decisions decisions...

My relationship with TV researchers is one of false hope followed by inevitable disappointment. Each time researchers have been putting together a new series of the Sex Education Show they have called me up. Like a fool my heart beats a little faster and my brain starts whirring and I believe, I really believe, that this time they actually want to get it right.

The first time abortion was mentioned on the Sex Education Show (an episode first aired in 2010) it was a description of an abortion method, accompanied by the presenter making eeuch faces and yeuch noises. I tweeted like a lunatic - Why the focus on the abortion procedure? Why the pulling of faces? Another missed opportunity to represent abortion and abortion education constructively.

This time when they rang asking for something I couldn't and wouldn't provide them with (probably a young woman who would talk about her abortion to the nation), I grabbed the bull by the horns. 'I'm afraid we can't help you with a real life case study, but what we can do is spend a bit of time helping you to consider useful ways in which to represent abortion and ways to address it within the Sex Education Show.' Silence at the other end of the phone.

'For example', I blathered on, 'I could send you the resources we use in schools. If you like you could come and observe one of our workshops to see what it is that young people really want to know about abortion and how you can usefully address the subject. I can send you a list of the questions they commonly ask and an explanation of how to answer them. Anything you'd like to know about this we'd be happy to explain, or to demonstrate '...SILENCE.

'It's just (I don't give up easily) it would be so much better if we could help the young people think about why abortion happens and how people come to that decision, rather than looking solely at the abortion process as you did last time. After all the abortion process is quick as a few minutes, and labour a few hours, but the decision to have a baby may be life changing.'

'Ok, well we'll get back to you, thanks' came the chirpy TV researcher voice on the other end of the phone.

So, did she get back to me?...No!
So, did the show focus on decision-making and avoid obsessing about the procedure itself?...No!
So, was I surprised?...No!

The show got some things right – abortion is a 'real' issue that YP aren’t given many opportunities to learn about. As one of the girl’s commented, the only stuff about abortion she knows comes from East Enders, hardly a reliable source of accurate information on the subject.  40,000 young women under 18 become pregnant in England and Wales each year many of whom face a real dilemma about what to do. As the show rightly stated, 18,000 abortions carried out for young women under the age of 18 every year in England and Wales, so it's a real shame so little good quality work is done around this topic within SRE. The young people interviewed were - as we find they always are - hungry for discussion of abortion.


Once again the opportunity to demonstrate good work was lost. Once again the abortion procedure took centre stage. As the presenter said 'we want to show teenagers the cold hard facts about abortion'.

At 40 minutes in to Episode 3 you can watch as a group of young people are led into the procedure room of a Marie Stopes abortion clinic. I've met the nurse who talked them through the procedure. She might even have participated in some of our training, and she was great - calm, clear and reassuring. But the constant camera fixation with the stirrups on the bed, and the cutting in of a photo of surgical instruments (which would only be used in a small proportion of the 9% of abortions that take place after 13 weeks) couldn't but make the whole procedure seem scary. One of the young women who had her hand over her mouth to denote 'I'm going to be sick' mode, before she even entered the room, became another point of repeated focus for the camera and editor.

Although both surgical and medical methods of abortion where mentioned, the information given was muddy and unclear, it implied that all abortions after 9 weeks are surgical which is not true - in fact the RCOG recommend medical procedures be used at all stages of gestation.

On the positive side it was instructive to see the small size of the cannula (a straw sized tube) which is inserted through the cervix and into the uterus to perform a 'surgical' or vacuum aspiration abortion. Many young people we talk to assume that it will be done using something the size of a hoover or, worse, that they have to actually cut you open. One of the young men in the programme said he had always assumed that this was how they performed abortion and it's not surprising since it's a common piece of misinformation deliberately disseminated by some anti-abortion organisations speaking to students in schools.)

As part of a comprehensive discussion of abortion it is natural that young people will ask about different abortion methods, but it really is only one part of the discussion and not, IMHO, the most important.

In Education For Choice workshops we explore the reasons women get pregnant when they don't intend to. That means looking at different contraceptive methods, different circumstances, positive and negative situations. We then get everyone to consider what that must feel like. What would the dilemma be like for the young woman and how would her partner be feeling. How easy would it be for them to talk to each other, what would they have to take into account in making a decision about pregnancy, who else could they talk to and would they get family support for whichever option they chose. We always ask them to consider adoption as well as parenthood and abortion and allow them to consider the pros and cons of all of these. We ask them to identify local services that can help with contraception, pregnancy testing and impartial pregnancy decision-making support. These lessons generate thoughtfulness and empathy as well as a lot of forthright views and interesting questions. Most young people leave the classroom with a much better understanding of what abortion is and why it is the right option for some people, but most importantly they are more motivated to avoid conception and to use contraception.

We always answer questions about abortion method clearly and simply, but just as I would if I had a pregnant young woman in front of me, we try to get them to prioritise thinking about the decision itself. However squeamish we are or fearful of pain and discomfort, the decision to bring a baby into the world and the lifelong commitment to caring for it must take priority over worrying about the relatively short abortion procedure or even the potentially long and painful labour.


