Exploring greater inclusivity in adolescent sexuality education.

By Helen Hollis

Last month CFRI’s Dr. Monica Faulkner, Jeni Brazeal, and Kate McKerlie, presented at the Texas Behavioral Health Institute Conference in Austin, Texas. All three have worked in the the field of adolescent sexual health; as a direct educators and program evaluators.

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Monica introducing her presentation at the Texas Behavioral Health Institute.

Dr. Faulkner’s workshop, Brave Conversations: Utilizing Trauma-Informed Approaches to Talk to Youth About Sexual Health, offered more than 100 youth-helping professionals the opportunity to consider many new ideas related to sexual health and education. In the workshop, attendees were encouraged to explore the social construct of male and female sexuality, and look at the messages we receive from the media about sexuality every day. The experiences of LGBTQ+ and gender nonconforming youth are often stigmatized or left out of discussions about sexual health. Dr. Faulkner described, “it is important to make sure youth who don’t fit the binary boxes of gender and sexuality feel accepted and safe”. Conversations about sexuality should not just be relegated to “the talk”, but rather messages about healthy sexuality need to be repeated and talked about for young people to really learn and absorb them.

Jeni and Kate lead a workshop titled Teen Parenting Inclusivity in Sexual Health Classrooms. This workshop encouraged professionals to consider teen parents within a socio-ecological model by brainstorming different challenges and experiences they face personally, in their community, and more broadly. They explained that, “it is possible to talk about teen pregnancy prevention without shaming teen parents”. To do so it is important to use non-shaming language, and create a more inclusive environment for parenting teens. Teen parents may experience being shamed when teen pregnancy is described as a mistake or burden, and when pregnancy is grouped with sexually transmitted infections as something bad that needs to be prevented. Jeni and Kate emphasized the fact that in a typical American sex education classroom you may have some teens who are sexually active, some are children of teen parents, and some may already have children themselves. It is important to respect these young people’s stories, and not send the message that they are bad or should be embarrassed about their experiences.

The group also explored some common myths and misconceptions about teen pregnancy, which helped reframe the experience of teen parents. For example, they shared that it is commonly cited that “almost two-thirds of young mothers rely on public assistance within the first year of their child’s birth and that 41% of mothers who gave birth before age 20 live below federal poverty line.” To reframe this statistic Kate quoted The Pushback stating “over 80% of teen mothers live in poverty before they become a parent, and that it is economic inequality and poverty that lead to the challenges young parents face, not parenthood itself.” Statistics often take a narrow view, but when looked at more broadly they can help us see the bigger picture and context of people’s experiences.

Jeni discussing teen pregnancy from a socio-ecological model at the Texas Behavioral Health Institute.

These workshops offered a new perspective to approaching different aspects of adolescent sexual health. In the media we often see a focus on teen pregnancy rates, and WHAT we should be teaching about sex. The debate between abstinence-only vs comprehensive sex education still dominates public discussion. These presentations offer guidance on HOW to teach about sex, encouraging professionals to consider and respect teens and their personal experiences.

I was interested in learning more about this work and CFRI’s Office of Assistant Secretary of Health Mobilization for Health Award so I decided to reach out to Jeni for an interview to learn more.

Jeni explained, “the OASH project was a 2 year grant through the Office of the Assistant Secretary of Health, focused on providing quality professional development and collaboration opportunities to youth-serving professionals, infrastructure support to the community-based coalition the Healthy Youth Partnership, and direct sexual health education to youth in foster care agencies, juvenile justice agencies, and charter schools”. Working with Cardea Services, Omega Point International, Inc., Planned Parenthood of Greater Texas, and the HYP Steering Committee, the OASH project was able support a variety of projects with these agencies. They offered professional development opportunities including leadership and collaboration trainings, and helped with the release of the report Teen Pregnancy Prevention Needs Assessment. In addition, Dr. Faulkner, in collaboration with Cardea Services, developed trainings that have been offered to more than 600 youth-serving professionals that address trauma-informed sexual health education. The Healthy Youth Partnership has offered many professional development opportunities in the past two years, including 2 youth provider conferences, 24 monthly workshops and 5 Collaboration & Leadership Development Trainings all of which were funded through the OASH grant.

The implementation of the grant posed some challenges, but also included some opportunities to address missing pieces in sexuality education. Jeni helped provide me with some insight about the process. She described that the first six months were used to identify adaptations that needed to be made to tailor the curricula to the community. Some of these adaptations include adding a lesson with inclusive reproductive anatomy, adjustments to make the language more trauma-informed and inclusive, making sure the medical accuracy of information was updated, and the inclusion of more messaging about abstinence. She further described that more adaptations could have been made if there was more time for development.

While discussing the implementation of the grant, Jeni explained some of the challenges that they encountered due to working with youth in foster care, juvenile justice, and charter schools. Youth in these settings often have more transient lifestyles, and are also at higher risk for teen pregnancy. While it isn’t realistic to expect youth living in these environments to participate in 75% of sessions (youth often have to deal with placements, court hearings, unique educational challenges, etc), this experience showed the importance of making sure these young people have access to this information. Jeni hopes that the evaluation information will be helpful to the grantor in planning for how to best serve these youth in the future.

Kate, Monica and Jeni at the 2016 HHS Teen Pregnancy Prevention Grantee Conference in Baltimore, MD

Jeni shares that this project highlighted for her the importance of taking a more trauma-informed approach to adolescent sexual health education. Many curricula use shaming language instead of working to make youth feel more included and understood. She describes that teen pregnancy prevention isn’t only an individual challenge, but rather one that needs to take into account young peoples’ lives and the society in which they live.
She is happy with the variety of trainings that were offered to the community, and at the release of the needs assessment report. She closes by saying, “I think the focus on a trauma-informed approach will live on beyond this grant, and the focus on identifying more systemic approaches to addressing sexual health outcomes may continue to grow in our community.”

I was interested in attending these presentations and learning more about CFRI’s teen pregnancy prevention grant because I have worked with teens in both school and clinical settings, and have seen firsthand the lack of access to accurate and comprehensive information related to sexuality. Teens are able to access inappropriate and inaccurate information on the internet, but often don’t have trusted adults who feel comfortable having these types of conversations with them. While talking about sexuality with teens can be uncomfortable, I think we should be encouraging teens to have these conversations so that they are able to develop a healthy and accurate understanding of sexuality and their own developing sexual identity.