Timing of Sexuality Education: Hong Kong Preteens' Perception of Sexual Health.

Monit Cheung, Patrick Leung, Shu Zhou, Miao Yu, Xin Chen, Amanda Ford, Yu-Ju Huang
Author Information
  1. Monit Cheung: Graduate College of Social Work, University of Houston, Houston, TX, USA.
  2. Patrick Leung: Graduate College of Social Work, University of Houston, Houston, TX, USA.
  3. Shu Zhou: Huazhong University of Science and Technology, Wuhan, China.
  4. Miao Yu: School of Social Work, University of Texas at Arlington, Arlington, TX, USA.
  5. Xin Chen: School of Social Sciences, Soochow University, Suzhou, China.
  6. Amanda Ford: College of Education and Behavioural Sciences, Houston Baptist University, Houston, TX, USA.
  7. Yu-Ju Huang: Department of Medical Sociology and Social Work, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan. yujuhuang2013@gmail.com. ORCID

Abstract

Although young people want to know more about sexuality, they do not feel they have received what they need to learn. In Chinese societies, scant research has solicited direct input from the youth to obtain their views on sexuality education (SE) deliverables. We found research gaps in the lack of Chinese preteens' input regarding SE timing, knowledge perception, learning readiness, and preteens' reasons for obtaining information about sexual health. In Hong Kong, a not-for-profit agency collected data from Chinese preadolescents who expressed opinions through a general survey. This agency surveyed students from 24 primary schools and provided anonymous secondary data for this team to analyze further. Among 4569 fifth- and sixth-grade students (average 11 years old), girls were more likely than boys to seek sex-related information from teachers, library books, and mothers. In contrast, boys were more likely than girls to obtain information from friends, pornographic comics, and the internet. Logistic regression analysis indicated that gender, age, instructional sources, openness to sexual health knowledge, and perceived and actual levels of knowledge predicted preteens' desire to receive SE earlier in grade school. Girls and older students were significantly more likely to report their preference to receive SE in an earlier grade. We recommend that preteens and their parents be encouraged to collaborate with teachers to participate in school-based SE programming.

