Comprehensive Sexuality Education
1. Context and background
Sweden is a Northern European country with a long history of sexuality education in its schools. Currently, about a quarter of the population is under the age of 25. During the past several decades, Sweden has reduced its HIV infection rate, adolescent pregnancies, and child marriages. The rate of contraception use is relatively high, though it is the lowest in the Nordic region.
The country is well-known for its sexuality education curriculum and is seen as a pioneer in the field. In 1935, the Population Commission was established to create public opinion on questions concerning sex life, family life, and population issues. Within the Commission, a broad social policy program was outlined, which included preventive maternal and child health care, school health care, housing hygiene, nutritional hygiene and sexual education, etc. Sexuality education first became an optional part of the Swedish curriculum in 1942 with a tutorial for teachers being provided in 1945. In 1955, Sweden became the first country in the world to mandate sex and gender education for all schools nationwide. Since then, the curriculum has been updated and revised. Significant changes took place in 2011, when terms such as sexuality, relationships, gender, gender equality and norms were included in several of the course and subject syllabi for compulsory and upper secondary school, compulsory school for pupils with learning disabilities and adult education. Sweden also has a long history of youth friendly reproductive health services. Adolescents can easily access sexual reproductive health (SRH) services through Youth Centers which first opened in the country in the 1970s.
2. Terminology
Sexuality education was previously referred to in the curriculum as sex och samlevnad or “sex and human relations”. However, in the autumn of 2022, the name was changed to sexualitet, samtycke och relationer or “sexuality, consent and relationships”.
The 2020 National Strategy for Sexual and Reproductive Health and Rights (SRHR) defines Sexual and reproductive health (SRH) based on the 2018 Guttmacher-Lancet Commission which states that SRH is “a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity. Therefore, a positive approach to sexuality and reproduction should recognize the part played by pleasurable sexual relationships, trust and communication in promoting self-esteem and overall well-being. All individuals have a right to make decisions governing their bodies and to access services that support that right.
Achieving sexual and reproductive health relies on realizing sexual and reproductive rights, which are based on the human rights of all individuals to:
- have their bodily integrity, privacy and personal autonomy respected
- freely define their own sexuality, including sexual orientation and gender identity and expression
- decide whether and when to be sexually active
- choose their sexual partners
- have safe and pleasurable sexual experiences
- decide whether, when and whom to marry
- decide whether, when and by what means to have a child or children, and how many children to have
- have access over their lifetimes to the information, resources, services and support necessary to achieve all the above, free from discrimination, coercion, exploitation and violence”
3. Laws and policies
3.1. Relevant international/regional agreements to which Serbia is a signatory
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3.2. Relevant national laws and policies mandating comprehensive sexuality education
Sweden’s 1996 Gender Equality Policy (amended in 2015) establishes six sub-goals: an even distribution of power and influence; economic equality; equal education; equal distribution of the unpaid domestic and care work; equal health; and ending men’s violence against women. Equal health covers physical, mental, as well as sexual and reproductive health. Even distribution of power and influence applies to SRH as well.
The Discrimination Act (2008:567) expressly prohibits “harassment: conduct that violates a person’s dignity and that is associated with one of the grounds of discrimination sex, transgender identity or expression, ethnicity, religion or other belief, disability, sexual orientation or age.” And “sexual harassment: conduct of a sexual nature that violates someone’s dignity.” In regards to education, providers may not discriminate against any child, pupil or student.
The Education Act (2010:800) calls for gender equality in the school system. The Act in Chapter 1, 4§ stipulates that “all education within the formal school system aims for pupils to acquire and develop knowledge and values. It must promote all pupils' development and learning as well as a lifelong desire to learn. The education must convey and anchor respect for human rights and the fundamental democratic values on which the Swedish society rests. Everyone who works within the school must also promote respect for each person's self-worth and respect for our shared environment.”
