Sex education as a disciplinary technique: Policy and Practice in England and Wales,

Nicki Thorogood


Sexualities, 2000, vol. 3, No. 4, ps. 425-438.



The education of young people about 'sex' remains a contentious area. It is suggested that this is because of the socially symbolic nature of sex and the necessary policing of the boundaries of heterosexuality. It is argued that sex education is a technique of governance. Forms of Sex Education are considered in relation to legislation over the last two decades and two models of sex education are proposed, that of 'restricted information' and of 'empowerment'. This latter seeks to challenge the normativiry of functional sex education and to validate the experience of the 'sexual other'. It is suggested that by so doing these alternatives also become subject to regulation and monitoring.

Keywords: heterosexuality, regulation, schools, sex education


Nicki Thorogood Dept of Public Health and Policy London School of Hygiene and Tropical Medicine



This article seeks to address the governance of sex education in England and Wales. Issues raised by Sex Education legislation have been the subject of fierce political debate for over a century (Mort, 1987) and remain a highly contested area (Allen 1987; Harris 1996; Melia 1989; Redman 1994; Stanley 1995). The consensus is still that sex education is 'a subject of considerable controversy' (Harris, 1996:12).


This article addresses the relationship between sex education and social regulation. Sex education, as used here, refers to that teaching about 'sex' which constitutes part of the formal education system. It should, however, be noted that what is formally imparted both produces and is produced by the informal exchange of knowledge taking place in other sites, e.g. playground, TV or home.


Indeed, various pieces of legislation point to the increasing statutory regulation of this part of the curriculum (DES, 1987; DoE, 1988; DfE, Circular 5/94; OFSTED, 1995) and to the general climate of fear engendered by Section 28 of the 1988 Local Government Act (DoE, 1988) which placed restrictions on the 'promotion of homosexuality'. Of course, policy documents are not simply straightforward statements of values and intents but are the outcome of negotiation and compromise and may remain contested. Neither are policies the only (or even the main) route through which social norms are achieved and enforced, as they may be supposed to reflect current ideas about what is socially acceptable or desirable. Therefore, although 'social regulation' is not only to be found in the statute book, perhaps these formal articulations of social norms might be taken as indicative of the wider discourse which seeks to produce and endorse particular social behaviours.


All formal education is subject to policy and legislation and many aspects are highly contested (for example the teaching of reading and writing). Why then should sex education be set apart from other curriculum subjects, even other parts of the personal and social education curriculum, to the extent that it should demand such precise and particular legislative attention? It is argued here that sex education is implicitly (and also, for the most part explicitly) about producing 'normal' (hetero)masculinity and (hetero)femininity and that these are core categories in the regulation of the social world. That is, sex education is a technique of governance in the Foucaldian sense (Foucault, 1979b). Any changes which might significantly disturb this 'balance' are, therefore, highly contentious and, in policy terms, unlikely to be forthcoming.


The 1986 Education (No 2) Act (DES, 1987) was the first legislation to formally regulate the provision of sex education in schools, although teaching about 'sex' has been part of the curriculum for much longer. Since then, governing bodies have had responsibility for determining a school's Sex Education Policy (that is, whether it should have one and, if so, what it should be). In 1988 sex education was not specifically included in the newly produced National Curriculum (DES, 1988) but this was amended in the 1993 Education Act (DfE, 1994). Since then, those parts of 'sex education' which occur in National Curriculum core subjects have been deemed compulsory, and the parental right to withdraw children limited to those aspects which fall under the remit of PSE or other areas outside of the core curriculum.


The increasing statutory attention to sex education and the consequences of this for the regulation of sexuality have been well explored in Redman's (1994) chapter 'Rethinking Sexuality Education'. He concludes that what is needed is a new agenda for sexuality education based on four factors: 'the need to address sexual diversity, relations of power, the construction of sexuality in schooling processes, and pupil sexual cultures' (p.147). Whilst I would agree whole-heartedly with this as an aim, the argument here is also that the 'explosion of discourse' around sex education indicates its centrality as a site for surveillance, monitoring and regulation and that to increase the remit of sex education will simultaneously increase the 'policing' of those boundaries (Steinberg et al., 1997).


