Beyond the Basics: A Sourcebook on Sexual and Reproductive

Transcription

Beyond the Basics:
A Sourcebook on Sexual and
Reproductive Health Education
Copyright 2005 Canadian Federation for Sexual Health/Fédération
canadienne pour la santé sexuelle.
All rights reserved. No part of this publication may be reproduced or transmitted
for commercial purposes in any form or by any means, electronic, mechanical
(including photocopy), recording, or any information storage or retrieval system
now known or to be invented, without permission in writing from the publisher.
Permission is granted for non-commercial reproduction.
The Sourcebook is for individuals and organisations working in the area of sexual
and reproductive health. While the most up-to-date materials were used to
prepare the Sourcebook, users should be aware that information changes
rapidly. Therefore, we urge users to consult a broad range of information and/or
contact us at (613) 241-4474 for more details. Users relying on this information
do so entirely at their own risk. Canadian Federation for Sexual Health does not
accept any responsibility for damage that may result from the use or misuse of
this information.
ISBN 0-9688118-4-1
Funding for this publication was provided by Health Canada.
The opinions expressed in this publication are those of the authors and do
not necessarily reflect the official views of Health Canada.
Foreword and
acknowledgements
The Canadian Federation for Sexual Health (CFSH) is pleased to present
Beyond the Basics: A Sourcebook on Sexual and Reproductive Health
Education. Developed under the guidance of an advisory committee of
Canadian experts, this curriculum was sponsored by CFSH and funded by
the Population Health Fund, Health Canada.
CFSH is a national voluntary organisation that works with affiliates in 68
communities in Canada. We envision a society that celebrates healthy
sexuality, its diversity of expression and a positive sexual self-image for
individuals throughout life. Our mission is to promote sexual and reproductive
health and rights to enhance the quality of life for all.
In producing this document, we hope to provide educators with the tools they
need to deliver an effective sexual and reproductive health education
program. We thank Health Canada for the funding that made this opportunity
possible, and all those that participated in this project.
Linda Capperauld
Executive Director
Canadian Federation for Sexual Health
Beyond the Basics: A Sourcebook on Sexuality and Reproductive Health Education
1
About the Sourcebook
Studies conducted world wide indicate that well designed adolescent
sexual health interventions reduce the risk of unintended pregnancy
and STI/HIV infection by increasing the use of condoms and other
contraceptive methods and delaying first intercourse. 1 Despite this,
there is a fragmented and inconsistent approach to teaching SRH
education across Canada. Youth, teachers, volunteers, public health
nurses, and professional and community organisations across the
country agree that there is a strong need for better information about
the practice and content of sexual and reproductive health education.
Beyond the Basics: A Sourcebook on Sexual and Reproductive Health
Education seeks to fill this gap.
A tool for educators who deliver SRH education to 9 to 18 year olds,
the Sourcebook is based on Health Canada’s Canadian Guidelines for
Sexual Health Education and A Report from Consultations on a
Framework for Sexual and Reproductive Health. Designed to
complement the existing programs and curriculum guidelines set by
provincial/territorial Ministries of Education, the Sourcebook can be
used in schools and community agencies. While every effort was made
to include Canadian resources, some American materials were also
used. Additional activities were developed at Canadian Federation for
Sexual Health.
We hope that this Sourcebook will improve the content, quality and
effectiveness of SRH education across the country in order to assist in
the healthy development of children and youth.
Funded by
Health Canada,
the Sourcebook:
respects
different
views on
sexuality in a
multicultural
environment
encourages
healthy
choices
focuses on
developing
selfconfidence
and
negotiating
skills
supports
healthy
sexuality by
providing
information,
motivational
support and
skill-building
opportunities
1
McKay, Alex (2004) Sexual Health Education in the Schools: Questions and Answers. The Canadian
Journal of Human Sexuality. 13(3-4):132.To review the entire document, please go to: www.sieccan.org.
2
The Right to Sexual and
Reproductive Health (SRH) Education
All individuals are sexual beings. According to Health Canada:
Healthy sexuality is a positive and life affirming part of being
human. It includes knowledge of self, opportunities for healthy
sexual development and sexual experience, the capacity for
intimacy, an ability to share relationships, and comfort with
different expressions of sexuality including love, joy, caring,
sensuality, or celibacy. Our attitudes about sexuality, our ability
to understand and accept our own sexuality, to make healthy
choices, and respect the choices of others, are essential aspects
2
of who we are and how we interact with our world.
At the most basic level, access to information that may prevent sexual health
problems and enhance sexual health is a fundamental right. This is the rationale
for providing SRH education to youth. In developing the Canadian Guidelines for
Sexual Health Education, Health Canada (1994) endorsed sexual health as a
state of physical, emotional, mental and societal well-being related to sexuality
and not merely the absence of disease, dysfunction, or infirmity:
Sexual health requires a positive and respectful approach to
sexuality and sexual relationships, as well as the possibility of
having pleasurable and safe sexual experiences, free of
coercion, discrimination and violence. For sexual health to be
attained and maintained, the sexual rights of all persons must be
3
protected and fulfilled.
Education that provides youth with the appropriate knowledge, critical
awareness, and skills to make informed decisions about their sexual health is
indispensable if the right to sexual health is to be achieved. Recognizing and
affirming young people’s right to SRH education is the cornerstone of the
development and implementation of sexual health education programs by
schools and other community-based organisations.
2 Health Canada (1999). A Report from Consultants on a Framework for Sexual and Reproductive
Health. Ottawa: Population and Public Health Branch, Health Canada, page 2.
3 Health Canada (2003). Canadian Guidelines for Sexual Health Education Ottawa: Population and
Public Health Branch, Health Canada, page 7.
3
Guiding Principles of Sexual and
Reproductive Health Education
Sexuality
Sexuality touches upon the physical, emotional, spiritual, and interpersonal
development of every person.
Sexuality influences thoughts, feelings, actions, interactions, and thereby our
mental and physical health.
Within every community, there is a diversity of personal and social moral
beliefs, values, and ethics related to sexuality.
The role of sexuality changes throughout the stages of an individual’s life.
Sexual Health
Sexual health involves the integration of the physical, emotional, and social
aspects of sexuality in ways that contribute to the overall health and well being of
the individual.
In a democratic society, sexual health includes the ability to make informed
choices about sexual and reproductive behaviour, within the context of
social and personal ethics.
In order to make informed choices conducive to sexual health, individuals must
have access to accurate sexual health information appropriate to their stage of
development.
Sexual Health Education
Sexual health education is a broadly based, community-wide activity.
Sexual health education is a responsibility shared by parents, students, schools,
places of worship, health, social and legal services, media, and a variety of
other relevant groups.
Sexual health education enables individuals, couples, families, and
communities to develop the knowledge and the skills needed to ensure
sexual health.
Sexual health education must be sensitive to individual beliefs, family,
community, cultural, and religious backgrounds.
Sexual health education provides education relevant to the individual
needs of all students.
Sexual health education recognizes, explores, and develops the
individual’s responsibility to respect the rights and needs of others.
Sexual health education emphasises the self-worth and dignity of the
individual.
Sexual health education is ongoing and sequential, reflecting the different
developmental stages of individuals’ lives.
Because schools have meaningful contact with nearly every young person, they
are pivotal organizations in providing sexual health education.
Effective sexual health education, at elementary and secondary school levels, is
taught within specific programs and is linked to related curriculum areas that
touch upon sexuality, relationships, and personal development.
4
The Need for Sexual & Reproductive
Health Education
Ample evidence exists that young Canadians do not have the information,
support, and/or services they need to ensure healthy sexual development.
Canadian teenagers have high rates of sexually transmitted infections (STIs),
which pose a significant threat to their health and well-being. For example, over
half of the reported cases of chlamydia are in the 15 – 29 year old age group. 4
The potential for HIV, then, remains significant among young Canadians since
STIs and HIV often coexist and STIs likely increase the efficacy of transmission
of HIV. 5 While the teenage pregnancy rate in Canada declined from 48.6
per 1000 in 1994 to 30.6 in 2001, 6 teenage pregnancy is still an important
concern given its implications for the health and well-being of young women as
well as its economic consequences. 7 These unintended pregnancies and sexually
transmitted infections, as well as negative body image, poor self-esteem, and
sexual violence among adolescents are frequently the result of failure to provide
timely and relevant information, enough positive role models, or enough support
to teenagers.
Key Definitions:
Reproductive Health – a state of complete physical, mental & social well-being
and not merely the absence of disease, in all matters relating to the reproductive
system and to its functions and processes.
Reproductive Rights – embrace certain human rights recognized in legal
documents and national and international human rights agreements. These
include the rights of couples and individuals to decide freely and responsibly on
the number and spacing of desired children, and to have the information and the
means to achieve this; the right to obtain the highest standard of sexual and
reproductive health; the right to make decisions free from discrimination, coercion
or violence.
Sexual health – the achievement of positive outcomes (e.g. self-esteem, respect
for self and others, non-exploitive sexual satisfaction, rewarding human
relationships, the joy of desired parenthood) and the avoidance of negative
outcomes (e.g. unintended pregnancy, sexually transmitted infection, sexual
coercion). 8
Sexual health education – enables individuals, couples, families, and
communities to develop the knowledge, motivation, skills, and critical awareness
needed to enhance sexual health and to avoid sexual problems. 9
4
Health Canada. (2004). 2002 Canadian Sexually Transmitted Infections (STI) Surveillance Report:
Pre-Release. Ottawa: Population and Public Health Branch, Health Canada.
5
Health Canada. (2000). Canada Communicable Disease Report. (Suppl.) 1998/1999 Canadian
Sexually Transmitted Diseases (STD) Surveillance Report. Vol. 26S6
6
Statistics Canada (2005) Teen pregnancy, by outcome of pregnancy and age group,
count, and rate per 1,000 women, Canada, provinces and territories, 1997-2001. Available at
www.statcan.ca
7
Dryburgh, Heather (2000) Teenage Pregnancy. Health Reports. 12(1).
8
Health Canada (1994). Canadian Guidelines for Sexual Health Education Ottawa: Population and
Public Health Branch, Health Canada, page 29
9
ibid, page 7.
5
Using The Sourcebook
The Sourcebook is comprised of 8 modules or chapters. Modules cover specific
topics, starting with more general, foundational skills (e.g. values, self-esteem,
relationships) and concluding with more specific issues (e.g. contraception,
STIs/HIV). A complete list of modules includes the following:
Values and sexuality
Puberty and reproductive health
Self-esteem
Sexual identity
Relationships, communication, and decision-making
Contraception and safer sex
STIs and HIV
Resources
Each module contains a one to two page primer that highlights key issues that
may arise when teaching that particular module. We strongly recommend
taking the time to read the primer! Each primer outlines the objectives,
provides background information, and indicates how activities from other
modules might be incorporated into more comprehensive lesson plans.
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
10
In addition to the primer, each module contains a series of activities for
participants, accompanied by answer keys and instructions for the educator. All
activities and handouts can be reproduced. Activities in each module are divided
into three levels:
Level I: ages 9-11: grades 4-6
Level II: ages 12-14: grades 7-9
Level III: ages 15+: grades 10+
Since children and adolescents develop physically, sexually, and emotionally at
different rates, the ages and grade levels associated with each level are to be
used as guidelines only.
One additional feature of the Sourcebook is the glossary (Appendix A). As with
any subject, SRH education has a unique collection of terms and phrases.
Designed specifically for the teacher, this glossary can be referred to in order to
ensure the use of proper language and to define terms that are used throughout
the Sourcebook.
10
Classroom teachers are strongly advised to consult their curriculum guidelines before selecting
activities from the Sourcebook as guidelines differ across Canada.
6
A Word about the Activities
Over the last two decades, a considerable body of research has been devoted to
identifying the key ingredients of effective SRH education. With respect to
pregnancy, HIV/AIDS, and STI prevention, a clear picture has emerged
identifying the two most effective approaches, both of which have been
incorporated into the Sourcebook:
1. Effective prevention programs clearly focus on reducing specific sexual risktaking behaviours. They provide directly relevant information, give young
people the opportunity to develop the motivation and personal insight to use
the information, and help them to develop the behavioural skills necessary to
carry out health promoting behaviours.
2. Effective prevention programs take a dual approach in which young people
are provided with the education necessary to delay first intercourse and to
consistently use contraception/condoms if and when they experience
intercourse. While abstinence is presented as an option, “abstinence-only”
programs, which do not provide choices and information regarding pregnancy
and STI prevention (e.g. contraception), have not been shown to be
11
appropriate or effective.
In addition to the above, activities in the Sourcebook are based on the
Information, Motivation, and Behavioural Skills (IMB) approach to SRH
education. 12 This model provides a clear theoretical basis for developing and
implementing effective programs. In essence, the IMB model asserts that the
acquisition of sexual health related information, motivation, and behavioural
skills, in an environment that is conducive to sexual health, are the fundamental
determinants of sexual health problem prevention and enhancement behaviour.
In order to change behaviour, SRH education must contain all four components
of the IMB model.
For example, with respect to unintended pregnancy and STI/HIV prevention, the
IMB approach suggests that:
1. An individual must possess information that is directly relevant to prevention
and that is easily translated, within the student’s social context, into riskreduction behaviour.
2. Once the relevant information is obtained, the student must have sufficient
motivation to act upon it. Motivation includes the personal motivation to
practice preventive behaviours (e.g., attitudes towards consistent condom
use, delay of sexual intercourse), the social motivation to engage in
prevention (e.g., perceptions of social support for performing such acts), and
perceptions of personal vulnerability to pregnancy or STI infection.
3. Once the individual has become sufficiently informed, and motivated to
reduce their risk, they must acquire the necessary behavioural skills to
perform preventive behaviours. Examples of behavioural skills include: the
ability to negotiate sexual limits or condom use with a partner, and the ability
11
McKay, Alex. (2004). Sexual Health Education in the Schools: Questions and Answers. The
Canadian Journal of Human Sexuality. 13(3-4): 135. To review the entire document, please go to
www.siecan.org
12
This approach provides a basis for understanding the psychological determinants of
sexual and reproductive health behaviours and a methodology for creating theoretically
based and empirically targeted educational programs. It can be used to focus on a wide
array of sexual/reproductive health behaviours and can be adapted to the needs of diverse
populations. The IMB approach has received considerable empirical support, and programs
using it have been shown to help people to modify their sexual/reproductive health
behaviour in order to enhance sexual health. For further information on this theoretical
model, please consult the attached Canadian Guidelines for Sexual Health Education available at:
www.hc-sc.gc.ca/pphb-sgspsp/publicat/cgshe-1dnemss/index.html
7
to reinforce patterns of preventive behaviour in themselves and their partner.
4. The acquisition of information, the development of motivation and personal
insight and the development of behavioural skills that support sexual health
should occur in an environment conductive to sexual health. Examples
include: opportunities to consider the ways in which the environment can
help or hinder individual efforts to achieve and maintain sexual health and
fostering an atmosphere of respect where participants feel comfortable
asking questions, discussing values and sharing their views with others.
A Word About Evaluation
Classroom teachers, in particular, may be responsible for providing a grade for
students participating in SRH education courses. While the Sourcebook contains
some evaluation ideas, the bulk of evaluation modalities remain at the teacher’s
discretion. There are several handouts in each module (e.g. quizzes, homework
assignments, etc.) in which assigning a grade is relatively straightforward.
However, many modules contain activities in which the participant is to seek out
an adult s/he trusts to complete an assignment. Please note that while the
“declaration of completion” slips provide proof of assignment completion and
preserve the privacy of the participants, not all young people may be able to
complete such assignments (e.g. safety reasons, having no one to talk to).
Please be sensitive to the diverse needs and circumstances of your group when
using these assignments.
References
Division of HIV/AIDS Surveillance, Bureau of HIV/AIDS, STD and TB, LCDC,
Health Canada (November 1999) HIV and AIDS Among Youth in Canada.
HIV/ AIDS Epi Update, Ottawa: Author.
Division of HIV/AIDS Surveillance, Bureau of HIV/AIDS, STD and TB, LCDC,
Health Canada (May 1998) Sexual Risk Behaviours of Canadians. HIV/AIDS
Epi Update, Ottawa: Author.
Fisher, W.A. & Fisher, J.D. (1998). Understanding and promoting sexual
and reproductive health behaviour: theory and method. Annual Review of
Sex Research. 9: 39-76.
Health Canada. (1999) A Report from Consultations on a Framework for
Sexual and Reproductive Health. Ottawa: Author.
Health Canada (1994) Canadian Guidelines for Sexual Health Education.
Ottawa: Author.
SIECCAN, The Sex Information and Education Council of Canada (2000)
Common Questions About Sexual Health Education. Toronto Author.
Wadhera, S. and Millar, W.J. (1997) Teenage Pregnancies, 1974 to 1994.
Health Reports. 9(3).
8
9
Contributors
Beyond the Basics: A Sourcebook on
Sexual and Reproductive Health
Education
Advisory Committee
Faye Bebb, BScN Education
Coordinator Planned Parenthood
Association of BC Vancouver, BC
Neil Burke, BCom, MPl HIV
Prevention Educator Canadian
HIV/AIDS Clearinghouse Canadian
Public Health Association Ottawa, ON
William Fisher, PhD Departments of
Psychology and Obstetrics and
Gynaecology University of Western
Ontario London, ON
Caitlin Hancey Youth for Social
Justice Halifax, NS
Louise Hanvey, BN, MHA Vice
President Canadian Federation for
Sexual Health Ottawa, ON
Bonnie Johnson Executive Director
(past) Canadian Federation for Sexual
Health Canada Ottawa, ON
Rena Kulczycki Halifax, NS
André Lalonde, MD, FRCSC, MSc
Executive Vice President Society of
Obstetricians and Gynaecologists of
Canada (SOGC) Ottawa, ON
Julie Lévesque, BScN, PHN OttawaCarleton Health Department Ottawa,
ON
Doug McCall, BEd Canadian
Association for School Health
Vancouver, BC
Christiane Ménard, BA Director of
Communications Society of
Obstetricians and Gynaecologists of
Canada (SOGC) Ottawa, ON
Alia Offman, MA Ottawa, ON Toronto,
ON
Line Sacchetti, RN, BScN, MEd
Supervisor School Based Sexual
Health Program Ottawa-Carleton
Health Department
Rozelle Srichandra, BA Facts of Life
Program Coordinator Sexuality
Education Resource Centre
Winnipeg, MB
Lisa Tobin, MSc Education
Coordinator Planned Parenthood
Metro Clinic Halifax, NS
Cathy Tocchi, BEd Executive Director
Planned Parenthood Ottawa-Carleton
Ottawa, ON
Writers
Erin Connell, MA Canadian
Federation for Sexual Health Ottawa,
ON
Corrine Langill, RN, BScN School
Based Sexual Health Program
Ottawa-Carleton Health Department
Alexander McKay, PhD Sex
Information and Education Council of
Canada (SIECCAN) Toronto, ON
Alia Offman, MA Ottawa, ON
Holly McKay Childhood and Youth
Division Health Promotion and
Protection Branch Health Canada
Rozelle Srichandra, BA Sexuality
Education Resource Centre
Winnipeg, MB
Alexander McKay, PhD Sex
Information and Education Council of
Canada (SIECCAN)
Cathy Tocchi, BEd Planned
Parenthood Ottawa-Carleton Ottawa,
ON
10
Project Officer
Erin Connell, MA
Project Manager
Julie Pentick, BA, BSc, BEd
Editing and Design
MAD Apples marketing
communications
Reviewers and Pilot Testers
Sue Ball Department of Education
Arviat, NU
Kristine Barr, BA and Trina Larsen, BA
Teen Talk Winnipeg, MB
Ann Barrett, BSc and Ruth Miller MEd
Toronto Public Health Toronto, ON
Jane Beveridge, BEd
J.L. Ilsley High School Halifax, NS
The Rev. Ruth Blaser, MDiv
Saskatchewan Christian Feminist
Network Regina, SK
Jason T. Blauer, BEd
W. Erskine Johnston Public School
Kanata, ON
Curriculum Branch Department of
Education Halifax, NS
Judy Desjarlais Department of
Education, Culture & Employment
Yellowknife, NT
Education Team Calgary Birth Control
Association Calgary, AB
Ruth Evans, MA, ThM Former Director
of Christian Development United
Church of Canada
David Holmes, MEd Caistor Public
School Caistor Centre, ON
Heidi Mack, MEd PinecrestQueensway Health & Community
Services Ottawa, ON
Carole MacFarlane Vancouver School
Board Vancouver, BC
Jay MacLeod, MEd University of
Manitoba Winnipeg, MB
Bill McFarlane Branton House Halifax,
NS
Judith McIntyre Department of
Education Whitehorse, YK
Davina Melanson, MEd Youth LIVE
Halifax, NS
Maria Nazaryan, BEd Clayton Park
Halifax, NS
Kathy Nicholson, BEd Churchill High
School Vancouver, BC
Dino Paoletti, MEd Central Toronto
Youth Services Bureau Toronto, ON
Debbie Richardson, MEd Halifax West
High School Halifax, NS
School Based Sexual Health
Program Ottawa-Carleton Health
Department Ottawa, ON
Sexual Health Specialists and
Education Team Calgary Regional
Health Authority Calgary, AB
Jamie Slater, BSW Planned
Parenthood Toronto Toronto, ON
Kevin Szajkowski,
BEd Dakota
Collegiate Winnipeg,
MB
Shelley Teal, BCS Reigh Allen Centre
Dartmouth, NS
Bohdanna Kinasevych, BA New
Directions for Children, Youth and
Families Winnipeg, MB
Margie Layden-Oreto and Mark
Holland Department of Education
Fredericton, NB
11
Contributing Programs
All in a Day: An Experiential Program
Manual for the Prevention of Disordered
Eating
Heidi Mack
Ananda Resources (613) 299-1035
[email protected]
www.ananda.on.ca
Anti-Homophobia Program
Joanne Mercier and Carolyn Claire
Calgary Birth Control Association #304,
th
301 14 Street NW
Calgary, AB T2N 2A1
(403) 283-5580 [email protected]
www.cbca.ab.ca
Be Proud, Be Responsible!
Loretta Sweet Jemmott, John B. Jemmott,
and Konstance A. McCaffree Select Media
Inc.
18 Harrison Street – 5th Floor
New York, NY 10013
1-800-707-6334 www.selectmedia.org
Bodywork: A Handbook of Body Image
Exercises
Vanessa Russell and Alice Te
Equity Department
Toronto District School Board
th
155 College Street – 6 Floor Toronto, ON
M5T 1P6
(416) 397-3797
Can We Talk?
Ruthie Patriquin
Cumberland County Family Planning P.O.
Box 661, 12 LaPlanche Street Amherst,
NS B4H 4B8
Changes in You and Me!
Toronto Public Health c/o Ann Barrett 40
St. Clair Ave. E. Toronto
(416) 392-0962
Community Health Promotion Program
Planned Parenthood Toronto 36-B Prince
Arthur Avenue Toronto, ON M5R 1A9
www.ppt.on.ca
Community Outreach Program Planned
Parenthood Ottawa-Carleton (613) 2263234 [email protected]
www.plannedparenthoodottawa.on.ca
Every BODY is a Somebody
The Body Image Coalition of Peel
Peel Health Heart Lake Town Centre 180B
Sandalwood Parkway E. Ste 200
Brampton, ON L6Z 4N1
(905) 791-7800 www.Region.Peel.on.ca
Facing Our Fears – Accepting
Responsibility: Report of the Safe Schools
Task Force
Lorne Mayencourt, Brenda Locke, Wendy
McMahon
Government Caucus of British Columbia
Parliament Buildings
Victoria, BC V8V 1X4
(250) 356-6171
Filling the Gaps – Hard to Teach Topics in
Sexuality Education Sexuality Information
and Education Council of the United States
nd
(SIECUS) 130 West 42 Street, Suite 350
New York, NY 10036-7802, U.S.A. (212)
819-9770
[email protected] www.siecus.org
F.L.A.S.H. Lesson Plans: Comprehensive
Sexuality Education Curriculum
Public Health – Seattle and King County
999 3rd Ave, Suite. 1200
Seattle, WA 98104
(206) 296-4600
Fully Alive Grade 4
Pearson Education Canada
26 Prince Andrew Place
Don Mills, ON M3C 2T8
(416) 386-3532
Fully Alive Grade 6
(416) 386-3532
Fully Alive Grade 7
(416) 386-3532
Get Real about AIDS
Comprehensive Health Education
Foundation (C.H.E.F.)
22419 Pacific Hwy S Seattle WA 98198,
U.S.A. 800-323-2433 www.chef.org
12
Girl Time: Grade 7 & 8 Healthy Sexuality
Program
Region of Waterloo Public Health
99 Regina Street South, 3rd Floor
Waterloo, ON Canada N2J 4V3
The GLSEN Jump-Start
Gay, Lesbian & Straight Education
Network
nd
90 Broad Street, 2 Floor
New York, New York 10004
(212) 727-0135
Growing Together!
Ruthie Patriquin
Cumberland County Family Planning P.O.
Box 661, 12 LaPlanche Street Amherst,
NS B4H 4B8
Growth and Development Lesson Plans for
Grades 5 & 6
Regional Niagara Public Health
Department, The Regional Municipality of
Niagara 573 Glenridge Avenue,
St. Catharines, ON L2T 4C2
(905) 688-3762
Healthy Body Image – Teaching Kids to
Eat and Love their Bodies Too! Kathy
Kater
Eating Disorders Awareness & Prevention
603 Stewart Street, Suite 803
Seattle, WA 98101 1-800-931-2237
[email protected] www.edap.org
Healthy Relationships: A Violence
Prevention Curriculum Men For Change
Box 33005, Quinpool Postal Outlet Halifax,
NS B3L 4T6 (902) 457-4351
[email protected] www.m4c.ns.ca
The New Positive Images
Peggy Brick Planned Parenthood of
Greater Northern New Jersey, Inc.
196 Speedwell Avenue Morristown
NJ 07960, U.S.A. [email protected]
www.plannedparenthoodnj.com
Ottawa-Carleton School-Based Sexual
Health Program
Ottawa-Carleton Health Department Child
& Adolescent Health Division 495
Richmond Road
Ottawa, ON K2A 4A4 (613) 724-4242
[email protected]
www.rmoc.on.ca/healthsante
Our Whole Lives: Sexuality Education for
Grades 7-9
Pamela M. Wilson
Unitarian Universalist Association
25 Beacon Street Boston, MA 02108,
U.S.A. (617) 742-2100 www.uua.org
The PASHA Activity Sourcebook: Activities
for educating teens about pregnancy and
STD/HIV/AIDS prevention Tabitha A.
Benner, M. Jane Park and Evelyn C.
Peterson Sociometrics Corporation
170 State Street, Suite 260
Los Altos, CA 94022, U.S.A.
(650) 949-3282 www.socio.com
Promoting Healthy Body Image: A Guide
for Program Planners
Carla Rice
Best Start Ontario Prevention
Clearinghouse
1900 – 180 Dundas Street West Toronto,
ON M5G 1Z8
1-800-263-2846 [email protected]
www.opc.on.ca/beststart/
Relationships Skills for Healthy Sexuality
Linda Findlay
Alberta Health & Wellness
23 floor, TELUS Plaza North Tower 10025
Jasper Ave NW PO Box 1360 STN Main
Edmonton AB T5J 2N3 (780) 415-2762
[email protected]
Respect Yourself and Protect Yourself:
Skill Building for STD/HIV Prevention
Pat Mauch and Ethel McLean
Vancouver/Richmond Health Board 1060
West 8th Avenue
Vancouver, BC V6H 1C4
School Health Education to Prevent AIDS
and STD UNAIDS
20, avenue Appia CH-1211
Geneva 27 Switzerland (+4122) 791-3666
[email protected] www.unaids.org
Sexual Violence in Teenage Lives: A
Prevention Curriculum
Judy Cyprian, Katherine McLaughlin, and
Glenn Quint
Planned Parenthood New England
Education and Training Department
23 Mansfield Avenue Burlington, VT
05401, U.S.A. 1-800-488-9638
www.plannedparenthood.org/ppnne/
13
Sexuality Education Materials for the
Classroom
Su Nottingham
4600 Stanton Road Oxford, Michigan
48371, U.S.A. [email protected]
Six Big Lies About Sex
Tamekia Reece
Planned Parenthood® Federation of
America, Inc.©
434 West 33rd St.
New York, NY 10001
Skills for Healthy Relationships Social
Program Evaluation Group Duncan
McArthur Hall, Room B164 Queen’s
University Kingston, ON K7L 3N6 (613)
533-6255 [email protected]
Values and Choices
Dorothy L. Williams, ed.
Search Institute
122 West Franklin Avenue Minneapolis,
MN 55404, U.S.A.
1-800-888-7828
[email protected]
www.search-institute.org
Youth Talk Back: Sex, Sexuality, and
Media Literacy
1 Nicholas Street, Suite 430
Ottawa, ON K1N 7B7 (613) 241-4474
[email protected] www.cfsh.ca
Smoke-Free for Life, Grades 7 to 9 – A
smoking prevention curriculum supplement
Tobacco Control Unit
Nova Scotia Department of Health P.O.
Box 488
Halifax, NS B3J 2R8 (902) 424-5187
Tackling Gay Issues in School: A
Resource Module
Leif Mitchell
GLSEN and Planned Parenthood
Connecticut, Inc.
29 Whitney Avenue
New Haven, Connecticut 06510, U.S.A.
www.GLSEN.org
Teacher’s Resource Kit – A Teacher’s
Lesson Plan Kit for the Prevention of
Eating Disorders
Carla Rice
National Eating Disorder Information
Centre
200 Elizabeth Street College Wing,
1-211 Toronto, ON M5G 2C4
www.nedic.on.ca
Teaching Safer Sex
Peggy Brick
Planned Parenthood of Greater Northern
New Jersey
196 Speedwell Avenue
Morristown, NJ 07960, U.S.A.
[email protected]
www.plannedparenthoodnj.com
Today’s Talk About Sexual Assault: A
Booklet for Teens
Victoria Women’s Sexual Assault Centre
754 Broughton Street, 2nd Floor Victoria,
BC V8W 1E1
14
15
Contents
Foreword and acknowledgements ........................................................................................1
About the Sourcebook...........................................................................................................2
The Right to Sexual and Reproductive Health (SRH) Education ..........................................3
Contributors ........................................................................................................................ 10
Contributing Programs ........................................................................................................12
Module 1: Getting Started ...................................................................................................19
Module 2: Values & Sexuality .............................................................................................31
Module 3: Puberty & Reproductive Health ..........................................................................63
Module 4: Self-Esteem......................................................................................................139
Module 5: Sexual Identity..................................................................................................181
Module 6: Relationships, Communication & Decision Making .......................................... 231
Module 7: Contraception and Safer Sex ...........................................................................289
Module 8: STIs and HIV ....................................................................................................345
Appendices
Appendix A: Glossary .................................................................................................. 376
Appendix B: Sample Letter to Parents.........................................................................383
Appendix C: Needs Assessment Activities ................................................................. 384
Appendix D: Community Mapping Activities ................................................................ 386
Appendix E: Using the internet to Access Sexual Health Information.......................... 388
Appendix F: Icebreaker Activities................................................................................. 392
Appendix G: Anatomy Diagrams ................................................................................. 396
Resources
The Sourcebook Evaluation Form..................................................................................... 414
16
17
Module 1: Getting Started
Teaching sexual and reproductive health education is not
like teaching math or physics where the answer is right or
wrong. This module will help you develop teaching
strategies in order to empower youth with accurate
information so they can make the best decisions for
themselves.
Topics include:
Building Support
Building Your Confidence and Assessing Your Values
Finding the Time to Teach
Creating a Safe Space
Responding to Crises
Teaching Tips
Getting Started
Building Support
Although the majority of Canadians are supportive, some people may not
understand, or are opposed to, the content and objectives of SRH education.
Three strategies have been proved useful in garnering support for SRH
education.
I.
Communicate the philosophy behind SRH education. Reproduce the
philosophy statement on page 3 of “About the Sourcebook” (or create your
own), and disseminate it to parents, administrators, and principals.
Among the single most important steps in the initiation, development,
and implementation of effective SRH education programs is the
creation of a statement of principles that serves as the foundation for
the program. This “philosophy statement” performs three important
functions.
1. It provides everyone with a common vision of the program’s overall
purpose, objective, and approach.
2. It provides a mechanism for consulting with parents, administrators,
community agencies, the media, and interested citizens about the nature
of the program and the values underlying it.
3. It provides a reference point from which the program can be evaluated at
various points in the development and implementation process.
We, as well as several school educators/administrators and health units, 13
have adapted versions of the philosophy statement presented below. A key
feature of this particular philosophy statement is its reflection of, and
emphasis on, basic democratic principles such as respect, tolerance,
understanding, compassion, honesty, access to information, and
cooperation. Because democratic principles are at the centre of accepted
and shared Canadian values, a philosophy of SRH education that embodies
democratic principles is well suited to building the community consensus
needed to provide effective broadly-based SRH education to youth. 14
Schools play a
critical role in
providing SRH
education.
According to the
anadian
Guidelines for
Sexual Health
Education:
As the single
formal educational
institution to have
meaningful contact
with nearly every
young person,
schools are a vital
resource for
providing children,
adolescents, and
young adults with
the knowledge and
skills they will
need to make and
act upon decisions
that promote
sexual health. 15
II. Assess and formalize your school’s/community’s stance and policies
on SRH education, using a community development approach. The
Michipicoten Board of Education of Algoma, Ontario developed the following
guidelines:
Establish a committee comprised of students, parents, teachers,
principals, board members, and agencies.
Inform and involve the community so that they can support and
participate in the process (e.g. hold information nights, hire consultants,
involve nationally based organizations that support SRH education).
Start the process by drafting a SRH education philosophy. This will
ensure that committee members agree on the basis of their work.
13
See Burgoyne, W (1998) Sexual Health Education Policy. Toronto: Ontario Prevention Clearing
House, and Haliburton, Kawartha, Pine Ridge (HKPR) District Health Unit (1999) Sexual Health
Education Survey. Whitby, Ontario: The Regional Municipality of Durham Health Department.
14
For more information on developing a philosophical statement, contact the Sex Information and
Education Council of Canada (SIECCAN): www.sieccan.org or consult the Canadian Guidelines on
Sexual Health Education enclosed in the Sourcebook or go to: www.hcsc.gc.ca/hpb/lcdc/publicat/sheguide/index.html.
15
Health Canada (1994) Canadian Guidelines for Sexual Health Education. Ottawa: Author, page 11
21
Survey parents and students to determine their needs and beliefs about
SRH education. This information will help the committee develop a more
effective and appropriate program.
Consider the broad spectrum of views and beliefs in the community. Invite
students, parents, teachers, principals, board members, and agencies into
discussion about ways to show or demonstrate respect for all religions
and faiths as recognised in a democratic society. Include time to identify
values that are not recognised in a democratic society.
Encourage the school board to take the lead role to ensure their ownership
of the process and the results.
Encourage the committee members to do the groundwork to ensure that they
are organized and ready for community input.
Provide support and training for teachers to help them develop their skills
and increase their comfort regarding SRH education.
Provide training and support to the committee to help members build
capacity for this work.
Select one person, preferably from the school board, to act as the media and
community contact. This will ensure a consistent voice for the committee.
Michipicoten Board of Education
Sexual Health Education Policy
The Michipicoten Board of Education is committed to providing appropriate
sexual health education to all of our students enrolled in Grades 1 to 12.
All programming will reflect the board’s Sexual Health Education Philosophy
Statement developed and approved by the community.
The responsibility for the implementation and review of the program rests
with the school principal and board supervisory staff.
The Michipicoten Board of Education respects the right of a student to
withdraw from sexual health education programming.
Where appropriate, every attempt will be made to inform parents about the
content and delivery method of the program.
III. Focus on parental involvement. Although most Canadian parents are in
favour of their children’s receiving SRH education, 16 it is important to inform
and involve them in the curriculum. This will not only clear up any
misconceptions about the content and the goals of the program, but will also
give parents an opportunity to provide input and to offer their support.
Classroom teachers are advised to familiarize themselves with their school’s
policy for notifying parents about the curriculum. Involve parents by:
sending a letter home that describes the course/program. 17 Remind them
that this is a mandated subject, and that they may “opt out.” If a student
opts out, provide him/her with alternate, acceptable activities.
showing them the materials you are using.
providing information about where students and parents can get followup material (e.g. obtain fact sheets, pamphlets, etc. from local health
units, sexual health centres, members of the Canadian Federation for
Sexual Health).
organizing an information session for parents about talking to their
children about sexuality.
16
McKay, Alex (2004) Sexual Health Education in the Schools: Questions and Answers. The
Canadian Journal of Human Sexuality. 13(3-4):131
17
See Appendix B for a sample letter to parents
22
Building Your Confidence &
Assessing Your Values
As with any subject, it is important to be prepared and to review curriculum
materials before teaching. Be ready to admit you do not know everything about
the subject but know where to look for more information. You may also want to
seek support and information from a mentor (e.g. a more experienced teacher,
public health nurse, Canadian Federation for Sexual Health member
organization staff person).
It is equally important to examine your own comfort level with SRH issues. Ask
yourself:
How comfortable am I with the topic?
Do I have the support of my school/organization?
What are my boundaries and how will I address them?
How will I react if a student discloses pregnancy, abuse, etc.?
How will I handle hard-to-answer questions?
Everyone has topics with which they are more or less comfortable.
Acknowledging your own awkwardness will make students feel more
comfortable, knowing that this is a difficult topic for everyone to discuss. Also,
students can sense if you’re uncomfortable, and may therefore be less attentive
or receptive to the information. Some teachers are uncomfortable because they
are worried about conveying their own attitudes and values about the subject
matter to their students. This can be addressed by talking about facts rather than
values. For example:
Value: “I think every woman should have access to abortion.”
Fact: “Abortion is a legal procedure in Canada.”
Value: “Too many teens are sexually active.”
Fact: “Many teens are sexually active.”
Assumptions
to avoid
All students come
from traditional
nuclear families
All students are
heterosexual
All students are
sexually involved
All students are
not sexually
involved
All students’
sexual
involvement is
consensual
All students who
are sexually
active are having
intercourse
All students have
the same
knowledge base
All students have
the same cultural
and religious
beliefs
However, there are some universal messages that can be shared:
1.
2.
3.
4.
Respect of self and others.
Fair treatment of people.
Equality of all people.
Honesty.
Values are personal and are influenced by our family, friends, school, media,
culture, religion, and by our own experiences and perceptions. Students should
be encouraged to respect the values and experiences of each person in the
room, so that each person can discuss their views openly and honestly.
23
Finding the Time to Teach
Many educators note a lack of time dedicated to SRH education. While it is ideal
to introduce these issues to young people over a period of a few years, the reality
is that many educators find that they have only a few hours to cover an entire
curriculum.
Strategies to overcome this barrier include:
1. Use teachable moments. This means using current events or topics of
conversation to initiate a larger discussion on SRH issues. For example, if a
student refers to a popular TV show that is exploring unintended pregnancy,
contraception and pregnancy issues can be explored in the larger group. This
technique encourages students to bring up, reflect upon, and critically
examine issues related to SRH as they occur in their everyday lives.
2. Incorporate SRH issues into other subjects. This
helps to normalize sexuality issues, and provides students with role
models and adult resource people
ensures that youth develop skills (communication, decision-making,
critical thinking, medial literacy, negotiation, values clarification) specific
to SRH issues
contributes to a broadly based approach to SRH education.
3. Make the most of your time by
conducting a needs assessment 18
picking activities that match the interests and developmental level of your
group—using the needs assessment as a guide
including a community mapping exercise 19
18
19
See Appendix C for sample needs assessment activities
See Appendix D for sample community mapping activities
24
Math
STI and HIV rates, percentages, ratios
pregnancy rates, percentages, ratios
abortion rates, percentages, ratios
Science
biological aspects of puberty
human reproduction
genetics
transmission of STIs and HIV
pathogenesis of STIs and HIV
treatment of STIs and HIV
methods of pregnancy prevention
Language Arts
journal writing about relationships, self-esteem, body image, etc.
media literacy (how sex and relationships are handled by the media)
SRH issues as essay/debate topics
Performing & Visual Arts
role play
write and produce a play, skit, video, or song
create collages, murals, posters, or banners
Social Studies
sexuality and the law (e.g. sexual assault, age of consent, prostitution)
media literacy (how sex and relationships are handled by the media)
social construction of sexuality, gender roles
history of birth control in Canada
history of abortion in Canada
the “ideal body” throughout history
history of sexual assault law in Canada
history of the contributions of gay men and lesbian women in Canada
population control issues
economics of unprotected sex
25
Creating a Safe Space
Teaching SRH
education is not like
teaching math or
physics where the
answer is right or
wrong. We cannot
teach someone to be,
or not to be, sexual,
for we are sexual
beings from the day
we are born. Rather,
teachers have the
more difficult role of
empowering youth
with accurate
information so they
can make the best
decisions for
themselves.
Two key issues that
often arise, when
teaching SRH
education, are how to
create a safe space
for students and how
to respond to crises.
To foster an environment where students feel comfortable and safe, pay close
attention to the physical space where you are teaching, as well as the climate in
the classroom.
To make the physical space more inviting and comfortable, you may wish to
use a more comfortable space than the classroom (e.g. lounge)
change the seating in the room to facilitate discussions (e.g. U shape, circles,
small groups, etc.)
stay in the room if you invite in a guest speaker (This will maintain the
integrity of the environment and prepare you for student and/or parent followup.)
have community resource lists, magazines, posters, and pamphlets available
in an accessible place, and bookmark related Web sites on the class
computer (Take into account the different levels of anonymity your students
may wish to have.)
set up activity centres (collection of books, posters, stickers, pamphlets, etc.)
in the room on issues related to SRH education. These work particularly well
when they coincide with topics discussed in the classroom or with awareness
days/weeks (e.g. World AIDS Day).
To foster a positive learning environment and increase the comfort level of the
group
use icebreaker activities 20
if possible, co-teach/facilitate. This often makes fielding questions and
facilitating discussions easier. A male-female team further enhances student
comfort level.
de-bunk myths and address double standards
Sample ground
rules:
use gender-neutral and inclusive language
Be respectful of
others.
turn instances of homophobia, racism, sexism, etc. into teachable moments
in order to address discrimination
Maintain
confidentiality.
develop and post ground rules. Ground Rules give structure to the lessons,
help the teacher and student to know what to expect, and can help avoid
difficult situations. Write the ground rules together with the class, and suggest
any appropriate rules that the students have missed. Post them on the wall
so everyone can see and review them, before teaching the first lesson.
All questions are
valid and
welcome.
Use exact terms.
validate participants’ concerns about asking questions and answer every
question as best as you can.
20
See Appendix E for sample icebreaker activities
26
Tips on Answering Questions21
1. If necessary, reinforce the ground rules.
2. Validate participants’ concerns about asking questions.
•
Give affirmation to the student who asked the question.
o
“Thanks for asking…”
o
“That’s a good question. Tell me more about what you’d like to
know.”
•
Consider every question to be a valid question.
Don’t assume you know what’s being asked. Questions indicate the
participant’s thoughts, not necessarily actions. To clarify without causing
embarrassment, try these cues:
o
“Sounds like you’ve got a real concern – can you tell me more
about what’s on your mind?”
•
‘Normalize’ the question.
o
“Many students probably wonder about this…”
3. Answer every question as best you can.
•
Assess whether the question is related to information, feelings values, or a
combination.
o
Answer the factual information part of the question first.
Consider the following:
o
Curriculum relevance, content and knowledge background of
student
o
Age appropriateness
o
The most simple and straightforward way to answer the
question
o
o
o
Address feelings that may arise from a question.
o
“I’m a bit uncomfortable with this”
o
“We all are embarrassed sometimes, but it is important to
discuss…”
Identify the value component of the question and if necessary
refer students to family or others for help with decision-making.
o
“This question relates to personal decisions and may vary
from individual to individual; so I can not give you a definite
answer. It’s best for you to get all the information you can
and discuss this with your ____”
Be honest about your information or your lack of information.
All teachers may have difficulty with a question. Don’t be afraid to
say, “I don’t know – I’ll have to check.” Ensure that you follow
through. If you say you’ll get information or a booklet, do it.
Teaching SRH education is not like teaching math or physics where the answer
is right or wrong. We cannot teach someone to be, or not to be, sexual, for we
are sexual beings from the day we are born. Rather, teachers have the more
difficult role of empowering youth with accurate information so they can make the
best decisions for themselves.
Two key issues that often arise, when teaching SRH education, are how to
create a safe space for students and how to respond to crises.
21
Calgary Regional Health Services. (2002). Responding to Questions. Available at:
www.teachingsexualhealth.ca
27
Responding to Crises
If you know or suspect
that someone under
16 is being, or is likely
to be, neglected or
emotionally,
physically, or sexually
abused, you have a
legal obligation to
report it to the Ministry
of Children and
Families or Child
Protection Office in
your province.
You may wish to
share this
information with
your group at the
beginning of the
SRH class/unit so
that all students are
aware of this legal
obligation.
Sometimes, students disclose pregnancy, a sexually transmitted infection,
abuse, suicidal ideation, or gay/lesbian/bisexual orientation during a SRH
education course. It is important that you
know where to send the student for help
make a commitment to get the student the help s/he needs
make sure you have a back-up person to support you (e.g. public health
nurse, school administrator, Canadian Federation for Sexual Health member
organization staff person)
know your school’s/centre’s policy on dealing with these issues.
The most important thing you can do is to ensure that s/he is not in any
immediate danger from him/herself or others. Listen, validate him/her and refer
him/her to services in the community. In the case of abuse:
Listen.
Thank her/him for confiding in you, and acknowledge how hard it must be to
talk about the abuse.
Tell her/him you believe her/him. It is important for someone who has been
abused to have people believe in what has happened. Most people do not lie
about being abused or assaulted.
Support her/his feelings by saying things like: “It sounds like it was really
scary” or “I understand why you feel so terrible.”
Tell her/him that it wasn’t her/his fault. The only person to blame is the
offender.
Inform her/him of your legal obligation to report.
Refer her/him to services in your community (e.g. sexual assault centre). On
the other hand, if someone admits to being a perpetrator of abuse:
Listen.
Support change in his/her behaviour.
Speak out and address abusive comments.
Help him/her understand that s/he is the only one responsible for the
violence, even if his/her partner is responsible for other problems in the
relationship. Violence is a learned behaviour that can be unlearned.
Encourage him/her to seek help in a counselling program. The violence will
not stop on its own.
If s/he abused someone under the age of 16, you have a legal obligation to
report the abuse, on behalf of the victim, to the Ministry of Children and
Families or Child Protection Office in your province. Give the student the
option to report the incident him/herself, or offer to report the abuse with
him/her in the room.
28
Teaching Tips
Use facilitation skills
React positively to questions.
Be sensitive to non-verbal communication.
If you are uncomfortable teaching the material, find people in your community
who are comfortable.
Use humour to ease embarrassment and create a comfortable environment.
Be student-centred/driven.
Listen.
Ask participants what they want to learn about.
Be patient.
Encourage self-confidence and decision-making skills.
Address different learning styles.
Be yourself.
Use interactive teaching strategies to accommodate different learning styles
Role-plays
Guest speakers (particularly those with personal experience)
Peer educators
Panel discussion with speakers from community services
Journaling, creative writing, poetry
“Dear Abby”
Anonymous question box
Creating posters, pamphlets, graffiti, etc.
Brainstorming and reflection exercises
Quizzes
Hands-on activities
Be an askable
teacher
Respect students’
feelings, values,
and opinions.
Challenge
harmful,
unhealthy
practices.
Use gender
neutral and
inclusive
language
(e.g. partner
instead of
boyfriend/
girlfriend).
Admit when you
don’t know an
answer and
commit to finding
it.
Allow youth the
opportunity to
pass, when
discussing
sensitive issues.
Know where and
when to send
them for help.
Debates
Theatre, songs, or videos
Story telling
Field trips (clinic, health centre, pregnant teen support centre, etc)
Current events (discuss, debate, write about newspaper/ magazine articles,
TV shows, movies)
Experiments
Decision trees
Interviewing
Surveys
Case studies
Reality-based teaching (e.g. What would it be like to be a teen parent?)
Games
Informal discussion
29
References
Burgoyne, W. (1998) Sexual Health Education Policy. Toronto, Ontario: Ontario
Prevention Clearing House.
Calgary Regional Health Services (2002) Responding to Questions. Available at:
www.teachingsexualhealth.ca
Drolet, Judy C & Clark, Kay (1994) The Sexuality Education Challenge Santa
Cruz: ETR Associates.
Gordon, Bill (1995) Relationship Skills for Healthy Sexuality. Fort Saskatchewan:
Alberta Learning.
Haldimand-Norfolk Regional Health Department, Birth Control-Reach & Teach.
Health Canada (2003) The Canadian Guidelines for Sexual Health Education.
Ottawa: Population and Public Health Branch, Health Canada.
Hubbard, Betty M. (1997) Sexuality & Relationships: Choosing Health High
School. Santa Cruz: ETR Associates.
Lipscomb Bridge, Kathy. Sex Education for the 90's: A Practical Teacher's Guide
J. Weston Walch Publisher.
McKay, Alex (2004) Sexual Health Education in the Schools: Questions and
Answers. The Canadian Journal of Human Sexuality. 13(3-4): 129-141.
Nottingham, Su & Craven, Al, Sexuality Education in the Classroom: How to be
more Efficient, Effective & Enjoyable" Guelph Sexuality Conference presentation
handout, June 1994.
Planned Parenthood Ottawa-Carleton 12 Helpful Hints for Talking about
Sexuality.
Regional Niagara Health Department (1990) Completing the Picture: Adolescents
Talk About What's Missing in our Sexual Health Services. St. Catherine’s:
Author.
Scarborough Health Unit , SHARE: An Interactive Health fair Promoting Healthy
Sexuality. Guelph Sexuality Conference presentation handout, June 1994.
Sexuality Project Team (1998) Teaching Sexuality Resource Kit. Ottawa: Region
of Ottawa-Carleton Health Department.
Victoria Women’s Sexual Assault Centre (1994) Today’s Talk About Sexual
Assault: A Booklet for Teens. Victoria: Author.
30
Module 2: Values & Sexuality
Understanding our values and what’s important to us is an
integral part of decision-making and fostering healthy
behaviour.
This module contains activities that will help participants to
identify, clarify, and evaluate their values related to
sexuality.
Values and Sexuality
This module will help students to identify, clarify, and evaluate their values
related to sexuality. Level I activities examine values in a general manner. Level
II and Level III activities apply the discussion of values to situations involving
relationships, sexuality, sexual violence, and unintended pregnancy. 22 Several
homework activities that encourage participants to discuss values with an adult
person they trust (e.g. parent, guardian, aunt, uncle, member of the clergy, etc.)
are also included.
Values, Moral Values, and Sexual Health Education
Because the moral aspects of human sexuality are often controversial, teaching
about these issues requires a balanced approach that respects diversity and
promotes the basic democratic principles of Canadian society. 23 While students
should be encouraged to articulate and discuss their value positions on sexuality
issues, the teacher can mediate these discussions by drawing students’ attention
to fundamental principles such as honesty, fairness, respect for self and others,
justice, etc. Students and teachers should also recognise that parents and
religious institutions often have strong value positions related to sexuality issues.
Facilitating classroom discussions in which different perspectives toward
sexuality issues are considered is an important step in helping students to
develop more mature ways of thinking about human sexuality.
Key Terms
Values are the qualities that a person thinks are important. For example, one
person may value intelligence as a quality while another may value loyalty.
OBJECTIVES OF
THE MODULE:
Participants will:
define and
explore
personal values
and democratic
values
describe how
the media
depicts and
influences our
values
identify values
related to
relationships,
sexuality,
unintended
pregnancy, and
other sexuality
issues.
Moral values are the concepts or principles that a person may use to make
moral judgements. For example, a person may use the criteria of honesty,
equality, and responsibility to arrive at a decision or judgement about a situation
or dilemma.
22
Fact sheets on sexual violence and unintended pregnancy can be found in the Resources section
of the Sourcebook.
23
See The Canadian Guidelines for Sexual Health Education for further information
33
Teaching Tips
Things to do:
Refer to your group’s ground rules for discussion. Students should be asked
to show a basic respect for points of view different from their own.
Level I:
Ages 9-11
Grades 4-6
Directly challenge discriminatory remarks by making reference to basic
democratic principles such as equality, justice, and respect for persons. For
example, if a student insists that a woman is “asking for it” if she is dressed a
certain way, ask the student how this assumption supports values such as
equality and respect for others.
Level II:
Ages 12-14
Grades 7-9
Encourage students to support their points of view in terms of their values
and moral beliefs.
Level III:
Ages 15+
Grades 10+
Support the right of students with unpopular points of view to express
themselves.
Play “devil’s advocate” if necessary to ensure that a range of views is
expressed.
Things to avoid:
Try to avoid steering classroom activities to a moral consensus that reflects
your own values.
While healthy debate in the classroom should be encouraged, do not allow
students to make fun of or denigrate each other’s opinions.
34
Defining Personal Values and Democratic Values
How Do They Apply to Our Sexuality?
Objective:
Participants will define personal values as well as
democratic values and examine how they can be applied
to sexuality issues.
Structure:
Large group discussion.
Time:
30 minutes.
Materials:
Flip chart or blackboard.
Level I/II/III
Procedure
1. Write a definition of personal values (e.g. things or qualities that a person
thinks are important) on the blackboard/flipchart.
2. Write a definition of democratic values (e.g. agreed upon principles or
concepts that are promoted in Canadian society) on the blackboard/ flipchart.
3. Ask participants to give some examples of personal values (e.g. loyalty,
intelligence, dedication, attractiveness etc.) and democratic values (e.g.
fairness, equality, justice, respect for others etc.) Note that there may be
some overlap between personal values and democratic values.
4. Ask participants to discuss where they learn their personal values and
democratic values (e.g. family, media, religion, friends).
5. Point out that, since each of us learns our values from different sources,
different people will have different values. In a democratic society like
Canada, people respect each person’s right to have his/her own values.
However, to live together in a free and fair society, we use basic democratic
values like equality, justice, responsibility, and respect for others as
guidelines for how our society is organized and how people treat each other.
6. Ask participants to give examples of how democratic values such as
honesty, equality, respect, and responsibility apply to sexuality and
interpersonal relationships. The following are some examples:
Being honest about your feelings (e.g. not deceiving a person about your
feelings in order to get something from them.)
Having an equal relationship (e.g. giving each person in a relationship an
equal say in decisions about the relationship including sexual behaviour)
Respecting the rights of others (e.g. treating everybody with equal
fairness whether they are male, female, gay, lesbian, heterosexual,
bisexual etc.; respecting the right of a partner to say no to sex.)
Taking responsibility for myself and others (e.g. always using condoms if
I have sex to protect myself and my partner.)
7. Conclude the discussion by suggesting that participants can keep these
ideas about personal values and democratic values in mind as the group
moves on to explore choices, relationships, and behaviour related to
sexuality and sexual health.
35
Television Value Analysis
Level I/II
Note: Depending on
your group, you may
need to define some
of the terms on the
worksheet
(e.g. respect).
.
Objective:
Participants will describe how the media depict and
influence our values.
Structure:
Individual activity followed by large group discussion.
Time:
10 minutes.
Materials:
“Television Value Analysis” handout.
Procedure
1.
Disseminate the handout.
2. Explain that this activity gives participants the opportunity to explore the
effect and influence of the media in the development and affirmation of their
personal values.
3. Conclude by pointing out that the development of our values and attitudes
does not occur in a social vacuum: the media may influence our perceptions
and behaviour. While we may learn one set of values from our family, friends,
school, culture, and religion, the media can reinforce, distort, or contradict
this learning. For example, the media, especially TV, sometimes depicts a
lack of respect for persons, abuse of sexuality, violence, and stereotyping.
.
(Adapted from: Ontario Conference of Catholic Bishops (1992) Fully Alive Grade 6.
Don Mills: Collier Macmillan Canada. Reprinted with permission by Pearson Education Canada.)
36
Handout
Television Value Analysis
1.
Choose a television show that emphasizes the following:
Honesty__________________________________________________________________________
Dishonesty________________________________________________________________________
Beauty __________________________________________________________________________
Wealth __________________________________________________________________________
Violence _________________________________________________________________________
Disrespect for people _______________________________________________________________
Power ___________________________________________________________________________
Respect for people _________________________________________________________________
Commitment ______________________________________________________________________
Respect for property ________________________________________________________________
Casual sexual relationships __________________________________________________________
Faithfulness in marriage / lifetime commitment____________________________________________
2.
Beside the name of the show use a plus (+) or a
minus (-) sign to indicate whether it is a positive or
negative example.
3.
Choose two of your examples (one positive, one
negative) and describe an event that illustrates the
value. Use the other side of this sheet to write your
answer. Prepare to discuss your answers with the
larger group.
37
What Do I Value? .
Level I/II
Objective:
Participants will identify and discuss their values.
Structure:
Activity with adult support person.
Time:
15 minutes in class.
Materials:
“What Do I Value?” handout.
Procedure
1. Explain that it is easier to deal with pressures if we know what’s important to
us—or what we value.
2. Ask participants to take home and complete the participant section of the
“What Do I Value?” handout.
Note: Some young
people may be
unable to complete
this assignment
with their parent(s)
or guardian(s).
Allow them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
3. Once each person has individually completed the worksheet, instruct
participants to ask an older person they trust (e.g. parent, guardian, aunt,
uncle, member of the clergy, neighbour, etc.) to also fill it out.
4. In order to maintain the privacy of participants, ask participants to submit the
Declaration of Completion slip once the assignment is done.
5. In follow-up, ask the following discussion questions:
What was it like doing this activity? Was it easy or difficult?
What did you learn about yourself: your adult support person?
6. Conclude the activity by pointing out how useful it can be to consult with
people we trust and care about when clarifying our values and making
decisions.
.
(Adapted with permission from: Patriquin, Ruthie (1995) Can We Talk? Amherst: Cumberland
County Family Planning.)
38
Handout
What Do I Value?
Participants: Draw a circle around the number that
shows how important each value is to you.
Adult support person: Draw a square around the
number that shows how important it is to you that the
participant values each item on this list.
Very
Important
A little
Important
Not
Important
1. Being honest
1
2
3
2. Feeling good about myself
1
2
3
3. Being happy
1
2
3
4. Caring for others
1
2
3
5. Doing what my parents think is right
1
2
3
6. Having fun
1
2
3
7. Being popular
1
2
3
8. Looking good
1
2
3
9. Having the “right” clothes
1
2
3
10. Being good in sports
1
2
3
11. Having a boyfriend or girlfriend
1
2
3
12. Having a good education
1
2
3
13. Taking responsibility for my actions
1
2
3
14. Getting along with my parents
1
2
3
16. Standing up for a friend who is picked on
1
2
3
(Detach and hand in this slip only)
We completed the What Do I Value? homework assignment.
___________________________________
Participant
_________________________________
Adult Support Person
39
Values and Decisions .
Level II
Objective:
Participants will identify democratic values.
Structure:
Small group work.
Time:
10 minutes
Materials:
“Values and Decisions: Situations for Small
Groups” handout.
Procedure
1. Ask participants, “What is a value?” (Answers may include: something you
believe in, what you think is right or wrong, something that really matters to
you, or beliefs that guide your behaviour.)
2. Introduce the activity by saying, “Now that we’ve defined values, we’re
going to spend some time looking at situations where a person made a
decision. We’ll be doing this in groups of 3-4 participants.”
If a group arrives at
a value that isn’t the
one intended for the
scenario, explain
that in analyzing
situations, there
may be more than
one “right” answer
and that some of
the scenarios
include more than
one value. Ask the
large group if they
see another main
value in the
situation. Reinforce
definitions of the
values in question,
and underline the
complexity of
values.
3. Form groups. Give each small group a scenario. Give participants five
minutes to think of the main value for their situation. Ask small groups each
to read their situation to the larger group and tell what value was involved.
After each group has reported, discuss the situation briefly, underlining the
value and Impact of either following or going against the value.
Democratic values illustrated in the paragraphs (in order):
Honesty
Equality
Responsibility
Promise-keeping
Self-control
Social justice
Respect
4. Conclude by pointing out how the values we’ve been talking about are
important because they help us to develop good relationships and make
good choices, and they promote the basic democratic principles of Canadian
society. It is important to complement our own personal values with these
principles, to foster healthy relationships and choices.
.
(Reprinted with permission from Williams, Dorothy L., ed. (1991) Values and Choices. Minneapolis,
MN: Search Institute. 1-800-888-7828.)
40
41
Values Auction .
Level II/III
Objective:
Participants will prioritize their values.
Structure:
Large group activity.
Time:
45 minutes.
Materials:
“Values for Auction” list; play money; flipchart or blackboard; one
index card for each value.
Procedure
1. Introduce Values Auction by explaining that you have a list of values that are
important to some people. Read the values you have posted on newsprint or
on the blackboard and ask participants to add others (give examples).
2. Explain the auction process. Give each participant $300 in play money. Tell
the group that you are going to auction off the values on the list. Give the
following instructions:
Use your money to purchase the values that are most important to you.
You must bid at least $20 or a multiple of $20: $20, $40, $60 and so on.
Once you have spent your $300, you are out of the auction.
3. Open the bidding. Award each value to the highest bidder by giving her or
him the index card with the value written on it. Record the amount paid for
each value on newsprint. After the auction, identify the values that received
the highest bids.
4. Lead a discussion, using the following questions as a guide:
How did you decide on which values to bid?
What value did you really want that you were not able to buy? (Point out
that in the real world people can have any values they want because
values are not for sale.)
What were the top five values?
Which values seemed less important?
Which of these values would you want to pass on to your children? What
process would you use to teach your children your values? How have
your parents communicated their values to you?
5. Conclude by pointing out how understanding our values and what’s
important to us is an integral part of decision-making and fostering healthy
behaviour.
.
(Adapted from: Wilson, Pamela M. (1999) Our Whole Lives: Sexuality Education for Grades 7-9.
Boston: Unitarian Universalist Association. Reprinted with permission of the Unitarian Universalist
Association.)
42
Values For Auction
1.
Being a good friend to others
2.
Being well liked and popular
3.
Being good looking
4.
Having a well-toned, fit body
5.
Being honest
6.
Having money and nice clothes
7.
Going out with someone I love
8.
Not having sex until marriage/lifetime commitment
9.
Respecting others in relationships
10.
Feeling good about myself
11.
Being comfortable with my sexual orientation (gay, bisexual, heterosexual)
12.
Accepting people who are different from me
13.
Having a close relationship with my family
14.
Practising my religion or spirituality
15.
Having the freedom to make my own decisions
16.
Enjoying lifelong health (avoidance of STIs, etc.)
17.
Giving back to the community/helping others
18.
Fighting to right the wrongs in our society
19.
Becoming a parent one day
20.
Getting married/having a committed life partner one day
43
Values Voting
.
Level II/III
Objective:
Participants will explore their values regarding
relationships and sexuality.
Structure:
Time:
45 minutes.
Materials:
“Values Statements” list; 3 signs: AGREE,
DISAGREE, UNSURE; masking tape.
Procedure
1. Post the three signs around the room leaving enough space for participants
to gather beneath them.
2. Choose six to eight of the statements from the Values Statements list.
3. Explain that this exercise is designed to explore personal values, and give
the following directions:
I will read several statements to you, one at a time. Most of the
statements are about relationships, dating, and sexual behaviour.
Go and stand under the sign that represents your response to the
statement: AGREE, UNSURE, DISAGREE.
When everyone is standing where they want to be, I’ll ask volunteers to
explain their positions.
Note: If participants
are all standing
under one sign,
explore the position
that is not
expressed. If
necessary, give
some of the beliefs
from that point of
view. Tell
participants that
they can benefit
from being exposed
to all points of view
and will be better
prepared to
respond when
someone
challenges their
values.
4. Read the first statement and ask everyone to take a position under a sign.
Ask volunteers to explain why they have chosen to stand where they are.
Congratulate those willing to stand alone.
5. When the first statement has been fully discussed, go on to the next one.
Pacing is important; don’t drag out the discussion, but make sure most points
of view have been heard.
6. End with these discussion questions:
How easy was it to vote on these values?
Which statements were the hardest for you? Why?
If your parents voted on these statements, would their votes be similar to,
or different from, those of this group?
How many of you have ever talked to your parents about any of these
issues?
What happens when your family’s values are different from your own or
your friends’ values? (Encourage them to discuss some of these value
statements with their parents.)
What is one thing you learned about your own values from this activity?
About the values in this group?
7. Conclude by pointing out how understanding our values and what’s
important to us, even when they differ from the majority, is an integral part of
decision-making and fostering healthy behaviour.
.
Boston: Unitarian Universalist Association.
Reprinted with permission of the Unitarian Universalist Association.)
44
Values Statements
1. Seventh and eight grades should be allowed to have parties at home without
adult supervision.
2. Most 13 year olds are too young to “go out” with someone alone (no group
and no adults).
3. Someone who comes to school wearing sexy clothing is asking to be
sexually harassed.
4. It’s okay to make comments about people’s body parts, unless they say they
don’t like it.
5. Gay, lesbian, and bisexual teenagers should be allowed to take their samesex partners to school dances and other social functions.
6. It’s okay for two people of different races to date.
7. When a girl is out with a guy, it’s really up to her to make sure that things
don’t go too far sexually.
8. Guys should only use condoms when they’re having sex with someone who
has had many sexual partners.
9. It’s irresponsible for a teenager to have sex without using protection from
pregnancy and STIs.
10. Talking someone into having sex before they are ready is taking unfair
advantage of them.
11. Having sex with someone who you don’t really care about is wrong.
12. A girl who carries condoms in her purse is probably “easy.”
13. Choosing not to have sex is the best choice for teenagers.
14. If a guy and girl are having sex, and she gets pregnant, they should get
married.
15. Teenagers are too young to be good parents.
16. There should be more restrictions on sexual images, language, and soliciting
on the Internet.
15. Teen fathers should be forced to pay child support.
16. When faced with an unintended pregnancy, a woman should have the right
to choose abortion.
45
What I Think .
Level II/III
Objective:
Participants will identify their values regarding sexual
expression.
Structure:
Activity with adult support person.
Time:
15 minutes (in class).
Materials:
“What I Think” handouts (one for participant, one for adult
support person).
Procedure
Note: Some young
people may be
unable to complete
this assignment
with their parent(s)
or guardian(s).
Allow them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy
1. Distribute the “What I Think” handouts. Explain that the homework involves
values. It should involve an adult that the participant trusts (e.g. parent,
guardian, aunt, uncle, member of the clergy, neighbour) and the participant.
There are separate sheets to complete. Participants should discuss the
activity with the adult after they each have completed their own sheet.
2. In order to maintain the privacy of participants, ask participants to submit the
Declaration of Completion slip once the assignment is done.
3. Conclude the activity with a discussion based on the following questions:
How difficult/easy was it to do this activity?
How similar/different were your answers from your adult support person?
What did you learn from the activity?
Would your/your adult support person’s answers be different if the teen
referred to was 13 years of age? 19 years of age?
Will the activity influence your choices? How?
.
(Reprinted with permission from Williams, Dorothy L., ed. (1991) Values and Choices. (Minneapolis,
MN: Search Institute. 1-800-888-7828.)
46
Handout
What I Think
My Opinion
Directions: Please fill in the blanks with your own ideas. Then
discuss your answers with an adult you trust.
1.
What do you think about teenagers seeing restricted movies or
reading pornographic magazines?
2.
What do you think about teenagers wearing revealing clothes?
3.
What do you think about teenagers’ use of swearing and slang?
4.
What do you think about sexual activity for teenagers?
5.
Is there some other question about how some teenagers dress, talk, or act that you’d like to ask an
adult?
(Detach and hand in this slip only.)
We completed the What I Think? homework assignment.
___________________________________
Participant
___________________________________
47
Handout
What I Think
Adult Opinion
Directions: Please fill in the blanks with your opinions about the following topics. Please feel free to discuss
this with the participant.
1.
What do you think about teenagers seeing restricted movies or reading pornographic magazines?
2.
What do you think about teenagers wearing revealing clothes?
3.
What do you think about teenagers’ use of swearing and slang?
4.
What do you think about sexual activity for teenagers?
5.
Is there some other question about how some teenagers dress, talk, or act that you’d like to ask a
teenager?
48
What Would You Say?
Objective:
Participants will describe family values about teenage dating.
Time:
Materials:
“What Would You Say? (Participant)” handout,
“What Would You Say? (Adult Support Person)” handout.
Level II/III
Procedure
1. Explain that the purpose of this exercise is to initiate a discussion of family
members’ values and feelings about teenage dating and to explore what
impact they have on teenage lives.
2. Distribute handouts.
3. Instruct participants to complete the handout with an adult person they trust
(e.g. parent, guardian, grandparent, aunt, uncle, member of the clergy, etc.).
Remind them to discuss their answers with their adult support person. Stress
that the answers will not be shared as a group nor will the assignment be
collected. Instead, participants will submit the Declaration of Completion as
proof of assignment completion.
4. After the homework activity has been completed, conclude the activity
with a discussion based on the following questions:
How did you feel doing the exercise?
What were some of the values and feelings that came up during the
exercise?
Will your adult support person’s opinions influence or affect your
decisions and actions? Why?
Note: Some young
people may be
unable to complete
this assignment with
their parent(s) or
guardian(s). Allow
them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
49
Handout
What Would You Say? (Participants)
1. You are active in sports, do OK at school, and
have several hobbies. Your friends are beginning
to date, but you’re not really interested. One day
after school, you ask your adult support person if
there’s something wrong with you. What would
your adult support person say?
2. You are in Grade 9. One day you come home
from school and tell your adult support person, “I
have a date with someone in Grade 12.” What
would your adult support person say?
3. You are 13.You and the person you have been
dating have decided to go steady and announce this to your adult support person. What would s/he say?
4. You overhear your adult support person talking to a friend on the phone about a teenage couple (ages 16
and 17) that are having sex. After s/he gets off the phone, you say, “Faye and John really love each
other—why isn’t it OK for them to have sex?” What would your adult support person say?
Next Step: Share and discuss your answers with your adult support person.
We completed the What Would You Say? homework assignment.
___________________________________
Participant
___________________________________
50
Handout
What Would You Say? (Adult Support Person)
1. The participant is active in sports, does OK at school, and has several hobbies. Her/his friends are
beginning to date, but s/he is not really interested. One day after school, s/he asks you if there’s
something wrong with him/her. What would you say?
2. The participant is in Grade 9. One day s/he comes home from school and tells you: “I have a date with
someone in Grade 12.” What would you say?
3. The participant is 13 and has been dating. They announce they are going steady. What would you say?
4. You are talking to a friend on the phone about a teenage couple (ages 16 and 17) that are having sex.
After you get off the phone, the participant says, “Faye and John really love each other—why isn’t it OK
for them to have sex?” What would you say?
Next Step: Share and discuss your answers with the participant.
51
Exploring Attitudes About Sexual Violence .
Level II/III
Objective:
Participants will identify their attitudes concerning sexual
violence.
Structure:
Large group.
Time:
30 minutes.
Materials:
“Is it All Right…” handout and “The Rape of Mr. Smith”
handout.
Procedure
Note: The “Is It All
Right ...” handout
often evokes strong
responses from
young people. If this
happens, you may
want to explore
their feelings and
what, if anything,
surprised them
about the survey. It
is important to point
out that while the
majority of sexual
violence is
perpetrated against
girls and women,
some boys and
men also
experience it. This
exercise aims to
explore common
attitudes and beliefs
perpetuated by
society at large.
1. Distribute the “Is It All Right ...” handout. Explain that the questions in “Is It
All Right ...”are about rape and that respondents answered for themselves,
not as they thought their friends would.
2. Ask what attitudes are reflected in the “Is It All Right …” handout (and maybe
in your class). Responses should include:
Sexual violence is okay in certain situations.
If someone behaves in a certain way (dresses sexily, turns a partner on,
doesn’t pay for expenses, or is drinking), they are perceived to be “asking
for it,” and can be blamed for the sexual violence that occurs to them.
3. Ask how these attitudes perpetuate sexual violence. Responses should
include:
The message, “sexual violence is always wrong,” is not clearly delivered
if we excuse violence in certain situations; if we believe that it is to be
expected; and if we blame the survivor for the violent behaviour that
occurred. If we make excuses and exceptions for acting violently, we are
allowing and supporting the continuation of sexual violence.
4. Explain that you want to look at a different type of violation and at the issue
of blame.
5. Have two volunteers read “The Rape of Mr. Smith” aloud.
6. Ask participants what the point of the story was and how it relates to sexual
violence. Responses should include:
Blaming the victim of a robbery for getting robbed is absurd. It is not
absurd in our culture, however, to blame the person who was raped for
the rape, or to blame the person who was sexually violated in other ways
for the sexual violence.
7. Ask participants how we develop our attitudes about what is right and wrong
behaviour. Point out that some of the ideas of how to behave and what to
expect in a relationship are hurtful and some are helpful.
.
(Adapted with permission from: Cyprian, Judy, McLaughlin, Katherine and Quint, Glenn (1994)
Sexual Violence in Teenage Lives: A Prevention Curriculum. Planned Parenthood New England. For
related information or a copy of this curriculum, call 1-800-488-9638.)
52
8. Give some examples of messages or ideas we get about how to behave and
what behaviour to expect from others that would harm a relationship. Some
ideas are:
We expect that some conflicts will be resolved with violence.
We are taught that we don’t need to talk about sexual intimacy: that one
should just know what their partner wants or doesn’t want.
Ask participants if they can think of other behaviours to add to the list.
9. Conclude by pointing out that: Sexual violence occurs, in part, because of
some of the messages in our society, about how we are to behave, and what
we are to expect from each other in a relationship.
We are all susceptible to those messages. It is important to be aware of
what those messages are, and to know which ones will lead to a
relationship that will be in the best interest of both people involved.
Young people can be part of the generation that changes some of those
messages into ones that promote relationships that are based on mutual
respect—not exploitation.
.
.
53
Handout
Is It All Right …
These are the results of a survey conducted by Jacqueline Goodchilds of the University of
California, Los Angeles. She asked high school students:
“Is it all right if a male holds a female down and physically forces her to
engage in intercourse if …”
Conditions
Percentage of “yes” responses
Males
Females
1.
He spent a lot of money on her?
39%
12%
2.
He is so turned on he thinks he can’t stop?
36%
21%
3.
She has had sex with other guys?
39%
18%
4.
She is stoned or drunk?
39%
18%
5.
She lets him touch her above the waist?
39%
28%
6.
She is going to have sex with him and then changes her mind?
54%
31%
7.
She has led him on?
54%
26%
8.
She gets him excited sexually?
51%
42%
9.
They have dated for a long time?
43%
32%
54
Handout
The Rape of Mr. Smith .
In the following situation, a lawyer asks questions of a hold-up survivor.
“Mr. Smith, you were held up at gunpoint on the corner of First and Main?”
“Yes.”
“Did you struggle with the robber?”
“No.”
“Why not?”
“He was armed.”
“Then you made a conscious decision to comply with his demands rather than resist?”
“Yes.”
“Did you scream? Cry out?”
“No, I was afraid.”
“I see. Have you ever been held up before?”
“No.”
“Have you ever given money away?”
“Yes, of course.”
“And you did so willingly?”
“What are you getting at?”
“Well, let’s put it like this, Mr. Smith. You’ve given money away in the past. In fact, you have quite a reputation
for giving your money to charity. How can we be sure that you weren’t trying to have your money taken from
you by force?”
“Listen, if I wanted – “
“Never mind. What time did this hold-up take place, Mr. Smith?”
“About 11:00 pm.”
“You were out on the street at 11:00 pm? Doing what?”
“Just walking.”
“Just walking? You know that it’s dangerous being out on the street that late at night. Weren’t you aware that
you could have been held up?”
“I hadn’t thought about it.”
“What were you wearing at the time, Mr. Smith?”
“Let’s see … a suit. Yes, a suit.”
“An expensive suit?”
“Well – yes. I’m a successful lawyer, you know.”
“In other words, Mr. Smith, you were walking around the streets late at night in a suit that practically
advertised the fact that you might be a good target for some easy money, isn’t that so? I mean, if we didn’t
know better, Mr. Smith, we might even think that you were asking for this to happen, mightn’t we?”
.
From The Legal Bias Against Rape Victims (The Rape of Mr. Smith), Connie K. Borkenhage, American Bar Association Journal, April
1975. Reprinted by permission of the ABA Journal.
55
What is “Sex”?
Level II/III
Objective: To explore the variety of beliefs, values and opinions young people
have concerning key sexuality concepts.
Structure: Individual and large group.
Time:
40 minutes
Materials: Flipchart, markers, “What is Sex”? handout.
Note: This activity gives young people the opportunity to clarify their values,
opinions and beliefs about sex, sexual activity, virginity and intimacy. It also gives
educators the opportunity to reflect upon the range of these opinions and to
challenge adult assumptions about young people’s sexual behaviour. For
example and contrary to popular belief, not “all” teens are having oral sex. In fact,
according to the Canadian Youth, Sexual Health and HIV/AIDS Study (2003: 7576), 28% of grade nine girls and 32% of grade nine boys reported having oral sex
at least once. That being said, oral sex has certainly become more a part of
people’s sexual repertoire in the past twenty years. Some teens don’t consider
oral sex to be “sex” and as such view oral sex as a way to maintain their virginity
and reduce their risk for pregnancy and infection. They also may see oral sex as
a less intimate act than sexual intercourse since it doesn’t involve nudity or eye
contact. Considering the ways in which young people conceptualize sexuality and
intimacy can help shape future educational initiatives.
Procedure
1. Introduce the activity by informing participants that this activity will give them
an opportunity to sift through their own beliefs and hear from their peers about
what constitutes sex, sexual activity, virginity, and intimacy.
2. Distribute the “What is Sex”? handout to each participant.
3. Give participants sufficient time to work through the handout. During this time,
post four pieces of flipchart paper in the room, each with one of the following four
headings: sex, sexual activity, virginity, intimacy.
4. Once participants have completed the handout, give them about five minutes
to visit a couple of flipchart stations where they can write down some of their
thoughts below each heading.
5. Reconvene the group and discuss each flipchart in turn, asking for elaboration
as needed. Point out how we all have different values, beliefs and opinions that
shape our understanding of sex and sexuality.
6. Conclude by discussing the following questions:
•
•
•
•
Do most young people think these words mean the same thing?
Do girls and boys think of these words in the same way?
Do adults and teens think of these words in the same way?
What influences our understanding of these words?
56
Handout
What is “Sex”?
SEX
What is “sex”?
SEXUAL ACTIVITY
What are some “sexual activities”? Are sexual activities the same as “sex” or different?
VIRGINITY
What is “virginity”? What does it mean to “lose” one’s virginity?
INTIMACY
What is “intimacy”? Is sex more intimate than sexual activities? Are some sexual activities more
intimate than others?
57
Values and Sexuality
Level III
Objective:
Participants will compare their own values related to sexuality
with those of their parents/guardians or friends.
Structure:
Individual and large group discussion.
Time:
20 minutes.
Material:
Moral/Moral Values and Sexuality” handout.
Procedure
1. Make the following points:
Thinking about our values as they relate to sexuality can help us to make
important decisions that we may face in our lives.
In making decisions about sexuality, we are often influenced by important
people in our lives, like our family and friends.
This questionnaire is designed to help us identify our own perspectives
and those of others who may be important to us with respect to sexuality
issues.
2. Distribute the “Values/Moral Values and Sexuality” handout. Inform
participants that their answers are confidential and that you will not be
collecting them.
3. Allow sufficient time for participants to complete the handout.
4. Conclude by asking participants if there were statements where they put
different responses for themselves, their parents, or friends. Briefly discuss
how decisions about sexuality issues can be complicated, and that it is
important to think carefully about our values when making decisions about
sexuality.
58
Handout
Values/Moral Values and Sexuality Questionnaire
Directions: Use a check mark to indicate agreement with the statement.
Statement
I Agree
My Parents Agree
My Friends Agree
Having sex before marriage/life time commitment
is wrong.
It is important for teenagers to know how to use
birth control and practice safer sex (use
condoms).
My religion should play an important role in how I
make decisions about sexual behaviour.
The most important thing about sex is having fun.
It’s important to be in love with your partner
before you have sex with him/her.
If two people are sexually attracted to each other,
that’s all that is needed to have a good
relationship.
Honesty and respect are essential to a good
relationship.
People who are gay or lesbian deserve as much
respect as anybody else.
There is too much pressure put on teenagers to
have sex.
There is too much pressure put on teenagers not
to have sex.
Most teenagers would be better off waiting until
they are older before having sex.
It’s OK for teenagers to masturbate.
It’s OK for a pregnant teenager to get an
abortion, if that’s what she decides is best for her.
After completing this exercise, I learned:
59
Dealing with an Unintended Pregnancy
Level III
Objective:
Participants will describe their attitudes and values
concerning unintended pregnancy.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Dealing with an Unintended Pregnancy” handout.
Procedure
1. Distribute the handout and ask participants to answer the questions
individually. Allow 10 minutes for participants to complete the handout.
2. Reconvene the group and ask the following questions:
What values, beliefs, and issues would people need to consider when
making a decision about an unintended pregnancy (e.g. attitudes/ values
about pregnancy, children, parenting)?
What information would people need to have about each option (e.g. cost
of raising a child, medical information about abortion, rights of natural
parents in adoption)?
Who would help a couple/individual as they make this decision (e.g.
parents, clergy, counsellor, other trusted adult, health agencies)?
3. Conclude the activity by pointing out that dealing with an unintended
pregnancy is a complex issue. It is important that, when faced with one,
individuals consider the impact of their decision on themselves, and other
important people in their lives. Support from parents, other family members,
friends, and/or clergy are valuable during such a time.
Extension
Divide participants into groups of 4 – 5. Instruct each group to pick a topic related
to parenting, abortion, and adoption (e.g. community services, abortion law and
policy, media treatment of the issues, teen parenting issues, single parenting,
adoption policies, etc.) and prepare a report, presentation, poster, video, etc.
60
Handout
Dealing with an Unintended Pregnancy
If you or your partner were to wake up tomorrow as the same person, but unintentionally pregnant, how would
you feel?
a)
I would be happy because…
b)
I would be unhappy because…
c)
My greatest adjustment would be…
Use three words to describe your attitudes regarding the following options: a) pregnancy
a)
adoption
b)
abortion
c)
parenting
If you were faced with an unintended pregnancy, what four issues would you consider before making a
choice?
1.
2.
3.
4.
61
Module 3: Puberty &
Reproductive Health
It is critically important that young people get information
about puberty, anatomy, and reproductive health, as this
information is the foundation of sexual responsibility and
self-care.
This module contains activities that will normalize the
changes associated with puberty, as well as explore human
reproduction and reproductive health issues.
Puberty & Reproductive Health
It is critically important that young people get information about puberty,
anatomy, and reproductive health, as this information is the foundation of sexual
responsibility and self-care. The classroom teacher is sometimes the only source
of this information. The study of these issues will provide participants with the
vocabulary and confidence they need, to successfully navigate the health-care
system. As well, it will help participants to feel more comfortable in making
healthy choices regarding their own sexuality.
Level I and Level II activities examine puberty, anatomy, and reproduction,
whereas Level III activities deal solely with reproductive health. Many educators
like to rely on videos to relay information on these issues. While this is not
entirely discouraged, videos tend to get outdated very quickly. Participants often
focus on the fashion, music and out-dated slang of the actors, rather than on the
message of the video! If you do use a video, ensure that there is sufficient time
left over for questions and discussion.
Teaching Tips
When teaching about puberty, the single most important message
you can give your group is that the physical, social, and emotional
changes they are experiencing are normal. 24
Be sensitive to the comfort level of your group. Often, this is the first
exposure youth have to formal sexual and reproductive health education.
Some participants may be embarrassed, nervous, or excited. Use
icebreaker activities to help reduce this tension, or call your local health
unit or Canadian Federation for Sexual Health member organization for
assistance.
Given the cultural, religious, and familial diversity of youth, be aware that
some topics may be considered inappropriate or taboo. 25Again, use
icebreaker activities or call your local health unit or Canadian Federation
for Sexual Health member organization for assistance.
Many educators like to facilitate single-sex rather than co-ed classes,
particularly when discussing puberty. Neither strategy is more nor less
effective than the other. However, if you do opt to facilitate single-sex
classes, it is very important that girls receive information about boys and
vice versa. It is also helpful to supplement single-sex classes with at
least one co-ed class. Boys often want and like to hear girls’
perspectives and vice versa.
To supplement some of the activities on reproductive health, you may
want to distribute pamphlets and brochures on breast self-examination,
pelvic examinations, testicular examinations and other reproductive
health issues that can be given to participants for their future reference.
Also note that some of the information on reproductive health
overlaps with the STIs and HIV and Contraception and Safer Sex
modules – you may want to supplement the reproductive health
activities with activities from these modules.
OBJECTIVES OF
THE MODULE:
Participants will:
describe the
common
changes
associated with
puberty
identify ways to
cope with the
stress
associated with
puberty
identify and
describe the
male and female
reproductive
systems
describe the
process of, and
issues related to,
pregnancy and
birth
identify and
describe the
reproductive
health concerns
of adolescents
and develop the
skills to talk
about
reproductive
health issues.
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
24
Hubbard, Betty M. (1997) Sexuality and Relationships: Choosing Health High School.
Santa Cruz: ETR Associates.
Toronto Public Health Department (1998) Changes in You and Me! Toronto: Author
25
65
Introduction to Puberty .
Level I
Objective:
Participants will describe some of the common external
changes associated with puberty.
Structure:
Presentation by educator with large group discussion.
Time:
50 minutes.
Materials:
Blackboard or flipchart, “Introduction to puberty”
handout, “Changes” handout.
Procedure
1. Introduce the topic by stating that often these classes are called sex
education classes. Ask what have you heard about these classes? What
topics do you think we will learn about in sex education classes? OR What
topics are we going to discuss today?
Use their answers to get a feeling for how many participants know about the topic
and observe their comfort level. Answers might be – growing, changes, bodies,
puberty, sex…
2. Continue by stating:
We are going to talk about the bodies of boys and girls and the changes
that happen to them as they grow from a child into an adult. There are 3
rapid periods of change in our bodies: conception to birth, birth to first
year, and puberty.
The beginning of the period of growing and changing from a child to an
adult is called puberty.
The time period that starts with puberty and ends with adulthood is called
adolescence (being a teenager).
3. Discuss why it is important for a young person to talk to a person they trust
whenever they encounter information that is confusing to them, or which they
don’t understand. Misinformation can lead to health problems, anxiety, and
uncertainty. They need to know what is true and what is not.
4. Talk about their feelings using the following script:
I think that many of you know the differences but it is difficult to talk about
them. Why is it difficult to talk about these changes?
Feel embarrassed; never talked about it in class before.
Not supposed to talk about it – especially with people of opposite sex.
It is private.
Difficult to discuss with adults around.
Afraid someone will laugh if answer is wrong.
.
(Adapted with permission from: Regional Niagara Public Health Department (1999) Growth and
Development Lesson Plans for Grades 5 & 6 and Toronto Public Health (1998) Changes in You and
Me!)
66
How do we act sometimes when we are embarrassed?
Giggle, blush, act silly, cannot look anyone in the eyes, get very
quiet, unable to ask questions.(Many participants will have
acted in some of these ways already.)
Many of us do find it difficult, even embarrassing, to talk about
our bodies, and we behave in these ways.
5. State that today, young people have access to information
about puberty and sexuality from a wide range of sources.
Some sources provide accurate information in a sensitive
and age appropriate way. Many sources provide
inaccurate, confusing, or disturbing information. Many
young people have unsupervised access to television, adult
magazines, and sexually explicit videos and Internet sites.
Write the word “PUBERTY” in the centre of the board and
draw a circle around it.
Ask participants to think of some of the places where young
people learn about puberty, e.g. parents, brothers and sisters,
other family members, TV, books, Internet, religious
institutions.
Ask which ones might be good sources of correct information?
Why?
Ask for 2-3 students to visit the school library to see what
books there are on this topic. Have them report back.
6. Distribute the “Introduction to Puberty” handout. Instruct participants to
answer the questions as you go over them.
7. Define puberty as “Stage of life in which the reproductive system matures,
and secondary sex characteristics appear”.
8. Ask how does puberty happen? Draw the
chart and make the following points.
Pituitary gland:
Master gland in the centre of the brain
Sends out chemical messages to all parts
of the body through the blood stream
“Messages” are in the form of substances called hormones
Puberty begins because the pituitary gland sends out hormone
messages to certain parts of the body to tell them to change.
These hormone messages go to two special glands:
In girls – ovaries
In boys – testicles
The ovaries and testicles then begin to produce their own hormones, which go
out into the blood stream and tell other parts of the body to change (drawing this
chart on the black board during the discussion may be helpful).
67
9. Ask how old are boys and girls when they go through puberty?
Girls change anytime between the ages of 9 and 16.
Boys change anytime between the ages of 10 and 16.
Emphasize that:
Everyone changes at his/her very own rate.
Some will begin to change much earlier or later than others, and that is
normal for them.
In general, girls begin to change a couple of years earlier than boys. (e.g.
it is very normal for girls to be taller than boys for a while, especially
during Grades 7 and 8.)
10. Ask what happens to your body during puberty? Instruct participants to:
Think of someone who has already gone through puberty.
How is he/she different from you? What changes have happened?
List on blackboard changes that relate to puberty.
Observe reactions of participants to your questions. May get a few
superficial, non-threatening answers – e.g. taller, bigger, deeper voice,
rounded hips, etc. They may be feeling too embarrassed to answer.
MALE
acne
perspiration
hair
grow taller
shoulders and chest broaden
muscles
voice deepens
genitals grow larger
FEMALE
acne
perspiration
hair
grow taller
breasts develop
hips widen
voice deepens
Note how many of these changes are common to both males and females.
11. When they have given you the main general changes, point out how it
seemed easier for them to talk about acne, perspiration, and voices changing
than testicles, hair, and breasts.
Why? How is everyone feeling about discussing these topics?
OR
If participants are just too embarrassed to give you any answers, just
stop making the list. Comment and discuss feelings.
12. Note the common external changes of puberty. Changes in the skin are often
the first signs of puberty in boys and girls.
Ask for some examples? (acne and perspiration).
1. Skin
a) Acne
At puberty and all during adolescence, glands secrete an
increased amount of oil.
Increased hormones are responsible for this change.
68
Pores get clogged with oil and dirt.
The blocked area can form a pimple.
Everyone will get a few pimples.
Some people may require treatment by a doctor. BUT: Most people
can reduce the severity by following these basic rules of hygiene:
Wash face with unscented soap and water daily.
Do not squeeze or pick pimples, as this can cause infection.
Avoid creams and cosmetics that contain oil, and make sure all
cosmetics are removed before going to bed.
Eat a well balanced diet, and drink lots of water.
Get lots of exercise and rest.
Wash hair regularly and keep back from face.
b) Perspiration
At puberty, perspiration (sweating) increases.
In combination with bacteria on the skin, an odour can result—
sometimes called “body odour.”
People perspire all the time – not just during physical activity.
Underarms, groin area, palms of hands, and soles of feet tend to
perspire more.
To combat perspiration, people can
bathe or shower regularly (or wash underarms, genitals, hands
and feet)
use deodorants or antiperspirants
wear clean clothes.
2. Body Hair
During puberty, the following changes may occur:
a) Hair on head Boys and girls may experience oilier hair. This is due
to an increased hormone production, which causes increased oil
secretion on scalp.
b) Underarm hair
Boys and girls will experience an increased hair growth in the
underarm area. This is normal. Because of increased activity,
perspiration, and the presence of hair, boys and girls may want
to cleanse this area daily.
Antiperspirants and deodorants are available. Antiperspirants
slow the sweating process. Deodorants cover/mask unpleasant
odours.
In our culture, some women shave underarms and legs. As this
may not be done in other cultures, be considerate of the
practices/habits of others.
13.
Ask the participants what other factors influence good health:
3 meals a day; healthy snacking; drinking water
Breakfast every day
Moderate exercise 2-3 times a week
69
Adequate sleep
Not smoking
Healthy weight (NOTE: Body Mass Index is not valid during
adolescence – many adolescents gain weight before their growth
spurt.)
14.
Distribute the “Changes” handout. Instruct participants to complete it for
homework.
OR
Divide participants into small groups. Give each group a copy of the
“Changes Chart.” Have each group fill in the chart. Collect and keep
until next class/session.
70
Handout
Introduction to Puberty
1. What is puberty?
2. How does puberty happen?
3. How old are boys and girls when they go through puberty?
4. What happens to your body during puberty?
MALE
FEMALE
5. Common external changes of puberty
SKIN
BODY HAIR
OTHER FACTORS THAT INFLUENCE GOOD HEALTH:
71
Answer Key
Introduction to Puberty
1.
What is puberty?
The period of growing and changing from a child to an adult.
2.
How does puberty happen?
The pituitary gland sends out hormone messages to certain parts of the body to tell them to
change.
3.
How old are boys and girls when they go through puberty?
Girls: anytime between the ages of 9 and 16.
Boys: anytime between the ages of 10 and 16.
Everyone changes at his/her own rate.
4.
5.
What happens to your body during puberty?
MALE
FEMALE
acne
acne
perspiration
perspiration
hair
hair
grow taller
grow taller
shoulders & chest broaden
breasts develop
muscles
hips widen
voice deepens
voice deepens
Common external changes of puberty
SKIN
BODY HAIR
acne
oilier hair
perspiration
increased growth in underarm
pubic hair grows
OTHER FACTORS THAT INFLUENCE GOOD HEALTH
3 meals a day
moderate exercise 2-3 times a week
adequate sleep
not smoking
healthy weight
72
Level I
Answer Key
Changes
.
Many changes happen to boys and girls during puberty. Some of the
changes are listed below. For each change, decide whether it could happen
only to boys, could happen only to girls, or could happen to both.
Put an “X” in the correct column. You do not need to put your name on this
exercise.
Changes
Could happen only to
girls
Could happen only
to boys
Can get pimples
Period begins
x
x
x
Can have mood swings
x
Shoulders get wider
Hips get wider
Could happen to
both
x
Pubic and underarm hair grows
x
Can have crushes on someone
x
Breasts get bigger
x
Increased sweating
x
Testicles increase in size
x
Sperm are made
x
Body odour
x
Sexual thoughts and feelings can
increase
x
Voice gets lower
x
.
(Adapted with permission from: Toronto Public Health (1998) Changes in You and Me! City of
Toronto.)
73
Handout
Changes
Many changes happen to boys and girls during
puberty. Some of the changes are listed below.
For each change, decide whether it could
happen only to boys, could happen only to girls,
or could happen to both.
Put an “X” in the correct column.
Changes
Could happen only to
girls
Could happen only
to boys
Could happen to
both
Can get pimples
Period begins
Can have mood swings
Shoulders get wider
Hips get wider
Pubic and underarm hair grows
Can have crushes on someone
Breasts get bigger
Increased sweating
Testicles increase in size
Sperm are made
Body odour
Sexual thoughts and feelings can
increase
Voice gets lower
74
Puberty Interview .
Objective:
Participants will discuss puberty with an adult that they
trust in order to develop a support system.
Structure:
Homework assignment: interview with an adult.
Time:
Materials:
Puberty Interview handout.
Procedure
1. State that puberty can be an exciting, confusing, and tumultuous time. This
activity will encourage participants to seek out an adult of the same sex, that
they trust (e.g. parent, guardian, aunt, uncle, neighbour, etc.), in order to
discuss the changes associated with puberty, thereby creating a venue for
discussion and support.
2. Some of these questions may be too personal or embarrassing for an adult
to answer. Encourage participants to share the interview guide with the adult
prior to the interview. That way, the adult can prepare what questions s/he Is
willing and able to answer and discuss.
3. Rather than handing in a completed interview guide, ask participants to hand
in the Declaration of Completion. That way, privacy is maintained for the
participant and the adult s/he interviewed, while providing proof that the
homework exercise was completed.
4. Conclude with the following questions:
Note: Some young
people may be
unable to complete
their parent(s) or
guardians(s). Allow
them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
How easy/difficult was the activity?
Did the answers surprise you?
What did you learn by doing this activity?
.
(Adapted with permission from: Ruthie Patriquin (1995) Growing Together! Amherst: Cumberland
County Family Planning.)
75
Handout
Puberty Interview
Instructions: Pick an adult of the same sex, that you trust (e.g. parent, guardian, aunt, uncle, neighbour,
member of clergy, etc.), to interview. Using the following questions as a guide, discuss the following:
1
What is the best thing about growing up?
2
How old were you when you started puberty? What changes did you experience?
3
How did you handle the stress and embarrassment sometimes felt during puberty?
4
How did you feel about boys/girls when you were my age?
5
What did you like best about your body and your looks when you were my age?
6
When did you start to feel grown up?
7
When did you have your first kiss?
We completed the “Puberty Interview” homework assignment.
_________________________________
Participant
_________________________________
76
Girls and Puberty .
Objective:
Participants will describe the internal and external changes
females experience during puberty.
Structure:
Time:
45 minutes.
Materials:
Blackboard or flipchart; “Female Anatomy” handout; Female
Anatomy resource sheet (Appendix F).
Procedure
1. Introduce the topic by stating:
Up until now, we have been discussing external changes of puberty. Today
we will learn about the changes that happen inside the female body at
puberty.
Level I
Note: It is important
that girls or boys
understand these
changes before they
begin to happen.
We can see external changes quite easily, but there are many more changes
happening internally, which are also important. It is sometimes more
embarrassing to discuss these parts because they are more private.
Review the ages that boys and girls go through puberty (if necessary).
We know that puberty happens to prepare males and females to be able to
reproduce. What do the words reproduce and reproduction mean? (To make
a baby, make another similar to the first.)
When we talk about the reproductive organs, we are talking about the parts
of the body that help reproduction happen.
Today, we will learn about the reproductive organs of the female and how
they change at puberty to make it possible for a woman to reproduce.
2. Visible changes to girls
Breast development—breasts may feel sore at times—one breast often
develops before the other breast—it can take 3-5 years before breasts are
fully grown. Breasts are often unequal in size (e.g. one may be bigger than
the other). Help the class to be aware that in addition to the job of making
milk, a woman’s breasts can be a source of sexual pleasure—both to herself
and to her partner.
Breast size is primarily determined by genes.
Breast size can be affected by nutrition, pregnancy and/or surgery.
Height and weight increases—an increase in body weight is normal and
healthy. Because weight is an issue for many young women, be positive
when you talk about this change. Explain that we all need fat for nutrition and
energy. About 25% of the female adult body is fat and 15% of the male adult
body is fat. 23% of the female body is muscle and 40% of the male is
muscle. This means, generally, that men have more strength (can lift more)
and run faster.
.
Me!)
77
Women can endure some kinds of physical stress more easily than men.
Women, in general, can survive famine, cold, and drought better and do very
well in endurance sports (long distance swimming, marathons, etc.).
Hips broaden to prepare for the delivery of a baby.
Armpit hair, pubic hair develops and hair grows on the legs and arms.
Discuss the following questions:
What are breasts for?
What determines whether a girl will have small breasts, medium sized
breasts, or large breasts?
Why might a girl worry about what size her breasts grow?
Why do a girl’s hips get wider but a boy’s don’t?
3. Introduce the female reproductive system. You may wish to have
participants complete the worksheet on labelling the reproductive system
during discussion. Orient participants to chart being used – e.g. front view or
side view and where these organs are located on the body.
External Genitals
Ones we are born with – sometimes they are altered.
Vulva
Consists of labia majora and labia minora (outer and inner folds of skin)
Function as protection for the internal sex organs
Clitoris
Small, sensitive organ located above the opening to the vagina
Function is one of sexual pleasure
Three openings
Urethra, vagina, anus
4. Introduce the internal reproductive organs.
Vagina
Leads to the other internal reproductive organs
Used for menstruation, intercourse, childbirth
Not used for urination – opening just above vagina, called the urethra, is
used for this purpose (external view diagram explains this concept best)
A thin membrane (the hymen) surrounds the vaginal opening, may not be
noticeable in some
78
Uterus
Also called the womb
Special place in woman’s body where baby grows
Very low in abdomen, nowhere near the stomach, about the size of a fist
It is the uterus that enlarges during pregnancy, not the stomach
Fallopian tubes
Two tubes on either side of the uterus
Passageway from the uterus to ovary
Ovaries
Females have 1-2 ovaries
Reproductive glands
Start producing hormones at puberty
Hold about 250,000 ova (eggs) until puberty when they start being
released – one released per month
Ovum
Also called egg cell
Special cell which, when fertilized (united with male sperm cell), can
create a baby.
All girls are born with their reproductive organs but they do not start to
develop and function until puberty.
Tell participants to imagine a very small pear. Explain that this is the usual
size of a mature woman’s uterus. Have participants put their fist where they
think the uterus is found in a woman’s body.
Explain that the uterus is low down in the pelvis and can grow and stretch in
pregnancy- up to the woman’s rib cage.
Ask participants where they think their stomach is. How many were told that
babies grow in their mother’s stomach? Is this true?
5. Discuss changes in reproductive organs at puberty.
Discharge
Keeps vagina clean and healthy
One of the early changes in puberty. A girl may notice some discharge
on her underwear or on toilet paper. It varies from whitish and pasty to
clear and slippery. This means a girl’s body is starting to mature and her
period will be starting.
If bad odour, itchy or unusual, may be an infection
Ovulation
Once ovaries start producing hormones, the message is given to start
releasing one ovum, once a month from one ovary
Usually a girl cannot feel this happening
If egg is not fertilized in a day or so, it dissolves
79
Menstruation
Uterus must prepare for growth of a baby if fertilization occurs
Hormones from ovaries send message to uterus to grow a thick, soft
lining of tissue and blood
This lining contains nutrients that would be needed to nourish the egg
and sperm if fertilization occurred
If the egg is not fertilized in the fallopian tube, the lining is not needed to
nourish a baby, so a message from ovary (by hormone) tells the uterus to
shed the lining, takes 5-7 days to shed lining – this is called menstruation
(having a period) – usually menstruate once a month – bloody discharge
trickles out of the body through the vagina
Once the lining is completely shed, a new lining begins to grow
Soon another egg is released, and if fertilization does not occur, the egg
dissolves and that lining is shed. This continues to happen over and over
again. That is why we call it the menstrual cycle
This is a normal change of puberty – something to be proud of – not
something dirty or bad
Some women experience menstrual cramps which can be relieved with
pain killers or hot water bottles
6. Discuss the following:
How does it feel if you fall and get a cut on your knee?
How does it feel if you have a nosebleed?
Do you think having a period is more like cutting your knee or more like a
nosebleed? Why?
7. Discuss personal care during menstruation using the following script:
Menstruation is a normal change of puberty. It is not a sickness – usually
can continue to participate in regular daily activities (e.g. physical
education classes, gymnastics, swimming, etc.)
Personal hygiene (i.e. bathing) even more important at this time as oil
secretion from hair and skin may increase and menstrual blood may get
dried in pubic hair
Sanitary pads or tampons are used to absorb menstrual fluid
You may want to show samples and explain
Always wipe from front to back to help prevent infection
Why does a girl get a period?
How long does a period usually last?
What does a girl use to absorb the menstrual blood?
How does a woman decide which type of menstrual product she will use?
80
9. Products
Pads
Various sizes of pads available, as the flow varies Pads have adhesive
strip that sticks to underwear
Necessary to wear protection 24 hours a day
Must change pads frequently, approximately every 3-4 hours
Dispose of pads in wastebasket rather than toilet (wrap in toilet paper
first)
Scented pads may irritate some people’s skin
Tampons
Swimming requires the use of tampons
With tampons, menstrual fluid is absorbed within the vagina
Tampons often not used by girls when period first starts
Should be changed every 3-4 hours (stress this point)
Held in place by vagina – can’t get lost or fall out
String used to remove tampon – very strong
Dispose of in wastebasket (wrap in toilet paper first)
Menstrual Caps
Small, reusable cup that is inserted in the vagina to collect menstrual
flow
Not often used by girls when period first starts
Available in health food stores
81
Handout
Female Anatomy
82
Handout
Female Anatomy
83
Quick Review of Girls at Puberty .
Level I
Objective:
Participants will assess their knowledge of female
changes during puberty.
Structure:
Time:
10 minutes.
Procedure
1.
Use this quiz for review purposes at the start or end of a class.
2.
Read each statement and have participants fill in the blanks.
Ovaries release ___________________ (eggs), usually about
_____________ per month. (one)
A girl starts releasing eggs when she
_________________________________ (starts having periods/is going
through puberty/is 9 – 16).
A period usually lasts _____________________. (3-7 days)
A woman has her period approximately once a _________________
(month)
When an egg and sperm come together, this is called
_____________________. (fertilization)
The place where a fertilized egg goes to grow and develop is called the
_________________________ (uterus/womb)
The warm, moist passageway that connects the uterus to the outside of
the body
is called the ____________________________. (vagina)
Some things that cause a girl to become sexually excited are
__________________________________________________________
(thinking about something sexy/feeling anxious/no reason at all)
Some feelings girls might have about starting their period are
__________________________________________________________
excited/worried/curious/frightened)
The only way another person can tell if a girl is having her ___________
(period) is if the girl tells her/him.
.
Toronto.)
84
Boys and Puberty .
Objective:
Participants will describe the internal and external
changes males experience during puberty.
Structure:
Time:
45 minutes.
Materials:
Blackboard/flipchart; “Male Anatomy” worksheet; male
reproductive system resource sheet (Appendix F)
Level I
Procedure
1. Introduce the topic by reviewing general male changes and feelings
(especially embarrassment) and need for respect. State that:
Although men do not have babies, they are part of reproduction, and thus
their reproductive organs must grow and develop to make this possible.
Today, we will learn the parts of the reproductive system, and how they
change at puberty to make reproduction possible.
2. Ask participants what external changes boys experience during puberty:
Adam’s apple will begin to show
Shoulders and chest will grow bigger
Muscles will become bigger
Hair on face will appear
Body hairs appears for some boys (e.g. underarms, face, pubic area,
later maybe on chest/back)
Voice changes for some boys
Testicles gradually grow a little larger
Penis will grow longer and wider as the rest of the body grows
Will begin to have erections and “wet dreams”
Breast development.
Breast
development:
This fact comes as
a surprise to most
students. Some
boys will find that
the area around one
or both nipples can
feel sore and may
swell. This is
because boys have
some female
hormones in their
body. The soreness
and swelling usually
go away. This is
normal.
Feelings of sexual attraction emerge
Sudden mood changes occur
Weight gain before growth spurt
.
Me!)
85
3. Ask participants:
Why do some boys get some breast swelling when they are going
through puberty?
As a group, discuss the following:
Someone has some breast swelling. When you change for gym or
swimming, other boys are making comments such as “You’re turning into
a girl” and “Look at those boobs.” You know this makes your friend feel
terrible and it makes you feel bad. What can you do?
4. Discuss the external and internal male reproductive organs. You may wish
to have students complete the worksheet on labelling the reproductive
system during discussion.
External Genitals
Penis
Tube-like organ of spongy tissue (leave rest of information about penis
until later)
Urethra runs lengthwise through centre of penis
Head of penis is called the glans, which is a source of sexual pleasure
Testicles
Male sex glands (1-2) held in a sac called the scrotum
On outside of body to keep temperature cooler than body temperature for
healthy sperm production
Sometimes one can grow faster than the other at puberty
One hangs lower – this is normal
Very sensitive area – easily damaged – important to protect e.g. During
sports activities
Never deliberately kick anyone there
Only need one testicle to be fertile (able to reproduce)
At puberty, begin to produce hormones and sperm
Sperm
Special cells produced in testicle at puberty
Very small (over 300 million in 15 ml of semen)
Millions are made every day
Mix with fluid in glands to form a white sticky fluid called semen
Swim up vagina, through uterus to fallopian tube to fertilize an egg
Internal Reproductive Organs
Vas Deferens
Special cells produced in testicle at puberty
Tube which carries sperm out of testicles
86
Prostate Gland
Starts producing a fluid at puberty in which sperm are kept alive
Sperm + fluid = substance called semen
Urethra
Tube that is located in penis
2 branches – one to bladder, one to vas deferens
Two substances which come out of the urethra are urine and semen,
they cannot come out at the same time
When penis is ready to release semen, a valve blocks off branch to the
bladder so urine cannot escape
Seminal Vesicles
Two small pouches behind the bladder that produce fluid
This fluid mixes with sperm and other fluid to produce semen
5.
Review some of the changes at puberty:
(Likely have mentioned some of the changes while explaining
Reproductive System.)
Production of sperm in the testicles
Growth of penis and testicles
Production of fluid in the prostate gland
6.
Ask what starts happening more often to a boy’s penis at puberty?
Explain erections:
Penis gets bigger, harder, and stands out from the body
Happens to babies and even before birth
7.
Ask why erections happen?
Sexual thoughts send message to penis – thickens and sticks out from
body
Spongy tissue fills up with extra blood
Happens for physical reasons even before puberty
Can happen when you least expect it or want it (e.g. First thing in the
morning, during sleep, vibrations e.g. Riding a bus, not always related
to sexual thoughts.)
Can be frightening and embarrassing
Important to realize that it is a normal process of growing up
An erection does not mean an ejaculation must occur – erection will go
away on its own
Size of penis varies – all sizes work well – less of a difference when
erect
Penis continues to grow as you do
87
8. Lead a discussion by asking the following questions:
Some boys talk about having a “boner”. Is there a bone in the penis?
What is an erection?
How old are boys when they get their first erection?
What causes a boy to get an erection?
9. Discuss the following true anecdotes:
A boy would often get an erection when he was sitting watching an
exciting hockey game.
A teenager would sometimes get an erection when he was concentrating
on getting ready to run and do a high jump.
Why do you think this happened?
Were they thinking sexy thoughts?
How do you think they felt when this happened?
10. Ask participants to define ejaculation:
Note: These
reproductive
changes are not the
first changes to
happen during
puberty. Usually,
they begin once
some of the other
changes like
perspiration, more
oil in hair, and acne
have begun.
The release of semen from penis during an erection
Millions of sperm in one ejaculation
Usually has to be some extra stimulation of the penis for this to happen
e.g. During sexual intercourse or masturbation – this is an orgasm
May happen during sleep (wet dream)
A boy knows he is producing sperm once he has started to have
ejaculations
11. Discuss the possibility of reproduction once a boy can ejaculate.
Explain the difference between ejaculation and urination using the following
exercise:
Tell participants to breathe in through their mouth.
Where does the air go?
Tell participants to swallow some saliva.
Where does it go?
Why doesn’t their breath go into their stomach, or their saliva go into their
lungs? (Because valves open or close the right passageways – usually.)
The same thing happens when a boy ejaculates or urinates.
12. Discuss wet dreams. Ask participants if they know what a “nocturnal
emission” is.
Ejaculation of semen during sleep
One time that semen comes out without any extra touching of the penis
Can be frightening and embarrassing
Important to understand that it is a normal part of growing up
Does not matter how many you have, some don’t have them, some
adults may have them
88
13. Explain circumcision.
Important to mention the difference between one penis and another
Usually it would be done soon after birth
Removal of covering over end of penis
Normal either way (no difference in sensation, performance, etc.)
Something they will have to decide about if they are parents
No health reason to have it done (not medically necessary, but a
personal choice). Boys who have not been circumcised should cleanse
beneath the foreskin of the penis regularly.
14. Explain jock itch.
Sometimes sweaty underwear or jockstraps can lead to a scaly, itchy
rash in the genital area
It is important to keep yourself clean, and the skin dry (e.g. Use of baby
powder)
It can be treated with anti-fungal preparations available at the drug store
without a prescription
If the problem persists, see your doctor
89
Handout
Male Anatomy
90
Quick Review of Boys at Puberty .
Objective:
Participants will assess their knowledge of male changes during
puberty.
Structure:
Time:
10 minutes.
Level I
Procedure
1. Use this quiz for review purposes at the start or end of a class.
2. Read each statement and have participants fill in the blanks
Changes at puberty are caused by ________________________(hormones)
How tall a boy will grow is determined by his ___________________ (genes)
Boys usually notice changes between the ages of ______________ (10 –16)
Sperm are made in the _________________________________ (testicles)
The number of sperm made each day in the testicles is _________________
(many millions)
Sperm and other liquids from glands make the white fluid called___________
(semen)
If semen is going to come out, the penis must be ______________________
(erect/hard)
The penis gets erect because it gets filled with __________________ (blood)
Boys get their first erections ______________________________________
(before they are born)
Some things that cause a boy to get an erection are
_____________________________________________________________
(thinking about something sexy/feeling anxious/clothes rubbing against the
penis/no reason at all)
Semen can come out when a boy is sleeping. This is called a
______________________________ (wet dream)
Sperm are needed to make a ____________________________ (baby)
.
Toronto)
91
Other Puberty Issues .
Level I/II
Objective:
Participants will describe other issues that males and females
sometimes experience during puberty.
Structure:
Time:
20 minutes.
Procedure
1. Introduce the topic by stating that you will be talking about masturbation and
feelings of sexual pleasure. Sometimes students are uncomfortable when
they hear about masturbation. They need to be reassured that many children,
teens, and adults will touch themselves because it feels nice, but many never
want to and don’t. It is OK if a person does this, and it is OK if a person does
not.
Common way for many guys and girls to deal with sexual arousal and
tension
Personal choice whether or not to do it
Won’t hurt the penis, testicles or clitoris
Guys won’t run out of sperm
Should be done in a private place (bedroom, bathroom)
2. Tell the following true story: A man once told a person that was teaching
about puberty that he wished someone had taught him this stuff when he was
growing up.
As a young man he did not know what was happening to his body and he
didn’t really understand what other boys were talking about when they
joked about “coming” and “jerking off.”
Discuss the following:
How do you think he felt?
It scared him because he thought that something must be really wrong
with his body.
Was there anything wrong with his body?
No. But it was a long time before he learned that this was normal and
could happen to any boy.
3. Discuss sexual orientation in terms of thoughts, feelings and activities.
Boys and girls can feel confused about whether they are heterosexual or
gay/lesbian
Most boys and girls feel close to a friend of the same sex and admire
older people such as athletes, coaches, or a teacher
Some boys and girls will experiment sexually with peers of the same sex
as part of curiosity about sex
.
Toronto.)
92
These things do not necessarily mean that the boy or girl is homosexual
Even having sexual dreams about someone of the same sex does not
necessarily mean that a boy or girl is gay
Some boys will know that their sexual interest has always been to males
and some girls will know that their sexual interest has always been to
females
Some boys and girls may be uncertain and want to wait and see what
happens over the next few years and some boys and girls may want to
talk to someone
Sexual orientation is often not completely clear to a person until
adulthood
4. Ask participants where they would tell a friend to go for help, if the friend
thinks that he/she might be gay and wants to talk to someone about it.
Answers include: a relative, a counsellor at a teen clinic, or someone at
school, at a community health centre, or at church.
93
How Appearance Changes Over Puberty .
Level I/II
It is important to
educate and
reassure children
about the rapid
growth so natural to
this stage. And in
particular, to
emphasize that it is
normal to gain
significant weight,
especially in the
form of fat for girls.
Boys and girls
routinely gain
weight before they
get taller. Research
shows that the
misinterpretation of
this body transition
is a major problem
contributing to body
image disturbances.
Objective:
Participants will identify the appearance changes to
expect in puberty, to help keep “looks” in perspective.
Structure:
Large group activity with questions and discussion as
puberty material is presented.
Time:
30 minutes.
Materials:
“How Appearance Changes Over Puberty” book text key
and handout.
Procedure
1. Hand Out and Introduce: Write-a-Book handout “How Appearance
Changes in Puberty.” In this lesson we will talk about how looks change
during puberty. You will become the expert and write a book on this subject.
2. Read the Book Text key “How Appearance Changes In Puberty,” slowly and
carefully. As you read, words that are underlined will be filled in by students
in their “Write a Book”. Allow time for questions and discussion.
Emphasize the following themes as you discuss the material:
The age range for puberty changes are extremely varied. All are normal.
Differences are not “good” or “bad.” They are simply different.
It is critical to
introduce the words
fatter and thinner
as descriptions, not
judgements.
.
(Adapted with permission from: Kater, Kathy (1998) Healthy Body Image – Teaching Kids to Eat and
Love their Bodies Too! Seattle: Eating Disorders Awareness & Prevention. For more information or for
a copy of the program, please contact: 1-800-931-2237.)
94
BOOK TEXT KEY: How Appearance Changes in Puberty
Dear Puberty Expert,
I know there is a lot to learn about how kids’ bodies grow during puberty. I have
some ideas, but I don’t know if they are right or true for everybody. I know kids
get taller, but I’m pretty sure they grow in other ways too. Some kids in my class
are already growing. I heard you had a class on this, and you might have the
answers to some of my questions.
1. Does everybody go through puberty sometime?
Yes
No
2. Will growth be more than just getting taller?
Yes
No
As you develop you will also be filling out.
3. Is everybody supposed to change at the same time?
Everyone changes at different times, according to their own inner “body
clock” or pre-determined schedule.
Yes
4. Do boys and girls change at the same time?
No
As late as
Average age
As early as
GIRLS change: sooner same later
16
10-12
9
BOYS change: sooner same later
12-13
10
16
Compared with each other:
5. So it’s normal for many girls to be taller than many boys at our age?
Yes
No
6. I heard someone say my friend was having a “growth spurt.” What’s that?
Growth spurts are when you grow faster than ever before. During puberty,
instead of growing about 2 inches per year, you may grow 4 inches or more
per year. You may hear your family say, “You are growing out of your clothes
too fast!” But, you can’t help it!
7. Is it better to start puberty sooner, or better to start later?
Better sooner
Better later
Not better either way
8. Why doesn’t everybody start puberty at the same time?
How and when we grow (circle) is not something anyone has control over. It
is predetermined before birth. Whether you start your growth spurt earlier or
later (circle) will not affect how big or small you will be in the end.
9. What if I’m really early or late in starting puberty? I don’t want to be different.
Being different in body changes (circle) is not something that can be judged
as good or bad. No one has control over when or how these changes occur.
It is like the colour of your eyes, or how fast your hair grows. It is not
something anyone should ever have to feel bad about. Even if it would be
easier to change at the same time or in the same ways as your friends,
differences are a normal and necessary part of life.
95
10. What if someone teases me?
It may mean they don’t understand puberty, or they may be being mean.
You could try ignoring or even educating them. Or you could try telling a
friend and getting their support. If that doesn’t help, you should ask a trusted
adult for help and support.
11. Please tell me all the details about puberty changes? Will I grow everywhere
all at once?
Some parts of your body will grow faster, while other parts grow slower. It is
different for everyone, but here is the usual order:
First feet. Feet can be full-size long before you are!
Then arms and legs.
Then back bone and other bones.
12. What exactly will make me “fill out?” What should I expect?
It is normal to gain weight from adding body fat and bone mass during
puberty. In later teen years, you will also gain some muscle.
13. Isn’t fat bad?
Yes
No
Many people have incorrect ideas about body fat. Sometimes fatness has
been thought of as “bad,” but this is not always true, and it is not realistic.
This idea needs to be changed.
All people are naturally pre-disposed or set-up before they are even born, to
be fatter, thinner, or in-between.
When something in nature is “pre-disposed,” it is like eye colour—not in
anyone’s control. If a fatter person is eating well and being active, their
fatness is probably just right for them. No matter what people say or think, if a
person eats well and gets plenty of movement, one body type is not better
than another—just different.
Because of this, saying someone is “fatter” or “thinner” should only be a way
to describe a body type, never a way to judge a person as “good” or “bad,”
as if they were doing something “right” or “wrong.” This would be the same as
judging someone because of their eye or skin colour. It is not correct or fair.
Because so many people have incorrect ideas about body size and weight,
we will be talking more about this in later lessons.
14. Girls develop earlier than boys. Are there other differences for girls?
Yes
No
96
Let’s Talk About Changes For Girls
1. How much can a girl gain during puberty?
While everyone is different, it is normal for girls to gain body fat rapidly in
puberty. Girls may gain 20 pounds or more in one year. This does not mean
they are getting fat.
2. Why do girls gain more body fat than boys?
This is the beginning of the normal, healthy rounding-out of a girl’s body as
she grows into a young woman. Nature intended most adult women to carry
more body fat than most boys and men. This is part of a woman’s special
design for bearing children, and it should not be confused with becoming
unnecessarily fat.
It is natural and healthy for a woman to have a more rounded figure than a
man. Puberty is when this begins.
3. What does a girl’s body do with the added fat?
At first a girl may develop a layer of fat all over, like an extra layer under the
skin. Then it will begin to be more obvious in certain parts: breast, hips, and
thighs.
4. Do girls get taller before they gain weight, or rounder first?
Either way. Everyone is different. Some may get rounder first, and only later
gain height. Others may get quite tall and thin first, later adding curves or
roundness.
A few girls will remain very thin and not very rounded all their lives, whether
they are taller or shorter. But despite what people think, a very thin body
(circle) is not the most common or natural body shape for a woman.
5. Are there any other changes in girls that boys don’t share?
Girl’s pelvic bones (just above her hips) very gradually begin to widen. This
is essential for a woman to be capable of having a baby when she is an
adult. For example, this occurred to allow your mother to have you. Wider
pelvic bones are the second reason why women normally have bigger hips
than men.
Overall, girls develop different shapes than boys. Following are some ways
girls may grow early in puberty. (Draw on board for students to copy).
In Puberty, Girls May Grow:
taller first
rounder first
not much
taller or
rounder
taller and
rounder
wider hips,
narrower at
the shoulders
97
Lets Talk About Changes For Boys
1. Aren’t men usually bigger than women? How can boys begin developing later
than girls?
Once outward growth begins, boys quickly catch-up. Many boys eventually
become taller and more muscular than girls.
2. Is it normal for boys to gain body fat during puberty too?
Often
Sometimes
Rarely
Some boys become fatter before they get taller. However, as boys grow
taller, they often stretch out their fatness into a taller, slimmer body. While
there are natural differences, most fully developed men carry (circle) less
body fat than most women.
3. What other changes occur for boys?
Later in puberty, shoulders can become wider and eventually more
muscular. However, boys usually do not fill out their bodies until later teen
years. Then, they will begin to look less like boys and more like men.
(Draw on the board for students to copy.)
In Puberty, Boys May Look:
rounder first
taller and
rounder
neither taller
or rounder
taller,
always thin
broader
shoulders
than at the
hips
4. Anything else?
More than half of all boys will have some breast swelling in puberty. This is
normal and does not mean he is developing breasts. It will go away in a few
months. Boys need to know not to worry about this.
5. What happens to boys’ voices during puberty?
When a boy’s voice box has grown larger, usually by age 14 or 15, his voice
becomes deeper. This may happen somewhat suddenly or in a gradual, less
noticeable way. Some boys experience a “cracking” of their voice as they go
through this change. Their voices may become high-pitched or “squeaky”
unexpectedly.
6. Isn’t that embarrassing? What if a boy gets teased?
There is no reason to be embarrassed, because it is simply part of growing
up. But unless someone knows you well enough to know you are comfortable
with change, it is mean to tease.
7. Aren’t there some other outward changes for both boys and girls in puberty?
Yes
No
98
Changes For Both Boys And Girls
1. What are some things in common for both boys and girls?
Boys and girls grow hair in new places: first pubic and underarm hair, then
on arms and legs, and for boys, eventually face and chest hair. Also, two
glands become more active: oil and sweat.
2. What about the glands?
When oil glands are more active, you may notice your hair gets oily faster.
Also, many kids have some pimples or skin acne when they are further along
in puberty.
When sweat glands are more active you may notice you perspire more. Also,
perspiration may have a more grown-up odour. When oil and sweat glands
become more active, kids usually need to bathe or shower and wash their
hair more often. You may want to ask a parent or guardian for deodorant.
3. It sounds like this puberty business goes on for a while. I guess it doesn’t
happen overnight.
That’s (circle) right.
4. It also sounds like different parts of the body grow earlier or later—even more
or less than other parts. If some bones grow faster than others, or I’m adding
body fat before I get taller—or the other way around—won’t I look kind of
funny or out of proportion?
Yes
No
Maybe
It is important to Understand that the way you grow in puberty may not be
even. For example, your arms and legs may grow long, while your backbone
is still short. Your feet may be as big as an adult’s, even 2 or 3 years before
the rest of you grows taller. Your ears and chin may grow before the rest of
your face.
For a while you will look very different than how you will end up. One day you
may look in a mirror and enjoy seeing the changes. Another day, you may
not be so crazy about them.
It may help you to know that many kids feel this way at one time or another.
Most kids feel a little awkward or clumsy when some parts of their bodies are
growing faster than other parts. Remember, you are not a finished product
yet! That is why teasing about body changes is especially unfair and hurtful.
This is not a time to judge or worry about looks. It is a time to be amazed at
the many wonderful changes your body is going through as you are growing
up.
99
Think about it this way:
It probably took from 5 to 8 years for you to gain your first fifty pounds and longer
yet to get to be four feet tall.
When you start your growth spurt, you may very well gain another 50 pounds in
only two or three years and a foot or two in height in just a few years. That’s a
Dear Puberty Expert,
BIG change.
Try to
If you
1)
relax,
1)
eat well,
2)
stay healthy, and
2)
stay active, and
3)
give your body time to
show you how it’s going to
end up.
3)
watch, you will see your
body develop naturally into
the size and shape it was
born to be.
100
Handout
How Appearance Changes in Puberty
By
NAME: ___________________________________________
AGE: _____________
Dear Puberty Expert:
I know there is a lot to learn about how kids' bodies grow during puberty. I
have some ideas, but I don’t know if they are right, or true for everybody. I
know kids get taller, but I’m pretty sure they grow in other ways too. Some
kids in my class are already growing. I heard you had a class on this, and
you might have the answers to some of my questions.
1. Does everybody go through puberty sometime?
Yes
2. Will growth be more than just getting taller?
No
Yes
No
As you develop you will also be ______________________________________________.
3. Is everybody supposed to change at the same time?
Everyone changes at times, according to their own inner body ” or pre-determined.
4. Do boys and girls change at the same time?
Yes
No
Compared with each other:
Average age
As early as
As late as
GIRLS change: sooner same later
__________
__________
_________
BOYS change: sooner same later
__________
__________
_________
5. So it’s normal for many girls to be taller than many boys at our age?
Yes
No
6. I heard someone say my friend was having a “growth spurt”. What’s that?
Growth spurts are when you grow ___________________________ than ever before.
During puberty, instead of growing about ________per year, you may grow _________or more per year.
You may hear your family say, “You are growing out of your clothes _____________________________.”
But, you can’t help it!
7. Is it better to start puberty sooner, or better to start later?
Better sooner
Better later
Not better either way
8. Why doesn’t everybody start puberty at the same time?
How and when we grow (circle) is / is not something anyone has control over. It is __________________
before birth. Whether you start your growth spurt earlier or later (circle) will / will not affect how big or
small you will be in the end.
101
9. What if I’m really early or late in starting puberty? I don’t want to be different.
Being different in body changes (circle) is / is not something that can be judged as _______ or _______.
No one has control over when or how these changes occur. It is like the colour of your eyes, or how fast
your hair grows. It is not something anyone should ever have to feel bad about. Even if it would be easier
to change at the same time or in the same ways as your friends, differences are a ____________ and
_________________ part of life.
10. What if someone teases me?
It may mean they don’t understand _______________, or they may be being ________.You could try
___________ or even ______________ them. Or you could try telling a _____________ and getting their
support. If that doesn’t help, you should ask a trusted ____________for help and support.
11. Please tell me all the details about puberty changes? Will I grow everywhere all at once? \
Some parts of your body will grow __________, while other parts grow _________. It is different for
everyone, but here is the usual order: First _______. Feet can be full-size long before you are! Then
_______ and _________. Then _______________ and other bones.
12. What exactly will make me “fill out? “What should I expect?
It is __________ to gain weight from adding ___________ and ___________ during puberty. In later teen
years, you will also gain some
13. Isn’t fat bad?
Yes
No
Many people have incorrect ideas about body fat. Sometimes fatness has been thought of as “bad,” but
this is not always true, and it is not realistic. This idea needs to be changed. ________ people are
naturally pre-disposed or set-up before they are even born to be _______________ or in-between. When
something in nature is “pre-disposed,” it is like eye colour—not in anyone’s control. If a fatter person is
____________ and being ____________, then their fatness is probably just right for them. No matter
what people say or think, if a person eats well and gets plenty of movement, one body type is not better
than another—just different. Because of this, saying someone is “fatter” or “thinner” should only be a way
to ___________ a body type, never a way to _______ a person as “good” or “bad,”—as if they were doing
something “right” or “wrong.” This would be the same as judging someone because of their eye or skin
colour. It is not correct or fair. Because so many people have incorrect ideas about body size and weight,
we will be talking more about this in later lessons.
14. Girls develop earlier than boys. Are there other differences for girls?
Yes
No
102
Let’s Talk About Changes For Girls
1. While everyone is different, it is normal for girls to gain body fat rapidly in
puberty. Girls may gain ____________ or more in one year. This does not
mean they are getting fat.
2. Why do girls gain more body fat than boys? This is the beginning of the
normal, healthy rounding-out of a girl’s body as she grows into a young
woman. Nature _____________ most adult women to carry more body fat
than most boys and men. This is part of a woman’s special design for
bearing children, and should not be confused with becoming unnecessarily
fat. It is __________ and ___________ for a woman to have a more
_________ figure than a man. Puberty is when this begins.
3. What does a girl’s body do with the added fat? At first a girl may develop
a layer of fat __________, like an extra layer under the skin. Then it will
begin to be more obvious in certain parts:
________________________________________________________.
4. Do girls get taller before they gain weight, or rounder first? Either way.
Everyone is different. Some may get rounder first, and only later gain height.
Others may get quite tall and thin first, later adding curves or roundness. A
_________ girls will remain very thin and not very rounded all their lives,
whether they are taller or shorter. But despite what people think, a very thin
body (circle) is is not the most common or natural body shape for a woman.
5. Are there any other changes for girls that boys don’t share? Girl’s pelvic
bones (just above her hips) very gradually begin to __________. This is
essential for a woman to be capable of having ________ when she is an
adult. For example, this occurred to allow your __________ to have you.
Wider pelvic bones are the __________ reason why women normally have
bigger hips than men.
Overall, girls develop different shapes than boys. Following are some ways
girls may grow early in puberty. (Draw the figures according to description).
In Puberty, Girls May Grow:
taller first
rounder first
not much taller
or rounder
taller and
rounder
wider hips,
narrower at
the shoulders
103
Lets Talk About Changes For Boys
1. Aren’t men usually bigger than women? How can boys begin
developing later than girls?
Once outward growth begins, boys quickly catch-up. Many boys eventually
become ___________ and more _______________ than girls.
2. Is it normal for boys to gain body fat during puberty too?
Often
Sometimes
Rarely
Some boys become fatter before they get taller. However, as boys grow
taller, they often stretch out their fatness into a taller, slimmer body. While
there are natural differences, overall, most fully developed males carry
(circle) more / less body fat than most women.
3. What other changes occur for boys?
Later in puberty, ___________ can become wider, and eventually more
muscular. However, boys usually do not ___________ their bodies until later
teen years. Then, they will begin to look less like boys, and more like men.
(Draw the figures according to description).
In Puberty, Boys May Look:
rounder first
taller and rounder
neither taller or
rounder
taller, always thin
shoulders than at
the hips
104
5. Anything else?
More than half of all boys will have some _____________ in puberty.
This is normal and does not mean he is developing breasts. It will go away in
a few months. Boys need to know not to worry about this.
6. What happens to boy’s voices during puberty?
When a boy’s voice box has grown larger, usually by age 14 or 15, his voice
becomes __________. This may happen somewhat suddenly, or in a
gradual, less noticeable way. Some boys experience a ___________ of their
voice as they go through this change. Their voices may become high-pitched
or “squeaky” unexpectedly.
7. Isn’t that embarrassing? What if a boy gets teased?
There is no reason to be embarrassed, because it is simply part of growing
up. But unless someone knows you well enough to know you are comfortable
with change, it is mean to tease.
8. Aren’t there some other outward changes for both boys and girls in
puberty?
Yes
No
105
Changes For Both Boys and Girls
1. What are some things in common for both boys and girls?
Boys and girls grow hair in new places: first pubic and underarm hair, then on
________ and________, and for boys, eventually _______ and ________
hair. Also, two glands become more active: ______ and __________.
2. What about the glands?
When oil glands are more active, you may notice your hair gets oily faster.
Also, many kids have some pimples or skin acne when they are further along
in puberty.
When sweat glands are more active you may notice you perspire more. Also,
perspiration may have more _____________ odour. When oil and sweat
glands become more active, kids usually need to bathe or shower and wash
their hair more often. You may want to ask a parent or guardian for
deodorant.
3. It sounds like this puberty business goes on for a while. I guess it
doesn’t happen overnight.
That’s (circle) right / wrong.
4. It also sounds like different parts of the body grow earlier or later—even more
or less than other parts. If some bones grow faster than others, or I’m adding
body fat before I get taller—or the other way around—won’t I look kind of
funny or out of proportion?
Yes
No
Maybe
It is important to understand that the way you grow in puberty may not be
even. For example, your arms and legs may grow long, while your backbone
is still short. Your feet may be as big as an adult’s, even 2 or 3 years before
the rest of you grows taller. Your ears and chin may grow before the rest of
your face.
For a while you will look very different than how you will end up. One day you
may look in a mirror and enjoy seeing the changes. Another day, you may
not be so crazy about them.
It may help you, to know that many kids feel this way at one time or another.
Most kids feel a little awkward or clumsy when some parts of their bodies are
growing faster than other parts. Remember, you are not a finished product
yet! That is why teasing about body changes is especially unfair and hurtful.
This is not a time to judge or worry about looks. It is a time to be amazed at
the many wonderful changes your body is going through as you are growing
up.
106
Think about it this way
It probably took from 5 to 8 years for you to gain your first fifty pounds, and
longer yet to get to be four feet tall.
When you start your growth spurt, you may very well gain another __________
pounds in only two or three years and a foot or two in height in just a few years.
That’s a BIG change.
Try to:
1)
______________________.
2)
______________________.
3)
Give your body _____________________ to show you how it’s going to
end up.
If you:
1) _______________________ __________________________, and
2) _________________________________________________, and
3) __________________________, you will see your body develop
naturally, into the size and shape it was born to be!
107
Level I/II
Ways to Cope
Objective:
Participants will identify ways to cope with the stress sometimes
experienced during puberty.
Structure:
Large group.
Time:
20 minutes.
Materials:
Blackboard or flipchart.
Procedure
1. Introduce the topic by telling your group that, along with physical changes,
there are a number of emotional changes associated with puberty.
2. Ask the group to brainstorm a list of physical responses to stress (e.g.
headache, stomach ache, loss of appetite, tiredness, inability to sleep, etc.).
3. Next, ask the group to brainstorm a list of emotional responses to stress
(e.g. sadness, loneliness, anger, irritability, withdrawal, anxiety, etc.).
4. Point out that we all experience stress in our lives, and that this is normal. It
is important for us to think about ways to deal with, and respond to, stress
and upset in our lives. Ask the group to brainstorm ways of dealing with
stress and upset (e.g. talk to someone you trust, cry, eat right, exercise, take
time to relax, be patient with mood swings, ask for help).
5. Conclude the activity by pointing out that puberty is a time of significant
change, and that there may be some stress associated with these physical
and developmental changes. This is normal. It is important to identify ways of
coping with these changes to ensure good physical and emotional health.
108
Puberty Review – Quiz
.
Objective:
Participants will identify the changes associated with
puberty.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Puberty Review – Quiz” handout.
Level I/II
This quiz can be used as a pre- or post-test to evaluate participant knowledge.
Answer Key:
1. What is puberty?
The period of growing and changing from a child into an adult.
2. The gland in the brain that triggers puberty is the
Pituitary gland
3. List 3 physical changes that occur in boys and girls during puberty.
4.
Male
Female
acne
acne
perspiration
perspiration
hair
hair
grow taller
grow taller
shoulders and chest broaden
breasts develop
muscles
hips widen
genitals grow larger & darker
voice deepens
voice deepens
Fill in the blanks using the correct words:
acne
ejaculation
wet dream
prostate
testicles
erection
deodorants
pituitary gland
scrotum
fallopian tube
uterus
menstruation
can
cannot
ovary
.
(Adapted and modified with permission of Niagara Regional Health Department (1999) Growth and
Development Lesson Plans for Grade 5 & 6.)
109
a) Eating good food, exercising and washing your body daily with soap and
water may help ACNE.
b) Bathing daily, changing clothes, and using DEODORANT will help control
body odours.
c) Ovulation occurs in the female when an egg is released from the OVARY.
d) Sperm is produced in the TESTICLES.
e) MENSTRUATION is a natural process that repeatedly prepares a woman’s
body for bearing a baby.
f)
Discharge of semen from the penis is called EJACULATION.
g) During menstruation, there is a shedding of the lining of the
UTERUS, through the vagina.
h) When a boy ejaculates semen during his sleep, it is called a WET DREAM.
i)
A girl CAN remain active when she is having her period.
j)
A boy has an ERECTION because blood fills up the spongy tissue of the
penis.
True or False?
T
Masturbation is a personal choice.
F
Only girls experience mood changes at puberty.
T
We learn about puberty through a variety of sources including family, school,
and the media.
F
Boys get erections only when thinking sexy thoughts.
T
A menstrual period usually lasts 3-7 days.
T
Some boys and girls will experiment sexually with members of the same sex
as part of their curiosity about sex.
F
If boys masturbate, they will eventually run out of sperm.
T
Puberty usually starts earlier for girls than for boys.
F
Ovulation involves the release of many eggs per month.
F
Only boys masturbate.
110
Handout
Puberty Review - Quiz
1. What is puberty?
2. The gland in the brain that triggers puberty is the ____________________.
3. List 3 physical changes that occur in boys and girls during puberty.
Male
Female
a) ___________________________
___________________________
b) ___________________________
___________________________
c) ___________________________
___________________________
4. Fill in the blanks using the correct words:
acne
ejaculation
wet dream
prostate
testicles
erection
deodorants
pituitary gland
scrotum
fallopian tube
uterus
menstruation
can
cannot
ovary
a) Eating good food, exercising and washing your body daily with soap and water may help
___________________________.
b) Bathing daily, changing clothes and using ___________________ will help control body odours.
c) Ovulation occurs in the female when an egg is released from the _____________
d) Sperm is produced in the ____________________.
e) ______________________ is a natural process, which repeatedly prepares a woman’s body for
bearing a baby.
f)
Discharge of semen from the penis is called ___________________________.
g) During menstruation, there is a shedding of the lining of the ____________________ through
the vagina.
h) When a boy ejaculates semen during his sleep, it is called a ________________.
i)
A girl ________________ remain active when she is having her period.
j)
A boy has an ____________________ because blood fills up the spongy tissue of the penis.
111
True or False?
_________ Masturbation is a personal choice.
_________ Only girls experience mood changes at puberty.
_________ We learn about puberty through a variety of sources, including
family, school and the media.
_________ Boys get erections only when thinking sexy thoughts
_________ A menstrual period usually lasts 3-7 days
_________ Some boys and girls will experiment sexually with members of
the same sex as part of their curiosity about sex
_________ If boys masturbate, they will eventually run out of sperm.
_________ Puberty usually starts earlier for girls than for boys.
_________ Ovulation involves the release of many eggs per month.
_________ Only boys masturbate.
112
Constructing Reproductive Systems
.
Level II/III
Objective:
Participants will review the parts and functioning of the
male and female reproductive systems.
Structure:
Small group activity.
Time:
30-40 minutes.
Materials:
Paper, poster board, pens, female and male reproductive
system resource sheets (Appendix F).
Procedure
1. Divide participants into two groups by sex and ask them to draw the
reproductive system of their sex.
2. Explain that the drawings should include both external and internal organs,
which should be identified with a label. Drawings will be built on pieces of
poster board or paper.
3. Suggest that each group begin by drawing an illustration of the reproductive
system to be constructed. Expect giggling and laughter along with confusion
and frustration. Circulate and provide a little assistance, but do not take over
the activity.
Note: This is a
review exercise for
participants who
have already been
introduced to the
male and female
reproductive
systems.
4. When the groups have completed their drawings to the best of their ability,
distribute copies of the Male Reproductive System handout and the Female
Reproductive System handout (found in Appendix 1 of this module). Answer
any questions that participants may have, and ask them to make any
necessary adjustments to their models using the handouts.
5. When the groups have finished, display the reproductive systems drawings
side by side and have a reporter from each group present their creation.
Briefly describe how each reproductive system functions. Ask for volunteers
to help with these descriptions.
6. Discuss the activity by asking a few of the following questions:
What was it like doing this activity?
How easy or difficult was it for your group to construct your (or the other)
sex’s reproductive system?
How many of you actually knew as much as you thought you knew,
before starting this project?
How could knowledge of male and female anatomy and physiology help
you in your development as a healthy sexual person?
Note: Alternatively,
you could have
each group draw
the system of the
opposite sex. Or if
your group is large
enough to have four
same-sex groups,
you could have two
groups draw the
system of their own
sex and two groups
of the other sex.
.
Boston: Unitarian Universalist Association. Reprinted with permission of the Unitarian Universalist
Association.)
113
Level II/III
O
Pregnancy and Birth
b
j Participants will describe the process of pregnancy and birth.
Objective:
e
Structure:
c Pairs activity.
t 25 minutes.
Time:
i
Materials:
v “Pregnancy and Birth” cards.
e
Procedure :
1. Divide participants into pairs. Give each pair a full set of “Pregnancy and
Birth” cardsPin random order. Give participants 10 minutes to put the cards
a order. In the large group, discuss the sequence of the cards
into sequential
r
using the following
answer key:
t
1. Decision to have a child
i
The first
c step toward pregnancy should be making the decision to have a
child. This
decision is based upon weighing parenting skills,
i
understanding
the day-to-day responsibilities of caring for a child,
p
assessing
a finances and support of family and friends, and the age of the
parents.
n The expense of raising a child from birth to age 21 is
considerable.
t
2. Male’sserect penis put into female’s vagina
When awman and woman have vaginal intercourse, the man’s erect penis
is put into
i the woman’s vagina. (For more mature groups, you may want
to add lthat if a woman does not have a male partner or if her male
partnerl is infertile, she can undergo artificial insemination where sperm is
manually placed in her vagina.)
d
3. Ejaculation:
sperm enter vagina
e
During sejaculation, millions of sperm spurt out of the penis and enter
the vagina.
c
4. Spermrswim up vagina
i
The sperm swim up the vagina, using their tails to propel themselves
b
forward. Some of the stronger sperm swim through the cervix to reach
e
the uterus, or womb.
5. Some tsperm meet ovum in fallopian tubes (if ovulation occurred)
h these sperm move through the uterus into the fallopian tubes.
Some of
e
For fertilization
to occur, the sperm must meet the ovum in the fallopian
tube. (If ovulation occurred, whereby the ovary releases one egg per
month,pand if the egg is not fertilized, a woman has a menstrual period.
r occurs about 14 days prior to a woman’s menstrual period
Ovulation
o
which makes
this a woman’s most fertile time of month.) Once the sperm
get up cinto the uterus and fallopian tubes, they can live for 3-5 days. The
e for 1-2 days. Sperm usually reach the fallopian tubes within 1eggs lives
s of ejaculation.
1/2 hours
s
6. Fertilization: one sperm enters ovum’s outer membrane
o has been released by an ovary (approximately two weeks
If an egg
before fa woman’s menstrual period—a woman’s most fertile time of
month) and is present in the fallopian tube, only one sperm is allowed
into thepovum’s outer membrane.
r
The process
of the sperm entering the ovum is called “fertilization” or
e
“conception.”
g
114
7. Fertilized egg (zygote) travels to uterus
The newly fertilized egg travels through the fallopian tube toward the
uterus. The fertilized egg is now called a zygote.
8. Zygote implants on wall of uterus
In the uterus, the zygote will develop into a baby during nine
months of pregnancy.
9. Confirm pregnancy
Tests of urine and blood samples can be done in laboratories to
confirm pregnancy on the 15th day after fertilization.
10. Good prenatal care
Diet during pregnancy is very important. If a woman’s diet is healthful,
she has a better chance of remaining healthy during pregnancy and
bearing a healthy child. Women should not smoke, drink alcohol or take
drugs during pregnancy, as these actions harm the developing baby.
Excessive and chronic alcohol use increases the risk of Fetal Alcohol
Syndrome. Most healthy women can continue regular physical activity
during pregnancy. Vigorous and strenuous exercise should not start in
pregnancy.
11. Nine months pass
The baby is ready to be born after nine months. Birth happens in three
stages: labour, delivery of the baby, and delivery of the placenta.
12. Contractions of uterus opens cervix
Contractions of the uterus gradually increase in intensity and occur more
frequently as labour progresses. The contractions of the uterus open the
cervix wide enough for the baby to exit.
13. Baby enters birth canal
When the cervix has completely opened, the baby enters the birth
canal, which results in the delivery of the baby out of the mother’s body.
14. Abdominal muscles propel baby through vagina
As the uterus contracts, the woman pushes with her abdominal
muscles to propel the baby through the vagina.
15. Umbilical cord cut
After the baby is born, it is still attached to the mother by the umbilical
cord. As soon as the baby begins breathing on its own or the cord no
longer pulsates, the umbilical cord is clamped and cut.
16. Delivery of placenta
The delivery of the placenta, or “afterbirth,” usually occurs 30 minutes
after the baby is born. The placenta grows on the inner wall of the
uterus and nourishes the baby during pregnancy. It is the size of a
large dinner plate. After the birth of the baby, it separates from the
uterus, which then contracts to push it out.
Conclude by pointing out that humans experience three rapid growth periods of
change in our bodies: conception to birth, birth to first year, and puberty.
115
Pregnancy and Birth Cards
116
Myth-Information – Pregnancy
.
Objective:
Participants will describe many aspects of pregnancy.
Structure:
Time:
35 minutes.
Materials:
Flipchart or blackboard, “Myths and facts about
pregnancy” resource sheet.
Level II/III
Procedure
1. Introduce this activity by telling the group that there are certain things
expectant parents need to know in order to have a healthy pregnancy.
Explain that in this activity, participants will divide into teams and compete to
see which team knows the most about pregnancy.
2. Divide the group into two (or more) teams and have them move to different
sides of the room. Ask each team to choose a name, and then write the team
names at the top of the flipchart or blackboard.
3. Explain that you will read statements about pregnancy to each team in turn,
and team members must decide together whether the statement is a fact or
a myth. Define “myth” as a statement containing incorrect information that is
often believed to be true.
4. Begin by reading a statement from Myths and Facts About Pregnancy to
the team. Encourage team members to talk briefly among themselves to
decide whether the statement is a myth or a fact. If the team’s answer is
correct, record a point for the team on the scoreboard. If the response is
incorrect, offer correct information and allow a few minutes for discussion. To
help youth avoid feeling embarrassed about incorrect answers, stress that
many people believe myths about pregnancy, and even many adults lack
accurate information.
5. Continue reading statements to the teams until all statements have been
read or you are out of time.
What was the most surprising new information you learned from this activity?
What is one myth about pregnancy that can be especially
dangerous if people believe it?
Why do you think such a large number of teen moms give birth to babies
with health and developmental problems?
.
(Adapted with permission from: Wilson, Pamela M. (1999) Our Whole Lives: Sexuality Education for
Grades 7-9. Boston: Unitarian Universalist Association and United Church Board for Homeland
Ministries.)
117
Resource Sheet
Myths And Facts About Pregnancy
Read the statements in bold type to participants. After you have received an
answer, use the paragraph below each statement to provide the correct
information.
1. Smoking during pregnancy will not hurt an unborn child.
MYTH: Infants of mothers who have smoked during pregnancy often weigh
less and are in poorer general condition than infants of non-smoking
mothers. Even second hand smoke can negatively affect the fetus. Men who
smoke have lower sperm counts.
2. Most sexually transmitted infections (STIs) will not hurt an unborn baby.
MYTH: STIs can cause a number of health problems for infants including
eye infections, heart defects, bone deformity, or other health problems in
early childhood. Genital herpes can be passed on to an infant during
delivery. Women that are considering parenthood need to protect
themselves from STIs in order to protect their future children.
3. Excessive drinking of alcohol increases the risk of fetal alcohol
syndrome.
FACT: Fetal alcohol syndrome is related to the chronic and excessive use of
alcohol. It is recommended that pregnant women not drink alcohol at all.
4. If a pregnant woman uses a drug like marijuana, cocaine, or speed, the
placenta filters out harmful substances and protects her developing
fetus from the drug.
MYTH: Virtually everything that enters a pregnant woman’s bloodstream
makes its way through the umbilical cord to her developing fetus. The
placenta is not able to prevent drugs from entering the fetal bloodstream. If
the substance is harmful to the woman, it can also harm her fetus. When is
comes to taking prescriptions drugs, a pregnant woman should consult with
her medical provider.
5. The biological father determines the sex of the baby.
FACT: The genetic material carried in the sperm cell determines whether
the child will be male or female, along with some of its other
characteristics. The genetic message of the mother has no influence on
the gender of her child.
6
.If a pregnant woman looks too long at the full moon she will have
twins.
MYTH: Twins can only result in one of two ways: (1) A fertilized embryo
divides in half and becomes two separate but identical developing embryos
(identical twins). And (2) two egg cells are released at the same time, one
from each ovary, and both are fertilized (non-identical or “fraternal” twins).
7. Having vaginal intercourse during pregnancy is not recommended
since it will probably cause problems for the developing fetus.
MYTH: Vaginal intercourse during pregnancy is not any more likely to cause
a problem than any other normal activity. However, if intercourse becomes
uncomfortable for the expectant mother, the couple will need to find a more
comfortable position, abstain from having intercourse until after the birth, or
engage in other sexual behaviour, such as shared masturbation or oral sex.
These activities will not harm the fetus. Engaging in unprotected intercourse
with a partner who could possibly have a sexually transmitted infection would
be harmful for both the woman and the fetus.
118
8. A mother’s nutritional intake during her pregnancy affects the
development of the fetus.
FACT: Mothers that eat nutritious diets during pregnancy have fewer
complications during pregnancy and childbirth than those that don’t, and their
babies are healthier at birth. Women that are unable to eat because of
nausea and vomiting should seek medical attention, as there are safe
medications available to address these symptoms.
9. If a woman has been having vaginal intercourse without using birth
control for six months and has not become pregnant, she is most likely
infertile and should seek medical attention.
MYTH: Approximately 9 out of 10 women who have unprotected vaginal
intercourse for one year will become pregnant. Only 1 out of 10 women will
not. A woman who has had vaginal intercourse without using birth control for
six months can still become pregnant at any time.
119
Level II/III
Reproduction and Prenatal Care Projects
Objective:
Participants will describe reproduction and prenatal care
issues.
Structure:
Individual or small group.
Time:
Two classes/sessions.
Procedure
1. Ask individuals or small groups to pick a topic related to reproduction and
prenatal care. Some possible topics include the following:
Fertility/infertility
Genetics (how and what traits are passed on to a baby)
Reproductive and Genetic Technologies
Smoking during pregnancy (can include second-hand smoke)
Nutrition and pregnancy
Fetal alcohol syndrome
Illegal drug use and pregnancy
Exercise and pregnancy
Premature labour
Prenatal care (midwifery, obstetrics)
Breastfeeding
Responsibilities of parenting
Adoption services
Woman abuse during pregnancy
2. Once participants have chosen a topic, ask them to prepare a presentation.
Information can be presented in a variety of ways, including: role-plays,
games, videos, etc.
Encourage participants to visit services in the community (e.g. sexual health
clinics, public health departments, etc.) to gather information and brochures
for the group. If participants plan to use the internet for research purposes,
you may want to introduce the activity “Using the Internet to Access Sexual
Health Information” to encourage them to access reliable, up-to-date
information (see Appendix E).
3. After each presentation, ensure enough time for questions and answers as
well as discussion.
120
My Birth
.
Objective:
In order to learn more about parenting and to develop a
support system, participants will discuss their own birth
with a parent/guardian.
Structure:
Interview.
Time:
Materials:
“My Birth” handout.
Level II/III
Procedure
1. Explain to participants that this activity will encourage them to interview a
parent/guardian in order to discuss their birth, thereby creating a venue for
discussion and support. (Note: there are two options for participants. One
section includes questions for birth parents and the second section includes
questions for a guardian, adoptive parent, etc.).
2. Rather than handing in a completed interview guide, ask participants to hand
in the Declaration of Completion slip. That way, privacy is maintained for the
participant and the parent/guardian s/he interviewed while providing proof
that the homework exercise was completed.
How easy/difficult was this activity?
How did you feel about doing this activity?
What did you learn?
.
Reprinted with permission from Williams, Dorothy L., ed., Values and Choices (Minneapolis, MN:
Search Institute, 1991, 1-800-888-7828.)
121
Handout
My Birth
If you live with a birth parent, interview the person who can best answer these questions. Write your
answers below.
1. Place of birth (city, hospital, etc.)
2. Time of birth (weather, historical events at this time)
3. Where were they when labour began?
4. How long was labour?
5. People present (family, medical, others)
6. Weight at birth
7. Any unusual happenings?
8. How did they pick your name?
9. Ask the questions you would like to know about your birth and early childhood, such as diseases, first
steps, first words, etc.
10. What sources of information about yourself are available to you (e.g. baby books, family records, albums,
photos, traditional stories)?
122
If you are adopted or not living with a birth parent, interview the person who can best answer these
questions. Write your answers below.
1. What do they know about my birth?
A. Where was it?
B.
Time (What was happening in the world at that time?)
C. Weight, length, etc.
2. What was it like the first time they saw you? How long had they known you were coming to live with
them?
3. Ask them about the day you came to live with them.
4. What were your first six months together like?
5. What can they tell you about your name?
6. What do they know about your early life (your first words, childhood illnesses, etc.)?
7. What sources of information are available (e.g. baby books, records, photographs)?
We completed the My Birth homework assignment.
_________________________________
Participant
__________________________________
123
Common Concerns Brainstorming
.
Level III
Note: Depending
on your group,
participants may be
too uncomfortable
to offer concerns
about penis/breast
size, etc.,
particularly in a
large group. Ask
participants to form
small groups to
brainstorm a list, or
use an anonymous
question box to
solicit responses.
Objective:
Participants will identify and describe the reproductive
health concerns of adolescents and build skills to talk
about reproductive health issues.
Structure:
Large group discussion.
Time:
20 minutes.
Materials:
“It’s the Truth: The Facts About Reproductive Health Care
for Males and Females” handout.
Procedure
1. Tell the group the session will address concerns that many teens have
regarding their reproductive or sexual health. Write “MALE CONCERNS” on
newsprint or blackboard and ask the group to brainstorm common concerns,
worries, or questions that many males have about the “sexual” parts of their
bodies. Repeat for “FEMALE CONCERNS.” Point out which concerns have
to do with sexual health, sexual responsiveness, and sexual attractiveness.
2. Discussion Questions:
Is there a difference of focus between male and female concerns? If so,
why?
Where can people go for help for a sexual health concern/problem?
3. Distribute handouts: It’s The Truth: The Facts About Personal Reproductive
Health Care For Males and Females. Ask participants to read through the
lists and see if the handouts address any of the concerns they listed. Discuss
any questions.
4. Conclude by pointing out how important it is to have accurate information on
reproductive health in order to both navigate the health care system and to
maintain good sexual health.
Extension
Ask participants to compile a list of community resources (sexual health clinics,
STI/HIV testing sites, hotline phone numbers, public health department, etc.).
This list will be useful for future reference.
.
(Adapted with permission from Brick, Peggy (1996) The New Positive Images. Planned Parenthood
of Greater Northern New Jersey. Reprinted with permission. All rights reserved. Order form p. 416)
124
Handout
It’s The Truth: The Facts About Personal Reproductive
Health Care For Adolescent Females
It is common for adolescent females to
be at a different stage of physical development from peers of the same age
have one breast of slightly different size and shape from the other
have breast swelling and tenderness just before their periods
have cramps before and/or during their periods
have nipples that turn in instead of sticking out or hair around the nipples
have some natural, healthy genital odour
have genital hair of a different colour from hair on other parts of their bodies
have a “regular” menstrual cycle length between 21 and 40 days
have irregular periods
have wetness in the vaginal area when sexually aroused
masturbate occasionally, frequently, or not at all (with no resulting physical harm)
have varying amounts of clear to cloudy discharge from the vagina, as part of their monthly cycle or
with antibiotics, birth control pills, or pregnancy
have their hymens stretched during routine physical activities like gymnastics (therefore not a clue to
virginity)
have labia, breast, nipples of various sizes, shapes, skin tones.
It is uncommon but possible for adolescent females to get
cysts in the breast
breast cancer
•cervical or uterine cancer
•ovarian cysts (sac or cavity of abnormal character containing fluid which may occur in the ovaries)
uterine fibroids (non-cancerous tumour of muscular and fibrous tissues which may develop in the wall
of the uterus).
Signs of possible problems for adolescent females include the following:
1. Pain:
General pelvic pain
Pain, burning and/or itching while urinating
Pain during intercourse
125
2. Change in menstrual cycle:
Suddenly irregular periods
Unusually late period
Unusual cramps
Cramps with no period
3. Change in body:
More frequent urination
Lump, growth or a sore on genitals
Unusually heavy or smelly vaginal discharge
Changes in appearance of nipples
A lump in the breast that wasn’t there before
Discharge from nipple or discharge with blood or pus in it
4. Prevent problems by
getting a yearly pap test if you are sexually active or age 18-20 and haven’t had one before
doing a self breast exam at the same time each month
tracking your menstrual cycles
keeping the outside of the vagina clean and dry
avoiding perfumed or scented soaps, douches, tampons, sanitary napkins, sprays, or bath bubbles
and oils
wearing cotton underpants and pantyhose with a cotton-lined crotch
not wearing clothes or pyjamas that are too tight in the crotch and thighs
sleeping without underwear
if having intercourse, using condoms to prevent STIs, contraception to avoid unintended pregnancy,
and water-based lubricant if needed
getting tested for STIs if you’ve had intercourse without a condom
5. If you think you have a problem, get help right away. Health problems rarely go away by
themselves and can often be fixed quite easily.
Visit the school nurse.
Make an appointment with your family doctor.
Visit a walk-in clinic.
Visit a sexual health or STI clinic.
126
Handout
It’s The Truth: The Facts About Personal Reproductive
Health Care For Adolescent Males
It is common for adolescent males to
be at a different stage of physical development from peers of the same age
have one testicle larger and lower-hanging than the other
have their testicles hang closer to, or further from, the body, depending upon temperature changes,
stress, or sexual arousal
be “normal” with either a circumcised or uncircumcised penis
have a whitish, cheesy substance (smegma) under the foreskin, if uncircumcised.
have a pimple or hairs on the penis
have genital hair of different colour from hair on other parts of their bodies
have some natural, healthy genital odour
have frequent erections, sometimes due to sexual arousal, stress or general excitement, and
sometimes for no apparent reason
wake up in the morning with an erection
sometimes lose an erection during intercourse
masturbate occasionally, frequently, or not at all (with no resulting physical harm)
have erections without ejaculating
have wet dreams (nocturnal emissions)
have a flaccid (limp) penis length of under 5”
believe, incorrectly, that penis size is crucial to proper sexual functioning
have an ache in the testicles (“blue balls”) after prolonged sexual arousal (which will go away by itself
or can be relieved through masturbation)
have breast swelling during puberty which disappears after puberty ends
have some breast tenderness, or a sore spot under one or both nipples.
It is uncommon but possible for adolescent males to
get breast cancer
get testicular cancer
have hernias
have foreskin stick to the penis (uncircumcised male)
127
Signs of possible problems for adolescent males include:
1. Pain:
Pain, burning and/or itching while urinating
Sharp pain in testicles that lasts more than a few minutes
Moderate pain in testicle or groin that lasts more than a day or two
Persistent itching around testicles, inside thighs, or in anal area
2. Change in body:
More frequent urinating
Coloured or smelly discharge from end of penis
Discharge from the nipple
Lump, growth, or sore in testicles or other part of genitals
3. Prevent problems by
having regular check-ups
doing a monthly testicle exam
examining genitals for sores, unusual lumps
keeping genitals clean and dry
not wearing tight jeans or pants
if having intercourse, using condoms to prevent STIs and unintended pregnancy and using waterbased lubricant if needed
getting tested for STIs if you’ve had intercourse without a condom.
If you think you have a problem get help right away. Health problems rarely go away by
themselves and can often be fixed quite easily.
Visit the school nurse.
Make an appointment with your family doctor.
Visit a walk-in clinic.
Visit a sexual health or STD clinic.
128
Reproductive Health Issues
Question/Answer Match
.
Objective:
Structure:
Time:
20 minutes.
Materials:
Reproductive Health Question and Answer Cards
educator resource, participant resource.
Level III
Procedure
1. Tell participants that they’re going to have a chance to find answers to
common questions about reproductive and sexual health problems.
2. Distribute one question or answer card to each participant. (Store question
and answer cards in pairs until you know the number needed for your group.
Shuffle the order of the question and answer cards before you begin the
activity.)
3. Explain that they each have either a question card or an answer card. Their
job is to find the person in the room holding the best match to their own card.
Demonstrate by doing an example with one participant.
4. Tell participants they will have five minutes to find their match, and they
should remain with their match until the activity is completed.
5. After everyone has found a match, ask each pair to read their question
and answer to the group, one at a time. If the group believes the match is
accurate, the pair sits down and the entire group adds information or asks
questions about that issue. If someone questions the accuracy of the match,
ask that pair to move to a specified section of the room until all of the pairs
have reported.
6. When all of the pairs have read their cards, have participants with the
questionable matches reread their cards, and others suggest the correct
match for any that were paired incorrectly.
What did you learn from doing this activity?
What feelings might people have when doing this activity?
What other reproductive or sexual health issues would you like to know
more about?
.
of Greater Northern New Jersey. Reprinted with permission. All rights reserved. Order form p.416)
129
Answer Key
Reproductive Health Issues
Question/Answer Match
1. What are some reasons a woman might get a pelvic exam?
She has a change in usual vaginal discharge
She’s 18 - 20 and hasn’t had one before
It’s been a year since she’s had one
2. How often should a man examine his testicles?
Once a month
3. How often should a woman examine her breasts?
Once a month
4. What is the name of the special instrument health care providers use
for a female pelvic exam?
A speculum
5. What percent of infected males know they have gonorrhoea because
they have symptoms?
About 85%
6. What percent of infected females know they have chlamydia because
they have symptoms?
About 15%
7. What are some signs or symptoms people might have if they have a
sexually transmitted infection?
Discharge from penis/ vagina
Painful sore
Pain or burning with urination
8. What are some early signs of pregnancy?
Missing a menstrual period (or period much lighter than usual)
Sore breasts
Nausea or upset stomach
9. Who has to give someone under the age of 18 permission to have a
sexual health exam or a test for a sexually transmitted infection?
Nobody
10. What are some ways a health professional checks to find if a person
has a sexually transmitted infection?
Visual exam of genital area
Swab/culture lab test
Exam of cells under microscope
Blood test
Urine test
11. What factors increase a female’s chances of getting pelvic
inflammatory disease, which may limit her ability to become pregnant in
the future?
Having been infected with gonorrhoea
Having many different partners
Beginning intercourse before age 18
130
12. What factors increase a female’s risk of getting cervical cancer?
Smoking
Beginning intercourse before age 18
Infection with HPV (Human Papilloma Virus)
Infection with HIV
13. What health benefits besides pregnancy prevention can condoms
provide?
Reduced risk of cervical cancer
Reduced risk of acquiring a sexually transmitted infection
14. Why is prenatal care important?
To increase the chance of having a healthy baby
To protect the mother’s health
15. What behaviours put a pregnant female and/or her fetus at risk?
Smoking
Drinking alcohol
Using drugs
Poor diet
Not seeking early prenatal care
16. What choices does a person have for dealing with an unintended
pregnancy?
Adoption
Abortion
Married or common-law parenthood
Single parenthood
17. When might a health care provider be forced to contact a minor’s
parent or guardian?
Only in the event of a medical emergency when the patient needs
additional specialized care
18. Why is it risky for people to take care of a sexual health problem by
themselves?
They may do an at-home test incorrectly. They may make diagnosis
difficult by using the wrong medication Home remedies may not work
19. What does it mean when medical information is “confidential”?
No one else will see the file without the person’s permission
20. What are some reasons why some teens don’t go to a health care
provider?
Embarrassed
Partner doesn’t want them to go
Afraid family will find out
131
Reproductive Health Question And Answer Cards
Questions
1. What are some reasons a woman might get a
pelvic exam?
9. Who must give permission for someone under
the age of 18 to have a sexual health exam or
a test for a sexually transmitted infection?
2. How often should a man examine his
testicles?
10. What are some ways that a health professional
checks to find if a person has a sexually transmitted
infection?
3. How often should a woman examine her
breasts?
11. What factors increase a female’s chances of
getting pelvic inflammatory disease, which
may limit her ability to become pregnant in the
future?
4. What is the name of the special instrument
health care providers use for a female pelvic
exam?
12. What factors increase a female’s risk of
getting cervical cancer?
5. What percent of infected males know they
have gonorrhoea because they have
symptoms?
13. What health benefits, besides pregnancy
prevention, can condoms provide?
6. What percent of infected females know they
have chlamydia because they have symptoms?
14. Why is prenatal care important?
7. What are some signs or symptoms people
might have if they have a sexually transmitted
infection?
15. What behaviours put a pregnant female and/
or her fetus at risk?
8. What are some early signs of pregnancy?
16. What choices does a person have for dealing
with an unintended pregnancy?
132
17. When might a health care provider be forced to
contact a minor’s parent or guardian?
18. Why is it risky for people to take care of a sexual
health problem by themselves?
19. What does it mean when medical information is
“confidential”?
20. What are some reasons why some teens don’t
go to a health care provider?
133
Reproductive Health Question And Answer Cards
Answers
She has a change in usual vaginal discharge. She’s
18 - 20 and hasn’t had one before. It’s been a year
since she’s had one.
Smoking Beginning intercourse before age 18
Infection with HPV (Human Papilloma Virus) Infection
with HIV
Once a month
Reduced risk of cervical cancer Reduced risk of
acquiring a sexually transmitted infection
Once a month
To increase the chance of having a healthy baby
A speculum
To protect the mother’s health
About 85%
Smoking Drinking alcohol Using drugs Poor diet Not
seeking early prenatal care
About 15%
Adoption Abortion Single parenthood Married or
common-law parenthood
Discharge from penis/ vagina Painful sore Pain or
burning with urination
Only in the event of a medical emergency when the
patient needs additional specialized care
Missing a menstrual period (or period much lighter
than usual) Sore breasts Nausea or upset stomach
They may do an at-home test incorrectly. They may
make diagnosis difficult by using the wrong
medication. Home remedies may not work.
Nobody
No one else will see the file without the person’s
permission.
Visual exam of genital area Swab/culture lab test
Exam of cells under microscope Blood test Urine test
Having been infected with gonorrhoea Having many
different partners Beginning intercourse before age
18
Embarrassed Partner doesn’t want them to go. Afraid
family will find out
134
Personal Reproductive and
Sexual Health Care .
Objective:
Structure:
Time:
20 minutes.
Materials:
“Check It Out: Your Personal Reproductive Health Care
for Females/ Males” handouts.
Level III
Procedure
1. Distribute the “Check It Out: Your Personal Reproductive Health Care (For
Females)” handout to the women and “Check It Out: Your Personal
Reproductive Health Care (For Males)” handout to the men.
2. Ask participants to complete the handout, or if they are uncomfortable doing
so, instruct them to think about their answers. Assure them that it is
completely confidential and will not be collected.
Which recommendations surprised you?
Which recommendations do many people not follow? Why?
4. Conclude by pointing out how important it is to have accurate information on
reproductive health in order to successfully navigate the health care system
and to maintain good sexual and reproductive health.
.
135
Handout
Check It Out: Your Personal Reproductive Health Care
(For Females)
This questionnaire is confidential and will not be collected. Put a check
mark if you follow the recommendation, put an “X” if you do not, and an
“O” if the item is not appropriate for you at this time.
1.
Check breasts once a month for changes, unusual
lumps.
2.
Wash genital area well with water and unscented soap
daily and dry well.
3.
Wear cotton or cotton-crotched underwear/ pantyhose
and loose versus tight fitting pants.
4.
Sleep without underwear.
5.
Trim breast hairs with scissors if necessary instead of
plucking.
6.
Use care in shaving or removing hair from genital area.
7.
Wipe from front to back after a bowel movement.
8.
Do not douche unless a professional health care
provider says to.
9.
Do not use feminine hygiene sprays, bubble baths,
scented menstrual pads, and/or tampons or scented
soaps on genitals.
10.
Change tampons and pads regularly (approximately
every four hours, more often if necessary).
11.
Use tampons that correspond to the amount of flow
you experience. Use natural fibre tampons if available.
12.
Ease mild to moderate cramps with hot water bottle, warm baths, walks or other exercises, a hot
beverage, or over-the-counter pain medications. (For severe cramps, consult health care provider.)
13.
Do not smoke: smoking increases risk of cervical cancer, irregular periods, infertility, ovarian cysts,
and Pelvic Inflammatory Disease.
14.
Always use contraceptive methods correctly (according to package instructions or health care
provider’s advice).
15.
Talk with partner about sexual health issues (including communicating sexual limits).
16.
Check self and partner for signs of sexually transmitted infections.
17.
Get tested for STIs if you’ve had sex without a condom.
18.
Wash sex toys or body parts before inserting them into your own or your sexual partner’s body.
19.
Use condoms, dental dams, and spermicides (along with other birth control methods) for sexual
activities in which there is contact with a partner’s bodily fluids.
20.
Have a physical exam at least once a year or whenever you suspect a problem. Get first pelvic
exam by age 18-20 or when first expecting to have sex.
21.
Ask questions and give honest information to health care provider.
136
Handout
Check It Out: Your Personal Reproductive Health Care
(For Males)
This questionnaire is confidential and will not be collected. Put a check
mark if you follow the recommendation, put an “X” if you do not, and an
“O” if the item is not appropriate for you at this time.
1.
Check testicles once a month for changes,
unusual lumps.
2.
Wear loose versus tight-fitting underwear,
pants and jeans.
3.
Wash genital area well with soap and water
daily: if uncircumcised, pull foreskin back to
clean smegma (white cheesy substance)
from under it.
4.
Dry genital area well after bathing,
swimming, etc.
5.
Change underwear daily.
6.
Use athletic supporter or cup for sports or
other vigorous activities.
7.
Do not smoke: smoking inhibits erections
and lowers sperm count in men.
8.
Talk with partner about sexual health issues (including communicating sexual limits).
9.
Check self and partner visually for signs of sexually transmitted infections.
10.
Get tested for STIs if you’ve had sex without a condom.
11.
Wash sex toys or body parts before inserting them into your own, or your sexual partner(s) body.
12.
Use condoms, dental dams, and spermicides (along with other birth control methods) for sexual
activities in which there is contact with a partner’s body fluids.
13.
Have a routine physical exam at least once a year or whenever you suspect a problem.
14.
Ask questions and give honest information to sexual health care provider.
137
Reproductive Health Care Projects
Level III
Objective:
Participants will expand their knowledge of reproductive
health issues.
Structure:
Time:
Two classes/sessions
Procedure
1. Ask individuals or small groups to pick a topic related to reproductive health
care. Some possible topics include the following:
Breast self examination
Testicular self examination
Pelvic examinations
Endometriosis
Pelvic inflammatory disease
Ovarian cancer
Neural tube defects
Testicular cancer
Infertility
Effects of drugs/alcohol/smoking on reproductive health
2. Once participants have chosen a topic, ask them to prepare a presentation.
Information can be presented in a variety of ways, including role-plays,
games, videos, etc. Encourage participants to visit services in the community
(e.g. sexual health clinics, public health departments, etc.) to gather
information and brochures for the group.
3. After each presentation, ensure there is enough time for questions and
answers as well as discussion.
138
Module 4: Self-Esteem
Self-esteem is crucial to accepting,
maintaining, and enhancing sexual health.
This module contains strategies to foster
healthy self-esteem in participants in order to
develop good relationships as well as
decision-making skills and communication
skills.
Self-Esteem
Self-esteem—how valuable, lovable, worthwhile, and competent we feel—is
crucial to accepting, maintaining, and enhancing sexual health. Self-esteem is
based on life experiences and personal relationships. It changes over time,
depending on life circumstances.
This module will help participants develop a language to identify themselves
(who am I) and examine factors that change how they feel about themselves.
Activities examine self-esteem, body image, media influences, and positive selftalk strategies.
Self-Esteem and Sexuality
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
Healthy self-esteem is a precursor to healthy sexuality. Healthy self-esteem
includes
the ability to develop healthy relationships
the acceptance of one’s sexuality
awareness/acceptance of personal limitations, vulnerability
the ability to accept responsibility for behaviour
OBJECTIVES OF
THE MODULE:
feelings of competence, independence, self-control, respect for others
Participants will:
limit setting.
Individuals with low self-esteem are more likely to
be influenced by peer pressure
pick partners or friends who mistreat them
stay in negative friendships or relationships because they are afraid to be
alone
be easy prey to an abuser
abuse alcohol and/or drugs
experience negative body image or develop an eating disorder
become sexually involved in order to “keep” a partner
have unsafe sex and be at risk for STIs
identify unique
and special
aspects of
themselves
identify the
factors that
affect selfesteem and
ways of
increasing selfesteem
identify
methods to
improve body
image
take chances with pregnancy
see early parenthood as a way to feel loved and important
become abusive.
141
Teaching Tips
It is important to be aware of, and sensitive to, the following issues:
Body Image We need to encourage girls and boys to develop their self-worth in
ways that are not appearance focussed. While some cultural and racial groups
have fared better than others in embracing diverse body types, 26 none are
immune to these societal pressures. Boys and girls of all cultures need to be
reassured that the rapid and sometimes out-of-proportion growth that they are, or
will be, experiencing during puberty is natural and normal. Boys and girls need to
develop an understanding that no specific weight is healthy and that a whole
range of weights is acceptable. A fact sheet on eating disorders is included in the
Resources section of the Sourcebook.
Gender Gender socialization can have detrimental effects on the mental and
physical health of girls and boys. The self-esteem of girls is most often linked to
external factors such as appearance, performing for others, and responding to
the needs of others for their approval. Further, many cultures (including North
American culture) tend to devalue women and girls and the qualities which they
are socialized to develop. The self-esteem of boys is more often linked to internal
factors such as assertiveness and independence. For example, boys are
encouraged to act tough, hide their feelings, and compete to win. This can result
in increased pressure and stress and in less meaningful relationships. It is
important to be sensitive to the gender dynamics of your group. Ensure that both
boys and girls are given sufficient and equal time to participate in the
class/session. The environment must feel “safe” for girls to participate and for
boys to express their feelings without fear of shame.
Sexual Orientation Gay, lesbian, and bisexual (GLB) youth also tend to suffer
from low self-esteem because we live in a society where gays, lesbians, and
bisexuals have few role models and are often seen as abnormal, perverted, and
immoral. As a result, some GLB youth experience shame and self-hatred and are
at an increased risk of suicide. 27 Homophobia (aversion to gay or lesbian people
or their lifestyle or culture) and heterosexism (the institutionalized assumption
that everyone is heterosexual) often negatively affect the self-esteem of GLB
youth. Activities from the Sexual Identity module can be used to supplement this
module in order to more directly address these issues. A fact sheet on Gay,
Lesbian, and Bisexual Youth is also included in the Resources section of the
Sourcebook.
Culture and Race Sometimes people are ridiculed or discriminated against
because of their skin colour, other physical traits, their culture, and/or their
religion. Young people that are new to Canada may encounter harassment
because of their manner of dress, their accent, and/or their first language. Such
racism and discrimination may contribute to low self-esteem, depression, and
anxiety. 28 Be sensitive to your group’s dynamics, and look for opportunities to
illustrate how racism and discrimination are harmful.
26
Kater, Kathy (1998) Healthy Body Image: Teaching Kids to Eat and Love their Bodies Too! Seattle:
Eating Disorder Awareness and Prevention, Inc.
27
GLSEN(1999) Tackling Gay Issues in School. Connecticut: The Gay, Lesbian and Straight
Education Network of Connecticut and Planned Parenthood Connecticut.
28
SERC Manitoba (1999) Enhancing Intergenerational Communication: For Healthier Communities.
Winnipeg: Author.
142
Physical/Developmental Disabilities
People with disabilities are often rejected by the community at large, which sees
their social and sexual behaviour as inappropriate. 29 This prejudice, related to
their right to sexual information and expression, often leads to feelings of low
self-worth. People with disabilities require information on negotiating
relationships, giving and receiving affection and protection from sexual
exploitation. This starts by acknowledging their sexuality and enhancing selfesteem.
Suicidal Feelings Sometimes feelings of isolation and worthlessness lead to
thoughts of suicide. According to the Suicide Information and Education Centre 30,
youth are at risk of suicide if they experience
unexpected reduction of academic performance
ideas and themes of depression, death and suicide
change in mood and marked emotional instability
significant grief or stress
withdrawal from relationships physical symptoms with emotional cause
high-risk behaviour
While these characteristics describe almost any teen, they are of concern if they
are sudden, intensified, and/or prolonged. Know your school’s/centre’s policy on
dealing with this and where to send a student for help. If you suspect that
someone is suicidal or admits to having suicidal feelings,
be honest (e.g. admit that you are scared, worried)
listen share your feelings by letting the person know that s/he is not alone
make a commitment to get the student the help s/he needs (e.g. from a
counsellor or crisis centre).
29
Ludwig, Susan (199-) Sexuality: A Curriculum for Individuals Who Have Difficulty with Traditional
Learning Methods. York Region Public Health: Author.
30
Suicide Information and Education Centre (October 1998) Considerations for School Suicide
Prevention Programs. SIEC Alert. 32.
143
Your Identity – Many Parts Make You Strong .
Level I/II/III
Objective:
Participants will list a number of talents and abilities that
comprise their identity.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Your Identity – Many Parts Make You Strong” handout.
Procedure
Note: This is an
excellent
introductory activity,
particularly for
those participants
who are unable to
find or have
difficulty identifying
positive
characteristics
about themselves.
Participants may
want to keep the
handout for
reference when
completing other
activities from this
module.
1. Distribute the “Your Identity – Many Parts Make You Strong” handout.
Encourage participants to check all the things they think are part of them.
This may include
All of the things they enjoy doing, whether or not they do them well
All of the things they can do well, even if they do not enjoy them or do
them often.
All of the things they have never tried, but want to try in the future
2. Give participants sufficient time to complete the handout.
3.Conclude by asking participants what they learned and how they felt
doing the activity. Ensure some of the following points are made:
Everyone has a variety of things to offer.
There are some things about us that can change or improve.
There are some things that we are born with, that will always be a part of
us.
Self-worth does not depend on looks. How we look is only one small part
of our identity.
Our worth cannot be measured by comparison to anyone else’s.
.
(Adapted with permission from: Kater, Kathy (1998) Healthy Body Image – Teaching Kids to Eat
and Love their Bodies Too! Seattle: Eating Disorders Awareness & Prevention.
For more information or for a copy of the program, please contact: 1-800-931-2237)
144
Handout
Your Identity - Many Parts Make You Strong
I have intelligence. I can do
_______ Math
_______ Spelling
_______ Foreign languages
_______ Science
_______ Reading
_______ Writing
_______ Creative Problem Solving
_______ Geography
_______ History
_______ Computers
Other:
I am physically active
I take pride in my appearance
_______ Run
_______ Jump
_______ Throw
_______ Climb
_______ Catch
_______ ift heavy things
_______ Lots of energy to be active a long time
_______ Walk
_______ Dance
_______ Take care of my health
_______ Eat well
_______ Like my hair a certain way
_______ Keep clean hands and face
_______ Like to wear my favourite colours
_______ Add hats, jewellery, or other
“decorations”
Colour of hair ____________________________
Eyes _______________Skin ________________
Sports:
_______ Skiing
_______ Skating
_______ Swimming
_______ Bicycling
_______ Gymnastics
_______ Wrestling
_______ Basketball
_______ Tennis
_______ Football
_______ Soccer
_______ Horseback
_______ riding
_______ Volleyball
_______ Track
_______ Hockey
List other physical activities or specific sports that
are part of who you are:
Hair is:
Curly
Straight
Another thing about my looks is
I am creative or artistic
_______ Artistic (What type? List below.)
_______ I dance
_______ I write poetry or stories
_______ I do drama (act in plays)
_______ I build things or do crafts (what kind?)
_______ I sew
_______ Musical (what type? List below.)
List other creative or artistic abilities below:
145
I learn new things
I am a citizen (part of my community)
_______ I try new things
_______ I learn from mistakes
_______ I try things I might not be successful at
_______ If something is hard, I can keep at it
_______ I finish projects or assignments
Other (list below):
_______ Respectful
_______ Provide my best effort
_______ Responsible
_______ Pitch in to help
_______ Participate, do my part
_______ Compassionate
_______ Take care of the environment
Other:
__________________________________________
I have relationships
_______ Make friends
_______ Share
_______ Am friendly
_______ Good listener
_______ People can count on me
_______ Can be serious
_______ Love
_______ Polite, good manners
_______ Am kind
_______ Like to learn new things
_______ Communicate well
_______ Sense of humour
_______ Have fun ideas
_______ Fun to be with
_______ Interested in a lot of things
_______ Can resolve conflicts
_______ Can be a leader, take charge
_______ Care about how people feel
_______ Can laugh at myself, and at my
mistakes
_______ Include people who are not my best
friends
_______ Team player—do what I’m asked for
the sake of the team
Other:
I manage my health and keep things in
balance
_______ Keep clean (shower or bathe)
_______ Excited
_______ Eat healthy food
_______ Angry
_______ Physically active
_______ Hurt
_______ Play safe
_______ Afraid
_______ Play smart
_______ Sad
_______ Think about healthy choices
_______ Happy
_______ Know what I need, and ask for it
_______ Able to make decisions
_______ Can say no and disagree if I need to
_______ Take time to relax
_______ Have realistic expectations of myself
_______ Organize and manage my time
_______ Can accept when things don’t work out
_______ Organize and manage my things
I have many feelings such as:
146
I have other interests (add as many as you like!)
_______ Collecting things (list things you collect)
My preferences or favourites (you may list one
or more than one):
Colour?_________________________________
_______ Having a pet, what kind(s)?
Food?___________________________________
Drink?___________________________________
List other hobbies and interests below or on the
back of this handout
_______ Games
_______ Magic
_______ Miniature golf
_______ Cooking
_______ Snorkelling
_______ Having a pen pal
_______ Computers
_______ Reading
_______ Building models
_______ Building something else (what?)
Quiet activity?_____________________________
Busy activity?______________________________
Person?__________________________________
Teacher?_________________________________
Vegetable?________________________________
Animal?___________________________________
Way to dress?______________________________
___________________________________
I have culture, values, or beliefs about life
My culture (may include religion or other
important values or beliefs):
Memory?__________________________________
Game?___________________________________
TV show?_________________________________
__________________________________
Subject in school?__________________________
__________________________________
Movie?___________________________________
__________________________________
Book?____________________________________
I think what is most important in life is:
Song?____________________________________
Fruit?____________________________________
Sport?____________________________________
___________________________________
Hobby?___________________________________
147
Inside-Outside Boxes
Level I/II/III
.
Objective:
Participants will identify unique and special aspects of
themselves.
Structure:
Individual and large group.
Time:
45 minutes in class or homework assignment.
Materials:
Shoebox for each participant, craft materials, magazines,
scissors, glue.
Procedure
Note: A hot glue
gun speeds up the
process! As can
having images and
words cut from
magazines,
otherwise
participants may
browse the
magazines.
1. As an in-class or homework assignment, ask participants to put together a
shoebox (or medium size box) that represents who they are. Instruct them to
decorate it and/or put in items that describe or symbolize how they see
themselves.
2. Encourage participants to use a variety of craft materials (wool, sparkles,
bits of sticks and stones, leaves, pinecones), fashion magazines, fabric,
photos, beads, foil, etc.—anything participants can find. Instruct participants
to think about what colours, textures, etc. that they like and how this can be
incorporated into the activity (e.g. using a lot of blue can represent a love of
swimming; using feathers can signify a love of freedom). The participants will
create who they feel they are, on the inside and the outside of the box (e.g.
sports they play, hobbies they enjoy, personal attributes, involvement in the
community).
3. Once completed:
Have participants form groups of 4-5 people.
Ask volunteers to share and explain their boxes to their small group, in
as much or as little detail as they feel comfortable with.
4. In the larger group:
Ask them how it felt to complete this activity.
Point out that there is something special about every person. Feeling
good about ourselves, and liking ourselves, is called good self-esteem.
Encourage participants to keep their boxes.
.
(Adapted with permission from: Mack, Heidi (1996) All in a Day: An Experiential Program
Manual for the Prevention of Disordered Eating. Ottawa: Ananda Resources.
For more information or for a copy of the program, visit www.ananda.on.ca).
148
Who Will You Choose as Your Role Models? .
Objective:
Level I/II/III
Participants will identify personal qualities that they admire
and wish to emulate.
Structure:
Individual.
Time:
15 minutes.
Materials:
“Who Will You Choose as Your Role Models?” handout.
Procedure
1. Inform participants that this exercise gives them the opportunity to reflect
upon the qualities they admire in a person and wish to emulate.
2. Distribute the “Who Will You Choose as Your Role Models?” handout.
Instruct participants to pick two people they admire and might choose as role
models. They are then to list at least five qualities of each person that they
admire and wish to model.
3. Once they have had sufficient time to fill it in, ask participants (if willing) to
share their answers with the larger group. Ask participants to think about
which qualities apply to them.
4. Conclude by pointing out the variety and great number of ways we admire
other people. Inform participants that our role models can influence our
identity, self-esteem, and value system.
.
(Adapted with permission from: Kater, Kathy (1998) Healthy Body Image – Teaching Kids to Eat
and Love their Bodies Too! Seattle: Eating Disorders Awareness & Prevention.
For more information or for a copy of the program, please contact: 1-800-931-2237).
149
Handout
Who Will You Choose as Your Role Models?
1. People we admire often become role models for us. Think of 2 people you admire and might choose as
role models: at least one should be someone you know personally. The other may be someone you have
read about or otherwise know a lot about.
(Hint: You should know more than one quality of your role model. For example, you may admire a famous
athlete, but if you only know they are a great athlete and nothing more, that would not be enough.)
2. List at least 5 things that you really admire about each of these people that you would like to model. If you
cannot think of 5, choose a different person for your role model.
More Hints:
Consider deeper qualities in your role models, not just what you see on the surface. For example,
what kind of people are they; what do they believe in; and how do they act?
If you tried to be like the role models you have chosen, would you feel good and stronger about who
you are, or would you feel mismatched?
Name:
Name:
1.
1.
2.
2.
3.
3.
4.
4.
5.
5.
150
Things I Do Well
Objective:
.
Participants will identify their personal qualities, with an
Level I/II/III
adult support person.
Structure:
Individual homework assignment.
Time:
10 minutes.
Materials:
2 pieces of blank paper for each participant.
Procedure
1. Ask participants to fold both pieces of paper into four equal size quadrants
and write the following titles at the top of each quadrant:
Hobbies and Talents
Personality
Relationships with others
Values and Beliefs (i.e. things that are important to me)
2. On one sheet of paper, ask participants to write down a personal
accomplishment or a positive quality about themselves under each of the
headings.
3. Ask participants to take the second sheet of paper home and have it
completed by an adult they trust such as a parent, guardian, aunt, uncle,
member of the clergy, neighbour, etc.
Note: Some young
people may be
unable to complete
their parent(s) or
guardian(s). Allow
them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
4. Ask participants to compare the information on their chart with that of their
family member. Conclude the activity with a discussion based on the
following questions:
What is the same?
What is different?
Did the adult’s comments surprise you?
How do the results make you feel?
What did you learn about yourself?
.
(Adapted with permission from: The Body Image Coalition of Peel (1997) Every BODY is a
Somebody. Brampton: Author.)
151
Level I/II/III
Feeling Good About You
.
Objective:
Participants will identify ways to improve their selfesteem.
Structure:
Individual.
Time:
10 minutes.
Materials:
“Feeling Good About You” handout.
Procedure
1. Inform participants that we sometimes need to make a conscious effort to be
good to ourselves. Doing special things for ourselves increases our selfesteem, self-confidence, and feeling of self worth.
2. Ask participants to fill in the handout. Ask volunteers to share what they
wrote with the larger group and/or talk about how it made them feel to do the
exercise. Encourage participants to keep the handout and try to do
something for themselves each day.
How successful were you in doing two things a day for yourselves?
How easy/difficult was it to do this?
How did it make you feel?
Why is it sometimes difficult for us to do special things for ourselves on a
regular basis?
Why is it important to try to do special things for ourselves on a regular
basis?
.
(Adapted with permission from: Rice, Carla (1989) Teacher’s Resource Kit –
A Teacher’s Lesson Plan Kit for the Prevention of Eating Disorders.
Toronto: National Eating Disorder Information Centre.)
152
Handout
Feeling Good About You
Make a list of some activities that make you feel good about yourself. Try to list a variety of items.
___________________________________________
___________________________________________
___________________________________________
___________________________________________
Listing the things you like to do is the first step in
making yourself feel good. These may include playing the tuba, skating with our friends, watching Star Trek
re-runs, or helping your father bake chocolate chip cookies. Making sure you do a few of these everyday is
the second step. At first, you will need to make an effort. After a while, you may find that doing good things for
yourself will come naturally.
The following schedule will help you begin. Fill in two good things you can do for yourself everyday. Review
these at the end of each week.
Day
Activity
Activity
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
153
Mapping Your Body Image .
Level I/II/III
Objective:
Participants will define body image.
Structure:
Pairs' activity.
Time:
40 minutes.
Materials:
Newsprint, markers, masking tape.
Procedure
1. With the help of the group, define the term body image. They should come
up with a definition that includes the following:
Your perception of your body
How you feel about your body
How you think others perceive your body
Note: It is important
to assess whether
individuals in a
group are
comfortable doing
this exercise. You
may want to
describe the activity
to the group and
ask their opinions
about doing it. Or,
to avoid making
participants
uncomfortable, let
everyone know that
they can choose not
to participate in the
exercise and
provide them with
an alternative
activity.
2. Hang on the wall sheets of newsprint as long as the tallest person in the
group. Ask the group to break into pairs and have them take turns tracing
each other’s body size and shape on the paper. Then instruct each person
to write their feelings about their bodies on the paper outline. Ask them to
write messages about each body part including their hair, nose, ears, eyes,
mouth, face, skin, torso, breasts, hips, thighs, arms, legs, hands, and feet.
