An education in sexual health

Although sex education is controversial in the Cayman Islands, the
reality is that, despite the continued and wholly futile prohibition
of pornographic magazines like Playboy, most young people today
have access to unlimited graphic pornography on the Internet and late
night cable television. In addition, as a video posted on YouTube (now
removed) ably demonstrates, the simulated sexual acts (hardly
dancing) at clubs and dances in the Cayman Islands leave little to the
imagination.

Unless Cayman society concedes the sexual education of young people to
such sources, a better way to provide them with a clear guide to
sexual health is obviously needed. Moreover, establishing sex
education into the schools’ curriculum follows trends in the developed
world, where teen pregnancy is viewed as undesirable for both teen
mothers and society as a whole.

In September 2008, the Department of Education Services (DoES) will
introduce the new curriculum into government schools that will include
age-appropriate sex education as part of a more holistic approach to
what students learn in schools, covering such objectives as self-
awareness, respect for others, and resistance to peer pressure among
the more traditional academic subjects.

Anecdotal evidence suggests that teen pregnancy is nothing new in the
Cayman Islands, but precise figures are not available. Statistics
on Live births to teenage
mothers  supplied by the Ministry of Health and Human
Services do not include abortions, miscarriages or births abroad.
Nevertheless, they show an expected correlation between age and birth
rate, with 41 teenagers giving birth in 2007, nine of them 17 years or
less. Figures have fluctuated between 41 and 26 over the last 5 years
(2003-2007), with an average of 35, though the birth rate to teen
mothers in 1995-99, especially to 17-year-olds, appears significantly
higher, reaching 58 in 1998.

 Ã¢â‚¬Å“Clearly by its very nature this is a very personal and
potentially emotive aspect of education,” says Head of Curriculum
Services Clive Baker. “Nonetheless, given the pressures of society and
the statistics about youth sexuality, it is an area that we have a
moral duty to deliver.”

Baker notes that the national curriculum considers the area of human
reproduction and sex education in separate documents and at different
age levels, and stresses the distinction between learning the biology
of the reproductive system and learning about sexual feelings and
behaviours.

“Whilst the two subjects can be intrinsically linked, they need not
always be so. For example, girls need to learn about changes in their
bodies ahead of them happening (typically beginning at about age 10).
We can recognize the need for them to understand the changes happening
in their bodies, and what its significance is, without them
necessarily considering the broader issues of sexual behaviour, which
would then be considered when the students were more mature.
Undoubtedly, there will be some students identified at higher risk of
premature sexual activity for whom targeted information would be more
appropriate or even necessary – but it is not a one size fits all
solution to give all students this information in Year 6,” says Baker.

A guidance policy from the Department of Education Services for sex
education is under construction and will be completed before the start
of the new curriculum in September 2008, he notes.

The Cayman Islands, however, does not have condoms available at
schools, although studies show that students at
schools in the US with condom-availability programs – as part of a
comprehensive sex education programme – have sex less often than those
at schools without these controversial initiatives. Condoms, both male
and female, which when used correctly help reduce the spread of
sexually transmitted diseases, are available at the Public Health
Clinic and all Health Centres at no cost. (CNS is expecting
clarification of the details of this policy).

Statistics on reported cases of sexually
transmitted infections  other than AIDS, also supplied by the
Health Ministry, are not broken down to show age and sex distribution,
nor is separate data kept for Cayman Brac. Since 2006, however,
figures for STI’s have been based on laboratory confirmations and
also age and sex, but the report is under preparation, the Ministry
reported.

According to Brent Holt, Head of Student Services at DoES, in addition
to the formal curriculum and the specified topics on human sexuality
and reproduction which are covered in the life skills and science
curriculum, government schools place a great deal of emphasis on the
broader issues of helping young people deal with the difficulties of
adolescence and of preparing them for the challenges of adult
life. 

“For this reason, teachers, counselors and a range of support and
pastoral staff work with students individually and in groups on all
kinds of issues, including sex education. Schools also take advantage
of the expertise of other groups interested in helping young people,
and government departments, non-governmental organizations, service
clubs and churches all provide valuable time and support for young
people in this area and in other aspects of what we would term
preparation for adult life.”

