#SexEdForAll: What We Need to Prevent Intimate Partner Violence

By | June 1, 2020
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We just wrapped up #SexEdForAll month in May, yet most people still believe sex education is just about sex. But it’s so much more than that!

That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center for Policy Studies in Family Medicine and Primary Care. The story map explores sexuality education legislation and policies by state, compared to each state’s respective health indicators, including sexual violence, physical dating violence, bullying/harassment, suicide, contraceptive prevalence, sexually transmitted infection (STI) rate, and teen birth rate. I encourage readers to use this story map as a visually accessible advocacy tool to demonstrate the breadth of health indicators impacted by comprehensive sex education.

In addition to the sexual and reproductive health benefits, comprehensive sex education is a powerful vehicle for addressing reproductive justice, gender equity, LGBTQ+ equality, violence prevention, and power and oppression. I previously authored a post here at The Medical Care Blog which discussed moving from stigmatization to healthy sexuality. This follow-up discusses how comprehensive sex education can help prevent intimate partner violence.

The intimate partner violence pandemic

COVID-19 has increased the visibility of the intimate partner violence pandemic. Intimate partner violence is defined as physical or sexual violence, stalking, or psychological harm by a current or former partner or spouse. Based on data from Johns Hopkins University, Avenir Health, and Victoria University in Australia, the United Nations Population Fund (UNFPA) predicts that if strict lockdowns continue for one year, there will be 62 million more cases of intimate partner violence than is typical.

While intimate partner violence is a multi-faceted issue, undoubtedly the failure to implement comprehensive sex education in the United States puts all people at increased risk for violence. Within the US, sex education is not standardized across states, counties, or even school systems, and a large proportion of sex education programs are not evidence-based or medically accurate.

What is comprehensive sex education?

Comprehensive sex education includes age-appropriate, developmentally and culturally relevant, science-based, medically accurate information on a wide range of topics, including human development, gender identity, relationships, sexual behaviors and health, intersection of sexuality with religious and cultural norms, communication skills, critical-thinking, negotiation, empathy, and mutual respect. Currently, 29 states mandate some form of sex education for youth.

Advocates for Youth, Answer, and SIECUS: Sex Ed for Social Change have partnered to create the Future of Sex Education initiative. This initiative has developed the National Sex Education Standards which provide guidance on core content that is recommended for all students grades K–12.

How does comprehensive sex education address intimate partner violence?

Healthy relationships are a primary focus of sex education. Currently, only nine states mandate comprehensive instruction on healthy relationships and sexual consent. According to the National Sex Education Standards, students learn the characteristics of healthy and unhealthy romantic and sexual relationships, examine the media’s influence on defining societal norms, describe ways to positively express intimacy and affection, demonstrate effective ways to communicate personal boundaries, define sexual consent and its implications, and establish strategies to avoid or end an unhealthy relationship.

Further, gender equality is a core tenant of comprehensive sex education, and research shows that gender equality ultimately decreases risk for gender-based violence. The National Sex Education Standards address gender equality by teaching students to develop healthy self-identities, generate tolerance and respect for people with diverse gender identities, analyze societal gender roles, challenge harmful gender norms, and encourage mutually respectful and equitable relationships.

Low self-esteem is also a key characteristic of people who perpetrate intimate partner violence. Sex education core concepts related to identity and personal safety largely address identity development, body confidence, and bullying and harassment, all of which influence one’s sense of self.

Comprehensive sex education is particularly important because gender-based violence starts at a young age. Based on data from the 2017 Youth Risk Behavior Surveillance survey, high school-aged girls and women:

  • Experience sexual violence (15%) more often than male students (4%)
  • Experience physical dating violence (9%) more often than male students (7%)
  • Have seriously considered attempting suicide (22%) more often than male students (12%)

How do we move forward?

If we are to adequately address intimate partner violence, our country must invest in comprehensive sex education. Within the United States, sex education is not standardized across states, counties, or even school systems, and a large proportion of sex education programs are not evidence-based or medically accurate. Just as we invest in math, language, and humanities education, we must also develop an educational platform for teaching the critical life skills that are encompassed in comprehensive sex education.

#SexEdForAll highlights that all young people deserve developmentally and culturally responsive, science-based, and medically accurate life skills education. Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators, presented as an interactive story map, can be used as a visually accessible advocacy tool to demonstrate that sex education is about more than just sex… instead, comprehensive sex education is a powerful vehicle for social change.

Rebekah Rollston

Rebekah Rollston

Rebekah L. Rollston, MD, MPH, is a Family Medicine Physician at Cambridge Health Alliance, Instructor in Medicine at Harvard Medical School, Faculty of the Massachusetts General Hospital Rural Health Leadership Fellowship (in partnership with the Indian Health Service Rosebud Hospital), Editor-in-Chief of the Harvard Medical School Primary Care Review, and Head of Research at Bicycle Health, a digital health startup that provides biopsychosocial treatment of opioid use disorder via telehealth. She earned her Medical Degree from East Tennessee State University Quillen College of Medicine (in the Rural Primary Care Track) and her Master of Public Health (MPH) from The George Washington University Milken Institute School of Public Health. Dr. Rollston’s professional interests focus on social determinants of health & health equity, gender-based violence, sexual & reproductive health, addiction medicine, rural health, homelessness & supportive housing, and immigrant health.