MONTPELLIER, France — How can we adapt the rhetoric surrounding emotional, relationship, and sexual health education, commonly known as "EARS" in France, without clear understanding of the practices and expectations of young people? A study presented at the French-speaking sexology and sexual health conference (JF3S) has opened the lid on behavioral changes in young peoples' sexuality in 2021, with increased exposure to intimacy via digital devices, as well as the development of oral sex practices, which have become, if we are to believe this study, a rite of passage into the world of sexuality.
Young People's Survey
"I've been going into schools for around 10 years, and the big discrepancy I noticed between the sex-related problems I encounter in my work and the literature published on the subject made me want to conduct my own survey," said Véronique Suquet, midwife and sexologist from Fontenay-sous-Bois, in the French department of Val-de-Marne. She presented her study at the aforementioned conference under the supervision of the Postgraduate Sexology Interdisciplinary Association.
This online survey (which comprised 37 closed questions and 7 open questions) was carried out in 2021 and involved 200 young people aged 17-30 years (median age, 23 years). Its aim was to identify the behavioral changes of young people in their sexuality, and then to develop France's emotional, relationship, and sexual health program "to provide a more relevant education," said Suquet. Despite the limitations and bias inherent to this type of statement-based survey, much can be learned from the data obtained, especially for doctors caring for young people, or even very young people.
The average age at which we have our first kiss is 13.6 years, and this hasn't changed since 1972. The average age at which we first have sexual intercourse has also remained relatively unchanged at 17 years (16.9 years for girls and 17.1 years for boys), with, however, a large range for the age at this first experience of sexual intercourse. The data showed that the age at which young people have their first sexual encounter is getting younger, with some being as young as 13 years. However, what has changed in 50 years is the number of partners, which has increased significantly, with men now having 10 partners (median of 5.5 partners) and women having 7 (median of 4 partners). For the previous generation, that of their parents, the medians were 4 and 2 for men and women, respectively.
Furthermore, Suquet stresses that oral sex, "which young people describe as foreplay, has become commonplace, with 77% of respondents declaring that they practice fellatio and 74% stating that they practice cunnilingus." Some disparities have come to light between the sexes, specifically concerning regular masturbation. Overall, 81% of male respondents and 35% of female respondents confirm that they engage in this practice (44% of girls report "occasional" masturbation).
The use of pornography is also mostly male, with 100% of young men having seen it (first seen at the age of 13 years) and 66% of young girls reporting having seen it (first seen at the age of 16 years on average).In addition, 21% of people older than age 20 years use dating sites, and the proportion increases as age increases, especially among single people. Concerning this last point, we must stipulate that the study was carried out in 2021, a year filled with long COVID lockdowns. Finally, according to the main parties, France's emotional, relationship, and sexual health education is deemed insufficient by 33% of men and 66% of women.
Young People's Expectations
Fewer taboos and prescriptive language; more learning about consent, pleasure, desire, masturbation, and foreplay; and finally, a more relationship-focused curriculum: these are the topics that girls would like covered in their sex education lessons. "Above all, they expect a relationship element,” summarized Suquet. “As for boys, their top priority is shared pleasure, moving away from the norms, to have a fulfilling sex life."
Boys' expectations involve fewer taboos and performance pressure, discussions about pleasure and knowledge, being taught about how the female body works and about risks, contraception, and pornography. And, to the question of what constitutes a fulfilling sex life, girls answer that this primarily comes with listening and communication, self-confidence, consent, and respect, followed by shared pleasure, intimacy, and fulfillment. Boys cite shared pleasure, communication, fantasy and novelty, and complex-free and taboo-free discussions about sex as their primary concerns.
Tomorrow's Sex Education
Suquet is convinced that we need to act earlier. "I think that we need to revise the prevention policy as regards to sex education. Teaching should begin early, in primary school, because if we wait until high school, we're already too late, especially with on-screen exposure. This practice is already in place in Canada, for example. This sex education program could include personal development (emotions, needs, self-confidence, etc.), communication (nonverbal communication etc.), relationship education (with the aim of preventing harassment), as well as education surrounding the use of screens (images containing sexual content, etc.).
"So, the need to act early can no longer be ignored: more than half of children between the ages of 7 and 14 years have a smartphone. And this proportion shot up in 2021, in particular in 9- to 10-year-olds," she said. "The number of children in this age range with a cellphone increased by 12%. To be more specific, by the end of September 2021, 41% of 9- to 10-year-olds and 26% of 7- to 8-year-olds had a smartphone, vs 29% and 15%, respectively at the end of 2020. This was probably fueled in part by the COVID-19 pandemic."
The sex education program could then be developed further in high school, tackling the impacts and risks related to pornography, with early teaching about the digital word and the risk of pornography (misconceptions about image rights; nudes; photos of penises sent via smartphone and which are often unsolicited; addictions), without forgetting education on consent. The latter has an important effect on a person's identity and sense of self. Knowing how to say "no," saying "Yes, but now I don't want to," and "I don't know," are learned skills. The gray zone in consent is indeed not evident at the time of discovering one's sexuality.
Reinforcing prevention in terms of sexually transmitted infections is essential. "Most young people I meet don't know that 60% of STIs are asymptomatic," stated Suquet, "or that penetration is not the only activity that exposes you to the risk of an STI." France's emotional, relationship, and sexual health program should also include sexual violence. "Redefining sexual violence is important,” continues Suquet, "since most young people only describe it as penetration of the vagina by a penis. For this reason, lots of young people don't know about the abuse they might have experienced."
Healthcare Professionals' Role
For Israël Nisand, MD, professor emeritus of gynecology and obstetrics at the University of Strasbourg, "homosexuality and sexual attraction, masturbation, sexual pleasure and orgasm, virginity, sexual violence, sexual abuse, and incest are essential topics of learning for young people. Dialogue with adults humanizes what pornography dehumanizes. The brutal comparison with documents produced by adults and for adults, who are in a race to the bottom as to who can sell themselves better, often remains their only source of information. Nowadays, young people can't get away from images and sounds which, for them, represent reality (there's a picture of it, so it's true).
"The critical faculty that exists in adults is not yet established in young people, making them incapable of distancing themselves from these types of spectacles."We don't talk to our children about sexuality (despite the fact that there is an actual law about this), and pornography is not fit to take our place in this regard, unless we're teaching our children to accept degrading images of women and, effectively, allowing the deterioration of sexuality from the moment it is no longer situated in the strictly virtual domain," Nisand said. "All in all, if basic education is the responsibility of the parents, who are the only ones to have total legitimacy for what we could call the moral education of the child, there comes a time when they need help from health professionals. We need the help of third parties when teaching about sexuality. Parents must be able to offer their child a point of contact whom they trust. This is their only possible option, once a teenager's sex life has begun."
This article was translated from the Medscape French edition.
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Cite this: What's the Future of France's Sex Education Program? - Medscape - Dec 16, 2022.