Young Men’s Project: Great Yarmouth, UK

Abstract

The Young Men’s Project has been working with young men and young fathers as part of Great Yarmouth Primary Care Trust in the UK since June 2001. The Project works in schools and other educational environments to promote positive personal development, particularly around sex and relationships, and to increase accessibility of sexual health and contraceptive services, and support for young fathers. Young men generally want to look after themselves and to act responsibly in sexual relationships. Knowledge through education and appreciation of how to understand and express themselves as men are crucial. If they are likely to engage in penetrative sex, then being able to access condoms and use them correctly for every sexual encounter is next. Culturally, we set low expectations of young men when it comes to sexual health and taking responsibility. The same is true of our expectations of young fathers. This is not due to their lack of desire to be involved. Our work challenges the much repeated notion that young men are a hard-to-reach group, which throws the responsibility onto them. I believe we should recognise that we, and the services we provide, have been failing to meet their needs.

Résumé

Le « Young Men’s Project » travaille avec des adolescents et des jeunes pères dans le cadre du Primary Care Trust de Great Yarmouth au Royaume-Uni depuis juin 2001. Le projet, mené, dans des écoles et d’autres environnements éducatifs, souhaite promouvoir un développement personnel positif, particulièrement autour de la sexualité et des relations, élargir l’accès aux services de santé génésique et de contraception, et épauler les jeunes pères. Les jeunes hommes veulent généralement se prendre en charge et agir de manière responsable dans les relations sexuelles. Il est fondamental d’obtenir des connaissances par l’éducation et de savoir comment se comprendre et s’exprimer en tant qu’hommes. S’ils pensent avoir des relations sexuelles avec pénétration, la prochaine étape est d’avoir accès à des préservatifs et de savoir les utiliser correctement lors de chaque rapport. Culturellement, nos attentes à l’égard des jeunes hommes en matière de santé génésique et de prise de responsabilités sont faibles. Il en va de même avec les jeunes pères. Cela n’est pas dû à leur manque de désir de participer. Notre travail remet en question l’idée très répandue selon laquelle les jeunes hommes sont un groupe difficile à atteindre et les en rend responsables. Je pense que nous devons reconnaître que nous-mêmes et les services que nous proposons ne sont pas parvenus à répondre à leurs besoins.

Resumen

El proyecto Hombres Jóvenes ha estado trabajando con hombres y padres jóvenes como parte de la Fundación de Atención de Primer Nivel de Great Yarmouth en el Reino Unido, desde junio de 2001. El Proyecto trabaja en escuelas y en otros ámbitos educativos para promover desarrollo personal positivo, particularmente en torno al sexo y las relaciones, así como para mejorar el acceso a los servicios de salud sexual y de anticoncepción, y el apoyo para los padres jóvenes. Los hombres jóvenes, en general, desean cuidarse y actuar responsablemente en las relaciones sexuales. Es fundamental que, por medio de la educación, adquieran conocimiento y noción de cómo entenderse y expresarse como hombres. Si es probable que participen en sexo con penetración, entonces es esencial que cuenten con la capacidad de acceder al condón y usarlo correctamente en cada encuentro sexual. Culturalmente, establecemos bajas expectativas de los hombres jóvenes en cuanto a la salud sexual y el asumir responsabilidad. Lo mismo se puede decir de nuestras expectativas de los padres jóvenes. Esto no se debe a su falta de deseo de participar. Nuestro trabajo cuestiona la arraigada noción de que los hombres jóvenes son un grupo difícil de alcanzar, la cual hace recaer la responsabilidad sobre ellos. Creo que debemos reconocer que nosotros, y los servicios que proporcionamos, no han estado cubriendo sus necesidades.

Key Words:

• young men
• sexual health services
• condoms
• access to services
• UK

The Young Men’s Project has been working with young men and young fathers as part of Great Yarmouth Primary Care Trust in the UK since June 2001. Primary Care Trusts are at the heart of the UK’s National Health Service and work with local authorities and other agencies locally to make sure that the community’s health and social care needs are being met.

The Project works with young men to:

•	promote positive personal development, particularly around sex and relationships;
•	increase accessibility of sexual health and contraceptive services; and
•	develop and promote support for young fathers.

Originally, there was one part-time worker. As the work developed and its value was recognised, this worker (the author) became full-time and eventually another part-time worker was employed.

We work in schools and other educational environments with boys and young men aged 13–16. We also work with young men who are over 16 through colleges and other training institutions. To ensure equitable practice, much of our work is done in partnership with GFS Platform Young Women’s Project, a community project of the Girls Friendly Society in England and Wales, that has been working with young women in Great Yarmouth for over 20 years.

What we have learnt through our engagement with large numbers of young men is that generally they want to look after themselves and want to act responsibly in sexual relationships with others. Research shows that this does not always happen and that complex reasons prevent good protective sexual health behaviour by young men and young women.

Breaking down the steps to enable good protective behaviour amongst young men, knowledge through education is the first stage. Knowledge gives young people one of the foundations for making informed decisions. If young men are likely to engage in penetrative sex, then being able to access condoms is the next stage. Using condoms correctly for every sexual encounter is another element. It is clear from Hatherall et al’s research with young people in 2005¹ and the UK National Survey of Sexual Attitudes and Lifestyles in 2000,² that this final stage is not always being reached. Condom use at first intercourse may be on the increase, but this use is inconsistent subsequently. The research also reveals that many young people are using condoms ineffectively, i.e. penetration is occurring both before and after using the condom. Clearly, there is much work to be done within the initial stages to enable effective and comprehensive condom use.

Teenagers, St Andrews, Scotland

Young men’s appreciation of masculinity, how to understand and express themselves as men, is one of their greatest obstacles to careful sexual health. We work with young men to look at the cultural pressures on them regarding relationships and sex, and we stress delay of sexual activity as a positive choice. We discuss different forms of contraception with young men, including emergency contraception, so that they are aware of these, but stress to them that condoms are the only form of contraception over which they have some control. By using condoms they can take responsibility to protect themselves and others. Young men express a keen interest in accessing condoms but are unlikely to do so unless services are set up with them in mind. I have come across several levels and obstacles which prevent young men from accessing sexual health support.

When I first tried to engage with young men aged 16+ at a further education college, I was told that young men at the college did not access any extracurricular education regarding health. When we began to unpack what was being delivered at that time, it became clear that nothing was directly targeted at young men. I arranged a workshop specifically about young men’s sexual health. I was then told by teaching staff that it would not really be worthwhile as young men would not be interested; they would not engage, and it would not have an impact on their behaviour. Part of the false logic behind this was the assumption that by that age it is too late and young men “know it all already”.

That year, 2002, I was only able to run one workshop with one group. There were 20 young men aged 17–19 and we spent a highly entertaining couple of hours discussing sexual health. Only one of them knew where the local sexual health services were based, in the family planning clinic, and they were interested to find out where they were. They all expressed a keen interest to use condoms in any future sexual experiences. I told them that if they visited the services they would be able to get their condoms free. They were very enthusiastic about this. I then asked them if they would access these services; my question was met with a resounding “no”.

When retelling this experience during a conference on teenage pregnancy in Norfolk in 2003, I heard a muttered and indignant: “Well, that’s just typical!” I will come back to discuss the significance of this in a little while.

With this same group, I then discussed what would prevent them from accessing services and what could enable them to do so. The main barrier they identified was embarrassment: entering a new building, not knowing where to go, what to say, what they might be asked and ultimately the fear of looking stupid. Giving them the time and space to discuss this allowed them to find a way to resolve the problem. Their solution was to plan a visit, with me, to the clinic. This was done and they were given a 30-minute introduction to the building, staff and procedures. Feedback from this was that 90% felt comfortable going back, either on their own or with a partner.

As well as bringing young men into the clinic, family planning staff began delivering outreach services in the college. Feedback from these staff and college staff has been very positive about the way in which this service is being used. College staff said that they had noticed a positive difference in young men’s communication and behaviour when using this service. There had been an expectation that young men would abuse this service and act irresponsibly. They found the opposite to be true and saw the young men behaving not only responsibly, but with greater levels of confidence and assertiveness. Family planning staff have noticed a development over time that young men accessing the service are bringing a wider range of health issues and queries to them. This may have significant implications with regard to health inequalities and how men access all health services.

Through the work of the learner–mentor team at the college we are now reaching the majority of young men in the college and the teaching staff are very positive and supportive of the work. Family planning staff have remarked on a difference in the way that young people are engaging with them at the clinic. They are using the services to address their sexual health and relationship needs in a more holistic way. These changes have not been formally evaluated, but they are probably related to the ways in which the services are being influenced by:

•	input into Sex and Relationships Education* for young people by the Young Men’s Project and GFS Platform Young Women’s Project in schools and other educational settings. Raising self-esteem is the foundation of this work;
•	development of outreach services, including school-based health services, giving young people greater confidence in local services; and
•	greater confidence amongst family planning staff through engaging with young people in youth-centred environments.

Returning to the comment “Well, that’s just typical!”. Yes, it may be typical, but the important question is, what is it typical of? The indignation with which the comment was delivered suggests that young men are irresponsible and we can hardly expect anything different from them.

Culturally, we set low expectations of young men when it comes to sexual health and levels of responsibility. The same is true of our expectations of young fathers: there is a widely held perception that young men are irresponsible, uncaring and uninvolved when they become parents. While it is true that a high percentage of young fathers are not involved in their children’s lives, research and experience show that this is not due to a lack of desire to be involved.^{3 4 5} It is linked to the barriers and obstacles which young fathers face. Unfortunately, I believe it is also indicative and typical of our inability to fully engage with, and listen to, young men and their unidentified needs.

Working with young men to give them the confidence to access services is only a part of the work we need to do. What is more crucial if we are to engage with equality of opportunity is to find ways to structure our services to make them accessible to young men through consultation, outreach, in-reach, staff training, literature, language, use of images, attention to environment and gender make-up of staff teams. These are all part of making services more accessible to young men.

When engaging with young men to reduce teenage pregnancy, cultural change lies at the heart of the work we need to do with boys and young men, to give a greater understanding of the construction of masculinity and how this impacts on their lives, their behaviour and their relationships. It is also about cultural change amongst all of us working with young men, to have greater expectations, to resist and challenge cultural norms and stereotypes regarding young men. It is about changing the cultural environment of service planning and delivery. I would challenge the much repeated notion that young men are a hard-to-reach group. This tends to throw the responsibility onto them. I believe we should turn this around and recognise that we, and the services we provide, have been failing to meet their needs.

Notes

* Sex and Relationships Education is the UK government term for sex education programmes in schools.