Does learning to say “yes!” help to say “no”? The impact of pleasure inclusive sex education on youth’s sexual wellbeing and the role of sexual autonomy: A systematic scoping review.

Abstract

A recent review study showed that pleasure-inclusive sex education can contribute to reducing sexual health risks such as unwanted pregnancy and STIs (Zaneva et al., 2021). Pleasure-inclusive sex education could also increase sexual autonomy, which in turn might improve sexual wellbeing. It is unclear whether this mechanism can be supported by existing evidence. The current study aims to fill this gap, by systematically reviewing the literature on associations between pleasure-incorporating sex education and sexual autonomy (or agency, assertiveness), and between these sexual autonomy related variables and sexual wellbeing. We searched in 5 scientific databases using a wide scope of variables related to pleasure inclusive sex education, sexual autonomy or related concepts, and various outcomes of sexual wellbeing, focusing on the last 2 decades. Forty-six articles were selected. In general, all studies reported associations between positive/ pleasure-based sex education and sexual autonomy or sexual wellbeing, but the literature is characterized by limitations and did not permit conclusions about the role of an added benefit of the pleasure component. There were, however, five longitudinal higher quality studies that found positive associations between sexual autonomy (and related variables) and sexual wellbeing (and decrease of sexual victimization). Sexual autonomy may be related to increased sexual wellbeing, but it is still largely unclear whether pleasure-inclusive sex education can significantly contribute to sexual autonomy. There is a great need for high quality research, using innovative evaluation designs, taking into account the role of other important sources of sex education.