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  3. Alesha Doan | Women, Gender, and Sexuality Studies
  4. Advancing Sexuality Education in Developing Countries: Evidence and Implications
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We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. Author links open overlay panel John S. Under a Creative Commons license. Abstract Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. In many ways, marriage marked the turning point, especially for young women.

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Today, however, the transition from childhood to adulthood takes longer—and as a result, adolescence as a stage in life has gained in significance. Most young people today begin to have sex at about the same age as in the past: The age at which young women in the United States typically initiate sex is similar: Parents and other family members, of course, have always played a critical role in the physical, emotional and sexual development of young people.

There is also a growing advocacy movement—including at the global level within the United Nations—for the recognition of comprehensive sexuality information and education as a basic human right. For example, many adolescents think that a young woman cannot get pregnant the first time she has sexual intercourse or if she has sex standing up. In regions and communities throughout the developing world, therefore, policymakers and youth-serving professionals are grappling with how best to address the wide-ranging needs of young people. They are weighing what is possible, considering both the political realities and context, and are taking a close look at the evidence for different approaches.

The last few decades have seen a proliferation of curriculum-based interventions, both in and out of school. For a long time, these curricula emphasized the medical aspects of sex and reproduction, human anatomy and development.

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Today, although having a basic understanding of human biology and the reproductive system is still considered crucial, programs have evolved to include a broader range of topics. Two basic approaches have emerged, each supported by different perspectives on what is best for children and young people. The abstinence-only approach focuses primarily, if not exclusively, on promoting abstinence outside of marriage, on moral as well as public health grounds.

Over the last three decades, especially in the United States but also in parts of the developing world, much of the focus of sexuality education—at least among politicians, if not program planners—has been on trying to convince young people to delay the initiation of sex, generally until after marriage. This approach is based on the premises that sex before marriage itself is a problem because it is morally wrong and that young people can be convinced to wait, even well into their 20s.

Alesha Doan | Women, Gender, and Sexuality Studies

These "abstinence-only-until-marriage" programs focus primarily or exclusively on the putative benefits of abstaining from sex. They may also distort and actively denigrate the effectiveness of contraceptives and safer-sex behaviors. This kind of education has become increasingly marginalized, as several well-designed studies conducted over the last 15 years have shown just how futile the focus on stopping young people from having sex is. For example, in , investigators at the Centre for Evidence-Based Intervention at the University of Oxford conducted an international literature search for randomized or quasirandomized trials of abstinence-only programs in high-income countries.

Despite its international focus, the search found only 13 studies that met the standards for inclusion—all conducted in the United States, and with a total sample of nearly 16, youth. The researchers concluded that programs that exclusively encourage abstinence are ineffective, saying "when compared with a variety of control groups, the participants in these 13 abstinence-only program trials did not report differences in risk behaviors or biological outcomes.

These findings are similar to those of another comprehensive review of sex and HIV education programs published in Study results indicate that abstinence-only programs are not effective at stopping or even delaying sex. Moreover, research suggests that strategies that promote abstinence while withholding information about contraceptives can actually place young people at increased risk of pregnancy and STIs.

Advancing Sexuality Education in Developing Countries: Evidence and Implications

For example, young people who take? For example, leaders of True Love Waits, probably the best known of these programs, report that nearly one million young people across Africa have signed their pledge.


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Further promotion of abstinence-only approaches would not only run counter to the evidence, but also to the desires of many educators, parents and adolescents. Some adults, parents and politicians—who may be conservative but pragmatic—believe that although sex among adolescents is troubling, it is inevitable and unavoidable, and society must accept this reality and concentrate on helping adolescents avoid the negative consequences of sex.


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  6. Others go further and assert that the formation and testing of romantic attachments and the physical expression of sexual feelings are a natural and developmentally appropriate part of the transition to adulthood. Therefore, they say, young people should be approached with respect and equipped with the knowledge and skills they need to feel comfortable and confident about their sexuality. These different motivations for comprehensive sexuality education have gradually made their way into policies and programs, which vary between countries.

    For example, in the United States, the focus on keeping young people safe has been translated into prevention-oriented programs.

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    Although these programs may cover a wide range of topics—from fertility and reproduction to STIs, from relationships and communication to gender norms, culture and society—they are primarily aimed at helping adolescents minimize their risk of adverse outcomes. Northern European countries such as Sweden and the Netherlands, by contrast, embrace a more positive attitude toward adolescent sexuality, based on the premise that young people are "rights-holders," and therefore are entitled to information and education, as well as the right to express and enjoy their sexuality.

    These rights-based or "holistic" programs are concerned, of course, with equipping young people to avoid unintended pregnancy and STIs, but they are focused less on behavior and outcomes per se, and more on reflection and choice.

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    The underlying assumption is that empowering young people to make considered, informed decisions about their own lives and helping them to develop the critical thinking skills and sense of self necessary to do so will result in better sexual and reproductive health in the broadest sense—including pleasure, love and sexual well-being. It has long been recognized that those countries that have a more open and positive attitude toward sexuality have better sexual health outcomes.

    Cross-national comparisons show that, despite similar levels of sexual activity, adolescent pregnancy rates are consistently lower in many Western European countries than in other regions of the world.

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    In keeping with this view, government-supported schools in many Western European countries provide—and even require—comprehensive sexuality education and offer easy access to reproductive health services. Sex instruction for teenagers -- Political aspects -- United States. Sexual abstinence -- Study and teaching -- Political aspects -- United States.

    Summary "The Politics of Virginity details what abstinence programs teach students, exposes the political and religious agendas behind such programs, and analyzes the damaging effects to women of the resurrection of the chastity belt: By focusing on the marriage of morality politics with gender politics and of ignorance with chastity that underlies abstinence-only education, the authors fill a major gap in the literature of reproductive politics and policy.

    Contents Under the radar: Title V and abstinence-only education "Good girls" or "dirty whores? Includes bibliographical references p. View online Borrow Buy Freely available Show 0 more links Related resource Table of contents at http: Set up My libraries How do I set up "My libraries"? These 8 locations in All: Open to the public ; HQ Open to the public ; Open to the public R N The University of Melbourne Library.