Sexuality education in Greek schools: student experience and recommendations.
Abstract: With the aim of eliciting input from Greek college students about school-based sexuality education, 92 Greek and 47 other nationals responded to two questionnaires that assessed self-appraised, sex-related descriptors, personal experience with, and recommendations for school-based sexuality education. The Greek public school was found to deliver unsatisfying sexuality education, of mostly one semester duration, to only about one third of its students, who become sexually active earlier than other nationals. Although the school ranked last among main sources of information on sexuality, and Greek youth considered the school less important than other nationals as a source of sexuality information, all youths unanimously asked for school-based sexuality education, to be repeated at different grade levels and delivered by a specially trained and approachable teacher, covering physiological and interpersonal aspects of sexuality. Findings are discussed in light of past research and recommendations made for improving sex education in Greek schools.
Article Type: Report
Subject: Sex education (Service development)
Sex education (Models)
Sex (Psychology) (Educational aspects)
Author: Fakinos, Michael
Pub Date: 01/01/2010
Publication: Name: Electronic Journal of Human Sexuality Publisher: The Institute for Advanced Study of Human Sexuality Audience: Academic Format: Magazine/Journal Subject: Family and marriage; Social sciences Copyright: COPYRIGHT 2010 The Institute for Advanced Study of Human Sexuality ISSN: 1545-5556
Issue: Date: Annual, 2010 Source Volume: 13
Topic: Event Code: 970 Government domestic functions; 361 Services development Computer Subject: Company service development
Geographic: Geographic Scope: Greece Geographic Name: Greece Geographic Code: 4EUGR Greece
Accession Number: 249136750
Full Text: Introduction

In reviewing the practices regarding sexuality education across 26 European Union member countries, Greece included, Parker, Wellings, and Lazarus (2009) report on the great diversity observed across and within countries, on almost all parameters related to sexuality education, i.e., curriculum content, delivery methods, and provision agencies amongst others. The authors conclude that "... the subject is controversial virtually everywhere and there is thus considerable scope for sharing lessons learned between European countries ..." (p. 241).

When one turns the focus of exploration specifically to the provision of sexuality education in Greece one is confronted with sporadic and limited research data, and at times conflicting information. In one of the earlier research reports on the topic, Agrafiotis and Mandi (1997) indicated that in Greece "sexual education is not the target of any systematic and well planned governmental program" (p. 4). When Kakavoulis (2001) explored the relationship between family and children's sex education he found that sexuality education is not taught in Greek schools as a distinct subject but rather as part of other subjects such as social sciences, biology, and home economics. At about the same time, Agrafiotis, Ioannidi and Mandi (2002) acknowledged that a few Greek schools had introduced some pilot projects providing limited information on sexuality issues, again incorporated into other academic subjects, with an emphasis on anatomy and physiology rather than on the relationship or pleasure aspects of sexuality. Contrary to the above Greek researchers' findings are those in the Safe Project report (2006) of the International Planned Parenthood Federation-European Network (IPPF-EN) which erroneously present sexuality education as "... mandatory in Greek schools since 1995." (p. 48). In the same report sexuality education is said to be taught under the name "diafilikes sheseis" or 'relations among members of different sexes', starting from the age of six, in school-based programs, by school teachers and nurses and the Family Planning Association of Greece (FPAG). Apparently based on information from the same resource (FPAG) sexuality education in Greece erroneously appears once more as "mandatory" in the Parker, et al. (2009, p. 235) study.

The more recent, yet quite limited, research available in Greece on sexuality education for adolescents has focused on issues of parental attitudes and readiness as agents of sexuality education for their children (Kirana, Nakopoulou, Akrita, & Papaharitou, 2007), on the role of health educators in the sexual education of adolescents (Papathanasiou & Lahana, 2007), on adolescents' knowledge of contraceptive methods (Roupa et al., 2007), and on the effectiveness of applied partnerships between school and community agencies in delivering sexuality education (Soultatou & Duncan, 2009).

A more in-depth investigation of current practices regarding school-based sexuality education in Greece clarified that the education policy for the two compulsory education levels, namely for primary education, kindergarten and primary school (nipiagogeio and dimotiko) and for lower secondary education or middle school (gymnasio) is set by the Greek Ministry of Education, Lifelong Learning, and Religions (2010a). For both educational levels, in addition to the analytic educational program, the Ministry of Education enforces a general policy of a non-compulsory curriculum that includes the Health Education Programs--HEPs (Programmata Agogis Ygeias) in which sexuality education is incorporated. A regional Health Education director (for gymnasio) or School Counselor (for dimotiko) acts as liaison officer between schools in a given region and the ministry, approving, organizing, assisting with, and overseeing the delivery of specific HEPs requested by teachers. The HEPs in primary education can be delivered by almost any teacher, can be made part of the day's curriculum, and may cover a wide variety of topics such as healthy eating habits and consumer education. Sexuality education and gender relationships is a possible HEP offering for 9-12 year olds, yet rarely offered by grade school teachers (A. Bamidou, School Counselor, Alexandroupolis, Greece; personal communication, November 27, 2009). In contrast, secondary education HEPs are to be offered outside the regular school program. A long list of about 20 possible HEPs is provided by the Greek Ministry of Education on such topics as substance use and abuse and environmental education. Among these topics only three sexuality-related topic offerings can be identified, namely gender issues-sexuality education, sexually transmitted infections, and AIDS-Hepatitis B (Greek Ministry of Education, 2010b). In secondary education, the HEPs are conducted by 1-2 volunteer school teacher(s) who receive training, educational materials, and overall assistance from the supervising regional Health Education director in conducting a HEP of interest on a particular topic. The teachers are administratively and academically responsible for the coordination and delivery of the program and for identifying and securing the participation of pertinent corroborative agencies and/or experts. Gymnasio students can elect to participate in their specific school and/or school district in a maximum of two such programs per year, of 15-30 students each, for 2-4 hours per week each, lasting for 2-5 months--from about mid-November to the end of April (Pediaditi, 2005; R. Voulgari, Health Education director, Alexandroupolis, Greece; personal communication, November 27, 2009). As it may have become obvious by now, the educational policy and practice described above allows for the strong likelihood that a great number of students may go through compulsory education in Greece while receiving minimal, if any, sexuality education.

In light of all the above, the present investigation was carried out setting as an initial goal the study of parameters pertinent to school-based sexuality education in the Greek school system as this education has been experienced by young people themselves. A second goal of the study was to explore the suggestions these young people would offer regarding the desirable elements of a school-based sexuality education program. Lastly, in the spirit of sharing lessons regarding sexuality education employed by different educational systems, the present study aimed to explore the similarities and differences in the experience of, and suggestions for school-based sexuality education, as a function of exposure to different systems of primary and secondary education (Greek vs. North American and other European educational systems).

Method

Participants

A total of 149 college students recruited from all departments of a private, multinational, American university located in Athens, Greece, served as the study's participants. Given the study's interest in young people's experience and attitudes towards sexuality education, 10 participants (6.7%) of the initial sample were excluded from analyses since their ages were scattered in the 28-40 years-old range. Thus, the remaining 18-25 year-old group of participants (N = 139) yielded a composition of 44 males and 95 females (M age = 21.1, SD age = 1.91). The multinational composition of the particular university campus was reflected in the study's sample which included Greek nationals (67.2%), nationals from various Balkan countries (10.2%), and nationals from a variety of other countries, i.e., United States, Canada, other European, Arab and Asian nations (22.6%). Likewise, participants reported a variety of religious affiliations with 58.6% reporting Greek-Orthodox, 27.9% Catholic and other Christian denominations, and 13.6% other religious affiliations, i.e., Muslim, Jewish. Furthermore, 63.2% of the participants reported Greece as the country where they received most of their primary and secondary education (hereafter Greeks), while 24.7% reported the US and Canada, 8.2% other European countries, and 3.9% other countries, i.e., Arab and Asian nations (combined hereafter as other nationals).