This article was conceived whilst I was working (from 1987-92) as a developer and then co-ordinator of the CHYPP (City & Hackney Young People's Project) (Thorogood, 1992). This is a Health Authority funded sex education project that developed from a government pilot scheme which funded and evaluated three very different approaches to its aim of reducing teenage pregnancies. Although Healthy Alliances were being pursued as part of the Health of the Nation strategy this was a Health Authority run education project and this was in itself fairly radical. Justifications necessarily both medicalised and problematised the sexual behaviour of young people and the main rationale for funding was cited as the above-national-average rates of teenage pregnancies and the consequent numbers of terminations or births in the area. Renamed CHYPS (service, not project) the organization is still in existence, providing, amongst other things, sex education workshops on request for primary and secondary schools (both staff and pupils) as well as training for Health Service staff.


Almost ten years on it is interesting to note what has, or has not, changed. Teenage pregnancies, terminations and births remain a cogent political concern. As recently as July 1999 we have seen the publication of the Social Exclusion Unit's report Teenage Pregnancy which outlines a detailed policy strategy with the aims of reducing both conceptions and the social exclusion of young parents (HMSO, 1999). The generally problematising thrust of this has been more clearly articulated in the media reports of the Prime Minister's response to news that two 12-year-old girls were pregnant. In the same week newspapers also reported the 'bragging' claims of paternity from an 11-year-old boy. The fact that these far from unusual events were deemed media worthy suggests that this remains a highly sensitive policy area.


The statutory legislation which has most inhibited a liberal approach to sex education (Section 28 of the 1986 Local Government Act) remains a statute despite the current Government's pledge to repeal it. The reluctance of this government to repeal Section 28 (DoE, 1988), the Fairness at Work Act (1998) and the emphasis on marriage in the recent Revised National Curriculum (DfEE, September 1999) all point to the way that the current government still privileges married heterosexual relationships as the preferred site for bringing up children. This is illustrated by the comments made by the Home Secretary, Jack Straw, defending this position at the launch of the Government's Green Paper on 'Supporting Families':

"What we know from the evidence is that generally speaking that stability is more likely to occur where the parents are married than where they are not." (Today Programme, BBC, Radio 4, 4.11.98)

A further example is given by David Blunkett's comment that:

"The commitment that is made by people through marriage is a way of emphasising. . . stability to children." (Education and Employment Secretary David Blunkett, Radio 4's Today Programme, 9.9.99)


These policy statements and accompanying pronouncements from ministers sit uneasily within a generally more liberal approach to family and education policy that encourages respect for diversity, see for example the non statutory framework for PSHE which aims, amongst other things to '. . .help pupils form relationships which are essential to life and learning, which recognize common humanity and respect the diversity and differences between people' (revised National Curriculum, PSHE: 3).


Perhaps the greatest change over the last ten years has been the lessening of the 'explosion of discourse' around HIV/AIDS, which in itself was the impetus for many innovative approaches to health education and promotion. It is clear that there remains a tension between a commitment to equalities and diversity and the need to actively regulate behaviour in keeping with 'acceptable' social norms. This is particularly apparent in the debate around sex education.


What is 'sex' and why must we be educated in it?


It is worth here briefly problematising 'sex education'. How does the concept 'sex' come to be constructed as a category of behaviour? And why should this apparently 'natural' phenomenon be so precarious, so necessarily subject to regulation and training? As has been well documented (Foucault, 1984; Mort, 1987; Weeks, 1986) 'sex' is symbolic of the social order in a highly condensed way. That such a slim segment of an individual's formal education should generate such a vast discourse is testament to its significance. As the recent sociologies of the body have shown, socially constructed bodies are a site of modern forms of regulation and monitoring. 'The body' is the object par excellence of disciplinary power (Armstrong, 1983; Foucault, 1979a; Martin, 1989).


This fabricated body is 'gendered' by the construction of 'male' and 'female' (hetero)sexual desire, which is then inscribed upon it in an apparently natural way (Zita, 1998). The regulation of individual bodies is therefore central to the production of 'sexualities' and 'sexuality' becomes subject to surveillance and regulation, thereby disciplining otherwise unruly bodies {Foucault, 1984; Steinberg et al., 1997). Sex Education is the formal expression of the training and disciplining of bodies in this most crucial arena, for Sex Education both constructs and confirms the categories of 'normal' and 'deviant' that are central to the regulation of social life (Zita, 1998).


