In a society where comprehensive sexuality education continues to be surrounded by debate and misinformation, its inclusion in the education system remains a slow process, challenged by political pressure and social taboos. Although concrete steps have been taken toward piloting the subject and preparing institutions, the lack of a sustainable and systematic approach continues to have a direct impact on the health and well-being of young people. In relation to these challenges and the role of civil society, Mollëkuqja.mk spoke with representatives of the Association for Health Education and Research HERA, who discussed achievements to date, existing obstacles, and the urgent steps needed to make comprehensive sexuality education an accessible and sustainable reality.
Several steps have already been taken in the country toward the introduction of comprehensive sexuality education. What has been achieved so far in practice, and which processes have been stalled or obstructed?
“In recent years, genuinely important steps have been taken toward the gradual introduction of comprehensive sexuality education, and from an institutional perspective, the process has neither been halted nor blocked. Initially, the Government adopted a decision to pilot the subject, followed by training for teachers and professional services aimed at preparing them for actual implementation. For the first time, the process moved from conceptual acceptance to practical classroom delivery.
Following the successful pilot and the positive evaluation results, work continued on developing the curriculum, providing additional training for teaching staff and professional services, and preparing appropriate teaching materials. Since institutional capacity-building is a long-term process, trainings are conducted continuously, and some of the already trained teachers are currently delivering the program as an extracurricular activity in ninth grade. Starting from the next school year, comprehensive sexuality education is expected to be offered as an elective subject in schools where trained teachers are available.
What has slowed the process is the influence of anti-democratic movements, which, through disinformation and falsehoods, have created fear, mistrust, and confusion about the content and purpose of comprehensive sexuality education—despite clear evidence showing that the program brings significant benefits to the mental, emotional, and physical health of young people.”
What are the main political, institutional, or social barriers that have hindered the inclusion of sexuality education in school curricula?
“For years, comprehensive sexuality education has been held hostage by political calculations and ideological clashes. Instead of being treated as a public health and education priority, the topic is often used for political promotion or to discredit certain public officials. In pre-election periods, political actors tend to distance themselves from comprehensive sexuality education due to fear of negative reactions from parts of the public—reactions that are largely the result of years of sustained disinformation. Political will, which should be stable and long-term, must not be swayed by short-term interests, especially when the best interests of children and young people are at stake.
From an institutional standpoint, a solid foundation already exists: a successfully piloted curriculum for primary education, trained professional staff, developed and standardized teaching materials, and existing mechanisms to support schools facing resistance or misinformation. However, several systemic solutions are still missing, including continuous teacher training across all levels of education, clear procedures for supervision and monitoring, and regular, transparent communication with the public about the program’s benefits. Budgetary resources are also lacking, which are in essence a key indicator of whether political support is merely declarative or genuinely substantive.
From a societal perspective, the main challenge lies in the lack of understanding of what comprehensive sexuality education actually represents. Some parents and members of the public perceive it as ‘too early’ or ‘dangerous,’ largely due to myths, stereotypes, and disinformation. Topics related to young people’s sexuality remain taboo in our society, creating resistance even when content is science-based, age-appropriate, and focused on health, safety, and prevention—rather than on encouraging sexual behavior.”
How do you assess the role of civil society, particularly HERA, which has advocated for comprehensive sexuality education for years? To what extent is the voice of the civil sector heard by institutions?
“Civil society, and HERA in particular, plays an important and constructive role in the development of comprehensive sexuality education. For years, the organization has provided education for young people, developed evidence-based materials, trained teachers and professional services, and conducted research that helps institutions make informed decisions. Civil society organizations also contribute concrete models and practical solutions that can be immediately implemented in schools. Cooperation between institutions and the civil sector exists, although there is always room for deeper collaboration, especially during moments of strategic decision-making. What remains essential is the fact that the sustained work of civil society organizations has ensured that sexuality education remains present in public discourse and continues to move toward a sustainable, systemic solution.”
Why is it important that sexuality education does not remain limited to NGO projects and informal initiatives, but instead becomes an integral part of the education system? What risks do young people face today due to this gap?
