Monday 30 December 2013

How did young people and sexual health fare in 2013?

I enjoy the end of year reviews. They are always partial, sometimes flawed and always interesting archives – the films, the songs, the books – which ones made it and which ones bombed.  So, here is mine for young people, sex, sexuality and sexual health. I put a shameless health warning on it - it is not scientific and the 'good year for, bad year for' doesn’t quite work, but I am going to squeeze a round peg into a square hole. And the only issue I am not going to put in a box is young people's voice - I think we are getting better at involving and hearing them and young people at Brook have felt heard by a number of senior politicians and decision makers this year. But it is so so important and we just have to keep getting better and better at it all the time. 

I hope you enjoy reading my review as much as i have enjoyed writing it - I don't necessarily expect you to agree but I hope it triggers your own assessment of the year to give space to congratulate yourself, build your optimism and reignite your determination to succeed for young people in 2014.

A bad year for;

1. Trusting young people to be responsible about sex 
The general view of immoral young people behaving more and more badly continued in 2013. It seems despite the evidence we continue to believe all young people are having sex before 16 and that far higher numbers of young people are getting pregnant whilst completely drunk or high. 

At Brook this year we have worked with over 280,000 young people, and it is clear that the absolute vast majority want to be good at relationships and want to be good at sex.  The National Survey of Attitudes and Lifestyles showed the average age of first sex remains at 16, and teenage pregnancy rates continue to decline.

2. Fear of technology
Technology is changing the way we live. The younger we are, the more likely it is our on and off line lives will be increasingly integrated. Technology is generally a force for good.   It’s the fear of technology - not technology itself that is on the bad list.  Online pornography, cyber bullying and ‘sexting' have been high on the agenda this year.

Three reasons fear of technology is on my bad list:

a) We need to think more about the way we protect, equip and empower across the spectrum from very young children and young adults. How we protect an 8 year old is very different than protection and empowerment of a 17 year old.

b) We need to listen more effectively to diverse groups of young people -including those who use new technologies well and without harm to understand the good as well as the bad.  It is too easy to exclusively hear the bad experiences and believe that is the norm.  Over Christmas I learnt how to use SnapChat from a 16 and 18 year old.  We talked about how they and their friends use social media. It was interesting to hear their experiences of the fun and the good and how they and friends respond when it is used badly. 

c) I worry we expect too much 'protection' from technological solutions such as blocking and filters alone and that we need to focus on creating a culture where young people, parents and other trusted adults know how to use technology well and to be discerning about 'good and bad content'.

3. Contraception and abortion 
A few years ago the importance of contraceptive choice for women and the economic value of investing in contraception moved up the policy agenda significantly.  Whilst its still early days in the heath reforms, too often at national level, contraception isn't getting the attention it deserves. 

Abortion continues to be politicised and abortion providers, already well regulated, have been subject to disproportionate scrutiny this year. The law on abortion  in Northern Ireland remains out of step with the rest of the UK and beyond our borders Spain's legislative changes are a worrying retrograde step in women's reproductive rights. 

At www.wecantgobackwards.org.uk Brook and FPA continue to collect stories of people’s experiences of sexual health services and it’s a mixed bag. Some local areas are continuing to provide excellent contraceptive choice in their services and others less so. The All Party Parliamentary Group on Sexual and Reproductive Health report on contraception and commissioning will be published in 2014.

Given 75% of contraception is provided by GPs and commissioning of abortion services remains with Clinical Commissioning Groups it will be important to ensure contraception and abortion are on NHS England's agenda as well as the agenda of Public Health England in 2014. 

4. National PSHE Policy 
We know from research with children and young people and from Ofsted report, ‘PSHE, not good enough yet’, that PSHE, particularly the SRE elements, are still not good enough and leave young people vulnerable.

That is why Brook and many of our partners were so disappointed and angry that the long awaited Department for Education PSHE Review concluded no change was needed and maintained the status quo wit PSHE as a non statutory subject.  As the UK enters its 25th year since ratification of the UN Convention on the Rights of the Child, the Children’s Rights Alliance for England 'State of Children's Rights in England' report was really damning about the state of SRE.

That said the National Curriculum states PSHE is important.  Ministers have repeatedly state PSHE is vital and insist it is now up to schools to decide how to do it.  It is therefore time for us to work differently  and for the experts to support schools and provide leadership and expert guidance. 

5. Sexual Health Commissioning
Since taking on public health in April 2013 some Local Authorities have had ambitious aspirations for service redesign - innovation and ambition will be absolutely vital to meet both the services people need and the economic challenges we face. 

However some of those early off the starting boards have had challenges with making change work. This led the British Association of Sexual Health and HIV and Royal College of Physicians to jointly write to all Councils to warn them of problems to service continuity in some areas as a result of commissioning decisions.  

6. Counselling and early support for young people 
Evidence from Youth Access and partners is showing that in many areas young people are finding it increasingly difficult to access counselling and early support. This early help is important for young people, extremely cost effective and provision is diminished at young people and society's peril. 

7. Violence against Women
Rape, violence and sexual assault against women continues to be unacceptably high in the UK, and whilst there is a very welcome policy focus on violence against girls and women follow @countingdeadwomen and @womensaid to know just how much there is to be be done. 

