Exploring age-old Xhosa values in the teaching of sexuality education

Research demonstrates that teachers’ cultural perspectives influence how they teach sexuality education; however, it is not clear how this occurs. Therefore, in my study, I explored how Xhosa teachers’ cultural perspectives influenced their practice of teaching sexuality education to adolescent Xhosa learners. I purposively selected 9 female Xhosa teachers and took them through the photovoice process, adopting a critical paradigm and drawing on a participatory visual methodology in achieving this aim. The findings reveal 2 themes: on the one hand, the participants used the past as a lens by drawing on some age-old cultural values and adhering to a didactic model of teaching, and on the other, they shifted towards a new practice by innovating their teaching method and refocusing on a safe lifestyle. The participants stated that the values of assertiveness and passivity were necessary for girls to navigate their adolescent sexuality successfully, even though the 2 values seemed contradictory. This presents a dichotomous dynamic, calling for the scrutiny of the Xhosa culture as it relates to sexuality. This work has implications for teacher professional development and training, as innovative and participatory methods are appropriate for use within sexuality education.


Introduction
One cannot write about sexuality education and not touch on what is currently unfolding in the country regarding the adoption of comprehensive sexuality education (CSE) in the school curriculum. The United Nations Educational, Scientific and Cultural Organization (UNESCO), in conjunction with other stakeholders, such as the United Nations Fund for Population Activities, the Education Development Centre and the Department of Basic Education, developed the CSE section of the life orientation curriculum to be taught in South African schools from Grade 4 onwards. This new development was not received well by religious and parent organisations in South Africa (Swain, 2019). There has been an outcry from these groups on social media, claiming that the content of CSE is too explicit and that it disregards children's innocence. This resistance is delaying the implementation of this curriculum and regrettably shows the long way that still needs to be travelled in South Africa.
In this article I look at how Xhosa teachers' cultural perspectives influence their teaching sexuality education to adolescent learners. I chose to work with Xhosa secondary school teachers from township schools, as I had been a teacher of life orientation (LO), an area that interests me as a teacher educator. I followed the call of Swanepoel and Beyers (2019) who maintain that sexuality education research should be conducted per city or by province to demonstrate its uniqueness and characteristic contextual influence. Moreover, as Preston (2013:20) claims, " [t]here exists a lack of literature on sexuality education teachers and how they think about and perform the work of educating youth about sexuality." UNESCO (2018) regards sexuality education as having to foster protection and support to adolescents, equipping them with values and skills that will assist them in developing fulfilling and healthy relationships, ensuring sexual safety and enhancing well-being. Teachers are critical to the success of sexuality education (Francis & De Palma, 2015); they can be the transformation agents that learners need. According to the available literature, culture, among other factors, influences how sexuality is taught to learners (Swanepoel & Beyers, 2019). Hence, considering how culture intersects with teaching sexuality education is crucial (Francis, 2021) which is what I aim to explore in this article. A need exists for research into how effective sexuality education could be culturally appropriate, and thus reach the (Xhosa) adolescent learner in a relevant manner (Clüver, Elkonin & Young, 2013). In fact, DePalma and Francis (2014) propose that a connection of teachers in schools and cultures be established to project how teaching and learning about sexuality could be done.

Literature Review
Francis (2013) notes that sexuality education, as it is conceptualised, is value laden. Thus, teachers invariably draw from their own personal values and their cultural values in teaching sexuality education (Swanepoel, Beyers & De Wet, 2017). Notably, culture provides the context for the primary socialisation of the child, determining appropriate male/female behaviour and values regarding sexuality (UNESCO, 2009b). However, culture is by nature not static, and so there has to be fluidity and adaptability in the values it purports to teach. This cultural dynamism needs to be realised and drawn on in sexuality education for it be effective. DePalma and  note that when culture is perceived as being fixed, it means that the school is not engaging effectively with the curriculum. In the next paragraphs, I review the literature on the interplay of culture in the sexuality education classroom, the sexuality education curriculum and aspects of Xhosa culture that relate to Xhosa adolescents' sexuality.
It is necessary to appraise the various factors that influence sexuality education, as they affect the modus operandi in the classroom. Swanepoel and Beyers (2019:8) advance that "the background knowledge and culture of teachers, religious underpinning of learners and teachers, and the contextual geographic of the place within which schools are located" inform the teaching of sexuality education. Due to their culture, teachers tend to draw on a moralistic worldview when teaching about sexuality (Moletsane, 2014). This is problematic, as the moralistic teaching of sexuality education has proved to be ineffective for adolescent learners. The way to remedy the situation would be for teachers to expose their own worldviews and challenge them (Wood, 2009), thereby being reflexive (Van Laren, Mudaly, Pithouse-Morgan & Singh, 2013). In the process, they could use that reflexivity to navigate innovative teaching strategies, which are learner centred.
Sexuality education in the LO curriculum is geared at equipping young people through teaching a wide range of life and decision-making skills, which includes information on human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Sexuality education is sometimes confused with sex education, which is a part of sexuality education dealing with the biomedical aspects or reproduction, also included in the life sciences (LFSC) and natural sciences (NS) curriculum. Sexuality education is not without controversy due to the debate that lingers on whether it increases sexual activity or actually contributes to safer sexual behaviour. Two positions within sexuality education are taken, namely abstinence-only and CSE . Sections 2.6.5 and 2.10 of the National policy on HIV/AIDS espouse both positions on sexuality education (Department of Education, 1999).
Abstinence-only sexuality education takes a moralistic stance where the focus is on the prohibition of sexual engagement until marriage. In a way, such sexuality education curriculum involves avoiding or eliminating risk (Kirby, 2008). Abstinence-only sexuality education is restrictive, not allowing learners to access information on contraception and sexual health relating to puberty and reproduction . Abstinence-only sexuality education goes along with heteronormativity in that it excludes those whose sexual lives are out of the norm and queer. CSE is seen as age-appropriate, culturally relevant teaching about life and decision-making skills, which includes information about HIV (UNESCO, 2009a). CSE has been proven to improve adolescent sexual reproductive health, attitudes and behaviours (Chandra-Mouli, Lane & Wong, 2015). In CSE, the curriculum does not only condone abstinence, but also offers options for those who become sexually active by encouraging the use of condoms and contraceptives (Kirby, 2008). However, CSE is criticised for confusing young people by sending mixed messages about sexual behaviour; however, its proponents argue that it is realistic and effective (Kirby, 2008). As I have mentioned in the introduction of this article, CSE has not been well received by certain sectors of the community in South Africa.
I now discuss aspects of Xhosa culture that relate to adolescents' sexuality. Xhosa adolescents were socialised sexually through different cultural practices for adolescents such as ukuhlolwa (virginity testing), ukuthomba (female initiation) and ulwaluko (male initiation). In addition, Xhosas used to teach their children to observe certain sexual behaviour like non-penetrative sexual intercourse between boys and girls (Mahoney & Parle, 2004). They could stroke between the thighs and thrust tightly on one another and not penetrate the sexual organs. Nonetheless, Western values seem to have influenced the sexual socialisation of Xhosa adolescents, with technology and media dominating the scene. To demonstrate the need for CSE, it is worth noting Shilumani (2010), who in her study with Shangaan adolescents from a strong rural background, observed that the majority of them felt that life skills or LO educational programmes gave them better information on sexuality, which they preferred to the information provided in traditional initiation schools. Without necessarily homogenising African cultures, this could also hold true for Xhosa adolescent learners. It could be that today's adolescents do not find resonance with what is taught in the traditional initiation schools that teach them about sexuality, making formal schools an effective mediating tool in the teaching of sexuality education.
In the next section, I outline the theoretical framework of the literature on sexuality education that underpinned the interpretation of the data generated through photovoice in the study.

Theoretical Framework
Cultural-Historical Activity Theory (CHAT) was the lens used to understand the literature, and analyse and describe the data in this article. CHAT acknowledges the role of cultural influences in an activity system of learning and teaching. Gray, Trotter and Willmers (2012) observe that the theory is "participatory and action-orientated" (p. 6). The actions of a subject (the sexuality education teacher in this study) are understood in the context of prevailing socio-cultural conditions (Wolhuter, Van der Walt & Steyn, 2016). CHAT is a Global North theory which evolved through three generations of development, from Vygotsky, to Leont'ev and Luria, and then Engeström. CHAT is gaining traction in the Global South as researchers such as Chineka and Yasukawa (2020) CHAT allows for a questioning of the structural determinants of prevailing practices in education (Nussbaumer, 2012). CHAT theory aims to aid the understanding of mediated complex learning situations and holds that there are six elements in activity systems that interact together towards a goal or outcome (Yamagata-Lynch, 2010) (see Figure 1). The mediated process is cyclical in that changes in a complex learning or social situation are driven by tension generating contradictions that arise within this activity system, providing premises for learning and development, and possibly the transformation of the situation (O'Brien, Varga-Atkins, Umoquit & Tso, 2012). Explained further, "[h]istory is important in CHAT, in that its various elements are seen as having themselves developed over time and therefore having developed their own dynamics and accumulated meanings for the actors involved. It emphasises the cultural setting and larger context of social, policy and work processes" (O'Brien et al., 2012:255).

Figure 1 CHAT as used in this research study
In the following section of the article I describe the data generation process used in the study to answer the research question.

Research Design and Methodology
This study was based on a qualitative research design, drawing on a critical paradigm and using a participatory visual methodology. The following research question was explored: How do the cultural perspectives of Xhosa LO, LFSC and NS secondary school teachers regarding sexuality influence their own practice of teaching sexuality education to Xhosa learners?
In trying to answer the research question, photovoice work was undertaken by the participants, generating data that was later thematically analysed. The participants were purposively sampled according to the following selection criteria: LO, LFSC and NS secondary school teachers, male and female teachers belonging to the Xhosa culture and teachers of LO Grades 8 to 12, LFSC Grades 10 to 12, or NS Grades 8 and 9 in a black Gqeberha township.
The final sample consisted of nine female teachers who were between 42 and 51 years of age, as they were the ones who volunteered to take part in the study (see Table 1). Data Generation Method -Photovoice In 1995 Wang developed photovoice as a method in her project with Chinese women labourers who worked the land, putting cameras in their hands to depict their poor working conditions and using the photographs to encourage policymakers to do something about the problem. Like Wang and Burris (1997), I used photovoice as a participatory research method to engage the teachers in exploring their own culture in relation to the sexuality education they teach, and to engage with it in a critical way. Photovoice was useful in this study, as it facilitated the participants' voices, enabling them to express ideas that they might have found difficult to put in words (Mitchell, De Lange & Moletsane, 2017). Participants used cameras to take photographs, after which they came together to talk about the meaning of their photographs, thereby generating photo-narratives. Photo-narratives are useful in data generation because taking photographs of choice and freely writing about them is non-intrusive to the participants. Photovoice also demonstrates a reflexivity and collectivity of knowledge production, as participants "become advocates of their own and their community's wellbeing" (Wang & Burris, 1997:373). I chose photovoice to gather data, as it is a non-threatening way of exploring sensitive issues and is said to be enjoyable, particularly to teachers (Taylor, De Lange, Dlamini, Nyawo & Sathiparsad, 2007). It provided space for the participants to reflect on their practice, their culture, and to make their voices heard (Hunting, 2012), which is important in the South African context where teachers' voices are usually overlooked in curriculum development (Baxen & Breidlid, 2004).
The teachers were responding to the following prompt: "In your groups, take 12 photographs of how you see yourselves teaching sexuality education as a Xhosa teacher to your Xhosa adolescent learners. Write captions for the photographs to tell your story." Using this visual method requires that ethical issues, such as anonymity and confidentiality, are carefully considered (Mitchell, 2015). Therefore, we negotiated ethics, although some of the participant teachers wanted to be identifiable while others chose not to show their faces. In groups, the participants discussed and agreed on which photographs to include. They selected the photographs, glued them on paper, and wrote captions, thereby making their own meaning of their photographs, as a first layer of participatory analysis. Then, the groups took turns to explain their photo-narratives, which was video-recorded and transcribed. I analysed the transcriptions using thematic analysis. Doing this photovoice was a buzz of activity, which took the teachers 2 hours to complete.

