如何开展性教育？—— 全面解读《国际性教育技术指导纲要》
如何开展性教育？——
全面解读《国际性教育技术指导纲要》
“如何开展性教育”经常成为人们讨论的热门话题，很多人认为，性教育就是“教孩子如何发生性行为”，但事实远非如此。性教育涵盖了一系列的核心概念，包括关系、价值观和权利以及文化、社会性别、暴力与安全保障、健康与福祉技能、人体与发育、性与性行为，以及性与生殖健康等，并且，针对不同年龄段的人，性教育的内容也有所不同。
为了进一步阐述什么是全面性教育以及如何有效开展全面性教育，今年一月，联合国教科文组织等多家联合国机构联合出版了《国际性教育技术指导纲要》修订版（以下简称《纲要》），并于今年七月发布了中文版。
那么，《纲要》是干什么用的？
《纲要》基于证据，总结了有效的全面性教育所具有的特征，推荐了适合5-18岁人群的全面性教育课程所需要包含的主题和学习目标，并且概述了有效规划、实施、监测全面性教育的策略和方法。
编写《纲要》是为了协助教育、卫生和其他相关权威部门进行全面性教育课程和教学材料的开发及有效实施。《纲要》主要面向课程开发人员、校长和教师，对参与校内外性教育项目的设计、实施和评估的人员也同样有帮助。另外，社会服务组织、以青年为对象的社会工作者和年轻人也可以利用《纲要》开展性教育的宣传倡导。
什么是全面性教育？
《纲要》旗帜鲜明地提出了全面性教育的概念，即：全面性教育是一个基于课程，探讨性的认知、情感、身体和社会层面的意义的教学过程。其目的是使儿童和年轻人具备一定的知识、技能、态度和价值观，从而确保其健康、福祉和尊严。全面性教育培养相互尊重的社会关系和性关系，帮助儿童和年轻人学会考虑他们的选择如何影响自己和他人的幸福，并终其一生懂得维护自身权益。
全面性教育不仅仅是关于生殖、风险和疾病预防的教育，而且同时展现性的积极意义，例如相互尊重、平等的爱与人际关系。全面性教育提供关于性与生殖健康的全方位信息，主张采用以学习者为中心的教学方法。学校是开展全面性教育的关键场所，同时非正规教育和社区教育也是开展全面性教育课程的重要机会。
为什么年轻人需要全面性教育？
《纲要》的第三章专门对此进行了论述。首先，全面性教育有助于保障儿童和年轻人的性与生殖健康，解决一些普遍被认识到的影响年轻人的关键的性与生殖健康问题，包括卫生、青春期发育、怀孕与避孕、人工流产、暴力（包括基于社会性别的暴力）、艾滋病病毒和艾滋病及其它性传播感染。
《纲要》同时强调了通过全面性教育可以解决影响儿童和年轻人健康与福祉的其它关键问题，包括信息与通信技术对性行为的影响（如色情短信、网络色情、网络欺凌），心理和情感健康问题，以及饮酒、吸烟和吸毒等问题对儿童和年轻人的影响。
《纲要》还特别指出了特殊的年轻人群体在性与生殖健康方面的特殊需求，例如感染了HIV的年轻人、生活贫困的年轻人、有身心障碍的年轻人、同性恋和双性恋以及跨性别和间性年轻人。
我们怎么知道全面性教育能产生积极效果？
《纲要》特别强调性教育中的循证原则。在《纲要》的开发及修订过程中，联合国教科文组织开展了两次全球证据回顾，第一次是2008年，共回顾全球各地的87项相关研究；第二次是2016年，共回顾全球各地77项随机控制试验研究以及22项严格的系统评估，其中大部分研究来自于发展中国家。这两次全球证据回顾的主要发现包括：
校内或校外开展的性教育不会增加性活动、风险性行为或性传播感染/艾滋病毒感染率
性教育在提高青少年的性与生殖健康知识水平，改善态度和行为方面有积极的影响
禁欲教育项目在推迟首次性交行为、减少性交行为频率或减少性伴侣数量等方面是无效的
使用明确的、以权利为本的方式开展全面性教育，能够增加性关系中关于个人权利的知识，促进年轻人与父母之间关于性和人际关系的交流，增加处理风险情形的自我效能感等。
关注了社会性别的性教育，相比于没有关注社会性别的性教育，在实现健康结果，例如降低非意愿怀孕和性传播感染等方面更为有效
按计划充分实施的性教育，与不忠实于原始设计和实施方式的性教育相比，更有可能对青年人的健康产生预期的积极影响
已经被证明有效的性教育计划在不同的环境下复制实施，同样会对知识、态度和行为产生积极影响
社会性别及其规范、暴力经历以及获取相关服务的障碍会严重阻碍年轻人采取更安全的性行为
当学校课程与青年友好型医疗健康服务相结合，并且有家长和老师的积极参与时，性教育的影响才能发挥到最大
全面性教育的内容框架是怎样的？
《纲要》的第5章提供了全面性教育的核心概念、主题和具体学习目标，以指导各国开发适合本国国情的性教育课程。全面性教育包括8个同等重要并相辅相成的核心概念（1. 关系； 2. 价值观、权利、文化与性； 3. 理解社会性别； 4. 暴力与安全保障； 5. 健康与福祉技能； 6. 人体与发育； 7. 性与性行为； 8. 性与生殖健康）。每个核心概念下都有2到5个不等的主题，每个主题下又界定了具体的学习要点和说明性学习目标，这些学习目标按照知识、态度和技能进行分类。学习目标按照四个不同的年龄段进行设定，即5-8岁，9-12岁，12-15岁，15-18岁及以上，内容随着年龄的递增而愈加复杂，呈螺旋式上升。
如何回应关于性教育的常见误解和担忧？
关于性教育的误解、质疑或者担忧依然广泛存在。《纲要》的第6章是关于如何为性教育争取支持并进行规划，其中专门针对一些常见的担忧与误解，基于证据、原则和常识对这些担忧和误解进行了回应：
谁将从中受益？
全面性教育的利益相关方包括：教育、卫生和社会性别平等部门，以及校长、教师和教育专业人士及其组织、研究者、社区领导人、为年轻人性与生殖健康服务的组织、为性少数人群服务的组织、艾滋病病毒感染者、媒体以及资助方等。所有这些利益相关方都应表达自己的想法，并充分参与国家、学校、社区层面的性教育规划与实施，其中也包括发挥学生和家长的作用。
有效开展全面性教育
《纲要》的第7章，总结了全面性教育有效实施的策略，其中包括4个方面：
第一，关于如何开发有效的全面性教育课程，提供了14条建议；
第二，关于设计和实施全面性教育计划，提供了10条建议；
第三，关于如何开展全面性教育的监测与评估，提供了3条建议；
第四，关于如何扩展现有的全面性教育计划，提供了10条建议。
欲下载《纲要》全文，请复制以下链接至浏览器打开：
中文版：http://unesdoc.unesco.org/images/0026/002607/260770c.pdf
英文版：http://unesdoc.unesco.org/images/0026/002607/260770e.pdf
相关阅读：
How to implement sexuality education?
—A comprehensive interpretation of the
International Technical Guideline on
Sexuality Education
“How to implement sexuality education” often becomes a hot topic. Many people think that sexuality education is about “teaching kids how to have sex”. Nothing is farther from the truth! In fact, sexuality education covers a range of key concepts including relationship, values, rights and culture, gender, violence and staying safe, skills for health and wellbeing, human body and development, sexuality and sexual behavior, and sexual and reproductive health, with specific topics and age-appropriate learning objectives.
