health and education

Comprehensive sexuality education: For healthy, informed and empowered learners

CSE Zambia

Did you know that only 37% of young people in sub-Saharan Africa can demonstrate comprehensive knowledge about HIV prevention and transmission? And two out of three girls in many countries lack the knowledge they need as they enter puberty and begin menstruating? Early marriage and early and unintended pregnancy are global concerns for girls’ health and education: in East and Southern Africa pregnancy rates range 15-25%, some of the highest in the world. These are some of the reasons why quality comprehensive sexuality education (CSE) is essential for learners’ health, knowledge and empowerment. 

What is comprehensive sexuality education or CSE?

Comprehensive sexuality education - or the many other ways this may be referred to - is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that empowers them to realize their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and understand and ensure the protection of their rights throughout their lives.

CSE presents sexuality with a positive approach, emphasizing values such as respect, inclusion, non-discrimination, equality, empathy, responsibility and reciprocity. It reinforces healthy and positive values about bodies, puberty, relationships, sex and family life.

How can CSE transform young people’s lives?

Too many young people receive confusing and conflicting information about puberty, relationships, love and sex, as they make the transition from childhood to adulthood. A growing number of studies show that young people are turning to the digital environment as a key source of information about sexuality.

Applying a learner-centered approach, CSE is adapted to the age and developmental stage of the learner. Learners in lower grades are introduced to simple concepts such as family, respect and kindness, while older learners get to tackle more complex concepts such as gender-based violence, sexual consent, HIV testing, and pregnancy.

When delivered well and combined with access to necessary sexual and reproductive health services, CSE empowers young people to make informed decisions about relationships and sexuality and navigate a world where gender-based violence, gender inequality, early and unintended pregnancies, HIV and other sexually transmitted infections still pose serious risks to their health and well-being. It also helps to keep children safe from abuse by teaching them about their bodies and how to change practices that lead girls to become pregnant before they are ready.

Equally, a lack of high-quality, age-appropriate sexuality and relationship education may leave children and young people vulnerable to harmful sexual behaviours and sexual exploitation.

What does the evidence say about CSE?

The evidence on the impact of CSE is clear:

  • Sexuality education has positive effects, including increasing young people’s knowledge and improving their attitudes related to sexual and reproductive health and behaviors.
  • Sexuality education leads to learners delaying the age of sexual initiation, increasing the use of condoms and other contraceptives when they are sexually active, increasing their knowledge about their bodies and relationships, decreasing their risk-taking, and decreasing the frequency of unprotected sex.
  • Programmes that promote abstinence as the only option have been found to be ineffective in delaying sexual initiation, reducing the frequency of sex or reducing the number of sexual partners. To achieve positive change and reduce early or unintended pregnancies, education about sexuality, reproductive health and contraception must be wide-ranging.
  • CSE is five times more likely to be successful in preventing unintended pregnancy and sexually transmitted infections when it pays explicit attention to the topics of gender and power
  • Parents and family members are a primary source of information, values formation, care and support for children. Sexuality education has the most impact when school-based programmes are complemented with the involvement of parents and teachers, training institutes and youth-friendly services .

How does UNESCO work to advance learners' health and education?

Countries have increasingly acknowledged the importance of equipping young people with the knowledge, skills and attitudes to develop and sustain positive, healthy relationships and protect themselves from unsafe situations.

UNESCO believes that with CSE, young people learn to treat each other with respect and dignity from an early age and gain skills for better decision making, communications, and critical analysis. They learn they can talk to an adult they trust when they are confused about their bodies, relationships and values. They learn to think about what is right and safe for them and how to avoid coercion, sexually transmitted infections including HIV, and early and unintended pregnancy, and where to go for help. They learn to identify what violence against children and women looks like, including sexual violence, and to understand injustice based on gender. They learn to uphold universal values of equality, love and kindness.

In its International Technical Guidance on Sexuality Education , UNESCO and other UN partners have laid out pathways for quality CSE to promote health and well-being, respect for human rights and gender equality, and empower children and young people to lead healthy, safe and productive lives. An online toolkit was developed by UNESCO to facilitate the design and implementation of CSE programmes at national level, as well as at local and school level. A tool for the review and assessment of national sexuality education programmes is also available. Governments, development partners or civil society organizations will find this useful. Guidance for delivering CSE in out-of-school settings is also available.

Through its flagship programme, Our rights, Our lives, Our future (O3) , UNESCO has reached over 30 million learners in 33 countries across sub-Saharan Africa with life skills and sexuality education, in safer learning environments. O3 Plus is now also reaching and supporting learners in higher education institutions.

To strengthen coordination among the UN community, development partners and civil society, UNESCO is co-convening the Global partnership forum on CSE together with UNFPA. With over 65 organizations in its fold, the partnership forum provides a structured platform for intensified collaboration, exchange of information and good practices, research, youth advocacy and leadership, and evidence-based policies and programmes.

Good quality CSE delivery demands up to date research and evidence to inform policy and implementation . UNESCO regularly conducts reviews of national policies and programmes – a report found that while 85% of countries have policies that are supportive of sexuality education, significant gaps remain between policy and curricula reviewed. Research on the quality of sexuality education has also been undertaken, including on CSE and persons with disabilities in Asia and East and Southern Africa .

How are young people and CSE faring in the digital space?

More young people than ever before are turning to digital spaces for information on bodies, relationships and sexuality, interested in the privacy and anonymity the online world can offer. UNESCO found that, in a year, 71% of youth aged 15-24 sought sexuality education and information online.

With the rapid expansion in digital information and education, the sexuality education landscape is changing . Children and young people are increasingly exposed to a broad range of content online some of which may be incomplete, poorly informed or harmful.

UNESCO and its Institute of Information Technologies in Education (IITE) work with young people and content creators to develop digital sexuality education tools that are of good quality, relevant and include appropriate content. More research and investment are needed to understand the effectiveness and impact of digital sexuality education, and how it can complement curriculum-based initiatives. Part of the solution is enabling young people themselves to take the lead on this, as they are no longer passive consumers and are thinking in sophisticated ways about digital technology.

A foundation for life and love

  • Safe, seen and included: report on school-based sexuality education
  • International Technical Guidance on Sexuality Education
  • Safe, seen and included: inclusion and diversity within sexuality education; briefing note
  • Comprehensive sexuality education (CSE) country profiles
  • Evidence gaps and research needs in comprehensive sexuality education: technical brief
  • The journey towards comprehensive sexuality education: global status report
  • Definition of Sustainable Development Goal (SDG) thematic indicator 4.7.2: Percentage of schools that provided life skills-based HIV and sexuality education within the previous academic year
  • From ideas to action: addressing barriers to comprehensive sexuality education in the classroom
  • Facing the facts: the case for comprehensive sexuality education
  • UNESCO strategy on education for health and well-being
  • UNESCO Health and education resource centre
  • Campaign: A foundation for life and love
  • UNESCO’s work on health and education

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Building an evidence- and rights-based approach to healthy decision-making

As they grow up, young people face important decisions about relationships, sexuality, and sexual behavior. The decisions they make can impact their health and well-being for the rest of their lives. Young people have the right to lead healthy lives, and society has the responsibility to prepare youth by providing them with comprehensive sexual health education that gives them the tools they need to make healthy decisions. But it is not enough for programs to include discussions of abstinence and contraception to help young people avoid unintended pregnancy or disease. Comprehensive sexual health education must do more. It must provide young people with honest, age-appropriate information and skills necessary to help them take personal responsibility for their health and overall well being. This paper provides an overview of research on effective sex education, laws and policies that shape it, and how it can impact young people’s lives.

What is sexual health education?

Sex education is the provision of information about bodily development, sex, sexuality, and relationships, along with skills-building to help young people communicate about and make informed decisions regarding sex and their sexual health. Sex education should occur throughout a student’s grade levels, with information appropriate to students’ development and cultural background. It should include information about puberty and reproduction, abstinence, contraception and condoms, relationships, sexual violence prevention, body image, gender identity and sexual orientation. It should be taught by trained teachers. Sex education should be informed by evidence of what works best to prevent unintended pregnancy and sexually transmitted infections, but it should also respect young people’s right to complete and honest information. Sex education should treat sexual development as a normal, natural part of human development.

Why is sexual health education important to young people’s health and well-being?

Comprehensive sexual health education covers a range of topics throughout the student’s grade levels. Along with parental and community support, it can help young people:

  • Avoid negative health consequences. Each year in the United States, about 750,000 teens become pregnant, with up to 82 percent of those pregnancies being unintended.[1,2] Young people ages 15-24 account for 25 percent of all new HIV infections in the U.S.[3] and make up almost one-half of the over 19 million new STD infections Americans acquire each year.4 Sex education teaches young people the skills they need to protect themselves.
  • Communicate about sexuality and sexual health. Throughout their lives, people communicate with parents, friends and intimate partners about sexuality. Learning to freely discuss contraception and condoms, as well as activities they are not ready for, protects young people’s health throughout their lives. Delay sexual initiation until they are ready. Comprehensive sexual health education teaches abstinence as the only 100 percent effective method of preventing HIV, STIs, and unintended pregnancy – and as a valid choice which everyone has the right to make. Dozens of sex education programs have been proven effective at helping young people delay sex or have sex less often.[5]
  • Understand healthy and unhealthy relationships. Maintaining a healthy relationship requires skills many young people are never taught – like positive communication, conflict management, and negotiating decisions around sexual activity. A lack of these skills can lead to unhealthy and even violent relationships among youth: one in 10 high school students has experienced physical violence from a dating partner in the past year.[6] Sex education should include understanding and identifying healthy and unhealthy relationship patterns; effective ways to communicate relationship needs and manage conflict; and strategies to avoid or end an unhealthy relationship.[7]
  • Understand, value, and feel autonomy over their bodies. Comprehensive sexual health education teaches not only the basics of puberty and development, but also instills in young people that they have the right to decide what behaviors they engage in and to say no to unwanted sexual activity. Furthermore, sex education helps young people to examine the forces that contribute to a positive or negative body image.
  • Respect others’ right to bodily autonomy. Eight percent of high school students have been forced to have intercourse[8], while one in ten students say they have committed sexual violence.[9] Good sex education teaches young people what constitutes sexual violence, that sexual violence is wrong, and how to find help if they have been assaulted.
  • Show dignity and respect for all people, regardless of sexual orientation or gender identity. The past few decades have seen huge steps toward equality for lesbian, gay, bisexual, and transgender (LGBT) individuals. Yet LGBT youth still face discrimination and harassment. Among LGBT students, 82 percent have experienced harassment due to the sexual orientation, and 38 percent have experienced physical harassment.[10]
  • Protect their academic success. Student sexual health can affect academic success. The Centers for Disease Control and Prevention (CDC) has found that students who do not engage in health risk behaviors receive higher grades than students who do engage in health risk behaviors. Health-related problems and unintended pregnancy can both contribute to absenteeism and dropout.[11]

What does the research say about effective sex education?

  • A 2012 study that examined 66 comprehensive sexual risk reduction programs found them to be an effective public health strategy to reduce adolescent pregnancy, HIV, and STIs.[12]
  • Research from the National Survey of Family Growth assessed the impact of sexuality education on youth sexual risk-taking for young people ages 15-19 and found that teens who received comprehensive sex education were 50 percent less likely to experience pregnancy than those who received abstinence-only-until-marriage programs.[13]
  • Even accounting for differences in household income and education, states which teach sex education and/or HIV education that covers abstinence as well as contraception, tend to have the lowest pregnancy rates.[14]
  • National Sexuality Education Standards provide a roadmap. The National Sexuality Education Standards, developed by experts in the public health and sexuality education field and heavily influenced by the National Health Education Standards, provide guidance about the minimum essential content and skills needed to help students make informed decisions about sexual health.15 The standards focus on seven topics as the minimum, essential content and skills for K–12 education: Anatomy and Physiology, Puberty and Adolescent Development, Identity, Pregnancy and Reproduction, Sexually Transmitted Diseases and HIV, Healthy Relationships, and Personal Safety. Topics are presented using performance indicators—what students should learn by the end of grades 2, 5, 8, and 12.[16] Schools which are developing comprehensive sexual health education programs should consult the National Sexuality Education Standards to provide students with the information and skills they need to develop into healthy adults.
  • 16 programs demonstrated a statistically significant delay in the timing of first sex.
  • 21 programs showed statistically significant declines in teen pregnancy, HIV or other STIs.
  • 16 programs helped sexually active youth to increase their use of condoms.
  • 9 programs demonstrated success at increasing use of contraception other than condoms.
  • 40 percent delayed sexual initiation, reduced number of sexual partners, or increased condom or contraceptive use;
  • 30 percent reduced the frequency of sex, including return to abstinence; and
  • 60 percent reduced unprotected sex.[17]
  • The Office of Adolescent Health, a division of the U.S. Department of Health and Human Services, keeps a list of evidence-based interventions, with ratings based on the rigor of program impact studies and strength of the evidence supporting the program model. Thirty-one programs meet the OAH’s effectiveness criteria and that were found to be effective at preventing teen pregnancies or births, reducing sexually transmitted infections, or reducing rates of associated sexual risk behaviors (defined by sexual activity, contraceptive use, or number of partners).[18]

What’s wrong with abstinence-only-until-marriage programs?

Many students receive abstinence-only-until marriage programs instead of or in addition to more comprehensive programs. These programs:

  • Depict abstinence until heterosexual marriage as the only moral choice for young people
  • Mention contraception only in terms of failure rates
  • Focus on heterosexual youth, ignoring the needs of LGBTQ youth
  • Often use outdated gender roles, urging “modesty” for all girls while painting all boys as sexual aggressors.
  • Have been found to contain false information
  • Are not supported by the majority of Americans.[19]

Only one abstinence-only program has ever been proven effective at helping young people delay sex; yet in withholding information about contraception, it leaves those who do have sex completely at risk. Studies show that 99 percent of people will use contraception in their lifetimes,[20] and that the provision of information about contraception does not hasten the onset of sexual debut or increase sexual activity.[10] Meanwhile, thirty years of public health research clearly demonstrate that comprehensive sex education can help young people delay sexual initiation while also assisting them to use protection when they do become sexually active. We want young people to behave responsibly when it comes to decisions about sexual health, and that means society has the responsibility to provide them with honest, age-appropriate comprehensive sexual health education; access to services to prevent pregnancy and sexually transmitted infections; and the resources to help them lead healthy lives.

All young people need comprehensive sexual health education, while others also need sexual health services. Youth at disproportionate risk for sexual health disparities may also need targeted interventions designed specifically to build self efficacy and agency. Further, administrators and other policy makers must recognize that structural determinants, socio-cultural factors and cultural norms have been shown to have a strong impact on youth sexual health and must be tackled to truly redress sexual health disparity fueled by social inequity.

How is the content of a student’s sex education decided?

Many factors help shape the content of a student’s sex education. These include:

  • State and federal funding the school district receives
  • State laws and standards regarding sex education
  • School district level policies and/or standards regarding curricula and content
  • The program or curriculum a district or individual school selects
  • The individual(s) who delivers the program.

With thousands of school districts around the nation, students’ experiences can vary drastically from district to district and school to school.

What are federal, state, and local structures that affect sex education?

In the United States, education is largely a state and local responsibility, as dictated by the 10th Amendment of the U.S. Constitution. This amendment states that “the powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.”[3] Because the Constitution doesn’t specifically mention education, the federal government does not have any direct authority regarding curriculum, instruction, administration, personnel, etc. In 1980, the U.S. Department of Education was created. While this move centralized federal efforts and responsibilities into one office, it did not come with an increase in federal jurisdiction over the educational system.

The U.S. Department of Education currently has no authority over sexual health education. However, there have been federal funds allocated, primarily through the Department of Health and Human Services that school systems and community-based agencies have used throughout the last three decades to provide various forms of sex education.[21]

  • Federal funding: Until FY2010, there was no designated funding for a comprehensive approach to sex education. In 1982, federal support of abstinence-only programs began, and in 1996, expanded drastically. From 1996-2010, over $1.5 billion in federal funding went to abstinence-only programs, which were conducted with little oversight and were proven ineffective. While one large stream of funding for abstinence-only programs was cancelled in 2010, at publication one still exists (as authorized by Congress through Title V funding) and is funded at $50 million per year.[22]

In 2010, two streams of funding became available for evidence-based sex education interventions.[22]

  • PREP: The Personal Responsibility Education Program (PREP) was authorized by Congress as a part of the Affordable Care Act of 2010. PREP provides grants ($75 million over five years) for programs which teach about both abstinence and contraception in order to help young people reduce their risk for unintended pregnancy, HIV, and STIs. In Fiscal Year 2012, 45 states applied for PREP. PREP grants are issued to states, typically the state health departments. All programs implemented with PREP funding are to educate adolescents about both abstinence and contraception for the prevention of pregnancy and STIs, including HIV/AIDS, and must cover at least three adulthood preparation subjects such as healthy relationships, adolescent development, financial literacy, educational and career success, and healthy life skills.
  • The President’s Teen Pregnancy Prevention Initiative (TPPI) funds medically-accurate and age-appropriate programs to reduce teen pregnancy. Seventy-five grantees in 32 states received TPPI funds in FY 2012. TPPI grants are distributed by the Office of Adolescent Health to local public and private entities. Grantees must implement an evidence-based program which has been proven effective at preventing teen pregnancy. According to OAH, 31 programs meet these criteria, including one abstinence-only-until-marriage program.
  • States may accept PREP, TPPI, or Title V funds. Many states accept funds for both abstinence-only programs and evidence-based interventions. In 2013, 19 SEAs and 17 LEA received five year cooperative agreements from CDC/DASH to implement ESHE within their school systems.

In addition, in 2013, CDC/Division of School Health issued a request for proposals to fund State Education Agencies (SEAs) and Large Municipal Education Agencies (LEAs) to implement Exemplary Sexual Health Education (ESHE). ESHE is defined as a systematic, evidence-informed approach to sexual health education that includes the use of grade-specific, evidence-based interventions, but also emphasizes sequential learning across elementary, middle, and high school grade levels.[23]

States may accept PREP, TPPI, or Title V funds. Many states accept funds for both abstinence-only programs and evidence-based interventions. In 2013, 19 SEAs and 17 LEAs received five year cooperative agreements from CDC/DASH to implement ESHE within their school systems.[22]

  • The Real Education for Healthy Youth Act: While there is as yet no law that supports comprehensive sexual health education, there is pending legislation. The Real Education for Healthy Youth Act (S. 372/H.R. 725), introduced in February 2013 by the late Senator Frank Lautenberg (D-NJ) and Representative Barbara Lee (D-CA), would ensure that federal funding is allocated to comprehensive sexual health education programs that provide young people with the skills and information they need to make informed, responsible, and healthy decisions. This legislation sets forth a vision for comprehensive sexual health education programs in the United States.
  • 30 states have no law that governs sex education, and schools are not required to provide it
  • 25 states mandate that sex education, if taught, must include abstinence, but do not require it to include contraception.
  • Six states mandate that sex education include either a ban on discussing homosexuality, or material about homosexuality that is overtly discriminatory.[22]

Each state has a department of education headed by a chief state school officer, more commonly known as the Superintendent of Public Instruction or the Commissioner of Education (titles vary by state). State departments of education are generally responsible for disbursing state and federal funds to local school districts, setting parameters for the length of school day and year, teacher certification, testing requirements, graduation requirements, developing learning standards and promoting professional development. Generally, the chief state school officer is appointed by the Governor, though in a few states they are elected.[23]

State departments of education may also have Standards which provide benchmark measures that define what students should know and be able to do at specified grade levels. These sometimes, but not always, address sexual health education. For instance, Connecticut and New Jersey have standards similar to the National Sexuality Education Standards in place and which address reproduction, prevention of STIs and pregnancy, and healthy relationships. A number of other states have general health education standards which do not directly address sexual health, while others make mention of HIV/STI prevention and abstinence but don’t demand the most thorough instruction in sexual health.[24]

  • Local Policy: At the school district level, Pre-K-12 public schools are generally governed by local school boards (with the exception of Hawaii which does not have any local school board system). Local school boards are typically comprised of 5 to 7 members who are either elected by the public or appointed by other government officials.[21]

Local school boards are responsible for ensuring that each school in their district is in compliance with the laws and policies set by the state and federal government. Local school board also have broad decision and rule-making authority with regards to the operations of their local school district, including determining the school district budget and priorities; curriculum decisions such as the scope and sequence of classroom content in all subject areas; and textbook approval authority. [21]

Typically, school boards set the sex education policy for a school district. They must follow state law. Some school boards provide guidelines or standards, while others select specific curricula for schools to deliver. Most school boards are advised by School Health Advisory Councils (SHACs). SHAC members are individuals who represent the community and who provide advice about health education.[21]

How can I work for comprehensive sexual health education for students in my community?

