how to be ‘sex-positive’: young people, sexual pleasure and sexual health services
TRANSCRIPT
How to be ‘sex-positive’:Young people, sexual pleasure and
sexual health services
Dr Ester McGeeney
BSMS Children and Young People mini-conference 2014
Key questions:
What does it mean to be ‘sex-positive’?
Why is it important to be sex-positive?
How can we be sex-positive in practice?
What is ‘good sex’?: Young people, sexual pleasure and sexual health services
PhD research (February 2009 – June 2013)
‘Good sex’?: Building evidence based practice in young people’s sexual health
ESRC funded knowledge exchange project: (June 2013 – June 2014)
What does it mean to be sex-positive?
Sex positive vs sex negative
What does it mean to be sex-positive?
• Supporting young people to enjoy their sexuality without harm
• Creating an open and honest sexual culture
• Celebrating sexual diversity
• Adopting a holistic approach to sexuality Dr Rachael Jones
Consultant – HIV and Sexual Health
Why is it important for clinicians to be ‘sex-positive’?
1. Because sexual health is more than the prevention of disease, and unwanted pregnancy and includes the right to enjoy your sexuality without harm.
2. Because we need to be realistic with young people. 3. Starting with pleasure rather than risk offers a more
inclusive (and more effective) framework for young people.
4. To enable young people to make positive informed decisions.
5. Its an essential part of safeguarding young people and supporting them to understand consent.
6. Because maybe no-one else will.
What is sexual health?
A state of physical, emotional, mental and social well-being related to sexuality; not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be protected, respected and fulfilled.
(World Health Organisation 2002)
Is there any support for a sex-positive approach in legal and policy frameworks?
• International policy: WHO
• National education policy: DfEE Sex and Relationship Education Guidance (2000) and Ofsted SRE learning outcomes (2002)
• National health policy: Framework for sexual health in England (2013)
• Legal frameworks: The Fraser Guidelines (1985)
DoH (2013) A Framework for Sexual Health Improvement in England.
1. The Framework recognises that a range of factors influence sexual health outcomes, including social norms, religious beliefs, relationships with families, stigma and attitudes
1. The framework advocates positive approach to young people’s sexual health.
‘A more positive approach is to identify the ‘assets’ that those resilient young people have, and to try and help at-risk young people to develop them. In this way, we can significantly improve their resilience – their ability to ‘enjoy life, survive challenges, and maintain positive wellbeing and self-esteem’. This also helps young people to challenge and change the taboos that are sometimes associated with sex and sexual health. Building resilience among young people is a shared objective across government, in particular the Home Office in terms of civic disorder and crime, the Government Equalities Office in relation to body confidence, and the Department for Education in terms of teenage pregnancy’ (DoH2013, p16-17).
The Fraser Guidelines (1985)
Contraceptive advice or treatment can be provided to a child under 16 without parental consent or knowledge provided that the health-care professional is satisfied that the following criteria are met:
1. The young person understands the advice being given.
2. The young person cannot be convinced to involve parents/carers or allow the medical practitioner to do so on their behalf.
3. It is likely that the young person will begin or continue having intercourse with or without treatment/contraception.
4. Unless he or she receives treatment/contraception their physical or mental health (or both) is likely to suffer.
5. The young person’s best interests require contraceptive advice, treatment or supplies to be given without parental consent.
How can clinicians be sex-positive
1. Find a language that works for you.
2. Include discussion of pleasure in sexual history taking and contraceptive decision making
3. Never assume
4. Ask simple exploratory questions
5. Use some of the great resources that are out there already.
6. Get some experience – shadow colleagues, support each other and confront your fears.
