Dear Editor,
The topic of sex education for adolescence hits close to home. My first child was born when I was only 17 years old. Proper sexual education could have better prepared me to deal with the risks involved with being sexually active. Abstinence-only programs used to be popular. Now we tend to see comprehensive sex education. However, which is better? This topic can be a struggle in some communities, and school nurses must make ethical decisions that affect their community while still following our nursing code of ethics. Remembering our commitment to our patients, we make decisions that are not the most popular in some communities and can lead to ethical debates.
As nurses, we practice with compassion and respect for the inherent dignity, worth, and unique attributes of every person. Provision 1.4 is the right to self-determination. Patients have the moral and legal right to determine what will be done with and to their own person: to be given accurate, complete, and understandable information in a manner that facilitates an informed decision. This provision tells us that it is part of our ethics to teach these teens accurate information so that they can make decisions about their own life and body.
Another commitment as nurses is to the patient, whether an individual, group, or population. Provision 2.1 is the primacy of the patient’s interests. Nurses provide patients with opportunities to participate in planning and implementing care and support that are acceptable to the patient. By giving them proper education about their bodies and sexual person, we allow them to be involved in the planning and care of their own bodies and sexual health.
School nurses will often plan sex education and health-related issues. Sex education was not a topic taught before the HIV and AIDS epidemic. My personal belief is that comprehensive sexual education is essential, and abstinence is unrealistic for teens. We are a multicultural society, and not all families are engaged in sexual education. For some families’ abstinence is a good tool, but having comprehensive sexual education is not just about pregnancy and STIs.
Abstinence-only programs aim to help young adults avoid pregnancy and sexually transmitted infections. The assumption is that while contraceptive use merely reduces the risk, abstinence will eliminate it. An overwhelming majority of studies in this field have shown that sexual education advocating abstinence-only-until-marriage is not effective in delaying sexual debut or in changing other sexual risk behaviors.
Comprehensive Sexual education teaches teens about their anatomy. How their bodies work, how they are different and the same. Education like this is vital for health and self-esteem as well. We should all know how our bodies work and how to keep them healthy. According to the article The Importance of Access to Comprehensive Sex Education, it can help teens “understand their body, gender identity, and sexuality. Build and maintain healthy and safe relationships, engage in healthy communication and decision-making around sex, practice healthy sexual behavior, understand and access care to support their sexual and reproductive health” (American Academy of Pediatrics, 2022). This reduces sexual activity, the number of sexual partners, the frequency of unprotected sex, increased condom use, and increased contraceptive use. Reviewing the literature of the past three decades supports comprehensive sex education across a range of topics and grade levels (Goldfarb & Lieberman, 2020).
When armed with facts, people can decide what is best for them, even if they decide to abstain. They should know their body, how it works, and the health information surrounding their sexual reproductive system.
References
Lameiras-Fernández, M., Martínez-Román, R., Carrera-Fernández, M. V., & Rodríguez-Castro, Y. (2021, March 4). Sex education in the spotlight: What is working? systematic review. International journal of environmental research and public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967369/
Goldfarb, A. S., & Lieberman, L. D. (2020, October 12). Three decades of research: The case for comprehensive sex education. PDF [801 KB] Figures Save Share Reprints Request Three Decades of Research: The Case for Comprehensive Sex Education. https://www.jahonline.org/article/S1054-139X(20)30456-0/fulltext
Badzek, L., Folwer, M., & Turner, M. (2017, October 26). Code of ethics for Nurses. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
American Academy of Pediatrics. (2022, August 11). The importance of access to comprehensive sex education. American Academy of Pediatrics. https://www.aap.org/en/patient-care/adolescent-sexual-health/equitable-access-to-sexual-and-reproductive-health-care-for-all-youth/the-importance-of-access-to-comprehensive-sex-education/#:~:text=Comprehensive%20sex%20education%20provides%20inclusive,reduce%20homophobic%20bullying%20in%20schools.