Keywords

References

  1. Andres, E. B., Choi, P. H. E., Fung, W. C. A., Lau, W. C. K., Ng, H. T. N., Yeung, M., & Johnston, J. M. (2021). Comprehensive sexuality education in Hong Kong: study protocol for process and outcome evaluation. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-10253-6
  2. Bale, C. (2011). Raunch or romance? Framing and interpreting the relationship between sexualized culture and young people’s sexual health. Sex Education, 11(3), 303–313. https://doi.org/10.1080/14681811.2011.590088 [DOI: 10.1080/14681811.2011.590088]
  3. Blake, S. (2002). Sex and relationships education: A step-by-step guide for teachers. Routledge.
  4. Bodnar, K., & Tornello, S. L. (2019). Does sex education help everyone? Sex education exposure and timing as predictors of sexual health among lesbians, bisexuals. Journal of Educational & Psychological Consultation, 29(1), 8–26. https://doi.org/10.1080/10474412.2018.1482219 [DOI: 10.1080/10474412.2018.1482219]
  5. Breuner, C. C., & Mattson, G. (2016). Sexuality education for children and adolescents. Pediatrics, 138(2), e20161348. https://doi.org/10.1542/peds.2016-1348 [DOI: 10.1542/peds.2016-1348]
  6. Caputo, R. K. (2007). Sex at an early age: A multi-system perspective. Race, Gender & Class, 14(3/4), 206–224.
  7. Che, F. S. (2005). A study of the implementation of sex education in Hong Kong secondary schools. Sexual Education, 5(3), 281–294. https://doi.org/10.1080/14681810500171458 [DOI: 10.1080/14681810500171458]
  8. Christensen, M. C., Wright, R., & Dunn, J. (2017). ‘It’s awkward stuff’: Conversations about sexuality with young children. Child & Family Social Work, 22(2), 711–720. https://doi.org/10.1111/cfs.12287 [DOI: 10.1111/cfs.12287]
  9. Fentahun, N., Assefa, T., Alemseged, F., & Ambaw, F. (2012). Parents’ perception, students’ and teachers’ attitude towards school sex education. Ethiopian Journal of Health Sciences, 22(2), 99–106.
  10. Fisher, C. M., Telljohann, S. K., Price, J. H., Dake, J. A., & Glassman, T. (2015). Perceptions of parents regarding sexuality education. American Journal of Sexuality Education, 10(1), 1–20. https://doi.org/10.1080/15546128.2015.1009595 [DOI: 10.1080/15546128.2015.1009595]
  11. Flores, D., & Barroso, J. (2017). 21st century parent-child sex communication in the United States: A process review. Journal of Sex Research, 54(4–5), 532–548. https://doi.org/10.1080/00224499.2016.1267693 [DOI: 10.1080/00224499.2016.1267693]
  12. Formby, E. (2011). ‘It’s better to learn about your health and things that are going to happen to you than learning things that you just do at school’: Findings from a mapping study of PSHE education in primary schools in England. Pastoral Care in Education, 29(3), 161–173. https://doi.org/10.1080/02643944.2011.599857 [DOI: 10.1080/02643944.2011.599857]
  13. Future of Sex Education Initiative. (FSEI, 2020). National sex education standards: Core content and skills, K-12 (2nd ed.). https://siecus.org/wp-content/uploads/2020/03/NSES-2020-web-updated-1.pdf
  14. Goldman, J. D. G. (2013). International guidelines on sexuality education and their relevance to a contemporary curriculum for children aged 5–8 years. Educational Review, 65(4), 447–466. https://doi.org/10.1080/00131911.2012.714355 [DOI: 10.1080/00131911.2012.714355]
  15. Guilamo-Ramos, V., & Bouris, A. (2009). Working with parents to promote healthy adolescent sexual development. The Prevention Researcher, 16(4), 7–11.
  16. Guo, W., Wu, Z., Qiu, Y., Chen, G., & Zheng, X. (2012). The timing of sexual debut among Chinese youth. International Perspectives on Sexual & Reproductive Health, 38(4), 196–204. https://doi.org/10.1363/3819612 [DOI: 10.1363/3819612]
  17. Haggis, J., & Mulholland, M. (2014). Rethinking difference and sex education: From cultural inclusivity to normative diversity. Sex Education, 14(1), 57–66. https://doi.org/10.1080/14681811.2013.824873 [DOI: 10.1080/14681811.2013.824873]
  18. Hino, Y., Eshima, N., Bacal, K., & Tokumaru, O. (2021). Age-and sex-related differences in morbidities of sexually transmitted diseases in children. Children, 8(1), 40–49. https://doi.org/10.3390/children8010040 [DOI: 10.3390/children8010040]
  19. Hirst, J. (2004). Researching young people’s sexuality and learning about sex: Experience, need, and sex and relationship education. Culture, Health & Sexuality, 6(2), 115–129. https://doi.org/10.1080/13691050310001600969 [DOI: 10.1080/13691050310001600969]
  20. Hirst, J. (2008). Developing sexual competence? Exploring strategies for the provision of effective sexualities and relationships education. Sex Education, 8(4), 399–413. https://doi.org/10.1080/14681810802433929 [DOI: 10.1080/14681810802433929]
  21. Holway, G. V. (2015). Vaginal and oral sex initiation timing: A focus on gender and race/ethnicity. International Journal of Sexual Health, 27(3), 351–367. https://doi.org/10.1080/19317611.2015.1014954 [DOI: 10.1080/19317611.2015.1014954]
  22. Hoyt, L. T., Niu, L., Pachucki, M. C., & Chaku, N. (2020). Timing of puberty in boys and girls: Implications for population health. SSM-Population Health, 10, 100549. https://doi.org/10.1016/j.ssmph.2020.100549 [DOI: 10.1016/j.ssmph.2020.100549]
  23. Hyde, A., Drennan, J., Butler, M., Howlett, E., Carney, M., & Lohan, M. (2013). Parents’ constructions of communication with their children about safer sex. Journal of Clinical Nursing, 22(23/24), 3438–3446. https://doi.org/10.1111/jocn.12367 [DOI: 10.1111/jocn.12367]
  24. Jackson, R. (2020, January 24). Sex education: How to start early. Focus on the Family. https://www.focusonthefamily.com/parenting/sex-education-how-to-start-early/
  25. Kahn, N. F., & Halpern, C. T. (2018). Experiences of vaginal, oral, and anal sex in the United States. Journal of Sex Research, 55(1), 99–105. https://doi.org/10.1080/00224499.2016.1247149 [DOI: 10.1080/00224499.2016.1247149]
  26. Laverty, E. K., Noble, S. M., Pucci, A., & MacLean, R. E. D. (2021). Let’s talk about sexual health education: Youth perspectives on their learning experiences in Canada. Canadian Journal of Human Sexuality, 30(1), 26–38. https://doi.org/10.3138/cjhs.2020-0051 [DOI: 10.3138/cjhs.2020-0051]
  27. Legislative Council. (2018). Information note: Sexuality education. https://www.legco.gov.hk/research-publications/english/1718in03-sexuality-education-20180109-e.pdf
  28. Liang, J. Y., & Bowcher, W. L. (2019). Legitimating sex education through children’s picture books in China. Sex Education, 19(3), 329–345. https://doi.org/10.1080/14681811.2018.1530104 [DOI: 10.1080/14681811.2018.1530104]
  29. Liu, T., Fuller, J., Hutton, A., & Grant, J. (2017). Factors shaping parent-adolescent communication about sexuality in urban China. Sex Education, 17(2), 180–194. https://doi.org/10.1080/14681811.2016.1276897 [DOI: 10.1080/14681811.2016.1276897]
  30. Lumen Learning. (2021). Gender differences in the classroom. Educational Psychology. https://courses.lumenlearning.com/educationalpsychology/chapter/gender-differences-in-the-classroom/
  31. Ma, Q., Ono-Kihara, M., Cong, L., Pan, X., Xu, G., Samani, S., Ravari, S. K., & Kihara, M. (2009). Behavioral and psychosocial predictors of condom use among university students in Eastern China. AIDS Care, 21(2), 249–259. https://doi.org/10.1080/09540120801982921 [DOI: 10.1080/09540120801982921]
  32. McKee, L. G., Forehand, R., Miller, K. S., Whitaker, D. J., Long, N., & Armistead, L. (2007). Are parental gender role beliefs a predictor of change in sexual communication in a prevention program? Behavior Modification, 31(4), 435–453. https://doi.org/10.1177/0145445506298411 [DOI: 10.1177/0145445506298411]
  33. O’Donnell, L., Wilson-Simmons, R., Dash, K., Jeanbaptiste, V., Myint-U, A., Moss, J., & Stueve, A. (2007). Saving sex for later: developing a parent-child communication intervention to delay sexual initiation among young adolescents. Sex Education, 7(2), 107–125. https://doi.org/10.1080/14681810701264441 [DOI: 10.1080/14681810701264441]
  34. Portner, J. (1997). Study finding earlier puberty raises sex ed. questions. Education Week, 16(29), 3.
  35. Powell, E. (2008). Young people’s use of friends and family for sex and relationships information and advice. Sex Education, 8(3), 289–302. https://doi.org/10.1080/14681810802218171 [DOI: 10.1080/14681810802218171]
  36. Renold, E. (2005). Girls, boys and junior sexualities: Exploring children’s gender and sexual relations in the primary school. Routledge Falmer.
  37. Roberts, C. (2018, January 18). Puberty is starting earlier for many children—sex education must catch up with this new reality. The Conversation. https://theconversation.com/puberty-is-starting-earlier-for-many-children-sex-education-must-catch-up-with-this-new-reality-89608
  38. Saraçoğlu, G. V., Erdem, I., Doğan, S., & Tokuç, B. (2014). Youth sexual health: Sexual knowledge, attitudes, and behavior among students at a university in Turkey. Archives of Neuropsychiatry, 51(3), 222–228. [DOI: 10.4274/npa.y6768]
  39. Schaalma, H. P., Abraham, C., Gillmore, M. R., & Kok, G. (2004). Sex education as health promotion: What does it take? Archives of Sexual Behavior, 33(3), 259–269. https://doi.org/10.1023/B:ASEB.0000026625.65171.1d [DOI: 10.1023/B]
  40. School Education Gateway. (2019). Survey on sex education—Results. https://www.schooleducationgateway.eu/en/pub/viewpoints/surveys/survey-on-sex-education.htm
  41. Seiler-Ramadas, R., Grabovac, I., Niederkrotenthaler, T., & Dorner, T. E. (2020). Adolescents’ perspective on their sexual knowledge and the role of school in addressing emotions in sex education: An exploratory analysis of two school types in Austria. Journal of Sex Research, 57(9), 1180–1188. https://doi.org/10.1080/00224499.2020.1802644 [DOI: 10.1080/00224499.2020.1802644]
  42. Sex Information and Education Council of Canada. (2020). Questions & answers: Sexual health education in schools and other settings. http://sieccan.org/wp-content/uploads/2020/08/Questions-and-Answers-Sexual-Health-Education-in-Schools-and-Other-Settings.pdf
