studies of sex education in schools have shown that

Sex Education in Schools

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First Online: 01 January 2021
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Jessica Smarr 3 &
Karen Rayne 3

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Comprehensive sexuality education ; Holistic sexuality education ; Sex Ed ; Sexuality education

The process of gathering accurate information, developing attitudes and beliefs, and gaining skills on the biological, sociological, and psychological facets of sexuality in a formal academic setting.

Introduction

Sexuality education provides individuals with information about their bodies, identities, relationships, and health-promoting skills as they relate to sexuality. International health and human rights organizations assert that access to developmentally and culturally appropriate sexuality education is a basic human right (UNESCO 2018 ). Adolescents receive sex education from formal sources, like schools or clinics, and informal sources, like family members, friends, or digital resources. While these can all be important, affirming sources of information, formal sources are more likely to provide students with accurate and age-appropriate information (UNESCO 2018 )....

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Jessica Smarr & Karen Rayne

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Department of Psychology, Oakland University, Rochester, MI, USA

Todd K Shackelford

Viviana A Weekes-Shackelford

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Smarr, J., Rayne, K. (2021). Sex Education in Schools. In: Shackelford, T.K., Weekes-Shackelford, V.A. (eds) Encyclopedia of Evolutionary Psychological Science. Springer, Cham. https://doi.org/10.1007/978-3-319-19650-3_2455

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Three Decades of Research: The Case for Comprehensive Sex Education

Affiliations.

1 Department of Public Health, Montclair State University, Montclair, New Jersey. Electronic address: [email protected].
2 Department of Public Health, Montclair State University, Montclair, New Jersey.
PMID: 33059958
DOI: 10.1016/j.jadohealth.2020.07.036

Purpose: School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.

Methods: Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving 39. In the next phase, researchers expanded criteria to studies outside the U.S. to identify evidence reflecting the full range of topic areas. Eighty articles constituted the final review.

Results: Outcomes include appreciation of sexual diversity, dating and intimate partner violence prevention, development of healthy relationships, prevention of child sex abuse, improved social/emotional learning, and increased media literacy. Substantial evidence supports sex education beginning in elementary school, that is scaffolded and of longer duration, as well as LGBTQ-inclusive education across the school curriculum and a social justice approach to healthy sexuality.

Conclusions: Review of the literature of the past three decades provides strong support for comprehensive sex education across a range of topics and grade levels. Results provide evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality. Findings strengthen justification for the widespread adoption of the National Sex Education Standards.

Keywords: CSE; K-12; National Sex Education Standards; National Sexuality Education Standards; Sex education; Sexuality education; Systematic Literature Review; comprehensive sex education.

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Sex Education: Broadening the Definition of Relevant Outcomes. Kantor LM, Lindberg LD, Tashkandi Y, Hirsch JS, Santelli JS. Kantor LM, et al. J Adolesc Health. 2021 Jan;68(1):7-8. doi: 10.1016/j.jadohealth.2020.09.031. J Adolesc Health. 2021. PMID: 33349360 No abstract available.

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Comprehensive Sexuality Education

Committee Opinion CO
Number 678
November 2016

Recommendations and Conclusions

Current quality of sexuality education, the role of the obstetrician–gynecologist, effective programs, reaching special populations, online communication and using cyberspace as a source of information, for more information.

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Number 678 (Reaffirmed 2023)

Committee on Adolescent Health Care

This Committee Opinion was developed by the American College of Obstetricians and Gynecologists’ Committee on Adolescent Health Care in collaboration with committee member Joanna H. Stacey, MD.

This document reflects emerging clinical and scientific advances as of the date issued and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.

ABSTRACT: Current sexuality education programs vary widely in the accuracy of content, emphasis, and effectiveness. Data have shown that not all programs are equally effective for all ages, races and ethnicities, socioeconomic groups, and geographic areas. Studies have demonstrated that comprehensive sexuality education programs reduce the rates of sexual activity, sexual risk behaviors (eg, number of partners and unprotected intercourse), sexually transmitted infections, and adolescent pregnancy. One key component of an effective program is encouraging community-centered efforts. In addition to counseling and service provision to individual adolescent patients, obstetrician–gynecologists can serve parents and communities by supporting and assisting sexuality education. Because of their knowledge, experience, and awareness of a community’s unique challenges, obstetrician–gynecologists can be an important resource for sexuality education programs.

Comprehensive sexuality education should begin in early childhood and continue through a person’s lifespan.

Programs should not only focus on reproductive development (including abnormalities in development, such as primary ovarian insufficiency and müllerian anomalies), prevention of STIs, and unintended pregnancy, but also teach about forms of sexual expression, healthy sexual and nonsexual relationships, gender identity and sexual orientation and questioning, communication, recognizing and preventing sexual violence, consent, and decision making.

Obstetrician–gynecologists can serve parents and communities by supporting and assisting sexuality education, by developing evidence-based curricula that focus on clear health goals (eg, the prevention of pregnancy and STIs, including human immunodeficiency virus [HIV]), and providing health care that focuses on optimizing sexual and reproductive health and development.

Obstetrician–gynecologists have the unique opportunity to act “bi-generationally” by asking their patients about their adolescents’ reproductive development and sexual education, human papillomavirus vaccination status, and contraceptive needs.

Comprehensive sexuality education should be medically accurate, evidence-based, and age-appropriate, and should include the benefits of delaying sexual intercourse, while also providing information about normal reproductive development, contraception (including long-acting reversible contraception methods) to prevent unintended pregnancies, as well as barrier protection to prevent STIs Box 1 . Comprehensive sexuality education should begin in early childhood and continue through a person’s lifespan. Programs should not only focus on reproductive development (including abnormalities in development, such as primary ovarian insufficiency and müllerian anomalies), prevention of STIs, and unintended pregnancy, but also teach about forms of sexual expression, healthy sexual and nonsexual relationships, gender identity and sexual orientation and questioning, communication, recognizing and preventing sexual violence, consent, and decision making. They also should include state-specific legal ramifications of sexual behavior and the growing risks of sharing information online 1 . Additionally, programs should cover the variations in sexual expression, including vaginal intercourse, oral sex, anal sex, mutual masturbation, as well as texting and virtual sex 2 . The American Academy of Pediatrics provides an overview of the published research on evidence-based sexual and reproductive health education 3 .

What Constitutes Comprehensive Sexuality Education

The following are components of comprehensive sexuality education:

Emphasis on human rights values of all individuals, including gender equality, gender identity, and sexual diversity, and differences in sexual development.

Encourage consideration of implants and intrauterine devices for all appropriate candidates.

Include information on consent and decision making, intimate partner violence, and healthyrelationships.

Participatory and culturally sensitive teaching approaches that are appropriate to the student’s age as well as identification with distinct subpopulations, including adolescents with intellectual and physical disabilities, sexual minorities, and variations in sexual development.

Knowledgeable about and inclusive of statespecific consequences of sexual activity duringadolescence, including online and social media activity.

Discussion of the benefits and pitfalls of online information (eg, gross misinformation on sexuality in cyberspace).

Current sexuality education programs vary widely in the accuracy of content, emphasis, and effectiveness. Evaluations of biological outcomes of sexuality education programs, such as pregnancy rates and STIs, are expensive and complex, and they can be unreliable, often relying on self-reported behaviors to measure effectiveness. Between 1996 and 2010, there was a strong emphasis in sexuality education on abstinence until marriage because of federal and state funding bans on comprehensive information about contraception. Several states have responded to parents’ and communities’ calls to provide education on not only abstinence, but on contraception, STIs (including human immunodeficiency virus [HIV]), and the proper use of condoms 4 .

State definitions of “medically accurate” vary widely, and most states require school districts to allow parental involvement in sex education programs 5 . Many states have requirements regarding topics that must be included in sex education programs. Although most federal funding goes to comprehensive sexual education programs, Title V Abstinence Education Grant funding is available to states that choose to provide activities meeting abstinence-only specifications, which can be found at www.ssa.gov/OP_Home/ssact/title05/0510.htm and www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1158 . Up-to-date state-level policy information can be found at the Guttmacher Institute’s State Center www.guttmacher.org/state-policy/explore/sex-and-hiv-education .

In addition to counseling and service provision to adolescent patients, obstetrician–gynecologists can serve parents and communities by supporting and assisting sexuality education by developing evidence-based curricula that focus on clear health goals (eg, the prevention of pregnancy and STIs, including HIV) and providing health care that focuses on optimizing sexual and reproductive health and development, including, for example, education about and administration of the human papillomavirus vaccine 6 . Because of their knowledge, experience, and awareness of a community’s unique challenges, obstetrician–gynecologists can be an important resource for sexuality education programs 7 . Additionally, obstetrician–gynecologists can encourage patients to engage in positive behaviors to achieve their health goals and discourage unhealthy relationships and behaviors that put patients at high risk of pregnancy and STIs. Clinicians also can evaluate adolescents’ level of engagement in risky behaviors, including those occurring online, and educate patients and guardians of the risks of social media and the Internet; and provide support to the parents and guardians of adolescents by encouraging them to be actively involved in their children’s sexuality education. Obstetrician–gynecologists have the unique opportunity to act “bi-generationally” by asking their patients about their adolescents’ reproductive development and sexual education, human papillomavirus vaccination status, and contraceptive needs. Although obstetrician–gynecologists are well-suited to provide sexuality education, some may encounter obstacles; local laws have been proposed to restrict family planning providers from giving sexual health information to adolescents outside of a medical setting (a physician’s office or community health clinic) 8 .

When a responsible adult communicates about sexual topics with adolescents, there is evidence of delayed sexual initiation and increased birth control and condom use 9 . Although many parents talk with their adolescents about risks and responsibilities of sexual activity, one third to one half of females aged 15–19 years report never having talked with a parent about contraception, STIs, or “how to say no to sex” 9 . Community and school-based programs also are an important facet of sexuality education.

Data have shown that not all programs are equally effective for all ages, races and ethnicities, socioeconomic groups, and geographic areas; there is no “one size fits all” program. However, one key component of an effective program is to encourage community-centered efforts. Innovative, multicomponent, community-wide initiatives that use evidence-based adolescent pregnancy prevention interventions and reproductive health services (including inclusion of moderately or highly effective contraceptive methods, such as long-acting reversible contraception) have dramatically reduced pregnancy rates among African American and Hispanic individuals aged 15–19 years old 10 . Although formal sex education varies in content across schools, studies have demonstrated that comprehensive sexuality education programs reduce the rates of sexual activity, sexual risk behaviors (eg, number of partners and unprotected intercourse), STIs, and adolescent pregnancy 11 . However, despite concerns raised by some involved in health education, a study of four select abstinence-only education programs reported no increase in the risk of adolescent pregnancy, STIs, or the rates of adolescent sexual activity compared with students in a control group 12 .

Adolescents with physical and cognitive disabilities often are considered to be asexual and, thus, have been excluded from sexuality education 13 . However, they have concerns regarding sexuality similar to those of their peers without disabilities. Their knowledge of anatomy and development, sexuality, contraception, and STIs (including HIV), should be on par with their peers, and they should be included in sexuality programs through their schools and communities.

Comprehensive sexuality education should not marginalize lesbian, gay, bisexual, questioning, and transgender individuals and those that have variations in sexual development (eg, primary ovarian insufficiency, müllerian anomalies). Curricula that emphasize empowerment and gender equality tend to engage learners to question prevailing norms through critical thinking and encourage adolescents to adopt more egalitarian attitudes and relationships, resulting in better sexual and health outcomes 14 .

Adolescents may use a variety of media sources to fill in gaps from the sexuality education they receive from schools, community programs, and parents; thus, media literacy is increasingly a key factor in children’s sexual health. Three quarters of adolescents use a social networking site, more than 80% own a cell phone, and the Internet is available to almost all adolescents at school and home 15 . Comprehensive sexuality programs should consider the benefits and pitfalls of social media. Adolescents should be aware of their “digital footprint” and the physical and legal dangers of their online behavior 1 .

There is a growing interest among adolescents to access sexual health information online that is written in language they can understand, that is in an interactive format, and that is presented in an entertaining manner 16 17 . Educational opportunities may be limited by the Internet because popular search engines often will include inappropriate sites or pornography as the first available choice, and some reputable sexual education sites will have their content blocked by social networking sites as “offensive.” Finally, adolescents are not likely to seek out and follow an organization through a social networking site, but will heed an RSS feed (an aggregation of information, including blog entries, news headlines, audio, and video) or text messages 18 . For more information, see Committee Opinion No. 653, Concerns Regarding Social Media and Health Issues in Adolescents and Young Adults 1 .

The American College of Obstetricians and Gynecologists has identified additional resources on topics related to this document that may be helpful for ob-gyns, other health care providers, and patients. You may view these resources at www.acog.org/More-Info/ComprehensiveSexualityEducation .

These resources are for information only and are not meant to be comprehensive. Referral to these resources does not imply the American College of Obstetricians and Gynecologists’ endorsement of the organization, the organization’s web site, or the content of the resource. The resources may change without notice.

Concerns regarding social media and health issues in adolescents and young adults. Committee Opinion No. 653. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;127:e62–5. [ PubMed ] [ Obstetrics & Gynecology ] Article Locations: Article Location Article Location Article Location
Addressing health risks of noncoital sexual activity. Committee Opinion No. 582. American College of Obstetricians and Gynecologists. Obstet Gynecol 2013;122:1378–82. [ PubMed ] [ Obstetrics & Gynecology ] Article Locations: Article Location
Breuner CC, Mattson G. Sexuality education for children and adolescents. AAP Committee on Adolescence, AAP Committee on Psychosocial Aspects of Child and Family Health. Pediatrics 2016;138(2):e20161348. [ PubMed ] [ Full Text ] Article Locations: Article Location
Bleakley A, Hennessy M, Fishbein M. Public opinion on sex education in US schools. Arch Pediatr Adolesc Med 2006;160:1151–6. [ PubMed ] [ Full Text ] Article Locations: Article Location
National Conference of State Legislatures. State policies on sex education in schools . Washington, DC: NCSL; 2016. Available at: http://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx . Retrieved June 27, 2016. Article Locations: Article Location
Human papillomavirusvaccination . Committee Opinion No. 641. American College of Obstetricians and Gynecologists. Obstet Gynecol 2015;126:e38–43. [ PubMed ] [ Obstetrics & Gynecology ] Article Locations: Article Location
Kirby D. Emerging answers 2007: new research findings on programs to reduce teen pregnancy . Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy; 2007. Available at: https://thenationalcampaign.org/sites/default/files/resource-primary-download/EA2007_full_0.pdf . Retrieved June 27, 2016. Article Locations: Article Location
Sexuality Information and Education Council of the United States. 2015 sex ed state legislative year-end report: top topics and takeaways . Washington, DC: SIECUS; 2016. Available at: http://siecus.org/index.cfm?fuseaction=document.viewDocument&documentid=574&documentFormatId=657 . Retrieved July 13, 2016. Article Locations: Article Location
Martinez G, Abma J, Copen C. Educating teenagers about sex in the United States. NCHS Data Brief 2010;(44):1–8. [ PubMed ] [ Full Text ] Article Locations: Article Location Article Location
Romero L, Pazol K, Warner L, Cox S, Kroelinger C, Besera G, et al. Reduced disparities in birth rates among teens aged 15–19 years—United States, 2006–2007 and 2013–2014. MMWR Morb Mortal Wkly Rep 2016;65:409–14. [ PubMed ] [ Full Text ] Article Locations: Article Location
Chin HB, Sipe TA, Elder R, Mercer SL, Chattopadhyay SK, Jacob V, 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. Community Preventive Services Task Force. Am J Prev Med 2012;42:272–94. [ PubMed ] [ Full Text ] Article Locations: Article Location
Trenholm C, Devaney B, Fortson K, Clark M, Bridgespan LQ, Wheeler J. Impacts of abstinence education on teen sexual activity, risk of pregnancy, and risk of sexually transmitted diseases. J Policy Anal Manage 2008;27:255–76. [ PubMed ] Article Locations: Article Location
Quint EH. Adolescents with special needs: clinical challenges in reproductive health care. J Pediatr Adolesc Gynecol 2016;29:2–6. [ PubMed ] [ Full Text ] Article Locations: Article Location
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Common Sense Media. Social media, social life: how teens view their digital lives . San Francisco (CA): Common Sense Media; 2012. Available at: https://www.commonsensemedia.org/research/social-media-social-life-how-teens-view-their-digital-lives . Retrieved June 27, 2016. Article Locations: Article Location
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Copyright November 2016 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.

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Comprehensive sexuality education. Committee Opinion No. 678. American College of Obstetricians and Gynecologists. Obstet Gynecol 2016;128:e227–30.

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Study Finds that Comprehensive Sex Education Reduces Teen Pregnancy

Researchers from the University of Washington found that adolescents who receive comprehensive sex education are significantly less likely to become pregnant than adolescents who receive abstinence-only-until-marriage or no formal sex education. The study, based on a national survey of 1,719 teens ages 15 to 19, is the first population-level evaluation of the effectiveness of both abstinence-only and comprehensive sex education programs. The results are very promising for comprehensive sex education.According to Pamela Kohler, the study's lead author, "It is not harmful to teach teens about birth control in addition to abstinence."This study joins a host of others that prove that abstinence-only does little and comprehensive sex education does much for our teens. The dangers of abstinence-only are nothing new – one well-known study by Mathematica found that students who participated in abstinence-only programs are just as likely to have sex as their peers who did not participate.Yet in the face of this overwhelming evidence, 1 in 4 teens receive only abstinence-only instruction. On top of that, 9 percent of teens receive no sex education at all, particularly those in rural or poor areas. Thankfully, that leaves two-thirds of students in comprehensive sex ed. As temporarily reassuring as that might be, we cannot also lose sight of the fact that 1 in 4 teen girls have an STD.This sobering fact also points to how much work we have left to do. The University of Washington study does not speak to how comprehensive sex ed should be implemented. Clearly this is a question to be handled carefully by both parents and administrators alike, as we continue to improve and expand the reach of comprehensive sex education programs.

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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.

Beautiful African American female teenage college student in classroom

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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New research: quality sex education has broad, long-term benefits for young people’s’ physical and mental health.

An extensive review finds that in addition to helping to prevent teen pregnancy and STIs, sex education can help prevent child sexual abuse, create safer school spaces for LGBTQ young people, and reduce relationship violence

Washington, DC – New research published in the Journal of Adolescent Health has identified a wide variety of benefits of comprehensive, quality sex education.

For Three Decades of Research: The Case for Comprehensive Sex Education , Eva S. Goldfarb, Ph.D. and Lisa D. Lieberman, Ph.D. examined studies from over three decades of research on sex education and found “evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality.”

From the authors:

“We undertook this research because of the glaring lack of work that examines the impact of sex education on all aspects of sexual health, rather than limiting the scope to pregnancy and STI prevention. Our research found that sex education has the potential do so much more. The impact of quality sex education that addresses the broad range of sexual health topics extends beyond pregnancy and STIs and can improve school success, mental health, and safety. As with all other areas of the curriculum, building an early foundation and scaffolding learning with developmentally appropriate content and teaching are key to long-term development of knowledge, attitudes, and skills that support healthy sexuality.

Further, if students are able to avoid early pregnancy, STIs, sexual abuse and interpersonal violence and harassment, while feeling safe and supported within their school environment, they are more likely to experience academic success, a foundation for future stability.”

The paper found that sex education efforts can also succeed in classrooms outside of the health education curriculum. Given that most schools have limited time allotted to health or sex education, a coordinated and concerted effort to teach and reinforce important sexual health concepts throughout other areas of the curriculum is a promising strategy.

Members of the Future of Sex Education Initiative, a coalition of organizations working to ensure all students in grades K–12 receive comprehensive, quality sex education which developed the National Sex Education Standards, welcomed the research:

Debra Hauser, President, Advocates for Youth:

“This paper confirms what educators and young people see every day in classrooms and school communities: sex education helps young people have healthier, safer lives and more affirming environments. We owe it to every young person to make sure they not only have the information and skills they need to protect their health, but that they are safe in their schools and their homes.”

Chris Harley, President & CEO, SIECUS:

“At SIECUS: Sex Ed for Social Change, we have been asserting that individual and social benefits of sex education extend far beyond simply decreasing rates of unintended pregnancies and sexually transmitted infections among young people. This new wealth of research is just the start of illuminating that the power and importance of comprehensive, inclusive sex education is in it’s ability to do so much more. The findings are clear: sex education helps all of our young people lead happier, healthier, safer lives—no matter who they are or how they identify. ”

Dan Rice, Executive Director, Answer:

“When it comes to most topics taught in school, the motto is often “ Knowledge is Power ;” but there’s often a double standard when it comes to sex education. This paper provides the evidence that access to comprehensive sex education is not only empowering to all students, but can also help to improve their emotional and social development.”

Eva S. Goldfarb, Ph.D. , and Lisa D. Lieberman, Ph.D. are available for comment; please reach out to [email protected] .

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Comprehensive sexuality education

Comprehensive sexuality education (CSE) gives young people accurate, age-appropriate information about sexuality and their sexual and reproductive health, which is critical for their health and survival.

While CSE programmes will be different everywhere, the United Nations’ technical guidance – which was developed together by UNESCO, UNFPA, UNICEF, UN Women, UNAIDS and WHO – recommends that these programmes should be based on an established curriculum; scientifically accurate; tailored for different ages; and comprehensive, meaning they cover a range of topics on sexuality and sexual and reproductive health, throughout childhood and adolescence.

Topics covered by CSE, which can also be called life skills, family life education and a variety of other names, include, but are not limited to, families and relationships; respect, consent and bodily autonomy; anatomy, puberty and menstruation; contraception and pregnancy; and sexually transmitted infections, including HIV.

Sexuality education equips children and young people with the knowledge, skills, attitudes and values that help them to protect their health, develop respectful social and sexual relationships, make responsible choices and understand and protect the rights of others.

Evidence consistently shows that high-quality sexuality education delivers positive health outcomes, with lifelong impacts. Young people are more likely to delay the onset of sexual activity – and when they do have sex, to practice safer sex – when they are better informed about their sexuality, sexual health and their rights.

Sexuality education also helps them prepare for and manage physical and emotional changes as they grow up, including during puberty and adolescence, while teaching them about respect, consent and where to go if they need help. This in turn reduces risks from violence, exploitation and abuse.

Children and adolescents have the right to be educated about themselves and the world around them in an age- and developmentally appropriate manner – and they need this learning for their health and well-being.

Intended to support school-based curricula, the UN’s global guidance indicates starting CSE at the age of 5 when formal education typically begins. However, sexuality education is a lifelong process, sometimes beginning earlier, at home, with trusted caregivers. Learning is incremental; what is taught at the earliest ages is very different from what is taught during puberty and adolescence.

With younger learners, teaching about sexuality does not necessarily mean teaching about sex. For instance, for younger age groups, CSE may help children learn about their bodies and to recognize their feelings and emotions, while discussing family life and different types of relationships, decision-making, the basic principles of consent and what to do if violence, bullying or abuse occur. This type of learning establishes the foundation for healthy relationships throughout life.

Many people have a role to play in teaching young people about their sexuality and sexual and reproductive health, whether in formal education, at home or in other informal settings. Ideally, sound and consistent education on these topics should be provided from multiple sources. This includes parents and family members but also teachers, who can help ensure young people have access to scientific, accurate information and support them in building critical skills. In addition, sexuality education can be provided outside of school, such as through trained social workers and counsellors who work with young people.

Well-designed and well-delivered sexuality education programmes support positive decision-making around sexual health. Evidence shows that young people are more likely to initiate sexual activity later – and when they do have sex, to practice safer sex – when they are better informed about sexuality, sexual relations and their rights.

CSE does not promote masturbation. However, in our documents, WHO recognizes that children start to explore their bodies through sight and touch at a relatively early age. This is an observation, not a recommendation.

The UN’s guidance on sexuality education aims to help countries, practitioners and families provide accurate, up-to-date information related to young people’s sexuality, which is appropriate to their stage of development. This may include correcting misperceptions relating to masturbation such as that it is harmful to health, and – without shaming children – teaching them about their bodies, boundaries and privacy in an age-appropriate way.

There is sound evidence that unequal gender norms begin early in life, with harmful impacts on both males and females. It is estimated that 18%, or almost 1 in 5 girls worldwide, have experienced child sexual abuse.

Research shows, however, that education in small and large groups can contribute to challenging and changing unequal gender norms. Based on this, the UN’s international guidance on sexuality education recommends teaching young people about gender relations, gender equality and inequality, and gender-based violence.

By providing children and young people with adequate knowledge about their rights, and what is and is not acceptable behaviour, sexuality education makes them less vulnerable to abuse. The UN’s international guidance calls for children between the age of 5 and 8 years to recognize bullying and violence, and understand that these are wrong. It calls for children aged 12–15 years to be made aware that sexual abuse, sexual assault, intimate partner violence and bullying are a violation of human rights and are never the victim’s fault. Finally, it calls for older adolescents – those aged 15–18 – to be taught that consent is critical for a positive sexual relationship with a partner. Children and young people should also be taught what to do and where to go if problems like violence and abuse occur.

Through such an approach, sexuality education improves children’s and young people’s ability to react to abuse, to stop abuse and, finally, to find help when they need it.

There is clear evidence that abstinence-only programmes – which instruct young people to not have sex outside of marriage – are ineffective in preventing early sexual activity and risk-taking behaviour, and potentially harmful to young people’s sexual and reproductive health.

CSE therefore addresses safer sex, preparing young people – after careful decision-making – for intimate relationships that may include sexual intercourse or other sexual activity. Evidence shows that such an approach is associated with later onset of sexual activity, reduced practice of risky sexual behaviours (which also helps reduce the incidence of sexually transmitted infections), and increased contraception use.

On sexuality education, as with all other issues, WHO provides guidance for policies and programmes based on extensive research evidence and programmatic experience.

The UN global guidance on sexuality education outlines a set of learning objectives beginning at the age of 5. These are intended to be adapted to a country’s local context and curriculum. The document itself details how this process of adaptation should occur, including through consultation with experts, parents and young people, alongside research to ensure programmes meet young people’s needs.

Comprehensive sexuality education: For healthy, informed and empowered learners

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

Transforming MENtalities: Engaging Young Men and Boys in Gender Equality in Eastern Africa

Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?

According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.

1. Introduction

According to the World Health Organization [ 1 , 2 ] and the World Association for Sexual Health (WAS) Declaration of Sexual Rights [ 3 ], sex education aims to provide children and adolescents with comprehensive knowledge, skills, values, and attitudes promoting equality and nondiscrimination while upholding freedom of thought and expression.

The WHO-Regionalbüro für Europa und BZgASalute Standards [ 4 ] state that sexuality education means “learning relative to the cognitive, emotional, social, relational, and physical aspects of sexuality” and enhancing “the empowerment of children and young people by providing them with positive information, skills, and values for understanding their own sexuality and enjoying it, having safe and rewarding relationships, and behaving responsibly with respect to their own and others’ sexual health and well-being. (…)” (p. 17).

At an international level, governments and education policy makers are reviewing the best practices in the delivery of relationship and sexuality education (RSE) [ 5 ]. Even if there are some changes to the most recent guidelines, like the New Zealand ones [ 6 ], modifications are mostly connected to a greater recognition of gender diversity rather than the active inclusion of diverse sexualities. These other issues could be mitigated by reimagining sexuality education in a way that could include explicit reference to sexual practices but also the possibility to adopt a ‘norm-critical’ approach to sexuality education, like the use of innovative strategies such as the careful choice of language to avoid unnecessary gendering and the adoption of an overt ‘norm-critical’ approach to avoid assumptions [ 7 ]. In other jurisdictions, inclusivity is more take into consideration, but is focused on cultural diversity rather than LGBTQIA+ perspectives [ 8 ].

For several years now, what were previously distinguished as different branches of sex education (“Sex Education” and “Comprehensive Sex Education”), have converged into the single representation of holistic sex education, promoting an integrated (between informational and emotional aspects), sex-positive, and inclusive perspective, accessible according to an intersectional view.

Adolescence can be considered as one of the most critical transitions in the life of the individual, during which facing a process of growth and change, characterized by different levels of maturation (physical, sexual, psycho-emotional, etc.), pushes adolescents toward the acquisition of dimensions such as social independence, identity development, and relational and emotional competencies.

As ascertained by leading scholars in Developmental Psychology and Developmental Psychosexology, this process may be more complex in cases where the individual is faced with the development of a non-heterosexual or non-cisgender sexual identity [ 9 ]. In this scenario, an additional element of difficulty may arise precisely from being differently included in sexual health promotion programs [ 10 ].

Talking about non-heterosexual and non-cisgender identities refers to movements to deconstruct the hetero-cis-normative framework, which defines “natural” and “normal” identities and behavior based on a complementarity between male and female. According to the hetero-cis-normative view, gender is thought of as corresponding to biological sex and as a dichotomous variable, and male and female are found to be mutually attractive, for both romantic and sexual and sentimental purposes. In sexuality education programs, one of the main limitations represented by this view in the context of sex education is the rigid prescription of stereotypes regarding gender identity and gender expression, as well as limiting knowledge and exploration of all legitimate components of sexual identity. LGBTQIA+ is the abbreviation for “Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, and Asexual” people. The additional “+” stands for all of the other identities not encompassed in the shorter acronym. It is an umbrella term that is often used to refer to the community of non-heterosexual and non-cisgender identities as a whole.

According to evidence from the scientific literature, sex education is more effective on heterosexual youth than on LGBTQIA+ youth [ 11 ]. This finding can be explained by the insufficient inclusion of Sexual Minorities (SMs) and Gender Minorities (GMs) within programs. Therefore, the current most widely used sex education is poorly able to meet needs, identities, and subjectivities, entailing the risk of being an information and growth tool only for a narrow part of the target audience for which it is designed. Thus, it may be interesting to have some risk-related data. In general, SM and GM youths experience more negative outcomes, relative to sexual health, than heterosexual peers; for example, homosexual male youths have an extremely higher risk of HIV infections [ 10 ].

As evident from Figure 1 , SM youth who are recipients of hetero-cis-normative sex education, in addition to being exposed to greater sexual risks, also reveal worse psychological health status, reporting higher rates of attempted suicide, substance abuse, depression, and anxiety, compared to their heterosexual cisgender counterparts [ 12 , 13 , 14 , 15 ].

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Effects of hetero-cis-normativity sex education.

What Figure 1 intends to show is the multidimensional (sexual, psychological, and relational) complex of negative factors that hetero-cis-normative culture entails for the health of young people belonging to SMs and GMs. Indeed, in societies and cultures strongly anchored in the hetero-cis-normative framework, the absence of a constructivist view of sexual identity and the lack of promotion of free self-knowledge can lead young people to incur in nonconscious, unwanted, and non-respectful experiences.

Effects such as these can be discussed by correlating them with the stressors that, following the Minority Stress model [ 16 ], are specific to SMs and GMs, originating phenomena such as internalized homo/transphobia, stigma, bullying, discrimination, and violence [ 15 ].

LGBTQIA+ youths who face bullying and bias in educational settings are more likely to suffer academically, displaying lower grade point averages, higher rates of absenteeism, a sense of alienation from their school environment, and diminished self-esteem, compared to their peers who do not encounter such victimization and discrimination at school [ 17 ].

The objective of this article is to review the published scientific literature in the field of sex education in order to highlight the presence or absence of inclusive programs and methodologies of work in the adolescent target audience; a further aim is to advance a critical discussion of the effects of the currently most popular programs and proposals for the use of more inclusive intervention methodologies [ 18 , 19 ]. The use of inclusive sex education aims to decrease school-based victimization that characterizes the experiences of SM and GM youth, the impact of sexually transmitted diseases (of which LGBTQIA+ youth are found to be one of the most at-risk groups), and the risk of experiencing violent relationships [ 20 ].

LGBTQIA+ students who received inclusive sexual health education showed the following outcomes: diminished levels of victimization, higher feelings of safety at school, less safety-related school absences, increased academic performance, and more feelings of connection with peers [ 21 ].

Evidence-based programs have also shown having an impact on sexual behavior. However, these programs are often not inclusive of LGBTQIA+ identities, thus limiting program effectiveness in the general population.

Programs that have taken more inclusive measures still have gaps, especially in the relationship aspect.

Recent research [ 22 ] has showed that digital spaces can be positively correlated with social support, self-esteem, diminished sense of loneliness, increasing identity socialization, expression of emotions, and development of positive interpersonal relationships.

It is important that practitioners and families consider digital tools as valuable allies, and turn their attention to a more inclusive and participatory promotion of sex education using both these tools and traditional ones.

In considering the use of a systemic perspective (which intends to involve all significant adults in the educational intervention on sexuality), it is important to consider educational action as a process of community empowerment and as a political action. Through educational processes on sexuality, it is possible to promote more inclusive and respectful communication skills, and to enhance dialogue within family units and peers. One example among all may be the recent debate on the use of inclusive language, which has raised (in some countries such as Italy) trends of opposition to the possibility of dealing with the topic of gender identity within school sex education curricula, especially in elementary school. At the same time, it has raised the debate on the topic, leading many parents, teachers, and educators to confront and activate processes of questioning some of the stereotypes present in the culture of reference.

2. Materials and Methods

This narrative review is based on the results produced by a search of several databases, such as Academic Search Index, CINAHL, Complementary Index, EBCO, Scopus, Medline, MLA International Bibliography, PubMed, Science Direct, and Springer Nature. The selected articles refer to publications dated from 2015 through 2024. The keywords used for the search are “LGBTQIA+ comics”, “LGBTQIA+ inclusive sex education”, “LGBTQIA+ narratives”, “LGBTQIA+ youth”, “sexual communication”, “LGBTQIA+ sexual education”, and “LGBTQIA+ students” AND “parent-adolescent sex communication”. Based on the results obtained and the purpose of this paper, the most relevant studies were selected. Subsequently, the references and citations in the articles were used to expand the documentation. The data from the studies and the authors’ positions were analyzed to frame the current “state of the art” in order to identify critical issues in current inclusive programs and promote new educational intervention strategies. To be included in this review, a quantitative study had to meet all the following inclusion criteria:

should have been published in peer-reviewed journals during or since 2015;
should have focused on LGBTQIA+ population;
should have been published in English and Spanish language.

Papers were excluded if:

inclusive criteria were not present.

Since this is a narrative review, no other guidelines were followed during the search and the selection of the studies.

In Figure 2 , a flow chart of the study selection procedure is provided.

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Flow chart of study selection procedure.

3.1. The Effects of Sex Education Targeting Heterosexuals

Most of the evidence on inclusive policies comes from the United States; it is generally focused on the impact of school-level policies rather than state-level policies [ 23 , 24 ]. In a study conducted by Evans, heterosexual young adult women reported receiving more information about sex before becoming sexually active than bisexual or lesbian young adult women [ 25 ]. Another research suggests that transgender identities are completely excluded from the contents addressed in sexuality education [ 26 ]. Regarding sexual risk, overall, SM and GM youths experience more negative sexual health outcomes than their heterosexual peers. It is found in the literature that gay and bisexual women run a higher risk of sexually transmitted infections (STIs) and unwanted pregnancies [ 27 ]. In addition, among transgender youth, those younger than 13 years old are three times more prone to experience sexual experimentation [ 28 ].

3.2. Suggestions for Improving Inclusive Sex Education

Research highlights the importance of dedicated youth work for LGBTQ+ youth, providing them with a safe, nonjudgmental, and welcoming space to explore their identities with professionals who can serve as positive LGBTQIA+ role models and to have the opportunity to network with peers what they can share the journey of knowing their identities [ 29 , 30 ].

Current sex education programs have taken measures to be more inclusive, but they still have gaps, especially in the relationship aspect, and students rarely actually receive sex health education inclusive of LGBTQIA+ population [ 31 ]. In the educational curriculum reported in the Chicago City Agency Newsletter, starting in 2nd grade (7–8 years old), students learn the distinction between gender and sex. In the 5th grade (ages 10–11), the specific topic of LGBTQIA+ identities is introduced, which is then brought up again in the 13–16 age range. In addition, issues such as the risk of STIs are addressed through various types of sexual stimulation (such as oral, anal, manual, and vaginal intercourse), and issues like insemination, adoption and surrogacy are considered for heterosexual and LGBTQIA+ families. Finally, guidelines have been adopted to support transgender and gender-nonconforming youths by ensuring they have access to facilities that legitimize them and allow them to affirm their gender identity in all school settings [ 32 ].

3.3. Perceptions of the Youth Population

In 2018, Hobaica and Know studied SM and GM students’ perceptions of sexuality education programs, finding that participants perceived their sexuality education to be permeated with normative elements.

Absence of visibility of all different sexual orientations, shame, and a lack of information on safe sexual practices emerged. This results in a feeling of unpreparedness for sexuality, which leads LGBTQIA+ youth to use other resources for self-education [ 33 ].

As summarized in Figure 3 , a study of the sex and relationship education (SRE) experiences of young bisexual and queer women in Tasmania [ 34 ] found that most had received information on menstruation, puberty, contraceptive methods, information on preventing STIs, and reproduction. However, only a small percentage reported addressing issues related to gender, sexuality, and relationships. Complaints from participants in SRE programs included an excessive focus on biological aspects and a reproduction of gender inequalities through a focus on risk, personal responsibility, ethics, and punitive self-regulation, as well as an exclusive focus on risk in heterosexual relationships [ 34 ]. The points highlighted by this study, as shown in Figure 3 , need to be taken into account when rethinking sex education programs from a perspective that can cross-cut the interests of all youth targets; the question educators can ask is: Is it possible to make the bio-psycho-social elements more inclusive? An example may be sexual anatomy: is there a way to be able to represent everyone’s experience and perception?

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Focus and limits of sex and relationship education.

An additional study conducted in the United States [ 35 ] collected information on the primary and secondary school sex education experiences of transgender youth (AMAB, AFAB, nonbinary) across a wide range of programs. These reports severely lack information on various identities, such as the complete absence of information on queer identities.

The experience of invisibility that characterizes the experiences of young people belonging to SMs and GMs with respect to sexuality education means that it is perceived as “uncomfortable” and not very conducive to the possibility of formulating the questions and elaborating on them in the growth of identity awareness and understanding. Pregnancy, abortion, STIs, and slut-shaming are the topics mainly addressed to promote fear and abstinence-oriented behaviors [ 36 ]. In addition, anatomical and biological aspects are often addressed in sex education programs with a division of classes according to a binary gender criterion (males and females) resulting in the exclusion of individuals belonging to GMs. Complaints from participants about sexual education programs concerned an excessive focus on biological aspects and a reproduction of gender inequalities through a focus on risk, personal responsibility, and self-regulation that was moralizing and punitive, as well as focused exclusively on risks in heterosexual relationships [ 37 ].

Regarding the period of puberty, transgender participants reported experiencing it with feelings of distress and alarm, particularly at the onset of gender dysphoria and the subsequent concerns associated with body image.

Figure 4 summarizes the main areas of intervention that should be addressed to achieve inclusive sex education. In continuity with what has been proposed in the bio-psycho-social approach, a sex education able to achieve the goal of developing and enhancing a positive attitude to the body and pleasure, as well as a healthy and respectful relationship with self and others, needs to work on several areas, such as: assertiveness (respect for one’s rights and sexual safety), body image, the expression of one’s sexual identity, and knowledge, free from taboos and prejudices.

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Perspectives and educational needs of LGBTQ+ youth.

Indeed, due to a description of body changes that did not propose representations accessible to transgender people, a perception was generated in them that their bodies would inevitably undergo changes, a source of inevitable discomfort [ 35 ]. In some parts of the world, so-called “homosexual acts” are prohibited by law resulting in prison sentences and, in some cases, the death penalty. The existence of laws such as these imply on LGBTQIA+ people, regardless of their narrow sphere of daily life, resistance and discomfort in expressing their sexual identity (i.e., the phenomenon called “in the closet”). In younger people, this state can lead to delays and discomfort in knowing, being aware of, and exploring one’s gender, sexuality, and relational experience [ 38 ]. People in the LGBTQIA+ community may, in fact, find themselves struggling to learn what it means to form a relationship and having to defend themselves from family members who do not accept their identity [ 39 ].

3.4. The Importance of the Web Context

In this landscape, LGBTQIA+ people are trying to fill the void of institutionalized sex education by sharing important information about sexual health and rights. Today, social media is a new dissemination medium used by SMs and GMs to achieve this goal [ 40 ].

For LGBTQIA+ youths, online access to information gives the opportunity for an equality of access. Online sexual health information has been shown to provide LGBTQIA+ youths with control over their sexual health needs, giving them the opportunity to self-educate on topics not covered in traditional sexuality education, like diverse sexuality, interventions (surgical and non) for transgender individuals, and gender identities [ 41 ].

3.5. The Importance of Inclusive Dialogue with Key Adults: The Role of Parents, Teachers, and Educators

It seems that promotion of sexual knowledge by the family can be effective in improving sexual safety. It seems, moreover, that family-based educational interventions, in which parent–child communication skills are improved, lead to significant reductions in the enactment of risky sexual behaviors [ 25 ].

Parent–child LGBTQIA+ communication about sexuality can be fraught with barriers, as youth often experience anxiety, fear, and discomfort. Young people often avoid initiating conversations about sex after hearing negative comments from their parents about SM and GM people. Moreover, in some cases, parents are believed to lack useful information. Parental support is fundamental in influencing youths’ willingness to engage in conversations regarding sex, making them more receptive and proactive to issues pertaining to sexual health promotion.

Topics such as romantic relationships, emotions, and dating safety may be rare in communication between parents and SM and GM children [ 42 ].

An interesting part of studies also focuses on understanding aspects supporting environmental and structural elements as a form of inclusion in schools.

Beasy and collaborators examined teachers’ and staff members’ perceptions, underscoring how the design and arrangement of spaces can either facilitate or hinder inclusion [ 43 ]. “Safe spaces” are particularly significant; they are environments where LGBTQIA+ students can express their identities without fear of discrimination or bullying. The study suggests that creating these spaces involves not only physical considerations—such as designated areas for LGBTQIA+ discussions and activities—but also the establishment of supportive relationships among staff and students. This can include training for teachers on LGBTQIA+ issues, promoting awareness and acceptance among the broader student body, and actively engaging LGBTQIA+ students in the process of defining what a safe space means to them.

Furthermore, the research points to the importance of ongoing dialogue among educators about their roles in creating inclusive environments. By negotiating and establishing these safe spaces, teachers and staff can contribute to a more supportive school culture that values diversity and fosters a sense of belonging for all students.

This approach aligns with broader educational goals of equity and inclusion, demonstrating how environmental and structural elements can be leveraged to support marginalized groups within educational settings.

In school settings, professionals involved in adolescent sex education recognize that this environment can be dangerous for SM and GM youth as victims of discrimination [ 44 ].

GLSEN (Gay, Lesbian, and Straight Education Network), a U.S.-based educational organization that addresses bullying, harassment, and discrimination based on gender identity, gender expression, and sexual orientation, has found that non-binary students perform worse academically than heterosexual students, but also compared to their lesbian, gay, and bisexual counterparts. According to data reported (2015), feelings of unsafety, fear, and experiences of harassment related to gender expression, discomfort, and gender-related insults are the motivations that lead young people to avoid and/or negative experiences with respect to the school environment.

A key finding to consider is that transphobic comments did not come from peers but, for 63.5% of respondents, from teachers and/or other adult figures in the school setting [ 44 ].

Among the adults involved, educators play an important role in this area. Therefore, it is a striking finding that most education professionals indicate that they do not have adequate knowledge to work with SM and GM students [ 45 ].

In the meta-analysis on LGBTQ-inclusive sexuality education, O’Farrell et al. (2021) discuss challenges faced by teachers. They suggest that there is an ambivalence and anxiety from some facilitators to carry on inclusive sexuality education that can be explained with their own stigma or perceived inability to talk about these topics because of a lack of information and training.

The literature, in fact, states that skills related to affirming young people’s identities, using neutral and specific language and creating relevance, are not often considered in teachers’ training [ 41 ].

Educators require training that broadens their understanding of biological sex, gender identity, sexual and romantic orientation, and sexual behavior.

The recognition that language is constantly evolving and that young people have the right to self-identify should be integrated into the teaching of basic terminology.

Considering that the biopsychosocial approach appears to be the most comprehensive in the implementation of effective sex education interventions, it is believed that the use of the integrated approach (which works on cognitive, emotional, and socio-cultural aspects regarding sexuality) can be a good reference for the training of educators. Through the integrated training methodology, it is possible to propose the study of the most effective models, in parallel with the experimentation of training experiences (through simulations, bioenergetics exercises, and graphic and creative exercises) that allow future sexuality educators to become more aware of implicit and explicit messages, taboos, personal beliefs, and values that they carry in their interventions. In this way, it is possible to imagine that educators can convey messages and content that are more inclusive and able to increase the self-determination resources of the target youth.

A recent study conducted in Europe [ 46 ] confirmed the importance of inclusive school policies for LGBTIyouth. Key takeaways include:

Improved Safety and Well-Being: Schools with more inclusive policies lead to lower odds of lack of safety and concealment among LGBTQIA+ youth. This indicates that when schools actively promote inclusivity, students feel safer and more accepted.
Higher Life Satisfaction: LGBTQIA+ youth in inclusive environments report higher levels of life satisfaction, suggesting that acceptance and support within the school context significantly enhance their overall well-being.
Impact of Teacher Training: Training teachers to be more inclusive positively affects school climate. It is associated with reduced feelings of depression and sadness among LGBTQIA+ youth, as well as reduced bias-based violence.
Role of Inclusive Curricula: Including LGBTQIA+ topics in the curriculum not only promotes visibility but also correlates with decreased experiences of harassment, both general and bias-based. This highlights the importance of representation in educational materials.
Visibility vs. Concealment: Teacher training is linked to greater visibility of LGBTQIA+ youth, which in turn reduces their need to conceal their identities. This suggests that supportive educators can create an environment where students feel comfortable being themselves.

Overall, the study emphasizes that comprehensive strategies involving both teacher training and inclusive curricula are essential for fostering a safe and supportive school environment for LGBTQIA+ youth. By equipping educators with the necessary skills and knowledge, and integrating inclusive content into the curriculum, schools can create an environment where LGBTQIA+ students feel accepted and protected. This dual approach addresses both the immediate need for a supportive atmosphere and the long-term goal of systemic change in attitudes and practices within the educational system.

Moreover, the findings underscore the critical role that inclusivity in teacher training and curricula plays in fostering a safer school environment for LGBTQIA+ youth. By incorporating comprehensive training that emphasizes diversity and the enumeration of protected groups, teachers are better equipped to create a supportive atmosphere that actively reduces feelings of depression and sadness among these students (by 10%). Moreover, these inclusive practices are essential in combating bias-based school violence, highlighting the need for educational institutions to prioritize training that promotes understanding and acceptance.

Increased inclusivity in teacher training and curricula was significantly linked to reduced likelihood of perceived lack of school safety (by 17% and 16%, respectively) and to 18% and 14% lower odds of bias-based school violence, respectively.

The significant reduction in the odds of perceived school safety issues and bias-based violence suggests that when educators are trained to recognize and value diversity, they can effectively model positive behavior and set norms that discourage bullying [ 47 ]. This aligns with existing literature that emphasizes the necessity of specialized skills in addressing bias-based victimization, indicating that targeted interventions can lead to substantial improvements in school climate and student well-being.

Overall, these findings advocate for the implementation of inclusive policies and training programs as a means to enhance safety and support for marginalized youth, ultimately contributing to a more equitable educational environment. Often, bias-based victimization prevention efforts require specific knowledge and skills [ 48 ].

A recent study aimed to gain a comprehensive understanding of the LGBTQIA+ community’s presence in sexuality education and the ways it is addressed. To achieve this, qualitative research was conducted using a collective case study approach within the context of sexuality education activities at two secondary schools in the province of Almería (Andalusia, Spain). Data collection methods included non-participatory observation, semi-structured interviews, and analysis of documentary sources. The findings indicate a significant prevalence of exclusionary perspectives, the perpetuation of discriminatory beliefs, and a tendency to silence. Furthermore, they demonstrate that the LGBTQIA+ community is treated in a superficial manner. Consequently, sexuality education is not viewed as a space for discussing non-hegemonic identities and experiences, nor are these realities recognized as part of the broader spectrum of sexuality. This perspective contributes to the continuation and legitimization of a stigmatized viewpoint, as non-hegemonic identities and experiences are seen as abnormal, rare, exceptional, and taboo [ 49 ].

4. Discussion

4.1. influence of sre in lgbtqia+ youths.

One of the most important factors that has emerged as influencing SRE in GM and SM youths seems to be their relationship with parents. In fact, communication between parents and LGBTQIA+ adolescents may be characterized, prior to their child’s coming out, by a hetero-cis-normative approach [ 50 ]. In this case, parents may have more difficulty, as they may be less aware, educated, and comfortable about same-sex sexual behaviors, or raising a transgender or nonbinary person, as well as being influenced by general and, potentially, negative beliefs and attitudes.

In Australia [ 51 ], research has found that LGBTQIA+ youth, unlike their heterosexual counterparts, perceive SRE programs as the least useful source of information. In contrast, they regard online information and social media as the most important sources. This datum seems to be strictly connected to the themes that are discussed in such interventions. Regarding the themes, it emerged from a study that from ages 14 to 15, certain issues receive more consideration, like the use of gender-neutral and inclusive language, and the utilization of gender-neutral terms like “partner” rather than “boyfriend” [ 52 , 53 , 54 ].

4.2. Use of a Neutral and Specific Language to Create an Inclusive Environment

Neutral language and specificity both play important roles in creating inclusive environments, particularly in educational settings.

Neutral language serves as an umbrella that encompasses a diverse range of identities, allowing individuals from various sexual orientations and gender identities to feel represented and included. This approach can foster a sense of belonging among young people who might otherwise feel marginalized or overlooked in traditional curricula. By using language that is inclusive and non-specific, educators can create a welcoming atmosphere that encourages all students to engage with the material without fear of exclusion.

On the other hand, specificity acknowledges and names individual identities, providing visibility to particular groups that may otherwise remain invisible in neutral language. This can help students see themselves in the scenarios presented, facilitating deeper reflection on their own experiences and the decisions they face [ 15 ]. When specific identities are highlighted, it can lead to richer discussions and a better understanding of the unique challenges and perspectives that different individuals encounter.

Both approaches have their merits: neutral language promotes inclusivity and broad appeal, while specificity fosters recognition and validation of individual experiences. Striking a balance between the two can enhance educational practices, ensuring that all students feel seen, heard, and valued.

4.3. What Topics to Include for Inclusive Sex Education?

A 2014 study by the U.S. Centers for Disease Control and Prevention (CDC) [ 55 ] found that 72% of high schools in the United States educate students on how to prevent pregnancy, 60% promote the effectiveness of contraception, and 35% instruct students in condom use.

It would be important for them to be included, in order to address issues regarding consent, safety, assertive communication, and negotiating sexual protections with partners. These aspects are of paramount importance, even more so when considering that young people belonging to SMs and GMs are found to be more at risk for sexual coercion, dating violence, and physical and psychological abuse [ 56 ].

Comprehensive sex education that includes discussions on consent, safety, and communication can provide them with the tools to navigate these challenges more effectively.

Teaching students about consent is crucial in fostering a culture of respect and mutual agreement in sexual activities. Ensuring safety ensures that students are better prepared to protect themselves in various contexts. In the context of sexual health, teaching students how to communicate assertively helps them to develop healthy relationship dynamics where both partners can voice their opinions and concerns without fear of judgment or retribution.

This education is essential in creating a safe environment where individuals feel empowered to make informed choices about their bodies and relationships.

The CDC’s findings highlight the progress made in sexual health education in U.S. high schools, but also underscore the gaps that still exist.

4.4. Narrative Approach in Educational Programs for an Inclusive Sexuality

Building on Plummer’s (1995) [ 57 ] work focused on sexual histories, the importance of adopting a “narrative” perspective in interventions on identity components has been increasingly reinforced in order to capture the dynamic meaning of the dimensions that structure human sexuality. Adopting a narrative perspective in interventions on identity components is crucial for capturing the dynamic and multifaceted nature of human sexuality. This approach allows for a more comprehensive and empathetic understanding of sexual identities, fostering a more inclusive and supportive environment for individuals to explore and express their sexuality. This approach contrasts with static models of identity, which often fail to capture the lived realities of individuals. Plummer’s work highlights the importance of these personal stories in understanding the diversity and fluidity of human sexuality.

Gilbert [ 58 ] argues that in order to recognize the rights of people in the LGBTQIA+ community, it is necessary to adopt a theory of sexuality that both tolerates and, at the same time, challenges the relationship one has to the categories used both from outside and within the community [ 59 ]. By focusing on the narrative aspects of sexual histories, interventions can also challenge and deconstruct harmful societal norms and stereotypes. This approach encourages a more inclusive understanding of sexuality, recognizing the validity of diverse sexual identities and experiences. It aligns with contemporary views on sexuality, which emphasize the importance of personal agency and the right to define one’s sexual identity free from societal constraints.

The issue of identity has been recognized [ 32 ] as a central aspect to be considered in sexuality education programs, including a welcoming and representative view of the different forms it can take, overcoming the conception of a “normative” and standardized pathway. In addition to the importance they represent for people living with commitment to the delicate topic of identity exploration, issues such as coming out, the transition process, asexuality, and nonbinary identities prove to be crucial across the board.

In this regard, it may be significant to reflect on the fact that “inclusion” means “welcoming within”; the perspective that educators need to implement most is to offer reflections, analysis, debate, and critical discussion for all and on all aspects of knowing, exploring, and expressing one’s sexual identity.

It is fundamental to consider that an individual may also belong to multiple SMs or GMs and/or other social groups and categories. Organizing interventions by grouping them into a single category, such as “sexual and gender minority”, can be misleading and ineffective in promoting sexual health [ 60 ].

4.5. Use of Alternative Sources of Information

Among the tools that can be used in order to tell and see diverse experiences represented, two can be proposed: narratives and comics. Narratives are an opportunity to highlight the significance of diversity and contextual sensitivity when one’s identity and Minority Stress are at stake, in situations where it is health that is being undermined: “Stories work well in representing the need, the difficulty and often the anger of choosing how to live” [ 61 ]. Through storytelling, people can articulate their experiences, desires, and challenges, providing a more nuanced view of their sexuality.

As far as LGBTQIA+ adolescents are concerned, an interesting option as an opportunity to read narratives is represented by comic books. Numerous lesbian, bisexual, and queer cartoonists have used this form of expression to popularize the various narratives aimed at this age group of the LGBTQIA+ population. Such representations provide an opportunity to examine how these stories are told, the use of iconographic details aimed at portraying romantic relationships between characters, and how representations of non-hetero-cis-normative relationships provide a positive view of LGBTQIA+ characters [ 62 ]. Seeing characters who share similar struggles, triumphs, and everyday experiences can be incredibly validating. This representation helps combat feelings of isolation and fosters a sense of belonging and visibility [ 63 ].

Moreover, the combination of visual art and storytelling in comics makes them particularly accessible and engaging. For adolescents, the visual aspect can make complex themes more understandable and relatable. The format often allows for a more immediate emotional connection, as facial expressions, body language, and visual metaphors complement the narrative [ 64 ].

The comic book medium encompasses a wide range of genres, from superhero tales to slice-of-life stories, fantasy, science fiction, and romance. This diversity means that there are narratives that can cater to various tastes and interests, all while providing meaningful LGBTQIA+ representation.

Delivering sexuality education focused on traditional heterosexuality (i.e., vaginal intercourse and reproduction) is not congruent with the daily experiences of youths today, many of whom are sexually fluid (and/or engage in a wide range of sexual practices regardless of sexual identity [ 54 , 65 ].

5. Conclusions

In light of the discussed contributions, it is of paramount importance that sex educators, but also all those who provide training to adolescents (teachers, parents, sport workers, and health professionals) engage in fully implementing the fundamentals of holistic sex education, which, as mentioned, involves an inclusive and cross-cutting epistemology [ 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ].

Inclusive education should discuss of all different experiences and practices, offering a non-judgmental environment and the possibility of feeling included in the education. In order to do this, it is important to have both a formal and an informal sexual education, suggesting also possible useful websites and/or apps that could be useful [ 3 , 78 ]. Narratives and comics could be two important tools to use with this specific target [ 54 , 63 ].

Different studies have demonstrated diminished well-being for lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA+) youths relative to their peers, with the most results focused on negative experiences at school as key factors associated with these differences [ 79 , 80 , 81 , 82 ].

All of this is central not only to make interventions more effective and more responsive to the needs of target audiences, but also to embrace the call of the technical documents to make sex education a process of growth, respect, and acceptance of all and for all.

In this regard, it is deemed necessary to further point out that knowing the specific educational needs of the LGBTQIA+ adolescent population does not mean working exclusively in the creation of ad hoc interventions.

Sexuality education that does not explicitly address diversity is ineffective for young people growing up in a world where sexual and gender diversity is prevalent and understandings of sexuality and gender differ significantly from previous generations. It is important that all young people—regardless of their gender identity—have access to appropriate and accurate information about sexuality that goes beyond the dominant heterosexist approach to include sexual and gender diversity. An inclusive approach to sexuality education should, at a minimum, mean that young people are well prepared for future consensual sexual relationships, whatever that may entail. Through an inclusive approach, all young people will have a better understanding of diversity.

The first limitation is that this is a narrative review, so a systematic one could provide data that are more detailed. Another limitation of the review is that it is based upon a compilation of peer-reviewed English and Spanish language literature. This literature largely comes from Europe and North America, much less often from Latin America and Australia, and Asian or African sources are completely absent. The studies referenced thus approach the subject of investigation from a predominantly Western perspective. The review provides little information on both the online sexual activities in non-Western populations and the non-English academic discourses on these activities. The last limitation that we think it is useful to address is that maybe different reviews could specifically concentrate on the different sexual and gender identities, in order to provide more detailed info on each of them.

What is proposed, instead, as a further perspective of development, is to broaden the attention and sensitivity in writing projects, defining themes, selecting tools and activities-stimulus, in order to make whole groups work, with all the different subjectivities and identities that compose and structure them. As highlighted by others [ 83 , 84 ] inclusivity in the wider school environment is central to LGBTQIA+ students’ sense of safety and belongingness in the school context.

Funding Statement

This research received no external funding.

Author Contributions

S.E.: Conceptualization; Validation; Writing—Review and Editing. M.G.: Conceptualization; Data Curation; Writing—Original Draft; R.S.: Methodology; Validation; Writing—Review and Editing. E.T.: Conceptualization; Validation; Writing—Review and Editing. All authors have read and agreed to the published version of the manuscript.

Conflicts of Interest

The authors declare no conflicts of interest.

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COMMENTS

Three Decades of Research: The Case for Comprehensive Sex Education
School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.
Full article: Assessing the role of school-based sex education in
All studies compared a school-based sex education intervention with a control group receiving no intervention (n = 14, ... The findings of this review have shown that school-based sex education interventions are giving greater attention to information relevant to risk reduction strategies (e.g. information on reproductive health and negative ...
Sex Education in the Spotlight: What Is Working? Systematic Review
Nevertheless, an overwhelming majority of studies in this field have shown that programs advocating abstinence-only-until-marriage (AOUM) are neither effective in delaying sexual debut nor in changing other sexual risk behaviors [14,15], and participants in abstinence-only sex education programs consider that these had only a low impact in ...
More comprehensive sex education reduced teen births: Quasi
Our analyses provide population-level causal evidence that funding for more comprehensive sex education led to an overall reduction in the teen birth rate at the county level of more than 3%. This study thus contributes causal evidence relevant to ongoing debates on the potential role more comprehensive sex education may play in reducing teen ...
Development of Contextually-relevant Sexuality Education: Lessons from
The effectiveness of school-based education programs depends highly on teachers. Studies have shown that instructors' commitment to, as well as comfort with the delivering of sex education impacted on ones' teaching ability . The positive relation between teachers training and implementation fidelity has been documented.
Comprehensive Sex Education Addressing Gender and Power: A ...
Background Delivered globally to promote adolescents' sexual and reproductive health, comprehensive sex education (CSE) is rights-based, holistic, and seeks to enhance young people's skills to foster respectful and healthy relationships. Previous research has demonstrated that CSE programmes that incorporate critical content on gender and power in relationships are more effective in ...
Sex Education in Schools
Developmentally appropriate sex education can be offered to students of any age within schools; however, research has overwhelmingly focused on youth between the ages of approximately 9 and 18. Similarly, this entry will focus on the impacts of sex education in schools that is delivered to students ages 9-18. While the goals of sex education ...
Sexuality Education for Children and Adolescents
Sexuality education can be disseminated through the 3 learning domains: cognitive (information), affective (feelings, values, and attitudes), and behavioral (communication, decision-making, and other skills). 5. Sexuality education is more than the instruction of children and adolescents on anatomy and the physiology of biological sex and ...
School-based Sex Education in the U.S. at a Crossroads: Taking the
School-based sex education in the U.S. is at a crossroads. The United Nations defines sex education as a curriculum-based process of teaching and learning about the cognitive, emotional, physical, and social aspects of sexuality [1]. Over many years, sex education has had strong support among both parents [2] and health professionals [3-6], yet the receipt of sex education among U.S ...
The impact of sex education mandates on teenage pregnancy
To date most studies of the impact of school-based sex education have focused either on specific, local interventions or experiences at a national level. In this paper, we use a new cross-country dataset to explore the extent to which laws on sex education affect teenage pregnancy rates in developed countries.
Three Decades of Research: The Case for Comprehensive Sex Education
Purpose: School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive ...
Comprehensive Sexuality Education
Data have shown that not all programs are equally effective for all ages, races and ethnicities, socioeconomic groups, and geographic areas; there is no "one size fits all" program. ... Although formal sex education varies in content across schools, studies have demonstrated that comprehensive sexuality education programs reduce the rates ...
Three Decades of Research: The Case for Comprehensive Sex Education
Public health practitioners and policy-makers have long considered school-based sex education to play a vital role in the sexual health and well-being of young people. Likewise, surveys of the public over several decades have consistently shown strong support for comprehensive sex education (CSE; also known as comprehensive sexuality education ...
Comprehensive Sex Education—Why Should We Care?
Sex education beginning in elementary school with a scaffolded approach and longer duration was shown to have significant impact on prevention of child abuse, social/emotional learning, better media literacy, fostering healthy sexual relationships, and decreased intimate partner violence. 8 The authors recommended national standards of CSE ...
Study Finds that Comprehensive Sex Education Reduces Teen Pregnancy
March 28, 2008. Researchers from the University of Washington found that adolescents who receive comprehensive sex education are significantly less likely to become pregnant than adolescents who receive abstinence-only-until-marriage or no formal sex education. The study, based on a national survey of 1,719 teens ages 15 to 19, is the first ...
A Meta-Analysis of the Effects of Comprehensive Sexuality Education
1. Introduction. The awareness of one's own sexuality is formed during childhood and adolescence and continues to develop and change throughout life [].Proper sexual education during childhood and adolescence is especially important for holistic growth and the development of healthy self-concepts [].Individuals establish independence and autonomy within the context of social and cultural ...
Sex Education that Goes Beyond Sex
Sex education, they say, should also be about relationships. Giving students a foundation in relationship-building and centering the notion of care for others can enhance wellbeing and pave the way for healthy intimacy in the future, experts say. It can prevent or counter gender stereotyping and bias. And it could minimize instances of sexual ...
What Works In Schools : Sexual Health Education
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 ...
New research: Quality sex education has broad, long-term benefits for
The paper found that sex education efforts can also succeed in classrooms outside of the health education curriculum. Given that most schools have limited time allotted to health or sex education, a coordinated and concerted effort to teach and reinforce important sexual health concepts throughout other areas of the curriculum is a promising ...
Federally Funded Sex Education Programs Linked to Decline in Teen ...
Photo credit: Alexmia/Getty Images. The implementation of federally funded sex education programs over a decade ago was followed by a decline in teen births in counties where these programs were implemented, finds a new study. The research, which encompasses a 20-year period, offers a long-term assessment of the impact of comprehensive sex ...
Comprehensive sexuality education
Comprehensive sexuality education (CSE) gives young people accurate, age-appropriate information about sexuality and their sexual and reproductive health, which is critical for their health and survival. While CSE programmes will be different everywhere, the - which was developed together by UNESCO, UNFPA, UNICEF, UN Women, UNAIDS and WHO ...
Sex Ed in Schools: What Parents Need to Know
Sex education in schools can be taught by a classroom teacher, school nurse or an outside speaker, and often begins in fifth grade. For some parents, the term "sex ed" conjures memories of dated ...
Comprehensive sexuality education: For healthy, informed and ...
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 ...
Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?
An additional study conducted in the United States collected information on the primary and secondary school sex education experiences of transgender youth (AMAB, AFAB, nonbinary) across a wide range of programs. These reports severely lack information on various identities, such as the complete absence of information on queer identities.