“Alarmingly clear research data point to the urgent need for a systemic solution and for integrating these contents into the formal education system. In recent days, highly concerning findings were once again presented from the HBSC study on health-related behaviors among school-aged children (11, 13, and 15 years old). A very high percentage of 15-year-old girls experience psychosomatic complaints; 67% of girls who report being in love at this age also report depressive symptoms, while 57% feel emotionally burdened. Among sexually active 15-year-old girls, 94% experience psychosomatic difficulties. Previous studies show that the average age of first sexual intercourse among young people in North Macedonia is 15, and 16 for girls.
By contrast, in countries where health education is integrated into school curricula, young people tend to delay their first sexual experience, in some cases until the age of 19. In 2023, the adolescent pregnancy rate was 13.4 per 1,000 girls aged 15–19, while the birth rate in this age group was 11.7 per 1,000 births. Young people aged 15 to 18 are more exposed to violence than other age groups in the country, while young people belonging to the LGBTI community experience bullying in schools up to four times more often than their heterosexual peers.
Sexuality education loses its essence if it remains confined to project-based activities, which are limited in duration, reach, and resources. In contrast, the formal education system ensures equal access for all students and guarantees that every young person—regardless of social background or place of residence—has access to accurate, verified, and age-appropriate information. Only a systemic approach can ensure long-term sustainability, quality, and clear standards.
In the absence of such education, young people are exposed to numerous risks, ranging from misinformation obtained online and through pornography to a lack of knowledge on how to recognize or report violence. This often leads to peer violence, unplanned pregnancies, sexually transmitted infections, and various mental health challenges related to body shame and low self-esteem. Marginalized groups of young people are particularly vulnerable, as without adequate support they grow up in environments that neither recognize nor address their needs. Therefore, comprehensive sexuality education should not be viewed as an additional activity, but as an essential protection and development mechanism that helps young people build healthy relationships, make informed decisions, and feel safe and supported.”
Sexuality education is often mistakenly presented as a “controversial” topic. To what extent do you believe this narrative stems from a lack of information, and to what extent from political manipulation? Who bears responsibility for creating this climate of mistrust?
“Sexuality education is often wrongly labeled as ‘controversial,’ primarily due to a lack of understanding of its essence and purpose. Many citizens are exposed to disinformation, mainly spread through social media, which fuels fear and misconceptions about the program’s content. In reality, comprehensive sexuality education is grounded in scientific standards and focuses on health, safety, emotional development, and the prevention of violent or risky behaviors—not on promoting values outside the educational and health context.
At the same time, some of these misleading narratives are the result of organized campaigns led by various anti-gender actors, among the most vocal being groups such as ‘Coalition for the Protection of Children,’ ‘Parental Front,’ ‘From Us for Us,’ ‘Take Responsibility,’ and ‘There Must Be Textbooks and Teaching.’ Their messages have also found support in political events, while protests against the Gender Equality Law were joined by religious leaders, public figures, intellectuals, and academics. This combination of factors contributes to a climate of mistrust surrounding comprehensive sexuality education, even though its purpose is precisely the opposite: to ensure healthy, informed, and safe development for young people.”
Given the current situation, what urgent steps should the Government, the Ministry of Education, and schools take immediately to make sexuality education a sustainable and accessible reality for young people in the country?
“Given the current context, the first and essential step is for institutions to publicly affirm the importance of sexuality education as part of safeguarding young people’s health, safety, and well-being. It is necessary to review all policies and practices that create ambiguity or restrict content related to health education, gender equality, and violence prevention. At the same time, continued development of sustainable curricula, provision of accredited teaching materials, and strengthened training for teachers and professional services are crucial, as their preparedness is key to quality implementation.
In parallel, public-facing activities are needed, including transparent communication about what sexuality education entails, regular information on its benefits, and open channels for dialogue with parents and the wider community. Schools must be equipped with clear guidelines and institutional support for implementation, particularly when facing uncertainty or misinformation. If these steps are undertaken in a coordinated and consistent manner, sexuality education can become a sustainable and accessible reality for all young people, as part of a high-quality and modern education system.”
There is still no dedicated subject on sexuality education in schools in North Macedonia. Although efforts have been made to introduce it as an elective subject and pilot programs have been implemented in several schools, comprehensive sexuality education has yet to become part of the official school curricula.