Materials and Procedure

Participants were approached during class time and an introductory statement was read to them by the investigator describing the study and inviting them to participate. Those volunteering were handed an Informed Consent Form which they completed and returned before responding to the study's questionnaires. Two instruments were especially constructed for the purposes of the study accompanied by a Demographics Data Sheet. The Demographics Data Sheet was used to assess such variables as sex, age, national origin, religious affiliation, schooling country, and school type(s) attended (public, private, and/or both). The first instrument, the Self-Appraisal Information Sheet, asked participants to estimate on a five-point scale the accuracy and adequacy of their knowledge/beliefs about sex, and the estimated benefit from additional sexuality education. A fourth question on the same instrument asked for the length of time (in years) participants had been sexually active, defined to them as "having participated in intercourse and/or oral sex". Lastly, a fifth question in open format asked participants to list what, for them, were the primary sources of information regarding sexuality while growing up. The second instrument used in the study, the Sexuality Education in Schools questionnaire, included 10 questions. Five of these questions assessed the participants' experience of sexuality education in school (whether received, at what type and level of school, for how long, and their satisfaction with it). Five additional questions asked for the participants' proposals for sexuality education in schools; should it be offered at all; at what level, i.e., high school; whom did they consider the most appropriate person to deliver it (any teacher, biology teacher, teacher with special training in human sexuality, nurse, counselor or school psychologist, a professional comfortable in frankly discussing sexual matters, other); and lastly, which topics should such a course include and exclude, selected among 18 different thematic areas usually encountered as chapters in a college human sexuality textbook.

Results

Self-appraised sex-related descriptors

The Mann-Whitney U tests indicated that Greeks and other nationals differed neither on the reported accuracy of their personal knowledge/beliefs on sex-related issues (Mdn = 4 for Greeks and Mdn = 4 for other nationals, U = 2043.0, p = .77) nor on the adequacy of this knowledge (Mdn = 4 for Greeks and Mdn = 4 for other nationals, U = 1863.5, p = .26). However, in contrast to females, males reported greater accuracy (Mdn = 4 for males and Mdn = 4 for females, U = 1484.5, p = .005), and greater adequacy (Mdn = 4 for males and Mdn = 4 for females, U =1563.5, p = .03) of personal knowledge/beliefs on sex-related issues. Also, greater estimated benefits from additional sexuality education were reported by Greek youths (Mdn = 4) as compared to those reported by other nationals (Mdn = 4), U = 1544.5, p = .006. Lastly, no differences were detected between males (Mdn = 3) and females (Mdn = 3.5) on estimated benefits from additional sexuality education (U = 1805.0, p = .21).

With regard to time length of sexual activity, Greeks were self-reported as being sexually active for a significantly longer time period, in comparison to their same-age group counterparts of other nationals, t(131) = 3.81, p < .001 (M = 3.46 for Greeks and M = 2.49 for other nationals), and males reported significantly longer time periods of sexual activity than females t(134) = 3.81, p < .001 (M = 3.86 for males and M = 2.79 for females) .

Independently of country of schooling or sex of participants, the same sources turned out to be reported as the main sources of sex-related information while growing up. Moreover, the main sources were placed by participants in identical order of importance. "Friends and classmates" ranked first followed by "mass media and magazines" in second place, "family members and relatives" in third place, "school" ranked fourth in importance, and "other sources" (self-experimentation, books, partners) ranked last. It is worth noting that "school" ranked fourth in importance for both Greeks and other nationals, and as Table 1 shows, other nationals rated "school" an important source significantly more often than Greeks, [chi square] (1, N = 134) = 14.11, p < .001 (32% for other nationals and 7.1% for Greeks). Furthermore, this difference was present between males, [chi square] (1, N = 42) = 4.23, p < .04 (3.8% for Greek males and 25% for males of other nationalities) as well as between females [chi square] (1, N = 92) = 10.12, p < .001 (8.6% for Greek females and 35.3% for females of other nationalities). In addition, "friends and classmates" was found to be an important source which Greek females more frequently considered important than Greek males, [chi square] (1, N = 84) = 6.49, p < .05 (86.2% for Greek females and 61.5% for Greek males), while "mass media and magazines" was reported more frequently as an important source by females of other nationalities than by Greek females, [chi square] (1, N = 92) = 7.79, p < .005 (82.4% for females of other nationalities and 53.4% for Greek females).

Experience of school-based sexuality education

The data analyses of parameters related to the experience of school-based sexuality education revealed significantly lower percentages of Greeks who reported having received formal sexuality education in school, compared to other nationals (see Table 2). Moreover, this significant difference appeared to hold true for those participants who reported attending public schools only, and combinations of public and private schools, but not for those attending private schools only. In addition, nonsignificant differences were observed in the reports of Greeks and other nationals regarding the school levels at which sexuality education had been provided. However, pattern differences were present. For the Greeks who reported being exposed to sexuality education this exposure occurred primarily in grades 7-9 (91.7%), in high school (4.2%), and at university level (4.2%). Other nationals receiving school-based sexuality education reported a wider range of educational levels of exposure (11.6% in primary school, 62.8% in middle school, 4.7% in high school, 4.7% in both middle and high school, 9.3% at all three school levels, and 7% at university level). Furthermore, significant differences were observed in the durations of sexuality education programs that Greeks and other nationals reported. Most Greek programs (85.7%) ranged from "up to six months" (33.3%) through "one school year" (40.7%) to "one to three school years" (11.1%), while the programs reported by other nationals included programs of "up to two-weeks" (14%) and "up to three-months" (11.6%), in addition to "up to six-months" (20.9%), "up to one-year" (14%), and "up to three-years" (30.2%). Finally, nonsignificant differences were observed between Greeks and other nationals in the satisfaction levels they reported experiencing from the sexuality education programs they had received. More specifically, on the five-point scale used, where higher ratings indicated lower satisfaction, mean satisfaction ratings for Greeks and other nationals were 3.33 and 3.36, respectively, t(73) = -.102, ns, with more than half in each group (60.1% of Greeks and 57.8% of other nationals) reporting from "so and so" to "not at all" satisfied. However, one-sample t-test analysis that compared the observed satisfaction mean for the sample (M = 3.34, SD = 0.93) against the neutral satisfaction value of 3 on the 5-point scale revealed a slight, yet significant, dissatisfaction with the sexuality education experienced (t = 3.2, df = 76, p < .002).

Proposals for school-based sexuality education

Greeks and other nationals almost unanimously (98.8% by Greeks and 100% by other nationals) endorsed the delivery of sexuality education in schools (see Table 3). Both groups indicated that sexuality education should be provided predominantly in grades 7-9 (39% by Greeks and 33.3% by other nationals), in grades 10-12 (25.6% by Greeks and 16.7% by other nationals), in the 5 th and 6 th grades of elementary school (14.6% by Greeks and 20.8% by other nationals) and "only when students ask" (8.5% by Greeks and 2.1% by other nationals). A third point of convergence in the views of Greeks and other nationals was observed on the person(s) considered most suitable to deliver sexuality education. Two choices received the highest ratings, namely "a teacher with special training in human sexuality" (42.2% by Greeks and 54.2% by other nationals) and "any professional comfortable with frankly discussing sexual matters" (18.1 % by Greeks and 18.8% by other nationals).

Finally, of the thematic areas offered as "topics that should always be included" in a sexuality education program in school (18 areas in total), "sexually transmitted infections" was the topic endorsed most frequently by all participants (91%). Similarly, without any significant differences in frequencies of endorsement, Greeks and other nationals proposed including the topics "sexual health care" (82.1%), "pregnancy and childbirth" (81.3%) and "female and male sexual anatomy, physiology and functioning" (80.6%). Average inclusion frequencies, again with no significant differences between Greeks and other nationals, were observed for non-physiological topics of sexuality such as "communication with partners on sexuality issues" (51.9%), "gender roles" (47.3%), "sex in society" (45%), and "sexual orientations" (40.5%). However, Greeks and other nationals differed significantly on reported inclusion frequencies for six of the 18 topics; for two of these Greeks reported higher frequencies than other nationals while the reverse trend was observed for the other four topics. More specifically, Greeks reported higher inclusion frequencies for "abortion" and "sexual dysfunctions" while other nationals reported higher inclusion frequencies for "contraception", for "sexual abstinence", for "sex and the law", and lastly for "adoption". Regarding topics to be excluded, no topic was proposed for exclusion (no topic received a higher exclusion than inclusion frequency). For both Greeks and other nationals the topics with the highest exclusion frequencies were "sexual behaviors--alone and with others" (17.2%), "sexuality cross-culturally" (16.4%), "adoption" (16.4%), and "sex and the law" (15.7%); all other topics received exclusion frequencies lower than 15%. The only significant differences in exclusion proposals involved the higher exclusion frequencies of Greek youths for "adoption" and "sexuality cross-culturally".

Discussion

The findings regarding self-appraised sexual functioning at college age appear rather clear. Greeks and other nationals described what they knew and believed about sexuality as valid and sufficient for them, apparently unaffected by whatever differences in school-based sexuality education they had received. However, Greek college students recognized much more so than other nationals the potential benefits to them from additional exposure to formal sexuality education, in spite of the significantly longer time periods they reported themselves to be sexually active. In other words, it appears as if young Greeks recognize a need to improve what they know about sexuality matters through formal sexuality education, while at the same time holding the view that what they already know is adequate and valid; a view that can be linked to the self discoveries likely to go along with their earlier start in sexual activities.

Turning now to the sex differences observed we can see that young men presented themselves as feeling much more certain than young women in considering what they already knew about sexual matters as both valid and adequate. This difference, however, may not necessarily correspond to actual differences in knowledge adequacy and validity since young men and women did not differ significantly in how much they estimated they could still benefit from additional sexuality education. The observed differences could be related to stereotypical beliefs that boys know more about sex than girls (Lance, 2004), and/or to gender differences in self-efficacy (Schultz & Schultz, 2009) whereby women tend to underestimate their capabilities, and in this instance the estimated validity and adequacy of their knowledge base in sex-related issues. Further research could clarify if indeed gender differences exist in knowledge levels concerning sexuality by comparing both what young men and women actually know (basic factual information regarding sexuality) and how adequate and valid they subjectively estimate that knowledge to be.

The longer period of sexual activities of young men as compared to women that was registered in this study seems to be in conflict with reports that were suggesting a closing of the gender gap in sexuality (Wells & Twenge, 2005). However, it is in line with the most recent meta-analytic results available indicating that men continue to report having slightly more sexual experiences than women (Petersen & Hyde, 2010). For Greek youths, this finding is in line with what was reported for young Greeks in the study by Parker et al. (2009) where three times as many boys as girls had indicated intercourse by age 15.

As for the main sources of information regarding sexuality while growing up, a "globalization" type effect becomes apparent in that all young people in this study, independent of the country providing their primary and secondary education, reported the same sources as main sources and in exactly the same order of importance ("friends and classmates" first, followed by "mass media and magazines", with "family members" next, and "school" the least important of all the main sources). For Greek youths, these findings mirror those reported by Kakavoulis (2001) who identified exactly the same sources and in the same order of importance reported by students in grades 10-12 as well as by college students. At this point it is worth noting the significantly lower importance attributed to school by Greeks, compared to other nationals, a difference that apparently holds true for both Greek men and women. Also, the women in the two groups of participants seemed to differ from the men in their group regarding the relative importance of certain sources for sexuality information. Greek women reported turning to "friends and classmates" more often than Greek men did, while young women of other nationalities considered "mass media and magazines" an important source of sexuality information for them much more often than the young men of their group.

