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Amid America’s reckoning with sexual harassment and violence, gender inequity, and discrimination, sex education is as fraught as it’s ever been. Anyone who received school-based sex ed in the U.S. anytime during the past four decades—including the majority of American students currently in school—might have difficulty relating that education to the massive renegotiation of sex, gender, and power that’s transforming the nation. But sex ed could play a significant role in helping today’s students navigate this transformation. It would just have to look a lot different than it does in most of the U.S. right now.

I spent several years exploring the state of sex ed in the U.S. and elsewhere for my latest book. What I found in America wasn’t great.

As of 2018, fewer than half of U.S. schools require that students receive information about human sexuality. While some states say school-based sex ed must be medically accurate and nonjudgmental, others mandate learning objectives that cast nonmarital sex and homosexuality in a negative light. Only about half of American teenagers who have had sex say they have received any sex ed at all, and just a fifth of American students learn in school how to use a condom correctly. Despite some recent improvement, U.S. teens give birth and contract sexually transmitted infections at much higher rates than teens in other developed countries. And few are learning anything that might help address social ailments such as sexual violence, gender inequity, or homophobia and other intolerances.

Before the mid-1990s, most American students who had school-based sex education received “medically accurate” sex ed, based in anatomical lessons. Picture the gym teacher with a filmstrip, and boys and girls segregated in separate classrooms. These lessons focused on the physiological workings of human sexuality, covering topics such as puberty, reproduction, and infection prevention, but likely omitting much in the way of social-emotional learning. Much of this instruction happened in middle and high school, arguably too late in students’ lives to be very effective. Although recently revised, medically accurate curricula can be more inclusive and socially conscious, many districts still use decades-old examples that center on cisgender heterosexuality.  

As of 2013, 28 percent of girls and 35 percent of boys who received formal sex ed at school learned about abstinence but not contraceptives. Whether it’s called “abstinence only” or “sexual risk avoidance” education, the product is the same: against nonmarital sex, ignoring diverse sexual orientations and gender identities, and lacking thorough information on preventing pregnancy, infection, and sexual violence.

Such programs tend to be widespread in geographic areas with high teenage-pregnancy and STI rates. Many lessons are taught by volunteers from outside organizations with religious ties. Studies of this approach to sex ed have produced overwhelming evidence that it’s not only ineffective—these lessons prevent pregnancy about as well as no sex ed at all—but also potentially harmful, leaving students at increased risk of contracting sexually transmitted infections and experiencing sexual violence.

In a 2010 policy statement, the American Academy of Pediatrics recommended against this approach. Still, in 2017, funding for abstinence-only sex ed once again began to increase.

Comprehensive sexuality education, the preferred approach of the World Health Organization and many of the most gender-equal countries, begins as early as kindergarten, combining thorough, medically accurate information (including the preventive benefits of abstinence) with social-emotional skills that build throughout childhood. It involves a progression of lessons, including both biological and social-emotional components, intended to teach children to know their own boundaries and how to form secure, respectful, safe relationships. This approach suggests a role for sex ed in combating gender inequity in American life.

When I went to the Netherlands to observe sex ed instruction in first-, third, and sixth-grade classrooms, I saw the comprehensive approach in action. Lessons about bodies and reproduction went hand in hand with lessons about respect, consent, friendship, fair treatment, love, relationships, and internet safety. Older students continued learning about consent, sexual-violence prevention, inclusive attitudes toward sexual and gender diversity, breaking down gender-role stereotypes, and porn literacy. They also practiced communicating with others about sex and relationships.

In America, comprehensive approaches to sex ed received peak funding during Barack Obama’s administration, when declining teen-pregnancy rates plunged even more dramatically. In 2017, Donald Trump’s administration cut support for comprehensive sex ed.

By far, the most common type of school-based sexuality education received by K–12 students in the U.S. is precisely none. This shortfall leaves young people ill-prepared to protect their basic physical health and safety. But the argument for comprehensive sex ed goes beyond that. Schools could also be preparing students to navigate and productively engage with the social changes of the sexual reckoning under way in American society.

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