What have 16- to 18-year-olds in England learnt about reproductive health? A survey of school students

Objective: Most countries teach limited information about sex and reproductive health education, often concentrating on how not to get pregnant. In this study, we examine what 16- to 18-year-olds in England have learnt and their views about reproductive health education. Design: This is a mixed-methods study. An anonymous, online survey was conducted on Qualtrics software using multiple-choice and open-ended questions. Schools were recruited via the Biotutors forum, and they distributed the survey to students aged 16–18 years. Setting: Data collection took place across England. Methods: A total of 931 students completed the survey, of whom 636 were girls, 250 were boys, 31 as other genders, and 14 did not disclose their gender. Quantitative data were analysed descriptively, and associations were explored using Chi-square tests. Qualitative data were analysed thematically. Results: Over half (65%) of the students rated the sex education they had received as adequate or below. Over half (74%) reported that they do not, or only sometimes, talk to their parents/guardians about these topics. Half (49%) did not know when a woman is most fertile. Students showed a better knowledge of female fertility than male fertility. There was no relationship between how much teaching respondents said they had received and their knowledge of reproductive health topics. From the free text question ‘How do you think we can improve sex and fertility education in schools?’, five themes were identified: inclusivity for all students; comprehensive with relevant topic variety; logistical improvements needed to teaching; the need for honest, transparent and non-judgemental teaching; and sex positivity. Conclusion: Schools should teach a wider range of issues relevant to sexual and reproductive health. Data from this study have assisted the creation of a teachers’ education resource which is being developed in partnership with the International Reproductive Health Education Collaboration (IRHEC).