Cleaning, clearing and archiving and changing the world

....are not normally favourite things to do. I understand they need to be done, and done well, I just don't enjoy it. However that was my task here at Brook yesterday and will be again today.

Contrary to my expectation, it has been an absolute treat because it has given me greater insight into the determination and courage of so many people in Brook who have provided high quality services for young people, often in a hostile environment. It has also reminded me how much has been achieved since 1964. There are boxes and boxes of letters, negotiations and records of discussions about confidentiality and young people's rights to sexual health services and education. Negotiations that have helped change attitudes towards a more positive view of young people's sexuality.

So, it is new year resolution time - if you make them, as you write your list consider the words of Marian Wright Edelman an American attorney and civil rights activist who said 'if you don't like the way the world is, you change it. You have an obligation to change it. You just do it one step at a time.'

The importance of eye contact

Most work Christmas parties are now over. Lots of us will now be set to spend time with family and friends over the holiday season. Last week, on the way home from my Christmas party I gave some money to a young man - lets say Adam - who is (presumably still) homeless and then spent some time talking to him in central London as he shivered by the cash machine.

Adam was grateful for the money, and even more grateful for the time I spent talking to him and making him feel 'worth something'. He told me it is always hard being homeless, physically more so at winter, and it is hard emotionally at Christmas because it is a particular reminder of what you do not have. As Adam sat there asking for some loose change, thousands of people were having a fantastic time. 'Begging' he said made him feel awful, disgusting and embarrassed.

We said goodbye, me offering to pay for a hostel, Adam saying it was too late that night, he would love the cash for the following night and a drunken 'well wisher' told me i was a ******* mug for giving the money - it would after all 'only go on special brew'. As i walked away it was me that felt awful, because what Adam, like we all, want is people who take the time to talk, people who take the time to notice and people who show us respect.

You don't have to be homeless to want time and company. So much happiness comes from human contact and our relationships. Lots of people will be sad and lonely this Christmas. Giving money and time to help others is important, spending time with friends and family is too - before meeting Adam my challenge to myself was to do both properly this Christmas. After meeting Adam I added one more thing to my list - don't pretend that people sat by the cash machine don't exist - make eye contact and if they want a conversation, have one. It means a lot - often more than we think.

Brook's annual party

Last week we had our AGM, a public meeting on abortion and a parliamentary reception kindly hosted by Baroness Massey of Darwen - a leader in advocating for young people's sexual health. Our AGM provided an opportunity for us all to reflect on the highlights of the year. It is my first full year as Chief Executive and i am proud of what the Brook Network has achieved this year - we see about 1500 young people every single day - and in a recent intelligence gathering exercise, one of our stakeholders said of young people, they come in scared and they go out skipping - what a marvellous tribute to the work of the staff.

The meeting on young women and abortion addressed a number of issues

the important balancing act of offering a platform for young women's views, supporting them to express their views safely and sometimes challenging the 'right or wrong' view on abortion that particularly younger young people can hold (and are often encouraged to hold at school through polarised debates) at the same time as advocating for them clearly and strongly

the importance of raising the bar on awareness of, and confidence in accessing contraception, and of discussing contraception when a young woman has an abortion - so they do not fall pregnant again within weeks of having an abortion

the importance of strengthening young people's current experiences of teaching and learning about abortion - bringing together health perspectives, cultural and value based perspectives and legal perspectives to provide an effective learning experience. This presentation from Education for Choice (www.efc.org.uk) demonstrated how brilliant they really are as an organisation and how much expertise they can offer those who are interested

the role of counsellors in providing supportive, positive and cost effective counselling, referral and support for young women. Brook's services in Birmingham provide this counsellor led referral and abortion service providers they work with have seen a zero rate of 'do not arrive' clients and noticed how well supported the young women are - what a brilliant success story with the potential for replication in other parts of the country.

Inspired and thoughtful after four brilliant presentations we went off to the parliamentary reception to chat, ponder, laugh, and learn about the extraordinary practice of knitting a uterus as sex education. The only unsatisfactory bit was seeing some people come and go, giving a smile and a wave and then not getting to the right side of the room before they had left. Much like any other good party i suppose.

being young, gay and resilient

Whilst I was in Manchester last week I picked up a leaflet about the Lesbian and Gay Foundation (www.lgf.org.uk). I was horrified yet again by the statistics they gave as part of their, ‘are we really going to let this keep happening’ fundraising campaign. The facts as they appear on the leaflet are;

1 in 5 of us have tried to commit suicide
9 in 10 of us have been verbally abused
1 in 10 of us are HIV positive
4 in 5 of us have been bullied at school
3 in 5 of us have been beaten up
1 in 4 of us suffer from alcohol or drug addiction.

There is clearly no room for complacency in challenging homophobia. That said it is an interesting space that charities occupy to secure the support of the public and generate funds from statutory and non-statutory sources – it probably wouldn’t be too appealing to insert at the end of these statistics – ‘remarkable that we contribute so much to society given these facts’ or ‘what impressive emotional resilience we have’. For Brook this sometimes means we are required to focus on the negative outcomes of sex and sexuality how many young people get pregnant, or get a sexually transmitted infection.

It is even more important therefore that we remember most young people DO want to take responsibility for their sex and sexuality and for protecting their sexual health; that most do not get pregnant, and with the right support those that do and decide to proceed with the pregnancy go on to make very very good parents.

