The National Condom Week challenge, JLS and visiting Brook in Salford

I think National Condom Week was launched in 1996, my first year as a full time, paid employee working in sexual health. If not 96, it was 97 and generally condoms were even less of an everyday conversation than they are now, and far far away from how much of an everyday conversation they should be.

Over the last 5 years or so I have  set a National Condom Week challenge to health professionals and all of us determined to empower young people and protect their sexual rights. The challenge is to say the word condoms in as many different contexts as possible, even where it does not make sense to do so.  Whatever the question, condom is the answer.  Befuddled faces and questions of why this answer can easily be explained when people know it is NCW.

So far I have had feedback that it has made teams of people laugh throughout the day, created useful conversations, and made others want to punch me.  As a challenge it seems it is doing its job, and therefore it would be wrong not to issue the challenge again this year.  So my challenge to you is: for at least one day through NCW get (discussions about) condoms into as many answers to questions and discussions as you can.  And if you choose to accept the challenge do let me know of any interesting stories and experiences that come out of it either on this blog or via twitter @simonablake

Yesterday to mark the launch of National Condom Week, boy band JLS teamed up with Durex and MTV to visit some sexual health projects.  Brook services in Salford was one of those, and teams of staff from Oldham, Wirral and Salford showed Marvin, Oritse, JB and Aston the type of education and clinical work staff and young peer educators do - from wearing the beer goggles, witnessing the rubber relay to finding out about sexually transmitted infections it was a really fun morning where the Brook teams showed off their creativity, skill and commitment to working with young people. I was incredibly proud of the team, all of whom told me they found the boys interested in them and what they do, interesting, easy to talk to and a real pleasure to spend time with.

And that has been true of every single experience of JLS throughout the last couple of years we have worked together - they are genuinely committed to, and interested in the issues - so when the journalist from the Manchester Evening News asked how important they are as role models for young people, I agreed they are undoubtedly so.  And they are also role models for other adults - both celebrities and the 'rest of us'.  In their groundbreaking support for young people's sexual health JLS are paving a way for other celebrities to take young people's sexual health seriously, and use their roles to champion the issue.  At the same time they are helping break down the barriers that mean the average person on the street can be freed from embarrassment and shame and start talking about relationships, sex and sexuality so as a country we continue to get better and better at supporting children through puberty, adolescence and into adulthood.

Opinion piece in The Times today - should chemists give the pill to under-16s?

There is an opinion piece from me in The Times today, but I know not everyone has a subscription so I thought I’d replicate our view here. There is also an opposing view from Norman Wells of the Family Education Trust. You can read both pieces in today’s The Times – it’s on page 5 of the newspaper - as well as on the online paid for service.

I’ve heard a lot of nonsense over the last few days from people who haven’t been paying attention. Perhaps, then, I should start with what this proposal is not and cannot be. Even as a currently unpiloted proposal it is not about ‘dishing out’ pills alongside deodorant to every 13 year old setting foot inside their local pharmacy. No right minded person would support that, and it is not what is proposed here.

No, what has been boldly suggested is that there may be some pharmacies where it might be appropriate to deliver wider contraceptive services to some under 16s. That’s a long way from some of the hysteria the proposal has been subject to.

The majority of young people under 16 are not having sex and the numbers of 13 year olds having sex remains very small. We know the younger a young person is when they first have sex, the more vulnerable they already are. It is right, therefore, that we make sure those young people get the very best support we can give if they are thinking about or having sex. We must ensure all young people trust and access high quality professional help and the right services when they need to.

Helping young people understand their sexual choices and take responsibility for their sexual health cannot be reduced to a 30 second chat over the counter. There are clear guidelines that any professional considering providing contraception to a young person must follow and criteria based in law that the young person must meet in order to receive treatment. Qualified professionals – doctor, nurse or pharmacist – must talk to the young person about why they are thinking about having sex, whether this is the right time for them, and whether there is an adult they can trust and talk to. They talk to them about their partner, their history, and ensure that they really understand the implications of having sex and using contraception. If the professional feels the young person is not mature enough to consent or understand the treatment then they will not provide contraception.

Extending the provision of the contraceptive pill in some suitable pharmacies to some 13-16 year olds may be one of the ways to improve young people’s access to supportive services, however there are a range of vital safeguards that must be must be in place first.
Brook would want to make sure several key questions were answered:

• Has the pharmacist had appropriate clinical training to ensure the consultation will be safe?
• Has the pharmacist had training in working with vulnerable young people?
• Do they have time to develop a trusting relationship and will the young person feel able to share their concerns and confidences?
• Is there an appropriate, confidential space for the pharmacist to spend time listening to and speaking with the young person?

If we can be sure that the answers to these questions are a confident ‘Yes’ we may want to consider pharmacy provision for under-16s.

