sex education in schools is bad

Sex Ed Is Negative, Sexist and Out of Touch: Study

A ll of the deep embarrassment you felt during sex-education class is still reddening the faces of kids all over the world. A new study has found that in at least 10 different countries, kids hate the way they’re being taught about sex in school.

In the study published in the journal BMJ Open , researchers pored over 55 qualitative studies that examined the views of young people — mostly ages 12 to 18 — who’d received sex-and-relationship education at school in the U.S., UK, Ireland, Australia, New Zealand, Canada, Japan, Iran, Brazil and Sweden between 1990 and 2015.

Even across all of those different countries and a 25-year time span, kids’ views were remarkably consistent: sex ed sucks.

The problems, researchers found, were numerous. “Everything we got in our class had a really clinical feel,” said one student. ‘They don’t mention anything about same-sex relationships,” said another. A group of students recalled their PE teacher Miss Plum, who was so uncomfortable giving her own presentation that she cried during it.

Still, the researchers were able to identify the two biggest issues with sex education. The first: schools don’t acknowledge that sex is a special subject that, unlike a standard English or math class, requires a bit more finesse to teach effectively. “They don’t take into account that sex is a potentially embarrassing and anxiety provoking topic,” writes study author Pandora Pound, a research fellow in public-health research methodology at the University of Bristol in the U.K., in an email to TIME. “The result can be awkward, painful and unsatisfactory for all involved.”

The second major problem was that schools seemed to deny that their students were sexually active, which made the information out of touch with reality, irrelevant and overly skewed toward heterosexual intercourse, the researchers say. There was little practical information: telling students about community-health services, for example, what to do if they got pregnant or the pros and cons of different kinds of birth control. Teachers also presented the information as overly scientific, with hardly a nod to pleasure and desire; female pleasure, specifically, was rarely mentioned.

But one of the worst parts of sex ed for students was that it was too often delivered by their teachers. “They describe it as ‘cringey’ and embarrassing to have their teachers speaking about sex and relationships,” Pound says.

The best way to improve sex education, Pound says, is to relieve embarrassed schoolteachers of their duties by having someone else do the topic justice. “[It] needs to be delivered by experts who are sex positive, who enjoy their work and who are in a position to maintain clear boundaries with students,” Pound says. “We need to get the delivery right — otherwise young people will disengage.”

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90% of americans feel unprepared by sex education, new survey shows.

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Woman hand writing 'Sex Education' on green blackboard

For most people, middle and high school sex education classes are not fond memories. But most sex ed isn’t just cringeworthy and awkward, it’s also ineffective, new research shows.

In a survey of 1,500 Americans ages 18 to 44, 90% of respondents said that their sex education had not prepared them for real-world sexual experiences. Specifically, more than 40% of women and 47% of men reported feeling unprepared for their first sexual experiences and 41% of both genders said they felt unprepared for communication with sexual partners.

Subpar sex education leads to gaps in knowledge for women about their own reproductive health. For example, 38% of women said they felt unprepared for changes in their menstrual cycle. One-third said the same about fertility and conception (34%) and birth and postpartum (33%). More than one-quarter (27%) said they weren’t prepared for perimenopause, a finding consistent with other recent surveys .

“I see a major gap in modern sex education,” Sylvia Kang, CEO and founder of Mira, a women’s health company that sponsored the survey, said in a statement. “Women often lack knowledge about their cycles, hormones, and fertility. Many Mira customers spend much time searching for answers they should've learned in school.”

Younger women were even less prepared. Nearly half (46%) of Gen Z female respondents said that sex ed hadn’t prepared them for changes during their menstrual cycle, compared with 38% overall. Another 37% weren’t prepared to find out that getting pregnant can be difficult.

Men were similarly ill-informed. About one-quarter of men surveyed said they didn’t feel sex ed had prepared them adequately about unplanned pregnancy (24%), fertility and conception (24%), or sexually transmitted infections (21%). Nearly one in five men (19%) said that sex ed hadn’t prepared them for birth or the postpartum period.

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One thing that men are learning about more than women: sexual pleasure. About half (51%) of men surveyed said formal sex ed classes taught them about sexual pleasure compared to just 32% of women.

Only one in five (21%) survey respondents said that they had learned that sex can be painful and 40% hadn’t learned anything formally about consent and respect in the context of sexual experiences.

Fewer than half (45%) rated their knowledge of sexual health as “good.”

Overall, 30% of respondents said they hadn’t learned anything about sex hormones. Thirty-seven percent of female respondents said their sex education hadn’t prepared them for hormone imbalances , which can cause irregular periods, weight gain, acne, and medical conditions such as diabetes or thyroid disease.

“Reproductive hormones are central to reproductive and sexual health,” Kara McElligott, MD, MPH, MMCI, an obstetrician/gynecologist and medical advisor at Mira said in a statement. “Failing to educate women leads to unnecessary anxiety, frustration, delayed care, preventable disease, unnecessary office visits, health disparity and increased health costs.”