Coming into view

I am the Vice Chair of the Black Health Agency (www.blackhealthagency.org.uk). On Friday last week I had an inspiring day visiting staff working in different programmes across Manchester. The skills, competence and commitment of the staff is truly remarkable. They daily find creative ways to reduce the health inequalities experienced by minority communities, and enabling people to speak out for themselves.

Whilst I was at one office the youth workers told me to look out of the window at the group of young people gathered in the garden. About eight young people from the local Further Education college were rolling and smoking ‘spliffs’ in their lunch break. I was surprised at how open they were. I was also surprised by how easy it is to tut loudly. Thankfully I quickly remembered that my peers smoked spliffs during lunch when I was at college – the only difference is that it was generally done out of sight of adults.

In a world in which all our lives are increasingly open to public view via the internet and reality TV, we will get used to young people reminding us of our faded or fading youth. If we don’t we will believe the myth that is peddled by some that young people are less moral than we were, shamefully forgetting the fun and the learning that doing ‘naughty things’ offers, and condemning youth in ways that I can’t see is particularly helpful.

Helping turn the tide on STI rise amongst young people

Today the Health Protection Agency confirmed again that rates of sexually transmitted infection are still rising amongst young people. In all my conversations today i have reminded people that if we encourage more people to test, we will find out about more infections that were previously undiagnosed. Doubtless for a small minority this will be confirmation of the sexual immorality amongst the young. I do not agree - I think it is confirmation that we are not doing enough to support young people to make good decisions and choices that enable them to protect their physical and emotional health. As a country we have a collective responsibility to;

Work to change our unhelpful culture where sex is viewed negatively and sexually active young people are seen as out of control. We need to help young people feel confident about relationships and sex, and equip them with the skills to make good decisions so they can enjoy and take responsibility for their sexual health

Ensure sexual health services do not see continued disinvestment in ongoing efforts to balance the books. If this continues, we will see the consequences in increased teenage pregnancy and STI rates in a very short time

Commit to make Personal, Social and Health Education statutory in schools so every child learns about sex, relationships and sexuality wherever they live.
Currently too many receive little if any good sex education.

Invest in innovative community outreach programmes that reach out to the most vulnerable, building bridges between them and services and helping them take control of their sexual lives.

What words for teaching about love?

Love and the overwhelming power of the feelings connected with love have been on the top of my mind over the last few weeks. At a friends wedding the lump in my throat was very big as speeches were made - the love was palpable and it felt amazing. A couple of friends have also had babies this month and alll parents are just describing the immediate strength of their love. And last night I went to a friends pre-wedding party (a modern day hen do, with men and women - is that a sten or a hag do?)

As often happens at these party's those who have already committed to marriage think nothing of the huge decision that has been made - to commit to someone for the rest of their life - and those who have not yet got to that point, stand in the corner and wander how she knows this is the right time and the right one - even though we can tell by the sparkle in her eyes and the ways she is that it is the right time. Last night a friend and I talked about how we can communicate the concept of love to young people so they understand it, look for it, feel it, work at it, treasure it and are not be fooled by it. In a world that is perhaps increasingly cynical about enduring love it seems important to me, that we spend some more time discussing love with our young. If anyone has found good ways of doing it, that have truly engaged with young people I would be interested to find out what you have found works.

Abortion matters (2)

Abortion is getting the most public discussion that we have seen for a while. If you are not sure why, it is primarily because this month was the 40th Anniversary of the 1967 Act which legalised women's right to abortion, and there is a forthcoming Human Embryology and Tissue Bill which provides opportunities for legislation to be included which could and should improve and extend women's rights. Much media attention has focused on reducing the time limit, despite there being no reliable scientific evidence about this being necessary.

Brook is involved in a consortia of organisations called Voice for Choice. Together we are working together to secure these improvements which include extending the law to Northern Ireland so women have the same rights there as the rest of Britain; removing the requirement for two doctors to authorise the procedure; and increasing the range of professionals and the range of health settings where abortions can be carried out.

And there is a another job for us to do at Brook, and that is to find out more about the specific issues for young women relating to abortion, and particularly to understand more about when medical abortion or surgical abortion is most appropriate and to understand more about what works in supporting them before, during and after either process.

There is no room for complacency on abortion rights. We need a strong united voice in support of women's rights. Make sure you are part of that voice.

Beautiful Within...

Finding happiness and confidence within your own skin, (www.simonsays.co.uk) is the name of Brook’s ambassador, Mica Paris’ new book. In the introduction she states ‘every woman has it in her to create the life she really wants. We can do whatever we like, be anything we choose. All that stops us is that we don’t think we can.’ How sadly true for so many people young and old today.

When I was growing up I used to visit an ‘old lady’ Mrs O’Brien, mostly on Sundays. She probably has no idea how much she influenced me by regaling with her stories of love, loss, happiness, the importance of grabbing your chances and most importantly to remember there were always choices. Thank you Edith! I often talked of the problems and difficulties of ‘a friend’ and went away confident in my decision (sometimes to find she was wrong and I was in trouble!). But too many people don’t have an Edith.