There are a number of ways to help ensure that students get the information they need to live healthy lives, build healthy relationships, and take personal responsibility for their health and well being.

  • Urge your Members of Congress to support the Real Education for Healthy Youth Act, in person, by phone, or online.
  • Contact your school board and urge them to adopt the National Sexuality Education Standards and require comprehensive sexual health programs.
  • Join a School Health Advisory Council in your area – both young people and adults are eligible to serve on most.
  • Organize within your community – a group of individuals, or a coalition of like-minded organizations – to do one or all of the above.

Young people have the right to lead healthy lives. As they develop, we want them to take more and more control of their lives so that as they get older, they can make important life decisions on their own. The balance between responsibility and rights is critical because it sets behavioral expectations and builds trust while providing young people with the knowledge, ability, and comfort to manage their sexual health throughout life in a thoughtful, empowered and responsible way. But responsibility is a two-way street. Society needs to provide young people with honest, age-appropriate information they need to live healthy lives, and build healthy relationships, and young people need to take personal responsibility for their health and well being. Advocates must also work to dismantle barriers to sexual health, including poverty and lack of access to health care.

Emily Bridges, MLS, and Debra Hauser, MPH

Advocates for Youth © May 2014

1. CDC. Youth Risk Behavior Surveillance, 2011. Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention; 2012.

2. Finer LB et al., Disparities in rates of unintended pregnancy in the United States, 1994 and 2001, Perspectives on Sexual and Reproductive Health, 2006, 38(2):90–96.

3. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2011. Atlanta: U.S. Department of Health and Human Services; 2012.

4. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2012. Atlanta: U.S. Department of Health and Human Services; 2013.

5. Alford S, et al. Science and Success: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections. 2nd ed. Washington, DC: Advocates for Youth, 2008;

6. Dating Matters: Strategies to Promote Health Teen Relationships. Atlanta: Center for Disease Control and Prevention; 2013.

7. National Sexual Education Standards: Core Content and Skills, K-12. A Special Publication of the Journal of School Health. 2012: 6-9. http://www.futureofsexed.org/documents/josh-fose-standards-web.pdf. Accessed October 2, 2013.

8. Davis A. Interpersonal and Physical Dating Violence among Teens. National Council on Crime and Delinquency, 2008. Retrieved November 15, 2013 from http://www.nccdglobal.org/sites/default/files/publication_pdf/focus-dating-violence.pdf

9. Ybarra ML and Mitchell KJ. “Prevalence Rates of Male and Female Sexual Violence Perpetrators in a National Sample of Adolescents.” JAMA Pediatrics, December 2013.

10. Gay, Lesbian, and Straight Education Network. The 20011 National School Climate Survey: The School Related Experiences of Our Nation’s Lesbian, Gay, Bisexual and Transgender Youth. New York, NY: GLSEN, 2012.

11. CDC. Sexual Risk Behaviors and Academic Achievement. Atlanta, GA: CDC, (2010); http://www.cdc.gov/HealthyYouth/ health_and_academics/pdf/sexual_risk_behaviors.pdf; last accessed 5/23/2010. 12. Chin B et al. “The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.” American Journal of Preventive Medicine, March 2012.

13. Kohler PK, Manhart LE, Lafferty WE. Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health. 2007; 42(4): 344-351.

14. Stanger-Hall KF, Hall DW. “Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the U.S.

15. National Sexual Education Standards: Core Content and Skills, K-12. A Special Publication of the Journal of School Health. 2012: 6-9. http://www.futureofsexed.org/documents/josh-fose-standards-web.pdf. Accessed October 2, 2013.

16. National Sexual Education Standards: Core Content and Skills, K-12. A Special Publication of the Journal of School Health. 2012: 6-9. http://www.futureofsexed.org/documents/josh-fose-standards-web.pdf. Accessed October 2, 2013.

17. Kirby D. Emerging Answers 2007. Washington, DC: National Campaign to Prevent Teen Pregnancy, 2007. 18. Office of Adolescent Health. “Evidence-Based Programs (31 Programs). Accessed March 5, 2014 from http://www.hhs.gov/ash/oah/oah-initiatives/teen_pregnancy/db/programs.html

19. Public Religion Research Institute. Survey – Committed to Availability, Conflicted about Morality: What the Millennial Generation Tells Us about the Future of the Abortion Debate and the Culture Wars. 2011. Accessed from http://publicreligion.org/research/2011/06/committed-to-availability-conflicted-about-morality-what-the-millennial-generation-tells-us-about-the-future-of-the-abortion-debate-and-the-culture-wars/ on May 13, 2014.

20. Daniels K, Mosher WD and Jones J, Contraceptive methods women have ever used: United States, 1982–2010,National Health Statistics Reports, 2013, No. 62, <http://www.cdc.gov/nchs/data/nhsr/nhsr062.pdf>, accessed Mar. 20, 2013.

21. Future of Sex Education. “Public Education Primer. “ Accessed from http://www.futureofsexed.org/documents/public_education_primer.pdf on May 13, 2014.

22. Sexuality Information and Education Council of the United States, Siecus State Profiles, Fiscal Year 2012. Accessed from http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1369 on May 13, 2014.

23. Centers for Disease Control and Prevention. “In Brief: Rationale for Exemplary Sexual Health Education (ESHE) for PS13-1308. Accessed from http://www.cdc.gov/healthyyouth/fundedpartners/1308/strategies/education.htm on May 13, 2014.

24. Answer. “State sex education policies by state.” Accessed from http://answer.rutgers.edu/page/state_policy/ on May 13, 2014.

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sexuality education essay

What is Comprehensive Sexuality Education (CSE)?

“Sexuality” is defined as “a core dimension of being human which includes: the understanding of, and relationship to, the human body; emotional attachment and love; sex; gender; gender identity; sexual orientation; sexual intimacy; pleasure and reproduction. Sexuality is complex and includes biological, social, psychological, spiritual, religious, political, legal, historic, ethical and cultural dimensions that evolve over a lifespan.” (ITGSE, p. 17)

What is Comprehensive Sexuality Education (CSE)?

Comprehensive sexuality education (CSE), therefore, is a curriculum-based process of teaching and learning about the cognitive, emotional, physical and social aspects of sexuality. It aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: realize their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives. (ITGSE, p. 16)

What is Comprehensive Sexuality Education (CSE)?

[World Health Organisation, 2010; Developing sexual health programmes: A framework for action ]

    • Delivered in formal and non-formal settings; whether in-school or out-of-school

    • Scientifically accurate , based on research, facts and evidence

    • Incremental . CSE starts at an early age with foundational content and skills, with new information building upon previous learning, using a spiral-curriculum approach that returns to the same topics at a more advanced level each year.

    • Age- and developmentally-appropriate . CSE content and skills grow in abstractness and explicitness with the age and developmental level of the learners. It also must accommodate developmental diversity, adapting for learners with cognitive and emotional development differences.

    • Curriculum-based . CSE is based in a written curriculum that includes key teaching objectives, learning objectives and the delivery of clear content and skills in a structured way.

    • Comprehensive . CSE is about much more than sexual behaviours. ‘Comprehensive’ refers to the breadth, depth and consistency of topics, as opposed to a one-off lesson or intervention. CSE addresses:

    • sexual and reproductive health issues, including, but not limited to: sexual and reproductive anatomy and physiology;     • puberty and menstruation;     • reproduction, contraception, pregnancy and childbirth;     • STIs, including HIV and AIDS.

CSE also addresses the psychological, social and emotional issues relating to these topics, including those that may be challenging in some social and cultural contexts. It supports learners’ empowerment by improving their analytical, communication and other life skills for health and well-being in relation to:

    • sexuality     • human rights     • a healthy and respectful family life and interpersonal relationships     • personal and shared values     • cultural and social norms     • gender equality     • non-discrimination     • sexual behaviour     • violence and gender-based violence     • consent and bodily integrity     • sexual abuse and harmful practices such as child, early and forced marriage and female genital mutilation/cutting.

Key values of CSE include:     • Human rights approach . CSE builds on and promotes universal human rights for all, including children and young people. It emphasises the rights of all persons to health, education, information equality and non-discrimination. It raises awareness among young people that they have their own rights, and that they must acknowledge and respect the rights of others, and advocate for those whose rights are violated.

    • Gender equality . Integrating a gender perspective throughout CSE curricula is integral to effective CSE programmes. CSE analyses “how gender norms can influence inequality, and how inequality can affect the overall health and well-being of children and young people, as well as the efforts to prevent issues such as HIV, STIs, early and unintended pregnancies, and gender-based violence. CSE contributes to gender equality by building awareness of the centrality and diversity of gender in people’s lives; examining gender norms shaped by cultural, social and biological differences and similarities; and by encouraging the creation of respectful and equitable relationships based on empathy and understanding.”

    • Culturally-relevant and context-appropriate . CSE must be delivered in the context of the range of values, beliefs and experiences that exist even within a single culture. It enables learners to examine, understand and challenge the ways in which cultural structures, norms and behaviours affect their choices and relationships within a variety of settings.

    • Transformative : CSE impacts whole cultures and communities, not simply individual learners. It can contribute to the development of a fair and compassionate society by empowering individuals and communities, promoting critical thinking skills and strengthening young people’s sense of citizenship. It empowers young people to take responsibility for their own decisions and behaviours, and how they may affect others. It builds the skills and attitudes that enable young people to treat others with respect, acceptance, tolerance and empathy, regardless of their ethnicity, race, social, economic or immigration status, religion, disability, sexual orientation, gender identity or expression, or sex characteristics.

    • Develops self-efficacy. CSE teaches young people to reflect on the information around them in order to make informed decisions, communicate and negotiate effectively and develop assertiveness rather than passivity or aggression. These skills foster the creation of respectful and healthy relationships with family members, peers, friends and romantic or sexual partners. (ITGSE, p. 16-17)

[Within the section above a call-out box or pop-up should appear with the following in it:

CSE and the Sustainable Development Goals

The 2030 Agenda and its global Sustainable Development Goals (SDGs) calls for action to leave no one behind, and for the realization of human rights and gender equality for all.” (ITGSE, p. 12). CSE is a part of these goals. The World Health Organisation’s fact sheet, Sexual and Reproductive Health, describes the connections between CSE and SDG 3 (Good Health and Well-Being), SDG 4 (Quality Education), SDG 5 (Gender Equality).]

CSE and the Sustainable Development Goals

sexuality education essay

Why education about gender and sexuality does belong in the classroom

sexuality education essay

Senior Lecturer, School of Education, Edith Cowan University

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There is currently no consistent standard of sex, sexuality, gender and respectful relationships education across Australian schools. Each state and territory makes decisions about what they teach in schools. Additionally, religious schools have exemptions under anti-discrimination laws to decide how they approach these issues, and whether they include them at all.

Despite the gains made in the marriage equality debate, Australia has been unable to translate this into inclusive sex and sexuality education for young people. While countries such as England and Canada are adopting progressive, consistent sex education programs at a national level, Australia has not.

Read more: Australian sex education isn't diverse enough. Here's why we should follow England's lead

The federal Department of Education is spending A$5 million to develop resources to teach respectful relationships in Australian schools. According to one news report , these resources will not include topics on toxic masculinity, gender theory or case studies about young people’s sexual activity. This project is a part of the women’s safety package announced in 2015 by the Turnbull government, which seeks to educate young people about violence against women.

The federal government is quietly trying to distance these resources from Victoria’s Respectful Relationships program, which has been criticised by some conservative commentators. Politics aside, there is an urgent need for these resources. Gendered violence against women and LGBTIQ people is too common in Australia.

No more federal funding for Safe Schools

Only a few years ago, Australia was very close to having a standard national resource for sex, sexuality and relationships education – the Safe Schools program. Its creators aspired to consistency across all state and territory educational jurisdictions in Australia, in line with the nationally consistent Australian Curriculum .

sexuality education essay

Safe Schools was designed as an evidence-based , educational anti-bullying program. The program had LGBTIQ inclusion at its core, and sought to create safe and inclusive environments for LGBTIQ students. Resources used to help deliver the program were developed by experts and carefully selected to ensure they were age-appropriate for the students using them.

The federal government stopped funding the program in mid-2017, following an extended public pillorying by conservative politicians and media commentators . This ranged from concern students were encouraged to cross-dress and role-play as gay teenages to false claims the program showed children how to masturbate and strap on dildos.

Read more: FactCheck: does the Safe Schools program contain 'highly explicit material'?

An inconsistent approach

Safe Schools has been replaced by an eclectic mix of programs, which vary from state to state. As a result, Australia has an inconsistent approach across state education systems.

In Victoria, the Building Respectful Relationships program was trialled in 2015 in response to recommendations Royal Commission into Family Violence and rolled out more broadly since 2016.

The program contains strong messages of healthy relationships, violence prevention and control, which young people can relate to, regardless of their situation. The program has received criticism claiming it’s simply a repackaged version of the Safe Schools program. It runs concurrently with Safe Schools, which is now implemented in nearly all government secondary schools in Victoria.

Safe Schools programs are also run in one government school in the NT, 21 government schools in Tasmania and 24 government schools, 3 independent schools and 3 other educational settings in WA.

At the federal level, funding has been confirmed to make the John Howard-inspired school chaplain program permanent. The School Chaplaincy program is intended to support the social, emotional and spiritual well-being of school communities across Australia. This may include support and guidance about ethics, values, relationships and spiritual issues.

Federal discomfort with sex, sexuality and gender discussions

Scott Morrison has made a number of comments about LGBTIQ issues in his short time as Prime Minister. Morrison said schools don’t need “gender whisperers”, referring to an article which stated teachers were being taught how to spot potentially transgender students.

It has since been clarified teachers were being trained on how to support students if they identify as transgender, not to identify potentially transgender students.

Morrison has also brushed aside concerns about gay conversion therapy , and publicly stated he sends his children to a religious schools to avoid “ skin curling ” discussions about gender diversity and sexuality.

Other members of the Coalition have publicly echoed similar beliefs, including Tony Abbott and Tasmanian Liberal senator Eric Abetz who actively spoke out against voting “yes” in the same-sex marriage plebiscite for fear it would lead to a “ radical sex education program for schools ”.

A strong case for sexuality, gender and sex education

Gender and sexual diversity are part of the rich multicultural landscape of contemporary Australian society. But research indicates there’s significant cause for concern about gender-based violence and family violence. Education about respectful relationships was identified as a key way to combat this in the Royal Commission into Family Violence .

Likewise, current research about young people and sex, sexuality and gender diversity is alarming. There are still high levels of mental health issues (such as depression, anxiety, self-harm, and suicide) among LGBTIQ young people as a result of bullying, discrimination, and harassment at school and in the wider community.

The data indicate increasingly high rates of sexually transmitted infections (STIs) among young people are also a significant concern. Rates of chlamydia and gonorrhoea diagnoses in Australia are highest amongst people aged 15-24 years .

sexuality education essay

Regardless of sexual orientation or gender identity, research indicates young people need to be reliably informed about safe sex. The ramifications of not doing so are far too significant. Research shows school-based sexuality education improves sexual health outcomes for young people.

Likewise, Australia has unacceptably high rates of family, domestic and sexual violence, while gender inequality permeates most aspects of society. This can be mitigated through reliable education about healthy relationships. Family, domestic and sexual violence is not a sign of a healthy society .

Read more: Young people want sex education and religion shouldn't get in the way

Sex, sexuality, respectful relationships, and gender all need to be discussed in schools as a component of a whole-school approach. This should not only include in-class education, but it should also be addressed in school cultures, policies and procedures, and in gender equity among the staff.

This is important because we need safe, inclusive schools that celebrate diversity. It’s also important to raise awareness among young people to mitigate family, domestic and sexual violence.

This article has been updated since publication to clarify that there are government schools in Victoria which run Safe Schools programs, and that the Building Respectful Relationships program is run concurrently, not as a replacement.

  • Sex education
  • Gender diversity
  • Culture wars
  • Respectful relationships
  • Toxic masculinity
  • Safe Schools
  • Gender studies

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Review article, a systematic review of the provision of sexuality education to student teachers in initial teacher education.

sexuality education essay

  • 1 School of Languages, Law and Social Sciences, Technological University of Dublin, Dublin, Ireland
  • 2 School of Human Development, Institute of Education, Dublin City University, Dublin, Ireland
  • 3 Department of Psychology, Faculty of Science & Engineering, Maynooth University, Kildare, Ireland

Teachers, and their professional learning and development, have been identified as playing an integral role in enabling children and young people’s right to comprehensive sexuality education (CSE). The provision of sexuality education (SE) during initial teacher education (ITE) is upheld internationally, as playing a crucial role in relation to the implementation and quality of school-based SE. This systematic review reports on empirical studies published in English from 1990 to 2019. In accordance with the PRISMA guidelines, five databases were searched: ERIC, Education Research Complete, PsycINFO, Web of Science and MEDLINE. From a possible 1,153 titles and abstracts identified, 15 papers were selected for review. Findings are reported in relation to the WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of core competencies for sexuality educators . Results revealed that research on SE during ITE is limited and minimal research has focused on student teachers’ attitudes on SE. Findings indicate that SE provision received is varied and not reflective of comprehensive SE. Recommendations highlight the need for robust research to inform quality teacher professional development practices to support teachers to develop the knowledge, attitudes and skills necessary to teach comprehensive SE.

Introduction

Sexuality education.

Our understanding of sexuality education is ever evolving, and differences exist in the terminology, definitions and criteria employed across various international documentation relating to SE (cf. Iyer and Aggleton, 2015 ; European Expert Group on Sexuality Education, 2016 ). While the term comprehensive sexuality education (CSE) has, in the last decade or so, come to be widely employed ( WHO Regional Office for Europe and BZgA, 2017 ; United Nations Educational Scientific and Cultural Organisation [UNESCO], 2018 ), given its more recent common usage, for the purpose of this paper, sexuality education (SE) is the broader term employed.

An international qualitative review of studies which report on the views of students and experts/professionals working in the field of SE ( Pound et al., 2017 ) provides recommendations for effective SE provision. According to that review, effective SE provision should include: The adoption of a “sex positive,” culturally sensitive approach; education that reflects sexual and relationship diversity and challenges inequality and gender stereotyping; content on topics including consent, sexting, cyberbullying, online safety, sexual exploitation, and sexual coercion; a “whole-school” approach and provide content on life skills; non-judgmental content on contraception, safer sex, pregnancy and abortion; discussion on relationships and emotions; consideration of potentially risky sexual practices and not over-emphasize risk at the expense of positive and pleasurable aspects of sex; and the production of a curriculum in collaboration with young people. Similarly, Goldfarb and Lieberman’s (2021) systematic review provides support for the adoption of comprehensive SE that is positive, affirming, inclusive, begins early in life, is scaffolded and takes place over an extended period of time.

Teachers as Sexuality Educators

While there are a variety of sources from which students access information for SE, and diversity in respect of students expressed preferences with regards to SE sources ( Turnbull et al., 2010 ; Donaldson et al., 2013 ; Pound et al., 2016 ), the formal education system remains a significant site for universal, comprehensive, age-appropriate, effective SE. Teachers are particularly well-positioned to provide comprehensive SE and create a climate of trust and respect within the school ( World Health Organisation [WHO]/Regional Office for Europe & Federal Centre for Health Education BZgA, 2010 , 2017 ; Bourke et al., 2022 ). Qualities of the teacher and classroom environment are associated with increased knowledge of health education, including SE, for students. Murray et al. (2019) found that the teacher being certified to teach health education, having a dedicated classroom, and having attended professional development training were associated with greater student knowledge of this subject. Inadequate training, embarrassment and an inability to discuss SE topics in a non-judgmental way have been cited as explanations provided by students as to why they would not consider teachers suitable or desirable to teach SE ( Pound et al., 2017 ).

Walker et al. (2021) in their systematic review of qualitative research on teachers’ perspectives on sexuality and reproductive health (SRH) education in primary and secondary schools, reported that adequate training (pre-service and in-service) was a facilitator that positively impacted on teachers’ confidence to provide school-based SRH education. These findings highlight the importance of quality teacher professional development, commencing with initial teacher education (ITE), for the provision of comprehensive SE. Consequently, ITE has increasingly been proposed as key in addressing the global, societal challenge of ensuring the provision of high-quality SE.

Initial Teacher Education

Teacher education provides substantial affordances to respond to the opportunities and challenges presented in the area of SE ( WHO Regional Office for Europe and BZgA, 2017 ). Furthermore, a research-informed understanding of teacher education is emphasized to better support teacher educators in their work with student teachers ( Swennen and White, 2020 ).

Quality ITE provides a strong foundation for teachers’ delivery of comprehensive SE and the creation of safe and supportive school climates. Research has found that teacher professional development in SE is a significant factor associated with the subsequent implementation of school-based SE ( Ketting and Ivanova, 2018 ). A recent Ecuadorian study reported that student teachers held a relatively high level of confidence in terms of their perceived ability to implement SE and to address specific CSE topics. Furthermore, favourable attitudes toward CSE, strong self-efficacy beliefs to implement CSE, and increased confidence in the ability to implement CSE were significantly associated with positive intentions to teach CSE in the future. Insufficient mastery of CSE topics, however, may temper student teachers’ intentions to teach CSE ( Castillo Nuñez et al., 2019 ). Internationally, research suggests there is inconsistency in the provision of SE in ITE and that access to professional development in SE in ITE, and after qualification, needs substantial development ( United Nations Educational Scientific and Cultural Organisation [UNESCO] , 2009 , 2018 ; Ketting et al., 2018 ; O’Brien et al., 2020 ).

Research is thus warranted to explore aspects at the institutional, programmatic and student-teacher level at ITE to address issues regarding the provision, and barriers to SE provision during ITE. Contemporaneous to the current review, O’Brien et al. (2020) undertook a systematic review of teacher training organizations and their preparation of student teachers to teach CSE. They found that teacher training organizations are often strongly guided by national policies and their school curricula, as opposed to international guidelines. They also found that teachers are often inadequately prepared to teach CSE and that CSE provision during ITE is associated with greater self-efficacy and intent to teach CSE in schools. The importance of ITE with regards to the provision of SE cannot be underestimated. Teachers are in an optimal position to provide age-appropriate, comprehensive and developmentally relevant SE to all children and young people.

The current systematic review will assess the provision of SE to student teachers in ITE and how this relates to the relevant knowledge, attitudes and skills required of sexuality educators as proposed by the international guidelines produced by the WHO Regional Office for Europe and BZgA (2017) . The WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of core competencies for sexuality educators adopts a holistic definition of core competencies, espousing an understanding of teacher competencies as “…overarching complex action systems” and as multi-dimensional, made up of three components: attitudes, skills and knowledge ( WHO Regional Office for Europe and BZgA, 2017 , p. 20). This framework outlines a set of general competencies, together with more specific attitudes, skills and knowledge competencies for sexuality educators. Attitudes, which may be explicit or implicit, are understood as a factor pertaining to the influencing and guiding of personal behaviour. Skills are understood in terms of the abilities educators can acquire which enables them to provide high-quality education. While knowledge is understood as professional knowledge (pedagogical knowledge, content knowledge and pedagogical subject knowledge) in all relevant areas required to deliver high-quality education. Overall, the framework endorses a holistic and multi-dimensional approach which focuses on sexuality educators and the inter-related competencies, in relation to the knowledge, attitudes, and skills that they should have, or need to develop to become effective teachers of SE.

Aims and Objectives

The current study aimed to systematically review existing empirical evidence on the provision of SE for student teachers in the context of ITE.

The objectives were:

• To review the existing peer-reviewed, published literature on SE provision during ITE.

• To synthesize the research on SE provision at ITE institutional/programmatic level.

• To synthesize the research on individual level student teachers’ knowledge, attitudes, and skills in relation to SE during ITE.

Materials and Methods

The systematic review was completed in accordance with PRISMA guidelines ( Liberati et al., 2009 ). A descriptive summary and categorization of the data is reported ( Khangura et al., 2012 ).

Eligibility Criteria

Articles were included in the review subject to adherence to specific inclusion criteria. An overview of inclusion criteria is outlined in Table 1 .

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Table 1. Screening and selection tool.

Information Sources

A three-reviewer process was employed. Searches were conducted in August 2019 on five databases selected for their ability to provide a focused search within the disciplines of education (ERIC and Education Research Complete), psychology (PsycINFO), and multi-disciplinary research in the disciplines of health/public health (Web of Science and MEDLINE).

Screening and Study Selection

Reviewers’ selected keywords from two domains, namely ITE and SE as outlined in Table 2 , for the searches. Search terms for each domain were combined using the Boolean search function “AND.”

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Table 2. Overview of Systematic Review search terms.

Where possible, limits were applied to include articles from peer reviewed journals as outlined in Table 3 .

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Table 3. Overview of database searches and limits applied.

In accordance with Boland et al. (2017) , a pilot screening of a sample of titles and abstracts were completed by two reviewers to assess the inclusion and exclusion criteria. All titles and abstracts were then screened using Abstrackr software ( Abstrackr, 2010 , accessed 2019; Wallace et al., 2010 ). A selection of abstracts were then cross checked by two reviewers. The final selection involved a three reviewer process. Duplicates and references which did not meet the eligibility criteria were removed at this stage. Full text papers of the remaining articles were obtained, where possible. All three reviewers blindly screened the texts of the remaining articles. Consensus was reached that 15 articles met the criteria for this review. Two experts in the field of SE reviewed the list of 15 articles to ensure there were no outstanding papers for consideration within the parameters of the review. No additional papers were identified.

Data Collection Process

A data extraction template was devised in accordance with Boland et al.’s (2017) recommendations. Information was collected on each study regarding: participant characteristics (data on participant gender, age, programme and institution of study, ethnicity, socio-economic status and religion were extracted, where provided); whether the studies examined programmatic input and if so the duration/extent of input; theoretical and conceptualization of SE within the programme; topics covered; whether this was a compulsory or elective programme; and whether the study addressed the WHO-BZgA competencies of knowledge, attitudes and skills of student teachers during ITE ( WHO Regional Office for Europe and BZgA, 2017 ). One lead author was contacted for the purpose of data collection and provided further information regarding their study.

Synthesis of Results

A qualitative synthesis was conducted; the purpose of which was to provide an overview of the evidence identified regarding research on the provision of SE in the ITE context. The findings of the reviewed studies were synthesized following consideration of the key learnings and recommendations from the studies and consideration of the WHO Regional Office for Europe and BZgA (2017) competencies of knowledge, attitudes, and skills necessary for the provision of SE at ITE. The WHO Regional Office for Europe and BZgA (2017) framework was selected to support the categorization and analysis of findings as it was developed by global experts in the field and is thus, an international standard for SE. While there are limitations to the use of this framework, it offered the ability to categorize and analyze findings through a multi- dimensional lens of knowledge, attitudes, and skills.

Quality Appraisal

The Mixed Methods Appraisal Tool (MMAT) ( Pluye et al., 2009 ; Hong et al., 2018 ) was used to appraise the quality of papers by two reviewers. This tool has been found to be reliable for the appraisal of qualitative, quantitative and mixed methods studies ( Pace et al., 2012 ; Taylor and Hignett, 2014 ) and has been successfully used in previous systematic reviews (e.g., McNicholl et al., 2019 ). For each paper, the appropriate study design was selected (i.e., 1. Qualitative, 2. Quantitative randomized controlled trials, 3. Quantitative non-randomized, 4. Quantitative descriptive, and 5. Mixed methods). Next, the paper was assessed using the checklist associated with the study design (see Appendix A for overview of checklist). For example, if the study was categorized as 4. Quantitative descriptive, the study was assessed against the five criteria (4.1–4.5) associated with this study design. An example of a question on the checklist includes “Are the measurements appropriate?” criteria were reported as “met,” “not met,” “cannot tell if criteria were met” or “criteria not applicable.” The results of the quality appraisal are presented in Table 4 . The same numbering as the methodological quality criteria of Hong et al.’s (2018) study was used.

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Table 4. MMAT quality appraisal.*

Study Selection

Fifteen articles reporting on thirteen empirical studies were included in the review (see Figure 1 ). Harrison and Ollis (2015) and Ollis (2016) articles are derived from the same dataset, as are Sinkinson and Hughes (2008) and Sinkinson (2009) articles. Given, however, that these articles refer to unique aspects of the particular studies, they have been described and discussed as separate studies in this review. An overview of the process of screening and study selection is outlined in Figure 1 .

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Figure 1. Flow diagram of systematic review process.

Study Characteristics

Six qualitative, five quantitative, and four mixed methods studies were reviewed. Where information was available, the research studies were identified as having been conducted predominantly in Australia, New Zealand, and South Africa. The studies were published between 1996 and 2016. Data was most frequently collected from one source; student teachers ( n = 10) and teacher educators/course providers ( n = 3). One study collected data from both student teachers and teacher educators/course providers ( Johnson, 2014 ). The samples size of studies varied from three to 478 participants but were generally small (eight of the studies had fewer than 90 participants: Vavrus, 2009 ; Carman et al., 2011 ; Goldman and Coleman, 2013 ; Johnson, 2014 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ).

Seven studies assessed SE educational inputs at ITE, and three conducted content analysis of content covered on SE educational input at ITE. As the studies were predominantly descriptive and explorative in design, specific outcome variables were often neither defined nor addressed. Educational input studies were classified as examples of research which assessed a particular course, module, or lecture on SE at ITE. With regards to theoretical approaches that may have informed the educational input studies reviewed, three did not report a specific theoretical approach ( Sinkinson, 2009 ; Gursimsek, 2010 ; MacEntee, 2016 ), and the remaining four reported that a critical approach was adopted ( Vavrus, 2009 ; Harrison and Ollis, 2015 ; Brown, 2016 ; Ollis, 2016 ). An overview of study characteristics are presented in Table 5 .

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Table 5. Overview of characteristics of reviewed studies.

Quality Appraisal Results

An overview of the results of the MMAT are presented in Table 4 . All the papers in the review were empirical studies and therefore could be appraised using the MMAT. Predominantly the studies reviewed employed the use of qualitative methods, and of the mixed methods studies there was often an emphasis on the qualitative data. Generally, the quality of the mixed methods studies was varied with only a minority of these studies providing a rationale for the use of mixed methods and reporting on divergences between the qualitative and quantitative findings.

The rigour and quality of the qualitative research was also varied. An explicit statement of the epistemological stance adopted and detail of the analytical process were reported in a minority of studies. With regards to educational input studies, data was often collected only after the educational input was completed and thus behavioral change as a result of engagement in the educational input could not be ascertained (e.g., Harrison and Ollis, 2015 ; MacEntee, 2016 ; Ollis, 2016 ). Only one study employed a quasi-experimental design ( Gursimsek, 2010 ), and in this case a purposive sample of student teachers who did not complete the SE course was selected as the control group. Within the remaining 14 studies there were no control groups, randomization, or concealment.

Findings are reported in relation to (a) institutional/programme level and (b) individual student teacher level aligned with the World Health Organisation ( WHO Regional Office for Europe and BZgA, 2017 ) Training Matters: Framework of Core Competencies for Sexuality Educators . An awareness of the interaction of these aspects of student teachers’ development was informative in terms of structuring the findings.

The research studies reviewed predominantly focused on examining a particular educational input on SE during ITE ( Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ) or investigating the SE content covered during ITE ( Rodriguez et al., 1997 ; McKay and Barrett, 1999 ; Carman et al., 2011 ). Fewer of the reviewed studies focused on student teachers’ skills to teach SE (e.g., Sinkinson, 2009 ; Vavrus, 2009 ; Harrison and Ollis, 2015 ; Goldman and Grimbeek, 2016 ; MacEntee, 2016 ) or student teachers’ attitudes regarding SE (e.g., Sinkinson and Hughes, 2008 ; Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Johnson, 2014 ; Brown, 2016 ). The findings of the studies were synthesized and categorized in relation to institutional/programmatic level or individual student teacher level. Findings which reflected responses and perceptions of student teachers were categorized as individual student teacher level. Institutional/Programme level related to studies assessing particular modules or comparing course content across programmes, and institutional level studies were categorized as studies where data was collected from multiple institutions. Individual student teacher level findings were reported in relation to the knowledge, attitudes, and skills competency areas required of sexuality educators. These competency domains, however, are not discrete entities or mutually exclusive. In taking a systemic approach, it is, therefore, acknowledged that they are dynamically interconnected, and influence and interact.

Institutional/Programme Level Findings

At a programmatic level, studies revealed variance in the type of SE provision (core/mandatory and elective), student teachers receive during ITE. May and Kundert (1996) found that coursework on SE was reported as part of a mandatory course by 66% of respondents and as part of an elective course by 14% of respondents. While McKay and Barrett (1999) reported that only 15% of the health education programmes in their study offered mandatory SE training with 26% of programmes offering an elective component. With regards to the provision of skill development and training for SE that student teachers received during ITE, Rodriguez et al. (1997) found that of a potential 169 undergraduate programmes, the majority (i.e., 72%) offered some training to student teachers in health education: A minority offered teaching methods courses in SE (i.e., 12%) and HIV/AIDS prevention education (i.e., 4%). Two of the reviewed studies also investigated programme time allocated to SE and found that time spent on SE varied from 3.6 hours ( May and Kundert, 1996 ) to between 9.6 and 36.2 hours ( McKay and Barrett, 1999 ). While at an institutional level, Carman et al. (2011) found that eight of 45 teacher training institutions did not offer any training in SE and of those that did, 62% offered mandatory, and 38% elective inputs.

Findings indicate the paucity of SE topics covered across ITE programme curricula. Rodriguez et al. (1997) reported that 90% of the courses they reviewed listed a maximum of three SE topic areas. The top three SE topics reported in terms of coverage were human development, relationships, and society and culture. Somewhat consistently, McKay and Barrett (1999) found that the topics least emphasized on courses were masturbation, sexual orientation, human sexual response, and methods of sexually transmitted disease prevention. Johnson (2014) sought to examine coverage of, what they defined as, “lesbian, gay, bisexual, transsexual and intersexual (LGBTI)” (p. 1249) issues on ITE courses and reported that of the three ITE institutions examined, none specifically reference LGBTI issues. Finally, one study reported that the provision of SE was found to be contingent on the interest and expertise of the university teacher educators ( Carman et al., 2011 ). Collectively, these findings bring to light the variance in mandatory and/or elective SE provision during ITE, as well as the diverse content covered and the role of teacher educators on its provision.

Individual Student Teacher Level Findings

Factors associated with student teachers’ attitudes regarding sexuality education topics.

Gender, geographical location, religious beliefs, and family background were identified as factors associated with student teachers’ attitudes regarding SE ( Sinkinson and Hughes, 2008 ; Gursimsek, 2010 ; Johnson, 2014 ). Attending a SE course may have positive implications for student teachers’ attitudes as Gursimsek (2010) found that students who had not attended the SE course reported more conservative and prejudiced views toward sexuality than those who had attended the SE course. Given that this was an elective course, however, it is important to consider self-selection bias regarding those who may have opted to take the course.

Student teachers in Johnson’s (2014) study reported that, through engagement in educational inputs which discussed sexuality issues in an open and inclusive way, greater awareness of student teachers’ own and others’ biases was developed. So, too, was knowledge to better understand sexuality issues. Student teachers did, however, acknowledge difficulty integrating these new learnings with their family backgrounds, and belief systems. MacEntee’s (2016) study also brought to light tensions between student teachers’ intentions to teach, and their own attitudes to SE topics and norms within schools. Since the educational input, however, none had used the participatory visual methods when teaching about HIV and AIDS during their teaching practice. Student teachers’ responses indicated that external factors made it difficult to independently continue to integrate participatory visual methods and HIV and AIDS topics into their teaching practice experiences in schools. The findings from Johnson (2014) , and MacEntee (2016) studies indicate that student teachers’ intentions and the realities of teaching subjects and using pedagogical approaches in schools do not always align.

Critical Consciousness

The WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework outlines the objectives of SE, including “open-mindedness and respect for others” (p.26). Although SE courses during ITE may be student teachers’ first exposure to issues of sexual and gender equality, for example, critiques of hetero-normativity ( Vavrus, 2009 ) and introductions to critical feminist discourses ( Harrison and Ollis, 2015 ), findings from several of the studies ( Sinkinson, 2009 ; Vavrus, 2009 ; Harrison and Ollis, 2015 ), indicated that the SE programmes offered during ITE may be insufficient in developing student teachers’ critical consciousness—the ability to recognize and analyze wider social and cultural systems of inequality and the commitment to take action to address such inequalities.

Vavrus (2009) found student teachers expressed varying degrees of critical consciousness as a result of completing a multi-cultural curriculum and assignment. While Harrison and Ollis’s (2015) examination of micro-teaching lessons indicated that completion of an educational input on SE from a feminist, post-structuralist perspective did not suffice in increasing student teachers’ understanding of gender/power relations but rather brought to light the challenges of employing such a perspective. Similarly, Sinkinson (2009) reported a noticeable lack of development of criticality regarding socio-cultural perspectives of SE from the completion of an introductory health education course (2004, first year) to the completion of a specialist health education course (2006, third year). Finally, albeit difficult to generalize given the study’s small sample size, Brown (2016) reported that experiential pedagogical approaches, through inclusion of a guest speaker living with HIV, and employment of a critical, creative arts-based pedagogical strategy offered a critical lens through which student teachers moved from a position of stigmatization toward one of understanding and compassion.

Factors Associated With Student Teachers’ Skills Regarding Sexuality Education Topics

With regards to student teachers’ skills, or potential skill development during ITE, several aspects of ITE were identified as significant in relation to the acquisition of the required skills to teach SE. These included the pedagogical approaches adopted during ITE; the learning environment; opportunities for practical teaching experience, and critical self- reflection.

Pedagogical Approaches and Practical Teaching Experiences

Seven of the studies reviewed examined aspects of pedagogical approaches to teaching SE ( Rodriguez et al., 1997 ; Sinkinson and Hughes, 2008 ; Sinkinson, 2009 ; Carman et al., 2011 ; Goldman and Coleman, 2013 ; Johnson, 2014 ; Goldman and Grimbeek, 2016 ). Goldman and Coleman (2013) reported that their small sample of six student teachers indicated that they learned very little regarding knowledge and pedagogical approaches specific to SE during ITE. Sinkinson (2009) , however, found that student teachers identified co- constructivist pedagogical approaches as being important when teaching SE. Student teacher participants in MacEntee’s (2016) study indicated that the use of participatory visual methods was a novel and thought-provoking way to learn about HIV and AIDS.

Several of the studies indicated the need for opportunities for student teachers to teach and develop the skills to teach SE. Harrison and Ollis (2015) article was the sole study to report on the evaluation of the potential pedagogical skills student teachers had acquired following the completion of SE input. Their examination of micro-teaching lessons indicated the value in examining student teachers teaching of SE. Through this experience, they identified that the educational input had been insufficient in providing student teachers with the opportunity to reflect on a critical approach to gender and sexuality, and to develop the pedagogical skills to teach SE from a critical perspective.

Vavrus (2009) suggested that, given the level of fear acknowledged by student teachers around teaching SE, interventions and programmes should provide structured opportunities for student teachers to construct lesson plans that critically address gender identity and sexuality in developmentally appropriate ways. Vavrus (2009) further suggests that instruction on conducting discussions related to gender identity and sexuality, and strategies to respond to homophobic and sexist discourse should also be provided. Participants in Brown’s (2016) study similarly reported that they would have liked to have had more opportunities to familiarize themselves with facilitating visual participatory methods when teaching about SE topics such as HIV and AIDS.

Learning Environment

MacEntee’s (2016) study provides provisional support for the use of workshops in learning about HIV and AIDS. Student teachers ( Goldman and Grimbeek, 2016 ) and course providers ( Johnson, 2014 ), indicated preferences for the use of tutorial groups, small group face-to-face discussion, and case studies when teaching about SE. In both studies, these approaches were associated with creating less threatening, and more comfortable environments for student teachers to engage with topics on a personal level. Across studies, student teachers remarked that respect and acceptance of other people’s views and opinions were critical to ensure that the environment in which SE provision takes place is safe. These views are aligned with two of the overarching skills outlined by the WHO Regional Office for Europe and BZgA (2017) ; the “ability to use interactive teaching and learning approaches” and the “ability to create and maintain a safe, inclusive and enabling environment” (p. 28). In relation to assessment of SE at ITE, Goldman and Grimbeek (2016) found that student teachers had a preference for group-based assessments, independent research, and self-assessment.

Consistent with the WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of Core Competencies for Sexuality Educators , sexuality educators should “be able to use a wide range of interactive and participatory student-centered approaches” (p. 28). These findings indicate that the creation of interactive and participatory learning environments is conducive to SE at ITE level. The opportunity to engage in these types of learning environments and student teachers’ positive perceptions of these learning environments may have consequences for the classroom environment which student teachers subsequently create.

Critical Self-Reflection

The ability of sexuality educators to reflect on beliefs and values is a vital skill, according to WHO Regional Office for Europe and BZgA (2017) . The reviewed studies consistently cited the importance of self-reflection in SE provision during ITE. Vavrus (2009) found that self-reflection was critical to the development of a more understanding, and empathetic, approach to teaching. Harrison and Ollis (2015) emphasized the need to support teachers in the development of reflective practices. Ollis (2016) concluded that the opportunity for self-reflection would impact on student teachers’ intention to include pedagogies of pleasure in their practice. Johnson’s (2014) study indicated that engagement in reflection regarding the self and others, helped students to develop a better understanding of their own beliefs and assumptions. The findings from Johnson’s study, however, also show that increased opportunity for self-reflection, and exposure to critical interpretations of content, do not necessarily transfer to teaching behaviours. Gursimsek (2010) recommended the inclusion of critical self-reflection components on future SE courses as it was suggested that components would assist student teachers in clarifying their own social and sexual values, life experiences, and learning histories. This clarification then assists, and supports, maturation in terms of attitudes, beliefs, knowledge as they relate to sexuality. Collectively, these findings indicate that teaching in ITE needs to provide safe spaces for self-reflection on the part of student teachers—and honest engagement with others.

Factors Associated With Student Teachers’ Knowledge Regarding Sexuality Education Topics

Two of the reviewed studies explored the topics student teachers perceived as important for school students to learn about, and the topics they themselves would like to study during ITE. Sinkinson and Hughes (2008) found that, of the aspects of health education student teachers prioritized for school students, the most important were mental health (62%); aspects of sexuality (61.2%); and drugs and alcohol (46.8%). Mental health included “personal development, relationships, emotional health and essential skill development such as decision making” (p. 1079). Student teachers’ responses indicate that they saw personal and interpersonal topics as important aspects of health education. Goldman and Grimbeek (2016) reported that, during ITE on SE, student teachers would most prefer to have social, psychological, and developmental factors associated with student/learner puberty and sexuality addressed. Older student teachers—those in the 22–48 year-old age range—were significantly more likely than their younger student teachers to strongly rate preferences for knowledge about wider socio-cultural contextual factors.

Student Teachers’ Confidence and Comfort to Teach Sexuality Education

Four of the studies reviewed reported student teachers’ comfort and confidence in teaching SE ( Sinkinson, 2009 ; Vavrus, 2009 ; Johnson, 2014 ; Ollis, 2016 ). Student teachers in Sinkinson’s (2009) study suggested that increases in knowledge and learning about SE topics increased comfort levels and intention to teach SE. Student teachers suggested that the opportunity to listen, learn, and discuss topics in an open environment reduced their embarrassment in discussing SE issues. These opportunities increased their comfort for answering pupils’ questions, and using language that they had previously considered taboo ( Sinkinson, 2009 ). Vavrus (2009) reported that having completed the educational input on SE, all student teachers felt they would create an open and safe space for students. Some student teachers reported confidence in their ability to create content, and think of topics to cover, relating to sexuality and gender identity. Responses also indicated challenges for student teachers regarding empathy; fears on how to respond to issues of sexuality and gender identity; lack of experience; feeling unprepared; and fear of reprisal for working outside traditional norms. Cognitive dissonance between the knowledge student teachers acquired about sexuality issues during ITE, and their personal and familial belief system in Johnson’s (2014) study was associated with discomfort for student teachers. Thus, findings from Vavrus’s (2009) and Johnson’s (2014) studies indicate that, although ITE had provided student teachers with knowledge on SE topics, wider socio-cultural/systemic factors may influence student teachers’ confidence or comfort to integrate or apply this knowledge outside of the ITE context.

A lack of student teacher knowledge about SE topics, especially with regards to “non- normative” areas, such as HIV/AIDS, was reported by Brown (2016) as associated with “othering” and discomfort regarding teaching SE content. Ollis (2016) reported the discomfort student teachers’ experience with topics on sexual pleasure and observed that engagement in teaching a 20-minute lesson on a positive sexual development theme—such as pleasure—resulted in increased confidence and skill to discuss sexual pleasure, orgasm, and ethical sex. The topic of student teachers’ comfort and confidence provides a prime example of the interaction of all three competency areas; knowledge, attitudes, and skills in relation to SE. Furthermore, the findings highlight that a more systemic consideration of these competency areas and teachers’ comfort and confidence to teach SE beyond the ITE context to the lived experience of school contexts, is warranted.

Overview of Findings

This systematic review sought to investigate the empirical literature on SE provision with student teachers during ITE. Fifteen articles, reporting on thirteen studies, from predominantly Western, English-speaking contexts met the criteria for review. The findings reveal the varied nature of the provision of SE during ITE for student teachers ( Rodriguez et al., 1997 ; McKay and Barrett, 1999 ; Carman et al., 2011 ). This is consistent with the findings of O’Brien et al.’s (2020) systematic review which similarly found variability in the provision of SE for student teachers. The current reviewed studies document an examination of SE provision at institutional/programme level, and individual student teacher level. The latter studies, in the main, reflected student teachers’ experiences regarding a particular educational input on SE, and to a lesser extent related to an examination of student teachers’ general knowledge, attitudes, or skills regarding SE.

Along with the acknowledged need to provide educational input on SE in ITE, the findings reflect that SE is perceived of as more than a stand-alone curriculum subject. Recommendations from the reviewed studies in respect of educational input provide some support for a more embedded and intersectional approach to SE provision during ITE. Similarly, O’Brien et al.’s (2020) systematic review emphasized the need for greater collaboration, integration and consistency in provision of SE at ITE. ITE in SE is typically seen within the realm of student teachers who are going to qualify as health educators, however, there is a strong argument to make that all pre-service teachers require a fundamental understanding of SE. With regards to the current review, for example, Vavrus (2009) concluded that there is a need for teacher education programmes that extend curricular attention to gender identity formation and sexuality, beyond specific SE modules, as it was suggested that this will help student teachers better understand socio-cultural factors that influence their teacher identities. Harrison and Ollis (2015) acknowledged that—as student teachers may not have engaged with critical approaches to material previously and may not have been provided with adequate time to consider these interpretations of gender and power—programmes over an extended period of time and engagement with these topics across the curriculum may facilitate increased engagement and reflection on this content. The findings provide some support that more time invested in educational input programmes may be beneficial. Courses covered over a semester ( Sinkinson, 2009 ; Gursimsek, 2010 ), for example, may be more beneficial than those covered over much shorter periods ( Harrison and Ollis, 2015 ; Ollis, 2016 ).

The WHO Regional Office for Europe and BZgA (2017) states that an important pre-requisite to teaching SE is the ability and willingness of teachers to reflect on their own attitudes toward sexuality, and social norms of sexuality. Sexual Attitudes Reassessment or values clarification has been an integral part of sexology education and training since the 1990s ( Sitron and Dyson, 2009 ). Indeed, many accreditation bodies set a minimum number of hours in this process-orientated exploration as a requirement for sexology or sexuality education work ( Areskoug-Josefsson and Lindroth, 2022 ). This involves a highly personal internal exploration that is directed toward helping participants to clarify their personal values and provides opportunities for participants to explore their attitudes, values, feelings and beliefs about sexuality and how these impact on their professional interactions ( Sitron and Dyson, 2009 ). This type of input would be valuable in the ITE space. The current findings indicate that educational inputs which facilitate self-reflection and the development of critical consciousness may be particularly beneficial and necessary in supporting student teachers to teach SE. Having the space and time to engage with one’s own belief systems, and experiences, can provide student teachers with insights regarding factors that shape identity and human interaction, which are fundamental to comprehensive SE. This is an important task for teachers and previously has been identified as a gap within existing teacher education programmes ( Kincheloe, 2005 , as cited in Vavrus, 2009 ).

With regards to pedagogical approaches for teaching SE during ITE, the findings indicate that the use of tutorial groups, small group face-to-face discussions, case studies, participatory visual methods, and the inclusion of guest speakers sharing their lived experiences may create less threatening, and more comfortable, environments for student teachers to engage with SE topics on a personal level ( Johnson, 2014 ; Brown, 2016 ; Goldman and Grimbeek, 2016 ; MacEntee, 2016 ). These findings are somewhat consistent with existing evidence that supports experiential and participatory learning techniques for SE (e.g., United Nations Educational Scientific and Cultural Organisation [UNESCO], 2018 ; Begley et al., 2022 ). A lack of practical teaching experience was acknowledged by student teachers as a barrier to teaching SE topics (e.g., Vavrus, 2009 ; MacEntee, 2016 ). Given the reported ( Ollis, 2016 ), and potential ( Vavrus, 2009 ) benefits from engaging in the practice of teaching SE the inclusion of skills-based and practical teaching experience of SE or its proxy as a minimum, within the ITE context may be warranted.

There were some notable absences from the literature reviewed. Although there are examples of research in this review which refer to positive SE topics such as pleasure, sexual orientation, and gender identity, the studies in the main do not reflect an examination of topics fundamental to a CSE curriculum. Studies did not consider or examine the impact of the Internet and social media in relation to SE. Apart from May and Kundert’s (1996) study, the research did not reflect consideration of the provision of SE for students with diverse learning abilities and needs. Some studies considered correlational factors pertaining to student teachers’ attitudes regarding SE. These included gender, geographical location of upbringing ( Gursimsek, 2010 ), and student teachers’ previous school experiences of SE ( Sinkinson and Hughes, 2008 ; Vavrus, 2009 ). Overall, in the studies reviewed there was a dearth of research on student teachers’ attitudes about SE, and the inter-dependence of factors that may influence student teachers’ attitudes.

Given that this field of research is in its relative infancy, the findings which may be inferred from the educational input studies ( Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ), are tentative. These studies are generally informative regarding a particular topic or educational input but tend not to shed light on student teachers’ experiences. Furthermore, the findings from Carman et al.’s (2011) and Johnson’s (2014) studies, highlight the role of teacher educators in relation to SE provision being taught during ITE. Teacher educators provide vital support and facilitate new understandings and guidance in the context of SE and teacher professional development. Consistent with O’Brien et al. (2020) , this review highlights the need to promote greater shared learning and evidence-based resources among teacher educators and ITE institutions.

Limitations

This systematic review should be considered in light of its limitations. There is inherent risk of bias across studies given that only peer reviewed articles written in English were reported on. Consequently, a wealth of potential research may have been precluded from review and the findings of the studies will pertain to and potentially reflect the experiences of those in the global north and/or a Westernized view. The exclusion of grey literature such as dissertations and theoretical papers is indicative of publication bias. The very process of selecting inclusion and exclusion criteria is subjective and may facilitate the exclusion of minority voices, or creative methodologies for conducting and or presenting research. Through the exclusion of position papers or articles that do not make reference to empirical data, important voices to this conversation may have been limited/excluded.

Findings were discussed in relation to the competencies outlined by the WHO Regional Office for Europe and BZgA (2017) . Although an international standard for SE, there are limitations to these guidelines. Our understanding of the provision of SE is continuously developing. In 2019, the Sex Information and Education Council of Canada (SIECCAN) updated their guidelines to include an emphasis on changing demographics in relation to sexual health, the need for sexual health educators to demonstrate awareness of the impact of colonialism on the sexual health and well-being of indigenous people, to recognize the impact of technology on sexual health education, to meet the needs of young people of all identities and sexual orientations, and the need to address the topic of consent within sex education. These aspects of SE are not reflected in the WHO Regional Office for Europe and BZgA (2017) guidelines, nor are they reflected in the studies reviewed. This is indicative of the dynamic and complex nature of the field of SE and specifically in ITE.

Given the design of the studies we cannot conclude that ITE experiences translate to teachers’ SE teaching practice. Some studies provided examples of the barriers student teachers can face in the translation of ITE experiences to classroom experiences (e.g., MacEntee, 2016 ). However, other than MacEntee (2016) , examples of research with both student teachers and in-service teachers were not identified nor were longitudinal studies examining the progression from ITE to classroom experiences. Notably, upon screening the abstracts, the literature tended to assess SE received by medical and health care professionals, and there were far less examples regarding research with teachers in general and as may be garnered from this systematic review, a very limited amount of research conducted with student teachers in ITE. As ITE programmes do not routinely publish their course content, there is also a chance that such professional learning and development is being provided but not being reported. Furthermore, given that research on SE within an ITE context is a relatively novel field, diverse methodological approaches have been adopted and there appears to be limited reporting of the theoretical basis informing on this work which has implications for cross-study synthesis of findings. The studies included in this systematic review, predominantly employed qualitative designs and consequently were more idiosyncratic in their selected methodological approach.

Recommendations

Drawing on the findings from the systematic review the overarching recommendation is for more quality research on teacher professional development in the context of SE during ITE. Aspects which require further research attention are outlined below.

Along with the provision of educational input on SE at ITE, an embedded and intersectional approach to SE at ITE programme-level requires further exploration. If student teachers are to meet their future school students’ SE needs, a foundational element of teacher preparation must involve actively addressing issues that are linked to teacher confidence and comfort for delivering SE. The reviewed studies broadly indicate that opportunities for critical self-reflection, practice-oriented and small-group, dialogical, inclusive and participatory pedagogical approaches may be beneficial to adopt with regards to the provision of SE during ITE, however, further robust research is required to support this.

Larger scale, multi-dimensional, integrative studies employing rigorous methodologies to assess inter alia student teachers’ knowledge, attitudes, and skills, regarding sexuality during ITE including student teachers’ knowledge, comfort, confidence and preparedness to teach sexuality are warranted. Furthermore, research which is inclusive of both student teachers’ and teacher educators’ voices, is needed.

Adoption of a systemic approach examining individual-level and contextual factors relating to SE provision during ITE is needed to develop theoretically derived, research-informed, and evidence-based SE programmes at ITE. In order to improve the provision of SE at ITE an evaluation of provision must be in place for best practice to be achieved.

ITE provision needs to adopt a holistic approach when supporting teacher development. As documented by the WHO Regional Office for Europe and BZgA (2017) guidelines, this involves supporting the development and acquisition of relevant knowledge, attitudes and skills pertaining to SE. Although ITE in SE often focuses on student teachers who will qualify as health educators, it can be argued that all pre-service teachers require a fundamental understanding of SE. Furthermore, the SE provided during ITE should be nuanced to support LGBTI students, students with special educational needs and/or from diverse racial and cultural backgrounds ( Whitten and Sethna, 2014 ; Ellis and Bentham, 2021 ; Michielsen and Brockschmidt, 2021 ). A series of indicators to assess the relevant factors pertaining to SE provision and how these indicators relate to the knowledge, attitudes, and skills required for sexuality educators would be helpful. Monitoring and evaluation of structural indicators such as the designated SE components of course programmes, whether courses are elective or core, whether practice elements are provided etc. would provide a baseline from which system change and improvements could be measured. This systematic review has provided tentative suggestions as to what may work to ensure best practice of SE during ITE. Further research is required to evaluate the outcomes associated with their implementation.

Author Contributions

AC, CM, CC, and AB were responsible for the development and design of the study and final decisions regarding the reviewed articles. AC and CM completed the initial pilot searches. AC completed the final searches and wrote the first draft of the manuscript. AC, CM, and CC reviewed the articles. AC and AB developed the data extraction template. All authors contributed to manuscript revision, read, and approved the submitted version.

This work was supported by the Irish Research Council IRC Coalesce Research Award (Strand 1E—HSE—Sexual Health and Crisis Pregnancy Programme) for the research study TEACH-RSE Teacher Professional Development and Relationships and Sexuality Education: Realizing Optimal Sexual Health and Wellbeing Across the Lifespan (Grant No. IRC COALESCE 2019/147).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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United Nations Educational Scientific and Cultural Organisation [UNESCO] (2018). International Technical Guidance on Sexuality Education. Paris: UNESCO.

Vavrus, M. (2009). Sexuality, schooling, and teacher identity formation: a critical pedagogy for teacher education. Teach. Teacher Educ. 25, 383–390. doi: 10.1016/j.tate.2008.09.002

Wallace, B. C., Small, K., Brodley, C. E., Lau, J., and Trikalinos, T. A. (2010). “Modeling annotation time to reduce workload in comparative effectiveness reviews,” in Proceedings of the 1st ACM International Health Informatics Symposium IHI’10 , Arlington, VA, 28–35. doi: 10.1145/1882992.1882999

Walker, R., Drakeley, S., Welch, R., Leahy, D., and Boyle, J. (2021). Teachers’ perspectives of sexual and reproductive health education in primary and secondary schools: a systematic review of qualitative studies. Sex Educ. 21, 627–644. doi: 10.1080/14681811.2020.1843013

Whitten, A., and Sethna, C. (2014). What’s missing? Anti-racist sex education! Sex Educ. 14, 414–429. doi: 10.1080/14681811.2014.919911

World Health Organisation [WHO]/Regional Office for Europe & Federal Centre for Health Education BZgA (2010). Standards for Sexuality Education in Europe: A Framework for Policy Makers, Educational and Health Authorities and Specialists. Cologne: Federal Centre for Health Education – BZgA.

World Health Organisation [WHO]/Regional Office for Europe & Federal Centre for Health Education BZgA (2017). Training Matters: A Framework of Core Competencies for Sexuality Educators. Cologne: Federal Centre for Health Education – BZgA.

Whidbey Films (1999). The War on Boys. Alexandria, VA: PBS Home Video.

WHO Regional Office for Europe and BZgA (2010). Standards for Sexuality Education in Europe: A Framework for Policy Makers, Educational and Health Authorities and Specialists. Cologne: Federal Centre for Health Education.

WHO Regional Office for Europe, and BZgA (2017). Training Matters: A Framework of Core Competencies for Sexuality Educators. Cologne: Federal Centre for Health Education.

www.frontiersin.org

Explanation of MMAT categorization ( Hong et al., 2018 ).

Keywords : systematic review, sexuality education, student teacher, initial teacher education, comprehensive sexuality education, sex education

Citation: Costello A, Maunsell C, Cullen C and Bourke A (2022) A Systematic Review of the Provision of Sexuality Education to Student Teachers in Initial Teacher Education. Front. Educ. 7:787966. doi: 10.3389/feduc.2022.787966

Received: 01 October 2021; Accepted: 08 February 2022; Published: 07 April 2022.

Reviewed by:

Copyright © 2022 Costello, Maunsell, Cullen and Bourke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Aisling Costello, [email protected]

Let's talk about (queer) sex: The importance of LGBTQ-inclusive sex education in schools

sexuality education essay

Editor's note: This story originally published in August 2021.

What's a three-letter word that prompts parents to pontificate and teens to plug their ears when their parents bring it up? 

You guessed it: S-e-x.

Just because teens can be hesitant to talk with their parents about sex  isn't a reason to give up on the conversation. Not talking about it could be dangerous or even deadly, and markedly so for  LGBTQ youth .

Just 8.2% of students said they received LGBTQ-inclusive sex education, according to LGBTQ education nonprofit GLSEN's National School Climate Survey in 2019 . It's not shocking when you uncover that it's only mandated in a minority of U.S. states.

Melanie Willingham-Jaggers, director of GLSEN, compares the fight for inclusive sexual education to that of critical race theory, noting   people can favor long-held narratives over the truth.

"What we're having right now in our country is a debate around what responsibility we have to our children when it comes to educating them," Willingham-Jaggers says. "Queer, inclusive sex ed is not critical race theory. But what you see in both of these arguments is do we teach our children what is true in reality and history and nature? Or do we teach them what we want them to know?"

Sex education looks drastically different depending on where you live (though  legislation  is ongoing ).

  • Thirty-nine states, plus Washington, D.C., require sex education and/or HIV education in schools, according to the Guttmacher Institute . But only 18 states mandate that sex and HIV education  be medically accurate.
  • As for LGBTQ inclusivity: 11 states (and D.C.) call for "inclusive content with regard to sexual orientation."
  • But on the other side of the coin, five states allow negative  information on homosexuality and/or a  positive push for heterosexuality. If you live in a state like Florida or South Carolina, for example, your children may be taught sexual education that discourages queer sex. 

Heads up: 'Pray Away' details trauma of LGBTQ conversion therapy – and new leaders are still emerging

What a lack of sex education means for LGBTQ youth

Dio Anthony , a 31-year-old writer in New York, remembers little about his high school sex education experience beyond   a weeklong course on sex.

"They weren't teaching you how to apply a condom like they show you in the movies," he says.

When he first slept with a man at 16, he had no idea what was going on. Future sexual encounters were not fun. He grew uncomfortable sharing details of his sexual escapades in his 20s even though his friends hooted and hollered about theirs.

"When we exclude LGBTQ+ young people from comprehensive education, we make them more isolated, behave in more risky ways and they are further pushed out and pushed into dangerous situations where negative outcomes are more likely," Willingham-Jaggers says.

The Human Rights Campaign Foundation found that LGBTQ youth, particularly Black and Latino LGBTQ youth, rarely receive sex education at school that is relevant to them.

This pattern reveals itself through statistics: Of the 36,801 people diagnosed with HIV in 2019 in the U.S., 25,842 were Black or Latino, according to the Centers for Disease Control and Prevention . That's over 70%. 

"It isn't an accident that HIV is still so prevalent where it's prevalent," says   Justin A. Sitron , associate dean of the College of Health and Human Services at Widener University. "It's because the public health system has not responded to both the access needs, and the cultural realities that men of color especially face." Widener University's Interdisciplinary Sexuality Research Collaborative is behind the website swagtoolkit.com , aimed at providing sex education to Black gay and bisexual men.

Such websites prove crucial, considering how often people pepper their search engines with questions – particularly about taboo topics, Sitron says. 

"Without LGBTQ+ inclusive sex education, queer and trans youth are left in the dark when it comes to making informed decisions about their health, understanding their body, understanding how their body relates to other bodies out in the world," Willingham-Jaggers says. "When sex education labels some topics as controversial, it hurts all students by failing to provide a full and medically accurate understanding of sexual health."

LGBTQ young people get stuck at questions like, "'So I know I'm supposed to wear a condom when I have anal sex. But, like, what is anal sex?' " Sitron says. 

In case you missed: LGBTQ students need inclusive sex ed – but less than 10% in US are receiving it, report says

LGBTQ advocates change landscape of sex education

LGBTQ advocates are battling preconceived notions of sex education.

Scout Bratt, outreach and education director at Chicago Women's Health Center, directs a program of sexual health education for Chicago public schools and area universities; they work with fourth through 12th graders as well as college students. Yes, inclusivity begins as young as fourth grade: Instead of saying girls menstruate or boys produce sperm, for example, you can say people who menstruate and people who produce sperm to incorporate trans and nonbinary people.

"We are trying to infuse queer inclusivity and gender expansiveness in the curriculum across all grade levels across all subjects," Bratt says.

Sexual health educator  Shafia Zaloom  consults around the country with schools about sexuality, and notes that curriculums vary among different types of schools – i.e., public schools don't have the same standards as independent schools.

After receiving feedback from LGBTQ youth, Zaloom worked to create a program that went in-depth on LGBTQ issues led by queer staff.

"When we provide kids with really inclusive, comprehensive sex education, they grow up to have more bodily autonomy, more healthy perspectives on their sexuality, they tend to delay and make more responsible decisions and be far more relational and communicative in their relationships," Zaloom says.

Aww: ‘Sesame Street’ to ‘Ridley Jones’: TV shows are teaching kids about LGBTQ issues, diversity

Where to turn if your school isn't teaching LGBTQ-inclusive sex education

  • Get involved in advocacy work . "The states that have passed comprehensive LGBTQ inclusive sexual health education laws did not happen because one person raised their hand and said, 'We should have that.' It took time, it took advocacy, it took education," Vincent Pompei, director of the Human Rights Campaign's Youth Well-Being Program. says. "What we need to do is provide opportunities for communities and parents and educators to understand why it's essential."
  • Turn to your local community.  Health educators, doctors and other sexual education resources and community centers abound. Talk to them, Sitron advises.
  • Look online for resources – but verify them. Planned Parenthood, Advocates for Youth and SIECUS are all solid resources, according to Sitron. Don't underestimate YouTube channels either. "When you live in a highly stigmatized area and you have no support, online might be the only community that you might be able to find," says Carmen Mojica, a reproductive justice movement leader. "And I don't think that there should be any shame in that." See also GLSEN and HRC .
  • Adults, affirm your children.  Sitron recommends doing away with your helicopter parent mindset and becoming more of a partner to your child as they navigate their concerns.
  • Children, talk to adults. Spend some alone time with your doctor without your parents if you have any specific questions, Sitron says. Bratt adds that young people are leading this movement – so adults, make time to listen. 

Above all, remember this: Sex should make you feel good – and feel good to talk about.

"It should be one of the things in our lives that makes us the most joyful," Sitron says. "And when queer people don't get to have that because their sex is problematized, we miss out on such an opportunity to be joyful and happy."

Hear, hear: We need to celebrate LGBTQ joy. Lives depend on it.

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The State of Sex Education in the United States

Kelli stidham hall.

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia

Jessica McDermott Sales

Kelli a. komro, john santelli.

Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York

For more than four decades, sex education has been a critically important but contentious public health and policy issue in the United States [ 1 – 5 ]. Rising concern about nonmarital adolescent pregnancy beginning in the 1960s and the pandemic of HIV/AIDS after 1981 shaped the need for and acceptance of formal instruction for adolescents on life-saving topics such as contraception, condoms, and sexually transmitted infections. With widespread implementation of school and community-based programs in the late 1980s and early 1990s, adolescents’ receipt of sex education improved greatly between 1988 and 1995 [ 6 ]. In the late 1990s, as part of the “welfare reform,” abstinence only until marriage (AOUM) sex education was adopted by the U.S. government as a singular approach to adolescent sexual and reproductive health [ 7 , 8 ]. AOUM was funded within a variety of domestic and foreign aid programs, with 49 of 50 states accepting federal funds to promote AOUM in the classroom [ 7 , 8 ]. Since then, rigorous research has documented both the lack of efficacy of AOUM in delaying sexual initiation, reducing sexual risk behaviors, or improving reproductive health outcomes and the effectiveness of comprehensive sex education in increasing condom and contraceptive use and decreasing pregnancy rates [ 7 – 12 ]. Today, despite great advancements in the science, implementation of a truly modern, equitable, evidence-based model of comprehensive sex education remains precluded by sociocultural, political, and systems barriers operating in profound ways across multiple levels of adolescents’ environments [ 4 , 7 , 8 , 12 – 14 ].

At the federal level, the U.S. congress has continued to substantially fund AOUM, and in FY 2016, funding was increased to $85 million per year [ 3 ]. This budget was approved despite President Obama’s attempts to end the program after 10 years of opposition and concern from medical and public health professionals, sexuality educators, and the human rights community that AOUM withholds information about condoms and contraception, promotes religious ideologies and gender stereotypes, and stigmatizes adolescents with nonheteronormative sexual identities [ 7 – 9 , 11 – 13 ]. Other federal funding priorities have moved positively toward more medically accurate and evidence-based programs, including teen pregnancy prevention programs [ 1 , 3 , 12 ]. These programs, although an improvement from AOUM, are not without their challenges though, as they currently operate within a relatively narrow, restrictive scope of “evidence” [ 12 ].

At the state level, individual states, districts, and school boards determine implementation of federal policies and funds. Limited in-class time and resources leave schools to prioritize sex education in competition with academic subjects and other important health topics such as substance use, bullying, and suicide [ 4 , 13 , 14 ]. Without cohesive or consistent implementation processes, a highly diverse “patchwork” of sex education laws and practices exists [ 4 ]. A recent report by the Guttmacher Institute noted that although 37 states require abstinence information be provided (25 that it be stressed), only 33 and 18 require HIV and contraceptive information, respectively [ 1 ]. Regarding content, quality, and inclusivity, 13 states mandate instruction be medically accurate, 26 that it be age appropriate, eight that it not be race/ethnicity or gender bias, eight that it be inclusive of sexual orientation, and two that it not promote religion [ 1 ]. The Centers for Disease Control and Prevention’s 2014 School Health Policies and Practices Study found that high school courses require, on average, 6.2 total hours of instruction on human sexuality, with 4 hours or less on HIV, other sexually transmitted infections (STIs), and pregnancy prevention [ 15 ]. Moreover, 69% of high schools notify parents/guardians before students receive such instruction; 87% allow parents/guardians to exclude their children from it [ 15 ]. Without coordinated plans for implementation, credible guidelines, standards, or curricula, appropriate resources, supportive environments, teacher training, and accountability, it is no wonder that state practices are so disparate [ 4 ].

At the societal level, deeply rooted cultural and religious norms around adolescent sexuality have shaped federal and state policies and practices, driving restrictions on comprehensive sexual and reproductive health information, and service delivery in schools and elsewhere [ 12 , 13 ]. Continued public and political debates on the morality of sex outside marriage perpetuate barriers at multiple levels—by misguiding state funding decisions, molding parents’ (mis)understanding of programs, facilitating adolescents’ uptake of biased and inaccurate information in the classroom, and/or preventing their participation in sex education altogether [ 4 , 7 , 8 , 12 – 14 ].

Trends in Adolescents’ Receipt of Sex Education

In this month’s Journal of Adolescent Health , Lindberg et al. [ 16 ] provide further insight into the current state of sex education and the implications of federal and state policies for adolescents in the United States. Using population data from the National Survey of Family Growth, they find reductions in U.S. adolescents’ receipt of formal sex education from schools and other community institutions between 2006–2010 and 2011–2013. These declines continue previous trends from 1995–2002 to 2006–2008, which included increases in receipt of abstinence information and decreases in receipt of birth control information [ 17 – 19 ]. Moreover, the study highlights several additional new concerns. First, important inequities have emerged, the most significant of which are greater declines among girls than boys, rural-urban disparities, declines concentrated among white girls, and low rates among poor adolescents. Second, critical gaps exist in the types of information (practical types on “where to get birth control” and “how to use condoms” were lowest) and the mistiming of information (most adolescents received instruction after sexual debut) received. Finally, although receipt of sex education from parents appears to be stable, rates are low, such that parental-provided information cannot be adequately compensating for gaps in formal instruction.

Paradoxically, the declines in formal sex education from 2006 to 2013 have coincided with sizeable declines in adolescent birth rates and improved rates of contraceptive method use in the United States from 2007 to 2014 [ 20 , 21 ]. These coincident trends suggest that adolescents are receiving information about birth control and condoms elsewhere. Although the National Survey of Family Growth does not provide data on Internet use, Lindberg et al. [ 16 ] suggest that it is likely an important new venue for sex education. Others have commented on the myriad of online sexual and reproductive resources available to adolescents and their increasing use of sites such as Bedsider.org, StayTeen.org, and Scarleteen. [ 2 , 14 , 22 – 24 ].

The Future of Sex Education

Given the insufficient state of sex education in the United States in 2016, existing gaps are opportunities for more ambitious, forward-thinking strategies that cross-cut levels to translate an expanded evidence base into best practices and policies. Clearly, digital and social media are already playing critical roles at the societal level and can serve as platforms for disseminating innovative, scientifically and medically sound models of sex education to diverse groups of adolescents, including sexual minority adolescents [ 14 , 22 – 24 ]. Research, program, and policy efforts are urgently needed to identify effective ways to harness media within classroom, clinic, family household, and community contexts to reach the range of key stakeholders [ 13 , 14 , 22 – 24 ]. As adolescents turn increasingly to the Internet for their sex education, perhaps school-based settings can better serve other unmet needs, such as for comprehensive sexual and reproductive health care, including the full range of contraceptive methods and STI testing and treatment services. [ 15 , 25 ].

At the policy level, President Obama’s budget for FY 2017 reflects a strong commitment to supporting youths’ access to age-appropriate, medically accurate sexual health information, with proposed elimination of AOUM and increased investments in more comprehensive programs [ 3 ]. Whether these priorities will survive an election year and new administration is uncertain. It will also be important to monitor the impact of other health policies, particularly regarding contraception and abortion, which have direct and indirect implications for minors’ rights and access to sexual and reproductive health information and care [ 26 ].

At the state and local program level, models of sex education that are grounded in a broader interdisciplinary body of evidence are warranted [ 4 , 11 – 14 , 27 – 29 ]. The most exciting studies have found programs with rights-based content, positive, youth-centered messages, and use of interactive, participatory learning and skill building are effective in empowering adolescents with the knowledge and tools required for healthy sexual decision-making and behaviors [ 4 , 11 – 14 , 27 – 29 ]. Modern implementation strategies must use complementary modes of communication and delivery, including peers, digital and social media, and gaming, to fully engage young people [ 14 , 22 , 23 , 27 ].

Ultimately, expanded, integrated, multilevel approaches that reach beyond the classroom and capitalize on cutting-edge, youth-friendly technologies are warranted to shift cultural paradigms of sexual health, advance the state of sex education, and improve sexual and reproductive health outcomes for adolescents in the United States.

Acknowledgments

Funding Sources

K.S.H. is supported by the National Institute of Child Health and Human Development #1K01HD080722-01A1.

Contributor Information

Kelli Stidham Hall, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Jessica McDermott Sales, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Kelli A. Komro, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

John Santelli, Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York.

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The Importance of Access to Comprehensive Sex Education

Comprehensive sex education is a critical component of sexual and reproductive health care.

Developing a healthy sexuality is a core developmental milestone for child and adolescent health.

Youth need developmentally appropriate information about their sexuality and how it relates to their bodies, community, culture, society, mental health, and relationships with family, peers, and romantic partners.

AAP supports broad access to comprehensive sex education, wherein all children and adolescents have access to developmentally appropriate, evidence-based education that provides the knowledge they need to:

  • Develop a safe and positive view of sexuality.
  • Build healthy relationships.
  • Make informed, safe, positive choices about their sexuality and sexual health.

Comprehensive sex education involves teaching about all aspects of human sexuality, including:

  • Cyber solicitation/bullying.
  • Healthy sexual development.
  • Body image.
  • Sexual orientation.
  • Gender identity.
  • Pleasure from sex.
  • Sexual abuse.
  • Sexual behavior.
  • Sexual reproduction.
  • Sexually transmitted infections (STIs).
  • Abstinence.
  • Contraception.
  • Interpersonal relationships.
  • Reproductive coercion.
  • Reproductive rights.
  • Reproductive responsibilities.

Comprehensive sex education programs have several common elements:

  • Utilize evidence-based, medically accurate curriculum that can be adapted for youth with disabilities.
  • Employ developmentally appropriate information, learning strategies, teaching methods, and materials.
  • Human development , including anatomy, puberty, body image, sexual orientation, and gender identity.
  • Relationships , including families, peers, dating, marriage, and raising children.
  • Personal skills , including values, decision making, communication, assertiveness, negotiation, and help-seeking.
  • Sexual behavior , including abstinence, masturbation, shared sexual behavior, pleasure from esx, and sexual dysfunction across the lifespan.
  • Sexual health , including contraception, pregnancy, prenatal care, abortion, STIs, HIV and AIDS, sexual abuse, assault, and violence.
  • Society and culture , including gender roles, diversity, and the intersection of sexuality and the law, religion, media, and the arts.
  • Create an opportunity for youth to question, explore, and assess both personal and societal attitudes around gender and sexuality.
  • Focus on personal practices, skills, and behaviors for healthy relationships, including an explicit focus on communication, consent, refusal skills/accepting rejection, violence prevention, personal safety, decision making, and bystander intervention.
  • Help youth exercise responsibility in sexual relationships.
  • Include information on how to come forward if a student is being sexually abused.
  • Address education from a trauma-informed, culturally responsive approach that bridges mental, emotional, and relational health.

Comprehensive sex education should occur across the developmental spectrum, beginning at early ages and continuing throughout childhood and adolescence :

  • Sex education is most effective when it begins before the initiation of sexual activity.
  • Young children can understand concepts related to bodies, gender, and relationships.
  • Sex education programs should build an early foundation and scaffold learning with developmentally appropriate content across grade levels.
  • AAP Policy outlines considerations for providing developmentally appropriate sex education throughout early childhood, middle childhood, adolescence, and young adulthood.

Most adolescents report receiving some type of formal sex education before age 18. While sex education is typically associated with schools, comprehensive sex education can be delivered in several complementary settings:

  • Schools can implement comprehensive sex education curriculum across all grade levels
  • The Sexuality Information and Education Council of the United States (SIECUS) provides guidelines for providing developmentally appropriate comprehensive sex education across grades K-12.
  • Pediatric health clinicians and other health care providers are uniquely positioned to provide longitudinal sex education to children, adolescents, and young adults.
  • Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents outlines clinical considerations for providing comprehensive sex education at all developmental stages, as a part of preventive health care.
  • Research suggests that community-based organizations should be included as a source for comprehensive sexual health promotion.
  • Faith-based communities have developed sex education curricula for their congregations or local chapters that emphasize the moral and ethical aspects of sexuality and decision-making.
  • Parents and caregivers can serve as the primary sex educators for their children, by teaching fundamental lessons about bodies, development, gender, and relationships.
  • Many factors impact the sex education that youth receive at home, including parent/caregiver knowledge, skills, comfort, culture, beliefs, and social norms.
  • Virtual sex education can take away feelings of embarrassment or stigma and can allow for more youth to access high quality sex education.

Comprehensive sex education provides children and adolescents with the information that they need to:

  • Understand their body, gender identity, and sexuality.
  • Build and maintain healthy and safe relationships.
  • Engage in healthy communication and decision-making around sex.
  • Practice healthy sexual behavior.
  • Understand and access care to support their sexual and reproductive health.

Comprehensive sex education programs have demonstrated success in reducing rates of sexual activity, sexual risk behaviors, STIs, and adolescent pregnancy and delaying sexual activity. Many systematic reviews of the literature have indicated that comprehensive sex education promotes healthy sexual behaviors:

  • Reduced sexual activity.
  • Reduced number of sexual partners.
  • Reduced frequency of unprotected sex.
  • Increased condom use.
  • Increased contraceptive use.

However, comprehensive sex education curriculum goes beyond risk-reduction, by covering a broader range of content that has been shown to support social-emotional learning, positive communication skills, and development of healthy relationships.

A 2021 review of the literature found that comprehensive sex education programs that use a positive, affirming, and inclusive approach to human sexuality are associated with concrete benefits across 5 key domains:

Benefits of comprehensive sex education programs 

Benefits of Comprehensive sex education programs.jpg

When children and adolescents lack access to comprehensive sex education, they do not get the information they need to make informed, healthy decisions about their lives, relationships, and behaviors.

Several trends in sexual health in the US highlight the need for comprehensive sex education for all youth.

Education about condom and contraceptive use is needed:

  • 55% of US high school students report having sexual intercourse by age 18 .
  • Self-reported condom use has decreased significantly among high school students.
  • Only 9% of sexually active high school students report using both a condom for STI-prevention and a more effective form of birth control to prevent pregnancy .

STI prevention is needed:

  • Adolescents and young adults are disproportionately impacted by STIs.
  • Cases of chlamydia, gonorrhea, and syphilis are rising rapidly among young people.
  • When left untreated , these infections can lead to infertility, adverse pregnancy and birth outcomes, and increased risk of acquiring new STIs.
  • Youth need comprehensive, unbiased information about STI prevention, including human papillomavirus (HPV) .

Continued prevention of unintended pregnancy is needed:

  • Overall US birth rates among adolescent mothers have declined over the last 3 decades.
  • There are significant geographic disparities in adolescent pregnancy rates, with higher rates of pregnancy in rural counties and in southern and southwestern states.
  • Social drivers of health and systemic inequities have caused racial and ethnic disparities in adolescent pregnancy rates.
  • Eliminating disparities in adolescent pregnancy and birth rates can increase health equity, improve health and life outcomes, and reduce the economic impact of adolescent parenting.

Misinformation about sexual health is easily available online:

  • Internet use is nearly universal among US children and adolescents.
  • Adolescents report seeking sexual health information online .
  • Sexual health websites that adolescents visit can contain inaccurate information .

Prevention of sex abuse, dating violence, and unhealthy relationships is needed:

  • Child sexual abuse is common: 25% of girls and 8% of boys experience sexual abuse during childhood .
  • Youth who experience sexual abuse have long-term impacts on their physical, mental, and behavioral health.
  • 1 in 11 female and 1 in 14 male students report physical DV in the last year .
  • 1 in 8 female and 1 in 26 male students report sexual DV in the last year .
  • Youth who experience DV have higher rates of anxiety, depression, substance use, antisocial behaviors, and suicide risk.

The quality and content of sex education in US schools varies widely.

There is significant variation in the quality of sex education taught in US schools, leading to disparities in attitudes, health information, and outcomes. The majority of sex education programs in the US tend to focus on public health goals of decreasing unintended pregnancies and preventing STIs, via individual behavior change.

There are three primary categories of sex educational programs taught in the US :

  • Abstinence-only education , which teaches that abstinence is expected until marriage and typically excludes information around the utility of contraception or condoms to prevent pregnancy and STIs.
  • Abstinence-plus education , which promotes abstinence but includes information on contraception and condoms.
  • Comprehensive sex education , which provides medically accurate, age-appropriate information around development, sexual behavior (including abstinence), healthy relationships, life and communication skills, sexual orientation, and gender identity.

State laws impact the curriculum covered in sex education programs. According to a report from the Guttmacher Institute :

  • 26 US states and Washington DC mandate sex education and HIV education.
  • 18 states require that sex education content be medically accurate.
  • 39 states require that sex education programs provide information on abstinence.
  • 20 states require that sex education programs provide information on contraception.

US states have varying requirements on sex education content related to sexual orientation :

  • 10 states require sex education curriculum to include affirming content on LGBTQ2S+ identities or discussion of sexual health for youth who are LGBTQ2S+.
  • 7 states have sex education curricular requirements that discriminate against individuals who are LGBTQ2S+.Youth who live in these states may face additional barriers to accessing sexual health information.

Abstinence-only sex education programs do not meet the needs of children and adolescents.

While abstinence is 100% effective in preventing pregnancy and STIs, research has conclusively shown that abstinence-only sex education programs do not support healthy sexual development in youth.

Abstinence-only programs are ineffective in reaching their stated goals, as evidenced by the data below:

  • Abstinence-only programs are unsuccessful in delaying sex until marriage .
  • Abstinence-only sex education programs do not impact the rates of pregnancy, STIs, or HIV in adolescents .
  • Youth who take a “virginity pledge” as part of abstinence-only education programs have the same rates of premarital sex as their peers who do not take pledges, but are less likely to use contraceptives .
  • US states that emphasize abstinence-only education have higher rates of adolescent pregnancy and birth .

Abstinence-only programs can harm the healthy sexual and mental development of youth by:

  • Withholding information or providing inaccurate information about sexuality and sexual behavior .
  • Contributing to fear, shame, and stigma around sexual behaviors .
  • Not sharing information on contraception and barrier protection or overstating the risks of contraception .
  • Utilizing heteronormative framing and stigma or discrimination against students who are LGBTQ2S+ .
  • Reinforcing harmful gender stereotypes .
  • Ignoring the needs of youth who are already sexually active by withholding education around contraception and STI prevention.

Abstinence-plus sex education programs focus solely on decreasing unintended pregnancy and STIs.

Abstinence-plus sex education programs promote abstinence until marriage. However, these programs also provide information on contraception and condom use to prevent unintended pregnancy and STIs.

Research has demonstrated that abstinence-plus programs have an impact on sexual behavior and safety, including:

  • HIV prevention.
  • Increase in condom use .
  • Reduction in number of sexual partners .
  • Delay in initiation of sexual behavior .

While these programs add another layer of education, they do not address the broader spectrum of sexuality, gender identity, and relationship skills, thus withholding critical information and skill-building that can impact healthy sexual development.

AAP and other national medical and public health associations support comprehensive sex education for youth.

Given the evidence outlined above, AAP and other national medical organizations oppose abstinence-only education and endorse comprehensive sex education that includes both abstinence promotion and provision of accurate information about contraception, STIs, and sexuality.

National medical and public health organizations supporting comprehensive sex education include:

  • American Academy of Pediatrics .
  • American Academy of Family Physicians.
  • American College of Obstetricians and Gynecologists .
  • American Medical Association .
  • American Public Health Association .
  • Society for Adolescent Health and Medicine .

Pediatric clinics provide a unique opportunity for comprehensive sex education.

Pediatric health clinicians typically have longitudinal care relationships with their patients and families, and thus have unique opportunities to address comprehensive sex education across all stages of development.

The clinical visit can serve as a useful adjunct to support comprehensive sex education provided in schools, or to fill gaps in knowledge for youth who are exposed to abstinence-only or abstinence-plus curricula.

AAP policy and Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents provide recommendations for comprehensive sex education in clinical settings, including:

  • Encouraging parent-child discussions on sexuality, contraception, and internet/media use.
  • Understanding diverse experiences and beliefs related to sexuality and sex education and meeting the unique needs of individual patients and families.
  • Including discussions around healthy relationships, dating violence, and intimate partner violence in clinical care.
  • Discussing methods of contraception and STI/HPV prevention prior to onset of sexual intercourse.
  • Providing proactive and developmentally appropriate sex education to all youth, including children and adolescents with special health care needs.

Perspective

sexuality education essay

Karen Torres, Youth activist

There were two cardboard bears, and a person explained that one bear wears a bikini to the beach and the other bear wears shorts – that is the closest thing I ever got to sex ed throughout my entire K-12 education. I often think about that bear lesson because it was the day our institutions failed to teach me anything about my body, relationships, consent, and self-advocacy, which became even more evident after I was sexually assaulted at 16 years old. My story is not unique, I know that many young people have been through similar traumas, but many of us were also subjected to days, months, and years of silence and embarrassment because we were never given the knowledge to know how to spot abuse or the language to ask for help. Comprehensive sex ed is so much more than people make it out to be, it teaches about sex but also about different types of experiences, how to respect one another, how to communicate in uncomfortable situations, how to ask for help and an insurmountable amount of other valuable lessons.

From these lessons, people become well-rounded, people become more empathetic to other experiences, and people become better. I believe comprehensive sex ed is vital to all people and would eventually work as a part to build more compassionate communities.

Many US children and adolescents do not receive comprehensive sex education; and rates of formal sex education have declined significantly in recent decades.

Barriers to accessing comprehensive sex education include:

Misinformation, stigma, and fear of negative reactions:

  • Misinformation and stigma about the content of sex education curriculum has been the primary barrier to equitable access to comprehensive sex education in schools for decades .
  • Despite widespread parental support for sex education in schools, fears of negative public/parent reactions have led school administrators to limit youth access to the information they need to make healthy decisions about their sexuality for nearly a half-century.
  • In recent years, misinformation campaigns have spread false information about the framing and content of comprehensive sex education programs, causing debates and polarization at school board meetings .
  • Nearly half of sex education teachers report that concerns about parent, student, or administrator responses are a barrier to provision of comprehensive sex education.
  • Opponents of comprehensive sex education often express concern that this education will lead youth to have sex; however, research has demonstrated that this is not the case . Instead, comprehensive sex ed is associated with delays in initiation of sexual behavior, reduced frequency of sexual intercourse, a reduction in number of partners, and an increase in condom use.
  • Some populations of youth lack access to comprehensive sex education due to a societal belief that they are asexual, in need of protection, or don’t need to learn about sex. This barrier particularly impacts youth with disabilities or special health care needs .
  • Sex ed curricula in some schools perpetuate gender/sex stereotypes, which could contribute to negative gender stereotypes and negative attitudes towards sex .

Inconsistencies in school-based sex education:

  • There is significant variation in the content of sex education taught in schools in the US, and many programs that carry the same label (eg, “abstinence-plus”) vary widely in curriculum.
  • While decisions about sex education curriculum are made at the state level, the federal government has provided funding to support abstinence-only education for decades , which incentivizes schools to use these programs.
  • Since 1996, more than $2 billion in federal funds have been spent to support abstinence-only sex education in schools.
  • 34 US states require schools to use abstinence-only curriculum or emphasize abstinence as the main way to avoid pregnancy and STIs.
  • Only 16 US states require instruction on condoms or contraception.
  • It is not standard to include information on how to come forward if a student is being sexually abused, and many schools do not have a process for disclosures made.
  • Because of this, abstinence-only programs are commonly used in US schools, despite overwhelming evidence that they are ineffective in delaying sexual behavior until marriage, and withhold critical information that youth need for healthy sexual and relationship development.

Need for resources and training:

  • Integration of comprehensive sex education into school curriculum requires financial resources to strengthen and expand evidence-based programs.
  • Successful implementation of comprehensive sex education requires a trained workforce of teachers who can address the curriculum in age-appropriate ways for students in all grade-levels.
  • Education, training, and technical assistance are needed to support pediatric health clinicians in addressing comprehensive sex education in clinical settings, as a complement to school-based education.

Lack of diversity and cultural awareness in curricula:

  • A history of systemic racism, discrimination, and long-standing health, social and systemic inequities have created racial and ethnic disparities in access to sexual health services and representation in sex education materials. The legacy of intergenerational trauma in the medical system should be acknowledged in sex education curricula.
  • Sex education curriculum is often centered on a white audience, and does not address or reflect the role of systemic racism in sexuality and development .
  • Traditional abstinence-focused sex education programs have a heteronormative focus and do not address the unique needs of youth who are LGBTQ2S+ .
  • Sex education programs often do not address reproductive body diversity, the needs of those with differences in sex development, and those who identify as intersex .
  • Sex education programs often do not reflect the unique needs of youth with disabilities or special health care needs .
  • Sex education programs are often not tailored to meet the religious considerations of faith communities.
  • There is a need for sex education programs designed to help youth navigate sexual health and development in the context of their own culture and community .

Disparities in access to comprehensive sex education.

The barriers listed above limit access to comprehensive sex education in schools and communities. While these barriers impact youth across the US, there are some populations who are less likely to have access to comprehensive to sex education.

Youth who are LGBTQ2S+:

  • Only 8% of students who are LGBTQ2S+ report having received sexual education that was inclusive .
  • Students who are LGBTQ2S+ are 50% more likely than their peers who are heterosexual to report that sex education in their schools was not useful to them .
  • Only 13% of youth who are bisexual+ and 10% of youth who are transgender and gender expansive report receiving sex education in schools that felt personally relevant.
  • Only 20% of youth who are Black and LGBTQ2S+ and 13% of youth who are Latinx and LGBTQ2S+ report receiving sex education in schools that felt personally relevant.
  • Only 10 US states require affirming content on LGBTQ2S+ relationships in sex education curriculum.

Youth with disabilities or special health care needs:

  • Youth with disabilities or special health care needs have a particular need for comprehensive sex education, as these youth are less likely to learn about sex or sexuality form their parents , healthcare providers , or peer groups .
  • In a national survey, only half of youth with disabilities report that they have participated in sex education .
  • Typical sex education may not be sufficient for youth with Autism Spectrum Disorder, and special methods and curricula are necessary to match their needs .
  • Lack the desire or maturity for romantic or sexual relationships.
  • Are not subject to sexual abuse.
  • Do not need sex education.
  • Only 3 states explicitly include youth with disabilities within their sex education requirements.

Youth from historically underserved communities:

  • Students who are Black in the US are more likely than students who are white to receive abstinence-only sex education , despite significant support from parents and students who are Black for comprehensive sex education.
  • Youth who are Black and female are less likely than peers who are white to receive education about where to obtain birth control prior to initiating sexual activity.
  • Youth who are Black and male and Hispanic are less likely than their peers who are white to receive formal education on STI prevention or contraception prior to initiating sexual activity.
  • Youth who are Hispanic and female are less likely to receive instruction about waiting to have sex than youth of other ethnicities.
  • Tribal health educators report challenges in identifying culturally relevant sex education curriculum for youth who are American Indian/Alaska Native.
  • In a 2019 study, youth who were LGBTQ2S+ and Black, Latinx, or Asian reported receiving inadequate sex education due to feeling unrepresented, unsupported, stigmatized, or bullied.
  • In survey research, many young adults who are Asian American report that they received inadequate sex education in school.

Youth from rural communities:

  • Adolescents who live in rural communities have faced disproportionate declines in formal sex education over the past two decades, compared with peers in urban/suburban areas.
  • Students who live in rural communities report that the sex education curriculum in their schools does not serve their needs .

Youth from communities and schools that are low-income:

  • Data has shown an association between schools that are low-resource and lower adolescent sexual health knowledge, due to a combination of fewer school resources and higher poverty rates/associated unmet health needs in the student body.
  • Youth with family incomes above 200% of the federal poverty line are more likely to receive education about STI prevention, contraception, and “saying no to sex,” than their peers below 200% of the poverty line.

Youth who receive sex education in some religious settings:

  • Most adolescents who identify as female and who attended church-based sex education programs report instructions on waiting until marriage for sex, while few report receiving education about birth control.
  • Young people who received sex education in religious schools report that education focused on the risks of sexual behavior (STIs, pregnancy) and religious guilt; leading to them feeling under-equipped to make informed decisions about sex and sexuality later in life.
  • Youth and teachers from religious schools have identified a need for comprehensive sex education curriculum that is tailored to the needs of faith communities .

Youth who live in states that limit the topics that can be covered in sex education:

  • Students who live in the 34 states that require sex education programs to stress abstinence are less likely to have access to critical information on STI prevention and contraception.
  • Prohibitions on addressing abortion in sex education or mandates that sex education curricula include medically inaccurate information on abortion designed to dissuade youth from terminating a pregnancy.
  • Limitations on the types of contraception that can be covered in sex education curricula.
  • Requirements that sex education teachers promote heterosexual, monogamous marriage in sex education.
  • Lack of requirements to address healthy relationships and communication skills.
  • Lack of requirements for teacher training or certification.

Comprehensive sex education has significant benefits for children and adolescents.

Youth who are exposed to comprehensive sex education programs in school demonstrate healthier sexual behaviors:

  • Increased rates of contraception and condom use.
  • Fewer unplanned pregnancies.
  • Lower rates of STIs and HIV.
  • Delayed initiation of sexual behavior.

More broadly, comprehensive sexual education impacts overall social-emotional health , including:

  • Enhanced understanding of gender and sexuality.
  • Lower rates of homophobia and related bullying.
  • Lower rates of dating violence, intimate partner violence, sexual assault, and child sexual abuse.
  • Healthier relationships and communication skills.
  • Understanding of reproductive rights and responsibilities.
  • Improved social-emotional learning, media literacy, and academic achievement.

Comprehensive sex education curriculum goes beyond risk reduction, to ensure that youth are supported in understanding their identity and sexuality and making informed decisions about their relationships, behaviors, and future. These benefits are critical to healthy sexual development.

Impacts of a lack of access to comprehensive sex education.

When youth are denied access to comprehensive sex education, they do not get the information and skill-building required for healthy sexual development. As such, they face unnecessary barriers to understanding their gender and sexuality, building positive interpersonal relationships, and making informed decisions about their sexual behavior and sexual health.

Impacts of a lack of comprehensive sex education for all youth can include :

  • Less use of condoms, leading to higher risk of STIs, including HIV.
  • Less use of contraception, leading to higher risk of unplanned pregnancy.
  • Less understanding and increased stigma and shame around the spectrum of gender and sexual identity.
  • Perpetuated stigma and embarrassment related to sex and sexual identity.
  • Perpetuated gender stereotypes and traditional gender roles.
  • Higher rates of youth turning to unreliable sources for information about sex, including the internet, the media, and informal learning from peer networks.
  • Challenges in interpersonal communication.
  • Challenges in building, maintaining, and recognizing safe, healthy peer and romantic relationships.
  • Lower understanding of the importance of obtaining and giving enthusiastic consent prior to sexual activity.
  • Less awareness of appropriate/inappropriate touch and lower reporting of child sexual abuse.
  • Higher rates of dating violence and intimate partner violence, and less intervention from bystanders.
  • Higher rates of homophobia and homophobic bullying.
  • Unsafe school environments.
  • Lower rates of media literacy.
  • Lower rates of social-emotional learning.
  • Lower recognition of gender equity, rights, and social justice.

In addition, the lack of access to comprehensive sex education can exacerbate existing health disparities, with disproportionate impacts on specific populations of youth.

Youth who identify as women, youth from communities of color, youth with disabilities, and youth who are LGBTQ2S+ are particularly impacted by inequitable access to comprehensive sex education, as this lack of education can impact their health, safety, and self-identity. Examples of these impacts are outlined below.

A lack of comprehensive sex education can harm young women.

  • Female bodies are more prone to STI infection and more likely to experience complications of STI infection than male bodies.
  • Female bodies are disproportionately impacted by long-term health consequences of STIs , including pelvic inflammatory disease, infertility, and ectopic pregnancy.
  • Female bodies are less likely to have or recognize symptoms of certain STI infections .
  • Human papillomavirus (HPV) is the most common STI in young women , and can cause long-term health consequences such as genital warts and cervical cancer.
  • Women bear the health and economic effects of unplanned pregnancy.
  • Comprehensive sex education addresses these issues by providing medically-accurate, evidence based information on effective strategies to prevent STI infections and unplanned pregnancy.
  • Students who identify as female are more likely to experience sexual or physical dating violence than their peers who identify as male. Some of this may be attributed to underreporting by males due to stigma.
  • Students who identify as female are bullied on school property more often than students who identify as male.
  • Young women ages 16-19 are at higher risk of rape, attempted rape, or sexual assault than the general population.
  • Comprehensive sex education addresses these issues by guiding the development of healthy self-identities, challenging harmful gender norms, and building the skills required for respectful, equitable relationships.

A lack of comprehensive sex education can harm youth from communities of color.

  • Youth of color benefit from seeing themselves represented in sex education curriculum.
  • Sex education programs that use a framing of diversity, equity, rights, and social justice , informed by an understanding of systemic racism and discrimination, have been found to increase positive attitudes around reproductive rights in all students.
  • There is a critical need for sex education programs that reflect youth’s cultural values and community .
  • Comprehensive sex education can address these needs by developing curriculum that is inclusive of diverse communities, relationships, and cultures, so that youth see themselves represented in their education.
  • Racial and ethnic disparities in STI and HIV infection.
  • Racial and ethnic disparities in unplanned pregnancy and births among adolescents.
  • Nearly half of youth who are Black ages 13-21 report having been pressured into sexual activity .
  • Adolescent experience with dating violence is most prevalent among youth who are American Indian/Alaska Native, Native Hawaiian/Pacific Islander, and multiracial.
  • Adolescents who are Latinx are more likely than their peers who are non-Latinx to report physical dating violence .
  • Youth who are Black and Latinx and who experience bullying are more likely to suffer negative impacts on academic performance than their white peers.
  • Students who are Asian American and Pacific Islander report bullying and harassment due to race, ethnicity, and language.
  • Comprehensive sex education addresses these issues by guiding the development of healthy self-identities, challenging harmful stereotypes, and building the skills required for respectful, equitable relationships.
  • Young people of color—specifically those from Black , Asian-American , and Latinx communities– are often hyper-sexualized in popular media, leading to societal perceptions that youth are “older” or more sexually experienced than their white peers.
  • Young men of color—specifically those from Black and Latinx communities—are often portrayed as aggressive or criminal in popular media, leading to societal perceptions that youth are dangerous or more sexually aggressive or experienced than white peers.
  • These media portrayals can lead to disparities in public perceptions of youth behavior , which can impact school discipline, lost mentorship and leadership opportunities, less access to educational opportunities afforded to white peers, and greater involvement in the juvenile justice system.
  • Comprehensive sex education addresses these issues by including positive representations of diverse youth in curriculum, challenging harmful stereotypes, and building the skills required for respectful relationships.

