Relationships and Sex in young people into 2020

A report about a million young people aged 12-15

Nick Opie, Jim Podbery, Angela Balding and David Regis

SHEU 2020

Summary (edited)

  • This report summarises recent findings from large opportunity samples of secondary-aged young people surveyed in schools from local authorities across England between 1985 and 2019.

A press release is linked at the end of this document, as is the whole report..


Sexual health information sources

  • 27% of pupils say that their main source of sex information is their parents; 34% say it's their school. 19% of Year 10 pupils say it is visitors in school lessons.
  • 38% of 7,539 pupils aged 12-15 in 2017-2019 said that parents should be their main source of sex information (Y8: 42%; Year 10: 33%; M: 35%; F: 41%) while 28% said school.

Sexual health knowledge

  • Just 84% of 24,549 Year 10 students 2017-19 say they have ever heard of gonorrhoea (39% in Y8).
  • 67% of all 14-15 yo 2017-19 (N=20,607) say that condoms can be relied upon to prevent pregnancy (M: 70%; F: 64%); the figure for 12-13yo is 54%
  • 63% of all 14-15 yo 2017-19 (N=20,428) say that the Pill can be relied upon to prevent pregnancy (M: 60%; F: 67%); the figure for 12-13yo is 34%.
  • 70% of 36,584 Year 10 students (aged 14-15yo) think that condoms are reliable to prevent infections like HIV/AIDS (48% of Y8).

Sexual health services

  • Just 23% of 20,007 Year 10 students know of a sexual health/advice service for young people available local to them (9% of Y8).
  • 58% of 40,902 Year 10 students aged 14-15yo said they knew where to get free condoms (36% of Y8).

    Sexual activity

  • Just under 14% of 23,746 14-15 year-old students in 2017-2019 reported that they have had sex.

    Dating relationships

  • 31% of 47,392 Year 10 students aged 14-15yo report that they have ever experienced at least one of a number of controlling, bullying or aggressive behaviours from a boyfriend or girlfriend (5% from their current partner).


  • 26% of 53,682 Year 10 students (aged 14-15yo) say they worry quite a lot or a lot about their friends (13% of males and 33% of females). The figure for Y8 students (12-13yo) is 23%.
  • Useful sex education lessons
  • 43% of 32,537 Year 10 students (aged 14-15y) reported that they had had useful lessons about sex and related topics at school (40% of Y8 students).

    Domestic violence

  • 5% of all 31,369 students in the sample report ever experiencing physical aggression at home between adults or adults and children. 1-2% say they experience this at least weekly.


  • 66% of 34,756 students aged 12-15y say that they can usually or always say no, if a friend asks them to do something that they don't want to do.

Summary of headlines and group differences

  • We can see that students from vulnerable groups were rather more likely to report having sex, but this was also often associated with better sexual health knowledge and awareness of local services. Worse knowledge was found with higher rates of sexual activity among students in residential care and those with low self-esteem.
  • Vulnerable groups were also more likely to report worry about friends, intimate partner aggression, domestic violence and lower confidence in refusal.

Comparing sexually active and inactive Year 10s

  • The minority of year 10 students (14-15yo) who report sexual activity are more likely to show better sexual health awareness and knowledge than their peers.

Relationships between RSE and other lifestyle topics

  • Students in Year 10 (14-15yo) who report having had sex, or domestic or partner aggression/violence, were likely to show significantly higher rates for several criteria that show additional vulnerability, such as being a young carer, or reporting health-risky behaviour, like use of drugs.
  • Students who report good sexual health knowledge and awareness of services are more likely to report planning to continue in full-time education and are more likely to report being in a single-parent family.


