On The Couch with Professor Jennifer Power

[00:00:00] Maddy Stratten: Hi, and welcome to another episode of On The Couch, where we collaborate with experts, practitioners, authors, advocates, and influencers to explore current social themes, sex positive topics, and share stories and insights that matter.

[00:00:24] Winnie Adamson: This podcast was recorded on Aboriginal country. We acknowledge the traditional custodians of the lands that were never ceded on which we live, work, and record upon.

[00:00:33] Maddy Stratten: We pay our respect to elders past and present, and to those who may be visiting our website or listening to our podcast today.

[00:00:40] Winnie Adamson: While listening, we encourage you to practice good self-care, and of course, check the show notes for further information.

[00:00:45] Maddy Stratten: Wherever you are, whatever you're doing

[00:00:47] Winnie Adamson: Enjoy this episode of On The Couch

[00:00:49] My name is Winnie and I'm really looking forward to today's episode of On the Couch, where we're going to be hearing from Professor Jennifer Power on the latest survey results from the Australian secondary students in sexual health study, also called SSSASH which is a national study exploring the sexual health and wellbeing of school aged young people in Australia.

[00:01:12] So Jen is the Deputy Director of the Australian Research Center in Sex Health and Society, otherwise known as ARCSHS at Latrobe University, where she leads sexual health and wellbeing research team and has been the lead investigator on the SSASH study since 2022.

[00:01:28]  So Jen, this is actually your second time on the couch and we did talk to you last year in March, unpacking your work across HIV activism, youth research and changing landscape of sex and relationships and education, as well as talking about the SSASH study. So we're really excited to have you back today to be sharing the findings from the SSASH eight survey, the latest survey.

[00:01:51] We do introduce our guests using the concept of fields of existence and coordinates of belonging. And these concepts were introduced to us by Leah from Co-Culture Communications, and they demonstrate that our beings are a field of activity made up of the stories we've been told, our ancestors that have existed, the land under our feet, the places in which we stand, and all these really enforce who we are in the moment as contextual beings.

[00:02:17] Last year, of course, you did share your coordinates of belonging with us and really around your work and how you've landed the job at ARCSHS and how HIV activism really was the catalyst to where you are now. So to expand on these concepts, I thought it might be good for us to really explore your yearnings and commitments to the SSASH eight study.

[00:02:36] How are you locating yourself where you are now?

[00:02:40] Jennifer Power: Thank you. Thank you so much for having me. And it's it's such a great question to start on, it took me a few minutes to work out how to answer it, and there's many different ways, but two things that do come to mind.

[00:02:52] Firstly, before I was kind of working in research in academia, I worked as a youth worker. Um, and specifically I worked on a HIV and STI prevention project with young people who were in out-of-home care or experiencing homelessness. Um, so since then, I guess I've always been trying to find a way to bring together the different elements of my professional life.

[00:03:16] Um, and SSASHa's been great. It's been really great to work with young people and to, to reengage with the youth sector again and kind of bring that previous experience to bear in this part of my life and career. But look, honestly, maybe more personally at this point in my life, I've also got two teenage children.

[00:03:34] Um, and it's really interesting doing this kind of study as a parent. It, it just, um, kind of gives me a whole different perspective on how weirdly complicated it is as an adult to understand what's going on for young people and can, I've always sort of held that position that you, we need to listen and let young people drive the initiatives and drive the space and, and be the leaders in their own way.

[00:03:59] And I'm absolutely committed all of that. But I'm also so aware that as a parent who's responsible for these young lives, everything feels scary and everything feels risky, and it's so much sort of easier and compelling to grab onto that, oh, no, no, no. The world's so different now and there's so much more danger out there now, and I need to just batten down the hats with and protect them.

[00:04:20] And actually it takes a bit of an emotional. Decision, I guess, or it's a bit of an emotional journey to, to be you know, a little bit more reflective and reflexive as a parent. I dunno if that makes sense, but I think that's been on my mind quite a lot and it's been really great actually, and really insightful hearing from all the thousands of young people in this study.

[00:04:40] Um so yeah, maybe that's part of my bearings for where I'm at at the moment.

[00:04:46] Winnie Adamson: Yeah. Thank you. I appreciate you sharing those coordinates and that yearning and it's really interesting to hear you talk about that.

[00:04:53] That's, um, really valuable and thanks for sharing 'cause it does really add to our chat today

[00:04:58] um, I do wanna give a little bit more context about the study before we do dive into the findings. So it is quite a unique study.

[00:05:05] It's the only large scale study that captures secondary school, aged 14 to 18-year-old young people's attitudes, knowledge and behaviors around sex, relationships, and sexual health. So there's seven iterations of the survey so far, and the study captures the shifts in secondary school students culture, identity, relationships, digital practices around sexual health, meaning that professionals alike practitioners, clinicians, educators, policy makers, health promotion officers, et cetera, can respond to real current trends emerging in young people's lives, ensuring that sexual health, education and interventions remain relevant, evidence-based and effective.

[00:05:46] The study has been really revolutionary for the sexual health sector with its findings, also informing national and state sexual health strategies, guiding educational programs and shaping health promotion campaigns. And so for us here at Cady Shack, this study has really influenced the strategies that actually underpin the work that we do, including the New South Wales and National STI Strategies and HIV strategies.

[00:06:10] And these influence our health promotion campaigns that reach and engage our priority populations, including the On the Couch Series. And actually, as I was writing this script, I was reflecting on how this is almost like a full circle moment of how you know this. Podcast in this vodcast series has been informed by the strategies that has been informed by your study.

[00:06:32] So having you sharing this data today is really exciting for us. So I can't wait to get into it. Um, so the report for SSASH eight is set to be released in May this year . And we're very excited to be here sharing these conversations ahead of this report release. And before we share and start getting into the findings, I also wanna acknowledge, uh, Sylvia Cower and Adam Bourne, who also were involved in the SSASH eight data.

[00:06:59] Jen, to set us off, I'd be great to get an understanding of the foundations of the SSASH study. And can you talk us through the methods and demographics represented in the data?

[00:07:10] Jennifer Power: Yes. Thank you. And thank you for that lovely introduction to the study. It's always really great to hear how people use the data.

[00:07:18] Um, the study funded by the Australian Department, of Health, disability and Aging. And it's, it's funded primarily to collect data to inform some targets in the national STI strategy related to young people, sexual health and condom use. But, um, we know it's used much more broadly than that.

[00:07:37] It's used in state and territory, STI and sexual health strategies, but it's used quite widely in the sector. And we have a lot of people coming up and telling us how they, um, are waiting for the next study and how they use it, and that's really helpful for us., It helps us tailor each version of the survey to the needs of people who use it.

[00:07:57] Um, it certainly helps us make a case for continued funding for this study.

[00:08:01] So the origin of this study, and you probably have heard me tell this story before, but I think it's kind of, it gives a lot of, I think it's important sort of contextualizes the way we approach this study. The very first one was done in 1992. it was initiated, fairly early on in the HIV epidemic when everyone was still kind of expecting that there might be a second wave of HIV and that young heterosexual people would be the, the group most affected by HIV. So there wasn't any treatment at the time, or certainly not any effective treatment like there is now. Um, there was still a lot of uncertainty, a lot of fear around HIV and people realized that if young people were at risk, we needed to know more about what was happening for young people, both in terms of their sex and relationship lives, but also what young people knew about HIV, what they knew about HIV prevention, how they felt about wearing condoms and so forth.

[00:08:58] So this study was initiated and schools were brought on board to help implement the study. Um, in fact, the very first study, there was a lot of concern about it. And, um, people from the health departments in, in different states and territories were recruited to stand in the classroom that young people were filling in the survey.

[00:09:19] 'cause there was a lot of concern that no one would understand why they were doing it, that there'd be a lot of questions or that young people would just be kind of. Mucking around and not taking it seriously. So it was done with a lot of sort of trepidation, which I think speaks to the reason it hadn't been done before.

[00:09:34] The idea of going into schools and asking young people to fill in a study about their sex life was just, um, unheard of, and I think would have continued to be unheard of if HIV hadn't created literally a life or death situation. So, um, that was very much the reason this survey was able to be initiated in schools, and it was conducted in schools from 1992 when it was first run through to 2013.

[00:10:04] So the process by which that was done was, um, we would contact a random selection of schools across the country. The first iteration it was just government schools, but over the next, over the next couple of iterations, independent and Catholic schools were brought on board.

[00:10:19] Um, but , from nine, seven onwards, boxes of the survey was sent out to schools. It was administered usually in P-D-H-P-E, , and then that was sent back to us. Um, it was expensive and took a huge amount of effort to make that survey happen, but it was the gold standard of data collection because we had this random sample, so it was, schools were randomly selected, um, and then everyone in year 10 and 12 within those random selected schools. Completed this survey. So, you know, we, we weren't reliant on young people opting into the survey. it was young people randomly selected.

[00:10:59] However, by 2008, 2013, it was getting really hard to recruit schools. So we were using the same process, but fewer and fewer schools were opting in.

[00:11:09] I think there was a few things going on. HIV was now considered a chronic manageable condition. There was like fear less um, immediate life or death concerns surrounding young people and their sexual health. Crowded curriculums were starting to happen, particularly for year 12. So there was a lot less interest in bringing anything in to add to that curriculum. And I think there was a bit of an increase in conservatism. So again, the idea of a survey about sex being conducted in schools was becoming less appealing.

[00:11:41] So that meant that even though we'd randomly selected schools, we we're getting a lot more inner city schools, progressive independent schools. You know, we weren't hearing from the demographic spread of young people that we had in the past.

[00:11:53] So in 2013, we introduced online recruitment. Uh, 2013 was the heyday of Facebook. It's hard to remember, but there was a lot of young people on Facebook in 2013, um, and then again in 2018. So we were able to collect these really large, um, and really diverse samples of young people just from throwing a few Facebook ads out there. So in 2018, within like a month, we heard from 6,000 young people from across all states and territories. They're really quite widespread in terms of gender and sexuality, um, in terms of the age group within that 14 to 18 year age range, school type, um, and sexual experiences as well.

[00:12:38] Winnie Adamson: Mm-hmm.

[00:12:39] Jennifer Power: That's become harder. Algorithms have become tighter.

[00:12:42] So we put an ad on Instagram now and it'll be shown to people who are already interested in that content. So in terms of reaching young people who are not necessarily already engaged with these issues or are not necessarily sexually experienced with, we're just not able to reach those young people online.

[00:12:59] So for 2024, we still relied heavily on, Instagram advertising. We haven't gone back into schools because, the environment is very difficult and we don't necessarily have the budget to make that happen anymore. Although we haven't sort of ruled that out for further iterations of the study.

[00:13:19] For this version SSASH8 for which data were collected from October, 2024 till April, 2025, we relied on Instagram advertising, but we augmented this, uh, with data collection using a professional survey panel.

[00:13:32] So we use the Student Edge panel, which is known to be quite a good panel for young people, and they recruited around about a thousand young people for us. That was really great because they've got particularly. Young heterosexual men part in their panel who we, we tend to struggle to reach online.

[00:13:51] Winnie Adamson: Mm.

[00:13:52] Jennifer Power: We also really put a lot of effort into reconnecting with the youth sector. So we hired the Youth Affairs Council of Victoria to, to work with us. They employed a young person to just make phone calls, really. Um, so all different youth services and programs across Australia, just asking if they'd be willing to do some of the on the ground work, promoting the study.

[00:14:16] Mm-hmm. Um, so in the end for SSASH eight, we heard from 4,396 young people, all of whom were aged between 14 and 18 years. All states and territories, although we struggle and have always struggled to reach young people in the Northern Territory. I think there's a number of reasons for that. There are other surveys that happen specifically within the territory and there's just fewer sort of channels and services through which we work in that, in that space.

