Week 1
Welcome to this course
What is sexuality according to WHO
Sexuality is a central aspect of being human throughout life that encompasses sex, gender
identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.
Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes,
values, behaviours, practices, roles and relationships.
Sexuality is influenced by the interaction of biological, psychological, social, economics,
political, cultural, legal, historical, religious and spiritual factors.
Important principles: Sexual development is a life-long, multidimensional process, it’s context-
related and has many paths.
Why this course matters
This course matters because youth face complex, evolving challenges around sex, gender,
relationships, and identity amid rising misinformation, shifting norms, and mental health risk,
making inclusive, accurate sex education more crucial than ever.
This statement has back up from the articles by Liang et al. (2019) and Graaf et al. (2024):
• Globally and in the Netherlands, adolescents have a later sexual debut. In the
Netherlands, the age of first vaginal sex rose from 17.9 (2012) to 18.7 (2023). Delays
are also seen in first kisses, oral sex, and other intimate activities. reasons are pressure to
make good choices, fear of social media judgement, and possible effects by COVID-19.
Adolescents more often have sexpartners without a romantic relationship.
• There has been a decline in contraceptive and condom use. Dutch girls using the pill
dropped from 76% (2012) to 46% (2023), spiral use rose. Over 50% of girls avoid
hormonal contraception and often opt for more natural/modern methods. Condom use
during first sex declined (boys: 75% to 64% & girls: 72% to 69%). There hasn’t been an
STI increases.
• There is mixed progress on Sexual and Reproductive Health and Rights (SRHR). Since
1994, globally; later marriage, later first sex, later childbirth, less teen-mom starving, more
contraceptive use, but an absolute incline in child marriage and less female genital
, mutilation. Absolute numbers of growth can be caused by population growth in some •
regions, and there is unequal progress worldwide.
• There are inequalities in sexual pleasure and health outcomes. First vaginal sex rated as
pleasant: 64% boys vs. 38% girls. Orgasm rates during sex: 85% boys vs. 59% girls.
Reported sexual problems: 23% girls vs. 10% boys. Globally, sexual health and pleasure
outcomes vary widely.
• Over 3% of Dutch youth identify as trans or gender-diverse; many experience lower
sexual & mental well-being. Global trends show long-term increases in LGTBQ+
acceptance, but recent declines in some regions. mental health disparities are sharp;
transgender youth have the highest suicide risk.
• In the Netherlands, girls reporting coercion into sexual acts rose from 12% (2017) to 20%
(2023). Consent misunderstandings are common; the need for clear, explicit consent is
growing. Globally, intimate partner violence remains high or increasing in some countries.
Non consensual sexting has risen as well.
• Dutch youth rate school sex education 5.6/10, citing lack of info on consent, pleasure, and
porn. Many turn to online sources for sexual health info. Social media and porn influence
expectations, body image, and behavior; especially among girls.
• Global rise in non-communicable diseases, cancer, and obesity among youth. Education
and job access strongly impact SRHR outcomes, but disparities persist. Dutch youth show
declining use of dating apps, but increased porn consumption; especially among girls (%
boys remained the same). Despite less condom use, STI diagnoses are stable due to
fewer high-risk partners.
• Toxic masculinity and the manosphere are present phenomena, there are debates about
what constitutes a man and what constitutes a woman.
Youth and sexuality in today’s society & psychosexual development
The Steps of Sexuality is an 11-step developmental model by Cacciatore et al. (2019) that
outlines the emotional, cognitive, and behavioral aspects of sexual development from
childhood to early adulthood. It emphasizes a holistic, emotion-centered approach, supporting
children and adolescents in understanding and respecting their own and others’ feelings,
needs, and boundaries. Unlike model focused only on risk prevention, it promotes self-
,awareness, aligning with WHO sexual education standards. The model is a tool for educators,
parents, and youth to better navigate and support healthy sexual development.
Sexual development in early childhood (age 0-5)
• Attachment style to caregivers influences future relationships (e.g. secure attachment
results in secure relationships); attachment can change over time.
• Motor skills allow children to explore their own and others’ bodies.
• Self-awareness develops (e.g. recognizing oneself as “I”), which supports self-esteem and
identity.
• Language development includes learning words for body parts, including genitals.
• Toilet training increases body awareness; diapers limit genital visibility and exploration.
• Rubbing hand over genitals isn’t called masturbation, because usually there aren’t clear
signs of arousal.
• Research on this age group is limited, mainly based on parental observations, due to age
and ethical considerations.
This development falls under step 1 of The Steps of Sexuality and might cover step 2 and 3
as well:
(1) Discovering own body parts and taking an interest in the differences between sexes
(infancy-toddlerhood).
(2) Affection for a friend, expressing affection through kissing and hugging and learning
intimacy-related rules and social norms (toddlerhood-middle childhood).