For so many questions, relationships and sex education is the answer

Over the last few months sexuality has been in the news for a wide range of reasons.  Everything from gay rights, homophobic bullying and equal marriage, access to contraception & abortion, sex & relationships education in the primary school to young people watching porn on the internet in secret.  Lots of the 'news' is driven by genuine worries and the changing ways that young people can access information about sex, as well as some irrational concern about the (im)morality of young people and their sexual behaviour combined with a lack of trust in young people and the professionals who work with them.

Each time I talk to a journalist, policy maker or parent about any of the issues - homophobic bullying, early sex, access to internet based porn there is one simple, straightforward and easy answer about what must be done - talk to children and young people about sex, relationships and sexuality in an open and positive way from a very early age.  Alongside other things we need to support parents to talk to their children confidently about sex, relationships and sexuality, and get relationships and sex education properly established in schools in this country once and for all.

Good RSE starts at home, and is then built on and complemented at school and in the community at youth clubs, churches and other settings that children and young people go to. It is a fundamental entitlement for all children and young people if we want to both protect and empower them.

Of course RSE is not a universal panacea.  However all the evidence tells us that good quality RSE that meets certain criteria (including discerning messages in the news and linking to confidential services) helps children and young people confidently navigate their way through puberty, into adolescence and adulthood, developing vital life skills along the way.  These life skills including discernment, negotiation and communication, self awareness, setting boundaries, understanding consent - saying yes, maybe or no, seeking help and respecting others rights.

The evidence is clear: RSE contributes to reducing teenage pregnancy and improving sexual health by delaying early sex and improving contraceptive use. Evidence also shows that where gay relationships and homophobia are integrated into RSE and there is a positive ethos/pastoral care system that tackles bullying well homophobic bullying is reduced.  And if anyone believes gay equality has been achieved, or is unsure of the need to tackle homophobia urgently read this brilliant article about its impact by Patrick Strudwick in todays Sunday Mail http://www.dailymail.co.uk/home/you/article-2135648/Bullying-schools-How-school-bullies-ripped-Crouch-family-apart.html).

The Secretary of State for Education, Michael Gove talked about sex education last week.  He may well be right that young people who do well academically are less likely to take risks with their behaviour (probably because risk taking behaviour and academic success is explicitly linked to vulnerability, rather than an indicator that we must focus all our attention on reading, writing and arithmetic).  ALL children and young people whatever their gender or sexuality and wherever they are from need and have a right to learn about emotions, relationships, sex and sexuality. This right is enshrined in the UN Convention on the rights of the child.

A small and vocal minority in the UK claim that relationships and sex education as a secular activity that is part of the problem, contributing to 'sexualisation' of the young, promiscuity and poor sexual health.  The truth of course is somewhat difference and RSE can, does and must address the range of faiths, cultures and values in the UK.  RSE at home and school is more important now than ever as a way of providing accurate, unbiased and evidence based information to counter all the misinformation, myths and prejudice available elsewhere.

So that is why RSE is the answer to so many questions.  It is 100% part of the solution (if I was a talent show judge I would probably say it is 1 million % part of the solution).  And that is why RSE is supported by the majority of children and young people, parents and professionals, and why Brook is campaigning for 21st Century sex and relationships education.  Add your name to the campaign at www.sexpositive.org.uk

You can also write to your MP to tell them you support relationships and sex education.  Through their mail bag they hear the voice of those who oppose it, and they need to hear the majority voice in support of RSE too.

Some examples of articles, positive or otherwise are included below

• gay rights and equal marriage 
• http://www.dailymail.co.uk/home/you/article-2135648/Bullying-schools-How-school-bullies-ripped-Crouch-family-apart.html 
• http://www.timeout.com/london/gay-lesbian/article/3295/marital-rights
• http://www.bbc.co.uk/news/education-17883093
• http://www.guardian.co.uk/education/2012/feb/18/anti-gay-book-gove-row  
• access to the contraception and abortion
• http://www.telegraph.co.uk/health/healthnews/9226892/Girls-13-should-be-able-to-get-Pill-from-pharmacies.html
• http://www.huffingtonpost.com/authorarchive/?simon-blake/2012/02/)
• http://www.guardian.co.uk/world/video/2012/apr/02/abortion-protests-mum-fought-video
• http://www.guardian.co.uk/commentisfree/2011/aug/31/abortion-advice-poundland-nadine-dorries
• Sex and relationships education
• http://www.politics.co.uk/news/2012/01/19/opposition-to-dorries-abstinence-bill-heats-up-ahead-of-prot
• http://www.bbc.co.uk/news/uk-politics-15444833
• Young people watching porn
• http://www.telegraph.co.uk/technology/internet/9230842/Is-your-child-secretly-watching-porn-on-the-internet.html
• http://www.independent.co.uk/news/uk/home-news/we-need-to-talk-about-porn-7685283.html 

Finally, young people's sexual behaviour is not generally cause for concern any more than adults.  Despite the headlines most under 16s do not have sex and our teenage pregnancy rates are the lowest they have been for 40 years. 