I'm sad that I couldn't get this message through and that once again Channel 4 has prioritised 'shock and awe' over quality information giving. I wonder whether the next time the Sex Education Show ring me up to ask for help will I rebutt them?


Somehow I doubt it. Once again, my heart will beat faster, my brain will start to whirr and I will try again. Maybe I'm stupid, but this is just too important to get wrong.

Download our Best Practice Toolkit: Abortion Education FREE

Letter to Channel Four re: sex shows

Education For Choice was pleased to be signatory to this letter asking Channel Four to rethink the way it commissions and makes shows about sex. We're part of a group of experts in sex education, sexual health, health promotion, and psycho sexual health who are up for supporting programmes that are informative, empowering, entertaining and positive about human sexuality and adolescent sexuality. We think Channel Four keeps missing a trick by focusing on the sensationalist at the expense of the informative. We're also worried that poor quality programme plays into the hands of the anti-sex education lobby. Here is the letter some of us have written to Channel Four asking for an expert panel to be put together to support quality programme making.




8 February 2011


Dear David Abraham


Cc: Sue Murphy, Andrew Jackson, Katy Boyd, Liam Humphreys, Kate Teckman, Dominique Walker


We are a group of professionals who are pro-sex education and accessible sexual and reproductive healthcare. We believe in accurate and open discussions about relationships and sex, and feel television can be an effective and powerful medium for sex education programmes that are entertaining as well as informative. 


For the past decade Channel 4 has been making programmes addressing sex and relationships issues for teens and adults including: The Sex Inspectors (2004), Orgasmatron/Body Shock (2005), The Dark Side of Modern Love (2005), Am I A Sex Addict (2007), The Sex Education Show (2008-present), and most recently The Joy of Teen Sex.  This clearly demonstrates a commitment on behalf of the Channel which we feel is important given how little coverage these topics receive. 


While these programmes may have attracted high viewing figures, they have been criticised by therapists, healthcare providers, and educators for portraying inaccurate or outdated and misleading representations of sex education, healthcare, clinical treatments and therapies.


Many of us have been approached to participate on these programmes, or publicise them to our colleagues/clients.  We have repeatedly shared our worries about the direction programmes appear to be taking, although have had little success in having those concerns heard.  


The recent series The Joy of Teen Sex has been even more problematic than previous similar shows, raising complaint and concern from sexual and reproductive healthcare staff, sex educators, youth workers, sex researchers, parents and young people.  In particular they have been worried by:


- the range of topics covered, which may not be representative of the needs/questions teens may have


- some of the skills and qualifications of the professionals used in the programme


- the advice given to programme participants which left little room for exploration, choice, and the right to refuse sexual activity that doesn't appeal to them


- misleading and/or factually incorrect information, and frequently used unreliable statistics to back up points made. For example the inaccurate claim made at the start of each programme that the average teen has had three sexual partners by the time they reach 16. In fact reputable research finds most teens have not had intercourse before they are 16.(1).


- little attention paid to communication, confidence, respect, romance, affection, closeness
- an overemphasis on sexual techniques and products 


- offering options that may not be realistic for viewers, particularly younger teens or those on a low income 


- valuing the 'televisual' over more relevant issues to young people - e.g. exploring vajazzling


- consistent muddling of key terms (e.g.  vagina used when vulva is meant), or using outdated terms such as 'hymen'


- inaccurate representation of what sex education is like, what sexual health services deliver, and how sex education and healthcare professionals should act. For example a medic making a client cry by showing her graphic images of STIs; telling young women to expect bleeding as part of losing virginity; or not making clear the difference between normal vaginal discharge and an STI


- mixed messages from programme makers in their casting calls to young people/parents, and what professionals being consulted for the series were told it would offer (see Appendices 1 and 2)


- an overall tone that encouraged teen blaming, slut shaming and homophobia, while perpetuating messages of hegemonic masculinities and narrow sexual norms


- not listening to numerous professional concerns during the development stage


- no awareness of, or respect for, cultural diversity


- producers of the show using twitter to promote the programme while simultaneously dismissing professional and parent complaints of the series, referring to anyone who questioned the series as ‘haters’  (see also Appendix 3) 


We are concerned the Commissioners and Channel Four have not shown due diligence over this series. It seems to be fitting a pattern of programme development where viewing figures are prioritised over empowerment but where programmes are still marketed as 'educational'.  It does not appear to fit with the Channel’s Public Service Remit or Corporate Responsibility.


We are worried misinformation about sexual and reproductive healthcare and education has been grossly misrepresented, leading to parents feeling anxious, young people's right to accurate information not being delivered, and professional advice being ignored at all stages of programme development. 


