Research into Sex Education: Positive Implications for the Church

David Paton FAITH Magazine May – June 2011

David Paton argues that academic studies of the effects of the government's Teenage Pregnancy Strategy strongly support the primary role of parents. He also brings out how this role is far from upheld by simply ensuring the parental right to withdraw a child from Sex Education. Professor Paton is Chair of Industrial Economics at the Nottingham University Business School.

The issues of sex education and teenage pregnancy are rarely out of the headlines. Although underage pregnancy rates in the UK have fallen slightly in the past two years, they are still among the highest in Europe, while rates of teenage sexually transmitted infections (STIs) remain at epidemic proportions and show no sign of coming down.

The response of the last government was essentially more of the same: earlier and more detailed sex education, family planning clinics in schools, promotion of emergency birth control (otherwise known as the "morning after pill") easier access to abortion, all without the need for parental consent even in the case of underage girls. Catholic pupils attending state schools are in the direct line of fire of these policies, but even Catholic schools are not necessarily exempt from their effects. The Connexions service, school nurse service and Healthy Schools standards are just a few of the many routes whereby inappropriate sex education or access to abortion and contraception may sneak in under the radar of unwary teachers and governors.

Matters came to crisis point a year ago when the last government's Children, Schools & Family Bill sought to impose a statutory sex and relationship education (SRE) curriculum on all schools from the primary stage (currently SRE is only compulsory in secondary schools and the content can be determined by each school) and to remove the right of parents to withdraw their children from inappropriate SRE lessons from the age of 15. The proposals were given broad, if somewhat ambiguous, support by the Catholic Education Service. Ultimately the clauses in the Bill relating to SRE were stood down in the government's "wash-up" before last year's General Election. Whether or not the present Government will seek to reintroduce some of these measures remains to be seen, but there has certainlybeen no let-up in the efforts of the sex education establishment to lobby in favour of statutory SRE and to remove the right of parents to opt out.

Although parents (and indeed governors and teachers) are often uneasy about early or explicit SRE or providing access to family planning services, their feelings are sometimes ambiguous due to a concern that, if they do not follow such a course, children will be at greater risk of underage pregnancy. In fact, an examination of the academic literature in the area makes it clear that irrespective of any ethical or moral considerations, most of the controversial measures simply do not reduce early pregnancy and may make matters worse.

Let's take the case of providing easier access to emergency birth control (EBC) to adolescents. Good evidence will try to examine the effect of a policy on a particular group by looking at, for example, how adolescent pregnancy rates changed before and after the policy, relative to the change among adolescents to whom the policy did not apply. Leaving aside the issue of whether or not EBC may act in an abortifacient way in some cases, every single such study has found that schemes promoting EBC simply do not reduce observed rates of unwanted pregnancies or abortions. The lack of impact of EBC schemes has been well known for some years and is admitted even by those who support EBC in principle. It might well be queried why these schemes continue to be promoted in pharmacies and schools.They are not cheap to run and, in an environment where resources are particularly scarce, there seem to be only two explanations: either policy makers are simply ignorant of the evidence or there is an ideological agenda at work.

Why don't EBC schemes cut unwanted pregnancy or abortion rates? In a recent Journal of Health Economics paper, Professor Sourafel Girma and I test whether the answer lies in the concept of "risk compensation" or "moral hazard". Insurance companies are well aware of the phenomenon in which people who take out insurance against, say, burglary, are known (on average if not in every case) to modify their behaviour so that the risk of being burgled increases. Could this same concept apply to teenage sexual behaviour? When adolescents have easy access to EBC, they may be more likely to engage in sexual behaviour or to take more risks when they do so, e.g. by being less likely to use condoms. More pregnancies will result from this increased risk taking and these will counter-balance anyreduction in pregnancies from those who were taking risks anyway but who are now more likely to use EBC. Given that EBC provides no protection at all against sexually transmitted infections, if moral hazard is indeed at work, then we might expect to see EBC schemes leading to increases in rates of STIs.

The Journal of Health Economics paper tested this by examining the effect of recent schemes in England in which EBC is provided free of charge and without a prescription to adolescents, including those under the age of consent, and without any need for parental consent. We examined how STI rates among teenagers changed before and after the scheme was introduced relative to changes in areas that did not introduce the schemes. We controlled for a variety of other factors that may also have influenced STI rates in particular areas and we also used older age groups, unaffected by the schemes, as a further control. The results were very clear. Areas with EBC schemes experienced a 5\% increase in STIs among all teenagers relative to other areas. The relative increase was 12\% amongst under-16s.This is a clear case of unintended consequences of Government policy. Scarce resources continue to be spent on a measure which does not cut teenage pregnancy rates, but appears to lead to greater numbers of young people getting sexually transmitted infections that may have serious repercussions for the rest of their lives.