  43. Somers, C. L., & Eaves, M. W. (2002). Is earlier sex education harmful? An analysis of the timing of school-based sex education and adolescent sexual behaviors. Research in Education, 67(1), 23–33. https://doi.org/10.7227/RIE.67.3 [DOI: 10.7227/RIE.67.3]
  44. Somers, C. L., & Surmann, A. T. (2005). Sources and timing of sex education: Relations with American adolescent sexual attitudes and behavior. Educational Review, 57(1), 37–54. https://doi.org/10.1080/0013191042000274178 [DOI: 10.1080/0013191042000274178]
  45. South China Morning Post. (2020). Sex education in Hong Kong: One city, no system. https://www.scmp.com/comment/letters/article/3106681/sex-education-hong-kong-one-city-no-system
  46. Spriggs, A. L., & Halpern, C. T. (2008). Timing of sexual debut and initiation of postsecondary education by early adulthood. Perspectives on Sexual & Reproductive Health, 40(3), 152–161. https://doi.org/10.1363/4015208 [DOI: 10.1363/4015208]
  47. Stone, N., Ingham, R., & Gibbins, K. (2013). ‘Where do babies come from?’ Barriers to early sexuality communication between parents and young children. Sex Education, 13(2), 228–240. https://doi.org/10.1080/14681811.2012.737776 [DOI: 10.1080/14681811.2012.737776]
  48. Suleiman, A. B., Johnson, M., Shirtcliff, E. A., & Galván, A. (2015). School-based sex education and neuroscience: What we know about sex, romance, marriage, and adolescent brain development. Journal of School Health, 85(8), 567–574. https://doi.org/10.1111/josh.12285 [DOI: 10.1111/josh.12285]
  49. Tesso, D. W., Fantahun, M. A., & Enquselassie, F. (2012). Parent-young people communication about sexual and reproductive health in E/Wollega zone, West Ethiopia: Implications for interventions. Reproductive Health, 9(1), 13–25. https://doi.org/10.1186/1742-4755-9-13 [DOI: 10.1186/1742-4755-9-13]
  50. Tonelli, M. (2009). Time for comprehensive sex education. Journal of Pediatric Adolescent Gynecology, 22, 57. https://doi.org/10.1016/j.jpag.2008.03.003 [DOI: 10.1016/j.jpag.2008.03.003]
  51. United Nations Educational, Scientific and Cultural Organization. (2018). International technical guidance on sexuality education: An evidence-informed approach. https://www.unfpa.org/sites/default/files/pub-pdf/ITGSE.pdf
  52. Villar, M. E., & Concha, M. (2012). Sex education and cultural values: Experiences and attitudes of Latina immigrant women. Sex Education, 12(5), 545–554. https://doi.org/10.1080/14681811.2011.627733 [DOI: 10.1080/14681811.2011.627733]
  53. Walker, J. (2004). Parents and sex education—looking beyond the ‘birds and the bees.’ Sex Education, 4(3), 239–254. https://doi.org/10.1080/1468181042000243330 [DOI: 10.1080/1468181042000243330]
  54. Wang, B., Hertog, S., Meier, A., Lou, C., & Gao, E. (2005). The potential of comprehensive sex education in China: Findings from suburban Shanghai. International Family Planning Perspectives, 31(2), 63–72. https://doi.org/10.1363/3106305 [DOI: 10.1363/3106305]
  55. Wang, B., Li, X., Stanton, B., Kamali, V., Naar-King, S., Shah, I., & Thomas, R. (2007). Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China. BioMed Central Public Health, 7. https://doi.org/10.1186/1471-2458-7-189
  56. Wang, B., Meier, A., Shah, I., & Li, X. (2006). The impact of a community-based comprehensive sex education program on Chinese adolescents’ sex-related knowledge and attitudes. Journal of HIV/AIDS Prevention in Children & Youth, 7(2), 43–64. https://doi.org/10.1300/J499v07n02_04 [DOI: 10.1300/J499v07n02_04]
  57. Wilson, E. K., Dalberth, B. T., Koo, H. P., & Gard, J. C. (2010). Parents’ perspectives on talking to preteenage children about sex. Perspectives on Sexual & Reproductive Health, 42(1), 56–63. https://doi.org/10.1363/4205610 [DOI: 10.1363/4205610]
  58. Wong, W. C. W., Lee, A., Tsang, K. K. A., & Lynn, H. (2006). The impact of AIDS/sex education by schools or family doctors on Hong Kong Chinese adolescents. Psychology, Health & Medicine, 11(1), 108–116. https://doi.org/10.1080/13548500500156105 [DOI: 10.1080/13548500500156105]
  59. Yip, B. H., Sheng, X.-T., Chan, V. W., Wong, L. H., Lee, S. W., & Abraham, A. A. (2015). ‘Let’s talk about sex’—A knowledge, attitudes and practice study among paediatric nurses about teen sexual health in Hong Kong. Journal of Clinical Nursing, 24(17–18), 2591–2600. https://doi.org/10.1111/jocn.12869 [DOI: 10.1111/jocn.12869]
  60. Zhang, L., Li, X., Shah, I. H., Baldwin, W., & Stanton, B. (2007). Parent-adolescent sex communication in China. The European Journal of Contraception and Reproductive Health Care, 12(2), 138–147. https://doi.org/10.1080/13625180701300293 [DOI: 10.1080/13625180701300293]
  61. Zhao, P., Yang, L., Sa, Z., & Wang, X. (2020). Propriety, empowerment and compromise: Challenges in addressing gender among sex educators in China. Sex Education, 20(5), 552–567. https://doi.org/10.1080/14681811.2019.1705779 [DOI: 10.1080/14681811.2019.1705779]