Findings
The themes produced were as follows: 1) Using the past as a lens by drawing on age-old cultural values and adhering to a didactic model in the teaching of sexuality; and 2) Shifting towards a "new" practice by innovating their teaching method, and refocusing on a safe lifestyle. I report on these themes, including a brief conceptualisation of each theme and relevant quotations to support my argument, followed by the photovoice. I must state upfront that in analysing this data, it was quite challenging to remain objective and critical as I had an emic perspective. However, the bracketing sessions with my mentor assisted towards making this exercise more objective.
Theme 1: Using the Past as a Lens The participants' cultural perspectives on their teaching practice of sexuality education to Xhosa adolescents showed how a teacher's personal life is intertwined with her professional work. These middle-aged participants appreciated ways in which sexuality used to be regulated in their Xhosa communities. For them, values that relate to sexuality in their age-old culture, which could be traced back to before colonisation in South Africa, were indispensable. For example, in the past, adolescents were trained to respect people in general and particularly to respect girls. Moreover, they were taught to develop self-respect, and girls were taught to develop assertiveness but also to be passive in accepting their role or position. One of the participants, Gcobisa, drew on values of Ubuntu and Christianity to teach sexuality education. The following quotations and Figure 2 support these statements: In the olden days, we used to hide when you are going with a boyfriend and emphasised selfrespect. We are trying to teach learners that it is important to respect girls…. In our culture there is that thing called Ubuntu as you can see in this picture, families would get together and advise on matters. Here, the word of God, if we can bring back the culture of Religious Education in our schools….

Figure 2 Sample 1 of the participants' photovoice work
Some of the participants, Cikky, for example, mentioned that they taught assertiveness in the same way as it had been done when they were growing up: "Be assertive as much as possible! Culturally we were taught assertiveness,

the parent would tell you if you say No! a No! is a No!"
However, the photovoice (see Figure 3) revealed that when confronted with cases of learners in their schools actively pursuing relationships with male teachers, teachers such as Phaphama taught girls to be passive, not to initiate sexual relations with men and rather to contain themselves.
We teach these girls that in our culture girls are expected to succumb, be submissive, and allow the male to approach the female, not the opposite ... we try to tell the girls they do not have to go out of their way and propose love, especially [to] a teacher….

Figure 3 Sample 2 of the participants' photovoice work
The traditional quality of a Xhosa woman and girl being subordinate to boys and men seems to contradict these women teaching girls in their classes to be assertive. The Xhosa culture of the teachers was seen as reinforcing the idea of submissiveness in Xhosa women and the notion that girls' sexuality is policed and under surveillance. Nevertheless, as teachers' cultural perspectives present some tensions (as in the case of assertiveness and submissiveness) in the teaching of sexuality education, how they negotiate these, becomes critical. CHAT speaks of the tension generating contradictions within an activity system, and these contradictions possibly lead to a transformation of the learning and teaching situation. This transformation occurs when individuals actively respond to their experiences. Not only did some of these teachers draw from the past to inform their teaching, but they also seemed to adhere stubbornly to a didactic teaching model with moral instruction as an ulterior motive.
In their teaching, the participants tended to moralise, communicating the dos and don'ts of sexual conduct to the learners. Their photovoice work showed that, in their teaching, teachers such as Ntombemsulwa, Phaphama and Cikky, attempted to address a few topics: how to dress; abstinence; the consequences of sex and teenage pregnancy; and the dangers and effects of alcohol abuse. In this way, they were constructing a gendered sexuality of the adolescents they teach. Heteronormative patriarchal ideas about gender, such as how girls should be controlled, how they should be more responsible and watch how they dress, and the positioning of boys as masculine, dominant and freer in the sexuality sphere, were characteristic of their teaching practice.
We are teaching the children how to dress. So, you must dress and hide your body, nѐh! … because as a woman you will get married one day and you need to be pure. At school as we teach, we do remind the children about abstinence, that it is good.
Being didactic, without allowing space for interrogation and critique, is not constructive and might not suit the realities of today's adolescents. For example, their ideas of dress might not be a way of preventing sexual violence as one teacher seemed to imply, and abstinence is not necessarily possible in a context of coercion, abuse and violence. The responsibility should not only be placed on the girls but also on the boys and men, who should learn to control themselves. Nevertheless, some of the participants did recognise that a "new" approach to teaching sexuality education was necessary.

