Or a Tale of Cock and Bull

Whether it’s music, politics, or culture – sometimes it takes a revolution to change perceptions. Sometimes a revolution creates an immediate explosion – sometimes it’s a quiet thing. Pick your favourite moment of change – love, peace and gentle persuasion? Or a sharp, reactionary confrontation? Or perhaps some people prefer a cosy conformity – content with their unchallenged status quo, maintaining hands held under tables – a comfortable monopoly dispensing jurisprudence? Given the rising rates of STIs, reports of a lack of awareness amongst young people around sexual health issues, and a sexualised society where the expectation and pressure is on young people to conform to the images portrayed by an omnipresent broadcast and print media – a media whose wealth and power dwarf the resources available to inform young people about sexual health and relationships, sexual health is indeed in need of a revolution.

Schools

Schools-based sex education is very much at the whim of school governors and head teachers beset with concerns about exam expectations and their school’s reputation; the level of sex education in a UK context varies from school to school – some are very good, providing hours of excellent SRE – whilst others may only manage a couple of hours a year – hardly the best basis for young people leaving school and beginning to explore their sexuality. PSHE teachers and school nurses working in SRE in schools can only wring their hands in despair at the opportunity denied to them by the lack of a law that makes a mandatory requirement for all schools to deliver compulsory quality SRE as part of the curriculum. School remains the one place that offers an opportunity for informing all young people about sex and relationships – valuing themselves and others.

Youth Services

Youth Services also attempt to provide good sex education – yet whilst there is quality work achieved with some young people, it is achieved on a voluntary basis. Youth Services do not come into contact with all young people, and whilst they may come into contact with the hard-to-reach, others from this group actively disengage from contact with statutory services. The situation is at best patchy.

Guidance?

Beyond the question of where sex education is carried out, there is the question of the guidance available on how to deliver SRE. On the one hand it may be perceived as too biological – as in a ‘nuts, bolts and this is how your plumbing works’ approach, which is fine in the context of a science lesson, as young people do need to have some knowledge of how their body works. On the other hand there is a sociological approach which focuses on participation and discussion around relationships and feelings – an approach promoted by statutory and government accredited organisations working in the field of sexual health. It is an approach that works for many young people. However, whilst this approach does work with many, it does not appear to be acknowledged that other young people find it difficult to discuss issues and would prefer to access information in other ways. Hammond and Pee’s study (1997) found that boys and girls preferred different media for the presentation of sensitive issues around health care – boys preferring private access to media formats such as videos, interactive resources, and written information; the same study found that young women preferred group discussion and talks from health professionals. In terms of sexual health work with young men we are missing a trick. Yes, we need to pursue an approach that focuses on discussion, but we also need to accept that other approaches also have credence – especially with hard-to-reach young men.

The guidance on SRE has unfortunately become a debating ground for gender politics. Whilst academics in ivory towers and social engineers grounded in the politics of feminism may promote gender deconstruction and ‘changing men’, levels of STIs continue to rise. In a survey commissioned by Brook (2001) when asked to rate 8 different sources of information as providers of knowledge about contraception, men rated television (57%) as the major source of information followed by magazines (54%); the same Brook survey asked the sample group whom they would have liked more information from – the men responded by saying doctors (33%) and magazines (31%). A significant minority gain their information from sources that do not consist of participative approaches – and some prefer written information on health that can be privately digested, rather than discussion and the possibility of peer group embarrassment or exposure. Yet the sexual health literature available to young men is limited, not culturally relevant, and is written in ‘statutory speak’; statutory and government accredited organisations are inhibited and unable to deliver ‘authentic’ publications and resources relevant to the lives of young men due to language concerns and the possible resulting outcry – many professionals working in the field are also culturally remote from the often chaotic lifestyles of the young men they wish to communicate with, which again provides another barrier to engagement. A professional’s own ethical code may also inhibit engagement with young men and further ethical concerns around stigma and STIs also create barriers. We need to move beyond these barriers to enhance the sex education we deliver – which means moving beyond a prescriptive participation and discussion approach to one that embraces a ‘horses for courses’ approach adapted to the particular group of young people we are working with – whether that means a discussion approach – or consideration of other methodologies.

Engaging with Young Men?

The educationalist Newkirk (2002) exploring masculinity and literature suggests that in order to engage with young men, we should do so through genres and literary formats of their own choosing – including comic books. A survey conducted on behalf of The Institute of Cancer Research (2001) revealed that men ‘under 25 are seriously risking their health by being too embarrassed to seek medical advice for personal illnesses’. Whether this concerns testicular cancer/self-examination, or engaging young men in a Chlamydia screening programme, if we wish to communicate effectively with young men about their health and encourage their positive engagement with health services, an exploration of media that appeals to them and can impart information to them in a culturally relevant way is a valid exercise. Hence The Red Knob.

The Gauntlet

The Red Knob advocates a gender sensitive approach to sexual health and work with young men – our work is to promote sexual health to young men, to encourage condom use, to consider choices and the outcomes of unprotected sex – not to try to change or deconstruct whatever makes up their masculinity. Sexual health is fettered by gender politics and political correctness that create barriers to effective delivery. Use of images that offend or may cause stigma may well be banned in Norway or elsewhere – but whilst professionals working in the field concern themselves whether today’s word is STD or STI, whether it’s ‘safe’ or ‘safer’ sex, or whether it’s safe to use ‘brainstorm’ or ‘wordstorm’ etc, etc (“is your coffee with milk or without”, “black or white” – please can we move on from this!) young people, young men whose lives are remote from the rarified debates of the architects of policy, live politically incorrect lives, read FHM, ZOO and Nuts, frequently use sexual slang and revel in their culture – they are subjects of a debate that has no meaning to them. No one is saying for a moment that we should condone oppressive and stigmatising behaviours – of course these should be challenged, but we need to ‘get real’ about how we communicate with young men. Men’s Health magazine may well receive criticism from professionals engaged in sexual health for it’s use of young women in lingerie and features on umpteen best sex positions to attract a young, heterosexual male audience, yet it also contains relevant articles on health issues and provides an approach that is more culturally accessible to the lives of many young men than publications produced by statutory agencies. If a ‘mechanistic’ approach appeals – then we should be using it alongside other proven methods; our efforts to promote sexual health should have a health focus and not a social engineering one. In the UK the idealogical hegemony sits firmly with a moribund sociology camp who are either unaware of or deny the efficacy of other approaches to sexual health.

Revolution now?

A restrictive hegemony should be challenged; a monopoly is in no one’s interest except those who control it. These are concerns not only of The Red Knob, but others working in the field of sexual health – they should not be dismissed as mere diatribe.

Sexual health needs a revolution. The Government needs to be challenged – but so do the architects of policy and guidance working for government accredited organisations sitting in the centres of sexual health; we need to be more creative in our delivery of sexual health and not be content with prescriptive approaches. Time to raise the banner? A revolution now?

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