Development of Sex Education in China

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 90571

Special Issue Editors

Vanke School of Public Health, Tsinghua University, 30 Shuangqing Road, Haidian District, Beijing 100084, China
Interests: global health and governance; maternal and child health; sexual and reproductive health; social determinants of health

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Guest Editor
United Nations Population Fund (UNFPA) Representative to China, Liverpool, UK

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Guest Editor
UNESCO Office Beijing, Beijing, China
Interests: sex education

Special Issue Information

Dear Colleagues,

As Chinese adolescents are becoming more sexually liberal and active, increasing social attention has been paid to their sexual and reproductive health and rights. Sexuality education, as an important means to bridge the knowledge and attitude gaps of human sexuality among Chinese children and adolescents while protecting their rights, has increasingly become critical and urgent. Sexuality education can help adolescents and children to acquire knowledge, skills, and motivation to make healthy decisions and life choices. Over the past few decades, multiple efforts have been made by diverse stakeholders to deliver sexuality education, with varying degrees of success and challenges. However, there still remain major policy, operational, and social–cultural bottlenecks which prevent children and adolescents from accessing high-quality sexuality education in China.

To develop this evolving field of sexuality education, the primary focuses of this Special Issue are:

  • The social background and current situation of sexuality education in China;
  • The progress of sexuality education from theoretical perspectives;
  • The advancement of sexuality education practices in China;
  • The effectiveness of related sexuality education interventions;
  • The influential factors affecting the implementation of sexuality education;
  • The improvement of sexuality education policies;
  • The comparison of the different approaches of sexuality education;
  • Volunteer management of sex education (participation of voluntary organizations in sexuality education);
  • The transformative power of the notions of gender and rights as important components of CSE.

This Special Issue aims to showcase and summarize the frontiers in the development of sexuality education in China. We cordially invite papers that address the relevant critical research topics regarding sexuality education in China from different professional fields, including but not limited to education, cultural and media studies, sociology, psychology, and public health.

Dr. Kun Tang
Dr. Justine Coulson
Dr. Hongyan Li
Guest Editors

Manuscript Submission Information

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Keywords

  • sexuality education
  • adolescents and children
  • china
  • comprehensive sexuality education
  • sexual knowledge
  • sexual behavior
  • sexual attitude
  • puberty health
  • hiv/aids prevention
  • sexual risk
  • sexual and reproductive health
  • gender equality

Published Papers (12 papers)