The Governments instruction to the National Agency for Education (2015:1047) states in §20, that the authority must “promote equality and integrate an equality perspective and the human rights perspective in its activities. In its activities, the authority must also promote equal rights and opportunities regardless of sexual orientation, gender identity or gender expression”.
During the years, the National Agency for Education has been given several government mandates to update the knowledge area CSE, and to reinforce support to schools, including developing and disseminating support material for teaching staff about sex and relationships.
The 2020-2023 Action plan for equal rights and opportunities for LGBTIQ people mandates that schools provide a safe environment for all children and pupils, with education characterised by “openness and respect for people’s differences and an active promotion of equal rights and opportunities, regardless of gender, sexual orientation, gender identity, or gender expression.”
Since January 2020, the UN Convention on the Rights of the Child (CRC) has been codified into Swedish law in the United Nations Convention on the Rights of the Child Act (2018:1197), making it clear that the commitments under the Convention must be ensured at all levels of public activity and that a child rights-based approach must permeate all activities that affect children and young people.
The 2020 National Strategy for Sexual and Reproductive Health and Rights (SRHR)’s main goal is “good, equal sexual and reproductive health for the entire population.” The strategy contains four sub-goals, seven areas for action, and a plan for follow-up and indicators. The sub-goals are:
- Sexuality and sexual health, the freedom to decide if, when and how they want to be sexually active, choose their sexual partners in equality and consent, have pleasurable sexual experiences, without the risk of sexually transmitted infections and unwanted pregnancies;
- Reproduction and reproductive health, the right to good reproductive health and the ability to choose if, when, how many and in what way they wish to have children and has the right to safe and secure care during pregnancy, childbirth and abortion;
- Empowerment, integrity, and identity linked to health, the right to be respected and strengthened in their empowerment, in their bodily integrity and in their privacy, as well as in their sexual identity and gender identity, without limitations and stigmatization. Everyone has the right to freedom from discrimination, including harassment and sexual harassment, as well as violence or oppression;
- Equal relationships with a connection to health, the right to freely choose if, when and with whom or whom they want to have a relationship or live together in equality. Everyone has the right to freely choose whether, when, and with whom marriage is entered into or dissolved.
Regarding education, the strategy aims to develop teaching about sexuality and relationships. Teaching about equality, identity, sexuality, and relationships needs to be developed within primary and secondary school and all corresponding school forms as well as within adult education. An all-round, recurring and inclusive teaching about sexual and reproductive health and rights forms the basis of knowledge in the sexual reproductive health rights (SRHR) area. All pupils, regardless of their circumstances, must have access to evidence-based, high-quality teaching that aims to strengthen pupils' knowledge, ability to act and awareness of standards. At the end of compulsory education, pupils should be competent in sexual and reproductive health and rights.
In 2022, and in response to the government mandate, the Swedish National Agency for Education (Skolverket), renamed “sex and human relations” to “Sexuality, consent, and relationships” (Sexualitet, samtycke och relationer).
3.3. Curricula
Mandatory or optional
Sexuality Education is mandatory and has been since 1955. Schools are mandated to follow the Education Act, the curricula and the syllabi. A paragraph was added in 2021 to all the curriculums, except for the preschool curriculum,
and implemented in 2022, from primary to upper secondary levels, to state that “the school has a responsibility to ensure that pupils repeatedly learn about sexuality, consent, and relationships in their education. The education shall thereby promote the health and well-being of all pupils and strengthen their conditions to make conscious and independent choices. The school must contribute to pupils developing an understanding of their own and others' rights and convey the importance of sexuality and relationships being characterized by consent. In the education system, power structures linked to gender and honour-related violence and oppression must be critically examined. The pupils must also be given the opportunity to develop a critical approach to how relationships and sexuality are presented in different media and contexts, including in pornography.” Everyone that work in the Swedish school should show respect for the individual and in everyday work proceed from a democratic and norm-conscious approach. Even in the adult education curriculum, there are writings about sexuality, consent and relationships. How the topics are integrated into the subject is a decision of individual schools in accordance with the curriculum.