When everyone is finished, stand back and view the body images. Discuss
them.
3. Take another large piece of paper and hang it on the wall. Ask participants to
write affirming messages about their bodies: messages they would like to say
to people who put them down, to advertisers, to family members, to friends,
and to themselves. Discuss these roots of body image problems:
Social values, including ideal images of beauty
Judgements/feedback from others
Actual occurrences to the body (physical and/or sexual abuse, accidents,
illness)
Gender socialization (women, and increasingly men, link identity to
appearance)
Major life events (e.g. adolescence)
4. Ask: How can we improve body image?
Focus on non-appearance attributes (talents, abilities, etc.).
Focus on parts of our appearance that we like.
Write to magazine editors expressing your objections to the lack of
diversity in their magazines.
Organize a discussion group with your peers.
Discuss your frustrations with members of your family and/or your
friends.
Plan and implement a body image awareness event at your school/
community centre.
.
(Adapted with permission from: Rice, Carla (1995) Promoting Healthy Body Image: A Guide for
Program Planners. Toronto: Best Start.)
154
Prejudice and Body Image .
Objective:
Participants will describe how the media affects
perceptions of, and feelings toward, body image.
Structure:
Individual activity and large group discussion.
Time:
30 – 45 minutes in class or as a homework assignment.
Materials:
“Story Starter” handout.
Level I
Procedure
1. Explain that there are billions of people living on the earth, each one unique
in colour, size, features, and personality. Each one of us has traits that make
us unique. Some of us are small; some are big: some of us are fair; some are
dark: some of us are girls; some are boys. Tell participants to look around the
room at their classmates. Look at all the differences among just the people in
this one room!
2. Explain that the people that we see in the media represent only a small
percentage of the different types of people that live in the real world, and this
is a problem. When we see the same type of people each time we turn on
our TV or open a magazine, or when we are told in advertisements that it is
better to look like one type of person than another, it can make us
dissatisfied with the way we look—with our body image.
3. Ask participants to think about the people that you see on TV and in
advertisements in North America.
What are some words that you would use to describe the women?
What are some words that you would use to describe the men?
What is the message that these images to tell us about how people
should look?
Think of your own family and friends—do they look like the people you
see in the media?
4. Explain that, in truth, very few people look like those you see in the media. In
fact, some of the people in the media don’t look anything like their media
image, because their photographs are touched up to make them look more
attractive. Or they are filmed using lots of make-up and special lighting. Did
you know that special computers can take a picture of someone and give
them longer legs, or even make them thinner? Like it or not, many of us are
influenced by these people, and our feelings about how we look can be
affected by the people that we see in the media.
5. Distribute the “Story Starter” handout. Allow sufficient time for participants to
complete the handout.
6. Complete the handout after participants have finished their stories, discuss
how they felt in their “alien worlds.”
7. Conclude the activity by relating this “alien” experience to the pressures to
conform to a certain look that exist in our own world.
.
(Adapted with permission from: Rice, Carla (1989) Teacher’s Resource Kit: A Teacher’s Lesson Plan
Kit for the Prevention of Eating Disorders. Toronto: National Eating Disorder Information Centre.)
155
Handout
Story Starter
This is a story about a strange vacation you took to another planet in a distant solar system. It tells of the day
you were discovered by a spacecraft of aliens and taken away to a strange world. These aliens were really
huge; they weighed about 400 pounds and were seven feet tall. At first you thought they were ugly. Yet when
you arrived at their planet you found that all the aliens were huge, and the largest were considered the most
beautiful by this society. When you opened a magazine or turned on a television, all you saw were enormous
aliens. You also saw advertisements and commercials promising to help the aliens become even bigger!!!
Please write an account of the vacation.
______________________________________________________________________________(story title)
Describe exactly where and how the aliens found you. Did you apply for an ad in the newspaper to go to a
strange world? Were you at an amusement park and picked up by aliens who thought you were their friends
in disguise?
What did they look like? What was your reaction to them? What was their reaction to you?
What was the inside of their spaceship like? Were you afraid? How long did the trip take you? How far away
was their planet from the earth? Did you meet any creatures your own age when you arrived? How big were
they? What was your reaction to them? Did they view you as a strange creature? Did they ask you questions?
Imagine that the aliens had television, magazines, and films like we do, and in their commercials and
advertisements, the male and female aliens were all huge. Write about a commercial that you saw featuring a
product that promises to make its customers larger. What is the product that they are selling? Is it a green
slime bath that will make their bodies expand or a reverse exercise machine that will add on pounds instead
of taking them off? And what does the commercial promise will happen when they become bigger? Will they
be more popular and get invited to the Galaxy Space Dance? Will they be more successful and become
presidents of their own spaceship companies? Will their lives suddenly become more exciting than the lives
that they have now?
156
Why were the most famous and admired creatures also the largest? How did the smaller aliens, who were
short or thin, feel about their bodies?
Describe the feelings you had after being on this planet for a few months. Did you start liking the way the
aliens looked? Did it make you feel worse or better about your own body size? When and how did you leave?
What did your experience tell you about social pressures to be a certain size or shape? If you could give one
important message to the people on earth about body size and shape, what would it be?
Final Instructions
When you have finished, reread your paragraphs. Add details where you think they are missing. Rewrite the
paragraphs with connecting sentences so that they make a continuous story. Read what you have written.
Change anything that needs changing. Read and change until you are pleased with your story.
Now try drawing a picture to illustrate your story!
157
Level I/II
Me
Objective:
Participants will describe themselves and their personal
ambitions.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Me” handout.
Procedure
1. Read and discuss the “Me” story with the class.
What was the story about?
What was the main message(s)?
2. Ask participants to write a poem or story, to assemble a collage, or to create
and perform a video or commercial about themselves.
3. Ask volunteers to share their work with the group or post their work on the
wall around the room.
4. Conclude by pointing out how we each have unique and special qualities
that are worthy of noting and celebrating.
158
Handout
ME
I am the only ME I’ve got. I am unique. There are two major parts of ME. There
is the inside ME and the outside ME.
The outside ME is what you see: the way I act; the image I portray; the way I
look; and the things I do.
The outside ME is very important. It is my messenger to the world, and much of
my outside ME is what communicates with you. I value what I have done, the
way I look, and what I share with you.
The inside ME knows all my feelings, my secret ideas, and my many hopes and
dreams. Sometimes I let you know a little bit about the inside ME, and
sometimes it’s a very private part of myself.
Even though there is an enormous number of people in this world, no one is
exactly like me. I take full responsibility for ME, and the more I learn about
myself, the more responsibility I am going to take.
You see my ME is my responsibility. As I know myself more and more, I find out
that I am an OK person.
Sometimes things happen that are not my fault. I am still wonderful and special
and full of potential.
I have some good things in my life because I am a good person. I have accomplished some things in my
life because I am a competent person. I know some special people because I am worth knowing. I
celebrate the many things I have done for myself.
I’ve also made some mistakes. I can learn from them. I have also known some people who did not
appreciate me. They’re missing out on knowing a great person.
I’ve wasted some precious time. I can start to make new choices now. As long as I can feel, think, grow,
and behave, I have great possibility.
I’m going to take those risks and those possibilities, and I am going to grow and love and celebrate. I AM
WORTH IT!
159
Level II
Image Gap
.
Objective:
Participants will describe self-image and self-image
“problems” and apply a problem-solving approach to
negative self-image.
Structure:
Individual and large group activity.
Time:
30 minutes.
Materials:
3 handouts: “Image Gap,” “Image Gap: Problems and
Strategies,” “How to Be Your Own Best Friend.”
Procedure
1.
Distribute the “Image Gap” handout and lead participants through each
step.
In Part A, participants check the five qualities they admire most in others.
Then they copy those five qualities onto the lines in Part B.
Ask participants to think about how these qualities apply to them by
circling a rating from 1 to 10.
What do we mean by “self-image” (how we see ourselves)?
What is our “ideal self-image” (how we see others)?
The difference between self-image and ideal self-image can be called our
“image gap.”
Is there a big gap between how you’d like to be and how you see
yourself?
How does this gap feel? When does it become a “problem”? How do you
try to solve the problem?
There are two basic approaches to solving an image gap problem: we try
to change the way we are, or we try to change the way we see ourselves
(e.g., we become more accepting of ourselves).
Example: Problem: I wish I were… more attractive.
Strategy 1: I could change the way I am by dressing better; using babysitting
money to buy new clothes. But I can’t really change most of the way I look.
Strategy 2: I could change the way I see myself by being less critical, not
comparing myself to others so much, and focusing more on my strong points
(nice hair).
How does each strategy make us feel about ourselves?
When is one type of strategy more appropriate than the other?
Discuss the “Serenity Prayer”:
Grant me the serenity to accept
The things I cannot change,
The courage to change the things I can,
And the wisdom to know the difference.
.
(Adapted with permission from: Nova Scotia Department of Health (1996) Smoke-Free for Life,
Grades 7 to 9 – A smoking prevention curriculum supplement, p. 21-26.)
160
3. Instruct participants to complete “Image Gap: Problems and Strategies.”
Extension
Distribute “How to be Your own Best Friend.” Discuss each point. Ask
participants to remind themselves of these points over the following week,
perhaps posting their sheet in the room. They could keep a journal for the week,
in which they make a note of any times they are able to “be their own best friend.
161
Handout
Image Gap
Answer the following questions honestly.
There are no right or wrong answers.
This is a chance to learn something about
yourself.
A. Read the list below. Check the five qualities you most admire in someone your age:
_______Good grades at school
_______Has money/things
_______Good at art, music and or /dance
_______Attractive
_______Cool clothes
_______Popular/lots of friends
_______Smart
_______Liked by teachers
_______Mature
_______Good at sports
_______Not afraid of parents/teachers
_______Healthy/strong
_______Being good-looking
_______Funny/sense of humour
_______Not influenced by what others say/think
_______Tough
_______Caring/sensitive
Other:__________________________________
B. Fill in the 5 qualities chosen in A in the spaces provided below. Circle a rating from 1 to 10 to indicate how
much you think that it applies to you.
A little
A lot
1._________________________
1
2
3
4
5
6
7
8
9
10
2._________________________
1
2
3
4
5
6
7
8
9
10
3._________________________
1
2
3
4
5
6
7
8
9
10
4._________________________
1
2
3
4
5
6
7
8
9
10
5._________________________
1
2
3
4
5
6
7
8
9
10
162
Handout
Image Gap: Problems and Strategies
Part A
Choose three qualities that represent an “image gap problem” for you. Think of all the ways you could try to
solve each “problem,” and then decide which is the best strategy.
Problem
Possible Strategies
Best Strategy
I wish…
I wish…
I wish…
Part B
Answer these questions truthfully. The first question requires a little more care and thought, so try to spend
more time on it.
1
What do you like best about yourself?
2
What did you learn from this exercise?
163
Handout
How to be Your Own Best Friend
Know Yourself
Accept your strengths and your
weaknesses. Everyone has both!
Accept Help
Some problems are too big to solve alone.
Confide in someone you trust, and lighten
the load.
Go Gently
Don’t be hard on yourself. Be careful not to
expect too much or over-react to your
mistakes.
Be True to You
Don’t try to be someone else. Be proud of who you are. Pay attention to your own thoughts and feelings, and
do what seems right for you.
Control Self-Talk
Listen to the voice inside your head. If you hear put-downs (I’m so stupid.” “ I’m not worth it.” “I should be
more like him/her.”) …STOP! Take a deep breath, and change the tune to “Everybody makes mistakes.” “I
deserve it.” “How I am is good enough for me.”
Take Time Out
Spend some time alone enjoying your favourite music, reading a book or magazine, or writing in your journal.
Stay Active
When you walk, run, dance, or play hard, your body gets rid of nervous energy and tension. And when you
feel fit and strong, you’re ready to meet life’s challenges.
164
YES! Bags .
Objective:
Participants will identify and celebrate their positive
qualities.
Structure:
Individual.
Time:
20 minutes.
Materials:
Stones, indelible marker for each participant.
Procedure
1. Inform participants that there are many ways to remind ourselves of the
wonderful qualities we possess. The objective of this exercise is to create a
physical reminder of the wonderful things that you are. A “YES!” bag is a bag
full of affirmations—things you know and love about yourself— created by
you for your own use.
Level I/II
Note: Participants
may need to refer to
handouts from other
activities in this
module to help
identity positive
qualities.
2. Instruct participants to create a list of words to describe themselves and
then to choose 10 – 15 qualities that will be put into their bag. The qualities
they choose need to be positive.
3. Instruct participants to write each affirmation with indelible marker onto a
small stone (or small pieces of coloured cardboard, etc.). Participants should
store their stones in a small bag or box. They can add to these affirmations
whenever they think of new ones.
4. Brainstorm a list of how the YES! bags can be used (e.g. without looking,
pick a stone and think of as many ways as you can that having this quality
has affected your life in the last 24 hours).
5. Conclude by reminding participants to read the stones in their YES! bag
often, to celebrate the wonderful qualities they know they possess.
Remember those qualities and believe in them!
.
For more information or for a copy of the program, please visit www.ananda.on.ca.)
165
Level II/III
What Do You Say?
Objective:
Participants will identify methods to improve self-esteem.
Structure:
Individual.
Time:
20 minutes.
Materials:
“What Do You Say?” handout.
Procedure
1. Distribute the handout to participants. Emphasize the fact that they are to
respond to these situations as though responding to a friend.
2. As a larger group, ask volunteers to share their answers.
3. Conclude by discussing the following:
All of us experience stress and upset at certain times in our lives.
It is important to have people in our lives that we can talk to and get
support from.
166
Handout
What Do You Say?
If these people were your best friends, what would you
say to them?
1. Shoba really loves basketball. She plays it all of
the time and watches basketball games on
television. She’s in grade 9 and just found out
that she didn’t make the basketball team. She
feels she is no good at anything and should give
up playing basketball.
2. Tyler has been dating the same person for three months. However, the relationship seems to be a bit
rocky. His partner does not want him to spend time with any other friends and acts jealous and
possessive. Tyler knows the relationship is not working out but is convinced that no one else would
want to date him. Tyler doesn’t want to be alone and thinks that any relationship is better than no
relationship.
3. Sylvanno just found out that he is failing math. He’s convinced that he’s stupid and thinks that he
should drop out of school.
4. Karyna is 15 years old. She has decided to stop taking her birth control pills because she wants to
have a baby in order to feel loved and needed.
167
Level II/III
Mirror, Mirror
.
Objective:
Participants will describe the connection between body
image and self-esteem.
Structure:
Pairs activity.
Time:
20 minutes.
Materials:
A mirror for each participant.
Procedure
1. Instruct participants to find a partner. Pairs should sit on the floor, knee to
knee. Ask participants to write as many observations about the person in
front of him/her as possible within the next two minutes (e.g. big brown eyes,
sparkling smile). Have them put their pieces of paper aside. Assure them that
this paper won’t be shared.
2. Now, alone, participants should lift a mirror to look at themselves, and with
another piece of paper, record everything they observe about themselves
within the next two minutes.
3. Participants then tally the number of positive comments they recorded about
their partners and the number of positive comments they recorded about
themselves. Instruct them to do the same with negative or neutral
comments.
4. Ask:
How did it feel to do this activity?
What did you notice about the tallies?
Why can it be difficult to see good in ourselves?
Why can it be difficult to not believe what others say about us?
Why is it easy to see the good in others and not in ourselves?
Do you think it is possible to give yourself positive affirmations when
looking in mirrors rather than focussing on the negative?
5. Encourage participants to write a positive physical or personality trait for
each negative trait they wrote about themselves.
.
For more information or for a copy of the program, visit www.ananda.on.ca.)
168
What Do You Think About Yourself?
.
Level II/III
Objective:
Participants will evaluate their self-esteem.
Structure:
Individual activity.
Time:
15 minutes.
Materials:
“What Do You Think About Yourself” handout.
Procedure
1. Define self-esteem as:
Appreciating my own worth and importance and having the character to
be accountable for myself and to act responsibly toward others.
Inform participants that this exercise will give them an opportunity to
evaluate their sense of self-esteem.
2. Distribute the handout “What Do You Think About Yourself?”.
3. Ask participants to complete this self-esteem questionnaire individually and
to tally up their total. Tell them to note the recommendations for their total.
4. Ask the following questions:
Is it easy for young people to feel good about themselves?
What things can make young people today feel badly about themselves?
How does self-esteem show in friendship relationships, in romantic
relationships, and in sexual relationships?
5. Conclude with:
Respecting yourself means that you believe you matter and your feelings
count. It also means that you treat others well and expect others to treat
you well.
Relationships should be a positive part of our lives, offering us support
and encouragement. At some point in their lives, most people become
involved in a romantic relationship, which can develop into a sexual
relationship. It is important to have a good sense of self-esteem in order
to respect yourself within relationships.
.
(Adapted with permission from: Mauch, Pat and McLean, Ethel (1999) Respect Yourself and Protect
Yourself. Vancouver: Vancouver/Richmond Health Board.)
169
Handout
What Do You Think About Yourself?
Check one column for each of the following statements:
Most of the time
Sometimes
Almost Never
1. I keep trying.
2. I am important to family and friends.
3. I like what I do.
4. I get along well with others.
5. I help others to be their best.
6. I take responsibility for my actions.
7. I am important.
8. I know what I do best.
9. I believe in myself.
10. People listen to me.
11. I listen to others.
12. I use positive self-talk.
13. The future looks bright.
14. I plan for the future.
15. I am a good friend.
16. I accept compliments with a “thank you”.
17. I can give sincere compliments to others.
18. I enjoy getting up in the morning.
19. Other people care about me.
20. I do my best.
21. I am a unique person.
22. I express myself to others.
23. I deserve the best.
24. I can forgive myself.
25. I am an attractive person.
Give yourself:
1 point for every check in the Almost Never column
2 points for every check in the Sometimes column
3 points for every check in the Most of the Time column.
Scores:
60–75 Keep it up!
47–60 You’re on the right track toward positive self-esteem.
25–46 You might want to talk to someone you trust, about ways to improve your self-esteem.
170
Who Can I Talk To? .
Level II/III
Objective:
Participants will identify people they can turn to for
support.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Who Can I Talk To?” handout.
Procedure
1.
Distribute the “Who can I Talk To?” handout. Inform participants that
this is an individual activity, and that they will not be required to share
their answers.
2.
Encourage participants to keep this handout to refer to in future
situations when they are experiencing stress.
3.
Conclude by pointing out that stress is a normal part of life, and that we
all experience it. It is important to identify healthy and constructive ways
of dealing with stress, such as turning to people we trust for guidance
and support.
.
(Adapted with permission from: The Body Image Coalition of Peel (1997) Every BODY is a
Somebody. Brampton: Author.)
171
Handout
Who Can I Talk To?
Seeking support can reduce stress. Who you turn to for
support may depend on the particular problem you are
experiencing. It is helpful to think ahead about whom
you would go to for support. In each of the situations
below, identify the person you would most likely seek
help from and the reason why.
Situation
Who
Why
1. Having problems in your relationship with your
romantic partner.
2. Getting into an argument with your best friend.
3. Problems at home with a
parent/guardian/sibling.
4. Deciding to become sexually active.
5. Getting an STI.
6. Becoming pregnant or partner becomes
pregnant.
7. Getting rated by others in the school hallway,
about your appearance.
8. Being pressured by your friends to diet.
9. Having friends turn on you.
10. Getting poor grades.
11. Being chosen last for a team sport.
12. Having a chronic illness (e.g. asthma,
diabetes) or disability.
13. Questions about sexual orientation.
14. Being pressured to smoke, use drugs, or
alcohol.
172
Positive Self-Talk
Objective:
Participants will identify ways to improve their selfesteem.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Positive Self-Talk” handout.
Level II/III
Procedure
1. Inform participants that it is usually easier to think of bad things about
ourselves than good things. Negative self-talk usually consists of angry,
demeaning, hurtful statements. Young people become experts at identifying
their shortcomings, as they compare themselves to unrealistic “ideals.”
Positive self-talk can help to reduce stress and build positive self-esteem.
This activity will encourage participants to use positive self-talk.
2. Distribute the “Positive Self-Talk” handout. Ask participants to fill it out. As a
group, take up the answers.
3. Conclude by pointing out how positive self-talk takes practice, but is an
important element of healthy self-esteem.
Sample answer key
Negative Thought
Positive Thought
I’ll never make this basket.
I know I can make this shot.
Nobody likes me.
I can name at least one friend.
I have no special talents.
I can name at least one thing I am
good at.
I will never be a good musician.
With practice, I will be a good
musician.
My new haircut makes me look like a
loser.
My hair will grow back and there is
at least one other thing that I like
about my appearance.
He/she will never go out with me.
I’ll never make it through high school.
I always screw up.
I’ll never know if he/she will go out
with me until I ask.
If I work hard, I will make it through
high school.
Everybody makes mistakes at
times.
173
174
Magazine Analysis
.
Objective:
Participants will identify the cultural messages that
contribute to low self-esteem and body image.
Structure:
Small group.
Time:
30 minutes.
Materials:
An assortment of advertisements from fashion and
entertainment magazines, “Magazine Analysis”
handout.
Level II/III
Procedure
1. Inform participants that our culture ignores the fact that we are biologically
different and insists that all women be thin and men muscular. Accepting this
cultural message leads many people to diet in search of the culturally
acceptable body image. Being aware of this message may help combat its
influence.
2. Instruct participants to form groups of 4 – 5 people. Give each small group a
few magazine advertisements. Instruct participants to analyze the
advertisements by using the “Magazine Analysis” handout.
Example: An extremely thin woman is depicted in a wedding dress
alongside a cut and muscular man in a tuxedo. The product advertised is
perfume.
1. What is the message?
If a woman is thin, she will have the perfect male at her side, and she
will have a dream relationship if she wears this perfume.
2. Is this accurate?
No.
3. What is the truth?
Thinness has little to do with establishing a perfect and
dreamlike relationship.
3. Conclude by asking participants how they can respond to misleading
advertisements. Some suggestions are:
Write to magazine editors expressing your objections.
Develop a discussion group with your peers.
Discuss your frustrations with members of your family.
Plan and implement a media awareness event at your school/
community centre.
.
For more information or for a copy of the program, visit www.ananda.on.ca.)
175
Handout
Magazine Analysis
1.
What is the message?
2.
Is the message accurate or inaccurate?
3.
If the message is inaccurate, what is the correct interpretation?
1.
2.
3.
1.
2.
3.
176
Who Am I?
Objective:
Participants will identify the factors that affect selfesteem and ways of increasing self-esteem.
Structure:
Individual.
Time:
30 minutes.
Materials:
“Who Am I?” handout
Level III
Procedure
1. Inform participants that this is an individual and reflective activity that will
encourage them to examine the factors that influence self-esteem and how
they feel about themselves. It also contains strategies that encourage
positive self-talk. Assure participants that they will not be required to share
their answers.
2. Give participants sufficient time to complete the handout.
How easy/difficult was the activity?
How easy/difficult was it to identify your strengths? Weaknesses?
How did you feel doing the activity?
What did you learn about yourself?
177
Handout
Who Am I?
In the first column, list all of your strengths and things you like about yourself. Think about your personal
appearance, relationships, personality, and talents. In the next column, list some of your weaknesses and
things you would like to change about yourself. In the last column, try to rewrite some of these
weaknesses by
using more positive descriptors (e.g. replace “buck teeth” with “prominent front teeth”)
not exaggerating (e.g. replace “always” with “sometimes”)
noting corresponding strengths (e.g. replace “lousy at arguing” with “don’t have killer instincts and I
don’t lose my temper with people”)
Strengths/things I like about
myself
Weakness/things I would like
to change about myself
Rewrite
178
Transforming Body Image
.
Level III
Objective:
Participants will identify ways to improve their body image.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Transforming Body Image” handout.
Procedure
1. Introduce and discuss the concepts of “instrumental” and “ornamental”
body views.
An “instrumental” view sees the body primarily in a functional way,
appreciating what it does for the individual.
An “ornamental” view is one in which the individual experiences the body
in terms of how it appears to others, judging it on how it looks, relating to
it primarily as an object.
2. Discuss the relationship between body image and self-esteem.
When we relate to our bodies ornamentally, we become vulnerable to
the opinions of others and to social images of perfection.
When we relate to our bodies instrumentally, on the other hand, selfesteem tends to be more within our control.
3. Distribute the “Transforming Body Image” handout. Give participants time to
complete and reflect upon the activity.
4. Conclude by pointing out how difficult it can be to develop an instrumental
view of our bodies, particularly when our society often places so much value
on appearances. However, an instrumental view is an important step towards
healthy body image and healthy self-esteem.
.
(Adapted with permission from Russell, Vanessa and Te, Alice (1999)
Bodywork: A Handbook of Body Image Exercises.
Toronto: Equity Studies Centre, Toronto District School Board.
179
Handout
Transforming Body Image
1. Can you remember a time when you liked your body? When
did you learn to worry about your appearance?
2. Do you diet, weigh yourself, punish your body, or spend a lot
of time worrying about your appearance? How do you think
this affects you? What do you think you can do about it?
3. Do you hide yourself in baggy clothing? If so, why? How
often do you wear clothing or shoes that are uncomfortable
(even physically harmful)? How does this affect you? What
can you do about it?
4. Do you judge yourself on the basis of appearance? Do you
believe you would be better or more capable, if you were
thinner, muscular or more attractive? How can you stop
judging your body?
5. Do you have primarily an ornamental or an instrumental view of your body?
6. List three things you can do to develop a more instrumental view of your body.
7. List four things you like about yourself.
List four things you like about your body.
8. Imagine that you are completely at peace with your body and yourself, and that you really appreciate the
person you are, to the fullest. Describe what you think and feel about yourself and your body, in the
present tense, as if it were true.
180
Module 5: Sexual Identity
All teenagers face the complex and sometimes
confusing task of developing their sexual
identity. Our sexual identity is multifaceted and
includes our sex, gender, sexual orientation,
and sexual expression.
This module includes activities that will assist
participants in understanding their sexual
identity and in making decisions about their
sexual expression.
Sexual Identity
All individuals are sexual beings throughout their lives. Whether we marry,
remain single, or develop significant relationships at different times in our lives,
we are all sexual. Whether we ever have sex or not, we are sexual people from
birth to death.
Level II activities 31 introduce participants to the concept of sexual identity and
more specifically to gender identity issues and mass media influences on sexual
identity. Level III activities build on these concepts and also explore sexual
orientation issues.
OBJECTIVES OF
THE MODULE:
Participants will:
Sexual Identity and Sexual and Reproductive Health Education
identify and
explore gender
stereotypes
and gender
equality
We often think about sexuality as a commodity: something we “get, have, or do,”
rather than as a cumulative process continuing throughout our lives. We are all
involved in a lifelong learning process about our sexuality. As we grow and
mature our needs change; our capabilities change; our desire for intimacy and
closeness changes. Our experiences, and the experiences of people close to us,
shape our expectations and our values about sexuality.
explain how
sexuality
develops and
changes
throughout the
lifespan
All teenagers face the complex and sometimes confusing task of developing their
sexual identity. Our sexual identity is multifaceted and includes our sex, gender,
sexual orientation, and sexual expression. In fact, it encompasses just about
every aspect of our lives. Often, when we think about sexual and reproductive
health education, we think only of the genital parts of our bodies. Our sexuality is
a much larger concept than that: our sexuality is about who we are. It has to do
with biology, psychology, pleasure, values, and relationships— relationships with
ourselves, our friends and those that might become our partners.
describe
media
portrayals of
sexuality
Our sexual identity has many dimensions:
examine
sexual
orientation
32
Sex: Am I male or female? Refers to our biological femaleness or maleness.
There are two levels: genetic (our chromosomal sex) and anatomical sex (the
external and internal sexual organs). A person can also be inter-sexual (mixed
sexual characteristics).
Gender: Describes the psychological and social meaning added to being a man
or a woman.
Gender Identity: Our personal sense of “I am man, I am woman” (which may or
may not be the same as biological sex, e.g. transgender).
Gender Role: What roles do men and women adopt? What’s different? What’s
the same? Gender role is a collection of attitudes and behaviours that are
considered normal and appropriate in a specific culture for a particular sex.
Sexual Orientation: To whom, am I sexually and emotionally attracted? Sexual
orientation refers to our capacity to develop intimate, emotional, and/or sexual
relationships with the same sex (lesbian, gay), the other sex (heterosexual), or
both sexes (bisexual).
Biology: What changes will I go through at puberty? What effect will my
hormones have on me? What physical and psychological changes will I
experience at various life stages?
Relationships: How do I know who I am? How will I relate to others?
31
Level I activities are not included because the issues and conceptualizations are complex and
abstract.
32
Boyer, Maggi Ruth P. Commitment of the Heart: Conversations between Parents and Teenagers
about Sexuality. League of Women Voters of Bucks County, PA.
183
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
Values and Beliefs: How do I make choices about what is right and wrong?
What is the basis for my sexual decision-making? How do my culture and/or
religion shape my values and beliefs regarding sexuality?
Reproductive Decisions: How important is it to me, to be a parent? Will I
become a parent? If so, when and with whom? If not, what will I do to prevent
that?
Sexual Health: How will I remain sexually healthy? How can I protect my partner
and myself, now and in the future, from diseases and emotional harm?
Feelings: What feelings do I have about sexuality and sexual relationships?
How do I experience intimacy?
Social Skills: How comfortable do I feel in social situations? Do I know the
appropriate boundaries?
Thoughts, Fantasies: Sometimes I will just wonder about things or imagine
them: is it something I would choose to do or not? How would I handle this?
Media: How do the media (TV shows, movies, music videos, print materials)
portray sex, relationships, and other sexuality issues?
Note: As an
educator, it is safe
to assume that your
class reflects the
community it is
drawn from. Your
students will exhibit
ways of expressing
sexuality and
sexual identity that
are similar and
different from you
and others in the
class. As many as
one-in-ten
participants may be
gay, lesbian,
bisexual, or simply
unsure of their
sexual orientation. It
is important to
provide
opportunities to
include discussions
on a wide array of
sexual orientations.
Teaching Tips
1.
Set/reinforce ground rules. See page 6 of “Getting Started” for more
information on establishing ground rules.
2.
Read the fact sheet on gay, lesbian, and bisexual youth in the Resources
section of the Sourcebook.
3.
Use inclusive language (e.g. “partner” rather than “girl/boyfriend,” “lifetime
commitment” in addition to “marriage”).
4.
Use respectful language. Refer to democratic values, such as respect for
self and others, equality and justice, to address harassment and put-downs
(e.g. anti-gay jokes, graffiti and labelling).
5.
Bring in openly lesbian, gay, bisexual youth and staff as resource people for
specific classes. Young people respond well to guest speakers, particularly
those from their age group.
6.
Identify gay, lesbian, bisexual contributions (e.g. history, literature, art,
science, religion, etc.) throughout the curriculum as well as a history of
oppression (e.g. the incarceration of gay men and lesbian women during the
Holocaust, the origin of the word “faggot”). See the Resources section of the
Sourcebook for sources of further information.
7.
Submit requests to improve library holdings (both fiction and non-fiction)
related to sexual orientation.
8.
Provide resources (e.g. support groups and other community referrals) for
lesbian, gay, bisexual youth, and their families.
184
Gender Stereotypes
Objective:
Participants will identify gender stereotypes.
Structure:
Time:
30 minutes.
Materials:
“Gender Stereotypes” handout; flipchart or
blackboard.
Level II
Procedure
1. Inform the participants that the activity will examine what it means to “act like
a man” and to “act like a woman.” Point out that these messages are referred
to as stereotypes.
2. Ask participants to form groups of 3 – 4 people. Assign each group one of
the scenarios from “Gender Stereotypes.” Instruct participants to discuss
their scenario in their small group.
3. In the larger group, ask a volunteer from each small group to summarize
their group’s discussion.
4. Explain to the larger group that gender roles are stereotypes or rules that
boys and girls are expected to live by.
There are specific meanings associated with acting like a man and acting
like a woman.
Ask participants what some of these meanings are (e.g. men are
encouraged to be strong and tough, and women are encouraged to be
nurturing and quiet). List these meanings on the blackboard/flipchart.
5. Ask participants where men learn these gender roles (e.g. people, media,
etc. – ask for specific examples). Then ask where women learn these gender
roles.
6. Discuss how stereotypes/gender roles are reinforced.
What names or put-downs are boys/girls called when they don’t fit these
roles?
How do these labels and names reinforce stereotypes/gender roles?
How does it feel to be called these names?
7. Conclude by explaining how such stereotypes can be destructive because
they limit our potential. This is not to say that boys shouldn’t fix cars or girls
shouldn’t cook. The problem is that we are told that we must perform certain
roles in order to fit in. It is important for all of us to make our own decisions
about who we are, what we do, and how we relate to others.
185
Handout
Gender Stereotypes
1. Mohammed is walking home from school, carrying his Science Project to show his family. Some of his
classmates run up behind him and knock his project out of his arms. Mohammed begins to cry.
Solution A
It is okay for Mohammed to cry. Why? How does this solution make him feel?
Solution B
It is not okay for Mohammed to cry. Why? How does this solution make him feel?
2. Fatima would like to help the teacher with the film projector, help move tables, and carry boxes. The
teacher always chooses boys to help with these tasks. Fatima thinks that she is just as strong as some
of the boys.
Solution A
Fatima should be asked to help the teacher. Why? How does this solution make her feel? How does
this solution make her feel?
Solution B
Fatima should not be asked to help the teacher. Why? How does this solution make her feel? How
does this solution make her feel?
3. Lynne would like a model airplane kit for her birthday. Her friends have been telling her she should ask
for a jewellery making kit, since model airplane kits are not meant for girls.
Solution A
Lynne should ask for a model airplane kit.
Solution B
Lynne should not ask for a model airplane kit. Why? How does this make her feel?
4. Scott would like to baby-sit for his next-door neighbour when she goes grocery shopping. The
neighbour
has one child who is six years old. Scott’s twin sister is always the one who is asked to
baby-sit.
Solution A
Scott should have a chance to go babysitting. Why? How does this solution make him feel?
Solution B
Scott should not have a chance to go babysitting. Why? How does this solution make him feel?
186
5. Tony has been taking ballet lessons since he was five years old. Recently he won an award for his
dancing. Tony has not told any of his classmates about his dancing.
Solution A
Tony should tell his classmates. Why? How does this solution make Tony feel?
Solution B
Tony should not tell his classmates? Why? How does this solution make Tony feel?
6. Jen wants to join the community hockey team. Some boys have told her she can’t join the team. Jen
thinks she is just as good a player as some of the boys and doesn’t understand why they don’t want
her on the team.
Solution A
Jen should be able to join the team. Why? How does this solution make her feel?
Solution B
Jen should not be able to join the team. Why? How does this solution make her feel?
187
Sexual Behaviour in Our Culture .
Level II/III
Objective:
Participants will define, identify, and explore sexuality and
sexual behaviour in our culture.
Structure:
Homework assignment followed by classroom activity.
Time:
Materials:
“Sexual Behaviour in Our Culture” handout; flipchart
paper and markers.
Preparation
A few days before this activity is taught, introduce the topic by discussing how
sexuality is a part of our culture and that sometimes we are not aware of how
many sexual images and messages we receive on a daily basis as we watch
television, read advertisements, listen to music, or watch the people around us.
Ask participants to complete the “Sexual Behaviour in Our Culture” handout
(which asks them to list all of the social messages about sexuality that they
observe in the next 24 hours, and list where and when they saw the behaviour).
Schedule the following activity the day the homework is due.
Procedure
1. Tell the group that they are going to discuss the theme that they began on
the day the homework was assigned. Ask them to take out their homework
where they observed and recorded social messages about sexuality.
2. Divide participants into groups of four to six students, and give each group
newsprint and markers. Ask them to make a list of all of the sexual
behaviours they have observed, as well as the context within which they
observed them. Ask them to write this information on the newsprint.
3. After they have completed their lists, ask them to post the lists on the wall.
Allow a few minutes for participants to read the lists composed by the other
groups. Head a discussion by asking each of the groups to respond to these
questions:
Which behaviours surprised you?
Which behaviours that you consider sexual are missing from this list?
Which behaviours are related to reproduction?
Which are related to pleasure?
Which behaviours made you uncomfortable?
How did you feel about the public nature of the behaviours?
In your view, what are the appropriate ages for these behaviours? (Infant,
8 years old, 14 years old, 16 years old, 20 years old, 50 years old, etc.)
Did anyone document seniors, people with disabilities, or gay/lesbian
couples on their worksheets?
.
(Adapted with permission from: SIECUS (1998) Filling the Gaps – Hard to Teach Topics in Sexuality
Education. New York: Author. For more information or for a copy of this program, visit
www.siecus.org).
188
Did anyone document men being affectionate with one another?
Important points to bring out in this discussion are:
Sexuality is all around us; it is pervasive.
The expression of sexual behaviour is used for a variety of purposes
(for love, pleasure, or procreation; to sell a product, for exploitation,
etc.). A single sexual behaviour can have more than one purpose
(pleasure and procreation for example).
There is a broad range of behaviour (hugging, sharing affection,
holding hands) that is called sexual behaviour.
Point out that people with disabilities, seniors, and gay couples are
often ignored as sexual beings. Point out stereotypes that are related
to the sexual behaviour.
4. Conclude by pointing out how it is important that each person
understands his/her own values as they relate to appropriate sexual
behaviour at various ages, in public, and in private.
189
Handout
Sexual Behaviour In Our Culture
Directions
In the first column, list all of the sexual behaviours that you observe in the next 24 hours (e.g. as you watch
television, read advertisements, listen to music, or watch the people around you). In the second column, list
where and when you observed each behaviour.
Sexual Behaviours That You Observed
Where and When You Observed The
Behaviour
A man and woman kissing.
Outside a restaurant; walking home from
school.
190
Sexual Orientation: A Lesson with Parents
.
Level II/III
Objective:
Participants will discuss and identify the degree to which
their feelings about sexual orientation are similar to, or
different from, those of their parents/ guardians.
Time:
30 minutes at home, 30 minutes class time.
Materials:
“Sexual Orientation: An Interview with Your Parents”
handout.
Procedure
1. Three days before class, introduce the activity by saying that most people
believe they know how their parents/ guardians feel about various sexual
issues. Most parents/guardians also believe their teenage children know how
they (the parents/guardians) feel about these issues, even though they might
not have discussed them. Most young people are influenced by their
parents’/guardians’ beliefs or values about sexuality. Sometimes however,
parents/guardians are not sending the messages they think they’re sending.
2. Distribute the “Sexual Orientation: An Interview with Your Parents” handout.
Ask participants to take it home and complete it with one or both parents/
guardians. Explain that the assignment is designed to get responses from
parents/ guardians on sexual orientation. Encourage them, if they feel they
can, to share with their parents/ guardians their own responses to the
questions.
Note: Some young
people may be
unable to complete
their parent(s) or
guardian(s). Allow
them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
3. Make sure students are able to define the following terms from the
worksheet:
Homosexual: a person who forms sexual and affectionate relationships
with, and attractions for, people of the same sex.
Heterosexual: a person who forms sexual and affectionate relationships
with, and attractions for, people of the opposite sex.
Bisexual: a person who forms sexual and affectionate relationships with,
and attractions for, people of either sex.
Sexual orientation: a person’s feelings of emotional and sexual
attraction—can be heterosexual, homosexual, or bisexual.
4. After participants have had a few days to complete the assignment, ask
them to bring in their sheets and read their interviews silently to
themselves. Collect the Declaration of Completion slips. Use these
questions to discuss the interview sheets:
What was it like to conduct this interview?
Was anyone nervous? Were you more (less) nervous than your
parent(s)?
Did any of you choose not to ask questions of one parent/guardian even
if she/he was available?
.
(Adapted with permission from: SIECUS (1998) Filling the Gaps – Hard to Teach Topics in Sexuality
Education. New York: Author. For more information or for a copy of this program, visit
www.siecus.org.)
191
For those of you who interviewed both parents/ guardians, who was easier to
interview about sexual orientation?
Was anyone surprised by their parents’/ guardians’ answers? If so, what
surprised you?
In general, did you find your own beliefs and values similar to, or different
from, your parents’/ guardians’?
192
Handout
Sexual Orientation: An Interview with Your Parents
Instructions
Using the following questions as a guide, interview one or both of your
parents/ guardians about their values and beliefs regarding sexual
orientation. Write their answers below. You will not hand in this
assignment or share it with the class. You will only share what it was
like to conduct the interview.
“This is a homework assignment from ______________________class.
The answers will remain confidential. I will not report them to the class.
You will, however, sign a form stating that we completed the
assignment together. It is about sexual orientation and the values and
feelings I have grown up with.”
1. When you were growing up, what messages did you receive about
homosexuality and/or bisexuality?
2. What messages did you receive about heterosexuality?
3. Were your values about sexual orientation the same as or different from those of your parents/
guardians? How so?
4. Do you know anyone who is gay, lesbian, or bisexual? (yes or no)
5. If you do know someone who is gay, lesbian, or bisexual, do you think their sexual orientation makes a
difference in our family’s relationship to her/him?
193
6.
What does our religion say about homosexuality?
7. How do you think most of your friends would feel if they discovered that their son or daughter was gay,
lesbian, or bisexual? What would they do?
8. What would you suggest to a teenager who thinks she or he might be gay, lesbian, or bisexual?
9. What do you think a teen or adult should do if they hear a person criticizing someone who is gay, lesbian,
bisexual, or someone who is thought to be gay, lesbian, bisexual?
We completed the
Sexual Orientation: An Interview with Your Parents
homework assignment.
____________________________________
Participant
______________________________________
194
Visualization
.
Level II/III
Objective:
Participants will discuss and challenge heterosexual
privilege.
Structure:
Large group.
Time:
30 minutes.
Materials:
“Visualization Story”.
Procedure
1. Ask participants to relax and listen to the story.
2. Read the story from the handout.
3. Ask participants to take a few moments to think about the story.
4. Facilitate a discussion:
What is your response to the story?
Was this real?
What did you think or feel while listening to the story?
5. Conclude by pointing out that gay, lesbian, and bisexual people face certain
challenges in our society. We should aim to respect all people, and where
possible, lend our support.
.
(Adapted with permission from: Mercier, Joanne and Claire, Carolyn (1996) Anti-Homophobia
Program. Calgary: Calgary Birth Control Association)
195
Visualization Story
It is a beautiful spring morning as you awake. You take a shower, dress, and sit down to your breakfast. You
glance outside and enjoy the tulips and daffodils that are finally starting to grow. It is a school day, but unlike
any other because today, for one day in your life, you are a heterosexual person living in a gay world—and
you are the minority.
You don’t feel any different, and you wonder how your day will go. You glance at a magazine and listen to the
radio. It’s almost time to go to school, but wait… a magazine ad catches your eye. Two women models hold
each other, sensuously displaying bathrobes on sale for half price. The cartoon on the opposite page tells of a
funny mishap in a family of two men and their dog.
You listen again to the radio playing a catchy song about the love between two women and the distance that
keeps them apart. The doorbell rings and you grab your coat. Your friends have arrived and it’s time to leave
for school.
On the way to school, your friends are talking about their latest same-sex love interests. It seems normal: no
one is surprised and the conversation continues. You would like to tell your friends about what you did this
weekend and about the cute opposite sex person that you met, but now you are kind of afraid of how your
friends will react.
When you arrive at school, you go to your locker. At the locker next to you there is a group of students
laughing as a joke about heterosexuals is shared. You leave, wishing you could have told them to shut up.
On your way to class, a group of guys purposefully bump into you, and they tell you they hate heterosexuals
and that you had better stay out of their way.
You make your way to class and take a seat. Your teacher is asking everyone to get into small groups: today
you are going to talk about the characteristics you would look for in a perfect life partner. You feel like you are
being forced to lie. You don’t feel that you can tell your group how you would look for someone of the opposite
sexy look out the window as the bright spring day continues…
196
The Porcupine Game
Level III
Objective:
Participants will identify aspects of sexual identity and
which are most important to them.
Structure:
Large group.
Time:
20 minutes.
Materials:
Procedure
1. Draw a circle on the board and label it sexual identity. Define sexual identity
as how we feel and express ourselves as sexual beings.
Point out that:
we are all sexual beings, whether we have sex or not.
Our sexual identity is formed by a number of factors.
2. Ask participants to identify these factors. Draw a spoke from the circle for
each descriptor. You may need to give a few examples to get the ball rolling
and/or provide definitions for the following factors:
sex
relationships
gender
biology
sexual orientation
values
culture
feelings
age
social skills
disability (physical, developmental)
thoughts/fantasies
religion
reproductive decisions
experiences
sexual health
media
3. Ask participants to think about which factor is the most important aspect of
their sexual identity, and which is least important (some can be equally
important). Ask them to think about why one is more important to them than
another.
4. Ask the following questions:
Which spoke is the most important to you? Least?
Do you think your spokes will change over time? Why or why not?
197
5.
Conclude by informing participants that everyone has a unique set of
“spokes” that make up their sexual identity. This identity is fluid and
changes over time as you grow, develop, make new friends, and change
your level of sexual involvement. Let participants know that understanding
their sexual identity will help them make decisions about their sexual
expression.
Extension
If you notice that participants had problems with specific “spokes,” you can
supplement your lesson plans with activities that address these issues more
directly.
198
Sexuality Through the Lifespan
.
Objective:
Participants will explain how sexuality develops and
changes throughout life, from birth to death.
Structure:
Small group.
Time:
40 minutes.
Materials:
“Human Sexuality Is…” and “Sexuality Through the
Lifespan” handouts.
Level III
Procedure
1. Introduce the activity by pointing out how in today’s society, when people
use the word “sex” they are usually referring to vaginal intercourse.
As young people internalize this message, they may feel pressured to
experience intercourse as an affirmation of their sexuality.
This lesson is structured to heighten awareness of sexuality, including
gender identity, gender role behaviour, interpersonal relationships, and
family life, as an intrinsic part of every person’s life.
By examining ways humans express their sexuality throughout their
lives, participants can broaden their understanding of their own sexual
experience.
2. Ask participants:
What questions do young children ask about sex?
What play activities do young children create, to find out about their
sexuality?
What are young children curious about regarding sexuality?
3. Divide the participants into small groups and distribute both handouts. The
groups should work to reach consensus in completing the assignment.
4. Review the handouts with the entire group.
What stage are people your age in? How does sexuality in the stage you
are in compare with sexuality in other stages of the lifespan?
How is sexuality in childhood similar to sexuality in old age? How is it
different?
Describe some forms of sexual activity that do not involve intercourse
(e.g. mutual masturbation, oral sex). What are some of the reasons
people choose these activities rather than intercourse?
What would help people to develop positive attitudes about their own
sexuality?
What aspects of human sexuality would be the same or different if a
person were gay or lesbian? Physically or developmentally disabled?
What is common in all age groups? (e.g. love, affection, etc.).
.
(Adapted with permission from Brick, Peggy (1996) The New Positive Images Planned Parenthood
199
Handout
Human Sexuality Is…
Directions: Human beings are sexual from birth to death. Sexuality, however, changes throughout the
lifespan as a person grows and develops. Place a check in the column that indicates the times in the lifespan
that each of the following needs or behaviours might occur.
Human Sexuality is …
Early
Childhood
Birth 3 yr
Late
Childhood
4-8 yrs
Early
Adolescence
9-11 yrs
Adolescence
12-18 yrs
Young Adult
19-30 yrs
Adult
31-45 yrs
Adult
46-64 yrs
Adult
65+ yrs
1. Love
2. Touch and affection
3. Sense of being male
or female
4. Curiosity about body
difference
5. Need for friends
6. Males: Erection
7. Females: Lubrication
of vagina
8. Possibility of orgasm
9. Possibility of
masturbation
10. Menstruation
11. Sperm production
12. Awareness of sexual
attraction to others
13. Possibility of sexual
intercourse
14. Possibility of other
sexual activity (kissing,
petting, etc.)
15. Possibility of
pregnancy or
impregnating
16. Possibility of
contraception and “safersex” decisions
17. Possibility of
becoming a parent
(parenting)
18. Flirting
19. Possibility of ending a
relationship
20. Need for
independence
1. Which stage in the lifespan seems most exciting?
2. Write the letter “P” next to the items that are pleasurable.
3. Write the letter “C” next to the items that involve choices and decision-making.
200
Handout
Sexuality Through The Lifespan
EARLY CHILDHOOD (Birth-3Yrs.)
Learns about love and trust through touching and
holding
Sucking (need for oral satisfaction)
Boys: erections of penis
Girls: vaginal lubrication
Gender identity develops (child knows “I am a
boy” or “I am a girl”)
Sex role conditioning (boys and girls are treated
differently)
Exploration of own body (hands, feet, genitals,
etc.)
Toilet training
Possibility of orgasm
Curiosity about differences between boys’ and
girls’ bodies
Curiosity about parents’ bodies
LATE CHILDHOOD (4-8 Yrs.)
Childhood sexual play (e.g. doctor)
Sex role learning: how to behave like a boy or girl
Learns sex words: “bathroom vocabulary”
Asks questions about pregnancy and birth
Begins to distinguish acceptable and not
acceptable behaviour
Possibility of masturbation
Becomes modest about own body
Media influences understanding of male/female
family roles
YOUNG ADULTHOOD (19-30 Yrs.)
Possibility of sexual activity
Possibility of mate selection
Decision-making about partnerships, marriage,
family life, and careers
Possibility of pregnancy, childbirth, and parenting
Possibility of contraception and “safer-sex”
decisions
Possibility of ending a relationship
ADULT (31-45 Yrs.)
Maintaining relationships (sexual and non-sexual)
Possibility of parenting responsibilities (sex
education of own children)
Possibility of pregnancy and childbirth
Decision-making about contraception and “safer
sex”
Possibility of grand parenting
Possibility of ending a relationship
EARLY ADOLESCENCE (9-11 Yrs.)
Puberty begins (growth of genitals, breast
development, etc.)
Closeness of same sex friends
Possibility of body exploration with others
ADULT (46-64 Yrs.)
ADOLESCENCE (12-18 Yrs.)
Puberty changes occur
Menstruation or sperm production
Pleasure from kissing and petting Greater
awareness of being sexually attracted to others
Possibility of pregnancy or impregnating
decisions
Strong need for independence
ADULT (65 to Death)
Menopause
decisions
Possibility of divorce or death of a loved one
Body still responds sexually, but more slowly
Need for physical affection
Possibility of death of a loved one
201
Level III
Gender Equality: Celebrating Who We Are
.
Objective:
Participants will identify gender stereotypes and discuss
gender equality.
Structure:
Time:
40 minutes.
Materials:
Flipchart or blackboard; index cards.
Procedure
1. Defining Gender Stereotypes
Ask participants what it means to “act like a man” (words or
expectations). Record their responses on the blackboard or flipchart.
Ask participants what it means to “act like a woman” (words or
expectations). Record their responses on the blackboard or flipchart.
Point out that, generally, these are roles that we learn—we are not born
this way.
2. Gender Equality and Relationships
Give each participant an index card, and instruct the group to write down
the three most important things they look for in a relationship (friends,
boyfriend or girlfriend). Alternately, the educator can prepare index cards
ahead of time (humour, intelligence, good looking, etc.) and participants
can vote on whether it is a desirable quality or not.
Ask participants to post their index card on the blackboard or wall. Then
read out the qualities participants have listed, identifying common themes
in content.
Tell the group that the qualities selected are not particular to gender. It’s
hard to tell which cards were written by boys and which ones were
written by girls.
Ask: what qualities or characteristics do you look for in male friends or
boyfriends? List their responses on the blackboard or flipchart under the
heading “Ideal Guy.”
Ask: what qualities or characteristics do you look for in female friends or
girlfriends? List their responses on the blackboard or flipchart under the
heading “Ideal Girl.”
Ask: Are all of these qualities fair and reasonable? Are there any that
you could not live up to? Are some harder to live up to than others?
2. Conclude by pointing out that gender equality starts when we treat each
other as human beings with needs and hopes and expectations. The list
you came up with (part B of the activity) is the first step beyond the box of
limiting stereotypes. We have a choice in our lives. We all know that we’re
constantly bombarded by restrictive, stereotypical images of what boys and
girls should be. What we must do is to remember who we really are and
what is important to us. When we assert our choices, we will not fall into the
trap of believing in the stereotypes more than we believe in ourselves.
.
(Adapted with permission from Men For Change (1994) Healthy Relationships: A Violence
Prevention Curriculum. Halifax: Author. (ISBN 0-9698188-0-7) All rights reserved.)
202
Sexuality and the Mass Media
.
Level III
Objective:
Participants will describe media portrayals of sexuality.
Structure:
Large group.
Time:
30 minutes to introduce topic and assignment, one class/
session for presentations (optional).
Materials:
“Sexuality and Mass Media” handout.
Procedure
1. Introduce the activity by saying: “Our attitudes about sex and sexuality
come from a variety of sources. Some people say that parents are a major
influence because our attitudes are formed when we are very young. Others
say peers affect us more. However, most agree that the mass media (e.g.
TV, movies, Internet, radio, magazines, newspapers, billboards, books) plays
an influential role in shaping our attitudes about sex and sexuality.”
2. Lead a discussion group by asking some of the following questions:
How do the mass media deal with youth sexuality (e.g. visual media
often depicts youth as sex-starved lunatics)?
Do the media deal with the consequences of sex? What about birth
control, STIs, and HIV?
Do the media depict a range of sexual activity, or do the media equate
“sex” with “intercourse”?
What are some of the myths about youth sexuality displayed in music
videos, TV shows, and movies (e.g. the boy is usually confident and selfassured, and the girl is often clueless)? Are there any examples of
realistic situations?
Is there a difference between how males and females are depicted in a
sexual situation (e.g. male as dominant, knowledgeable, the seducer;
female as passive, innocent)? Are men and women portrayed as having
different reasons for having sex (e.g. men have sex for pleasure; women
have sex to get pregnant in order to “trap” a man)?
Do the media better serve straight people than gays and lesbians? Do
you see many examples of bisexuality?
Is cross-dressing portrayed in a serious way or just for laughs? What
about transsexual behaviour?
Are there many examples of relationships between young women and
older men? Young men and older women?
How is the sexuality of people with physical or developmental disabilities
depicted?
What about couples from differing cultural backgrounds?
3. Distribute the “Sexuality and Mass Media” handout and ask participants
(individually or in small groups) to pick one of the seven media monitoring
activities. Participants can then prepare either a written response or a
presentation.
4. Conclude by asking participants what they learned from doing the activity.
Point out that we must all be critical consumers of the mass media since the
media’s depictions of sexuality are sometimes unrealistic, unhealthy, and
non-inclusive.
.
(Adapted with permission from Planned Parenthood Federation of Canada (2000) Youth Talk Back:
Sex, Sexuality and Media Literacy. Ottawa: Author.)
203
Handout
Sexuality and the Mass Media
Media Monitoring Activity #1
Catcher in the Rye, J. D. Salinger’s classic book
about a young boy’s sexual coming-of-age, is the
third most banned book in libraries. Why are adults
so frightened by sexuality in young people? Why are
they so afraid of young people viewing sexual
situations or reading about young people exploring
their sexuality? If you’ve read Catcher in the Rye, do
a comparison between the book and a recent teen
movie that deals with young people having (or trying
to have) sex. One example is American Pie.
Do your favourite magazines, songs, videos, TV shows, and movies reflect your personal views on sex and
sexuality? Give examples supporting your answer by referring to a specific situation in a movie or TV program
or by quoting from an article or song. For example: “I believe that abstinence is best, and an article in
Seventeen validated my point of view.” Or: “I don’t think that guys always have to make the first move. I liked
it when Nell asked out John Cage (Ally McBeal) or when Willow took the initiative to try to patch things up with
Oz, after he caught her kissing Zander (Buffy the Vampire Slayer). “I like Phoebe’s (Charmed) attitude
towards sex. She’s comfortable with her body and her relationships. She sees something she wants and goes
for it”.
Check out the new shows for teens. What age group are these shows really aimed at? Are they aimed at men
or women? Assess their treatment of youth sexuality. Do they present realistic situations? Do they deal with
responsibility? How do they differ from other shows aimed at a larger audience? Are they better, worse, more
realistic, less?
Identify male and/or female characters on TV or in movies or singers/groups that you feel best convey a
healthy, responsible, and realistic attitude towards sex. What makes their attitudes healthy, responsible, and
realistic? Give examples to back up your answer.
Identify young celebrities or fictional couples – from books, movies, TV programs, or in music videos – that
you feel have a relationship based on sexual equality. What do they say and/or do that makes theirs a healthy
relationship?
204
Some pop culture observers have noted that society seems to be more accepting of same-sex situations if
they involve females than if they involve males. Some say that’s because men find it very exciting when two
females have sex, but repulsive, even frightening, when it’s two males. As you’re watching, readings, and
listening to media, keep your eyes and ears open to see if you can spot this attitude in storylines, jokes,
cartoons, talk shows, etc. You might want to check out the undertones to the Xena/Gabrielle relationship.
Could you imagine the same undertones to the relationship between Hercules and Ioalus? Try to vary your
exposure to potential situations by checking out mainstream, late-night shows such as the Tonight Show as
well as male-oriented magazines or more controversial programs such as the Howard Stern Show.
Watch some movies and TV programs (sitcoms and dramas). Compare the number of gay characters in key
roles to those in supporting roles. Are gay characters one-dimensional stereotypes? Or are they portrayed the
way heterosexuals are—where their sexuality is just one part of who they are? Give each show/movie with a
gay/lesbian character a letter grade (A, B, C, D, or F) based on how fair and accurate (to you) it is regarding
sexual orientation. Then, check out more sensational TV shows such as the Howard Stern Show, Jerry
Springer, Montel Williams, Jenny Jones, Hard Copy, and tabloids such as the National Enquirer. Give each of
them a letter grade and compare their approach to same-sex relationships with the more mainstream media.
Are there any differences? If so, what are they? Which portrays same-sex relationships in a more positive
light—mainstream media or more sensational media?
205
Evaluating Television
Preparation
In preparation for
the session,
videotape ten to
fifteen minutes of a
television program
that is popular with
your group. You
may want to get
some suggestions
from participants
regarding popular
TV programs or
even have one of
your students do
the videotaping for
you (in which case,
you will need to
preview the clip).
Familiarize yourself
with the subject by
reading How
Television and
Movies Portray
Sexuality:
Background
Information for
Educators.
(attached)
.
Objective:
Participants will identify television messages regarding
sexuality and sexual violence.
Structure:
Large group.
Time:
45 minutes.
Materials:
“Checklist for Evaluating Television and Movies”
handout, TV and VCR. Flipchart or blackboard.
Procedure
1. Ask participants the following questions:
What do we mean by “the media”?
What are the different media?
2. Introduce today’s activity by saying something like, “One of the greatest
changes in our society since the 1920s has been the advent of television.
Through television and mini-cams, we are now able to see events as they
occur throughout the world. One hundred years ago, news of an event would
be communicated through newspapers and magazines days or weeks after
the fact. The influence of television has been quite apparent in a number of
fields, such as political campaigns, sporting events, and current events
(hostage situations, car chases, and murders filmed live). There have been
many accounts of the negative effects of television on habits of reading and
conversation. Today, we’re going to look at the influence television has on
the way we think about sexuality.”
Ask participants if they think TV programs and the people in them are “reallife.” Ask them to describe some things that aren’t “real-life.” Ask participants
what they would look for if they were going to evaluate a favourite TV
program for its messages about males, females, and relationships. Make a
list of their responses on the board. Tell participants that you have another
checklist for evaluating television and that it includes many (or all, or some)
of the same things that they would be looking for.
3. Distribute and discuss the handout, “Checklist for Evaluating Television and
Movies.”
4. Show the TV clip. Participants may work on the checklist while they are
viewing the clip, but you should also give them time to complete the sheet
afterwards.
5. Discuss the show, using participant’s checklists as the basis. Start with
some general questions, such as, “So, what do you think?” or “Any
surprises?” Ask several students to share their “Final Analysis.”
.
206
6. Conclude the lesson with a discussion based on the following questions:
Some psychologists say that the more frequently material is presented to
people, the more likely they are to internalize it (make it a part of how
they think and behave). What does this say about TV’s effects on
sexuality and sexual violence?
How can television create healthier portrayals of sexuality and still be
entertaining? What can you do to see that this happens?
Extension
Divide participants into teams, with each team monitoring a different
program for three to four weeks: pass out additional checklists for this
purpose. After the monitoring time, have each team present its findings
to the other teams.
Another way to examine sexuality in the media is in the selection of
different kinds of programming. Examples of cartoons for children, soap
operas, movies, music videos, or sitcoms can each provide an
opportunity to see messages about sexuality. Comparisons can be made
within categories or between categories
207
How Television and Movies Portray Sexuality:
Background Information for Educators
Body Image Or Appearance
Characters’ appearances tell who they are, and how they want to be viewed. A
character can become a role model, with many viewers seeking the same kind
of “look” either in themselves or in partners. The “sex appeal” of a character is
often related to his or her attractiveness and style of clothing.
Ask yourself:
What do characters’ appearances/body sizes say about who they are and
how they want to be viewed? How do the dress and mannerisms of stars
affect the way we view and present ourselves to the world? Are bodies or
body parts used to sell commercial products? How? Are people with
certain body types ridiculed?
Emotional Expression
The open and honest discussion of feelings generally provides for healthy
relationships; however, many popular television shows thrive on deceit and
emotional manipulation. The role models and the examples of relationships may
not be positive. The tone of voice, body language, and touching can be either
loving or exploitative in nature.
Ask yourself:
How do characters show their feelings for one another? Do they touch
each other in loving ways? Do they touch each other in exploitative ways
(using one another selfishly to meet their own needs)? Do they discuss
their real feelings, or do characters expect others to be mind readers?
Romantic Relationships
People meet under strange circumstances in TV and movies; their relationships
often progress at astounding rates. Sometimes they don’t even seem remotely
right for each other.
Ask yourself:
Are these people “meant” for each other? Is this relationship realistic? Who
makes the decisions in this relationship? How is respect demonstrated?
Gender Roles
Female and male characters are often limited to stereotypical roles or to comic
portrayals of a person fighting the stereotype. Too often, female characters are
not allowed to be intelligent and strong, while male characters are not allowed to
be sensitive and loving.
Ask yourself:
Are female and male characters limited by their gender to certain
behaviours or activities? Are females allowed to be as smart and
accomplished as males? Are they “bitches” if they’re too successful? Are
males allowed to be as sensitive and loving as females? Can they both be
strong, physically and emotionally?
208
Sexual Behaviour And Consequences
Since it is nearly impossible to witness the intimate interactions of family and
friends, the media often provide us with our only models of communication (or
non-communication). On television, the possible physical and emotional
consequences of the characters’ behaviours are often not mentioned. The
outcomes of sexual behaviour tend to be either simplistic or contrived.
Ask yourself:
Do characters talk before they act on their sexual desires? Do they
discuss possible consequences? Are the outcomes of their behaviours
realistic? What are the ages of characters involved in sexual situations?
Portrayal Of Violence
There are four aspects of violence that must be considered when evaluating its
portrayal in the media. They are as follows:
1. Violence is often valued over discussion and compromise as a method of
solving disagreements.
2. Violence is often viewed as an acceptable method of acquiring personal
power. It is thought by some that characters, such as “Rambo,” have a
particular appeal for those whose lives are not structured and secure, and
who feel they are affected by things “out of their control.” It has been
suggested that people who are alienated and feel they have no impact on
society may vicariously obtain a sense of power by viewing films in which
heroines and heroes gain control through violence. There are few films
depicting peaceful resolutions of conflict. Many characters are portrayed as
peace-loving individuals who resort to violence because they are pushed too
far.
3. We are desensitized to the effects of violence because we see so much of it
on TV and in the movies.
4. We are seldom shown the connection between violence and the suffering of
victims and their families or the legal and social penalties for offenders.
