Thursday, 9 April 2015

21 years in sexual health: my last day today (30th April)

In 21 (today) days' time I will be packing up my things and leaving the Brook offices for the last time, after close to nine fantastic years. I have to keep saying it out loud to remind and prepare myself. Brook has changed a lot during that time. It is an organisational journey I am proud and feel privileged to have been on along with fantastic young people, volunteers, staff and trustees.  We have also been lucky to have the support of individuals and organisations such as CASS Business School and Bain and Company along the way.

I am very excited about going to work at the National Union of Students and a whole new sector  - the learning curve is going to be enormous - I will also be very sad to be leaving Brook and my colleagues here - I love the values, the passion, the commitment to putting young people in the driving seat, and the dogged determination to demonstrate the importance of trusting young people and their developing sexuality rather than have a relentless focus on the negative and the bad.  It is not just Brook and valued colleagues within Brook that I will be leaving - I will be leaving the sexual health sector after 21 years.

I first started working in sexual health in 1994 as one of the founding group of student volunteers who set up SHAG (sexual health awareness group) at Cardiff University, before joining Cardiff AIDS Helpline (1995), Family Planning Association (1995), Sex Education Forum (1999), National Children's Bureau (2002), Department of Health (2004) and then Brook (2006).

So, I figured – 21 years of working in the sector, 21 days to go, I must have 21 things to say or things I have learnt. I intend to publish my final 'sexual health blog' on the last day, so in advance of that I am going to add one thing I have learnt or think to this blog each day as I count down. It will be in no particular order of importance. In fact I have no particular idea where I am going with this. Some of it will be really obvious I am sure, but it is part of my ending process which may or may not be interesting: let's see what happens.

30th April 2015 my last day
Three weeks ago, today seemed in the dim and distant future. But my final day is here and this time tomorrow I may well be having an identity crisis after working over two decades - more than half my life - in the sexual health sector. I have had enormous fun in that time from getting the SHAG safer sex T shirts made, to helping young men express themselves through music, dance and creative writing, to finally having 'the sex chat' with my parents at the age of 40 because I knew I could by then, to repeating incessantly that sex education is 'too little, too late, too biological' and I don't care what we call it lets get on with it and understanding more about Patient Group Directions than I ever thought I would. And from time to time I have even enjoyed arguing with those ideologically opposed to sex and relationships education (although mostly they are pretty dull arguments) and being aggressively accused of being a homosexualist (I still don't actually know what one is!).

I leave Brook and the sexual health sector

  • frustrated that Personal, Social and Health Education is still not a statutory part of the curriculum. How much money and time have we collectively spent setting out the evidence and the arguments, lobbying and campaigning and still not enough action. I hope whatever colour government we wake up with on 8th May will quickly remedy this. There is not time to waste. 
  • hopeful that Local Authorities will continue to commission high quality specialist young people's services and ensure both mainstream and targeted provision, and more than a little fearful that emerging approaches to whole system commissioning put young people's services and therefore their health and well being at risk
  • worried that in some areas, despite best intentions, we are heading backwards and in other areas * we are just not making enough progress so we will see a worsening of sexual health outcomes and a limiting of individual choices *insert your own thoughts about which areas 
  • confident Brook will continue championing a sex positive approach: leading the required culture change so ALL young people will be trusted and valued so we can achieve our mission of enabling young people to enjoy their sexuality without harm
  • proud of all that the teams at Brook have achieved together as an organisation through a major change programme and unprecedented social, economic and political change
  • grateful to have worked with such extraordinary people as trustees, partners, collaborators, colleagues and friends within and outside Brook who work with passion, commitment, determination and verve, often in testing circumstances; and so grateful to have had the privilege of being CEO at Brook
  • excited to be started at NUS next week, and excited to see who the next CEO of Brook will be and how they will shape the next phase of Brook's journey.
Finally some particular thanks: to David Gold who has been an outstanding mentor; to Eve Martin who has been an excellent Chair, providing so much support, insight, challenge and sound judgement; to the Executive and Management Team who have been amazing to work with; and of course particularly heartfelt thanks to Jules Hillier who less than six weeks before she was due to be leaving Brook agreed to change her plans so she could take up the helm as interim CEO until a permanent appointment is made. I think thats pretty special and I know Jules will do a fantastic job.

That's me done folks! 

21. Having sex for the first time/first time sex - most of the research about first time sex that I am familiar with in the UK seeks to establish whether it was regretted or not and to what extent.  An interesting reflection of our views on young people and sex. At the same time when I talk with sex educators - not necessarily the specialists - but people who teach Maths or Biology as their core subject and are trained in sex and relationships education find the whole issue of first time sex a difficult one to teach with very few good resources available to help them.

Those resources that are available sometimes seem to operate from a perspective that young people are probably not ready for sex and the job of the facilitator is help young people to reach that conclusion.  I was talking at a conference with a very well respected trainer a number of years ago and they offered a series of questions for working with young people to think about whether they wanted to have sex.  The list was long, detailed and mostly seemed helpful. With skilful facilitation in the right atmosphere I could see how useful it would be to get people thinking. Until the last statement  'and if you answered no, or have any doubts then it is probably best not to do it'.