1. Sex Education Forum (www.ncb.org.uk/sef) publish a series of factsheets on best practice in sex and relationships education including publications on Faith, Values and SRE
2. FPA (www.fpa.org.uk) publish a book - Speakeasy - to help parents talk to their children about sex and relationships
3. Stonewall (www.stonewall.org.uk) and Diversity Role Models (www.diversityrolemodels.org) support schools in tackling homophobia and learning about gay relationships 

Follow me on twitter @simonablake

Follow Brook on twitter @brookcharity or Facebook

Another day, another headline, some more myth busting

Yesterday the news was littered with stories about 'girls as young as 13 getting contraceptives without prescriptions in pharmacists'.  I quickly want to put the record straight;

• most young people under the age of 16 don't have sex so the headline about girls as young as 13 is an overly sensationalist headline which perpetuates myths about the average age of sexual activity  
• those young people who are having sex at a very early age can be amongst the most vulnerable who they need and deserve excellent help and advice from a well trained professional whether that be a school nurse, a pharmacist, a community nurse or a doctor
• the pilot scheme run in South East London was as we understand it for people over the age of 16.  It was delivered by pharmacists who were trained and working within Patient Group Directions e.g. strict conditions approved for providing the contraception
• where pharmacists do provide the contraceptive pill, like any professional working with young people under 16 would need the appropriate skills and knowledge, including being able to use the Fraser Guidelines established over 25 years ago to ensure young people are consenting, safe from harm, mature enough to understand contraceptive treatment and to encourage them to talk to their parent, or another adult they trust.  They will not be handing pills out over the counter 'when they ask to get the pill with their Lucozade' as claimed 
• this is not going to be rolled out to every pharmacy in England - only pharmacies that have the right environment and staff with the right skills to provide appropriate support to protect young people and promote positive sexual health should even consider providing this service

And on a second lot of myths that underpinned the story;

• our teenage pregnancy rates are the lowest they have been for 40 years - they are not, at this stage, rising year on year
• there is no evidence that providing contraception, in whatever setting, encourages an increase in sexual activity at an earlier age.  None whatsoever.  All the evidence shows that good quality sex and relationships education at home and school, connected to visible and trusted sexual healths services delays the age of first sex and encourages contraception use when a young person chooses to have sex
• sex and relationships education is still not well established in schools, and much more needs to be done to provide young people with the facts and information, skills and confidence they need to be safe, enjoy and take active responsibility for their sexual and relationship choices, and seek help, advice and treatment from a range of sources when they need it. 

Won't it be fantastic when the headline reflects the reality that we see everyday at Brook that young people want to be, can be and are responsible about sex and sexual health, and that the most vulnerable young people need our care, support and attention, not our condemnation and finger wagging.  I await that day. One day soon.

It’s time we learned to trust

Last month I was at the lively, energetic Bloomsbury Pro-Choice Alliance counter protest to the 40 Days of Life vigil that was held outside the BPAS service in Bedford Square. It was fantastic to see hundreds of men and women out to defend and protect women’s reproductive rights. The pro-choice movement should be proud of the numbers and the positivity of those came out to show their support.

But the Bloomsbury event and the ongoing noise about sexual rights including gay equality makes me angry: Angry that women’s right to choose is under such attack yet again and angry at the lack of trust in young people, women and health and education professionals.

I shouldn’t really be surprised. This lack of trust in young people and their developing sexuality is perennial. The persistent attacks on abortion provision have always demonstrated a lack of faith in women’s ability to make their own reproductive choices. And public trust in professionals is constantly undermined by insidious reporting on the sexual health and education of children and young people.

This lack of trust results in a vocal, spiteful and noisy minority in despair about the immorality of youth. They lay the blame squarely at the feet of organisations like Brook, on sex and relationships education, the availability of contraception, the internet and what is now increasingly referred to as the “sexualisation” of young people. Their moral outrage drives their desire for a return to the illusionary halcyon days when young people waited until marriage for sex; when women didn’t have abortions because they weren’t legal; when a child of 7 didn’t need to know what a penis or vagina was because the wicked internet didn’t exist and neither of course did sexual abuse. They long for the days when pregnant women went into hiding and had their children taken away, whilst gay men and women had the decorum not to flaunt their love in public.

