Educating ideal neoliberal citizens: discourses of agency and responsibility in comprehensive sexuality education

Keywords:

• Comprehensive sexuality education
• adolescents and youth
• development interventions
• INGOs
• neoliberalism

Comprehensive sexuality education (CSE) is an imprecise and broad term, encompassing programmes that address sexual consent and pleasure, as well as programmes that strictly focus on sexual risk reduction. Despite the wide variability in curriculum content, CSE generally refers to medically accurate sexual health education that discusses both abstinence and use of contraception. International non-governmental organisations (INGOs) implement CSE programmes in the Global South, often through interventions that target upwardly mobile young people, such as upper secondary students.^1–5

Instead of treating sexual health as inextricable from a web of political and historical factors, CSE tends to portray it as existing outside of these structures. Elliott connects the individualism of mainstream CSE to the rise of neoliberalism in the late twentieth century. Neoliberal reforms imposed by Western-dominated multilateral financial institutions led to the global restructuring of economies, deprioritising public sector investment. In 1996, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), the welfare reform enacted by the Clinton administration in the United States, stated the “dangers” of sex outside monogamous relationships, along with “the importance of attaining self-sufficiency before engaging in sexual activity”.^{6 (p. 211 )} While “proper” sex was not necessarily linked to marriage, it was connected to economic status, with the message that poor young people must earn their right to pleasure through economic mobility, which was, ironically, becoming more difficult to achieve due to PRWORA’s welfare cuts.⁷

During this period, U.S. sexuality education programmes embraced individualising discourses to access funding through PRWORA. Observing a CSE class in a high school with over 75% Black and Latino students, Elliott⁶ reported that girls were coached to view themselves as the bearers of rationality, with the teacher probing, “Who usually decides how far things are going to go?” Students answered, “The girl!” Under the guise of “empowerment,” girls were constructed as logical decision-makers while boys were portrayed as enslaved by their libidos. Students were assumed to be heterosexual. CSE is often laden with sexual and gender norms, producing girls as “respectable,” heteronormative, and calculating subjects.

The late twentieth century also saw the expansion of neoliberal development. Examining development projects in Lesotho, Ferguson⁸ explains how World Bank reports on low-income countries overemphasised technical issues (e.g. lack of paved roads) and underemphasised structural issues (e.g. corruption and colonialism): Relatedly, Adely⁹ and Khoja-Moolji¹⁰ examine how hegemonic “empowerment” discourse – a feature of many development interventions targeting gender inequities – obfuscates the root causes of women’s oppression, upholding the notion that “development” is achieved through “logical” choices (e.g. staying in school or starting a business) without acknowledging that “underdevelopment” stems from structural injustice. CSE interventions that entirely focus on individual decisions align with this neoliberal development paradigm.

In this commentary, I review the literature on CSE programmes in the Global South funded and implemented by INGOs based in the Global North, identifying key themes that emerged from the literature, and presenting a call to action based on my findings. I argue that CSE interventions that fail to account for structural constraints on students’ lives, upholding neoliberal values of individualism and personal responsibility, will never be truly comprehensive, much less transformative.

Initial review of CSE interventions in the global south

Critical scholarship on CSE programmes in the Global South funded and implemented by INGOs based in the Global North is limited. I conducted an initial review of the first 300 entries on Google Scholar for peer-reviewed journal articles published in English in the last ten years, using the keywords “sex education” or “sexuality education”; “development”; “intervention”; and “qualitative.” My inclusion criteria included qualitative research that drew upon in-depth interviews with local stakeholders, such as students and teachers. By prioritising literature that engaged with local perspectives, I was able to better understand the discourses of adolescent and youth sexuality in CSE programmes, and how these discourses are internalised by young people.

Five articles met my inclusion criteria. The articles evaluated CSE interventions in ten countries: Bangladesh, Bolivia, Ecuador, Ethiopia, Ghana, Indonesia, Kenya, Nicaragua, Thailand, and Uganda. The articles were all based on qualitative studies, utilising in-depth interviews and focus group discussions with students and teachers involved in the CSE interventions.^1–5 Other methods included observations of class sessions^1,2,4,5 and curriculum content analysis.⁴ There was limited information about the content of CSE curricula, which made it difficult for me to analyse the discourses of adolescent and youth sexuality that circulated in the interventions. It is possible that some articles omitted details that could have altered my analysis.

Three key themes emerged from my reading of these five articles: the problem-focused view of adolescent and youth sexuality^1,3; neoliberal assumptions about subjectivity and agency^2,3; and the transformative potential of culturally responsive dialogic approaches.^4,5

Problem-focused view of adolescent and youth sexuality

The literature describes how CSE interventions often perpetuate a problem-focused view of adolescent and youth sexuality, emphasising risk over pleasure, constructing students as subjects who must bear full responsibility for their sexual health. Roodsaz³ analysed a Dutch-funded CSE intervention in primary and secondary schools in Bangladesh, interviewing representatives from seven local NGOs implementing the programme. They attested that NGO-based facilitators often refused to discuss sexuality issues and instead focused on hygiene. One NGO representative shared that, “ … [the] adolescents don’t have any problem with talking about sexuality in front of each other, the problem is from our side”.^{3 (p. 114)} Browes¹ examined another Dutch-funded CSE programme in a secondary school in Ethiopia, conducting interviews with over fifty teachers, students, and community leaders. She found that the most sensitive topics in this context, homosexuality and masturbation, were ignored in the programme, despite the curriculum being intended to develop critical thinking and informed decision-making skills. Sex was only discussed in a positive light regarding the future, framed as a prize that needed to be earned through diligent work and economic success.¹

Neoliberal assumptions about subjectivity and agency

CSE interventions discussed in the literature were characterised by neoliberal assumptions about subjectivity and agency, constructing students as self-interested actors who could be primed to make “rational” decisions, failing to recognise their cultural, political, and historical contexts. Roodsaz found that the Dutch-funded CSE intervention in Bangladesh constructed parents as “naïve yet malleable” stakeholders.³ Likewise, Nelson et al. described how an intervention in Latin America portrayed sexual health communication between students and parents in a cultural vacuum.² This CSE programme funded by the European Commission in Bolivia, Ecuador, and Nicaragua, promoted open dialogue between students and parents, creating a binary between speaking and silence: “To not be open implies withholding the truth, a moral act”.^{2 (p. 190)} However, students and parents valued a definition of confianza, or trust, which conflicted with the intervention. For many parents, confianza implied trusting their children without prying into their lives, and for many students, confianza entailed withholding information from their parents. Rather than acknowledging local understandings of confianza, the intervention appropriated this term, promoting itself as building confianza between students and parents. According to the authors, the lack of cultural responsiveness prevented the programme from being embraced by target communities.

Transformative potential of culturally responsive dialogic approaches

Singh et al.⁴ and Vanwesenbeeck et al.⁵ illustrate that CSE interventions are better received when they are co-developed with local stakeholders and address local histories and material conditions, rather than perpetuate the neoliberal logic that individuals alone are responsible for their sexual health.^4,5 Singh et al. studied a Dutch-funded CSE intervention in Ghana and Kenya, which targeted both in-school and out-of-school young people, through curriculum content analysis, interviews with local facilitators, class observations, and focus group discussions with students.⁴ Like Roodsaz,³ they found that educators often avoided sensitive topics, such as pleasure and abortion. However, they observed that educators who were given extra support and training became more capable of facilitating open discussions, moving past the problem-focused view of adolescent and youth sexuality to engage in dialogic pedagogy. Similarly, Vanwesenbeeck et al.⁵ praised a Dutch-funded programme implemented in secondary schools in Ethiopia, Ghana, Indonesia, Kenya, Thailand, and Uganda for addressing relevant issues above sexual risk. For example, instead of portraying HIV as a punishment for “bad” choices, the programme acknowledged that some students might be HIV-positive themselves, providing resources for HIV-positive students rather than only sharing guidance on HIV prevention. Vanwesenbeeck et al. attributed students’ positive responses to the programme to its immediate relevance and lack of fear-based messages.⁵

Call to action

Young people in the Global South often receive CSE that is anything but comprehensive, failing to speak to their lived experiences and upholding the neoliberal myth that young people are autonomous agents who can be programmed to make “logical” decisions.^1–3 More research is needed on the effects of Global North-funded and implemented CSE programmes in the Global South, along with a radical reimagination of what these programmes could encompass. Further curriculum content analysis is necessary to better understand the discourses of adolescent and youth sexuality that circulate within these programmes, along with more research with students to uncover how these discourses are internalised and enacted.

One solution proposed by interdisciplinary feminist scholar Laina Ya-Hui Bay-Cheng¹¹ is “critical sexuality education,” which “engages youth in the collective critical analysis of the interplay between sexual well-being and social conditions”.^{11 (p. 344)} Rather than attempting to discipline and normalise students, “critical sexuality education” scrutinises the political and historical conditions that shape their lives. Bay-Cheng includes an example curriculum that she designed, with activities that prompt students to examine structural oppression as the basis for sexual risk. One activity presents hypothetical scenarios where consent is ambiguous. Students discuss why individuals may say “yes” to unwanted sexual interactions due to power imbalances, such as age disparities, and structural injustice, like poverty. This activity enables students to understand the difference between “bad” choices and a lack of options.

Following Bay-Cheng’s model, Global North INGOs would be well-advised to develop “critical sexuality education” curricula with local stakeholders when designing CSE interventions. “Critical sexuality education” involves dialogic learning in which students collaboratively interrogate the political and historical factors, including (neo)colonialism and capitalism, that affect their sexual health. As Bay-Cheng writes, “When youth sexual well-being is understood as predicated on equal and adequate rights, access, and resources, change efforts are redirected away from individual behaviour and toward social conditions”.^{11 (p. 352)}

However, Global North INGOs seek to align themselves with their funders, which often include multilateral financial institutions, like the World Bank and the International Monetary Fund, and corporations, like Anadarko Petroleum¹² and the Coca-Cola Company,¹³ which have vested interests in maintaining the status quo rather than supporting the political conscientisation of young people. For this reason, grassroots organisations are more likely to preserve the integrity of Bay-Cheng’s critical dialogic approach.

As sexual health advocates and practitioners, it is our duty to rethink what makes sexuality education truly comprehensive. While CSE interventions often construct students as self-interested actors who exist in a vacuum,^3,6 sexual risk is largely produced by structural oppression, not individual choices.¹¹ In the U.S., Black adolescent women are 8.8 times more likely to contract gonorrhoea than white adolescent women.¹⁴ Physically disabled adolescent women are twice as likely to experience sexual assault than non-disabled adolescent women.¹⁵ By responding to students’ lived experiences and prompting them to critically examine how their political and material conditions are linked to their sexual health, CSE could be reimagined as transformative praxis, which does not teach students to individually aspire to sexual “respectability” but to demand structural change to ensure more equitable sexual health for all.

Disclosure statement

No potential conflict of interest was reported by the author(s).