The Long-term Psychological Impact of Poor Sex Education

27 Feb 2025. 

In the autumn of 2024, the new Government launched a Curriculum and Assessment Review – at the FPA we’ve lucky enough to see part of the response from the British Psychological Society’s Faculty of HIV and Sexual Health.

Consultation Question

“In which ways does the current a) primary curriculum, b) secondary curriculum and qualification pathways and c) qualification pathways and content at 16-19, support pupils to have the skills and knowledge they need for life and further study, life and work? What could be changed to better support this?”

Answer

The British Psychological Society, Division of Clinical Psychology, Faculty of HIV and Sexual Health would like to submit a brief response to this question, with particular focus on Relationships, Sex and Health Education (RSHE).

From discussions with the Family Planning Association we understand that there has been considerable review and thought that has gone into the current curriculum.

We strongly support the inclusion of facts about HIV, including adherence to medication and having an undetectable viral load preventing transmission (Undetectable = Untransmissible) (Okoli et al 2021).

The guidance produced by the UN and Unicef (Women, UN & UNICEF, 2018; Herat et al 2018) provides a very comprehensive and helpful guide to RSHE at different developmental stages.

We also support continued discussion and review of this aspect of the curriculum, given the ongoing changing landscapes of culture around sexual wellbeing.

“inadequate RSHE can have significant consequences in terms of later psychosexual problems and consequent mental health distress”

We would also like to emphasise that inadequate RSHE can have significant consequences in terms of later psychosexual problems and consequent mental health distress (e.g. Argerap & Agair, 2024).

Lack of understanding about sexual response, and difficulties negotiating sexual relationships can have very negative consequences for people’s future relationships, self-esteem and potential ability to conceive and start a family (e.g. Ayling & Usher 2008; Laumann et al 2005; Jenkins & Jenkins, 2006; Sotomayer, 2005).

Many of the psychosexual problems and distress seen in adult NHS services appear to be directly related to poor education about how our bodies work and unhelpful beliefs about sex.

Therapy sessions provided to adults often focus on providing basic sexual education and challenging unhelpful myths. A thoughtful approach to providing this education in schools has the potential to prevent future distress.

“education in schools is likely to be considerably more cost effective”

Additionally, providing earlier education in schools is likely to be considerably more cost effective than providing this in NHS funded therapy sessions during adulthood.

Ideally education would include psychological, emotional and motivational dimensions of sex alongside physical aspects.

The UN & Unicef guidance (section 7.2) briefly notes the importance of recognizing when there are problems with sexual functioning (Women, UN & UNICEF, 2018). As difficulties with sex are very common (e.g. Mitchell et al 2016), we would argue that this should be normalised and de-shamed, with a view to people feeling more confident to seek support if needed (Laumann et al 2005; Sotomayer, 2005).

An additional educational issue seen within NHS sexual health services is a lack of accurate education regarding genital herpes. This is a very common and usually benign viral infection.

However, myths and cultural beliefs about genital herpes can cause extreme distress to people receiving a diagnosis which can lead to subsequent mental health problems requiring treatment (e.g. DiCaita, H., & Kleinplatz, 2023).

Overall we would like to support the continued work with expert groups to agree appropriate content and the time and training needed to provide this content across the learning and development stages.

Dr Jane Vosper
Consultant Clinical Psychologist
Chair Faculty of HIV and Sexual Health
British Psychological Society

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References for “The Long-term Psychological Impact of Poor Sex Education”

Agtarap, T., & Adair, L. (2024). Healthy Body, Healthy Mind: Exploring the Mental Health Implications of Comprehensive Sex Education. Women’s Reproductive Health, 11(3), 471-490.

Ayling, K., & Ussher, J. M. (2008). “If sex hurts, am I still a woman?” The subjective experience of vulvodynia in hetero-sexual women?. Archives of Sexual Behavior, 37: 294–304.

DiCaita, H., & Kleinplatz, P. J. (2023). The more you know? Knowledge about genital herpes and factors affecting adjustment. The Canadian Journal of Human Sexuality, 32(2), 178-190.

Herat, J., Plesons, M., Castle, C., Babb, J., & Chandra-Mouli, V. (2018). The revised international technical guidance on sexuality education-a powerful tool at an important crossroads for sexuality education. Reproductive health, 15, 1-4.

Jenkins, J., & Jenkins, G. (2006). What to do when a couple has problems conceiving. Women’s Health Medicine, 3(6), 241-243.

Laumann, E. O., Nicolosi, A., Glasser, D. B., Paik, A., Gingell, C., Moreira, E., & Wang, T. (2005). Sexual problems among women and men aged 40-80 y: prevalence and correlates identified in the global study of sexual attitudes and behaviors. International Journal of Impotence Research, 17(open in a new window)(1(open in a new window)), 39–57. https://doi.org/10.1038/sj.ijir.3901250

Mitchell, K. R., Jones, K. G., Wellings, K., Johnson, A. M., Graham, C. A., Datta, J., Copas, A. J., Bancroft, J., Sonnenberg, P., Macdowall, W., Field, N., & Mercer, C. H. (2016). Estimating the prevalence of sexual function problems: The impact of morbidity criteria. Journal of Sex Research, 53: 955–967.

Okoli, C., Van de Velde, N., Richman, B., Allan, B., Castellanos, E., Young, B., … & de Los Rios, P. (2021). Undetectable equals untransmittable (U= U): awareness and associations with health outcomes among people living with HIV in 25 countries. Sexually transmitted infections, 97(1), 18-26.

Sotomayor, M. (2005). The burden of premature ejaculation: The patient’s perspective. The Journal of Sexual Medicine, 2, 110–114. https://doi.org/10.1111/j.1743-6109.2005.20371.x

Women, U. N., & UNICEF. (2018). International technical guidance on sexuality education: an evidence-informed approach. UNESCO Publishing.