Conference Agenda
| Session | ||
08 SES 10 B: Sexuality, Health and Wellbeing
Paper Session | ||
| Presentations | ||
08. Health and Wellbeing Education
Paper Sexual Health and Well-being in Duchenne Muscular Dystrophy University of East London, United Kingdom Presenting Author:It has been established that young people and adults with disabilities, and particularly those with chronic conditions, receive very little support for sexual health issues, despite there being a strong link between sexual health and well-being (Moller et al 2024). Young people with the chronic muscle-wasting condition Duchenne Muscular Dystrophy (DMD), who are predominantly male, are living longer due to new treatments and advances in multi-disciplinary care (Birnkrant et al 2018) , and they have reported that sexual health is important to them. According to the UN Sustainable Development Goal 3, by 2030 there must be ‘universal access to sexual and reproductive health-care services including for family planning, information and education, and the integration of reproductive health into national strategies and programmes’ (SDG3, UN 2015). Despite this, there is a prevalent misconception that people with disabilities are asexual and therefore do not need to be taught about sexual health (Bonder et al 2021). These ‘false ideologies’ around the lack of sexual needs of people with disabilities reinforce the stigma that people face and increase the likelihood of poor self-esteem and mental health problems (Bonder et al 2021). Furthermore, newly introduced Relationships and Sex Education (RSE) Guidance for Schools in the UK (2025) does not discuss issues affecting disabled pupils nor does it offer them any specific guidance. Young people with DMD have reported that RSE lessons are often not relevant to them (Hoskin et al 2024). Young people with DMD therefore have nobody to discuss their sexual health questions with and are often left to find out information on their own. There is very little published on DMD and sexual health, but a review of literature about people with chronic conditions that encompassed 114 studies found many professionals lack confidence and avoid discussing sexual health with people with chronic conditions and rarely initiate conversastions about it (McGrath et al 2021). A recent Danish study of young adults with neuromuscular conditions reported that both professionals and parents were often reluctant to raise what they believe to be false hopes of relationships or parenthood in the aim of protecting them (Moller et al 2024). These barriers can decrease the self-esteem of young adults with DMD and lead them to internalise the attitudes around them, as well as increasing the risk of STDs where individuals engage in sexual activity without access to sexual health services (Hoskin et al 2024). Despite all of these challenges, young men with DMD have reported both an interest and success in finding a partner and having sexual intercourse (Hoskin et al 2024). This is the first part of a two-part project that will co-create support and information for young people with DMD. In the first part, we will develop a co-created consensus on what good sexual health looks like for people with DMD and identify the key enablers and disablers of this vision. Using this information, Part 2 of the project will co-create a peer-led training programme to be run in schools and the community. The research questions for Part 1 of this project are:
And for Part 2:
We are currently conducting Part 1 of this study and my presentation will talk about emerging findings from Part 1 of the project. I will also share ideas and proposals for Part 2. Methodology, Methods, Research Instruments or Sources Used We are using a mixed methods approach for our study. Part 1 of this project is using a Delphi Consensus style approach to find out what young people and adults with DMD, parents/ carers and neuromuscular teams view as good sexual health for people with DMD. A Delphi Consensus brings together the views of a range of expert stakeholders in order to reach a shared understanding. This Delphi Consensus approach involves recruiting three panels – one consisting of 10 – 20 young people over the age of 13 years and adults with DMD in the UK and Denmark, one panel consisting of 10-20 parents and or carers in the UK and Denmark, and one panel consisting of 10 – 20 neuro-muscular health professionals in the UK and Denmark. Each panel will engage in 2 rounds of data collection. In Round 1, Panel 1 (young people and adults with DMD) will take part in face to face workshops and focus groups in the UK and Denmark in order to explore what good sexual health looks like for people with DMD and what helps and hinders this. Round 1 for Panels 2 and 3 (parents and professionals) will consist of online qualitative questionnaires. Round 2 for all three panels will consitute a short online questionnaire asking all participants to rank and prioritise challenges and solutions and to choose between definitions of sexual health in DMD. Part 2 will use an emancipatory approach (Barton 2004) to research design