(3) Adoring a parent, taling frequently of loving parents and wanting to marry them
(toddlerhood-middle childhood).
Sexual development in childhood (age 6-11)
• Children begin taking others’ perspectives.
• Growing awareness of social norms and appropriate behavior.
• School plays a central role in learning and socializing.
• Friendships are mostly with same-sex peers.
• Increasing exposure to (social) media and easy access to content.
• Parents remain a key source of emotional support and guidance.
• First body insecurities emerge, especially among girls (e.g. feeling “fat”).
, • Children may explore their bodies in private.
• Begin to feel shame or embarrassment about nudity.
• Start experiencing romantic feelings and may have early “relationships”.
• Have basic knowledge of sexuality and show curiosity about the topic.
• In this age group research uses both parents’ observations and children’s self-report.
This development mainly falls under step 2-5 of The Steps of Sexuality:
(2) Affection for a friend, expressing affection through kissing and hugging and learning
intimacy-related rules and social norms (toddlerhood-middle childhood).
(3) Adoring a parent, taling frequently of loving parents and wanting to marry them
(toddlerhood-middle childhood).
(4) Loving idols, a public idol or teacher as a distant and safe object of love (middle childhood-
adolescence).
(5) A nearby secret love, covertly loving some familiar person (middle childhood-adolescence).
Sexual development in early adolescence (age 12-14)
• Physical changes begin (e.g. puberty).
• Identity development is key; adolescents are sensitive to peer pressure, often triggered by
physical changes. Brain development is ongoing; the frontal lobe is not yet mature,
leading to impulsivity and a focus on rewards over risks.
• Parents remain important sources of support. Friends become increasingly influential.
• (Social) media plays a major role; online and offline experiences are deeply connected.
• Insecurities increase, especially among girls, partly due to physical changes in genital
appearance.
• Arousal and masturbation become more common; interest in pornography may emerge.
• Love and romantic relationships start to develop.
• Kissing and occasional touching occur.
• Most are not emotionally or cognitively ready for further sexual experiences.
• Adolescents who start sexual activity early (before age 14) face greater risks because of
less knowledge of protection and consent.
• A positive sexual experience is more likely when there is gradual progression, the debut is
expected and self-chosen and communication with trusted adults is open and supportive.
This development mainly falls under step 6-9 of The Steps of Sexuality:
Welcome to this course
What is sexuality according to WHO
Sexuality is a central aspect of being human throughout life that encompasses sex, gender
identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction.
Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes,
values, behaviours, practices, roles and relationships.
Sexuality is influenced by the interaction of biological, psychological, social, economics,
political, cultural, legal, historical, religious and spiritual factors.
Important principles: Sexual development is a life-long, multidimensional process, it’s context-
related and has many paths.
Why this course matters
This course matters because youth face complex, evolving challenges around sex, gender,
relationships, and identity amid rising misinformation, shifting norms, and mental health risk,
making inclusive, accurate sex education more crucial than ever.
This statement has back up from the articles by Liang et al. (2019) and Graaf et al. (2024):
• Globally and in the Netherlands, adolescents have a later sexual debut. In the
Netherlands, the age of first vaginal sex rose from 17.9 (2012) to 18.7 (2023). Delays
are also seen in first kisses, oral sex, and other intimate activities. reasons are pressure to
make good choices, fear of social media judgement, and possible effects by COVID-19.
Adolescents more often have sexpartners without a romantic relationship.
• There has been a decline in contraceptive and condom use. Dutch girls using the pill
dropped from 76% (2012) to 46% (2023), spiral use rose. Over 50% of girls avoid
hormonal contraception and often opt for more natural/modern methods. Condom use
during first sex declined (boys: 75% to 64% & girls: 72% to 69%). There hasn’t been an
STI increases.
• There is mixed progress on Sexual and Reproductive Health and Rights (SRHR). Since
1994, globally; later marriage, later first sex, later childbirth, less teen-mom starving, more
contraceptive use, but an absolute incline in child marriage and less female genital
, mutilation. Absolute numbers of growth can be caused by population growth in some •
regions, and there is unequal progress worldwide.
• There are inequalities in sexual pleasure and health outcomes. First vaginal sex rated as
pleasant: 64% boys vs. 38% girls. Orgasm rates during sex: 85% boys vs. 59% girls.
Reported sexual problems: 23% girls vs. 10% boys. Globally, sexual health and pleasure
outcomes vary widely.
• Over 3% of Dutch youth identify as trans or gender-diverse; many experience lower
sexual & mental well-being. Global trends show long-term increases in LGTBQ+
acceptance, but recent declines in some regions. mental health disparities are sharp;
transgender youth have the highest suicide risk.