From this perspective it is easy to see why education in 'sex' exists and why it is invariably controversial (Meredith, 1989). It is also clear why it focuses on 'young people'. Teenagers are a socially marginal group who inhabit that dangerous moral territory between the acknowledged roles of 'childhood' and 'adulthood'. 'Teenage' is allocated as the space for notoriously wild and socially deviant behaviour, it is also the space most in need of policing. This is seen to be particularly true for sexuality, which is thought to be emergent but as yet not conclusively fixed, and therefore subject to influence, both 'desirable' and 'undesirable' (Weeks, 1986). This too is only a construction; there is nothing biologically given about the period of 'teenage' or about the precarious formation of sexuality. But modernity deems it such {Mort, 1987; Weeks, 1986) and as a consequence it becomes vital to educate to produce appropriate sexual behaviour.


In this article it is suggested that there are two models of sex education, the 'restricted' and the 'liberal'. This mirrors the central tension of many aspects of modernity: that is, between state regulation and individual liberty. On the one hand, state regulation (e.g. the banning of smoking in public places) is deemed profoundly anti libertarian and is decried by conservative thinkers {and pursued by democratic liberal thinkers). On the other hand, when it comes to matters such as sex and drugs, the moral conservatives are reluctant to leave this in the hands of the untrustworthy general public and are more likely to argue for strong state interventions where liberals, conversely, prefer a relaxed regulatory approach {Thorogood and Jessopp, 1990). In the case of sex education, both perspectives claim to be about producing sexually responsible citizens, albeit their definitions of this goal are very different, as are their preferred means for achieving this. This article goes on to describe both models and concludes that, despite claims to the contrary, both also act as forms of monitoring and surveillance, as disciplinary techniques.


Forms of sex education


The form that sex education should take is necessarily a site of struggle and there are a range of possible approaches to it. These can be loosely grouped into four categories, which, whilst not discrete or unchanging in practice, can serve analytical purpose here. First, there are those who feel that any sex education is potentially dangerous in terms of (a) the values expressed; (b) the 'appropriateness' of such education for each individual child; and (1) in terms of it spoiling the supposed 'innocence' of childhood and possibly even inciting sexual activity which is deemed 'wrong'. These fears have been expressed by groups such as Family and Youth Concern and other organizations which, during the 1980s, formed part of the Moral Right's campaigning over sex and sexuality in schools (Redman, 1994: 132). This moral traditionalism is still a potent political voice, apparent, for example, in the recent debates over the lowering of the age of consent for gay men.


Second, there are others who see sex education as essential for promoting the 'right' values and behaviours. This takes a more pragmatic line which recognizes that 'if they are going to do it anyway' an education strategy could influence this behaviour to remain within socially acceptable bounds. Third, there are those who take a more liberal humanist line and regard education about sex as a right and as a means of achieving a more personally fulfilling experience of life, albeit implicitly within a stable heterosexual relationship. Finally, there is the 'empowerment' model which is a refinement of the humanist approach. This suggests a sex education which makes explicit its values; which acknowledges the experiences of the students and of the educators and which seeks to 'empower' its participants to make their own sexual choices, regardless, in theory at least, of what these choices are.


There is, however, little likelihood of this latter being formally adopted within the present education system. As previously discussed, even the current Labour Government, at the level of both ideology and legislation, espouse the view that married heterosexuality is the preferred form of sexual relationship (particularly for the bringing up of children) and that although no blame is to be attached to those who fall short of this ideal, 'alternatives' are certainly not to be encouraged.


The four approaches to sex education outlined can be further grouped into two basic analytical categories: the 'restricted information' perspective, (the first three, and almost certainly the most widespread practice), and the 'liberal model' (the fourth, in which Redman's views would be incorporated). Let us consider the forms of the 'restricted information' model first.


The 'restricted information' perspective


During the 1960s and 1970s 'youth' became the focus of the moral panic/debate over 'permissiveness':

". . .violence, drugs and sex, three major moral preoccupations of the 1960s and 1970s blended symbolically in the image of youth revolt. . . . Here then was one area of social life that posed the question of control. . ." (Weeks, 1986: 212)


For the moral conservatives, control is best exercised by removing sex education from the school curriculum and entrusting it to 'the family'. This is, of course, problematic in two ways - at a conceptual and at a practical level. First, 'the family' is never defined. It presumably invokes the ideological 'normal, stable, nuclear family', but what will become of the children raised and educated in sex in families other than these? What values will be imparted to, for example, Jenny who 'lives with Eric and Martin'? (Bosche, 1983) Second, at a practical level, research evidence demonstrates that leaving parents responsible for sex education is a dismal failure in terms of quantity, relevance and accuracy (Weeks, 1986).