A lack of comprehensive sex education can harm youth with disabilities or special health care needs.

  • Youth with disabilities need inclusive, developmentally-appropriate, representative sex education to support their health, identity, and development .
  • Youth with special health care needs often initiate romantic relationships and sexual behavior during adolescence, similar to their peers.
  • Youth with disabilities and special health care needs benefit from seeing themselves represented in sex education to access the information and skills to build healthy identities and relationships.
  • Comprehensive sex education addresses this need by including positive representation of youth with disabilities and special health care needs in curriculum and providing developmentally-appropriate sex education to all youth.
  • When youth with disabilities and special health care needs do not get access to the comprehensive sex education that they need, they are at increased risk of sexual abuse or being viewed as a sexual offender.
  • Youth with disabilities and special health care needs are more likely than peers without disabilities to report coercive sex, exploitation, and sexual abuse.
  • Youth with disabilities and special health care needs report more sexualized behavior and victimization online than their peers without disabilities.
  • Youth with disabilities are at greater risk of bullying and have fewer friend relationships than their peers.
  • Comprehensive sex education addresses these issues by providing education on healthy relationships, consent, communication, and bodily autonomy.

A lack of comprehensive sex education can harm youth who are LGBTQ2S+.

  • Most sex education curriculum is not inclusive or representative of LGBTQ2S+ identities and experiences.
  • Because school-based sex education often does not meet their needs, youth who are LGBTQ2S+ are more likely to seek sexual health information online , and thus are more likely to come across misinformation.
  • The majority of parents support discussion of sexual orientation in sex education classes.
  • Comprehensive sex education addresses these issues by including positive representation of LGBTQ2S+ individuals, romantic relationships, and families.
  • Sex education curriculum that overlooks or stigmatizes youth who are LGBTQ2S+ contributes to hostile school environments and harms the healthy sexual and mental development .
  • Youth who are LGBTQ2S+ face high levels of discrimination at school and are more likely to miss school because of bullying or victimization .
  • Ongoing experiences with stigma, exclusion, and harassment negatively impact the mental health of youth who are LGBTQ2S+.
  • Comprehensive sex education provides inclusive curriculum and has been shown to improve understanding of gender diversity, lower rates of homophobia, and reduce homophobic bullying in schools.
  • Youth who are LGBTQ2S+ are more likely than their heterosexual peers to report not learning about HIV/STIs in school .
  • Lack of education on STI prevention leaves LGBTQ2S+ youth without the information they need to make informed decisions, leading to discrepancies in condom use between LGBTQ2S+ and heterosexual youth.
  • Some LGBTQ2S+ populations carry a disproportionate burden of HIV and other STIs: these disparities begin in adolescence , when youth who are LGBTQ2S+ do not receive sex education that is relevant to them.
  • Comprehensive sex education provides the knowledge and skills needed to make safe decisions about sexual behavior , including condom use and other forms of STI and HIV prevention.
  • Youth who are LBGTQ2S+ or are questioning their sexual identity report higher rates of dating violence than their heterosexual peers.
  • Youth who are LGBTQ2S+ or are questioning their sexual identity face higher prevalence of bullying than their heterosexual peers.
  • Comprehensive sex education teaches youth healthy relationship and communication skills and is associated with decreases in dating violence and increases in bystander interventions .

A lack of comprehensive sex education can harm youth who are in foster care.

  • More than 70% of children in foster care have a documented history of child abuse and or neglect.
  • More than 80% of children in foster care have been exposed to significant levels of violence, including domestic violence.
  • Youth in foster care are racially diverse, with 23% of youth identifying as Black and 21% of identifying as Latinx, who will have similar experiences as those highlighted in earlier sections of this report.
  • Removal is emotionally traumatizing for almost all children. Lack of consistent/stable placement with a responsive, nurturing caregiver can result in poor emotional regulation, impulsivity, and attachment problems.
  • Comprehensive sex education addresses these issues by providing evidence-based, culturally appropriate information on healthy relationships, consent, communication, and bodily autonomy.

Sex education is often the first experience that youth have with understanding and discussing their gender and sexual health.

Youth deserve to a strong foundation of developmentally appropriate information about gender and sexuality, and how these things relate to their bodies, community, culture, society, mental health, and relationships with family, peers, and romantic partners.

Decades of data have demonstrated that comprehensive sex education programs are  effective  in reducing risk of STIs and unplanned pregnancy. These benefits are critical to public health. However, comprehensive sex education goes even further, by instilling youth with a broad range of knowledge and skills that are  proven  to support social-emotional learning, positive communication skills, and development of healthy relationships.

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sexuality education essay

Simple & Easy Sex Education Essay Titles

  • The Other Side: the Importance of Sex Education in High School
  • The Ongoing Debate Over Sex Education and Its Influence on Our Children
  • Why Sex Education for Children Is Very Important
  • The Importance of Sex Education in Today’s Schools
  • The Religious and Cultural Aspect of Sex Education
  • Single Sex Education Are Becoming More Complicated Countries
  • Why There Should Be Comprehensive Sex Education in Schools
  • The Reasons Why Sex Education Will Help Reduce Teen Pregnancy
  • The Importance and Need for Sex Education to Deal with Teenage Pregnancy
  • What Sex Education Topics Are Most Effective in Elementary Schools
  • Gender Discrimination for Single Sex Education
  • How Sex Education Can Change Teenage Sexual Behaviour
  • Why Teens Need Comprehensive Sex Education

Good Essay Topics on Sex Education

  • The Importance of Sex Education in America and to American Teenagers
  • The Main Features of Sex Education in Traditional Societies and Its Importance
  • The Effects of State‐Mandated Abstinence‐Based Sex Education on Teen Health Outcomes
  • Why Sex Education Should Be Taught in Schools
  • The Issue of Teaching Sex Education in Public Schools
  • The Importance of Teaching Sex Education and Homosexuality
  • The Three Forms of Sex Education in the United States
  • The Inclusion of Sex Education in the School Curriculum
  • When Values Clash with Faith: Sex Education in Religious Based Schools”
  • What Are the Pros and Cons of Sex Education in Hong Kong Secondary Schools
  • Should Sex Education Be Increased in Schools to Curb Problems in Society?
  • The Impact of Single Sex Education on Girl ‘S Academic Performance
  • The Need for a Comprehensive Sex Education in American Schools
  • The Benefits of Sex Education in Public Schools
  • Why High schools Should Have Sex Education Starting Freshman Year

Research Questions About Sex Education

  • What Age Should Sex Education Be Taught?
  • How Should Sex Education Be Taught?
  • What Are the Pros and Cons of Sex Education in Hong Kong Secondary Schools?
  • Can Single-Sex Education Improve Students’ Academic Achievement in Middle School?
  • What Sex Education Topics Are Most Effective in Elementary Schools?
  • Has the Media and School-Based Sex Education Reduced the Prevalence of Sexually Transmitted Diseases?
  • Why Should High schools Have Sex Education Starting Freshman Year?
  • Does Sex Education Influence Sexual and Reproductive Behaviour of Women?
  • Why Is Same-Sex School Education Better?
  • How Far Should Schools Teach Sex Education?
  • Why Is Sex Education for Children Very Important?
  • Does Sex Education Work?
  • Why Should Sex Education Be Taught in Schools?
  • How Can Sex Education Change Teenage Sexual Behaviour?
  • Why Do Teens Need Comprehensive Sex Education?
  • Will You Choose CoEd or Single-Sex Education?
  • Our Current Sex Education, Why Doesn’t It Work?
  • Demand for Sexual Services in Britain: Does Sex Education Matter?
  • Co-Education and Single-Sex Education: Which Will Benefit Children More?
  • Why Do Teens Need Sex Education?
  • When Values Clash with Faith: Sex Education in Religious Based Schools?
  • Should LGBT History Be Taught in Schools?
  • Which City or Country Has Sexual Education for Parents of Children with Autism Spectrum Disorder?
  • How to Educate the 4th-6th Elementary Student About Sex?
  • How Successful Is Abstinence-Only Sex Education in Reduce Teen Pregnancy?
  • Is Introduction Sex Education in Schools Useful?
  • Does the School Provide Enough Information on Sex Education?

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Matthew Lynch

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The Importance of Sexual Education Essay

Personal sexuality.

Sexual education has an integral role in removing one’s doubts on sexuality and sex related topics. It has often been identified that sexual education helps one to get a clear picture of the male and female sexuality. The sexual counseling and orientation class that I received was really effective in taking away the veil of sexual illiteracy and it enabled me to understand what human sexuality is. Regarding my personal experience with the class, I can identify it as one of the most effective classes which I ever attended and it helped me in changing my concepts about sex. As it was a class that covered almost all the sections of sexuality, the participants got the opportunity in properly identifying and clarifying their doubts on this topic. It was effective to get a clear picture of sexually-transmitted diseases and their evil effects on mankind. The proposed paper is an attempt to explore what sexuality is and the misconceptions of individuals about sexuality, based on personal experience of attending an orientation class on sexuality.

Researchers show their willingness to reach the conclusion that misconceptions and vague beliefs about sexuality contribute severe physical and mental disorder and behavioral problems. Various studies prove that effective orientation courses and sex education programs help to solve sexual problems and permit a person to mould a desired outcome in a person’s sexual life. The course promotes enormous knowledge and scientific information about sexuality in adolescence. In case of an adolescent, physical and mental changes affect seriously. In case of a male, biological changes such as puberty, growth of sexual organs and sexual attractions towards opposite sex are very common. In my own personal opinion the orientation course helped me to create scientific notions about sexual difficulties and sex-related diseases. The course helped me to deal sex as something serious and responsible phenomena in a person’s life. The web article entitled Sexual Difficulties remarks that; “Sexual difficulties belong to the group of conditions known as psychosomatic disorders, in which the body expresses the distress via a symptom, such as low libido.” ( Sexual Difficulties, p. 1).

Adolescent period is the most crucial time in a person’s life and the detailed description by the course person gives new knowledge about the behavioral changes and disorder problems. Both male and female suffer from lack of love, consideration, respect and proper interaction. Like other people, I also have some vague concepts about sexual changes and psychological impacts on a person’s life. After the orientation course I could understand more about male and female anatomy and their psychological impacts. Through the course I have got an opportunity to comprehend the term gender problem. Effective interaction between the course person and the listeners reduced the complications of the topic and it enabled me to admit sex is not only a means of enjoyment and merrymaking but a vital part of the process of human growth.

Like any other student, I was also not an exception and I had kept a false illusion over sexuality. One of the prominent lessons that I learned during the classes was about the gender issues. As I am one of the members of the male chauvinist society, I had formed my concept of sexuality with male possessing dominance. These classes planted in me the seeds that sexuality is a positive and healthy experience in which man and woman have equal roles. It was the class that cultivated in me the due respect to my opposite sex and I began to regard them equal to me. Understanding of female and male sexual anatomy and physiology helped realizing the genital change and growth in male and female. The transitional period of male and female from adolescence to youthhood is always problematic to children that their ignorance often leads them to mental and physical disorders. Some of the studies have identified children becoming depressed caused with the lack of sexual education. But it is possible for one to say that sexual education is always effective. The words of Dr. D Kirby, et al. make clear this fact when they rightly comment thus, “…there can also be many negative consequences of adolescent sexual behavior.”(Kirby, et al ). Now I am capable of recognizing the real physiological problems of children. I have also understood the ill-effects of prostitution and sexually transmitted diseases.

The course which I attended says how the relationship between partners can make a stronger one. They are of the opinion that if the partners build up a good communication with each other along with a good sexual relationship they can lead their life happily. While going through this class I realized that it is only by making a deep communication I can make my family relationship an ardent one. In the relationship with my partner I find some dissatisfaction because we are not always sharing our likes and dislikes. I think it is because of this there is a great gap between us. Now there is no good relationship between us because there is no deep communication between us. But after attending this class I understood about the relationship between the male and female sexual anatomy and how deep love and communication can help to make a good relation with my partner. I also got a good idea about sexually-transmitted diseases and what all difficulties will be there in the sexual relationship and by hearing the solutions I tried to change my attitudes toward my partner. Earlier I was not concerned about my partner’s wish or difficulties but now I care my partner and I try to understand the difficulties which my partner faces and in the coming days I will take care to make our relationship a success. I understood from the class that if there is a true love between partners and if they try to understand each other one can make their life a fruitful one.

The course gave a lot of valuable information about how to lead a happy and peaceful married life and what are the ways to attain such perfection. The course mainly focused on to have an understanding about the good and bad effects of keeping a sexual relation. The course gave comfortable contents which every one can put into practice. First of all the good content I consider is keeping a deep love and communication between the partners. This information is enough to lead a happy life, because if these two are put into practice there will be no clash and quarrel between the partners in sexual matter. For instance if one does not reveal his or her dissatisfaction about the manner of the partner in sexual relation, it will make a silent pain in the mind of the dissatisfied person and this will lead the person to be in a great hatred to his or her partner and thereby the relation too. So there should be a healthy communication and a kind of ardent love between the partners to avoid such hatred and other similar situations. The other comfortable content I found in the course is the description and discussion of male and female anatomy and physiology as it helps both the partners to understand every likes and dislikes of the other and can mingle with the other in an appropriate way. The discussion about sexual difficulties and solutions are also comfortable as it is highly favorable to know the causes of such difficulties and also the methods to solve those problems. The most important content I found in the course is the discussion about sexually transmitted diseases as it will create awareness among the people who keep different relations. So it will play a crucial role to change such attitudes and thereby the relation. These are the comfortable contents that I found in the course and are valuable to lead a better life.

Male and female anatomy and physiological features constituted more important knowledge for me. Each male and female has his/her own physical and genetic features. Comparing the physical changes of female in adulthood, female development is too fast and noticeable. I think one of the most valuable one is that the course provided proper awareness about inevitable relationship between physical growth and psychological changes. The given information helped me to know more about the structure of both male and female physical organs, especially the various changes of genital organs and their biological functions. The knowledge about opposite sex enabled me to respect persons from opposite sex. Childhood sexuality and its significance in development process were highly thought-provoking areas of the discussion. Genetic abnormalities and various sexual diseases are not familiar topics for me. Jane Coad and Melvyn Dunstall write “There are genetic conditions that result in a range of variable sexual development, such as Klinefelter’s syndrome and Turner’s syndrome.” (Coad, and Dunstall, p. 100). The course and orientation programs were helpful to number of people who have only some vague knowledge about personal sexuality.

To conclude, one can infer that there should be attempts to educate children on sexuality and the human body. From my personal experience of attending the class on sexuality, I have understood the importance of sexual education as it helps students to understand persons of their opposite sex. Proper understanding of male and female anatomy and physiological features is important in one’s life. Attending such classes remind one about the significance of a healthy sexual relation and its role in promoting better life situations. Scientific information about sexuality and the transition in the adolescent period also assumes significance. Male biological changes such as, puberty, growth of sexual organs and their sexual attraction to their opposite sex are quite common and if one is totally ignorant of these facts he/she may face some mental stress or in some cases it may lead to mental depression. Regarding sexual relation in married life, one can see that sex and sexual satisfaction have integral roles. Failure in understanding his/her pair in sexual relationship often leads to the ruin of family relationships. So, one is sure of the fact that sexual education has an elite role in one’s life. Proper sexual education should be given to children to avoid sexual illiteracy and sexual crimes.

Works Cited

  • Coad, Jane., and Dunstall, Melvyn. Anatomy and Physiology for Midwives . Elsevier Health Science. 2001. Web.
  • Kirby, Douglas., etal. School- Based Program to Reduce Sexual Risk Behaviors: a Review of Effectiveness . Public Health Report, 109. 3(1994): 339-360. Pub Med Central Journal List. 2009.Web.
  • Sexual Difficulties. Andrology Australia.2006.
  • Chicago (A-D)
  • Chicago (N-B)

IvyPanda. (2021, November 14). The Importance of Sexual Education. https://ivypanda.com/essays/the-importance-of-sexual-education/

"The Importance of Sexual Education." IvyPanda , 14 Nov. 2021, ivypanda.com/essays/the-importance-of-sexual-education/.

IvyPanda . (2021) 'The Importance of Sexual Education'. 14 November.

IvyPanda . 2021. "The Importance of Sexual Education." November 14, 2021. https://ivypanda.com/essays/the-importance-of-sexual-education/.

1. IvyPanda . "The Importance of Sexual Education." November 14, 2021. https://ivypanda.com/essays/the-importance-of-sexual-education/.

Bibliography

IvyPanda . "The Importance of Sexual Education." November 14, 2021. https://ivypanda.com/essays/the-importance-of-sexual-education/.

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sexuality education essay

Most CMS families aren't responding to 'parent rights' permission requests

Smile North Carolina offers on-site dental care at Charlotte-Mecklenburg Schools.

Tens of thousands of students in Charlotte-Mecklenburg Schools are missing out on sex education, health screenings and well-being surveys this year because of the district’s response to a new state Parents’ Bill of Rights.

The 12-page bill approved in July includes a multitude of requirements, such as ensuring that parents can review all classroom material and notifying parents if their kids ask to use a different name or pronouns. It also requires parental consent for students to participate in health services, surveys and sex education.

The CMS board acted quickly to revise its policies before classes began in August. Among the changes: CMS used to let students participate in surveys, screenings and sex ed unless their parents opted out, but now it requires them to opt in through an online consent form.

Before leaving the board in December, Jennifer De La Jara requested participation data. As she expected, the vast majority of parents simply didn’t respond. For instance, more than 58,000 students were eligible to take part in sex education during the first semester, but fewer than 22,000 submitted consent forms. Trends were similar for a Panorama survey that asks about some touchy subjects — and for seemingly unobjectionable activities such as vision, hearing and dental screenings.

Suicide prevention screenings include 159 'yes' and 26 'no' responses.

De La Jara said in December she suspects it’s not that parents don’t want their kids to take part, but that they’re deterred by cumbersome forms. For instance, some online forms require parents to enter a student ID number.

“Many parents don’t have that readily available and I think that they’re turning it off and just not doing it,” De La Jara said.

Advice to NC districts trying to comply

But it’s not clear that other North Carolina districts will see similar effects. Many took more time to review policies, and in October state lawmakers extended the deadline to this week. The law clearly requires explicit permission for students to take part in surveys that ask about mental health, sexual behavior, political beliefs, religious practices and “illegal, antisocial, self-incriminating or demeaning behavior.” But state officials say it doesn’t ban an opt-out system for sex ed or health screenings.

“It seems as though some districts are looking to be overly cautious and very thorough in what they provide to parents in an effort to be in compliance,” Department of Public Instruction Communications Director Blair Rhoades wrote in response to a query about the CMS participation numbers.

The North Carolina School Boards Association has also advised districts that opt-out is allowed for sex education, but notes that local boards can choose to require families to opt in, Policy Director Christine Scheef said.

Impact on surveys that ask sensitive questions

De La Jara says she’s especially concerned about reduced participation in surveys that ask about sensitive subjects. “This data helps us understand suicide ideation numbers, drug abuse, alcohol abuse and reproductive health,” De La Jara said.

The largest of those surveys is produced by Panorama Education , which works with about half a dozen North Carolina districts , including CMS, Wake, Winston Salem-Forsyth, Chapel Hill-Carrboro, Johnston and Rowan-Salisbury.

Last year only 324 families asked that their children not participate in the Panorama survey, according to numbers provided by CMS. This year almost 110,000 students were eligible to participate, but only 36,800 opted in. More than 60% of parents simply didn’t respond — and of those who did, just over 90% gave consent.

Plunging participation makes the data less reliable and not comparable to previous years. De La Jara says that affects not only CMS, but other agencies that use the data to get funding for after-school support programs. She cited Alianza , a substance-abuse prevention program targeting Latino students, as an example.

CMS also reported even lower parent response rates from three other surveys it conducts, including a youth drug screening.

The drop in sex ed and screenings in CMS

CMS sought permission for more than 58,000 students to take sex education, formally known as reproductive health and safety education. More than 36,000 families, or almost 63%, didn’t respond. Of those who did, 94% consented to their children’s participation.