where people with DMD will co-design a peer-led sexual health training programme to be used in schools and hospitals. The theoretical framework used in this study is the Biopsychosocial Model of Disability that acknowledges the social and psychological challenges of good sexual health for a person with DMD as well as the biological and medical difficulties (Engel 1977). We are interested to explore the overlap of these different areas, acknowledging the role structural ableism and disableist attitudes play in support for sexual health, as this is often an overlooked area for disabled people, as well as the challenges caused by the progression of DMD. Conclusions, Expected Outcomes or Findings We anticipate that structural ableism in health and education impacts on the sexual health of young people with DMD. We anticipate that many young people with DMD are not sexually active, or put themselves at risk, because they do not have necessary knowledge about sexual health. We anticipate that professionals will be reticent to talk to young people about sexual health References Birnkrant, D., K. Bushby, C. Bann, S. Apkon, A. Blackwell, M. Colvin, L. Cripe, et al. 2018. “Diagnosis and Management of Duchenne Muscular Dystrophy, Part 3: Primary Care, Emergency Management, Psychosocial Care, and Transitions of Care Across the Lifespan.” Lancet Neurology 17 (5): 445–455 Bonder, R., Wincentak, J., Gan, C., Kingsnorth, S., Provvidenza, C.F. and McPherson, A.C., 2021. “They assume that you’re not having sex”: a qualitative exploration of how paediatric healthcare providers can have positive sexuality-related conversations with youth with disabilities. Sexuality and Disability, 39(3), pp.579-594. Engel, G. L. (1981). The clinical application of the biopsychosocial model. The Journal of medicine and philosophy, 6(2), 101-124. Hoskin, J., Cheetham, T. D., Mitchell, R. T., Wong, S. C., & Wood, C. L. (2024). Sexual health and fertility in Duchenne muscular dystrophy—An exploratory study. Muscle & Nerve, 70(3), 402-408. McGrath, M., Low, M.A., Power, E., McCluskey, A. and Lever, S., 2021. Addressing sexuality among people living with chronic disease and disability: a systematic mixed methods review of knowledge, attitudes, and practices of health care professionals. Archives of Physical Medicine and Rehabilitation, 102(5), pp.999-1010. Møller JPK, Hansen KW, Handberg C. (2024) “It doesn't get more normal than that!" - challenges with sexuality experienced by people with neuromuscular diseases and their needs for rehabilitation knowledge and guidance on sexual life. Disabil Rehabil. 2024 Dec 18:1-10. doi: 10.1080/09638288.2024.2440635 08. Health and Wellbeing Education
Paper Assembling ‘the Inspired Sexuality Teacher’: a Material-semiotic Exploration of Danish Initiative to Improve “Health, Sexuality and Family Education” in Schools Danish School of Education (DPU), Aarhus universitet, Denmark Presenting Author:The objective of this paper is to explore the configurations of teacher subjects and subjectivities within a national initiative to improve the implementation of “Health, sexuality and family education” in Danish primary and lower secondary schools. In scholarly literature on school-based sexual health education (SE), the teacher’s role and responsibilities are central points of interest. The teacher takes a position of a ‘critical variable’ (Mulcahy, 2011) in terms of implementing successful sexuality education, which is why many initiatives aimed at improving sexual health and wellbeing involve teachers as main facilitators of change (Janssens et al., 2020). The ‘controversial’ nature of curricular topics specific to sexuality education often entails particular attention paid to teachers’ inner experiences or personality traits which are understood to support or impede the implementation. These include factors such as teachers’ personal beliefs (Lockhart et al., 2025), comfortability (Cumper et al., 2024; Walker et al., 2021) and attitudes and willingness to teach (Bruno et al., 2025; Cohen et al., 2012). Thus, the significance of the teacher, including their subjectivities, is well established. However, so far, little attention has been paid to how sexuality education policies and practices are not only facilitated by, but may also be generative of, particular teacher subjectivities. With this paper, I aim to explore this issue by attending analytically to the generative effects of a national initiative to improve the compulsory topic “Health, sexuality and family education” in Danish primary and lower secondary school. My research question is: How are particular teacher subjectivities configured in the initiative, and which implications (and possible tensions) emerge with their embedded logics of ‘teacher responsibility’ and ‘teacher choice’? The paper contributes new knowledge that nuance European scholarly debates on the implementation of health, sexuality and wellbeing curricula, particularly by addressing the challenges of teaching sensitive topics such as gender, sexuality and diversity. Theoretically, the study draws on a material-semiotic framework, inspired by scholars such as Mol (2008), Law (2008) and Mulcahy (2012), allowing for an analysis of the national initiative as “a performative knowledge practice constituted and enacted by people and tools in complex collectives or assemblages” (Mulcahy, 2012, p. 132). Furthermore, it draws on recent material-semiotic and posthumanist analyses of sexuality education which have encouraged a movement away from humanist, individualist and essentialist ideas of the teacher as a detached agent of change (Cardell & Lindgren, 2024). In this line of thought, sexuality education is conceptualised as a situated and contingent practice, produced by heterogenous assemblages involving a multitude of human and non-human actors (Planting-Bergloo et al., 2022). This implies that difficulties with implementation of sexuality education cannot be understood as individual, nor immaterial, but rather as related to fragility or instability of the capacity of the working assemblages. This approach facilitates bottom-up explorations of how practices do not only produce local versions of sexuality education, but also continuously generate the objects, spaces, and subjects involved in them (Alldred & Fox, 2019). In line with Fenwick (2015), Kiær et al. (2024), and Mol (2008) ideas of teacher ‘responsibility’ and ‘choice’ are not understood as inherent individual qualities or capabilities, but rather as situated capacities entangled in practice. Methodology, Methods, Research Instruments or Sources Used This paper is based on a multi-site, qualitative study of the project “Initiative to strengthen health, sexuality and family education” (UCL, n.d.) funded by the Danish government. The initiative was launched in 2021 to improve primary and lower secondary schools’ implementation of the compulsory, cross-curricular topic “Health, sexuality and family education” after an evaluation had shown that many schools did not meet the official learning outcomes (Følner et al., 2019). Similarly to other European countries (European Commission, 2020), especially the curricular theme “Gender, body and sexuality” which involves rights-based and critical approaches to sexual health, seemed difficult for schools to address sufficiently compared to the traditional risk-based medical approaches. The initiative incorporates several resources and activities. It includes a digital platform with information about curricular topics and didactic approaches as well as a catalogue of teaching materials (SSF-Kompasset, n.d.). It also provides different course formats and networking activities aimed at relevant professionals such as school leaders, nurses and teachers. One central strategy of the initiative is to appoint and build capacity of in-service teachers to serve as so-called ‘resource persons’ who will act as local school experts in the curriculum and coordinate its implementation. The empirical material was generated during 2025 and consists of: 1. Observations of courses for ‘resource persons’ 2. Qualitative interviews with individuals involved in the national initiative, including course coordinators and participating school staff 3. Key documents and communicative materials related to the initiative, including the digital catalogue of online resources From this heterogeneous archive of empirical materials, I analyse the initiative as a ‘messy’ practice in which sexuality teacher subjects and subjectivities are understood as relational effects continuously configured in socio-material assemblages embedded in the initiative, rather than stable and pre-existing entities (Law, 2008). Conclusions, Expected Outcomes or Findings This paper presents an analysis of how the initiative’s practices iteratively configure a particular teacher subject, that I call ‘the inspired sexuality teacher’. This teacher subject emerges as passionate, positive, open-minded, as well as being focused on the wellbeing of students and themselves. The configurations of this particular subject is generated by an array of different involved actors, from which I emphasise the overarching mobilisation of ‘inspiration’ as a recurring subjectivity-strategy to roll out the initiative. I explore this mobilisation which is carried out by and in the digital platform, course pedagogies, learning spaces and by the course participants’ collective discussions. The mobilisation of ‘inspiration’ help generate the teaching experience as positive, pleasant and autonomous and may work as an effective strategy to secure teacher engagement and therefore also the roll out of the curriculum as intended. However, it may at the same time generate boundaries for sexuality teacher subjectivity that limit pedagogical possibilities to facilitate discomfort, disagreement and critical discussions within the classroom. Lastly, I argue that subjectivity of ‘the inspired sexuality teacher’ is entangled with particular versions of ‘teacher responsibility’ (Kiær et al., 2024) and ‘teacher choice’ (Mol, 2008) by which critical pedagogies and controversial topics such as gender and power are easily diminished or omitted from sexuality education by being deemed ‘not appropriate’ or not in the interest of the wellbeing of students. References Alldred, P., & Fox, N. J. (2019). Sexualities education and sexual citizenship: A materialist approach. Bruno, V., Baiocco, R., & Pistella, J. (2025). Teachers’ Attitudes and Opinions Toward Sexuality Education in School: A Systematic Review of Secondary and High School Teachers. American Journal of Sexuality Education, 20(3), 390-428. Cardell, D., & Lindgren, A.