To further elaborate on the concept of comprehensive sexuality education (CSE) and explain how to effectively conduct CSE, in January 2018, UNESCO and multiple United Nations agencies jointly published the revised International Technical Guideline on Sexuality Education (the Guidance), and issued a Chinese translation in July 2018.
So, what is the purpose of the Guidance?
Based on evidence, the Guidance summarizes the characteristics of effective Comprehensive Sexuality Education (CSE), recommends the topics and learning objectives of a CSE curriculum appropriate for learners aged 5-18, and outlines the strategies and methods to effectively plan, implement, and monitor CSE programmes.
The Guidance was developed to assist education, health and other relevant authorities in the development and implementation of the comprehensive sexuality education programmes. It is immediately relevant for curriculum developers, school principals and teachers. It is helpful for the development, implementation and evaluation of school-based and out-of-school CSE programmes. Civil societies, youth workers and young people can also use the Guidance to advocate for more support to sexuality education.
What is CSE?
The Guidance provides a clear definition of CSE: a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: improve their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives.
CSE goes beyond education about reproduction, risks and disease. It provides an opportunity to present sexuality in a way that also includes its positive aspects, such as love and relationships based on mutual respect and equality. It uses a learner-centered approach to deliver information on all approaches for healthy sexuality. While schools play a central role in the provision of CSE, non-formal and community-based settings are also important opportunities to provide curriculum-based CSE.
Why do young people need CSE?
The third chapter of the Guidance specifically discusses this topic. First, CSE helps to ensure children’s and young people’s sexual and reproductive health (SRH); as well as addresses key SRH issues that are widely recognized to affect young people, including hygiene, puberty, pregnancy, modern contraception, unsafe abortion, violence (including gender-based violence), and sexually transmitted infections (STI) including HIV and AIDS.
The Guidance also highlights other key issues affecting children’s and young people’s health and wellbeing that can be addressed through CSE, such as how to address the influence of information and communication technologies on sexual behavior (for instance, “sexting”, exposure to pornography and pedophilia, abuse, and cyberbullying), poor mental / emotional health, and negative impacts from alcohol, tobacco and drugs.
In addition, the Guidance points out the specific SRH needs and other issues affecting subgroups of children and young people, for example, young people living with HIV, young people living in poverty, young people with disabilities, and lesbian, gay, bisexual, transgender and intersex young people (LGBTI).
How do we know CSE produces positive results?