McElligott said that women may not recognize certain health risks if they don’t know what to expect or what to consider abnormal. Specifically, she said that women with infrequent periods are at higher long-term risk of endometrial cancer and women with heavy periods are at higher risk of anemia, which could require emergency care. Women who are unaware of perimenopause symptoms may not know what is going on and needlessly suffer without treatment as a result.

Where people turn for sex education

Healthcare professionals and formal classes were the most trusted sources for sex education, as rated by 42% and 35% of participants, respectively. But that doesn’t mean that’s where people turn for information, especially young people.

Among Gen Z and Millennial respondents, 48% said their primary source for sex education was online sources (48%) while 32% look to friends and one-quarter cited porn (26%) or social media (25%). Healthcare professionals (37%) and formal sex education (33%) also made the list of primary sources.

When asked which information sources have had the biggest impact on their perceptions of sex and relationships, as many people (26%) cited porn as formal sex ed classes. Fewer pointed to the influence of family (16%), healthcare professionals (21%), and friends (23%).

Improving sex education

Survey respondents had ideas about how sex education could better prepare people for real-life situations.

More than half of participants said sex ed should address building healthy relationships and communication with a sexual partner (57%) and exploring emotional and psychological aspects of sexual wellness (52%). Nearly half (46%) suggested that sex ed should teach people how to avoid misinformation and debunk stigmas relating to sex.

Forty-five percent of women suggested that sex ed should address self-esteem and body image and 43% said it should include hormonal imbalances.

According to McElligott, less than half of high schools and less than one-quarter of middles schools teach all the topics recommended by the CDC guidelines on formal sexual education.

Worse, she said that the guidelines themselves barely touch hormone health, leaving out sufficient information on how reproductive hormones (estrogen and progesterone) affect women and specifically how they affect mental health, cognition, bone health, and other systems.

To improve formal sex education, McElligott suggests including more content on the menstrual cycle, contraception, fertility, and major reproductive milestones such as perimenopause and menopause.

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Sex Education: 4 Questions and Answers About the Latest Controversy

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The perennially touchy issue of sex education has erupted again—this time in states not known for being especially prudish about the topic.

Both Illinois and New Jersey rolled out changes to health and sex education standards this school year. And in both states, the revisions have sparked complaints—often specifically about what the standards say about LGBTQ issues and on sexual identity.

Here are some answers to common questions about the latest flare-ups.

Hasn’t sex ed. always been controversial?

For sure. It’s frequently the subject of intense local debates, in part because sexuality education is probably the most local of all curriculum topics in schools: Sex education is not mandatory in all of the states, which means it’s often up to school districts to decide whether—and how—to offer it.

Many states do set some parameters for sex ed., usually in legislation, but these guidelines are still pretty sketchy—often framed in terms of what educators can’t mention (abortion, same-sex relationships) than what they should mention. And it’s still left up to school districts to craft teaching materials or to hire outside organizations to provide curriculum and training.

There are no national sex education mandates, but historically, federal funding for health education has shaped what’s covered in the classes. Abstinence continues to be a core theme of this programming.

One common thread in the evolution of sex education has been risk avoidance and prevention, which have driven the emphasis of specific topics over the years: sexually transmitted infections in the 1970s, teen pregnancy in the 1970s and 1980s, and HIV/AIDS beginning in the 1980s.

Now, health researchers and practitioners have tried to shift away from trying to frighten kids away from behavior that carries any risk. Instead they favor an approach that emphasizes informed decisionmaking, risk management, and self-advocacy.

“Because when kids feel confident in their skills, they’ll act in more healthy ways,” said Judy LoBianco, the supervisor of health and physical education for the Livingston public schools in New Jersey.

What’s ‘comprehensive sex education’ anyway?

This is basically the term of art for a more holistic approach towards sex education that goes beyond abstinence or risk prevention. It includes topics like gender roles and identity, consent, healthy relationships, and sexual diversity presented in the context of social and emotional skills.

This is the approach taken by the groups that have crafted the National Sex Education Standards, last updated in 2020. Despite their name, these are not mandated. States use them to inform their own guidelines. (Illinois adopted these guidelines, but allows districts to opt out of using them, and many have.)

Counter to popular claims, the guidelines do not introduce specific sexual practices in early grades. In 2nd grade, for instance, the national standards require that students can list medically accurate names for the body parts, including genitals, and that students can define “bodily autonomy” and personal boundaries.

How are national politics affecting the sex-ed. discussion?

Despite polling that generally shows that adults favor the tenets of comprehensive sex education, many of the new complaints about sex education echo national political discourse that casts schools as the sites of indoctrination about gender identity.

In New Jersey, whose new standards draw on but aren’t identical to the National Sex Education Standards, opponents have claimed that they show young children “sexually explicit” material and are “indoc t rinating” kids into “woke ideology.”