The academic evidence relating to the impact of SRE in schools is not much more hopeful. For example, an official analysis of the English Teenage Pregnancy Strategy published in the Lancet found no link between those areas judged as having high quality SRE and reductions in teenage pregnancy rates. Most other studies have similarly found that SRE in schools has little or no impact on unwanted pregnancy or abortion rates.

In a way the finding that SRE in schools has such modest effects is very liberating. Schools often feel that they must implement a particular SRE scheme because otherwise their pupils will be at greater risk of early pregnancy. The evidence is just not there to support such a view. This does not mean that SRE has no place in schools. Rather it frees governors and headteachers to focus more on deciding what type of sex education parents want their children to experience in school and, in the case of primary schools, whether there should be any formal sex education at all.

Being aware of the evidence base should also encourage the Bishops of England and Wales and the CES that they can unambiguously promote the fundamental primacy of parents in the area of SRE without any risk that they will compromise the sexual health of young people. Indeed, the academic evidence is clear that involving parents in all aspects of the decision-making process (including whether a minor receives an abortion) actually promotes adolescent sexual health.

With this in mind, we can think of a number of specific measures which could be taken forward by the Catholic Church in England and Wales. In the first place, Bishops and the CES should vigorously oppose any attempt to weaken or remove the current right of parents to withdraw their children from school SRE should they feel it necessary to do so. Further, the CES could helpfully encourage schools to be completely transparent and open about the content and delivery of SRE. It should be easy, for example, for any parent to view and comment on the SRE materials used by Catholic schools.

More fundamentally the Church's teaching concerning the primary role of parents and the delegated role of teachers puts her in a good position to share an important practical insight with policy makers. For, contrary to assumptions of the sex education establishment, it may sometimes be desirable for schools to do less rather than more.

Take for example, the case of a school nurse putting up posters with contact details for local sexual health services that provide contraception and abortion services. Some parents may believe such a practice to be acceptable, while others would be fundamentally opposed. It is impossible for parents to exercise the right to opt out and to stop individual children accessing the information. So, in such a case, the only way of maintaining the primacy of parents with regard to SRE is for schools not to undertake such activity and to leave such matters to the discretion of parents. Of course, giving this information in a Catholic school would be wrong on principle, but that is a slightly different point.

In terms of what actually should be provided in SRE, a recent trend has been to suggest that schools should be doing more on relationships (e.g. renaming Sex and Relationships Education to Relationships and Sex Education). At one level, this is very appealing, but it is hard to pin down what it means in practical terms. Further, teaching about personal relationships is an area in which parents have a significant advantage over schools and one in which we should have low expectations about the benefits that schools can deliver.

The area in which schools should have a very significant role to play (and where perhaps some Catholic schools currently underperform), is the promotion of a culture in which young people understand and engage with the Church's key teachings relating to sexuality and the inherent dignity of human life. In this regard, several external groups such as the Challenge Team and the Ten-ten Theatre Company offer useful services to schools, while some good supporting materials are available - the primary school "This is My Body" scheme and Education for Life aimed at secondary schools spring to mind. In many schools, however, the activity is ad hoc, often dependent on one or two key staff members and not systematically embedded across the whole life of the school. So, for example, there iscurrently no comprehensive PSHE text available to secondary schools written from a Catholic perspective. Similarly, although many schools do excellent work promoting knowledge and understanding of racism and poverty, it is much rarer to find even Catholic schools having Pro-life Awareness Weeks as a standard annual whole-school activity in which pupils are encouraged to understand the justice and coherence of Church teaching on abortion and related issues. These are all initiatives on which Bishops and the CES could take a lead and disseminate good practice.

So there is much to be worried about, especially with regard to the continuing pressures the Church faces to conform to the perceived wisdom about how to respond to problems such as early sexual activity, teenage pregnancy and STIs. At the same time, Catholics need to be aware that the existing research evidence base is largely consistent with orthodox moral teaching. Such an understanding is essential in giving policy makers, Bishops, governors, teachers and parents the confidence to promote an authentic and positive view of Church teaching on human sexuality and the inherent dignity of human life in schools, parishes and the home.

Faith Magazine

May - June 2011