'Restricted information' sex education is frequently set within a scientific discourse (e.g. biology, human development, health education, even physical education, etc.) but, despite this, is clearly about the transmission of social values. So 'traditional pragmatists' favour limited sex education with an explicitly normative function.


From a more 'progressive' perspective, effective control of youthful sexuality would include more formal and more relevant sex education. Sex education in this approach is seen to have two major functions -that of imparting 'basic scientific facts' and that of setting these 'objective facts' into a 'moral' framework. This approach shares the goals of sexual normativity held by the moral traditionalists but feels they are best achieved through open and frank discussion. That is, children have a right to be educated about sex in order to allow them to make socially desirable decisions regarding their sexual and reproductive relationships. It is this view which underpins the sex education legislation and much current sex education in schools and is evidenced in the recent ministerial statements. Sometimes the moral aspect is made more explicit, for example the eugenic-based sex education in the 1920s, cited by Mort (1987) and in 'A Moral Framework for Sex Education' (DES, 1987) and also Tony Blair's recent call for 'Britain to rediscover its sense of morality' (a statement made in response to the news of the pregnant 12-year-olds mentioned above). Sometimes scientific objectivity takes precedence:

"The aims of a programme of sex education should be to present facts in an objective and balanced manner so as to enable pupils to comprehend the range of sexual attitudes and behaviour in present day society." (DES, 1987: Para. 19)


But this 'objectivity' sits uneasily with moral obligation, so the above quoted circular also went on to recommend that 'pupils should be helped to appreciate the benefits of stable married and family life' (DES, 1987: Para. 19) which demonstrates the unresolved contradiction between objectivity and moralism. This was reiterated in the 1994 DfE Circular (Para. 8) which stated that 'Pupils should accordingly be encouraged to appreciate the value of stable family life, marriage and the responsibilities of parenthood'.


The contradiction underlying the desire to help people to appreciate that which is hailed as naturally superior has not been lost on those engaged in challenging these presumptions.


As might be expected from this approach, scientific objectivity is taken as unproblematic and ignores any theorizing of 'science' itself as a value system with its 'objectivity' a myth it has created about itself (see, for example, Kuhn, 1970; Mulkay, 1979; Thorogood, 1997). This critique is, of course, no less relevant in the arena of sex and gender. As Meredith points out:

". . .the history of sexology has revealed how conventional scientific methods have served an ideological purpose under the guise of objectivity . . . ideology has everywhere been disguised as fact; [that] sex education has incorporated a masculine view of sexuality defined in reproductive terms in which the male is seen as active and the female passive and receptive." (Meredith, 1989: 55)

Thus, normative, 'limited information', sex education, whether in its traditional or permissive, moral or scientific guise, serves to promote heterosexual monogamy, and to render invalid and invisible all who exist outside: the 'normal' stable, married, heterosexual unit (Melia, 1989; Redman, 1994).


The emphasis on sex as synonymous with reproduction implied within this framework is the regulation of reproduction, and often the emphasis of sex education is on reproduction. Meredith, for example, urges European Governments to: 'equip young people with the means to understand and protect their own reproductive health' (1989: 1, my emphasis). This focus persists as the 1993 Education Act (DfE, 1994) made 'knowledge of how sexual reproduction takes place' a target at Key Stage 3 and this is retained in the new PSHE guidelines where the only references to human sexuality are within the context of reproduction and the avoidance of disease. Indeed, rising numbers of teenage pregnancies are: frequently cited as the reason for increasing regulation of this part of the curriculum (i.e. the rationale for continuing and expanding sex education), and the 1999 report from the Social Exclusion Unit states that 'New sex education guidance for primary and secondary schools will be produced by DfEE in consultation with PSHE Advisory Group by end of 1999'. This confirms government interest in the monitoring of sexual activity amongst young people and of any resultant pregnancies and parenthood (Harris, 1996: 2).