When we look to the questions posed in this study related to young people's experience with school-based sexuality education the pertinent findings demonstrate a significant contrast. Based on the responses of the participants in the present study, only about one in three of the youths who went through the Greek primary and secondary educational system reported receiving sexuality education. In contrast, 9 out of 10 of the youths who had attended schools in North America and other European countries, reported doing so. Even more informative is the finding that the above differences hold true only for those attending public schools (or combinations of public and private schools) but not for those attending private institutions. Said another way, the Greek public school system (primary and secondary) appears to lag far behind in reaching its students with sexuality education. When it does, it is primarily in grades 7-9, while in the educational systems of other countries some sexuality education seems to be offered in lower and higher grades, as well. Moreover, the sexuality education offered in the Greek educational system is usually of a shorter duration. Compared to other nationals, Greek youths reported much more frequently receiving sexuality education for up to one year while other nationals reported being exposed to sexuality education for longer time periods (up to three years). The exposure durations reported by Greek youths seem to confirm the identified current practices in the Greek school system which, as already indicated (Pediaditi, 2005) allow for HEP program durations of 2-5 school months (from mid-November to late April). Another interesting finding was the nonsignificant difference in satisfaction ratings for the sexuality education received. Indeed, comparable satisfaction levels were reported, independently of the country of schooling, duration of sexuality education exposure, or sex of participants. As a matter of fact, it is more fitting to speak of comparable dissatisfaction levels as two pertinent findings suggest. First, that over half of Greeks and other nationals reported feeling from "so-and-so" to "not-al-all satisfied", and second, that the average satisfaction level reported was slightly but significantly lower than the neutral satisfaction level. However, while for Greek youths this dissatisfaction seems understandable in light of the significantly lower importance they attributed to school as a source of information, along with the short durations of school-based programs they reported, for other nationals it is difficult to interpret. The mixture of participants in the "other nationals" group of this study makes it difficult to identify characteristics of national programs that might help to explain this dissatisfaction. We can only speculate that the registered dissatisfaction, if it were not a spurious finding, may be associated with the philosophy of some sexuality education programs of the recent past that carried a strong medical focus on anatomy and physiology, employed primarily scare strategies to be disease-preventative, and placed a strong emphasis on abstinence. (DiCenso, Guyatt, Willan, & Griffith, 2002).

When we examine the suggestions young people in this study make about school-based sexuality education what we observe are strong similarities with some minor differences on secondary issues. First and foremost, there is a very loud, almost unanimous YES that all youths express to school-based sexuality education. For Greece, this comes in support of similar attitudes reported by parents, students and educators (Kakavoulis, 2001; Kirana, et al., 2007), health care providers (Papathanasiou & Lahana, 2007; Tsarmaklis, 2007), and Greek Ministry of Health and Social Solidarity officials (2009). It also echoes what a variety of writers and investigators have reported in the relevant literature worldwide (DiCenso et al., 2002; Daria & Campell, 2004; Sommers & Surmann, 2004, Wong, Lee & Henry, 2006; Smiley et al., 2008).

Moreover, it is requested that school-based sex education is offered relatively early on and continues being offered at different educational levels. Young people believe that it should start in the 5 th and 6 th grades, certainly offered again in grades 7-9, but also in the higher grades (10-12). Such a request seems only sensible if we consider the different awareness and understanding young people have of their sexuality-related needs as they proceed through adolescence as well as the differences in their willingness and capacity to tackle different sexuality issues. The need expressed in this study for repeated exposures to sexuality education through one's school years also appears in line with assertions made by past investigators that most school-based sex education programs are quite limited (Langille, 2002) and are offered much later than needed (Scherf, 2002).

Young people also seem to share views on the person most suitable for the delivery of the education program: a person with expertise through special training and comfortable in speaking openly about sexual matters. As noted in previous studies (Kakavoulis, 2001; Daria & Campell, 2004; Kirana, et al., 2007) the preferred "comfortable expert" doesn't have to be some highly qualified professional but can be anyone of the school teachers as long as they carry special training in human sexuality and feel comfortable about open and frank discussions regarding sexual issues.