Ask yourself:
Are conflicts resolved peacefully? Is violence glorified? Who wins the
conflicts that are resolved through violence? Is the victor punished by a
legal or social system?
The Relationship Between Sex And Violence
One of the media’s worst aspects is its frequent linking of sex and violence.
There are music videos that feature women who are tied down, physically
threatened, or hit. There are TV shows in which characters fall in love with the
person who raped them. Or, a TV show in which the sexy male and female
detective team shoot the bad guy dead, and congratulate each other with a long
kiss—standing over the body; gun still in hand. Many horror movies have
underdressed, sexy women, in vulnerable situations, getting slashed.
Ask yourself:
Does violence play a part in sexual or erotic encounters? Who is the
victim and who is the perpetrator?
209
Handout
Checklist for Evaluating Television and Movies
Evaluating television and movies for their handling of sexuality and sexual
violence is no easy task. Here are some of the things to look out for.
Body Image Or Appearance
A character’s looks can say a lot about who that character is. Think about the
heroines and heroes in most TV shows and movies. How do they look? A
character can become a role model, with many viewers seeking the same kind
of “look” either in themselves or their partners.
Emotional Expression
The open and honest discussion of feelings generally provides for healthy
relationships; however, many popular television shows thrive on deceit and
emotional manipulation. What are some examples?
Romantic Relationships
People meet under strange circumstances in TV and movies; their relationships often progress at astounding
rates. Sometimes they don’t even seem remotely right for each other. What are some examples?
Gender Roles
Too frequently, female characters are not allowed to be intelligent and strong, while male characters are not
allowed to be sensitive and loving. What are some examples?
Sexual Behaviour And Consequences
The possible physical and emotional consequences of the characters’ behaviours are often not
mentioned. What are some examples?
Portrayal Of Violence
There are four aspects of violence that must be considered when evaluating its portrayal in the media.
They are as follows:
1. Violence is often valued over discussion and compromise as a method of solving disagreements. What
are some examples?
2. Violence is often viewed as an acceptable method of acquiring personal power. What are some
examples?
3. We are desensitized to the effects of violence because we see so much of it on TV and in the movies.
4. We are seldom shown the connection between violence and the suffering of victims and their families or
the legal and social penalties for offenders.
The Relationship Between Sex And Violence
One of the media’s worst aspects is its frequent linking of sex and violence. What are some examples?
210
Use The Following Checklist For Evaluating
A Particular TV Program Or Movie
Yes
No
1.
Do characters’ appearances/body sizes say something about who they are?
_____
_____
2.
Do characters discuss their real feelings?
_____
_____
3.
Are relationships portrayed realistically?
_____
_____
4.
Do males make the decisions in the relationships?
_____
_____
5.
Do females make the decisions in the relationships?
_____
_____
6.
Are female and male characters stereotyped?
_____
_____
7.
Do characters talk before acting on sexual desires (e.g. condom use)?
_____
_____
8.
Do characters discuss possible consequences of sex (e.g. STIs, pregnancy)?
_____
_____
9.
Are conflicts resolved peacefully?
_____
_____
10. Is violence valued over gentleness?
_____
_____
11. Do males win the conflicts that are resolved through violence?
_____
_____
12. Do females win the conflicts that are resolved through violence?
_____
_____
13. Does violence play a part in sexual encounters?
_____
_____
14. Are males the victims in these sexual encounters?
_____
_____
15. Are females the victims in these sexual encounters?
_____
_____
Final Analysis
What does this TV program or movie say about sexuality?
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
211
Level III
Relationships Questionnaire
Objective:
Participants will examine heterosexism.
Structure:
Time:
20 minutes.
Materials:
“Relationships Questionnaire” handout.
Procedure
1. Disseminate the handout.
2. After participants have had sufficient time to complete it, conclude the
activity with a discussion based on the following questions:
What was it like for you to complete the questionnaire?
What would it be like for a gay, lesbian, or bisexual person to answer this
questionnaire?
Would a gay, lesbian, or bisexual person answer yes to many of these
questions?
How would a gay, lesbian, or bisexual person feel?
How are gay, lesbian, and bisexual relationships sometimes difficult?
212
Handout
Relationships Questionnaire
Write “yes” or “no” at the end of each statement.
1.
I can talk freely about my family life and important relationships to friends at school, work, church,
etc.
2.
My partner and I can go shopping together pretty well assured that we will not be harassed.
3.
I can kiss my partner farewell at the bus stop, confident that onlookers will either ignore us or smile
understandingly.
4.
I can be pretty sure that our neighbours will be friendly or at least neutral.
5.
Our families and church community are delighted to celebrate with us the gift of love and
commitment.
6.
I can walk into any bookstore, sure that I will find books that reflect my relational experiences.
7.
When my partner is seriously ill, I know I will be admitted to the intensive care unit to visit him/her.
8.
The books I read contain stories and picture of relationships like ours.
9.
I can find appropriate cards for my partner, to celebrate special occasions like anniversaries.
10.
I grew up thinking my loves and friendships were healthy and normal.
11.
If I experience violence on the street, it will not be because I am holding hands with my partner.
12.
I have always known there are people in the world like me.
213
Toward Understanding that Some of Us are Gay or Lesbian .
Level III
Objectives:
Participants will evaluate the messages received about
homosexuality.
Structure:
Individual and small group activity.
Time:
30-45 minutes.
Materials:
"Toward Understanding that Some of Us are Gay or Lesbian”
handout.
Procedure
Background Notes
As many as 10% of individuals are lesbian, gay, or bisexual and about 30% of us
have a same-sex sexual experience at some time in our lives. 33
Gay, lesbian, and bisexual youth are at particular risk in this society. They are
surrounded by images and references that imply the normality of heterosexuality
and the unacceptability, even sinfulness, of their own feelings and identity. Even
human sexuality instruction may reinforce their alienation by presenting curricula
that overwhelmingly assumes heterosexuality.
Studies have shown that sexual orientation issues were a concern of 30% of
youth who have committed suicide. There is often little help for young people who
are, or who think they may be, homosexual.
This activity attempts to sensitize participants to the difficulties society imposes
on lesbian and gay youth and provides participants who are lesbian, gay, or
bisexual with suggestions for finding support. However, if participants are very
immature, the activity could backfire. Instead of providing support as
intended, the activity could expose lesbian, gay, and bisexual youth to
additional abuse. It is important to be conscious of the fact that there are gay,
lesbian, bisexual, or questioning participants in your group.
1. Distribute “Toward Understanding Some of Us are Gay or Lesbian” handout.
Note: The following
activity should be
attempted only with
participants who are
ready to handle it,
and ground rules
should be
reinforced before
beginning.
2. Tell participants to complete each statement by filling in the corresponding
blank spaces. Explain that this is a personal exercise and that they should
refrain from asking other participants about their responses. All responses
are private.
3. Allow participants sufficient time to write their answers before proceeding.
Suggest that they answer quickly, writing the first ideas that come to their
minds. This is a good way to get “in touch” with their feelings.
4. Once they have completed all the questions randomly, divide the large group
into groups of four. Tell participants they will have about 10 minutes to
discuss any part of the exercise they choose.
.
(Adapted with permission from Brick, Peggy (1989) Teaching Safer Sex.
Planned Parenthood of Greater Northern New Jersey. Reprinted with permission.
All rights reserved. Order form p. 416)
33
GLSEN. Tackling Gay Issues in School. Connecticut: GLSEN and Planned Parenthood of
Connecticut, Inc., 1999.
214
5. Remind them that:
No one has to talk unless they wish to.
Everyone should have a chance to speak.
They should actively listen to each other.
6. Reconvene the group as a whole and write, “I learned that…” on the board.
Ask participants to turn their handout sheets over and write down three
things they have learned from the handout and/ or from talking with others
afterwards. Ask for volunteers to read one of their “I learned” statements.
Explain that the responses will not be discussed, only listened to.
7. Conclude by asking participants for suggestions as to how youth who are
lesbian or gay can get support. List these suggestions on the board. Ask
participants which of these resources they think would be most helpful and
why.
215
Handout
Toward Understanding that Some of Us are Gay or Lesbian
Complete each of the following statements. Do not take a long time to think about your answer; try to write the
first thing that comes to your mind.
1.
Three words or ideas I associate with
a) Homosexuality:
b) Heterosexuality:
c) Bisexuality:
2.
Three messages I learned about
a) Homosexuality:
b) Heterosexuality:
c) Bisexuality:
3.
Three concerns I would have if someone told me they were
a) Lesbian:
b) Gay:
216
c) Bisexual:
d) Heterosexual:
4.
Three ways life is different for people who are
a) Lesbian:
b) Gay:
c) Bisexual:
d) Heterosexual:
5.
Three ways the following youth can get support:
a) Homosexual:
b) Heterosexual:
c) Bisexual
217
Level III
Guess What, Mom?
.
Objective:
Participants will identify homophobia and stereotypes and
describe and empathize with the “coming out” process.
Structure:
Role-play.
Time:
30-40 minutes.
Materials:
Blackboard or flipchart, “Coming Out Role Play” handout,
“Gay, Lesbian & Bisexual Identity” handout.
Procedure
Note: This activity
requires a certain
level of maturity and
confidence. If
students are very
immature, the
activity could
backfire. Instead of
eliciting empathy as
intended, the
activity could
expose lesbian and
gay youth to
additional abuse.
1. Ask for six volunteer actors to play the following characters: Mother,
Grandparent, Daughter, Daughter’s Lover, Sibling, and Father (feel free to
use a son and a son’s lover and any gender of sibling). Give the actors a
sheet of paper or card describing their character’s motivation and feelings,
from the “Actor’s Roles” handout.
2. The role-play:
Setting: The actors are gathered around the dinner table for a holiday
dinner. During the conversation, the daughter will come out to her family
and reveal that her roommate is actually her lover.
Instructions to Audience: “As you watch this role-play, try to put yourself in
the roles. Stay in touch with the feelings this exercise brings up for you.”
Instructions to Actors: “As best as you can, imagine that you are in the
shoes of the person described on your sheet. When we begin, react to what
is happening in a way that is consistent with what your character believes
and feels, and try to become the person on your card.”
3. You may want to hand out the following structured exchange to begin the
role-play:
Grandparent [to grandchild]: So, have you met any nice young men at
school?
Daughter: No, I haven’t.
Mother: Oh honey, come on—a beautiful girl like you? You can tell us. I
want to know… I’m your mother. I wish you’d tell me more about school
than just what you and your roommate do together.
Daughter: All right, all right. I have something I want to tell everyone. But
before you say anything, I want you all to know that I love you very much…
but I just can’t stand the distance between us any more. My roommate and I
are much more than roommates. We are lovers. I love her very much, and
she loves me. We are very happy together…
4. The role-play continues as each character reacts and joins the discussion.
.
(Adapted from: Mitchell, Leif (1999) Tackling Gay Issues in School: A Resource Module.
GLSEN Connecticut & Planned Parenthood Connecticut.
To order a copy of Tackling Gay Issues in School, visit www.GLSEN.org)
218
5.
After acting out the role-play, conclude the activity with a discussion
based on the following questions:
What were your feelings as you watched this?
What did you feel toward each of the characters?
What made you feel this way?
What stereotypes emerged?
What kinds of homophobia did you observe, and how did it affect the
gay/lesbian people and the heterosexuals?
Ask the actors how they felt about their roles and interactions with the
rest of the family.
You can ask the audience to think about which character they most
identified with (they needn’t volunteer this aloud) and why. Which
character most shared your feelings and values? (Note: Draw on
democratic values such as equality, respect for self and others, and
justice to respond to discriminatory remarks.)
Note: It may be
useful to use the
“Gay, Lesbian and
Bisexual Identity”
handout as a way
for participants to
begin identifying
where each
individual in the
role-play might be
with regards to their
stages of identity
formation. You can
list the first column
(“stages”) and have
participants fill in the
rest or copy the
chart and review it
with the group.
219
Handout
Coming Out Role Play
Actors’ Roles
The person coming out (daughter): You have a positive lesbian identity. You want to help your
parents understand you. You want them to know that you love them. You are who you are, and you are
happy with yourself. You cannot be “changed,” and you wouldn’t want to be anyone but who you are
anyway. You invited your lover to be present when you tell your family, but they think she is just your
roommate and friend.
The lover: You had discussed your lover’s desire to “come out” to the family, and you were willing to be
present when she chose to “come out” to them. Your role is to be as supportive as possible. You
demonstrate this in any way you wish.
The mother: You can’t understand how your child could be gay. After all, you tried to provide a nice
home for your family. You feel hurt and guilty, and you make this known in any way you wish.
The father: As a military officer for 25 years, you are also the authority around your home. When you
find out about your child’s sexual orientation, you are extremely angry. You won’t believe that any child of
yours could be gay. You won’t have her running around acting like a dyke.
The grandparent: Your main opinion is that homosexuality is a sin. You are afraid that your grandchild
will land in hell. Nevertheless, you try to act as a mediator between parents and children.
The sibling: You love and support your sister. You try to get your parents to see things from your
sibling’s point of view.
220
Handout
Gay, Lesbian and Bisexual Identity
Background: Virginia Cass developed a theoretical model to describe the stages of identity formation
that a gay, lesbian, or bisexual person may go through. This model may also be useful when explaining
to the family of a lesbian, gay, or bisexual person that achieving full acceptance of her or his loved one’s
identity often reflects very similar steps.
How to use: It may be useful to review or refer to this model with participants during the role-play
activity.
Discussion: Ask the group questions like:
What kinds of things would someone say, or feel, in each step?
What could an educator, friend, or family member do to help support someone?
Stages
Synopsis of Main Features of Stage
Original State
Person holds image of self as being heterosexual.
Stage 1: Identity Confusion
Questioning sexual orientation.
Stage 2: Identity Comparison
An acceptance of the possibility that identity may be homosexual.
Stage 3: Identity Tolerance
An acceptance of the probability that he/she is homosexual.
Stage 4: Identity Acceptance
An acceptance of a gay, lesbian or bisexual self-image.
Stage 5: Identity Pride
Deepening of identification with homosexual community and personal
identity; increasing pride in accomplishments of the community.
Stage 6: Identity Synthesis
Coming to see no clear dichotomy between the heterosexual and
homosexual worlds; synthesis of personal and public sexual identities
into one image.
221
Social Barometer .
Level III
Objective: To measure, describe and improve the school’s climate (i.e. anti- or
pro-LGBT practices).
Structure: Large and small group.
Time:
35 minutes in-class plus homework assignment.
Materials: Blackboard or flipchart, “School Climate Outlines” resource sheets,
“The Real Story: Facts About LGBT Youth and Bias in Schools”
handout, “In His Own Words” handout.
Note: This activity requires a certain level of maturity and confidence. If students
are very immature, the activity could backfire. You may want to reinforce ground
rules at the beginning of this activity.
Preparation
Use four sheets of flipchart paper or four sections of the blackboard to write the
following headings: “The Hostile School”, “The Resistant School”, “The Open
School”, and The Inclusive School”.
Procedure
1. Inform participants that this activity will assess the climate of their school, i.e.,
how frequently participants hear anti-LGNT, racist and sexist remarks, how safe
or unsafe participants feel because of their sexual orientation, gender, gender
expression, and race.
2. Ask participants to stand at the sign – Hostile School, Resistant School, Open
School or Inclusive School – that they feel best describes their school. Inform
participants that these four categories form a continuum and are not rigid and
that participants may want to stand somewhere between two signs.
3. Once everyone’s decided on a spot, ask volunteers to explain why they chose
to stand where they did.
4. Post the four School Climate Outlines next to the corresponding signs. You
may want to ask a volunteer to read the outline points aloud.
5. Ask participants if anyone feels that they’d like to move to a different spot
along the continuum. If anyone changes position, ask volunteers to explain why.
6. Ask participants to return to their seats. Discuss the following questions:
How does your school climate compare or contrast to the School Climate
Outlines?
Is there anything in the outlines that you didn’t consider in choosing your first
position on the social barometer?
Are their aspects of your school’s climate that aren’t reflected in the School
Climate Outlines?
How does anti-LGBT bias hurt us all?
How can you respond to anti-LGBT comments? Emphasize the name it, claim it,
stop it technique:
.
Adapted with permission from GLSEN (2001) The GLSEN Jump-Start. New York: GLSEN.
222
Name it: When you witness bias, call the offending party on it by saying, “That
term is not cool,” or “Using words like that is hurtful and offensive.”
Claim it: Make it your issue. Say, “I have people I care about who are LGBT, and
I don’t like to hear those words.”
Stop it: Make a request for the behavior to stop by saying, “Please don’t use
those words,” or “Cut it out, please.”
7. Ask participants to form groups of 4-6 people. Give participants a copy of “The
Real Story: Facts About LGBT Youth and Bias in Schools” handout and the “In
His Own Words” handout.
8. Based on their climate assessment, instruct participants to choose one of the
following homework activities:
Develop an anti-discrimination policy statement for their school.
Develop an anti-discrimination awareness poster.
Develop an anti-discrimination commercial.
223
Resource Sheet
The Hostile School
1. School policies do not protect the rights of LGBT people
2. Curricula are devoid of LGBT themes
3. Books/materials with LGBT content are nonexistent
4. Organized and vocal opposition to any LGBT inclusion exists; homosexuality is characterized as “sickness
and sin”
5. LGBT-themed clubs are non-existent and strongly discouraged
6. Athletic programs are unwelcome spaces for LGBT or gender-nonconforming students
7. Health and guidance support for LGBT students/families is non-existent
8. Anti-LGBT language/harassment is rampant
9. LGBT people are invisible and feel unsafe being open about their sexual orientation/gender identity
224
Resource Sheet
The Resistant School
1. Non-discrimination policies may include sexual orientation
2. Curricular inclusion of LGBT issues is limited to clinical references in health/sex education classes
3. Access to books/materials with LGBT content is limited
4. Adults feel discomfort -- may feel there is “danger” in exposure to LGBT people/issues
5. LGBT-themed clubs appear infrequently; students feel unsafe attending
6. Athletic programs are moving toward gender equity, but anti-gay attitudes remain an issue
7. Health/guidance staff show compassion, but information/ support is not generally accessible
8. Anti-LGBT language is common in hallways, locker rooms, school-yard, etc., though not in classrooms
9. A “don’t ask, don’t tell” atmosphere exists for LGBT people.
Resource Sheet
The Open School
1. Non-discrimination policies are inclusive of sexual orientation and students are made aware of this
2. LGBT themes are occasionally included in English, history and health classes
3. A variety of books/materials with LGBT content are available
4. Adult community is open to LGBT inclusion, but may not be sure how to achieve it
5. LGBT-themed clubs are tolerated and attended by a core group of people
6. Coaches interrupt anti-gay behavior; LGBT athletes are relatively safe, though not very visible
7. Health/guidance staff have had training on LGBT issues and offer information/capable support
8. There are few instances of intentional harassment against LGBT students
9. LGBT people are moderately visible; they may be seen as “different,” but a safe and respectful atmosphere
exists
Resource Sheet
The Inclusive School
1. School policy both protects and affirms LGBT people; proactive education about such policies exists
2. LGBT themes are fully integrated into curricula across a variety of subject areas and grade levels
3. Books/materials with LGBT content are visible and available to all students/staff
4. Adult community has prioritized LGBT inclusion as a part of a larger commitment to social justice
5. LGBT-themed clubs are visible, regularly attended, and considered as valid as other clubs
6. Education around anti-gay bias is a part of athletic programming; LGBT athletes are treated as equals on
the playing field
7. Health/guidance staff work with outside agencies to provide outreach, support and education to LGBT
people
8. Anti-LGBT language/behavior is rare and is dealt with swiftly and decisively; anti-bias education that
embraces respectful, inclusive language is common in classrooms
9. LGBT people are visible and fully integrated into school life; there is a high degree of comfort and
acceptance regarding LGBT people
Handout
The Real Story: Facts About LGBT Youth and Bias in Schools .
The statistics below are from the GLSEN 2001 National School Climate Survey, which was taken by 904
students in 48 states.
Homophobic Remarks
84.3% of LGBT students reported hearing homophobic remarks such as “faggot” or “dyke,” frequently or
often.
90.8% reported hearing the expression “that’s so gay,” or “you’re so gay,” frequently or often.
23.6% reported hearing homophobic remarks from faculty or school staff at least some of the time.
81.8% reported that faculty or staff never intervened or intervened only some of the time when present when
homophobic remarks were made.
Harassment and Assault
83.2% of LGBT students reported being verbally harassed (name-calling, threats, etc.) because of their
sexual orientation.
48.3% of LGBT students of color reported being verbally harassed because of both their sexual orientation
and their race/ethnicity.
65.4% of LGBT students reported being sexually harassed (sexual comments, inappropriate touching, etc.)
74.2% of lesbian and bisexual young women reported being sexually harassed.
73.7% of transgender students reported being sexually harassed.
41.9% of LGBT students reported being physically harassed (shoved, pushed, etc.) because of their sexual
orientation.
21.1% of LGBT students reported being physically assaulted (punched, kicked, injured with a weapon)
because of their sexual orientation.
31.3% of LGBT students reported physical harassment based on their gender expression.
13.7% reported experiencing physical assault based on their gender expression.
Feeling Safe in School
68.6% of LGBT students reported feeling unsafe in school because of their sexual orientation.
89.5% of transgender students reported feeling unsafe based on their gender expression.
31.8% of LGBT students had skipped a class at least once in the past month because they felt unsafe based
on sexual orientation.
30.9% had missed at least one entire day of school in the past month because they felt unsafe based on
sexual orientation.
LGBT Resources and Supports in School
80.6% of students reported that there were no positive portrayals of LGBT people, history, or events in any of
their classes.
39.7% of students reported that there were no teachers or school personnel who were supportive of LGBT
students at their school.
.
From GLSEN (2003) GLSEN Safe Space. A How-To Guide for Starting an Allies Program. New York: Author.
Handout
In His own Words... .
I’ve been teased and harassed in school ever since I can remember. I was the quiet, shy kid that was easy to
make cry. But it never got serious until I reached grade 11 and came out of the closet.
I didn’t announce it or anything, but through the great teenage gossip ring, it got around and soon people
started to up the harassment level. It started with general name-calling.
Words like “Fag, faggot” and “queer” were shouted at me as I walked down the hall. It started to escalate into
vandalism the 2nd semester when my locker was torched. The assailants attempted to set my locker with my
personal and school belongings on fire, and I had to be moved across the school to a new location and locker.
Notes soon appeared on my new locker with threats of violence or name-calling on them. Names were called
out in the crowded halls, and most times I couldn’t make out who said them. Bottles full of water and other
fluids were thrown at my body also. People approached me trying to goad me into fights or other acts of
violence.
My grade 12 year was much worse though where - as in grade 11, people I knew harassed me, this year
brought in a large fluctuation of new students. With more people in the school, it became more dangerous.
The threats continued, but became more frequent. I was shoved around in the halls, and people I didn’t know
and have never had any contact with started harassing me. It got so bad that I had to leave class five minutes
early so I could go to my locker without someone trying to hurt me.
I couldn’t use the student washrooms because guys would harass me until I left, and signs started to appear
saying things like, “No fags allowed”.
It got too unbearable during the beginning of the second semester, when random people would walk by me in
the stairwell and push me so I would fall. I couldn’t walk in the halls anymore unless I was with a group of
people because I was afraid I would be hurt. I couldn’t go outside without my group because people would
throw whatever was available. And sometimes even having people around me didn’t stop them.
There was even a rumor going around about a collection that would be given to whoever could beat up or kill
my gay friend and I. I couldn’t handle the stress anymore; it was affecting my schoolwork and attendance
record. I was too afraid to stay in school. So in early February I dropped out of school. Now I will not finish my
grade 12 education in a public school for fear of the same situation happening again. I must find an alternative
way to getting my Dogwood because of harassment and bullying.
.
This testimonial is from: Mayencourt, Lorne, Locke, Brenda and McMahon, Wendy. (2003). Facing Our Fears – Accepting
Responsibility. Report of the Safe Schools Task Force. Bullying, Harassment and Intimidation in BC Schools. Victoria: Safe Schools Task
Force. Reprinted with permission.
Module 6: Relationships,
Communication & Decision Making
One of the major developmental tasks of adolescence is to
gain experience and competence in building peer
relationships, friendships, and eventually, romantic
relationships.
This module contains ideas to help participants develop
healthy relationships as well as good communication and
decision-making skills (including sexual decision-making).
Relationships, Communication
and Decision Making
One of the major developmental tasks of adolescence is to gain experience and
competence in building peer relationships, friendships, and eventually, romantic
relationships. 34 This module is concerned with identifying healthy and unhealthy
relationships and developing good communication and decision-making skills.
“Healthy relationships” is a huge topic area and this module provides an
overview of the many issues involved.
Level I activities explore healthy relationships in the context of family and friends:
parents are a significant source of social support through the early years of
adolescence, and friends have a major impact on the self-esteem and confidence
of youth. 35 A decision-making model and exercises to develop communication
skills are also introduced.
Level II activities examine healthy relationships in the context of dating.
Participants are given the opportunity to build on their decision-making skills with
the overall objective of delaying of sexual activity. Participants will build on their
communication skills, and media portrayals of adolescent relationships and
sexuality are introduced.
Level III participants will continue to examine and discuss sexual
decision-making, communication skills, and media messages.
OBJECTIVES OF
THE MODULE:
Participants will:
identify healthy
and unhealthy
relationships
demonstrate
assertive
communication
skills
use decisionmaking skills
discuss sexual
decision-making
34
Wilson, Pamela M. Our Whole Lives: Sexuality Education for Grades 7-9. Boston: United
Universalist Association, 1999.
35
King, Alan J.C. et al. Trends in the Health of Canadian Youth. Ottawa: Health Canada, 1999.
233
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
About Relationships
Adolescent relationships are a basis for self-esteem and personal growth. 36 It is
important that young people learn the skills to develop relationships, maintain
and improve relationships, and recognize and end unhealthy relationships.
Relationships are often influenced by unrealistic expectations and sexist
attitudes. Many of us have preconceived notions of what it is to “be a man” and to
“be a woman.” The media often perpetuates these attitudes. Young people need
to learn how to deconstruct these messages and develop good communication
skills, including an assertive style of communicating.
The use of power is a fundamental dynamic in all relationships. 37 When power is
shared with someone, it builds trust and a common understanding based on an
attitude of equality. When power is used as control over another person, it can
be abusive. Young people need to recognize the difference between the two and
how sharing power is part of a healthy relationship.
Teaching Tips
This module overlaps with many of the issues in the Contraception and Safer
Sex module. You may want to supplement your lesson plans with activities
that examine safer sex, particularly when discussing sexual decision-making.
You might also want to supplement your lesson plans with activities from the
Values module, such as those that explore attitudes and values relating to
sex and dating.
Participants may choose this time to disclose abuse or bullying. Knowledge
of local referral agencies, as well as knowing your organization’s policies on
violence, and abuse or bullying, would be beneficial. A fact sheet on Sexual
Violence, which includes tips for dealing with the disclosure of abuse and
abusive behaviour, can be found in the Resources section.
36
Hubbard, Betty M. Sexuality and Relationships: Choosing Health High School. Santa Cruz: ETR
Associates, 1997.
37
Men for Change. Healthy Relationships: A Violence-Prevention Curriculum. Halifax: Men for
Change, 1994.
234
Your Friends
Level I
Objective:
Participants will begin to identify healthy and unhealthy
relationships.
Structure:
Individual activity with large group discussion.
Time:
20 minutes.
Materials:
“Your friends” handout, black board or flip chart.
Procedure
1. Introduce the activity by pointing out that having friends and other important
people in our lives makes us feel good about ourselves. It is important that
we surround ourselves with people who treat us well and make us feel good
about ourselves.
2. Ask participants to fill out the “Your Friends” handout. Use the following
example:
Friend
What they say/do
How this makes you feel
Qualities
Mai
1. Plays soccer with me
-energetic
- fun
2. Tells me I’m smart
-confident
-supportive
3. Pokes fun at my
accent
-embarrassed
-disrespectful
3. Once completed, ask participants to share what they wrote in the “qualities”
column only.
4. List their responses on the blackboard/flipchart in two columns: one column
for the qualities of a healthy relationship and the other for unhealthy
relationships.
5. Once the lists are complete, point out what qualities constitute a healthy
versus unhealthy relationship.
6. Conclude by pointing out the importance of recognizing which qualities
constitute a healthy versus an unhealthy relationship, in order to develop
good relationships with others.
235
Handout
YOUR FRIENDS
Having friends and other important people in our lives makes us feel good about ourselves. List the
names of 4 friends/special family members. Beside each name, list up to 3 things they say to you or
activities you do together. For each activity, record how it makes you feel. Then indicate what qualities in
your friend make you feel good.
Friend
1.
What they say/do
How this makes you feel
Qualities
1.
2.
3.
2.
1.
2.
3.
3.
1.
2.
3.
4.
1.
2.
3.
236
Someone I Need
.
Objective:
Participants will identify people who support them.
Structure:
Individual, followed by large group discussion.
Time:
20 minutes.
Materials:
“Someone I Need” handout.
Level I
Procedure
1. Introduce the activity by pointing out that it is important for young people to
identify those that they can turn to for support. This activity will help
participants identify the people who support them and make a special
contribution to their lives.
2. Distribute the “Someone I Need” handout.
3. Give participants sufficient time to fill it out.
4. Ask volunteers to share their answers to the last question: “my family and
friends are important to me because…”
5. Ask: “In what ways do your family and friends support you? In what ways do
they help you grow and develop?”
6. Conclude by pointing out that we all need people that support us and are
there to listen when we are happy, sad, angry, or frustrated.
.
237
Handout
Someone I Need
There are special people in your life who support you and help you develop. They
are your life-givers. With their help, you grow physically, intellectually, socially,
emotionally, and spiritually. Who are some of these people? What is their special
contribution to your life?
Someone who cares for me when I am sick:
Someone who listens to me:
Someone who laughs at my jokes:
Someone who knows when I’m sad:
Someone who helps me to learn something new:
Someone who shares my culture or religion with me:
Someone who helps me to find an interesting book:
Someone who makes me something special to eat:
Someone who loves me no matter what:
My family and friends are special to me because:
I am a good friend because I:
I would be a better friend if I:
238
Television Families
.
Level I/II
Objective:
Structure:
Materials:
Participants will develop media literacy skills by critiquing
media portrayals of family life.
Individual homework activity, followed by large group
discussion.
“Television Families” handout.
Procedure
1. Give each participant a copy of the “Television Families” handout.
2. Instruct them to watch a TV show that has a family in it and fill out the
worksheet.
3. In the following session, ask participants to share their answers, question by
question.
4. As a large group discuss the following:
What message(s) does the mass media (TV, film, newspapers, magazines,
etc.) offer regarding family life?
What makes these messages realistic/ unrealistic?
What are family relationships really like?
How do people usually show caring and affection to family members?
6. Conclude by pointing out that the media sometimes depicts a distorted view
of family relationships and relationships in general. It is important for us to
evaluate how realistic these messages are.
.
239
Handout
Television Families
Name of show: _______________________________________________________________________
Date show was watched: _______________________________________________________________
What did you notice about the following:
1. Family relationships (affection, respect for each other,
discipline, resolving conflicts)
2. The way family members spend their time (jobs,
school, household tasks, recreation)
3. Family lifestyle (type of house or apartment, furnishings, clothes, car, appliances, travel, recreation)
4. Is the portrayal of family life realistic? Unrealistic? Give two examples for each.
240
Making Decisions
Level I/II
Objective:
Participants will identify decision-making skills.
Structure:
Individual or small group activity.
Time:
40 minutes.
Materials:
Flipchart/blackboard, “Making Decisions” (level I) or
“More Making Decisions” (level II) handout and
“I.D.E.A.L.” handout.
Procedure
1. Introduce the activity by pointing out that the ability to make decisions
effectively has an on-going impact on our health. This activity will give
participants a model for decision-making.
2. Introduce the I.D.E.A.L. model to the participants (write it on the blackboard/
flipchart):
I
Identify the Problem
D
Describe all possible solutions
E
Evaluate the consequences of each solution
A
Act – Choose a solution and try it
L
Learn – Did it work? Why or why not?
For example:
I
Jodi has to walk the dog every day after school, but she wants to spend time
with her friends who hang out at the mall.
D
Jodi can
go to the mall
tell her friends she will see them tomorrow at school
ask her friends to take a walk with her and the dog.
E
Going to the mall means letting her dog down, and her dog might
misbehave.
She won’t get to spend extra time with her friends.
She can walk her dog and spend time with her friends, which will also
give her the opportunity to exercise and enjoy nature.
A
Jodi decides to ask her friends to go for a walk with her.
L
While not all her friends go for a walk, the one that does go with her turns out
to be a very good friend. By inviting her friends to walk the dog with her, Jodi
kept the lines of communication open with them without sacrificing her
obligations to her beloved dog.
241
3. Explain that, when making a decision, it is important to:
Think of all your choices.
Think of the most likely result of each choice.
Think of the risks involved with each choice.
4. Give each participant a copy of the “Making Decisions” (level I) or “More
Making Decisions” (level II) and “I.D.E.A.L.” handouts. Individually or in small
groups, instruct participants to work out each problem using the I.D.E.A.L.
model. Participants can speculate the last two stages (“act” and “learn”).
5. After 20 minutes, reconvene the large group. As each small group reports,
invite reactions from others. Can they think of any other choices? Do they
disagree with anything? What would they really do in this situation?
Encourage people to be honest about how they would really handle these
situations.
6. Make the following points:
Consequences can be good or bad.
A good consequence might be to meet new people or to try a new skill or
activity. These consequences are a little scary because you might be
rejected or you might fail. However, we do not grow if we do not take
risks.
Bad consequences are those that may result in getting hurt or getting into
trouble. These risks are the kind that might adversely affect our lives and
future plans.
7. Conclude by explaining how difficult decision-making can be, but that with
practice, we can all learn how to make good decisions for ourselves. Good
decisions lead to healthy relationships and a healthy sense of self-esteem.
242
Handout
Making Decisions
1.
You deliver newspapers on a paper route. You really enjoy this job—especially the extra money you
make to buy CDs. You love basketball, and you just found out that your school is in the finals. Your
friends urge you to come and see the game with them after school. It’s going to be the best game of
the season. But you have to do your paper route and can’t possibly do both. You could tell your boss
that you’re sick and then go to the game, but you’re really unsure. What should you do?
2.
You have an agreement with your parent that you are to go home every day after school and do your
homework until s/he gets home from work. Since this is an opportunity to get homework done, you
are not allowed to have friends over after school. Today, however, a couple of friends try to talk you
into hanging out with them after school. Since your parent doesn’t get home until almost 6 p.m., you
could see your friends and then go home and s/ he would never know. What should you do?
3.
Every Monday, you walk your neighbour’s six-year-old child home from school. However, you just
found out that you got a part in the school play and rehearsals are on Mondays. What should you do?
4.
Tim has asked Carlos if he can borrow his bike to go to soccer practice. Tim is a friend that Carlos
just started hanging out with. Carlos’ bike is new, and he is a little worried that something might
happen to it. What should Carlos do?
5.
One of Kerri’s best friends is having a sleep over. However, a more popular friend invites her to a
party scheduled for the same night. What should Kerri do?
243
Handout
More Making Decisions
.
1.
It is a hot day, and Clark and Beth have been playing
hard. They find several cans of beer in the refrigerator
at Beth’s house. Clark suggests they have beer instead
of water. What should Beth do?
2.
Brian invited Ricco to come over to his house after
school to mess around with computers and spend time
on the Internet. They discover a chat room and start
some conversations that make Ricco feel pretty
uncomfortable. Ricco is ready to move on to some
other activity, but Brian seems to be really enjoying the
chat room. What should Ricco do?
3.
Twelve-year-old Mia is out with her friend Cheryl,
Cheryl’s boyfriend Tony, and another friend Chris. After
a while Cheryl and Tony start to kiss. Chris then starts
kissing Mia. This feels pretty good to Mia. But then,
Chris tries to get Mia to go into the bedroom. Mia says
no, but her friend Cheryl tells Mia not to be so lame.
What should Mia do?
4.
Vera and Jennifer find a pack of cigarettes on the
kitchen table. Jennifer heard that smoking can help you
keep your weight down, and wants to try one. She asks
Vera to try one too. Vera isn’t that interested because
she thinks cigarettes stink, but she wants to support her best friend. What should Vera do?
5.
Rod thinks he’s very cool. He hangs out with the older guys in his neighbourhood after school. Some
of them smoke pot. Today, one of his friends passes him a joint. Rod doesn’t want to smoke it, but he
also doesn’t want to look like a jerk to his friend. What should Rod do?
.
Boston: Unitarian Universalist Association. Reprinted with permission of the Unitarian Universalist Association.)
244
I.D.E.A.L. Worksheet
I
Identify
D
Describe possible solutions
E
Evaluate consequences of each solution
A
Act. Choose a solution and try it.
L
Learn. Did it work? Why or why not?
245
Starting Relationships .
Level II
Objective:
Participants will identify different types of relationships and the
positive/ negative reasons for starting relationships.
Structure:
Large group.
Time:
30 minutes.
Materials:
Procedure
1. Introduce the activity by pointing out that there are different kinds of
relationships and different kinds of love. Ask participants to brainstorm about
different types of relationships. The following list contains different kinds of
interpersonal relationships that participants may mention,
People who
we love or care about
are in our family
we go to school with
we are in a club or on an athletic team with
we hang out with
teach us or train us
we don’t like
we work with
we’re attracted to
2. Create three columns on the board/ flipchart using relationship types as
headings: Social/Athletic, Friends, Intimate/ Love.
3. Begin with one column at a time, asking participants to give the reasons they
enter into that type of relationship. List their suggestions in the appropriate
column. The following is a list of reasons they might suggest:
Love
Power
Infatuation (how is this different
from love?)
Recognition
Communication
To feel good about themselves
(self-esteem)
Companionship
Sex
Respect
Trust
Friendship
.
(Adapted with permission from: Benner, Tabitha A., Park, M. Jane and Peterson, Evelyn C. (1998)
The PASHA Activity Sourcebook: Activities for educating teens about pregnancy and STD/HIV/AIDS
prevention. Los Altos: Sociometrics Corporation.)
246
4. If the participants do not mention some of the reasons listed above, offer
them as suggestions, and ask participants to help decide which column they
should be added to.
5. By the time the last column is reached, many of the participants’ responses
will be repetitive. At this point, the purpose of the activity will begin to be
apparent. After listing the reasons on the board, initiate a discussion about
the lists, using the following points:
Separate the positive factors (e.g., love, communication, friendships,
companionship, etc.) from the negative factors (e.g., power, sex,
recognition, etc.) for starting a relationship.
Discuss those reasons that seem to be important across all types of
relationships.
Discuss ways the media influences how relationships are chosen. For
example, a young person may choose someone because s/he is
muscular, because s/he dresses in popular styles, or s/he hangs out with
certain groups.
Discuss how people may choose a relationship based on their own
upbringing or moral values.
Discuss how young people may end up in relationships because of peer
pressure.
Discuss how romantic relationships, in particular, have a certain level of
emotional risk and heartbreak
6. Ask participants to identify alternative ways of satisfying their needs for
belonging, love, and attention, other than having a sexual relationship (point
out similarities in the other columns). Some suggestions include:
Peer Support Groups
Sports Teams
Mentoring Programs
Groups from Places of Worship
Civic Groups/ Clubs
7. Conclude by pointing out that we all need people in our lives to foster a
sense of belonging. However, it is important to develop relationships that are
motivated by positive and healthy factors that coincide with our upbringing
and values.
247
Level II/III
Being Assertive
Objective:
Participants will identify ways of expressing their feelings
directly.
Structure:
Large group and small group activity.
Time:
40 minutes.
Materials:
“Being Assertive” (level II) or “More Being Assertive” (level III)
handout, blackboard/flipchart.
Procedure
1. Introduce the activity by pointing out that communication is a basic
component of relationships. Communication is the exchange of thoughts,
ideas, or feelings between two or more people.
2. Point out that we communicate verbally (talking or writing) and non-verbally
(posture, facial expression). Listening is also an important part of
communicating.
3. It is important that we all learn to communicate directly with each other.
Typically, there are three ways of communicating:
Passive:
Give in and saying yes when you don’t want to.
Put the feelings and concerns of others before yourself.
Keep your concerns to yourself.
Aggressive:
Dominate others.
Put yourself first, at expense of others.
Use threats or force.
Assertive:
Stand up for your rights without denying other people theirs.
Respect yourself and others.
Ask for what you want in a straightforward manner.
4. In order to develop an assertive style of communication, it is important to
make eye contact (without staring) and to speak in a clear and firm voice.
The use of “I messages” is also helpful:
I feel ____________ when ____________ and I want ______________.
For example:
Situation – My brother is making fun of the way I’m talking.
Response – I feel upset when I’m made fun of and I want you to stop.
5. For some situations, it is helpful to practice what you are going to say, ahead
of time. It is also helpful to think about how the other person might respond to
you, and how you are going to react to this response. Thinking and planning
ahead helps to build confidence.
248
6. Distribute the “Being Assertive” handout. Give participants sufficient time to
fill in their responses. Ask volunteers to share their answers to each situation.
7. Instruct participants to form pairs. Ask each pair to role-play one of the
situations from the handout (or to make up their own). Role-plays can be
performed in front of the entire group.
8. Conclude by pointing out that developing an assertive style of
communication, which includes using “I messages” and compromise, is an
important skill to learn. Like any new skill, it requires practice and will
become easier with time. This skill will foster healthy relationships, decisionmaking, and self-esteem.
249
Educator’s Copy
Being Assertive
Directions: Write an assertive response for each situation.
1. Your teacher gives you an unfair grade on an assignment.
Could we go over this assignment together and talk about it?
2. You are standing in line, and someone cuts in front of you.
Excuse me, maybe you didn’t realize it, but the end of the line is over
there.
3. Your sister is playing the stereo too loud.
Could you please turn down your music? It’s too loud.
4. You made plans to see a movie with a friend. Your younger brother wants to
tag along, but you don’t want him to come.
This time, I’d like to spend time alone with my friends, but let’s make
plans for another time.
5. A friend repeatedly asks to copy your homework. Although you’ve let him/ her
copy your work in the past, you don’t want to give it to him/her this time.
When you copy my homework so often, I feel used. Can we work on it
together next time?
6. You want to tell a friend that you have a crush on him/her.
I like being friends with you, and I wish we could be more than just
friends.
7. A friend borrows a CD from you and doesn’t return it.
I would really like you to return that CD you borrowed from me. I
really miss listening to it.
8. Someone asks you to dance at the school dance, but you don’t want to
dance with him/her.
No, but thanks for asking.
250
Handout
Being Assertive
1.
Your teacher gives you an unfair grade on an assignment.
2.
You are standing in line, and someone cuts in front of you.
3.
Your sister is playing the stereo too loud.
4.
You made plans to see a movie with a friend. Your younger brother wants to tag along, but you don’t
want him to come.
5.
A friend asks to copy your homework but you don’t want to give it to him/her.
6.
You want to tell someone that you have a crush on him/her.
7.
A friend borrows something from you and doesn’t return it.
8.
Someone asks you to dance at the school dance, but you don’t want to dance with him/her.
251
More Being Assertive
Educator’s Copy
1.
Your friend tells you to “shut up” during an argument.
I don’t like it when you speak to me that way. It makes me feel
as though you don’t care about me.
2.
You want to tell your best friend that you are gay.
There’s something I need to tell you, but I’m worried about how
you might react. I’m gay.
3.
You are starting to worry that a friend likes you in a romantic way, but
you do not feel the same way.
This is really hard for me to talk about, but I’m getting the feeling
that you want to be more than just friends. I really like being friends
with you, but I’m not attracted to you in that way.
4.
Your parents have been arguing a lot lately, and the situation is upsetting
you.
I feel upset and worried when I see you arguing so often. Can we
talk about the situation?
5.
Your boyfriend/girlfriend tells you that s/he wants to have sex, but you
don’t want to.
I’m just not ready for sex. I don’t feel like having sex tonight. Can
we just hug/kiss/touch each other instead?
6.
You need to tell your boyfriend/girlfriend that you have chlamydia.
I have something important to tell you, but I’m really worried that
you will get upset. I just got some test results back from the doctor,
and it turns out I have chlamydia.
7.
Your boyfriend/girlfriend refuses to use condoms.
I always use condoms. Using condoms is really important to me.
Condoms can be fun. Let me show you… Let’s go buy some
together.
8.
You have decided to break up with your boyfriend/girlfriend.
You know that I care about you a lot, but I think the time has
come for us to break-up.
252
Handout
More Being Assertive
1.
Your friend tells you to “shut up” during an argument.
2.
You want to tell your best friend that you are gay.
3.
You are starting to worry that a friend likes you in a romantic way but you do not feel the same way.
4.
Your parents have been arguing a lot lately and the situation is upsetting you.
5.
Your boyfriend/girlfriend tells you that s/he wants to have sex, but you don’t want to.
6.
You need to tell your boyfriend/girlfriend that you have chlamydia.
7.
Your boyfriend/girlfriend refuses to use condoms.
8.
You have decided to break up with your boyfriend/girlfriend.
253
Level II/III
Healthy Relationships Comparison
Objective:
Participants will define a healthy and an unhealthy
relationship.
Structure:
Large group and small group activity.
Time:
15-20 minutes.
Materials:
Flipchart or blackboard.
.
Procedure
1. Depending on the size of the group, divide them into 2 or 4 equal groups.
2. Assign one group the topic of “healthy relationships” and the other group
“unhealthy relationships”.
3. Give each group 5 minutes to brainstorm as many characteristics of their
subject as possible.
4. Have each group present its list, either written on the board or on taped up
flipchart papers. After all of one subject has been presented, let anyone else
contribute to the list until there is a list for healthy and another for unhealthy
relationships. Leave these lists up on the walls for the rest of the class.
Sample List:
Healthy Relationships:
• Happiness
• Comfort
• Trust
• Kindness
• Love
• Acceptance
• Affection
• Equality
• Strong self-esteem of both partners
• Humour
• Mutual respect
• Fun
• Friendship
• Can be yourself
• Laughter
• No fear of partner
• Common interests
• Still independent people
• Support
• Honesty
• Fair fights
• Communicate well
• Acceptance
• Faithfulness
• Empathy
(Adapted with permission from: Planned Parenthood Ottawa-Carleton (1998) Community Outreach
Program.)
254
Unhealthy Relationships:
• No trust
• Unfair fights
• No respect
• Partner tries to change you
• Jealousy
• Lies
• Abuse-emotional, physical
• Bad/no communication
• Manipulation mental, sexual
• Lack of understanding
• Low self-esteem
• No fun
• Power issues
• Fear
• Based only on physical attraction
5. Lead a discussion by asking:
How do you feel in a healthy relationship?
How do you feel in an unhealthy relationship?
Why do people sometimes stay in unhealthy relationships?
What can you do if you know someone is in an unhealthy relationship?
Who can help them?
What are some ways to end an unhealthy relationship?
6. Conclude the activity by pointing out how important it is to recognize the
qualities of both healthy and unhealthy relationships. This helps us to
develop and negotiate satisfying and meaningful relationships.
255
Song lyrics: Healthy or Unhealthy? .
Level II/III
Note: Prior to this
session, instruct
participants to
transcribe the lyrics
of one of their
favourite songs.
Ask them to bring in
the lyrics and the
corresponding tape
or CD. This activity
could also be done
with music videos,
evaluating how the
images reflect the
lyrics, and whether
the video and lyrics
depict healthy or
unhealthy
relationships.
Objective:
Participants will use the media to identify healthy and
unhealthy relationships.
Structure:
Time:
30 minutes.
Materials:
Tape or CD player, index cards (one per
participant/per song), flipchart or blackboard, “Song
Lyrics: Healthy or Unhealthy?” handout.
Procedure
1. Introduce the activity by pointing out that we spend a lot of time listening to
music, but often don’t listen to the words or think about their meaning. This
activity will give us the opportunity to listen to some of our favourite songs in
order to see what kinds of relationships are being described. Ask:
What are the characteristics of healthy relationships? What do people
with healthy attitudes do together? How do they treat each other? List
these responses on the board/flipchart under the heading “healthy.”
What are some characteristics of people in unhealthy relationships? How
do they treat each other and talk to each other? List these responses
on the board/flipchart under the heading “unhealthy.”
2. Instruct participants to refer to these lists as they listen to each song. The
lists will help them assess what are healthy or unhealthy attitudes in
relationships.
3. Distribute index cards to participants and play a song. It may be helpful to
provide a copy of the lyrics, so participants can follow along. Write the song’s
title near the top of the blackboard.
4. After each song is played ask participants to write on the card whether they
think the relationship being described is healthy or unhealthy. Write an “H” for
Healthy, a “U” for Unhealthy, and if they’re not sure, write “N.”
Here is a sample of lyrics from the song, Bring it All Back, by the Tragically Hip:
“…The obvious turns out to be true. All that I couldn’t see, how it was turning
me on. I don’t want to pare you down. No, I don’t want to wear you down. I
don’t want any more than what’s there. No. I don’t want to pare you down.”
Note: In this song, the person is appreciated for who s/he is, as opposed to
getting the message that s/he is not good enough.
5. Instruct participants to tape their cards on the board/flipchart. Cards with
an “H” should go beside the “Healthy” list, cards with a “U” should go beside
the “Unhealthy” list. “N” cards should comprise a third cluster.
.
(Adapted with permission from Men For Change (1994) Healthy Relationships:
A Violence Prevention Curriculum. Halifax: Author. (ISBN 0-9698188-0-7)
All rights reserved.)
256
6. Ask:
Why did some of you indicate that this song contained unhealthy images
or attitudes?
What words from the list were you referring to?
What words in the song suggest a healthy relationship between the
people involved?
For those who put an N on your card for “not sure,” does that mean that
the lyrics contain both negative and positive attitudes, or do you mean
that it is unclear?
Do you think that the attitude in this song could contribute to violence?
Does if affirm or go against basic human values like self-worth, dignity,
and respect that we listed under our “healthy” category on the board?
7. Repeat this activity with other participants’ song lyrics and tapes/CDs, as
time allows.
8. Conclude the activity by asking:
What did you learn about some types of music?
Had you noticed the meaning of the words before this activity?
What effect do you think music can have?
What effect can listening to violent lyrics have on someone?
This is not to say that some kinds of music are good and others are bad. The
goal of this activity was not to judge the kind of music being listened to. But
it’s important to pay attention to lyrics when we listen to music, so that we
can become active participants, rather than passive consumers.
Extension
For either an in-class exercise or homework, have participants explore the
messages in the lyrics that they transcribed using the “Song Lyrics: Healthy or
Unhealthy?” handout.
257
Handout
Song Lyrics: Healthy or Unhealthy?
Instructions: Select a song to read or play, and answer the
following questions.
Song title: ____________________________________________
Singer: ______________________________________________
1. What is this song about?
2. Describe the nature of the communication between the two people. Is there respect and an
atmosphere of give-and-take, or is their communication one-sided?
3. Is the relationship described healthy or unhealthy? Why do you think so?
4. What lyrics, if any, might suggest an unhealthy or abusive attitude?
5. Describe the characteristics of the woman in this song (if there is one). Are these characteristics
stereotypical of women? What do you think of these stereotypes? How do stereotypes play a role in
relationships?
6. Describe the characteristics of the man in the song (if there is one). Are these characteristics
stereotypical of men? What do you think of these stereotypes? How do stereotypes play a role in
relationships?
7. Do the lyrics suggest violent solutions to problems?
a) If so, why does this sort of violence seem to be OK, within the context of the song?
b) What would be a healthier way to relate?
258
Love and Infatuation
.
Level II/III
Objective:
Participants will recognize the differences between, and
the relative importance of, love and infatuation.
Structure:
Large group.
Time:
30 minutes.
Materials:
Flipchart/blackboard, “The Six Stages of a Relationship”
resource sheet.
Procedure
1. Inform participants that they’re going to look at the differences between love
and infatuation, also known as love and lust.
2. Divide participants into two groups. Give each group a piece of paper or
flipchart paper with the question “What’s the difference between love and
infatuation?” written on the top. Ask each group to brainstorm as many
differences as possible. Remind participants that in a brainstorming activity
all responses are acceptable and should be written down.
Preparation
Before teaching this
activity, prepare
“The Six Stages of a
Relationship” sheets
(see resource
sheet).
3. Reconvene the large group. Go around the room asking each group for one
difference and post them on newsprint. Continue until there are no more
suggestions. If necessary, augment with differences from the list given
below:
Love develops gradually over time. Infatuation occurs almost
instantaneously.
Love can last a long time. It becomes deeper and more powerful over
time. Infatuation is powerful but short-lived.
Love accepts the whole person, imperfections and all. Infatuation
flourishes on perfection—you have an idealized image of your partner,
and you can only show your partner your good side.
Love is more than physical attraction. Infatuation brings out jealousy and
obsession. It causes you to neglect other relationships.
Love survives arguments. Infatuation glosses over arguments.
Love considers the other person. Infatuation is selfish.
Love is being in love with a person. Infatuation is being in love with love.
.
259
4. Explain that you will be giving an oral test with ten questions requiring “yes”
or “no” answers. Ask participants to record their answers on a piece of scrap
paper. Participants may apply the questions to a past, present, or fantasy
relationship. It is important to stress that there are no right or wrong answers,
that they will not be required to share their answers, and that this activity is
not meant to pass judgement on people or their relationships.
Ask the following test questions:
A. If your girlfriend/boyfriend is having a bad day, does that make your
day bad, too?
B. Do you get extremely jealous whenever s/he looks at someone else?
C. Do you feel your heart flutter, your stomach flip-flop, or are you unable
to eat when you are near or even just thinking about her/him?
D. Do you feel “swept away,” “dizzy,” or “light-headed”? Does the “earth
move,” or do you feel like you’re “walking on air” when you’re near
her/him?
E. Do you daydream and let the rest of the world melt away when you
are with your girlfriend/boyfriend?
F. Are you in a constant state of sexual arousal when you’re with or
thinking about her/him?
G. Do you get lonesome for your girlfriend/boyfriend when s/he isn’t around?
H. Do you feel lucky s/he likes you—almost not believing your luck?
I.
Does everything else in life seem unimportant compared to being with
her/ him?
J.
Do you feel that without her/him life would barely be worth living?
Explain that if the number of “yes” answers was two or more for their past,
present, or fantasy relationship, there is a good chance the relationship leans
toward infatuation or lust.
5. Then make the following points:
There is nothing wrong or bad about being in a lust relationship, as long
as both partners realize they are in lust together. In fact, many love
relationships start out as lust relationships.
It is developmentally appropriate for a teen to be in a lust relationship,
since they often serve as practice for more mature relationships in the
future. Teens can often use failed lust relationships to assess the
undesirable aspects of such relationships.
The younger the partners in a relationship, the more possibility of “yes”
answers. People normally have a higher number of “yes” answers early
in their relationships, but as the relationship matures, the number of “yes”
answers tends to diminish. Even so, some people have leftover “yes”
answers.
260
6. Ask participants to think about most love songs and poems, romantic
comedies on TV or in the movies, and soap operas. Ask the following
questions:
Are they about lust or love? Ask for examples.
Do you think the audience recognizes the difference? Would it depend
upon the audience?
If the audience doesn’t recognize the difference, what will the effect be?
7. Post “The Six Stages of a Relationship” sheets in random order on a wall.
Tell participants that long-term relationships go through a number of stages.
Ask two volunteers to come up and rearrange the sheets in what they think is
the correct sequence of stages.
8. When the volunteers are done, ask the rest of the group if they agree. Try to
get consensus, but if all else fails, put the sheets in the correct order yourself.
What stage caught your eye? Why?
At what stages are most of your friends’ relationships?
Of the six stages, which ones are lust stages, and which ones are love
stages? (The first three are lust stages, and the last three are love
stages.)
Is it possible to skip the lust stages on the way to the love stages? How
does that happen? (A close friendship develops into a romantic
relationship.)
What’s something new you’ve learned about love and infatuation?
261
Resource Sheet
The Six Stages of a Relationship
Directions:
Write each stage on its own sheet of flipchart paper. You can
either copy the following stages in their entirety or just the phrases or sentences
that appear in bold type. The second option will shorten your preparation time,
but you may have to read the remaining sentences aloud for clarification
purposes. Note that the stages listed here are in their correct order.
1. People display their availability by looks, bumping, or generally inventing
ways to be with each other after ascertaining mutual physical interest.
2. Actual contact is made for the purpose of getting together.
3. Each person tries to be who s/he thinks the other wants her/him to be.
4. People are learning to accept each other for who they truly are. This
stage may be characterized by multiple break-ups and make-ups.
5. The disagreements are fewer, and the comfort level is greater between
the partners. They have learned to complement each other’s strengths and
weaknesses.
6. Feelings of jealousy cease to exist. Pat says to Chris: “I love you, but I
have always wondered what it would be like to be with Leslie.” Chris
responds, “I’m so glad you shared that with me. I’ve always fantasized about
being with Dana.” Neither partner gets upset because fantasy and curiosity
are normal, healthy, and human: each feels loved and secure in the
relationship. Many couples live happily without ever reaching this stage.
262
You Decide
Objective:
.
Level II/III
Participants will explain that boys/men and girls/women
sometimes have different ideas about sex and dating.
Structure:
Time:
25 minutes.
Materials:
“You Decide” handout.
Procedure
1.
Distribute the handout “You Decide” to each participant. Have the group
do the activity individually, in pairs, or in small groups.
2.
Explain to participants that they should read each statement.
3.
Ask participants to change the old statements into new ones by
completing the unfinished statements.
4.
After participants have completed the activity, conduct a group
discussion. Ask participants to volunteer their answers to the unfinished
sentences.
5.
Ask participants to suggest new statements and choose the one that
receives wide consensus.
6.
Conclude by pointing out that we all need to consider and challenge
stereotypes of women, men, sex, and dating. To do so, it helps to
consider values such as equality and respect for self and others. This
helps to foster healthy relationships.
.
(Adapted with permission from: World Health Organization and UNESCO (1994) School Health
Education to Prevent AIDS and STD. Geneva: Author. Reproduced by kind permission of UNAIDS.)
263
Handout
You Decide
Boys/men and girls/women sometimes have different ideas about
sex and dating. Most of the following statements are stereotypes that
we’ve heard many times. In this activity, you’ll get a chance to
change these old ideas into new ones. Read each statement. Below
each statement, complete a new one.
1.
The success of an evening out can be judged by how
sexual it was.
The success of an evening out should be judged on…
2.
When someone says “no” to sex, it means that s/he does
not like the other person.
When a person says “no” to sex, it means…
3.
If a lot of money is spent on a date, sex should be given in return.
If a lot of money is spent on a date it means…
4.
When someone says “no” to sex, it really means “maybe”, and “maybe” really means “yes”.
No to sex really means…
5.
A real man is one who has had sex with a woman.
You are a real man if…
6.
Someone who dresses in a sexy way wants to have sex.
If someone dresses or acts in a sexy way…
7.
If someone accepts an invitation to go to somebody’s house alone, s/he would be expected to have
sex.
If a person wants to go to someone else’s house when there is no one home…
8.
It is the woman’s responsibility to decide how sexual a relationship becomes.
It is ____________________________ responsibility to set sexual limits.
264
How Do I Know When…
.
Level II/III
Objective:
Participants will discuss sexual decision-making skills.
Structure:
Time:
30 minutes.
Materials:
Paper and pens.
Procedure
1.
Introduce the activity by pointing out how it can be very confusing to
decide when you are really ready to do a new thing. In order to consider
how we make decisions, we will look at something that will be a
possibility for most of you within a few years… getting your driver’s
licence.
2.
Point out that they will all be legally able to try for a driver’s licence
when they turn 16. Some may rush out to get their licence on their 16th
birthday; others may wait a year, several years, or forever before going
for a learner’s permit.
3.
Ask: How many want to drive sometime? How many want to get your
driver’s licence as soon as you turn 16?
4.
In groups of four, instruct participants to:
a) Make a list of all the reasons you can think of why a teen might
want to get their driver’s licence.
b) Make a list of all the reasons you can think of why a teen might
hang back from learning to drive.
c) Your group has the power to give or refuse a driver’s licence to a 16
year old that you test. Identify the 3 most important factors that
would influence your decision as to whether this person is ready to
be licensed to drive.
5.
In making decisions as to whether or not to become sexually active,
there is no licence or official age. For some people, it is very clear—they
won’t have sex until they are in a lifetime commitment or a stable
relationship. For many others, it can be confusing.
6.
Ask: How many of you think they want to have sex some time in their
life? How many are very definite about when the right time would be to
have sex?
7.
In groups of four, instruct participants to:
a) Make a list of all the reasons a teen might want to have sex.
To demonstrate love for partner
Desire, curiosity
Feels good
Wanting to feel loved
Social pressure (from partner, perception that “everyone’s doing
it”)
.
(Adapted with permission by City of Toronto: Toronto Public Health.)
265
b) Make a list of all the reasons a teen might hang back from
having sex.
Worried about pregnancy, STIs
Religious/cultural values
Not ready, not the right person
Family expectations
Waiting until marriage/lifetime commitment
You or your partner are drunk (alcohol can lead to poor
decisions)
c) If society issued a Lover’s Licence, how would people qualify for
one? What would people need to know? What skills need to be
developed?
STI prevention
Contraception, pregnancy prevention
Communication skills
Negotiation skills
8.
Use the following questions to further help young people decide
whether they are ready for sex:
Will I feel good about myself if I have sex now?
Does my partner want to have sex now?
Am I being pressured to make a decision?
If the relationship breaks up, will I be glad that I had sex with this
person?
If we have sex, will I use effective birth control and/or STI protection
every time?
Am I afraid of anything?
Am I prepared to deal with the consequences of not practicing safer
sex?
9.
Conclude by pointing out that the decision whether or not to have sex is
not one to be taken lightly. A number of issues (e.g. STI and pregnancy
prevention) and skills (communication and negotiation) need to be
considered. The decision whether or not to become sexually active or to
cease being sexually active (if you said “yes” once does not mean you
have to say “yes” again) is one that each individual needs to consider.
266
Road to Romance .
Objective:
To identify the steps of sexual intimacy and to practice setting
sexual limits.
Structure:
Large group and individual.
Time:
30 minutes
Materials:
“Steps of Sexual Intimacy” cards, “My Sexual Health Plan” handout.
Level II/III
Procedure
1. Inform participants that this activity will help them to identify the steps of
sexual intimacy and let them practice setting sexual limits.
2. Inform participants that there are many road signs along the Road to
Romance. Some people travel too quickly down the road that leads to sexual
intercourse and skip steps along the way. Others watch for caution signs along
the way and talk to their partners about how far to travel. Some people slam on
the brakes and stop. Still others take a detour on abstinence avenue and decide
not to travel on the road at all. Sometimes, people are under the influence of
drugs or alcohol and make poor decisions.
3. Give the “Steps of Sexual Intimacy” cards to each participant. Ask participants
to put the steps of sexual intimacy in the order in which they think they should go
in. Ask volunteers to explain what order they placed their cards in and why.
4. Next, point out how sexual activity can progress very quickly unless you set
limits. Ask participants to place the road signs along the road way.
5. As a group, discuss where the road signs should go and why:
•
•
•
Discuss the importance of communicating with your partner.
Discuss the need to use birth control/condoms if sexual activity
progresses.
Discuss how alcohol and drugs can impair judgment (refer to the “Sex,
Drugs & Alcohol” fact sheet in the Appendix for ideas).
6. Conclude by discussing how identifying your own personal values can help
you to create a sexual health plan. Distribute the “My Sexual Health Plan”
handout to participants and ensure sufficient time for participants to complete it.
.
