Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Stepwise sexual development of adolescents: the Dutch approach to sexuality education

Dutch adolescents develop their sexuality in a stepwise manner, gradually progressing from first kiss to first sexual intercourse. Adolescents who follow a stepwise sexual development are more confident and engage in less risky sexual behaviour than those who do not. Thus, the stepwise 'sexual career' is an excellent model for guiding development of age-appropriate sex education.

Your institute does not have access to this article

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. Adamson, P. Child Well-being in Rich Countries: A Comparative Overview (UNICEF Office of Research, Florence, Italy, 2013).

    Google Scholar 

  2. Advocates for Youth. Adolescent sexual health in Europe and the United States. The case for a Rights. Respect. Responsibility Approach. Advocates for Youth (2011).

  3. de Graaf, H., Kruijer, H., Van Acker, J. & Meijer, S. Seks onder je 25e. Seksuele gezondheid van jongeren in Nederland anno 2012 [Dutch]. (Eburon Publishers, Delft, 2012).

    Google Scholar 

  4. Rutgers and Soa Aids Nederland. Summary: Sex under the age of 25. Seks onder Je 25e (2017).

  5. van de Bongardt, D. Developing adolescent sexuality in context: relations with parents and peers. Thesis, Utrecht Univ. (2015).

    Google Scholar 

  6. Schalet, A. Not Under My Roof. Parents, Teens and the Culture of Sex. (Univ. Chicago Press, 2011).

    Book  Google Scholar 

  7. United Nations Population Fund. Comprehensive Sexuality Education: Advancing Human Rights, Gender Equality and Improved Sexual and Reproductive Health. (UNFPA, New York, 2010).

  8. de Haas, B. Sexuality education in Uganda: Teachers' reasoning in a 'morally upright' context. Thesis, Univ. Groningen (2017).

    Google Scholar 

  9. Boonstra, H. D. Advancing sexuality education in developing countries: evidence and implications. Guttmacher Policy Review 14, 17–23 (2011).

    Google Scholar 

  10. Vanwesenbeeck, I. Westeneng, J., de Boer, T., Reinders, J. & van Zorge, R. Lessons learned from a decade implementing comprehensive sexuality education in resource poor settings: the world starts with me. Sex Education, Sexuality, Society and Learning, 16, 471–486 (2016).

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Sanderijn van der Doef.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Additional information

Author contributions Both authors made substantial contributions to discussions of content, wrote the article, and reviewed and edited the manuscript before submission.

PowerPoint slides

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

van der Doef, S., Reinders, J. Stepwise sexual development of adolescents: the Dutch approach to sexuality education. Nat Rev Urol 15, 133–134 (2018).

Download citation

  • Published:

  • Issue Date:

  • DOI:


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing