Why Dutch Teens Have Better Sexual Health Than American Teens

This week in my study abroad course on sex and culture in the Netherlands, we're focusing on cross-cultural differences in sexual health and sex education. As a starting point, we're reviewing some statistics that highlight how dramatically different teens’ sexual health outcomes are in the Netherlands relative to the U.S. Check out the infographic below for a quick overview, which shows that teen girls in the Netherlands have much lower rates of pregnancy, birth, and abortion. Below, we’ll discuss why.

As you can see, teen girls in the U.S. have a pregnancy rate that’s nearly four times higher and an abortion rate that’s about twice as high as Dutch girls of the same age [1]. Though not depicted in the infographic above, Dutch girls (and boys) have far lower rates of STIs, too [2]. So what accounts for why teens in the Netherlands seem to fare so much better in terms of their sexual health?

Well, it’s not just one thing—the entire cultural view of sex is different in the Netherlands. For starters, the Dutch have mandated comprehensive sex education for all students. In effect, they offer sex education at all grade levels with age-appropriate material. As part of their education, students are provided with medically accurate information and teachers actually answer students' questions. In other words, Dutch students are truly learning what they want--and need--to know.

By contrast, most U.S. states do not currently (as of 2018) require sex education. Those that do typically stress abstinence and focus primarily on teaching students about the negative outcomes that will occur if they have sex. Further, only a handful of states require that any sex education provided be medically accurate. Some states go further, even placing restrictions on what sex educators can and can’t discuss in the classroom. For example, some states explicitly prohibit discussion of sexual orientation. The end result? Far too many American students aren’t really being taught useful or accurate information.

Differences in sex education are just one part of the equation here, however. It’s also important to note that, in Dutch culture, sex is viewed as a normal and natural component of adolescent development. Also, parents and healthcare providers speak candidly with teens about sex, and teens have the ability to access free or low-cost contraception. Given all of this, it shouldn't be surprising that Dutch teens use condoms and contraceptives far more reliably than their American counterparts [2].

Together, what all of this tells us is that if we want to enhance the sexual health of adolescents in the U.S., we definitely have our work cut out for us. There are no simple or easy solutions--we can't just change one small thing here or there and expect dramatic improvements. Of course, we desperately need to change our approach to school-based sex education, but that alone isn't enough. We also need to change the way Americans think about teenage sex, which means moving away from the view that it's always a problem and toward the view that it can potentially be a part of normal and healthy development. It also means changing the climate of shame that stifles open dialogue about sex and promoting positive sexual communication skills for parents and teenagers alike.

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[1] Sedgh, G., Finer, L. B., Bankole, A., Eilers, M. A., & Singh, S. (2015). Adolescent pregnancy, birth, and abortion rates across countries: Levels and recent trends. Journal of Adolescent Health56(2), 223-230.

[2]Alford, S., & Hauser, D. (2011). Adolescent sexual health in Europe and the US

Image Source: 123RF/Mirko Vitali

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