A good year for

1. The Sexual Health Improvement Framework 
This long awaited framework  was published in March ahead of the April 1st transition by Anna Soubry, then Public Health Minister.  The Framework takes a Life Course Approach and sets out aspirations for people across the life course and its aspirations for young people which match Brook's goals for young people: good SRE for all, high quality information and services.

2. Consent, Sexual Exploitation, abuse and violence against women
These important issues have received significant policy attention across central government and the Local Government Association. The Office of the Children's Commissioner published their report on sexual exploitation; the Home Office 'This is Abuse' campaign won an award at the UK Sexual Health Awards. The PSHE Association published draft advice on teaching and learning about consent to support schools in addressing this important area.

3. Data and Evidence 
The findings of the NATSAL 3 survey - the largest dataset on sex and sexuality undertaken once a decade - were published which showed the importance of sexual health services, the central role of education and a positive culture in creating positive, happy, healthy sex lives. 

The first six NATSAL 3 papers provided rich sources of data and information, and there will be much more to come. 

Brook and FPA,  in collaboration with Reckitt Benckiser, published an important report Unprotected Nation which demonstrated the economic benefits of investment and the potential costs of disinvestment.

4. Sex and Relationships Education
2013 was the year that so many influential and sensible people acknowledged sex and relationships education makes a real difference to young people, and that talking about sex and relationships in the home, school and community is part of the solution to national and local concerns about teenage pregnancy, sexualisation, abuse and exploitation, FGM and online pornography.  

NATSAL showed school based sex and relationships helps reduce teenage pregnancy and that receiving sex education mainly from a non-school based source almost doubled the odds of having an unplanned pregnancy.

Notable support for SRE came from;

UK Youth Parliament said they need a Curriculum for Life; Office of the Children’s Commissioner and Child Exploitation Online Protection (CEOP) part of the National Crime Agency said sex and relationships education should be statutory in all schools as part of national measures to reduce sexual exploitation; David Cameron said SRE is important to address the issues of online pornography in the Telegraph; Home Office supported SRE as part of its This is Abuse campaign; Department of Health emphasised the importance of SRE in their sexual health improvement framework and Department for Education said SRE was important as part of a balanced curriculum. The Teacher Unions said SRE was important to address sexualisation, pornography and ‘sexting’

Two important campaigns showed just how deep the consensus in support of SRE is;

The Telegraph Wonder Woman launched a campaign to get government to update its SRE Guidance and over 50,000 people supported their petition.

A Coalition for Consent - #yes2NC20 was established by Stella Creasey, Lisa Nandy and Sharon Hodgson to get a New Clause 20 for statutory SRE as part of the Children and Families Bill. Like the Telegraph campaign it was a galvanising moment online and in the media, and highlighted just how broad and deep support for better SRE is. It was inspiring to see bring together charities, pressure groups, MPs across the political spectrum, the public, and education bodies. 

With growing support from those with influence and a recognition of its increasing urgency there has to be a step change in the provision of SRE ahead. Surely, its time has come.

5. Social media
This year has seen young people, adults and organisations use social media to provide information, to challenge, to hear oft silent and unheard voices and to campaign for change - from challenging sexism and transphobia to raising awareness of FGM. 

At Brook our young people led twitter account @BeSexPositive has continued to grow and to share articles and posts about gender, sexuality, and what it means to be #sexpositive. @besexpositive made a lot of noise on #IDAHO 2013 - http://storify.com/BeSexPositive/idaho-2013

Our @brookcharity Brook focuses on policy and evidence - for example live tweeting the #OBRUK debate in Parliament on SRE. The highlights are storifyed here:http://storify.com/BrookCharity/sre-debate-in-parliament-for-obruk

The #safeXESmas @XEScampaign in partnership with @fpacharity and @durex has been very successful in getting people's attention and spreading the safe sex message. With engaging content on Twitter and Facebook and prizes to be won, it's shown how social media can get the word out to people who might not otherwise have heard it.

6. Equal Marriage 
Despite the promise from some that the world would end if the Marriage (Same Sex Couples) Bill became law, it did receive Royal Assent and another equality milestone is reached.  Interestingly as @ruthhunt from Stonewall predicted the world didn't end. In fact it became a better place.

7. Teenage Pregnancy
The teenage pregnancy rates continue to decline in England. Polly Toynbee's article in the Guardian in December highlighted the success of the teenage pregnancy strategy in reducing teenage pregnancy rates and supporting young parents. Alison Hadley established the Teenage Pregnancy Knowledge Exchange based at Bedford University to maintain the knowledge and momentum from the national strategy in the new environment. 

In Scotland,  the Health and Sport Committee Inquiry into Teenage Pregnancy made a series of helpful recommendations and a strategy is being developed for Scotland. 

As with everything 2013 has been a mixed year with good and bad when it comes to young peoeple's sexual health.  2014 will continue to see significant change that brings enormous challenge and opportunity.  Brook turns 50 next year. We will be doing all we can with partners and collaborators to apply our best learning of the past 50 years to achieve our goal of enabling young people to enjoy their sexuality without harm. 

Thank you to everyone at Brook as well as our partners, collaborators, funders, commissioners and supporters for hard work, commitment and support in 2013. Happy New Year. Hope 2014 brings much happiness and laughter. 

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