Model of delivery
Sexuality education is spread throughout the compulsory educational programe, starting in preschool class- and continuing through upper secondary school. The curriculum and subject syllabi, regulate the content area of sexuality, consent and relationships. But the teaching can be included in several contexts. The basis of the teaching is subject-integrated and interdisciplinary work. Concepts such as sexuality, relationships, equality, norms, and identity are included in several subject syllabi. This gives pupils perspectives and contexts such as how the view of sexuality has shaped entire societies and people's life opportunities. The content can also be apart of everyday work which is referred to as “seizing every opportunity”. This means that current events and things relevant to pupils’ lives may and should be discussed as pupils may want to have a dialogue about issues related to conflicts, bodily integrity, relationships, and equality. It also means that teachers and staff are obligated to act immediately if they find out that a child or a pupil has been subjected to any form of harassment. The teaching about sexuality, consent and relationship can also be supplemented with individual lessons or theme days. The school may incorporate lessons related to themes such as human rights or equality, sexuality, or consent. This can be done optionally during events such as Worlds AIDS Day, International Women’s Day, or #MeToo.
Comprehensiveness of Content
According to the curricula, the knowledge area sexuality, consent and relationships, must: promote the health and well-being of students, strengthen the ability to make conscious and independent choices, contribute to an understanding of one's own and others' rights, convey the meaning of consent, include knowledge of power structures linked to gender and honour-related violence and oppression, and develop the students' critical approach to representations of relationships and sexuality in various media and contexts. Topics include human puberty, reproduction, gender roles, sexuality, sexual orientation and identity as well as questions about relationships, love, mutual consent to sexual activity, responsibility and human rights, sexually transmitted diseases and contraception. Other cross-cutting themes in the curriculum include social norms critique, identity and media literacy.
For example, in Sweden’s syllabus for biology class for grades 4-6 includes “human puberty, reproduction, sexuality and identity and questions about human relations, love and responsibility.” In grades 7-9, core content includes, “Human reproduction, sexuality, and identity, and questions concerning human relations, love, responsibility, consent and reciprocity. Sexually transferable diseases and contraceptives are also included. In religious education for grades 4-6, conversation about and reflection on everyday moral issues based on the pupil’s own arguments and different religious views that for instance concern responsibility violations, equality and sexuality, may be discussed.
At the preschool level, the curriculum ensures that the preschool should provide each child with the conditions to develop respect and an understanding of the equal value of all people and human rights. This includes preschool staff promoting respect for the inviolability of human life, individual freedom, and integrity. Furthermore, the preschool should provide each child with the conditions to develop their identity and feel security in it, and awareness of the right to their physical and personal integrity.
Learning resources (specific textbooks): The National Agency for Education develops and distribute support material for teaching staff about sexuality, consent and relationships. The material should be a support for school staff to give young people the opportunity to reflect on the view of sexuality, equality and norms.
For the new curriculum, “sexuality, consent, and relationships,” teachers can access resources and instruction on the Swedish National Agency for Education’s website.
3.4. Teachers
New diploma goals for teacher training regarding sexuality education came info effect in January 2021 and was implemented in June 2021. The diploma goals states that teachers should be able to communicate and reflect upon questions regarding identity, sexuality and relations, and be familiar with the Convention on the Rights of the Child. Today, the diploma goal is included in teacher education for primary school teachers, secondary school teachers and vocational education teachers. All teacher training institutions were expected to introduce specific objectives for this.
The National Agency for Education offers free online courses for teachers for early primary grades, later primary grades, and high school for the new curriculum, “sexuality, consent, and relationships,” on the Swedish National Agency for Education’s website. The agency also provides further support for teachers in special schools in the elementary and upper secondary level.
