Beyond Basic Care: Cultivating Comprehensive Sexual Health Education for Malaysian Children with Special Educational Needs (SEN)

Children with special educational needs (SEN) experience developmental trajectories that require close attention, especially as they are highly vulnerable to sexual violence. Ensuring their well-being requires systemic attention to their needs. However, literature on children with SEN has critical limitations including insufficient focus on their sexual health education (SHE), inattention to parents’ perspectives, and a dearth of multilevel approaches to understanding SHE, particularly in conservative contexts like Malaysia. Using Bronfenbrenner’s Ecological Systems Theory, this study explored parents’ perspectives on SHE for their children with SEN across different layers of the socio-ecological environment. We interviewed 14 Malaysian parents of school-going children with SEN aged 4 to 24 years and conducted thematic analysis. At the individual level (child characteristics), we found that children with SEN receive unstructured and inconsistent SHE and are perceived as unready for SHE. At the microsystem level (family and school), parents displayed a belief-action gap towards SHE, and feared for their children’s sexual safety. The mesosystem (interactions between microsystems) highlighted the lack of teacher-parent collaboration in SHE delivery. Within the exosystem (external policies), parents noted a deficiency in stringent policies, leading parents to rely on unverified resources for SHE delivery. Finally, at the macrosystem level (cultural and societal influences), Malaysia’s diverse religious and cultural beliefs shape SHE implementation. This study emphasizes the importance of socio-cultural factors in SHE for children with SEN and stresses prioritizing their needs in policymaking and practice. It also calls for developing parent-centered programs and culturally tailored resources to improve parental awareness and knowledge.