Some of these complaints cite purported materials and lesson plans in use, claiming they are required by the state. But the state does not pick what curriculum, lesson plans, or training teachers receive; districts select those.

In general, sex-ed. advocates say, these complaints are linked to wider moves to censor what happens in classrooms. About 17 states have restricted lessons about race and gender—and some of them, like a Florida law that forbids talk about sex or sexuality in grades K-3 , have led to the accusations that teachers are “grooming” students. Sociologists and health experts say conflating grooming—in which an adult inappropriately develops a close relationship with a child to facilitate abuse—with sex education puts both teachers and students at risk.

Is the U.S. Supreme Court’s decision in the ‘Dobbs’ case affecting sex ed.?

Surprisingly, abortion is not a common theme in most states’ sex-ed. guidelines . Only nine states and the District of Columbia direct whether or how to discuss abortion in sex education, according to a 2022 policy review from the Sexuality Information and Education Council of the United States, or SIECUS, a nonprofit.

Six of those states prohibit discussing abortion, while Vermont, Colorado, and the District of Columbia affirm abortion as an option.

More states—about 15—include abortion in the context of social studies classes, where it’s often taught in lessons about interpretations of the U.S. Constitution, the 14th Amendment, and the expansion of civil liberties.

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• What’s the State of Sex Education In the U.S.?
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There’s broad public support for sex education, but many young people aren’t receiving the sex education they need and deserve.

Who Supports Sex Education?

Sex education is widely supported by the vast majority of people in the U nited States. In Planned Parenthood’s most recent poll  on sex education, 84 percent of parents supported having sex education taught in middle school, and 96 percent of parents supported having sex education taught in high school. Parents support sex education covering a wide range of topics in age-appropriate ways from elementary through high school, including self-esteem, healthy relationships and peer pressure, how to stay safe online including how to deal with pornography, anti-bullying, and consent and setting boundaries. The vast majority of parents support teaching topics like STIs, birth control, sexual orientation and gender identity, and pregnancy options including abortion in high school. Other national, state and local polls on sex education have shown similarly high levels of support.

Sex education is supported by numerous health and medical organizations including the American Medical Association, the American Academy of Pediatrics, and the Society for Adolescent Health and Medicine. More than 150 organizations are members of the National Coalition to Support Comprehensive Sexuality Education.

Federal & State Policy Related to Sex Education

Sex education programming varies widely across the United States. Currently, 39 states and the District of Columbia mandate some kind of sex education and/or HIV education. 

Although almost every state has some guidance on how and when sex education should be taught, decisions are often left up to individual school districts, creating a patchwork of inconsistent policies and practices within states. The sex education someone receives can come down to what school district they live in or which school they attend.

Planned Parenthood advocates for federal funding that supports sex education, such as the Teen Pregnancy Prevention Program (TPPP) and the Division of Adolescent and School Health . Planned Parenthood also advocates for better sex education policies, practices, and funding at the state and local levels.

What Sex Education Do Teens Get in the US?

The gap between the sex education students need and what they actually get is wide. According to the 2018 CDC School Health Profiles , fewer than half of high schools and less than a fifth of middle schools teach all 20 topics recommended by the CDC as essential components of sex education. These topics range from basic information on how HIV and other STIs are transmitted — and how to prevent infections — to critical communication and decision-making skills.

A  study published by the Guttmacher Institute found that adolescents were less likely to report receiving sex education on key topics in 2015–2019 than they were in 1995  Overall, in 2015–2019, only half of adolescents reported receiving sex education that met the minimum standard articulated in Healthy People 2030. Among teens reporting penis-in-vagina sex, fewer than half (43% of females and 47% of males) received this instruction before they had sex for the first time. Despite these declines in formal education, there was no increase in the proportion of teens who discussed these sex education topics with their parents.

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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.

The Problem With Sex Education

Pornography begins where sex education ends.

Posted June 14, 2013

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In the school where I work, I teach a lot of very factual sex education to teenage boys. In an ideal world, I’d have time to get to know each class and we’d be able to talk honestly about our hopes and fears and feelings. But there isn’t an exam in sex education, so the subject gets squeezed to the edges of the curriculum and, in some schools, squeezed out altogether. In the brief time I have with each class, I talk a bit about the importance of relationships and love but the teenagers sitting there are far more interested in hard information about sex because, without that information, they’re vulnerable. Like Shakespeare’s Romeo and his friends, they joke and tease each other about sex because they’re anxious about sex. The more they know, therefore, the more confident and relaxed they feel and the less inclined they are to take their anxieties out on other people.

Reducing unplanned pregnancies and sexually transmitted infections are important governmental aims but the more important reason for providing good, factual sex education is to reduce anxieties about sex which cause unhappiness. Without information, young people mock the ignorance of others to hide their own ignorance; they project their own anxieties about sexual experience and performance onto others and attack it.

Sitting there, waiting for me to begin, the boys don’t laugh and don’t snigger. For me to suggest that they don’t already know everything there is to know about sex would be a mistake, so I begin by saying that I’m quite sure they know most of this stuff already but that there may be the odd bit of information that’s new and that it’ll therefore be worth paying attention . Reassured, they listen, not because I’m a famous disciplinarian or a particular authority on sex but because they’re desperate to pick up anything they don’t already know. I’m frank which surprises them but is also, evidently, a relief. Sometimes they ask questions but more often are too embarrassed to ask and it’s my job to anticipate the questions they would ask if only it wasn’t so embarrassing. Sometimes I get them to write down questions in private. “Does the foreskin have to be pulled back before sex?” they ask. “Do girls pee out of their vaginas? Does sex hurt? What if the penis is too small? In anal sex, what happens to the shit? How do you know if someone wants to have sex? What’s the point of ribbed condoms?”

We talk about the difference between pornographic bodies and real bodies, pornographic sex and real sex. Most of them have watched porn in secret and I find myself wondering…. Of course, one of their purposes in watching will be for arousal – that never changes - but I suspect that they also watch porn for information. Internet pornography begins where sex education for young people ends. When there are questions about sex that adults daren’t or won’t answer, young people search the internet. The trouble is that the answers they get back from pornography may be grossly distorted. It stands to reason, therefore, that with better, earlier and more explicit sex education, with questions answered rather than fudged and with opportunities for educators to describe sex in the context of love, young people might need to watch porn rather less urgently.

Nick Luxmoore is a counselor at King Alfred's College, in the U.K.

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Summary State Policies on Sex Education in Schools

Why is sexual education taught in schools.

A 2017 Centers for Disease Control and Prevention (CDC)  survey  indicates that nearly 40 percent of all high school students report they have had sex, and 9.7 percent of high school students have had sex with four or more partners during their lifetime. Among students who had sex in the three months prior to the survey, 54 percent reported condom use and 30 percent reported using birth control pills, an intrauterine device (IUD), implant, shot or ring during their last sexual encounter.

The birth rate for women aged 15-19 years was  18.8 per 1,000 women  in 2017, a drop of 7 percent from 2016. According to CDC, reasons for the decline are not entirely clear, but evidence points to a higher number of teens abstaining from sexual activity and an increased use of birth control in teens who are sexually active. Though the teen birth rate has declined to its lowest levels since data collection began, the United States still has the highest teen birth rate in the industrialized world.

Certain social and economic costs can result from teen pregnancy. Teenage mothers are less likely to finish high school and are more likely than their peers to live in poverty, depend on public assistance, and be in poor health. Their children are more likely to suffer health and cognitive disadvantages, come in contact with the child welfare and correctional systems, live in poverty, drop out of high school and become teen parents themselves. These costs add up, according to The National Campaign to Prevent Teen and Unplanned Pregnancy, which estimates that teen childbearing costs taxpayers at least $9.4 billion annually. Between 1991 and 2015, the teen birth rate dropped 64%, resulting in approximately  $4.4 billion  in public savings in one year alone.

Sexually transmitted infections (STIs) disproportionately affect adolescents due to a variety of behavioral, biological and cultural reasons. Young people ages 15 to 24 represent  25 percent  of the sexually active population, but acquire half of all new STIs, or about 10 million new cases a year. Though many cases of STIs continue to go  undiagnosed and unreported , one in four sexually-active adolescent females is reported to have an STI.

Human papillomavirus  is the most common STI and some estimates find that up to 35 percent of teens ages 14 to 19 have HPV. The rate of reported cases of chlamydia, gonorrhea, and primary and secondary syphilis increased among those aged 15-24 years old between 2017-2018. Rates of reported chlamydia cases are consistently highest among women aged 15-24 years, and rates of reported gonorrhea cases are consistently highest among men aged 15-24 years. A CDC analysis reveals the annual number of new STIs is roughly equal among young women and young men. However, women are more likely to experience long-term health complications from untreated STIs and adolescent females may have increased susceptibility to infection due to biological reasons.

The estimated direct medical costs for treating people with STIs are nearly $16 billion annually, with costs associated with HIV infection accounting for more than 81% of the total cost. In 2017, approximately  21 percent  of new HIV diagnoses were among young people ages 13 to 24 years.

Sex Education and States

All states are somehow involved in sex education for public schoolchildren.

As of October 1, 2020:

• Thirty states and the District of Columbia require public schools teach sex education, 28 of which mandate both sex education and HIV education.
• Thirty-nine states and the District of Columbia require students receive instruction about HIV.
• Twenty-two states require that if provided, sex and/or HIV education must be medically, factually or technically accurate. State definitions of “medically accurate" vary, from requiring that the department of health review curriculum for accuracy, to mandating that curriculum be based on information from “published authorities upon which medical professionals rely.” (See table on medically accuracy laws.)

