Showing your bra straps, having tattoos, girls wearing pants, phone calls after 9:00pm—what do these things have in common? Not so long ago these now social norms were taboo. Unfortunately, lacking comprehensive sex education cannot be added to the list. Within only three years of implementation, the progressive 2015 sex education program covering topics such as consent, same-sex relationships and the gender spectrum was scratched in favour of re-implementing a now 21 year old curriculum. This means in our schools we are now actively teaching a sexual education curriculum from 1998. While 1998 may not seem so long ago, let’s consider that at that time Canada was seven years away from legalizing same-sex marriage, Google was just founded by two Stanford PhD students, Apple was nine years away from revealing the first iPhone and United States President Bill Clinton was denying having “sexual relations” with former White House intern Monica Lewinsky.
A dated, and frankly under researched, curriculum is rendered irrelevant by the youth it is meant to educate because it is not seen as relatable to their very much “in-the-now” lives. This type of anatomy-focused, biology-based, abstinence-begging sexual education does not prepare students to engage in healthy adult relationships. LGBTQ (Lesbian, Gay, Bisexual, Trans, Queer) youth, as a marginalized group, are particularly vulnerable to the consequences of this narrow education. LGBTQ youth show higher rates of sexual risk behaviours, yet the school-based sexual health education they are receiving is largely heteronormative and cisnormative. Not only is this education ineffective at preventing sexual health indicators such as unintended pregnancy and STIs, but it promotes stereotypes that create an unsafe and unwelcoming learning environment. Ultimately, a lacking education is failing LGBTQ youth by accounting for the hugely disproportional rates of peer victimization in schools. LGBTQ students who reported higher levels of victimization and discrimination at school based on their sexual orientation or gender expression are more than three times as likely as their peers to have missed school in the past month, have lower GPAs, lower self-esteem and higher levels of depression. While suicide is never the result of one cause, bullying can have a long-lasting effect on suicide risk, mental health and life achievement and satisfaction. The relationship between bullying and suicide is stronger for lesbian, gay and bisexual youth than for their heterosexual peers.
It is critical that education is comprehensive, and this has the ability to effect positive changes in sex knowledge and behaviours among adolescents in order to prevent these negative health outcomes. All students, regardless of sexual orientation or gender identity, want relevant information beyond the restrictive discourse of monogamous heterosexual intercourse for strictly reproductive purposes. In the 2015 Toronto Teen Survey, healthy relationships and sexual pleasure were among the top areas young people said they wanted to learn about. The reality? Less than 30 percent had learned about healthy relationships, and not one person reported learning about sexual pleasure. As Sandeep Prasad, Executive Director for Action Canada for Sexual Health and Rights stated, “Providing the kind of sex-ed that young people want isn't about special interests, it's about making sure that every kid in the classroom gets the information they need to live a safe, healthy and fulfilling life”.
Although no Canadian studies are currently available, we look to examples in the United States. A comprehensive sex education curriculum called Safer Choices was studied for cost-effectiveness throughout the United States. Safer Choices aims to prevent HIV, STDs and unintended pregnancies. The results were a staggering 265% return on investment or, in other words, a substantial amount of taxpayer’s money that can be invested elsewhere. The savings are directly related to prevented medical and social costs attributed to medical treatment, medical labour and care for young children. Further, a thesis study placed a maximum cost-savings of $5.19 on every dollar invested in Safer Choices when considering delayed sexual activity and an increase in percent of condom use during the last sexual encounter. Overall, conclusions range between 2 to 6 dollars USD in taxpayer savings for every dollar invested towards sexual education, with estimates of $43 million USD in annual STD savings alone.
While these primary outcomes of sexual behaviour and health are vital, it is necessary to consider the broader impact on secondary outcomes such as knowledge acquisition, attitude change and non-health/behaviour effects. These indicators are particularly important when considering long-term life indicators for LGBTQ youth. The United Nations Educational, Scientific and Cultural Organization (UNESCO) stated that positive effects of sexual education such as knowledge about different aspects of sexuality, behaviours, risks and attitudes are more likely when curricula are both comprehensive in scope and delivered as part of a holistic strategy. If this is considered, education can go beyond just primary cost savers, and increase equitable norms, recognition of their importance in relation to violence and create a safe school environment for all youth.
Evidence shows time and again that LGBTQ students benefit from attending schools with inclusive curricula and supportive policies. A study of LGBTQ youth perspectives on their experiences with school-based sexuality education found youth desired more direct discussion of LGBTQ issues, emphasis on STI prevention and addressing of healthy relationships. When LGBTQ youth see their interests represented in the curricula, they are not only learning about what they find important, but their non-LGBT peers are also receiving an inclusive education. After receiving a gender fluid and sexual orientation sensitive education, peers report increased willingness to intervene when witnessing LGBTQ name calling. In fact, the occurrences of name-calling are reduced altogether. A New York City piloted curriculum called Reducing the Risk demonstrated that students reported higher satisfaction and greater knowledge scores upon receiving the LGBTQ-inclusive program than those who did not. Educators and policymakers can use this information to improve the quality of sexual education not only for LGBTQ students, but for all students.
Canadian law protects people from discrimination on the grounds of sexual orientation, but our public schools do not currently fulfill their ethical and legal obligations where sexual and gender minority youth are concerned. Schools, with their current curricula, are neither safe nor respectful for sexual and gender minority students, and this ongoing exposure to stigma and discrimination can create long-term economic and health implications. Bullying can cause LGBTQ students to miss or drop out of school, a determinant of economic status and health across the life course. As a result, LGBTQ youth are more likely to become homeless, unemployed or underemployed. These outcomes are not only harmful to LGBTQ youth, but also have a burdening societal impact by reducing the capacity of these youth to contribute to their full economic potential as adults. Confounding variables of homelessness, juvenile justice involvement and poor educational and employment outcomes cost nearly $8 billion USD per cohort that ages out of foster care each year, with a disproportionate one-fifth, if not more, being LGBTQ youth. A more supportive environment early on, in our schools where youth must spend the majority of their young adult lives, can create a large and lasting economic and social impact. It is through preliminary education that we will be able to create not only an inclusive environment in schools, but later a safe workplace and welcoming public life for all.
Shannon Loveless is a practicum student working as a Research Analyst at the Ivey International Centre for Health Innovation. She is in her fourth year pursuing her Honours Specialization in Health Sciences at Western University.