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13 pages, 248 KiB  
Article
Secondary Education and Class Stratification: Understanding the Hierarchy of Sexuality Education in a Chinese Vocational High School
by Chong Liu
Children 2022, 9(10), 1524; https://doi.org/10.3390/children9101524 - 5 Oct 2022
Cited by 2 | Viewed by 2495
Abstract
The discussion of sexuality education has a long history in China since the onset of modernisation in the early 20th century. Sexuality education has also existed in China’s educational system for a long time but in various forms. However, the discussions regarding students’ [...] Read more.
The discussion of sexuality education has a long history in China since the onset of modernisation in the early 20th century. Sexuality education has also existed in China’s educational system for a long time but in various forms. However, the discussions regarding students’ experiences and the influence of social stratification in China’s particular social context are still limited. From March to September 2019, the author visited an academic high school (pugao) and a vocational high school (zhigao) in Tianjin, China, to gain first-hand data to understand young people’s sexuality education experiences. In this paper, the author specifically paid attention to China’s social class, a rarely discussed topic in China’s society. She also tried to listen to the voices of young people and schoolteachers and help them to be heard. By presenting the insights from schoolteachers, students, as well as the materials from a nationally approved textbook, the author conducted a thematic analysis about how social class influences young people’s sexuality education experiences in secondary education in China. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
16 pages, 2635 KiB  
Article
Promoting Sexuality Education for Children and Adolescents on a Large Scale: Program Design, Organizational Cooperation Network and Administrative Mobilization
by Huina Dong and Hongyan Li
Children 2022, 9(10), 1474; https://doi.org/10.3390/children9101474 - 27 Sep 2022
Cited by 3 | Viewed by 1732
Abstract
In China, the promotion of sexuality education for children and adolescents is hindered by a relatively conservative culture and insufficient drive from the government. With the government and the market failing to deliver in this area, social organizations, such as the third sector, [...] Read more.
In China, the promotion of sexuality education for children and adolescents is hindered by a relatively conservative culture and insufficient drive from the government. With the government and the market failing to deliver in this area, social organizations, such as the third sector, are playing an important role. This paper mainly discusses how Chinese social organizations promote sexuality education for children and adolescents on a large scale. This paper studied NW, the largest sexuality education support platform in China at present, and 16 frontline implementing organizations in its cooperation network. This research collects empirical data through participatory observation and semi-structured interviews, involving a total of 37 interviewees, plus relevant text data. The study follows the analytical method of process tracking, trying to extract the key mechanisms of how social organizations promote sexuality education from the processes demonstrated by the specific cases. This paper focuses on the key phases of a standardized sexuality education program, from its design to promotion and then to implementation. It is found that, based on the large-scale operation strategy, the operation process of the sexuality education program exhibited three core mechanisms: standardized program design, organizational cooperation network and administrative mobilization. These three mechanisms have become the key force to break through many of the cultural and institutional obstacles and achieve large-scale implementation of sexuality education. Finally, this paper discusses the challenges of operationalizing the sexuality education program, with compromised teaching quality as a major one, and points to the direction for future research. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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10 pages, 269 KiB  
Article
Gender Differences in the Effects of BMI on School Bullying and Victimization in China: Comparing Normal Weight, Underweight and Overweight Secondary School Students
by Yang Xie, Xiying Wang, Xiaotao Wang and Liu Liu
Children 2022, 9(9), 1388; https://doi.org/10.3390/children9091388 - 14 Sep 2022
Cited by 3 | Viewed by 1705
Abstract
Weight-related school bullying and victimization have become important public health issues among adolescents around the world. This study aims to examine gender differences in the effects of Body Mass Index (BMI) on school bullying and victimization among secondary school students. This study conducted [...] Read more.
