During my time in Cape Town, I was very fortunate to be able to have a conversation with Dr. Eli Rosen who seems to be tackling the current gaps in sex education curriculum in South Africa one classroom at a time. We had a lengthy conversation about their work which I attempted to edit down for the sake of brevity.
On their pathway to the field of sex education
Dr: Rosen: For the most part I am educated as a homeopath and I have a master’s degree in homeopathy. I was in private practice for quite a while and part of that was that it was very difficult for me to actually get a practice established because of the fact that I am a very out, very open, very obviously queer non-binary person. As such I ended up starting to look for other employment and something fell into my lap which was doing sex education. And I started doing sex education because a friend of mine has been working in the industry for about 20 years and she had a school where one of the learners in the class was a gender non-conforming person and she wanted somebody to be there that would be relatable. So, I started doing sex-ed with her, doing the gender and sexuality components. I also lecture gender and sexuality at the university level and I’ve been around the country doing gender and sexuality for social work, psychology, and nursing students. So basically a lot ofhealthcare people. I started doing the gender and sexuality component at schools for high school sex-ed and I really love it and as a result I’ve ended up getting into it more - I do the entire program now. We do a comprehensive sex education program which is actually part of the curriculum for life orientation. Now comprehensive sex education is based on a very specific model, it moves away from both the medicalized and moralistic models. The medical model is where you get shown very graphic images of STIs and are told if you have sex you are either going to get an STI and die or you’re gonna get pregnant. Then you’ve got the moralistic approach which is the very much religion based abstinence only, and in itself also has been proven not to work.
Comprehensive sex education is coming into the schools all over the world. Sex educators and policy makers from all around the world got together and drafted a policy document in Madrid a couple of years ago.
And in this paper, they actually discussed what would have to be covered in the curriculum in order to be effective to deal with societal issues. And you can’t just look at things like domestic violence or sexual health or pregnancy or HIV infection, because those things in isolation don’t actually help if you just address them as individual issues. It has to be included as a holistic approach to sexuality.
On the ineffectiveness of legislation
Dr. Rosen: Now in South Africa our law gives every child above the age of 12 the right to healthcare, reproductive healthcare, access to contraception, access to abortion, access to education on matters related to sex. Even though it’s laid out in the law, it still hasn’t been followed through with a comprehensive sex education curriculum that has been rolled out to all schools. Last year, there was a framework that was created, the adolescent sexual health five-year plan by the department of basic education. They have written out what needs to be covered by a comprehensive sex education curriculum. The sex ed curriculum is supposed to be getting rolled out in all the schools, whether it be the independent board schools or government schools. All teens should be getting the same comprehensive sex education. In South Africa we’ve got a massive issue with teen pregnancy and increasing HIV infection rates between the ages of 18 and 25. So these are young people who should be getting good information but unfortunately are not, and are engaging in risky sexual behaviour even though they should know better because of all the money that’s been spent on HIV education. It’s just not translating. So, there is actually a mandate for people to talk about these things in schools. And as part of sex ed, that’s what I’m doing. At this point time, it’s a case of trying to find a way to take what we’re doing and make it available to more people and focus on people who need it most.
On the heavy workload taken on by non-profit organizations
Dr Rosen: There are really good NPOs and advocacy groups who are doing really, really great work and they are completely underfunded, understaffed and overburdened with functions that should have been part of the government to begin with. The fact that there needs to be NPOs to fulfill the functions of our government social services is frankly ridiculous. The entire system is run by NPOs which is such a precarious situation when you have funding one year and then don’t have funding the next year. It means the follow through on projects is just about zero. Somebody dies and suddenly the entire organization collapses because they were doing all the work singlehandedly. I mean if you look at Intersex South Africa, when Sally [Gross] passed away everything else came to a grinding halt and there has been nobody to take over and that’s typical of the entire system. There are lots of really passionate people who are doing really good work but it's an entirely hand to mouth, or project to project, situation for most NPOs.
On the positive aspects of their work
Dr. Rosen: I think on a personal level, I get to see that there’s a lot of things that happen that are really affirming. I’ve had kids come up to me after sex-ed classes and say “Hey Doc listen, I run an LGBT Instagram account and I know all the stuff that you said from reading, but I never thought I would see an adult or a doctor standing in front of me saying all these things. It almost makes it real instead of it just being something that we’ve made up”. Actually being able to validate young people’s sexual and gender identities, and affirm all of these complicated concepts which they, because they are internet users, they have already been exposed to. Being able to stand in front of them and say “Hi, I’m a real life non binary person, I’m married, I have kids. I’m a doctor with a Master’s degree. Oh, and I also have blue hair and yes someone like me can be successful”. The kids get to fill out a feedback form afterwards. Quite often they’ll say things on the feedback forms that have me in tears. I’ve actually had a couple of them which I’ve kept on my phone for moments where I feel disheartened, so that I can go back and have a look at it and remind myself why I do what I do.
On what’s next
Dr Rosen: At some point in 2017 I’m hoping to get an NPO set up so that I can start looking at accessing international funding. I want to work on things with a broader scope. I'd like to speak to school boards and administrative staff, and start discussing policy around comprehensive sex education, including LGBTIAQ matters, teen pregnancy, and policies around what healthcare is provided by the school nurse. The school nurse needs to be a first contact practitioner who is able to sensitively deal with sexual health matters, they shouldn't be perpetuating very harmful myths about virginity or be judgemental when a teen comes to them asking for contraception. Those kids have the right to access contraception by law and yet how do they access healthcare without missing school? The only way to deal with this to make sure there is a policy shift. The only way to make sure there is a policy shift is to start speaking to the people who are making the policies.
Agatha Nyambi was working as an Intern in Sexual Minority Health with the University of Cape Town in South Africa.