Many states define parents’ rights concerning sexual education:

• Twenty-five states and the District of Columbia require school districts to notify parents that sexual or HIV education will be provided.
• Five states require parental consent before a child can receive instruction.
• Thirty-six states and the District of Columbia allow parents to opt-out on behalf of their children.

*Medical accuracy is not specifically outlined in state statue, rather it is required by the New Jersey Department of Education, Comprehensive Health and Physical Education Student Learning Standards.

** Medical accuracy requirement is pursuant to rule R277-474 of the Utah Administrative Code.

***Medical accuracy is not outlined in state statute, rather it is included in the Virginia Department of Education Standards of Learning Document for Family Life Resources.

Source: NCSL, 2019; Guttmacher Institute, 2019; Powered by StateNet

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• Sex Education Laws and State Attacks

In This Section

• Abstinence-Only-Until-Marriage Programs
• How Sex Education is Funded
• How Planned Parenthood Teaches Sex Education
• Advocating for Sex Education in Your Community

Decisions about sex education are usually made at the state and local level — no federal laws dictate what sex education should look like or how it should be taught in schools. 

Almost every state in the U.S. has some guidance around sex education. Currently, 39 states and the District of Columbia require that HIV and/or sex education is covered in school. However, there’s no guarantee that the sex education students get is high quality or covers the topics young people need to learn about to stay healthy. 

Of the states that require sex and/or HIV education, fewer than half require it be medically accurate. And more states require sex education to stress abstinence than ensure medical accuracy. Fewer than half of high schools and only a fifth of middle schools are teaching the sexual health topics that the Centers for Disease Control and Prevention (CDC) considers “essential” for healthy young people. This is unacceptable.

Sex Education Laws Are Decided By State and Local Legislators

Lawmakers in statehouses and city halls are the ones making decisions about what is (and isn’t) taught in school-based sex education. That means they decide whether or not educators can discuss birth control, how educators can talk about LGBTQ+ experiences, and how much educators must stress abstinence.

• While 37 states have laws requiring that abstinence is included in sex education, only 18 states require educators to also share information about birth control.
• Sometimes state and local requirements on sex education are helpful. For example, 18 states require instruction to be medically accurate, and 26 states and the District of Columbia require that it be age-appropriate.

Whether or not sex education is LGBTQ-inclusive is also left up to state and local governments to decide.

• Only ten states require discussion of LGBTQ+ identities and relationships to be inclusive and affirming
• Six southern states either prohibit sex educators from discussing (or even answering questions about) LGBTQ+ identities and relationships, or actually require sex educators to frame LGBTQ+ identities and relationships negatively. These laws further stigmatize LGBTQ+ youth and leave them without the information they need to protect their sexual health, putting them at greater risk for STDs, pregnancy, and unhealthy or abusive relationships.

Here’s what we know for sure: Too many young people aren’t getting the sex education they need and deserve.

While most states have some kind of law or policy about sex education, day-to-day decisions are often left up to individual school districts. This means that students in the same state attending different schools could have totally different sex education experiences.

The Unstable State of Sex Education in the United States

Because sex education laws and policies are developed at the state and local level, sex education is constantly under attack. Politicians have used a variety of tactics to limit access to sex education, promote conservative agendas, and push Planned Parenthood sex educators out of schools. 

These restrictive bills are just a way for politicians to block access to sexual and reproductive health information, education, and services — especially from Planned Parenthood.

Advocate for Sex Education in Your Community!

• Birth Control
• Health Care Equity
• Voting Rights
• Sexual Assault
• Attacks on Access to Care at Planned Parenthood
• State Attacks on Sexual and Reproductive Health
• Ohio state courts
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Planned Parenthood Clergy Advocacy Board

Clergy Statement on Sex Education

State Attacks on Reproductive Health

Learn how backwards politicians in states across the country are attacking access to reproductive and sexual health care through dangerous bills, regulations, and executive actions.

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What Works In Schools : Sexual Health Education

CDC’s  What Works In Schools  Program improves the health and well-being of middle and high school students by:

• Improving health education,
• Connecting young people to the health services they need, and
• Making school environments safer and more supportive.

What is sexual health education?

Quality provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted infections (STI) and unintended pregnancy.

A quality sexual health education curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development. 1

The curriculum is age-appropriate and planned across grade levels to provide information about health risk behaviors and experiences.

Sexual health education should be consistent with scientific research and best practices; reflect the diversity of student experiences and identities; and align with school, family, and community priorities.

Quality sexual health education programs share many characteristics. 2-4 These programs:

• Are taught by well-qualified and highly-trained teachers and school staff
• Use strategies that are relevant and engaging for all students
• Address the health needs of all students, including the students identifying as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ)
• Connect students to sexual health and other health services at school or in the community
• Engage parents, families, and community partners in school programs
• Foster positive relationships between adolescents and important adults.

How can schools deliver sexual health education?

A school health education program that includes a quality sexual health education curriculum targets the development of functional knowledge and skills needed to promote healthy behaviors and avoid risks. It is important that sexual health education explicitly incorporate and reinforce skill development.

Giving students time to practice, assess, and reflect on skills taught in the curriculum helps move them toward independence, critical thinking, and problem solving to avoid STIs, HIV, and unintended pregnancy. 5

Quality sexual health education programs teach students how to: 1

• Analyze family, peer, and media influences that impact health
• Access valid and reliable health information, products, and services (e.g., STI/HIV testing)
• Communicate with family, peers, and teachers about issues that affect health
• Make informed and thoughtful decisions about their health
• Take responsibility for themselves and others to improve their health.

What are the benefits of delivering sexual health education to students?

Promoting and implementing well-designed sexual health education positively impacts student health in a variety of ways. Students who participate in these programs are more likely to: 6-11

• Delay initiation of sexual intercourse
• Have fewer sex partners
• Have fewer experiences of unprotected sex
• Increase their use of protection, specifically condoms
• Improve their academic performance.

In addition to providing knowledge and skills to address sexual behavior , quality sexual health education can be tailored to include information on high-risk substance use * , suicide prevention, and how to keep students from committing or being victims of violence—behaviors and experiences that place youth at risk for poor physical and mental health and poor academic outcomes.

*High-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice involvement, school dropout, loss of life). This includes misuse of prescription drugs, use of illicit drugs (i.e., cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy), and use of injection drugs (i.e., drugs that have a high risk of infection of blood-borne diseases such as HIV and hepatitis).

What does delivering sexual health education look like in action?

To successfully put quality sexual health education into practice, schools need supportive policies, appropriate content, trained staff, and engaged parents and communities.

Schools can put these four elements in place to support sex ed.

• Implement policies that foster supportive environments for sexual health education.
• Use health content that is medically accurate, developmentally appropriate, culturally inclusive, and grounded in science.
• Equip staff with the knowledge and skills needed to deliver sexual health education.
• Engage parents and community partners.

Include enough time during professional development and training for teachers to practice and reflect on what they learned (essential knowledge and skills) to support their sexual health education instruction.

By law, if your school district or school is receiving federal HIV prevention funding, you will need an HIV Materials Review Panel (HIV MRP) to review all HIV-related educational and informational materials.

This review panel can include members from your School Health Advisory Councils, as shared expertise can strengthen material review and decision making.

For More Information

Learn more about delivering quality sexual health education in the Program Guidance .

Check out CDC’s tools and resources below to develop, select, or revise SHE curricula.

• Health Education Curriculum Analysis Tool (HECAT), Module 6: Sexual Health [PDF – 70 pages] . This module within CDC’s HECAT includes the knowledge, skills, and health behavior outcomes specifically aligned to sexual health education. School and community leaders can use this module to develop, select, or revise SHE curricula and instruction.
• Developing a Scope and Sequence for Sexual Health Education [PDF – 17 pages] .This resource provides an 11-step process to help schools outline the key sexual health topics and concepts (scope), and the logical progression of essential health knowledge, skills, and behaviors to be addressed at each grade level (sequence) from pre-kindergarten through the 12th grade. A developmental scope and sequence is essential to developing, selecting, or revising SHE curricula.
• Centers for Disease Control and Prevention. Health Education Curriculum Analysis Tool, 2021 , Atlanta: CDC; 2021.
• Goldfarb, E. S., & Lieberman, L. D. (2021). Three decades of research: The case for comprehensive sex education. Journal of Adolescent Health, 68(1), 13-27.
• Centers for Disease Control and Prevention (2016). Characteristics of an Effective Health Education Curriculum .
• Pampati, S., Johns, M. M., Szucs, L. E., Bishop, M. D., Mallory, A. B., Barrios, L. C., & Russell, S. T. (2021). Sexual and gender minority youth and sexual health education: A systematic mapping review of the literature.  Journal of Adolescent Health ,  68 (6), 1040-1052.
• Szucs, L. E., Demissie, Z., Steiner, R. J., Brener, N. D., Lindberg, L., Young, E., & Rasberry, C. N. (2023). Trends in the teaching of sexual and reproductive health topics and skills in required courses in secondary schools, in 38 US states between 2008 and 2018.  Health Education Research ,  38 (1), 84-94.
• Coyle, K., Anderson, P., Laris, B. A., Barrett, M., Unti, T., & Baumler, E. (2021). A group randomized trial evaluating high school FLASH, a comprehensive sexual health curriculum.  Journal of Adolescent Health ,  68 (4), 686-695.
• Marseille, E., Mirzazadeh, A., Biggs, M. A., Miller, A. P., Horvath, H., Lightfoot, M.,& Kahn, J. G. (2018). Effectiveness of school-based teen pregnancy prevention programs in the USA: A systematic review and meta-analysis. Prevention Science, 19(4), 468-489.
• Denford, S., Abraham, C., Campbell, R., & Busse, H. (2017). A comprehensive review of reviews of school-based interventions to improve sexual-health. Health psychology review, 11(1), 33-52.
• Chin HB, Sipe TA, Elder R. 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. Am J Prev Med 2012;42(3):272–94.
• Mavedzenge SN, Luecke E, Ross DA. Effective approaches for programming to reduce adolescent vulnerability to HIV infection, HIV risk, and HIV-related morbidity and mortality: A systematic review of systematic reviews. J Acquir Immune Defic Syndr 2014;66:S154–69.

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Sex education often leaves out queer people. Here's what to know

Lilly Quiroz

Audrey Nguyen

Sex can be a nerve-racking experience no matter what. That's especially true if you have no clue what to do. And since LGBTQ topics are often left out of the conversation in school sex ed classes, many queer people know this feeling well.

There is no national mandate for sex education in the U.S., and even in the states that do provide courses, LGBTQ issues are often disregarded or vilified. According to the organization SIECUS: Sex Ed for Social Change , six states require instruction that discriminates against LGBTQ individuals, while ten states have policies that include affirming instruction on LGBTQ sexual health or identity. There are only five states that specifically mandate comprehensive sex education, which "affirms and is inclusive of sexual orientation, gender identity and expression," says Christine Soyong Harley, president and CEO of SIECUS.

But more states are cutting back on sex education that includes LGBTQ issues. In April 2022, NPR reported that legislators in more than a dozen states proposed bills that "seek to prohibit schools from using a curriculum or discussing topics of gender identity or sexual orientation."

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Aside from leaving some queer people in a panic searching for "how to have sex" online, there are consequences when students don't receive proper sex education. For example, lesbian and bisexual youth or those with both male and female partners experience a higher rate of unintended pregnancies when compared to their heterosexual peers.

Some sexuality educators are pushing for comprehensive sex education that leaves behind abstinence-only and shame-based messages, especially in the wake of the Supreme Court's recent decision to overturn the constitutional right to abortion.

Life Kit spoke with sexuality educators to understand what sex education could look like for queer students.

A Guide To Navigating Birth Control

Get to know your body and discover what pleasure feels like to you..

Ericka Hart , a sexuality educator with a focus in racial, social and gender justice, reminds us that messages about sex in education and in the media are typically for a white, cisgender and straight audience. To get a better understanding of what you like, "I think it's a matter of just taking in messages that you're receiving from the world and seeing if they are fit or not," they say. If those messages don't fit or affirm you, Hart suggests masturbation as a way to unlearn that in order to discover what does please you.

Another way to figure out what you do or don't like can be through watching porn. If this is your preference, consider watching porn created by queer performers — and make sure it's made ethically , by paying performers and using safe practices.

It's also possible to discover you might not have any of those needs or wants.

Touch & Pleasure Are Essential: Here's How To Give Them To Yourself

There isn't a singular or "right" way to have sex..

Historically, sex education in the U.S. has revolved around the idea that sex involves a penis and vagina. However, it can involve different kinds of genitalia, body parts or none of the above. Sex is whatever brings you pleasure.

"Just because you are queer doesn't mean that there's such a thing called queer sex," Ericka Hart says. "We all have sex differently. It's really just [however] you are defining it."

Sexuality educator Melina Gioconda Davis , who also goes by their stage name "Melina Gaze," is co-founder and director at Vulgar , a sex education project in Mexico. "When we're looking to explore our sexuality, or our pleasure, it's a really great tool to think of our explorations as pleasure-oriented instead of goal-oriented," Gaze says. In other words, the end goal doesn't need to be an orgasm.

Navigating Consent Is All About Communication. Here's Where To Start

Communication should be ongoing with sexual partners to make sure everyone is comfortable and satisfied..

Of course, consent is always necessary. Hart says how you communicate what you want is also important. "I" statements are good to communicate what you find pleasurable. Be forthright about what you want and discuss with your sex partner(s) where you all agree. If someone draws a boundary, respect it and move on. This communication will evolve over time. Ensuring that a person is comfortable with terms or sexual acts that continue to affirm their identity is crucial.

Shots - Health News

How to pick a doctor (or break up with one).

Hart recommends Scarleteen's " Yes, No, Maybe So: A Sexual Inventory Stocklist " to discover what your physical and non-physical boundaries are. It reviews questions like whether you are comfortable with your top off with a partner, whether you want to be the one to put on the condom, whether you want to share your sexual history with your partner and more. ( Life Kit has a whole episode on navigating consent, too.)