Weight-related school bullying and victimization have become important public health issues among adolescents around the world. This study aims to examine gender differences in the effects of Body Mass Index (BMI) on school bullying and victimization among secondary school students. This study conducted a survey among 2849 adolescents—1393 girls (48.9%) and 1456 boys (51.1%). The students were between 12 and 18 years of age and were recruited from ten secondary schools in 2019 in Suqian City in China. The study showed that overweight boys were more likely to bully others and be bullied by peers compared to normal weight boys. In contrast, overweight girls reported less bullying than normal-weight girls. No significant relationship was found between overweight and victimization among female students. The implications for comprehensive sexuality education practices are also discussed. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
12 pages, 261 KiB  
Article
Chinese Sexual Minority Students Experiencing Microaggressions: Implications for Sexuality Education
by Diana K. Kwok and Kim Kwok
Children 2022, 9(9), 1331; https://doi.org/10.3390/children9091331 - 1 Sep 2022
Cited by 2 | Viewed by 1915
Abstract
The sexual prejudice faced by sexual minorities or lesbian, gay, bisexual, and questioning/queer (LGBQ) students has been studied extensively around the world in the last two decades; however, it has only recently received attention from Hong Kong Chinese society, specifically in relation to [...] Read more.
The sexual prejudice faced by sexual minorities or lesbian, gay, bisexual, and questioning/queer (LGBQ) students has been studied extensively around the world in the last two decades; however, it has only recently received attention from Hong Kong Chinese society, specifically in relation to this subtle form of prejudice. In the last decade, there has been an increase in the amount of literature examining the experiences of individuals encountering sexual orientation microaggressions, which are defined as discrimination or sexual prejudices manifested in subtle forms, particularly when directed toward socially marginalized groups, such as sexual minority students. The current study used a qualitative descriptive approach and semi-structured interviews to explore the themes of sexual orientation microaggressions experienced by Chinese sexual minority students. Several contextual themes to categorize microaggressions emerged: (1) the approval of heteronormative culture; (2) the use of heterosexist languages; (3) the assumption of sexual abnormality; and (4) the allowing of institutionally endorsed microaggressions. The results suggest that sexual minority students in Hong Kong experience diverse forms of microaggression in schools. The implications for the need to support LGBQ students are discussed, especially in addressing sexuality education in schools and the training of school professionals. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
14 pages, 287 KiB  
Article
Comparing the Perceptions of Gender Norms among Adolescents with Different Sibling Contexts in Shanghai, China
by Chunyan Yu, Xiayun Zuo, Qiguo Lian, Xiangyang Zhong, Yuhang Fang, Chaohua Lou and Xiaowen Tu
Children 2022, 9(9), 1281; https://doi.org/10.3390/children9091281 - 25 Aug 2022
Cited by 1 | Viewed by 1446
Abstract
Individuals’ gender development is influenced by the characteristics of personal and contextual environments. However, the role of sibling contexts in shaping gender norms has rarely been studied among Chinese youth at early adolescence as most of them were the only child. The aim [...] Read more.
Individuals’ gender development is influenced by the characteristics of personal and contextual environments. However, the role of sibling contexts in shaping gender norms has rarely been studied among Chinese youth at early adolescence as most of them were the only child. The aim of this paper is to compare perceived gender norms among adolescents aged 10–14 with different sibling configurations, to help inform and tailor guidance for sexual and reproductive health education in the future. We used the Global Early Adolescent Study baseline data collected from Shanghai, China. The sample for analysis was 1615 students. We used univariate analysis and multivariate ordinal logistic regression to compare perceived gender-stereotyped traits and gender role attitudes, stratified by age and sex. The results showed that sibling context was more influential for boys than girls at early adolescence in their gender socialization process. Among boys those who were with mixed-sex siblings scored higher on gender-stereotyped traits (ORonly-childvs. mixed-sex siblings = 0.67, 95% CI: 0.48–0.94, p = 0.019; ORsame-sex siblingsvs. mixed-sex siblings = 0.59, 95% CI: 0.37–0.96, p = 0.033). Younger early adolescents aged 10–12 who were the only child or who had mixed-sex siblings perceived more traditional gender role attitudes than those living with same-sex siblings (ORonly-childvs. same-sex siblings = 1.71, 95% CI: 1.06–2.75, p = 0.028; ORmixed-sex siblingsvs. same-sex siblings = 1.74, 95% CI: 1.03–2.94, p = 0.037). Comprehensive sexuality education with gender and power components being well addressed, both in and out of the family, is needed to provide extra gender-inclusive and gender-egalitarian environments for youth. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
10 pages, 250 KiB  
Article
Associations of Gender Dissatisfaction with Adolescent Mental Distress and Sexual Victimization
by Qiguo Lian, Xiayun Zuo, Chunyan Yu, Chaohua Lou, Xiaowen Tu and Weijin Zhou
Children 2022, 9(8), 1221; https://doi.org/10.3390/children9081221 - 12 Aug 2022
Cited by 1 | Viewed by 1440
Abstract
Gender dissatisfaction is often linked to adverse health outcomes and is an under-researched area of adolescent health. The aim of our study was to examine the associations of gender dissatisfaction with adolescent mental distress and sexual victimization. We conducted a cross-sectional study in [...] Read more.
Gender dissatisfaction is often linked to adverse health outcomes and is an under-researched area of adolescent health. The aim of our study was to examine the associations of gender dissatisfaction with adolescent mental distress and sexual victimization. We conducted a cross-sectional study in April 2019 using a computerized self-administered questionnaire to collect data on the gender dissatisfaction, mental distress, and sexual victimization among Chinese adolescents. We used multivariate logistic models to estimate sex-stratified adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the associations of gender dissatisfaction with mental distress and sexual victimization. Our study involved 538 female and 556 male students from grades 7 to 11. Among the female students, gender dissatisfaction was significantly associated with depression (AOR, 2.04, 95%CI, 1.17–3.58), anxiety (AOR, 2.13, 95%CI, 2.00–2.27), suicidal ideation (AOR, 2.36, 95%CI, 2.02–2.76), sexting victimization (AOR, 1.67, 95%CI, 1.11–2.51), and nonphysical sexual harassment (AOR, 1.72, 95%CI, 1.08–2.76). Among the male students, gender dissatisfaction was significantly associated with oral-–genital contact (AOR, 5.86, 95%CI, 2.74–12.54), attempted sexual assault (AOR, 9.63, 95%CI, 6.91–13.42), and completed sexual assault (AOR, 14.71, 95%CI, 1.16–187.33). Our findings suggest gender dissatisfaction is associated with adolescent mental distress and sexual victimization, underscoring the importance of implementing comprehensive sexual education with gender perspectives in China. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
11 pages, 664 KiB  
Article
Sexual-Related Knowledge, School and Family Sexuality Education and Its Association with Experience of Sexual Intercourse among Vocational Secondary School Students in China
by Yuhang Fang, Yujia Zheng, Yan Jin, Chunyan Yu, Xiayun Zuo, Qiguo Lian, Chaohua Lou, Lihe Li, Ping Hong and Xiaowen Tu
Children 2022, 9(8), 1206; https://doi.org/10.3390/children9081206 - 11 Aug 2022
Cited by 2 | Viewed by 5924
Abstract
Objectives: To investigate the associations between sexual-related knowledge, access to school and family sexuality education, and the experience of sexual intercourse, in order to make recommendations on sexuality education for vocational secondary school students in China. Methods: A cross-sectional study was conducted among [...] Read more.
Objectives: To investigate the associations between sexual-related knowledge, access to school and family sexuality education, and the experience of sexual intercourse, in order to make recommendations on sexuality education for vocational secondary school students in China. Methods: A cross-sectional study was conducted among 3180 vocational secondary school students in the Shanghai municipality and the Shaanxi province, China. Data were collected through an online, electronic questionnaire, which included socio-demographics, sexual-related knowledge, sources of information, and sexual-related behaviors. Results: The score on sexual-related knowledge among girls (53.8) is higher than that of boys (48.8), and that of participants from Shanghai (55.2) is higher than their counterparts from Shaanxi (47.6). The proportions of girls (70% and 41.7%, respectively) and participants from Shanghai (65% and 35.7%, respectively) who reported acquiring sexual information from their schools/teachers and parents are higher than that of boys (54.3% and 21.0%, respectively) and their counterparts from Shaanxi (59.7% and 27.4%, respectively). About 6% of participants had experienced sexual intercourse and 10% had watched porn actively. Experience of sexual intercourse was associated with higher sexual-related knowledge scores (OR = 1.01, 95% CI: 1.00–1.02) and active porn watching (OR = 2.63, 95% CI: 1.79–3.84) but was not associated with school and family sexuality education. Conclusions: Vocational secondary school students had poor sexual knowledge and inadequate school and family sexuality education. School and family-based comprehensive sexuality education should be promoted among vocational secondary school students. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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9 pages, 567 KiB  
Article
The Influencing Factors of Comprehensive Sexuality Education Capacity and Its Correlation with Subjective Social Status among Chinese Junior High School Students
by Fan Zhu, Guiyin Zhu, Bibo Jia, Pei Wang, Tianjie Zhao, Yinghua Ma and Bin Dong
Children 2022, 9(8), 1201; https://doi.org/10.3390/children9081201 - 10 Aug 2022
