A Closer Look at Utopia: Strengths and Weaknesses of Sex Ed in Sweden

Imagine this: Sweden's school-based sexuality education is so strong that a yearly national youth poll shows that the majority of young people report that they get the best information on contraception and STIs from school.

Imagine a teacher who lets her 8th grade students
say all the dirty, sex-related words they know, and writes them down on the
chalkboard. That’s how Malin Hammarström, science teacher for seventh- through
ninth-graders at a school in Bålsta, Sweden, starts her first sex ed lesson.
The point is to de-dramatize the subject and show her students that she won’t
be shocked and embarrassed, no matter how hard they try – and they will try,
she tells me. That first lesson is followed by at least 12 more, which devote
significant time to discussing the students’ own questions about sexuality and
relationships. She finds sexuality education the most rewarding subject to
teach, because it relates so directly to her students’ own lives. And she has
never heard from any angry parents.

In the light of studies that show how abstinence-only
programs are ineffective, a growing movement in the United States is pushing for
accurate, comprehensive and reality-based sexuality education. Many U.S.-based
sex ed advocates point to Sweden
and the other Scandinavian countries as models for effective programs.

"It is time that the US looks to its northern European
colleagues for lessons learned in adolescent sexual health promotion," says
Debra Hauser, Vice-President at Advocates for Youth.  "In these countries, young people’s right to
honest sexual health information and confidential services is respected and
adolescent sexual development is recognized as normal and healthy. As a result
the rates of teen pregnancy, birth and abortion are significantly lower than in
the United States."

Studies show very small
differences in levels of teenage sexual activity across developed countries.
But when it comes to teen pregnancy, the US rates are much higher than those
of comparable countries. A study from the Guttmacher Institute show that in the
year 2000, the US had a
teenage birthrate of 49 per 1,000 women aged 15-19, which was five times higher
than the rate in Sweden.
Teenagers in the US
are also less likely to use contraception, and they have higher rates of STD
infection.  A 2001 Guttmacher Institute
study show that the chlamydia rate among US
teens aged 15-19 was 1,132 cases per 100,000, which is nearly twice that of Sweden.

Of course these differences
cannot be attributed to different approaches to sex ed alone, but are also
likely to depend on socioeconomic, political and cultural factors. In Sweden,
teen sexuality is largely seen as normal and positive, but there is also an
expectation that intercourse will take place within committed relationships
(not only marriage) and that those involved will protect themselves and their
partner. In the US,
teen sexuality is often seen as problematic in itself, and abstinence-only
programs underscore that view.

In Sweden, the debate over sex ed is far beyond whether or
not the curriculum should emphasize abstinence-only. Sex ed is an
uncontroversial subject, and isn’t discussed much outside circles of educators
and experts. The topic of debate is how to better educate teachers on the
subject, and how to move away from curricula that perpetuates the gender norms
and heteronormativity that still permeate our understanding of sexuality.

The history of sex ed in Sweden goes back more than a
century. It became a mandatory school subject in 1955, but the first classes
were held in the early 1900s at a girls’ school in Stockholm. The Swedish Association for
Sexuality Education, RFSU, was one of the main proponents of mandatory sex ed.
RFSU was founded in 1933 by pioneer sex educator Elise (Ottar) Ottesen-Jensen,
and a group of doctors.

Early sex ed was met with critique, not for addressing the
subject, but for being out of touch with young people’s lives. A national 1945
poll found that only 18% of Sweden’s population thought that abstinence until
marriage was important, so the moralizing tone of sex ed that portrayed girls
as responsible for keeping their virginity and boys as only wanting sex, did
not correspond with most people’s perceptions about sexuality. From the 1970s,
a more reality-based approach prevailed, related
to broader political shifts in society. It was acknowledged that young
people have a sexual life, often with a partner, and the focus was on helping
them to be responsible.

Today, the curriculum emphasizes that sex ed belongs in
various subjects, not only biology, but also history, social studies and
psychology. It is often tied to other ethical discussions, such as drugs and alcohol,
peer pressure, beauty standards and gender norms. In comparison with previous
detailed guidelines that told teachers exactly what to say and not, the
curriculum today is very open and general. There are no rules on how to carry
out the course, or how many hours it should take, so this is up to the
individual school to decide. This is both an opportunity and a challenge for
teachers, and it means that the quality of education varies a lot from school
to school. A study commissioned by the National
Agency for Education in 1999 found that students who had received a rather
conventional sexuality education thought that it had been enough or even
unnecessary, as they "already knew everything from magazines." Students who had
taken part in more interactive and varied forms of sex ed were satisfied or
wanted more. Interviews with students suggest that the most valued part of sex
ed is not the facts, but the chance to discuss those facts and relate them to
their own lives. Despite differences in quality and in the students’ own
perceptions of sex ed, a yearly national youth poll show that the majority of
young people aged 16-25 feel that they got the main and best information on
sexuality, contraception and STDs from school.

"Our sex ed was good because you found out things you didn’t knew
before," says Viktor Svensson, 19 years old and due to graduate from the
Swedish equivalent of high school this summer. Though he hasn’t received any
sex ed in high school, he still remembers the classes from earlier grades. The
curriculum at his school was part discussion about ethics and morals, gender
roles and views and sexuality, and part pure facts about things like
reproduction, STDs and contraception.

"Both parts were equally important," he says. "The discussion part was
held by a substitute teacher who normally taught P.E. and you could tell that
she was a bit insecure and embarrassed. Then our biology teacher, a man in his
50s, came back for the facts part of the course. He wasn’t embarrassed at all,
and he made the students feel comfortable."

The quality of sex ed is also affected by the fact that it
is not a mandatory part of teachers’ education today. A study carried out by
RFSU in 2004 showed that only 6% of recently graduated teachers had received
any sex ed teachers’ training. Hans Olsson, responsible for school issues at
RFSU, says that when teachers don’t have knowledge about how to handle the
subject, they risk focusing too much on biology, and giving short shrift to
broader issues related to sexuality. It’s easy to talk about biological facts
because those can be found in a book, but to discuss the role of sex in
society, or emotionally charged issues such as abortion or pornography, in a
meaningful way requires a deeper level of knowledge.

The relative openness about and acceptance of young people’s
sexuality is one of the big advantages of Swedish sex ed, according to Hans
Olsson, RFSU. That the education is focused around the students’ own questions,
and that all students will receive sex ed, are other pros. Like teacher Malin
Hammarström, he has never heard any negative reactions from parents. It is
sometimes said that certain immigrant groups would have problems with the
subject, but when RFSU have visited courses in Swedish for immigrants, they
have only received positive reactions.

Despite over 50 years of mandatory sex ed in Sweden, there
has been no systematic evaluations of the results. RFSU emphasizes that such
research, together with mandatory training for teachers and clearer guidelines,
are needed to improve the quality of sexuality education, and they call for a
professionalization of the subject. As the example of Sweden shows, comprehensive sex ed is not
without its problems, and for US
sex ed advocates, ending abstinence-only is just the beginning. The real
challenge may lie in developing an alternative.