This is a condensed description of what sex education for queer folks should cover. If you would like to learn more, here are some additional resources you can check out:

• The Sex School , Berlin — educational videos created by sexuality professionals
• The Human Rights Campaign Foundation's Safer Sex for Trans Bodies
• The Ultimate Guide to Sex and Disability: For All of Us Who Live With Disabilities, Chronic Pain & Illness by Cory Silverberg, Miriam Kaufman and Fran Odette
• Planned Parenthood's All About Sexting
• Queer Media like Autostraddle and Food 4 Thot
• Girl Sex 101 by Allison Moon and Kd Diamond
• Stevie Boebi's YouTube channel for lesbian sex tips
• ACE: What Asexuality Reveals about Desire, Society, and the Meaning of Sex , by Angela Chen

Don't let shame or stigma prevent you from caring for your sexual health.

Melina Gaze believes a big priority for sexuality educators should be to reduce the stigma and shame surrounding STIs. Gaze says testing is important and a great way to check your status. They recommend speaking with a trusted physician to decipher what your individual risk assessment looks like. "Risk is not a moral judgment," they say, "it's kind of like a statistical equation." If you don't have access to healthcare services, you can also visit a community clinic like Planned Parenthood for testing and treatment.

Gaze also believes that sexual health includes mental, emotional and physical health. "I think sexual health has to do with general bodily well-being," Gaze says. "Are the social conditions present for me to be able to feel good as a sexual being?"

And, it's important to remember that sexual health is intersectional. "We're not just individuals, right? We're inserted in structures that go beyond just individual social structures, like racism, like classism, like ableism. And those things impact how we have sex. They impact whether we feel entitled to our bodies or not."

The podcast version of this episode was produced by Audrey Nguyen . Engineering support from Alex Drewenskus and Tre Watson.

We'd love to hear from you. Leave us a voicemail at 202-216-9823, or email us at [email protected] .

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School Drinking Fountains: Is the Water Safe for Kids?

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In Harford County, Maryland, students are bringing water bottles to school — and not just because they want to stay extra hydrated. At the end of August, 10 campuses in Harford County Public Schools shut down their drinking water systems after tests revealed alarming levels of toxic “forever chemicals” in their wells.

But a lack of clean water at schools isn’t just a problem in Harford County, a semi-rural area about 30 miles northeast of Baltimore. From Flint, Michigan, to Jackson, Mississippi, school systems in  communities across America — particularly those serving low-income and minority students — are grappling with contaminated water. 

A Wake-Up Call from the EPA

The crisis in Maryland started last Wednesday when officials with Harford County Public Schools reported high levels of Per- and Polyfluoroalkyl Substances (PFAS) in at least 10 schools’ water systems. The culprit? Wells with PFAS levels up to 25 times higher than the Environmental Protection Agency’s new limit of 4 parts per trillion. 

“PFAS are a family of man-made toxic forever chemicals that are in the blood of nearly 99% of Americans,” ​Jared Hayes, a senior policy analyst at Environmental Working Group told local station WMAR .” They were first developed back in the 40’s and 50’s and have been leaching into our environment ever since then.”

The EPA warns that FAS exposure over long periods “can cause cancer and other serious illnesses that decrease quality of life or result in death.” Yet water utilities nationwide are just starting to test for PFAS so the scope of the problem remains unknown.

Schools in Harford were advised that students and staff shouldn’t consume the water. Students were encouraged to bring refillable water bottles to school and were told that “corrective action may be a lengthy and costly process,” according to the HCPS advisory.

A Tale of Two Water Fountains

Although Harford public schools are about 60% white and 20% Black, water quality problems are far more common in majority Black communities and school districts . Typically, the issue is abnormally high levels of lead in drinking water, although some schools have run out of water completely. 

While it may seem like a mundane or secondary education issue, contaminated water or lack of water entirely is disruptive to a school at best, and at worst can have a profound, lasting impact on a child’s education. 

In Flint, Michigan, for example, a report released in March found that — a decade after the municipal water system switched from Lake Michigan to the polluted Flint River — the children who drank the unclean water lost the equivalent of five months of learning . Test scores for the city’s children declined, with the biggest gap among low-income children, and the number of special-needs students climbed 8%, with boys overrepresented in the increase. 

Andrew Whelton, a civil engineering professor at Purdue University, has extensively studied water systems in schools across the country. He said the barrier between healthy and contaminated drinking water can be as thin as a state line. 

“You can live on one side of the [state] border and your children will be drinking 14 (parts per billion) of lead in water,” an unsafe level, he said.  “On the other side of the border, it’s less than 1 ppb.” 

In 2018, the Government Accountability Office, a non-partisan watchdog group, reported that more than a third of all the public schools that had tested their water in the previous two years and reported the results found elevated levels of lead. But just 43% of all schools had even tested for lead during the previous two years. 

Only about 10 states and the District of Columbia require lead testing in schools; otherwise, it’s entirely voluntary.

Researchers like the American Academy of Pediatrics , have asserted for years that no level of lead in water is safe for humans. Prolonged exposure can contribute to conditions like ADHD, behavioral problems, incontinence, and a drop in IQ. 

Experts recommend robust testing of faucets, fountains, and pipes can help districts pinpoint the highest-risk areas and prioritize improvements to minimize costs.