[00:14:45] Among that 4,396 group of young people, um, the average age was 17, so a little bit older, which I think reflects the, um, algorithm and also restrictions in social media. They actually weren't allowing us to advertise to people under 16. So we were primarily reaching an older age group online.

[00:15:02] We allow young people to define gender in their own terms. So the options are, woman, man or male, female, and then trans and non-binary. And then there's an option to define gender in other terms, um, people self define. So whether or not someone has trans experience, if they identify as a woman, that's the category that we use those data in.

[00:15:23] So there were 7% of young people who identified as trans, um, which is using that umbrella, trans, non-binary and gender diverse term. They young people for whom that's their gender identity and their preferred gender identity for the survey. So with that in mind, there were 61% young women, 32% young men and 7% trans young people.

[00:15:46] Uh, one in four was from culturally and linguistically diverse backgrounds, which we defined as speaking another, uh, language other than English in the home or having been born overseas in a non-English speaking country. So it's a slightly complicated definition, but, but that's a standard definition that's used for quite a lot of studies.

[00:16:06] Winnie Adamson: Mm-hmm.

[00:16:07] Jennifer Power: Um, and about 3% identified as First Nations, and we had about 44% who identified as lesbian, gay, bi, or queer. Um, which I think is probably an overrepresentation, no, there aren't a lot of sort of national data sets to compare this to, but it's probably a slightly higher representation of queer young people than, than what we see in other studies.

[00:16:32] Yeah. That long long answer to that first question.

[00:16:36] No,

[00:16:36] Winnie Adamson: that's great. I think it's really important that we actually really get this foundational understanding of the survey and how you are reaching those, those demographics and where people are coming from.

[00:16:47] Um, and I understand that element of digital landscapes is evolving so quick and fast. It's challenging. So, it's great to hear how many people responded.

[00:17:01]  Um, I think the way we feel about, uh, sex and relationships, of course, has changed over time for all of us, and it's an ever evolving relationship that we do have with ourselves and with other people. And the dynamics of relationships, of course, are changing over time too, and especially when we're thinking about the evolving social climates and young people and how they're growing up, you know?

[00:17:24] Um, Can you talk us through what young people are saying and how they're feeling about sexual practices and relationships?

[00:17:31] Jennifer Power: Yeah. Um, yeah, look, as you say, people's experience of sex, it's so variable and it changes. How someone feels about their sex life or a particular sexual encounter depends on, age, how experience you are, who your partner is, the circumstances, like, there's, there's so many different things that come into play and for us it makes it actually really difficult to ask questions about people's sex lives and, and how they're experiencing sex and relationships.

[00:18:03] And we spend a lot of time, honestly, trying to work out the best way to ask those questions in a ticker box survey. Um, and we do ask some sort of general questions about sexual experiences, but we also ask quite a few questions about the last time people had sex.

[00:18:18] So we, with that in mind, um, of the 4,396 young people who took part in the study around half, um, indicated that they were sexually active. We define sexually active for the purposes of this study as having experienced vaginal, anal or oral sex. That is, we absolutely know that is not how all young people define being sexually active. Um, penetrative sex is not necessarily people's definition of real sex or being sexually active or having had sex by any stretch.

[00:18:53] The reason we use that definition is partly because in this sort of quant research, we do need to create meaningful groups to some extent. It also speaks to the history of this survey where condom use was really central. So over time comparisons. We need a group that is about pen penetrative sex that involves a penis and a condom potentially.

[00:19:15] But also it's most useful way we can capture where people are at in their lives in terms of sexual experience. So 49% was sexually active or had had sexual experiences. The average age at which young people became sexually active was 15.

[00:19:30] So. 15.6 for oral sex, 15.9 for vaginal or anal sex. Um, hasn't changed much over the years. Actually, that's been pretty consistent since the nineties. That age group. When we asked those people, so the people who were sexually active, we then went on to ask them about their most recent sexual encounter.

[00:19:52] For most young people, this was with a steady or an ongoing sexual or romantic partner. For most young people, their partner was around the same age as them or within a few years. There are some exceptions to this, of course, but, generally that's the most common story.

[00:20:08] Most young people describe their most recent sexual encounter as enjoyable. So 80% said they enjoyed it very much, um, and 80% said they felt safe in that sexual encounter. And I always find it's important to lead with that because we do tend to fall into the risk and danger narrative. Which is important because that is why we're doing this research to look at, needs to look at where supports are required to look at what young people do or don't, don't know, or where there may be risks or danger.

[00:20:38] But also I think in a study like this, a lot of what we wanna do is understand what's going on with the young people who are having really positive sex and relationship experiences. What is it that supports that? Who are these young people? How do we ensure other young people are able to have positive sexual experiences and positive relationship experiences? The aim here is to actually be supporting people to have those good experiences.

[00:21:04] Um, we asked people how they felt after that sexual encounter and most people said they felt happy or fantastic.

[00:21:13] But it was really common for there to be mixed emotions. So a lot of people said they felt happy but also stressed or fantastic, but also guilty. So guilty and stressed come up quite a lot in terms of the emotions that people feel after having sex. Um, we didn't have capacity in this iteration of the survey to go kind of deeply into why people felt those emotions.

[00:21:37] We did that more in the last survey though, and in 2021, people in open text responses said that often the guilt or the worry was related to, um, parents finding out, worrying about pregnancy, worrying about STIs, but also a lot of people were really worried that about what their partner would think of them after the sex

[00:21:56] So worried that they weren't good enough. Worried they weren't desirable enough, worried their partner wouldn't like them anymore. So there was a lot of sort of worries that intermingled with feeling good and feeling safe and happy, which I think is very normal. It's very common the idea that we can, create a survey that then creates a very neat answer about what young people are experiencing when it comes to sex and relationship.

[00:22:17] It's just false, it's not gonna happen. What these data is sort of telling us is that it, it's complicated and it's complex and there's a variety of things that happen and there isn't really a clear distinction between safe and unsafe or, comfortable, uncomfortable and, we need to be working as much as we can in those complicated spaces, I guess.

[00:22:39] Winnie Adamson: Yeah, definitely. It's a very nuanced area. Um,

[00:22:43] Jennifer Power: yeah,

[00:22:44] Winnie Adamson: and there's a lot of, intersectionality and history that's around that. You know, we're not really taught to embrace our desire so openly. Yeah. Um, and especially when we're so young being taught such complex and different narratives around what we should be doing and what's right.

[00:23:03] Um. I do wanna talk about sexual health more specifically. Obviously you mentioned that condom use has been a big part of the survey and the questions. Um, for us here at Caddyshack and our colleagues at the sexual health clinic, we're really excited to see if there's any new emerging trends or, um, changing in condom use and contraceptive options and especially how young people are engaging with STI testing and screenings.

[00:23:28] And I know that we're seeing a change in behavior around condoms being, more readily available for young people, but they're seeming to be using them less. And as I understand this iteration of the survey, you were gonna give a bit more information and context around these trends.

[00:23:44] So what are these trends around these sexual health practices, knowledge and behaviors?

[00:23:50] Jennifer Power: Uh, yeah. Um, look, we tried to really unpack what's happening. I do think there's probably a need for some good contemporary qualitative work on condoms and STIs and how young people feel about, whether or not it's , acceptable, normal to ask a partner to use a condom and when they wouldn't, wouldn't use a condom.

[00:24:12] I, I do feel like the environment's changed as the environment around HIV has changed and we're more, biomedical prevention, prep and pep and you equals, you, um, are leading the way in terms of HIV prevention rather than condom use. There is a know, effect potentially on young people's attitudes to condoms, but there hasn't been a lot of recent qual research on that.

[00:24:34] So we did ask quite a few questions about condom use, um, generally and in relation to that most recent sexual encounter. So around one in four young people, so about 25, 26 percent said that they always used a condom and just under one in three.

[00:24:52] So about a third said they often did, there was around one in 10 who said they never used a condom. Um, but at their most recent sexual experience, only 50% used a condom. 80% had one available and 50% actually used one. And that's the figure that's changed over time. So since 1992, there's been an increasing, percentage that say they had a condom available at their most recent sexual encounter, but a decreasing number that actually use that condom.

[00:25:21] And there's probably quite a few things in the mix, long-acting reversible contraception has become more widely used, um, certainly since the nineties. Um, and certainly people who were using long-acting reversible contraception or the pill. We're less likely to report a condom use.

[00:25:40] Um, and what we do see in these data is that young people are more likely to see condoms or use condoms for preventing pregnancy than preventing sti. That's not new, but it is useful to have that in the data and be reminded of that.

[00:25:56] of those who didn't use a condom the most recent time they had sex, the reasons why we did ask why, um, for quite a lot of people, they just weren't concerned about STIs, they either didn't see it as relevant to them, they didn't feel at risk or they were in a steady relationship, so they felt safe within that relationship. Um, there's sort of nothing new like those have been the reasons since the nineties, since we started asking these questions that people say they're not using a condom. But I think that's still important to know, actually reiterating that this is still the pattern, that there's not some sort of magical thing that's happened. That means young people are now fully aware of the importance of using condom. Actually, condoms still sit in this funny space around, um, trust risk perception, knowing your partner, um, the decisions all affected by these sort of social factors and the relational factors that are happening in that moment.

[00:26:56] uh, the, the people who were in a relationship were much more likely to have a condom available. So they were sort of more prepared for sex, but less likely to use them. People who were not in a relationship with the person they were having sex with, were more likely to use a condom.

[00:27:11] The one thing that stood out for us , so when we asked these questions about the type of contraception people used in their most recent sexual encounter, people could pick more than one. And there were quite a few people that were on the pill, but also used a condom. Um, there were 30% of people that said they used withdrawal, which is something we noticed last time.

[00:27:29] So that's where you pull the penis out before ejaculation, in order to prevent pregnancy. And there were 30% who used that overall, and one in 10 had used that entirely. So withdrawal was the only contraception method that they used. So that stands out a little bit in terms of quite a few young people using an ineffective contraception method. And maybe not necessarily understanding that it's ineffective.

[00:27:53] Mm. Uh, we asked quite a few questions also about young people's confidence and capacity to access sexual healthcare. And there were mixed responses in that. So only 12% had ever been for an STI screen.

[00:28:06] Most of these were young women so it's probably being offered when people go for the pill or, or LARK , but it's also possible that young people just didn't feel they needed STI screening. Over 80% told us that they were aware they could ask for an STI test even without symptoms. And only 6% said that they felt they couldn't access STI screening if they needed it so most people felt pretty confident.

[00:28:31] But there are other things that stood out as potential barriers. So even though 80% said they could. access STI screening if they needed it. Only 50% said they knew where to find a doctor for STI testing.

[00:28:45] Um, about 40% said they didn't know how to access free services if they needed it. And about 40% were unaware they could get their own Medicare card prior to 18. So there were these sort of things that acted as barrier to people accessing STI tests.

[00:29:03] I kind of read this as people being pretty confident that they could find a doctor if they needed one, but in the moment they don't necessarily know how and that would make sense, right? People are pretty savvy at at tracking things down if they really need to, but people certainly aren't accessing sexual healthcare in a routine way.

[00:29:21] Um, there were also quite a few people who didn't know that their parents couldn't access their Medicare records after 14. So about 70% of people weren't aware of that. Um, and of the people who did indicate that they had some sort of unmet need when it came to contraception or STI testing or other forms of sexual healthcare, fear of parents finding out was one of those barriers cited or reasons they had this unmet healthcare need.

[00:29:48] So I think a bit of confusion about confidentiality, what services they can access without their parents finding out, particularly if they need to use Medicare. Um, there, there was a little bit of a gap in there.

[00:29:58] And also stigma, you know, 80% said that they felt it would be shameful or embarrassing to have an STI, and 76% said they thought that STI testing was just not something their peer group did. So there's kind of these other potential stigma related barriers to STI testing.

