Let's talk about sex

Britain is officially the worst place in Europe for teenage pregnancies and STD's, ranking amongst America in international standards. Conception rates among girls rose from 40.9 per 1,000 in 2006 for those aged 15-17, to 41.9 per 1,000 in 2007. The number of conceptions per 1,000 girls aged 12 to 15 has risen from 7.8 in 2006 to 8.1 in 2007, today's figures show. In 2008, 1.2 million sexual health screens were carried out at GUM clinics in the UK, an increase of nearly 50 per cent since 2004. In the same year, there were 399,738 new sexually transmitted infection diagnoses at GUM clinics in the UK, an increase of 53 per cent on 1999. So what are we doing incorrectly? And what are we failing to do in order to correctly address this issue? Who do we turn to in order to resolve this ever-growing problem?

The Netherlands could probably be my favourite example of how sex should be treated; liberal attitudes and open-mindedness having actually proven to be effective in the battle against underage sex, especially promiscuous sex. With a teen pregnancy rate of under 1% Netherlands has virtually eliminated a health and social problem. Sex education and free contraceptives, along with fostering liberal attitudes toward sex, has virtually eliminated teen pregnancy as a health and social problem in the Netherlands. Holland has fewer pregnant teenagers than most Western countries. In the Netherlands less than 1 percent of 15- to 17-year-old women get pregnant each year. Nearly 5 percent became pregnant in Britain, the highest rate in Western Europe; in America it's an astonishing 10% prevalence of teenage pregnancies that have become a stumbling block for their society. The Dutch have seen a steady drop in the number of young mothers for decades, even as the teen pregnancy rate has been increasing in other countries. While other countries have been teaching celibacy, the Dutch have accepted that teens are sexually active and have introduced measures to deal with it.  Oral contraceptives are available at pharmacies and free through the National Sick Fund, a state-funded system that ensures that low-income people have medical care. Statistics show that Dutch teenagers are using them. In 1995, 70 percent of sexually active 18-year-olds were using birth control pills. Eighty-five percent of teens used a condom, the pill or both during their first sexual experience.

With the lowest teenage pregnancy rate in Europe (8.4 per 1,000 girls between 15 and 19), any initiative in the Netherlands deserves attention. “There is no country that has invested so much in research into family planning…, media attention and improvement of service delivery than the Netherlands,” wrote experts from the Netherlands Institute of Social and Sexological Research (NISSO) in a specialised journal. Although the country has no mandatory national curriculum, nearly all secondary schools provide sex education as part of biology classes and over half the country’s primary schools address sexuality and contraception. According to H. Roling, a professor of education at the University of Amsterdam, “the Dutch government has always accepted the fact that education was better than denial,” and the subject has been tackled in schools since the 1970s. Since 1993, the government, without stipulating the contents of classes, has stressed that schools should aim to give students the skills to take their own decisions regarding health, and in particular sexuality. Textbooks were revised and according to Reinders, now take a more “comprehensive approach to sexuality. The curriculum focuses on biological aspects of reproduction as well as on values, attitudes, communication and negotiation skills.” Some schools simply use these textbooks, others complement them with the foundation’s pack, which includes a video, a teacher’s manual and a student magazine. “The education system is very much built not only around transmitting knowledge but giving the skills to apply that knowledge in everyday life,” says Reinders. “Decision-making skills are very important.”

But sex education in schools is not enough to explain the Dutch record. The Rutgers Foundation, a family planning association that has launched several large-scale public information campaigns in the past decades, sees a constellation of other factors. The media has been at the forefront of an open dialogue: between 1993 and 1997, a prime-time talk show featured a leading Dutch pop star discussing sexuality. Confidentiality, guaranteed anonymity and a non-judgmental approach are hallmarks of the health care system. Last but not least, “parents in the Netherlands take a very pragmatic approach. They know their children are going to have sex, and they are ready to prepare them and to speak with them about their responsibility. This is the key word,” says Mischa Heeger of the Rutgers Foundation. Contraceptives are widely used. According to a NISSO study, 85 per cent of sexually active young people use a contraceptive, and the pill is freely available. The average age of a youth’s first sexual intercourse is 17.7 years. Even with this record, the Foundation for STD control recognises that it is still difficult for many teachers to talk with students about sexuality, despite training provided over the years, notably by the Rutgers Foundation. Family planning organizations are also concerned about the higher rates of teenage pregnancy among Turkish and Moroccan girls, and are developing programmes specially geared towards them. But the country’s record has attracted attention from abroad. The Rutgers Foundation provides training to doctors and social workers as well as assistance to education ministries in developing curricula, notably in Central and Eastern Europe and Central Asia. To some critics who argue that “talking about sex gives children the wrong idea,” Jos Poelman of the Foundation for STD control has one answer. “Face the facts. We have the lowest number of teenage mothers [in Europe], and Dutch students do not start having sex at a younger age than their foreign counterparts.”

I personally would like to see the introduction of this model in Britain, as well as the more practical approach of openly talking about sex and relationships from adolescence onwards. Raise the issues of prostitution, of the age of consent for gays, or of sex education and the very public debate that ensues seems to reveal that the British remain resolutely reactionary about their most intimate relations; we must be able to break that stigma, the last social taboo of (whisper it) sexual intercourse. Britons have become strikingly liberal over a range of key issues. Among a plethora of fascinating, revealing and sometimes contradictory findings, this significant degree of tolerance and an increasing appetite for more adventurous sex comes through strongly. But is this quiet sexual revolution we are undertaking enough? In a 2006 survey 84 per cent agree that schools should teach children about sexual behaviour and relationships - going beyond the basic biology of reproduction, the only sex-related education they are currently obliged to provide. On that issue, public opinion is far ahead of the government, which will almost certainly reject the recent call by its own independent advisers on sexual health to make such tuition mandatory. Similarly, about two-thirds (65 per cent) believe prostitution should be legalised, an increase of 4 per cent since our last survey in 2002. The number of people who have had some form of same-sex 'sexual contact' has also risen, from 11 to 15 per cent. And almost one in three people (27 per cent) has slept with someone from a different ethnic background.

The average age of first-time sex is fourteen in Britain, and it's not extremely unusual to see some start even younger than that; surely we must be able to finally speak out and do what is right in order to halt this before it spirals out of control? Every year, almost 50,000 girls under 18 fall pregnant, leading critics to claim that government-led efforts to encourage safer sex are backfiring. The number who conceive is at its highest level since a multi-million-pound teenage pregnancy crackdown almost a decade ago. As a result, Britain tops the league table of teenage mothers in western Europe, despite also having a record number of school-age abortions. This comes despite the Government investing more than £150 million in an attempt to stem the tide of conceptions - and pledging to cut teenage pregnancy rates by half by the end of this decade. Maybe it's about time we looked to the Dutch to see what we need to do in order to dramatically cut teenage pregnancies and a soaring rate of STI's in Britain; it certainly wouldn't take an instant, we could be looking at whole decades, but it would be effective and it would protect young people from a life damaged by a potential reckless mistake. The levels of sexually transmitted diseases are growing. It's worth shooting down one myth. There is no relation between the amount of sexual activity and the frequency of pregnancy. Young people in Sweden are more sexually active than their US counterparts but teenage pregnancies are four times lower.   There is nothing wrong with teenage sex - apart from the risks shared by all sexually active adults. So surely we should be finding ways to minimise these risks and ensure that sex at any age is safe and consensual rather than moralising about perceived loss of innocence. Not havin sex isn't a realistic option for teenagers - but educating them about sex and relationships in an appropriate manner will give them the aid they need to at least practice safe sex.