And at Brook we see many of those young people without the confidence and self esteem, or the emotional and social skills to take control of their lives. Their dreams shattered by their experience of love and care, pressure and influence, they lose confidence and hope, and settle for second best in all areas of their lives, including sex and relationships.

Brook’s mission is ‘to enable all people to make informed choices about their personal and sexual relationships so that they can enjoy their sexuality without harm’. It is our joint belief and commitment that (young people) have the power to create the life they want that has led us to work together.

Mica’s story provides many practical ideas and personal insights that will be helpful for women, young women and for those that work with them. At Brook we look forward to working with Mica to change the world by helping young people change it for themselves. If I take anything from the book it is a reminder that there is nothing ‘nice’ about hiding talent, nothing brilliant about ‘settling for our lot’ and that sometimes choices are difficult and life it tough, but with a dollop of courage and lots of support there is always hope for fulfilment and happiness.

We get what we expect

In 2001 I went on a sex education study tour to the United States of America. I met with a range of people working in the USA including Kristin Luker, a researcher from California who has done significant research on teenage pregnancy. Amongst many interesting and helpful points she said 'you get what you expect from young people'.

Expect them to be rude, feckless, 'hoodies', drunken and that is what you get. Expect them to be thoughtful, hopeful, engaged and brilliant and they will be. I was reminded of her point earlier this week when talking to a young person excluded from school and finding life at a Pupil Referral Unit a bit tough. I asked him what he thought his chances of getting back to school this year were . His reply went something like, 'i have been written off. School doesn't want me, here they don't expect me to turn up very often, and my mum has given up.'

He went on to say that even if he tried to sort things out now he won't get the chance - he is labelled. I wonder how the conversation would have gone if through effective relationship somebody had touched the imagination of this nice young man - helped him to believe in himself and found something he was brilliant at and interested in.

Only if we expect the best for young people, and let them(and all the people who are cynical and suspicious of them) know we want and expect the best for them and from them, only then we will our young dream of a world they want. And when people dream we know brilliant things happen.

Human Papilloma Virus - the case for a vaccination programme

Yesterday the Health Protection Agency announced new findings that at least 10% of young women have the human papillomavirus by the age of 16. HPV leads to increased risk of cervical cancer in women. We now have a vaccination for HPV which saves lives.

We urge government must urgently implement a vaccination programme for girls and boys before they become sexually active and ensure suffficient resource is available to do so. A key human resource is of course the school nurse, part of our workforce so badly affected by the NHS deficit and a service seriously underfunded.

Most times I speak to school nurses, they are compassionate, passionate about public health and desperate to do more, to have more opportunities to build genuine relationships with children and young people, rather than a snatched moment here and there as they rush from duty to duty, school to school. Dialogue about implementing a HPV vaccination programme will necessarily involve dialogue about how to ensure there are enough school nurses, with enough resource to do the job. And I sincerely hope the opportunity will be taken to ensure serious conversation about the wider role of the school nurse in promoting children and young people's public health as well.

Finally, a vaccination programme is not a universal panacea, it is only part of the solution. It must be backed up with proper education about sex and relationships, opportunties for children and young people to develop skills, hopes and aspirations and a change in culture so young people expect much from the relationships and sex they choose to have.

Good news story about the contraceptive pill

This positive story about the overall protection the contraceptive pill provides against cancers in women is worth reading

http://news.bbc.co.uk/1/hi/health/6987889.stm

Whenever stories about sexual health and relationships are in the media, Brook gets asked whether we work with young people who are willing to talk to them about the issues concerned. We know that are many young people who have very strong views about sex and relationships education, sexual health services and access to contraception. If you are one of those young people and you would like to talk about getting involved with Brook's work and being an ambassador for young people and sexual health please contact Juliet Hillier at julieth@brookcentres.org.uk or phone 020 7284 6052

I went to the dentist today...

...and for most people the link between this and a blog which addresses sexual health and relationships may be tenuos - less so for me perhaps because my partner is a dentist but that is not the purpose of this post.

However, when I was a child i had some pretty grim experiences with my dentist. I always hated it and when I asked him to stop or give me a minute with a squeak or a frantic wiggle of the hand he just carried on regardless. Until this year i have had to be sedated for any treatments. After much coaxing from my partner, some self determination and patience from my suitably selected dentist today i had only my second session of treatment without sedation in 15 years.

So here is the link to relationships and sexual health - firstly our experiences when we are young will often lay the pattern for relationships and create expectations for the future. It is therefore crucial that we respect young people's developing sexuality, help them expect and want to give and get a lot from their relationships, only have sex that they choose to have and ensure their early experiences of sexual health services are good.

Second, as i have learnt from my recent dental episode, it can take a lot of reassurance, a lot of encouragement and a lot of determination to do things differently or to expect something better - for those young people who have had poor early experiences which may include abuse and harm we can help them create a new map for themselves by providing that reassurance and encouragement to foster their determination. Unless we do young people expecting too little, become adults who expect too little and they in turn become the parents of our next generation, who in turn will also expect too little from their relationships.

Lessons at the Fringe

I have just spent some time at the Edinburgh Fringe Festival. We saw some fantastic stand up comedy, brilliant physical dance theatre and theatre (and of course we saw some not so fantastic). Two shows were moving - the first Stonewall, billed as one persons memory of the Stonewall riots in New York in 1969. Many of us know about the Stonewall riots and their central role in starting the gay liberation movement. Judging from the audience gasp, less of us realised that gay sexuality was finally legalised across the whole of the United States of America in 2003. And of course, it was only in 2000 that the age of consent was equalised here and let us not forget that young people who are perceived to be gay or lesbian are often teased and bullied in schools across the UK on a daily basis.

The second - a physical dance show, 'As a mother of a brown boy' was about the untimely death of a mixed race boy, killed whilst being chased by the police from a burglary scene in 2005. This superb theatre focused on the importance of identity and of feeling comfortable in our skin - an important development task for all of us, something we must help children and young people to do whatever their ethnicity, faith or beliefs, and at the heart of all good sexual health work.

If you are in Edinburgh this August, I recommend both of them.

sometimes semantics are important

I have just been asked about Brook's view on abstinence education as a form of sex and relationships education. Abstinence education is not a form of sex and relationships education. Sex and relationships education involves the acquisition of accurate information, the development of emotional and social skills, and an exploration of values. A good curriculum brings together different legal, health cultural and religious perspectives to help children develop their own beliefs and values and to respect the right of others to have different beliefs.

Abstinence education, on the otherhand, is based on a particular set of moral beliefs that emphasises the importance of 'saving' sex until marriage and often offers inaccurate information about condoms and the transmission of sexually transmitted infections.

Sex and relationships education is about empowerment, about learning to make choices and about respect for diversity and from what I know about abstinence education, there is no evidence that it fits the bill on that front either.

Good quality sex and relationships education at home, at school and in the community, coupled with high quality young people friendly sexual health services has been shown to help young people delay sex and to use contraception and condoms when they do have sex. Abstinence education does not do that.

Sometimes semantics are simply semantic. Sometimes they are important. This is one of those times when it is right to be fussy.

Talking SHARP

Brook is currently funded by the Camelot Foundation (www.camelotfoundation.org.uk)to run a project called SHARP (sexual health advocacy and research project). The project aims to train and support young people to be researchers and advocated on sexual health issues that matter to them. After a residential event a group of young people have begun exploring issues with their peers. Their first piece of research focuses on sexual health services. Yet again their findings confirm that they want any services to be close enough to get to, open when they want them to be, and friendly towards young people. These don't seem like big asks, however if young people still feel it necessary to tell us this is what they want, then clearly we haven't got there yet.

So let us imagine as sexual health service providers we get this universal access right. Young people know where we are, trust us to be nice to them and can get to us easily. As we work to get this bit right, we also need to find creative ways of motivating young people to think about contraception before they have sex. Last week one young man involved inour work told us that it was the chance to get tested for STIs and free condoms that motivating him and it struck me we often focus on finding out about those who don't access services and that we need to invest a bit more resource in finding out more about the stories of those young people who do access services and do use contraception successfully, so we can learn about the motivators and barriers, and develop our strategies and approaches accordingly.

Emergency contraception in schools - setting the record straight

Yet again there is a misleading story in the press about school based sexual health services this week. According to the story there are hundreds of eleven year olds having sex and being encouraged to do so by the provision of emergency contraception in schools.

Most young people under the age of 16 do not have sex. At 11 the numbers of children who have consensual sex, that is not abusive are tiny. Any professional told by an 11 year old they are having sex is always extremely concerned. In almost all cases it will be viewed as a child protection issue, and sensitive work with the child so they can identify what help is needed and the best way to get help will take place. Telling the parent may not always be the answer, if there is abuse or violence in the family for example.

This is true whether the health service provision is located in the community or provided on school premises. Across the country schools decide to establish health services on school grounds because young people and professionals tell them they are needed. Not just for sex advice but so young people can get help on a whole range of issues from stress, pressure and emotional well being, sorting out spots and smelly feet, getting contraception and emergency contraception, issues with family and friends etc. Providing these services is the right and moral thing for schools to do, particularly where young people cannot get to any others, for example those who live in rural areas and are bussed many miles to school each day.

And schools develop these services with the support of the absolute vast majority of parents and the community - yet we never hear their voices because of the deafening cry from the tiny numbers of parents who do not support them. We get many calls at Brook from parents who find themselves upset when they find their daughter is on the pill, or has found themselves pregnant. Typically the story takes a similar path - i wish she wasn't having sex, and if she is i wish she had been able to talk to me, and as the conversation develops parents say if felt she couldn't talk to me I am so pleased there was somewhere she could go to get help to stay safe.

That somewhere may be Brook, it may be a school based service, or it may be the local GP. The important thing is not where it is, but that it is provided by trained staff who are committed to young people's safety, who will help them think about the rights and choices they have, including the right not to have sex, and will also encourage them to talk to an adult they trust.

Up and down the country professionals are working hard to work in partnership with parents and to support young people to make real choices about relationships so they can enjoy and take responsibility for the sex they have, when they do decide to have it.

Six things i have said a lot recently and need others to say them to.

I have found myself saying the following things a lot to young people we work with, journalists, friends, my partner, family, parents, carers and professional colleagues over the last month or so - please pass them on to others by making people aware of this blog or email me and I can send them to you.