Adapted with permission from Region of Waterloo (2003) Girl Time: Grade 7 & 8 Healthy Sexuality
Program. Waterloo: Public Health
267
Cards
Steps of Sexual Intimacy
Eye contact
Mutual masturbation
Attraction
Oral sex
Arousal
Sexual intercourse
Holding hands
Road sign: abstinence
Hugging
Road sign: caution
Kissing
Road sign: stop
French kissing
Road sign: talking
Touching on top of clothes
Road sign: birth control/condom
Touching under clothes
Road sign: alcohol & drugs
Other:
Other:
268
Handout
My Sexual Health Plan
MY PERSONAL VALUES: Values and beliefs about sexuality that I feel are important to me (i.e. I value
protecting myself, I value honesty, etc.):
1.
2.
3.
MY SEXUAL ACTIVITY SCALE: Check the appropriate box to indicate how far you might go in six months,
one year, two years, etc. if you were in a relationship.
6 months
1 year
2 years
Long-term
relationship
Married/lifetime
commitment
No dating
Dating
Abstinence
Holding hands
Kissing
French kissing
Touching on
top of clothes
Touching
under clothes
Mutual
masturbation
Oral sex
Sexual
intercourse
Other:
I plan to prevent pregnancy and/or STIs/HIV by: ________________________________
________________________________________________________________________
269
Sexual Decision-Making Case Studies
Level II/III
Objective:
Participants will identify circumstances that would make
having sex a good or poor choice.
Structure:
Large group.
Time:
30 minutes.
Materials:
Procedure
1. Read the following case study to your group:
Ann is seventeen years old. The summer after graduation, Ann was offered
a job at a hotel outside of town. She took the job, even though it meant
being away from her family and friends for three months.
At the hotel, Ann felt lonely. The other girls had worked at the hotel for
several summers and seemed to be in a clique that excluded her. Then
Ann met James. He was a really hot lifeguard and all of the girls wanted his
attention. James became really interested in Ann and asked her out.
Suddenly, the other girls paid attention to Ann. They included her in their
activities and pumped her for information about James. Ann wanted to be
popular, so she decided to go out with James. Everyone would think she
were nuts if she didn’t.
James very quickly began to pressure Ann to have sex with him. He even
made it clear he wouldn’t keep dating her if she refused. One night, after
drinking beer and getting high on marijuana, James walked Ann back to the
hotel and asked if he could go up to her room with her.
2. Ask your group:
Ann needs to decide if she is ready to have a sexual relationship with
James or not. What factors does she need to consider (sample list
follows)?
Pressure (from James, from friends)
Wanting to be popular, to belong
Alcohol, drug use
Attracted to James
Looking back: will she feel good about her decision?
STI protection
Pregnancy prevention
Alternatives to intercourse
3. Ask the group if, in this case, sex would be a good choice.
4. Next, read the following revised case study:
Ann is seventeen years old. The summer after graduation, Ann was offered
a job at a hotel outside of town. She took the job, even though it meant
being away from her family and friends for three months.
At first, Ann felt lonely. Although the other girls had worked at the hotel over
several summers and seemed to be in a clique, Ann persisted and eventually
made a couple of friends. One evening, Ann met James. He was a really hot
lifeguard and all of the girls wanted his attention. James became really
interested in Ann and asked her out.
270
James was really nice to Ann and they spent a lot of time together. James taught
Ann how to swim and Ann taught James how to play tennis. They took long
walks together and talked about everything. They were inseparable and seemed
very happy.
At one point during the summer, Ann and James started talking about
having sixthly wanted to demonstrate their love for each other. They both
agreed that if they were to have sex, they should use condoms in order to
protect each other from unintended pregnancy and STIs.
5. Ask your group:
What factors are present for Ann and James in deciding whether or not to
have sex (sample list follows)?
Good communication skills
Equal relationship
Sharing relationship (both contribute)
Pleasure
Love
STI, pregnancy prevention
Possible virginity
6. Ask the group if, in this case, sex would be a good choice.
7. Ask: Apart from the ones presented in these two case studies, what are
some additional factors that people need to consider when deciding whether
to have sex or not (sample list follows)?
Comfort with own body
Parental expectations
Cultural expectations
Religious expectations
Freedom to say yes or no
8. Conclude by pointing out how difficult and important a decision it is to
determine whether or not to start, or continue, a sexual relationship. Whether
we are deciding for the first time ever or with a new partner, there are several
factors that need to be considered. It is important that we weigh all factors in
order to make good choices.
Extension
Instruct participants to write their own case studies and to determine which
circumstances are present that would make sex a good or poor choice.
271
What’s in a Relationship? .
Level III
Objective:
Structure:
Time:
Materials:
Participants will identify the qualities that are most important for
them in a romantic relationship.
Large group.
20 minutes.
“Relationship Quality” cards, flipchart or blackboard.
Procedure
1. Distribute 1 – 2 relationship quality cards to each participant (if you have
cards left over, ensure that you have distributed an even number of “healthy”
and “unhealthy” cards).
2. Ask participants to look at the quality on the card and determine whether or
not it is a quality that they value and would want in a partner.
3. Ask participants to stand up and move around the room to meet other
participants to find out what qualities they have on their cards.
4. Explain to the group that if a participant has a card that is not a quality s/ he
values in a partner, s/he can try to switch cards by negotiating with other
participants. If the other participant says “no” to switching cards, the person
must move on to someone else.
5. Give the group 10 minutes to move about the room.
6. Bring the group back together. Have each participant read out her/his quality
card(s). Ask the following questions:
Did anyone want to change their quality card?
If so, were you able to switch it with another participant? Why or why
not?
Having only one (or two) quality cards is limiting. What other qualities
would you have liked?
7. On the board/flipchart, create two columns: healthy relationship qualities and
unhealthy relationship qualities. Ask participants to read aloud their cards
again. Ask the group if the quality is a healthy or unhealthy quality in a
relationship. Write the quality down in the appropriate column. Explore any
differences that may arise in the group.
8. Ask what other qualities the group thinks are important for a healthy
relationship. Ask what other qualities constitute an unhealthy relationship.
Write these on the board/flipchart. Explore any differences that may arise in
the group.
9. Discuss how each person tends to bring a mixture of qualities to a
relationship. Pick one of the qualities from the unhealthy list and ask the
group how to deal with this in a relationship. Use the example of a
relationship that was good in many other ways but had this one issue that
one of the partner’s wanted to resolve.
10. Conclude the activity by pointing out that it is important to think about what
qualities are important to us in our relationships. No one and no relationship
is perfect, However, it is important to prioritize what is important to us and to
ensure that our relationships are as healthy as possible.
.
(Adapted with permission from: Planned Parenthood Toronto (1998) Community Health Promotion
Team)
272
Handout
Relationship Cards
Wants to have sex all
the time
Never wants to
have sex
Is confident
Is not motivated
Is a good kisser
Calls me everyday
Is really smart
Knows how to please me
sexually
Likes to hug and cuddle
Holds anger in
Knows how to deal with
conflict in a positive way
Puts a lot of time and effort
into the relationship
Tells me what to wear
Puts me down in front of
others
Doesn’t follow through with
promises
Has a good sense of style
Chooses my friends
Remembers important dates
Doesn’t like to talk
about feelings
Likes to buy me lots of gifts
Sometimes hits during
arguments
Doesn’t like to say sorry when
responsible for a problem
Makes time to see me
Won’t let me go out with
friends
Complains all of
the time
Doesn’t want a long-
Has lots of money
Likes to party
Religious
Sleeps with other people
Listens to me
Is accepting of
others
Accepts me as a
person
Has a good body
Trusts me
Communicates
feelings
Doesn’t try to change
me
Can be trusted
Accepts differences
Shares some of my
interests
Sexually attractive
Makes me feel special
Talks easily
Makes me laugh
Able to discuss sexual limits
and safer sex
Criticizes me
Often wants own way
term relationship
Puts up with tiredness,
disagreements and
mistakes
273
Healthy Relationships Statements
Level III
.
Objective:
Participants will identify the myths and facts surrounding
relationships.
Structure:
Time:
Materials:
Large group.
30 minutes.
3 signs: “Agree”, “Disagree,” and “Unsure” and masking tape.
Procedure
1. Before the activity begins, paste the 3 signs on different walls within the
room.
2. Read out one statement from the list below. Have participants walk towards
the sign that describes how they feel—agree, disagree, or are unsure. This
activity can be modified so that seated participants hold up signs. Use
different coloured signs to make tabulating easier.
3. Ask them to explain why they feel this way. Try to bring up relevant points
with each statement.
4. Continue by reading another statement. They don’t have to be done in any
particular order, and if the points relating to the statement have already been
discussed, skip that statement and move on. Choose the ones that are most
appropriate to your group.
5. Conclude by pointing out that we are exposed to a lot of stereotypes and
misinformation about sex and relationships. It is important to challenge these
messages in order to develop healthy relationships and a positive sense of
self-esteem.
Statements
1. Most people my age are having sex.
No, most people are not having sex: it just seems like it.
Influence of the media, people lie, etc.
Why do people have sex? Popularity, love, insecurity, etc.
Why don’t people have sex? Religion, readiness, values, etc.
Don’t feel you have to do something just because everyone else seems
to be.
2. A girl who has sex with several different partners is easy but a guy is a
player.
Double standards—fair?
How girls see each other: how guys see each other.
How can we stop double standards?
.
(Adapted with permission from: Planned Parenthood Ottawa-Carleton (1998) Community Outreach
Program.)
274
3. Young women have sex to get their partner to love them.
Self-esteem. With a healthy self-esteem, you know someone loves you
for who you are not how far you go.
What can you do to boost your self-esteem?
Sex will not make someone love you.
4. Young people feel social pressure to be sexually involved in some way.
Where does it come from (e.g. media, peers)?
Is it effective?
How is this pressure dealt with/resisted?
Self esteem issues.
5. Everybody has to put up with a certain amount of disrespect in a
relationship.
Self-esteem issues.
Abuse (physical, verbal, emotional, sexual).
Where do you draw the line?
What is disrespect?
What do you do if you see a friend in an abusive relationship? Who can
you call?
6. It’s easier to have sex than to talk about it with your partner.
Difficulty in talking about sex—going one step further because you are
too embarrassed to talk about it (e.g. kissing to petting).
Why is this difficult? (Sex is considered a taboo subject—not often talked
about at home, therefore not used to talking about it.)
Importance of communication skills.
7. Dating someone is better than dating no one.
Self esteem issues.
Love and value yourself for who you are and not for whom you’re with.
8. S/he wouldn’t be so jealous if s/he didn’t really love me.
Trust, respect.
Abuse.
What is love?
275
9. It is possible to confuse love and infatuation.
What is the difference?
What are signs of infatuation? Love?
Is infatuation healthy?
Can you date someone even if you don’t love him or her?
10. The only way to show love is through intercourse.
Abstinence
Intimacy
Alternatives (e.g.: mutual masturbation, oral sex etc.)
276
Relationship Quiz .
Level III
Objective: Participants will evaluate their romantic relationships.
Structure: Individual.
Time: 15 minutes.
Materials: “Relationship Quiz” handout.
Procedure
1.
Distribute the “Relationship Quiz” handout. This is an individual,
reflective activity, so inform participants that the quiz is confidential, and
that they won’t be required to share their answers.
2.
Introduce the activity by stating that sometimes it is necessary to step
back and evaluate our romantic relationships. In particular, it can be
difficult to see unhealthy trends in a romantic relationship when we are in
it. This quiz is intended to evaluate how healthy or unhealthy a
relationship might be.
3.
Head a discussion by asking the following questions:
What characterizes a healthy relationship?
What characterizes an unhealthy relationship?
If someone is in an unhealthy relationship, what can s/he do?
4.
.
Conclude by pointing out how hard it can be to admit that a relationship
is unhealthy. If a relationship is unhealthy, it is important to get support
and assistance from friends, family members, and other people we trust.
(Adapted with permission by City of Toronto: Toronto Public Health.)
277
Handout
Relationship Quiz
1.
It is O.K. with you when your partner spends time alone with friends or family.
No
Yes
Sometimes
2.
It is O.K. with your partner when you spend time alone with friends or family.
No
Yes
Sometimes
3.
Your partner likes the way you look and act and tells you so.
No
Yes
Sometimes
4.
You both decide how to spend your time together.
No
Yes
Sometimes
5.
Your partner has the power to make you feel bad and uses it
No
Yes
Sometimes
6.
Your partner pressures you to do sexual things you don’t want to do.
No
Yes
Sometimes
7.
When you refuse to do certain sexual things, your partner puts you down
No
Yes
Sometimes
8.
Your partner has threatened to hurt you or has hurt you.
No
Yes
Sometimes
9.
You usually feel happy in this relationship.
No
Yes
Sometimes
10. You are afraid of your partner’s temper, so you avoid making him/her angry.
No
Yes
Sometimes
11. Your partner scares you by driving fast, drinking too much or doing other risky things.
No
Yes
Sometimes
12. Your partner says, “I can’t live without you” and it scares you that it might be true.
No
Yes
Sometimes
13. You worry that the relationship might end and s/he would do anything to keep it
No
Yes
Sometimes
14. You think you can make your partner’s problems go away.
No
Yes
Sometimes
15. Your partner believes that jealousy is proof of love.
No
Yes
Sometimes
16. You have both agreed that you are a couple and you trust each other to stick to it.
No
Yes
Sometimes
17. You and your partner are safe from sexually transmitted infections (STIs) and/or
unintended pregnancy.
No
Yes
Sometimes
18. You both can be honest about your feelings and talk about them freely.
No
Yes
Sometimes
Did you answer “YES” to questions 1,2,3,4,9,16,17, and 18? If so, you are probably in a
pretty comfortable relationship.
If you answered “YES” or “Sometimes” to questions 5,6,7,8,10,11,12,13,14, and 15, you
may be in an uncomfortable or even dangerous relationship.
If your relationship is dangerous or uncomfortable, get support. Talk to an adult that you
trust, or call your local sexual assault centre.
278
Dear Expert
Objective:
Structure:
Time:
Materials:
Level III
Participants will identify sexual decision-making issues.
Small group.
30 minutes.
“Dear Expert” participant handout; “Dear Expert”
Procedure
1. Introduce the activity by pointing out how difficult and important a decision it
is to determine whether or not to start, or continue, a sexual relationship.
2. Divide participants into seven groups.
3. Assign each small group one of the “Dear Expert” letters from the handout.
4. Give participants enough time to formulate a response.
5. Bring the group back together, and ask one volunteer from each small group
to read the letter and another volunteer to read the response. Do this with
each of the seven groups. Use the answer key to add to the discussion or to
correct any misconceptions.
6. As a group, discuss:
What are the best reasons not to have sex?
Reasons to have sex?
7. Conclude by pointing out how important it is to consider our personal beliefs
and values as well as our relationships when making sexual decisions.
279
Dear Expert
Educator’s Copy
1.
Dear Expert:
Pat and I have been dating for four months. Pat is really wonderful and
really wants to have sex with me, but I’m just not sure. How do I know if I’m
ready?
feelings for Pat
personal values (e.g. cultural, religious)
alternatives to intercourse
looking back: will you feel good about decision?
prepared to take responsibility with birth control and STI prevention?
2.
Dear Expert:
I just had sex for the first time last weekend. Sam is really wonderful, but I
kind of regret having sex. I don’t know if I want to continue a sexual
relationship. But now that I’ve “done it,” I guess there is no going back. What
should I do?
just because you said yes once does not mean you have to say yes
again
freedom to say yes or no
important to communicate concerns to Sam
alternatives to intercourse
3.
Dear Expert:
My boyfriend and I started going out a few months ago. Our relationship is
great, but he always wants to hold my hand and kiss me when we’re in
public, and I don’t feel comfortable with that. What should I do?
important to do what’s right for you
important to talk to each other
4.
Dear Expert:
I’ve been going out with Sue for ten months. She always threatens to break
up with me if I don’t have sex with her. Sometimes I don’t feel like it. I tried
to talk to her about it, but she just won’t listen. I’m worried she’ll spread
nasty rumours about me. What should I do?
abuse issues
important to get support from trusted friend/adult
may need to end relationship
280
.
Dear Expert:
Robin and I have been together for over a year. We really care about each
other and enjoy spending time together. We haven’t had sex, and we both
feel good about that decision. But everyone assumes that we’ve had sex
and even make jokes and comments about it. There’s just so much
pressure—it seems like everyone is doing it, so maybe we should, too. What
should I do?
not everyone is having sex, although it may seem like it
don’t feel you have to do something just because everyone else
seems to be
6.
Dear Expert:
Chris and I have been going out for over six months. I really care about and
want to be close to Chris. But there are parts of my body that I really hate,
and I’m afraid that once he sees me naked, he won’t want me. What should
I do?
self esteem and body image issues
try talking to Chris or someone else you trust about concerns
take things slowly
7.
Dear Expert:
My boyfriend and I really care about each other, and we’re getting really
serious. We both want to have sex and want to be safe, but we’re too
embarrassed to buy condoms. What should we do?
buy them together
go to a sexual health clinic/youth centre (youth friendly) to get them for
free
ask someone else to buy them for you
reconsider having sex
281
Handout
Dear Expert
1.
Dear Expert:
Pat and I have been dating for four months.
Pat is really wonderful and really wants to
have sex with me, but I’m just not sure. How
do I know if I’m ready?
2.
Dear Expert:
I just had sex for the first time last weekend.
Sam is really wonderful, but I kind of regret
having sex. I don’t know if I want to continue
a sexual relationship. But now that I’ve “done
it,” I guess there is no going back. What
should I do?
3.
Dear Expert:
My boyfriend and I started going out a few months ago. Our relationship is great, but he always wants to
hold my hand and kiss me when we’re in public, and I don’t feel comfortable with that. What should I do?
4.
Dear Expert:
I’ve been going out with Sue for ten months. She always threatens to break up with me if I don’t have sex
with her. Sometimes I don’t feel like it. I tried to talk to her about it, but she just won’t listen. I’m worried
she’ll spread nasty rumours about me. What should I do?
5.
Dear Expert:
Robin and I have been together for over a year. We really care about each other and enjoy spending
time together. We haven’t had sex, and we both feel good about that decision. But everyone assumes
that we’ve had sex and even make jokes and comments about it. There’s just so much pressure—it
seems like everyone is doing it, so maybe we should, too. What should I do?
6.
Dear Expert:
Chris and I have been going out for over six months. We’ve been talking lately about having sex and I
think I’m ready. I really care about and want to be close to Chris. But there are parts of my body that I
really hate and I’m afraid that once he sees me naked, he won’t want me. What should I do?
7.
Dear Expert:
My boyfriend and I really care about each other, and we’re getting really serious. We both want to have
sex and want to be safe, but we’re too embarrassed to buy condoms. What should we do?
282
Breaking Up Is Hard To Do
.
Objective:
Participants will identify skills to develop healthy
relationships and end unhealthy ones.
Structure:
Large group role-play and individual activity.
Time:
40 minutes.
Materials:
“Breaking Up is Hard to Do” participant handout;
”Breaking Up is Hard to Do” educator’s copy.
Level III
Procedure
1.
Distribute the “Breaking Up is Hard to Do” handout to participants.
Introduce the activity by pointing out how difficult it can be to end
relationships, and that this activity will help participants to develop the
skills to do so, if necessary.
2.
Have participants complete the worksheet. This can be an in-class or
homework assignment. As a group, take up the answers.
3.
Ask participants to role-play scenes that demonstrate ways to end a
relationship. To get ideas, they can use their answers from the handout.
Participants may choose to do role-plays that demonstrate both negative
and positive methods of handling a break-up.
4.
Some educators prefer to have participants in the class assist the
“actors” by making suggestion throughout the scene.
“Try saying it this way instead…”
“Let me show you what I mean…”
“What if the other person answered this way…”
5. Conclude by pointing out that romantic relationships involve a certain
amount of emotional risk and heartbreak. Ending relationships is a difficult
but important skill to learn. It is important that we identify people in our lives
who can support and assist us through this process.
.
(Adapted with permission from Gordon, Bill (1995) Relationships Skills for Healthy Sexuality.
Edmonton: Alberta Learning.)
283
Breaking Up Is Hard To Do Worksheet Key
Educator’s Copy
1.
What reasons might a person have for ending a relationship/ friendship?
Answer might include: no longer caring for the other person,
finding someone else, having increasingly different interests,
realizing that their first impressions were wrong, constant fighting,
abuse/violence, parents’ disapproval, having too many differences,
moving away, being just a “summer thing”…
2.
Singer Paul Simon once sang about “50 ways to leave your lover.” What
are some common ways of ending a friendship/ relationship?
Answers might include: face-to-face honesty, writing a letter, calling
on the phone, dropping hints, aggravating the other person until he/
she breaks up first, cheating on the person and hoping word gets
back, having a huge fight, having a friend tell a friend, not calling
and hoping they get the hint… (The question doesn’t say common
positive ways!)
3.
a) Have you ever had to end a friendship or relationship? How did you
tell the other person that was “over”?
Answers will vary.
b) Did the ending of the friendship go well? Explain.
Answers will vary.
4.
a)
Has anyone ever “broken up” with you? How did they let you know?
Answers will vary. Some may never have had the experience; some
will have dozens of stories.
b) Do you remember how you felt at the time? Did you think they could
have handled it differently?
Answers will vary.
c) If one of your friends were about to end your relationship, how would
you prefer to be treated?
Answers will vary.
5.
a) Why might it be difficult or even dangerous to end an abusive or
violent relationship?
Answers might include: Despite the abuse; s/he may still love him/
her; s/he may be afraid; s/he may blame herself/himself and keep
trying to make things right; s/he may feel that /she will never find
someone else…
b) Why is it important to end a violent or abusive relationship?
Without professional help, the level of abuse will not decrease. In
fact, the cycle of abusive behaviour will likely, not only continue but
also escalate over time.
284
c) How can friends support or help someone ending a violent or
abusive relationship?
Listen, believe her/his story, let her/him know you care and
want to help, let her/him know s/he is not to blame,
encourage her/him to speak with a trusted adult and/or
professional.
Let’s assume that the method chosen to break up with someone is
one in which the two people meet face to face. Using the
assertiveness method that you have learned, write a “script” for one
of the breaking up situations listed below. (Your facilitator may ask
you to join a group to role-play a breaking up scenario.)
Mike finds out that his partner has been dating someone else
behind his back.
Joanne no longer trusts her friend Sharon, who has been telling
others about Joanne’s personal problems.
Mariette is tired of having to fight with Jared to purchase
condoms or even to use them if she buys them.
Lee’s partner, Chris, has become verbally abusive.
Although it seemed as if they could be good friends, Brie has
realized that Dini and she have very little in common after all.
Even though she has been open about her sexual past, Olivia
has been unable to persuade Brad to be equally open with her
about his past.
Participants can do this assignment individually or in small groups.
They could try doing two approaches for each break-up, one in which
the person handles the situation poorly or non-assertively, and
another in which the person has strong communication and
assertiveness skills.
285
Handout
Breaking Up is Hard to Do
1.
What reasons might a person have for ending a
relationship/ friendship?
2.
Singer Paul Simon once sang about “50 ways to
leave your lover.” What are some common ways
of ending a friendship/ relationship?
3.
a) Have you ever had to end a friendship or
relationship? How did you tell the other
person that it was “over”?
b) Did the ending of the friendship go well? Explain.
4.
a) Has anyone ever “broken up” with you? How did they let you know?
b) Do you remember how you felt at the time? Did you think they could have handled it differently?
c) If one of your friends were about to end your relationship, how would you prefer to be treated?
5.
a) Why might it be difficult to end an abusive or violent relationship?
b) Why is it important to end a violent or abusive relationship?
c) How can friends support or help someone ending a violent or abusive relationship?
286
6.
Let’s assume that the method chosen to break up with someone is one in which the two people
meet face to face. Write a “script” for one of the breaking up situations listed below. Join a group
to role-play a breaking up scenario.
Mike finds out that his girlfriend has been dating someone else behind his back.
Joanne no longer trusts her friend Sharon, who has been telling others about Joanne’s personal
problems.
Mariette is tired of having to fight with Jared to purchase condoms or even to use them if she
buys them.
Lee’s partner, Chris, has become physically violent.
Although it seemed as if they could be good friends, Brie has realized that Dini and she have very
little in common after all.
Even though she has been open about her sexual past, Olivia has been unable to
persuade Brad to be equally open with her about his past.
287
288
Module 7: Contraception
and Safer Sex
Everyone needs information on contraception
and safer sex in order to prevent unintended
pregnancy and sexually transmitted infections
(STIs).
This module includes strategies to help
participants consider the consequences of
early sexual activity in their own lives, give
participants accurate information on
contraception and safer sex and link youth
with appropriate community resources.
Contraception and Safer Sex
Information about risk and how to minimize risk must be presented in a way that
will help youth make healthy and responsible decisions. Our role is to provide
these facts, to help youth consider their values and attitudes, and to help them
consider where these values and attitudes will lead them. Our efforts must focus
on triggering a thinking process in youth, rather than giving advice.
1
This module includes level II and level III activities on contraception. These
interactive activities will help youth to personalize consequences and link youth
with appropriate community resources. Extensive detail is not required when
presenting this information in a non-clinical setting. Youth need to know
what birth control methods are available to them, how they work, their
effectiveness, how they can access them, and some basic
advantages/disadvantages. Educators can provide information on other methods
(and more detailed information) in the form of printed materials, like booklets or
fact sheets. We have chosen to focus attention on methods that are most
effective for, and most likely to be used by, youth. Fact sheets on these and other
methods are included in the Resources section of the Sourcebook. Educators
may want to review the processes of ovulation and menstruation to increase
participant understanding of how contraception works.
According to Canadian law, there is no minimum age to prescribe
contraception, and youth are under no legal obligation to inform their
parents that they are being prescribed/using contraception. Clinical staff
is also under no legal obligation to report contraceptive use to parents. In
fact, reporting contraceptive use would breach client-patient
confidentiality.
This section also includes activities to address safer sex. Level II participants will
consider the consequences of early sexual activity in their own lives, will clarify
their own values concerning sexual activity, and will develop an assertive style of
communication. Level III activities will focus on risk awareness and attitudes by
addressing barriers to condom use and communication.
OBJECTIVES OF
THE MODULE:
Participants will:
identify the
risks of early
intercourse
identify the
risks of having
sex without
using
contraception
and/or
condoms
describe
various
methods of
birth control
identify ways
to negotiate
condom use
practice
gathering
information
and resources
from different
sources.
291
Teaching Tips
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
.
Remind your group that many teens are not having sex. According to the
Canadian Youth, Sexual Health and HIV/AIDS Study (2003), by grade 9 only
23% of boys and 19% of girls have had intercourse and by grade 11 these
figures are 40% and 46% respectively. 38 Of those boys and girls who have had
intercourse, approximately one half reported having only one sexual partner. 39
Many youths have the feeling that being sexually inactive is to be in the minority,
to be abnormal. We need to help youth recognize that it is normal not to have
sex, without alienating those young people who are sexually active.
Sometimes, in our efforts to provide information about safer sex, we
unintentionally give the message that we expect all youth to be having sex. Try to
use language that will make everyone feel that they are “normal” and included;
for example, “…for young people who have decided to have sex, it is important
to…”
It is very likely that you will have participants, in the sessions you lead, who are
gay, lesbian, bisexual, or questioning their sexual orientation. Regardless of
sexual orientation, everyone needs information on contraception and safer sex.
Be sure to use inclusive language so that gay, lesbian, bisexual, or questioning
youth feel that you are speaking to them as well (e.g.” partner” instead of
“boyfriend/girlfriend,” include anal and oral sex in safer sex discussions). You
may wish to acknowledge to the group that the sessions you will be providing will
address the needs of all participants: gay, lesbian, straight, and those who are
questioning their sexual orientation.
Be sensitive to the religious and cultural diversity of your group as some faiths
and cultures are not supportive of some forms of contraception.
Note: Contraception and safer sex issues overlap with the STIs/HIV and
Relationships and Decision-Making modules. You may want to supplement your
lesson plans with activities from either module.
.
Level I activities are omitted because these issues are generally not appropriate for level I
students.
38
Boyce, W., Doherty, M., Fortin, C., and Mackinnon, D. (2003). Canadian Youth, Sexual Health and
HIV/AIDS Study: Factors Influencing Knowledge, Attitudes and Behaviours. Toronto: Council of
Ministers of Education, p. 75.
39
Ibid.
292
Group Discussion –
Postponing Intercourse vs. Having Intercourse
.
Objective:
Participants will list reasons why young people choose to
postpone intercourse or have intercourse.
Structure:
Large group.
Time:
20 minutes.
Materials:
Procedure
1.
On the board or flipchart paper, make a simple chart, as illustrated
below. Have participants brainstorm about the reasons why young
people would choose to postpone having intercourse, and then about
why youth would choose to have intercourse. Sample responses are
included.
Reasons why young people choose to
postpone having intercourse…
Reasons why young people choose to
have intercourse…
Religious/cultural beliefs
“Hormones”/desire/curiosity
Not ready
To demonstrate love for partner
Not wanting to hide something from
parents
Feeling pressured by your partner/or
Avoid guilt, fear, and disappointment
“Social” pressure, feeling that everyone
is doing it, and you’re not
No worries about STIs or pregnancy quite
normal if you’re not (because abstinence
is the only method that is 100% effective
in preventing STIs and pregnancy)
Wanting to feel loved/wanted
More time for friends and other activities
Feels good
More time for the relationship to develop
To get someone to love you, to prevent
the relationship from ending
Concern about reputation
Influence of alcohol and/or drugs
Personal belief that sex belongs only in
Not knowing how to say “no”, just “going
along”
certain kind of relationship
Belief that sex too soon can hurt a
relationship (with a partner, friends,
or parents)
Had sex once before and decided s/he is
not ready for a sexual relationship (for
any of the above reasons: just because
someone says “yes” to sex once does not
mean s/he has to say “yes” again)
2.
others
Both partners really love each other, and
want to express it this way
Those questioning their sexual orientation
may have sex in an attempt to “figure out”
if they are attracted toopposite or same
sex partners
Remind participants that MOST young people their age are NOT
having intercourse! According to the Canadian Youth, sexual Health
and HIV/AIDS Study (2003), by grade 9, only 23% of boys and 19%
of girls have had intercourse.
Level II
Note: Presenting
the issues in this
way helps
facilitators avoid
preaching about the
values of
abstinence and
offers participants
an opportunity to
clarify their own
values towards such
topics. Asking
participants to
consider why
young people in
general would
choose one course
of action over
another, puts them
in the position of
“objective observer,”
so that they do not
feel obliged to share
their personal
beliefs or opinions.
Note: This activity
can be completed
as a large group, or
divide the class into
smaller groups for
discussion. The
smaller groups will
need someone to
record their
responses, and
someone to report
when the large
group reconvenes.
You can discuss
each response as it
is raised, and
extend the activity
by getting
participants to
decide for
themselves, which
reasons for having
intercourse are
“good enough”
reasons.
.
(Adapted with permission from: Region of Ottawa-Carleton (2000) Ottawa-Carleton School-Based
Sexual Health Program. Ottawa: Author.)
293
Level II
Considering the Consequences of Early Sexual Intercourse .
Purpose:
Participants will identify the risks of early sexual intercourse.
Structure: Small group.
Time:
20 minutes.
Materials: “Consequences of Early Sexual Intercourse” handout, blackboard or
flipchart.
Procedure
1. Divide the group into small groups of about 5 or 6. Give one handout to each
group and have them choose a recorder.
2. Ask the individual groups to brainstorm together to identify the
consequences of early intercourse (e.g. having vaginal or anal intercourse at
their age).
the physical (health)
emotional consequences (including relationships with friends, parents,
partner) for youth of their age
what can be done to decrease the risk of consequences.
3. Once the groups have completed the worksheets, ask for volunteers to share
their results. Record the responses on the board or flipchart. Discuss and
expand on the responses as they arise. You may wish to raise some issues
yourself, if they are not raised by youth. Some issues for possible discussion:
Physical Consequences of Early Sexual Intercourse:
Increased probability of pregnancy.
Increased probability of STIs (sexual transmitted infections) & associated
complications (e.g. infertility).
Increased probability of HIV.
Increased probable risk of cervical cancer for women (because possibility
of more sexual partners, cervix at puberty more vulnerable).
Emotional Consequences and Relationships:
Reputation can be affected. (Would it be the same for girls as for boys?)
Guilt (about keeping this from one’s parents).
May damage the relationship with one’s partner—or change it.
Relationship may not develop any further; partners may feel very
awkward around each other.
May not take the time to develop emotional closeness with partner.
.
294
Friends may disagree.
Worries about pregnancy, STIs, etc. could take time and energy away
from other activities.
May feel pressured, resentment in relationship.
May have a negative effect on self-esteem, especially if person feels
“used.”
May feel regret.
May find it more painful to cope if the relationship breaks up.
What can be done to decrease the risk of consequences:
Abstain from intercourse (or postpone it until older).
Use condoms and effective contraception.
Engage in lower risk sexual activities (kissing, hugging, touching, etc.).
4.
Conclude by discussing the physical and emotional risks involved with
having intercourse at a young age. It is important to be aware of these
consequences, as well as strategies to reduce the risk of consequences,
before becoming involved in sexual relationships. Remind participants
that the majority of youth their age are not having intercourse. According
to the Canadian Youth, sexual Health and HIV/AIDS Study (2003), by
grade 9, only 23% of boys and 19% of girls have had intercourse.
295
Level II/III
Note: This activity can
be used with a broad
range of youth. The
responses of the
participants and the
character of the
discussion will depend
on their
developmental stage.
For younger teens,
much of this
information will be
very new; older teens
will likely have more
knowledge. Older
teens will be
interested in more
detailed information
than will younger
teens.
It is important not to
overload participants
with information, but
to give them enough
information, so that
they can access
reliable methods of
contraception when
they need to.
Abstinence/
postponing
intercourse as a
method of pregnancy
prevention is
presented as a wise
choice for young
teens. Also, a review
of conception/
ovulation may be
needed for younger
participants, so they
will be able to
understand how
several pregnancy
prevention methods
work.
Please be sensitive to
the religious and
cultural diversity of
your group, as some
faiths and cultures are
not supportive of
some forms of
contraception.
Flip Chart Questions for
Methods of Pregnancy Prevention .
Objective:
Participants will describe various methods of pregnancy
prevention.
Structure:
Small group.
Time:
About 30 minutes.
Materials:
Flip chart paper, markers, tape. Strongly
recommended: samples of various methods of
contraception for participants to examine. 40 “Flip Chart
Questions for Methods of Pregnancy Prevention”
answer key.
Procedure
1. Prepare six sheets of flip chart paper by listing a different method of
pregnancy prevention at the top of each one. List the questions participants
will be answering as well. Be sure that the sheets can be read from a
distance, and leave enough space for participants to record their answers.
(Answer key follows that will list methods you may wish to discuss with your
group, questions to include on the flip chart paper, and basic information
about each method to share with the group).
2. Tape the sheets of flip chart paper up at various points in the room. Place the
appropriate sample method nearby for those who wish to get a closer look.
3. Divide the participants into groups and assign each group to a method. Ask
the participants to do their best to answer the questions on the flipchart paper
and to record their answers on the sheet. If participants are really stumped,
you can give them some written information for guidance (call your local
Health Department or Canadian Federation for Sexual Health member
organization for copies of brochures and fact sheets, or have participants
search for answers on the internet or in the library).
4. Circulate between the groups to keep them on task, or to assist them by
asking them leading questions or giving information.
5. Once participants have completed the questions (to the best of their ability),
review each method with them, by following the answer key. You may wish
to have each group “report” their findings. Remember that the answer key will
not provide all information about each method. The goal of this activity is to
introduce participants to the different methods of pregnancy prevention
available (particularly the methods that young people most commonly use),
and to let them know about community resources. For more information
about the methods, you can consult the fact sheets provided in the
Resources section. Provide information that participants can take away about
resources in the community (fact sheets, youth friendly clinics, phone lines
etc.).
.
(Adapted with permission from: Region of Ottawa-Carleton (2000)
Ottawa-Carleton School-Based Sexual Health Program. Ottawa: Author.)
40
Contact your local Health Unit or Planned Parenthood affiliate and ask about getting packages of
expired birth control pills (remove the pills so that participants have access to only the packaging),
condoms, spermicides (sponge, VCF, foam, applicator).
296
5. Conclude by asking the following question:
o
o
o
Which methods do you think are most effective for young people?
(Abstinence/postponing intercourse, oral contraceptives/DepoProvera/The Patch/Vaginal Ring [used with condoms], condoms, and
emergency contraception [for ‘emergencies’ only].)
When is the best time to talk about contraception with one’s partner?
(Before having sexual intercourse)
Do you agree or disagree with the following: “Birth control is not a guy’s
responsibility because he’s not the one who could get pregnant.”
(Disagree. Guys should also be knowledgeable about the range of
methods of pregnancy and disease prevention in order to support their
partner’s effective use of a method and to effectively decrease the risk
of STIs and unintended pregnancy.)
participants to identify which methods they think would be most effective for
young people. (One hopes they will identify: abstinence/postponing intercourse,
oral contraceptives [used with condoms], Depo-Provera [used with condoms],
condoms, and emergency contraception [for “emergencies” only].)
Extension
Instruct participants to create posters or commercials advertising a method of
pregnancy prevention.
297
Answer Key
Flip Chart Questions For Methods of Pregnancy Prevention
Method: Abstinence/Postponing
How does it work?
It means not having vaginal or anal intercourse.
However, there are differing views on the definition of abstinence.
For some: kissing is the limit.
For some: everything short of vaginal or anal intercourse is OK.
Others: have limits somewhere in between.
People have to set limits for themselves, and communicate their limits to their
partner.
How effective is it?
Very effective in preventing pregnancy, but you have to use it all the time.
(Male ejaculation near exposed female genitals presents a risk of pregnancy)
What do you need to do to use it?
STIs may be transmitted oral sex or through genital-to-genital contact.
Decide what your limits are (before you are in a sexual situation).
Think about how you will discuss this with your partner. (Consider how to
respond to your partner’s questions and reactions.)
Talk to your partner about your limits.
People may wish to avoid situations where they may feel pressured or unable
to stick to their limits (e.g. being at home alone with their partner, getting
drunk or high).
Why would someone choose this method?
Very effective protection from STIs and pregnancy.
Not ready for sex or not interested in the stress that is involved in having
intercourse at an early age.
Wanting to spend time on other things: sports, school, friends, and to focus
on personal growth before having intercourse.
Religious beliefs, cultural beliefs.
Why not?
Person really feels ready, and is ready to take responsibility for having
intercourse (getting/paying for birth control method, buying and using
condoms to avoid STIs and/or unintended pregnancy).
Feeling pressure from partner; not wanting to lose partner.
Sexual desire. (Are there other ways of dealing with sexual feelings without
having intercourse?)
Not feeling able to communicate personal limits
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Method: Condoms and Spermicides
How do they work?
Condoms prevent pregnancy and transmission of STIs by preventing semen
from getting into the vagina (and swimming up to the ovum).
Condoms prevent semen from entering the anus.
Spermicides kill sperm. (Spermicides should NOT be used for anal sex
because the skin in the anus is too delicate.)
How effective are they?
Typical effectiveness of condoms is 88% in preventing pregnancy.
Effectiveness of condoms combined with spermicides is 97%. (Spermicides
is not effective enough to use on it’s own.)
Spermicides vary in the duration of effectiveness and in how quickly they
become effective. For example, VCF (vaginal contraceptive film) is effective
for one hour, but couples must wait 15 minutes after insertion for the film to
dissolve. Sponges must be left in place for 6-8 hours after sex. In general,
most are effective for about one hour. Users must read package directions
carefully.
Where can you get them? How much do they cost?
No prescription is needed.
Drugstore: condoms – about $7 for 12; spermicidal foam – about $16.
Many Sexual Health Clinics provide free condoms and spermicides at low
cost. (Call your local Health Department or Canadian Federation for Sexual
Health affiliate to find locations.)
Many youth drop-in centres also have free condoms.
Easy to get, no prescription needed, not expensive.
Protection from most STIs. (Condoms do not provide complete protection
from herpes, or from HPV-Human Papilloma Virus—the virus that causes
genital warts.)
Concerned about side effects associated with other methods.
Effective contraception.
Why not?
Must plan ahead to have method available: some people don’t like to
interrupt lovemaking to put on a condom.
Some men feel that condoms reduce sensation (but with condoms, erections
can last longer).
Allergy to latex (in which case a latex condom can be doubled up with a
lambskin condom).
Some women may feel uncomfortable or have an allergic reaction to putting
spermicides in their vagina.
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Method: Emergency Contraception (Morning After Pill)
How does it work?
It is a concentrated dose of estrogen and progesterone that
can reduce the risk of pregnancy after unprotected vaginal intercourse,
can delay or prevent ovulation (it’s primary mode of action), and
can cause changes to the endometrium, to make implantation less likely.
A woman must take it within 72 hours (3 days), after unprotected vaginal
intercourse. (Sometimes up to 5 days, but the sooner, the better.)
Prevents 75% of the pregnancies that would have occurred, if taken within
the first 72 hours after unprotected sex. (98% of women who take it will
menstruate within 3 weeks.)
More effective if taken as soon as possible after unprotected vaginal
intercourse (within 5 days).
Important note: Nausea is a very common side effect, so emergency
contraception should be taken with Gravol.
A woman should menstruate within 14 to 21 days.
Where can you get it? Is it expensive?
It is available directly from a pharmacist across Canada, without a doctor’s
prescription. When purchased directly from a pharmacist the average cost is
between $25 and $45.
Many walk-in clinics and doctor’s offices, some hospitals. (Call first.)
Sexual Health Clinics, Sexual Assault Treatment Programs. (Call your local
organization to find out where it is available in your community.)
Usually free from Sexual Health Clinics
Vaginal intercourse without any contraception.
Condom breakage.
Sexual assault.
Missed taking 2 or more birth control pills and had vaginal intercourse without
using condoms.
Why not?
Too late. (More than 3-5 days have passed since the unprotected vaginal
sex.)
Medical reasons for not taking birth control pills. (alternatively, a copper IUD
can be inserted into the uterus, by a physician, up to seven days after
unprotected vaginal intercourse or failed contraception. An IUD could
theoretically facilitate the spread of an sexually transmitted infection (STI)
into the reproductive tract and as such, emergency IUDs are best reserved
for women who’ve had unprotected sex within the context of a long-term,
monogamous relationship.)
Spotting is also a common side effect.
Emergency contraception should not be considered a routine form of birth
control, but repeated use will not cause harm.
300
Method: Oral Contraceptives (‘the Pill’)
How does this method work?
Contains estrogen and progesterone (hormones normally present in a
woman’s body).
Prevents ovulation.
Thickens cervical mucous to block sperm.
Thins the endometrium (lining of the uterus).
Typical effectiveness is about 95-98%.
Very important to take it every day, at about the same time each day.
Antibiotics interfere with pill efficacy, as do vomiting and diarrhea. It is
important to use a back-up method for the rest of the month.
Need to see a doctor for a prescription. (Young women need a check-up first
and sometimes a pap test.) Costs about $20 for each pack (a month’s
supply) from a regular pharmacy. (Many workplace drug plans cover it, and it
is covered on drug card for people receiving welfare benefits.)
Sexual Health Clinics usually provide low cost pills. (Contact your local
organization to find clinics in your community.)
Partner can share the cost.
Very effective.
Easy and safe.
Can reduce cramping and acne
Many women experience regular and predictable periods.
It is completely reversible. Once you stop using the patch, your body
resumes its natural cycle.
Why Not?
Rare, but serious, side effects. A careful medical history, examination and
follow up can help to prevent them from occurring. It is important to note that
young women (under age 35) are at greater risk of dying in a car accident or
from not using any method of birth control, than from using oral
contraceptives. Most other side effects resolve within 3 months of pill use, or
can be resolved by switching to a different kind of birth control pill.
Difficulty remembering to take every day.
No protection from STIs.
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Method: Contraceptive Patch
How does this method work?
The contraceptive patch is a small beige patch that sticks to a woman’s skin
and continuously releases estrogen and a progestin into the bloodstream.
One patch is worn each week for three weeks (the fourth week is patch-free,
allowing withdrawl bleeding to occur).
Typical effectiveness is 96% - 99%.
For women who have trouble remembering to take a pill every day, the patch
may work better than the Pill.
Doctor or health clinic.
It costs approximately twice as much as the Pill, and may not be covered by
all drug plans.
Some family planning clinics may offer it at a reduced rate.
Helpful if partners share the cost.
Very effective.
Many women experience regular and predictable periods.
It is completely reversible. Once you stop using the patch, your body
Why Not?
Women who cannot take estrogen due to a medical condition cannot use the
patch.
Skin irritation can occur – try wearing the patch in a different spot each week
to minimize this problem.
When starting the patch, you may notice side effects such as breakthrough
bleeding (between periods), breast tenderness, headaches, or nausea as
your body gets used to the hormones. Most of these side effects resolve
within 3 months of use.
No protection from STIs (use WITH condoms).
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Method: Injection (Depo-Provera™)
How does it work?
Contains progesterone (a female hormone).
Prevents ovulation.
Thins the endometrium (lining of the uterus).
Thickens cervical mucous to block sperm.
Because this method prevents ovulation and thins the endometrium, women
using Depo-Provera don’t have regular periods (either no periods at all, or
irregular “spotting” or light bleeding).
Over 99%, as long as the woman returns every three months for the
injection.
Where can you get it? How much does it cost?
It is an injection: you can receive it from a physician or a clinic.
Women also need a check-up and pap test.
Doctor’s office: about $40 per injection. (If someone receives social
assistance, it will be covered on their drug card.)
Sexual Health Clinics usually provide it at lower cost. (Contact your local
Health Department to find such clinics in your community.)
Helpful if partners share the cost.
Only have to think about it once every 3 months.
Very effective.
Some women would prefer not to have their period.
Why not?
Recent studies indicate that Depo-Provera causes a significant loss of bone
mineral density that may not be reversible once the injections are stopped.
Calcium and Vitamin D supplements can help protect the bones.
Some women may feel funny not getting their period.
May not be willing to live with irregular spotting. (About 50% of women get
this in the first year on Depo-Provera; the other 50% have no periods or
bleeding at all. The longer one is on Depo-Provera, the less likely it is that
there will be bleeding)
Side effects (e.g. can make existing depression worse).
Fear of injections.
No protection against STIs.
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Method: Withdrawal
How does it work?
Withdrawal means pulling the penis out of the vagina before ejaculation, in
the hope that sperm and egg won’t meet.
Not reliable.
Difficult to know when you are going to ejaculate, and to pull out in time.
Although pre-ejaculate contains no sperm, a previous ejaculate may have left
some sperm hidden within the folds of the urethral lining, which can cause a
pregnancy to occur.
While withdrawal shouldn’t be promoted as a primary method of pregnancy
prevention, it is a great deal better than nothing. Failure rates vary from 5%
to 20%.
Nothing else available.
Poor understanding of the risks of this method.
Why not?
Some men have difficulty controlling their ejaculation and may not pull out in
time (especially true for teens).
Depends on cooperation and commitment of the male partner.
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Method: Vaginal Ring (NuvaRing™)
How does it work?
The vaginal ring is a soft, flexible, clear plastic ring that is inserted into a
woman’s vagina (by the woman herself) where it slowly releases estrogen
and progestin for three weeks (the ring is removed on the fourth week to
allow a period to occur). At the end of the ring-free week, the woman inserts
another ring.
Typical effectiveness is 96% - 99%.
For women who have trouble remembering to take a pill every day, the
vaginal ring may work better than the Pill.
Where can you get it? How much does it cost?
Prescribed by a doctor and picked-up at a pharmacy.
Costs about $35 per ring or a month’s supply or about $80 for a package of
three
Very effective.
Women’s periods are sometime more regular, lighter and less crampy.
Completely reversible. Once you stop using the vaginal ring, your body
Why not?
No protection against STIs.
Some women don’t like inserting or removing the ring.
Women who cannot take the birth control pill for medical reasons cannot use
the ring either.
Side effects can include headaches, vaginal irritation, discomfort or
discharge, nausea, breast tenderness, breakthrough bleeding (bleeding
between periods) especially in the first few months.
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Method: Fertility Awareness
How does it work?
A woman keeps track of her menstrual cycle to figure out when she is
ovulating. She then only has vaginal intercourse when it is “safe”, or uses
another form of contraception when she is fertile.
Not very reliable, especially for teens since many young women do not have
regular cycles, so it is very difficult to predict ovulation.
The failure rate is around 20%.
What do you need to do to use this method?
Women who use this method record their morning temperature, the character
of vaginal mucous and their periods on a calendar for six months prior to
using this method. (They take special classes to learn how, and their partners
are usually very involved.) They avoid having vaginal intercourse for several
days before, during, and after they ovulate (or use another form of
contraception), because sperm can live 4-7 days inside a woman’s body, and
an ovum (egg) lives for 24-48 hours. Therefore, sperm might still be present
in the fallopian tubes several days after having vaginal intercourse.
To plan a pregnancy.
Poor understanding of the risks of this method, especially for teens.
A sense of really understanding one’s fertility.
Why not?
Not effective for pregnancy prevention.
Complicated to keep track of.
Requires a substantial time commitment and cooperation from male partner.
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Method: Calendar/Rhythm Method
How does it work?
A woman keeps track of her menstrual cycle to figure out when she is
ovulating. She then only has vaginal intercourse when it is “safe.”
Not very reliable.
Many young women do not have regular cycles, so it is very difficult to
predict ovulation.
What do you need to do to use this method?
Women who use this method record their morning temperature, the character
of vaginal mucous and their periods on a calendar for six months prior to
using this method. (They take special classes to learn how, and their
partners are usually very involved.) They avoid having vaginal intercourse for
several days before, during, and after they ovulate, because sperm can live
4-7 days inside a woman’s body, and an ovum (egg) lives for 24-48 hours.
Therefore, sperm might still be present in the fallopian tubes several days
after having vaginal intercourse.
To plan a pregnancy.
Poor understanding of the risks of this method.
A sense of really understanding one’s fertility.
Why not?
Not effective for pregnancy prevention.
Complicated to keep track of.
Requires a substantial time commitment.
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Level II/III
Note: While
abstinence is the only
100% effective
method for preventing
STIs/HIV and
unintended
pregnancy, young
people should be
informed of the
effectiveness of
condoms. While
condoms do not
provide 100%
protection against
STIs, “there is clear
and unequivocal
evidence hat
consistent use of latex
condoms significantly
reduces the risk of
STIs and this is
particularly the case
for HIV/AIDS.”
In order for condoms
to be effective in
preventing unintended
pregnancy and
STI/HIV, they must be
used correctly and
consistently. When
discussing condom
use with youth, it is
helpful to provide a
demonstration of the
correct way to put on
a condom.
It may be helpful to
have lubricated
condoms for
participants to
examine—just ensure
that all condoms are
returned before the
end of the session, so
that they are not used
for water balloons, etc.
You can use a penis
model, or alternately,
the condom can be
unrolled onto the
index and middle
fingers of one hand,
although it will be very
loose.
Demonstration: Using a Male Condom Properly
Objective:
Participants will describe how to use a condom.
Structure:
Large group.
Time:
20 minutes.
Materials:
Condoms, penis model, “How to Use a Condom”
handout, “How to Make an Oral Dam” overhead,
overhead projector.
Procedure
Distribute the handout to participants and instruct them to read the instructions.
The handout can be completed during the demonstration or directly afterwards.
Follow the demonstration guidelines below. The phrases that are in bold type
indicate what participants should be drawing or describing on their handouts.
1. Let participants know that latex condoms are necessary to prevent
transmission of STI/HIV. Lubricated condoms should be used for anal and
vaginal sex and must be put on before any genital contact. Non-lubricated
condoms are generally used for oral sex, as the lubricated ones have a
medicinal taste. The expiration date should be checked. Condoms must
be stored where they won’t be damaged by heat (e.g. a drawer, coat pocket,
wallet).
2. Condom package must be torn open carefully, so as not to damage the
condom. Fingernails and jewellery can also damage condoms.
3. Unroll the condom a little (about ½ inch) and then hold it by pinching
the receptacle tip with the fingers of one hand. This is an easy way to
hold a slippery condom, and doing this squeezes the air out of the tip at the
same time. (Air trapped at the end of a condom can cause pressure to build
up, and the condom can break.)
4. Hold the condom onto the tip of the erect penis (still pinching the end),
and with the other hand, roll the condom all the way down the shaft of
the penis to the base. Either partner can do this.
5. Pull the penis out immediately after ejaculation by holding onto the
base of the condom first. If the penis begins to return to its normally flaccid
(limp) state, the condom may slide off and semen may leak out.
6. The condom should be removed away from one’s partner, and the used
condom thrown away (preferably into a garbage can lined with a plastic
bag). Condoms should never be used more than once.
Inform the group that while lubricated condoms are usually sufficient on their
own, extra lubrication can be used to prevent excess friction and to enhance
sensation. Lubrication can be put on the inside and outside of the condom. The
only lubrication that is safe to use with condoms is water-based lubricant, as oil
or petroleum based products (e.g. Vaseline, hand lotion, etc.) can damage latex.
Water-based lubricants are often found in drugstores near the medication used
for vaginal yeast infections.
Once the demonstration is completed, show the “How to Make an Oral Dam”
overhead to your group. Explain that the oral dam is placed over the genitals
and/or anus to prevent STI transmission during oral sex. When making an oral
damn, it is important to use a non-lubricated condom. (Lubricated condoms have
a medicinal taste, and spermicidal condoms will make the mouth go numb.)
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Handout
How to Use a Condom
Instructions: Draw or describe in the boxes below, the six steps to
correct condom usage.
1.
2.
3.
4.
5.
6.
309
Overhead
How to Make an Oral Dam
For women
A latex dam is recommended in male-to-female and female-to-female oral-genital or oralanal sex.
How to make a dam out of a non-lubricated condom:
You can easily make your own dam out of
a condom. Since you will be putting your
mouth on one side of the condom, use a
condom that isn’t lubricated.
They are simple to make. Before you
begin, unroll the condom, then:
1. Cut off the tip.
2. Cut off the base.
3. Now cut down one side.
You now have a square latex dam.
For Men
For oral-genital sex between male-to-male or female-to-male, simply use a nonlubricated condom to cover the erect penis.
For oral-anal contact, use an oral dam (above).
310
Methods of Pregnancy Prevention Quiz
Objective:
Participants will identify effective methods of pregnancy
and STI prevention.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Methods of Pregnancy and STI Prevention” handout.
Answer Key
1.
Level II/III
Note: This quiz can
be done as a pre- or
post-test exercise.
If you are under 16 years of age, you need parental consent to obtain
birth control pills.
FALSE. There is no minimum age to prescribe contraception and youth are
under no legal obligation to inform their parents that they are being
prescribed/using contraception.
2.
Condoms can be used with water-based lubricants.
TRUE. Oil or petroleum based lubricants (e.g. Vaseline or hand lotion)
cause condoms to break.
3.
Spermicides, when used alone, are an effective method of birth
control.
FALSE. However, spermicides, when used with condoms, are 98%
effective.
4.
Oral contraceptives (the birth control pill) should be taken at the
same time every day.
TRUE. To maximize efficacy, the pill should be taken at the same time
every day.
5.
Women must receive Depo-Provera injections every 6 months.
FALSE. Women must receive Depo-Provera injections every 3 months.
6.
Spermicides are an effective protection against the AIDS virus.
FALSE. Condoms provide the best protection against HIV. The only 100%
effective way to avoid HIV is to abstain from high-risk activities.
7.
It is possible for a woman to become pregnant if she has vaginal
intercourse during her period.
TRUE. It is unlikely that a woman would become pregnant during her
period. However, some women with shorter menstrual cycles ovulate
earlier than day 14, and sperm can survive 4-7 days inside a woman’s
body.
8.
Air must be squeezed out of the tip of the condom before putting it
on.
TRUE. This helps to decrease the chance of breakage.
9.
Non-lubricated condoms work best for oral dams.
TRUE. Lubricated condoms have a medicinal taste.
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10.
Withdrawal is an effective method of birth control.
FALSE. Withdrawal is not a reliable method.
11.
Emergency contraception (the Morning After Pill) can be taken up to
five days after unprotected vaginal intercourse.
TRUE. However, the earlier a woman takes emergency contraception, the
more effective it is.
12.
Douching is an effective method of birth control.
FALSE. Douching is not effective at all.
13.
A condom can be used more than once.
FALSE. A condom can only be used once and should be discarded after
use.
14.
Abstinence is 100% effective in the prevention of STIs and pregnancy.
TRUE. However, if having vaginal or anal intercourse, it is important to use
condoms each and every time, especially if “doubled up” with the pill,
spermicides, or Depo-Provera.
15.
The vaginal ring can be obtained from a physician.
TRUE. A physician at a clinic or physician’s office must prescribe the
vaginal ring.
16.
The patch can be worn for up to one year.
FALSE. One patch is worn each week for three weeks (the forth week is
patch-free allowing a period to occur.)
17.
Birth control is not a guy’s responsibility because he’s not the one
who could get pregnant.
FALSE. Guys should also be knowledgeable about the range of methods
of pregnancy and disease prevention in order to support their partner’s
effective use of a method and to effectively decrease the risk of STIs and
unintended pregnancy.
312
Handout
Methods of Pregnancy Prevention
True or false…
1. _______
If you are under 16 years of age, you need parental consent to obtain birth control pills.
2. _______
Condoms can be used with water-based lubricants.
3. _______.
Spermicides, when used alone, are an effective method of birth control.
4. _______.
Oral contraceptives (the birth control pill) should be taken at the same time every day.
5. _______.
Women must receive Depo-Provera injections every 6 months.
6. _______.
Spermicides are an effective protection against the AIDS virus.
7. _______
It is possible for a woman to become pregnant if she has vaginal intercourse during her
period.
8. _______.
Air must be squeezed out of the tip of the condom before putting it on.
9. _______.
Non-lubricated condoms work best for oral dams.
10. _______
Withdrawal is an effective method of birth control.
11. _______
Emergency Contraception (Morning After Pill) can be taken up to five days after
unprotected vaginal intercourse.
12. _______
Douching is an effective method of birth control.
13. _______
A condom can be used more than once.
14. _______
Abstinence is 100% effective in the prevention of STIs and pregnancy.
15. _______
The vaginal ring can be obtained from a physician.
16. _______
The patch can be worn for up to one year.
17. _______
Birth control is not a guy’s responsibility because
he’s not the one who could get pregnant.
313
Considering Pregnancy Risk and Impact
Level II/III
.
Participants will gain an understanding of the significant
risk of pregnancy associated with having unprotected
intercourse, will increase their knowledge of the
effectiveness of various methods of contraception, and
will articulate the effects a pregnancy would have on their
lives, relationships, and plans.
Note: Cards for
Depo-Provera and
choosing not to
have intercourse
are not necessary,
as pregnancies
would not be
expected if these
methods were used
for one year.
Structure:
Time:
About 30 minutes.
Materials:
index cards, coloured markers, “Pregnancy Impact”
handout
Preparation
Prepare a set of 39 index cards. Designate the index cards as follows:
4 cards with a blue circle drawn upon it. (These represent the number of
people who would experience a pregnancy after one year of using condoms only,
for contraception.)
1 card with a green circle (hormonal methods: birth control pills, the
patch, the vaginal ring).
1 card with a purple circle (condom and spermicide).
6 cards with an orange circle (spermicide only).
27 cards with a red circle (sex without any protection).
The differently coloured cards illustrate the number of pregnancies that would be
expected to occur in a group of 30 people, after one year of typical use of various
methods of contraception. See the ‘Chances of Pregnancy’ chart for
percentages of women experiencing accidental pregnancy while using specific
methods, as well as the numbers of women becoming pregnant. (Numbers of
women have been calculated so that this activity can be used with groups of 15
or 20.) To accommodate the size of your group, use the percentage value to
modify these calculations.
Procedure
1. Tell participants that this activity will help them to understand the number of
pregnancies that would occur in the group through the use of various
methods of pregnancy prevention. Tell them that, for the purposes of this
activity, you’ll be making the assumption that everyone in the class is having
intercourse, even though in reality, many teens are not. (MOST grade 7, 8, 9
& 10 students have never had intercourse.) Remind the group that you are
fully aware of the fact that, though young men do not get pregnant, they
share the responsibility for a pregnancy. Young men are greatly affected
when their partner becomes pregnant.
2. Distribute all of the cards with coloured circles. Some participants will have
more than one card.
.
314
3. Discuss each method of pregnancy prevention in turn. Begin by asking
everyone with a blue circle on their card to stand. Tell the group: “This is
how many people in this group would experience a pregnancy after using
condoms only as protection for one year.”
Remind the group that the number of people standing reflects the failure rate
(in terms of pregnancy prevention) of condoms with typical use (meaning
that people may not use the method correctly or consistently for every act of
intercourse). Methods of pregnancy prevention can be more effective if used
perfectly. (We are, however, human). Ask those standing to sit down again
before you address the next method of contraception.
4. Continue with the other methods in the same manner:
Blue: Male condoms only (described above).
Orange: Spermicide only.
Purple: Male condoms and Spermicide.
Green: Hormonal methods: birth control pill, the patch, the vaginal ring.
Red: Vaginal intercourse with no protection
Depo-Provera. (Since no one would stand up, tell the group that there would
be no pregnancies in the group if they all used Depo-Provera for one year.)
Choosing not to have vaginal intercourse. (Since no one would stand up, tell
the group that there would be no pregnancies if they all chose not to have
vaginal intercourse for one year. Be sure to remind participants that there is a
chance of pregnancy if the male ejaculates near the vaginal opening of his
partner.)
5. Suggest to the group that you’d like to give them an opportunity to think
about what a pregnancy would mean in their own lives. Distribute the
“Reactions to Pregnancy” handout. Give participants 5 – 10 minutes to
complete the worksheet.
6. Ask volunteers to share their responses to each question on the handout. Be
sensitive to the possibility that some participants may have already
experienced a pregnancy or “pregnancy scare.”
7. While facilitating the discussion, be mindful of these points:
Both young men and young women are strongly affected by a pregnancy,
regardless of whether or not the pregnancy continues.
Most people who choose to have an abortion do so after much thought, and
they do not take the decision lightly.
Research indicates that having a child during one’s teen years is associated
with lower levels of education, employment, and enjoyment of life. Children of
teen parents may also have more difficulties, as their young parents struggle
with their own problems, often on a low income.
Acknowledge that teen parents who remain in school can find it very difficult
to juggle the demands of school and the demands of their young child.
(Those who succeed often say that this is extremely stressful.)
8. Conclude by focussing on the dreams and plans that participants have for
the future. Point out how much easier it would be to achieve their goals if
they do not have to be concerned about raising a child while still a teen.
315
Chances of Pregnancy. (Figures represent the percentage of women
experiencing an accidental pregnancy, after using a particular method of
contraception for a year.) “Numbers who would experience a pregnancy” have
been rounded off to the nearest whole number for clarity, to avoid “0.3” of a
person experiencing a pregnancy. Reference: Contraceptive Technology, 16th
Edition, Hatcher, Robert A. p. 113
Method of
contraception
% of women
experiencing a
pregnancy
after one year
of use
# that
would
experience
a
pregnancy
(group of
15)
# that
would
experience
a
pregnancy
(group of
20)
# that would
experience
a pregnancy
(group of
30)
Oral
contraceptive
(birth control
pill)
3% (3 women
in 100)
0
0
1
Depo-Provera
.3% (less than
1 women in
100)
0
0
0
Spermicide
only
21% (21
women in 100)
3
4
6
Vaginal Ring
1% (1 woman
in 100)
0
0
0
The Patch
1% (1 woman
in 100)
0
0
0
Female
condom only
21% (21
women in 100)
3
4
6
Male condom
only
12% (12
women in 100)
2
2
4
Condom &
spermicide
3% (3 women
in 100)
0
1
1
Unprotected
sex
90% (90
women in 100)
14
18
27
Choosing not
to have
intercourse
0
0
0
0
316
Handout
Pregnancy Impact
You (or your partner) just received a positive pregnancy test.
