Who Are The People Included In The Sexuality Education Triangle - T-Tees - Your Answers Await, Life's Questions Unraveled

1. Introduction

Talking about sexuality is complex for most of the population; nevertheless, a comprehensive education on sexuality is essential to enjoy good health [1]. From the biological approach, the social, cultural, and historical implications position knowledge of the body in a distant and unknown place that hides health problems, including discrimination and violence.

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The historical differences between sex and gender addressed by feminist theory [2] show the importance of the study of sexuality from a new point of view that includes sexual identity as a performative expression and understand it as a mechanism of power abuse that is presented in these applied experiences through violence. The approach of pleasure is the salutogenic strategy that allows us to apply theories about sexuality in the improvement of health and well-being, as we show in this article [3].

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Therefore, the approach to comprehensive sexuality education, from now on CSE, as a public policy has been established in regions such as Latin America, given the need to reformulate knowledge about sexuality, where the focus on gender, health, and pleasure are fundamental aspects that can address fundamental issues such as child pregnancy, sexual abuse, and sexual health [4]. Comprehensive sexuality education includes training on formal and non-formal contexts based on scientific evidence appropriate to each stage and age, which is comprehensive and transformative and then generates health, but it also has a gender and human rights perspective [5].

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Currently, worldwide, medical schools debate the importance of gender mainstreaming in medical education and training as a tool to guarantee human rights and equality in medical care [6]. The incorporation of gender mainstreaming in the education of health professionals has focused on four main areas: the relationship of gender with cardiovascular health, gender and violence, gender and mental health, and gender and sexuality [7,8].

A study carried out in Colombia reflects the need to incorporate the study of sexuality from a gender perspective in medical education as a tool to guarantee human rights, especially sexual and reproductive rights. This study indicates that if the approach to integral sexuality is not part of the education and training process and is included as a requirement in the professional profile, important changes in care will not be achieved [9,10]. In both the European and Latin American contexts, there are research and applied health intervention groups that seek to improve comprehensive sexuality education. In some cases, emphasis is placed on addressing different forms of sexual violence [11]; in others, discourses on desire and pleasure are analyzed [10]. UNESCO’s institutional campaign “Comprehensive sexuality education: a basis for life and love” aims toward addressing relationships between mothers/fathers and sons/daughters and shared learning about sexuality [5].

The approaches in the studies in Latin America and Europe oriented to comprehensive sexuality education from a gender perspective apply the qualitative methodology of data collection and analysis, including the perceptions of professionals, patients, and citizens. A retrospective study developed in Ecuador between 1998 and 2017 on the situation of sexuality education reflects the importance of deepening the analysis of individual management experiences in populations that seek to guarantee access to rights and the eradication of gender inequalities in the exercise of sexuality. In Ecuador, sexuality education policies have a strong political and not very technical component [11].

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In 2021, in Ecuador, United Nations organizations such as UNESCO or UNFPA, in alliance with the Ministry of Education, published a strategic plan for the incorporation of comprehensive sexuality education based on the fulfillment of sustainable development goals and a comprehensive educational agenda until 2030 [12], where the importance of gender and human rights mainstreaming in educational transformation is evidenced.

From the gender point of view, sexuality transcends the biological binary of sex, placing the body in a context of social relations, crossed by culture as a reflection in education public policy. This approach is aimed at working from education on the prevention and eradication of gender-based violence, including the prevention of teenage pregnancy and sexual violence in the classroom as well as the empowerment and mainstreaming of sexual and reproductive rights, which focuses on the needs of each age group either in basic education or high school [13].

Although the models at a descriptive level are not identical, in this article, they are taken as synonyms, as they both respond to the characteristics described above, with a positive positioning toward sexuality that accepts desire and pleasure as essential parts of sexuality. In particular, the importance of mainstreaming gender and human rights in medical education and in health professionals’ education is confirmed by some working group publications that support with scientific evidence the necessary reform of curricula [8,9,14]. Concerning the content of adequate comprehensive sexuality education, the relevance would be in improving the health of the population, including the good overall health of health workers, and considering that sexuality is formed by “individual practices, values, and cultural norms” [15]. However, our reflection goes further, given that the advances of previous research lead us to consider this combined approach of gender and human rights as a requirement for those who work with people in the fulfillment of constitutionally recognized fundamental rights—that is, health, education, and justice [16].

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Several research questions guide the work presented here: Are there any lessons that can be useful (even enforceable) to improve clinical health care? Are the rights of the population using the health systems being violated when these training deficiencies occur? What methodology and learning objectives would we have to incorporate into the medical curriculum to ensure adequate health care with a gender and human rights approach? In this sense, our objective with the research we present is to apply the comprehensive sexuality education model to develop health promotion competencies [17] with a salutogenic approach [18] based on gender and human rights [19]. This conceptual framework [7] allows us to develop health empowerment in an applied way both in those who are trained in the classrooms where we teach in Ecuador and Spain (Faculty of Health Sciences, UDLA; Faculty of Communication Sciences, URJC) and in the intervention workshops that we carry out in different institutions.

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