Theme 2: Shifting towards a "New" Practice
In keeping with the times, the participants seemed to have realised the need to use a small repertoire of participatory approaches when teaching adolescents. This shift also came from the recognition that there were taboos that seemed to silence Xhosa people (parents, teachers and learners alike) when it comes to sexuality. Teaching sexuality education is often seen as challenging owing to the nature of the content taught and to the tendency of teachers to draw on old methods, such as chalk and talk and reading from the textbook. However, innovating their teaching methods by drawing on democratic and interactive ways to teach sexuality to the adolescents in their classes could ease the challenges of teaching sexuality education. The participants' photovoice work showed that they did at times use innovative methods, such as debate and role-play, to engage with the learners. In addition, they acknowledged the learners' life experiences in their teaching. This is reflected in Figure 4 and the following: I normally have a debating session where you want them to talk because culture, Xhosa culture, they don't want to express themselves, their opinions and their feelings. … where you can have a role-play kind of situation where you have two girl learners together moving away from one girl learner….

Figure 4 Sample 3 of the participants' photovoice work
Participants such as Nolwazi and Cikky appraised the status quo in sexuality education and saw the possibility of debate and role-play, in keeping with participatory approaches, which are called for in CSE. Debates are structured contests over an issue, with two sides opposing each otherone proposing and the other opposing. An issue is viewed from many points of view. Role-play enables acting out a part or character by putting oneself in the shoes of somebody else.
Some of the participants acknowledged technological advancement and its role in aiding in the teaching of CSE: I would like to say that culturally, as you have already touched on it Ntandokazi's group and Gcobisa, it [condoms] was not there in the olden days, it's an advancement in technology that we invented these so that people can be safe from HIV. If you take a look at our chart, we are referring to issues that are taking place these days not things that happened long time ago because of how technology has improved.
In sexuality education, it is necessary to focus on enabling a safe lifestyle, rather than emphasising scare tactics in trying to ensure that adolescents do not engage in unsafe sexual activities. Some of the participants' photovoice work, such as that of Khethiwe, Ntandonkazi and Gocbisa, showed that, to achieve this aim, they ought to teach the adolescents not only norms and values and cautious and careful living, but also the use of condoms. This stance is in line with what the South African curriculum prescribes for CSE. This is reflected in the following: So, in the classroom situation we are teaching these learners to be more cautious so that they don't find themselves in a situation where they wake up in a bed with someone they don't know. Still on this one on condoms, we've been introduced to them as this generation … we must face it that young people are sexually active out there.