Take a few minutes to think about how this would affect you
by answering the questions below. (You will not have to hand
this in.)
1. What is your immediate reaction?
What are you feeling?
2. Whom will you tell?
3. What decisions will you have to make?
4. Where can you go for help?
5. How could this affect your relationship with your partner?
6. How will your life change in the next year?
7. I don’t want to have a child right now because I want to…
317
Field Assignments
Level II/III
Objective:
Participants will practice gathering information and
resources from different sources.
Structure:
Individuals or pairs.
Materials:
“Visit or Call a Clinic” handout, “Buying a Condom”
handout
Procedure
Note: Educators are
well advised to call
clinics first to inform
clinic staff of the
assignment.
1.
Instruct participants to, individually or in pairs, visit or call a clinic or go
on a condom hunt (disseminate appropriate handouts).
Visit or Call a Clinic
This approach allows participants to see for themselves what a clinic is
like, and to ask questions. A visit under these “non-stressful”
circumstances will help participants overcome inhibitions that could
prevent them from calling or visiting a clinic (or doctor’s office) when they
need advice in the future.
Condom Hunt
A field trip to a local pharmacy can be a good way of providing
participants with information about the types of condoms available, cost,
etc.
2.
Follow-up by asking:
How did you feel completing the assignment?
How easy/difficult was it? If you had to do the assignment a second
time, would it be easier or harder?
Ask participants to make a brief presentation (5 minutes) to the
group to share what they learned.
You may want to put all of the handouts in a binder for participants’
future reference.
Extension
Design a poster encouraging young people to use the service. Illustrate the
location, setting, staff, and range of services offered.
318
Handout
1.
Name of clinic:
2.
Address and phone number of clinic:
3.
Clinic hours:
4.
The following services are available at this clinic:
.
Birth control ____
Prenatal care _____
STI testing ____
Pregnancy tests ____
Distribution of condoms ____
STI treatment ____
HIV test ____
Support groups ____
Counselling ___
HIV counselling ___
Referral to other agencies ____
5.
What is the clinic’s policy on confidentiality?
6.
The following languages are spoken at this clinic:
7.
I felt the following level of comfort in this clinic (include such things as friendliness and helpfulness of
staff, décor, magazines/pamphlets available in waiting room, etc.):
1
2
3
4
Very comfortable
Comfortable
Somewhat uncomfortable
Uncomfortable
8.
I would/wouldn’t tell a friend to visit this clinic for an examination/consultation about protection. Write
two sentences telling why or why not.
9.
Something I learned at this clinic:
.
(Adapted with permission from Gordon, Bill (1995) Relationships Skills for Healthy Sexuality. Edmonton: Alberta Learning.)
319
Handout
Buying a Condom .
Name of the store: ____________________________________
1.
Where were the condoms displayed?
____ not displayed
2.
Store hours: __________________
___ behind counter
Were the condoms easy to find?
___ on shelves
___ yes
___ other: _____________
___ no
b) Why or why not?
3.
Did you have to ask someone where to find the condoms?
___ yes
___ no
b) If yes, how did s/he react?
4.
Information about brand names and types displayed:
Brand Name
5.
Type (lubricated, male/female,
spermicide, ribbed…)
Price
Other information
How would you feel if, at some time in the future, you purchased condoms from a location like the one
you visited?
.
(Adapted with permission from: Social Program Evaluation Group (1994) Skills for Healthy Relationships. Queen’s University, Kingston:
Author.)
320
Red Light/Green Light .
Objective:
Participants will identify sexual activities that can transmit
STIs/HIV.
Participants will identify ways to decrease the chance of
becoming infected with STIs/HIV.
Structure:
Large group.
Time:
20-30 minutes.
Materials:
Construction paper to make a red, a green, and a yellow
circle (about 8’’ in diameter), large index cards, markers,
tape. Facilitators can also make a large “traffic light” from
construction paper, containing a red, a green, and a
yellow light. “Red Light / Green Light” facilitator’s guide.
Level II/III
Note: STIs stands
for sexually
transmitted
infections,
sometimes also
referred to as STDs
or sexually
transmitted
diseases.
Procedure
1. Brainstorm with the large group, asking them for ways that people can
demonstrate love and sexual feeling. With a marker, have a volunteer record
the responses on index cards.
For example:
2.
kissing
holding hands
writing letters
massaging
cuddling
doing things
together
having unprotected
vaginal intercourse
sending e-mails or
letters
using latex
condoms for vaginal
or anal intercourse
talking
performing oral sex
being naked
together
doing mutual
masturbation
petting
showering together
having unprotected
anal intercourse
buying gifts
having dinner
Stick the coloured circles up on the board, about 45cm (18”) apart. Explain
the meaning of each of the colours as follows:
Red represents activities that are high risk for transmitting STIs/HIV.
Yellow is for activities that pose some risk for the transmission of STIs/
HIV.
Green indicates activities that do not present any risk for the transmission
of STIs/HIV.
.
321
4.
3.
Distribute the
4.
cards, listing the various ways to show love and sexual feeling, to
participants. Ask them to come up to the board (perhaps two at a time)
to tape their card under the appropriate risk category. Some
participants may feel very uncomfortable having to categorize certain
sexual activities. Be sensitive to the needs of individual participants by
giving “less threatening” cards to those who may find aspects of this
activity embarrassing.
Involve the group in the process, asking for feedback as the cards are
placed, e.g. “Would you consider oral sex a no risk activity?” Correct any
misconceptions that participants may have (see “Facilitator’s Discussion
Guide”; and/or fact sheets provided in the “Resources” section).
Sample: Categorizing the activities from group brainstorming:
Green: No Risk for STIs/HIV transmission
kissing
having dinner
writing letters
massage
cuddling
doing things together
talking
petting
mutual masturbation
buying gifts
sending emails
holding hands
showering together
Note that there are many more activities in the “No Risk” category!
6. Once all cards have been placed, conclude by asking the group to
brainstorm ways to make some activities safer. Ask them to think about the
reasons people may not always practice safer sex, and to come up with
ideas for ways to overcome these obstacles to safer sex (see facilitator’s
discussion guide).
322
Red Light/Green Light Facilitator’s Guide
This guide will provide the facilitator with some basic information about the
principles of transmission of HIV and STIs. For more detailed information, please
refer to HIV and STI fact sheets located in the “Resources” section of this
Sourcebook.
HIV
Two conditions are needed for the transmission of HIV:
1. A body fluid with sufficient numbers of virus particles
2. A way for the virus to get from an infected person into the bloodstream of
another person.
Some conditions may also make it easier for HIV transmission to occur, such as
the inflammation and irritation caused by STIs. Irritation caused by the use of
spermicides may also increase the risk of HIV infection.
Body fluids that contain enough virus particles to cause an infection in another
person include blood, semen, pre-semen, vaginal secretions, and breast milk.
HIV in these fluids could enter the bloodstream of another person through sex
(anal, oral, and vaginal), sharing needles or other injecting equipment, or from a
mother to her baby (before or during birth, or during breastfeeding).
Activities considered “High Risk” for passing on HIV:
anal or vaginal intercourse without a condom
sharing needles for injection (or sharing other injecting equipment)
Activities posing “Some risk” for HIV transmission:
performing oral sex on a partner
anal or vaginal sex with a condom
Activities with “No Risk” for HIV transmission:
kissing, massage, touching partner’s genitals (as long as there are no cuts,
etc. on the hands)
using new, sterile needles for injection (no sharing of other injecting
equipment)
performing oral sex with a latex barrier
Other Sexually Transmitted Infections: (chlamydia, gonorrhoea, herpes,
human papilloma virus, syphilis, hepatitis B and C)
These organisms do not necessarily have to enter the bloodstream to cause
infection (although Hepatitis B and C do). For most, contact between the mucous
membranes of two people is all that is required. Mucous membranes describe
the moist, delicate tissue that lines body openings like the eye, mouth, nose,
vagina, penis, and anus. This tissue is very thin and has less protection from
pathogens than does skin on other parts of the body. Intimate contact is required
to transmit STIs (anal, oral, or vaginal sex), and penetration is not always
necessary to pass on an STI.
323
Intimacy and Affection
Level II/III
Objective:
Participants will identify ways of showing love, intimacy,
and affection that do not involve a risk of pregnancy or
STI.
Structure:
Large group.
Time:
25 minutes.
Materials:
Blackboard or flipchart.
Procedure
1. Introduce the activity by asking participants why we have sex (e.g.
reproduction, pleasure, to show love/feeling, etc).
2. Point out that there are many ways to express intimacy and love. Some
involve physical intimacy, and others involve emotional intimacy. Couples
can show their affection for one another without risk of pregnancy or STIs.
3. Ask participants to brainstorm ways to show love and sexual feeling. List
these on the blackboard or flipchart. For example:
Holding hands
Masturbation
Hugging
Anal intercourse
Talking
Petting
Letters or e-mails
Touching
Exchanging phone calls
Oral sex
Massage
Mutual masturbation
Kissing
Cuddling
Vaginal intercourse
Watching a romantic movie
4. Lead discussion by asking the following:
What is affection? (fondness) Intimacy? (physical and/or emotional
closeness) Love? (deep affection, passion)
Are some activities more intimate than others? (Point out that people
view intimacy differently, e.g. some view kissing as more intimate
than others do.)
Which activities are least intimate? Most intimate?
Which behaviours encourage the development of emotional intimacy?
Must you have vaginal or anal intercourse in order to be intimate with
your partner?
Is it necessary to love someone in order to be intimate?
How do the media portray intimacy? Is its depiction realistic?
5. Conclude by pointing out that there is a range of sexual intimacy, not all of
which involves vaginal or anal intercourse. While we often think that
intercourse is the ultimate goal of all sexual activity, there are other ways of
showing intimacy that will satisfy both partners, while avoiding STIs and/or
pregnancy. In fact, there is no “goal” with sexual activity.
324
Attitudes About Condoms .
Objective:
Participants will identify ways to negotiate condom use.
Structure:
Time:
20-30 minutes.
Materials:
“Unfinished Sentences About Condoms” handout,
“Summary of Condom Comments” handout,
“Overcoming Embarrassment” discussion guide.
Procedure
1. Introduce the activity by discussing the importance of having a positive
attitude toward the situations that we encounter in our daily lives. Someone
who thinks positively is more likely to act and to succeed. Having a positive
attitude toward condoms makes it more likely that a person will use a
condom and use it correctly. Explain that, as a group, you’ll also consider
ways to overcome the embarrassment some people feel about buying and
using condoms.
2. Distribute the “Unfinished Sentences” handout. Ask participants to take a
few minutes to complete it individually.
3. Divide the group into smaller groups of 3-6, and give each group a
“Summary of Condom Comments” handout. Ask them to discuss the
comments they made on the “Unfinished Sentences” handout, and to record
the positive comments in the summary box.
4. Have the groups select three negative comments, and consider how to
substitute a positive comment for each negative one (by following the
example on the handout).
Level II/III
Note: Depending on
the age of your
group, many
participants will
have never had
intercourse. Remind
participants that the
activities in this
program can
prepare them for the
future, and can help
people who are
presently having
intercourse to
protect themselves.
Participants may
need to imagine
how they would feel
in a certain
situation.
5. Reconvene as a larger group once the smaller groups have completed their
tasks. Record the collective responses on the board or on flip chart paper.
Ask the groups to report on the comments they collected (positive and
negative), and on how they substituted positive comments for the negative
ones.
6. Have a brainstorming session with the large group (following the Overcoming
Embarrassment worksheet) to determine how to become more comfortable
with condoms, and how to get them. Worksheet follows, with responses you
may receive (or may wish to draw out) from the group. Record responses on
the board or flip chart paper, as you wish.
Extension
Ask the smaller groups to imagine that a school/youth centre has recently
installed condom machines in the washrooms. Have participants brainstorm
ideas for a slogan, to be displayed next to the condom machines, saying
something positive about condoms. Share the slogans of the smaller groups with
the larger group.
.
(Adapted with permission from: Social Program Evaluation Group (1994) Skills for Healthy
Relationships. Queen’s University, Kingston: Author.)
325
Handout
Unfinished Sentences About Condoms
Write an ending you think would best complete each sentence.
1. When it comes to condoms, males believe
2. When it comes to condoms, females believe
3. Buying condoms can be
4. Asking a partner to use a condom would be
5. Using a condom is
6. Storing a condom is
7. Personally, I think condoms are
326
Handout
Summary of Condom Comments
Comments
Negative Comments
e.g. Condoms are really messy
Negative Comments
Substituted by A Positive One
Actually, using condoms can be less
messy because semen is contained in
the condom.
327
Discussion Guide
Overcoming Embarrassment
These questions can guide your discussion or brainstorming session. Also included are some responses
you may get from your group, and items that you may wish to draw out of the group. These potential
responses are by no means exhaustive: together, you and your group may have many more to add!
1. List ways that would help some people overcome the embarrassment they feel about purchasing and
using condoms.
Buy them from a vending machine.
Have a friend buy them.
Go to a store where no one knows you.
Get free ones from a clinic.
Practice using one by yourself.
Go to the store when it’s not busy.
Check out a store before you plan to buy there, so that you will know where to look, and won’t
spend too much time searching.
2. How can people get condoms, other than going to a store?
Clinics, youth drop-in centres (identify where they are in your community)
Vending machines (where are these located locally?)
Friends
3. Where can people get free condoms?
Clinics, youth drop-in centres (again, stress actual agencies in your community)
Youth serving agencies, shelters
Needle exchange programs
4. Where could someone get a condom after regular store hours?
Convenience store (where? Which ones?)
Some gas bars
Vending machines in some restaurant washrooms
328
Objections to Condoms
.
Level II/III
Purpose:
Participants will identify ways to negotiate condom use.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Objections to Condoms” handout.
Procedure
1.
Introduce the activity by saying that you’d like to talk about how people
can deal with objections that their partners may have to condoms.
Considering how to respond to these objections beforehand can make it
easier for someone to stick to their decision to use condoms.
2.
Distribute the “Partner Objections to Condoms” handout. Have
participants read through it, and match up the lettered responses to the
“objections” that they feel would be appropriate. If they have time, they
can list a few objections and/or responses of their own.
3.
When everyone has completed the handout, reconvene the group, and
ask for volunteers to share their responses to each objection. Ask if
anyone came up with additional objections or responses.
4.
Conclude by pointing out that it is often helpful to anticipate possible
objections in order to communicate assertively and effectively.
.
Relationships. Queen’s University, Kingston: Author.)
329
Handout
Objections to Condoms
Read through these objections to condom use and the possible responses below. Record the letter (or
letters) of appropriate responses to these objections on the line beside each objection. If you have time,
list a few objections and/or responses of your own on the back of this sheet.
Possible Objections:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Don’t worry; I’m on the pill.
I’m clean; I don’t run around, and I don’t have any infections.
Condoms don’t feel good. It won’t be natural.
By the time you put a condom on, you’ve lost the mood.
I feel stupid buying condoms, and then trying to hide them from my parents.
I’d be embarrassed to use one.
Condoms are gross; they’re messy; I hate them.
Just this once; we hardly ever have sex.
I don’t have a condom with me.
They cost too much.
_________
_________
_________
_________
_________
_________
_________
_________
_________
_________
Possible Response(s) to Objections
A. Maybe I can help by keeping the condoms for you.
B. Once is all it takes to get pregnant or to get an infection.
C. I’d like to use a condom anyway. It protects both of us from infections we may not realize we have.
D. Let’s satisfy each other without having sex.
E. Let’s put sex on hold, until we have a chance to work out our differences.
F. We can buy them together.
G. Condoms may be a little awkward the first time, but it will get better.
H. I’ll get the condom – it’ll only take a few minutes.
I.
I think we could get used to condoms after a while. With a little imagination, it might even be fun.
J.
I can help pay for them, or we can get them for free at a clinic.
K. Millions of people are infected without knowing it. Isn’t it better to be
safe?
L. Maybe we’re not ready for sex, if we can’t talk about condoms.
M. Embarrassment never killed anyone.
N. I know how to turn you back on.
Can you think of any other objections that people may have? List them
here with a possible response:
Objection:___________________________________________________
Response:___________________________________________________
Objection:___________________________________________________
Response:___________________________________________________
330
Mountain Climbing
.
Objectives: Participants will increase their awareness of the barriers/
obstacles to safer sex and healthy choices, and will be introduced to
strategies that can be used to overcome barriers to safer sex.
Level II/III
Structure: Large group discussion with some small group work.
Time: About 30 minutes.
Materials: With coloured markers or chalk, draw a “mountain” on flip chart
or board. Using coloured paper, create outlines of “mountain climbers” and
“boulders” (e.g. cut out 4-inch circles). Prepare one climber for each
participant, and about half as many boulders. Blackboard or flipchart.
Procedure
1.
Describe the activity to the group:
“This activity is called ‘mountain climbing’. We want to get to the top of
this mountain because, at the top, there is a city with no HIV, no STIs,
and no unintended pregnancy. We’ll divide into small groups, and each
group will be given 3 ‘climbers’. To help our climbers get to the HIV, STI,
and unintended-pregnancy-FREE city, we’ll have to come up with ideas
and strategies for preventing HIV, STIs, and unintended pregnancy.”
2.
Divide the group into smaller groups of 3 or so. Distribute three or more
“climbers” to each group. Ask the groups to record a behaviour, a
choice, a feeling, or information needed to prevent HIV, STIs, or
unintended pregnancy on each “climber.” Also encourage participants to
include some individual or relationship qualities that would make it easier
for people to make healthy choices for themselves. Examples some
groups have come up with:
Condoms
Abstinence
Masturbating
Oral sex (does not eliminate risk of HIV or STIs but reduces it
significantly)
Communication
Using contraception
Having information about risks and prevention
Being assertive
Healthy self esteem
Love, caring about the person
3.
Give the groups a few minutes to label their climbers, and then ask a
representative from each group to tape their climbers somewhere on the
mountain while reading aloud what they’ve written on each one. Review
and discuss all the responses.
.
331
4.
Continue with the script:
“Now mountain climbing is not easy and sometimes a climber’s ascent
can be hindered by rock slides or other obstacles.” Hand out the
“boulders” (about one per small group). Ask the groups to think about
obstacles to safer sex or making healthy choices. (What would make it
hard to do what we must do to prevent HIV, STIs and pregnancy?)
Again, encourage participants to think broadly; to consider
characteristics of relationships or individuals. Some examples of
“boulders”:
No money for condoms, birth control
Drugs/alcohol
Having incorrect information, myths
Dishonesty, lying
Embarrassed to talk about condoms, etc.
Sexual feelings
Afraid to lose partner
Nervous about seeing a doctor about contraception
Afraid of partner, not able to speak up
5. When the groups are ready, have a member of each group tape their
boulders up on the mountain as well. Review each boulder and facilitate a
discussion about how the various obstacles may be overcome. If there is an
important “boulder” that you think has been missed, raise the issue. Record
the strategies the group has identified for dealing with the “boulders” on the
blackboard or flip chart.
6.
Conclude the discussion with a review of the choices people can make
to prevent HIV, STIs, and unintended pregnancy, the barriers that may
make it difficult to make healthy choices, and the strategies that can be
employed to overcome barriers to sexual health.
332
Six Big Lies About Sex .
Objective: Participants will reflect on sex and relationships, condom negotiation
and gender stereotypes when considering common lies partners tell each other
about sex.
Structure:
Large group.
Time:
45-60 minutes.
Materials:
“Six Big Lies About Sex” handout.
to
orgasm.
However,
there is
no danger
if he does
not reach
orgasm
each time
he gets
aroused
and has
an
erection.
Procedure
1. Set up two chairs next to each other.
Level III
2. Select four volunteers to come up to the front. Have two of the volunteers sit
down in the chairs, and have the other two volunteers stand behind each chair.
3. Explain that the two teens sitting down will role-play that they are two sexual
partners.
The two teens who are standing will represent the minds of the teens sitting in
the chairs.
4. Read a line from the list below, and ask teens to improvise a brief dialogue
where one partner is telling the other a lie related to their sexual relationship. The
lie must include the line. The “minds” should speak throughout the skit to reflect
what each partner is really thinking.
• “If you don’t, I’ll get blue balls.”
• “I’m a virgin.”
• “The condom is too small.”
• “Of course I had an orgasm.”
• “I love you. Let’s have sex.”
• “I’m pregnant.”
5. When the improvisation is finished, ask for another set of volunteers, and
repeat the process for the remaining five lines on the list.
6. Distribute the “Six Big Lies About Sex” handout and ask the group to read the
article.
7. Lead a brief discussion by asking the following questions:
What is “blue balls”? What does it imply if a guy says he has blue balls when
his partner “stops” during sex play? Is this type of suggestion a lie? Why
(not)?
o
The discomfort men can feel when they have been sexually
aroused but have not ejaculated is sometimes called "blue balls."
Although blue balls can feel uncomfortable, the discomfort goes away
fairly quickly. If a man is extremely uncomfortable, he can masturbate
.
Reprinted with permission from Planned Parenthood ®Federation of America, Inc.© 2006 PPFA. All
rights reserved.
Reece, Tamekia (2004) Six Big Lies About Sex.
333
Why might people lie and say they are virgins when they are not? Why might
people lie and say that they are not virgins when they are? How does this
issue differ for girls and guys?
o
Many people lie about virginity. Some girls might lie about being a
virgin to make their partners feel “special,” and because they’re afraid
of getting a bad reputation. On the other hand, guys might lie and say
they aren't virgins when they really are. There's a strong double
standard when it comes to virginity — it says that girls who have sex
are sluts but guys who have sex are studs. Of course, neither is true,
but these gender stereotypes put a lot of pressure on both girls and
guys to conform to them.
What are some lies people might tell to avoid using a condom? How can you
respond to these lies?
o
Many people tell lies to their partners to avoid using a condom.
Even though the ring at the end of some condoms can be constricting
for some very large penises, condoms are available in a variety of
sizes and can accommodate even the largest penis. And being
allergic to latex, even if it’s not a lie, is not a valid excuse either.
People who have allergies to latex can use female condoms or male
condoms that are made out of polyurethane.
Why might people lie about having an orgasm? Is it healthy in a relationship
to lie about this? Why (not)?
o
Some women lie about having an orgasm to spare their partners’
feelings. But when a woman lies, her partner doesn’t know that
anything is wrong. The truth is a lot of girls have trouble having an
orgasm when they have sex play with a partner. Communication is
key — girls should let their partners know that they haven't reached
orgasm so their partners can help them get there, too.
Do people ever say “I love you” just to coerce others to have sex with them?
Is this OK? Why (not)?
o
Saying “I love you” just to get sex is hurtful. Having sex with
someone is about doing what's right for you whether she or he says
the love word or not. We all have sexy feelings. But we don't always
have to have sex when we have them.
Why might someone lie about being pregnant? Is this OK? Why (not)?
o
Faking a pregnancy to trap a guy is wrong and deceitful.
What does it say about your relationship if you feel that you have to lie?
Why is honesty and communication essential to healthy relationships?
o
No one can read your mind. Communicate clearly and be honest.
If you have to lie, maybe you're with the wrong person. Lies, no matter
how small, hurt and lead to distrust. Honesty is an essential part of a
healthy relationship.
334
Handout
Six Big Lies About Sex
by Tamekia Reece
"If we don't, I'll get blue balls." "I'm a virgin." "The condom is too small." Sound familiar? More than likely,
you've been told at least one of those things before. Or were you the one who told one of those little lies to get
your partner to do something or think a certain way? Now that you're a little older and wiser — and you've
figured out that sex doesn't have much to do with birds or bees — it's a good time to be chatting "Everyone
tells small lies in their relationships," says April. She's right — most people do. But small lies can lead to big
lies, and just like a big lie, a small lie can destroy a relationship.
Little Lies
Lie #1: "If you don't, I'll get blue balls."
While it's true that guys may have some discomfort if they're aroused and they don't ejaculate, it won't kill
them, it won't even hurt much, and the feeling goes away pretty quickly. Melanie says, "Whenever a guy tells
me the 'blue balls' story and I'm not in the mood, I tell him to get rid of it himself." He does have a hand, and
there's always a cold shower!
Lie #2: "I'm a virgin."
Lies about virginity. People lie to friends, parents, and even boyfriends and girlfriends. "I tell guys I'm a virgin
so they'll feel special and I don't get a bad reputation," says Brenda. On the other hand, guys might lie and
say they aren't virgins when they really are. There's a strong double standard when it comes to virginity — it
says that girls who have sex are sluts but guys who have sex are studs. Of course, neither thing is true, but
these gender stereotypes put a lot of pressure on both girls and guys to conform to them.
Bigger Lies
Lie #3: "The condom is too small."
Even though the ring at the end of some condoms can be constricting for some very large penises, condoms
can accommodate even the largest penis. Some guys use this fib about size to avoid strapping on the latex.
Tony takes it even further: "I tell girls I'm allergic to condoms." Charlotte says, "I believed my boyfriend when
he said he was allergic. Then I got gonorrhea." 'Nuff said.
Lie #4: "Of course I had an orgasm."
Meagan laughs, "I say I had an orgasm because I don't want to hurt his feelings. It takes too long." She may
spare her boyfriend's feelings, but when a woman lies, her partner doesn't know anything's wrong. You have
to either continue lying (and continue missing out) or 'fess up. The truth is, a lot of girls have trouble having an
orgasm when they have sex play with a partner. Communicating with a partner is key — girls should let their
partners know that they haven't reached orgasm so their partners can help them get there, too.
Even Bigger Lies!
Lie #5: "I love you. Let's have sex."
Love. It can feel so good at times and so painful at others. But it may be most hurtful when it's used to get
sex. John admits, "I've told girls I love them, to have sex. It usually works, but I always feel like a jerk
afterwards." The fact is that having sex with someone is about doing what's right for you whether she or he
says the love word or not. We all have sexy feelings. But we don't always have sex when we have them.
Lie #6: "I'm pregnant."
Faking a pregnancy to trap a guy can only cause hurt and anger. "I said I was pregnant to get him to stay with
me," says Erica. And he did. But not for long. "I could only keep it up for so long. Once he found out, he broke
up with me anyway. Now he hates me."
Caught
One lie usually leads to others. Small details are bound to be forgotten. A slip here, a slip there and what?
You're caught. "He told me he never had oral sex, so I thought he'd love me more if I did it," says Amber.
"Then I found out this girl did it to him and his friends at a party, just days before I did. I felt so stupid."
335
Lessons Learned
The one thing most people who have told lies have in common is that they often hurt themselves, get caught,
and lose out on worthwhile relationships with other people. So you don't have to learn the hard way, here are
a few suggestions:
•
•
•
•
No one can read your mind. Communicate clearly.
If you have to lie, maybe you're with the wrong person.
Lies, no matter how small, hurt and lead to distrust.
Honesty is an essential part of a healthy relationship. Without it, a relationship is doomed.
So before you tell your partner that little white lie, think about it. Is it worth it?
336
Safer Sex Role Playing .
Level III
Objective:
Participants will identify strategies for negotiating safer
sex practices.
Structure:
Pairs' activity.
Time:
45 minutes.
Materials:
“Role play cards” handout.
Procedure
1.
Explain: Knowing what is best for you and your health, and doing
something about it, can be two different things. Even though condom use
can prevent the transmission of STIs, including HIV infection, raising the
subject can be difficult. However, it is very important that you talk with
your partner about condoms and safer sex. An open and honest
discussion can protect you and correct some common
misunderstandings.
In this activity, we are going to practice our skills in negotiating safer sex
with friends and partners. You will be performing role-plays of situations
in which you might find yourself someday. This will give you an
opportunity to practice handling a variety of situations.
2.
Define role-playing: Role-playing is a technique that can help you learn
what it feels like to be someone else or to practice how to handle a
situation that is new, difficult, or stressful. You should do your best to
feel, sound, and behave like the person whose role you are assigned to
play. Role-playing is a lot like acting, but the situations are more realistic,
and you are trying to behave in a way that will help you and everyone
else to learn. It is important to try to follow some guidelines when you do
role-plays.
3.
Divide participants into pairs/teams and give participants role-plays to
do. Inform participants that they should try to do the following in the roleplays:
Say “no” to unsafe behaviour in a positive and assertive way.
Explain why you want to be safe.
Provide safe alternatives, to show that you still want to be intimate
and have a relationship with this person.
Talk openly about feelings.
Note: Your job is to be sure that important issues are addressed and that
participants feel that they can effectively use their skills. Provide suggestions and
help as needed. Do not allow disagreement to continue for too long or allow anticondom roles to win. You might have participants repeat the role-play showing
alternatives, let the audience help out, or play the role with one of the players. It is
important that participants practice communicating, even when the situation is
difficult. In real life, one of the hardest things to do is to fully explain yourself and to
be understood. You can also rotate couples or have couples switch roles.
.
(Adapted with permission from: Jemmott, Loretta Sweet, Jemmott, John B. and McCaffree,
Konstance A. (1999) Be Proud, Be Responsible! New York: Select Media.)
Note: There are three
ways to do the roleplays, depending on
the maturity level, the
numbers, and the
ability of the pairs to
work together.
Option 1: Choose one
pair, read the
situations to the
players, and have
them act out the
conversation in front
of the class. After the
role-play, the
audience will
comment on what they
saw happening and
suggest how things
might have worked
better.
Option 2: All
participants are
paired, and each pair
is given a role-play to
do, all at the same
time. Afterwards, the
facilitator encourages
each group to discuss
what happened and
what the players
thought should have
happened.
Option 3: Break the
participants into two
teams. One member
of each team will act
in the role-play.
Encourage the
members of the team
to “coach” their team
members on how to
respond. The actors
will practice talking to
a partner in a role-play
situation. Give teams
a few minutes to
decide how they will
perform their role-play.
If the group can
handle it, use option
2, which involves
more participants
and gives them all
practice
communicating. If
things are likely to
get out of hand, use
option 1 or option 3.
337
4.
At the end of each role-play, ask participants the following:
(Ask the role players) How did you feel about the situations that you
were in?
(Ask the group) Do you think what you saw happening was realistic?
(If it is not realistic to them, then encourage them to talk about what
would be and how they would practice safer sex in that situation.)
How was safer sex considered?
Was there poor communication or any misunderstanding?
How else might the situation be handled?
5.
Conclude by summarizing the entire activity with the following: “In doing
these role-plays, we had an opportunity to experience potentially
dangerous situations by pretending, in the safety of the classroom. Now
that you have excellent skills and have had lots of practice, you can
make sure that your future sexual behaviour, in real life, will be engaged
in responsibly. Knowing and practicing these skills will empower you to
always respect and protect yourselves, your family, and your community.
338
Role Play Cards
Role Play A: Tom and Jason
The goal of this role-play is for Tom to persuade Jason not to have sex, or to wait
until he is sober before involving himself in a sexual relationship.
Tom
You are at a party with your best friend, Jason.
You see him flirting with someone at the party. It looks like he’s interested in
having sex with the person.
You are concerned because he is high or drunk.
You know that he doesn’t have any condoms.
You know he’s had too much to drink to ask if his partner has one.
Persuade him to wait until he’s sober before involving himself in a sexual
relationship.
Jason
You have been drinking at a party and flirting with someone.
You can tell the person wants to have sex with you.
You really want to have sex also.
You have no condoms.
Tom suggests that you wait until you are more clearheaded before you have
sex.
Summarize Role Play A by saying:
“If you are out of control, or your friend is, get help. Alcohol and other drugs
decrease your inhibitions, which may make you do risky things.”
Role Play B: Cathy and Monique
The goal of this role-play is for Cathy to convince Monique to use condoms.
Cathy
Your close friend Monique is about to have sex with her new boyfriend.
Monique does not think she should be concerned about using condoms with
him.
She thinks that if she asks him to use a condom, she’ll lose him.
Encourage her to use a condom.
Monique
You have just started dating a new guy.
You really like him and think this might be serious.
You have decided to have sex with him.
You are afraid to discuss condoms with him because you think he might
dump you if you suggest using them.
Summarize Role Play B by saying:
“If you value your close friend and care about her you should help her make safe
decisions. You can even teach your friend how to make condoms pleasurable.”
339
Role Play C: Ann and Maurice
The goal of this role-play is for Ann to defend her stand and to persuade Maurice
that it is OK for them to stay together without being in a sexual relationship.
Ann
You and your boyfriend, Maurice, have been dating for three months.
You had sex with Maurice two nights ago.
You decided that, although having sex with Maurice was very special, you
are not ready for a sexual relationship at this time.
You care deeply for him and are afraid of losing him.
Maurice
You have a new girlfriend, Ann, and you just had sex with her.
You enjoyed having sex with her and want to continue a sexual
relationship.
You have been sexually active with other women.
All of your friends are having sex, and they are pressuring you to be in a
sexual relationship with your new girlfriend.
Summarize Role Play C by saying:
“Just because you said ‘yes’ before does not mean you have to say ‘yes’ again.
Abstinence is a choice that some people make to reduce their risk of STI/HIV
infection as well as unintended pregnancy. It is the only 100 percent effective
method. Further, there are alternatives to vaginal or anal intercourse (e.g. mutual
masturbation). If your partner truly cares, s/he will understand. If not, there are
others out there that will understand. It is your decision. Make the right choice
for you.”
Role Play D: Yvonne and Marc
The goal of this role-play is for Yvonne to talk Marc into using condoms and
persuade him that using condoms can be fun and pleasurable.
Yvonne
You and your boyfriend, Marc, are in his living room with the light down low.
You are starting to get physical.
You have just started to tell him that you want to use a condom.
He begins to get angry.
Your health is important to you, and you want to protect yourself.
You need to persuade him that sex can be just as pleasurable with condoms.
Marc
You and your girlfriend Yvonne are at your place and things are getting
intimate.
She starts to discuss condoms.
You get angry with her because you think she thinks you have been
sleeping around, and you haven’t.
You don’t think condoms could ever be pleasurable.
You believe that condoms will ruin the mood.
340
Summarize Role Play D by saying:
“Condoms don’t have to ruin sex. Some techniques can make condom use
pleasurable and fun. It is important to talk about condom use ahead of time,
before any touching or kissing begins. If something happens that you don’t like,
say so. The bottom line is for you to take responsibility and be comfortable and
confident in your choice to be safe.”
Role Play E: Clayton and Robin
The goal of this role-play is for Clayton to persuade Robin to use condoms
without offending her.
Clayton
You are going out with Robin and you want to talk to her about using
condoms.
You know she has had other boyfriends, and you want to protect yourself.
You also don’t want to lose her.
You are concerned about STIs, HIV, and pregnancy and want to use
condoms.
Robin
Your boyfriend, Clayton, just suggested that you start using condoms.
You are on the pill and you are offended that he must think you are dirty.
You think he is afraid to have sex with you without condoms.
You are also afraid that maybe he has been sleeping with someone else and
is afraid he might give you something.
Summarize Role Play E by saying:
“Which decisions would you make in this situation? Would you risk losing the
relationship in order to protect yourself? There are females that do not want their
partners to use condoms! Remember, the pill prevents pregnancy but not HIV or
other sexually transmitted infections. The responsible thing is to use latex
condoms if you have sex.”
Role Play F: Charles and Sheryl
The goal of this role-play is for Charles to abstain from sex with Sheryl.
Charles
You know that many guys your age are having sex.
Sheryl has been pressuring you to have sex.
Sheryl is older and much more experienced than you are.
You are scared and don’t want to have sex.
You want to talk to your partner about this, instead of just avoiding it and
acting macho in front of your friends.
341
Sheryl
Your boyfriend, Charles, has been acting funny every time you start going
further sexually.
To you, sex is fun.
Sex would establish the two of you as a real couple.
You are alone with him
You try to persuade him to have sex.
Summarize Role Play F by saying:
“Men don’t have to take advantage of every sexual opportunity that’s offered to
them. The responsible thing is to remember that it’s always better to take your
time, to know your partner, and when you’re ready, to protect yourself and each
other by using condoms. There are also alternatives to vaginal or anal
intercourse (e.g. mutual masturbation).”
Role Play G: Sonia and Felicia
The goal of this role-play is for Sonia to begin negotiating safer sex with her
partner.
Sonia
Recently, you’ve realized that you may be bisexual.
You’ve been sexually active with males in the past.
Lately you’ve had strong feelings for a female friend from school, Felicia.
The two of you have been intimate, but mostly just kissing and touching.
You can accept your bisexuality.
You’re not sure if you have to worry about STIs/HIV infection when two
women have sex.
You decide to talk to Felicia about your concerns, particularly safer sex.
Felicia
You have become intimate with Sonia
You’ve mostly just been kissing and touching.
Sonia has been intimate with males in the past.
You have been involved in other lesbian relationships for two years.
She’s concerned about STIs and HIV and unclear on how diseases can be
spread between two women or how to protect against them.
You begin to wonder if she’s worried she may be HIV positive.
Summarize Role Play G by saying:
“Everyone needs to practice safer sex: it is not who you are (gay, straight,
bisexual) but what you do (sexual behaviour) that counts. Protection (e.g. dental
dams for oral sex) should be used to protect against STIs and HIV.”
342
Role Play H: Gerald and Allen
The goal of this role-play is for Gerald to negotiate condom use with Allen while
keeping his relationship.
Gerald
You and your boyfriend Allen have been getting very close.
You have never had sex with him.
You both have had sex with other men before.
Allen has been pushing you to have sex with him.
Allen has never used condoms.
You want to have sex with him but not without using condoms.
You are concerned about STIs and HIV.
You decide to talk to Allen about your concern and insist that you use
condoms.
Allen
You and your partner Gerald have been getting very close.
You have never had sex with him.
You care about him and you want to have sex now.
You have never used condoms before because they don’t make sex feel
good.
Gerald is concerned about STIs and HIV and insists that you use condoms.
You are offended and refuse to use condoms.
Summarize Role Play H by saying:
pleasurable and fun. It is important to talk about condom use ahead of time,
before any touching or kissing begins. If something happens that you don’t like,
say so. The bottom line is for you to take responsibility and be comfortable and
confident in your choice to be safe.”
343
Role Play I: Kenny and James
The goal of this role-play is for Kenny to persuade James to use condoms.
Kenny
Your friend James and his girlfriend are getting close.
James tells you that he thinks he is ready to have sex with her.
Both of them have had sex with other people before.
You begin to discuss condom use with James.
James does not like the way condoms feel.
You try to persuade James that he should use condoms.
James
You are having a conversation with your friend, Kenny, about your girlfriend.
You and your girlfriend are getting very close.
You believe that you want to have sex with her now.
Both of you have had sex with other people.
Kenny begins to talk about using condoms.
You don’t like the way condoms feel.
You think that Kenny is crazy for even bringing up the topic.
You do not feel that you are at risk of any diseases from your girlfriend.
You do not want to use condoms.
Summarize Role Play I by saying:
pleasurable and fun. You can behave responsibly by helping your friends make
safe decisions.”
344
Module 8: STIs and HIV
Adolescents need to develop healthy behaviour
patterns to protect themselves from STIs and HIV.
This module contains ideas that will give participants
a solid understanding of how STIs and HIV are
prevented, transmitted, detected, and treated.
STIs and HIV
Sexually transmitted infections (STIs) 41 and the human immunodeficiency virus
(HIV) are of great concern to young people. After years of decline, reported
cases of Chlamydia and gonorrhea have been steadily increasing since 1997 in
Canada. Adolescents and youth continue to be disproportionately affected since
over half of the reported cases of Chlamydia are in the 15-29 year old age group
and females account for over two-thirds of the reported cases. 42 Left untreated,
these STIs can cause sterility. Similarly, the 15-29 years old age group
accounted for about 64% of the total reported cases of gonorrhea. 43 The
potential for HIV, then, remains significant among young Canadians since STIs
and HIV often coexist and STIs likely increase the efficacy of transmission of
HIV. 44
Level II and level III activities 45 will give participants a solid understanding of how
STIs and HIV are prevented, transmitted, detected, and treated.
Teaching Tips
This module should not be taught in isolation because it provides information
only. To help motivate and support behaviours that prevent STIs and HIV,
supplement your lesson plans with safer sex activities from the Contraception
and Safer Sex module and communication skill-building activities from the
Relationships, Communication and Decision-Making module. For example, it
may be worthwhile to revisit the activities that deal with condom use. While
abstinence is the only 100% effective method for preventing STIs/HIV and
unintended pregnancy, young people should be informed of the effectiveness
of condoms. While condoms do not provide 100% protection against STIs,
“there is clear evidence that consistent use of latex condoms significantly
reduces the risk of STI and this is particularly the case for HIV/AIDS.” 46
Many educators like to use videos for STI/HIV education. If you use a video,
make sure there is sufficient time left over for discussion.
Young people like guest speakers. Contact your local AIDS service
organization (ASO) to book a speaker who can discuss his/her experience
living with HIV. Call the Canadian AIDS Society at: 1-800-884-1058 or visit
www.cdnaids.ca to find an ASO in your area. Or contact your local public
health department to find names of speakers to talk about STIs/HIV and/or to
discuss the role of public health in the prevention of STIs/HIV. In either case,
ensure there is sufficient time left over for discussion.
Contact your local public health unit to obtain fact sheets, brochures, and other
printed information to give to participants for their future reference. Or
41
STI stands for Sexually Transmitted Infection. This term is used interchangeably with STD
(Sexually Transmitted Disease) throughout this module
42
Health Canada (2004). 2002 Canadian Sexually Transmitted Infections (STI) Surveillance Report:
Pre-Release. Ottawa: Population and Public Health Branch, Health Canada.
43
ibid
44
Health Canada (2000). Canada Communicable Disease Report. (Suppl.)1998/1999 Canadian
Sexually Transmitted Diseases (STD) Surveillance Rport. Vol. 26S6
45
Level I activities are omitted because these issues are generally not appropriate for level I
participants.
46
McKay, Alex. (2004). Sexual Health Education in the Schools: Questions and Answers. The
Canadian Journal of Human Sexuality. 13(3-4): 134.
reproduce the
resource material
located in the
Resources
section of the
Sourcebook.
OBJECTIVES OF
THE MODULE:
Participants will:
identify and
describe the
most common
STIs
define and
describe HIV
list the
behaviours
that increase,
decrease, or
have no effect
on the spread
of STIs and
HIV
identify ways
to prevent STIs
and HIV
Level I:
Ages 9-11
Grades 4-6
Level II:
Ages 12-14
Grades 7-9
Level III:
Ages 15+
Grades 10+
347
Level II
Note: You may wish
to make an overhead
transparency from the
handout, and have the
groups record their
responses directly
onto the transparency
with overhead
markers, so the entire
group can view the
responses. You can
also copy individual
questions onto sheets
of flipchart paper, and
tape each sheet up at
different points in the
room (participants will
get up and moving
with this option).
Note: This activity
focuses on general
principles concerning
sexually transmitted
infections. It may be
an introduction to the
topic. You may wish
to follow up with
activities that will
address STIs in a
more detailed way, or
assign specific STIs
as a research project.
General STI Questions
.
Objective:
Participants will identify general issues related to STIs:
transmission, effect, treatment, community resources, and
prevention.
Structure:
Small group.
Time:
20-30 minutes.
Materials:
“General STI Questions” handout, overhead
transparencies, and overhead markers (optional).
Information about community resources related to STIs.
Procedure
1.
Divide your group into smaller working groups (less than 5 or 6).
Distribute one handout per group (each group will be working on a
different question).
2.
Have the groups choose a recorder and a reporter. Give participants 5 to
10 minutes to answer their question. If you have chosen the flipchart
option, you can give the groups a few minutes at each station, then have
them rotate to the next question, so that each group can add their
responses to each question. Continue until each group has added
something to each question.
3.
Reconvene 4. as a larger group, and have the reporters, from each
group, share their group’s responses with everyone (the activity leader
can review the responses instead of a reporter). Provide additional
information as necessary (following the answer key).You can also ask
the group if they have anything to add to the responses.
Conclude by pointing out that the best ways for people to protect
themselves from STIs is to abstain from intercourse, engage in lower risk
sexual activities, or if having intercourse, use condoms each and every
time.
.
348
Handout
1.
What are the names of some STIs (Sexually Transmitted Infections)?
2.
How are STIs transmitted?
3.
How do you know if you have an STI?
4.
Can all STIs be treated? Where can you go for help?
5.
How can you protect yourself?
349
Answer Key
What are the names of some STIs?
Chlamydia
Gonorrhoea
HIV/AIDS (Human Immunodeficiency Virus/Acquired Immune Deficiency
Syndrome)
Human Papilloma Virus (causes genital warts)
Herpes (one strain of this virus causes cold sores on and around the
mouth)
Hepatitis B
Syphilis
Through sexual contact: vaginal intercourse, anal intercourse, oral sex
Some transmitted through blood-to-blood contact (needle sharing,
piercing or tattooing equipment that is not properly sterilized)
Many can be passed from a pregnant woman to her unborn baby (before
or during birth, HIV can also be passed from an infected mother to her
baby through breast milk)
How do you know if you have an STI?
Get tested (the test for chlamydia and gonorrhea, for example, is a
simple, non-invasive urine test)
People can have STIs without any symptoms!!!!
People may also have symptoms such as –
o
o
o
o
o
o
o
burning during urination
clear, white, or yellowish discharge from the male’s urethra
a change in the usual vaginal discharge that a woman
experiences (different colour, increased amount, unusual odour)
pain in testicles
lower abdominal pain (for women), pain during intercourse
sores or “bumps” on the genitals
unexpected bleeding from the vagina (not a period)
Can all STIs be treated? Where can you go for help?
Some STIs can be cured with antibiotics (chlamydia, gonorrhoea,
syphilis).
STIs caused by viruses cannot be cured: although there is often
medication that can slow the virus down and improve symptoms. A
vaccine has been developed against Hepatitis B.
For help: Family physician, Sexual Health Centre, Community Health
Centres, AIDS and Sexual Health Information Line.
How can you protect yourself?
Choose not to have sex (the only choice that is 100% effective in
preventing STIs)
Engaging in low-risk sexual activities (kissing, petting, etc.)
Using condoms every time you have sex (condoms can be used with
water based lubricant and must be used correctly)
350
Handshake Virus .
Objective:
Participants will explain how quickly a virus can spread
within a population.
Structure:
Large group.
Time:
25 minutes.
Materials:
3 x 5 cards (one for each participant).
Level II/III
Preparation
Get enough 3 x 5 cards for each person in the group.
Write, “HSV” on one of the 3 x 5 cards.
Write glove on 20% of the cards.
Leave the rest of the cards blank.
Fold and staple or glue them closed.
Further ideas
Write, “MONOGAMOUS” on some cards.
Write, “ONLY SHAKE HANDS WITH ONE PERSON AND THEN SIT
DOWN” on some cards (although this person can demonstrate that having
one partner that has the virus may still be at risk).
Write, “POSTPONE AND LEAVE THE ROOM” on some cards to show
that a person can postpone or abstain from high-risk activities.
Step One
Give each person in the group one card; making sure someone gets the HSV
card (be sensitive and careful about who you give the HSV card to).
Instruct each person to move about the room and to shake hands with 3
people.
As they shake hands with a person, they are to write their name on the
outside of the other person’s card.
Step Two
After everyone has been given sufficient time to shake hands with other
people, have all participants open their cards.
Have the person with HSV written on their card stand. Say: “This person has
the handshake virus. It is transmitted though handshakes.”
Have this person read off the names of the people on his/her card.
Have these people stand and explain that these people have been exposed
to the handshake virus.
Explain that people can protect themselves by the use of gloves. Instruct
anyone that has “glove” written on their card to sit down because they
protected themselves from the virus.
Continue to have people read the names of people on their cards until all
participants who did not have protection are standing.
.
(Adapted with permission from: Su Nottingham (1993) Sexuality Education Materials for the
Classroom. Michigan: Author.)
351
Step Three
Discuss how HSV is similar to STIs and HIV:
o
There is protection against getting STIs/HIV (gloves, for example,
symbolized condoms in the activity; postpone and leave the room
symbolized abstaining from high-risk sexual activities)
o
Can’t tell when a person has it.
o
Many have it and may not know it.
Discuss how HSV is different from STIs and HIV:
o
Can’t get STIs/HIV from a handshake, touching, casual contact.
o
Handshake is a greeting: high-risk sexual activities are not.
o
Handshake is not as intimate as high-risk sexual activities.
Conclude by pointing out how a virus can rapidly spread throughout a
community. The best ways for people to protect themselves from STIs and
HIV is to abstain from intercourse, engage in lower risk sexual activities, or if
having intercourse, use condoms each and every time.
352
STI Quiz
Objective:
Participants will explain the prevention, transmission,
symptoms, and treatment for a variety of STIs.
Structure:
Individual.
Time:
20 minutes.
Materials:
“STI Quiz” handout.
Answer key
1.
A person can have an STI and not know it. TRUE
2.
It is normal for women to have some vaginal discharge. TRUE
3.
Once you have had an STI and have been cured, you can’t get it again.
FALSE
4.
HIV is mainly present in semen, blood, vaginal secretions, and breast
milk. TRUE
5.
Chlamydia and gonorrhoea can cause pelvic inflammatory disease.
TRUE
6.
A pregnant woman who has an STI can pass the disease on to her baby.
TRUE
7.
Most STIs go away without treatment, if people wait long enough.
FALSE
8.
STIs that aren’t cured early can cause sterility. TRUE
9.
Birth control pills offer excellent protection from STIs. FALSE
10.
Condoms can help prevent the spread of STIs. TRUE
11.
If you know your partner, you can’t get an STI. FALSE
12.
Chlamydia is the most common STI. TRUE
13.
A sexually active woman should get an annual pap test from her doctor.
TRUE
14.
What advice would you give someone who thought s/he might have a
STI?
Level II/III
Note: This quiz can
be done in a group
(orally) or
individually (written).
It can be used as a
pre- test or as a
post-test.
Go to an STI clinic or physician’s office for a check-up.
15.
How can you avoid getting an STI?
Abstain from sexual intercourse.
Engage in lower risk sexual activities.
Use condoms every time you have sexual intercourse.
Get a hepatitis B vaccination.
Refuse to share needles.
353
Handout
STI Quiz
True or False?
1.
A person can have an STI and not know it.
2.
It is normal for women to have some vaginal
discharge.
3.
Once you have had an STI and have been cured,
you can’t get it again.
4.
HIV is mainly present in semen, blood, vaginal
secretions, and breast milk.
5.
Chlamydia and gonorrhoea can cause pelvic
inflammatory disease.
6.
A pregnant woman who has an STI can pass the
7.
Most STIs go away without treatment, if people wait long enough.
8.
STIs that aren’t cured early can cause sterility.
9.
Birth control pills offer excellent protection from STIs.
10.
Condoms can help prevent the spread of STIs.
11.
If you know your partner, you can’t get an STI.
12.
Chlamydia is the most common STI.
13.
A sexually active woman should get an annual pap test from her doctor.
disease on to her baby.
Short answer ________________________________________________________
14.
What advice would you give someone who thought s/he might have a STI?
15.
How can you avoid getting an STI?
354
Interviewing Parents about HIV
.
Level II/III
Objective:
Participants will describe HIV issues.
Time:
Materials:
“Reporter Interview” handout.
Procedure
1.
Distribute the “Reporter Interview” handout as a homework assignment.
2.
Ask participants to play the role of a reporter and interview a parent/
guardian or an adult they trust (aunt, uncle, neighbour, clergy member)
about HIV. By using the interview format, they are able to talk about this
sensitive topic in a non-threatening way.
3.
Instruct participants to follow the directions on the interview sheet: ask
the six questions, and write down the responses in the spaces provided.
After the interview, the participants are to write a summary report of what
they learned from the interview.
4.
Ask participants to turn in the interview sheets at the start of the next
class/session.
Follow Up
After obtaining permission and deleting names, combine the one-page writeups, about what participants learned from the interviews, and make a booklet
to give to participants.
Note: Some young
people may be
unable to complete
their parent(s) or
guardian(s). Allow
them the
opportunity to
complete the
assignment with
another trusted
adult such as an
aunt, uncle, sports
coach, or member
of the clergy.
In the follow-up class/session, discuss the interview process. How did they
feel asking the interview questions? How did their adult support person react
to being asked the questions? Did they talk with this person afterward about
what it was like to be an interviewee?
Conclude by pointing out that talking about sexual health issues can be a
difficult thing to do. It is important that we all obtain and share accurate
information about sexual health, and in doing so, identify people we can go to
for support and assistance.
.
(Adapted with permission from: Benner, Tabitha A., Park, M. Jane and Peterson, Evelyn C. (1998)
The PASHA Activity Sourcebook: Activities for educating teens about pregnancy and STD/HIV/AIDS
prevention. Los Altos: Sociometrics Corporation.)
355
Handout
Reporter Interview
Date:
_____________________________________________________________
Reporter’s Name:
_____________________________________________________________
Age:
_____________________________________________________________
Time of interview:
_____________________________________________________________
Interviewee:
_____________________________________________________________
“Hi, my name is and I’m a Reporter. My assignment is to interview adults
about HIV. I would like your cooperation in answering a few questions. The
interview will not take long to complete. If you prefer not to answer a
particular question that is all right. Let’s begin…”
1. When did you first hear about HIV/AIDS?
2. When you were my age:
a) Were there diseases like HIV/AIDS? Can you tell me what they were?
b) Did your parents talk with you about sex?
If yes, what did they say?
If no, what do you wish they had told you?
3. If HIV/AIDS were around when you were my age, what would your parents have told you about safer
sex?
356
4. Do you worry about HIV/AIDS? How?
a) Would you feel comfortable around someone living with HIV/AIDS?
b) Do you know anyone with HIV/AIDS? How do you know this person?
c) Have you helped someone with HIV/AIDS? How?
5. How has the HIV/AIDS epidemic affected you?
6. What do you think the parents’ role or responsibility is in helping their children to prevent getting HIV?
Summary Report
Write a paragraph summarizing what you learned from this interview.
357
STI Research
Objective:
Participants will identify and describe the most common
STIs.
Structure:
Small group.
Time:
30 minutes plus one class/session for presentations.
Materials:
“STI Research” handout, “STI Research” answer key,
flipchart/blackboard
Procedure
1.
Divide the class into 8 groups. Distribute the “STI Research” handout to
each group. Each group will pick one of the following STIs to research
and present: chlamydia, gonorrhoea, human papilloma virus (HPV),
herpes, syphilis, human immunodeficiency virus (HIV), hepatitis (B and
C) and vaginal infections (yeast, vaginitis and trichomonas).
2.
Explain the group assignment:
Complete the worksheet by using the Internet, resources in the
library, or fact sheets/pamphlets (call your local Health Department
or Canadian Federation for Sexual Health member organization for
copies).
Plan a report on the STI for the class.
3.
Have groups make their presentations.
4.
Discuss the group assignments. Ask participants:
What are some common symptoms of STIs?
Do any of these diseases have the same treatment?
What are some of the common treatments?
What generalizations can we make about preventing transmission of
STIs?
5.
Conclude by pointing out that abstaining from intercourse is the only
100% effective method of prevention. Engaging in lower risk sexual
activities also decreases risk. If having sex, it is important to use
condoms each and every time.
Extension
Instruct each small group to create a poster, pamphlet, or fact sheet
using the information collected from the “STI Research” handout. These
items can be displayed/distributed to increase awareness, particularly
during STI or HIV awareness week.
358
Handout
STI Research
Name of STI:
1.
What are the symptoms of this STI?
2.
How is this STI transmitted from person to person?
3.
What are some of the effects of this STI?
4.
How can this STI be treated?
5.
How can this STI be prevented?
359
Answer Key
STI Research
STI
Symptoms
Transmission
Effects
Chlamydia
(bacteria)
Often no symptoms.
Symptoms of infection for women can
include:
•
A vaginal discharge
•
A burning sensation when
urinating
•
Pain in the lower abdomen,
sometimes with fever and chills
•
Pain during sex
•
Vaginal bleeding between
periods or after intercourse.
Symptoms for men can include:
•
A discharge from the penis
•
urinating
•
Burning or itching at the opening
of the penis
•
Pain and/or swelling in the
testicles.
Often no symptoms.
Symptoms of infection for women can
include:
•
urinating
•
A vaginal discharge that is yellow
or occasionally bloody
Symptoms of infection for men can
include:
•
urinating
•
Yellowish white discharge from
the penis
•
Painful or swollen testicles
Often no symptoms.
Symptoms can sometimes take years.
Cervical changes.
Warts that have cauliflower-like
appearance (in women, the warts may
appear on the vulva, cervix, rectum or
thigh area. In men, they may appear
on the penis, scrotum, rectum or thigh
area).
Unprotected
vaginal, oral,
or anal sex.
If left untreated it can
cause sterility, pelvic
inflammatory disease,
and Reiter’s disease
(inflammation of the
joints) in women and if
pregnant, premature
delivery and other
complications.
Many people who have genital herpes
are unaware that they have the virus
because they have no symptoms, mild
symptoms, or mistake the symptoms
for other conditions
Those with symptoms may experience
a tingling sensation or itching in the
genital area within two to twenty days
of having sex with an infected person.
Women's symptoms can include:
•
Blister-like sores inside or near
the vagina, the cervix, on the
external genitals, near the anus
or on the thighs or buttocks.
•
Tender lumps in the groin
(lymphadenopathy).
Men's symptoms can include:
•
Blister-like sores on the penis,
around the testicles, near the
anus or on the thighs or buttocks.
•
Tender lumps in the groin
(lymphadenopathy).
Gonorrhea
(bacteria)
Human
Papilloma
Virus
(HPV)
(virus)
Genital
Herpes
(virus)
Detection &
Treatment
Urine test or
vaginal swab.
Prevention
Abstaining from
intercourse.
Condom use.
Cured with
antibiotics.
If left untreated, it can
cause scarring of the
urethra, infertility, and
Reiter’s disease in men.
cause sterility, pelvic
inflammatory disease,
and Reiter’s disease
(inflammation of the
joints) in women and if
pregnant, it can be
passed on to a baby
during birth.
cause urethral scarring,
infertility and Reiter’s
disease in men.
Urine test or
vaginal swab.
Direct contact
of the skin or
lining of the
vagina or
rectum during
vaginal, anal
or oral sex.
Increased risk of cervical
cancer in women.
Can also lead to other
types of cancer in both
men and women, such
as cancer of the penis,
anus or vulva.
More warts can grow.
Direct contact
of the skin
during vaginal,
anal or oral
sex even if the
infected
person has no
open sores or
any other
symptoms of
infection.
Blisters may recur.
Regular pap
test
Cannot be
cured.
Symptoms
treated with
medicated gel,
liquid nitrogen,
laser treatment
or other
medications.
Regular pap
test.
Unprotected
vaginal, oral,
or anal sex.
Abstaining from
intercourse.
Condom use.
Cured with
antibiotics.
Cannot be
cured.
Symptoms
managed with
anti-viral drug
therapy.
Abstaining from
intercourse.
Condom use.
Regular pap test.
Abstaining from
intercourse.
Condom use.
Avoid sexual contact at
first sign of outbreak
(tingling or redness) and
when sores present.
360
Hepatitis B
&C
(virus)
Often no symptoms.
Flu-like symptoms.
Urine can become dark brown.
Jaundice.
Unprotected
sex.
Sharing
needles.
Mother to
child
transmission.
Liver disease.
Cancer of liver.
Syphilis
(bacteria)
Often no symptoms.
st
1 stage: painless, open sore on
mouth or genitals (will disappear).
nd
2 stage: rash, flu-like symptoms.
rd
3 stage: damage to vital organs
Unprotected
vaginal, oral,
or anal sex.
Mother to
child.
Injection drug
use (but less
common).
If untreated, can cause
damage to heart, liver,
brain and eyes.
Individuals with the
genital ulcers that
appear in primary
syphilis are three to five
times more likely to
contract HIV.
Vaginal
infections
(yeast,
vaginitis,
trichomoni
asis)
(bacteria)
At times no symptoms.
Females: unusual vaginal discharge or
odour; vaginal itching & redness;
burning with urination; pain during
intercourse.
Males: may have itching or rash on
penis.
Sometimes
spread
through
sexual contact
but some
types are not
(e.g. antibiotic
use).
Human
Immunodeficiency
Virus
(HIV)
(virus)
Often no symptoms.
Flu-like feelings, unexplained weight
loss, night sweats, persistent diarrhea.
Unprotected
vaginal, oral,
anal sex.
Sharing
needles.
Mother to
child
transmission.
Blood test.
Cannot be
cured.
Sometimes the
virus goes
away on its
own.
Antiviral
medication for
Hepatitis C.
Can lead to AIDS &
many life- threatening
diseases.
Blood test.
Cured with
penicillin
injections.
Vaginal swab.
Trichomonas
and bacterial
vaginosis are
treated with
prescription
drugs.
Yeast infections
are treated with
medication
available at the
drug store (no
prescription
needed).
Blood test.
Cannot be
cured.
Many
medications
available to
manage the
virus.
Hepatitis B vaccination.
Abstaining from
intercourse.
Condom use.
Do not share needles or
other drug equipment. Do
not get a tattoo, body
piercing or acupuncture
from an operator who does
not use sterilized
equipment or techniques.
Do not share toothbrushes
or razors.
Universal precautions.
Abstaining from
intercourse.
Condom use.
other drug equipment.
Abstaining from
intercourse.
Condom use.
Wipe from front to back.
Do not douche.
Wear cotton underwear.
Do not wear underwear to
bed.
Urinate after intercourse.
Abstaining from
intercourse.
Condom use.
other drug equipment.
Do not get a tattoo, body
piercing or acupuncture
from an operator who does
not use sterilized
equipment or techniques.
Universal precautions.
361
STI Case Studies
Level III
Objective:
Participants will describe STI symptoms and consequences.
Structure:
Small group.
Time:
25 minutes.
Materials:
“STI Case Studies” handout.
Procedure
1.
Divide participants into groups of 4 – 5 people. Give each group a copy
of the “STI Case Studies” handout. Explain the group assignment:
Read the case studies.
Complete the worksheet by using the Internet, resources in the
library, or fact sheets/pamphlets (call your local Health Department
or Canadian Federation for Sexual Health member organization for
copies).
2.
Discuss group work on the case studies, and correct any
misconceptions (answer key provided).
3. Conclude by pointing out that many STIs are quite serious. While some
STIs are curable, others are not. The best thing to do is to prevent
getting an STI in the first place. The only 100% effective method of
prevention is to abstain from intercourse. Engaging in lower risk sexual
activities decreases risk. If having sex, condoms should be used each
and every time.
362
Handout
STI Case Studies
A. Chris and Pat
Chris and Pat had been attracted to each other for a long
time. When they finally began to date, things moved very
quickly and they decided to have sex. Almost a month after
having sex with Chris, Pat developed small, fluid-filled
blisters on his genitals.
1.
Which STI might Pat have?
2.
3.
How can Chris be protected from getting this STI?
B. Laura and Shane
Laura and Shane have dated throughout high school. They love and care for each other very much.
One evening, Laura told Shane that she had an abnormal pap test and may have HPV.
1.
What symptoms might Laura experience?
2.
What are the consequences of HPV?
3.
How can Shane protect himself from getting HPV?
363
C. Greg
Greg was excited to go away to university. At university, he began to visit a local bar on weekends.
One night, Greg went home with someone he had just met at the bar and they had intercourse. A few
weeks later, Greg experienced pain with urination and discharge from his penis.
1.
What STI might Greg have?
2.
3.
What will happen if Greg does not get treated?
D. Karen
Karen had a crush on someone she worked with at her part-time job. They dated a couple of times
and then one night they had intercourse. A few weeks later, after a full gynaecological examination by
her doctor, Karen found out she had chlamydia.
1.
How is chlamydia treated?
2.
What symptoms might Karen have?
3.
What are the consequences of chlamydia if left untreated?