Historically, the conflation of 'sex' with 'reproduction' might be seen as emerging from a eugenic interest in sex education. From theories of Charles Darwin and Francis Galton in the latter part of the 19th century through to the doctrines of the Fabian Society in the first part of the 20th century, 'birth control' and 'family planning' have been regarded as the bedrock of 'racial hygiene'; literally a way of improving society through improving the 'stock', or the 'gene pool'. This has been well documented in the work of Kevles (1986) and Mort (1986). It is important to note that these arguments have been used to support both conservative and liberal viewpoints. Sex education in this model, therefore, becomes concerned with contraception, and by implication hetero-sex, fertile sex and childbearing. This of course marginalizes all other forms of sexuality and defines them as against the 'norm' of monogamous, heterosexual, married, fertile and penetrative sex. Thus, in this model, sex education is at least one of the means by which 'normal' heterosexual women and men are produced (Carabine, 1991; Bibbings, 1996).


The 'liberal' perspective


More recently, however, there has been a shift away from the traditional and functional 'restricted information' approach to the regulation of sexual (and social) behaviour towards a more liberal pluralist model. This emphasizes 'rights' as opposed to 'duties' and might be located as part-of an emergent liberal humanist framework, as characterized by the 'permissive' and 'liberation' movements of the 1960s and 1970s (Weeks, 1986). During the 1970s and 1980s an emergent liberal educational consensus took a more radical approach to the issues of class, gender and ethnicity within the classroom and the curriculum. Following on from this (although at least a decade later) were a number of sex education initiatives which took this further, seeing 'rights' within the school curriculum as necessarily to be extended to include 'sexual minorities' (see Redman, 1994 for a full discussion) as they had been to 'ethnic minorities' and to girls and working-class children.


This liberalism is also articulated in the so-called 'new teaching methods' which privilege participation and individual responsibility for learning over didactic approaches (Tones, 1986). The educator's role in this model is to facilitate learning by creating access to its processes, that is, by empowering the participants. I shall call this the 'empowerment model'. Of course, as with all patterns of social behaviour, it is not universally present at any one time and there will be resistances to it. This was apparent (see above) in the 19805 with the New Right challenges to the liberal humanist perspective in many arenas, including education. This was also highlighted by the manner in which the 1986 Education Act (DES, 1987) and Local Government Act (Section 28) (DoE, 1988) addressed sex education, where, as we have seen, an obligation to retain and emphasize a particular moral framework for the teaching of social values was felt to be necessary. However, by 1994 the contradiction between the demand for 'a moral framework' and the requirement to acknowledge pupils' diversity was apparent and the 1994 DFE Circular (Para. 8) also went on to exhort: 'Teachers need to acknowledge that many children come from backgrounds that do not reflect such values or experiences' and to avoid 'causing hurt or offence. . . and to allow such children to feel a sense of worth'.


The tone of this caution was both patronizing and clearly privileged dominant cultural values but it did at least provide the potential for a shift in the focus of sex education. However, this was unlikely to impact on the majority of teachers as the overriding effect of Section 28 has been to produce amongst them a tendency towards self-censorship (Thomson and Scott, 1992). Such an ambivalent recommendation was therefore unlikely to produce the confidence to change.


Nevertheless, as has been documented elsewhere (see, for example, Thorogood and Jessopp, 1990), the advent of HIV and AIDS as social and medical phenomena necessitated simultaneously more explicit discussion of sexual behaviours, both 'normal' and 'deviant', and more pervasive forms of control. Particularly since sexual identity in adolescents is not considered 'fixed', and therefore, possibly subject to the influence of others, sex education had a duty to be more 'morally responsible' as well as more explicit. Thus, although the explosion of the discourse around sex during the late 1980s and early 1990s prompted by HIV /AIDS made visible 'lifestyles' and sexual practices not previously acknowledged in sex education, it simultaneously invoked a desire for more explicit moral regulation. Meredith, although seemingly in favour of the empowerment approach, warned against 'going too far':


It is the task of the school to assist in the process of enabling the young person to understand and where necessary to survive society's conflicting signals, to recognise and absorb its higher values, and to value its more durable structures (e.g. the family). (Meredith, 1989: 58, my emphasis)


This clearly demonstrates how it was felt that the 'liberal approach' also needed to be tempered by an emphasis on the 'moral framework' and the value of stable married family life and, as noted earlier, this tension remains today. Further, where the concept of 'safer sex' had to be embraced in this arena it was restricted to exhortations about condom use. Once again, this construction privileged penile penetration (overwhelmingly presumed to be heterosexual), regarding this as synonymous with 'sex' and thereby failed to challenge dominant sexual relations (Segal, 1989).


