In my study abroad course on sex and culture in the Netherlands, one of the things we have been discussing is cross-cultural differences in sexual health and sex education. Teens’ sexual health outcomes are dramatically different in the Netherlands compared to the United States, as you can see in the infographic below. Check out the stats and then keep reading to learn why.
Teen girls in the U.S. have a pregnancy rate that’s nearly four times higher and an abortion rate that’s about twice as high as Dutch girls of the same age . Though not depicted in the infographic above, Dutch girls (and boys) have far lower rates of STIs, too . So what accounts for why teens in the Netherlands seem to fare so much better in terms of their sexual health?
Well, it’s not just one thing—the entire cultural view of sex is different in the Netherlands. First, the Dutch have mandated comprehensive sex education for all students. Schools get to choose the material they want to cover, which means that not all Dutch teens are learning the same thing—and some schools certainly do a better job than others. However, when you look at the most popular program (Long Live Love), which is used in more than half of all Dutch schools, what you’ll see is a great model of what comprehensive, age-appropriate sex education looks like. Students don’t just learn how to protect their sexual health—they also receive education on pleasure, healthy dating and relationships, obtaining consent, communicating what you want, and so much more.
By contrast, there is no federal mandate for sex ed in the US, and there are currently 20 states in which it is not required by state law. In states where sex ed is required, programs typically stress abstinence and focus on teaching students about the negative outcomes that will occur if they have sex. Further, only a handful of states require that any sex education provided be medically accurate. Some states go further, even placing restrictions on what sex educators can and can’t discuss. For example, some states explicitly prohibit discussion of sexual orientation. The end result? Far too many American students aren’t really being taught useful or accurate information.
Differences in sex education are just one part of the equation here, though. It’s also important to note that, in Dutch culture (compared to American culture), sex is more likely to be viewed as a normal part of adolescent development. Also, Dutch parents and healthcare providers tend to speak more candidly with teens about sex, and free or low-cost contraception is more widely available. If the Dutch are anything, they are pragmatic—they recognize that teens will have sex whether we like it or not and therefore take steps to reduce any potential harm/risk. Given all of this, it shouldn’t be surprising that Dutch teens use condoms and contraceptives far more reliably than their American counterparts .
Of course, I want to be careful not to paint the Netherlands as this utopia for sex education and sexual health. Teen pregnancies and STIs certainly still exist there (albeit at much lower rates) and not all Dutch teens receive high quality sex ed. Likewise, some American teens receive great sex ed, and sexual health outcomes for teens can vary widely from state to state. In both countries, there is individual (and regional) variability. Overall, however, there are large differences on average.
What all of this tells us is that if we want to enhance the sexual health of adolescents in the U.S., we have our work cut out for us. Yes, we need to change our approach to school-based sex education, but that alone isn’t enough. We also need to change the way Americans think about teenage sex, which means moving away from the view that it’s always a problem and toward the view that it can potentially be a part of normal and healthy development. It also means changing the climate of shame that stifles open dialogue about sex and promoting positive sexual communication skills for parents and teenagers alike.
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 Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health, 56(2), 223-230.
 Alford, S., & Hauser, D. (2011). Adolescent sexual health in Europe and the US.
Image Source: 123RF/Mirko Vitali
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