I suspect none of the adults in the room would ever have had sex if they had to answer yes or have no doubts about any of them before having sex. I certainly wouldn't have.  And apply it to any other area of life and we would essentially be telling young people to only make decisions that are fear and risk free with certain outcomes. That can't be the best way to go.

Later that year I was speaking at a University in Wellington, New Zealand and one of the presenters had a very similar model with a series of questions, except, when you read the literature it was a bit more caring, a bit more forgiving and therefore felt more relevant. It was branded as 'only when you are ready'. It felt like it was written with high expectations for young people, it was centred around consent, it had clearly been written by adults together with young people, and it had clearly been written knowing that everything applied equally to young people and adults - not as if young people's decision making was a world away from adults.

It was also clear that having sex was an important decision but decisions were not fool proof; that having sex was appropriately risky business and that with all the best thinking, the best relationships and the best choices there was a chance that sometimes you may wish you hadn't done something, but that was ok and there was help available in families, in friendship groups and from trained professionals.

A few years ago Brook was a co-funder of a PhD programme seeking to understand young people's understanding of good sex in which some video resources were produced - you can read more about it here - and from this it became clear that whilst it is undoubtedly true that we need to put more emphasis on the R in sex and relationships education, we also need to put some more emphasis on the S in a relevant way in sex and relationships education particularly for older young people. And more specifically on helping young people to think about the conditions and context in which they would want to think about having sex for the first time and the possible implications of doing so - both the positive and the negative.

With such a preoccupation on the link between having sex for the first time and associated levels of regret do we risk missing the point and the very nature of being human? There are lots of things I regret having done in all areas of my life, but few things I really regret and feel very sad or worry about.  Most of the time I have learnt from my regrets, if not the first time I did it, the second time or if I haven't learnt yet, I suspect I will at some point. If we expect young people to learn from their mistakes, including those related to sex and relationships, we may need to have a more honest, granular and helpful conversation about the different choices we make and the lessons we can learn from those.

With open access resources available on the internet there may already be some short video vignettes representing real life stories about first time sex available that I don't already know about.  If not they would be a valuable resource for the many practitioners working in school, youth and community and FE settings across the country.

20. Effective teaching and learning - when i learnt to deliver sex and relationships education we spent a lot of time learning about developing a safe group work environment and using active learning methods to facilitate learning that drew on people's understanding and experience as part of the learning process.

When I help children and young people in our family network with their homework I am often surprised at how different the approaches can be. I was recently helping with some Maths Homework which was all done online via a school portal and there was a series of different tests, some quick fire, some you were allowed to use a calculator for, some you were not. The quick fire round (My term, not the official one I am sure) was part of an experiment to see whether it could encourage boys to do their homework through a competitive element.  I am not equipped to know whether this is the most effective way of teaching and learning about Maths, but I do know about SRE, and sometimes I see people using worksheets and resource packs, or evolved versions of that have been around a long time I wonder whether we have taken account of the changing way that technology allows young people to learn, the changing nature of knowledge and its application and both the method and the message that young people take from all aspects of SRE.

What do we know from the literature about online courses about their effectiveness and how could that literature be applied to SRE? What do we know about how people process information, connect with others and communicate and how does that influence the planning, method of delivery and content of SRE?  How do people discern, critically analyse and make judgements about information? Are there new influences on our beliefs and behaviours and if so are they integrated positively into the way we plan, deliver and assess learning in SRE?

I think apps are good and have their place, but I am not talking about an app, here. I am asking  whether we are thinking and about and assimilating knowledge about the changing way that (young) people learn, connect and communicate with others as a result of the changing nature of technology into the way we teach SRE so it is memorable, exciting and relevant. Seems to me it is a space that is genuinely ripe for innovation and development.

19. Pornography and body image - there is no doubt that it is easier to access pornography than it ever has been.  When I first started working in sexual health we had little knowledge about good sex and relationships education for boys and young men.  It quickly became apparent that in the absence of relevant sex and relationships education too many boys and young men were turning to pornography to learn about sex. Whatever you think about pornography, I think we can all agree,  it is not acceptable that boys or girls turn to pornography because we have failed to teach them about sex and relationships adequately, and pornography will never be the best place for young people to learn about sex.

So 20 years on we still haven't sorted sex and relationships education adequately, but we do have a growing narrative that all young people are watching pornography all the time, that increasing numbers of very young children are viewing it and that it is changing the nature of sexual attitudes and sexual behaviour and leading to greater exploitation, violence and abuse. The best review of the evidence that I have heard questioned the quality and robustness of the available research.

At policy level the adult conversation focuses on protecting young people from 'exposure' and the government's key policy intervention is the adoption of parental filters in every home.  Meanwhile young people are saying that they know the difference between fantasy and reality and what they need better education, better support and to be empowered to make choices and to seek help if they need it.  Despite this repeated plea from young people for better education, at national policy level, successive governments have largely ignored young people's requests for better Personal, Social and Health Education and the adoption of filters as the main policy intervention miss the much wider point that better education would address - that images of beautiful people are everywhere and most of them don't look like most of us.

Increasingly I hear and read more and more about both young (and old people) and body image. It seems to me this wider context of beautiful bodies being everywhere is having a pernicious impact on the way we think about ourselves and our bodies. Like with pornography and most other issues we best protect and empower young people to manage through education at home, at school and in the community.  At the heart of that education has to be the promotion of self esteem, self awareness and confidence that will build resilience to help young people navigate their way through the opportunities, thrills and challenges of their everyday lives.

18. We need to find a better way to talk about consent to sex - sometimes when you listen to people talk about, or you read academic and practitioner focused articles about sexual consent it would be easy to believe that there were other acceptable options - as if there are variations on consent.  Consent is consent. Full stop. There are no acceptable variations of consent and we need to find a language which enables us to express that clearly to young people. We don't love consent because it is loveable or want consent because it is desirable. We expect consent because anything less than consent is completely unacceptable and illegal. So let us find a better way to talk about consent, no ifs, no buts, no excuses.
17. It is not ok to lie to (young) people about sex and sexuality - yesterday there was an article in the Telegraph about a Catholic School in Croydon teaching young people that sex outside marriage destroys your soul and that condoms put your health at risk.  It is not ok to lie to young people.  Ever. Whatever our personal views and beliefs about different issues good teaching and learning will include the law and civil rights, health perspectives based on real science, not phoney made up stuff (abortion doesn't cause breast cancer or mental illness in the real books, condoms are not porous, men can control themselves even if they have an erection, we are a population with our souls largely in tact despite the amount sex that takes place outside marriage, gay people are not ill etc etc) and then different beliefs and values including humanist, religious,  cultural and personal beliefs.

If you don't like carrots you don't make things up about carrots to stop other people eating carrots. Likewise when it comes to sex we work with facts first and then be clear that people have different beliefs and values, we do not make up facts based on beliefs and it is not ok for people and organisations driven by ideological beliefs about sex and sexuality to scare young people in our classrooms.

16. Contraception - we need to talk about contraception because at both national and local level it often doesn't get enough policy attention and we don't big it up and value it enough. Contraception is amazing. The availability of contraception has changed women's lives and choices in ways that could only have been imagined a century ago. We need more focus on ensuring people know about and can access the full range of contraceptive choices. Contraception is cost effective medicine (for every £1 spent by the health service £12 is saved). Contraception needs just as much of a policy and practice focus as sexually transmitted infections.

I suspect some of you will read that and shrug your shoulders and say, "...and so?". That is the point. Too often shoulders are shrugged as if the way we educate, teach and provide contraception is sorted. Not quite yet. Think about this - 'contraception - worth talking about' is the first and only national campaign to promote awareness of contraception; high level policy meetings have a tendency to prioritise HIV and sexually transmitted infections and rarely is the cost benefit of contraception discussed; teaching and learning about contraception can be limited to facts about contraception an tends to focus less on motivations, drivers and barriers to using contraception; evidence shows that many (young) people will know very few different methods of contraception; too many (young) people do not really know how different forms of contraception including emergency contraception works and how or why condoms protect against sexually transmitted infections when hormonal contraception does not; often (young) people will only be offered a limited range of contraceptive choices; and sometimes commissioning arrangements mean there are limits on the number of long acting methods of contraception that can be provided in a period. Contraception is amazing. We need to talk about and big up contraception.

15. We can do more to encourage inter generational experiences - as a child I remember being bewildered that 'old' people could forget their age, go out dancing, have sex, not know their school grades or which year they went on holiday. I certainly didn't think they could teach me much about love, politics and relationships until I met Edith (more later). Now I am even older than those people I considered old and I too forget my age, have no idea about my school grades and indeed am known to dance sometimes albeit badly and with a distinct and allegedly adorable lack of rhythm.

At the same time as old people are a mystery to the young, us old people can be mystified, and sometimes scared by the young.

But inter generational conversation can change that. My experience with a wonderful woman called Edith convinced me of that. I used to do her shopping and in return she taught me a lot about love, relationships, happiness, heart break, dreaming big and equality.

Her tales taught, enthralled and inspired me. I, she said, gave her the chance to remember the good times, advise through the bad and live vicariously because her 'damned legs wouldn't take her anywhere anymore.'

I was in my late 20s when the age of consent was equalised. At the Stonewall party to celebrate I talked to two men in their late 70s who were sobbing with happiness. They had loved each other for a long time. Their love had first been illegal, then unequal. Their experience makes me value the rights I now have even more.

Lots of formal inter-generational work takes place in pockets, but do we really take advantage of all the wisdom available to young people. How can we maximise that invaluable resource - older people be engaged in school or community programmes talking about love, marriage, separation, rights and social change.

14. We need a blend of online/digital and face to face activity. 
The digital revolution is truly a revolution and despite all the fears of cyber bullying and grooming or online pornography and the challenges of ensuring young people know what is reliable and good quality information the internet is an overwhelming force for good. Young people can find information, people they connect with and come together to provide peer advice and support in all manner of exciting ways.

The internet provides us with opportunities to really reach out and make information more relevant, more easily accessibly and in real time. Virtual classrooms, virtual seminars or clinics provide opportunities to be more efficient and reach more people. Utterly utterly fantastic.

But, and there is always a but, we cannot simply replace face to face services or hard copy leaflets with digital solutions. Young people need the right combination of both on and off line information and services to meet their wide and different needs. Some things can be done online but not offline, some offline and not online, some both.

13. Apply the same common sense and logic to teaching about sex, sexuality and relationships as we do with other areas of life - we expect children to learn about maths because we know that numeracy is important even though we know it doesn't stop people getting into debt. We expect children to learn to read even though we know it doesn't mean everyone will read books. We know that you teach children about nutrition in a way that is relevant to their age and maturity, i.e. at a young age they learn they must eat some fruit and veg each day, later they learn what and why.  In most other aspects of life we trust the intrinsic value of education, awareness and understanding and we accept without question that information will come from a combination of friends, parents, school and self learning.

Yet when it comes to sex and relationships sometimes we don't always apply the same logic and common sense.  We look at relationships and sexuality through an 'adult lens' rather than a 'child lens' so when a 5 year asks how the baby got in mummies tummy we fear we must explain the ins and outs of conception rather than talk about a special cuddle; when a 7 year old asks why Uncle John and Uncle Max or Auntie Jane and Auntie Rosa live together we imagine they need to know the nature/nurture debates on sexual orientation rather than a simple answer such as 'because they love each other'. We hear people say SRE in schools is difficult because children are at different stages of development. Yes they are, as they are when it comes to teaching Maths, English, French, Science or Spanish. We talk about the challenge of different community values and beliefs yet schools are working with diversity in their day to day life for example in the managing of bullying and curriculum choices, not just in SRE.

Sometimes applying the standard logic and common sense we apply in education to teaching and learning about sex, sexuality and relationships might help move us on from some of the circular conversations that for the sake of children and young people we really need to move on from.

12. We have to have a gender lens - my first role in sex and relationships education was to develop a community based project targeting boys and young men. This came off the back of the anti-sexist work in the 80s and a lot of the resources I could find started from a position of boys were bad. Of course we live in a society which affords privilege to (particular groups of) men, and some boys behaviour is bad, but as a culture we then bully boys up and seek to make them tough, and then criticise them for behaving in the way we have taught them to. I learnt a lot about the 'macho mask' that young men would put on in a group setting and how to work effectively in groups and how to promote more positive and diverse images of what it means to be a man.  I had a co worker who ran a project for young women and we used to compare notes, and very quickly realised that with boys it was acceptable to talk about masturbation, sex and orgasms but not about emotions at the start of a group, and with girls it was acceptable to talk about emotions but not about masturbation, sex and orgasms. Later if we had done our job well they would all want to talk about everything including that which was typically off limits at the start. All were limited by gendered expectations in different ways and with different pressures. Our job was to ensure that all young people knew there were a myriad ways of being that should not be limited by gendered expectations, that we reflected as many different role models as possible and that all young people had access to all the relevant information and opportunities for skill development and values exploration delivered in a safe and positive way.

Later I managed a project about gender issues in the secondary school which reinforced the fact that gender stereotypes and expectations are limiting for ALL boys and girls, young men and young women including those who identify as LGBT+.  There is an enormous amount of work to be done to address systemic inequalities. 20 years on from developing my own professional awareness of the pernicious impact of gender stereotypes and expectations it is clear that progress is simply far too slow (look at the pay gap, women's experience of violence).

Discussions about gender and sexual identity with young people are some of the most dynamic I have ever facilitated. All of us working with children and young people at the class, youth group and individual level we have the opportunity to explore positive images of people with different sexual and gender identities, different talents, dreams and experiences.  To enable all children and young people to live their dreams we have to tell them explicitly that we have ripped up the 'gender rules fax' that has gone before them; helping them articulate their dreams, make a plan and develop their skills and talents, including the skills to manage any backlash when pushing the boundaries and achieving their goals.
11. Shout loudly about the importance of, and help young people nurture friendships - I have just spent the weekend with fantastic friends.  It has been a fairly mixed few years with lots and lots of highs alongside our fair share of lows. Through both the highs and the lows everyone has rallied around, tried to laugh, and cried as necessary and as often as possible. There is, of course, little better than time with friends who know each other well enough to enjoy, love and trust each other, warts and all.

I remember vividly the moment that I read the section on friendship in Jo Adams' book, Girlpower, how far does it go? It described the importance of helping girls build friendships so they can be who they want to be, feel confident in who they are and when necessary get support to face any backlash if they behave in ways that challenge expected norms. This book inspired a lot of work on friendship with young men when I ran Strides the young men's project in South Wales and then training for professionals.

When I used to run the boys and self esteem training course for professionals at the Centre for Sexual Health and HIV we ran an exercise on the power of friendship as a catalyst for thinking about how to promote friendships amongst boys and young men. It was without doubt one of the single most powerful exercises I have facilitated in training as people reflected on the power of friendship in their own lives and how they can help young people nurture friendships so they can enjoy the good times and support each other through the bad times.

Already lots of good work with young people nurtures friendships, often though without naming that as an explicit objective. I think we could helpfully name the promotion of friendships amongst young people and an understanding of their importance as an explicit goal in youth work, Where we have chance to think about the importance of friendships in our lives and truly understand and value the importance of our friendships we will actively seek to provide shared experiences that nurture friendships and help young people understand the importance and value of friendship in good times and in bad. That has got to be a good thing.

10. Embrace the UN Convention on the Rights of the Child wholeheartedly - In 1989 the UK ratified the UN Convention on the Rights of the Child - remarkably the United States has yet to do so but that is another story. UNCRC sets out 42 core rights which should drive our domestic law and policy.  It sets out children and young people's rights to education, protection, freedom of expression, health services and involvement in decisions that affect them.  The UNCRC has triggered a significant and welcome culture change in the way we involved children and young people in decisions that affect them across the voluntary and public sectors that must be celebrated.

We do still have a culture that can demonise, infantalise and stigmatise young people and their behaviours - if challenged on this think whether we would allow the mosquito alarm, used in public spaces to disperse groups of young people, if it was targeting any other group in society.

Combine this culture with the impact of austerity on funding and public services, and the fact that young people are not able to vote until they are 18 and it is easy to see how achieving the rights set out in the UNCRC is slower than many of us would like.  UNCRC provides a frame for all of us involved in the health, education and welfare of children and young people. We can use it in our advocacy, organisational and workforce development and direct work with children and young people to improve the quality and quantity of support for children and young people, and to motivate, inspire and support children and young people to be advocates for their own rights.

Each of the four countries in the UK has a Children's Commissioner tasked with holding government to account for implementation of the UNCRC. Scotland policy makers, it seems to me, are better than their English and Northern Irish counterparts at framing policy in the context of UNCRC. Wales has gone even further and enshrined UNCRC in domestic law. The Children's Commissioner for England responded to the UN Committee analysis of the UK record on children's rights a couple of weeks ago. - read it here.

Like some other children and young people's organisations, at Brook we have formally adopted and work within the UNCRC and use it underpins our values, strategy, policy and practice. If you work with children and young people and your organisation hasn't adopted it yet, I recommend you start the dialogue about doing so and use it to frame the way you talk about children's rights. I believe it helps keep us focused on the 'right' things with a combined rights based and needs led approach.

I blogged about the importance of UNCRC and why we must talk about it more a while ago.

9. Remember what it feels like to be young - how often have you been in the pub, at a party or a meeting, seminar or conference where people talk about young people and young people's lives as if this generation of young people are a different species with completely different feelings and experiences?

Yes of course the context changes but the underlying feelings of being human - of falling in love for the first time, feeling confident or unconfident about our bodies, ending a relationship, deciding whether to have sex and negotiating it, talking about sexually transmitted infections, pregnancy or abortion with a partner or health professional or fears of not being good enough at sex - remain the same. If we remember and connect with how we felt when we were young, not only will it often make us smile, but more importantly will ensure we are not unhelpfully scared about not knowing, not understanding something or worse by young people themselves. Fear can impact our judgement negatively and mean we don't respond with empathy or care. Young people often tell me that they felt judged by professionals or were frightened they were going to be judged and so didn't talk to them in the first place - training of course is essential but most important is starting from a position of trusting and liking young people.

When you are young you do not have the luxury of developing empathy through remembering what it is like to be old, it is therefore incumbent on us - the older and the old - to ensure that we remember what it felt like it to be young and demonstrate due empathy, care and respect.

8. Abortion - it is time to trust women - the majority of the country is pro choice. The scientific evidence is clear.  So why is abortion and women's right to choose still so politicised - see recent calls for women to have counselling and a cooling off period to ensure they don't make the 'wrong' choice,  two signatures required from doctors to approve the procedure , mischief making undercover journalism, propaganda masquerading as pregnancy choices counselling, inequitable access across the UK, 1967 Act doesn't apply in Northern Ireland and whether it is easy or hard to get an abortion will depend on your postcode, protestors outside clinics harassing women, visitors allowed into schools to tell lies to young people in schools.  It is absolutely right that people hold their own views and make their own choices about abortion.  That is why I am pro choice. But it is not right  to frighten young people, harass women going to abortion clinics and making dubious claims about links between abortion, breast cancer and mental health in counselling services without being clear about the organisations position on abortion.  Women deserve more than that. It is time we trusted women to make choices about their bodies without ifs or buts.

