Wearing a face mask during the COVID-19 pandemic has been the norm in some places — such as China, Taiwan, Japan and South Korea — but has been polarizing in others, such as the U.S., where mixed messages have resulted in confusion about whether or not to wear one.
But sex educators would like have a word with everyone. One sexologist, Jill McDevitt, recently highlighted how lessons from sex education can be applied to encourage face mask use.
“It’s not our first rodeo when it comes to convincing people they should wear a barrier for protection from a deadly virus,” McDevitt wrote in her June 29 Facebook post, using the analogy of condom use.
McDevitt outlines some of the approaches deployed in sex education that could help public health messaging around face masks.
“I was just hoping to give people a set of tools, a new way of thinking, a new framework for applying what we already know about sexuality and how it might be helpful with the current crisis,” she said.
Shame won’t work
Shaming people into wearing masks is not going to work just like shaming people into condom usage isn’t helpful, McDevitt said.
“It just doesn’t work,” she said. “We need to be more strategic.”
Instead, McDevitt chooses to lead by example.
“I wear a mask all the time and I compliment other people when I see them also wearing a mask, to give kind of a positive reinforcement,” she said.
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Sex educator Samantha Bitty says Canada issued messaging about face masks before it had all the information about their efficacy.
The way she sees it, face masks weren’t immediately encouraged due to fears around resultant shortages for health care professionals, which the WHO had already warned of. Masks weren’t presented as an official recommendation until late May.
According to Bitty, that might have made some people “resistant” to the message. “Because the trust is broken,” she said.
The federal government recommends wearing a non-medical mask when you can’t maintain a distance of two metres.
McDevitt’s viral Facebook post is everything she would have listed, Bitty said.
“We’ve got to talk about communication, we have to talk about risk negotiation, we have to talk about the risks and benefits and all these things,” she said.
When it comes to face masks and social distancing, “we’re talking about moving people’s ideology from an individualistic perspective to a community wellness perspective.”
People are being asked to think not just of themselves but for “the well-being of the whole,” Bitty explained.
This is new for many people, she said. “And so that is … why people are resistant to it.”
The shame and stigma around HIV, for instance, was rooted in homophobia, she said. It was treated like a morality issue.
With COVID-19, Bitty sees a similar approach of using morality to regulate people’s behaviour — as if people can be blamed for contracting the disease.
“How do we make decisions that are rooted in care for not just ourselves but each other,” she said.
For Bitty, sex education is about “communicating to our communities the different ways that we can make decisions around taking care of our health.”
People can’t be “fueled by guilt” — they need good information in order to make their own choices, Bitty said.
“The most sustainable approaches and the most effective approaches are always going to be rooted in that strength-based place of, like, how amazing is it that you have the opportunity to help take care of not only yourself but your community,” she said.
“Here’s the information. Make a decision for yourself.”
Martha Kempner, a freelance writer and sexual health expert, wrote a piece in May about how to get people to wear a face mask using sex education as a parallel.
“I think there a lot of parallels between face masks and condom use,” she said.
“I think what we’ve learned from the condom debate is that if we don’t acknowledge people’s feelings, they just get more defensive.”
But the analogy breaks down because condom use is mostly about protecting yourself, she pointed out.
“Right now we’re talking to people about using a mask to protect other people,” Kempner said. “And particularly to protect people they don’t know. And that’s a hard sell in this environment where we have very little empathy right now.”
Public messaging about face mask use should also be specific to regions because the impact of COVID-19 is felt differently depending on where you are in Canada, Bitty said.
“We can’t have an umbrella message for all of Canada,” she said. We need “regionally relevant information and demographically relevant information.”
“If you live in a community where the majority of the people are seniors, like in a long term care facility, as an example, it’s like, yeah, the messaging around masks needed to be different there.”
Not everyone will get on board
For Kempner, it’s important to recognize you can’t win over everyone — either in sex education or the current debate around face masks.
“There’s always going to be the people who say this doesn’t work,” she said. “I think you can’t let them define the debate. We’ve done that for a long time in sex ed and we have to get ahead of it and define the debate.”
She’s not alone in that line of thinking. Bitty said there are “many different” approaches to sex education.
“But mine is acknowledging the fact that not everybody is going to be with it,” she said.
People are more likely to wear masks if they’re the default, according to McDevitt.
Recently she visited a post office, where everyone in line was wearing a mask. A man walked in without one, paused, then asked someone to hold his spot in line while he grabbed a mask from his car.
“There was a sign on the on the front door of the post office that said ‘Masks required,'” McDevitt said.
“But that’s not what compelled him. What compelled him was he didn’t want to be the one not doing it.”
Better and accessible
McDevitt’s post calls for face masks to be easily accessible to anyone who wants to wear one — similar to how condoms are often freely available in places like community health clinics.
“Make them accessible. They should be free or at cost. They should be distributed in communities so wearing it is as easy as possible,” she wrote.
Bitty agrees. She makes masks for friends because she has the resources, she said.
“We have to look at all of the barriers and address them to the best of our ability,” Bitty said. “Whether those are cultural, financial, emotional, physical, economic … all those things are relevant.”
Part of this is also acknowledging when people with asthma or claustrophobia, for instance, signal that face masks are far from a perfect option for them.
“I’m kind of being like, ‘Yeah, that’s a challenge, what are some ways that we can modify this for you?’ Like maybe wearing a face shield,” McDevitt said.
This is similar to people with latex allergies who can’t use condoms, she said.
“Can you use another material? Let’s problem-solve a way that you can stay safe and you and your partner can stay safe, not just ‘Don’t wear a condom,'” McDevitt said.
Condom companies have been working over decades to improve their product. People can do the same with face masks, Kempner said.
“I think there’s acknowledging people’s discomfort and making a better product,” she said.
“Find the one you like the best is a good message.”