3.5. Schools
Access to sexual and reproductive healthcare is universal in Sweden. A network of around 300 Youth Clinics (YCs) are available in the country to provide free information and services. The YCs are designed to work alongside schools. Secondary schools also occasionally conduct classes at the YCs to help familiarize them with the clinics. Condoms are freely available in some schools and youth health centres, and contraceptive pills are generally subsidized, as is the morning-after pill for those under 20 (under 23 in some regions). The YCs also have an online webpage where youth can make appointments and find information about SRH. A website for targeting newly arrived young migrants/immigrants has also been developed and is accessible in different languages.
4. Governance
4.1 Responsible ministries
The Public Health Agency (Folkhälsomyndigheten) is responsible for national coordination and knowledge building in sexual and reproductive health and rights (SRHR) in Sweden. The Public Health Agency and the National Agency for Youth and Civil Society (MUCF), play an important role in producing a knowledge base; they also allocate funds to the other actors.
Teaching about sexuality, consent and relationships is regulated through curricula and syllabi. The National Agency for Education provides support for sex education in the form of continued professional development, materials and by highlighting good examples in the school system.
4.2. Level of responsibility/decentralization and autonomy
Based on the Education Act (2010:800) and current curricula and other regulations, the education provider/municipal organiser and the public and private principals are responsible for ensuring that children and pupils are given equal opportunities to acquire knowledge in various areas, which includes subject-integrated knowledge about sexuality, consent and relationshipbased on age and maturity. The principal is responsible for planning, following up, evaluating and developing the education in relation to the national goals. Teaching about sexuality, consent and relationships needs to be developed within primary and secondary school and all corresponding forms of school as well as within adult education. According to the curricula, the principal has the specific responsibility for ensuring that “the knowledge area sexuality, consent and relationships as well as knowledge of honor-related violence and oppression are included repeatedly during the education in compulsory school and upper secondary school.”
The school's health promotion work, where student health has a central role, should also include questions about sexual and reproductive health and rights. The principal is also responsible for ensuring that teachers have the proper training required to provide CSE education. Teachers are asked to adapt the teaching structure, content and working methods according to pupils’ changing needs and conditions.
4.3. Government budget allocation
During recent years, several governmental measures has been taken to strengthen sexuality education. In the light of #metoo and the national review about CSE conducted by the Swedish Schools Inspectorate, the government set aside 50 million SEK (4.8 million USD) for skill enhancement measures regarding, for example, sexual harassments. In 2021, the government set aside 11 million SEK (1 million USD) to strengthen the work against honor-related oppression within the school system. In 2022, the National Agency for Education was given a government mandate to offer school staff skill enhancement measures regarding prevention of male violence against women. The measures are also expected to promote equality and prevent discrimination, racism, intolerance and honor-related oppression. The mandate took its origins in the revised curricula and the new knowledge area sexuality, consent and relationships.
5. Monitoring and reporting
The National Agency for Education is now planning for follow-up of curriculum changes at a national level.
The principal is responsible for the monitoring and evaluation of the school’s sexuality education.-. The Swedish Schools Inspectorate carries out both thematic reviews and regular monitoring of schools. Regular thematic reviews of CSE are not carried out. To follow the delivery and impact of CSE on a national level remains a challenge. A review from the Swedish Schools Inspectorate, concludes that schools that are successful in providing high quality CSE for all pupils have these things in common: 1) They carry out a systematic developing work that includes clear goals for CSE, that are followed-up and evaluated. These schools also intergrate CSE in the school’s general value-based work, 2) The principals regularly monitor that teachers have the competence to teach about CSE and provide relevant capacity building when required, 3) Teachers give the pupils real influence in planning, implementation och evaluation of CSE, and 4) Teachers regularly give the pupils opportunity to reflect on a number of different norms relating to the area of sex and human relations – together with the teachers. Student health’s mission is also anchored in the group of employees at the school.
This profile has been reviewed by the Programme Coordinator Swedish National Commission for UNESCO
