Many unanswered questions, anxiety, shame, and misinformation from social media—this is the reality facing adolescents in North Macedonia, stemming from the absence of sexual education in schools. Sheruze Osmani Ballazhi, a psychologist and lecturer, told Mollëkuqja.mk that the solution lies in structured sexual education that provides young people with knowledge about their bodies, relationships, and personal boundaries. Among other issues, she spoke about the consequences of the lack of such education and the decisive role played by parents and teachers.
How does the lack of sexual education affect adolescents’ psychological development and their interpersonal relationships?
“Adolescence is a period of intense physical, emotional, cognitive, and sexual development. During this phase, young people begin to experience romantic attraction, a need for closeness and intimacy (not necessarily sexual), and a strong desire to be accepted by others. These feelings often emerge in unclear ways, prompting adolescents to seek answers. When young people do not have access to accurate information—such as that provided through sexual education—about the natural bodily changes that occur during puberty, the influence of media in creating unrealistic body image ideals, understanding sexual violence, the importance of healthy friendships, the consequences of early sexual activity, and the modes of transmission of sexually transmitted infections, they become more vulnerable, both emotionally and socially.”
She added that the consequences of this lack of information are significant.
The absence of this knowledge leads to confusion, anxiety, shame, and low self-esteem. Furthermore, the lack of sexual education creates difficulties in building healthy interpersonal relationships, as young people fail to develop skills for communicating emotions, setting personal boundaries, and recognizing abusive relationships. Data from the Health and Behaviour of School-Aged Children (HBSC) – 2022 study show that 30% of 15-year-olds in North Macedonia are sexually active. This percentage is higher compared to Western European countries such as Denmark (22%) and Germany (19%), where sexual education is included in school curricula.
What emotional and psychological consequences arise when young people receive information from inaccurate sources such as social media?
“Human nature is oriented toward seeking meaning and explanations for personal experiences, particularly during adolescence. When young people lack access to accurate, relevant, and scientifically based information, the informational gap is often filled with misinformation from social media, closed online groups and forums, rigid traditional interpretations, and peers who transmit myths and rumors. Receiving inaccurate information creates deep emotional insecurity and makes adolescents more vulnerable to impulsive decisions and unwanted situations. This can lead to engagement in risky behaviors, such as early sexual activity, exposure to manipulation or sexual violence, and decision-making without fully understanding the risks involved. The emotional and psychological consequences are substantial: fear, anxiety, confusion, low self-esteem, feelings of guilt, and emotional harm. In some cases, exposure to misinformation may contribute to the development of depressive symptoms and suicidal ideation. For illustration, the same study shows that sexually active adolescents experience significantly more psychosomatic difficulties than 15-year-olds who are not sexually active, with these symptoms occurring twice as often among girls as among boys.”
How willing are students to talk about sexuality-related topics in school settings, and how do taboos influence their “silence”?
“Students’ willingness to receive answers to their curiosity about sexual development and sexual health is far greater than adults often assume. Their silence is not a lack of interest, but rather the result of inhibition imposed by adults, who have framed sexuality as a shameful, forbidden, or dangerous topic to discuss. A clear indicator of students’ readiness to talk about these issues is the strong interest shown in participating in pilot programs for sexual education.”
How can structured sexual education help reduce fear, stigma, and taboos related to the body and sexuality?
“Human beings often develop fear toward what is unknown, and in this context, structured sexual education plays a crucial role in reducing fear, stigma, and taboos related to the body and sexuality. When young people receive accurate, clear, and scientifically grounded information, they gain confidence, understanding, and the ability to anticipate situations related to their physical and emotional development. This knowledge not only frees them from uncertainty, but also weakens the influence of myths and traditional interpretations, which often form the basis of stigmatization. Organized sexual education creates an environment in which the body and sexuality are approached not with shame, but with normality and respect, offering students a safe space to ask questions and express their concerns. In this way, it not only informs, but also transforms cultural attitudes toward these topics, contributing to the development of a more open, aware, and confident generation.”
Despite the absence of sexual education in school curricula, should teachers and parents discuss these issues more openly?
“Not only should they, but it is also a duty—a moral, parental, and social obligation—for adults, both parents and teachers, to openly discuss adolescents’ sexual development and behavior. Teachers have a professional responsibility to educate young people on topics related to sexuality using scientifically based information and to create a safe environment for questions and discussion. At the same time, parents face the challenge of overcoming the taboos and stereotypes with which they themselves were raised, finding appropriate ways to help their children understand their bodies, emotions, and sexual health in a responsible manner.”
Would introducing sexual education into the curriculum help reduce gender-based violence and risky behavior among young people? How?
“Absolutely. Structured sexual education provides adolescents with accurate knowledge about their bodies, healthy relationships, and personal boundaries, helping them identify and avoid abusive situations. Such a curriculum teaches young people communication skills and mutual respect, while also raising awareness about the consequences of risky behavior and strengthening their ability to set clear boundaries and make informed decisions—directly contributing to the prevention and reduction of gender-based violence.”
Currently, schools in North Macedonia do not offer a dedicated subject on sexual education. In the past, there have been attempts to introduce comprehensive sexual education as an elective subject, and pilot programs have been implemented in several schools. Nevertheless, despite stated intentions, sexual education has yet to be incorporated into regular school curricula and remains unavailable to students on a systemic level.