  • There was a gradual decline in the proportion of young people who said that parents were their main source of sex information from 1997-2009; figures from the last decade are generally about the same level or lower, but samples have been smaller and more variable. It will be interesting to see if the most recent figures are a blip or the start of a trend.
  • There was a gradual complementary increase in the proportion of young people who said that teachers/lessons were their main source of sex information from 1997-2012; figures from the last few years are rather lower, but samples have been smaller and more variable.
  • There was a gradual increase in the proportion of young people who said that parents should be their main source of sex information from 1985-2012; figures from the last two decades are generally about the same level or higher, but samples have been smaller and more variable.
  • There was a sharp rise in the proportion of young people who said that teachers/school lessons should be their main source of sex information from 1992 which soon settled at a new higher level; figures from the last two decades are generally about the same level, but samples have been smaller and more variable.
  • Awareness of gonorrhoea is much higher among Year 10 students than in Y8; it rose to a peak in about 2,010 which has been fairly stable since.
  • Understanding that HIV/AIDS can be treated but not cured has declined throughout since 2000.
  • Confidence that condoms are reliable to stop pregnancy has declined since 2014.
  • Confidence that The Pill is reliable to stop pregnancy has declined since 2010.
  • Confidence that condoms can prevent infections has mostly been stable over the last two decades.
  • Awareness of a local sexual health/advice services for young people has greatly declined since its high pint in around 2003.
  • Awareness of a source of free condoms reached a peak in the 2000s; we have no explanation for the short dip and recovery during this high period. Figures for the last decade are lower and have been in decline.
  • Reports of sexual activity among Year 10 students has been fairly stable in the last decade, at something over 10%. This figure is consistent with retrospective studies of adults.
  • We have only a few years' figures for aggression/controlling by an intimate partner, but findings for the most recent surveys are among the highest we have seen, so we have no evidence that rates are declining.
  • Worrying about friends was steady for many years, but for the last decade has fluctuated around a higher level. In alternate years, we have a large sample from an area which regularly reports high levels of concern about friends, and then one from an area where concern is low; minor changes in wording may have had a larger influence than we hoped. We suspect that the peaks and troughs are both drifting upwards, and can confirm this using a two-year smoothing of the figures:
  • Figures for 'useful school lessons about sex' have dropped since we started recording in 1999, when figures for all groups were around 50%, and in some areas are among the lowest we have recorded (as low as 30% in 2018).
  • Figures for confidence in saying no rose markedly for the first years of the millennium, but have been quite steady for the second decade, at least until the last couple of years.
  • Figures for shouting between adults at home have been steady during the last decade.
  • Figures for hitting or pushing between adults at home have been steady during the last decade.


  • Sexual health knowledge and awareness of sexual health services among Year 10 students is fair but not great.
  • Sexual health knowledge and awareness of sexual health services among Year 10 students is in decline.
  • Risky behaviours like tobacco and drug use may be associated with higher rates of sexual activity.
  • Vulnerable groups often report higher rates of sexual activity: children in residential care in particular.
  • Groups of students with higher rates of sexual activity are often more aware of sexual health services and sexually active students show better sexual health knowledge than average.
  • Some groups of young people show higher rates of sexual activity with poorer understanding of contraception and sexually transmitted infections; they may show other vulnerabilities, like higher rates of domestic violence in their homes.


  • The overall impressions we have is a decline in young people's understanding and awareness of sexual health services and sexual health knowledge. We have no evidence about the causes of this decline, but it may be because of poorer provision associated with 'austerity' cuts and a diversion of schools' attention from PSHE. In this regard, the new guidelines for relationships, health and sex education due to be implemented in Autumn 2020 are very much to be welcomed.
  • It can be argued that imperfect sexual health knowledge is not important among young people who are not having sex; we can see that sexual health knowledge is better but not by much among those who are having sex and we also believe that an amount of sexual activity among young people is not planned.





Comments about SHEU

"Please send an additional copy of our report - it is the most requested and borrowed item in the whole library." Health Promotion Unit

Health Promotion Unit

"The Schools Health Education Unit has gained a reputation as one of the most reliable sources of information about young people's health." BBC


"Thank you from my staff to you and all your staff. The speed of 'turn-around' of the questionnaires is outstanding in anyone's terms." Headteacher


"The data for (us) are very useful ... This is especially important when evaluating the impact of interventions regarding alcohol or other areas, as the survey data are likely to provide an earlier indication than routine data sources."

Specialist Registrar in Public Health

“(The SHEU survey) was very, very useful. It gave us reassurance we weren’t missing a trick. For example not many pupils in the sample year groups were taking illegal drugs, which re-enforced our opinions. But the survey also raised issues and flagged some things up. We discovered that some of our girls weren’t eating enough – the percentage of girls in our school not eating lunch the day before the survey was higher than the county average. There were other concerns too, specifically around cigarettes, alcohol and attendance.
The school used this data and took a number of actions to address it. More female peer mentors were put in place and the school asked NEXUS (the Extended Schools service) for help, so they developed a programme for girls which addressed their eating patterns, healthy eating, sex education and self-esteem issues.
We ran an anti-bullying group for Year 9 as a preventative measure, based upon data provided by our current Year 10 students.
The travel data revealed that a high number of pupils took the car to school so we involved the BIKE-IT scheme who ran assemblies, brought in their bikes (including one with a pedal-powered smoothie maker!), and raised awareness of health and green issues.
The information about how happy the students were with their lives raised some concerns as far fewer girls were as happy as the boys, so work was done around developing aspirations, role-models and self-esteem."        

Deputy Head, Secondary School

"It's good to talk with you again - we used so much of those data and did so much with it in schools - we really got the place buzzing!"

Consultant in Public Health
"The credit goes to you for the fabulous information the survey yields!"
Assistant Director Schools and SEN

"Your work in developing the Health Related Behaviour Survey was ground breaking and has continued to evolve." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

"Thanks for presenting the survey to local schools this morning, I just wanted to thank you for such interesting and thought-provoking information.  
I’m really glad we were able to take part - the information (particularly headline data and differences) will support us to have some really interesting questions with the Year group as a whole about the sense they’re making of this; what they think it might mean in terms of changes they might make, and what they need to support them in this."

Deputy Headteacher

"The Unit produces an invaluable body of knowledge... providing exceptional information across time and throughout the country." Kelloggs


"I would like to say how much we appreciated the work you and your team have put in to this project, a big thank you for the excellent reports that you have completed on our behalf." Assistant Director of Public Health

Assistant Director of Public Health
We were all very impressed with the spreadsheet and can see that an incredible amount of work has gone into creating this!
Health Improvement Specialist

"Every school involved in the National Healthy School programme should start with an HRBQ survey." Health Education Co-ordinator

Health Education Co-ordinator

"Brilliant - thank you Angela. As always you and your team are so proficient at getting our requests dealt with so promptly - it is a real pleasure to work with such a great organisation."

Health Improvement Adviser

"This week I have been working on a major strategy for service design -- it is easy to get solely focussed on hospitals, performance targets, and work force planning -- all very important; but at the same the needs of young people and how we need to work across agencies to address the health needs of today and tomorrow must be recognised. SHEU is founded to do just this."

PCT Performance Manager
I would be extremely interested to see the results as I know how useful this information has been to the other schools in the borough

"We would like to take part in the next ECM survey. We have found the data produced invaluable for supporting evidence in our SEF etc."

School Vice Principal

"As a Deputy Head in a large secondary school I was involved in taking part in a city wide health and wellbeing survey over a period of six years. Completing the survey every two years grew in importance year on year, with the final cycle having a major impact on our SDP, PHSE curriculum, Ofsted outcomes and governor understanding.
Over the six year period we moved from a small sample in two tutor groups filling in a paper survey to two year groups completing an online survey. The reports produced give graphical analysis of a wide range of issues. As a result of the survey we increased the number of PSHE workshop days for students to address issues such as smoking, drug and alcohol awareness, anti-bullying workshops. The surveys helped Governors make a positive informed decision to allow Brook Advisory Clinic nurses on site to support students.
As a result of taking part and using the evidence provided we were able to offer more support for students which had a direct impact on improved attendance and outcomes."

Deputy Head Secondary School

Any comments on specific survey questions that may have caused difficulty? No problems. My children were fully briefed before the survey and they understood that they could miss questions if they did not want to answer them. We did not have any children with any concerns regarding the survey at all.

Any comments on the use of the web site? No it was easy to use.

Any general comments on the exercise? The children really enjoyed completing the survey, It has lead to many positive discussions about our health and how we all have slightly different experiences and home lives.

Class teacher

"The data from last time were spot-on and we have done lots of work with it. We are very keen to repeat the survey." Headteacher


Any comments on specific survey questions that may have caused difficulty?
Pupils at our primary school found the questionnaire very easy to understand and most of them completed the questions in less than 45min.

...Many thanks for all your work with this year’s survey. It’s already proving to be invaluable especially against the severe cuts in services that are looming.
Health Promotion Manager
"This is amazing! Thank you." (school report)
I think the HRBQ is an absolutely wonderful, informative tool and I am keen to really encourage schools/other relevant partners (as appropriate) to utilise this invaluable data to encourage voice of the child, and subsequently contribute to shaping priorities and services.
Senior Health Improvement Practitioner (Children and Young People)

"...the only question to cause a problem was 'has everyone got a pen?" Supervisor's notes following a school survey

Supervisor's Notes

"Many thanks to SHEU for your excellent professional support over the years."

PSHE teacher

"I would like to say that this survey was very useful and made me realise things about PE and health that I had never realised before......Food at school is groovy, especially if your school does Jamie Olivers School Dinners. Viva apples and thanks for the survey." Female pupil, 13 yrs old

Female pupil, 13yrs

"We never make a move without looking at these excellent reports." Public Health Consultant

Public Health Consultant

"You have often stood alone against the media who were often looking for the sensational headline. I have noticed an important change: the media now look out for and report very fairly and fully on the reports from the team." 
Tributes from a Health Education Advisor to John Balding, presented at his retirement lunch, May 2005

Health Education Advisor

(Our) Senior team were very enthused with the rich source of data provided within the reports (and thought that the analyses including within the appendices section of the main reports were really interesting).

Health Improvement Specialist (Children, Schools and Families)

 “The (SHEU survey) helped us to prioritise where we needed to be in terms of PSHE education. We delivered assemblies based on the evidence as well as curriculum development, and dealt with whole school issues – particularly in regard to pastoral care. The answers received to the question on the survey “Who are you most likely to approach if you needed help” worried staff as “teacher” was not a popular answer. Subsequently the staff asked themselves why this had happened and what needed to be done to address the issue. There was more emphasis on wider aspects of PSHE education delivery, which needed more attention.

To summarise, the (SHEU survey) allows the PSHE department to assess the impact of teaching and learning and modify future lessons accordingly. It allows our school to look at whole school issues such as the extent to which the pastoral care system is meeting the needs of our pupils. It helps us to do need analysis of our pupils. It helps to provide important evidence for SEF / the extent to which we are meeting wellbeing indicators / National Healthy School standards.”  

Secondary School Head
Good morning You are an absolute life-saver!
PSHE Teacher

"The service you provide is of national significance." Health Development Agency

Health Development Agency

"I very much value the contribution the Health Related Behaviour Survey has made to the public health agenda and feel confident it will continue to do so." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Director of Public Health

"The system works and I find quite a lot of it useful in my work. I've also recommended it to others."

Teenage Pregnancy Manager

"On behalf of all the health promoters in Scotland I would like to say a big thank to you and your colleagues for your excellent work over the years. This includes not only your survey work but your role as a visiting examiner in Scotland and adviser on course development."
Tribute from a Health Commissioner to John Balding, presented at his retirement lunch, May 2005

Health Commissioner

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." Tribute from OFSTED to John Balding, presented at his retirement lunch, May 2005


"Many thanks for all of the fantastic information that you have sent to me over the years, it has really helped me to plan relevant courses for my students to follow and to help me to focus on the needs of the students I teach."

PSHE teacher
"The data from the 2018/19 survey is still in heavy use here, the physical activity related findings were pivotal in changing the relevant strategy recently to target less active groups like girls towards the end of secondary school, and I’ve three fairly hefty jobs on the to-do list that will use the data with other sources to identify target schools for mental health and physical activity projects, and another looking at community safety. I call it the gift that keeps giving and that certainly seems to be the case!"
Senior Public Health Specialist (Intelligence)

"Just to say a huge thank you for all your efforts in helping us with the Health survey amongst pupils. It has provided us with significant data which will be used across the school to help us improve. It helped us to obtain a healthy schools standard as well. I hope we can make this an annual feature as we can track the changing health of our pupils." Headteacher


"...the most comprehensive health education survey."

Daily Telegraph

"We were talking about (the SHEU survey) data at our recent NSCoPSE Conference, for PSHE advisers and consultants. It would be really helpful if some of this powerful data and the trends could be shared in the consultation around the PSHE Review. Colleagues shared their very positive experiences of (the SHEU survey). It provides excellent evidence of behaviour change for children and young people and of the impact of PSHE and wider interventions."

Personal and Social Development Consultant

"We are planning next year's programmes around this information." Health Education Adviser

Health Education Adviser

"I have valued greatly the work I have done with the team in Exeter, it has been a highlight of my years here." Health Promotion Specialist

Health Promotion Specialist

"We did this last year with Year 8 and 10 and was incredibly useful. It is WELL worth doing and so useful to inform PSHE planning. The safeguarding audit team were delighted that we had done it. The findings are so so interesting.
"The findings are really comprehensive and range from what percentage of year 8 have breakfast in the morning to how many have tried this particular drug, to identity, health and sleep patterns, mental health, citizenship issues....
"It's essential for the PSHE and pastoral curriculum."

PSHCEE coordinator

"Many thanks for a major contribution to the health of children in the UK and elsewhere over many years and putting in place the continuation of the Unit." Tribute from a Director of Public Health to John Balding, presented at his retirement lunch, May 2005

Director of Public Health

"I really appreciate the professional service which SHEU offers.  We have had a great experience working with Angela on the school surveys." 

Health Improvement Specialist

"The Schools Health Education Unit has been a unique inspiration to all of us. For me, as I have worked in the many different areas of the NHS, the SHEU, its principles and your determination have always been a cornerstone in what a health promoting service should be about."
PCT Performance Manager paying tribute to John Balding, presented at his retirement lunch, May 2005

PCT Performance Manager

Any comments on specific survey questions that may have caused difficulty?
All questions are clearly worded and easy to answer

Class teacher

"You have made a truly significant contribution to health education and health promotion of young people in, not only England, but all over the United Kingdom and beyond." Colleague from NHS Scotland paying tribute to John Balding, presented at his retirement lunch, May 2005

NHS Scotland

"We use the data to inform whole school practice: Pastoral programmes for target groups of pupils; Items for discussion with School Council; Information to help us achieve the Healthy School gold standard; To develop and dicuss with pupils our Anti-Bullying Policy; Targeted whole class sessions with the Police Community Support Officers; To share pupil perceptions of all aspects of their school life with parents, staff and governers." 

Learning Mentor

"This is an excellent way of keeping up to date belt and braces style."

School Drugs Advisor
...our analyst here in Public Health- is beside himself with excitement about all the juicy data pouring in...he can't wait to get his hands on it!!!! He is happier than I have seen him for years.
Public Health Principal

"Thank you very much, David, for another excellent survey.  We look forward to receiving our reports."

Healthy Schools Co-ordinator

Thank you for following up with schools the comments that caused concern. It is very sad to hear that some of our children have these thoughts and feelings and I am so grateful that you were able to make the schools aware of this so that they can attempt to offer some support.

This is another reason why I am so pleased that we have been able to work with you to offer this survey.

Health and Wellbeing Adviser
I've just spent a really interesting half an hour reading through our ...survey (report). Always food for thought and a good way to look at how we can improve.

"We're very happy to commission another survey from you. Our colleagues in School Improvement are dead keen to work with us on this. During our last LA Inspection, we were flagged from our Tellus data as having a bullying problem. We could demonstrate with our SHEU data - which had a much better sample size and coverage of the authority - that we did not have the problem they suggested. The Inspectors went away happy and we are definitely surveying again with SHEU."

Local Authority Senior Adviser

"SHEU data proved the best source of the kind of information we were looking for (...) to provide research support to the National Healthy Schools Programme." 

Department of Health
I would just like to say thank you very much to Angela, yourself and all of the SHEU team for making the [survey] so successful. The survey has been well received and we are using data in new ways to help support work on local Public Health priorities.
Senior Public Health Specialist

"One year (following the SHEU survey) responses from our Year 4 cohort caused us concern, so we put in place a number of team building, motivational projects. We then assessed their effectiveness by requesting the SHEU questionnaires for these pupils as Year 5's."

