We recognise that in order to meet young people’s needs we must lead the debate in the controversial, difficult subjects that affect them. We will continue to be proactive in our lobbying and advocacy work in order to keep young people’s rights at the forefront of the political agenda. Our position statements outline our beliefs, our vision for young people and our approach, all supported by evidence and useful resources. Read our position statement on: Relationships and sex education (RSE)Reproductive rights and abortionSharing youth produced sexual imageryMasturbationPornographyTrans and non-binary people and experienceGender terminology Relationships and sex education (RSE) Brook believes… All young people have the right to high quality Relationships and Sex Education RSE).RSE is protective and supports young people to stay safe, be healthy and develop healthy and enjoyable relationships.Relationships and Sex Education should begin at the start of primary school and continue to the end of secondary education through a spiral or developmental curriculum which begins in reception and builds year on year on children’s knowledge and understanding.The introduction of mandatory RSE in all secondary schools from September 2020 is a positive development.RSE must be taught across a range of alternative settings including pupil referral units, informal education, criminal justice and social care settings to meet the needs of young people outside of schools.Primary schools need clarity about how Relationships and Health Education and science can and should provide factual and timely information on the human body, puberty, and human reproduction; and on which aspects of the curriculum are mandatory and which are defined as sex education and are non-mandatory.RSE should be comprehensive – addressing biological, developmental, and emotional aspects of sex, sexual development, sexuality and relationships.RSE should be evidence-based – drawing on accurate scientific and medical information and directing young people to reliable sources of accurate information.RSE should be timely and age-appropriate – to ensure that it is relevant to children’s experiences, developmental levels and behaviours; and so that children are prepared for forthcoming changes to their bodies, feelings and lives.RSE must be up to date and address current and emerging challenges and issues; and that it is informed by expert intelligence from sexual health and young people’s organisations locally and nationally.RSE must be inclusive of and relevant to all students including LGBT+ students, and students of all abilities and disabilities; including those that are educated in PRUs, alternative provisions and home-schooled.RSE must reflect young people’s expressed needs and that schools and other providers should routinely ask and evaluate what young people want to learn and the most effective methods of teaching and learning.Comprehensive RSE is relevant to all young people regardless of their cultural, ethnic or religious background and that depriving any child of their entitlement to accurate RSE makes children and young people more vulnerable and denies them the necessary tools to lead a healthy life.The right of parents to withdraw their children should be discouraged and must be mitigated by excellent communication by schools to promote the benefits of RSE including: guidance on the contents and timing of the curriculum; and provision of evidence-based materials to support parents to supplement school RSE at home.Schools should inform young people whose parents have withdrawn them from RSE lessons that they have the right to opt into participating in lessons 3 terms before their 16th birthday.Brook’s young people’s manifesto and the 12 principles agreed by the Sex Education Forum and its partners (including Brook) represent a good basis for quality RSE.RSE must inform young people of their rights to confidential health information, advice and treatment and support young people to access health services in their local area. Brook would like to see… Every young person to have experienced good quality, comprehensive, inclusive RSE whatever the religious character of their school or whether they experienced their education in other settings.All young people to be able to make active, informed and healthy choices; and enjoy healthy and pleasurable relationships.RSE included in initial teacher training for all primary and secondary teachers.RSE developed as a specialist subject for teachers.The government to provide adequate resource to upskill the teaching workforce and ensure sufficient numbers of teachers are skilled, informed and confident to delivery RSE in time for mandatory RSE in 2020.An ongoing programme of continuing professional development for teachers to ensure RSE keeps up to date with pedagogical developments, and continues to reflect up to date intelligence on current and emerging challenges for young people.An update of the statutory guidance in three years’ time to provide more clarity for primary schools on what they need to teach; to remove caveats that schools may use to deprive their students of comprehensive, accurate and inclusive RSE.The Government actively promote LGBT inclusivity in RSE and across school life, and to support schools to tackle anti-LGBT campaigning at local and national level.The removal of parents’ rights to withdraw children from RSE, so that RSE is brought in line with other statutory subjects.For appropriate RSE topics to be taught across further and higher education. Brook teaches… Through participative, informative workshops in schools and other settings aimed at generating evidence-based discussion around sex, sexuality and relationships; increasing young people’s knowledge; and providing them with vocabulary and skills to communicate with their peers, parents and professionals.Factual information about sex, sexuality, reproduction, sexual behaviour and relationships.Young people the importance of accessing accurate information from reliable sources.Lessons on: puberty; consent and sexual boundaries; sex and the law; sexuality and gender; sex and pleasure; safer sex and how to prevent unintended pregnancy and STIs; pregnancy testing, pregnancy decision-making and pregnancy options including abortion; healthy relationships; thinking critically about pornography and its impact; the legal, moral and practical issues around sharing sexual images; body image, body diversity and healthy bodies; HIV, PreP and the importance of prevention, early diagnosis, testing and treatment; and about child sexual exploitation, gangs and keeping safe.Through our online platform, Brook Learn which is free at point of access and available to professionals and parents. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making, and onwards signposting or referral to the appropriate services.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their sexual health and relationships.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour.Recognition of young people’s evolving capacity to consent; and work within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’. Factual briefing, useful links and resources Factual briefing: Most parents want children to learn about RSE from school as well as home.Young people say that school is their preferred first choice for RSE.Associations between source of information about sex and sexual health outcomes in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) finds that young people who cite school as their main source of information about sex were less likely to report a range of negative sexual health outcomes including: lower age at first intercourse, lower likelihood of safe sex and higher likelihood of STI diagnosis amongst young people of both genders. Specifically, those citing schools as their main source of sexual information reported having had first intercourse at comparatively later ages than did those who reported their main source was ‘other’.Provision of good quality RSE can help to delay first sex, ensure a smaller age-gap between sexual partners at first sex, increase condom use. Not Yet Good Enough, the 2012 Ofsted report on PSHE and RSE in English schools reports that over a third of schools required improvement in their RSE. Many young people were discovered to be “unprepared for the physical and emotional changes they will experience during puberty, and later when they grow up and form adult relationships”. Substandard secondary schools often failed to emphasise “relationships, sexuality, the influence of pornography on students’ understanding of healthy sexual relationships, dealing with emotions and staying safe”, and often “teachers lacked expertise in teaching sensitive and controversial issues, [resulting in] some topics such as sexuality, mental health and domestic violence being omitted from the curriculum.”The United Nations Convention on the Rights of the Child (UNCRC) is a human rights treaty ratified by the governments of 196 countries and monitored under international law. Article 2 of the UNCRC states that participating governments “shall take all appropriate legislative, administrative, social and educational measures to protect the child from…exploitation.”Findings from Brook and CEOP’s ‘Digital Romance’ research revealed that technology exaggerates the positive and negative aspects of young people’s relationships and the young people involved in the project were keen to have support from adults to enjoy positive relationships online and offline without harm. Useful links and resources: Brook education pagesBrook Learn, free e-training for teachers including courses on How to Deliver RSE, Consent, Pleasure and moreRSE in the legislation – The Children and Social Work Act, Part One, Chapter Four which makes Relationships Education and Health Education mandatory in all primary schools in England; and Relationships and Sex Education, and Health Education mandatory in all secondary schools in England, 2017Statutory guidance for schools on Relationships Education, RSE, and Health Education, 2019UNESCO International Technical Guidance on Sexuality Education: an evidence informed approach, 2018 12 Principles of Good Quality RSE. Sex Education Forum, 2017 Context: In 2012 OFSTED published a report on Personal Social and Health Education in schools which found significant shortfalls in provision of PSHE including RSE Not yet good enough: personal, social, health and economic education in schools. 2013.Associations between source of information about sex and sexual health outcomes in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). British Medical Journal Open, 2015. The prevalence of unplanned pregnancy and associated factors in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Lancet, 2013. Reproductive rights and abortion Brook believes… Reproductive health and rights (as defined by the United Nations) are human rights and should be given a higher priority in UK health policy.Reproductive rights (which include, but are not limited to, the right to choose the number and spacing of your children, access to contraception, safe maternity and safe abortion) are fundamental to health, gender equality and to women’s* ability to fully participate in society.Denying or limiting people’s sexual and reproductive rights can have lifelong consequences.The risk of unplanned pregnancy should be addressed through RSE, better public education and easy access to high quality contraceptive services in a range of settings.Anyone who is pregnant should have the legal right to decide whether to continue or end their pregnancy and the practical support to enact their choice.Impartial support with decision-making and/or counselling should be provided for those who need or request it.Teenage parents should be given practical support in pregnancy and parenthood to achieve the best possible outcomes for parents and children.Abortion should be free, safe and accessible.Abortion should be regulated and delivered in line with current evidence in order to ensure best clinical careAbortion is healthcare and should not sit within the criminal law.People accessing abortion and those providing abortion services should have their privacy respected; feel safe; and be free from harassment, intimidation and interference. Brook would like to see… Abortion taken out of the criminal law and regulated like other medical procedures.Suitably trained nurse practitioners to be allowed to provide early medical and surgical abortions in the NHS and independent sector.Clinics protected from protestors by Buffer Zones.All young people – regardless of the religious character of their school or beliefs of teaching staff – given good quality, evidence-based education around pregnancy prevention, pregnancy options, pregnancy decision-making, parenting and abortion as part of a comprehensive RSE curriculum.Reproductive health and rights given a higher priority in health policy with a focus on eradicating health inequality (for example higher levels of unintended pregnancy and maternal mortality within BAME communities).Information and services that are inclusive and recognise that, *while most reproductive health service users are women, some trans men and non-binary people need services including contraception, abortion, cervical cancer screening and maternity care.Closure of anti-abortion pregnancy advice centres, crisis pregnancy centres, or pregnancy counselling services that provide misinformation, and unethical practices with the aim of obstructing or deterring people from accessing abortion services.An end to anti-abortion organisations being invited into schools where they provide misinformation about contraception and abortion; and sometimes promote homophobic and discriminatory views. Brook teaches… Using an educational approach which aims to build a strong sense of self-worth and health literacy, to enhance motivation for self-determination and self-care.That young people have a right to confidential advice and support with contraception and abortion.The reasons that unwanted pregnancies happen and how they can be prevented including comprehensive information about contraceptive methods.That not all unintended pregnancies are prevented by contraceptive use.That not all abortions are a result of a pregnancy being unwanted.Young people to reflect on what it might be like to be faced with the decision to end or continue a pregnancy including who they could talk to and where they could get support.Young people to think about the factors that can inform decision-making about pregnancy, including considerations about the best context for successful parenting.Evidence-based information about abortion including: the different treatment options for abortion; that abortion is a safe and legal option; how to get support with pregnancy decision-making; legal timeframes for abortion; and how to access services.That there are a range of different views and values about abortion.How to distinguish between areas of opinion that are open to debate, and matters of verifiable fact.Where to find accurate and reliable information.How to access impartial support.The importance of accessing abortion care or ante-natal care as soon as possible. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making, and onwards signposting or referral to the appropriate services including abortion services.Counselling, or referral to a service that can provide counselling, for those experiencing unintended pregnancy and who need support with the decision about whether to continue pregnancy or have an abortion.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their sexual health and relationships.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour.Recognition of young people’s evolving capacity to consent; and work within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’. Factual briefing, definitions, useful links and resources Factual briefing: Abortion is a safe procedure for which major complications and mortality are rare at all gestationsAbortion is common. At least one third of British women will have had an abortion by the time they reach the age of 4590% of abortions take place within the first 12 weeks and 76% within the first 10 weeks of pregnancy Over the last 10 years abortion rates have decreased year on year for under 18s. There were 1,267 abortions to those aged under 16. Of these, 363 were to those aged under 15 (0.2% of the total).The abortion rate in 2018 was highest for those aged 21 (at 30.7 per 1,000 women).The majority of abortions are carried out using medication. Only a small proportion require a general anaestheticThe majority of people who have abortions have already had at least one childStatistics on abortion in England and Wales are collated by the Department of Health and Social Care are updated and published annuallyStatistics on abortion in Scotland are updated annually and published by NHS ScotlandAbortion in Northern Ireland was decriminalised in 2019 and guidance on how abortion can be provided in NI will be published in 2020Most people are fully fertile immediately after abortion and within three weeks of childbirth. The majority of people express relief following abortion. Most do not experience adverse psychological outcomes. Many have mixed feelings e.g. feeling it was the right decision, but feeling sad that it wasn’t the right time to have a(nother) childFigures collected by the Advisory Group for Contraception show that contraceptive spending has been cut by nearly 18% in real terms since 2015/16. This has resulted in cuts to and closures of services. Specialist young people’s sexual health services are increasingly being shut in favour of moving people into all-age services. United Nation’s definitions of reproductive health and rights: ‘Reproductive Health is a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capacity to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are: the rights of men and women to be informed, have access to safe, effective, affordable and acceptable methods of family planning including methods for regulation of fertility’‘Reproductive Rights embrace certain human rights that are already recognized in national laws, international laws and international human rights documents and other consensus documents. These rights rest on the recognition of the basic rights of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes the right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights’ documents Useful links and resources: Brook learn free e-training for teachers to teach about abortion, contraception and other RSE topicsBrook information on abortionFactsheet on abortion from the Royal College of Obstetricians and Gynaecologists and Faculty of Sexual and Reproductive HealthcareTeenage pregnancy prevention framework, Public Health EnglandTeenage mothers and young fathers support framework, Public Health EnglandAnnually updated statistics on abortion prevalence in England and Wales from the Department of Health and Social CareReproductive health information published by Public Health EnglandInformation on abortion worldwide from the Guttmacher InstituteReproductive rights are human rights, UN DocumentSexual and reproductive health and rights – the key to gender equality and woman’s empowerment – IPPF Sharing youth produced sexual imagery Brook believes… That curiosity about bodies, sex, and sexuality is a normal aspect of