However, the need to inform and educate about 'safer sex' also made possible discussion of other sorts of sexual relationship and/or activity. These aspects of the discourse have taken place largely within the 'empowerment' model. This model allows for a less prescriptive or proscriptive stance and suggests the possibility of individuals being 'empowered' to make a range of sexual choices. Melia, for example, favoured this approach as the preferred alternative to the 'moral framework' of the DES:


"Sex Education should promote discussion of a wide range of different lifestyles and make explicit reference to the ways in which various institutions and groups seek to mould and prescribe our social and sexual roles. Such education should be used to counteract some of the racist, sexist, heterosexist and classist elements which characterise young people's education today and should be designed to equip young people with the knowledge and skills with which to take control of their own lives." (Melia, 1989: 229-30, my emphasis)


Patton also addresses the concept of empowerment as a means of making explicit the values held in so-called morally neutral science:

"We do not educate in a neutral environment. People have more than a right to know, more than a right to choose, people have a right to understand the ideologies of science education as processes to which they are subjected." (1990: 15-16)

Empowerment in these examples implies resistance to dominant forms of knowledge and techniques of control. Similarly, Hendrikson (1990) argues that the practice of safer sex, because it challenges accepted notions of 'real' sex and because it constructs alternatives, acts as a form of resistance. This is perhaps borne out by the HEA's advertising campaign in the early 1990s which was explicit about alternatives to penetrative sex when targeting gay men, but restricted itself to recommending condom use when addressing a heterosexual audience (Hart, 1992).


Nevertheless, we might also see the 'empowerment model' as located within another framework; one which characterizes contemporary discourse as that of the 'urge to confession' (Rose, 1990). This constant drive to reveal through talking the 'truth ' about ourselves can be seen as a subtle technique of control. It renders visible and public parts of our lives which previously remained hidden and offers them up to scrutiny (Green and Thorogood, 1998). Thus, all our sexual behaviours, dreams and fantasies are revealed and are regulated by our peers, our educators and ourselves, as well as by statute. In this way, empowerment is constructed as a micro-technique of surveillance and control, a form of governance, as well as a discourse of resistance.




In conclusion, sex education, as any education, does not take place in a neutral environment. It is always about the transmission of values and by implication acts as a form of control. This is most clear in the traditional, 'restricted information' approach, which uses the twin bases of 'objective scientific fact' and 'moral frameworks' to achieve the 'sexual socialisation of young people' (Meredith, 1981:1). This approach has rightly been criticized for omitting, invalidating and rendering invisible the experiences of all lesbian and gay young people, any children of single parents, including the divorced, the separated and the unmarried, or others who live in forms of household which do not meet the heterosexual, monogamous, nuclear family criteria. In response to this, 'empowerment' models of education seek to redress the balance by validating these 'others', thereby creating the potential for resistance. But, I suggest, the very act of rendering these forms of experience valid and visible simultaneously also constructs them as sites for monitoring and regulation, as the objects of disciplinary power. Liberal pluralist 'empowerment' models of sex education have the unintended consequence of producing micro-techniques of power and are not unequivocally liberating or resisting.


I have argued that sex education in both models is implicitly (and mostly explicitly) about producing 'normal' (hetero)masculinity and (hetero)femininity and that these are core categories in the regulation of the social world and that sex education is therefore a technique of governance. This is no less apparent in the most recent flurry of political activity around sex 'education and the need to educate for morality.


However, as has been demonstrated elsewhere (Epstein, 1994; Steinberg et al., 1997; Thorogood, 1995; Zita, 1998), 'heterosexuality' has to be constantly (re) produced through the articulations of (hetero) masculinity and (hetero) femininity. For those of us working, if not always thinking, within the modernist discourse of equality, it might be encouraging to see the continued resistance at a political level to these technologies of empowerment as evidence of the fragility of heterosexuality as an institution.




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Biographical Note


Nicki Thorogood PhD is Senior Lecturer in Medical Sociology at the London School of Hygiene and Tropical Medicine. She has had a long-standing interest in the social regulation of sexuality and once worked in a Health Authority funded Sex Education Project (the inspiration for this article) and is a member of the BSA Lesbian Studies Group. She is currently working on the sociology of mouths as boundary and on the feminisation of dentistry. Address: Health Promotion Research Unit, Dept. of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT.