Sex Ed? Not in Hong Kong.

Sex Ed? Not in Hong Kong.

Since their official introduction in 1994, the concepts of sexual and reproductive health have evolved into a holistic framework that addresses matters of sexuality and reproduction. The definitions of this framework extend beyond simply ensuring the ‘absence of disease, dysfunction or infirmity’ by highlighting the importance of positive, dignified, and safe sexual experiences (1,2). It recognizes that sexual and reproductive rights are integral to our overall well-being, encompassing mental, social, psychological, and emotional dimensions. Such an inclusive perspective affirms that well-being is not merely the absence of problems but the presence of supportive environments that empower individuals to make informed decisions about their bodies and relationships. These concepts are public health concerns and human rights issues relevant to the contemporary discourse of the 21st century. 

Nevertheless, in a world where sexual and reproductive health have emerged as high-profile topics of interest in many countries, Hong Kong has largely remained unengaged (3). The absence of discussion, however, should not be misconstrued as a sign of progress. Despite being a developed city and society, Hong Kong still falls short in terms of comprehensive sexual education, even as access to reproductive healthcare has improved.

The integration of sex education into Hong Kong’s formal curriculum, as reported by Andre et al., is virtually non-existent (4). Instead, sex education has consistently been relegated to special assemblies or designated days. A 2022 report from the Equal Opportunities Commission of Hong Kong deemed sex education inadequate, with 1 in 7 schools failing to teach it. Of the schools that did, instruction centered on anatomy and neglected an inclusive overview of the additional psychological, social, and emotional aspects mandated by the United Nations Educational, Scientific and Cultural Organization (UNESCO) guidelines (5,6). The rapid accessibility of sexual content through the internet and social media exacerbates the issue, as it immerses young people in a highly sexualized culture that makes it nearly impossible to avoid exposure to explicit material utterly inevitable. RIn fact, research indicateshas indicated that the average age of first exposure to pornography is as low as 12 years;  this early exposure could lead to significant consequences, including the development of distorted and unrealistic perceptions of sexuality in impressionable young minds (7). 

In conservative environments like Hong Kong, where discussions surrounding sexual and reproductive health are considered taboo, the repercussions of insufficient sex education are becoming glaringly apparent. A 2016 study revealed that the rates of Chlamydia trachomatis infections in sexually active young adults in Hong Kong surpass those in the US, UK, and China (4). Additionally, the Family Planning Association’s Report on Youth Sexuality Study found that young people’s sexual knowledge in Hong Kong is ‘undesirably low,’ with many students unable to answer basic questions about conception and sexually transmitted infections (STIs) (8). Moreover, researchers have noted a troubling decline in sexual health knowledge among Hong Kong’s youth (4). The need for comprehensive sex education has never been more urgent. Providing extensive and holistic sexual education to adolescents is not merely beneficial; it is an ethical imperative that respects their rights, promotes their health, and prepares them for responsible and fulfilling sexual lives. 

According to Kantian deontological ethics, individuals have the right to make informed choices about their lives. Young adults deserve access to thorough, accurate information about their bodies, relationships, and sexual health. They should not face alarm or confusion when they begin to navigate sexual activity and should know where to seek help when needed. Mother’s Choice, a Hong Kong charity supporting orphaned children and pregnant teenagers, conservatively estimates 5,400 crisis pregnancies annually, primarily among single women under 25 (9). AThey also highlight data from a 2016 Commission on Youth survey also that shows concerning trends: 40% of respondents acknowledged their lack of understanding about sex, 44% admitted they do not use birth control, and over 40% reported primarily learning about sex from pornography and media. Schools, as crucial sources of a child’s development, must be able to counteract this reliance on the internet – often rife with misinformation – and empower students to critically evaluate these messages, fostering healthy attitudes towards their sexuality and enabling them to fully exercise their autonomy. 

Furthermore, comprehensive sexual education can nurture moral development in young people. By learning that their choices impact not only their health but also the well-being of their partners, students becomeare encouraged to cultivate atheir sense of responsibility. Sex education should emphasize the importance of respect in relationships and involve teaching qualities such as boundaries, communication, and empathy – traits increasingly essential in today’s society. TFor instance, the BBC has reported that the influence of online extremism is visible in children’s behavior, with schools noting that the presence of misogynistic content on social media, particularly from influencers such as Andrew Tate, has led boys as young as 11 to adopt sexist language and demonstrate misogynistic behavior towards girls (10). By addressing stereotypes and norms surrounding sexuality, sex education empowers children to challenge the harmful beliefs perpetuated in the online sphere. The ideals developed through this education can extend beyond adolescence, positively impacting future relationships and interactions. 

Opposition to sex education often originates from the unfounded belief that it promotes premature risky sexual behavior. However, researchers have strongly refuted these claims. UNESCO findings show that comprehensive sexual education not only delays the initiation of sexual activity but also decreases the rates of unprotected sex, lowers the number of sexual partners, and promotes responsible contraceptive use (6,11). To support the advantages of inclusive and thorough sexual education, we need only to consider the example of the Netherlands, which has one of the most effective sexual education systems worldwide (12). Required for all primary and lower secondary students, their curriculum, according to Rutgers International, encompasses anatomy, puberty, contraception, STIs, and healthy relationships, emphasizing values like communication and consent. Rutgers International further reported that within a decade of launching this program, the Netherlands reduced its teenage pregnancy rate by half, saw a significant decline in new HIV diagnoses, observed a later age of sexual initiation, and maintained one of the lowest abortion rates in the world (13, 14). 

As such, from a utilitarian perspective, educating young people about contraception and healthy relationships certainly yields significant ethical benefits. Local organization Teen Key, which supports young people with sexual and reproductive issues, emphasizes that the lack of proper sex education, combined with cultural taboos about discussing these topics with parents, has left many teenagers ill-informed about safe sex practices and boundary-setting with partners (15). This knowledge gap directly contributes to the many teen pregnancy cases the organization tackles daily. Equipping young people with the necessary knowledge to engage in safe sexual practices can mitigate health risks and emotional distress, ultimately fostering a better-informed and healthier society.

While discussions about sex education may be uncomfortable, they are conversations that society must engage in. Sexuality is an inevitable aspect of the human experience, especially in an increasingly open environment regarding sexual behavior. Ignoring the educational needs of Hong Kong’s youth will only have detrimental long-term consequences. Therefore, implementing mandatory comprehensive sexuality education is imperative, not only for the benefit of the next generation but also to create a more supportive environment for discussions about sexual and reproductive health. Meaningful change on this matter will require time and sustained effort, but the positive impacts on the overall health of the people in Hong Kong will undoubtedly be worth it.

Bibliography

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2. World Health Organization: WHO. Sexual and reproductive health and rights [Internet]. 2024. Available from: https://www.who.int/health-topics/sexual-and-reproductive-health-and-rights#tab=tab_1

3. Lucey C, Thomas K. Trump Risks Losing Suburban Women Over Abortion. The Wall Street Journal [Internet]. 2024 Apr 12; Available from: https://www.wsj.com/politics/elections/abortion-poll-trump-swing-state-voters-2024-election-3e12f57c

4. Andres EB, Choi EPH, Fung AWC, Lau KWC, Ng NHT, Yeung M, et al. Comprehensive sexuality education in Hong Kong: study protocol for process and outcome evaluation. BMC Public Health [Internet]. 2021 Jan 22;21(1). Available from: https://doi.org/10.1186/s12889-021-10253-6

5. Equal Opportunities Commission. EOC Releases Findings of a Study on Comprehensive Sexuality Education in Secondary Schools of Hong Kong [Internet]. 2022 Nov [cited 2024 Oct 28]. Available from: https://www.eoc.org.hk/en/PressRelease/Detail/18517#:~:text=The%20Equal%20Opportunities%20Commission%20(EOC,the%20teaching%20hours%20are%20insufficient.

6. International technical guidance on sexuality education: an evidence-informed approach [Internet]. UNESCO eBooks. 2018. Available from: https://doi.org/10.54675/uqrm6395

7. What happens when children are exposed to pornography? [Internet]. Institute for Family Studies. Available from: https://ifstudies.org/blog/what-happens-when-children-are-exposed-to-pornography

8. Family Planning Association of Hong Kong. Report on Youth Sexuality Study 2021 (Secondary School Survey) [Internet]. 2022 Jun [cited 2024 Oct 28]. Available from: https://www.famplan.org.hk/textonly/en/media-centre/press-releases/detail/report-on-youth-sexuality-study-2021-secondary-school-survey#:~:text=Concerning%20their%20sexual%20orientation%2C%20a,5%25%20of%20both%20genders%20said

9. Mother’s Choice. For Youth [Internet]. Mother’s Choice. 2024. Available from: https://www.motherschoice.org/en/what-we-do/for-youth/

10. Morris J, Buckland C. Teachers want better support to deal with misogyny. BBC [Internet]. 2024 Oct 19; Available from: https://www.bbc.com/news/articles/c625yleq8w7o

11. Research Office, Legislative Council Secretariat. Information Note: Sexuality education [Internet]. Legislative Council of the Hong Kong Special Administrative Region; 2018 Jan [cited 2024 Oct 29]. Report No.: IN03/17-18. Available from: https://www.legco.gov.hk/research-publications/english/1718in03-sexuality-education-20180109-e.pdf

12. Rutgers International - For sexual and reproductive health and rights. Sexuality education in the Netherlands [Internet]. 2022 Nov. Available from: https://rutgers.international/wp-content/uploads/2022/11/Sexuality-education-in-the-Netherlands-2022-Digitaal_LowRes.pdf

13. Rutgers International - For sexual and reproductive health and rights. Comprehensive sexuality education in the Netherlands - factsheet [Internet]. 2023 Feb. Available from: https://rutgers.international/wp-content/uploads/2023/02/20230123-CSE-factsheet-Rutgers.pdf

14. Rutgers International - For sexual and reproductive health and rights. Comprehensive sexuality education in the Netherlands - factsheet [Internet]. 2023 Feb. Available from: https://rutgers.international/wp-content/uploads/2023/02/20230123-CSE-factsheet-Rutgers.pdf

15. Sui C. Operation Santa Claus: young Hongkongers learn about respect, consent in relationships by charity dealing with sexual and reproductive health issues. South China Morning Post [Internet]. 2023 Nov 17; Available from: https://www.scmp.com/news/hong-kong/society/article/3241698/operation-santa-claus-young-hongkongers-learn-about-respect-consent-relationships-charity-dealing?module=perpetual_scroll_0&pgtype=article