Putting the S back into SRE
Whilst we’re here preaching the sexual health revolution, we need to remind ourselves that there are things we do get right; it’s just that we don’t get them right in enough places, and when we do it’s not often enough. I’m talking about the R in SRE – relationships.
The guidance that drifts down occasionally from the centres of sexual health stresses the importance of talking about emotions, feelings – valuing ourselves and others. Yes, our teenage pregnancy rate is nothing to be proud of, but the teenage pregnancy strategy is working, albeit slowly. Turning the tide on a culture where sex is a marketable commodity, and a culture that many young people identify with is a difficult thing to do. The unfortunate truth is that the current strategy is drawing to a close with still much work to be done – some services are being mainstreamed, but other worthy initiatives are falling by the wayside as the statutory services in control of funding have other priorities and money to channel elsewhere in the name of achieving targets. One can only wonder if rates will begin to rise again in the next few years – only time will tell.
But back to the R word. Yes, we should have an emphasis on relationships and discussion – about honesty and negotiation in relationships; this needs to be at the core of a mandatory PSHE programme in every school; the consequences of not doing so will continue to be reflected in teenage pregnancy and STI figures. However, we live in a sexualised society where some young people will be beyond the reach of services – this shouldn’t be the case – but let’s get real again, it does happen. Not all of those young people will be ‘hard-to-reach’ in terms of issues of social deprivation etc – other young people, influenced by the cultures they inhabit and the expectation of those cultures, will run the gauntlet of consequences regardless of their personal environment ; experience and experimentation without consequence? Consequences that include STIs, failure to negotiate in relationships, to delay sex, failed relationships in later life – issues that are well documented in research. So whilst it’s vital that we get the R right – it’s also important that we get the S for sex right too. It’s something we don’t do as well. Yes, we do the nuts and bolts biology bit – that too is important – but we don’t apply the science to our delivery – the psychological, the biological science behind why we behave as we do.
It’s perfectly natural for heterosexual young men to look at the hip to waist ratio of a young woman; without putting to fine a point on it – it’s in his biology to want to breed with her – it’s the nurture, the ‘socialised’ part of males that prohibits them from carrying out the act – and so (hopefully) attempt to negotiate a relationship. But for some young men (and women), they don’t necessarily want a relationship – they want to have sex. Period. Thus it’s important that we do get the S right. We need to let them know about the consequences of unprotected sex, and for heterosexual young men a gender sensitive approach, concentrating on masculine cultural groups is a method of doing this. I mention heterosexual rather than gay men in this context, because despite real concerns about increasing levels of HIV and syphilis amongst gay populations, the sexual health promotion material available to adult gay men is leaps and bounds ahead of material available to the heterosexual male; you only have to look at publications available from Terrence Higgins Trust on safer sex for gay men and compare them to some of the resources produced by statutory organisations aimed at the heterosexual population to see the difference. Material developed by THT is steeped in gay cultural references familiar to many gay masculinities. The rates of HIV amongst gay male populations have led to a considered social marketing response to sexual health – one that is lacking in heterosexual culture.
It could be concluded that one of the apparent reasons for the lack of such a response to the heterosexual population is the guidance that comes from the centres of sexual health – a guidance that rightfully concentrates on relationships but advises that we shouldn’t show images of STIs to young people due to fear and stigma concerns (but it’s OK for adults) – yet young people will be confronted by the real thing at a GUM clinic as a consequence of unprotected sex; a guidance that recommends humour as a way of interacting with young men, but baulks at the very real and definitely not politically correct humour of many young men as a way of getting messages across to them.
European Professor of Men’s Health, Dr Ian Banks in his inaugural lecture at Leeds Metropolitan University made this very point with regard to what he terms the ‘mechanistic approach’ (quote about 54 minutes into speech if you want to hear it!) – if it works, if it identifies with a male culture we should be using it. We may slowly be bringing the teenage pregnancy figures down, but we have an epidemic of STIs out there. Please – let’s get real about this. We may be improving the way in which young men conduct their relationships with young women – or each other – but we are not making them wear condoms, despite all the worthy condom distribution schemes out there – young women may be considering contraception – but young men are not considering the word protection. Protecting themselves with condoms and therefore protecting others. If we really want to engage with young men about this – yes we can do the research – but we also need practical solutions that identify with the real lives of young men – and that young men can identify with, and not just half a solution that is bound by the politics of social engineering. We need the other half of the solution too, putting the S back into SRE, and if it means going against perceived wisdom, then we should be prepared to do so. Let’s get the balance right.
To be continued…
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