[00:30:17] Um, the one interesting thing that did show up, and I don't quite know how we should report this necessarily, but, , young people living in regional and remote areas of Australia were more likely to have had an STI screen. They were more likely to have spoken to a GP about sex and relationships, and they were more likely to say that they had a GP initiate that conversation about sex and relationships, which kind of goes against what we expected to find. We hear a lot about barriers to sexual healthcare in rural and regional areas.

[00:30:48] So we looked a bit more closely at that. We had this really, um, big group of young people from rural Western Australia, which we think was, because there was a few, um, teachers and service providers who really promoted the survey, which is awesome. So we thought, oh, maybe they're the ones that are bringing up this average 'cause they're, they're already engaged with these service providers. So we took them out of the mix and that pattern sustained.

[00:31:11] Um, I looked around at other studies to see if people had found that, and there was just a little bit that showed in rural healthcare, they do tend to adopt an integrated model a little bit more readily, particularly in aboriginal community controlled health services.

[00:31:27] So that integrated model is where there might be a variety of healthcare providers in the one practice. Um, also the national STI guidelines for rural and Regional Healthcare suggest offering STI testing as part of routine GP consultation. So maybe that sort of combination of integrated care and the regional guidelines are actually showing in these data, which I don't think obviates the significance of barriers to sexual healthcare for young people in regional and rural areas. But it's an interesting finding.

[00:31:57] Winnie Adamson: Yeah, that's really interesting. It does go against what we would kind of expect.

[00:32:03] Jennifer Power: Yeah.

[00:32:03] Winnie Adamson: Um, thanks for sharing that data. That's gonna be really valuable for us and reaching those young people. That's really interesting to hear about some of those statistics there and the knowledge around those services and STI testings more specifically.

[00:32:21] In our last episode, we talked with Dr. Giselle Woodley and Dr. Sarah Vrankovich about how young people are increasingly learning about sex and relationships in online and digital spaces. And we chatted about the role that digital landscapes play in relationships and sexuality education, also called RSE, and how we balance the realities of spaces exposing young people to harmful and accurate information, but also being powerful spaces for learning peer support and accessing sexual health.

[00:32:49] Um, and as digital landscapes are evolving so fast, it's important that we do really understand how young people truly feel about these topics so we can actually meet them where they're at. So how are young people, um, engaging with digital sexual practice? Or what are these sexual practices in that digital space?

[00:33:10] Jennifer Power: Um, it, it's such an interesting space and one of the things I get asked a lot what's changed over time in this survey, and the most profound changes over time, and not necessarily the answers to the questions that we ask, but the questions that we ask.

[00:33:27] because the questions that we ask in this survey reflect the changes in the world over time. They reflect what's changed politically, what's come into view that wasn't in view 10 years ago, um, and fundamentally reflects the internet, the rise of the internet. So what we've captured in this survey since 1992 is the profound changes that have happened because of digital media and the ways in which digital media is now so integrated into people's sex lives and their relationship lives.

[00:33:57] Having said that, we didn't include a huge amount about that in this iteration of the survey. Partly 'cause we need to not make this an hour long survey. So we, we tried really hard to make this a 15 minute survey.

[00:34:08] Um, and given there has been such a, significant amount of work done by other researchers, you know, we didn't feel like we needed to include a huge amount, but we certainly did ask people about digital sexual engagement. Um, around half the young people in our study had done some sort of sexting. No one uses that word, but it's a researcher word, but sending a nude or sexual image to someone. In most cases that was with someone they were in a relationship with. Um, around half received a nude sexual image they did not ask for or consent to so a sort of non requested dick pick, for example, um, more concerningly, 13% said that they had had a nude or sexual image of themself shared without their consent. So there was certainly those, non-consensual, image-based abuse experiences happening out there.

[00:35:00] Um, most young people have looked at online porn, and these are figures I think we will be asked about quite a lot. We asked people the average age at which they first, um, did , did sexual practices. Um, and we asked at the average age, they first came across pornography online, unintentionally, and then intentionally. So the average age young people told us they first saw porn unintentionally was 11 and intentionally was 13. So quite young. Um, I think, you know, we know that we've all known that, but it is useful to have data that that speaks to that, and that really does speak to the need to start having these conversations in RSE in primary school, which I think is starting to happen a little bit

[00:35:44] um, but you know, as Sarah and Giselle spoke about, the digital environment is a really important place young people go to, to learn about sex and relationships, and that was very much reflected in these data.

[00:35:54] Um, and it isn't just young people going to look up a government funded website on STI symptoms, like what young people are going online to do is talk about their relationships, find people with similar experiences, understand their emotions, understand what's going on for them. That's from previous studies, not necessarily what we picked up in this, but I think , um, responses reflect that it's online forums, it's wanting to learn about sex that, that people go to.

[00:36:24] Winnie Adamson: It's, that is interesting and having that data from 1992 would really show that evolving of digital spaces and how we're all shifting in the workforce as well to use those digital spaces.

[00:36:39] Um, what are the experiences of sexual violence or coercion and attitudes to consent in the data? I think this is really valuable and important data to collect and especially when we're thinking about comprehensive RSE initiatives as primary prevention against gender-based and sexual violence.

[00:36:59] And we know there have been recent changes to the curriculum in 2022 to cover respectful relationships, digital consent, coercion and power imbalances, and moving beyond simply just say no and teaching that affirmative consent model and bodily autonomy, nonverbal communication. We are seeing a lot of conversations around the rise of misogyny young men and the views and beliefs adolescent men have about women.

[00:37:25] And recent research by the University of Melbourne did find that a third of teenage boys aged 13 to 17 agreed with these misogynistic attitudes. What is the data showing us here around this topic?

[00:37:39] Jennifer Power: Yeah. Um, we spent quite a lot of our questionnaire real estate. Like we asked quite a few questions about, um, intimate partner violence and unwanted sexual experiences.

[00:37:51] We've also got some data on, attitudes to gender roles in relationships.

[00:37:56] Winnie Adamson: Mm-hmm.