The right of young people to comprehensive sex and relationships education is still contested in this country. Many individuals and organizations oppose sex education on the grounds it will sexualise their children, claim it will not give accurate information, or will encourage sexual activity rather than encouraging thoughtful decision-making about relationships.  For this reason it is vital that any programme claiming to provide education about sex and sexuality does not provide fuel for these arguments.  Sadly we have seen reactions to The Joy of Teen Sex in public discussions and on places like twitter that indicate the programme is already being used as evidence of the 'failings' of sex education.
As a result we fear this style of programme making could lead to young people and adults not getting the sexual and relationships advice they need; making the job of healthcare providers, therapists, educators, parents and youth workers more difficult; and causing distress to young people and parents. We have been overwhelmed with emails from anxious teens and parents who support sex education, but are concerned about the messages of teenagers, sex, relationships and sexuality portrayed in this series.


Channel 4 clearly intends to continue making programmes about sex and relationships.  We are hoping as Channel Directors you will wish these future broadcasts to be accurate, entertaining and empowering.  To ensure this happens we are calling on Channel 4 to establish an advisory group made up of sexual and reproductive health practitioners, sex educators, youth workers, parents and young people to oversee the development of future programming and ensure that it is entertaining, accurate and empowering.  This idea is endorsed by Brook, the young people’s sexual health service.  All of the signatories below are happy to help you with this endeavor, and are now expecting you to listen to our concerns, and promise quality sex and relationships broadcasting in the future.  We look forward to hearing your response soon.


Signed
Petra Boynton PhD, Social Psychologist and Sex Researcher, University College London
Dr Stuart Flanagan, Genito Urinary Physician
Justin Hancock, Bish Training, trainer and consultant
Lisa Hallgarten, Director, Education For Choice
Wendy Savage MBBCh FRCOG MSc (Public Health) Hon DSc
Marge Berer, Editor, Reproductive Health Matters
Romance Academy - a nation-wide, holistic, relationships and sex education initiative
Dr. Meg Barker, Sex therapist and social psychologist, The Open University
Chris Ashford, Principal Lecturer in Law, University of Sunderland
Alice Hoyle, Sex and Relationship Education Advisory Teacher
Alison Terry, Second year student, Applied Community and Youth Work Studies, University of Manchester
K. Barratt, Second year student, Applied Community and Youth Work Studies, University of Manchester
Becca Thompson, BSc MA COT
Steven Norris, Student Teacher
Clare Bale, RGN, BA (Hons),MPH, PhD Candidate, University of Sheffield
Dr. Lesley Hoggart, Principal Research Fellow, School of Health and Social Care University of Greenwich
Matthew Greenall, advisor on international HIV & sexual health programmes
David McQueen, International Speaker and Youth Advocate 
Janet Horrocks, Healthy Schools Project Officer
Joelle Brady, MSc, Researcher
David Evans, Researcher and Chief Executive SRE Project
Peter Bone, Chair of the Advisory Council, PSHE Association  









(1) Wellings, K, Nanchahal, K, Macdowall, W, McManus, S, Erens, B, Mercer, CH, Johnson, AM, Copas, AJ, Korovessis, C, Fenton, KA, Field, J Sexual behaviour in Britain: early heterosexual experience. Lancet, 2001: 358; 1843-1850




APPENDIX ONE


Example email correspondence from researchers on The Joy of Teen Sex, to professionals:
"We are in the early stages of shaping our series and are keen to talk to industry professionals, so we can get it right. I understand your concerns and I can reassure you that our aim is to make a thought-provoking and positive series that will look at relationships, emotions and identity as well as “the act of sex”."The Joy of Teen Sex will not be gratuitous, voyeuristic or salacious. Our aim, working alongside dedicated professionals, is to provide a platform for teenagers and parents to discuss the emotional, physical and psychological pressures young people face when they are seeking to forge loving relationships." 




APPENDIX TWO


Example of casting call information to recruit participants to the programme:
SO YOU THINK YOU KNOW IT ALL WHEN IT COMES TO SEX?
• How much is too much porn?
• Which STIs are untreatable?
• Are you still a virgin?
• How easy is it for a girl to orgasm?
We want to talk to teenagers, 16+ who need sex and relationship advice or who are keen to share their sex and relationship experiences.
OR
We want to talk to teenagers and their parents who need sex & relationship advice from a team of professionals.
No issue is off limits.
Sex is the most important thing in a teenager’s life….and the biggest worry for their parents…
If you’re a parent, concerned about what your teenagers are getting up to in the bedroom, we want to hear from you.
• Do you think your teenager is addicted to porn?
• Do you think your teenager is sleeping around?
• Has your teenager told you they’re bi-sexual?
• Is your daughter a virgin, but you fear her boyfriend is pressuring her into having sex?
• What do you do when your son says he wants to have unprotected sex?
TV Production company betty are making a new Channel 4 series featuring frank and candid discussion of sexually aware teens.
(see other calls here http://www.starnow.co.uk/Casting-Calls/Reality-TV/new_channel_series_the_joy_of_teen_.htm and here
 http://www.channel4.com/programmes/take-part/articles/the-joy-of-teen-sex) 




APPENDIX THREE


Metro Newspaper’s account of Twitter remarks from one of the producers on The Joy of Teen Sex, made during and after episodes were aired
http://www.metro.co.uk/tv/853872-the-joy-of-teen-sex-prompts-doctor-twitter-outrage 
(These have since been removed from twitter by said producer).