Each year, hundreds of teenagers get pregnant or have abortions. Is the 'abstinence' message in existing sex education programmes still effective, or should parents and teachers be more open in using the C-word? 
KEN KWEK and ZAKIR HUSSAIN report

Two years ago, Mrs S. L. Tan faced her first major crisis as the mother of a teenager.

She found out that her eldest son, then 14, had sent an intimate SMS message to his girlfriend, 13 'Something about taking a shower together.'

After discussing the situation with the girl's mother, who had alerted her about the SMS, the pair decided to put an end to their children's relationship.

Mrs Tan, 44, a housewife and mother of two sons, now aged 16 and 14, and a daughter, aged 11, confessed to being 'freaked out' by the incident.

'I've always taught my kids that sex is something special that should only be shared between husband and wife. But as a realist, I'm also aware that by the time they are 17 or 18, they can probably do whatever they want without telling me. It's a struggle, but I would rather teach them how to protect themselves properly, than not at all.'

Her view If schools won't teach contraception, then parents have to step in.

But Mrs Regina Lau, 47, a mother of a 10-year-old boy, has a different view. She does not want schools to teach contraception because condoms have 'a high risk of failure' and would give teens a false sense of security.

 
Room for more?

In a nutshell, the two parents above represent a schism of view on sexuality education for teens.

Most Singaporeans would probably agree that the no-sex message to teens is a good one.

One group thinks sex education should stop at teaching no-sex and not talk about contraception. Others think that sex education should also talk about contraception so that teenagers who experiment, at least know about safe sex.

The issue of what teens should be taught about sexuality is coming to the fore, in the face of data showing a significant minority of teenagers getting pregnant or having abortions.

More teens are also being infected with various types of sexually transmitted diseases In 2002, it was 238 youngsters aged 10 to 19 years. Last year, it was 600.

While these figures represent less than 1 per cent of the total teen population - they do add up to a picture of thousands of teens experimenting sexually.

Three separate polls suggest as many as one in four or one in five teens are sexually active. Insight's informal street poll of 60 teenagers in Orchard Road this week showed 13 - or just over one in five - had had sex. Of these 13, nine did not use a condom the first time, and continue to have unprotected sex.

A previous survey by Action For Aids (AFA) found that one in four of 500 at-risk and out-of-school youths, aged 15-21 years, had had sex. Of these, 80 per cent had done so 'at short notice', and 60 per cent said they never used condoms.

These surveys may be anecdotal, but are enough to lead some parents and social workers to question if the current approach to sexuality education is working.

In particular, is the values-based approach emphasising abstinence effective, or should sexuality education also teach teens how to protect themselves from disease or unwanted pregnancy?

 
Conflict of interest

Pro-abstinence groups are clear on this issue Keep talk of contraception out.

'Promoting abstinence is promoting a virtue, whereas promoting condoms is promoting a lifestyle,' says Mr Andrew Kong, 48, a senior executive at the Family Life Society.

'Say you tell a teenager, 'You should try to abstain, but if you can't control yourself, use a condom'. That's like saying 'Don't cheat, don't steal, but if you can't help yourself, don't get caught'.'

He believes that abstinence is the one - and only - method to be promoted.

Concurring, Methodist Bishop Robert Solomon explains 'To teach moral and holy living, and in the same breath, promote protective measures in promiscuous behaviour, will dilute or distort our message and confuse the congregation.'

While other groups may want to emphasise protective measures, the church has to 'promote abstinence and marital fidelity as the best protection, and the best option for individuals and society,' he said.

This code of 'moral living' is also upheld by secular groups here, including social organisations, schools and government agencies.

In primary and secondary schools, teachers deliver the Ministry of Education's (MOE) sexuality education programme as part of the Civics and Moral Education classes.

It is part of the Pastoral Care programme in junior colleges. It is only in science lessons that issues on reproduction and contraception are taught.

One major component of the sex education programme is a set of four videos called the 'Growing Years' series.

The overriding message to students in these videos Learn about the human body and how to manage relationships - but stay away from pre-marital sex, or you may end up getting hurt.

According to an MOE spokesman, surveys were conducted in 2003, a year after the 'Growing Years' programme was implemented.

'More than three-quarters of the upper secondary students, who were specifically surveyed on the key value of sexual abstinence, indicated that the programme helped them to realise the importance of setting boundaries in boy-girl relationships and to put more value on sexual abstinence,' she said.

Student Navin Sregantan, 16, felt that an emphasis on abstinence rather than protection was appropriate, 'because at our age, we shouldn't be having sex anyway - it's illegal.'

Business executive Jasmani Buang, 45, a father of two daughters aged 16 and 17, and a son aged 15, feels that schools are on the right track in promoting abstinence while teaching youths 'the biological facts'.

'At the end of the day, the value system has to be right. Teens are vulnerable and can easily be misguided by their peers, so schools and parents must do what they can to inculcate the right values.'

Social worker Hannah Neo of Ling Kwang Youth Centre adds 'If we encourage young people to use condoms, we are compromising on our values. We are indirectly implying that, hey, it is okay to have sex before marriage, as long you use a condom.

'This will only encourage a generation of young people without self-control and who do things without thinking of consequences.'

 
As simple as 'A-B-C'?

On the opposing camp are those who appreciate the value of the pro-abstinence message, but are sceptical of its delivery and efficacy.

Mao Bo Yuan, 16, a Secondary 4 student, said most of his classmates found the MOE video, 'Sense and Sexuality', unrealistic, even ridiculous.

'After two of the characters confessed to having sex, there was no mention of whether they had or should have used a condom,' he said.

'The thing is, no matter how many times you tell teenagers not to have sex, they're going to do it anyway. I don't think we got anything out of the video at all,' he added.

Accountant Celine Lai, 47, a mother of two sons aged 11 and 16, and a daughter, 21, wants schools to be more open in teaching kids about contraception.

'It's partly because I find it quite difficult talking to my children - particularly my sons - about it. Nonetheless, it's important that they are aware of these things - I don't think it necessarily encourages them to have sex,' she said.

Pro-contraception lobbyists think that an over-emphasis on abstinence is unrealistic. After all, the world at large, including the media and the Internet, is already feeding teens countless images and stories about sex, often in a way that treats casual sexual encounters as the norm.

While teens are imbibing the cultural messages that pre-marital sex is the norm, they are however not educating themselves on how to practise safe sex.

Mr Justin Ng, 21, director of the Youth Outreach programme at AFA, says a didactic or moralistic approach is a surefire way to alienate teens today.

He advocates the 'A-B-C' method expounded by HIV/Aids activists worldwide 'Abstain. Be faithful to one sexual partner. And Condom use. Each of the three must be taken in equal consideration.'

Ms Carol Balhetchet, director of youth development at the Singapore Children's Society, is one who does not think that raising awareness about condom use leads to a decline in moral values.

'Are we also subconsciously saying it's okay to have sex? No. It's like having a fire hydrant in the house, but that doesn't mean a fire's going to happen, right?'

 
A layered approach

Ms Balhetchet says that maintaining a 'values-based' approach to abstinence is a good thing, but there must also be a recognition of uncomfortable facts that teenagers are engaging in sex.

She would like to see 'multi-layered' sexuality education.

'The ideal situation is abstinence, but there must also be concern about protection and prevention of venereal diseases.

'Abstinence is the first layer, but there's the second layer, preventing pregnancy, and then protecting yourself (from STDs).'

She thinks schools should go beyond preaching no-sex, to talking about safe sex.

'Schools take a more traditionalist position, a more conservative position. But they should strive to be as open as youths, be in step with them, rather than simply dictate what they should do. Educators feel that teaching about condoms will open up another door to children's minds. But they should consider, isn't the door already open? If it is, what do we do about it?'

But a junior college teacher, who did not want to be identified, said any such attempts would result in a backlash from parents.

Right now, schools don't teach teenagers about different contraception methods or how to use them.

Nor do schools give information on who to contact if teenagers find themselves in some kind of a sexual crisis such as pregnancy. There is good reason for this, the teacher said.

'Singapore remains a very conservative society, and many Singaporeans' values are deeply rooted in religion. There will be a major outcry among parents if such overly practical measures were incorporated into sex education in schools.

'As has been reported in the media, such methods of educating young people on sex have been seen as promoting sexually promiscuous behaviour, not curbing it.'

It is inevitable that any discussion on sex education will end up being one about values.

But strip the debate of all considerations about morality, and the stark truth is this Most teenagers don't have sex, but a significant minority do. And among the latter, there are those who do so dangerously, without protection.

So should the state's sex education programme stop at abstinence, making itself irrelevant to the tens of thousands of teens who are already sexually active?

Or should it also incorporate messages about safe sex and preventing pregnancy, in a way that does not compromise the overall abstinence message?

One argument is that perhaps the state's schools should not be involved in promoting contraception, as teachings on sexuality are so rooted in religious and moral values.

Then it is families, and community groups, which must get real and reach out to teens about responsible safe sex.

The longer the adults tiptoe around the issue, the more teenagers there will be each year who risk sexually transmitted diseases and pregnancy or end up getting abortions.

* * * * *

For two years, 16-year-old Sofia gave little thought to protecting herself while having sex. Last month, she was diagnosed with a venereal disease.

Now, she wishes her sex education lessons in school or her parents had stressed the importance of safe sex.

The Secondary 4 student said she had met one of her lovers on a popular Malay website. If only it had a pop-up message advising condom use, she mused.

Such messages are common on the Internet and cable TV stations like MTV. But they are not found on Singapore TV stations and websites or in public places here.

The proposed efforts by Malay-Muslim community leaders to manage teen sexuality suffers the same flaw helpful, but not realistic. Said Sofia 'They know we're having sex, but they pretend they don't know.'

A poll of 500 at-risk and out-of-school youths aged 15 to 21 here by voluntary welfare organisation Action for Aids reports one in four admitting to having had sex.

Like the other communities, Malay youths by and large are still not having sex, suggesting that the vast majority accept Islam's teachings against premarital sex, and that conventional sex education, which stresses abstinence, is working.

But there is still a sizeable minority of sexually active teens, and both polls show that about two in three Singapore youths do not use condoms all the time.

Last year, for example, 600 youths aged 10 to 19 were infected with sexually transmitted diseases, according to government data. Almost half were Malays, when they make up just 19 per cent of all teens in this age group.

Malays also form a disproportionately large group among the teens who get pregnant or have abortions each year. Last year, 417 Malays aged 19 and younger gave birth. This is about 53 per cent of all teen births. In fact, for the past five years, Malay mums had about half of all the babies born to teens.

Many of these teen mums are also among the 414 Malay brides who are younger than 21. Most of these pregnant brides married against the advice of religious leaders who felt they were not ready for marriage.

Malay teens are also over-represented in abortion statistics - last year, 434 Malays aged 19 and younger had abortions. This is almost one-third of all teen abortions, a proportion that has been rising since 2000 when it was 21 per cent.

Why are so many pregnant teens Malay? Mr Mohamad Maidin Packer, Senior Parliamentary Secretary for Home Affairs, attributed it to ignorance.

He said 'Because if you have sex, you can always protect yourself from getting pregnant. These people are acting spontaneously without thinking of the repercussions of their action.'

Religious and community leaders should try to address this issue, he added.

'In Islam, engaging in sex before marriage is not allowed, but we should try to overcome this ignorance so that unnecessary pregnancies can be prevented.'

How should the Malay community reach out to this group of youths? How do religious groups convey religious teachings on sex in a way that will resonate with this group?

Community organisations have formulated an action plan that centres on giving troubled youth confidential advice. Youth workers are being trained and troubled youth will have a network of support services like hotlines and drop-in centres, by January. A report by community leaders recommends boosting teens' self-confidence and 'imbibing the correct values at an early age' to curb rising sexual activity by teens.

The hope that they stay off sex, which leaders say has often been the result of a search for acceptance or self-esteem.

Minister-in-charge of Muslim Affairs Yaacob Ibrahim has told community leaders they cannot deny that Malay-Muslim children are experimenting sexually, but has left the question of dealing with that open. He acknowledges it is a sensitive subject. Still, the community should look at tackling the root causes of teen sexuality, he said.

Religious leaders said their stand is clear. Ustaz Yusri Yubhi Yusoff, an imam at the Al-Falah Mosque, said contraception is a short-term solution and as a religious leader, he cannot condone it.

Over the past months, people of all races have mooted ideas to prevent teen pregnancies. Among the ideas make religious education 'more hip' to coax youth to abstain, help parents discuss sex with their children, strengthen teens' sense of moral worth and community involvement in abstinence education.

One radical suggestion is to have accessible condom machines in public locations for these teens.

In August, Minister Mentor Lee Kuan Yew offered his take on the subject of teen pregnancies.

'Surely things can be done even before the pregnancy,' he said. 'I mean, let's live with reality. You can go with the Catholic Church and say, condoms, birth control, out, not even for Aids. But in this modern world, in today's age, do you think it will work?'

One solution that has not been aired is for volunteers to reach out to sexually active teens and talk about safe sex, or even distribute condoms to sexually active youth.

The Malay community has been urged to take greater ownership of its own problems. In the end, it has to choose the approach to take.

Its efforts to promote a holistic values-based approach and work with parents are certainly desirable - and have been effective - in keeping the majority of teens out of sexual trouble.

But to reach out to the group who are already tasting forbidden fruit or likely to start, the community may have to start using the dreaded C-word few dare advocate openly - contraception. It will be a controversial step, and one that concerned groups could initiate since leaders in the community are unlikely to do so.