364
Answer Key
Case Studies
Chris and Pat
1. Herpes.
2. There is no cure for herpes. Medication can be used to heal sores more
quickly and to reduce the multiplication of the virus.
3. Condoms provide some protection but they do not protect all of the skin that
touches during intimate contact. Pat should not have intercourse when sores
are present or at the first signs of an outbreak (tingling or redness in the
usual attack area). Pat may have been infected by Chris or by a previous
partner.
Laura and Shane
1. Small, cauliflower-like warts on and around the genitals—sometimes there
are no symptoms
2. HPV can be passed on to other sexual partners and can increase the risk of
cervical cancer.
3. Shane has likely been infected. Condom use is not always helpful in
preventing transmission. Condoms provide some protection but they do not
protect all of the skin that touches during intimate contact. Having warts
removed will decrease the virus particles on the skin. Laura should get
regular pap smears.
Greg
1. Gonorrhoea or chlamydia.
2. Antibiotics.
3. If left untreated, Greg may transmit chlamydia/chlamydia to his other sexual
partner(s) or become infertile.
Karen
1. Antibiotics cure chlamydia.
2. Discharge from genitals, burning or pain while urinating, unusual bleeding
from the vagina, pain in the pelvic area. Often there are no symptoms.
3. Can cause pelvic inflammatory disease and infertility.
365
Protecting Myself
Level III
Objective:
Participants will identify strategies for dealing with STIs.
Structure:
Individual.
Time:
20 minutes.
Materials:
“Protecting Myself” handout.
Procedure
1.
Disseminate the “Protecting Myself” handout to participants. Inform
them that they will not be required to share their answers. Allow sufficient
time to complete the handout.
2.
Discuss the following questions:
What advice would you give to someone who thinks s/he has an
STI?
(Get STI testing at a physician’s office or clinic)
What advice would you give to someone who just tested positive for
an STI?
(Get treatment, get regular pap tests, inform sexual partners)
What are the best ways to avoid getting STIs?
(Abstaining from vaginal and anal intercourse or using
condoms)
3.
Conclude by pointing out how important it is to be supportive of people
who test positive for STIs and to seek out support if testing positive for
an STI. There are several ways to help prevent the transmission of STIs,
including abstaining from intercourse, engaging in lower risk sexual
activities, or if having sex, using condoms each and every time.
366
Handout
Protecting Myself
1.
I know I do not have an STI because:
2.
If I noticed a symptom of an STI, I would:
3.
If I were contacted by a clinic and told I had been exposed to an STI, I would:
4.
In order to protect myself from an STI, I will:
367
Spreading the Word About HIV
Level III
Note: This activity
can be expanded to
include other STIs
as well.
.
Objective:
Participants will describe how to prevent HIV.
Structure:
Small group.
Time:
30 minutes.
Materials:
“Spreading the Word About HIV” handout; blackboard
or flipchart.
Procedure
1.
Participants work in small groups. Each group chooses a Recorder and a
Reporter. The Recorder takes notes during the discussion; the Reporter
presents the team’s work to the rest of the class. Participants should be
familiar with HIV transmission and prevention and understand the
consequences of having HIV.
2.
Distribute the “Spreading the Word About HIV” handout. Ask
participants to pretend that they have been asked to advise the
school’s/organization’s administration how to get messages out to
teenagers about safer sex and HIV prevention. Give the groups several
minutes to complete the handout and several more minutes to discuss
the responses and reach a consensus. The Reporters then share their
respective team’s information. Record and summarize the teams’
responses on the blackboard/flipchart.
3.
Referring to the summary statements, participants discuss how they will
deliver the messages. They have determined that HIV is serious, and
that it can affect them, their friends, and their families, and that they are
in a position to influence people’s attitudes. Ask participants how they
can make a commitment to give others messages about HIV. Remind
them that HIV is an epidemic, and that it is the responsibility of all young
people to stop the spread of HIV because it is they who can most
effectively reach their peer group.
Extension
Encourage participants to act on their commitment to spread the
word about HIV to their family and friends.
Have participants develop artwork, posters, videos, etc. that are
representative of their messages. Post or display the work in the
school/ organization, especially for AIDS awareness week/World
AIDS Day.
.
(Permission to include the “Spreading the Word About HIV” worksheet and instructions from the
grade 9-12 Get Real about AIDS curriculum, which is copyrighted by Comprehensive Health
Education Foundation (C.H.E.F.), was granted by C.H.E.F., Seattle, Washington.
All rights reserved.)
368
Handout
Spreading the Word About HIV
Complete this handout individually and then
discuss your responses with the small group.
1.
Why do you think teenagers are now
considered a high-risk population?
2.
What are some reasons that teenagers
might put themselves at risk of becoming
HIV positive?
3.
What is the single most important thing you’d tell other people your age about HIV?
4.
What advice would you give to people of your age that are sexually active?
5.
What advice would you give to people of your age that aren’t sexually active?
369
STIs/HIV: Influence of Alcohol & Other Drugs .
Level III
Objective: Participants will recognize that poor decisions about alcohol and
other drugs and sexual behaviour can put a person at increased risk for
STIs/HIV.
Structure: Large group and individual.
Time:
50 minutes
Materials: Overhead projector, “Beer Ad” overhead, “Lily and Gina’s Story”
handout, “Eric’s Story” handout.
Procedure
1. Set the stage by brainstorming the physical and emotional effects of alcohol
and other drugs on the body. Possible answers include:
High, light-headed
Nauseous, dizzy, drowsy
Depressed
Silly
Feel good
Less shy or anxious
Less concerned about privacy, values, responsibility, etc.
More aggressive: fighting, shouting, using weapons, etc.
Less cautious: driving when drunk, being in sexual situations, swimming at
night, etc.
More confident: talking to people that normally make them nervous, asking
someone out on a date, etc.
2. Discuss the impact of alcohol and other drugs on decision-making and
STI/HIV risk. Possible answers include:
People think less clearly.
People don’t make the same decisions they would if the were not using
alcohol or other drugs.
People often make decisions they later regret.
3. Point out that alcohol and other drugs all increase the user’s chances of
getting STIs/HIV. Emphasize how the inability to think clearly and make good
decisions can lead to taking risks, such as using injection drugs and having
unprotected sex. Using drugs and alcohol should not be used as an excuse to
have unsafe sex. People who are drinking or using drugs can still choose
abstinence or use condoms to protect themselves.
While all drugs and alcohol affect a person’s ability to make decisions, using
needles to inject drugs can actually transmit HIV and Hepatitis C infection.
4. Show the Beer Ad overhead. Analyze the advertisement, focusing on the use
of alcohol to meet social and emotional needs. Ask:
What is it about this ad that makes people want to buy the beer? Possible
answers include
.
Adapted with permission from Public Health – Seattle and King County. (2002). F.L.A.S.H. Lesson
Plans: Comprehensive sexuality education curriculum. Available at:
www.metrokc.gov/health/famplan/flash/
370
o The people are having fun.
o The people feel like they’re fitting in.
o The people are hanging out with close friends.
Is it okay to want to have fun, to fit in and have friends?
Sure. Everyone needs that. It’s part of being human. The
ad implies that the way to achieve that is with beer.
Can you think of other less dangerous ways that people build friendships, fit
in, have fun)?
o Give students a chance to share their responses.
5. Distribute the “Lily & Gino’s Story” handout. Have a volunteer read Lily &
Gino’s Story aloud. Discuss the following questions from Part A as a large
group:
Why did Lily use alcohol and other drugs in this situation?
As an excuse to have sex (although Lily can say, and even believe, that
having sex with Gino was an accident)
So she wouldn’t really have to think about whether this was a good or “right”
time for her to have sex
To excuse her from having to talk with Gino about it first
To make her feel less nervous about having sex
o Exactly what risks did Lily take?
Getting and STI or HIV
Getting pregnant
Getting talked about by Gino
Feeling bad, guilty, scared
Damaging her relationship with Gino
Disappointing her family. [Note: If your class brings this up and seems to
dwell on it, you might point out that communicating about problems can make
a family closer. A young person who has lied or made a mistake can often
recover their family’s trust in time.]
Did her decision to have sex have any possible benefits?
o She might have satisfied her curiosity.
o She might have had a good time.
o She might feel less left out with her friends.
o Gino might want to see her more.
Were the possible benefits worth the risks, in your opinion?
o Most students will conclude that the risks were not worth the
benefits.
Did Lily consider Gino’s feelings about having sex?
o As far as we can tell, Lily didn’t consider Gino’s feelings.
She encouraged him to drink and had sex with him. Based on what he said in
the past, it doesn’t look like he wanted to have sex.
o What are some steps that Lily could take now?
As soon as she can (but at least within the next three to
five days), go to a clinic to get emergency contraception
— a kind of birth control pill that prevents pregnancy if
taken right away.
If Lily doesn’t use emergency contraception, she can get
a pregnancy test in 2 weeks.
Go to a clinic to get an STI checkup including an HIV
antibody test. [Note: Lily can get a chlamydia test result
in 7 days, but other STD’s may take longer to show up.
For example, it might take 6 months to get an accurate
Hepatitis B test, and it will take about 3 months to learn if
she got HIV. Ongoing check-ups are a good idea.]
Get condoms and learn how to use them.
Talk to Gino about what happened, how they are feeling,
and whether or not they are going to have sex again.
371
Talk over the situation with her family or other trusted
adults.
Give participants a few minutes to complete Part B of the handout. Discuss
their responses.
Distribute the “Eric’s Story” handout. Have a volunteer read “Eric’s Story”
aloud. Then, discuss each of the questions in Part A as a large group:
Why did Eric use alcohol and other drugs in this situation? Although we don’t
really know why Eric used alcohol and other drugs, here are some possible
reasons:
o To feel good or get high. (Note that not all people feel good on
drugs. Some drugs cause some people to feel pretty bad.)
o To impress the older guys (peer pressure).
o To do what he usually does for fun with his friends. It felt familiar.
o To relieve boredom.
o To fit in.
o To relieve anxiety.
o To escape from problems.
Exactly what risks did Eric take?
o Getting injured in a car accident, if he or a friend drove
o Getting in trouble with the police.
o Disappointing his family.
o Feeling bad, guilty, or scared.
o Getting HIV or hepatitis B or C infection.
o Becoming addicted to alcohol or other drugs.
o Making sexual decisions that he might regret later.
Did his decision have any possible benefits?
o He might have had a good time.
o He might feel less left out with his friends.
o He might have satisfied his curiosity.
Were the possible benefits worth the risks, in your opinion?
o Most students will conclude that they were not.
Eric is worried about STIs/HIV, what should he do about it?
o Go to a clinic to get an STI checkup including an HIV antibody
test. [Note: Lily can get a chlamydia test result in 7 days, but
other STD’s may take longer to show up. For example, it might
take 6 months to get an accurate Hepatitis B test, and it will take
about 3 months to learn if she got HIV. Ongoing check-ups are a
good idea.]
o Talk about the situation with his family or other trusted adults.
Give participants a few minutes to complete Part B of the handout. Discuss
their responses.
Conclude the activity by recognizing the great advice participants gave to
Lily and Eric, in terms of how to stay healthy, but still have fun.
372
Overhead
Beer Ad
[insert an ad from a magazine depicting a group of friends drinking beer and having fun]
373
Handout
Lily & Gino’s Story
Part A
Lily and Gino are in Grade 9. Lily likes Gino a lot. They’ve gone out a couple of times and she thinks
she might want to try sex. She’s not really sure. She has a couple of older girlfriends who’ve tried it, and she’s
starting to feel a little weird about waiting. She’s feeling a little left out too. Gino has said he didn’t think he
wanted to.
Lily doesn’t want to talk to Gino about it because she worries what Gino would think. She knows
condoms are important, but she’s too embarrassed to buy them.
So, Saturday night at a party, she smokes marijuana, which she doesn’t usually do, and drinks some
beer. She encourages Gino to do the same. They both get pretty drunk and end up having sex before they
leave.
The next morning, everything is still a little hazy. Lily can’t remember everything exactly, but she
doesn’t think Gino used a condom. She starts counting the days until her next period.
1. Why did Lily use alcohol and other drugs in this situation?
2. Exactly what risks did Lily take?
3. Did Lily consider Gino’s feelings about having sex?
4. Did her decision to have sex have any possible benefits?
5. Were the possible benefits worth the risks, in your opinion?
6. What are some steps that Lily could take now?
Part B
1. Tell Lily at least 2 things you think she should do in the next days or weeks.
2. Give Lily at least 2 pieces of advice about how to avoid getting in this situation in the future. Be sure to
suggest a healthier, less dangerous thing to do next time she’s feeling left out.
374
Handout
Eric’s Story
Part A
Eric is 15. He went to a party, too, on Saturday night, with some of his friends. There was an
assortment of alcohol and other drugs. Just like always, Eric was pretty high and drunk after a couple of
hours.
About then, some older guys showed up. They were using needles to inject drugs. They kept
pressuring Eric to try it. Eric was too drunk and high to be sure what he wanted, but he ended up using a
needle.
When he woke up the next morning, he couldn’t believe he had injected drugs. He was scared. What
about HIV or hepatitis C?
1. Why did Eric use alcohol and drugs in this situation?
2. Exactly what risks did Eric take?
3. Were the possible benefits worth the risks, in your opinion?
4. Eric’s worried about HIV. What could he do about it?
Part B
1. Tell Eric at least 2 things you think he needs to know about HIV testing.
2. Give Eric at least 2 pieces of advice about how to avoid getting in this situation in the future.
375
376
Appendix A
Glossary
A
abstinence – Voluntarily not engaging in sexual activity. Definition varies from
individual to individual. Some may abstain from all sexual activity, others may
engage in any or all sexual activity outside of vaginal or anal intercourse, and
others set limits somewhere in between.
acquaintance rape – Sexual assault perpetrated by someone the victim knows.
Acquaintance rape is against the law.
adolescence – The period between sexual maturity at puberty and the
attainment of adult social status; psychosocial development during the teenage
years.
amenorrhoea – An absence of menstruation.
amniotic fluid – The fluid within the amniotic sac that surrounds and protects
the fetus.
amniotic sac – A thin membrane forming a closed sac around the fetus that
contains the amniotic fluid.
anal intercourse – Intercourse that occurs when the penis is put into the anus
of a man or woman.
anus – The excretory opening at the end of the digestive system.
artificial insemination – Semen introduced into the vagina with a syringe rather
than by sexual intercourse.
B
bacterial vaginitis/vaginosis – A bacterial infection and inflammation of the
vagina.
bisexual person – A person who forms sexual and affectionate relationships
and attractions with people of either sex.
blue balls – Ache in the testicles after prolonged sexual arousal.
breast self-examination (BSE) – Technique a woman uses to check her own
breasts for unusual lumps or changes.
C
cervical cap – Small latex cup that fits over the cervix to prevent sperm from
reaching an ovum.
cervical mucus – Fluid produced by the cervix that changes in amount and
consistency at different times of the menstrual cycle. Around the time of ovulation
it is clear and slippery.
cervix – The lower part or neck of the uterus that opens into the vagina.
chlamydia trachomatis – A sexually transmitted infection caused by bacteria.
circumcision – Surgical removal of the foreskin of the penis.
clitoris – A small, female, genital organ. Its function is one of sexual pleasure.
coitus interruptus – Male withdraws his penis just before ejaculating. Also
called withdrawal or pulling out.
377
coming out – This is a term used to describe the process by which an
individual reveals that she/he is lesbian, gay, or bisexual. The beginning of this
process is acceptance of oneself. Following this, openness may occur with
family, friends, co-workers, etc. This is a life-long process for lesbian, gay and
bisexual people.
condom – A sheath of thin latex that covers the male’s penis (male condom) or
the female’s vagina and cervix (female condom) to prevent conception and/or
transmission of infection during intercourse.
cross-dresser – Men and women who enjoy wearing the clothes of, and
appearing as, the other sex. Also known as a drag queen or drag king.
cyst – A sac or cavity of abnormal character containing fluid, which may occur
in the ovaries.
cystitis – An inflammation of the urinary bladder, often caused by infection and
usually accompanied by frequent and painful urination.
D
Depo-Provera – A long-acting, synthetic progesterone injection used as a birth
control method.
diaphragm – A flexible latex disk that fits over the cervix to block the opening of
the uterus and prevent sperm from reaching an ovum.
douching – Rinsing the vagina with water, water and vinegar, or a medicated
solution. Health care providers do not recommend this practice as it often
causes irritation.
dysmenorrhoea – Painful or difficult menstruation.
E
ejaculation – In men: the action of having semen ejected from the penis as a
result of sexual activity. In women (less common): the G-spot swells and fills
with fluid (which is not urine or vaginal fluid) and spurts out when a woman has
an orgasm.
endometriosis – Painful condition involving the appearance of endometrial
tissue outside the womb.
endometrium – The inner lining of the uterus, which is partially shed during
menstruation.
erection – An enlarged and erect state of erectile tissue, esp. of the penis.
estrogen – Hormone produced by the ovaries, responsible for female sexual
maturation, regulation of the menstrual cycle, and maintenance of the uterine
lining.
F
fallopian tubes (oviducts) – Two tubes leading from the ovaries to the uterus;
place where the ovum may be fertilized by a sperm.
female genital mutilation (FGM) – The alteration and/or removal of parts of the
female genitals. Practiced in African, Asian, Middle-Eastern cultures, FGM is
illegal in Canada.
fertilization – Union of the female egg and male sperm; usually occurs in one of
the fallopian tubes.
Fetal Alcohol Syndrome (FAS) – A condition characterized by birth defects and
alcohol withdrawal symptoms in the infant. Caused by chronic and excessive
alcohol consumption by a pregnant woman.
378
fibroid – Benign tumour of muscular and fibrous tissues, which may develop in
the wall of the uterus.
flaccid – Limp (e.g. penis)
foreskin – Loose fold of skin that covers the end of the penis; removed during
circumcision.
G
gamete – Sperm or egg cell.
gay man – A man who forms sexual and affectionate relationships and
attractions with other men.
gender identity – The personal, internal sense of oneself as a man or woman.
May or may not correspond with biological sex.
gender roles – The behaviours that a society or culture assigns to people on
the basis of being male or female.
genital – Of or relating to the external reproductive organs.
genital warts – Small benign growths located in the genital region, caused by a
virus.
glans – Head of penis; source of sexual pleasure.
g-spot – A sensitive area felt through the upper or front wall of the vagina. The G
spot does not lie on the vaginal wall itself, but can be felt through it. It is usually
felt about half way between the back of the pubic bone and the cervix and feels
like a small lump that swells as it is stimulated.
gynaecological exam – Examination by a health care provider of a
woman’s external genitals, as well as the vagina and cervix.
H
haemorrhoids – A mass of dilated veins in swollen tissue at the margin of the
anus.
hernia – Displacement and protrusion of part of an organ through the wall of the
cavity containing it (e.g. abdomen).
herpes – A virus with outbreaks of blisters on the skin, mucous membrane, etc.
heterosexism – The institutionalized assumption that everyone is heterosexual
and that heterosexuality is inherently superior to and preferable to homosexuality
or bisexuality.
heterosexual – A person who forms sexual and affectionate relationships and
attractions with people of the opposite sex.
homophobia – The irrational fear or hatred of, aversion to, or discrimination
against homosexuals or homosexual behaviour.
homosexual – A person who forms sexual and affectionate relationships with
people of the same sex.
Human Immunodeficiency Virus (HIV) – A retrovirus, which causes AIDS.
Human Papilloma Virus (HPV) – The virus that causes genital warts.
hymen – A thin membrane that partially covers the entrance of the vagina. Its
rupture or absence is not necessarily evidence of sexual activity, as it can
rupture from physical activity (e.g. gymnastics).
379
I
Implants (Norplant) – Six silicon capsules containing synthetic progesterone
that are inserted in the upper arm as a means of birth control.
impotence – Inability to have or maintain an erection sufficient for sexual
activity, despite stimulation.
infertility – Inability to conceive a child after a year of unprotected sex; can
occur in both males and females.
internalized homophobia – The experience of shame, aversion, or self-hatred
in reaction to one’s own feelings of attraction for a person of the same sex
(produced from living in a homophobic society).
inter-sexual – A person with mixed sexual characteristics.
in the closet – Phrase is used to describe the hypothetical place we say
someone is before they come out. Reasons for this could be fear, safety, denial,
etc.
Intra-Uterine Device (IUD) – An object that a physician places in the uterus to
prevent pregnancy.
L
labia – Folds of skin that surround the vaginal and urethral openings.
labia majora – The larger outer pair of folds of skin that enclose the vulva.
labia minora – The smaller inner pair of folds of skin that enclose the vulva.
Lea Contraceptive – A contraceptive method that resembles both a cervical
cap and a diaphragm.
lesbian – A woman who forms sexual and affectionate relationships and
attractions with other women.
LGB – Acronym for lesbian, gay, bisexual.
M
masturbation – Arousing oneself sexually or causing another person to be
aroused by manual stimulation of the genitals.
menopause – The period in a woman’s life when she stops menstruating.
menstrual cycle – Repeated changes that prepare the female reproductive
system for childbearing; cycle averages 28 days and begins with the
development of the ovum, continues through menstruation, and ends when the
uterine lining degenerates. Measured from the beginning of menstruation.
menstruation – The process of discharging blood and other materials from the
lining of the uterus in sexually mature, non-pregnant women at intervals of about
one lunar month until the menopause.
mononucleosis – An infectious virus characterized by swollen lymph nodes
and fatigue (mono is not a sexually transmitted infection).
mons pubis – The soft, fatty tissue over the female pubic bone that becomes
covered with hair after puberty; also called the mons veneris.
N
New Reproductive and Genetic Technologies (NRGTs) – The wide range of
technologies available to assist in human reproduction (e.g. IVF, artificial
insemination)
380
nocturnal emission – Involuntary discharge of semen during sleep; also called
wet dream.
O
oral contraceptives – Pills containing synthetic estrogen and progesterone that
are taken each day to prevent pregnancy. Also known as the birth control pill.
oral sex – Sexual activity in which the genitals of one partner are stimulated by
the mouth of the other.
orgasm – The climax of sexual excitement.
ovaries – Female organs that store and release egg cells and produce estrogen.
ovulation – The release of an egg, or ovum, from an ovary.
ovum – Egg cell produced by the female.
P
Pap smear – A routine test for cervical cancer in which cells are scraped from
the cervix and examined.
partner or “significant other” – Primary domestic partner or spousal
relationship(s). May be referred to as “girlfriend/boyfriend,” “lover,”
“roommate,” “life partner,” “wife/husband” or other terms.
Pelvic Inflammatory Disease (PID) – Ascending infection, from the vagina or
cervix to the uterus and fallopian tubes, caused by a bacteria. Can cause
infertility.
penis – Male sex organ made up of spongy tissue.
pituitary gland – A small ductless gland at the base of the brain secreting
various hormones essential for growth and other bodily functions.
placenta – A temporary organ located in the uterus through which the fetus
receives nutrients and oxygen from its mother and expels waste products; it also
produces hormones needed to maintain pregnancy.
prostate – A gland surrounding the neck of the bladder and urethra in the male
that secretes a fluid that forms most of the semen. Stimulation during anal sex
results in sexual pleasure.
puberty – Stage of life in which the reproductive system matures, and
secondary sex characteristics appear.
pubic lice – Parasitic insects, Pediculus humanus, that infest human hair and
skin in the genital region.
R
reproductive health – a state of complete physical, mental & social well
being, and not merely the absence of disease, in all matters relating to the
reproductive system and to its functions and processes.
reproductive rights – embrace certain human rights recognized in legal
documents and national and international human rights. These include the
rights of couples and individuals to decide freely and responsibly on the
number and spacing of desired children, and to have the information and the
means to achieve this; the right to obtain the highest standard of sexual and
reproductive health; the right to make decisions free from discrimination,
coercion or violence.
rhythm method – Birth control in which sexual activity is avoided during times
when fertilization is most likely (e.g. during ovulation).
381
S
same-sex relationship – An intimate relationship between two people of the
same sex.
scabies – A contagious disease with severe itching and red papules, caused by
a mite.
scrotum – Loose, wrinkled sac of skin, sparsely covered with hair, that holds
the testicles.
semen – Milky-white fluid made up of sperm and secretions from various
glands, discharged from the urethra of the male during ejaculation.
seminal vesicles – Two sac-like structures in the male, connected to the vas
deferens, that secrete a viscous fluid that forms part of the semen and activates
the sperm.
sexual activity – The wide range of sexual and intimate behaviours.
sexual assault – Any sexual activity without consent. Sexual assault is against
the law. (See fact sheet in Resources section).
sexual health – The achievement of positive outcomes (e.g. self-esteem,
respect for self and others, non-exploitive sexual satisfaction, rewarding human
relationships, the joy of desired parenthood) and the avoidance of negative
outcomes (e.g. unintended pregnancy, sexually transmitted infection, sexual
coercion).
sexual health education – Enables individuals, couples, families, and
communities to develop the knowledge, motivation, skills, and critical
awareness needed to enhance sexual health and to avoid sexual problems.
sexual intercourse – Refers to both vaginal intercourse (penis-vagina) and
anal intercourse (penis-anus).
sexual orientation – A person’s feelings of emotional and sexual attraction; can
be heterosexual (with people of the opposite sex), homosexual (with people of
the same sex) or bisexual (with people of both sexes).
sexually transmitted diseases, sexually transmitted infections (STD, STI) –
Diseases or infections that are transmitted via blood or body fluids, or from a
pregnant woman to her fetus or baby, that are contracted through sexual
contacts.
smegma – White substance composed of glandular secretions, dead cells, dirt
particles and bacteria that accumulate under the foreskin of the penis.
sperm – The male reproductive cell.
SRH – Acronym for Sexual and Reproductive Health.
symptothermal method – A method of birth control using both temperature and
monitoring of symptoms (e.g. vaginal mucous) as a method of birth control.
T
testes (testicles) – The male organs that produce spermatozoa, located
behind the penis.
testicular self-examination (TSE) – Technique a man uses to examine his
own testicles for lumps or other abnormalities.
Toxic Shock Syndrome (TSS) – A bacterial infection associated with the use of
tampons. It is rare but sometimes fatal.
382
transgender (TG) – A broad term used to describe the continuum of individuals
whose gender identity and expression, to varying degrees, does not correspond
with their biological sex. Transgendered individuals may be heterosexual,
bisexual, or homosexual in their sexual orientations.
transsexual (TS) – An individual who presents him/herself and lives as the
gender “opposite” to his/her biological sex. Transsexuals may be heterosexual,
bisexual, or homosexual in their sexual orientations.
U
urethra – A tube leading from the bladder that carries urine out of the body—in
females, its opening lies in the vulva between the vagina and clitoris. In males, it
runs through the penis to an opening at the tip of the glans and serves as a
passage for semen as well as urine.
uterus – A pear-shaped hollow organ with muscular walls, where the fertilized
egg becomes embedded and the fetus grows and is nourished.
V
vagina – Hollow, muscular, tunnel-like structure that leads from the cervix to the
vulva at the outside of the body; also called the birth canal.
Vaginal Contraceptive Film (VCF) – A contraceptive that requires the insertion
of nonoxynol 9 in a thin, soluble sheet into the vagina.
vaginal intercourse – Intercourse that occurs when the penis is put into the
vagina.
vas deferens – Tube that transports sperm from the epididymis on each testicle
to the urethra in the prostate gland.
vulva – Collective term for the external female genitals; including the mons
pubis, the labia majora and minora, the clitoris, and the vaginal and urethral
openings.
W
wet dream – Orgasm with ejaculation that occurs during sleep; also called
nocturnal emission.
withdrawal – Male withdraws his penis from the vagina just before ejaculating.
womb – uterus.
Y
yeast infection – Internal or external infection caused by a fungus (e.g. vaginal
yeast infection).
Z
zygote – Single cell created by the union of egg and sperm; a fertilized egg.
.
.
Sources:
“Glossary” in Planned Parenthood Association of B.C. (2000) Reproductive and Sexual Health
Resource Manual. Vancouver: Author.
“Glossary” in Hubbard, Betty M. (1997) Sexuality and Relationships. Santa Cruz: ETR Associates.
“Glossary of Terms” in GLSEN (1999) Tackling Gay Issues in School. Connecticut: GLSEN and
Planned Parenthood of Connecticut, Inc.
383
Appendix B
Sample Letter to Parents
[Date]
Dear Parent/Guardian;
Your son/daughter will commence a sexual and reproductive health program at [school]. The program
runs from [date] to [date] and is mandated through the Ministry/Department of Education. The objectives
and outcomes of this program are outlined in the [provincial/territorial] curriculum. The topics we will
discuss include:
[topic]
[topic]
[topic]
If you have any questions about the program, or if you would like to review program materials, please
contact me. If you do not wish your son/daughter to participate in this program, please return the bottom
portion of this letter to me. S/he will be provided with alternate activities during classes on sexual and
reproductive health education.
Thank you,
[Name and contact information]
OPT-OUT OPTION
I do not want ________________________________________________to participate in the sexual and
reproductive health education program.
___________________________________
(Name)
___________________________________
(Signature)
384
Appendix C
Needs Assessment Activities
1.
Anonymous Question Box
At the beginning of a unit or at the beginning of each class/session, ask
participants to write down a question on either a particular topic or in
general. All participants should write down something to ensure
anonymity. Collect all questions in a box (e.g. a decorated shoebox).
Either
read the questions aloud, at random, and answer them
read the questions outside of the class/session in order to prepare
accurate answers for the subsequent class/session
use the questions to determine what issues are most pressing for the
group and plan future sessions accordingly
2.
Selecting Topics
At the beginning of a unit, distribute a handout listing possible topics
(see sample, attached). Participants choose the top five topics they
want to learn most about. Tally the results and see what issues the
majority is interested in.
3.
Brainstorming
Participants generate a list of topics related to sexuality and reproductive
health education. Write their responses on the blackboard or on flip-chart
paper. Then, as a group, determine what issues and topics will be
examined in future classes (e.g. majority vote).
4.
Focus Groups with Youth
Well in advance of teaching the unit, facilitate a focus group with 5 to 7
youths who represent the population you plan to work with. This can
give you ideas as to what to teach, what not to teach, and how to teach
it. You may want to consider asking someone else to facilitate the focus
group (e.g. a peer counsellor) to eliminate bias. Some sample
questions include:
What kinds of sexual health information have you received in
school? What topics are covered?
Do you think these topics are well covered? Why or why not?
Think about the people, places, or ways that you have received
information or support concerning sexual health. Of these, which was
the most/least helpful and why?
If you were to design a course on sexual and reproductive health,
what would the main topics be?
What would help you/your peers make good decisions about sexual
health/ sexual behaviour?
385
Appendix C
Selecting Topics
Instructions
Pick the five (5) topics that interest you the most.
_______ values
_______ puberty
_______ reproduction (how babies are made)
_______ prenatal care
_______ reproductive health (e.g. pap smears, testicular exams)
_______ self-esteem
_______ body image
_______ family
_______ friends
_______ dating relationships
_______ gay, lesbian, bisexual issues
_______ homophobia
_______ sexual decision-making
_______ negotiating safer sex
_______ masturbation
_______ contraception/birth control
_______ unplanned pregnancy
_______ pregnancy
_______ STIs (sexually transmitted infections)
_______ HIV (prevention, transmission, symptoms, treatment)
_______ sexual assault
_______ information on resources in my community
other: _________________________________________________
386
Appendix D
Community Mapping Activity.:
1.
Name of clinic:
2.
Address and phone number of clinic:
3.
Clinic hours:
4.
The following services are available at this clinic:
.
______ Birth control
______ Prenatal care
______ STD testing
______ Pregnancy tests
______ Distribution of condoms
______ STD treatment
______ HIV test
______ Support groups
______ Counselling
______ HIV counselling
______ Referral to other agencies
Other: ________________________
5.
What is the clinic’s policy on confidentiality?
6.
The following languages are spoken at this clinic:
7.
I felt the following level of comfort in this clinic (include such things as friendliness and helpfulness of
staff, décor, magazines/pamphlets available in waiting room, etc.):
1
2
3
4
Very comfortable
Comfortable
Somewhat uncomfortable
Uncomfortable
8.
I would/wouldn’t tell a friend to visit this clinic for an examination/consultation about protection. Write
two sentences telling why or why not.
9.
Something I learned at this clinic:
.
(Adapted with permission from Gordon, Bill (1995) Relationships Skills for Healthy Sexuality. Edmonton: Alberta Learning.)
387
Appendix D
Community Mapping Activity :
Buying a Condom
.
Name of the store:
1.
Store hours:
Where were the condoms displayed?
_______ not displayed
_______ behind counter
_______ on shelves
other: ______________________________________________________
2.
Were the condoms easy to find?
_______ yes
_______ no
Why or why not?
3.
Did you have to ask someone where to find the condoms?
_______ yes
_______ no
If yes, how did s/he react?
4.
Information about brand names and types displayed:
Brand Name
5.
Type (lubricated,
male/female, spermicide,
ribbed…)
Price
Other information
How would you feel if, at some time in the future, you purchased
condoms from a location like the one you visited?
.
Relationships. Queen’s University, Kingston: Author)
388
Appendix E
Using the Internet to Access Sexual Health Information .
Level II/III
Objective: Participants will practice accessing valid sexual health information
using the internet.
Structure:
Time:
25 minutes as a large group (plus homework option)
Materials: Flipchart/blackboard, computer with internet access, “Internet Health
Information” handout, “Web Sites for Youth” handout.
Note: Students should have basic knowledge of use of PCs and Internet
browsers to search for and access information.
Note: This activity can be done in-class (if there is computer and internet access)
or as a homework assignment. If done in-class, review your school's policies and
procedures related to use of the Internet and sexuality education. It is important
to follow guidelines for discussion of sensitive personal health topics in
secondary classrooms. If done as a homework assignment, you may need to
contact parents by letter to discuss the purpose and objectives of this lesson
prior to assigning students the task of searching the Internet.
Procedure
1. Begin the lesson by asking students to brainstorm which people,
publications, and places provide accurate sexual health information.
a. Sample responses include: parents, teachers, health professionals,
trade or scientific publications, community health agencies and
organizations, and electronic sources.
b. Together with students, list criteria that can be applied to distinguish
valid from inaccurate sexual health information.
c. Sample responses include: legitimacy of the source, connection to
commercial health products, currency of the information, content of
the message, consistency with similar messages obtained from other
sources on the same subject, professional references (or links)
provided.
2. Distribute the “Internet Health Information” handout and review the nine
questions aloud.
3. Discuss the use of key words, links, and URLs. Practice as a group
accessing a single site (i.e. Canadian Health Network home page).
4. If done as an in-class assignment, supervise students as they work either
independently, or in small groups.
5. Conclude the activity by:
a. Encouraging students to discuss their answers to the “Internet Health
Information” handout.
b. Highlighting the accuracy and inaccuracy of specific sexual health
information located by students.
.
Adapted with permission from Dr. Brian F. Geiger. This activity was originally posted on the
Educator’s Reference Desk: www.eduref.org
389
c.
Asking students to share examples of the informational resources
they obtained from the Internet.
d. Giving participants a copy of the “Web Sites for Youth” handout for
their future reference. Alert participants to the fact that although there
is some very good and reliable information on many American web
sites, there are significant legal and cultural differences in the way
sexual and reproductive health is regulated in Canada and the U.S.
390
Handout
Internet Health Information
Instructions: Pick 2-3 sexual health topics of interest. Sexually explicit materials are prohibited. Sample
topics include: puberty and human development, STIs, birth control, breast cancer prevention, testicular
cancer, and fetal alcohol syndrome.
1. What specific sexual health topics did you choose for the Internet search?
2. Where did you begin your search? (name of search engine)
3. What key words did you use to conduct the search for information?
4. List the web sites or home pages that you visited (include URLs and full names).
5. Describe the criteria you actually used to select accurate health information. (How did you determine
whether a web site contained suspicious information?)
6. Describe three ADVANTAGES of using the WWW/Internet over traditional sources of information.
7. Describe three DISADVANTAGES of using the WWW/Internet over traditional sources of information.
8. What are the most important things you have learned about accessing consumer health information from
the Internet?
9.
Attach samples of printed pages describing health information you obtained from the Internet.
391
Handout
Web Sites for Youth
Canadian Sites
Canadian Federation for Sexual Health: www.cfsh.ca
Spiderbytes: www.spiderbytes.ca/
Sexualtyandu: www.sexualityandu.ca/eng/teens/
Teen Net: www.cyberisle.org
Planetahead www.planetahead.ca
Young People’s Press Online: www.ypp.net
YouthCO AIDS Society: www.youthco.org/
Teen Health: www.chebucto.ns.ca/Health/TeenHealth/index.html
Kids Help Phone: http://kidshelp.sympatico.ca/
National Eating Disorders Information Centre: www.nedic.ca
Lesbian, Gay, Bi, Trans Youth Line: www.youthline.ca/
American Websites
Planned Parenthood Federation of America: www.teenwire.com
gURL: www.gURL.com
Go Ask Alice: www.goaskalice.columbia.edu/index.html
Sex Etc.: A Website for Teens by Teens: www.sxetc.com/
It’s Your (Sex) Life: http://www.itsyoursexlife.com/
Something Fishy Website on Eating Disorders: www.something-fishy.org
Adbusters: http://adbusters.org
The Cool Page for Queer Teens: www.bidstrup.com/cooldat.htm
Coalition for Positive Sexuality: www.positive.org/
392
Appendix F
Icebreaker Activity
Level I
.
To get some of the giggles out, ask the participants to listen to the following
statements and do as suggested. When reading them, go at a fairly quick
pace so that participants are standing up and sitting down at the same time.
Change or add statements to meet the needs of your group.
Stand up if you like pizza.
Sit down if you watched TV last night.
Stand up if you play hockey.
Stand up if you don’t like broccoli.
Sit down if you are wearing blue today.
Stand up if your favourite colour is green.
Sit down if you have gone to the movies this past week.
Stand up if you like hamburgers and French-fries.
Sit down if you enjoy listening to music.
Stand up if you think it is embarrassing to talk about sex.
.
Development Lesson Plans for Grades 5 & 6.)
393
Appendix F
Icebreaker Activity
Human Bingo Answer Key
Level II/III
Move about the room and have a person sign their name below the statement. A
person can only sign the sheet once. When you have the whole card signed, yell
“bingo.”
Find someone who…
Knows what HIV
stands for
Human Immunodeficiency
Syndrome
Knows what
“Reality” is Brand
name for a
female condom
Can name a
movie/TV show
with a gay
character shown
positively
Can name 3
symptoms of a
STI Burning at
urination, pain
during sex,
unusual
discharge, warts
or blisters
Knows how long
sperm lives 3 – 5
days
Knows if you
need a
prescription for
the pill
Prescription
needed
Can name 5
intimate activities
that don’t risk
someone’s health
Kissing,
hugging,
masturbation,
touching,
massage
Can name an
unhealthy
relationship in a
TV show or
movie
Can name a
healthy
relationship in a
TV show or
movie
Learned where
babies came
from their parents
Feels pressure
from the media
to look or act in a
specific way
Can give 3
reasons not to
get sexually
involved
Cultural
reasons,
religious
reasons, not
ready
Can name 4
kinds of
contraception
Condom, the
pill, depoprovera,
emergency
contraception,
spermicide, IUD,
diaphragm,
vaginal ring, the
patch
Can name 3
signs of
pregnancy
Nausea, breast
tenderness,
fatigue,
increased
urinary
frequency,
weight gain
Knows what kind
of condom
protects against
HIV Latex
condom
Knows how long
an egg lives
1 – 2 days
394
Handout
Appendix F
Human Bingo
Move about the room and have a person sign their name below the statement. A person can only sign the
sheet once. When you have the whole card signed, yell “bingo.”
Find someone who…
Knows what HIV
stands for
Can name a movie/TV
show with a gay
character shown
Can name 3 symptoms
of a STI
Knows how long sperm
lives
Knows what “Reality”
Knows if you need a
prescription for the
Can name 5 intimate
activities that don’t risk
someone’s health
Can name an
unhealthy relationship
in a TV show or movie
Can name a healthy
relationship in a TV
show or movie
Learned where babies
came from their
parents
Can name 4 kinds of
contraception
Knows what kind of
condom protects
against HIV
Feels pressure from
the media to look or act
in a
Can give 3 reasons not
to get sexually
Can name 3 signs of
pregnancy
Knows how long an
egg lives
395
Level II/III
Appendix F
Icebreaker Activity
What Am I?
Procedure: Tape one card on the back of each participant. Have participants
circulate amongst their peers to try to guess what is written on their card.
Participants can ask only yes or no questions to a maximum of three questions
per person.
Condom
Body image
Pill
Menstruation
Puberty
STI
Communication
Penis
Values
Vagina
Sperm
Dating
Pregnancy
Love
Self esteem
Kissing
Peer pressure
Ovulation
Media
Sexuality
396
Appendix G
Anatomy Diagrams
Female
mons pubis
clitoris
labia majora
labia minora
urethral opening
vaginal opening
anus
397
Appendix G
Anatomy Diagrams
Female
ovary
fallopian tubes
ovary
uterus
cervix
vagina
398
Appendix G
Anatomy Diagrams
Male
vas deferens
seminal vesicle
prostate gland
urethra
anus
testicle
penis
scrotum
399
Web sites for Educators
Canadian Sites
Canadian Federation for Sexual Health: www.CFSH.ca
Canadian Health Network: www.canadian-health-network.ca
Sex Information and Education Council of Canada: www.sieccan.org
Canadian Guidelines for Sexual Health Education: www.phacaspc.gc.ca/publicat/cgshe-ldnemss/index.html
Sexual and Reproductive Health Promotion (Health Canada): http://www.hcsc.gc.ca/hppb/srh/
Canadian Association for School Health: www.schoolfile.com/CASH.htm
Canadian Association for Health, Physical Education, Recreation and Dance:
www.cahperd.ca
Canadian Mental Health Association: www.cmha.ca
Suicide Information and Education Centre: www.suicideinfo.ca
Canadian Abortion Rights Action League: www.caral.ca
Adoption Council of Canada: www.adoption.ca
National Clearinghouse on Family Violence: www.hcsc.gc.ca/hppb/familyviolence/
Canadian Association of Sexual Assault Centres: www.casac.ca/
Parents, Families and Friends of Lesbians and Gays: www.pflag.ca
Canadian AIDS Society: www.cdnaids.ca
Sexual Health and Sexually Transmitted Infections: www.phac-aspc.gc.ca/stdmts/index.html
Canadian HIV/AIDS Information Centre: www.aidssida.cpha.ca
Community AIDS Treatment Information Exchange: www.catie.ca
Canadian Public Health Association:
www.cpha.ca
Sexualityandu: www.sexualityandu.ca/eng/teachers/
Infertility Awareness Association of Canada: www.iaac.ca/
Canadian Women’s Health Network: www.cwhn.ca
400
American Sites
Canadian Federation for Sexual Health of America: www.plannedparenthood.org
Sex Information and Education Council of the U.S.: www.siecus.org
National Campaign to Prevent Teen Pregnancy: www.teenpregnancy.org
Resource Center for Adolescent Pregnancy Prevention:
www.etr.org/recapp/programs/index.htm
National Sexual Violence Resource Centre: www.nsvrc.org/
Gay, Lesbian, Straight Education Network: www.GLSEN.org
Parents, Families and Friends of Lesbians and Gays: www.pflag.org
The Alan Guttmacher Institute: www.agi-usa.org/
The National Center for Health Education: www.nche.org/
Centers for Disease Control: www.cdc.gov/
American School Health Association: www.ashaweb.org
401
Web sites for Youth
Canadian Sites
Canadian Federation for Sexual Health: www.CFSH.ca
Spiderbytes: www.spiderbytes.ca/
Sexualtyandu: www.sexualityandu.ca/eng/teens/
Teen Net: www.cyberisle.org
Planetahead www.planetahead.ca
Young People’s Press Online: www.ypp.net
YouthCO AIDS Society: www.youthco.org/
Teen Health: www.chebucto.ns.ca/Health/TeenHealth/index.html
Kids Help Phone: http://kidshelp.sympatico.ca/
Lesbian, Gay, Bi, Trans Youth Line: www.youthline.ca/
American Websites
Canadian Federation for Sexual Health of America: www.teenwire.com
gURL: www.gURL.com
Go Ask Alice: www.goaskalice.columbia.edu/index.html
Sex Etc.: A Website for Teens by Teens: www.sxetc.com/
It’s Your (Sex) Life: http://www.itsyoursexlife.com/
The Cool Page for Queer Teens: www.bidstrup.com/cooldat.htm
Coalition for Positive Sexuality: www.positive.org/
402
Eating Disorders
What are eating disorders?
Clinical eating disorders include anorexia nervosa, bulimia nervosa, and bingeeating disorder. All eating disorders are expressions of underlying psychosocial
problems. Both anorexia nervosa and bulimia nervosa are characterized by fear
of weight gain, feelings of ineffectiveness, and low self-esteem.
Anorexia nervosa is identified by drastic weight loss from extreme food
restriction. Most individuals with anorexia don’t recognize how underweight they
are. Even when down to 80 pounds, these individuals may still “feel fat,” making
it difficult to persuade them to seek help. Alternatively, they may know that they
are emaciated but experience an intense fear of food.
Bulimia nervosa is identified by frequent fluctuations in weight, with periods of
uncontrollable binge eating followed by some form of purging. They rid the body
of the unwanted calories through self-induced vomiting, laxative abuse,
excessive exercising, or fasting. Each of these methods is harmful and
counterproductive.
Binge-eating disorder, or compulsive eating, may be described as food intake
that
is emotionally “driven” to the point of physical discomfort or beyond
often occurs in secret
is experienced as comforting to the individual and
may be a continuation of a regular meal or initiated apart from meals.
This type of behaviour is different from bulimia in that it is not followed by any
form of purging.
Eating disorders are caused by a combination of societal, individual, and family
factors. They are a manifestation of complex, underlying struggles with identity
and self-concept, and of problems that often stem from traumatic experiences
and patterns of socialization. Eating disorders are coping behaviours that provide
the individual with an outlet for displacement of feelings or with a (false) sense of
being in control. Common to all eating disorders is a pervasive underlying sense
of powerlessness.
Regardless of clinical diagnosis, any food and weight issues that affect an
individual’s ability to live a full and pleasurable life are of concern.
Signs of an eating disorder
Excessive concern about weight, shape, and calories
Unusual eating habits
Irregular menstruation or cessation of menstruation
Depression or irritability
Guilt or shame about eating
Strict avoidance of certain foods, particularly those considered fattening
Feeling fat when not “overweight”
Use of laxatives, diuretics, purgatives
403
Excessive exercise
Vomiting to purge food
Noticeable weight loss in anorexia
Frequent weight fluctuation in bulimia
Extreme concern about appearance, both physical and behavioural
I suspect that someone I know has an eating disorder— how
can I help? .
When first approaching the person, understand that they might not welcome your
concern and may even react with anger or denial. They will discuss their eating
disorder with someone when they feel ready.
They will probably feel more able to do so if they know that you are concerned
but not going to force them into anything before they are ready (an exception
may be if the condition constitutes a medical emergency). Be prepared for the
possibility that a discussion about their eating problems might not lead to any
change in attitude or behaviour on their part. This is because the person may
have very good reasons not to give up the eating disorder, as a “coping strategy”.
Here are a few further suggestions:
Be aware of community resources and encourage her/him to use them.
Focus on feelings and relationships, not on weight and food.
Convey concern for her/his health while still respecting their privacy. Eating
disorders are often a cry for help, and the individual will appreciate knowing
that someone is concerned.
Avoid commenting on appearance; the person is already overly focused on
this. Comments on weight or appearance, even if the intent is complimentary,
will only perpetuate the obsession with body image.
Realize that the individual needs to work to get better at his or her own pace.
By providing information and being supportive, you are enabling them to see
and consider alternatives to the present situation.
Examine your own attitudes about food, weight, body image, and body size
to ensure you do not convey any fat prejudice or exacerbate their desire to
be thin. If she/he expresses feeling fat or wanting to lose weight, instead of
saying “you’re not fat,” suggest they explore their fears about being fat and
what they think they can achieve by being thin. Encourage reflection on the
pressures in society to look a certain way and how this negatively affects our
self-esteem. Think about the way you, personally, are affected by bodyimage pressures and share these with the person in a supportive manner.
.
(Adapted with permission from: National Eating Disorder Information Centre (1998)
www.nedic.on.ca.)
404
Facts and Figures on
Lesbian, Gay & Bisexual Youth
Lesbian, gay, and bisexual youth have many of the same health and safety
concerns as other youth. These include everything from acne to puberty and
hormones to making friends. However, there are some health issues and risk
factors that affect gay, lesbian, and bisexual youth somewhat differently than
other youth.
Realization
Gay youth report becoming aware of feeling “different” between the ages of 5
and 7 but did not link that to issues of sexuality. (Treadway & Yoakum, 1992)
The average age at which lesbian and gay youth become aware that their
feelings of “difference” are linked to sexual orientation is 13. (Sears, 1991)
Suicide
Lesbian, gay, and bisexual youth compromise 30% of completed youth
suicides. (Gibson, 1989)
Lesbian, gay, and bisexual youth are up to fourteen times more likely to
attempt suicide than their heterosexual counterparts. (Bagley & Tremblay,
1997)
More than 50% of lesbian, gay and bisexual youth experience suicidal
thoughts and between 25% and 50% attempt suicide. (Schneider, 1991)
Drugs/Alcohol
Lesbian, gay and bisexual youth experience substance abuse problems 3 to
5 times higher than heterosexual youth: 68% of young gay males use alcohol
and 44% use drugs and 83% of young lesbians use alcohol and 56% use
drugs. (Hunter, 1992)
Gay youth are twice as likely to report binging on alcohol. (Vermont, 1998)
Isolation
80% of lesbian, gay, and bisexual youth report severe isolation problems
including having no one to talk to, feeling distanced from peers and family,
and lacking access to good information about gay, lesbian, and bisexual
issues. (Hetrick & Martin, 1987)
Family
Half of lesbian, gay, and bisexual youth reported being rejected by their
parents. (Remafedi, 1987)
19% of gay men and 25% of lesbians report suffering physical violence from
family members because of their sexual orientation. (Philadelphia, 1992)
Between 20% and 40% of youth living on the streets identify themselves as
lesbian, gay, or bisexual. (Travers and Schneider, 1997)
Up to 25% of lesbian, gay, and bisexual youth, whose parents react
negatively to their sexual orientation, are disowned or forced to leave home.
(Remafedi, 1987)
405
School Atmosphere .
45% of young gays and 20% of lesbians report receiving verbal harassment
and/or physical violence as a result of their sexual orientation being known in
high school. (National Gay and Lesbian Task Force, 1984)
Lesbian, gay, and bisexual youth are two to five times more likely to skip school
due to feeling unsafe. (Vermont, 1998)
28% of lesbian, gay, and bisexual youth drop out of school because of
harassment. (Remafedi, 1987)
97% of students in high schools report regularly hearing homophobic remarks
from their peers. (Massachusetts, 1993)
53% of students report hearing homophobic comments made by school staff.
(Massachusetts, 1993)
2/3 of guidance counsellors harbour negative feelings toward gay and lesbian
people. (Sears, 1992)
Less than 20% of guidance counsellors have received any training on serving the
needs of gay and lesbian students. (Sears, 1992)
.
(Adapted with permission from: Lesbian, Gay and Bisexual Youth Project (1999) Halifax.)
406
Pregnancy & Options
Some Reasons for Pregnancy
Many couples don’t talk about intercourse, condom use, birth control, and
pregnancy. It’s easier to have sex than to talk about it. Advertising,
television, movies, and videos give messages that promote sex and the idea
that “it just happens.” There are few messages about respecting ourselves
and taking responsibility for our behaviour.
Sometimes a couple uses birth control, but don’t use it consistently or
correctly every time. Even when used correctly, birth control can fail. No
method is 100% effective.
Sometimes pregnancy is a result of sexual assault or coercion.
Birth control is not easily available in all communities. People may not know
how or where to get it or are concerned about confidentiality or cost.
Drugs and alcohol affect judgement. Even a couple who plan to use birth
control can get “carried away” and have unplanned intercourse or forget to
use birth control.
Everyone wants to be loved and needed: some people believe a baby will
meet this need.
Facts about Teenage Pregnancy
90% of teenage pregnancies are unplanned.
1 out of 10 teenage girls will be pregnant before 18 years of age.
About 50% of these pregnancies will end in abortion.
85-90% of teens who deliver a baby choose to parent.
Over half of teens that parent do not finish school.
2 out of 3 women who become mothers as teens spend their lives in poverty.
Three options exist for women who are pregnant .:
1. Terminate the pregnancy by having an abortion.
2. Continue the pregnancy and place the child for adoption
3. Continue the pregnancy and become a parent.
Abortion
Abortion is legal in Canada.
An abortion is the termination of a pregnancy by the removal of the embryo
or fetus from a woman’s uterus.
The earlier an abortion is performed, the safer and less complicated the
procedure. The majority of abortions are performed within the first 12 weeks
of pregnancy.
Abortions performed in hospitals are free under Medicare. The cost of an
abortion at an abortion clinic varies: at some it is free, and at others the client
may have to pay a part of the cost. This varies from province to province.
Women under 18 may need a parent’s or a guardian’s consent to have an
abortion in a hospital.
.
Discussing pregnancy options can be difficult and challenging. Young people need information on all
available options. It is important to present and discuss each option openly, accurately, and without
judgement.
407
Adoption
There are 2 kinds of adoption
1) Public (or Agency) Adoption: These are administered through Child
and Family Services. The birth mother can have some input into the
selection of adoptive parents. She can also choose to meet the adoptive
parents beforehand.
2) Private Adoption: A woman 18 years or older can arrange an adoption
through a private lawyer. She must approve of the couple that will adopt
the child. In some cases, the adoptive parents may allow the birth mother
to visit the child.
In both types of adoption, the biological father (if known) must be informed of
the planned adoption before it occurs.
A birth mother may re-establish contact with the adopted child when the child
is 18 years old, if the mother and adoptive child both place their names on a
registry with Child and Family Services.
Less than 5% of adolescent women who deliver a baby choose adoption.
Parenting
Parents are legally responsible to provide care for a child until the child is 16
years old.
There are resources in the community to assist mothers with housing,
education, and training.
Mothers may be entitled to welfare assistance if they have no other means of
support.
Mothers are entitled to some financial support from the child’s father, even if
he has no contact with the child.
The child’s father may request access to the child, whether or not he’s
providing financial support.
Studies show that most teen mothers end up raising their children alone.
90% of youth who deliver a baby choose to parent.
.
References
Manitoba Children and Youth Secretariat (1996)
Steering Committee on Adolescent Pregnancy.
Planned Parenthood Cape Breton (1996)
Peer Counselling Training Manual. Cape Breton: Author.
Sexuality Education Resource Centre (1999)
Youth, Sex and Pregnancy. Winnipeg: Author.
Wadhera, S. and Millar, W.J. (1997)
Teenage Pregnancies, 1974 to 1994. Health Reports. 9(3).
408
Sex, Drugs & Alcohol.
Drugs and alcohol impair your decision-making so you may end up having
sex when you wouldn’t if you were sober. People may take advantage of you
in this situation—sex without consent is sexual assault.
If you’re drunk or stoned, you might have unsafe sex, putting yourself at risk
of sexually transmitted infections (STIs) and unintended pregnancy. If you’ve
had unprotected sex, or can’t remember what happened, get tested for STIs.
To prevent an unintended pregnancy, consider using emergency
contraception (or “the morning after pill”). It is effective in preventing a
pregnancy within 5 days of unprotected sex. You can get it from any clinic,
doctor, or emergency room or directly from a pharmacist, without a doctor’s
prescription.
If you share needles or other drug equipment, you will be at high risk of
contracting HIV and Hepatitis B. Needles must be clean to be safer. Do not
share equipment!
Drugs and alcohol have lots of health risks, but they can also negatively
affect sexual performance and enjoyment (e.g. low desire, reduced vaginal
lubrication can make sex uncomfortable, problems getting erections, etc.)
Also, getting drunk and throwing up isn’t very sexy!
Pregnant women using alcohol, drugs, or tobacco risk harmful effects on the
developing fetus.
People with lower self-esteem are more easily influenced by peer pressure to
use drugs and alcohol. If friends are pressuring you, they’re not really your
friends. If a partner pressures you, it’s not a healthy relationship. You
deserve better—find people who respect you!
Some gay, lesbian, and bisexual youth may use drugs and alcohol to cope
with feelings of loneliness, shame, fear, and harassment. Getting drunk or
high won’t make coming out any easier. Remember that you are not alone.
Tips for being safer:
o
Choose not to use drugs and alcohol. If you do, set limits for yourself.
o
Be a buddy! Friends can watch out for each other. Take turns!
o
Do not share needles and drug equipment.
o
If you’re going to have sex, practice safer sex: don’t exchange bodily
fluids like semen, vaginal fluids, and blood. Be prepared, with lubricated
latex condoms. Choose less risky things like making out. Get more
information about safer sex from a clinic or doctor.
o
To protect yourself from date rape drugs, don’t drink anything you didn’t
open yourself and never leave a drink unattended. Don’t drink something
that looks or tastes odd.
Substances can reduce our inhibitions, but they also involve a lot of risks. If
you need drugs and alcohol in order to have sex, maybe you’re not really
ready to have sex at all!
Sober is Safer and Sexier!!!
.
(Adapted with permission from Planned Parenthood Metro Clinic, Halifax.)
409
Sexual Violence
Sexual assault is any sexual activity without consent, and it is against the law.
Sexual violence is not about sex: it is about power. It is most often an issue of
men exerting power over women, with some groups of women disproportionately
affected. Although it occurs less often, boys and men are also victims of sexual
violence, and girls are capable of pressuring boys in dating relationships.
1 in 3 girls and 1 in 6 boys will experience some form of unwanted sexual
contact before the age of 18.
Only 6% of sexual assaults are reported to the police.
The victim knows the offender 85% of the time.
57% of rapes occur on a date.
49% of rape victims are 16 or under.
Girls and women with disabilities are twice as likely to be sexually assaulted.
Men commit 99% of all sexual assaults.
If someone discloses abuse to you:
Listen.
Thank her/him for confiding in you, and acknowledge how hard it must be to
talk about the abuse.
Tell them you believe them. It is important for someone who has been
abused to have people believe what has happened. Most people do not lie
about being abused or assaulted.
Support her/his feelings by saying things like: “It sounds like it was really
scary” or “I understand why you feel so terrible.”
Tell them that it wasn’t their fault. The only person to blame is the offender.
Inform her/him of your legal obligation to report (see box below).
Refer her/him to services in your community (e.g. sexual assault centre).
If you know or suspect that someone under 16 is being, or is likely to be,
neglected or emotionally, physically, or sexually abused, you have a legal
obligation to report it to the Ministry of Children and Families or Child Protection
Office in your province.
If someone discloses abusive behaviour to you:
Listen.
Support change in their behaviour.
Speak out and address abusive comments.
Help him/her understand that s/he is the only one responsible for the
violence, even if his/her partner is responsible for other problems in the
relationship. Violence is learned behaviour and can be unlearned.
Encourage him/her to seek help in a counselling program. The violence will
not stop on its own.
410
Sexual Assault: The Law.
Level 1 – Sexual Assault
It is a crime if someone forces any form of sexual activity on someone else (e.g.
kissing, fondling, touching, sexual intercourse, etc.) without that person’s
consent.
Level 2 – Sexual Assault with a Weapon
It is a crime if, during a sexual assault
the attacker either uses a weapon or threatens to use a weapon (imitation or
real)
the attacker causes bodily harm to the victim
the attacker threatens to harm a person other than the victim
more than one person assaults the victim in the same incident.
Level 3 – Aggravated Sexual Assault
It is a crime if, while committing a sexual assault, the attacker
wounds, maims, disfigures, or brutally beats the victim
endangers the life of the victim.
Sexual Interference (against children under 14)
It is a crime if someone, for a sexual purpose, touches any part of the body of a
child (under the age of 14).
Invitation to Sexual Touching (against children under 14)
It is a crime if someone, for a sexual purpose, encourages a child to touch them
with any part of the child’s body or with an object.
Invitation to Sexual Touching (against children 14-17)
It is a crime if someone who is in a position of trust or authority towards a young
person (someone between the ages of 14 and 17) or a person with whom the
young person is in a relationship of dependency (guardian, foster-parent, parent)
commits the offence of “sexual interference” or “invitation to sexual touching”
described above.
Incest
It is a crime if a blood relation has sexual intercourse with another blood relation
(e.g. parent, brother, half-brother, sister, grandparent, etc.).
Exposure
It is a crime if someone, for a sexual purpose, exposes his or her genitals to a
person who is under the age of 14. (If this happens to someone over the age of
14, it is only against the law if it happens in a public place.)
Offence in Relation to Juvenile Prostitution
It is a crime if someone buys or attempts to buy the sexual services of a person
who is under the age of 18.
.
REFERENCES
1. Metropolitan Action Committee on Violence Against Women and Children (METRAC) (1998)
Preventing Sexual Assault. Toronto: Author.
2. Victoria Women’s Sexual Assault Centre (1994) Today’s Talk About Sexual Violence: A Booklet
for Teens. Victoria: Author.
3. Education Wife Assault (1993) Preventing Violence in Dating Relationships: A Teaching Guide.
Toronto: Author.
411
Smoking and Your Health.
Taking birth control pills and smoking can be a dangerous combination. It is
associated with an increased risk of heart disease and stroke.
Smoking increases a woman’s risk of cervical cancer—if you can’t quit, make
sure you get regular pap smears!
Female smokers have an increased chance of irregular periods, infertility,
tubal pregnancies, ovarian cysts, and Pelvic Inflammatory Disease.
Smoking can limit your birth control choices.
Pregnant women who smoke risk premature and low birth-weight babies who
might have impaired physical and intellectual growth.
Smoking may increase the risk of miscarriage.
Smoking inhibits erections and lowers sperm counts in men.
Smoking can bring on earlier menopause.
Smoking reduces sex drive.
Some people find the smell of cigarettes a turn-off.
Be Healthy – Butt out
.
(Adapted with permission from Planned Parenthood Metro Clinic, Halifax.)
412
Tattooing & Body Piercing: Making it
Safer.
You may be thinking of getting a tattoo or a piercing. Here are a few tips to help
you protect yourself.
Amateur tattooing/piercing may cause serious infections like HIV/AIDS, hepatitis
B or hepatitis C. The safest way to get a good tattoo or piercing is to go to a
professional.
Professional Piercers...
don’t use “stud guns”;
use the right kind of jewellery (i.e., surgical steel, niobium).
Professional Tattooists...
pour ink into new, disposable containers just for your art.
Both Professional Piercers and Tattooists...
use single-use, sterile needles;
use latex gloves;
sterilize re-usable equipment (autoclave is recommended);
give after-care instructions to help prevent infection;
are experienced and knowledgeable.
Shop around first; ask friends who have had good experiences to recommend
places. Before you make up your mind, check out a few businesses and ask
questions; and if you’re not satisfied, LEAVE!
Ask to see:
special containers for used needles;
disposable ink cups for tattoo colours;
the autoclave (with a temperature gauge) used to sterilize equipment;
black lines on packages indicate equipment has gone through autoclave
(it is sterilized if autoclaved at 121 C/250 F for 30 min.).
What if you already have an amateur tattoo or piercing?
A professional can help answer questions that you may have. If you think
there is a chance that you may have been exposed to HIV, hepatitis B or
hepatitis C, testing can be done by a doctor, health clinic, or by contacting
your local health department. Vaccination against Hepatitis B is also
available.
.
(Adapted with permission from: Region of Ottawa-Carleton School-Based Sexual Health Program.)
413
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Beyond the Basics: A Sourcebook on Sexual and Reproductive

Transcription

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