Cited by 3 | Viewed by 1955
Abstract
(1) Objective: Evidence suggests that comprehensive sexuality education (CSE) can protect and empower younger generations to advocate for their reproductive health and wellbeing. This survey aims to investigate the current status and influencing factors of CSE among Chinese junior high school students, and [...] Read more.
(1) Objective: Evidence suggests that comprehensive sexuality education (CSE) can protect and empower younger generations to advocate for their reproductive health and wellbeing. This survey aims to investigate the current status and influencing factors of CSE among Chinese junior high school students, and to evaluate its correlation with the learning experience of sex education and subjective social status (SSS) to provide evidence for the implementation of CSE in the future. (2) Methods: A total of 4109 participants aged 11 to 16 years were recruited using data from a cross-sectional survey among junior high school students in China in 2021. CSE knowledge, attitude, and skills were used to generate the CSE comprehensive capacity by a principal component analysis. One-way ANOVA was used to assess the different effects of school sex education and family sex education. Multiple linear regression was used to assess the association between CSE comprehensive capacity and SSS. (3) Results: The average score of CSE comprehensive capacity was 82.44 ± 8.60 (with a total score of 100 points) among participants. After the adjustment, subjective social status was positively related to CSE comprehensive capacity (B = 0.28, 95% CI: 0.20–0.36), and SSS (School) (beta = 0.62) had a higher impact on CSE comprehensive capacity compared to SSS (Family) (beta = −0.10). School sex education was associated with the CSE knowledge level with a larger magnitude compared to family sex education (mean deviation = −0.53, p = 0.031), whereas family sex education was related to the CSE skill level with a greater magnitude (mean deviation =1.14, p = 0.005). (4) Conclusions: These findings suggest that sex education at school and within the family might have a different impact on CSE capacity, which was positively associated with SSS among junior high school students. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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14 pages, 303 KiB  
Article
Does Friend Support Matter? The Association between Gender Role Attitudes and School Bullying among Male Adolescents in China
by Binli Chen, Xiying Wang and Yutong Gao
Children 2022, 9(8), 1139; https://doi.org/10.3390/children9081139 - 29 Jul 2022
Cited by 2 | Viewed by 1734
Abstract
This study investigated the association between gender role attitudes, perceived friend support, and school bullying among male adolescents from 11 schools in two cities in China. A total of 3172 Chinese adolescents between 12 and 20 years of age (48.80% girls and 51.20% [...] Read more.
This study investigated the association between gender role attitudes, perceived friend support, and school bullying among male adolescents from 11 schools in two cities in China. A total of 3172 Chinese adolescents between 12 and 20 years of age (48.80% girls and 51.20% boys) completed questionnaires that included measures of bullying, gender role attitudes, and perceived social support. In terms of outcome measures, the Chinese version of the Illinois Bully Scale (IBS), Attitudes toward Women Scale for Adolescents (AWSA), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess bullying perpetration, gender role attitudes, and perceived friend support, respectively. Based on masculinity theories and the stress-buffering theory, the study found that male adolescents held more traditional gender role attitudes (t = 30.78, p < 0.001) and reported higher prevalence of bullying behaviors (36.02%) than girls (31.20%). In addition, boys’ bullying behaviors were significantly predicted by gender role attitudes through perceived friend support. That is, male youth with more conservative gender role attitudes reported less perceived friend support (adjusted OR = 1.055; SE = 0.013), which elevated their risks of bullying perpetration (adjusted OR = 2.082; SE = 0.302). These findings have critical implications for bullying intervention and prevention through gender equity education. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
13 pages, 576 KiB  
Article
Bullying Perpetration and Homophobic Teasing: Mediation through Gender Role Attitudes
by Yutong Gao, Zhenying Zhang, Binli Chen and Xiying Wang
Children 2022, 9(8), 1127; https://doi.org/10.3390/children9081127 - 28 Jul 2022
Viewed by 2645
Abstract
Homophobic teasing or name-calling, one form of school-related gender-based violence, refers to the use of derogatory language or actions towards sexual- or gender-nonconforming individuals. Research in the Global North has indicated that it is highly prevalent among adolescents, and is associated with a [...] Read more.