[00:37:56] Jennifer Power: Um, partly because there's surprisingly little data out there for young people on these experiences, particularly intimate partner violence. There's very little, virtually none for young people under 16. Most of the research on relationships or intimate partner violence starts at 16 or 18. So it felt like it was important for us to try and collect some of these data. Um, it's the data that gets reported most from this survey is actually related to unwanted sex. And so we, we wanted to do it really carefully and make sure it's presented really carefully.

[00:38:33] Um, what we did find, so, we asked young people if they'd ever been in a relationship, sexual or romantic relationship for more than three months. That was kind of the definition of a relationship. Again, that's tricky because, you know, a relationship for anyone but especially young people might be six weeks, but we needed a cutoff point. Um, so around 60% have been in a relationship may or may not have been sexual, um, but a romantic or sexual relationship. Of these, 37%, had an experience of being frightened by someone they were in a relationship with.

[00:39:10] Winnie Adamson: Mm-hmm.

[00:39:10] Jennifer Power: So that about 23% of the sample as a whole.

[00:39:14] 44% of those who've been in a relationship had experienced verbal abuse within a relationship. So being called names insulted, shamed, um, that's 27% of the entire sample.

[00:39:26] 31% so one in three had experienced some form of technology facilitated harassment or tracking by a partner. So it's about 20% of the entire sample.

[00:39:37] Um, and 18% reported some experience of physical violence such as being hit, pushed, or shoved or grabbed by a partner. So that was 11% of the sample as a whole, and then 2.6% reported being forced to have sex by a partner. So it's about 1% of the whole sample.

[00:39:56] And as you might expect, young women and trans young people were significantly more likely than young men to report having had these experiences. Um, this isn't a population based sample, so because of the way we recruit the, the data, we, it's an opt-in survey.

[00:40:14] We advertise online, we use, flyers and things. We can't claim that this is a sample that reflects the population. Um, in order to do that, you need to use a randomization process so that everyone in the population has an equal chance of being involved in the sample. So we don't claim this to be a population based data set or a representative sample.

[00:40:36] So we did look at these figures against other studies where they do have this representative sample, so where they use randomization to recruit people to the study. Um, and one of those studies is The Longitudinal Study of Australian Children (LSAC), it's a nationally representative study that's followed about 10,000 young kids in Australia since they're about four years old.

[00:40:58] Um, those young people are now in their twenties. So in 2018 they did a survey of the young people who were 18 to 19 at that point and did ask if they had a relationship and if they'd experienced any form of intimate partner violence within that relationship within 12 months prior to the survey was the kind of criteria they used, and they found that 25% had experienced emotional abuse within a relationship.

[00:41:24] 12% had experienced physical violence and 8% had experienced sexual abuse within their relationship. And that's just in the last 12 months. Another population based study, which was the Australian Child Maltreatment Study, which was a big study of, um, people of all ages, but they have a 16 to 24 age group.

[00:41:40] About 40% had experienced psychological violence in a relationship ever, not just in the last 12 months. That one in four had experienced physical violence, and about 18% had experienced sexual violence. So our figures are very much in line, in fact, a tiny bit lower in some cases than other population based studies.

[00:41:59] So I feel like we aren't over representing young people's experiences of intimate partner violence and that these are important findings because programs, primary prevention of sexual and gender-based violence isn't necessarily reaching 14 year olds. But there's a really important opportunity because of what you said before, Winnie around, um, the, introduction, reintroduction expansion of consent and respectful relationships, education in schools.

[00:42:27] So, um we also asked questions about unwanted sex that was more nuanced. So we asked, have you ever experienced sex including oral sex when you did not want it?

[00:42:38] Winnie Adamson: Mm-hmm.

[00:42:39] Jennifer Power: And then there was a range of circumstances that people could point to. So 21% had experienced sex that they did not want.

[00:42:47] Um, for about 13% of these young people that was because they wanted to keep the peace, they didn't wanna upset their partner. Another 12% said they didn't wanna hurt their partner's feelings. Another 12% said it was because someone kept asking and they eventually relented. 6% said they were too intoxicated to consent. 6% said they were physically forced and 2% were threatened.

[00:43:11] So, um, that answer I think we need to report really carefully as well because it is speaking to the complexity of consent, the challenge, um, for all of us. But particularly young people with more limited experience, creating boundaries in a relationship, what it feels like to say no, even though you, you love someone and care for them, but you don't wanna have sex and why that might be hard. And then what that means for consent and non-consent.

[00:43:38] I think, unwanted sex is really complicated and hopefully data like this helps us to unpack some of those nuance in a way that will be helpful for education.

[00:43:48] Winnie Adamson: Yeah. It is valuable and that data really does support the fact that we do need whole of school and whole of community approaches and early intervention when we are thinking about these young people and how they navigate sex and relationships.

[00:44:06] Jennifer Power: Yeah. Is.

[00:44:07] Winnie Adamson: As you're saying, that is hard to get that data on people who are that age so that whole community approach is really important.

[00:44:15] So I do wanna talk about how, young people are talking about sex. I know those who are joining us today will be quite interested to know, how are young people talking about sex with their partners, with their friends, their family? Has this changed at all?

[00:44:29] Jennifer Power: Um, hasn't necessarily changed actually. We asked quite a few questions about sexual communication because communication is so central to safe sex and to seeking help , and to learning. So we wanted to know more about who young people are talking to, um, what they're talking about, what messages they're hearing.

[00:44:52]  . Um, we found that as you might expect, friends are the group of people, the source of information, the sounding board that young people are most likely to go to, to turn to, to talk to. Um, either have had those conversations about sex and relationships with their friends, or they're the ones they would intend to have those conversations with. That hasn't changed over time. It makes sense, I'm sure to all of us that friends are the preferred source.

[00:45:19] Um, young people were also quite willing to talk to gps. Um, that didn't necessarily mean they had done, but they did feel like they could do and were confident that they could raise a conversation about sex or relationships with the GP if they needed.

[00:45:33] About one in three had spoken to their parents about sex or relationships. And I never quite know, I haven't quite worked out how to talk about that because to me, on one level, one in three, having had a conversation with a parent about sex feels good.