adolescent development.That sharing sexual imagery carries significant risks for young people, including around legality, safeguarding, wellbeing, and self-esteem – specifically: participating in criminal behaviour; vulnerability to sexual exploitation and bullying; embarrassment; and risk to reputation and ongoing impact on digital footprint.That there are no technical solutions that can effectively mitigate the risks associated with sharing naked images.Young people are experts in their own peer and digital cultures and do not respond well to simplistic messages.Young people do respond well to being asked to identify for themselves the risks associated with different online/digital behaviours.Young people need to be included in identifying solutions, behaviours and interventions that will help keep them safe.Young people that seek help with incidents should receive support and safeguarding without automatically being criminalised or criminalising their peers.Even when image sharing is legal (i.e. because of the age of those involved) it is still very important that images are never made or shared without consent, and that nobody ever puts pressure on another person to create or share an image.That the term ‘revenge porn’ is unhelpful and unfair implying that the victim of this abuse is being punished for something they’ve done wrong. The term ‘intimate image abuse’ is a better description of this criminal activity. Brook would like to see… All children and young people provided with good quality, inclusive, comprehensive RSE and health education which helps them to develop a sense of self-respect and mutual respect; an understanding of the law, of consent, and of everyone’s right to privacy and safety.All schools have policies on how to respond to ‘sexting’ incidents underpinned by the principle of proportionality, with the primary concern being the wellbeing and protection of young people.Teachers have appropriate training and feel confident when managing issues related to image sharing.Young people to be able to access broad educational, recreational, pastoral and wellbeing opportunities to support them to build resilience, improve self-esteem and increase their knowledge and understanding of how to stay safe and healthy.Children and young people empowered and supported to be good digital citizens, and develop healthy bystander behaviour and supportive online communities. Brook teaches… About the law in relation to making and sharing naked images.That young people have the right to refuse to provide or view sexual imagery.About the right to privacy and the tools, skills and vocabulary to negotiate consent and resist pressure to make or share sexual imagery.Young people to be able to identify the features of safe and healthy relationships and behaviours, and unsafe or abusive relationships and behaviours.Young people to explore issues around consent and coercion in all relationships – whether they take place off or online.Young people to identify for themselves the range of risks of sharing sexual imagery.That young people can seek help – if they are concerned about requests to share images or previous incidents of sharing images – without automatically criminalising themselves or their peers.How to seek help within and outside of school.That there are no technical solutions or fixes that can effectively reduce or remove the risks of sharing sexual imagery.A gendered and critical analysis of the ‘sexting’ culture that reflects on evidence that sharing of sexual imagery disproportionately impacts some groups e.g. LGBT young people, and young women.Nurturing community approaches amongst young people to keeping themselves and their peers safe – including good bystander behaviour in relation to being sent or witnessing sharing of sexual images. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making, and onwards signposting or referral to the appropriate services.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their sexual health and relationships. This might include the issues around pressure to make or share sexual imagery, or concerns about images already made or shared.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour.Recognition of young people’s evolving capacity to consent; and work within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’. Factual briefing, definitions, useful links and resources Factual briefing: The police have the discretion to record illegal sexting incidents without taking action against the young people involved.Police dealing with incidents of underage production and sharing of sexual imagery must record the incident on their systems. However since 2016 the police have been given discretion to code an incident as ‘Outcome 21’ on the system which means that they do not believe it is in the public interest to further investigate or take action in relation to an incident.90% of 16-24 year olds and 69% of 12-15 year olds own a smartphone, giving them the ability to quickly and easily create and share photos and videos.The majority of young people have not taken or shared sexual imagery of themselves.A 2016 NSPCC/Office of the Children’s Commissioner England study found that just over one in ten boys and girls (13%) had taken topless pictures of themselves (around one in four of those were girls) and 3% had taken fully naked pictures. Of those who had taken sexual images, 55% had shared them with others. 31% of this group had also shared the image with someone that they did not know.Research from the PSHE Association found that 78% of parents were either fairly or very concerned about youth produced sexual imagery. Definition of ‘sexting’ from UK Council for Child Internet Safety: In the latest advice for schools and colleges (UKCCIS, 2016), sexting is defined as “the production and/or sharing of sexual photos and videos of and by young people who are under the age of 18. It includes nude or nearly nude images and/or sexual acts. It is also referred to as ‘youth produced sexual imagery’. ‘Sexting’ does not include the sharing of sexual photos and videos of under-18 year olds with or by adults. This is a form of child sexual abuse and must be referred to the police.” A young person under 18 is breaking the law if they take an explicit photo of themselves or a friend; share an explicit image or video even if it’s shared between children of the same age; possess, download or store an explicit image or video of someone under 18, even if the person in the picture gave their permission for it to be created. Intimate image abuse aka ‘Revenge Porn’: Guidance from the Ministry of Justice defines ‘revenge porn’ as ‘the sharing of private, sexual materials, either photos or videos, of another person, without their consent and with the purpose of causing embarrassment or distress.’ The offence applies both online and offline, and to images which are shared electronically or in a more traditional way. Useful links and resources: Sexting in schools and colleges: responding to incidents and safeguarding young people, UK council for Child Internet Safety.Brook sexual behaviours traffic light tool to support professionals working with children and adolescents in identifying behaviours which may present concerns about the safety and healthy development of the child or young person and may require a specific response, intervention or action. Brook pages on sexual image sharingBrook Learn online training for teachers on ConsentNSPCC – protecting children from online abuse Masturbation Brook believes… Children are naturally curious about themselves and their bodies and it is normal for them to touch their own bodies from an early age.Young children do not distinguish between different parts of their body or know which are considered to be sexual.Young people with learning disabilities may touch their genitals or masturbate as a part of exploring sensory touch or self-stimulatory behaviour.Children should learn that their bodies are their own and that they can choose to touch any part of themselves.Children should know that there are certain parts of their bodies that are private and that other children or adults should not touch them there. For young children resources like the NSPCC Pantasaurus can be helpful for teaching about this.Children should understand that they and only they have the right to give or refuse permission for someone else to touch any part of their body even if it is not considered ‘private’ e.g. hands or hair.Children should be taught that they should not touch themselves in places identified as private in front of other people because it can make other people feel uncomfortable or upset them.As part of a spiral curriculum children can be taught from early years in an age-appropriate way about how to stay safe, and about appropriate behaviour in relation to touching their own genitals.It is normal for young people (male and female) during and after puberty to experiment with touching themselves in a way that gives them sexual pleasure or results in orgasm or ejaculation i.e. masturbating.Learning about your own body through masturbation may make you better able to communicate about and enjoy sex with a partner.Male ejaculation may be good for prostate health.There is no medical evidence that masturbation is harmful in any way.There are myths across many cultures about masturbation and/or ejaculation weakening a man’s power, virility or fertility – these are not true.Belief systems that prohibit masturbation may engender feelings of guilt or shame in young people who masturbate – this is not helpful or healthy. Brook would like to see… Young people understand their rights in relation to their own bodies.Young people know how and where to get reliable information and advice about their bodies.Young people feel confident, knowledgeable, and comfortable about their own bodies.An end to the taboo of discussing masturbation (especially female masturbation) and the stigma and shame that is sometimes associated with it. Brook teaches… Children and young people to recognise and report unwanted touch and abuse.That masturbation is natural and harmless, but should be done in a private place such as your own bedroom or bathroom.That some young people do and some don’t like to masturbate.That it is normal and healthy for people of all genders to masturbate if they find it enjoyable.Masturbation alone is not only medically safe, but it is free from most of the risks associated with partnered sex e.g. STIs, pregnancy (see useful links).That ‘mutual masturbation’ is a form of non-penetrative sex that many couples enjoy. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making, and onwards signposting or referral to the appropriate services.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their sexual health and relationships. This might include any questions they have around masturbation.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour.Recognition of young people’s evolving capacity to consent; and work within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’. Useful links and resources Brook info on masturbation.Brook Learn free online training for teachers on teaching about pleasure.The risks associated with mutual masturbation are low, but BASHH guidelines say that ‘Chlamydia is sometimes passed on from genitals to fingers to eyes, causing painful, red eyes (conjunctivitis)’ for example if your partner had Chlamydia and you were to rub your eye without washing your hands following mutual masturbation.NHS info on masturbation includes guidance on avoiding STIs, or causing unwanted pregnancy during mutual masturbation; and the importance of keeping sex toys clean. NHS info on research that shows that frequent male ejaculation (through masturbation or intercourse) might decrease the risk of prostate cancer.NSPCC Pants resources to teach children about staying safe. Pornography Brook believes… It is natural for young people to be curious about sex.Due to its accessibility some young people will access pornographic material accidentally.Some young people actively seek out pornography to satisfy their curiosity, for sexual stimulation or to explore their evolving sexual feelings.Many young people do not like or choose to watch porn.Many young people think it is normal to watch porn.Young people may be more likely to seek out pornography if RSE has failed to provide appropriate information or representations of different bodies, referenced people of different sexualities, or has failed to address sexual feelings and sexual pleasure.Pornography is produced as entertainment for adults. It is not intended to be, and is not, a reliable source of education for young people.There are many types of porn, but concern about porn often centres on the type of porn which includes acts of violence against and humiliation of women; represents unsafe sexual practices; and presents sex as something which is primarily for men’s enjoyment.That viewing pornography can