Romeo and Juliet Painting by Sir Frank Bernard Dicksee

Professor John Ashton, president of the Faculty of Public Health, has suggested that the Government consider lowering the age of sexual consent from 16 to 15. He has certainly put the cat amongst the political pigeons (which is fun to observe in itself!) – but his intervention should also raise some deeper questions amongst social scientists operating in the world of health and medicine. His intervention into the debate raises questions about the relationship between evidence and policy, and the role that public health can (and does) play in privileging one over the other.

There are all sorts of things about sexual activity which, like it or not, are very clearly within the domain of Public Health. To begin with there are lots of sexually transmitted diseases which can be diagnosed, tracked, treated and even prevented. In a minority of cases, sex between males and females can bring about pregnancy (sometimes planned, sometimes not) and this can occasionally be associated with a whole gamut of health questions, ranging from termination issues, gestational problems for mother and baby through to post-natal depression and other psychological fallout. And then, of course, there are the physical consequences and often devastating emotional damage caused by rape, sexual violence and abusive sexual relationships.

All of the above may well be sex issues that, at an individual level, you might be pleased to get the opinion and help of a doctor or health professional of some kind. And, at the population and policy level, it is both sensible and desirable to get Public Health involved. Public Health practitioners can tell us how much of this stuff is happening, who it’s happening to and usefully suggest ways of either stopping the bad things from happening in the first place or mitigating their effects if they can’t be prevented.

But just because the Public Health establishment are so valuable in dealing with the wellbeing problems that can be related to sex doesn’t necessarily mean that we want them to rule on everything associated with it. Even in the over-medicalised world in which we live, some of sex still belongs to the rest of us. The regulation of sexual activity at the level of who does what with who is not necessarily an area of life that falls under the rubric of “doctor knows best”.

From a social science perspective, before we get too deeply involved in a debate about the detailed regulation of sexual activity in terms of the precise age at which young people are “allowed” to be sexually active, we would do well to ponder some bigger questions and their social/historical context.

For example, which aspects of sex should be regulated by law at all in a society that values individual liberty? When, if at all, should we make laws about sex for based on health imperatives, rather than working to develop good education and good sense in the context of a caring society? If protection of the vulnerable from abuse is the key shared goal we have, is the difference in age between those having sexual contact not more important than age itself? Just like our rules and mores concerning sex involving power and authority differentials. (See link “Romeo and Juliet Laws” below). Given that the social rules of sexual activity, including age regulation, are known to vary over time, geography and culture – where are we now? Is a medic the best person to ask? Or an anthropologist – or a sexologist, maybe? (Yes they do exist). Legislating on the legal age of a particular behaviour (whether it’s signing a contract, driving, boozing or having sex) is quite a ‘draconian’ thing for a Government to do. Are we happy for one particular professional group to attempt to take the whip hand in the discussion? The legal age of sexual consent is strongly linked to the existence of a stage of life our society calls “childhood”. Although clearly related to objective physiological development, the detailed ‘contents’ of childhood at any one moment are known to be culturally constructed. Can Public Health specialists have anything relevant to say about this? Or would they be overstepping their professional boundary on this one?

It might have been more useful for Professor Ashton to have raised some of these issues and then to concentrate on the details of the Public Health arguments that might support a change in the law. All we got was a couple of vague assertions (based on broad brush international comparison) that changing the age from 16 to 15 would somehow cut teenage pregnancy rates and make it easier for teenagers to access sexual advice and contraceptive services. For all I know that might be true, but coming from the leader of a profession that is forever banging on about evidence-based policy and practice, it was pretty thin stuff.