“To Talk or Not To Talk”: Parents Perspectives on Sex Education

Sex education is a crucial facet of health education. Sex education can help improve parent-child communication on sexuality and help in preventing instances of rape and sexual abuse in future. The goals of the present study were to gain a deeper insight on the attitudes of parents towards sex education and to apprehend the differences in the attitudes they have towards sex education. The target population of the present study included 29 parents including 15 mothers and 14 fathers having children in the age group of 8-12 comprised of both genders. A qualitative method was adopted. Data was collected using semi structured interviews with parents independently. Data was analysed using thematic analysis.

Parents who support sex education accept the reality regarding the exposure of the children towards the sex education. At any point of time, children are to be provided with the answers to the overt or covert questions they have in their mind regarding sex (Nyarko, Adentwi, Asumeng and Ahulu, 2014). Linda et al (2000) investigated the Australian Parents Perception of sexuality education and communication. The findings of the study showed that parents consider sexuality as an important part of their children's lives and they want their own children to be better informed than they were as adolescents. They also felt it would be wrong and ineffective to attempt to dictate the sexual decisions to their children. Instead felt they should try to provide them with the knowledge and skills to make informed choices.
There are parents who consider about the inclusion of various sexual health topics in school curriculum provided the contents were in line with religious teachings. (Abdul, Nurullah, Imam & Rahman 2009). Some of the parents think it is suitable to be included with the biology curriculum (Nwakonobi & Onwuachu, 2009). Many of the parents expect information regarding prevention of STI including HIV/AIDS to be integrated with sex education (Esther, Magbagboela & Adeleye, 2011). However, there are cultures in which parents have unfavourable attitudes towards sex education. Talking about sex especially to children is considered a taboo in many African communities (Esther, Magbagboela, & Adeleye 2011). One of the major reasons behind unfavourable attitude towards sex education among the individuals is their lack of knowledge about sexuality education program (Christina , Timothy, & Stacey, 2015). It was found that parents themselves lack scientific knowledge when Sharma and Mahajan (2005) examined the attitudes of 200 parents having adolescent girls in Jammu.
Attitude of the parents on sex education sometimes differed with respect to their gender. According to Wenli and Carolyn (2003) mothers talk more with children about sexuality than fathers. Contradictory to this report, the study by Sharma and Mahajan (2005) revealed that mothers were reluctant to talk about sex education to their daughters as they felt uneasy discussing regarding sexuality with their children. The mothers avoid talking about sex in their day-to-day relationships with their children as sex is still considered a taboo subject in Indian society. However, there is a huge discrepancy between fathers' and mothers' perspectives about who delivers sexual health education in the home. Most mothers think that deliver most of the information about sexuality, while most fathers think that they do it together (Lee and Peggy, 2003).
Education is identified to have an influence on the attitude towards sex education in parents (Nyarko, Adentwi, Asumeng and Ahulu, 2014). Higher education, higher income, access to satellite programs and internet were associated with a liberal attitude towards sex education among parents. (Mohammadi, Alikhani, Farahani, & Bahonar 2007). It was indicated that highly educated parents had significantly more positive attitude towards sex education than less educated parents when Kamalpreet.K. T (2012) investigated the attitudes of teachers, parents and adolescents towards sex education.
In the Indian scenario, there is a lot of hesitation and discomfort to talk about sexuality and sex education. The current study would help understand if this uneasiness still persists in the era of globalisation or the perspectives of parents have changed as a result of greater exposure and awareness. The insight gained from the current study will help to identify & differentiate the perspectives of Indian fathers & mothers (parents) towards sex education, which can provide greater clarity among the parents on the roles they acquire as Sex Educators and help them take measures to divide the responsibility to impart sex education to their child rather than leaving the responsibility to Teachers or the Digital Media.

Objectives
1. To explore the perspectives and experiences of parents towards sex education. 2. To identify and understand the differences in the attitudes of the mothers and fathers towards sex education.

METHODOLOGY
The purpose of the study was to explore the attitudes of parents towards sex education. A Qualitative research design was adopted for this study. 29 parents participated in the study. 29 parents having children (either boys or girls) in the age group of 8-12 was approached for the study. Out of 29 parents, 15 of them were mothers and the remaining 14 of them were fathers. An initial rapport was established with the parents (either the mother or the father) after which informed consent from the parents to participate in the study and they were debriefed about the purpose of the study. The researcher also clarified and answered the doubts and queries of the participant before conducting the interview. Then a semi-structured interview was conducted on a one-on one basis with the father and the mother separately by administering a set of openended questions prepared for the interview on the basis of the four objectives which have been stated below. i) To assess the openness of parents in discussing about sexuality with their children. ii) To explore and understand the various resources parents rely on seek information on sexuality iii) To assess the parental responsibility in imparting sex education iv ) To explore the parents views on the importance and necessity of sex education. Ethical considerations were followed wherein it was made clear to them that they can quit participation at any time they want to and the answers obtained in the questionnaires will be kept confidential. After the interview session, a pamphlet was given to each participant as part of acknowledging their participation in the study. A handout providing insights and suggestions to parents on how they can improve their communication with their children on sexuality and acts as effective sex educators will be given to the parents. However, this was decided on the basis of the interaction during the interview session and their awareness on sex education. The objectives of providing handouts to the parents would be to provide assistance to them on important technical terms used in sex education, to provide them with important tips that can help them in initiating communication with their children on sexuality and provide important insights and guidance on helping them provide assistance to their child on 'Good touch and Bad touch', which can help them be more aware of danger and help them encounter situations where they face abuse and report it to their parents. The participants were debriefed about the purpose of the study at the end of the interview session. Inferences were drawn on the basis of themes that emerge based on the qualitative data.

RESULTS AND DISCUSSION
A Qualitative data analysis was conducted among fathers & mothers which revealed predominant themes. These themes addressed a number of issues associated with sex education among children in the age group of 8-12. Results of the semi-structured interview are presented under specific themes/outcomes. It is important to note that these results are representative of the interview participants only. However, it provided in-depth details of their attitudes, thoughts and opinions. All the participants provided information by providing answers to specific questions by actively participating in the interview and the responses were recorded by the interviewer. The themes /outcomes derived from the semi-structured interview are as follows:

THEME 1: PARENTAL VIEWS ON CHILD'S SEXUAL EXPLORATION
One of the aspect of childhood sexuality that make parents uncomfortable revolves around their children's questions about sexuality, pregnancy and birth as well as their children's sexual exploration. In the present study the parents were asked how they would react when they notice their children explore their body parts.The views on the exploration of body parts can be divided into subthemes.
Some of the views of parents on frequency of exploration have been indicated below:

"(Mother) "I think such behaviour can be ignored unless it is not predominant."(Father)
The parents also came up with strategies to handle such behaviour in children.
"I think firstly I will find out the reason for the behaviour displayed and explain her that it is not nice to indulge in such behaviour as it may develop into a bad habit or a outlet to derive sexual pleasure.In certain others times as a mother if I am not able to explain it ,I will seek the help of a professional counsellor."(Mother) "I feel the best way to handle this behaviour in children is to tell them that this is not the right age to indulge in such behaviour.I would state from my experiences, strategies to control it."(Father) Parents were asked how they would react when they see their children indulge in such behaviour at home and at a public place.Some of the opinions are stated below: "When she is exploring it at home I will find out why she is doing it and explain her that it is not nice to do it.At a relatives place,If I happen to notice I will be embarassed and ask her to stop it immediately,I will also make sure that no one notices it.I will explain it to her later in a private place."(Mother) "My reaction to this behaviour at home will depend on whether it is intentionally done or casually done.At a relatives place,I will advice him not to do it."(Father) The parents were then asked whether they have not noticed their children indulging in such behaviour and their views on whether they consider it as an atypical behaviour. The opinions of parents regarding this have been indicted below: "No I have not noticed her exploring,but she asked me when she found my breast is bigger than hers.I tried to tell her that I am woman and she is still a girl when she reaches my age she would notice similar differences in her."(Mother) "I think it is not normal at this age,may be after 15 it is quite normal."(Father) There were parents who considered child's sexual exploration as a normal phenomena.Some of the opinions of parents regarding this have been stated below: "I have not noticed him indulging in such behaviour but I feel it is quite normal for children to indulge in such behaviour."(Father) "I feel it is quite normal for children to indulge in such exploration"(Mother) Overall,this question was not comphrehended well by the parents.Most of the parents were hesitant and took time to understand that the exploration that is being referred here is with respect to masturbation. Further as already stated a larger portion of the parents failed to notice this behaviour in their children. When hypothetically asked how they would react when they notice this behaviour in children, parents stated that their reaction at a relatives place would be slightly harsh compared to their reaction at home. The consensus among parents regarding their outlook that they would converse with their children regarding this behaviour in private reminds us of the stigma attached to discussing on sensitive topics like body exploration.

THEME 2: REACTIONS TO REPORTS OF ABUSE AND IMPACT OF DIGITAL MEDIA
There has been an increase in incidents of physical abuse on children. According a World Health Organisation (WHO) study over 50 percent children have faced one or more forms of sexual abuse. They keep quiet and live with the trauma throughout their lives. Sex education can provide children with appropriate tools to report and resist abusive behaviours. It will help in creating a forum for expressing their fears and feelings honestly and openly. They need to be taught the difference between gentle touch and bad touch in order to protect themselves from various forms of child abuse.
When parents were asked how they would react to news of abuse and rape, they indicated their emotional reaction to such instances and expressed their fury and recommended that severe reprimand should be given to people who indulge in such acts. Some of the emotional reactions of parents are discussed below: "I feel ashamed and sad when such incidents happen. I also feel ashamed because of the people who indulge in such acts" (Father) "I feel very bad, who ever is doing it have to be punished."(Mother) Parents also uttered their feelings of anxiety while reading such instances. Some of the parents expressed their insecurity during the interview session: "I feel extremely anxious and insecure because I cannot keep monitoring my daughter all the time."(Father) When asked, what could be the probable reasons for the rise in the instances of rape: Exposure to digital media, culture of men, parenting style, the frame of mind and the stigma attached to gender were the likely reasons stated by parents. Parents also suggested some protective measures like setting up of CCTV cameras, keeping a check on the school staff, interacting with school staff on a regular basis and employing more women staffs. Largely parents recommended building the right attitude among children and providing knowledge to them on appropriate behaviour, self defense classes for both boys and girls were some steps that can be taken in this regard. Lastly, parents were asked what contribution they can do in this regard; these were some of the responses of parents:

"I feel all the women should protest and protect our children; I think we need to educate boys and men."(Mother) "I feel all parents should voice out and be stubborn. Keep a check on the qualification of teachers and van drivers."(Mother)
This strongly indicated that parents did realise the importance of contributing to a large extent from their side apart from suggesting for improvements on others external factors like safety measures in schools, creating awareness among parents and children to prevent abuse.
In an Essay on "Is Sex Education necessary in Schools" by Manish Rajkumar he clearly states that surveys indicate that on an average, every urban student watches television for two hours daily. The foreign television channels, the vulgar scenes shown in Indian cinema and video albums create a negative impact on them. The movie and serials on the small screen stimulate the younger generation sexually. Thus, in the absence of sound knowledge about sex they commit mistakes which result in unwanted pregnancies, HIV positive cases and other sexually transmitted diseases.
Parents felt digital media can have an impact on the child's sexual behaviour by increasing their curiosity and the urge to practically experiment. When asked about the causes of impact on the child's behaviour, parents stated that: family upbringing, lack of parental love, the level of addiction of the child to digital media can be possible causes. Parents believe that concern for children's sexual development should start even from pre-school years and that immodest scenes may have a negative influence upon children's sexual behaviour. (Kakavoulis,2001). Parents voiced their opinions on the influence of media (television,computer,youtube, social media) and stated a lot of reasons for the influence of different media on child's behaviour.Some of the opinions of parents have been stated below: "If the child is fickle minded and does not have the power of critical evaluation then there will be an impact on the child's sexual behaviour."(Mother) "Because of this impact it might lead to some form of mental disturbance, raise some questions out of their curiosity and lead them to practical experiments.When they practically experiment, it will harm them mentally and physically."(Father) Thus overall parents felt that exposure to different forms of media coupled with attitude of parents towards sexual content in the media were possible factors in fluencing the child's behaviour.
When asked how they can monitor their Child's behaviour and the techniques that they can utilize to achieve this, fathers and mothers quoted the following strategies. Thus, overall it was found that parents did feel monitoring or preventing exposure to sexual content on the media should be one of the strategies adopted. Parents also realised that too much of monitoring will further increase their curiosity and lead them to experiment. Thus, they felt that educating them on the consequences and giving them the freedom to choose assess to channels on television or videos on YouTube could be a more effective way of handling the child. Adopting a friendly approach by courteously telling them that certain sites are not intended for them, keeping their mind occupied in extracurricular activities and academics and observing the videos and sites that are accessible to them were the other suggestions given by parents.
Overall parents felt that the child's age is one of the major aspects that could have an impact on the child's sexual behaviour. Parents expressed their point of view on child's age as a factor of influence. Parents conveyed that the glorification through the media of certain concepts like size zero etc should be handled properly, instead of keeping the child ignorant of certain concepts it is better to educate them and make them aware. The child cannot be totally blamed for getting influenced by media as the accessibility to sexual content on media is high. Thus, helping the children not get addicted to media, being open and approachable to children in discussing with them and clearing their doubts and guiding them on the right path is an important responsibility that parents need to fulfil.

THEME 3: RESOURCES ON SEXUALITY AND EXPOSURE TO SEX EDUCATION
Parents were introduced to the concept of sex education through different avenues and they wanted their children to be introduced to the concept of sex education through different modes. The ideas of parents on these topics have been summarised under this theme. Firstly, the parents were queried on the age at that they were introduced to the concept of sex education. The varied thoughts of parents regarding this have been indicated below:

"No there was no such concept called sex education. I got to understand it when I was in my X standard."(Father) "I got to know about it when I was in my I and II PUC as a part of my curriculum."(Father) "When I was in the convent school, at 14 years I was shown a film on menstruation."(Mother) "I got to know about it only after college, just before I got married."(Mother)
Thus, on an average majority of the mothers and fathers said that there was no such concept as sex education. They were either introduced to the concept when they were in high school as a part of the biology classes. Still others were not aware of the concepts until they entered their graduation or got married.
The parents had different notions on the medium through which they were introduced to the concept of sex education. Some of the opinions of parents were as follows: "I was introduced to it through media. In college, they mostly concentrated on concepts like abortions, periods and right time to have kids."(Mother) "No it was all about experiencing it, I never felt convenient asking about it because of the controlled social background and family."(Father) Fathers generally acquired information on sexuality through peer communication or by reading on their own. The other means by which they were introduced was through the biology curriculum in schools. A major proportion of parents stated that they themselves acquired knowledge on sexuality. Mothers stated that they were commonly introduced either through their mothers, through schools or through their teachers about puberty or sexual hygiene.
Overall parents felt their children should be introduced to the topic. The perspectives of parents on this have been summarised under the subtheme age as a factor of exposure for children. Parents conveyed that they wanted girls know about puberty and menstruation when they are around 12 years of age. Still others felt to children of either gender can be introduced to the concept at around 14 or 15 as a part of the biology curriculum.
Fathers and mother's perspectives on medium as a factor of exposure for children were as follows: "I do not think a formal education is necessary for this topic."(Father) "I think separate classes for boys and girls about puberty need to be given." (Mother) Summarising the opinions of parents on this subtheme: The school, parents and a combined effort of the school and teacher were the medium through which parents wanted their children to be introduced to the concept. Further parents also came up with creative techniques through which they wanted their children introduced to the concept. There was an understanding that parents do realise that times have changed. As children, they were not formally introduced to the concept of sex education. However, they want their children to be introduced to the concept of sex education. The various strategies that parents felt they can utilise to accomplish this objective were as follows: Children can be introduced to the concept through reading materials and books, parents can explain the concepts by providing appropriate guidance at each stage of life, separate classes need to be conducted for girls and boys stressing on the bodily changes. However, there were other parents who felt that formal sex education classes are not necessary and selfexperiences are the best ways of learning such concepts.
The sources of information parents rely on to keep themselves updated on sexuality in order to provide guidance to their children on sex education have been compiled under the subtheme Resources on sexuality.
Parents indicated that articles in the newspaper, magazines, television programmes, news channels, Internet were the various forms of media parents relied on to acquire information on sexuality.
Parents expressed that interaction with significant others including peers, friends, relatives and siblings served as a significant resource to help them acquire information on Sexuality. Parents indicated that they would interact with their significant others and other knowledgeable people who are competent enough and would help their children with doubts on topics related to sex education.
The major source of information parents rely on is their own self-experiences. The parents who expressed that they consider self-experiences as a major resource on sexuality generally felt that special efforts are not required to acquire information on sexuality. They also indicated that observation of people around them, interacting with other people and learning from their experiences helped them a great deal than any other source of information. Parents also specified that school and parents should share the responsibility equally. They also felt that parents should take the active responsibility; additionally, teachers and school should take efforts in this regard as the child spends a lot of time in the school. Other opinions were that school should not play an active role as they felt instead of enabling them to acquire knowledge it would initiate them to comment; as both boys and girls would be present in the classes. Still other parents said that school should play an active role but after a specified age of about 12 or 15 when they actually experience the physical changes and this can vary from one child to another.
Some of the ideas on the different methods used to impart sex education are indicated below: "I think since I am an artist I feel using graphics or the means of drawing and explaining it or using nude paintings and drawings in the room to help them understand the anatomy and physiology can be quite beneficial. Parents also felt that relying on the lecture method would be boring to the child and ineffective method to address this topic. Instead they felt giving children examples apart from human beings particularly to explain concepts like reproduction by talking about such concepts in plants and animals, avoiding complex language and using simple terms to explain concepts like body hygiene would be effective. A small number of parents suggested that using stories as a medium to explain concepts can be quite helpful. Also, some parents expressed that there should be no discrimination between boys and girls. Children should be allowed to play with each other and too much of restriction should not be placed on them in terms of touching each other. However, a control has to be placed even without their knowledge. Thus, Parents should understand that ignorance of children regarding such topics will not destroy their innocence but will create a lot of myths and misbeliefs among them. This view can be supported on the basis of the outcomes of a study which indicated that the adolescents need to be taught about this topic since ignorance propagates myths and misbelief. (Sharma & Mahajan (2005). Thus, it is adviced that parents provide age-appropriate explanations to children in order to clarify their doubts on sexuality and their curiosity on sexuality is quite normal as it is with their curiosity on certain other topics.

LIMITATIONS
During the interview the factors like personal inhibitions, indifferences and reluctance on the part of the participants to open up on the topic could have an influence on the responses of the participants to the questions. The sample comprised of the urban population, thus the findings of the study cannot be representative of the larger population. The study did not aim to conduct an awareness programme for parents on Sex Education.

IMPLICATIONS
The conversation during the interview session helped remind parents of their responsibility as Sex Educators. The suggestions and perspectives of parents on various aspects of Sex Education that were inferred from the present study can be used to work on an awareness programme on Sex Education for children. The study facilitated in summarising the experiences and outlooks of parents on various strategies that can be adopted to introduce children to the concept of sexuality. This can serve as a guide for other parents to initiate communication with their children on sexuality.