Considerations for the Field
PENIS, VAGINA
LGBTQ youth are largely unable to benefit from sexual health education to the same extent as their straight and cisgender peers because they frequently do not see themselves represented in the sexual health education they receive. A GLSEN study (2015) showed that less than 6% of LGBTQ students surveyed reported that their health class had included positive LGBTQ representation, while another survey of 18-–35-year-olds showed that only 12% of respondents ever had same-sex relationships mentioned in their health classes (Jones & Cox, There is limited guidance or established best practices for developing new or adapting existing sexual health education curricula to make them inclusive of all genders and sexual orientations (Ioverno & Russell, Ensuring relevance is an especially important strategy since LGBTQ teens are at an increased risk for unintended pregnancy and other poor sexual health outcomes (Hafeez et al., Using nuanced, inclusive language also requires careful reflection, continual refinement, input from youth, and careful attention to literacy levels. For example, when discussing birth control methods that suppress ovulation, a neutral approach would state that these methods are “for a person who has ovaries,” rather than stating that they are for women. The advantage of this is that it is broad and non-exclusive. Any person with ovaries can use existing hormonal birth control methods unless they have been medically advised not to. However, there are drawbacks to this approach. “Person with ovaries” requires much higher literacy to comprehend than “woman.” Simply stating woman, however, leaves some people out. Additionally, “person with ovaries” or “person with testicles” may be seen as objectifying, identifying a person by the parts of their body. The approach studied here utilized a mix of strategies. Birth control lessons describe a “person with ovaries” when discussing hormonal birth control and describe a “condom for a penis” or a “condom for the vagina or anus” when discussing condoms. However, the introduction to the reproductive system lesson states that “these parts are usually on a man's body,” or are “usually on a woman’s body” to provide needed context to students with lower health literacy.Another disadvantage of neutral language is that it does not provide visibility. Specifically, individuals whose identities have been marginalized are unlikely to see themselves reflected in neutral language. For example, educators may use neutral language to explain that the content is for “all young people” instead of using specific language to explain that the content is for “lesbian, gay, bisexual, and straight young people.” Lesbian, gay, and bisexual young people will likely not assume the content is relevant to them, despite the teacher’s attempt to welcome all young people. Conversely, a drawback of specific language is that it fails to be fully inclusive. The term “LGBTQ” is specific only to five identities. The terms people use to describe their identities are personal, numerous, and evolving. These points illustrate that approaches to inclusivity have advantages and disadvantages; there is no universal fit.An additional drawback to the use of neutral language involves a specific application. An approach sometimes used in the field is to construct neutral scenarios that do not specify the gender of the characters and use gender-neutral names such as Chris. This strategy has significant drawbacks. Young people will likely assume “Chris” to be a straight cisgender person, negating any potential benefit. Neutral language is sometimes used in this way when the educator is uncomfortable naming the specific identity, believes others will find it offensive, or believes the climate to be hostile. In these situations, use of neutral language can reinforce the idea that LGBTQ identities are taboo. Educators should exercise caution to ensure they are not using neutral language in this way.The challenges reflect, in part, the dynamic nature of language and of identities. An approach that is perceived as affirming and inclusive at one time will not always be experienced in that way. Teachers who are adept at providing inclusive instruction are aware that language is constantly changing. Educators would benefit from being aware of these issues and developing these skills in the sex ed classroom, as they do in other subject areas.Finally, teachers must be provided adequate training to implement these strategies and to be prepared to answer young people’s questions. There are skills related to the use of neutral and specific language, to creating relevance, and to affirming young people’s identities that are not often part of teachers’ professional development. In their meta-analysis of the literature on LGBTQ-inclusive sex ed, O’Farrell et al. (Educators need training that helps them broadly understand the concepts of sexual orientation, gender identity, assigned sex, and sexual behavior. Basic terminology should be covered with an understanding that language is always evolving, and that young people have the right to self-identify. Teachers need an opportunity to practice using key concepts and answering difficult questions using strategies that maintain an affirming environment for all young people in their classrooms.