• In the Netherlands, girls reporting coercion into sexual acts rose from 12% (2017) to 20%
(2023). Consent misunderstandings are common; the need for clear, explicit consent is
growing. Globally, intimate partner violence remains high or increasing in some countries.
Non consensual sexting has risen as well.
• Dutch youth rate school sex education 5.6/10, citing lack of info on consent, pleasure, and
porn. Many turn to online sources for sexual health info. Social media and porn influence
expectations, body image, and behavior; especially among girls.
• Global rise in non-communicable diseases, cancer, and obesity among youth. Education
and job access strongly impact SRHR outcomes, but disparities persist. Dutch youth show
declining use of dating apps, but increased porn consumption; especially among girls (%
boys remained the same). Despite less condom use, STI diagnoses are stable due to
fewer high-risk partners.
• Toxic masculinity and the manosphere are present phenomena, there are debates about
what constitutes a man and what constitutes a woman.
Youth and sexuality in today’s society & psychosexual development
The Steps of Sexuality is an 11-step developmental model by Cacciatore et al. (2019) that
outlines the emotional, cognitive, and behavioral aspects of sexual development from
childhood to early adulthood. It emphasizes a holistic, emotion-centered approach, supporting
children and adolescents in understanding and respecting their own and others’ feelings,
needs, and boundaries. Unlike model focused only on risk prevention, it promotes self-
,awareness, aligning with WHO sexual education standards. The model is a tool for educators,
parents, and youth to better navigate and support healthy sexual development.
Sexual development in early childhood (age 0-5)
• Attachment style to caregivers influences future relationships (e.g. secure attachment
results in secure relationships); attachment can change over time.
• Motor skills allow children to explore their own and others’ bodies.
• Self-awareness develops (e.g. recognizing oneself as “I”), which supports self-esteem and
identity.
• Language development includes learning words for body parts, including genitals.
• Toilet training increases body awareness; diapers limit genital visibility and exploration.
• Rubbing hand over genitals isn’t called masturbation, because usually there aren’t clear
signs of arousal.
• Research on this age group is limited, mainly based on parental observations, due to age
and ethical considerations.
This development falls under step 1 of The Steps of Sexuality and might cover step 2 and 3
as well:
(1) Discovering own body parts and taking an interest in the differences between sexes
(infancy-toddlerhood).
(2) Affection for a friend, expressing affection through kissing and hugging and learning
intimacy-related rules and social norms (toddlerhood-middle childhood).
(3) Adoring a parent, taling frequently of loving parents and wanting to marry them
(toddlerhood-middle childhood).
Sexual development in childhood (age 6-11)
• Children begin taking others’ perspectives.
• Growing awareness of social norms and appropriate behavior.
• School plays a central role in learning and socializing.
• Friendships are mostly with same-sex peers.
• Increasing exposure to (social) media and easy access to content.
• Parents remain a key source of emotional support and guidance.
• First body insecurities emerge, especially among girls (e.g. feeling “fat”).
, • Children may explore their bodies in private.
• Begin to feel shame or embarrassment about nudity.
• Start experiencing romantic feelings and may have early “relationships”.
• Have basic knowledge of sexuality and show curiosity about the topic.
• In this age group research uses both parents’ observations and children’s self-report.
This development mainly falls under step 2-5 of The Steps of Sexuality:
(2) Affection for a friend, expressing affection through kissing and hugging and learning
intimacy-related rules and social norms (toddlerhood-middle childhood).
(3) Adoring a parent, taling frequently of loving parents and wanting to marry them
(toddlerhood-middle childhood).
(4) Loving idols, a public idol or teacher as a distant and safe object of love (middle childhood-
adolescence).
(5) A nearby secret love, covertly loving some familiar person (middle childhood-adolescence).
Sexual development in early adolescence (age 12-14)
• Physical changes begin (e.g. puberty).
• Identity development is key; adolescents are sensitive to peer pressure, often triggered by
physical changes. Brain development is ongoing; the frontal lobe is not yet mature,
leading to impulsivity and a focus on rewards over risks.
• Parents remain important sources of support. Friends become increasingly influential.
• (Social) media plays a major role; online and offline experiences are deeply connected.
• Insecurities increase, especially among girls, partly due to physical changes in genital
appearance.
• Arousal and masturbation become more common; interest in pornography may emerge.
• Love and romantic relationships start to develop.
• Kissing and occasional touching occur.
• Most are not emotionally or cognitively ready for further sexual experiences.
• Adolescents who start sexual activity early (before age 14) face greater risks because of
less knowledge of protection and consent.
• A positive sexual experience is more likely when there is gradual progression, the debut is
expected and self-chosen and communication with trusted adults is open and supportive.
This development mainly falls under step 6-9 of The Steps of Sexuality:
