowledge, and skills
• Connect with participants’ real lives
• Introduce and/or reinforce positive social norms
• Introduce or reinforce ground rules—guidelines for working and being together
• Establish (or maintain) a comfortable environment while motivating learners
• Teach to all learning styles
• Help participants expand their learning abilities
• Present and gather information; correct misinformation and myths
• Stimulate verbal articulation and analysis of feelings, values, and attitudes while building respect and tolerance for others’ different values
• Help participants reflect, analyze, and draw conclusions
• Help participants conceptualize, test theories, solve problems, and make or project practical applications of new information
• Help participants apply knowledge and skills

Excerpted from Teaching About Sexuality and HIV by Evonne Hedgepeth and Joan Helmich. New York: New York University Press, 1996.

The Elements of Learning
Learning Domains
Underlying the formation of all effective sexuality education lessons are the three domains of learning: cognitive, affective, and behavioral (which can be thought of as the head, heart, and hands). Each domain requires different methods of teaching and assessment.

The cognitive domain is the domain of knowledge. Cognitive content is objective and provable. It can usually be assessed as correct or incorrect, true or false. For example, messages like “STIs (sexually transmitted infections) can be transmitted through unprotected sex” and “HIV infection cannot be cured” are within the cognitive domain.

The affective domain is subjective in nature and includes feelings, beliefs, attitudes, and values. There are usually no correct and incorrect answers in this domain, but participants should be encouraged to ground their beliefs and feelings in correct knowledge. How someone feels about asking a partner to use a condom and beliefs about one’s risk of getting an STI are within the affective domain.

The behavioral domain is the domain of actions and skills. Practice is required to master a skill and develop confidence in one’s ability. Behavioral content, for example, includes the ability to talk to a partner about practicing safer sex and the ability to negotiate condom use.

All three domains must be addressed for any given sexuality education topic. For instance, in teaching about STIs, students may know how STIs are transmitted and how to negotiate and use condoms with a partner, but if they do not believe that they can get an STI they are unlikely to use a condom.

Interactive Methods
Traditionally, the teacher is the giver of knowledge and the student the passive vessel that receives it. Interactive methods, however, require the active engagement and participation of the students in their own learning. This is the antithesis of the lecture, which is one of the most common yet least effective teaching methods. Students not only retain more information when they are engaged, they develop their capacity to think critically and creatively. Ideally, they learn to question, reason, justify their reasoning, make associations, and synthesize learning. The process asks them to wonder, imagine, explore, seek information, remember, and connect information, feelings, and skills.

The Teacher as Guide
When using interactive, learner-centered methods, the teacher’s main role is to be a guide to learning. The teacher sets up activities that enable the students to share prior knowledge, to think about problems and come up with solutions, and to discover the information and ideas they are intended to learn. The teacher shows the way, indicates what is correct and incorrect, gives necessary information, and facilitates learning. However, the teacher must always know the purpose, content, and desired results in any given part of the lesson—a guide with no clear map or destination is going to get everyone lost. Interactive teachers must think on their feet. They must react quickly to what the students are doing and saying and be able to critically
analyze what is happening in the group as it happens. To do this well, the teacher must know the topic and the key messages thoroughly.

Teachers who have never used interactive methods will need some time to adjust to them. They will need to get used to asking questions and waiting for answers rather than dispensing information immediately. They will need to get used to more noise in the room. They will need to develop trust that the methods will work and their students will come up with appropriate and intelligent ideas, answers, and material to work with.

Some benefits of using interactive methods:

• Students understand and remember more.
• Students’ curiosity is piqued and their minds are more open to learning—they want the knowledge.
• The active mental engagement of students in their own education keeps them interested.
• Teachers can explore the affective domain without imposing one set of ideas and values.
• Students are more likely to master skills and change behavior.
  

Becoming a Sexuality Educator
Sexuality educators must be trained. Even the most informed people harbor biases about sexuality that need to be examined and understood so that they do not interfere with teaching. Training should:

• Provide sexuality educators with accurate factual knowledge of the broad range of content included in sexuality education
• Enable educators to examine and clarify their personal attitudes and values related to sexuality and to consider those of others
• Develop educators’ comfort with talking and teaching about sexuality
• Develop educators’ teaching skills and familiarity with interactive methods

During the training, the trainer should model interactive methods and give trainees the opportunity to practice using them and exchange feedback. Training helps teachers develop comfort with the topic of sexuality, which is extremely important because the teacher will be the students’ model for the normality and acceptability of sexuality. Other professional expertise may have no bearing on a person’s ability to teach sexuality. The most important factors are one’s interest, openness, empathy, flexibility, and ability to learn.

Criteria for Choosing Sexuality Educators
Ideally, sexuality educators select themselves.

• They are very interested in teaching sexuality education and believe it to be important.
• They are open-minded and nonjudgmental, with an open personality, good communication skills, and flexibility.
• They are well liked by students—young people would feel comfortable discussing sensitive issues with them.
• They respect and care about young people.
• They are willing to be trained in sexuality education.

Answering Participants' Questions
The Anonymous Question Box
The anonymous question box is a time-honored element of sexuality education. Recognizing that participants may have many questions that they are too shy, embarrassed, or fearful to ask directly, educators often set up a closed box with a small slot in the top. Participants can put their questions into the box at any time. The anonymous question box helps educators know what is on participants’ minds—concerns that otherwise might not come up—and gives educators time to think carefully about or research the answers.

Whether asked anonymously or in the presence of others, participants’ questions can be one of the most challenging parts of teaching sexuality. Every teacher needs to use his or her own judgment and think carefully before answering. Below are some guidelines for answering participants’ questions.

General Considerations

• Think about each question carefully. What is being asked? Could it be interpreted in more than one way? If you are not sure what a question means, rephrase it and ask the participants to help you clarify.
• Validate the question. Use phrases such as “This is a really good question” or
  “Many people are curious about this.”
• Give complete, direct, and clear answers. Be specific.
• Don’t give too much information. Avoid unnecessary or irrelevant information,
  but use the question to reinforce important key messages when appropriate.
• Take all questions seriously, even if they seem funny to you, unless they are
  clearly disrespectful.
• Do not use medical or technical terms with which your participants are unfamiliar.
• If the question includes slang or incorrect terms, rephrase the question so that it uses standard language.
• Make sure your answers are factually correct. Be honest: if you don’t know the answer, say that you will try to find out and respond later.
• Make sure your answers are nonjudgmental and inclusive. Be sensitive to the varied feelings, experiences, and backgrounds of your participants. Some types of questions are more difficult to answer than others. Some questions that pose
  particular challenges include personal questions and questions about values.

Answering Personal Questions

• Think very carefully before answering any questions about your personal life or experiences.
• Don’t give personal information unless you have a solid reason to do so and have considered possible consequences.
• Decide if answering the question will have an impact on your teaching or life. Will it increase or decrease your effectiveness or credibility in teaching? If it is neutral, you may decide to answer. For example, most people would consider it harmless to tell students whether they were married or had children.
• Do not discuss your own sexual life or experiences. If asked about them, remind students of the need to respect everyone’s privacy. You can rephrase the question so that it is about people in general rather than your own experience and answer that question.
• For some questions, such as “Are you gay?” or “Have you ever been raped?” your impulse may be to simply say “No,” especially if it happens to be true. However, these questions can also be used to enable participants to think about their attitudes. Rather than just responding “No,” it would be more educational to ask, “What difference would it make if I said yes?” and then “What difference would it make if I said no?” (That is, would it change who you are? Or their opinion of you? Or how they react to you? If so, why?)

Answering Questions About Values

• Think carefully before giving any personal opinions about issues unless these positions are clearly defined in your course values and agreed to by the participants already.
• Clearly distinguish between facts and opinions.
• State that the question is about values and doesn’t have one answer. The answer will depend on the person’s beliefs.
• Give related factual information first.
• Ask participants what all the different points of view are on the question. Turning the question back to the participants is a technique that can be used for any question to which there is not one correct answer.
• Do not give your opinions on controversial topics.
• Encourage students to discuss values questions with their families.

How to Use this Book
The guidelines in this introduction apply to teaching about all aspects of sexuality. The chapters that follow address specific topics in the curriculum. Each contains an overview of the particular topic, plus an introduction to each reproduced lesson plan, offering advice on how best to utilize the material The lesson plans, which are reprinted with permission from other sources, are on bordered pages.

>>Browse Positively Informed by chapter

>>To request a free copy of Positively Informed, email Whitney Welshimer at wwelshimer@iwhc.org. Please don't forget to include a valid mailing address!