lead to sexual arousal and can shape sexual desires and practices.Porn often involves actors with a narrow range of body types and that this may have an impact on some young people’s feelings about what a normal or desirable body should like.That some young people are more affected than others by watching porn.That patterns of exposure to porn, response to porn and behaviours relating to porn may be gendered and that education about pornography should be gender-sensitive.There is insufficient robust evidence to demonstrate whether, why or how porn causes harm; who is most affected by it and why; and what legal, educational, therapeutic, and technological interventions could reduce these risks and harms.Young people must be engaged in developing any responses to current concerns about pornography.Technological approaches to making porn less accessible are unlikely to be effective – except in preventing ‘accidental’ access to porn. Brook would like to see… A more positive culture around discussing sex and sexuality.Education which acknowledges and challenges gendered ideas about sex.Better evidence and a more open conversation about how children and young people can be supported to live safely and develop healthy, pleasurable relationships in a context in which pornography is easily accessible.All children and young people provided with good quality, inclusive, comprehensive RSE which would include accurate information, depict diverse bodies and relationships and address sexual pleasure so that pornography isn’t relied upon or stumbled upon as a source of information and education.All young people to know their right to relationships that are safe and enjoyable and their own responsibility to ensure that everybody’s rights are respected.All young people know who they can talk to if they are concerned by something they or their peers have seen. Brook teaches… About the law as it relates to pornography and the wider production, sharing and viewing of sexual images, with the aim of preventing young people becoming a victim or perpetrator of illegal activity.Young people to think about the reasons people watch porn and what the they perceive the risks and benefits to be.Young people to think critically about messages and images relating to bodies, sex, sexuality and relationships in pornography and other online and offline media.Young people to identify the characteristics of safe, healthy, respectful, consenting relationships.The importance of seeking active consent from sexual partners.That young people have the right to refuse to participate in any sexual activity, including viewing sexual imagery.That nobody is entitled to sexual pleasure at the expense of another person’s safety, or enjoyment.Young people to recognise images, narratives and material that depict or promote unhealthy, non-consenting and harmful behaviours.That body diversity is natural and normal and that healthy bodies come in a range of shapes and sizes.Young people to recognise harmful patterns of engagement with pornography and to know where to get help.About reliable sources of information about sex and sexuality that might reduce the likelihood of young people accessing pornography accidentally.Professionals and older young people to reflect on the concept of ‘ethical’ porn.Parents carers and teachers about monitoring and managing young childrens’online life and particularly the possibility of accessing pornography. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making and onwards signposting or referral to the appropriate services.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their sexual health and relationships; including their responses to confusing or distressing pornographic content.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour; might include the impact of pornography consumption on their relationships and their own or their partner’s behaviour.Recognition of young people’s evolving capacity to consent; and work within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’. Factual briefing, useful links and resources Factual briefing: In the UK it’s legal to watch or buy porn when you are 18 years old, as long as it doesn’t involve: people who are under 18; sexual assault or rape; scenes of life-threatening violence or acts that are likely to cause serious injury to a person’s anus, breasts or genitals; animals (often called bestiality); dead people (necrophilia).It is illegal for an adult to show a young person under 18 porn, or to allow them to watch it.Any sexual content online that involves anyone under the age of 18, can be reported (anonymously if requested) to the Internet Watch Foundation (IWF). The IWF can remove this content and look to safeguard the child or young person involved. If you have seen content like this and want to talk to somebody about what you have seen, you can call ChildLine anonymously on 0800 1111. ‘I wasn’t sure it was normal to watch it’, a report by NSPCC, the Office of the Children’s Commissioner and Middlesex University includes a range of findings on exposure to, impact of, attitudes to, and feelings about pornography including:More boys view online pornography, through choice, than girlsAt 11, the majority of children had not seen online pornography (28% of 11-12 year olds report seeing pornography)By 15, children were more likely than not to have seen online pornography (65% of 15-16 year olds report seeing pornography)Children were as likely to stumble across pornography via a ‘pop up’ as to search for it deliberately or be shown it by other people Useful links and resources: Brook Learn online training for teachers on Consent, Pleasure, and *coming soon* PornographyBrook pages on pornographyBrook pages on consentBrook pages on relationshipsCrown Prosecution guidance on extreme pornography Basically Porn Is Everywhere: a rapid evidence assessment on the effects that access and exposure to pornography has on children and young peoplePorn Laid Bare survey, via DeltaPoll, on young people aged 18-25 years, Feb 2019 BBC 3 Trans and non-binary people and experience Brook believes… Trans and non-binary people have the right to dignity; an entitlement to the highest attainable standard of healthcare; full realisation of their sexual and reproductive health and rights including the right to safe, enjoyable relationships. Find out more about trans and non-binary gender identities.Relationships and sex education should be inclusive and celebrate diversity including recognising different kinds of families, different kinds of relationships and the full range of gender identities and expressions.Trans and non-binary identities are natural and part of the rich tapestry of human experience and identity.Interactions between sex, gender identity, gender expression and sexual orientation / sexuality are individual, complex and nuanced. Gender is not always fixed, but can be fluid.It is important to acknowledge the social, cultural and religious factors which impact on gender, cisnormativity and heteronormativity and that contribute to and shape attitudes.Relationships and sex education should be relevant to all and ensure that young people have the information they need to maintain good reproductive and sexual health throughout their lives.Sexual and reproductive health services should ensure that information is inclusive of trans and non-binary people so that they can identify and access the services they need to stay safe and be healthy.Training should be available for healthcare professionals in the broad healthcare needs of trans people to ensure all healthcare is inclusive and accessible.Training for educators and healthcare professionals should include a review of values and beliefs and unpacking of the impact of gender roles, expectations and attitudes to physical sex and sexuality as key to providing equal services to trans and non-binary people.The experience of puberty and adolescence can be challenging and it is normal for young people to ask questions about, express concern about and explore their feelings around their changing bodies, changing relationships, sex, sexuality and gender identity. They should be supported to do this and given space to have these conversations.Comprehensive care for young people who identify as trans should be delivered in line with the best available evidence.Professionals and organisations across education, information guidance, and clinics should model respectful, caring and inclusive language and communication.Trans and non-binary people have a right to see diverse gender identities, experiences and expressions represented in their totality in all forms of media, and school curricula should seek to represent diversity in all subject areas.The intellectual burden of educating the wider population about gender identity should not fall on trans and non-binary people. Everyone has responsibility for education, information sharing and guidance. Brook would like to see… All schools to implement inclusive, comprehensive, evidence-based RSE in line with the UNESCO technical guidance on comprehensive sexuality education.Fully funded, accessible and inclusive sexual and reproductive health services for all.Better monitoring and disaggregation of data in relation to sex, sexuality and gender identity to ensure research is accurately capturing trans and non-binary people’s needs and experience of healthcare; and can help ensure services are inclusive accessible and work for everyone.Easier access to gender identity services for young people.More research evidence on clinical and psychological outcomes of different approaches and protocols in care and treatment of trans young people; better enabling clinicians and young people to make evidence-based, informed decisions.Information, education and services to avoid cisnormativity (assuming everyone is cis, aiming provision or information solely at people whose gender identity corresponds to their biological sex: thereby excluding trans and non-binary identities or experiences).Information, education and services to avoid transnormativity (assuming that all trans and non-binary people will present in particular ways, choose to transition in the same kinds of ways or have the same needs: thereby excluding people whose experience or body doesn’t conform to a stereotype of a trans man or trans woman).Professionals and organisations to model respectful discussion around young people’s lives, health and choices including trans healthcare issues which acknowledges different perspectives, responds to evolving evidence and centres on young people and their needs. Brook teaches… Using language and concepts that are age and stage appropriate and do not make assumptions about young people’s existing knowledge and understanding.About the Equality Act and the right of all young people to equality, safety and respect.Young people to explore issues around the law and consent.How the core elements of healthy relationships, safety, dignity, enjoyment and pleasure are an entitlement for all regardless of sex, sexuality or gender.About puberty and the changing body.About sexual and reproductive health including STIs, contraception and abortion, in ways which recognise the range of different people who will need to access these services, acknowledging that people’s behaviours are what determine sexual health risk and outcomes not their sexuality or gender.About the components of healthy relationships on and offline.That a person’s gender identity does not affect their worth. Brook services provide… The range of clinical sexual and reproductive health services including STI prevention, testing and treatment, contraception, emergency contraception, pregnancy testing and support with pregnancy decision-making, and onwards signposting or referral to the appropriate services.Support with young people’s sexual health and wellbeing including a confidential and non-judgmental space in which young people can discuss any concerns they have about their bodies, their sexual health and relationships. This might include their issues around gender identity and how that intersects with physical health issues, reproductive choices and mental health and wellbeing.Robust safeguarding for service-users by building trust and providing young people with a safe space and consistent process to explore problems and risks in relation to their lives, relationships and sexual behaviour.Recognition of young people’s evolving capacity to consent; and Brook works within the Fraser guidelines which allow staff to maintain confidentiality and provide contraceptive treatment and abortion referral for under 16s when it is believed to be in the best interest of the young person to do so and when they have the capacity to understand the treatment they are requesting.One to one personal development work to help young people identify their goals and what will help/hinder them in achieving those.Small group work offered to young people identified as