1. Most young people under the age of 16 do not have sex and if we forget this we contribute to young people's belief that everyone else is doing it
2. Teenage pregnancy rates in the UK are the lowest they have been for over twenty years and nationally the rates are continuing to go down
3. Sexually transmitted infection rates are increasing at least in part because we are encouraging more young people to get tested - eight years or so ago when we were developing the national sexual health strategy for England we did predict rates would go up before we expected to see them coming down
4. Celebrity culture is only one aspect of our culture around sex, sexuality and relationships - we must not get overly distracted by this and our challenge is to keep our eye on the big picture to promote a culture that values young people's developing sense of identity and sexuality and respects their rights
5. There is no scientific evidence to support reducing the time limit for abortion and we must maintain the upper limit at 24 weeks
6. Not all young people receive good quality Personal, Social and Health Education in schools (this is the subject in which teaching about sex and relationships takes place).

Inclusion at the heart of it

Last night Heart n Soul held their quarterly club night at the Albany Centre in Deptford. The club night is an inclusive event for people with disabilities. I was a member of a sexual health strategy group many years ago. When we were identifying groups of people vulnerable to sexual ill health the discussion became difficult. In that context, people were really talking about reducing STIs, not promoting positive sexual health, so people with disabilities were not established as a priority group.

Some of us believed then, as i do now, that promoting positive sexual health is about HIV and STI prevention. And it is about ensuring that groups of young people who have limited opportunities for social relationships, including those with physical and learning disabilities have opportunities to develop friendships and intimate relationships. Heart n Soul is a fantastic example of putting this philosophy into action, with disabled people right at the heart of it.

what a treat

A very good friend of mine who lives in New Zealand has been staying at my flat this week with my godson who is a baby/toddler of 18 months. Both are absolutely divine to have around. And i was enthralled and delighted watching him grasp new things, meet new people, new words and new ideas. What a treat to have them here. To celebrate their visit and another friend moving to Australia we had a BBQ last night. The rain held off. Some friends who i see regularly and those i haven't seen for a while came. We had a great evening that went on too late, but felt too short, and as people left we all pronounced how silly it is not to see each other often and we promised we would not leave it so long this time.

And this morning as I clear up the mess I really hope that it is true. Having done lots of sex education with young people about friendship and on occassion the activities i have used have felt a bit trite, and today i wonder if we really do enough to help young people develop a range of friendships and provide opportunities and learning which enable them to experience the fun, the support and the joy that i do from mine.

A bit of a do

Last night at a brilliant event held by MAC Cosmetics in Bloomsbury Ballrooms , Holborn, Mica Paris, the soul singer and presenter of What Not to Wear accepted a cheque on behalf of Brook. Dita Von Tees presented the cheque as a promoter of Viva Glam VI, the new lipstick, all the proceeds of which go to MAC AIDS Fund which supports children and their families affected by HIV (www.macaidsfund.org).

The money will fund pilot work at Brook services in Manchester and London to reduce stigma and homophobia in relation to HIV, and to provide testing to those young people who are at particular risk of HIV. Find out more at www.brook.org.uk. Dita Von Tees, did a stunning burlesque performance which reminded me of my new years resolution to exercise and remain supple.

Alcohol and sexual cultures

My week didn't start too well. About two hours ago my leg got trapped in the tube door. My lovely clean trousers have a big black mark on them and I am now going to be speaking at the NAZ (find out more about NAZ at www.naz.org.uk) conference taboos and mixed messages : sexual health promotion among black and minority ethnic youth this afternoon feeling grubby. This coupled with my guilt at forgetting to send Dad a card for fathers day is not, i hope, an indicator of how Monday is going to pan out.

Last week I was pleased to see the attention on the links between sex, alcohol and other drugs in the newspapers. A few years ago whilst at the National Children's Bureau I worked on a youth participation project on the issue (www.ncb.org.uk). Young people told us time and again that we need to do more to help them understand the links, and develop skills in identifying, assessing and managing risk. They also reminded us that whilst we have a smutty culture around sex and young people feel embarrassed or ashamed to talk about it with a partner they are much more likely to use alcohol and other drugs as part of their sexual experience.

Recent research by Brook in Blackburn found that 67% of young people said they were more likely to have unprotected sex when they were drunk. The facts are clear, we need to overcome our cultural reticence about sex as part of our commitment to helping them build healthy relationships and look after their sexual and emotional health.

Abortion Matters

Thankfully a Bill which would effectively put more barriers in the way of women accessing abortion was defeated in parliament this week.

Ask Brook our helpine gets a significant number of calls from young people about abortion. Many call when they have been to their GP and experienced barriers when they have tried to to arrange an abortion. They have either been refused a referral; have been actively encouraged not to have an abortion; feel as though they have had wrong information; or that delaying tactics are being used so their choices are limited.

When they ask for help young women deserve high standards of care. Anything that gets in the way of this is simply unacceptable.

Tell me what you think!

Over the last week several people have said 'i've been reading your blog and enjoying it' or 'I've been reading your blog and i thought the point you made was interesting but.....'. I am really interested in hearing your views about what I am saying so we can hear and learn from each other. So next time you read something and think, 'that is interesting but' or 'no way i don't agree with that' write a comment so we can all learn from each other and elevate the debate. You do have to have a google account, and it only takes 1 minute to set it up.