Finally, young people seem to endorse a great number of thematic areas as the high inclusion frequencies for most topics suggest. Moreover, the list of most preferred topics is very similar for both Greeks and other nationals. At the very top of reported frequencies stands "sexually transmitted infections", followed by "sexual health care", "pregnancy & childbirth", anatomy & physiology", "abortion", and "contraception". The strong preference for physiology-related topics may reflect the actual needs of adolescents to learn and understand how their body works and how they can best care for it. It may also express what adolescents think they should be interested in, considering that the sexuality education practices they have experienced have traditionally focused more on clinical aspects of sexuality and less on interpersonal skills and strategies within sexual relationships. The finding of this study that adolescents endorse inclusion of such topics as communication with sexual partners, gender roles, sex in society, and sexual orientations suggests that adolescents are indeed interested in these topics as well.

The significant differences between Greeks and other nationals on specific topics for inclusion and exclusion may be reflective of differences in cultural practices, i.e., abortion or abstinence. Abortion, for example, may be of greater interest to Greek youth considering that abortion in Greece is legal and can be carried out in private medical clinics never becoming an official statistic. Abstinence, on the other hand, may simply be of greater interest to the American youths in the other nationals group of this study, considering that abstinence is an issue promoted strongly in sexuality education programs in the U.S. during the last decade.

Before closing, a few points are necessary regarding the limitations of the present study. First, the convenience nature and relatively small size of the sample suggest caution in the generalizability of at least some findings. Second, females made up about two thirds of the study's sample, possibly introducing a self-selection bias. Third, the comparison group of other nationals was small in size and consisted of participants from a number of possibly quite different educational systems, possibly not representative of European or North American educational systems, unlike the group of young Greeks who formed a relatively homogeneous group in this regard. Finally, the sample in the present study consisted of youths attending a private college in the capital, most likely having attended compulsory education within such a large urban center. Therefore, it cannot claim to have tapped into the experience of school-based sexuality education of Greek youths from different regions of the country, especially from the more remote regions or the islands where the available resources for the delivery of sexuality education might be even scarcer. Future research that would take these and other factors into account could yield a more detailed picture of the experience and needs of young Greek people for school-based sexuality education.

Summary and Conclusions

The present study provides some very clear findings from the perspective of young college students who are not far removed from the experience of compulsory schooling and school-based sexuality education. The strongest finding is the unequivocal request of young men and women for school-based sexuality education that will meet their needs in a more satisfactory way than it does at present. Currently, it appears that school is listed last in importance as a main source of information on sexuality, offering sexuality education that is at best half-satisfying. Young people ask that school-based sexuality education be offered at different educational levels starting in grades 5 and 6 and continuing at least through grade 9. It can be delivered by any school teacher with specialized training in human sexuality, comfortable also in discussing sexuality issues openly and frankly. It should encompass a wide spectrum of thematic areas pertaining to how their bodies work, how they can best care for their health and protect themselves form physical risks, along with how to handle communication issues with sexual partners and how to deal with gender roles and sexual orientation concerns. For Greek youths in particular, these requests carry special valence when seen in light of the additional findings of this study. First, that at present the Greek public school system manages to deliver sexuality education to only about one third of its students. Second, that the education provided extends mostly through a period of about 2-5 school months. Third, that young Greeks consider school significantly less important as a source of information on sexuality than other nationals. And fourth, that Greek youth tends to engage in sexual activities earlier than the other nationals studied. All these factors combined point to a multitude of very real risks for Greek youths as they apparently embark on sexual experimentation with inadequate and inaccurate preparation.

The findings of the present study clearly identify the need for further research on school-based sexuality education delivered by the Greek compulsory education system. While ministerial decrees call for evaluation of results from the delivery of HEPs (those on sexuality education included), as well as the dissemination of outcomes, and while a number of such outcomes are made available on the internet in the form of participating student presentations or reports by regional health education administrators, there is lack of systematic research that would inform on such important issues as the extent of educational services delivered, the student populations reached, or the effectiveness of programs used in reaching educational and preventive goals. At best, the available research evidence is scant and of limited scope, merely identifying specific problem areas such as collaboration difficulties between the education and family systems on sex education issues (Kirana, et al., 2007) or the problematic and limited effectiveness of partnerships with community organizations for the delivery of specific educational units (Soultatou & Duncan, 2009).

In addition, given the strong need for school-based sexuality education expressed by young Greek people in the present study, along with the support for such education from Greek parents and educators evidenced in available past research, it appears timely that the current educational policy and practices in Greece be reconsidered. School-based sex education units can be offered as part of the regular school curriculum at various points of compulsory education, beginning with preschool education, through grade and high school, encompassing those characteristics that systematic research shows as effective in informing, educating, and supporting young people towards a responsible and enjoyable sexual life.

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Michael Fakinos

Assistant Professor

Department of Education Sciences in Pre-School Ages Democritus University of Thrace
Table 1

Observed differences in main sources of sex-related information by
schooling country and sex of participants

Country of Schooling
                                   Greek                     Other
                                                             Nationals
                                   Males   Females   Total   Males
Main Source                        %       %         %       %

School                   Males      3.8                      25
                         Females            8.6
                         Total                       7.1

Friends and Classmates   Males     61.5
                         Females           86.2

Mass media and           Females           53.4
magazines
                                   Other Nationals
                                   Females   Total
Main Source                        %         %

School                   Males
                         Females   35.9
                         Total               32

Friends and Classmates   Males
                         Females

Mass media and           Females   82.4
magazines

                                   Statistic
Main Source                        [chi square]           p

School                   Males     (1, N = 42) = 4.23     *
                         Females   (1, N = 92) = 10.12    ***
                         Total     (1, N = 134) = 14.11   ***

Friends and Classmates   Males
                         Females   (1, N = 84) = 6.49     *

Mass media and           Females   (1, N = 92) = 7.79     **
magazines

* p <.05 ** p <.01, *** p<.001

Table 2

Parameters of experiencing school-based sexuality education as a
function of country of schooling

                              Country of Schooling
                              Greeks    Other
                                       Nationals
Parameter                       %          %

Received sexuality             34.9      90
education
Received sexuality
education in:
  Public school                 4.3      90.5
  Mixed (public and private)   36.7      88.9
  Private school               60.7      66.7

School level(s) offering
sexuality education
  Primary school                0        11.6
  Middle school                91.7      62.8
  High school                   4.2       4.7
  Middle and high school        0         4.7
  All three levels              0         9.3
  University                    4.2       7
Duration(s) of sexuality
education programs
1 school year                  40.7      14
1-3 school years               11.1      30.2
Satisfaction with sexuality
education received

                               Statistic

Parameter                      [chi square]           p

Received sexuality             (1, N = 136) = 38.83   ***
education
Received sexuality
education in:
  Public school                (1, N = 44) = 32.84    ***
  Mixed (public and private)   (1, N = 39) = 7.58     **
  Private school               (1, N = 31) = 0.04     ns

School level(s) offering       (5, N = 67) = 8.11     ns
sexuality education
  Primary school
  Middle school
  High school
  Middle and high school
  All three levels
  University
Duration(s) of sexuality       (5, N = 70) = 11.98    *
education programs
1 school year
1-3 school years
Satisfaction with sexuality    (4, N = 75) = 4.86     ns
education received

* p < .05, ** p < .01, *** p < .001.

Table 3

Proposals for school-based sexuality education as a function of
country of schooling.

                                 Country of Schooling
                                 Greeks   Other Nationals
Proposal                           %             %

YES to sexuality education:       98.8        100
  In grades 7-9                   39           33.3
  In grades 10-12                 35.6         16.7
  In grades 5-6                   14.6         20.8
  Only when students ask           8.5          2.1
  Other                           11           27.1
Person(s) most suitable
to deliver sexuality education
  Teacher trained in              42.2         54.2
Human Sexuality
  Professional comfortable        18.1         18.8
discussing sexual matters

                                      Statistic
Proposal                             [chi square]       p

YES to sexuality education:      (5, N = 130) = 9.32    ns
  In grades 7-9
  In grades 10-12
  In grades 5-6
  Only when students ask
  Other
Person(s) most suitable          (6, N = 131) = 10.57   ns
to deliver sexuality education
  Teacher trained in
Human Sexuality
  Professional comfortable
discussing sexual matters
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