Learning Mentor

"You and the team have the evidence to show how young people's behaviour has or hasn't changed over time." 
Tribute from a Health Education Co-ordinator to John Balding, presented at his retirement lunch, May 2005

Health Education Co-ordinator

"The survey reports have been used to inform commissioning at specific commissioning groups. They are also being used within our Extended Schools Clusters and to inform The Annual Public Health and the Joint Strategic Needs Assessment." Programme Manager - Young People

"I would like to take this opportunity to thank you for your work regarding writing and compiling the sex education survey. The survey was well executed and the schools have found their individual reports very helpful. The results of the survey have enabled the Local Campaign Group to justify the need for young men's campaigns and given us invaluable insight as to the thoughts and experiences of this target group."

Teenage Pregnancy Strategy Manager

"The (named) Children and Young People's Partnership has benefitted from the results of the SHEU survey locally for many years now, and we should like to continue to do so in future."

Consultant in Public Health Medicine

"I really think that the HRBQ is a wonderful piece of work in terms of getting useful information for so many different organisations in one go." Healthy Children's Research and Statistics Officer

Research and Statistics Officer

"The children found the survey very interesting and enjoyed doing it." Class Teacher

Class teacher

"Over the last twenty years you have achieved much. The surveys and subsequent reports have painted the clearest picture we have of what young people are doing and what they think." OFSTED 1998

Please could our College be part of the SHEU survey this academic year? We did it in 2016 and 2017 and found it incredibly informative and it helped us shape our PSHE provision.
Assistant Principal
"They really enjoyed the animations and found the questionnaire fun to fill out"
School Nurse
Many thanks to you and your team for turning this around so quickly. We really appreciate it, and also your extra support with the administration this time.
PSHE Lead Advisor

"The Schools Health Education Unit is the jewel in the crown of the Health Education Authority." Major General Sir John Acland 1928 - 2006

Major General Sir John Acland

"We have never consulted our young people like this before. The survey makes a great contribution to our 'best value' planning." Sports Development Officer

Sports Development Officer

"Within the curriculum, we are part of the Healthy Schools programme - and the local, Director of Public Health Award. We cover many facets of health from emotional intelligence to safety education and our very strong, Anti-Bullying and Child Protection programmes. You can imagine our delight when the Local Authority and our school nurse made the following comments after we took part in the regional Schools Health Education Unit Survey: " Head Teacher.
“This was an amazing set of outcomes and really good evidence that (your school) is doing a wonderful job in prioritizing the health and well-being of its pupils … Well done to staff, governors and parents for all your work on this through the Director of Public Health award and other strategies. It is very clear that pupils feel happy, safe and involved at the school and your caring ethos shines through this data.”
Healthy Schools Coorduinator.


Headteacher & Healthy Schools Coordinator

"I have never looked at myself in this way before." Pupil


"As a result of the survey we reviewed and amended PSHE schemes of work, we are currently working on a "Green Travel Plan", a morning breakfast club was established and we further developed 6th Form mentoring."

Health Education Coordinator
My school took part in the Health Survey last year and found it incredibly beneficial. It has been an invaluable tool for planning our PSHE/well being provision and actioning our school development plan.
Primary School Wellbeing Lead
I just wanted to write and tell you how much I enjoyed your talk at last week's conference.
Chief Executive, substance use charity

"Our use of the Health-Related Behaviour Questionnaire was commended as part of our accreditation for the National Healthy Schools Scheme." Headteacher

"The Unit is to be congratulated in preparing ... material of the highest standard and worthy of wide dissemination." National Association for Environmental Education

National Association for Environmental Education

"The Unit has a unique historical and contemporary archive of young people." Prof. Ted Wragg 1938-2005

Prof Ted Wragg, 1938-2005

"The Health Related Behaviour Survey is an incredibly useful resource for (us) as it provides schools, with invaluable data which can inform curriculum content, methods of lesson delivery and empower schools to better meet the needs of their pupils."

Health Education Advisor

"You have made a fantastic contribution to children’s health education and promotion. I am personally grateful to you for helping to kickstart my research career." Prof. Neil Armstrong tribute to John Balding, presented at his retirement lunch, May 2005

Prof Neil Armstrong
At the time, the results were very useful and the feedback report very useful and insightful. Significant changes will occur in our schools health and wellbeing provision next year and conducting another survey will certainly help me to ensure I am planning effectively for the needs of our pupils.
Head of Health and Wellbeing