The case for vaccinating girls against HPV

A new study published in the Lancet today has strengthened the already convincing evidence that vaccinating girls and young women against the human papilloma virus that causes cervical cancer is important. The combined results of four trials across the world show the vaccine is 99% effective for girls who have never had sex.

So, we have a vaccine that saves lives. This vaccine is a major scientific breakthrough and it is much more effective if we vaccinate young women before they become sexually active. No arguments then - ensuring universal access to the vaccination is scientifically and morally the right thing to do. My guess is most people would agree. Despite this there is a minority voice that argues vaccinating children is likely to encourage earlier sexual activity. This assertion is no more rooted in fact or evidence than the well refuted claim that sex and relationships education does the same.

Like sex and relationships education however, the vaccination is not a universal panacea. It must be administered in a macro and micro cultural context where emotional literacy and competence is developed, sex and relationships are talked about honestly; where young people learn that trust within relationships is important and they have rights to make choices about the sex they do or don’t choose to have.

First class service all round

I was recently in Manchester for a Black Health Agency Board meeting. I took the opportunity to visit our services in Manchester. The speed of Virgin trains leaves me feeling decidedly sick for the first half an hour after arriving so to right myself, I walked in the rain to the Centre which is 15 minutes from the station. When I arrived, I couldn’t help but wonder if this is what Chief Executives are supposed to look like. Vanity fears aside, I met some staff who I have not met before, and others who I recognise, but still struggle desperately to remember the names of. Their determination to make the centre a welcoming and comfortable place for young people and to keep on getting better and better at what they do is simply remarkable. (And the new building is lovely too!)

I also visited Stockton to meet some of the team who have just established our new services there. They are already starting to fly – they are getting out and about in the schools and youth settings as part of their outreach. 17 young people attended one of the clinic sessions in the last couple of weeks, and whilst some of the other sessions are slower to start, I am sure it won’t take long before those who are visiting the service tell others, who tell others, who…

Then when I got on the train and looked at my seat reservation, I realised I was in first class – two single tickets, including one first class ticket had been cheaper than a return… Probably a very good job I won’t be getting used to it - the size of the seats make it harder to use a laptop comfortably anyway.

Making time to listen

One of the high points of last week: the manager of Ask Brook is taking the lead for young people’s participation at Brook’s central office. She is tasked with ensuring young people are at the beginning, middle and end of everything we do. Next week a young woman who is part of the Education 2 Employment scheme will begin six weeks’ work experience with us. At our team meeting we reminded each other of the opportunities and challenges this affords us. In essence the message was ‘this means we will have to change the way all of us work. We will all need to make time and prepared to listen and help and receive feedback about the way we do things’. The feeling amongst the team is excited trepidation and a desire to make it a good experience. What a privilege to lead a team that are really willing to change the way they work ensure we meet the needs of those we are here to support. We intend to have young people from our local communities on work experience with us all the time. Watch this space - there will be many lessons for sure.

Let's talk condoms

It’s National Condom Week 2007. We know that to bring about the dramatic decline we need to see in rates of sexually transmitted infections (STIs) we must encourage much greater use of condoms, alongside other forms of contraception that protect against pregnancy.

In 20 years we have seen dramatic changes in public attitudes towards condoms, but there is a long way to go.

This week see how many times you can talk about condoms, see if you can slip them into conversations wherever you are and whoever you’re with. Have one hour each day when whatever you are asked you reply condoms, play word association games starting with condoms, have serious conversations with your children and friends about condoms & safer sex. Just get everyone talking about them. Be a condom champion.

Emergency contraception - myths and misinformation

About a decade ago I went with a friend to a health centre for emergency contraception. Let’s call my friend Susie. Susie went bright red as she was asked loudly at reception why she was there – “the morning after pill” she tried to whisper and was asked to repeat louder. She was so red and hot, I thought she may explode. We were told to sit down and wait. I tried reassuring Susie who felt embarrassed and ashamed, “accidents happen, no, you are not a slag. No, no-one heard you”. Imagine her horror when the receptionist bellows “where’s the one who needs the morning after pill?” And then, dropping her voice to normal levels to say, “room one”.

Fast forward ten years – A woman like you, a woman like me - a report published yesterday by Schering Health Care Limited, is an interesting read. It is a tale of myths, misinformation and embarrassment about emergency contraception. Emergency contraception is most often used by women aged 25-29 who are in a long term relationship, and yet the report reveals the incorrect perception that it is most likely to be used by teenagers, students and single women. It also shows that many women still lack basic knowledge about where to get emergency contraception, how it will affect them and how it works.

I wish I had been surprised by the findings. So what can we do so things change in the next ten years?

- Stop talking about the morning after pill and start talking about emergency contraception
- Accept mistakes happen and that taking emergency contraception is much more responsible and gives greater peace of mind than crossing your fingers
- If or when you use it, tell someone – don’t keep it a guilty secret
- Think about your workplace, school or college – what can be done to promote the truth about emergency contraception….which is that it is responsible, safe and easy to use it and that it is used daily by women just like YOU.

With these changes the next time someone like Susie needs emergency contraception there should be no stigma; no shame or embarrassment, just a recognition that she is taking responsibility for her sexual health.

Brook meets the young farmers

Last weekend Brook had a stand at the National Federation of Young Farmers Clubs annual convention in Torquay. Five people from across the Brook Network gave out condoms and talked with delegates about sex, sexually transmitted infections and sexual health on two of the three big ‘disco’ nights. We also ran a quiz about sexual health which included the question “what is the most important thing for you to know about sexual health?” Among the responses: “be careful it can kill you”; “it’s good fun”; “always use a condom”; and “practice often but be safe”.

Both Brook and Young Farmers staff observed how much more confident people were coming to our stand on the second night to ask for condoms or advice. We know that changing cultures and attitudes towards condoms requires community interventions. We need to promote dialogue with young people and make the issue visible.

We enjoyed ourselves thoroughly and are now busy identifying other opportunities like this through which we can help make condoms a mandatory requirement for young people on a big night out.

Valuing health

I recently went into the West End for some new clothes and apart from the crowds (I am from Cornwall) I loved the big stores. I started thinking about advertising and what attracts us to buy things or catches our attention. Young people, like adults, are bombarded with sophisticated advertising, and when they go shopping, it is a real experience. Stores are exciting, slick and cool and researchers have spent thousands and thousands working out what will appeal to their audience. I was left wondering how do adolescent health services fare in comparison and if they don’t fare well what message does that give to our young people – that their health is not as valuable as fashion or music? And if that is the case, what do we have to do better to make health an important asset for young people that they value and ‘invest’ in?

Brilliant relationships education

The other day I was just walking home from the bus. A few feet in front of me two women were holding hands, and between the two women and I, a man was walking with two children aged probably about 4 and 6. The older one asked, ‘daddy why are they holding hands?’ and he simply said, ‘probably because they love each other and so it is nice to hold hands’. And then they carried on talking about what they had done at their friend’s house. Brilliant, brilliant relationships education. I am not a fan of listening in to other people’s conversations but I am glad I couldn’t help but overhear this one – it set my day off to a flying start.

Why the words 'sex' and 'secret' don't go together

Last week I was given some publicity about a condom scheme for young people. Generally it was brilliant. But there was a sentence that worried me. It described their policy on confidentiality as being about keeping a secret. I fully understand the message it was trying to convey to young people and yet to me the words ‘secret’ and ‘sex’ should not go together. Too many people with huge courage and dignity who I know personally and professionally have told me that as a child they never told anyone about the sexual abuse they experienced because they were told it was a secret between them and the adult who hurt them.

About a decade ago, Brook published a poster with the simple and powerful statement, here to listen, not to tell. It was produced because young people told us they worried their parents or carers would be told if they asked for contraception or sexual health advice. Ten years on, confidentiality continues to be one of the top concerns of the young people who come to us. Brook is the leading advocate for confidential services for young people and I believe absolutely and passionately in young people’s right to confidential services. But still I am unsettled by the word ‘secret’.

If sex is not talked about openly and sensibly children learn to be embarrassed and ashamed by it. Nowadays many live in two worlds – one where sex is everywhere, with sexually explicit images easily available via new technologies; and another where sex evokes virtual silence. With silence there is inevitably shame, embarrassment, guilt and secrecy.

So when I read publicity for services that says ‘we keep everything secret’ I worry about the message this gives young people about sex. Yes, we must recognise where we are now and the importance of confidentiality. But to really change the world, we must also open up the conversation and help create an environment in which young people can talk about sex so they can enjoy it, take responsibility for it, and get the help they need from parents and professionals. I look forward to the day when young people are as confident about going for sexual health and relationships advice and counselling, as they are about going for a haircut or to the dentist.

A bit of respect!

I was leaving a Brook Centre yesterday just as it was opening. About 12 young people had settled in the waiting room within the first few minutes. As always I listened and watched for the intimidating young people that the papers write about – I couldn’t see them. I looked for the noisy and uncontrollable youth that people talk about on the bus – I couldn’t see them, and I looked for the sexually irresponsible young men that dads warn their daughters about – there were none to be seen.

The young women and young men sitting in this waiting room were waiting patiently for their turn, talking to each other and supporting one another. They were excited, nervous, worried, brave, responsible and respectful. Are they unusual? Not in my experience. As I left the Centre I said to the receptionist that I would love to bring those adults who fear or condemn young people to observe this waiting room. Her response: ‘as long as you are good to young people, they are good to you. The trouble is, if you bring someone who doesn’t like young people into the room, they smell it and the mood changes, so it wouldn’t really work’.

Many of our European neighbours have very different attitudes to young people. They want young people to be happy, to be safe and responsible in their intimate relationships. We rightfully continue to look for evidence of the effectiveness of our work but how do you measure the impact of care, respect and attention on young people’s sexual health? A randomised control trial won’t do it – but if you want to visit a Brook waiting room you will see that it works. As Dona Milne said in her reply to an earlier blog yes we need to involve young people and listen to their views, but they don’t really ask for much, a bit of respect, a friendly service and people who like them. I agree with her and in my experience when you really enjoy young people’s company you keep on learning, you keep on living and you keep on laughing. A win-win situation.

The risk of ruling out risk

As always March is proving a busy month for conferences. Recently I’ve spoken at two: one in North Yorkshire with a focus on personal development and well being, and the British Association for Teachers of the Deaf (BATOD) conference which focused on the need for positive and proactive support through all different transitions including puberty, adolescence, bereavement, divorce and separation.

A couple of themes came through at both - first, to be effective in all of this work we must remember what it feels like to be young - the excitement, the anticipation, curiousity and the fear.

Secondly - the lack of confidence some people have in pushing the boundaries and providing exciting opportunities for young people. In a risk adverse society, the perceived threat of litigation when things go wrong prevents them from 'taking risks' and trying new activities and new approaches. One delegate described a trust building activities where young people are responsible for catching one of their peers as potentially risky. What if they don’t catch the person, they fall and hurt themselves? School trips similarly off the timetable - too risky.

Engage with a group of people who feel this fear for an hour and you start to see the logic. But these activities are important because they help us learn about ourselves, the world around us and our interactions with others. They help us learn that trying new things is exciting, challenging, inspiring and affirming. And they help us to learn how to manage risk so that we can take responsibility for ourselves in potentially risky situations.

Understanding risk is a vital part of every young person’s development and learning to manage it will help them take informed decisions in many areas of their lives, including their sexual health, as they grow older.

If children and young people are constantly sheltered from the possibility of things going wrong are we really preparing them for their lives now and in the future?

Young people, pregnancy, punk and participation

Yesterday Brook launched its new evening and weekend sexual health services for young people in Stockton on Tees - a really exciting initiative funded by Stockton’s Teenage Pregnancy Partnership and the Stockton Renaissance and Neighbourhood Renewal Fund.

The launch was led by young people aged between 15 and 17 who had made a film about sex and sexual health for the event. They had also come up with ideas for a range of activities and entertainment, and got their friends involved (including an up and coming young punk band who covered songs by the Buzzcocks and the Clash). The energy and enthusiasm they all brought to the event was infectious and invaluable.

I listened to two of the young people talking to each other: 'just been talking to her [nodded head towards a woman on other side of the room] for ages. She was really interested in what I had to say about sexual health.' She beamed as she spoke - clearly pleased that someone had listened.

The same two young women were also part of a group interviewed by their local radio station, and did a great job of explaining succinctly to the reporter why young people in Stockton needed these new services. ‘We don’t want to go somewhere where you might bump into your mum or your friend’s mum’, explained one, ‘we need somewhere just for young people’. ‘Teenage pregnancy is really common round here’, explained her male friend, and another proudly told the reporter she had just done a chlamydia test, explaining why it was important that other young people did the same.

Later I spoke to them and asked if they had enjoyed the afternoon. They had - the best thing, they told me, was giving their views and being listened to by adults, and they were really pleased they might make a difference for other young people. So easy to do, so important and yet still so many young people are not involved in decision making and service development.

Do we really think we can get services and education right without seeking the ideas and help of those young people we are trying to support?

Contraceptive awareness week

This week is Contraceptive Awareness Week: an important opportunity to reflect on what more needs to be done to help people of all ages take control of their contraceptive choices, as well as welcoming the progress that has been made over the past 40 years or so.

We are still taking two steps forward and one step back. Currently we are seeing the constant threat to community contraceptive services as a result of the NHS funding crisis. This is an issue for us all. We must not let it happen without protest. It is short sighted and irresponsible, with undoubted personal, social and economic costs over time.

In this changing policy context, one fact remains true – far too many young people are growing up without the education, support and services to help them enjoy and take responsibility for their sexual choices and well being. In Contraceptive Awareness Week 2007, why not identify at least one thing you can do personally or professionally to promote an open and positive culture about sex, sexuality, contraception and sexual health? Tell us here what you think should be done. Share your ideas and inspire others.

At Brook we will continue supporting young people and providing a platform through which they can express their views and ideas and share their experiences. Watch this space.

'Love in the time of phone porn' - a response

An article in Tuesday’s Guardian (Love in the time of phone porn, 29 January 2007 http://education.guardian.co.uk/egweekly/story/0,,2001171,00.html) again highlighted the worrying levels of sexual imagery that young people are exposed to via television, magazines and a range of new media including bluetoothing on mobile phones. The article rightly underlined the importance, in this environment, of sex and relationships education (SRE) in schools that counters the potentially damaging messages about sex and relationships that young people are likely to have received through the media.

Improving Personal, Social and Health Education (PSHE), the curriculum subject in which teaching about sex and relationships takes place is certainly important. Brook believes it is an entitlement for all children and young people and should be made part of the national curriculum. Unfortunately, however, PSHE is not the universal panacea. For decades young people have been telling us they need more reliable, consistent, open discussion about sex, gender, relationships, body image and so on. More recently young men in particular have been telling us the education they receive at home, at school and in the community was not helping them learn how to be good at relationships and to understand sex. They tell us they turned to pornography for this vital information, and as technological change races on the dissemination of porn via the internet and bluetooth has become ever easier to access. But porn in turn is confusing and reinforces stereotypes, fears and concerns.

The Guardian article talks a lot about the role of schools, but much less about the responsibilities of us all as parents, uncles, aunts, brothers, sisters and family friends. No one person or organisation can bring about the cultural change we need so that when young people decide to have relationships and sex they are emotionally ready, can communicate well, respect themselves and their partners and take responsibility for and enjoy sex. Many things have changed since Brook first opened its doors in 1964 to provide contraception for unmarried people, not least the explosion in the number of ways in which people receive information about sex. However, the need for reliable, objective information and advice and our shared responsibility to provide it remains as great as ever.