Homophobic teasing or name-calling, one form of school-related gender-based violence, refers to the use of derogatory language or actions towards sexual- or gender-nonconforming individuals. Research in the Global North has indicated that it is highly prevalent among adolescents, and is associated with a broad range of negative outcomes for both victims and perpetrators. However, such behaviors remain understudied in China. Using a cross-sectional design, the present study investigated the structural relations between homophobic teasing, bullying perpetration, and gender role attitudes among 1915 Chinese high school students. The results showed that 11.5% of the participants had perpetrated such harassment in the past month. Structural equation analyses revealed that bullying perpetration predicted more teasing involvement, and that the relationship was partially mediated by gender role attitudes among both female and male youth. The moderation effect of sex was found only for the direct effect of bullying; such that males who engaged in bullying were more likely to perpetrate homophobic teasing than females. These findings suggest the need for further examination and effective interventions and preventions for the behavior in Chinese contexts. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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18 pages, 1326 KiB  
Article
Gender Differences in Sex Education in China: A Structural Topic Modeling Analysis Based on Online Knowledge Community Zhihu
by Wen Shi, Yuxuan Lin, Zihan Zhang and Jing Su
Children 2022, 9(5), 615; https://doi.org/10.3390/children9050615 - 26 Apr 2022
Cited by 1 | Viewed by 40864
Abstract
Considering the traditional concept of sex in China’s official discourse and lack of social support system for sex education in China, burgeoning Internet knowledge community serves as an important forum for unprepared Chinese young parents to discuss and improve sex education. In this [...] Read more.
Considering the traditional concept of sex in China’s official discourse and lack of social support system for sex education in China, burgeoning Internet knowledge community serves as an important forum for unprepared Chinese young parents to discuss and improve sex education. In this study, we conducted a structural topic modeling analysis of sex education discussions on Zhihu, the biggest online knowledge community in China. We found attention towards sex education are biased in China, where basic sexual terminologies are mentioned, but other important topics such as reproductive health, emotional attachment, and gender identity are insufficient or even absent, failing to fulfill the goal of Comprehensive Sexuality Education (CSE). This study paid special attention to gender differences in discussants, expected educators, and expected receivers of sex education. Findings show that boys are not considered as important sex education objects as girls, although many of them suffered from sexual assault and sexual diseases. They are always mentioned as roles that offend women rather than promoting or protecting themselves through sexual knowledge. Most discussants and expected educators of sex education are women, reflecting men’s lack of attention to sex education issues as both individuals and fathers. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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11 pages, 220 KiB  
Project Report
Adaptation of Global Standards of Comprehensive Sexuality Education in China: Characteristics, Discussions, and Expectations
by Wenli Liu, Jiayang Li, Hongyan Li and Haoran Zheng
Children 2023, 10(2), 409; https://doi.org/10.3390/children10020409 - 20 Feb 2023
Viewed by 2094
Abstract
This is a project report to introduce the Comprehensive Sexuality Education Technical Guideline—Adaptation of Global Standards for Potential Use in China (First Edition) (hereafter referred to as the Guideline) as the first adaptation of the International Technical Guidance on Sexuality Education (ITGSE) in [...] Read more.
This is a project report to introduce the Comprehensive Sexuality Education Technical Guideline—Adaptation of Global Standards for Potential Use in China (First Edition) (hereafter referred to as the Guideline) as the first adaptation of the International Technical Guidance on Sexuality Education (ITGSE) in China. The project was supported by the United Nations Population Fund (UNFPA) and the United Nations Educational, Scientific and Cultural Organization (UNESCO) from 2018 to 2022. The development process included rounds of participatory consultation, validation, and revisions led by the project team and a group of technical advisers from diverse backgrounds. The Guideline is developed to respond to the increasing demands of a technical tool integrating international standards and local context that can be used by all comprehensive sexuality education (CSE) stakeholders in China. While keeping the structure of the ITGSE, the Guideline made modifications and additions in light of the up-to-date Chinese policies, laws, and relevant national programs, as well as Chinese culture and social norms. It is expected that the Guideline could be widely acknowledged, distributed, and used to inform and support the future development of CSE in China. Full article
(This article belongs to the Special Issue Development of Sex Education in China)
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