At the International Conference on Sexuality in Kunming, China, HIV/AIDS activist Humphrey Wou attended a panel on sex education, hoping to learn about the textbooks used to teach Chinese students about sex. He remembered one presenter reading aloud from a book that had been widely used in high school classrooms in the city of Hangzhou for years: “Masturbation will lead to mental disorders and homosexuality,” he said.
Wou, who had been in the region for months providing rapid HIV testing to gay men, was not surprised. In a country where sex and sexuality remain taboo topics of discussion, such misinformation remains common. In fact, out of ninety Chinese science, psychology, and sex-education textbooks surveyed by the Gay and Lesbian Campus Association, a Guangzhou-based student advocacy group, 80 percent characterized homosexuality as psychologically aberrant. Although homosexuality was removed from the official list of mental disorders in 2001, LGBT people in China have few legal protections against discrimination and still face widespread social disapproval and harassment.
“Traditional values have come back in a big way over the past decade,” Wou said. “The government is very old-fashioned and refuses to adapt to modern times. Students are reading Confucius in the classroom and then having unprotected sex at hourly lodging hotels just outside of the college gates.”
China lacks a unified, national sex-education policy, which means the quality of sex education varies dramatically across the country. Sex education—or “puberty education,” as the Chinese government calls it—is optional in many schools. Even when it is offered, students are limited to learning about the biological differences between boys and girls, basic anatomy, and family-planning practices. The curriculum does not explore the social and emotional dimension of sex and sexuality, essential for entering into mature sexual relationships.
“When it comes to sex-education, most people only consider three categories: anatomy, disease/infection, and condom use,” Wou said. “It made me think, if I were teaching a student how to drive, would I only open the hood, show them pictures of car wrecks, and teach them how to operate the pedals?”
While all students suffer from the system’s deep inadequacies, no group is as underserved by China’s sex-education system than LGBT people. According to China’s Ministry of Health, in 2006 men who have sex with men accounted for 2.5 percent of new HIV cases; by 2013, that number had jumped to 20 percent. While the increase can in part be attributed to heightened awareness about HIV/AIDS and better access to testing, gay men continue to be disproportionately affected. In response to the surge in infection rates, the Ministry of Health announced in 2008 that gay men would be specifically targeted for HIV/AIDS prevention programs. Syphilis and HPV are on the rise, too.
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Having lost many friends and his partner to AIDS, Wou decided to take action, founding the AIDS Relief Fund for China (ARFC) in 2003. Dedicated to honoring the lives lost to the disease, ARFC relies on donations to provide HIV prevention and care services to LGBT people in China and gives small grants to local groups like the Parents and Friends of Lesbians and Gays chapter in Guangzhou. The organization also sponsors multi-year initiatives like Heart Talk, a support group that encourages gay men to examine issues of identity, sex and love, and social pressure. Founded in 2008, the program has spread to more than thirty cities in the country.
Wou has recently shifted his attention to youth, reasoning that early outreach offers the best chance of arming people with the reproductive-health information they need. In 2013, he created Youth Decoding, which uses storytelling and audience participation to engage students—LGBT and straight alike—in thinking and talking about sex.
“Youth Decoding focuses on prevention, instead of the aftermath,” he said. “If a person only spends time working on HIV/AIDS, it always feels like something is already broken and we are just trying to stuff our fingers into a leaking dam. We need to first figure out the problems upstream like sex education before we can see big changes downstream.”
Abandoning the lecture format that is standard in Chinese schools, Wou conducts small seminars. Students participate in four workshops over six months—according to Wou, spreading the lessons out helps the information sink in. Youth Decoding is divided into two programs, one targeted toward gay men and another for straight men and women. For gay men, rapid HIV testing is mandatory in the first and final sessions.
At the beginning of a typical session, students are divided into two groups, each presented with a different version of the same narrative, many of which are evocative of popular Chinese soap operas. The groups are then asked to describe the characters and their attitudes toward sex. The stories serve as jumping-off points for participants to examine their own sexual behavior and to reinforce safe-sex practices.
In one example, Wou has one group of students read about a young gay man named Bailey. The other is given a story about the people who have sex with him. Bailey, a military student, wants to make his parents proud and is deeply ashamed of his attraction to his male classmates. One night, he goes to a gay bar, where an older officer from his military school invites him home. Bailey accepts. During sex, the officer is rough and forcefully enters Bailey. He bites his lips and muffles a cry. Bailey does not talk about his first time to anyone.
Wou presses students to consider various questions: What conditions create imbalanced power dynamics? Do you think their sex was consensual? Consent is one of the most contested topics in the program. “The concept of consent does not exist in China yet,” Wou says. “Most students are resistant to the idea or have never heard it. Students get into very heated arguments over whether it is necessary to ask for consent at every stage of sexual activity. We need to teach them how to be respectful and rational in the heat of the moment.”
A space for gay men to safely question sexuality and sexual health is rare in China. According to Wou, many find this environment of open expression to be highly addictive and linger long after the seminar comes to a close. Youth Decoding not only gives students the knowledge to protect themselves physically, but also addresses the impact sex can have on a persons’ emotional well-being. The workshops are often moving for participants. After discussing whether Bailey’s night with the Sergeant could be considered rape, Wou remembers one session where he asked participants to raise their hands if they, too, had had a similar experience. Hands shot up around the room.
In 2014, Wou led twenty training sessions at colleges and LGBT NGOs in cities like Nanjing, Fuzhou, and Shanghai. Although ARFC has yet to implement a lesbian or transgender version of the workshop, the program has proved to be popular with all who exist under the LGBT umbrella. If demand persists, Wou plans to retune the program to address the needs of those communities. He hopes that in the next five years, 15 percent of Chinese LGBT organizations will have adopted Youth Decoding as the sex-education program.
It is difficult to measure the success of a program that is so new. Wou can’t observe what happens behind bedroom walls, but he was witnessed a shift in some sexual-health practices. Flossing, for example, which can reduce the risk of oral HPV infections and gingivitis (gum disease ups your chances of being exposed to STIs during oral sex), is not a traditional Chinese health practice. Seeing students pulling out floss at lunchtime after a session of Youth Decoding is a small victory.
