sex education in schools around the world

The journey towards comprehensive sexuality education: Global status report

Publication year: 2021.

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Comprehensive sexuality education is central to children and young people’s health and well-being, equipping them with the knowledge and skills they need to make healthy, informed, and responsible choices in their lives, including to prevent HIV and promote gender equality.

This report seeks to provide an analysis of countries’ progress towards delivering good quality school-based comprehensive sexuality education to all learners around the world.

The report is intended to help inform continued advocacy and resourcing efforts, as governments and partners work towards the goal of ensuring all learners receive good quality comprehensive sexuality education throughout their schooling.

The review maps out a number of forward-looking recommendations to countries, including actions to ensure implementation of policies and programmes that:

• support the availability of good quality comprehensive sexuality education for all learners;
• increase investments in quality curriculum reform and teacher training; and
• strengthen monitoring of the implementation of comprehensive sexuality education.

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International technical guidance on sexuality education

An evidence-informed approach

- Revised edition - 

Comprehensive sexuality education (CSE) plays a central role in the preparation of young people for a safe, productive, fulfilling life in a world where HIV and AIDS, sexually transmitted infections (STIs), unintended pregnancies, gender-based violence (GBV) and gender inequality still pose serious risks to their well-being. However, despite clear and compelling evidence for the benefits of high-quality, curriculum-based CSE, few children and young people receive preparation for their lives that empowers them to take control and make informed decisions about their sexuality and relationships freely and responsibly.

Countries are increasingly acknowledging the importance of equipping young people with the knowledge and skills to make responsible choices in their lives, particularly in a context where they have greater exposure to sexually explicit material through the Internet and other media. 

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What great sex education looks like around the world

There are more young people in the world than ever before. With this in mind, sex education is critical for young people to realizing and claiming their human rights.

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There are more young people in the world than ever before. With this in mind, sex education – or as we call it, Comprehensive Sexuality Education (CSE) – is critical for young people to realizing and claiming their human rights.

Sexuality is a fundamental aspect of human life. Being able to express one’s own sexuality freely and openly is central to being human and is important to young people’s well-being, happiness and health. When young people are supported to become critical thinkers, empowered in their sexuality, and informed about their sexual and reproductive choices, the positive impact is felt across society. 

Without great CSE, young women and girls in particular can experience severe forms of inequalities – including sexual violence, child, early and forced marriage, female genital mutilation (FGM), and other harmful practices.

So you get the point – CSE is absolutely vital, and this is what it looks like around the world when it’s done brilliantly:

Every Saturday, about 40 people gather at a youth center in Mekelle, Ethiopia, to hear about a subject they don’t get taught in schools, and don’t want to discuss with their parents – sexual and reproductive health. 

This youth center, located in the Tigray region, is run by the Family Guidance Association of Ethiopia. It has a playground and library at the front for studying and socializing, and in the back lies a clinic offering free contraceptives, abortion care, and STI testing. The center is aimed at people aged between 10 and 24 years old and runs a range of activities, including weekend group sessions where young people usually do some performance art based on a particular SRH subject, and hold debates and discussions around a coffee ceremony – a traditional Ethiopian social gathering. “I’m proud of this work because I am educating my friends and my family and protecting them,” says Teklehaimanot, a young volunteer at the center. Learn more about the Mekelle center  

21 January 2022

Comprehensive Sex Education

A volunteer at Makelle demonstrates to a group of young people how to put on a condom

Serbia, Romania, Latvia, and Estonia

Can relationship and sexuality education help prevent violence? Through theatre-based workshops, the Youth SpectActors project is aiming to do just that in Serbia, Romania, Latvia, and Estonia. Adolescents are encouraged to take part in role plays and walk in one another's shoes in order to help challenge and dismantle harmful gender roles. 

“I found it amusing to have to role play [as a boy]...I actually noticed what type of stereotypes boys have about girls and how they consider a girl should act,” says Valentina, a participant from Romania. Learn more about this type of 'social theatre'

Peer educator Chariette Socgnia Nguepi juggles her full time-time job as a phone counsellor for young people with organizing education sessions with young people on sexual health through Cameroon National Planning Association for Family Welfare (CAMNAFAW). 

Chariette, third from right, during a discussion about contraception with a group of adolescents

Chariette’s work day starts at 7am, when she takes calls all morning from young people on a range of topics including pregnancy and violent partners. She then settles in for an afternoon session in a school or youth center to provide accurate information on STIs, contraception, pregnancy and much more. Learn more about Chariette’s work  

The Palestinian Family Planning and Protection Association (PFPPA) has been considered a pioneer in its CSE program since 2013. Throughout the years, the activities implemented have been diverse: from advocating for changes in school curriculums, to running youth summer camps and facilitating peer education. PFPPA continues in its efforts to ensure no one is left behind, placing an emphasis in reaching young people residing in remote and marginalized areas, refugee camps, and within the West Bank and the Gaza Strip.

Palestinian youth taking part in a CSE workshop

In 2021, over 13,000 people aged 15 to 25 were provided with CSE sessions, of which approximately a third were reached through social media channels. These online channels were further developed to deal with the obstacle of not being able to deliver services face-to-face during the COVID-19 pandemic. Over 60% of those reached were female, and nearly 40% were reached by their own peers.  Follow PFPPA on Instagram

Before the COVID-19 pandemic, the Famia Planea Aruba would regularly run sessions in schools for students aged 11 to 13, when young people are starting to experience changes to their bodies and hormones. Suddenly, FPA were bombarded by parents requesting one-on-one sex education sessions, but lockdown restrictions ruled this out as an option. “That was when we started looking for a way to reach both parent and child in the safety of their own homes,” says Evelyn Yarzagaray, FPA’s Executive Director. 

A mother and daughter watch a sex education video together

Her team embraced the challenge by creating, developing, and launching FPA’s first Online Puberty Educational News Program (OPEN). “By converting materials used during our in-person CSE program, we developed an educational video that can be viewed by both parent and child”, says Evelyn. Learn more about OPEN and FPA’s work

Ghana 

The Planned Parenthood Association of Ghana is a real masterclass in innovative strategies to advance sex education. For example, their “Sista's Clubs” seek to create safe spaces for adolescent girls to interact and grow, where they can learn about issues such as sexual and gender-based violence and pregnancy. PPAG also launched the Yenkasa Hotline last year, a toll-free confidential contact centre staffed by friendly peer counsellors, as well as the Girl Bozz Programme, which seeks to provide young girls with a comprehensive ecosystem to access sexual and reproductive health services and information through outreaches, referral partnership programmes with pharmacies and chemists, and support through the Yenkasa Hotline. Follow the Planned Parenthood Association of Ghana on Twitter

El Salvador 

ADS/Pro-Familia, IPPF’s Member Association in El Salvador, proudly trains roughly 600 young people a year in being peer educators, who in turn share their knowledge, reaching nearly 6,000 other youth with their active participation. They also have a confidential hotline and an app specifically for adolescents to access information and guidance, and the youth volunteers have a theater group to promote CSE. Follow ADS/Pro-Familia on Twitter  

An outdoor sex education session in El Salvador

CSE: a win for everyone

It is clear that a great CSE program can empower, build self-esteem, and lead to better health and well-being for young people. Additionally, they have been shown to be not only cost-effective, but also cost saving for governments – a win for everyone. 

The starting point, and the absolute minimum requirement, is that CSE must reach all young people – wherever they are, both in and out of school. But a final reminder that we cannot achieve gender transformative change by focusing only on health outcomes. We must equip young people with information about health as well as positive aspects of sex and sexuality, including pleasure and consent. After all, it is their human right.  

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Advancing Sexuality Education in Developing Countries: Evidence and Implications

Educators, researchers, policymakers and parents alike have become increasingly interested in the potential for sexuality education to help meet the needs of young people. The quality and quantity of evaluation research in this field has improved dramatically over the last decade, and there is now clear evidence that sexuality education programs can help young people to delay sexual activity and improve their contraceptive use when they begin to have sex. Moreover, studies to date provide an evidence base for programs that go beyond just reducing the risks of sexual activity- namely, unintended pregnancy and sexually transmitted infections (STIs)-to instead address young people's sexual health and well-being more holistically. Yet, the fact remains that, too often, young people do not get even the most basic sexuality education and that misinformation about sex and its consequences remains common. Indeed, implementing comprehensive sexuality education programs remains a challenge in many parts of the world. To address these challenges, experts say that stronger responses are needed to engage governments, communities, families and young people themselves in sexuality education policies and programs. Specifically, they assert that sexuality education policies and programs must be based in human rights and respond to the interests, needs and experiences of young people themselves.

How Different Sex Education Methods Affect Students Around The World

Across the nation, students have vastly different experiences learning about a somewhat taboo but super important health topic: sexual health education, or sex ed.

According to  Sex Ed for Social Change , or SIECUS, 29 states and D.C. mandate sex ed as of July 2022. But 17 of those states require that abstinence be stressed, and only 11 of them require the curriculum to be medically accurate. Some states choose to leave discussions around healthy relationships, contraception and sexual orientation out of the conversation entirely.  

"Due to the lack of guidance and policy implementation at the federal level, the United States has a patchwork of laws that vary, which determine what and if sex education is being taught," said Michelle Slaybaugh, director of social impact and strategic communications at SIECUS. "When it comes to education, policy, decisions have largely been left to local control, So we're talking very local at the school board level, not even the city or state level. It's very, very local." 

Currently at the federal level, SIECUS is one group working to get the Real Education and Access for Healthy Youth Act passed. This legislation promotes comprehensive sex ed, which means giving young people the knowledge and skills they need to make healthy choices about their sexual lives, and the act makes sure access to this education is protected.

Related Story Why Isn't There Consensus On Sex Education?

In March, Congress passed the Consolidated Appropriations Act of 2022, but funding for comprehensive sex ed programs is not included.

On the state level, according to the SIECUS mid-year report, the number of bills introduced this year aimed at restricting sex ed was almost equal to the number of bills introduced advancing sex ed. But more regressive bills were passed in states this legislative session than progressive ones.

"I think there is this big myth that if we teach young people about sex, that they're going to go and have it," Slaybaugh said. "The evidence does not show that. Additionally, I think it is very important for us to understand that age appropriate or developmentally appropriate sex education is key."

A Georgetown University study shows that sex ed helps with a lot of things, like preventing unplanned pregnancy, maternal death, unsafe abortions and sexually transmitted diseases. But a survey from the Public Religion Institute found that nearly a quarter of millennials were not taught sex ed in middle or high school.

There is also a big gap in sex ed that's inclusive and talks about LGBTQ+ identities. Less than 10% of LGBTQ+ students say their school's sex ed is inclusive. When talking about gender identity and orientation, this is sometimes where curriculum can become "medically inaccurate." 

"Medically accurate sex education is vital to promoting long term health outcomes, and a part of that, which I think is really where we're seeing the rub, is this idea of gender norms, gender stereotypes and orientation," Slaybaugh said. 

Florida in particular has become a bit of a hotspot when it comes to sex ed and what can or should be taught. New laws there, like what critics dubbed the " Don't Say Gay " bill, limit discussion of sexuality and gender identity for some elementary students.

Related Story Curriculum Wars Are Intensifying Amid Rising Teacher Burnout

Katie Lagrone , a correspondent at Newsy's sister station in Tampa, Florida, explains a confusing mix of standards on whether the new laws are altering old policies on sex ed.

"In Florida, while laws mandate health education include teen dating and disease control, we discovered there's actually no statewide curriculum for sex education," Lagrone said. "What and how students are taught about sexual and reproductive health is left to individual school boards who approve policies, principals who interpret them and instructors who ultimately drill it down for students. What's more… we found about a one-third of Florida's 67 school districts are teaching students, even high schoolers, abstinence only."

Studies show abstinence-only instruction doesn't prevent teens from having sex. In fact, a 2019 study by the CDC found by the 12th grade, more than half of Florida teens surveyed have already engaged in sexual intercourse, with some STD rates among teens in Florida being four times higher than the national average.

In some counties that have adopted this abstinence-only teaching method in Florida, teen birth rates are actually higher. One district spokesperson told Newsy these limits are because they "are respectful of parents rights."

Elsewhere in the world, some countries have been recognized for comprehensive sex ed programs that help combat these issues, especially in Europe.

In the Netherlands, it's required by law that all primary school students are taught sex ed. It starts as early as 4-years-old, but they're not talking about the full birds and the bees at that age. They are simply covering the basics of healthy relationships.

In the U.S., some people argue that that is too young to be teaching sex ed, but three decades of research shows that sex ed can help prevent child abuse.

On average, teens in the Netherlands are also waiting longer to have sex when compared to Europe or the U.S. Researchers found that most young people in the Netherlands had "wanted and fun" first sexual experiences, while many American teens said they wished they waited longer to have sex for the first time.

The Netherlands has one of the lowest teen pregnancy rates in the world. Dutch teens are some of the most likely to use birth control pills, though part of that could be because contraception is easily accessible.

The Netherlands also works to educate parents on how to talk to their kids about sex to help get everyone on the same page.

In Denmark, for a long time, their sex ed program emphasized preventing unplanned pregnancy and promoting safe sex. In 2015, the country's birth rate fell below the rate necessary to maintain population, and Danish officials went as far as actually encouraging people to have babies at a younger age. At the time, only point 5% of teen girls in Denmark had a baby. That rate was six times higher in the United States.

In recent years, the birth rate has started to rise again. While neither Denmark nor any country has a perfect system, they experienced some outcomes that other places could learn from.  

This highlights good models for comprehensive sex ed, but there are also other countries, like the U.S., where it isn't widely taught, there are inconsistencies or it's not available at all. Experts stress the importance of making sure students have the information necessary to live healthy lives.  

"We really need to push for something that is rooted in age-appropriate, medically-accurate and affirming content that is taught by trained educators to be able to deliver the most comprehensive and age-appropriate education around sexuality as possible," Slaybaugh said.

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5 Places Around The World Where Sex Ed Is Changing

By: Rachel Sanoff

Publisher: Bustle

Date: May 5, 2015

The incredible work of activists across college campuses has opened up a long overdue conversation about consent and  sexual education in schools . At the same time, horrifying rapes at high schools in  Steubenville ,  Maryville , and  Texas  have become national news stories.  STD outbreaks  are happening at schools where there’s no sex ed. Survivors and advocates are encouraging comprehensive sex education as a method to combat the sexual violence that is often ignored and normalized in our culture.

A few months ago, two Democratic senators introduced a bill, the Teach Safe Relationships Act of 2015, that would make it  mandatory to include curriculum about consent, emotional safety, and dating and domestic violence in sex education programs at public middle and high schools . Organizations such as  Partners in Sex Education  in Boston, Massachusetts are already bringing comprehensive and progressive sex education to many public schools in the city. Educators, many with backgrounds in queer justice and disability justice, host workshops that teach consent, communication, contraception, and healthy relationships at various middle and high schools.

Ontario, Canada has adopted a new program for middle and high schools that will teach same-sex relationships, gender identities that go beyond the binary, sexually transmitted diseases, and masturbation — among other topics.  Despite organized strikes by conservative parents , Ontario Premier Kathleen Wynne spoke in support of the curriculum with the badass response that angered parents “ will have to agree to disagree .”This is an exciting and important time for sex education and consent advocacy worldwide, so let’s take a look at a few other cities and countries where sex education is changing for the better:

1. New Zealand

Towards the end of April, government health officials announced a plan to improve youths’ sexual and reproductive health in New Zealand not only by  increasing access to education for teenagers, but by educating community leaders about problems faced by the country’s younger population . Nancy Pego, the adolescent health program coordinator for Solomon Islands Ministry of Health, says the topic of youth sexuality is ” …a bit sensitive in our country.” Pego hopes that once older and respected community members learn about the increasing rate of unplanned pregnancy and STD transmissions among youth, they will understand the need for comprehensive sex education, and encourage teenage access to contraceptives and reproductive health information. The government is funding such initiatives in Solomon Islands, Tonga, Samoa, Vanuatu, and Kiribati — regions of New Zealand where sex ed is especially lacking. Pego also says that the Ministry of Health is planning to develop youth recreation centers that offer sexual and reproductive health services in rural areas so that teens in those communities will have increased access to medical and educational resources.

This year, the  Personal, Social, and Health Education Association  (PSHE Association), as a part of the Call to End Violence Against Women and Girls, has instituted an  education program to teach sexual consent to students as young as 11 ! The program came into fruition, as the PSHE Association described, at a “crucial time.” The Office for National Statistics (ONS) reports that, in 2014, over “7,000 sexual assaults against children aged 13 or younger, and more than 4,000 rapes of children under 16” were recorded by police — a horrific piece of information. While, not surprisingly, the program is attracting controversy, teachers who have adopted it into their curriculum embrace its ability to educate young students about consent and healthy relationships in a safe space within an unsafe world. As Phil Ward, head teacher of Heston Community School, says, “We need to provide opportunities for young people to think about what consent means, because they’re going to face experiences in their lives which could involve sexual assault or even rape.” PSHE defines consent in a healthy relationship as an agreement that must be directly asked for, and that can be “withdrawn at any moment.” The consent lessons for 11-year-olds include exercises such as telling a classmate to stop moving towards them once they feel their personal space is being invaded, and discussing who should ask for consent during an encounter wherein personal space is invaded (the person initiating the contact). Participation in the PSHE program for 11-16 year old students is not mandatory for schools, but we can only hope that more schools will sign up and adopt the program into their curriculum. It is already apparent how important it is for young children to learn that they are allowed to say no. As a young 12-year-old student named Ayesha said after a lesson, “If a stranger walks up to you and does something you don’t like, I think you should have the confidence to tell him or her ‘No.’ Saying ‘No’ doesn’t mean you’re being rude… it means that you don’t like someone to be entering your personal space.”

3. New Orleans, Louisiana

Some New Orleans politicians are describing the issues of teenage pregnancy and STD transmission as “out of control,” and many community members are referring to it as a crisis. To combat the upsetting state of teenage reproductive and sexual health, Democratic State Representatives in New Orleans are currently proposing “ a bill that would mandate sex education for public school students in grades seven to 12 ” in the Orleans Parish school district. On April 29, the House Education Committee voted 8-6 to pass the bill through the House panel. While all public schools in New Orleans currently have the option of teaching sex ed, it is not a requirement and that is what House Bill 359 is trying to change. The results of lacking education about safe sex are painfully obvious, as State Rep. Patricia Smith, D-Baton Rouge mentioned hearing some teenage girls discuss drinking Mountain Dew soda as a way to stop pregnancies.

If the bill becomes law, parental rights will still allow parents to remove their kids from the lessons, but the bill will also grant public schools the option to teach sex ed to students from third grade to sixth grade. A similar bill was voted down last year, and there is still much opposition to HB 359, especially from Christian organizations who don’t want youth to learn about contraceptives. Because that’s worked out so well. If the bill is successful (FINGERS CROSSED!), comprehensive sex ed will be mandatory beginning in the 2017-18 school year.

4. Indonesia

In the last week of April of this year,  five Indonesian civil society organizations hosted a large conference pushing for comprehensive sex education for the nation’s youth . School district leaders, Social Affairs Minister Khofifah Indar Parawansa, and hundreds of young students attended the event in Jakarta and called for community members and government leaders to support a new program. The conference comes at a time when survivors of sexual assault in Indonesia are getting younger and younger, as they are most frequently aged between 13 and 18 years old. A goal of the conference is for comprehensive sexual education to be used as a weapon against sexual assault toward teenagers, so the desired curriculum discussed would not only encompass reproduction and sexually transmitted diseases, but also healthy vs. abusive relationships, “empowerment, and anti-violence skills.”

5. Guatemala

Activists in Guatemala have been working to bring comprehensive sex education to the country for years. Lack of access to contraceptives, lack of education regarding reproductive/sexual health, and increasing sexual abuse toward young girls has resulted in 1 in 5 mothers being aged between 10 and 19. Ana Lucía Ramazzini, a Guatemalan sex educator, as well as a sociologist and women’s rights activist, told a newspaper last year that  sex education cannot be successful in Guatemala without being taught from a feminist viewpoint that addresses consent, assault, and the power dynamics and social inequalities between men and women . Specifically, she mentioned that the sex education courses have to challenge the cultural ideology that girls are only meant to be mothers, discuss gender-based violence as criminal behavior and teach students how to identify assault, and challenge gender and sexuality stereotypes in the media and culture, especially the stereotypes that strip women of their bodily autonomy. In 2013, the ministries for health and education began creating a program for nine regions in Guatemala, similar to the curriculum Ramazzini described. There are ten organizations working together for Campaña Nacional por la Educación Sexual to increase the program’s reach and funding.

Organizations such as Asociacion Pro-Bienestar de la Familia de Guatemala (APROFAM) are especially focused on bringing  comprehensive sex education to rural areas where there is limited access to both contraceptives and sex education . APROFAM also spends a lot of its energy on re-education, as men and religious ideology have long had power over the cultural beliefs regarding consent and reproduction. APROFAM designs lessons to teach men new ideas about family planning and gender equality, and also “provides counseling for women to raise their self-esteem, and runs workshops and discussion groups aimed at asserting women’s rights to control their own health and well-being.” Likewise,  Incide Joven  is a youth-run organization that exists to bring comprehensive sex education and resources to rural areas where young Guatemalans are without access to contraception, STD testing, psychological counseling, and other services.

Source: https://www.bustle.com/articles/80266-5-places-around-the-world-where-sex-education-is-improving-because-comprehensive-and-progressive-programs-do

Comment: The above article discusses the change being made within public schools around the world. In 2015, Democratice senators introduced a bill called the Teach Safe Relationships Act in the United states. The act makes it mandatory to include information and teachings about consent, emotional safety, dating, and domestic violence in public high schools. New Zealand has attempted to increase sex education to teen agers but also educate the rest of the community, especially leaders on problems faced by the country’s younger population including teen pregancy. Over the years, it has been England and Indonesia’s mission to reduce the number of reported rapes, more specifically in adolescent children under the age of 16. Louisiana claims that STD and teen pregnancy reports have sky-rocketted and they have worked towards a bill that would mandate sex ed for public schools 7-12.

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I found that Guatemala’s case can be very typical among developing countries. Successful sex education must depend on a gender-equal social environment.

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Federal Policy Snapshots

Federally Funded Sex Education: Strengthening and Expanding Evidence-Based Programs

Reproductive rights are under attack. Will you help us fight back with facts?

All young people should have access to comprehensive sexual and reproductive health information that is medically accurate, LGBTQ inclusive, and culturally and age appropriate so that they can make informed decisions about their sexual behavior, relationships and reproductive choices. Sex is already part of many adolescents’ lives , and they deserve to receive high-quality information to inform their decision-making. Unfortunately, just 30 states and the District of Columbia require sex education to be taught in schools, and fewer states require that the school curricula include key sex education topics or even medically accurate information. The federal government also wastes $110 million per year on misleading and harmful programs that only cover abstinence. Federal policymakers have an opportunity to strengthen existing sex education programs by funding them at adequate levels and to create a new comprehensive sex education funding stream through the Real Education and Access for Healthy Youth Act.

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How federally funded sex education programs work

There are currently two federal funding streams for evidence-based and medically accurate sex education: the Teen Pregnancy Prevention Program (TPPP) and the Personal Responsibility Education Program (PREP).

Teen Pregnancy Prevention Program

• TPPP supports the implementation and evaluation of evidence-based programs and innovative approaches to reducing pregnancy among adolescents. Its primary purpose is to build an evidence base of effective sex education programs.
• The program was established in 2010. Since 2014, it has been funded at $101 million each year. Ten percent of funding goes to training, technical assistance, evaluation and other forms of program support. Of the remaining funds, 75% goes to grantees that replicate effective programs (Tier 1) and 25% goes to grantees that test innovative strategies to reduce adolescent pregnancy rates (Tier 2). Both Tier 1 and Tier 2 programs are evaluated as part of TPPP.
• The program currently supports Tier 1 grants in 29 states and Puerto Rico and Tier 2 grants in 13 states. Grantees include for-profit and nonprofit organizations, clinics, hospitals, state and local governments, schools and universities.

Personal Responsibility Education Program

• PREP supports a variety of evidence-based programs that aim to prevent pregnancy and STIs among adolescents by emphasizing abstinence and contraception.
• The program focuses on young people aged 10–19 who are homeless, in or aging out of foster care, living with HIV or AIDS, victims of human trafficking or living in areas with high adolescent birth rates. It also focuses on people younger than 21 who are pregnant or parenting.
• The program was established in 2010 and has been funded at $75 million per year.
• PREP currently supports three types of grantees— state , tribal and nongovernmental —across 50 states , the District of Columbia and seven territories or countries.
• PREP-funded curricula are not required to be comprehensive, but the majority incorporate elements of comprehensive sex education: healthy relationships (98%), healthy life skills (81%) and adolescent development (73%).

Comprehensive sex education

• There are currently no federal programs dedicated to funding and expanding access to comprehensive sex education, which is considered the gold standard of sex education.
• Comprehensive sex education covers a broad range of topics, including human development, relationships, communication and decision-making skills, sexual behavior, sexual health, and cultural representations of sexuality and gender. These curricula frame sexuality as a normal part of life and are medically accurate, LGBTQ inclusive, and culturally and age appropriate.

Impact of sex education programs

• To date, HHS has identified 48 programs funded by TPPP that meet criteria for program effectiveness, including one or more favored outcomes in increased contraceptive use or reduced sexual activity, number of sexual partners, STIs or pregnancy.
• These programs and their evaluations provide useful information about where, when and with whom programs are most effective, allowing program organizers to design curricula that best fit their context and audience.
• Curricula funded by PREP fulfill the goals of the program by changing behaviors related to pregnancy risk. For example, after taking part in PREP-funded curriculum in 2016–2017, half of participants said they were more likely to abstain from sex for the next six months. Among those who said they might have sex, 70% reported they were more likely to use birth control and 77% were more likely to use a condom than before participating.
• PREP curricula also resonate with young people: About 70% of participants expressed interest in the content, 87% felt respected by the program, and more than 70% said that PREP helped them prepare for adulthood.
• A 2018 review of curricula from around the world, commissioned by the United Nations, found that comprehensive sex education programs contribute to numerous outcomes for adolescents, including delayed initiation and decreased frequency of sexual intercourse, fewer sexual partners and increased use of condoms and other contraceptives.
• Research indicates that comprehensive sex education programs also can reduce homophobia, expand students’ understanding of gender and gender norms, decrease intimate partner violence and improve communication skills.

What policymakers can do

Congress and the Biden-Harris administration should take the following steps:

• Pass the Real Education and Access for Healthy Youth Act , which would—among other provisions—eliminate funding streams for abstinence-only-until-marriage programs and establish five-year grants for comprehensive sex education programs. Curricula funded through these grants must follow standards established by experts and cover a variety of sex and sexuality topics, including puberty and adolescent development; anatomy and physiology; sexual orientation, gender identity and gender expression; contraception, pregnancy and reproduction; STIs, including HIV; healthy relationships; and interpersonal violence.
• Increase annual TPPP funding to $150 million to help the Biden-Harris administration restore program integrity, high-quality evaluation and adequate technical support after years of damage under the Trump-Pence administration. Notably, the prior administration halted funding to the Teen Pregnancy Prevention Evidence Review , which informs TPPP grantmaking by systematically reviewing teen pregnancy prevention research.
• Increase PREP funding to $150 million for five years, which would allow the program to double the number of young people served, from 110,000 to 220,000 annually. Guaranteed funding for five years would enable grantees to develop programs that best fit their communities’ needs as they recover from the pandemic .
• Eliminate abstinence-only programs. Abstinence-only programs are not sex education—they are misinformation campaigns that fail to meet the needs of young people. Congress must stop funding programs that stigmatize sex, ignore or bully LGBTQ children and reinforce harmful gender norms.

Adolescents' Receipt of Sex Education in a Nationally Representative Sample, 2011–2019

The path ahead: restoring and advancing sexual and reproductive health and rights, sex and hiv education, adolescents deserve better: what the biden-harris administration and congress can do to bolster young people’s sexual and reproductive health, assessing state-level variations in high school students’ sexual and contraceptive behavior: the 2019 youth risk behavior surveys, adolescent sexual and reproductive health in the united states, united states.

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The Facts of Life

Sex ed around the world, by jill lepore.

Too Hot to Handle: A Global History of Sex Education

By jonathan zimmerman.

"'Where do little children come from?’ This is an embarrassing question,” admitted Jean-Jacques Rousseau. Best, he thought, was to hope your kid doesn’t ask it. But if the question does come up, Rousseau advised in 1762, answer it “with the greatest plainness, without mystery or confusion.” The important thing is to avoid having this conversation with your kid during the impossible years. Wrote Rousseau: “If you are not sure of keeping him in ignorance of the difference between the sexes till he is sixteen, take care you teach him before he is ten.”

It’s not the worst advice I’ve ever heard, but honestly, what on earth did Rousseau know about it? He had five illegitimate children and, at birth, deposited all of them in a foundling hospital in Paris, l’Hôpital des Enfants-Trouvés. Every year, it seems, his mistress got pregnant: “There came the same inconvenience and the same expedient,” as he put it in his Confessions , a book of remorse. Rousseau’s children almost certainly died as infants—at the time, seven out of ten newborns left at the hospital died in their first year—and in any case, he never saw any of them ever again.

It might be that Rousseau is an extreme case, but suffice it to say, there is no end to the hypocrisy of people who tell other people how or whether or when to tell kids about sex. Much the same, in fact, can be said of people who tell other people how to run their countries. That’s because teaching sex in schools, as educational policy, has rather a lot in common with foreign policy, not least in the way that arrogance, suspicion, and self-interest override generosity, cooperation, and amity. In the eighteenth century, Rousseau told other parents how to talk to their children about sex; at the start of the twentieth century, in some countries, the task of explaining sex began to move from the home to the school; and by the middle of the century, those countries started telling other countries how to teach sex in their schools, too. In Europe and the United States, sex ed began about 1913, at the height of the Progressive movement—a moment, one commentator remarked, when the clock chimed “Sex O’Clock in America.” A century later, it’s sex o’clock all over the world.

There is no end to the hypocrisy of people who tell other people how or whether or when to tell kids about sex.

Not surprisingly, this has proved controversial. Human sexuality and reproduction are matters of biology, but they’re much more than that, too. Sex can be spiritual; many people consider it sacred. It has medical implications and economic consequences. And the forms it takes are regulated both by legal statutes and by religious strictures. Sex, in short, is not easily contained. It’s also hard to talk to kids about it without making judgments and setting rules, which, in any case, is usually the point.

Where, what, and when should kids learn about sex? On this subject, there is a great deal of disagreement, from house to house, from nation to nation, and from one era to another. Disputes about teaching sex in schools have commonly been figured as fights between traditionalists and modernists, like the debate over the teaching of evolution, or as battles over authority in which the family or religion vies against the state or science. Those were once tenable interpretations; they aren’t any longer. Why that is can be seen only from the vantage of history.

BIRDS, BEES, AND ABCS

The rise of sex education a century ago depended on two things: the development of the biological sciences and the rise of public schooling. A mammalian egg was first seen only in 1827, and before the 1840s, no one knew that human females ovulated monthly; the menstrual cycle remained a mystery, as did what determines the sex of a human embryo. In the second half of the nineteenth century, Darwin’s On the Origin of the Species transformed the study of evolution and genetics. Meanwhile, the development of germ theory and the discovery of antibiotics launched a series of campaigns to eradicate contagious diseases.

These revolutions in the biological sciences happened to coincide with the emergence of the modern public school system in the United States and much of Europe. To reformers, bringing the study of human sexuality and reproduction into those schools seemed not only logical but also inevitable, as Jonathan Zimmerman demonstrates in a rich new study, Too Hot to Handle . The educational argument seemed self-evident (surely biology belongs on the curriculum), and the public health argument seemed clear, too (explaining human reproduction in schools was meant to halt the spread of sexually transmitted diseases). A staggering number of soldiers had contracted venereal diseases during World War I. In the United Kingdom, reformers founded the National Council for Combating Venereal Disease, later known as the British Social Hygiene Council. That group had its analog in the United States in the American Federation for Sex Hygiene, later combined with another group to form the American Social Hygiene Association and today called the American Sexual Health Association (ASHA). By the 1920s, 40 percent of schools in the United States offered some form of instruction in human reproduction.

There were classes in much of Europe as well. They took many names, from Mothercraft in Denmark to Marriage and Motherhood in Germany. Sex ed was most widespread in Sweden, owing in great part to the leadership of the social activist Elise Ottesen-Jensen, who in 1933 founded the Swedish Association for Sexuality Education. (In 1956, Sweden became the first country to mandate instruction in sex in schools.)

Wherever it is taught, sex ed carries with it a national character and a political slant. (So does a lot of what’s taught in high schools.) In Russia, a 1925 essay titled “Sexual Education in the Context of Marxist Pedagogy” condemned masturbation as counterrevolutionary. In Mexico, sex education in schools was recommended by the socialist government, and protested by the Catholic Church.

Moviegoers outside of a theater showing a sex-education film in Bundaberg, Australia, 1949.

Like much else in the Progressive era, including intelligence testing, the birth control movement, and immigration law, sex education had ties to eugenics. Teaching the science of sex, social hygiene reformers believed, would not only help stop the spread of venereal diseases and end ignorance but also improve the “race.” Mexico’s sex-education program was the product of cooperation between the National Block of Revolutionary Women and the Mexican Eugenics Society. “A carefully devised scheme of biological training could not fail to stimulate a sense of individual responsibility in the exercise of the racial function,” stated a resolution introduced by the British delegation to the League of Nations in 1928. In support of the resolution, ASHA pledged $5,000 to fund a study of “the methods adopted in various countries for the imparting of sex knowledge to young people.” The League of Nations demurred, one Belgian delegate remarking that he didn’t think the matter lent itself to international cooperation. And maybe it doesn’t.

Nevertheless, as Zimmerman demonstrates, Western nations “spread the subject to their overseas colonies and territories.” They met with considerable resistance. In India, Mahatma Gandhi declared sex “too special and sacred a subject” for the classroom.

A FEMINIST CAUSE

Zimmerman’s account is patchy. He pays almost no attention to the calls for sex education sounded by feminists, or to the movement itself as a feminist cause, and although he is interested in venereal diseases (and therefore in condoms), he is much less interested in the relationship between education and other forms of contraception. Beginning in the 1910s, feminists, who quite explicitly linked sex education with birth control (and with the broader need for public education for girls), made some of the strongest and best arguments for introducing the study of human sexuality into the public school curriculum. Zimmerman doesn’t much consider those arguments. Nor does he reckon with the degree to which resistance to sex education, in the United States and around the world, is very often part of a larger rejection of claims for political and economic equality 
for women.

Wherever it is taught, sex ed carries with it a national character and a political slant.

This shortcoming affects Zimmerman’s account of the second half of the twentieth century, too. World War II led to yet another dramatic rise in sexually transmitted diseases and, with it, new and broader support for education aimed at combating them. After the war, American nongovernmental organizations brought sex education to countries occupied by the United States. In 1947, the International Union against the Venereal Diseases, which was closely allied with ASHA, recommended a curriculum for schools that was later adopted by countries including Finland, France, and Romania. ASHA officials visited dozens of countries and distributed thousands of pieces of literature. In 1954, its director visited 21 countries across Asia and Africa. “The ASHA’s slogan, ‘The American Home, the American Hope,’” one official wrote in 1959, “may soon become ‘The World Home, the World Hope.’” What Zimmerman’s analysis makes no effort to explain, though, is what part of this effort—and the resistance to this effort—had to do with American ideas not about sex but about gender.

Margaret Sanger, an early advocate of birth control and sex education, with a group of unidentified women, circa 1920–1940.

During the Cold War, “family life education,” the then preferred euphemism, led to a political backlash. Beneath family life education’s rhetoric of internationalism, Zimmerman argues, many commentators found nothing but Americanism. “A seks manual in the Soviet Union is about as hard to find as a Barry Goldwater button in the Kremlin,” one reporter remarked in 1964. In postcolonial and communist countries, in particular, sex ed came to be seen as just another suspicious U.S. import. Its critics pointed out that the very evils that family life education was supposedly meant to combat—promiscuity, sexual abandon, and unwed mothers—were themselves the product of other American imports: rock ’n’ roll and Hollywood films. Emancipated women, of course, posed a problem, too.

In the 1960s, sex education was often called “population education,” animated by new fears about a so-called population bomb. As Zimmerman points out, “By the 1970s, nearly every country in the Western world had instituted some form of sex education.” Exactly what was taught is difficult to say. Zimmerman writes, “Almost all countries continued to avoid discussion of the ‘Big Four’ taboos, as sex educators around the world called them: abortion, contraception, homosexuality, and masturbation.” The global health crisis presented by the outbreak and spread of HIV changed all that. For countries in the developed and the developing world alike, the AIDS epidemic of the 1980s and 1990s “made it impossible to ignore sex entirely in their schools,” Zimmerman writes. This hardly closed the debate.

EVERYTHING YOU EVER WANTED TO KNOW . . .

Is there such a thing as educated sex? Today, sex for beginners, in one form or another, is taught in schools nearly everywhere. Lately, in European countries with aging populations and low birthrates, the curriculum has taken a turn. “For many, many years, we only talked about safe sex, how to prevent getting pregnant,” Marianne Lomholt, the national director of Sex and Society, a nonprofit group that provides sex education in Denmark, told The New York Times earlier this year. “Suddenly we just thought, maybe we should actually also tell them about how to get pregnant.”

Resistance to sex education is very often part of a larger rejection of claims for political and economic equality for women.

Zimmerman’s argument is that sex education has been, on the whole, a failure. This is more easily asserted than proved, and the book ends up being unpersuasive owing to the author’s lack of interest in particular outcomes. A great many social scientists would argue that sex education, like the availability of contraception, has improved and continues to improve girls’ ability to finish their education and is therefore part of a larger set of gains for women in the pursuit of equal rights. Whether sex education is a failure depends on what counts as success, and on that score, there is no consensus. Is the aim of sex education a reduction in the rate of teenage pregnancy, or disease, or family size, or the rate of divorce, or violence against homosexuals? Or is it an increase in the rate of high school graduation for girls, or the age of first marriage, or the frequency of female orgasm, or the use of contraception, or the birthrate? Zimmerman, a professor of education, never answers these questions; he barely even raises them. He’s not interested in public health outcomes: he’s interested in the history of education. His measure of success is whether, a hundred years after it started, sex education has become uncontroversial. It has not.

Nevertheless, Zimmerman’s international and centurylong vantage is important: it casts new light on old fights. In the United States, controversies over sex ed are rooted in a political realignment that dates to the 1960s. In 1964, Mary Calderone, a director of Planned Parenthood, founded the Sexuality Information and Education Council of the United States to promote frank and informed conversation in public schools. In 1968, Gordon Drake, the education director of the Christian Crusade, wrote a pamphlet called Is the School House the Proper Place to Teach Raw Sex? Almost 50 years later, the American conversation on the subject is more or less still stuck in the same place.

Zimmerman’s main contribution is to set the more familiar dispute in the United States alongside arguments from other times and places in order to make a claim about the rise of a global conservative movement. He suggests that the ideological fight between American progressives and traditionalists has exported itself to other parts of the world. On a now-global stage, organizations dedicated to cosmopolitan internationalism pledge, in the words of UNESCO not to “leave children to find their own way through the clouds of partial information, misinformation and outright exploitation that they will find from media, the Internet, peers and the unscrupulous” and promise to instead provide them with “scientifically-grounded sexuality education based in the universal values of respect and human rights.” Meanwhile, on the opposing side, groups such as the World Congress of Families, a conservative Christian group founded in 1997, condemn the spread of secularism and the power of the administrative state. “Ideologies of statism, individualism and sexual revolution, today challenge the family’s very legitimacy as an institution,” the group proclaims on its website. And: “School curricula should not undermine the right of parents to teach their children moral and spiritual values.”

Zimmerman suggests that the ideological fight between American progressives and traditionalists has exported itself to other parts of the world.

Zimmerman’s effort to trace the origin of these disputes provides critical insights. But his approach also has grave limitations. One problem is that global histories such as Zimmerman’s tend to have only the scantest sense of or appreciation for the force and endurance of the local. Global history often suffers from provincialism. Zimmerman’s research, for instance, is largely confined to English-language sources. Too Hot to Handle gives the false impression that all over the world, both support for and opposition to sex ed come from organizations headed by, founded by, or funded by Americans. Another problem is that Zimmerman is relatively uninterested in the way the history of sex education intersects with the history of the struggles for political equality for women, reproductive rights, and gay rights. Those struggles have been waged on the streets and in the courts—and in classrooms, too.

But there’s a bigger, deeper problem. However tempting it is to see the debate over sex ed as a proxy war between the state and the family or between science and religion, this perspective misses the way a fight once figured as a battle between traditionalists and modernists has come to be figured as a battle over rights: the left invokes the rights of women and children; the right invokes the rights of parents and families. Meanwhile, all over the world, girls are still coerced into sex and forced into marriages, contraception can be hard to come by, homosexuals are beaten and killed, and sexually transmitted diseases rage on. Is that because sex education has failed? No. It’s because the rights revolution has become a counterrevolution.

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• JILL LEPORE is David Woods Kemper ’41 Professor of American History at Harvard University. She is also a staff writer at The 
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In which countries do children attend single-sex schools?

• 29 March 2021 (updated on: 28 January 2022 )
• By: GEM Report

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While enrolment rates disaggregated by sex might be easy to find, comparative cross-country data on how many children are in single-sex schools are scarce. As another International Women’s Day passes us by, it seems fitting to also ask the question whether single-sex schools are beneficial or not; evidence on this front is mixed as well. What do we know?

One place to look is cross-national learning assessments, such as the Programme for International Student Assessment and the Trends in International Mathematics and Science Study (TIMSS). In about 60% of education systems in the mostly upper-middle and high-income countries that took part in the 2015 TIMSS, less than 5% of primary schools were single-sex.

However, as the graph above shows, gender segregation in separate classes or schools is common in countries as diverse as Chile, Ireland, Israel and Singapore and is prevalent in many Muslim-majority countries. The prevalence of single-sex schools also generally increases in secondary education, for instance from close to zero for primary to almost one in five for lower secondary education in England (United Kingdom).

In most countries, the proportion of students in single-sex schools corresponds to the proportion of such schools. Exceptions relate to the size and type of schools that tend to be single-sex. In the Islamic Republic of Iran, for instance, single-sex primary schools (66%) enrol 84% of grade 4 students, partly because public single-sex schools are larger than private co-education schools. By contrast, single-sex primary schools in the Russian Federation (8%) account for only 1% of grade 4 enrolment, as single-sex religious and/or private schools are smaller, on average.

We can also capture some information about changes over time from the countries that participated in both the 2007 and 2015 TIMMS. We find that single-sex schooling decreased in Australia and the Republic of Korea. The latter shifted to co-education schools in the 1980s, and a recent policy decisively favours co-education.

The situation is more complex in Western Asia, however. In Jordan, the share of single-sex lower secondary schools increased by 8 percentage points and the share of students attending them by 12 points. One reason may be the influx after 2011 of Syrian refugees, who attended public single-sex schools. The share of single-sex schools meanwhile decreased in Bahrain and Kuwait. While public schools remain segregated in Gulf Cooperation Council countries, the changes are attributable to an increasing share of mixed private international school.  \The United Arab Emirates introduced co-education primary schooling in 2018.

Are single-sex schools advised?

From a gender inclusion perspective, single-sex schooling may be an acceptable temporary compromise when the de facto alternative in some culture- or country-specific contexts is females not attending school at all. Parents may prefer to send daughters to single-sex schools once they reach adolescence; the fact that such schools do not exist in parts of Pakistan is one reason reported for low female enrolment for instance.

Some argue that gender social dynamics are educationally counterproductive. Females may show greater affinity for and achievement in science, technology, engineering and mathematics when less exposed to negative gender stereotypes about ability and to males monopolizing equipment. Yet single-sex schooling is unlikely to affect choices, attainment or achievement unless it challenges dominant notions of masculinity and femininity. The counterargument is that single-sex schooling might be alien to reality, and may prevent females from developing social skills needed to navigate unsegregated workplaces and adult life.

Evidence on the effects of single-sex schooling, meanwhile, is mixed. The main difficulty is isolating the characteristics of students likely to attend single-sex schools and those of segregated schools so that evidence is not biased. In Thailand and Trinidad and Tobago, single-sex schools tend to attract wealthier females, for instance, leading to overestimation of the benefits. A meta-analysis of 184 studies from 21 countries found that, while some showed modest learning outcome benefits of gender segregation, higher-quality research that adjusted for confounding factors showed little to no benefit and a slight negative effect on female education aspirations. The Republic of Korea provides one of the few natural experiments, as students are randomly assigned to secondary schools. A study exploring this particular case found that single-sex schooling had a small positive effect on achievement.

Malta presents an interesting case of a country that has moved from predominantly single-sex secondary school to co-education. State-run primary schools there have been co-educational since 1980, while secondary schools were single sex until 2013. Due to this history and the many single-sex church-run schools, the prevalence of single-sex secondary schools is among the highest for non-Muslim-majority countries. A study on the centralized lottery for Catholic school admission suggested that students with single-sex schooling subsequently chose less gendered subjects. Malta’s recent move towards public co-education occurred as part of a framework of policies to support and promote social inclusion. One benefit is easier inclusion and freedom of expression of lesbian, gay, bisexual, transgender and intersex students, who may be particularly excluded in single-sex schools premised on a homogeneous gender identity. With its 2015 Gender Identity, Gender Expression and Sex Characteristics Act, Malta adopted Europe’s first comprehensive education policy focused on their needs; it included confidentiality and ended gender segregation in uniforms and some sports.

Single-sex schools may reflect parental choice – a type of self-segregation, which is a challenge to the purest sense of inclusion in education. But there are many reasons why parents might choose single-sex over co-educational schools for their children, as the Pakistan example above attests. This is why the 1960 UNESCO Convention against Discrimination in Education accepted that, under certain conditions, single-sex schools did not constitute discrimination. The question, then, perhaps should not be which setting is better but why single-sex schools sometimes produce better outcomes and how to replicate those benefits in more inclusive settings.

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This is fascinating. Thank you.

Q- why are some countries missing eg Germany, Spain, France etc?

Banning single-sex schools is a form of discrimination. It denies “parents” and older students the “freedom” to choose the educational environment that best suits their needs

Children do not have the cognitive capacity to make informed decisions about their education, and pushing them into co-ed schools is society’s immoral “straight” agenda talking. You can’t fool me

Single-sex schools achieve the same educational outcomes as co-ed schools, making it unfair to restrict access to them. Not all LGB people feel alienated in single-sex environments. I, a lesbian, felt and feel more comfortable in women-only environments. Segregation is something I CHOOSE. Something I WANT. Something I NEED. Something that’s GOOD for everyone

Presenting only one side of the argument, the side against single-sex schools, is biased and discriminatory. All perspectives should be considered when making decisions about education, and everyone should have the right to choose the educational setting that works best for them

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The case for starting sex ed in kindergarten (hula hoops recommended)

Lee V. Gaines

Elizabeth Miller

A class of fifth-graders are sitting through an hour-long sex-ed lesson at Louis B. Russell Jr. School 48 in Indianapolis. Some fidget, others giggle. And they have a lot of questions.

How old do you have to be to start using tampons?

What's acne?

It's April, and sex ed teacher Haileigh Huggins does her best to answer them all.

One boy asks, "Can boys have babies?"

"No, they cannot get pregnant," she tells him.

"Because they both would have sperm cells right? There wouldn't be an egg cell."

Huggins is trained to teach age-appropriate, comprehensive sex education. But she only has an hour with these students — and that's just enough time to cover the basics, like puberty and reproduction.

When most people think of sex ed, those are the lessons that often come to mind. But comprehensive sex ed goes beyond that. It's defined by sex ed advocates as a science-based, culturally and age-appropriate set of lessons that start in early grades and go through the end of high school. It covers sexuality, human development, sexual orientation and gender, bodily autonomy and consent, as well as relationship skills and media literacy.

With abortion access changing in many states, advocates for comprehensive sex ed say it's more important than ever. But, like so many things related to schools, sex education is highly politicized.

Only three states require schools to teach age-appropriate, comprehensive sex education: Washington, California and Oregon. That's according to SEICUS, a group that advocates for progressive sex education policies. In other states, what students learn about sex ed depends on what school leaders choose to teach.

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How one author is aspiring to make sex education more relatable for today's kids.

And yet, research shows these lessons can lead to better health outcomes for students.

"The major finding of the research is that comprehensive sex education scaffolded across grades, embedded in supportive school environments and across subject areas, can improve sexual, social and emotional health, as well as academic outcomes for young people," says Eva Goldfarb, a researcher at Montclair State University in New Jersey. She is co-author of a 2020 paper on the topic.

"Even though it may seem like sex education is controversial, it absolutely is not," says Nora Gelperin, director of sex education and training at Advocates for Youth — an organization that promotes access to comprehensive sex education.

She says comprehensive sex ed is "always in the best interest of young people."

Here's what it looks like, for different age levels from grades K-12:

Elementary school: Consent, personal boundaries and healthy relationships

Age-appropriate sex ed for kindergartners introduces topics like consent, identifying who is in your family and the correct names for body parts.

"When we're talking about consent with kindergartners, that means getting permission before you touch someone else; asking if it's OK if you borrow somebody's toy or pencil or game, so that kids start to learn about personal boundaries and consent in really age- and developmentally appropriate ways," says Gelperin, who was part of a team that released the first national sex education standards in 2012.

Gelperin loves to use hula hoops to teach young kids about bodily autonomy: Each student gets one, and is instructed to ask for permission to go inside someone else's hula hoop. The hoops are an analogy for boundaries.

"If someone is touching you inside your boundary in a way that makes you uncomfortable, it's OK to say no and talk to a trusted adult," Gelperin tells students.

Another good lesson for younger children is how to identify those trusted adults. Mariotta Gary-Smith, a sex ed instructor based in Oregon, asks students to write a list of people they trust in their communities: "People that you know care about you, people who are accessible to you, people who could support you."

The list can include peers, immediate and extended family members or chosen family members. Then Gary-Smith, who co-founded the Women of Color Sexual Health Network, asks students to think about how they would talk to the people on their list about safety, respect and boundaries.

The Birds And The Bees — How To Talk To Children About Sex

"When they knew that they had trust and safety in their circle, they felt like they could express themselves without judgment," she explains.

As students head into third grade, Gelperin says they should start learning the characteristics of healthy relationships with friends and family.

"Sometimes there's teasing and bullying that's going on in those grade levels. So you want to talk about how to interrupt teasing and bullying and how to stand up for others that may be getting teased or bullied," she explains.

There should also be a focus on respecting others' differences, including different family makeups, cultural backgrounds and faith traditions.

Gelperin says lessons on consent should continue throughout elementary school. And she recommends lessons on puberty begin in fourth grade, because that's when some students begin to see and experience changes in their bodies.

Middle school: Real talk about puberty

As students transition from elementary school to middle school, they should learn about the details of reproduction, including biological terms and why some people menstruate while others create sperm.

"That for me is a real hallmark of middle school sex education, is kind of really starting to understand how those parts and systems work together for reproduction," Gelperin says.

A new puberty guide for kids aims to replace anxiety with self-confidence

It's also a good time to connect the physical effects of puberty and hormones with the feelings of attraction that come along with them.

"Who gives you butterflies in your stomach? Who makes your palm sweaty?" Gelperin says. "Because we know with puberty, one of the changes is experiencing new hormones that make us feel feelings of attraction often for other people in a new and different way."

Students should also learn about sexually transmitted infections, like HIV, and how they're transmitted.

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

And middle school is a good time to start learning about gender expression and sexual orientation, as well as gender stereotypes. One Advocates for Youth lesson includes a scavenger hunt homework assignment where students look for gender stereotypes in the world around them, like a sports ad that only features men or an ad for cleaning supplies that only features women.

High school: When conversations about healthy relationships get deeper

Healthy relationships are a "hallmark" of comprehensive sex education, Gelperin says. As students move into high school, the conversation should expand from family and friends to partners and intimate relationships.

"What makes a relationship healthy? How do you know if a relationship is not healthy?" Gelperirn says.

Those conversations should also cover sexual abuse, sexual harassment and sexual assault.

At Mountainside High School in Beaverton, Ore., school health teacher Jenn Hicks shares statistics with students about the disproportionate rates of sexual violence for women, women of color and members of the LGBTQ communiity.

"Sexual violence can happen to anyone," she tells her class, "but it doesn't happen equally to everyone."

That leads to a conversation about consent.

"We have to talk about how we treat each other better, why consent is so important and why we need to listen to each other and protect each other," Hicks says. "Again, violence is used as a form of control to keep groups of people disempowered and fearful."

What Your Teen Wishes You Knew About Sex Education

And then, of course, come the classic lessons of high school sex ed, about pregnancy, how to prevent sexually transmitted infections and how to use contraception – a lesson Gelperin says is especially important.

"We can't expect young people to know how to use condoms correctly unless we help them learn how to do that."

One classic method: bananas. Specifically, having students practice placing a condom on a banana, as one Advocates for Youth lesson recommends.

Finally, there are lessons that don't have anything to do with sex (or fruit) — like how to find credible sources of information.

Think about all the rumors about sex that can circulate in a high school – those rumors are also all over the internet. And for a kid looking for information, it can be hard to know what to believe.

"We're allowing children to learn what's out there, and they are," says sex ed researcher Lisa Lieberman, who co-authored that Montclair State University paper. "They are accessing pornography; they are accessing the internet. They are learning in ways that are not the message that most parents and schools want children to have."

Advocates for Youth recommends asking students to evaluate different sexual health websites, and identify the ones that are trustworthy.

For Hicks, the goal of all this is to give every student the tools they need to stay safe.

"It's recognizing everybody that's in the room and giving them the knowledge and skills to make the best possible decisions for themselves and to lead a happy, fulfilled life."

Sex ed recommendations are always evolving

Mariotta Gary-Smith, with the Women of Color Sexual Health Network, says 10 years ago sex education wasn't culturally reflective or respectful to everyone, including to communities of color.

"The images that are used, that have been used historically ... you don't see bodies that are not white, able-bodied, cis, slender, slim," she explains. "You don't see or hear about young people who choose to parent if they become pregnant. You hear about teen pregnancy as this thing to be stopped, but not honoring that there are cultures and communities where young people who choose to parent are celebrated."

Texas got a sex ed update, but students and educators say there's still a lot missing

Gary-Smith has helped create more inclusive lessons through the Women of Color Sexual Health Network, and the sex ed standards Gelperin helped create in 2012 were updated in 2020 to include racism, inequality and their impact on sexual health. An Advocates for Youth lesson points students to examples of how racism has impacted the health and reproductive rights of low-income women of color, among other groups.

The national sex ed standards were also updated to touch on gender identity, sexual orientation, reproductive justice and sexually explicit media.

"It really allowed us to reflect the times in 2020 and what young people were saying was their lived experiences that they were so hungry to learn and talk about," Gelperin says.

Keeping sex ed inclusive and culturally reflective means teaching about systemic oppression, discrimination and the history and impacts of racism on certain communities, Gary-Smith explains. For example, a lesson on reproductive health might discuss historical examples of forced sterilization of Indigenous women or Black women, or the criminal justice system as it connects to family relationships.

These lessons may seem a far cry from those on consent or gender, and Gary-Smith understands that.

"Everything I'm talking about now, 10 years ago, we weren't talking about it," she explains.

That highlights one of the most important characteristics of sex ed for Gary-Smith: It should always be evolving.

"It needs to shift and change because things shift and change."

Lee Gaines is from member station WFYI, and Elizabeth Miller is from member station OPB. Nicole Cohen edited this story for broadcast and digital.

Global Review finds Comprehensive Sexuality Education key to gender equality and reproductive health

The evidence is clear. Comprehensive Sexuality Education (CSE) leads to improved sexual and reproductive health, resulting in the reduction of sexually transmitted infections (STIs), HIV, and unintended pregnancy. It not only promotes gender equality and equitable social norms, but has a positive impact on safer sexual behaviours, delaying sexual debut and increasing condom use.

The findings have been revealed in a new report examining CSE status in 48 countries across the world, ‘Emerging Evidence, Lessons and Practice in Comprehensive Sexuality Education - A Global Review 2015’. Published by UNESCO, in consultation with the United Nations Population Fund (UNFPA) and the UNAIDS Secretariat, the report shows that almost 80 per cent of assessed countries have policies or strategies in place that support CSE.

In the Asia-Pacific region, 21 out of 25 countries’ national HIV strategies referenced the role of education, in West and Central Africa, most countries had a policy on life-skills based HIV and AIDS sexuality education, and in Latin America and the Caribbean, health and education ministers signed a declaration affirming a mandate for national school-based sexuality and HIV education.

However, Senior Programme Specialist in Health Education at UNESCO, Joanne Herat said that, despite the increased political will, there remained a significant gap between the many global and regional policies in place and the implementation on the ground.

“Young people are consequently often denied even the most basic information about their sexual and reproductive health and rights,” Herat said. “Thankfully, a global movement has galvanized around ensuring universal access to CSE, with youth-led movements calling for stronger responses, and sustained commitment. This has played a major role in the scaling-up of sexuality education and sexual and reproductive health services globally.”

The report also found that teacher training was crucial to the effective delivery of CSE. In fact building teacher capacity to deliver age-appropriate, culturally-relevant CSE, is proven to support the development of learners’ life skills.

“We also need to be looking to programmes which address gender or power relations, as they have been associated with a significant decrease in pregnancy, childbearing or STI’s,” Herat said. “CSE empowers young people to reflect on their behaviours, their environment, and their attitudes regarding gender and rights, all critical factors for improving health outcomes and HIV infection rates.”

The report found that effective implementation and scale-up of CSE is reliant on engagement and support from parents and whole communities.

The report was made possible with support from the Governments of Sweden and Norway.

Download the Full Report HERE

Download the Executive Summary here, in ENG , FR

More on this subject

Other recent news

School Sex Education Around the Globe is Out of Touch With Teens, Study Finds

Surveys of young people in 10 countries found dissatisfaction with sex ed.

&#151; -- Sexuality is a common human trait, but the ways that schools teach about sex varies radically around the globe, from comprehensive sex education in progressive countries like the Netherlands and Sweden to abstinence-only programs in some parts of the United States.

Recent data suggests, however, that schools in many nations are falling short in educating young people effectively about sex and relationships. Students and young adults in different countries express frustration at school-based sex education programs, according to a new review published earlier this week in the British Medical Journal.

Researchers in the United Kingdom analyzed 48 studies conducted from 1990 to 2015 that reported on young people's impressions of school-based sexual education for the review, which is titled, "What do young people think about their school-based sex and relationship education? A qualitative synthesis of young people's views and experiences."

The review looks at surveys of students aged 4 to 19; youth age 19 and under not necessarily in school; and young adults reflecting on their schooling. They were from 10 countries around the globe -- the United Kingdom, Ireland , the U.S., Australia, New Zealand, Canada , Japan, Iran, Brazil and Sweden.

Consistent themes arose from the surveys, including that young people regard current teachings as negative about sexuality and biased based on gender and toward heterosexuality.

Pandora Pound, lead author of the review and a research fellow at the University of Bristol’s School of Social and Community Medicine in the United Kingdom, told ABC News, “Although we knew that young people were dissatisfied with their [school-based sex education], the reasons for their dissatisfaction were less clear … We were surprised that young people's views were so consistent across all the different countries [over] 25 years.”

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One common theme to emerge is that many teens want teachers to acknowledge that sexuality can be an uncomfortable or embarrassing topic for instruction and can’t be taught like other subjects or with a disapproving tone. Many teens surveyed indicated they dislike having sex education taught by their regular teachers "due to blurred boundaries, lackof anonymity, embarrassment and poor training," the study said.

"Young people report feeling vulnerable in [sex and relationship education], with young men anxious to conceal sexual ignorance and young women risking sexual harassment if they participate," the authors wrote in their summary of results. "Schools appear to have difficulty accepting that some young people are sexually active, leading to [sex education] that isout of touch with many young people’s lives."

None of this surprises Barbara Velategui, a veteran health educator who taught at Newport High School in Bellevue, Washington, for 41 years before retiring.

“[Sexual] health education in the academic setting is very much like the ugly stepchild," Velategui told ABC News. "[Schools] do it if the state requires it, but it’s delivered like a core subject, and it doesn’t work.”

Velategui started teaching sex education in 1974 with a brief lesson that was part of a wedding-planning course called “Two for Tomorrow.” Young men did not enroll in the course. Over the course of four decades, she noticed a palpable shift in her students’ desire to actively learn about and take command of their sexual health.

“The biggest change I’ve seen in my career is kids’ comfort level with [lesbian, gay, bisexual, transgender, or queer issues] … I don’t think sexuality education can be taught without it because otherwise there are too many kids you leave out," she said.

The study found that schools struggling to recognize that some students are already engaging in sexual practices often fail to provide practical information such as on the pros and cons of different contraceptives, health services available for students who become pregnant or contract sexually transmitted diseases , and how to handle the intense emotions that may arise in a sexual relationship.

In the U.S., 24 states and the District of Columbia require public schools to teach sex education, according to the National Conference of State Legislatures. The content varies widely among states from an abstinence-only approach to a comprehensive review, and only 20 of these states mandate that information taught to students be “medically accurate,” according to the conference.

When Washington State mandated in 1993 that all students in grades 5 through 12 receive education about HIV , Velategui created a peer-led program called AIDS Student Peer Educators at Newport High School (ASPEN). Students with a passion for social justice , medicine, and peer counseling were trained to deliver 90-minute interactive presentations to their classmates about sexual health, including how to prevent sexually transmitted diseases, choose contraceptives and access community resources.

Over the next 21 years, the peer education program was regularly asked to present at the other area high schools and was recognized by the World Affairs Council as an effective model, which drew attention from international health education groups.

“There are teachers around the country who want to teach this sensitive topic but aren’t getting the backing they need from their school districts,” Velategui said.

For many U.S. teens, school is the primary source of sexual health information. Health experts generally agree that classroom-based sexual education is a tremendous opportunity to safeguard and empower the next generation to make informed decisions about their physical and emotional health. However, this study warns that unless instructors adapt their curriculum to the lives of today’s teens, young people will continue to disengage.

"While it is important to get the content of sexual and relationship education right, it's also vitally important to get the right people to deliver [it]," said Pound.

Dr. Kathryn J. Horton is a senior internal medicine resident at the University of Washington in Seattle and is currently working in the ABC News Medical Unit.

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Fighting Sexual Temptation? Play Badminton, Hong Kong Tells Teenagers.

Top officials in the Chinese territory have defended new sex education guidance that critics call regressive. Young people are amused.

By Olivia Wang and Mike Ives

Olivia Wang reported from Hong Kong.

A 15-year-old girl and her boyfriend are studying alone together on a hot summer day when she removes her jacket and clings to his shoulder. What should he do?

In Hong Kong, the authorities advise the young man to continue studying or to seek a diversion, including badminton, to avoid premarital sex and other “intimate behaviors.”

Critics, including lawmakers and sex educators, say that the Chinese territory’s new sex education materials are regressive. But top officials are not backing down, and the standoff is getting kind of awkward.

“Is badminton the Hong Kong answer to sexual impulses in schoolchildren?” the South China Morning Post newspaper asked in a headline over the weekend.

Hong Kong teenagers find it all pretty amusing. A few said on social media that the officials behind the policy have their “heads in the clouds.” Others have worked it into sexual slang, talking about “friends with badminton” instead of “friends with benefits.”

The sex ed materials were published last week by the Education Bureau in a 70-page document that includes worksheets for adolescents and guidance for their teachers. The document emphasizes that the lessons are not designed to encourage students to “start dating or having sexual behaviors early in life.” It also advises people in a “love relationship” to fill out a form setting the limits of their intimacy.

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