-L. (2024). The sex-map as didactic object: Ontonorms in Swedish sex education. Childhood, 31(2), 212-229. Cohen, J. N., Byers, E. S., & Sears, H. A. (2012). Factors affecting Canadian teachers' willingness to teach sexual health education. Sex education, 12(3), 299-316. Cumper, P., Adams, S., Onyejekwe, K., & Michelle, O. R. (2024). Teachers’ perspectives on relationships and sex education lessons in England. Sex education, 24(2), 238-254. European Commission. (2020). Sexuality education across the European Union – An overview. Fenwick, T., Edwards, R., & Sawchuk, P. (2015). Emerging approaches to educational research: Tracing the socio-material. Routledge. Følner, B., Jensen, M. K., & Larsen, T. N. (2019). Evaluering af Sundheds- og seksualundervisning og familiekundskab (SSF). A. Research. Janssens, A., Blake, S., Allwood, M., Ewing, J., & Barlow, A. (2020). Exploring the content and delivery of relationship skills education programmes for adolescents: A systematic review. Sex education, 20(5), 494-516. Kiær, K., Albrechtsen, T. R. S., Knudsen, L. E. D., Wiberg, M., Haastrup, L., & Petersen, K. B. (2024). Enacting professional responsibility in literacy coaching: A sociomaterial perspective Law, J. (2008). Actor Network Theory and Material Semiotics. In The New Blackwell Companion to Social Theory (pp. 141-158). Lockhart, E., Bickmore-Brand, J., & Doecke, P. (2025). Perspectives of Secondary School Educators Teaching Gender and Sexuality in Health Education. Youth, 5(1), 4. Mol, A. (2008). The Logic of Care: Health and the Problem of Patient Choice (1 ed.). Routledge. Mulcahy, D. (2011). Assembling the ‘Accomplished’ Teacher: The performativity and politics of professional teaching standards. Educational Philosophy and Theory, 43(s1), 94-113. Mulcahy, D. (2012). Thinking teacher professional learning performatively: a socio-material account. Journal of Education and Work, 25(1), 121-139. Planting-Bergloo, S., Orlander, A. A., & Jakobson, B. (2022). The Production of Contraceptive Cyborgs in Swedish Upper Secondary Sexuality Education. Cultural Studies of Science Education, 17(2), 541-556. SSF-Kompasset. (n.d.). https://ssfkompas.dk/ UCL. (n.d.). Indsats for styrkelse af SSF i folkeskolen. https://www.ucviden.dk/da/projects/national-indsats-for-styrkelse-af-sundhed-seksualundervisning-og-/ Walker, R., Drakeley, S., Welch, R., Leahy, D., & Boyle, J. (2021). Teachers' perspectives of sexual and reproductive health education in primary and secondary schools: a systematic review of qualitative studies. Sex education, 21(6), 627-644. 08. Health and Wellbeing Education
Paper Temperament-Sensitive Classroom Seating as a Factor of Learning Effectiveness NIS (Nazarbayev Intellectual School in Taldykorgan), Kazakhstan Presenting Author:This study investigates how temperament-sensitive seating of students in the classroom influences learning effectiveness and engagement during classroom activities in the middle school. According to psychoanalytic and psychodynamic approaches to education, learning could be effective only by taking into consideration unconscious dynamics, anxiety regulation, and rational position or their sitting in the classroom (Britzman, 2011; Youell, 2006). Students' seating positions also influence perceived safety and patterns of interactions (McCorskey and McVetta, 1978; Wannarka and Ruhl, 2008). Temperament is known as a biologically grounded and relatively stable disposition that is connected with emotional reactivity, effortful control, and classroom engagement (Rothbart, 2007; Zentner and Bates, 2008). This educational research also takes into consideration associations between temperament and academic behavior (Keogh, 2003; Thomas and Chess, 1977). The research question of this study: How do temperament-sensitive classroom seating arrangements function as mechanisms of effective containment, influencing middle school students' learning effectiveness and engagement during classroom work? General objective of this research was to examine how temperament-sensitive classroom seating arrangements function as mechanisms of effective containment and contribute to middle school students' learning effectiveness, engagement and emotional comfort during classroom work. Specific objectives: - to identify differences in learning effectiveness and on-task behaviour across homogeneous, heterogeneous and random seating arrangements for students with different temperament types. - to explore students' affective and subjective experience of classroom seating in terms of emotional safety, anxiety regulation and comfort with participation. - to analyze psychoanalytical processes (e.g., containment, acting-out and peer co-regulation) emerging in classroom with different seating configurations). - to examine teachers' perception of the role of seating arrangements in managing classroom affect, behavioral dynamics and learning engagement. Methodology, Methods, Research Instruments or Sources Used Convergent mixed methods were used in this research. There were 30 students (aged 12-14) participated in this research. All of them were from Nazarbayev Intellectual School in Taldykorgan. Their temperament types were sanguine, choleric, phlegmatic and melancholic. It was identified by means of standardized temperament inventory grounded in Eysenck's typological framework (Eysenck 1975). Three seating conditions were implemented over four month or two terms. They are homogeneous seating positions according to temperament, heterogeneous (mixed-temperament) seating positions and the last was random seating position. Learning effectiveness was measured through task performance scores (from 1 to 100) and structured observation of on-task behaviour (5-point engagement scale). The qualitative method of this study included 30 student interviews and 3 teacher interviews. Classroom observation was analyzed with attention to anxiety, containment and defensive participation strategies (Bion, 1962; Youell, 2006). Ethical considerations were obtain before data collecting. Attention was given to emotional safety, confidentially and the non-pathologizing interpretation of temperament differences in accordance to psychoanalytic ethical principles. Conclusions, Expected Outcomes or Findings Quantitative analysis demonstrated that heterogeneous seating showed significantly higher engagement, compared to homogeneous and random seating. Also, it is interesting to analyze on-task behaviour engagement. Students with sanguine temperament type showed the following results: in heterogeneous seating - 83%, in homogeneous seating - 72% and in random seating - 68%. Students with choleric temperament type showed the following results: in heterogeneous seating - 77%, in homogeneous seating - 63% and in random seating - 59%. Students with phlegmatic temperament type showed the following results: in heterogeneous seating - 75%, in homogeneous seating - 78% and in random seating - 69%. Students with melancholic temperament type showed the following results: in heterogeneous seating - 70%, in homogeneous seating - 57% and in random seating - 54%. Qualitative analysis demonstrated that mixed temperament seating reduced performance anxiety among melancholic students, moderated acting out behaviours in choleric students and supported affective containment through peer co-regulation. Seating position was considered as a non-verbal pedagogical intervention which helped to make level of anxiety in the class lower and stabilized classroom emotional climate. It was mentioned by teachers that temperament-sensitive seating improved the classroom emotional climate. The findings of this study highlight a critical distinction between knowing and acting in educational practice. While some teachers may have theoretical knowledge about temperament differences (knowing), this knowledge does not automatically transformed into pedagogical action (acting) within everyday classroom routine. This study demonstrated that temperament-sensitive seating arrangements function as a concrete bridge between knowing and acting, transforming psychological understanding into material pedagogical practice. References Bion, W. R. (1962). Learning from experience. London, UK: Heinemann. Britzman, D. P. (2011). Freud and education. London, UK: Routledge. Eysenck, H. J., & Eysenck, S. B. G. (1975). Manual of the Eysenck Personality Questionnaire. London, UK: Hodder & Stoughton. Keogh, B. K. (2003). Temperament in the classroom: Understanding individual differences. Baltimore, MD: Paul H. Brookes. McCorskey, J. C., & McVetta, R. W. (1978). Classroom seating arrangements: Instructional communication theory versus student preferences. Communication Education, 27(2), 99–111. https://doi.org/10.1080/03634527809378281 Rothbart, M. K. (2007). Temperament, development, and personality. Current Directions in Psychological Science, 16(4), 207–212. https://doi.org/10.1111/j.1467-8721.2007.00505.x Thomas, A., & Chess, S. (1977). Temperament and development. New York, NY: Brunner/Mazel. Wannarka, R., & Ruhl, K. (2008). Seating arrangements that promote positive academic and behavioural outcomes: A review of empirical research. Support for Learning, 23(2), 89–93. https://doi.org/10.1111/j.1467-9604.2008.00375.x Winnicott, D. W. (1965). The maturational processes and the facilitating environment. London, UK: Hogarth Press. Youell, B. (2006). The learning relationship: Psychoanalytic thinking in education. Journal of Child Psychotherapy, 32(1), 79–94. https://doi.org/10.1080/00754170500536346 Zentner, M., & Bates, J. E. (2008). Child temperament: An integrative review of concepts, research programs, and measures. European Journal of Developmental Psychology, 5(1), 7–37. https://doi.org/10.1080/17405620701620854 | ||