The Guidance emphasizes the principle of an evidence-informed approach to CSE. During the development and revision of the Guidance, UNESCO conducted two global evidence reviews in 2008 and 2016. The 2008 evidence review was based on results from 87 studies conducted around the world. The 2016 evidence review was based on results from 22 rigorous systematic reviews and 77 randomized controlled trials in a broad range of countries and contexts, in which more than half were situated in developing countries.
The key findings are:
• Sexuality education – in or out of schools – does not increase sexual activity, sexual risk-taking behavior or STI/HIV infection rates.
• Sexuality education has positive effects, including increasing young people’s knowledge and improving their attitudes related to SRH and behaviors.
• Programmes that promote abstinence-only have been found to be ineffective in delaying sexual initiation, reducing the frequency of sex or reducing the number of sexual partners.
• Using an explicit rights-based approach in CSE programmes leads to positive effects on knowledge of one’s rights within a sexual relationship; increased communication with parents about sex and relationships; and greater self-efficacy to manage risky situations.
• Gender-focused programmes are substantially more effective than “gender-blind” programmes at achieving health outcomes such as reducing rates of unintended pregnancy or STIs.
• Programmes with implementation fidelity are much more likely to have the desired positive impact on young people’s health outcomes than programmes that do not remain faithful to the original design, content or delivery approaches.
• Effective educational interventions transported from one setting to another have a positive impact on knowledge, attitudes or behaviors, even when they are implemented in a different setting.
• Social and gender norms, experience of violence as well as barriers in access to services, are factors that can hinder many young people from adopting safer sexual behaviors.
• Sexuality education is most impactful when school-based programmes are complemented with youth-friendly medical health service and active participation of parents and teachers.
Content framework of CSE
Chapter 5 provides key concepts, topics and learning objectives, to guide different countries to develop locally-adapted CSE curricula. CSE covers 8 equally important and mutually reinforcing concepts (1. Relationship; 2. Values, rights, culture and sexuality; 3. Understanding gender; 4. Violence and staying safe; 5. Skills for health and well-being; 6. The human body and development; 7. Sexuality and sexual behavior; 8. Sexual and reproductive health). Each key concept covers 2 to 5 topics, each defining specific learning points and illustrative learning objectives that are categorized by knowledge, attitudinal, and skills-building. Learning Objectives are identified separately for four age groups: 5-8 years, 9-12 years, 12-15 years and 15-18+, with only content appropriate for each age group being presented to them.
How to respond to common concerns and misconceptions about CSE?
There still exist common misconceptions and concerns about CSE. Chapter 6 of the Guidance discusses how to build support and plan for the implementation of CSE programmes. Based on evidence, principles and common sense, it responds to common misconceptions and concerns that are frequently raised：
Concern: CSE leads to early sexual initiation
Response: CSE does not lead to early initiation or more sex, it leads to delayed initiation increased responsible sexual behavior.
Concern: CSE deprives children of their 'innocence'
Response: Evidence shows that children benefit from scientifically accurate, non-judgmental and age- and developmentally-appropriate information through formal schooling.
Concern: CSE goes against our culture or religion
Response: CSE programmes should build support among the custodians of culture in order to adapt content to the local cultural context, while also addressing negative social norms and harmful practices that are not in line with human rights.
Concern: Parents will object to sexuality education being taught in schools
Response: CSE programmes are meant to work in partnership with, involve and support parents. Most parents are among the strongest supporters of CSE.
Concern: Teaching CSE is too difficult for teachers
Response: Teachers constantly have to face students’ questions regarding sexuality and relationships and need to respond appropriately. Most teachers already have certain skills and they can also be trained in CSE as included in national curricula.
Concern: CSE is already covered in other subjects (biology, life-skills or civics education)
Response: Effective CSE covers a comprehensive set of topics, attitudinal and skills-based learning outcomes which may not necessarily be included in other subjects.
Concern: Young people already know everything about sex and sexuality through the Internet and social media
Response: Online media doesn’t necessarily provide age-appropriate, evidence-based facts. CSE also offers young people a healthy space for discussion.
Concern: CSE is a means of recruiting young people towards alternative lifestyles
Response: CSE does not endorse or campaign for any particular lifestyle other than promoting health and well-being for all, without making judgement on sexual behavior, sexual orientation, gender identity or health status.
Who can benefit from the Guidance?
CSE stakeholders include ministries of education, health, and gender equality; principals, teachers and education professionals and their organizations; researchers; community leaders; organizations serving the SRH for young people; LGBTI organizations; people living with HIV ; media; and sponsors. All of these stakeholders, including students and parents, should be able to express their ideas and be fully involved in the planning, implementation of the sexuality education at the national, school and community levels.
Delivering effective CSE programmes
Chapter 7 outlines the strategy to deliver the CSE programmes effectively:
First, how to develop the CSE curriculum effectively. 14 advices provided.
Second, how to design and implement the CSE plan. 10 advices provided.
Third, how to monitor and evaluate the CSE programmes. 3 advices provided;
Fourth, how to scale up the exist CSE programmes. 10 advices provided.
To know more about the details, please click here to download the Guidance:
http://unesdoc.unesco.org/images/0026/002607/260770e.pdf
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