vulnerable or ‘at risk’.Groups which provide safe spaces for LGBT+ young people where they can share their experiences, get support, learn about issues relevant to them and socialise.Signposting to useful sources of information and support on gender identity issues. More support with your work, useful links and resources More support with your work: Brook training on sexuality and gender for professionalsBrook Learn free digital training courses for teachers on a range of issues and topics Useful links and resources: Brook volunteers worked with the LGBT Foundation to create this glossary of terminology about gender identityUNESCO Technical Guidance on Comprehensive Sexuality Education is guidance on providing good quality RSE, drawing on the best available evidence around the worldSummary of the United Nations Convention on the Rights of the Child (UNCRC) which describes many rights relevant to our work with trans and non-binary young people including the rights to: reliable information, protection from violence and abuse, good quality healthcare, privacy, to make decisions in line with evolving capacity, to have views respected and more.What are sexual and reproductive health and rights this report from European Humanist Federation breaks down the termsExclaim, a young person’s guide to sexual rights: an IPPF declaration includes an explanation of description of young people’s sexual rightsStatutory RSE guidance Government guidance on RSE which includes reference to LGBT rights under the Equality Act 2010. It doesn’t include anything specific about teaching trans children or about trans people and relationshipsThe Women and Equalities Select Committee report into trans issues which addresses some of the discrimination experienced by trans people including in healthcareGeneral Medical Council video on making your practice more inclusiveNHS information on gender dysphoria and trans healthcare optionsNHS England service specification for the NHS GIDS Gender terminology Gender terminology in the context of sexual and reproductive health The vast majority of those needing and using contraceptive care, abortion services, menstrual health, menopause, fertility and maternity care are women. However, there are non-binary and intersex people who do not identify as women, as well as some trans men, who have a uterus, cervix, ovaries; and ovulate, menstruate are fertile and experience menopause. There are non-binary and intersex people who do not identify as men, as well as some trans women, who have a penis, testicles, and produce sperm. Everyone needs access to sexual and reproductive health services, cancer screening, education and information relevant to their bodies. Considerations and principles in language choices Brook provides clinical services, Relationships and Sex Education and training, online information and advice, and policy and advocacy perspectives. As an organisation we think carefully about our language. Our various strands of work require us to be flexible in the language and terminology we use. Our decisions are informed by context, audience and the purpose and objectives of our communication. All are underpinned by four key principles: Inclusivity We want to ensure that everyone feels welcome in our clinical services; feels included and able to engage fully in our education and training; can access the right care and feels seen and included in the information we provide. Accessibility/clarity We work and communicate with people of different ages, comprehension, and knowledge levels, and with different language ability. It is important that the language we use is clear and that it supports people to access the services they need even if they are unfamiliar with terminology specific to sexual health or anatomy. Accuracy The language we use in our data collection must help us to understand who is using our services. This informs ongoing improvement and development and ensures that each service user is accessing the right form of care for their needs. Impact In our advocacy and public engagement, we acknowledge the impact of gender stereotypes and multiple forms of prejudice on attitudes, laws, policy, and practice. The language we use must increase public understanding of the way sex, sexuality and gender intersect with sexual and reproductive health. It must make the most compelling case to reduce inequality, improve inclusion and to tackle the harmful stigma associated with aspects of sex, sexuality, sexual and reproductive health. Different approaches to language There are different ways to talk about people in relation to sexual and reproductive healthcare: Gender neutral e.g.people, service-users, people who need contraception, anyone who needs an abortion, anyone who uses external condoms Physiological language e.g. people with a uterus, people who menstruate, people with a penis, anyone with a prostate, if you have a cervix Gendered language e.g. women, men, girls, boys Gender-additive language e.g. women and all people who need abortion, men and anyone who needs to check their testicles Gender inclusive language e.g. cis women, cis men, trans men, trans women, non-binary people Choosing the best terminology None of the approaches above is right or wrong in every context. We try to choose and use appropriate language depending on the aim of the communication and the target audience. Thoughtful ‘mixing up’ of different language approaches can usefully expose people to all the available terminology, draw attention to the sexual and reproductive health needs of trans and non-binary people which are not always recognised, and normalise diversity. We believe that this approach supports the development of critical thinking skills in young people. How well is Brook doing? Brook’s sexual health and wellbeing information spans websites, social media, e-learning for professionals, podcasts, classroom resources, education and training presentations, as well as face-to-face support through our clinics, counselling and wellbeing programmes. We are working hard to ensure our language is inclusive, accessible, accurate and impactful throughout all we do. This is an ongoing project and we always welcome feedback and suggestions on how we can improve. We recognise that language is always evolving and that different people prefer different forms of language. In our face-to-face work we aim to always respect people’s choices about the language they prefer to use in relation to their own identity and body.