MeSH Term

Male
Female
Adolescent
Humans
Child
Sex Education
Hong Kong
Sexual Health
Sexual Behavior
Perception

Word Cloud

Created with Highcharts 10.0.0SEknowledgesexualityChinesepreteens'informationsexualhealthstudentslikelyresearchinputobtaintimingreadinessHongKongagencydatagirlsboysteachersreceiveearliergradeSexualAlthoughyoungpeoplewantknowfeelreceivedneedlearnsocietiesscantsoliciteddirectyouthviewseducationdeliverablesfoundgapslackregardingperceptionlearningreasonsobtainingnot-for-profitcollectedpreadolescentsexpressedopinionsgeneralsurveysurveyed24primaryschoolsprovidedanonymoussecondaryteamanalyzeAmong4569fifth-sixth-gradeaverage11 yearsoldseeksex-relatedlibrarybooksmotherscontrastfriendspornographiccomicsinternetLogisticregressionanalysisindicatedgenderageinstructionalsourcesopennessperceivedactuallevelspredicteddesireschoolGirlsoldersignificantlyreportpreferencerecommendpreteensparentsencouragedcollaborateparticipateschool-basedprogrammingTimingSexualityEducation:Preteens'PerceptionHealthChildabusepreventionEarlyLearningPreteenpromotion

Similar Articles

Cited By