Sexual matters are often inadequately explained to persons needing advice, whatever their age, because of religious beliefs or taboo. The inadequacy of education of children in practical matters of contraception and intercourse is often based on the belief that this information will encourage promiscuity. Older women and men may be given insufficient advice by doctors and hospitals. Contraception is banned in certain countries; abortion is illegal in a great many; masturbation is usually held to be deviant. Lack of sexual education reinforces existing taboos and leads to sex by trial and error, possible impotence or lack of satisfaction, guilt complexes and, where contraceptive advice is lacking, unwanted pregnancies and abortion because of ignorance. Sexual repression may lead to sexual violence and deviancy. Anti-authoritarianism among young people may make them shy of using advice facilities.
In countries where sex education is not part of the accepted curriculum and is being introduced and expanded, great sensitivity has to be exercised to allow for public opinion and cultural and religious mores. Sectors of the public may consider that, because of their own moral values, information given in a sex education programme could have a corrupting influence on the young and they will try to prevent its introduction. The term 'sex education' may be an obstacle in itself, as it is often seen in isolation as 'education in sexual intercourse' rather than as a preparation for adulthood.
Sex education for young people in the European region ranges from areas where it is a compulsory and accepted part of the school curriculum to areas where it is non-existent. In no country is it prohibited by law. However, even in countries where it has been compulsory since 1971 and integrated into the school curriculum, the specific aim of preventing sexual and personal problems due to ignorance of sexual matters has not been met completely.
It is recognized that knowledge alone will not prevent emotional and personal problems in this essential area of life, but findings reveal a lack of preparation even for immediate events such as puberty. A recent study showed that twice as many boys (25%) as girls (12%) had had no information prior to the event and were unprepared for the biosocial changes of menarche and spermarche. The median age when information on sex was introduced was 12-13 years for boys as well as girls, and only a minority had had any sex education before the age of 10 years. The primary source of sex education for boys was the teacher (53%), with mothers (5.5%) the next most frequent source, while for girls, mothers (41%) and teachers (32%) were quoted. Fathers played a very small part. As a group, girls were better informed at an earlier age and had knowledge of a wider variety of topics. Boys were found to be much more dependent on teaching at school. The fact that fathers were hardly ever mentioned may reflect the fact that in many societies they spend less time with their children and are less involved in their intimate care. It may, however, also be due to the fact that women relate sex to reproduction and babies, which provides an easier introduction to the topic, whereas men may related it more to pleasure or desire, which may be harder to discuss with their children.
Not all teachers are naturally adept at sex education, although their skills can be improved with training, which should be part of the basic teacher-training syllabus. Similarly, doctors and nurses may have the factual knowledge that would appear to make them suitable sex educators, but they may be unskilled in communication and would also benefit from further training.
A study of teenage pregnancy in 1986 in 37 countries showed that those countries with the lowest rates of pregnancy were those with a high degree of acceptance of teenage sexuality, good quality education about sexual matters and high quality, user-friendly clinical services for young people. Countries which are prudish about sex are less likely to produce explicit sex education material and more likely to have high teenage pregnancy rates.