Results for vision, hearing and dental screenings were even more dramatic, with response rates below 10%. That meant more than 74,000 students couldn’t participate in one or more of those screenings because their families hadn’t opted in.

The district also asked for permission to do suicide prevention screening for almost 21,000 students and depression screening for about 10,500. Fewer than 1% of parents responded to either request, the CMS numbers show. But more than 80% of those who did respond said yes.

Other districts’ responses vary

The Parents’ Bill of Rights requires districts to notify parents of any physical or mental health services offered and provide “the means for the parent to provide consent for any specific service.” It also requires that parents can “consent or withhold consent for participation in reproductive health and safety programs.”

Wake County, the state’s largest district, recently approved a parental involvement policy that requires written consent for participation in “certain health services as required by law” and surveys “concerning protected topics." But Wake requires action from parents only if they want to opt their kids out of sex education.

The Union County school board also recently adopted policies that clarified the need for written consent for surveys on protected topics, but left the sex-education opt-out policy unchanged.

In Iredell-Statesville Schools, spokeswoman Jada Jonas says parents have been required to opt into sex education participation for years. She said the district will begin seeking permission for vision, hearing and dental screenings “as we move toward fully implementing the Parents’ Bill of Rights.” She said the district’s only survey is an optional school climate survey.

In CMS, De La Jara said Superintendent Crystal Hill and her staff were looking at ways to make the opt-in process easier, including for sex education, and hoping for adjustments from the state as well. “We know based on previous opt-out data that there’s not a real groundswell of parents that don’t want this education for their children,” she said.

De La Jara says the district will also work harder to reach families and urge them to do consent forms. But she noted that family communications must be “in multiple, multiple languages.”

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sexuality education essay

Jeffrey Epstein list: What to expect from court filings unsealed in New York

  • Published 1 day ago

U.S. financier Jeffrey Epstein appears in a photograph taken for the New York State Division of Criminal Justice Services' sex offender registry March 28, 2017

A long list of people associated with the late sex offender Jeffrey Epstein is expected to be made public in the coming days.

The disclosures may throw new light on the sex trafficking network directed by Epstein, who died in 2019, and his associate Ghislaine Maxwell.

The disgraced millionaire mixed with high-profile figures from the worlds of politics, business and royalty.

A judge ordered the court documents in a lawsuit linked to Maxwell must be unsealed.

There are 187 mentions of "J Doe" in the court papers, and many of these will now be given their real names.

Why are these names being made public?

The identities are being revealed under a settled lawsuit against Maxwell, the daughter of a British media tycoon.

She is serving a 20-year prison term for the crimes she committed with Epstein.

The defamation lawsuit was brought by Virginia Giuffre, one of Maxwell's accusers, and at the time the names were kept secret under a court-ordered seal.

But last month a judge in New York ruled these could now come to light.

What did the judge say about the names?

Judge Loretta Preska noted that many of the individuals named in the lawsuit have already been publicly identified by the media or in Maxwell's criminal trial.

She added that many others "did not raise an objection" to the release of the documents.

Some of the names on the list will remain sealed, including those belonging to child victims, the judge said in her ruling.

And some individuals may have appeared more than once under different Doe numbers, so the exact number of names to emerge is unknown.

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Holly Baltz, investigations editor at the Palm Beach Post, told CNN on Tuesday that new details may be revealed.

Even if the names on the list turn out to be already known, she said, new light may be shed on the exact nature of their relationship with Epstein and Maxwell.

Whose names may be on the Epstein list?

They will be a mixture of people accused of wrongdoing, people making these accusations, and others who were potential witnesses to crimes.

There could be employees of Epstein or people who visited his home or went on his private plane.

Prince Andrew is expected to be on the list. The court filings include 40 documents of evidence from a woman who has made accusations against the prince.

Johanna Sjoberg claimed Prince Andrew groped her breast while sitting on a couch inside Epstein's Manhattan apartment in 2001.

Buckingham Palace has previously said the allegations are "categorically untrue".

Last year, the prince paid millions to Ms Giuffre to settle a lawsuit she filed claiming that he sexually abused her when she was 17 years old.

He said he had never met Ms Giuffre and denied her allegations.

Will Bill Clinton be on the Epstein list?

The former US president is mentioned more than 50 times in the court documents, according to ABC News . But there is no implication of any illegality.

He travelled on Epstein's plane on humanitarian trips to Africa in the early 2000s and at the time praised Epstein as a committed philanthropist.

Mr Clinton's team have previously said that he cut ties with Epstein before the financier came under investigation. They have in the past said he knows nothing about Epstein's crimes.

Many of his mentions in these court filings relate to Ms Giuffre's unsuccessful attempts to make the former president testify about his relationship with Epstein, says ABC.

Who is Jeffrey Epstein?

Epstein, a millionaire known to mix with high-profile figures like Prince Andrew, died in jail in 2019.

His death, as he awaited federal sex-trafficking charges, was ruled to be a suicide by the New York medical examiner.

He was accused of running a "vast network" of underage girls for sex. He pleaded not guilty.

A decade earlier he had been convicted of soliciting prostitution from a minor.

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56 French stars defend actor Gerard Depardieu despite sexual misconduct allegations

FILE - Actor Gerard Depardieu attends the premiere of the movie “Tour de France” in Paris, France, Monday, Nov. 14, 2016. More than 50 French performers, writers and producers published an essay Tuesday defending film star and national icon Gerard Depardieu amid growing scrutiny of his behavior toward women. (AP Photo/Thibault Camus, File)

FILE - Actor Gerard Depardieu poses for photographers during a photo call for the film Valley of Love, at the 68th international film festival, Cannes, southern France, Friday, May 22, 2015. More than 50 French performers, writers and producers published an essay Tuesday defending film star and national icon Gerard Depardieu amid growing scrutiny of his behavior toward women. (AP Photo/Thibault Camus, File)

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PARIS (AP) — More than 50 French performers, writers and producers published an essay Tuesday defending film star and national icon Gerard Depardieu amid growing scrutiny of his behavior toward women during his five-decade career. Advocates for sexual abuse victims expressed dismay at the outpouring of support.

Depardieu was handed preliminary rape and sexual assault charges in 2020 following allegations from actor Charlotte Arnould, and has been accused by more than a dozen other women of harassing, groping or sexually assaulting them. Depardieu denies wrongdoing, and called the essay ‘’beautiful.’’

Published Tuesday in the conservative-leaning Le Figaro, it was signed by figures including former first lady and singer Carla Bruni, Depardieu’s former partner Carole Bousquet, and actors Pierre Richard, Charlotte Rampling and Victoria Abril. Two dozen of the 56 signatories were women. Many are from Depardieu’s generation; he is 74.

A recent documentary outlined accusations of sexual misconduct by 16 women against Depardieu, and showed the actor making obscene remarks and gestures during a 2018 trip to North Korea. The France-2 documentary prompted calls by some to stop airing Depardieu’s films, which include classics of modern French cinema.

FILE - Actor Gerard Depardieu attends the premiere of the movie "Tour de France" in Paris, France, Monday, Nov. 14, 2016. French actor Gerard Depardieu's behavior came under scrutiny in France after a new documentary showed him repeatedly making obscene remarks and gestures towards women, as new sexual misconduct accusations emerged against him. (AP Photo/Thibault Camus, File)

In response, Tuesday’s essay says: ’’We cannot remain silent in the face of the lynching targeting him, the torrent of hate being dumped on his personality.

‘’When Gerard Depardieu is targeted this way, it is the art (of cinema) that is being attacked,’’ it said. ‘’France owes him so much. ... Depriving ourselves of this immense actor would be a drama, a defeat. The death of the art. Our art.’’

Paris lawmaker and feminist Raphaëlle Rémy-Leleu said the signatories are experiencing a ‘’denial of reality.’’ She said she would have preferred for them to support initiatives against sexual violence instead.

’’They are refusing to see what this man did … because he is an artist,″ she told broadcaster France-Info.

Emmanuelle Dancourt, whose #MeTooMedia group supports sexual misconduct victims in the media industry, said on BFM television that the essay’s message is particularly painful for victims of sexual abuse by powerful men.

French President Emmanuel Macron also drew ire when he said last week that Depardieu ’’makes France proud.″

The recent documentary includes a segment where Depardieu is heard making crude sexual comments about a young girl riding a horse. Macron suggested that the segment could have been edited in a misleading way. France Televisions, which broadcast the documentary, later said that the segment in question was authenticated by a bailiff who viewed the raw footage.

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Florida Sex Scandal Shakes Moms for Liberty, as Group’s Influence Wanes

The conservative group led the charge on the Covid-era education battles. But scandals and losses are threatening its power.

Bridget Ziegler sits by herself at a long desk used for meetings of the Sarasota County School Board. Nameplates for each board member are arranged along the front of the desk, and the logo of Sarasota County Schools hangs on the wall behind her.

By Lisa Lerer and Patricia Mazzei

Moms for Liberty, a national right-wing advocacy group, was born in Florida as a response to Covid-19 school closures and mask mandates. But it quickly became just as well known for pushing policies branded as anti-L.G.B.T.Q. by opponents.

So when one of its founders, Bridget Ziegler, recently told the police that she and her husband, who is under criminal investigation for sexual assault, had a consensual sexual encounter with another woman, the perceived disconnect between her public stances and private life fueled intense pressure for her to resign from the Sarasota County School Board.

“Most of our community could not care less what you do in the privacy of your own home, but your hypocrisy takes center stage,” Sally Sells, a Sarasota resident and the mother of a fifth-grader, told Ms. Ziegler during a tense school board meeting this week. Ms. Ziegler, whose husband has denied wrongdoing, said little and did not resign.

Ms. Sells was one of dozens of speakers who criticized Ms. Ziegler — and Moms for Liberty — at the meeting, an outcry that underscored the group’s prominence in the most contentious debates of the pandemic era.

Perhaps no group gained so much influence so quickly, transforming education issues from a sleepy political backwater to a rallying cry for Republican politicians. The organization quickly became a conservative powerhouse, a coveted endorsement and a mandatory stop on the G.O.P. presidential primary campaign trail.

Yet, as Moms for Liberty reels from the scandal surrounding the Zieglers, the group’s power seems to be fading. Candidates endorsed by the group lost a series of key school board races in 2023. The losses have prompted questions about the future of education issues as an animating force in Republican politics.

Donald J. Trump, the dominant front-runner for the party’s nomination, makes only passing reference in his stump speeches to preserving “parental rights” — the catchphrase of the group’s cause. Issues like school curriculums, transgender students’ rights and teaching about race were far less prominent in the three Republican primary debates than abortion rights, foreign policy and the economy. And the most prominent champion of conservative views on education — Gov. Ron DeSantis of Florida — has yet to unite conservatives behind his struggling presidential bid.

John Fredericks, a Trump ally in Virginia, said the causes that Moms for Liberty became most known for supporting — policies banning books it deemed pornographic, curtailing the teaching of L.G.B.T.Q. issues and policing how race is taught in schools — had fallen far from many voters’ top concerns.

“You closed schools, and people were upset about that. Schools are open now,” he said. “The Moms for Liberty really have to aim their fire on math and science and reading, versus focusing on critical race theory and drag queen story hours.”

He added: “It’s nonsense, all of it.”

The two other founders of Moms for Liberty, Tina Descovich and Tiffany Justice, have distanced themselves from Ms. Ziegler, saying she has not been an officer in the national organization since early 2021. Ms. Ziegler did not respond to a request for comment.

In a statement, Ms. Descovich and Ms. Justice dismissed criticism that the group was hypocritical. They argue that it is not opposed to racial justice or L.G.B.T.Q. rights, but that it wants to restore control to parents over their children’s education.

“To our opponents who have spewed hateful vitriol over the last several days: We reject your attacks,” Ms. Descovich and Ms. Justice said. “We are laser-focused on fundamental parental rights, and that mission is and always will be bigger than one person.”

Ms. Justice declined to answer questions about the continued influence of their organization or their electoral losses.

Nearly 60 percent of the 198 school board candidates endorsed by Moms for Liberty in contested races across 10 states were defeated in 2023, according to an analysis by the website Ballotpedia, which tracks elections.

The organization claims to operate 300 chapters in 48 states and to have about 130,000 members.

Jon Valant, the director of the Brown Center on Education Policy at the Brookings Institution, a left-leaning think tank, found in a recent study that the group had an outsize presence in battleground and liberal counties. Yet in those areas, the policies championed by Moms For Liberty are broadly unpopular.

“The politics have flipped on the Moms for Liberty, and they’re turning more people to vote against them than for them,” Mr. Valant said.

In November, the group announced that it had removed the chairwomen of two Kentucky chapters after they had posed in photos with members of the Proud Boys, a far-right group with a history of violence. That came several months after a chapter of Moms for Liberty in Indiana quoted Adolf Hitler in its inaugural newsletter. The year before, Ms. Ziegler publicly denied links to the Proud Boys after she had posed for a photo with a member of the group at her election night victory party.

The episodes have transformed the group’s image and alienated it from the voters it once claimed to represent. The group was at one time particularly strong in the suburbs of Northern Virginia, where education issues helped spur Glenn Youngkin, a Republican, to victory in the 2021 governor’s race. (This year, Mr. Youngkin failed in his high-profile attempt at a Republican takeover of the Virginia Statehouse.)

Anne Pogue Donohue, who ran for a school board seat in Loudoun County, Va., against a candidate endorsed by the group, said she saw a disconnect between the cause of Moms for Liberty and the current concerns of voters.

On social media, Ms. Donohue, a former government lawyer and mother of two young children, faced a barrage of personal insults, death threats and accusations that she was trying to “groom” children to become transgender, she said. But during her in-person interactions with voters, she added, a vast majority of parents seemed more concerned with practical issues like math and reading scores, support for special education and expanding vocational and technical programs.

Ms. Donohue won her seat by nearly seven percentage points.

“There is a pushback now,” she said. “Moms for Liberty focuses heavily on culture-war-type issues, and I think most voters see that, to the extent that we have problems in our educational system that we have to fix, the focus on culture-war issues isn’t doing that.”

One place where Moms for Liberty maintains a stronger hold is the state where the group has had perhaps the most influence: Florida.

Since forming in 2020, the group has aligned itself with Mr. DeSantis, backing his parental-rights-in-education law that critics nicknamed “Don’t Say Gay.” The law prohibits classroom instruction on L.G.B.T.Q. topics.

Mr. DeSantis then campaigned for conservative candidates for local school boards, turning nonpartisan races into ones heavily influenced by politics. Several school boards with newly conservative majorities ousted their superintendents.

In Brevard County, the school board is now entirely conservative except for Jennifer Jenkins, whom Mr. DeSantis has already listed as someone he would like to help defeat in 2024.

Ms. Jenkins, an outspoken Moms for Liberty critic who wrested Ms. Descovich’s school board seat from her in 2020, said the organization, while small, had remained a vocal fixture in school board meetings, with about 10 regulars who sometimes bring along people from Indian River and other nearby counties.

“Their members are definitely more extreme than they ever were before,” said Ms. Jenkins, who has been a frequent target of the group. They have picketed outside her house, sent her threatening mail and, she said, taken photos of her in the grocery store as recently as a couple of weeks ago.

On Tuesday, some Moms for Liberty members from Brevard and Indian River Counties attended a Brevard County School Board meeting to protest books that they say should be pulled from schools. Most of the books they named had already been formally challenged.

Still, one by one, group members stood behind the lectern and read explicit scenes from the books until the board’s chairwoman — whom Moms for Liberty and Mr. DeSantis endorsed last year — warned them to stop.

It was what the speakers wanted: Under a Florida law enacted this year, if a school board denies a parent the right to read passages deemed “pornographic,” then the school district “shall discontinue the use of the material.” In other words, cutting off the reading would effectively result in pulling the book from schools, board members said.

“I highly encourage all of you to look at this statute,” Julie Bywater, a member of the Brevard County chapter of Moms for Liberty, told the school board.

Such tactics have become typical for Moms for Liberty members. In response, opponents have started showing up to school board meetings in force, trying to counter the group’s message — including in Sarasota, where Ms. Ziegler’s critics turned out to try to push her out.

The school board, which includes several conservatives who have aligned with Ms. Ziegler before, voted 4 to 1 on Tuesday for a nonbinding resolution urging her to resign; Ms. Ziegler was the only one on the board to vote against it.

Lisa Lerer is a national political reporter for The Times, based in New York. She has covered American politics for nearly two decades. More about Lisa Lerer

Patricia Mazzei is the lead reporter for The Times in Miami, covering Florida and Puerto Rico. More about Patricia Mazzei

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List of Jeffrey Epstein's associates named in lawsuit can be unsealed, judge rules. Here are details on the document release.

By Cara Tabachnick

Updated on: January 2, 2024 / 9:31 AM EST / CBS News

A list of Jeffrey Epstein's  alleged victims and associates — some of whom have been accused of being involved in the disgraced financier's exploitation and abuse of underage girls — could be unsealed and made public as soon as today. That comes after a judge ruled in mid-December that the information should be unsealed, but delayed the release until January to give those involved time to appeal their listing.

More than 150 names may be made public as part of a settled civil lawsuit against British socialite Ghislaine Maxwell  — who was found guilty of conspiring with Epstein to sexually abuse underage girls for at least a decade — brought by  Virginia Giuffre,  who accused Maxwell of recruiting her for abuse.

Giuffre has called Maxwell "the mastermind" behind Eptein's sex trafficking ring.

The list of names could include Epstein's accused co-conspirators as well as a wide range of people listed in the lawsuit. 

Giuffre told CBS News in July 2020  that Maxwell had access to very well-known people, including "government officials, politicians and royalty."

Judge Loretta Preska said they would be released in January to give the people listed in the court filing enough time to appeal the decision. It is unclear whose names are on the list, but many of them have already been mentioned in the media, Preska noted in her ruling. 

What documents will be unsealed?

Judge Preska listed 187 "J. Does" on the court documents and ruled many of them should be "unsealed in full." Some of those "J.Does" appear twice, and others are minors, so it is not yet known what the final tally of names released will be. 

Epstein's associates were named in a settled civil defamation suit filed by Virginia Giuffre in 2015 against Maxwell .

The judge detailed the reasoning behind the publication of the names, noting that many had already been mentioned in the media. For others, the substance in question was not salacious and should not be kept sealed, the rulings said.

Some "J. Does" are minors and possible victims, and Preska ruled that those names and "any identifying information" will remain sealed. 

When will the list of names be released?

The ruling stated that the list of names is expected to be made public in January, after giving the listed "J. Does" about 14 days to object to the publication of their names. 

The ruling allows any "impacted Doe the opportunity to appeal," the court documents said. After the window to appeal closes, the documents will be unsealed and posted to the docket. 

What were the accusations against Epstein?

Epstein  was accused of sexually assaulting countless teenage girls, some of them as young as 14 years old, according to prosecutors. Epstein allegedly exploited a vast network of underage girls for him and his wealthy clients to have sex with at his homes in Manhattan; Palm Beach, Florida; and his private island near St. Thomas. He was also accused of  utilizing a network of employees  to ensure continued access to victims. 

Britain's Prince Andrew is one of the high-profile figures who  has been accused of being one of Epstein's alleged co-conspirators. Giuffre has alleged that she and the British royal had sex in three locations when she was underage. Andrew has denied any wrongdoing and has said he didn't know anything about Epstein's criminal behavior. 

Epstein was charged by federal prosecutors in 2019 with one count of sex trafficking conspiracy and one count of sex trafficking with underage females. The 66-year-old financier died by suicide in his jail cell  in Manhattan a little over a month after being arrested. Charges against him were dropped after his death. 

In June, JPMorgan Chase reached a  $290 million settlement  with victims of Epstein over claims the bank overlooked the financier's sex trafficking and abuse because it wanted to profit from a banking relationship with him.

Editor's note: This story has been updated to clarify that the list is expected to be released in January, not a specific date.

  • Sex Trafficking
  • Ghislaine Maxwell
  • Jeffrey Epstein

Cara Tabachnick is a news editor and journalist at CBSNews.com. Cara began her career on the crime beat at Newsday. She has written for Marie Claire, The Washington Post, and The Wall Street Journal. She reports on justice and human rights issues. Contact her at [email protected]

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