[00:45:49] Like, yeah, that's quite a lot, but equally, that's also two in three that haven't yeah, I haven't quite landed the narrative on that one yet, but either way, parents are featuring in that list. So people are up for speaking to their parents.

[00:46:05] The internet is on that list, although that comes underneath in real life people. So friends, parents, doctors come above people who are online. That may be to do with how we asked the question. We did use the term internet forums, like chat forums , that may not have been the language that captures, where people are going online, but we were sort of trying to tap into people who did go to Reddit forums or have conversations with people, that they only know in online spaces about sex and relationships.

[00:46:36] Um, we asked quite a few questions about the messages young people are getting from their parents. Just, you know, what, what are the messages they're left with? And as you might imagine, a lot of people are talking with their parents about, well, one in three people are talking with their parents about sex and relationships.

[00:46:49] Some people are getting really open inclusive information, other people are getting really reductive, don't have sex information. Um, other people are getting the basic just stay safe kind of information. Um, and this, I think, does speak to the core thing that comes up again and again in this study is that young people wanna learn about sex.

[00:47:10] They want to have conversations with other people, including other adults, whether that's doctors, educators, or parents, about what's going on for them when it comes to relationships and sex. They wanna learn what sex is gonna be like, what it's gonna feel like, how they initiate it, what to do. But having those conversations is really difficult.

[00:47:30] Um, particularly with adults. I'm sure people have better conversations with their friends about this stuff, but, adults are awkward. Um, this includes teachers in schools as well as parents. They don't know what to say. They fall back on, narrow risk-based, you know, just don't do it kind of narratives.

[00:47:49] Mm. There's very few avenues where young people are finding open, honest, relaxed conversations about sex. Um, I think that's universal. I don't think that's new, but I do think that we see this repeatedly in these findings. Um, what young people are looking for when it comes to learning about sex and relationships is not what they're getting.

[00:48:09] Winnie Adamson: Mm-hmm.

[00:48:11] What about, um, young people's experiences of school-based education?

[00:48:15] Jennifer Power: Yeah, so we asked quite a few questions about RSE and there's a few things I think that stand out.

[00:48:21] The finding that we have consistently received in this study since we started asking about RSE, which was in the early two thousands, is that most young people have received RSE um, but that less than half find it relevant to their needs or to their lives. Um, we have some data in this that I think unpacks that a little bit and there's, there's lots of reasons why young people might find it not relevant.

[00:48:45] Um, for some young people it happen too early, like what was being taught was so far removed from where they were at in their lives. Other young people found it too late. They'd already had sex they knew this they needed it years before. So there was a timing issue for a lot of young people. A lot of young people just thought the education that they received in schools wasn't open enough. It wasn't direct enough, it wasn't broad enough, it wasn't inclusive enough. Um, the teachers were awkward or uncomfortable or didn't seem like they wanted to be there, or didn't seem like they knew what they were talking about.

[00:49:20] Um, but fundamentally is that young people thought they would learn about sex in sex education and they really didn't learn about sex. They, they wanna learn, what to expect, What is this? Like, you know, what, what should I do? How do I have conversations about this? How do I initiate sex? you know, everyone here would know is so important to conversations about consent, um, and understanding desire and understanding what you do want and how you articulate what you do want, because you need to do that to say what you don't want.

[00:49:47] Like, that's so important. But it seems like that's not happening in RSE. The one thing that I did notice in this survey, it's a little unclear how we separate what's happening in relationships and sexuality education compared to respectful relationships, compared to consent education.

[00:50:05] they're a little bit merged, I suspect, within the schools, when we ask people about RSE, I think we're sort of getting it all kind of in the mix, but I couldn't tell you necessarily from these data what's changed because of the introduction of mandatory consent education in 2022.

[00:50:20] And I think that would be worth exploring in future iterations of SSASH because I, I do think things will change. In this survey, we asked people what topics they'd learned about, and 90% had learned about t and reproduction, which is, you know, the topic you learn about first in, uh, any sort of relationships and sexuality education.

[00:50:43] But the next most common topic, around 82%, had said that they'd learned about consent. It's certainly being picked up. I do think consent and respectful relationships and healthy relationships are part of what young people are learning. I don't have a sense from these data what's changed because of mandatory consent education, but I get a sense that things are changing and it would be useful to, to follow that up.

[00:51:06] Winnie Adamson: Yeah, that's really interesting and a good thing to think about. Um. I'd really like to hear a bit more about the diverse experiences of young people. At Caddyshack Project we work with priority populations, including Aboriginal and Torres Strait Islander communities. Those with culturally and linguistically diverse backgrounds, people who identify with sexuality or gender diverse communities, and often in sexual health research, I think these priority populations can be underrepresented.

[00:51:36] Um, there can be a lack of attention to the cultural and political issues and inequalities that affect the communities, their experiences of sex, relationships, and sexual health. And we know these barriers and challenges include racism, homophobia, transphobia, and stigma, and have huge impacts on people's sexual health.

[00:51:53] So I know you've shared a bit already, but was there any more data specifically in diverse experiences.

[00:52:00] Jennifer Power: Yeah. Um, yes. Firstly I would like to direct people's attention to the GOANA study, which is a study of young people age 16 to 29, from First Nations community. So it's a sexual health study of First Nations young people, um, which is the best source of data for that population group and those communities when it comes to sexual health.

[00:52:25] Um, and there is some crossover. So some of the questions we have in SSASH are also in the GONA study. We do, um, obviously have data from First Nations young people in SSASH, but this is not a, first Nations led study and we're really mindful of that.

[00:52:41] We do invite First Nations researchers who are interested in this space, who might be interested in leading some analysis to get in touch. 'cause we can make those data available. We can work with you to do some analysis to present those data, but GOANA is also doing it. So that would be my first point of call for more information on First Nations young people and sexual health.

[00:53:02] Um, when it comes to culturally and linguistically diverse communities, this is a really tricky one to ask because one in four of our participants in this study were culturally and linguistically diverse by that definition I spoke about before. So speak a language other than English as their first language at home, or were born in a non-English speaking country. Um, but equally there's a huge amount of diversity across that group and it's, you know, we don't wanna presume that a young person. From Southeast Asia has the same experience as a young person whose family migrated 10 years ago from a country in the Middle East or, or whatever the, the differences are there, there's just a lot of diversity there.

[00:53:41] And so we, we want to, provide data that is meaningful in terms of showing the impact of racism and structural barriers and inequalities while also sort of not being reductive, um, or narrow in those findings. And it's just, it's, it's a perpetual challenge with this work. And we're also really careful to present a strength face narrative, which can be hard when there's comparisons like we tend to do, um, we compare person from a culturally linguistically diverse background with the Australian born white person, and vulnerabilities often get presented as deficit. So if this sort of constant reflective. Careful presentation of the data when it comes to that, which sounds like, I'm trying to avoid the question, but it's sort of, I guess, trying to speak to wanting to do a good job with the data and tell a story that doesn't perpetuating inequalities and stigma and racism essentially.

[00:54:42] Um, so what we did was present a separate chapter in the report on young people from culturally and linguistically diverse backgrounds. That was, for the most part, descriptive with a little bit of, pointing out where the findings were different to the sample as a whole. And there were a few differences, although not a huge amount.

[00:55:00]  So we found young people from culturally and linguistically diverse backgrounds were less likely to be sexually active than we found in the sample as a whole and a little bit less likely to have spoken to people about sex and relationships. So there was, you know, generally less, confidence or comfort speaking to parents in particular about sex and relationships within young people from those communities.

[00:55:25] Um, but we weren't necessarily seeing big differences in terms of accessing sexual healthcare services or some of those other, areas where we might really see the impact of structural racism. Um, we will come back to those data as we present more, certainly in the different presentations that we do.

[00:55:44] But, but yeah, for now, those are the standout findings for that group. Um, when it comes to lesbian, gay, bi queer, young people and also trans and gender diverse young people. Um, because we have such a big group, it's a little bit easier to speak to those experiences and, you know, we really did find that young people who are queer or trans had some quite unique strengths compared to the group as a whole, as well as some challenges.

[00:56:11]  we looked at sexuality and gender separately. So when I say LGBQ and trans, it's sort of speaking to those two different groupings We did find that queer people and trans we're much more aware of STIs, much more likely to attend sexual health screening.

[00:56:26] Had a sort of greater grasp on sexual health and STI prevention more generally, which I do think we find quite often within queer community. I guess because of the HIV history, there is, um, more education touchpoint, and community-based knowledge than what we see, I think in the general population.

[00:56:45] And that's definitely evident often in these surveys with young people. But we also certainly saw some barriers to accessing healthcare, um, and, and accessing education and support. So queer young people were less comfortable talking to their parents often about sex and relationships than heterosexual young people were.

[00:57:04] LGBTQ plus young people were less likely to find RSE relevant than heterosexual young people. Something that we have long found, like that's not a new finding in these data, although we didn't necessarily find trans young people saying the same thing, which is interesting and a bit of a change.

[00:57:21] Pansexual and bisexual young people were more likely to report an unmet sexual health need than heterosexual young people were. Um. Which we haven't said a lot about bi, bi plus young people in this study, but there were quite a few young people identifying as so bi, which includes bi and pan. Um, and we do know that within that group there are often some discrepancies in terms of healthcare access and feeling like sexual health needs are met.

[00:57:50] So that's something we will come back to in our analysis. Um, but also in terms of barriers to healthcare, feeling this fear of being judged or or feeling shamed or embarrassed, were much more commonly cited as barriers to sexual healthcare for LGBQ, young people than heterosexual young people.

[00:58:09] some of that shame and stigma related to sexuality was showing up in these data for that particular group.

[00:58:15] Winnie Adamson: Mm-hmm. Yeah. Thank you for sharing that. Um, it's interesting and important to recognize those diverse experiences and see the data . um, Jen,

[00:58:25] Can you share some final takeaway and key messages to leave the listeners with today?

[00:58:30] Jennifer Power: Look, This is always hard and I, I was saying before I wish there were some you know, standout amazing unfound out before finding that we could share. But actually in some ways nothing in here is unexpected. It is a little bit business as usual, but I think that's really important because we're showing that there is this ongoing need to improve RSE to improve the way we talk to young people about sex and relationships and that young people are wanting this and needing it.

[00:58:57] So some of the standout findings obviously relate to digital sexual experiences. Young people are online, they are looking at porn, they are sexting. We need to make this part of the conversation in ways that are meaningful, and speak to young people's experiences.

[00:59:13] Um, access to sexual healthcare I think is showing up as an area where there is need. And we do need to do things like talk about Medicare, talk about how to access services, particularly in this environment where there's such limited, access to bulk billing services. Like cost is a big issue, I think, when it comes to sexual healthcare for young people and will continue to be.

[00:59:33] But also I think, you know, it is important to come back to that finding I highlighted before that a lot of young people are finding their sexual experiences to be, safe and enjoyable, and that that's important and we need to maintain this message that, sex isn't inherently bad for young people as long as they're safe. Um, respected and supported.

[00:59:52] And that is fundamentally what we're trying to do here. But that isn't the case for all young people. And we are certainly seeing in this data that young people are experiencing sex that is unsafe and uncomfortable, and we need to talk more about that as well and make sure primary prevention services are, targeting younger adolescents.

[01:00:11] Winnie Adamson: Thanks for listening to On The Couch. We create this podcast because we're allies in actively challenging discrimination, microaggressions, and exclusionary behaviors.

[01:00:36] Maddy Stratten: We wanna create spaces where people feel safe to share their thoughts, knowing that they will be heard and respected. Such an environment fosters collaboration, innovation, and contributes to a more inclusive society.

[01:00:48] Winnie Adamson: Follow us on your favorite podcast platform. That way, you will receive every new episode when it's released. You can also help us grow the podcast by giving us a rating and leaving us a review.

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[01:01:05]Winnie Adamson: On The Couch is made by the team at Caddyshack Project. Until next time, peace, love, and protection.