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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 30; 334(7608): 1376.
PMCID: PMC1906635
From the Frontline

Talk the talk

Des Spence, general practitioner, Glasgow

“We had ‘the talk'.” I blushed. My 10 year old daughter had just had her first sex education class. My sex education involved somebody's big brother graphically describing sexual intercourse to hunched groups of ashen faced and goggled eyed 12 year olds in the first few weeks of secondary school. Our formal “sex education” involved a grainy black and white video of a woman giving birth, while we were supervised by a terrified science teacher caught in the headlights of adolescent questioning. I couldn't speak to my parents for three weeks. We are a modest nation.

On our holiday campsites this summer less modest Europeans will be wandering naked in the shower block, standing too close to us, and openly discussing their sex lives. We Brits on the other hand will be tightly wrapped in towels, will double lock the cubicle doors, and will edge away as these naked European invaders intrude on our wide interpersonal exclusion zone. The United Kingdom is comfortable with this splendid naked isolationism and the silly sexual innuendo that goes with it. So should I discuss the “birds and the bees” with my children?

The government is trying to reduce teenage pregnancies, but despite its best efforts there has been only a 10% fall in underage pregnancy rates since 1999. Our rates remain three times higher than in the Netherlands. Teenage pregnancy is concentrated in the inner cities and so perhaps is under the middle class radar. But it has consequences for society as a whole, as it is strongly associated with poverty, low educational achievement, and the cycle of social exclusion—the scourges of our Anglo-American economic system.

Different countries have tackled teenage pregnancy in different ways. The Americans flirt with celibacy programmes, such as the Silver Ring Thing (see BMJ 2004;328:292 but this frankly this seems pointless and a type of mass hysterical denial. Our own initiatives focus on improving sex education and providing local specialist youth health services. This may have limited impact but at least it is pragmatic. One criticism of our policy is that we could do much more to engage with young men, but this would require challenging the comfortable stereotype of male sexuality.

It is those naked Europeans who have been the most successful in limiting teenage pregnancies. They seem to have a maturity and openness about sex that we lack. So we need to spare our parental blushes, for much of the UK solution involves taking responsibility for educating our own children about sex. The key is presenting sex in the context of relationships, rather than as some unreal and irrelevant media-spun image. I fear that if we don't, Big Brother-style television will sell our naive children a yet more distorting and dangerous picture.

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