In the United States, sex education varies greatly and is not present in all schools. Many states have no sex education requirements, while some require teaching about STIs (especially HIV/AIDS) and a few have requirements for teaching abstinence.

Teachers often have little room in the curriculum for comprehensive sex education because of the many other government requirements. When schools do make room, sex ed is often taught by under-qualified and uncomfortable teachers who do not specialize in the subject.

A flawed curriculum

Another, perhaps even more destructive, problem with American sex education is the preference to push abstinence over safe sex.

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Any useful information about pregnancy and STIs comes as a threat, scaring students out of having sex, rather than as context to help them make informed decisions for themselves. Abstinence education has loosened in recent years, moving from “Just Say No” rhetoric to “Sex Can Wait,” which aims to create an environment where students don’t feel pressure to have sex by teaching them that abstinence is a valid option.

Though this version of abstinence education is an improvement, it is still somewhat unrealistic and overgeneralizing, in that it assumes adolescents don’t actually want to have sex. Even if this is true, eventually the students will want to and when this time comes, they will not have the information that would keep them safe. Surveys of parents reveal that they favor sex education in schools, think it’s already being taught, and trust the schools to provide comprehensive education to their children, though they do not know what’s actually being taught.

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Adolescence and depression: pubertal timing

Coinciding with the time sex education becomes relevant to students, the divide in depression rates between boys and girls begins to emerge. Adolescence is the first time we begin to see a noticeable increase in depression among girls that is absent among boys. This difference is linked to pubertal changes, peer stress, and the interaction between these two factors. In the case of pubertal changes, girls’ #mental health is affected by puberty’s disruptive physical changes, psychological and self-esteem changes, and social effects of exclusion and victimization. Further, depression among #Adolescent girls is linked to pubertal timing: girls who develop early relative to their peers are more prone to depression.

Pubertal timing and peer stress in connection to sex ed have a prominent impact on depression among girls. The most obvious possible reason is that adolescent girls simply do not have enough information in time for the physical changes of puberty.

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They have not yet been educated about the physical changes they’re facing, and they haven’t learned about the process of menstruation, which can be shocking and frightening for girls who are unprepared.

Even if girls do know beforehand that menstruation awaits, those who begin menstruating before their friends may feel shame about deviating from the norm. Girls who experience this before their friends will not have the peer support that could help buffer against depression. This reveals the link between puberty, depression, and peer relationships.

The difference in pubertal timing between friends may cause conflict in friend groups, which is especially harmful considering that peer relationships have profound effects on adolescent mental health. Adolescence is a time where peer relationships outrank all other relationships: the opinions of peers are weighted heavily and conformity is common. Thus, when girls experience peer conflict, interpersonal stress, or low social support—all of which can stem from early pubertal timing in relation to peers—they are very prone to depression.

Adolescence and depression: socialization and sexualization

Another link between peer relationships and adolescent depression lies in the way girls are socialized. Though adolescent girls’ bodies are often sexualized by media and advertising, girls learn very early that sex is bad. In fact, abstinence-based sex ed assumes girls don’t want sex and that the reason they have sex is because of peer pressure. This assumption may have some grounding in a society where sex is shameful for girls: high self-esteem is associated with negative perceptions of sex, which suggests that adolescent girls consider sex a behavior that decreases their sense of self worth. But girls who reach puberty early may be experiencing their first sexual urges while their peers continue to have negative perceptions of sex.

This can be extremely conflicting for a girl whose urges are deemed “wrong” by society despite the sexualization of her body. Few sex education programs address the sexual double standard, and those that do may begin too late for the girls who develop early. Such girls have no tools for coping with these contradicting feelings and social messages.

The depression that may stem from these conflicting urges and environmental forces may in turn cause adolescent females to engage in sexual intercourse earlier, when they aren’t ready or educated. Research shows that adolescent females with depression engage in sexual intercourse earlier than their non-depressed peers, despite the fact that most adolescent females, especially those with depression, have negative or ambivalent perceptions of sex. So, as insufficient sex ed and early puberty cause depression in girls, depression causes girls to have sex earlier, which further contributes to depression, creating a cycle of low self-worth, risky behavior, and societal pressure. This is thought to stem from the fact that depressed adolescent girls have not have formed a clear perception of sex and so they can be swayed easily in either direction.

Girls who reach puberty early without the tools to form this clear concept can become depressed and therefore likely to engage in sexual intercourse early. Adolescent girls with clear perceptions of sex are less likely to be depressed and less likely to engage in risky early sexual behaviors, which suggests that early sex education with lessons on forming perceptions of and making decisions about sex could greatly improve this problem.

What can be done?

I am far from the first to argue against abstinence-based education. Many have pointed to statistics that show abstinence programs are ineffective except for scaring teenagers. However, I do think some aspects of such programs are salvageable. For example, teaching girls that abstinence is a valid option is useful as part of the discussion about making decisions about sex. However, we have to teach girls that the decision is theirs to make, and any choice is valid as long as they are educated on the consequences and safe practices.

Further, the consequences of sex are not just pregnancy and STIs: girls need to learn about how sex affects relationships, be it with partners, friends, or family. Girls also need help navigating the societal messages they are exposed to daily, including the sexual double standard. All of these conversations would be extremely valuable in teaching girls to build their own concept of sex (while not judging others’ concepts as better or worse than their own) and to make their own decisions. However, these conversations are virtually impossible as long as sex is considered taboo, and teachers leading the discussions are uncomfortable. For this reason, it is vital to employ educators who specialize in sex and sexuality, rather than gym teachers and health teachers who are trained in other areas.

Once we have specialized educators having these conversation with students, depressed girls who would otherwise engage in risky sexual behaviors due to an ambiguous perception of sex are instead given the tools to form this perception and delay sexual activity if they so choose.

In terms of the depression caused by reaching puberty early, the solution is simple (though difficult to execute). The problems that early puberty causes generally revolve around the lack of information these girls have at the time they reach puberty. Thus, if we provide comprehensive sex education earlier, these girls will be better prepared for the changes ahead of them.

Comprehensive sex education would need to emphasize that puberty is different for everyone, and no single experience is deviant from the rest. This could help reduce the stigma surrounding female puberty among peers who have not yet reached that stage, which improves the peer relationships aspect of adolescent female depression. In calling for earlier sex education, I am imagining early elementary school lessons, which most schools fail to provide. These lessons of course would need to correspond with the children’s level of understanding as well as the experiences and physical attributes relevant to them, but discussions about the body cannot start early enough if we want to reduce the stigma surrounding genitals and eventually sex.

Teaching children about their own bodies, their differences and how to talk about them sets them up to be prepared for more difficult discussions later in life. I believe sex education should begin even earlier than elementary school: from parents at home. Yet, I have shown that parents tend to leave such discussions up to the schools.

Moving forward

Lastly, I recognized that I have largely ignored non-heterosexual experiences as well as experiences of adolescent boys, and I have assumed environmental factors rather than biology to be the main causes of depression. This was done for the purpose of my analysis of relevant research, which pertains mainly to adolescent heterosexual females, and my discussion of what can be improved about sex education, which is an environmental influence on female self-concept and mental health. In sum, our current sex education is lacking, and this fact must be recognized and improved upon if we are to combat adolescent depression.