By Michelle Gamage
Local Journalism Initiative Reporter
Immigrant teenagers aren’t having as safe sex as their Canadian-born high school classmates, according to a new study published in the BMC Public Health journal.
The study looked at teenage use of condoms, birth control pills or both contraceptives over eight years and found contraceptive use dropped slightly among teenagers in general, with the highest declines reported by newcomer teens.
The term “newcomer” refers to anyone not born in Canada and can include immigrants, people with Canadian permanent residency or citizenship, refugees or someone on a school visa.
That drop in contraceptive use could be because newcomers to Canada are missing their school’s sex education due to when they arrive, or because they’ve gotten misinformation from social media, Elizabeth Saewyc told The Tyee.
Saewyc is a co-author of the study, a professor in the school of nursing at the University of British Columbia and head of the Stigma and Resilience Among Vulnerable Youth Centre at UBC.
Overall, fewer 15- and 16-year-olds are having sex than eight years ago, Saewyc said. The biggest drop is with immigrant teens. In 2014, 14 percent of immigrant teen girls said they had had sex; by 2022, that had dropped to 8.7 percent. In 2014, 23 per cent of Canadian-born girls, 21 percent of immigrant boys, and 22 percent of Canadian-born boys said they had had sex. By 2022, that had dropped to 16 per cent for all three categories.
That’s a pretty small number of sexually active teenagers, Saewyc said — but among the teens who are having sex, rates of condom and birth control use are dropping.
Saewyc said that’s concerning because it suggests young people aren’t getting the information they need to make healthy decisions.
This hasn’t led to a spike in unplanned teenage pregnancies, but there has been a recent increase of sexually transmitted infection rates for all teens in Canada and around the world, she said.
When youth get a gold-standard, evidence-based sexual health education, they wait to start having sex until an older age, use more condoms and contraceptives and can better navigate interpersonal relationships.
Good sex education also leads to lower rates of sexual and physical violence, said Carlie McPhee, a comprehensive sexual health educator with a decade’s worth of experience working with high school students across the country. McPhee was not involved in the study.
Unfortunately, Canada is bad at teaching sex education, said McPhee, who uses both she and they pronouns.
That disproportionately affects immigrants who already face barriers accessing public education and health systems, they said.
Saewyc’s study analyzed data from nearly 31,000 teenagers who had participated in the Health Behaviour in School-Aged Children study, which is a World Health Organization research project that surveys youth aged 11 to 15 every four years about a wide range of health-related topics. Teens are only asked about sexual health starting in Grade 9.
Saewyc’s study looks at data for students in grades 9 and 10 from 2014, 2018 and 2022.
Each province and territory has its own curriculum, with most of them written in the 1990s and early 2000s, which means “it’s pretty outdated,” McPhee said.
Teachers also aren’t taught how to teach sex ed.
“You give them some really vague curriculum objective and say, ‘Go teach this highly sensitive topic you’re probably going to get grilled on by families and the administration,’” they said. McPhee added that some teachers go above and beyond, but many are overworked and just don’t want to deal with it.
McPhee said any teacher wanting free resources to improve their lessons should check out the Sex Information and Education Council of Canada or a digital resource recently launched by McPhee called Sexuality Understanding and Education for Digital Equity, or SUEDE, which offers free, online, comprehensive sex-ed classes in a Canadian context.
McPhee said she created SUEDE to help address inequality that can happen when schools outsource sex education to educators like her. Private schools can hire educators to come in several days throughout the year, while public schools tend to try to cover all grades in a single day, which radically reduces how much they can teach.
In B.C., sex education is taught only until Grade 10, which means a student who arrives in Canada after that, or who somehow missed the one day of sex ed, is out of luck.
“The best health outcomes come when you spend actual time on the content and practise skills,” McPhee said.
It’s not as simple as giving students information on how contraceptives work; they also need to know where they can get them, what to say in a doctor’s appointment or to a pharmacist, and how to navigate asking a partner to use contraceptives, and to practise putting on a condom correctly, they said.
Teenagers also need to be taught how to self-advocate and to navigate and negotiate interpersonal relationships.
When youth have a comprehensive sex education, they’re more likely to spot misinformation from online sources, like AI or social media, Saewyc said.
McPhee said there’s room in sex ed for different perspectives, beliefs and values and that she’s taught alongside faith leaders before, where she “brings the facts and they bring the values.”
Parents often relax once they realize sex education doesn’t teach their kid how to act but gives them information they can incorporate into their own beliefs and values, McPhee said.
To help contextualize the data, the study authors worked with an advisory group of immigrant youth aged 16 to 24 from across Canada, who could confirm that condoms and birth control pills are the main forms of contraceptives used by teenagers today.
The birth control pill can protect from unwanted pregnancies, and condoms can protect from sexually transmitted infections and unwanted pregnancy. Dual-method use for heterosexual couples offers the most protection, but the number of teens using this strategy is dropping.
In 2022, around one in four Canadian-born teen girls used both condoms and birth control pills, but that drops to just one in 10 for immigrant teen girls.
Canadian-born boys were 2.5 times more likely to use the dual method than immigrant boys, Saewyc said.
“I wouldn’t say those are great numbers,” she added, but it’s better than teenagers who are deciding to use no protection, which is increasing.
Not using any protection is a big problem because sexual health “isn’t a one-and-done,” Saewyc said. “Every time you have sex, you are potentially at risk.”
This study didn’t ask whether teenagers were using other methods to prevent the spread of STIs, like regular STI testing or limiting their number of sexual partners.
But overall, it’s clear educators across Canada need to improve how sex education is taught and work to make information more, not less, available.
Alberta’s recent decision to make sex education less accessible by requiring parents to opt in is “puzzling,” Saewyc said.
In Canada, a teenager can legally consent to have sex at 16 years old.
“If you are legally allowed to make these decisions about your behaviour, why do you need parental consent to learn about how to protect yourself and make good decisions around that behaviour?” she said.
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