7. We get what we expect and we have to expect more for young people - about 15 years ago I went on a sex education study tour to the United States with Gill Frances. We met with the academic Kristin Luker whose book Dubious Conceptions, the politics of teenage pregnancy, is well worth a read if you haven't read it. She spoke a lot of sense but one of the most powerful things she said was that we get what we expect from young people and we spend a lot of time expecting too little from them and for them when it comes to relationships.

We know that people dramatically over estimate the number of young people who have sex before the age of 16, how many young women get pregnant each year and more recently we are all consumed by the amount of pornography young people are accessing. And so it goes on - we tend to lurch from one 'moral panic' to another. We need to reflect on whether our problem focused approach to relationships and sex in the UK means we focus on the issues that worry us such as abuse, exploitation, pregnancy, HIV, pornography, (so called) sexting etc etc at the expense of setting out high expectations and hopes for young people's relationships and helping them develop their confidence to make decisions that are right for them.

When I worked at the FPA I was one of the workshop facilitators for a touring theatre in education production. The play was about relationships. It was fun to watch and exciting, but it was inadvertently showing young people how not to communicate or negotiate well in a relationship, what happens if you don't use a condom and what not to do when one of your friends tells you they are gay. In one of the workshops a young man said something along the lines of 'great show, but didn't really teach us how to be good in relationships did it'.

If we were to really to have high expectations, focus on the positive and identify what we DO want for young people - to be active decision makers about sexual and reproductive health, to have healthy relationships, to be equal and free whatever their gender and sexual identity, to only have sex they choose when they can enjoy and take responsibility for it, to have the skills and confidence to get help - what would good education look like, what would good campaigns look like, how would services work, what information would we be providing, how might we need to communicate differently with young people about sex and human sexuality?

When we ask young people what they want to learn about they will say they want to be good at relationships, to know about consent and to understand about sex, sexualities and identities. They often say adults spend a lot of time thinking all young people are a homogenous group and have the same feelings, experiences and beliefs and telling them not to do something they weren't going to do anyway, or that our perspective is a world away from their realities. If that remains true we will continue to fall short in our shared goal of protecting and empowering children and young people.

We must have high expectations for young people so they have high expectations for themselves. All the evidence shows we can trust that with the right information and tools young people will be active decision makers. My challenge to all of us, including Brook, is to continually review our own websites, our lesson plans, our campaigns and our ideas and reflect on whether the balance between the positive and the empowering and the dangerous and the protection is the right one, and if not to involve young people in changing it.

6. Ensure young people are active partners at the heart of the organisation - Article 12 of the United Nations Convention on the Rights of the Child sets out their right to participate and to be involved in decisions that affect them. In my teens I had volunteered as a support worker for young people with disabilities, and then went on to be a peer educator so it made intuitive sense to me when I go to to FPA that young people would be in the driving seat in the design and delivery of sex and relationships education programmes. Then at Sex Education Forum and National Children's Bureau the Children's Development Department were at the heart of building new approaches to involving young people in all of our work, and building an organisational culture of participation.

When you engage well with children and young people they are able to articulate what they needed better than we could as professionals. At SEF and NCB we wanted to make sure that policy proposals and evidence were built upon young people's views and voices. We therefore realised early on that the more routes and platforms we could establish to ensure their voices were heard directly, rather than mediated through us the better. Initially we sought to make short films and booklets to provide to policy makers and professionals who were not as effective at listening to children and young people's voices as now.  And even now we have a very very long way to go before they are truly listened to.

Two of my favourite participation projects at Sex Education Forum and National Children's Bureau were Please Minister can we have better sex education - a video and young people's charter for sex and relationships education produced in response to Mr Blunkett's consultation on the sex and relationships education guidance, and Journeys: young people's experiences of bullying -  a comic book mapping young people's stories of bullying and how they managed to get help and support to stop the bullying published by the Office of the Children's Commissioner.

They are my favourites because Please Minister subverted the process to make the consultation relevant to what they wanted to say.  The video and charter was sent directly to Secretary of State with a letter saying along the lines of 'we didn't think your consultation questions about the guidance were the right ones so we have made this film for you to watch and this Charter to read.'  And with Journeys we were able to start changing the nature of the debate from one which was seeking to find the one best way to stop bullying and start putting young people's voices at the heart of policy by understanding their experience of being bullied, as well as what enabled or stopped them from getting help and what worked and didn't work in the process. The project was important because it started looking to young people to help us find the answers to tackling bullying.

I am enormously proud of the work that we have done at Brook to ensure young people are at the heart of the organisation from design, delivery and evaluation of services, to advising on our business strategy and resource allocation, designing and delivering campaigns including control of the Be Sex Positive campaign (@besexpositive). They are right at the top table with allocated places for young people on the board and we are in the process of establishing one of the young people's places being a joint Chair role. Brook is a much better organisation as a result of the involvement and leadership of young people - as we have got better at building strong partnerships with young people together we have been able to keep ourselves focused on the issues that are important to them.  They challenge our thinking and old orthodoxies  - if they don't think it is important should we still be doing it?

Through a range of mechanisms young people keep us grounded in their realities in which they are actively seeking to manage their relationships and health well. They want to ensure we present a positive perspective about young people and sexuality. They are mindful of the discourse of 'young people = all sex is bad sex' position and are clear Brook must never fall into that trap and that whilst the media headlines do not deal in shades of grey, young people's diverse experiences are definitely many shades of grey and we must reflect that in all our work.

About 5 years ago we had the most fantastic opportunity through a partnership with V Inspired to hand over our campaigning function to a group of young people.  They were very clear that they wanted a different approach to campaigning.  Less about safer sex and contraception (they are ten a penny) and more about sex (challenge to orthodoxy number 1). They were clear we must tell people what they need to help young people manage their relationships and created the Be Sex Positive campaign (@besexpositive).  Through this work and having young people in the office all the time we became even more acutely aware of how often young people are demonised, how often their views are ignored and how deeply ingrained society's negative attitude to young people and sexuality can be.  We felt the brunt of their anger when they were asked to input into the Bailey Review on sexualisation of children and they didn't think the report addressed their concerns at all. I felt the joy when they felt their voices had truly been heard as was the case with Amber Rudd's inquiry into pregnancy and contraception.

I have learned that young people's voice and view is supremely powerful and compelling - their stories and perspectives are real and they can win hearts and minds in ways that we as adults simply cannot.  I have watched as young people have held audiences attention with such power you can hear a pin drop and I have seen light bulb moments as professionals as young people cut through the fluff and get to the heart of the matter fantastically well.

It is our duty to work in partnership with young people to ensure we truly work for them, to ensure their voices are heard first hand wherever possible, that we create platforms for them to influence decision makers on their terms as much as possible. We must open up our organisations to young people and actively invite them in to work in partnership with us, share power and to truly shape what we provide, offer and say.  My experience of doing this at Brook is that it is a real game changer for the young people involved and the whole organisation. I very much look forward to watching Brook's youth leadership and participation work continue to flourish.

5. Help (young) people imagine their futures and dream of possibility -  The Teenage Pregnancy Strategy in England identified raising aspirations as an important aspect to young people making choices about contraception, sex and relationships. This has been echoed as critical in other areas of youth policy, too.

I first started working with young people in sexual health in the South Wales Valleys in the mid 90s not long after the communities were devastated by the closure of the mines.  Very quickly it became apparent that many of the young men had not been encouraged to dream about their futures and we spent a lot of time in sessions talking about the art of the possible.  It took a while for people to be comfortable talking about their dreams, some time to nurture and develop their skills and confidence to name their dreams for lots of reasons including lack of belief about their options, school and community dampening down the dreams and in some cases a lack of experience and resources from which to draw.

I learnt that good sexual health work isn't always straightforward when I was working with one young man who was in his final year at school. He had been repeatedly excluded ffom school and was in alternative education. I was doing one to one work to support him particularly around appropriate behaviour. We were struggling to build a relationship. I was part of the system and the system was crap. He resented having to spend an hour a week with me. I had been on holiday and so had been away for two weeks. The following week he was so furious with me he couldn't speak. I asked him what he had been doing when I was away. His response 'nothing'. I responded with a gentle challenge that you couldn't do nothing in two weeks. He assured me he could and told me I didn't know how lucky I was to be able to go on holiday.

After a lot of talking he said he would really like to go on holiday abroad one day and would really like to get a passport. He didn't believe he would ever be able to go abroad and that was something he really wanted to do.  And so our sessions changed a course - we got travel brochures and picked dream holidays and then holidays that were more immediately affordable; we worked out budgets and travel routes, we did a photo project with my passport. He became animated and interested. I discovered he could really draw when he brought in a fantastic cartoon style story board. We filled out the passport form and wrote to the Head to ask if she could help fulfil part one of his dream by paying for the passport. She did. Through this work we built a relationship and we did work on behaviour and attitude and motivation. It was easy because the dream was a springboard and motivator for change. I know he went to France four years later. He made sure he told me so.

I learnt a lot from that experience. Dreams help us think big. Sometimes our life experiences can suppress our imagination, under nourish our capacity to dream, or worse knock our dreams out of with talk of being 'too big for your boots'. All of us working with (young) people and with our staff teams do well to nurture imagination, cultivate dreams and build the confidence and skills to believe they can turn dreams into plans. Often time we won't have the experience of dreaming out loud and so don't immediately have the resources or language to dream. Dreaming is a skill that can be nurtured and is an essential pre-requisite for a life well lived.

Right now I am dreaming of finishing the Brighton Marathon today. Rob helped me think this was a possible and even sensible goal when I couldn't even run 5 kilometres and patiently helped me build the confidence and skills to run the distance.

4. We don't have to wait for government, we, the experts, should lead the way - sometimes government will develop policy that is supportive and helpful - a driver for change with resources attached - and sometimes government makes policy that is unhelpful, counter intuitive or a road block to change.

Either way rarely is government really radical or right at the forefront of innovation. It is not a criticism. Just fact (in my view). This is ever more true in the context of localism where more and more decisions are being made locally. Despite this often time we wait for government to tell us we are allowed to do something, what to do or how to do it.

I am not suggesting that government policy is not important. Of course it is. Take the recent focus on Mental Health, it has really shone a light on the importance of mental health - some areas will be providing better education, advice and services as a result. But for those areas that were already doing excellent work the policy focus will probably not have made much difference to their work. So depending on our role and what we want to achieve, it is our responsibility to be mindful how change can best be achieved, to consider how much time to invest in influencing policy, who we seek to influence and how best to influence them. It is up to us to ask whether the investment of time and energy would be better spent in direct work with our client group, working with governors of the school or the Local Authority.

We can, I have learned, liberate ourselves from believing government knows best and that we need to be told what to do - if you believe it is right to do something, if there is evidence about what works or there is a need to innovate and develop approaches then you probably won't and don't need national policy to provide you with the mandate to do it. There are often plenty of partners from across the private, public and voluntary, community and social enterprise sector to work with and help achieve the goal.

P.S I finished the Brighton Marathon in 4 hours 16 mins. I remembered that 26.2 miles is a long way. The unfortunate thing is that this time, unlike the last time I ran a marathon, I didn't say never again.

3. Process is important to get right but it is not the task - I first learnt about the theory of group processes on FPA's group work course. How fascinating to understand why introductions and closing rounds, warm up games and icebreakers were important and why to focus on knowledge at the beginning of a groups life and do the really hard work when the group were comfortable together and operating at their best.

Process is important but it is not the task itself - for example in education and training with young people or adults the purpose of a group working well together is so they can learn new knowledge or skills.  Similarly in consultation and engagement about sex and relationships education the process of consulting with children, young people, parents and communities is not the task - the task is to build confidence and support and get the content right.

Sometimes, probably too often, process becomes the task itself - especially in a time when everyone knows that user participation and involvement is important - but as young people tell me time and again there is no point asking us what we want and then not make any changes as a result. Too often you see the same questions asked time and again of different groups of young people without any evidence of change.

And whilst we are on process it would be remiss of me not to call time on the ludicrous national PSHE policy process over the last 8 years.  We have more reviews and reports on why PSHE is important and cost effective etc than we can shake a stick at. Parliamentarians, there is no need for any further process or consultation about whether Personal, Social, Health and Economic Education should happen, or what it should include. We are collectively 'processed' and consulted out on this.  There is a clear consensus about the importance of PSHE. Process is stopping progress. This is starting to be silly. It is not possible to claim to be doing all you can to tackle mental health, FGM, Child Sexual Exploitation, teenage pregnancy, body confidence, substance misuse, relationship violence and domestic abuse or online safety whilst simultaneously refusing to make PSHE a statutory part of the national curriculum. It is incongruent. PSHE in schools is sensible, cost effective, early intervention. Everyone from us, Brook, the Children's Commissioner, ParentZone, UK Youth Parliament, NSPCC, the Teaching Unions, Sex Education Forum, PSHE Association, Mentor UK and Royal Colleges such as the Royal College of Obstetricians and Faculty of Sexual and Reproductive Health. Take heed of professional expertise and wise counsel based on evidence. Stop wasting time, acting against the UN Convention on the Rights of the Child and leaving children and young people without the education and support they need to navigate childhood and adolescence well. Be bold. You will be universally thanked for it.

No further consultation on PSHE is required. Saying we must call the sex and relationships education bit of PSHE relationships and sex education is a distraction from the task (call it whatever, I don't mind, I just want it to happen). The task is making PSHE statutory in all schools to ensure there is enough curriculum time, teachers are trained and it is inspected.

National PSHE policy is an exemplary case study in making the process the task, but it happens a lot. Whether it is organisational mergers, governance reviews, national policy, changes to employment contracts, PSHE in the classroom or youth club, the process of design, delivery and evaluation is important if it is focused on achieving the task. Process is exciting as long as it is genuine, iterative, agile and proportionate. It is dull and potentially harmful if it becomes the task, is unnecessarily unwieldy and nothing improves as a result.

2. We have to learn, relearn or discover how to trust - to trust young people and their developing sexuality, to trust women to make their own choices, to trust teachers to deliver good sex and relationships education, individuals to explore and develop their own moralities and to explore and understand their gender and sexual identities; trust health professionals to provide timely and relevant advice and treatment for young people. Trust is the starting point and a necessary pre-condition for quality thinking, for setting high expectations, for developing good policy, protocols and training and for protection and empowerment.

On all things sex and sexuality young people tell me time and again that many adults tell them what to think or what not to do, instead of helping them understand an issue, develop their views and understand how to navigate relationships well; on sex and relationships education we still read that '4 years olds to be taught about sex'; on homosexuality and equal marriage, that it will lead to incest, beastiality and the sky falling in and still, remarkably after a land mark judgement in the mid 1980s young people's right to confidentiality is contested.  We are, it sometimes seems, forgetting the art and importance of trust.  It is one of the most important tools we have. 

1. Sexual rights are human rights as shown in this Charter from IPPF -

1 comment:

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