Health experts are calling for sex education to be included in China's school curriculum, saying the lack of formal tuition, allied with misunderstandings and outdated ideas, is putting young people at risk of sexually transmitted diseases and unwanted pregnancies.

The topic has recently been at the center of a heated debate on Sina Weibo - China's version of Twitter - after campaigners condemned a sex education textbook that claimed premarital sex has a "tremendously negative psychological and physical impact on girls".

"Girls do not earn more love from boys by sacrificing their bodies, but rather are seen as 'degraded' by their 'conquerors'. As a result, premarital sex can cause women to lose love," according to the book, published by the 21st Century Group. Since 2004, about 2,000 copies have been issued to school libraries in Jiangxi province in Southeast China.

For thousands of years, sex could not be discussed openly in China. Even today, it is taboo in most of the schools. There is no sex education in schools, only lectures on psychological health that contain little practical knowledge. Parents also avoid discussing the issue with their children.

Fully developed concept

Sex education is a comprehensive definition - it's not simply about sexual practices but is a fully developed concept related to many other issues, according to Gou Ping, a professor of psychology at Chengdu University, the only college in the country that offers sex education as a minor course.

Gou said comprehensive sex education includes age-appropriate, medically accurate information about a broad range of topics related to sexuality, including human development, relationships, decision-making, abstinence, contraception and prevention of disease.

"It's really needed, especially to combat child sex abuse, rising rates of sexually transmitted diseases and unwanted pregnancies," she said.

The number of cases of sexually transmitted diseases registered at the Center for Disease Control and Prevention soared to 750,000 in 2003 from 5,800 in 1985.

Taking HIV/AIDS as an example, China now has 575,000 carriers (people who are HIV positive, but have not developed full-blown AIDS), and patients (those with the fully developed disease), more than 90 percent of whom were infected via sexual contact.

Unwanted pregnancies and abortions are also threatening the younger generation. In 2014, the Sichuan Sex Education Society launched a six-province survey of more than 5,000 students ages 12 to 24. It showed that 24 percent of respondents had engaged in premarital sex, and 20 percent had abortions.

While the government is still trying to formulate a nationally recognized sex education curriculum, some nonprofit organizations have taken the initiative and launched pilot projects.

The Youth Love Station, supported by the AIDS Prevention Education Project for Chinese Youth, is one of them.

By providing comprehensive sex education, the project not only teaches students about gender differences and safe sex, it also aims to convey the basic values of "love with respect" to young people.

Growing confidence

"Using a condom is one of the most effective forms of contraception."

"If my girlfriend told me she was pregnant, I would calm her down first and tell her to avoid overexertion and manual labor. Still, we would need to tell both sets of parents."

"Girls should keep warm during their menstrual periods. Sometimes, before and during their periods, they are much easier to anger."

The statements above are answers to the question, "What do you know about girls and safe sex?" posed by a teacher at Yingjiang No 3 High School in Yunnan province. The answers, shared by three 13-year-old male students, indicate that young people are becoming more knowledgeable and confident about sexual activity.

Although there is no official sex education at the school, its Youth Love Station is one of 61 that have been operated by the nonprofit organization in Yingjiang county since 2012.

"Before we launched the project, many girls whose breasts were developing walked with their heads down because of 'shame'. Some even wore several items of clothing in summer to hide their breasts," said Nie Yongxian, the school's sex education teacher.

"That sort of thing is no longer seen, and sometimes, students even come to my office and discuss love and sex with me. There are also fewer cases of 'puppy love' now," Nie said.

Promotion via parents

In addition to delivering lectures about age-appropriate sex and gender knowledge to students at primary schools and colleges, the AIDS prevention project also promotes sex education among parents.

Jiang Jun participated in his first sex education class at the Dujiangyan Dingxin New Primary School in Sichuan province along with 60 other parents.

The father of sons ages 9 and 2 used his smartphone to take photos of every slide the teacher showed the class.

"My 9-year-old son started to ask me questions about sexual behavior when he saw animals having sex on a TV documentary. I didn't know how to respond," he said.

"Many parents of my generation who didn't receive this education have the same problem. We hope such knowledge can be taught in schools," Jiang said.

"Of course, parents should be educated too, so they can better understand their children's concerns."

Optional choice

Sex education is not a required course in China's nine-year compulsory education system. In the country's "normal" universities - those that teach a range of unrelated subjects and are also responsible for teacher training - there are no majors in sex education.

In 1994, Capital Normal University in Beijing became the country's first college to offer sex education as a minor for undergraduates.

The minor consisted of 12 courses and took two and a half years to complete, according to Zhang Meimei, the professor in charge.

"Participants were mostly driven by their own interest," she said. "The course is not listed in the education system, so there are no related positions in the job market."

Sex education is now an optional course at the college, and the duration has been shortened to one semester.

Zhang said the course offers basic comprehensive sex education, but those seeking deeper knowledge need to consult with professional teachers who specialize in the field.

According to Zhang Jianxin, a professor at the West China School of Public Health in Sichuan, stereotyping is a major obstacle to the promotion of sex education in China.

"Many people still define sex education as 'introducing knowledge about sexual activity', but it covers far more than that," he said.

From physical differences, self protection and safe sex, to tolerance and respect based on gender differences, Zhang said sex education addresses the root issues that help teens make responsible decisions that will keep them safe and healthy.

"Sex education is about love - an inescapable topic for all of us. It guides us to know ourselves and others. It will be easier to build better social and close relationships based on such understanding," he said.

"Those pilot projects will initiate some changes among the younger generation, which I believe could be a great driving force for a national campaign in the future."

Contact the writer at yangwanli@chinadaily.com.cn

yangwanli@chinadaily.com.cn

Experts urge age-appropriate action

In the Netherlands, sex education, or more accurately education about sexuality, begins at the earliest levels of schooling, according to Zhang Meimei, professor of sex education at Capital Normal University in Beijing.

Far from young people running wild, however, the type of sex education promoted in the Netherlands has resulted in one of the lowest teenage pregnancy rates in the world (six births per 1,000 women aged 15 to 19), according to the World Bank.

Zhang said comprehensive sex education should be age-appropriate:

Kindergarten (ages 2 to 6): Children are taught about body parts, the physical differences between males and females, and privacy around body issues.

Primary school (ages 6 to 11): Body development during puberty, basic social conventions of privacy, nudity and respect for others in relationships. Knowledge about human reproduction may also be available.

High school (ages 11 to 18): Safe sex and contraception, understanding what makes a positive relationship and what makes a bad one. The class may include an introduction to gender pluralism.

College (18 and older): Gender roles in society, expressing oneself, desires and boundaries, how to handle close relationships with others.