Discussion
The findings confirmed that teachers taught sexuality in line with their own cultural and/or religious beliefs (Swanepoel & Beyers, 2019). Drawing on culture in the teaching of sexuality education is seen as important since studies postulate that the ineffectiveness of sexuality education may be due to the failure of designing culturally appropriate materials and reimagining teaching approaches (Haberland & Rogow, 2015;Sorcar, 2015). However, navigating that space can be complicated and confusing as seen in the photovoice work described in this article. At times, the participants seemed to be contradicting themselves because they would call for values that seem incompatible with each other. Moreover, the lines between culture and religion were blurred, with one of the participants talking about Christianity as if it had become one with the Xhosa culture. An example of this is when they asked girls to be assertive yet passive (implying that they expected them to be submissive), as was the case in the past as they recalled it, which conflated the value of Ubuntu with Christianity. Contemporary Xhosa culture is noted as being male dominant or patriarchal leading to women and girls taking up sexually subservient roles (Mehlomakulu, 2008). Cain, Schensul and Mlobeli (2011) speak of Xhosa men holding powerful positions as far as their sexuality is concerned compared to women. This is problematic in the era of women emancipation and of the scourge of gender-based violence in the country. Ngabaza, Shefer and Macleod (2016) found in their study that even at school, normative and patriarchal views are being perpetuated in sexuality education and the necessary critique thereof is missing. Francis (2021) views this as if there is "an unstated agreement that schools are normative spaces that regulate and reinforce normative expressions of race, gender, and sexuality" (p. 2). Bhana, Crewe and Aggleton (2019) make the same observation about teaching sexuality education and add that its framing is "in so-called traditional values" (p. 361). This is another area of concern: the mediating tool, which is the teachers' culture, has been influenced by another actor in the activity system of sexuality education, which is the prevailing cultural ethos in the community. Could schools play an active role in the redefinition of the contemporary cultural values regarding sexuality? CHAT identifies a bidirectional relationship between all the actors within an activity system implying that for this study, school teaching influences the community and, conversely, the community tends to influence school teaching. Strong partnerships between schools and communities need to be forged to alleviate the tensions that might result in teaching sexuality education.
Further, reflexivity on the part of sexuality education teachers is necessary to appraise consciously the contradictions in transforming how they teach. Teachers need to establish whether the culture they draw on can give some insights into how they might teach adolescents (Msutwana & De Lange, 2017). This has implications for the attainment of comprehensive sexuality education outcomes, thereby enhancing a healthy navigation of sexuality in adolescents. Ngabaza and Shefer (2019) observe that teaching practice regarding sexuality has tended to reinforce problematic discourses, which should be stopped. Thus, Jewkes (2010) envisages a teaching practice that operates within a gender and sexual justice framework: one that guarantees gender equality, safety and healthy relationships. Continuous professional development of sexuality education teachers and bringing adolescent learners' voices into the space would be a way of meeting these objectives.
The findings also indicate that the women teachers wanted their learners to be respectful. However, it is a tricky exercise to demand respect for adults unreservedly or undeservedly in the Xhosa culture, as this has implications for children. It might be challenging for the children and adolescents to say No! to abuse or to report cases of abuse if it comes from the adult who ought to be respected (Hill, 2005). In addition, respect may inhibit them from communicating openly about taboo topics like sexuality. The participants also demonstrated that they were still adhering to didactic teaching methods (Jearey-Graham & Macleod, 2015), perhaps echoing what Moletsane (2014) understood about sexuality education in that teachers tend to take a moralistic stance in their teaching. There is a glitch in teaching sexuality education in South Africa, as teachers tend to focus less on the prescribed CSE and unrealistically dwell more on abstinence as the only desired option .
These teachers' didactic pedagogies focus on moral instruction and might mean that the teachers construct the adolescent learners as being still in the process of moral development, and thus being unable to decide for themselves what is right and what is wrong in terms of sexuality. Hence, in their teaching practice, the participants see the need to focus on what the adolescents should not do in terms of sexuality. By doing so, the teachers are underestimating the adolescents' level of reasoning and development, and according to Hunting (2012) and Moletsane (2014), are overlooking adolescent sexuality and the context in which adolescents negotiate their sexual spaces. The problem with a didactic approach is that it has not had a marked impact on lowering the negative outcomes of risky adolescent sexual behaviour (Moletsane, 2014;Wood & Rolleri, 2014) nor facilitated a healthy sexuality in adolescence. Thus, I largely critique the teachers' use of the past as a lens in approaching sexuality education. On the one hand, it is seen to be effective in that it is fashioned for specific cultural groups (Swanepoel & Beyers, 2019). On the other hand, it is futile in that intended goals and the necessary learning for current times are not achieved (Moletsane, 2014;Wood & Rolleri, 2014).
However, the photovoice method used in the study made participants more mindful of their teaching practice, as voiced in their accompanying reflections. Sani, Abrahams, Denford and Mathews (2018) and UNESCO (2009b) advocate for participatory teaching methods for sexuality education as they are relevant for today's adolescents and interesting to those taking part in them. The methods are relevant as they largely draw on ubiquitous technology and visual tools (Mitchell & De Lange, 2013). Facilitating a lesson by using what is familiar to the adolescents, which is technology, might spark learner interest in the teaching of sexuality education. Participatory methods are fun (Punch, 2002), and enjoying learning might mean internalising what is being taught. These methods also promote a democratic atmosphere as power is renegotiated (Mitchell, 2015) away from the teacher and towards the learners whose meanings are accommodated. Helleve, Flisher, Onya, Mῦkoma and Klepp (2011) acknowledge the challenge of creating open dialogue in sexuality education classes, as some of the participants noted. Participatory visual methodologies could disrupt this tendency as teachers facilitate a more interactive atmosphere in class. In fact, there is a push, the world over, for more participatory pedagogies in sexuality education classes (Sanjakdar, 2019).

Conclusion
The participants' photovoice work revealed that their cultural perspectives influenced their own practice of teaching sexuality education to Xhosa learners, not only by drawing on the past, but also by shifting their practices. I noted that all the participants found value in some of the teachings from culture, but contradictions surfaced when they taught the adolescents. This calls for reflexivity on the part of the sexuality education teacher to scrutinise their culture to alleviate these contradictions in teaching. If teaching sexuality education should be culturally appropriate and not lead to a didactic teaching practice, it is necessary to embark on this exercise. Targeted continuous professional development workshops and pre-service teacher training are key to the successful teaching of sexuality education. These should also include training in participatory visual methods, as they are effective in facilitating sexuality education lessons.