One such organization, the Women’s Resource Centre (WRC), has given
talks in the schools in Grand Cayman and Cayman Brac on topics such as
healthy relationships, domestic abuse, and entering into non-
traditional careers based upon sex, says WRC Director Tammy Ebanks-
Bishop. “We would like to expand our services to increase the number
of times that we visit the schools during the year in order to provide
students with information on healthy interpersonal relationships,” she
says.

“We have recently had a staff member trained to conduct information
sessions for a programme entitled ‘Owning Up’. This programme targets
young people and seeks to empower them, either as perpetrators,
bystanders or targets, to stop violence and humiliation in personal
relationships. We see providing information to young persons on topics
such as these as a proactive approach to spread knowledge about
healthy relationships. When young persons are equipped with knowledge
as to what a healthy and unhealthy relationship is, then perhaps they
will be more empowered to not enter into relationships in which they
are either perpetrators or victims of intimate partner violence,” says
Ebanks-Bishop.      

“Social and cultural norms do influence how we raise our boys and our
girls; this is called gender socialization,” says Ebanks-Bishop.
“Gender socialization determines the roles, responsibilities, values,
etc, that we assign our children based upon their sex (which later
translates at many levels into adulthood). This in turn assists us as
a society in determining what we consider ‘normal’ masculine and
feminine behaviour for our culture.”

She points out that, in regards to teenage sexual activity and
pregnancy, there are many gender socialization issues at work, such as
the double standard of sexual activity and fidelity when it comes to
men, young adolescent men and women and young adolescent women.

“It is more acceptable for males to be promiscuous and have affairs
than it is for women. Females are labeled with negative names, and
males are viewed by their peers as being more ‘successful’ the more
partners that they have.  Bearing that in mind, it is almost as
if too often the young girls who do get pregnant are met with
dismissing attitudes that they no longer are worthy of support or are
of no value to society. It does not seem as though the males who are
the fathers of the teenage mothers are met with the same kind of
dismissing attitudes,” Ebanks-Bishop says, noting that another aspect
of gender socialization differences when it comes to boys and girls is
self-image.

Based upon her observations, Ebanks-Bishop says it appears that young
girls have limited access to contraception. The reasons for this
observation are unknown and could be a result of various contributing
factors, she commented.

“Perhaps it is that Cayman is such a small place and the younger
adolescent women are not comfortable accessing services from clinics
or medical health facilities because of being afraid that their
confidentiality would be breached to their parents. Perhaps it is due
to gender socialization. Some females may not be confident or educated
enough to demand that their partner uses protection during
intercourse. They may not be aware that there is, or have access to, a
female condom. Perhaps it is because of parenting practices and/or
religious beliefs.

“Young adolescents may not feel comfortable talking to their parents
about their sexuality and thus do not get educated at all on (sexual
health). Perhaps there are issues of sexual abuse. We have to be
mindful that in some instances of teenage pregnancy, the young woman
was being sexually abused and therefore there really is no room for
consensual decision making with the male about contraception. Perhaps
there is a legal aspect at work. Does society think that young persons
under the age of consent should not have access to contraception?
Unfortunately, there seems to be more questions than solid answers.”

Ebanks-Bishop also points to a socio-economic aspect to teenage
pregnancy, since young peoplewho are in lower socio-economic levels
often don’t have correct information about sexual health or lack
information about contraception or access to contraception.

“Additionally, perhaps due to economic situations, young women are
‘groomed’ and exploited by their own family members in order to
reap economic gain from older men. This could be in the form of gift
giving or even covering expense such as rent, etc. There seems to
be an attitude again of blaming the young woman instead of the adults
who have ‘groomed’ her or the older men who have exploited her,” she
says.  

“Finally, I would stress that teenage pregnancy has to be addressed in
a more holistic manner including examining parenting practices, gender
relations and socialization, and socio-economic and education
factors.”

Holt adds, “Young people learn best when the entire community comes
together to support them in their learning and development as
individuals and citizens, and this ideal is enshrined in the
description of the ‘Educated Caymanian’ that is the touchstone of the
new education curriculum.”

When it comes to sexual health, knowledge is power (including the fact
that it’s OK to say “no”) and ignorance can have far-reaching
consequences. AIDS cases and deaths
are still low in the Cayman Islands, but this is a disease that can
lie dormant for years and reap disastrous consequences on a community.