Whilst this small, ill-informed and vocal minority increasingly find their voice, it is critical we remember there is a broad consensus in support of fair and equal rights, good quality sex and relationships education and access to services, including abortion services. And despite this consensus there is still a risk that the trust in young people and the professionals who work with them will continue to be undermined. At Brook week in, week out we see thousands of young people who are making moral and responsible decisions about sex and relationships. Yes, they need a guiding hand, an empathic and well trained professional who can ensure they understand their rights, have the information they need, and the confidence, skills and abilities to make choices that are right for them.

Of course there are also some who are frightened or confused, who don’t know how their bodies work, or feel uncomfortable in their skins. We also see those who are exploited, hurt, those settling for sex or relationships that aren’t good enough. These young people need more from us and need help and support at home, at school and from other services.

Young people know they are not trusted by many and their trust in us can also be frail. We know that for young people to continue accessing services, they must trust they will not be judged, that they will be cared for, supported and respected and they will be treated in confidence. They also expect us to protect them from harm and take all necessary steps to do so - a responsibility I know professionals take very seriously

The trust young people have in Brook, and other agencies including the NHS must be protected and maintained at all costs, and that is why I am so angry at people who undermine it whether by myth making about sex and relationships education or by harassing people entering sexual health services – something we know young people can find intimidating or frightening.

It is not acceptable under any circumstances to stand outside an abortion clinic or a young people’s sexual health service, and harass people as they enter. I was recently told of a confident and assured young woman who had to cover her face with a coat, and have support from by a member of staff to get through the door because she was being prayed for loudly and –worse still – photographed. That is simply wrong.

My concern that we are seeing a subtle change with the vocal minority becoming more vociferous was reiterated at a parliamentary briefing yesterday morning. If, at the same time as we are seeing an increase in anti-abortion protests, sex and relationships education in schools becomes politicised and undermined; if GPs are not supported to provide what young people want in sexual healthcare, and specialist services for young people reduce because of funding cuts we will have some serious work to do to protect young people’s sexual health.

All of us want to stop that happening because we want young people and women to be safe. Our critical starting point then is one of trust – we must trust women to make their choices, trust parents, teachers and health professionals to do their jobs, and trust young people to be responsible about sex, sexuality and relationships.

The Wrong Question

Today, I'm giving my blog over to Julie Bentley, Chief Executive of FPA who has given a great deal of thought to the sex-selection debate from a feminist, pro-choice perspective.

The stories in the press over the past weeks, instigated by The Daily Telegraph undercover investigation into sex selective abortions, have left me, as a pro-choice feminist, struggling with the issue and frustrated by the public debate. I have felt personally conflicted on the matter and I don’t think I have been alone in that. This doesn’t make me a hypocrite or water down my pro-choice values. But it does mean I’m asking myself some really difficult questions.

The debate has been focused around the rights or wrongs, lawfulness or not of such abortions. The 1967 Abortion Act does not list all the circumstances in which an abortion is considered lawful; rather it requires that certain grounds for abortion are met. This includes ‘that the continuation of the pregnancy would involve risk, greater than if the pregnancy was terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family; or that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman, or that the continuation of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy was terminated.’

There is a range of different factors that might mean these grounds were fulfilled, such as already having several children and feeling that economically another would not be possible to support – or for darker reasons, such as pregnancy resulting from rape.

The headlines have focused on the hysterical demonization of abortion professionals and the condemnation of the pursuit of ‘designer babies’, but I fear we are missing the point. Abortion is a red herring. We should be asking ourselves, why? Why are women requesting to abort female fetuses?

The reality is that through history and across cultures girls are not consistently valued equally. For generations women have found themselves pressurised into ‘producing a boy’. This ‘expectation’ can manifest itself in numerous ways and with varying degrees of seriousness. In the most serious cases, sex selective abortions can, regrettably, fall under the grounds of grave permanent injury to the mental health of a pregnant woman, even possibly the physical health of that woman.

My dilemma is this; if sex-selection abortion is rooted in the most unacceptable gender discrimination, how should a feminist who is pro-choice respond? If we accept sex-selection on the grounds that the woman’s wellbeing is at risk if the pregnancy continues, are we also indirectly colluding with unacceptable discrimination? And therefore, allowing it to go on unchallenged for generations to come.

Conversely if we know that women are facing an indescribable pressure not to bear a girl, are we further oppressing and isolating those women (or possibly putting their lives at risk) by not affording them access to safe, legal abortion?

I don’t think there are simple answers to dilemmas of this complexity and I’m not afraid to say I certainly don’t have them. But I do know that if a woman is pregnant and doesn’t feel confident that the future child will be fully supported, or that her physical or mental health would be at risk, they must have the choice not to continue with the pregnancy.

We must trust health professionals to do their job

Here is my article in the Huffington Post about young people's rights to contraceptive advice and treatment, and the importance of trusting professionals to do their job

http://www.huffingtonpost.co.uk/simon-blake/underage-contraceptive-implant-schools_b_1271636.html?ref=uk-lifestyle