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The Importance of Sex Education Essay

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Power to Decide

Why sex education matters.

Maggi LeDuc

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An engaged middle school classroom with a teacher at the head and several hands raised.

In 2014, a study found that 93% of parents supported having sex education in middle school and 96% supported teaching sex ed in high school. A 2017 study again found that 93% of parents favored sexuality education in schools. These are not isolated results; decades of research support the benefits of comprehensive, inclusive sex education.

Comprehensive sexuality education is also supported by professional organizations such as the American Medical Association, the American Academy of Pediatrics, the Society for Adolescent Health and Medicine, and the 184 organizations—including Power to Decide—who joined in coalition in May 2020 to support the Sex Ed for All movement.

At the moment, 28 states (and DC) require some kind of sex education and HIV education and seven states only require HIV education. However, only 17 require that education to be medically accurate and 29 states require schools to stress abstinence . Because sex education in schools is legislated on the state (or individual school district) level, not the federal, the quality of what is taught varies widely across the country. The CDC’s 2018 School Health Profiles found that only 43% of high schools and 18% of middle schools taught ‘key’ topics in sex education. Some of the topics the CDC labels as ‘key’ include information on how to prevent STIs and unplanned pregnancy, maintaining healthy relationships, avoiding peer pressure, and using appropriate health services.

The World Health Organization notes that the focus of sexuality education in Europe has shifted from preventing pregnancy in the 1960’s to preventing HIV in the ‘80’s to today covering these topics alongside such issues as sexism, homophobia, and online bullying gender norms, the sexuality spectrum, and emotional development. In contrast, a 2018 study reported that students in the US were less likely to receive sex education on key topics in 2015-2019 than they were in 1995. The same study found that only 43% of females and 47% of males who had penis-in-vagina sex covered safe sex in school before they engaged in sex for the first time.

Truly comprehensive sex education includes, but isn't limited to:

Taught by trained sex educators.
Begun early and progresses at an age-appropriate pace.
Evidence-based.
Inclusive of LGBTQ young people.
Explicitly anti-racist.
Learner-centered.
Community-specific.

Sex ed that is for everyone includes (but isn't limited to) information about:

Healthy relationships.
Anatomy and physiology.
Adolescent sexual development.
Gender identity and expression.
Sexual orientation and identity.
The full range of birth control methods and pregnancy options.

All young people have a right to this kind of high-quality, evidence-based information and care to ensure their lifelong sexual and reproductive health. Again , and again , and again both national and international research has found that young people who have experienced comprehensive sexuality education delay having sex for the first time, are less likely to engage in risky behavior, and are more likely to use birth control.

Plus, beyond giving young people facts, inclusive sex ed provides skills such as effective communication, active listening, and the ability to make informed decisions that will help them to grow and live safe, healthy, and fulfilling lives.

View the discussion thread.

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The Importance of Sexual Education Essay

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Personal Sexuality

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

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

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

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

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

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

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

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

Works Cited

Coad, Jane., and Dunstall, Melvyn. Anatomy and Physiology for Midwives . Elsevier Health Science. 2001. Web.
Kirby, Douglas., etal. School- Based Program to Reduce Sexual Risk Behaviors: a Review of Effectiveness . Public Health Report, 109. 3(1994): 339-360. Pub Med Central Journal List. 2009.Web.
Sexual Difficulties. Andrology Australia.2006.
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Kurzweil-3000 for Students With Dyslexia
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The Importance of Sex Education

This essay will argue for the importance of comprehensive sex education in schools. It will discuss how proper sex education can lead to informed decisions, safer practices, and a reduction in teen pregnancy and sexually transmitted infections. The piece will explore the debate over sex education and the potential benefits of a well-rounded program. At PapersOwl, you’ll also come across free essay samples that pertain to Adolescence.

How it works

“This is the real world, and in the real world, you need protection,” – Cherie Richards. Students, specifically teenagers, need correct information and the right resources to learn, help and protect themselves. When students have no knowledge whatsoever, they turn to media or even pornography to get information because their parents aren’t open enough about sex or the topic. Sex education is a type of teaching where students are taught about sexuality, contraceptive methods, how to prevent sexually transmitted diseases, the importance of protection and attitudes and principles about sex.

There is also another kind of sex education which is abstinence-only. While being abstinence-only, some also teach about the process of sex education which could then lead to students learning how to make the right choices.

Implementing more sex education or different types of sex ed. programs would be very beneficial for students and parents both. Both parties would receive education about the topic without the awkwardness of it all. Some parents prefer the abstinence-only method which is not an accurate way to teach, especially hormonal teenagers. Nolan mentions that “Young people won’t stop having sex because they are not given information and contraceptive advice” (Nolan 1998). Most teens are already curious and saying they can’t do something and then not informing them on the topic makes them want to know about it more. Abstinence also excludes the teaching of healthy adult relationships. Richard Hoefer states in one of his writings that “abstinence-only education is less effective at preventing pregnancy and sexually transmitted infections (STIs) than comprehensive sex education” (Hoefer 2017).

Another issue with abstinence only teaching is that if students don’t use this method they are more prone to STIs and pregnancy. Also abstinence programs usually offer inaccurate medical information and outdated stereotypes and assumptions. Hoefer believes that this “misinformation can contribute to larger societal problems such as sexism and heterosexism, and make it difficult for students to engage in healthy and safe intimacy even into adulthood” (Hoefer 2017). Right now, the rate of teen birth and abortions is the highest among other countries, with over one million teens becoming pregnant every year. In another study aimed towards younger adults and teens (18-24), it showed that they have the highest rate of stds. At the same time, “Africa also has the highest number of teen pregnancies in the world” (UNICEF 2017). And even though the rate of teen marriage and pregnancy has gone down in Malaysia and Indonesia, it is still considered quite high compared to the others.

In Japan and South Korea, more developed countries, their teen pregnancy rates are at 4.6% and 2.9%, which are the lowest in the world. Japan and China, among other countries, use the abstinence-only method, and this is more than likely why their rates are extremely low. If these countries were to implement sex education in their communities, they could possibly lower their teen pregnancy rates in the cases where child marriages are higher, or in the abstinence only countries, they could higher their adult pregnancy rates meaning people would not be scared of getting pregnant. It is proven that sex education can reduce teen pregnancy and teen births. Sex education has lowered the United States’ teen birth rate based on a report done in California. The statistics showed that “the birth rate went from 36.2 to 34.1 per 1,000 births to adolescent mothers” (Ventura County Star, 2008). An epidemiologist, Trisha Mueller, found that sex education does work and it also delays teens having sex which then leads to the teen pregnancy rate lowering. Based on a national survey of 2,019 teens aged 15 to 19 in 2002, it was found that teenage boys were three times more likely to use contraceptive methods compared to those who did not have sex ed. For teenage girls who took sex education, having sex before the age of 15 was reduced 59%, while boys’ was 71%, compared to those who didn’t take sex ed. That specific study concluded that “Sex education provides youth with the knowledge and skills to make healthy and informed decisions about sex, and this study indicates that sex education is making a difference in the sexual behaviors of American youth” (Mueller 2008).

Sex education should be implemented in schools because it can reduce teen pregnancy. Informing students how to protect themselves with different contraceptive methods would urge students to use those instead of having unprotected, uninformed sexual relations. Teaching them about contraceptives would also give students places to get different types of contraceptives, male or female, such as condoms, birth control, spermicide, etc. It’s also better for students to get information about sex and different contraceptives from the right resources like schools, rather than from the media. The media could offer potentially harmful resources or ways to do things if a student is desperate, such as the “plastic bag condom” or “double wrapping” methods. Klopp stated in his article “sometimes the only place left to go for this information are peers and the popular media, both of which often give confusing, misinformed, and even dangerous information regarding sexuality” (Klopp 2003). Sex education in schools can also protect younger children and teenagers in many different forms including molestation at a young age, informing them about their own bodies, among other things. To protect children from violence or sexual abuse, children should be given a brief accurate lesson, or a few, about sex at an early age. We should provide children with an adequate sex education. The only “issue” would be how do we represent this sex education without scaring the children or going too in depth for certain ages. When would it be appropriate to provide sex education to children, and can sex education be guaranteed to avoid sex harassment to children? To figure out how to answer these questions, we’d first have to answer these questions. What is sex education mean? How important is it to teach sex education to children? Who should teach sex education to young children? With the thoughts of early sexeducation, the expectation would be to limit the amount of harassment happening. There are many sexually abused children who never came out or received the attention for what was been done to them. Shame, guilt and the fear of being blamed has leaned them away from telling parents or guardians. This is mainly because the victims, more often than not, do not understand what sexual abuse is and they don’t think about their rights to decline being treated this way.

Sex education has only recently become important in the past few years but child sexual abuse has existed throughout history. Implementing sex education into schools can decrease the rate of child sexual abuse and would provide a way out for children and teenagers. Child sexual abuse is any form of sexual activity forced onto a child whether by a person younger or older than the child. Children and teenagers are vulnerable and can be exposed to sexual abuse without anyone knowing. If they did not receive any counseling or teaching, they do not have full understanding of what being taken advantage of means. It also leaves them in a situation where they could be preyed on again. In America, there are 39 million survivors from child sexual abuse. By their 18th birthday, one in four females and one in six males are sexually abused. Sex education gives children and teenagers information about how to prevent sex abuse, that sexual abuse does not happen to everyone else and that they need to get help if they were abused. It teaches children and teenagers to be well aware of sexual abuse. In order to decrease the rate of child sexual abuse, bringing sex education into schools is well needed because children and teenagers would learn about child abusers and sex abuse and they could distinguish them from the good. Children and teenagers would be more aware of the current situation in this modern society and they would know the actions to be taken if necessary. With that, victims would be able to understand that they are not alone and many are willing to lend a hand. There has also been one sex ed program that was organized where students learned to say no to inappropriate acts committed by someone else.

In this specific program, 10 eighth graders from 3 middle schools participated in a yearlong training program. Its motto was “Diplomas Before Diapers”, and its mission is to reduce teenage pregnancy and prepare young people to become healthy, responsible adults. It does not teach abstinence, but urges safe sex and saying no to sexual acts to prolong the amount of childhood before parenthood. The program wants to help young people postpone sexual involvement and parenting, build self-esteem, develop leadership qualities and improve communication and decision-making skills. The curriculum also covers information and discussion of drug and alcohol use and violence prevention. The program helps the students enrolled and their peers. The students enrolled are trained not to give advice, but to listen and to be the first to refer others to the appropriate help. The New Haven public schools offer both a special school for pregnant students, which is Polly McCabe, and a free day care center at Wilbur Cross High School. Although it was said that “One student thought these services might actually encourage teenagers to have babies” (Tuhus 1998) it is very unlikely. All the rest thought that those programs wouldn’t be nearly enough to make up for the large negative change in the lives of young parents. One of the things they hope to convey to their peers is that “contrary to popular belief, not everyone their age is having sex” (Tuhus 1998). The adults in the program also let students know that they are available to talk if they feel uncomfortable speaking to other adults. There wasn’t very much research on how to implement sex education in schools but I believe there could be quite a few solutions. Federal funding for sex education could be raised so more programs could open. By raising funding, colleges could open classes specifically for sex education, rather than having school nurses or PE teachers teaching the class. Another plus of bringing more funding could mean more classes taught by educated individuals would mean better, more reliable information would be taught.

For young teens and adults, sex ed would provide students with the right resources and information involving sex, their own identities and different contraceptives. With these tools, students would utilize this in their everyday lives, whether it be at a younger age or an adult. Donovan mentioned “if young people can discuss sexual drives both at home and at school, they are more likely to accept their own sexuality and take early advice on family planning” (Donovan 1990). When teens are more comfortable speaking about this topic, they are more likely to ask questions from the correct resources and receive reliable information.

Children and teenagers need reliable and factual information about sex, sexual relationships and other various related issues in order to make a right decision for their present and future. They need to understand about what can happen if there are misconceptions about sex, it in turn becomes dangerous. These children are responsible for bringing up the next generations. The implementation of sex education in schools will be able to prepare them properly. Not only that, based on the evidences and research done as well as collected carefully, it proves that sex education brings many benefits by reducing the rate of teen pregnancy, providing teenagers with accurate and helpful information, and also protecting them from harm.

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Peter DeWitt's

Finding common ground.

A former K-5 public school principal turned author, presenter, and leadership coach, Peter DeWitt provides insights and advice for education leaders. Former superintendent Michael Nelson is a frequent contributor. Read more from this blog .

Should Sex Education Be Taught in Schools?

Thinking about sex education conjures up all of those uncomfortable moments as an adolescent when we had to sit at our desks and listen to our health teachers talk about things that we joked about with friends but never wanted to have a conversation about with adults. But things have changed a lot since then.

There has been an increase in the number of LGBT students who have come out while in high school, or sometimes, even middle school. We are surrounded images that inspire conversations about sex education and other images created by fashion that offer so much skin that there is nothing left to the imagination.

AVERT defines Sex Education as

the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. Sex education is also about developing young people’s skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices.

First and foremost, there is a debate between the use of sexual education programs, where they openly teach about sex and prevention, and abstinence-only programs, which Advocates for Youth say,

“has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
teaches abstinence from sexual activity outside of marriage is the expected standard for all school-age children;
teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity;
teaches that sexual activity outside the context of marriage is likely to have harmful psychological and physical side effects;
teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances, and
teaches the importance of attaining self-sufficiency before engaging in sexual activity.”

Advocates for Youth also believe,

Accurate, balanced sex education - including information about contraception and condoms - is a basic human right of youth. Such education helps young people to reduce their risk of potentially negative outcomes, such as unwanted pregnancies and sexually transmitted infections (STIs). Such education can also help youth to enhance the quality of their relationships and to develop decision-making skills that will prove invaluable over life. This basic human right is also a core public health principle that receives strong endorsement from mainstream medical associations, public health and educational organizations, and - most important - parents.

But is it the job of teachers in schools to educate students about sex or is it the job of the parents? According to the National Conference of State Legislatures ,

All states are somehow involved in sex education for public schoolchildren. As of Jan. 1, 2015: 22 states and the District of Columbia require public schools teach sex education (20 of which mandate sex education and HIV education). 33 states and the District of Columbia require students receive instruction about HIV/AIDS. 19 states require that if provided, sex education must be medically, factually or technically accurate. State definitions of “medically accurate” vary, from requiring that the department of health review curriculum for accuracy, to mandating that curriculum be based on information from “published authorities upon which medical professionals rely.” Many states define parents’ rights concerning sexual education: 37 states and the District of Columbia require school districts to allow parental involvement in sexual education programs. Three states require parental consent before a child can receive instruction. 35 states and the District of Columbia allow parents to opt-out on behalf of their children.

Of course, if it’s taught in schools, how properly are the students being educated? This debate between whether it’s the school’s job or a parent’s job will last for a very long time, and quite frankly it is an area that many parents and teachers may agree. There are parents who do not want their children to be taught sex education in schools, just as there are some teachers who don’t think it is their job to teach it.

On the other side are parents and teachers who agree it should be taught in schools and at home because it is a topic that we all cannot escape. And I’m sure there are a bunch of people in the middle who do not even want to discuss the topic at all and just hope for the best.

The NPR story, called “Beyond The Birds And The Bees: Surviving Sex Ed Today” ( which can be heard here ) inspired me to think about all of the places that the topic of sex comes up in conversation. Sometimes it’s through jokes on television or social media, other times it’s in stories on the news, and most times it’s the center of the conversation on the back of a school bus. Whether it makes us uncomfortable or not, we can’t seem to escape the topic.

In the NPR story, Lena Solow, a teacher of ten years,

Covers the topics you’d expect: how to prevent STDs, pregnancy. But Solow talks about way more than going all the way. “One of my biggest goals as a sex educator is to be sex-positive,” she explains, “to talk about pleasure and to talk about sex not just as something that just makes babies.”

Listening to the story made me blush a little as I drove alone in my car through Massachusetts, and made me laugh a bit when Solow said that when she was a student her sex education class was taught by the physical education teacher and revolved around spelling tests.

Yes, spelling tests. She said,

“I definitely had spelling tests as a big part of my sex-ed when I was in middle school: ‘Spell gonorrhea. Spell gonococcus. Now you pass or don’t pass health.’ Literally, that was what was prioritized.”

She wants her students to have a much more knowledgeable experience, and she also explores topics that are unfortunately still controversial in today’s schools, which is the topic of LGBT students. In the NPR story, Garsd writes,

“Beyond the basics, Solow is delving into topics that many teachers would skirt. Things like tolerance. Solow recently asked her students if they thought LGBT people would feel comfortable at the school. A lot of the kids say they didn’t think so.”

It’s definitely a complicated debate, which will last for a very long time. What are your thoughts?

The opinions expressed in Peter DeWitt’s Finding Common Ground are strictly those of the author(s) and do not reflect the opinions or endorsement of Editorial Projects in Education, or any of its publications.

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The Role of Education in Preventing Sexual Misconduct

Three ideas for improving sex education to create a culture of consent and help prevent sexual misconduct.

Students in a biology class, surrounded by human anatomical models and paper handouts

As a consultant and researcher on sexuality and misconduct, I know that preventing sexual misconduct starts with education that shifts the paradigms and norms we have about sex, relationships, and bodily autonomy.

Adulthood is not the best time to start these conversations—by then, our culture and media have already sent millions of messages in the wrong direction. And making sex and sexuality the enemy is the least effective approach. Research shows that the more we talk about sex and agency in the late childhood and teen years, the less likely it is that abusive dynamics will arise—and, if they do, the more likely that self-efficacy and personal advocacy will be present.

As educators, it’s our goal and responsibility to nurture the whole student. Excluding consent and sexual agency from our educational objectives has long-lasting, tragic implications—ones we see, for example, in the scandal that has hit Chicago Public Schools .

Based on my experience as a teacher, trainer, and sex education expert, here are my top three guidelines for creating cultures of consent in our schools.

Discuss Consent in All Its Forms

Consent is not as simple as a cup of tea (as an infamous video would have it). We’ve all grown up in a culture that promotes assault and harassment—through movies, music, and advertisements, we’re fed a steady stream of stories about unhealthy relationships that are presented as romantic, seductive, or humorous. Interpersonal communication continues to follow scripts that promote dishonesty and toxic gender roles—with boys being depicted as sexually insatiable and never victimized, and girls as either “good” and sexually pure, or “at-risk” and hypersexualized.

All of these depictions feed into the concept we call rape culture: the beliefs, myths, and social scripting that promote and maintain sexual violence.

Consent is far more than “no means no,” and even “yes means yes” does not cover all the dynamics involved in authentic, affirmative, and enthusiastic consent. Consider the concepts of token resistance (TR) and token compliance (TC). TR is the expectation of a no when the individual really wants to say yes—e.g., “good girls” are supposed to not like sex, and their no supposedly masks their genuine desires. TC is the flip side: a person saying yes under pressure when they’d rather say no. To educate on consent, we must address these points honestly.

School districts and educators can bridge the gap in subject matter competency around the affirmative consent paradigm by bringing in sex education experts. Sexuality and consent are topics that many educators hesitate to bring up because of a lack of resources and understanding of how to address these deeply complex topics appropriately with children, tweens, and teens, and a sex education expert can help.

Having these conversations in health classes where sex and relationships are already discussed is too limiting to create the shift in cultural values that we need to heal the structural inequalities that lead to sexual misconduct and abuse. We need to train all teachers and administrators on sexual misconduct, consent, dating violence, and reporting and response obligations under Title IX. We then need to infuse these conversations across the curriculum so that students receive these messages consistently throughout their school years.

Explain Sexual Agency and Subjectivity

Sexual agency is the ability to assert sexual needs, desires, and boundaries effectively. Sexual subjectivity is an individual’s ability to reflect on their sexual needs, identity, and rights to pleasure. Together, these concepts form the foundation for creating cultures of consent.

All communal transformation begins with empowering the individual. We can help students unlearn messages about sexual shame, victim-blaming, and slut-shaming, and teach them about body image, sexual empowerment, and their right to sexual pleasure and autonomy. Doing so can shift the current paradigm. Not including sexual pleasure in the conversations we have in sex education classes, for example, feeds into the cultural norms that lead to sexual abuse .

Promote Healthy Relationships for Everyone

Part of creating a consent culture is exploring what defines a healthy relationship. Any time two or more people are interacting—whether in friendship, flirting and dating, or long-term and marital relationships—both empathy and consent must be present.

Conversations that assume that everyone is cisgender or heterosexual are not the answer, and neither are ones that paint every victim of assault as female (they aren’t) and every perpetrator as male (women and girls commit abuse and assault too).

We must break away from these stereotypes and decolonize these discussions. Every culture, ethnicity, and religion has a unique perspective on and expectation for courtship, love, and sex. Ensuring that consent is culturally humble and inclusive is key to guaranteeing its applicability in every community.

We must look critically at whether our depictions of sexuality are centered on straight, white, or cisgendered narratives. If the curriculum or facilitators are focusing on a limited cultural perspective, we should consult with consent educators from other cultures and communities to ensure that messages are inclusive and not resting on a framework of Western moral superiority.

When do we begin this work? As soon as our children can understand language. The seeds of consent are planted in the way we show our children how to share, how to ask before touching or taking, and that every person has the inalienable right to their body.

Our children need to know their right to assert their ability to say no and to require an authentic yes from even those in positions of power. This cannot begin soon enough, because consent is about so much more than sex—it is about the human rights that we are gifted at birth. Schools are in a uniquely important position to do this challenging, grassroots work.

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

After Roe, Sex Ed Is Even More Vital

By Eva Goldfarb and Lisa Lieberman

Drs. Goldfarb and Lieberman are professors of public health at Montclair State University and authors of “Three Decades of Research: The Case for Comprehensive Sex Education.”

Religious-right political groups that have spent decades dismantling abortion rights in much of the country have been gunning for sex education for just as long. Their dangerous and cynical efforts now appear under the guise of “parental rights” and “school transparency” on the floors of state legislatures and at school board meetings.

High quality, evidence-informed sex education is critically important, effective and supported by an overwhelming majority of Americans . Limiting access to that instruction threatens the health and safety of young people, particularly those in states where access to reproductive health care is scarce in post-Roe v. Wade America.

Sadly, sex education is on shaky ground in many parts of the United States. Florida’s “ Don’t Say Gay ” law, which went into effect this month and denies students in younger grades the opportunity to learn about gender identity and sexual orientation, was just one of many recent state bills seeking to restrict access to comprehensive sex education. While groups pushing these laws argue that such instruction puts children at risk of sexual exploitation, our research has found that comprehensive, medically accurate sex ed in fact protects them.

Despite the lies and distortion meant to scare parents away, adults across the political spectrum have said they support sex education for their children. And for good reason: States or counties that support teaching about both contraception and prevention of sexually transmitted infections have lower rates of S.T.I.s and adolescent pregnancies ; states that rely on abstinence-only approaches, now rebranded as “sexual risk avoidance,” have higher teenage pregnancy rates.

In a systematic review of 30 years of peer-reviewed research that explored sex education outcomes beyond pregnancy and S.T.I. prevention, we found that high-quality sex education decreases intimate-partner violence, as well as homophobic bullying and harassment. It promotes healthy relationships and helps prevent child sex abuse by increasing skills to identify and report such offenses.

Sex education improves skills like empathy, communication, managing feelings and ability to establish and maintain positive relationships and increases a sense of self-control and safety. It also strengthens media literacy, which can help young people find reliable information about sexual and reproductive health and rights while being able to detect false or misleading information.

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Int J Environ Res Public Health

Sex Education in the Spotlight: What Is Working? Systematic Review

Associated data.

The data presented in this study are available from the corresponding author on reasonable request.

Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology : We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results : 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion : A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.

1. Introduction

Adolescence is a period of transition, growth, exploration and opportunities that the World Health Organization defines as referring to individuals between 10 years and 19 years of age [ 1 ]. During this life phase, adolescents undergo physical, psychological and sexual maturation and tend to develop an increased interest in sex and relationships, with positive relationships becoming strongly linked to sexual and reproductive health as well as overall wellbeing [ 2 ]. Sexual health is understood as a state of wellness comprising physical, emotional, mental, and social dimensions [ 3 ]: it represents one of the necessary requirements to achieve the general objective of sustainable and equitable societies in terms of the 2030 Agenda [ 4 ], which advocates the need for a sexual education that is anchored in a gender- and human rights-oriented perspective.

In high-income countries, sexual debut usually occurs during adolescence [ 5 ], though research suggests that sexual initiation is increasingly occurring at earlier ages [ 6 ]. Adolescents have to deal with the results of unhealthy sexual behaviors, including unplanned pregnancies and sexually transmitted infections [ 7 ], as well as experiences of sexual violence [ 8 , 9 ]. Adolescents are aware that they need more knowledge in order to enjoy healthy relationships [ 10 ], yet do not receive enough of the kind of information from parents or other formal sources that would allow them to develop a more positive, respectful experience of sexuality and sexual relationships [ 11 ].

Sexual education can be defined as any combination of learning experiences aimed at facilitating voluntary behavior conducive to sexual health. Sex education during adolescence has centered on the delivery of content (abstinence-only vs. comprehensive instruction) by teachers, parents, health professionals or community educators, and on the context (within school and beyond) of such delivery [ 12 ]. As regards content, the proponents of abstinence-only programs aim to help young adults avoid unintended pregnancies and sexually transmitted diseases (STDs), working on the assumption that while contraceptive use merely reduces the risk, abstinence will eliminate it entirely [ 13 ]. 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 their lives [ 16 ]. On the other hand, holistic and comprehensive approaches to sex education go beyond risk behaviors and acknowledge other important aspects, as for example love, relationships, pleasure, sexuality, desire, gender diversity and rights, in accordance with internationally established guidelines [ 17 ], and with the 2030 Agenda [ 4 ]. Comprehensive Sexuality Education (CSE) “plays a central role in the preparation of young people for a safe, productive, fulfilling life” (p. 12) [ 17 ] and adolescents who receive comprehensive sex education are more likely to delay their sexual debut, as well as to use contraception during sexual initiation [ 18 ]. Comprehensive sexual education initiatives thereby promote sexual health in a way that involves not only the biological aspects of sexuality but also its psychological and emotional aspects, allowing young people to have enjoyable and safe sexual experiences.

With regard to context, sexual education may occur in different settings. School settings are key sites for implementing sexual education and for promoting adolescent sexual health [ 19 ], but today internet is becoming an increasingly important source of information and advice on these topics [ 20 ]. Access to the internet by adolescents is almost universal in high-income countries. The ubiquity and accessibility of digital platforms result in adolescents spending a great deal of time on the internet, and the search for information is the primary purpose of health-related internet use [ 21 ]. At the same time, this widespread use of technology by young people offers interesting possibilities for sexual health education programs, given the ease of access, availability, low cost, and the possibility of participating remotely [ 22 ]. The topics that young people search for online include information on everyday health-related issues, physical well-being and sexual health [ 23 ]. The majority of internet users of all ages in the US (80%) search online for health information including sexual health information [ 24 ], and among adolescents social media platforms are the most frequent means of obtaining information about health, especially regarding sexuality [ 25 ].

Thanks to the ubiquity and popularity of technologies, digital media interventions for sexual education offer a promising way forward, both via the internet (eHealth) and via mobile phones (mHealth, a specific way of promoting eHealth), given the privacy and anonymity they afford, especially for young people. Digital interventions in school—both inside and outside the classroom—offer interesting possibilities, because of their greater flexibility with regard to a variety of learning needs and benefits in comparison with traditional, face-to-face interventions, and because they offer ample opportunities for customization, interactivity as well as a safe, controlled, and familiar environment for transmitting sexual health knowledge and skills [ 26 ]. As Garzón-Orjuela et al. [ 27 ] argues, contemporary adolescents’ needs are mediated by their digital and technological environment, making it important to adapt interventions in the light of these realities. Online searches for sexual health information are likely to become increasingly important for young people with diminishing access to information from schools or health care providers in the midst of the lockdowns and widespread school closures during the COVID-19 pandemic [ 28 ], with more than two million deaths and 94 million people infected around the world [ 29 ]. Specifically, blended learning programs, consisting of internet-based educational interventions complemented by face-to-face interventions, may prove a significant addition to regular secondary school sex education programs [ 30 , 31 ]. Blended learning programs can be especially helpful in promoting sexual and reproductive health in the context of the COVID-19 pandemic, which is challenging the way we have so far approached formal education, with its focus on face to face interventions, given the need, now more than ever, to “develop and disseminate online sex education curricula, and ensure the availability of both in-person and online instruction in response to school closures caused by the pandemic” [ 28 ].

The present study sets out to research the dissemination and effectiveness in different settings (school, digital and blended learning) of sex education programs that promote healthy and positive relationships and the reduction of risk behaviors, so as to make current sexual health interventions more effective [ 32 ]. Numerous researchers have carried out trials and systematic reviews so as to evaluate the effectiveness of school-based sexual health and relationship education [ 19 , 27 , 33 , 34 , 35 ], as well as that of digital platform programs [ 36 , 37 , 38 , 39 ]. However, there has not been a review that is representative of the literature as a whole. Furthermore, in the reviews that have been carried out, differing aims and inclusion criteria have led to differences in the sampling of available primary studies [ 19 ]. As Garzón-Orjuela et al. [ 27 ] asserts, the field of adolescent sex education is continuously evolving and in need of evaluation and improvement. Better assessments are necessary in order to clarify whether they offer a viable and effective strategy for influencing adolescents, especially with respect to improved ASRH behaviors. Hence, given the need for an up-to-date revision so as to consider more recent emerging evidence in this field, in this study we carry out a review of reviews that includes reviews of interventions both in school settings and via digital platforms, as well as, for the first time, those that combine both formats (blended learning).

The decision to conduct a review of reviews (RoR), assessing the quality and summarizing the findings of existing systematic reviews, rather than working directly with primary intervention studies, addresses the need to include as wide a range of topics covered within the field of sex education as possible [ 40 ]. As Schackleton et al. [ 35 ] (p. 383) point out, in order to provide overviews of research evidence that are relevant to policy making, it is important “to bring together evidence on different forms of intervention and on different outcomes because it is useful for policy makers to know what is the range of approaches previously evaluated and whether these have consistent effects across different outcomes.” Carrying out and publicly sharing reviews of reviews such as the present study constitutes one way of better providing practitioners with evidence they can then carry over into their interventions [ 32 ].

2. Methodology

(1) To systematically review existing reviews of Sex Education (SE) of school-based (face-to-face), digital platforms and blended learning programs for adolescent populations in high-income countries.

(2) To summarize evidence relating to effectiveness.

2.2. Methods

The review is structured in accordance with the PRISMA checklist (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) (see Figure A1 ), and the systematic review protocol has previously been published on the PROSPERO International Prospective Registry of Technical Reviews (CRD42021224537).

2.3. Search Strategy

This systematic review is based on international scientific literature and only peer- reviewed papers have been included. Only meta-analyses (publications that combine results from different studies) and systematic reviews (literature reviews that synthesize high-quality research evidence) were used for this review. Findings from reviews of reviews were not analyzed. To identify reviews, we electronically searched the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. After the list was completed the duplicated papers were automatically removed. Two reviewers working independently applied inclusion criteria in screening citations by titles, abstracts, and keywords to identify records for full-text review. A third reviewer reconciled any disagreement. The same procedure was carried out in screening the full text of studies selected after the title and abstract screening phase. Two reviewers then examined the full text of each article to determine which satisfied inclusion criteria. Data extraction was carried out independently by the first and second reviewer. The extracted data included specific details about the interventions, populations, study methods and outcomes significant to the review question and objective. Any discrepancies were discussed until consensus was reached. Search terms are included in Table A1 .

This RoR included the reviews published since 2015, when the United Nations decided on new Global Sustainable Development Goals, until December 2020. The 2030 Agenda for Sustainable Development [ 4 ] takes into account the relevance of Sexual Health to achieve peace and prosperity.

2.4. Inclusion Criteria

We extracted data using a “Population, Intervention, Comparison, Outcome” structure, PICO [ 41 ].

Population: Reviews of interventions targeting adolescents (aged 10–19 years), school-setting, digital platforms or blended learning education were eligible for inclusion. Reviews in which studies of interventions targeted youth and adults were eligible if the primary studies included people between the ages of 10–19 years.

Intervention: Reviews of interventions developed in school-setting (school-based), digital (digital platforms) or blended learning programs were included. Interventions based on multiple settings or targeted multiple health-related issues were only considered for inclusion if any primary studies were linked to school-based, digital or blended learning interventions, as well as targeting Sexual and Reproductive Health (SRH).

Comparison groups: Randomized controlled trials (RCTs) and studies using a quasi-experimental design (including non-randomized trials—nRCTs). Single group, pre- and post-test research designs, group exposed to sexual education (SE) program (school-based, digital platforms or blended learning) compared with non-exposed control group or another intervention.

Outcomes: Primary outcomes: (1) Sexual behavior and (2) Health and social outcomes related to sexual health. Secondary outcomes: (1) Knowledge and understanding of sexual health and relationship issues and (2) Attitudes, values and skills.

2.5. Exclusion Criteria

Reviews were excluded if:

Their primary focus was adult people and adolescents were not included.
Their primary focus was sexual-health screening, sexual abuse or assault or prevention of sexual abuse or rape.
The studies targeted specific populations (e.g., pre-pubertal children, children with developmental disorders, migrant and refugee, or sexual minorities).
The interventions focused on low- and middle-income countries or if high income countries were not included in the study.
Recipients were professionals, teachers, parents or a combination of the latter.

2.6. Risk of Bias and Assessment of Study Quality

Review quality was assessed by the first author using the AMSTAR II checklist [ 42 ]. This is an updating and adaptation of AMSTAR [ 43 , 44 ] which allows a more detailed assessment of systematic reviews that include randomized or non-randomized studies of healthcare interventions, or both. It consists of a 16-item tool (including 5 critical domains) assessing the quality of a review’s design, its search strategy, inclusion and exclusion criteria, quality assessment of included studies, methods used to combine the findings, likelihood of publication bias and statements of conflict of interest. The maximum quality score is 16.

2.7. Data Synthesis

After manually coding the papers and extracting relevant data, we used a narrative/descriptive approach for data synthesis to summarize characteristics of the studies included. Considering the heterogeneity of outcomes, their measures and research designs, meta-analysis of all the studies included was not carried out. Two researchers were involved in data synthesis. Discrepancies were resolved through discussion, and a third researcher was consulted to resolve any remaining discrepancies. For the classification of the information and presentation of the effects of the interventions reported, data was separated (school setting, digital platforms or blended learning) and structured around population, intervention, comparison, and outcome. To address the main review questions, data was synthesized in two phases. Phase 1 addressed the first question, the description of sex education/sexual health interventions. Phase 2 addressed the second question, the effectiveness and benefit of the interventions; studies with a low risk of bias were highlighted, so as to strengthen the reliability of findings (AMSTAR II) [ 42 ].

3.1. Results of Search

Our searches yielded 1476 unique citations. After excluding 776 records based on title and abstract screening, we reviewed 217 full-text articles for eligibility, of which 20 ultimately met inclusion criteria, and proceeded to data extraction. Of the 197 studies that we excluded after full-text review, 82 were carried out in low- and middle-income countries, 47 targeted exclusively adults, 56 dealt with minority groups, and 12 targeted exclusively pre-teen students.

3.2. Risk of Bias in Included Studies

According to the AMSTAR II quality assessment tool’s developers [ 42 ] scores may range from 1 to 16: in this case only 2 reviews scored 16 out of 16: 1 in a school setting [ 45 ], and 1 on a digital platform [ 46 ]. 6 of the 20 systematic reviews were of high quality: 5 in school settings [ 45 , 47 , 48 , 49 , 50 ], and 1 in digital platforms [ 46 ]; there was one study of medium quality in a school setting [ 51 ]. The remaining studies were of low or very low quality (N = 13). It is possible that low quality reviews may not provide reliable evidence, so those scoring in low and critically low quality should be regarded skeptically.

3.3. Reviews Included

Key information regarding the 20 reviews included is shown in Table A2 and Table A3 .

3.3.1. Setting

Ten studies (50%) dealt with school-based interventions [ 45 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ], 9 (45%) referred to online interventions [ 46 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 ] and 1 (5%) was a review of blended learning programs [ 64 ]. In total 491 studies were included in the 20 reviews covered by the present RoR. The 10 reviews of school setting interventions include a total of 266 studies (54%), the 9 reviews of online interventions cover a total of 216 (44%) studies, and the only review of blended learning interventions includes a total of 9 studies (2%). All studies were conducted in high-income economies following the World Bank classification [ 65 ], including US samples in 16 of the 20 studies, although there are two studies in which the country of the sample is not identified [ 51 , 52 ]. Most of the studies evaluating interventions in school settings also include developing countries (low- and middle-income economies) [ 45 , 47 , 50 , 52 , 53 , 55 ], as is also the case in three reviews of online interventions [ 46 , 61 , 62 ] (see Table A2 ).

3.3.2. Population

The targeted age for reviews in school settings, as shown in Table A2 , is the period of adolescence, from 10 to 19 years of age, though one of the studies covers ages from 7 to 19 years [ 53 ]. All the online studies also include young adults (20–24 years old), alongside the adolescent sample [ 46 , 56 , 57 , 59 , 60 , 61 , 62 , 63 ], whilst the review by DeSmet et al. [ 58 ] extends the upper limit to 29 years of age. Along with the sample of adolescents and young adults, the blended learning studies review also incorporates adults of over 25 years of age [ 64 ].

3.3.3. Interventions/Types of Study

All the studies included in this review of reviews used randomized controlled trials (RCTs), non-randomized controlled trials (non-RCT), and a quasi-experimental design or a pre-test/post-test design to examine program effects.

3.3.4. Outcomes

The term “sexual outcomes” refers to the attitudes, behaviors, and experiences of adolescents consequent to their sex education [ 14 ] (p. 1), and an extensive range of variables was included (see Table A2 ): knowledge (e.g., knowledge of contraceptive effectiveness or effective method use); attitudes (e.g., about sex and reproductive health); beliefs (e.g., self-efficacy); skills (e.g., condom skills); intentions/motivation (e.g., use of birth control methods; condom use); behaviors (e.g., sexual debut; condom use; contraception use; intercourse; initiation of sexual activity) and; other outcomes related to sexual behavior (e.g., pregnancy prevalence; number of partners; rates of sexually transmissible infections (STIs); cervical screening; appreciation of sexual diversity; dating and intimate partner violence prevention; sexual violence).

3.3.5. Country of Review

Of the 10 reviews of interventions in school settings, the authors are from the USA in 7 reviews [ 47 , 48 , 49 , 50 , 53 , 54 , 55 ], from the United Kingdom in 1 [ 45 ], from Australia in 1 [ 51 ], and from Thailand in 1 [ 52 ]. Of the 9 reviews of interventions in digital settings, the authors are from the United States in 3 reviews [ 59 , 60 , 63 ], from the United Kingdom in 2 [ 46 , 56 ], from Australia in 1 [ 62 ], from Belgium in 1 [ 58 ], from France in 1 [ 61 ] and from Turkey in 1 [ 57 ]. The authors of the blended learning review are from the USA [ 64 ].

3.3.6. Year of Last Paper Included

The studies cited in the reviews that met the inclusion criteria for this review were published over a wide range of years (between 1981–2019), although only one [ 61 ], with articles published up to and including 2019 was published later than 2017. Of these, 3 were carried out in school settings [ 49 , 51 , 53 ], and 1 on digital platforms [ 46 ].

3.3.7. Search Tools

All reviews include more than 2 tools to carry out the search, in a range of 3–12, and in 7 of them the review of gray literature was included.

3.3.8. Multicenter Studies and Number of Studies Included

All reviews from school settings are multicenter, except that of Mirzazadeh et al. [ 49 ], which includes only one North American sample. The same is true for the blended learning review [ 64 ] and for the reviews of digital platforms, except for the reviews by Bailey et al. [ 56 ], L´Engle et al. [ 60 ], and Widman et al. [ 63 ]. Regarding the number of countries included in the reviews, the range in the school-setting reviews is from 1 to 11, in digital platforms reviews from 1 to 16, and in the only review of blended learning, 3. As for the range of studies included, in the reviews in school setting the range is between 8 and 80, in digital platforms, between 5 and 60, and in the only review of reviews of blended learning 9 studies were included.

3.3.9. Number of Reviews Covered That Include Meta-Analysis

As for the number of reviews that carry out a meta-analysis, there are 8 in total: 4 in school settings [ 45 , 48 , 49 , 55 ] and 4 on digital platforms [ 43 , 46 , 56 , 58 ], while in the only review of blended learning there is no meta- analysis.

3.4. Effectiveness

3.4.1. school settings.

Half of the reviews conclude that interventions are not effective in promoting healthy sexual behaviors and/or reducing risks [ 45 , 47 , 48 , 49 , 50 ]. These reviews are of high quality and with a reduced risk of bias (see Table A4 ), so that the results are highly reliable, even though in most of the studies cited the risk of bias was judged to be high and the quality of evidence was low or very low. These reviews include those of the Marseille et al. [ 48 ] and Mirzazadeh et al. [ 49 ] team, who in two studies—each led by one of the two authors—analyze, on the one hand, the effectiveness of school-based teen pregnancy prevention programs [ 48 ], and, on the other hand, the effectiveness of school-based programs prevent HIV and other sexually transmitted infections in North America [ 49 ]. The results of the studies question the usefulness of interventions carried out in schools to prevent both unwanted pregnancies and the incidence of HIV and other sexual transmitted infections in adolescents in North America. In addition to these results, those of Lopez et al. [ 47 ] focus on analyzing the effectiveness of programs implemented in schools to promote the use of contraceptive methods and conclude that many trials reported contraceptive use as an outcome but did not take into consideration whether contraceptive methods and their relative effectiveness were part of the content. For its part, the review by Mason-Jones et al. [ 45 ] also concludes that the educational programs covered had no significant effect as regards the prevalence of HIV or other STIs (herpes simplex virus, moderate evidence and syphilis, low evidence), nor was there any apparent effect in terms of the number of pregnancies at the end of the trial (moderate evidence). Finally, the review by Oringanje et al. [ 50 ] finds only limited evidence for program effects on biological measures, and inconsistent results for behavioral (secondary) outcomes across trials and concludes that it was only the interventions which combined education and contraception promotion (multiple interventions) that led to a significant reduction in unintended pregnancies over the medium- and long-term follow-up period.

In contrast to these negative results in terms of the effectiveness of the programs implemented in the school environment (identified in 5 of the 10 reviews included), 3 of the 10 reviews concluded that the programs evaluated were mostly effective in promoting knowledge, attitudes and/or in reducing risk behaviors [ 51 , 52 , 53 ] whilst programs were effective in terms of some of the primary outcomes in the reviews by Haberland et al., [ 54 ], and Peterson et al. [ 55 ]. However, these data must be taken with caution since the level of bias in these reviews—excepting that of Kedzior et al. [ 51 ] with a medium quality level—is at a low or critically low-quality level. In the review by Chokprajakchad et al. [ 52 ], 22 programs reviewed were effective in changing targeted adolescent psychosocial and/or behavioral outcomes, in 12 of 17 studies evaluating delay in the initiation of sexual intercourse, the programs were effective and many of the reviewed studies demonstrated impacts on short-term outcomes, such as knowledge, attitudes, perception and intention. The review by Goldfarb et al. [ 53 ] identifies changes in appreciation of sexual diversity, dating and intimate partner violence prevention, healthy relationships, child sex abuse prevention and additional outcomes. According to the review by Kedzior et al. [ 51 ], focused on studies promoting social connectedness with regard to sexual and reproductive sexual health, the programs reviewed improved condom use, delayed initiation of sex, and reduced pregnancy rates. Additionally, in this review, program effectiveness was influenced by ethnicity and gender: greater improvements in condom use were often reported among African American students. For its part, in the study by Peterson et al. [ 55 ] the meta-analysis of three randomized trials provided some evidence that school-environment interventions may contribute to a later sexual debut while their narrative synthesis of other outcomes offered only mixed results.

Finally, the review by Haberland et al. [ 54 ], which focused on studies analyzing whether addressing gender and power in sexuality education curricula is associated with better outcomes, concluded that where interventions addressed gender or power (N = 10/22) there was a fivefold greater likelihood of effectiveness than in those that did not.

3.4.2. Online Platforms

The reviews included show a very diverse panorama of digital platforms used to carry out educational interventions (e.g., websites, social media, gaming, apps or text messaging and mailing), which makes it difficult to compare the results. Of the 9 reviews of studies included, only one—in which the effects of TCCMD (Targeted Client Communication delivered via Mobile Devices) are evaluated [ 46 ]—meets the quality criteria according to the AMSTAR II quality assessment tool [ 42 ] (see Table A4 ); the rest include biases that limit the reliability of the results so that these must be taken with caution. In the studies reviewed by Palmer et al. [ 46 ] among adolescents nine programs were delivered only via text messages; four programs used text messages in combination with other media (for example, emails, multimedia messaging, or voice calls); and one program used only voice calls.

When compared with more conventional approaches, interventions that use TCCMD may increase sexual health knowledge (low certainty evidence), and may modestly increase contraception use (low certainty evidence) while the effect on condom use remains unclear given the very low certainty evidence. Additionally, when compared with digital non-targeted communication, the effects TCCMD on sexual health knowledge, condom and contraceptive use are also unclear, again given the very low-certainty evidence. The review finds evidence of a modest beneficial intervention effect on contraceptive use among adolescent (and adult) populations, but that there was insufficient evidence to demonstrate that this translated into a reduction in contraception.

Most of the reviews included refer to changes to a greater or lesser extent [ 56 , 57 , 59 , 60 , 62 , 63 ], while no changes determined by the intervention were identified in the study by DeSmet et al. [ 58 ]. Finally, the review by Martin et al. [ 61 ] does not include details about changes as a result of the programs.

The review by L´Engle et al. [ 60 ] assesses mHealth mobile phone interventions for ASRH (almost all of which were carried out via SMS platforms, with the notable exception of only four of the programs covered which used other media formats instead of or as well as SMS). The interventions reviewed set out to foster positive and preventive SRH behaviors, augment take-up and continued use of contraception, support medication adherence for HIV-positive young people, support teenage parents, and encourage use of health screening and treatment services. Results from the studies covered in the review offer support for diverse uses of mobile phones in order to help further ASRH. The health promotion programs that made use of text messaging demonstrated robust acceptability and relevance for young people globally and contributed to improved SRH awareness, less unprotected sex, and more testing for STIs. However, the review also found that improved reporting on essential mHealth criteria is necessary in order to understand, replicate, and scale up mHealth interventions. Holstrom’s [ 59 ] review, focused on evaluations of internet-based sexual health interventions, finds that these were associated with greater sexual health knowledge and awareness, lower rates of unprotected sex and higher rates of condom use, as well as increased STI testing. Moreover, the review explores young people’s continuing use of and trust in internet as a source of information about sexual health, as well as the particular themes that interest them. Specifically, the study finds that young people want to know not only about STIs, but also about sexual pleasure, about how to talk with partners about their sexual desires, as well as about techniques to better pleasure their partners.

The review by Widman et al. [ 63 ] reveals a significant weighted mean effect of technology-based interventions on condom use and abstinence, the effects of which were not affected by age, gender, country, intervention, dose, interactivity, or program tailoring. The effects were more significant when evaluated with short-term (one to five months) follow-ups than with longer term (over six months) ones. Moreover, digital programs were more effective than control programs in contributing to sexual health knowledge and safer sex norms and attitudes. This meta-analysis, drawing on fifteen years of research into youth-oriented digital interventions, is clear evidence of their ability to contribute to safer sex behavior and awareness. In the review by Wadham et al. [ 62 ] the majority of studies used a web-based platform for their programs (16 out of 25). These web-based programs varied between complex, bespoke multimedia interventions to more simplified educational modules. Five studies employed SMS platforms both via mobile phone messaging and web-based instant message services. Three of the programs used social networking sites, either for live chat purposes or alongside a web-based platform. Several studies showed that variety in terms of media and platforms was associated with stronger positive responses among participants and improved outcomes. Eleven of the twenty-five studies focused specifically on HIV prevention, with seven finding a statistically significant effect of the program with regard to knowledge levels about prevention of HIV and other STIs, as well as about general sexual health knowledge. However, only twenty percent of the programs that assessed intended use of condoms reported significant effects due to the intervention.

The review by Bailey et al. [ 56 ] (p. 5) assesses interactive digital interventions (IDIs), defined as “digital media programs that provide health information and tailored decision support, behavioral-change support and/or emotional support” and focuses on the sexual well-being of young people between the ages of thirteen and twenty four in the United Kingdom. IDIs have significant though small effects on self-efficacy and sexual behavior, although there is not sufficient evidence to ascertain the effects on biological outcomes or other longer-term impacts. When comparing IDIs with in-person sexual health programs, the former demonstrate significant, moderate positive effects on sexual health knowledge, significant small effects on intention but no demonstrable effects on self-efficacy. The review by Celik et al. [ 57 ] looks at digital programs (the majority internet- and computer-based with only six making use of mobile phone-based applications) and sets out to understand their effectiveness in changing adolescents’ health behaviors. Findings from the studies ( n = 9) suggest that the digital interventions carried out with the adolescents generally had a positive effect on health-promoting behaviors. However, in another study focused on fostering HIV prevention [ 66 ], there was a statistically significant increase in health-promoting behavior in only one of the four studies reviewed.

In the review by DeSmet et al. [ 58 ], no significant behavioral changes as a result of the interventions for sexual health promotion using serious digital games are identified, although the interventions did have significant though small positive effects on outcomes. The fact that so few studies both met the inclusion criteria and also analyzed behavioral effects suggests the need to further investigate the effectiveness of this kind of game-based approach.

Finally, in the review by Martin et al. [ 61 ] 60 studies were covered, detailing a total of 37 interventions, though only 23 of the reviews included effectiveness results. A majority of the interventions were delivered via websites ( n = 20) while online social networks were the second most favored medium ( n = 13), mostly via Facebook ( n = 8). The programs under review favored online interaction, principally amongst peers ( n = 23) but also with professionals ( n = 16). The review concludes that ASHR programs promoting these kinds of online participation interventions have demonstrated feasibility, practical interest, and attractiveness, though their effectiveness has yet to be determined, given that they are still in the early stages of design and evaluation.

3.4.3. Blended Learning

In the only blended learning review included in our study [ 64 ], the authors conclude that blended learning approaches are being successfully applied in ASHR interventions, including in school-based programs, and have led to positive behavioral and psychosocial changes. However, these results should be treated with caution as the review does not follow the guidelines recommended in the AMSTAR II quality assessment tool [ 44 ] (see Table A4 ) and only includes nine studies.

4. Discussion

The present review of reviews assesses, for the first time jointly to our knowledge, the effectiveness of sexual education programs for the adolescent population (ASRH) developed in school settings, digital platforms and blended learning. Of the twenty reviews included (comprising a total of 491 programs, mostly from the USA), ten correspond to reviews of programs implemented in school settings, nine to those dealing with interventions via digital platforms and only one deals with studies relating to blended learning. Twelve (60%) of the reviews included (6 out of 10 in school settings, 5 out of 9 on digital platforms, and the only blended learning review) have been published in the last 3 years (between 2018 and 2020). Thus, the present study constitutes the most up-to-date and recent review of reviews incorporating several contemporary studies not covered by earlier reviews [ 19 , 27 , 33 , 35 , 36 , 37 , 38 , 39 ].

4.1. Interventions Reviewed

The interventions included in the reviews covered by our study were largely focused on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), and envisaging sex as a problem behavior. Programs reviewed often focused on the physical and biological aspects of sex, including pregnancy, STIs, frequency of sexual intercourse, use of condom, and reducing adolescents´ number of sexual partners. One exception is Golfard’s et al. [ 53 ] review about comprehensive sex education, which is centered on healthy relationships and sexual diversity, though it also makes reference to prevention of violence (dating and intimate partner violence prevention and sex abuse prevention). However, Golfard’s et al.’s [ 53 ] rejects more than 80% of the studies initially reviewed because they were focused solely on pregnancy and disease prevention. In the reviews of interventions on digital platforms and via blended learning all the outcomes focused on behaviors related to sexual health (focused on the prevention of risk behaviors), and in several cases also addressed perceived satisfaction and usability. These results are in line with other studies that confirm the over-attention given to risk behaviors, to the detriment of other more positive aspects of sexuality [ 67 , 68 ]. Teachers continue to perceive their responsibility as combating sexual risk, whilst viewing young people as immature and oversexualized [ 69 ], even as adolescents themselves express a preference for sex education with less emphasis on strictly negative sexual outcomes [ 16 ], and more emphasis on peer education [ 70 ].

As for more positive views of sexuality, only on rare occasions do interventions address issues such as sexual pleasure, desire and healthy relationships. Desire and pleasure were not included in the outcome evaluations for school settings, nor for digital and blended learning programs included in this review: again this is in line with the position of other authors cited in the present study, who advocate the need to also embrace the more positive aspects of sexuality [ 53 , 56 ]. Specifically, Bailey and colleagues [ 56 ] (p. 73) suggest as “optimal outcomes” social and emotional well-being in sexual health. Young people want to know about more than STIs, they also “want information about sexual pleasure, how to communicate with partners about what they want sexually and specific techniques to better pleasure their partners” [ 59 ] (p. 282). Similarly, Kedzior et al. [ 51 ] also argue for the need to move beyond a risk-aversion approach and towards one that places more emphasis on positive adolescent sexual and reproductive health.

Pleasure and desire are largely absent within sex and relationship education [ 71 ] and, when they are included, they are often proposed as part of a discourse on safe practice, where pleasure continues to be equated with danger [ 72 ]. The persistent absence of a “discourse of desire” in sex education [ 73 , 74 ] is especially problematic for women, for whom desire is still mediated by (positive) male attention, and for whom pleasure is derived from being found desirable and not from sexual self-expression or from their own desires [ 75 ]. Receiving sexualized attention from men makes women “feel good” by increasing their self-esteem and self-confidence [ 76 ]. However, it is still men who decide what is sexy and what is not, based on the attention they pay to women “girl watching”, [ 77 ] (p. 386), which leads the latter to self-objectify [ 78 ] with all the attendant negative consequences for their overall and sexual health [ 79 ]. In fact, women experience “pushes” and “pulls” [ 80 ] (p.393) with regard to sexualized culture. In one sense, the sexualization of culture has placed women in the position of subjects who desire, not just that of subjects who are desired, but at the same time it becomes a form of regulation in which young women are forced to assume the current sexualized ideal [ 81 , 82 ] in order to position themselves as “modern, liberated and feminine,” and avoid being seen as “outdated or prudish” [ 83 ] (p. 16). Koepsel [ 84 ] provides a holistic definition of pleasure as well as clear recommendations for how educators can overcome these deficits by incorporating pleasure into their existing curricula. At present, sexual education is still largely centered on questions of public health, and there is as yet no consensus on criteria for defining sexual well-being and other aspects of positive sexuality [ 85 ]. Patterson et al. [ 86 ] argue for the need to mandate “comprehensive, positive, inclusive and skills-based learning” to enhance people´s ability to develop healthy positive relationships throughout their lives.

The absence of desire and pleasure in the outcomes of the evaluated reviews is connected with the absence of gender-related outcomes. Only one of the reviews addresses the issue of gender and power in sexuality programs [ 54 ], illustrating how their inclusion can bring about a five-fold increase in the effectiveness of risk behavior prevention. Nonetheless, men are far less likely than women to sign up for a sexuality course, and as a result of masculine ideologies many young males experience negative attitudes towards sex education [ 87 ]. To date we still have little idea as to what are the “active ingredients” that can contribute to successfully encouraging men to challenge gender inequalities, male privilege and harmful or restrictive masculinities so as to help improve sexual and reproductive health for all [ 88 ] (p.16). Schmidt et al.’s [ 89 ] review looks at 10 evidence-based sexual education programs in schools: the majority discuss sexually transmitted diseases and unplanned pregnancy, abstinence, and contraceptive use, while very few address components related to healthy dating relationships, discussion of interpersonal violence or an understanding of gender roles.

The International Guidance on Sexuality Education [ 90 ], and the International Technical Guidance on Sexuality Education [ 17 ] promote the delivery of sexual education within a framework of human rights and gender equality to support children and adolescents in questioning social and cultural norms. The year 2020 marked the anniversaries of several path breaking policies, laws and events for women’s rights: the 100th anniversary of women´s suffrage in the United States; the 25th anniversary of the Beijing Platform for Action, a global roadmap for women´s empowerment; and, the 20th anniversary of the United Nations Security Council Resolution for a Women, Peace and Security agenda. Although there have been important advances in recent years in research relating to the inclusion of gender equality and human rights interventions in ASRH policies and programming still “fundamental gaps remain” [ 40 ] (p.14). Gender equality, and to an even greater extent human rights, have had very little presence in sexual and reproductive health programs and policies, and there is a pressing need to do more to address these issues systematically. Specifically, issues such as abortion and female genital mutilation, with clear repercussions in terms of gender equality and human rights, are rarely dealt with [ 40 ].

Furthermore, sexual education that privileges heterosexuality reinforces hegemonic attributes of femininity and masculinity, and ignores identities that distance themselves from these patterns. Our collective heteronormative legacy marginalizes and harms LGB families [ 91 ] and LGBTQ+-related information about healthy relationships is largely absent from sexual and reproductive health programs [ 92 ]. Students want a more LGBTQ+ inclusive curriculum [ 92 ]: in the present RoR one review [ 53 ] addresses the issue of non-heteronormative identity in sexuality programs with significant results; and other authors are exploring promising initiatives which are also challenging this lack of inclusivity [ 93 ] and rectifying heterosexual bias [ 94 ]. However, unfortunately, the underlying neoliberal focus of the majority of contemporary sexuality education militates to assimilate LGBTQ+ people into existing economic and social normative frameworks rather than helping disrupt them [ 95 ].

4.2. Effectiveness

This present review of reviews shows a variety of types of sexual health promotion initiatives across the three settings (school-based, digital and blended learning), with inconsistent results. The reviews with lower risk of bias are those carried out in school settings and those that are most critical regarding the effectiveness of programs promoting ASRH, both in the prevention of pregnancies and of HIV/STIs. Reviews dealing with digital platforms and blended learning show greater effectiveness in terms of promoting adolescent sexual health: however, these are also the studies that incorporate the highest risks of bias. Specifically, in digital platforms programs the great variety of alternatives makes comparability difficult. Moreover, these programs, along with blended learning, are in a more incipient state of evaluation, compared to school-setting evaluations, and present greater risks of lower quality than reviews in school settings.

The results of the present RoR are in line with those of previous RoRs [ 19 , 32 ]. The review of reviews by Denford et al.s´ [ 19 ] RoR covered 37 reviews up to 2016 and summarized 224 primary randomized controlled trials: whilst it concludes that school-based programs addressing risky sexual behavior can be effective, its reviews of exclusively school-based studies offer mixed results as to effectiveness in relation to attitudes, skills and behavioral change. Some of those studies report positive effects while others find there are no effects, if not even negative effects, in terms of the aforementioned outcomes [ 19 ]. As regards pregnancy, programs appear to be effective at increasing awareness regarding STIs and contraception but overall the findings suggest that the impact of these interventions on attitudes, behaviors and skills variables are mixed, with some studies leading to improvements whilst others show no change. Moreover, the fact that community-based programs were also taken into consideration might have led to the effectiveness of school-based programs being exaggerated [ 19 ].

However, although in our RoR the higher quality/lower bias studies—in keeping with the findings of previous reviews [ 19 , 33 ]—fail to show a clear pattern of effectiveness, the interventions could nevertheless be generating changes as Denford et al. [ 19 ] suggest, though not in the measured outcomes, bearing in mind the low incidence of sexual intercourse and pregnancy in school-going adolescents.

With regard to school settings, Peterson et al. [ 55 ] conclude that further, more rigorous evidence is necessary to evaluate the extent to which interventions addressing school-related factors are effective and to help better understand the mechanisms by which they may contribute to improving adolescent sexual health. With regard to digital platform programs, Wadham et al. [ 62 ] (p. 101) argue that “although new media has the capacity to expand efficiencies and coverage, the technology itself does not guarantee success.” An interesting observation in their review was that interventions which were either web-based adaptations of prior prevention programs, or were theory-based or had been developed from models of behavioral change appeared effective independently of the chosen digital media mode. However, digital programs are still in the early stages of design and evaluation, especially in terms of the effects of peer interaction and often diverge from existing theoretical models [ 61 ] (p. 13). The expert opinion-based proposal of the European Society for Sexual Medicine [ 96 ] argues that e-sexual health education can contribute to improving the sexual health of the population it seems the future of CSHE is moving towards smartphone apps [ 97 ].

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” [ 17 ] (p. 12), and during “the current public health crisis, the sexual and reproductive health of adolescents and young adults must not be overlooked, as it is integral to both their and the larger society’s well-being” [ 28 ] (p. 9). In the light of these challenges, Coyle et al.’s [ 64 ] suggestion that the blended learning model may end up achieving a far more dominant role in the future of sexual education acquires even more relevance.

4.3. Limitations

This study represents the first review of reviews, as far as we are aware, in which the effectiveness of sex education programs in different settings (school-based, digital and blended learning) is evaluated, using a rich methodology and providing interesting conclusions. However, the present review of reviews is not without its limitations.

While systematic reviews and reviews of reviews can offer a way synthesizing large amounts of data, the great heterogeneity and diversity of measured outcomes make it difficult to establish a synthesis of the results, even more so in cases where it is not possible to apply meta-analysis. Furthermore, the quality of reviews of reviews is limited by that of the reviews they include and RoRs do not necessarily represent the leading edge research in the field.

In addition, although we searched for a wide range of keywords on the most commonly used databases in the field of health (namely ERIC, Web of Science, PubMed, and PsycINFO) to identify relevant papers, it is possible that the choice of keywords and database may have resulted in our omitting some relevant studies. Moreover, our review has focused on articles in international journals published in English, allowing us access to the most rigorous peer-reviewed studies and to those with greater international diffusion, given that English is the most frequently used language in the scientific environment: notwithstanding, this has also limited the scope of our review by precluding research published in other languages and contexts. Nor have documents that could have been found in the gray literature been included, given that only peer-reviewed studies have been considered for inclusion.

It is worth remembering moreover that most of the data on the outcomes of the studies included are self-reported, with mention of only occasional biological outcomes, which may limit the reliability of the effectiveness results. This represents another interesting reflection on the way in which the evaluation of the effectiveness of programs on sexual education is being carried out, and alerts us to the need for change.

Finally, it should be noted that this review of reviews is focused on adolescents from high-income countries, and our results show that studies carried out in the United States are largely overrepresented, since it is the country that provides the highest number of samples, especially in school settings: this may give rise to bias when it comes to generalizing from these results. Once again, this raises another necessary reflection on the capitalization that studies focused on American samples are having in the construction of the body of scientific knowledge on sexual and reproductive behavior, when in reality sexuality is conditioned by socio-economic variables that require a far-more multicultural and world-centric approach.

5. Conclusions

This review of reviews is the first to assess jointly the effectiveness of school-based, digital and blended learning interventions in ASRH in high-income countries. The effectiveness of the sex education programs reviewed mostly focused on the reduction of risky behaviors (e.g., STI or unwanted pregnancies) as public health outcomes; however, pleasure, desire and healthy relationships are outcomes that are mostly conspicuous by their absence in the reviews we have covered. Nonetheless, the broad range of studies included in this RoR, with their diversity of settings and methods, populations and objectives, precludes any easily drawn comparisons or conclusions. The inconsistent results and the high risk of bias reduce the conclusiveness of this review, so a more rigorous assessment of the effectivity of sexual education programs is pending and action needs to be taken to guarantee better and more rigorous evaluations, with sufficient human and financial resources. Schools and organizations need technical assistance to build the capacity for rigorous program planning, implementation and evaluation [ 98 ]. To this end, there are already examples of interesting proposals, such as that of the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to help public school districts develop and deliver comprehensive sexuality programs in the USA [ 99 ].

The extent of the risks of bias identified in the reviews and studies covered by this RoR points to an important conclusion, allowing us to highlight the precariousness that characterizes the evaluation of sexual education programs and the consequent undermining of public policy oriented to promoting ASRH. Public policies that promote ASRH are of vital importance when it comes to minimizing risks related to sexual behavior, and maximizing healthy relations and sexual well-being for the youngest members of our society.

Above all it is important to recognize the opportunities afforded by new technologies, so ubiquitous in the lives of young people, since they allow for programs that are far more cost-effective than traditional, in-person interventions. Finally, blended learning programs are perhaps even more promising, given their combination of the best of face-to-face and digital interventions, meaning they provide an excellent educative tool in the new context of the COVID-19 pandemic, and may even become the dominant teaching model in the future.

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Flow diagram Preferred reporting items for systematic reviews and meta-analysis, PRISMA).

Search Terms Used.

Characteristic	Search Terms
Sex education	“sex education” OR “sexuality education” OR “sex education program” OR “sexuality education program” OR “reproductive education” OR “Sexual health education” OR “reproductive health education” OR “sexual and reproductive health” OR “sexual health”
Study population (adolescents)	“adolescent” OR “adolescents” OR “teenagers” OR “young people” OR “young person” OR “primary students” OR “Secondary Students” OR “student”
Setting (school, online, blended learning)	“internet” OR “online” OR “offline” OR “virtual” OR “digital” OR “computer” OR “computer-technology” OR “technology” OR “computerized” OR “internet-based intervention” OR “computer based approach” OR “computer-assisted education” OR “school” OR “school-based” OR “K-12 setting” OR “school based programs” or “school setting” OR “blended learning”
Evaluation (review of reviews)	“evaluation” OR “assessment” OR “impact” OR “intervention” OR “impact evaluation” OR “outcome evaluation” OR “process evaluation” OR “comparative effectiveness research” OR “review” OR “review of reviews” OR “systematic reviews” OR “narrative reviews”

Description of studies.



Chokprajakchad et al. (2018)	Sexual Health Interventions Among Early Adolescents: An Integrative Review.	Thailand	PubMed, CINAHL, Scopus, Science Direct, Web of Science, Thaijo and TCI.	2006–2017	2016	33 studies	International.	Narrative
Goldfarb et al. (2020)	Three Decades of Research: The Case for Comprehensive Sex Education.	USA	ERIC, Psycinfo and MEDLINE.	1990–2017	2017	80 studies	USA ( = 55), Israel ( = 1), Canada ( = 6), Australia ( = 3), New Zealand ( = 1), The Netherlands ( = 2) Kenya ( = 1), Mexico ( = 2), South Africa ( = 1), Ireland ( = 2), South Korea ( = 1), China ( = 1), Holland ( = 1) U.K ( = 1), Europe ( = 2).	Narrative
Haberland et al. (2016)	The Case for Addressing Gender and Power in Sexuality and HIV Education: A Comprehensive Review of Evaluation Studies.	USA	PubMed, ERIC, Cochrane Central Register of Controlled Trials and Eldis.	1990–2012	2011	22 studies	USA ( = 14). High income countries other than the United States ( = 2). Low or middle income country ( = 6).	Meta-analysis (one outcome) and Narrative
Kedzior et al. (2020)	A Systematic Review of School-Based Programs to Improve Adolescent Sexual and Reproductive Health: Considering The Role of Social Connectedness.	Australia	PubMed, CINAHL, Embase, Psycinfo, ERIC and SCOPUS.	July 2019	2017	18 studies	International.	Narrative
Lopez et al. (2016)	School-Based Interventions for Improving Contraceptive Use in Adolescents.	USA	PubMed, CENTRAL, ERIC, Web of Science and POPLINE.	1981–2016	2014	11 studies	USA ( = 6). U.K ( = 1). Mexico ( = 3). South Africa ( = 1).	Narrative
Marseille et al. (2018)	Effectiveness of School-Based Teen Pregnancy Prevention Programs in The USA: A Systematic Review and Meta-Analysis.	USA	Cochrane Central, ERIC, PubMed, Psycinfo, Scopus, Web of Science and The Gray Literature.	1985–2017	2016	21 studies	USA ( = 14). Canada ( = 4).	Meta-analysis
Mason-Jones et al. (2016)	School-Based Interventions for Preventing HIV, Sexually Transmitted Infections, and Pregnancy in Adolescents.	United Kingdom	MEDLINE, CENTRAL, OMS, AIDS, AEGIS, CDC, and ONUSIDA.	1990–2016	2015	8 studies	Sub-Saharan Africa: (South Africa, Tanzania Zimbabwe, Malawi Kenya) = 5, Europe: (England and Scotland) = 2, Latin America ( = 1).	Meta-analysis
Mirzazadeh et al. (2018)	Do School-Based Programs Prevent HIV and Other Sexually Transmitted Infections in Adolescents? A Systematic Review and Meta-Analysis.	USA	PubMed, Cochrane Central Register of Controlled Trials, ERIC, Psycinfo, Scopus, Web ofScience andThe Gray Literature.	May 2017	2017	9 studies	USA ( = 9).	Meta-analysis
Oringanje et al. (2016)	Interventions for Preventing Unintended Pregnancies Among Adolescents	USA	CENTRAL, The Cochrane Library, MEDLINE, EMBASE, LILACS, Social Science Citation Index and Science Citation Index, Dissertations Abstracts Online, Network, HealthStar, Psycinfo, CINAHL, POPLINE and The Gray Literature	1994–2015	2015	53 studies	USA ( = 41), England ( = 2), Scotland ( = 2), Canada ( = 1), Italy ( = 1), Mexico ( = 2), Low and middle income countries ( = 4).	Narrative
Peterson et al. (2019)	Effects of Interventions Addressing School Environments or Educational Assets on Adolescent Sexual Health: Systematic Review and Meta-Analysis.	USA	BiblioMap, CINAHL Plus, ERIC, IBSS, Open Grey, ProQuest, Psycinfo, Medline and Web of Science.	1999–2016	2016	11 studies	Australia and USA ( = 5), South Africa and Kenya ( = 4), Malawi and Zimbabwe (n = 2).	Meta-analysis and narrative


Bailey et al. (2015)	Sexual Health Promotion for Young People Delivered Via Digital Media: A Scoping Review.	United Kingdom	CENTRAL, DARE, MEDLINE, EMBASE, CINAHL, BNI, Psycinfo and The Gray Literature.	1989–2013	2013	19 studies	United Kingdom ( = 19).	Meta-analysis andNarrative
Celik et al. (2020)	The Effect of Technology-Based Programmes On Changing Health Behaviours of Adolescents: Systematic Review.	Turkey	PubMeb and Science direct databases.	2011–2016	2016	16 studies	Canada ( = 2), New Zealand ( = 1), Australia ( = 3), Norway ( = 1), USA ( = 9).	Narrative
Desmet et al. (2015)	A Systematic Review and Meta-Analysis of Interventions for Sexual Health Promotion Involving Serious Digital Games.	Belgium	PubMed, Web of Science, CINAHL and Psycinfo.	July 2013	2012	7 studies	USA ( = 6), United Kingdom ( = 1).	Meta-analysis
Holstrom (2015)	Sexuality Education Goes Viral: What We Know About Online Sexual Health Information.	USA	Medline, EBSCO, ERIC and PubMed. The EBSCO.	2004–2014	2012	5 studies	USA ( = 3), Australia ( = 1), Europe ( = 1).	Narrative
L’Engle et al. (2016)	Mobile Phone Interventions for Adolescent Sexual and Reproductive Health: A Systematic Review.	USA	PubMed, Embase, Global Health, Psycinfo, Popline, Cochrane Library, Web of Science and The Gray Literature.	2000–2014	2014	35 studies	USA ( = 35).	Narrative
Martin et al. (2020)	Participatory Interventions for Sexual Health Promotion for Adolescents and Young Adults on The Internet: Systematic Review.	France	PubMeb, Aurore database and The Gray Literature.	2006–2019	2019	60 studies	USA ( = 38), Canada ( = 1), United Kingdom ( = 4), Netherlands ( = 1), Europe ( = 2). Australia ( = 3), Uganda ( = 4), Brazil ( = 2), Chile ( = 2), Asia ( = 3),	Narrative
Palmer et al. (2020)	Targeted Client Communication Via Mobile Devices for Improving Sexual and Reproductive Health.	United Kingdom	Cochrane Central Register of Controlled Trials, MEDLINE, POPLINE, WHO Global Health Library and The Gray Literature.	July 2019	2017	33 studies	Colombia ( = 1), China ( = 2), Australia ( = 2), USA ( = 9), U.K. ( = 2), Peru ( = 1), Lower middle income ( = 16).	Meta-analysis AndNarrative
Wadham et al. (2019)	New Digital Media Interventions for Sexual Health Promotion Among Young People: A Systematic Review.	Australia	CINAHL, Medline, Psycinfo, Socindex, Informit, PubMed and Scopus.	2010–2017	2016	25 studies	USA ( = 16), Canada ( = 1), Netherlands ( = 2), Australia ( = 2), African American communities ( = 1), Chile ( = 1), Uganda ( = 1), Thailand ( = 1).	Narrative
Widman et al. (2018)	Technology-Based Interventions to Reduce Sexually Transmitted Infections and Unintended Pregnancy Among Youth.	USA	Medline, Psycinfo and Communication Source.	May 2017	2015	16 studies	USA ( = 16).	Meta-analysis


Coyle et al. (2019)	Blended Learning for Sexual Health Education: Evidence Base, Promising Practices, and Potential Challenges.	USA	Google Scholar, PubMed and the Cumulative Index of Nursing.	2000–2017	2015	9 studies	USA ( = 6), U.K ( = 2), Europe ( = 1).	Narrative

Characteristics and main results of the studies included.



Chokprajakchad et al. (2018)	To describe and analyze methodological and substantive features of research on interventions to delay the initiation of sexual intercourse and prevent other sexual risk behaviors among early adolescents.	10–13 years	14 studies used randomized controlled trials (RCTs), 16 used quasi-experimental designs and three used a pre-test, post-test design.	(a) Adolescent sexual behavior. (b) Initiation of sexual activity. (c) Condom use and other. Contraceptive use. (a) Adolescents’ attitudes. (b) Self-efficacy. (c) Intentions related to sexual behavior.
Goldfarb et al. (2020)	To find evidence for the effectiveness of comprehensive sex education in school-based programs.	3–18 years	Randomized controlled trial (RCTs), quasi-experimental, and pre- and post-test.	Homophobia, homophobic bullying, understanding of gender/gender norms, recognition of gender equity, rights, and social justice. Knowledge and attitudes about, and reporting of, DV and IPV; DV and IPV perpetration and victimization; bystander, intentions and behaviors. Knowledge, attitudes, and skills and intentions. Knowledge, attitudes, skills and social-emotional outcomes related to personal safety and touch. Social emotional learning. Media literacy.
Haberland et al. (2016)	Evaluation of behavior-change interventions to prevent HIV, STIs or unintended pregnancy to analyze whether addressing gender and power in sexuality education curricula is associated with better outcomes.	Adolescents under 19 years	Randomized Controlled Trials (RCTs) or quasi-experimental.	(a) STIs. (b) HIV. (c) Pregnancy. (d) Childbearing.
Kedzior et al. (2020)	Determine the impact of school-based programs that promote social connectedness on adolescent sexual and reproductive health.	10–19 years	Randomized controlled trials, non-randomized controlled trials (including quasi), controlled before-after (pre-/post-) interrupted time series, and program evaluations. Program evaluation without a control group were eligible if they reported on outcomes pre- and post- program implementation.	(a) Contraception use. (b) Intercourse (frequency or another outcome as defined by authors). (c) Risk of adolescent pregnancy and birth. (d) Rates of sexually transmissible infections (STIs). (e) Attitudes, beliefs and knowledge about sex and reproductive health. (f) Autonomy. (g) Connectedness.
Lopez et al. (2016)	To identify school-based interventions that improved contraceptive use among adolescents.	19 years or younger	Randomized controlled trials (RCTs). (Of 11 trials, 10 were cluster randomized).	(a) Pregnancy (six months or more after the intervention began). (b) Contraceptive use (three months or more after the intervention began). (a) Knowledge of contraceptive effectiveness or effective method use. (b) Attitude about contraception or a specific contraceptive method.
Marseille et al. (2018)	To evaluate the effectiveness of school-based teen pregnancy prevention programs in the USA.	10–19 years	Randomized controlled trials (RCTs) (10 studies) and non-RCTs (11 studies) with comparator groups were eligible yielded 30 unique pooled comparisons for pregnancy.	Pregnancy. (a) Sexual Initiation. (b) Condom Use. (c) Oral Contraception Pill Use.
Mason-Jones et al. (2016)	To evaluate the effects of school-based sexual and reproductive health programs on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents.	10–19 years	Randomized Controlled Trials (RCTs) (both individually randomized and cluster-randomized included 8 cluster-RCTs).	(a) HIV prevalence. (b) STI prevalence. (c) Pregnancy prevalence. (a) Use of male condoms at first sex. (b) Use of male condoms at most recent (last) sex. (c) Initiation (sexual debut).
Mirzazadeh et al. (2018)	To evaluate the effectiveness of school-based programs prevent HIV and other sexually Transmitted Infections in adolescents in the USA.	10–19 years	Three RCTs and six non-RCTs describing seven interventions.	(a) HIV/STI incidence or prevalence. (b) HIV/STI testing. (a) Frequency of intercourse. (b) Number of partners. (c) Initiation of sexual intercourse. (d) Sex without a condom. (e) HIV/STI knowledge, attitude, and behavior.
Oringanje et al. (2016)	To assess the effects of primary prevention interventions (school-based, community/home-based, clinic-based, and faith-based) on unintended pregnancies among adolescents.	10–19 years	53 Randomized Controlled Trials (RCTs) comparing these interventions to various control groups (mostly usual standard sex education offered by schools).	(a) Unintended pregnancy. (a) Reported changes in knowledge and attitudes about the risk of unintended pregnancies. (b) Initiation of sexual intercourse. (c) Use of birth control methods. (d) Abortion. (e) Childbirth. (f) Morbidity related to pregnancy, abortion or child birth. (g) Mortality related to pregnancy, abortion or childbirth. (h) Sexually transmitted infections (including HIV).
Peterson et al. (2019)	To examine whether interventions, addressing school-level environment or student-level educational assets, can promote young people’s sexual health.	10–19 years	Randomized trial or quasi experimental design, in which control groups received usual treatment or a comparison intervention, and they must have reported at least one sexual health outcome, such as pregnancy, STDs or sexual behaviors associated with increased risk of pregnancy or STDs.	(a) Knowledge. (b) Attitudes. (c) Skills. (d) Services related to sexual health.


Bailey et al. (2015)	To summarize evidence on effectiveness, cost-effectiveness and mechanism of action of interactive digital interventions (IDIs) for sexual health; optimal practice for intervention development; contexts for successful implementation; research methods for digital intervention evaluation; and the future potential of sexual health promotion via digital media.	12–19 years	Randomized controlled trials (RCTs).	(a) Sexual health knowledge. (b) Self-efficacy. (c) Intention/motivation. (d) Sexual behavior and biological.
Celik et al. (2020)	To determine the effect of technology-based programmes in changing adolescent health behaviors.	10–24 years	Randomized control group.	Adolescents’ health-promoting behaviors: pregnancy, HIV/disease-related knowledge, condom use, condom intentions, condom skills, self-efficacy, and related infectious diseases risk behavior.
Desmet et al. (2015)	To analyze the effectiveness of interventions for sexual health promotion that use serious digital games.	13–29 years	Randomized control group, and randomized on an individual.	Behavior, knowledge, behavioral intention, perceived environmental constraints, skills, attitudes, subjective norm, and self-efficacy. Clinical effects (e.g., rates of sexually transmitted infections).
Holstrom (2015)	To draw a more comprehensive picture of how online sexual health interventions do and do not align with real world habits and interests of adolescents.	10–24 years	Randomized controlled trials (RCTs), and focus groups participants.	(a) Sexual Health information. (b) What topics they want to know about. (c) Evaluations of Internet-based sexual health interventions.
L’Engle et al. (2016)	To assess strategies, findings, and quality of evidence on using mobile phones to improve adolescent sexual and reproductive health (ASRH).	13–24 years	Randomized controlled trials (RCTs), quasi-experimental, observational, or descriptive research.	(a) Promote positive and preventive SRH behaviors. (b) Increase adoption and continuation of contraception. (c) Support medication adherence for HIV-positive young people. (d) Encourage use of health screening and treatment services.
Martin et al. (2020)	To describe existing published studies on online participatory intervention methods used to promote the sexual health of adolescents and young adults.	10–24 years	16 Randomized Controlled Trial (RCT), 15 Control group (NI = 2), 4 Information-only control website, 7 Before-after study (no RCT), 3 Cross-sectional study, 8 other design, 3 Unspecified.	Acceptability, Attractiveness, Feasibility, Satisfaction and Implementation. Behaviors. Condom use, condom use intention, self-efficacy toward condom use, and attitude toward condom use attitudes. Communication. Knowledge. Behavioral skills. Self-efficacy. Contraception use. History of sexually transmitted infections. HIV stigma. HIV test history (date and result of the last test). Incidence of sexually transmitted infections. Intentions related to risky sexual activity. Internalized homophobia. Intimate partner violence. Motivation. Pubertal development. Sexual abstinence. Waiting before having sex.	= 23)
Palmer et al. (2020)	To assess the effects of targeted client communication via delivered via mobile devices on adolescents’ knowledge, and on adolescents’ and adults’ sexual and reproductive health behavior, health service use, and health and well-being.	10 -24 years	Randomized controlled trials (RCTs).	• STI/HIV prevention. • STI/HIV treatment. • Contraception/family planning. • Pre-conception care. • Partner violence. • STI/HIV prevention/treatment. • Contraception/family planning. • HPV vaccination. • Cervical screening. • Pre-conception care. • Use of services designed for those who have experienced partner violence. • STI/HIV prevention. • STI/HIV treatment. • Contraception/family planning. • Partner violence. • Well-being. • STI prevention and/or treatment. • Contraception/family planning. • Cervical cancer screening. • Sexual violence. • HPV vaccination. • Puberty. •Patient/client acceptability and satisfaction with the intervention. •Resource use, including cost to the system and unintended consequences.
Wadham et al. (2019)	To assess the effectiveness of sexual health interventions delivered via new digital media to young people.	12–24 years	Randomized to a control group and pre-/post-test evaluation design, uncontrolled longitudinal studies and the remaining studies comprised a mixture of qualitative cohort, observational and mixed methods.	(a) Behavior (number of sexual partners, number of unprotected sexual acts, frequency of condom use, negotiation skills for condom use, sex under the influence of alcohol and other drugs, testing seeking behavior). (b) Self-efficacy (condom use). (c) Skills and Abilities (sexual communication and risk assessment). (d) Intentions (to use condoms). (e) Attitudes. (f) Knowledge (HIV, STI, general sexual health). (g) Efficacy of the Intervention (feasibility, acceptability, usability, satisfaction). (h) Well-being (mental health, sexuality, self-acceptance).
Widman et al. (2018)	To synthesize the technology-based sexual health interventions among youth people to determine their overall efficacy on two key behavioral outcomes: condom use and abstinence.	13–24 years	Randomized to a control group and experimental or quasi-experimental design.	(a) Condom use (b) Abstinence. (a) Safer sex attitudes. (b) Social norms for safer sexual activity. (c) self-efficacy. (d) Behavioral intentions to practice safer sex. (e) Sexual health knowledge.	< 0.001) and abstinence (d = 0.21, 95% CI [0.02, 0.40], p = 0.027). < 0.001), safer sex norms (d = 0.15, = 0.022), and attitudes (d = 0.12, = 0.016)


Coyle et al. (2019)	To identify sexual health education studies using blended learning to summarize the best practices and potential challenges.	13–24 years, and adults of over 25	Randomized Controlled Trials (RCTs).	(a) Initiation of sexual intercourse (vaginal, oral or anal intercourse). (b) Other sexual risk behaviors (condom use, communication, condom use skills, frequency of sex, unprotected sex, number of partners with whom had sex without protection, frequency of using alcohol and or other substances during sex). (c) Sexual coercion or dating violence (sexual coercion, dating violence). (d) Sexuality-related psychosocial factors (attitudes, beliefs, perceptions regarding abstinence, and protection). (e) Perceived satisfaction and usability (of blended learning).

Evaluation of the studies included (AMSTAR II).

School
Authors	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	Overall Rating
Chokprajakchad et al. (2018)	Y	N	Y	Y	N	N	N	Y	N	N	NM	NM	N	Y	NM	N	CL
Goldfarb et al. (2020)	Y	Y	N	Y	Y	Y	Partial Y	Y	N	N	NM	NM	N	Y	NM	Y	CL
Haberland et al. (2016)	Y	Y	Y	Y	N	N	N	Partial Y	N	N	NM	NM	N	Y	NM	N	CL
Kedzior et al. (2020)	Y	Y	Y	Y	Y	Y	Partial Y	Y	Y	N	NM	NM	Y	Y	NM	Y	M
Lopez et al. (2016)	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	NM	NM	Y	Y	NM	Y	H
Marseille et al. (2018)	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	Y	Y	H
Mason-Jones et al. (2016)	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	H
Mirzazadeh et al. (2018)	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	Y	Y	Y	Y	Y	Y	H
Oringanje et al. (2016)	Y	Y	Y	Y	Y	Y	Y	Y	Y	N	NM	NM	Y	Y	NM	Y	H
Peterson et al. (2019)	Y	Y	Y	Y	Y	Y	N	Y	Y	N	Y	Y	Y	Y	Y	N	L

Bailey et al. (2015)	Y	Y	Y	Y	Y	Y	N	Y	Y	N	Y	Y	Y	Y	Y	Y	L
Celik et al. (2020)	Y	Y	Y	N	N	N	Y	Y	N	N	NM	NM	N	Y	NM	Y	CL
DeSmet et al. (2015)	Y	Partial Y	Y	Y	Y	Y	N	Y	Partial Y	N	Y	Y	Y	Y	N	Y	CL
Holstrom (2015)	N	N	N	Y	N	N	N	Y	N	N	NM	NM	N	N	NM	N	CL
L´Engle et al. (2016)	Y	Y	Y	Y	Y	Y	Partial Y	Partial Y	N	Y	NM	NM	N	Y	NM	Y	CL
Martin et al. (2020)	Y	Y	Y	Y	Y	Y	Y	Y	N	N	NM	NM	N	Y	NM	Y	CL
Palmer et al. (2020)	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	Y	H
Wadham et al. (2019)	N	Y	Y	Y	Partial Y	Partial Y	N	Y	N	N	NM	NM	N	N	NM	Y	CL
Widman et al. (2018)	Y	Y	Y	Y	Y	Y	Partial Y	Partial Y	Y	N	Y	Y	N	Y	Y	Y	L

Coyle et al. (2019)	Y	N	N	Y	N	N	N	Y	N	N	NM	NM	N	Y	NM	N	CL

1 1. Did the research questions and inclusion criteria for the review include the components of PCIO?; 2. Did the report of the review contain an explicit statement that the review methods were established prior to the conduct of the review and did the report justify any significant deviations from the protocol?; 3. Did the review authors explain their selection of the study designs for inclusion in the review?; 4. Did the review authors use a comprehensive literature search strategy?; 5. Did the review authors perform study selection in duplicate?; 6. Did the review authors perform data extraction in duplicate?; 7. Did the review authors provide a list of excluded studies and justify the exclusions?; 8. Did the review authors describe the included studies in adequate detail?; 9. Did the review authors use a satisfactory technique for assessing the risk of bias (RoB) in individual studies that were included in the review?; 10. Did the review authors report on the sources of funding for the studies included in the review?; 11. If meta-analysis was performed, did the review authors use appropriate methods for statistical combination of results?; 12. If meta-analysis was performed, did the review authors assess the potential impact of RoB in individual studies on the results of the meta-analysis or other evidence synthesis?; 13. Did the review authors account for RoB in primary studies when interpreting/discussing the results of the review?; 14. Did the review authors provide a satisfactory explanation for, and discussion of, any heterogeneity observed in the results of the review?; 15. If they performed quantitative synthesis did the review authors carry out an adequate investigation of publication bias (small study bias) and discuss its likely impact on the results of the review?; 16. Did the review authors report any potential sources of conflict of interest, including any funding they received for conducting the review? 2 H = Hight; M = Media; C = Low; CL = Critically Low. N = No; Y = Yes.

Author Contributions

Conceptualization, M.L.-F. and R.M.-R.; methodology, M.L.-F.; R.M.-R.; Y.R.-C. and M.V.C.-F.; formal analysis, M.L.-F.; R.M.-R.; Y.R.-C. and M.V.C.-F.; investigation, M.L.-F.; R.M.-R.; Y.R.-C. and M.V.C.-F.; writing—original draft preparation, M.L.-F. and R.M.-R.; writing—review and editing, M.L.-F.; R.M.-R., and Y.R.-C. and.; supervision, M.L.-F.; R.M.-R.; Y.R.-C. and M.V.C.-F. All authors have read and agreed to the published version of the manuscript.

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Data availability statement, conflicts of interest.

The authors declare that they have no conflicts of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Why education about gender and sexuality does belong in the classroom

Senior Lecturer, School of Education, Edith Cowan University

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

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

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

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

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

No more federal funding for Safe Schools

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

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

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

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

An inconsistent approach

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

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

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

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

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

Federal discomfort with sex, sexuality and gender discussions

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

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

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

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

A strong case for sexuality, gender and sex education

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

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

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

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

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

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

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

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

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

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

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Sex Education Essay: Argumentative Essay Sample

At What Age Should Sex Education Be Introduced at Schools?

Introduction

Sex education has vital importance for preventing teen pregnancy and sex-related risks, and providing kids with the knowledge of the proper sexual behavior. While sex education should be introduced in schools, it is also critical that parents educate their children about sex before school even begins. Therefore, sex education should be introduced to children at the earliest age, providing children with information which corresponds to their needs at a certain age. In addition, sex education at schools should be introduced as early as possible, ensuring children’s healthy sexual development.

Parental Role in Starting Sex Education at Home

Sex is a sensitive topic that, as a rule, is not usually discussed by parents with their children. Parents may often feel uncomfortable when asked by their children about how children are conceived and born and other related topics. It is essential to communicate with children regarding sex and name things as they are from an early age, making them understand what may not be appropriate when interacting with other children (“When Is the Right Age to Teach a Child Sex Education”). This should be done as soon as a child goes to kindergarten and is exposed to communication with other boys and girls.

The Benefits of Early Sex Education

While parents should start educating their children as early as possible, there are debates regarding the age at which sex education should be introduced at school. Some parent groups consider that sex education should not start until grade 5 or 6. At the same time, others believe that this should start earlier. Namely, grades 3 and 4 should be suitable for giving students more knowledge about sex and their bodies (Walsh). This would decrease the chances of facing negative effects of the lack of knowledge about the topic for children.

There are numerous reasons why sex education is relevant from an early age. First, it helps children understand their bodies and not be surprised when their bodies start changing during puberty. Second, children will not be ashamed of discussing sex-related topics and not make rude jokes in their groups (Walsh). Third, students will be aware of the risks and negative effects that can arise in the case of improper sexual behavior. Lastly, they will be introduced to safety measures and ways to avoid damaging situations that can harm psychological health of children which can also affect their adult life. Therefore, children will possess sufficient knowledge about the required behavior and will become competent in understanding their bodies and sexuality.

Sex education is also critical considering the exposure of children to media where messages related to sex may not be clear to them. In this way, without necessary knowledge, they can misinterpret the messages of a sexual nature presented in the media and develop incorrect ideas about their bodies. This is especially relevant when it comes to images shown in media representing the bodies of men and women, which are often believed to be role models for children, especially girls, which can later result in eating disorders and low self-esteem.

Finally, sex education should begin in early childhood, with parents giving children an understanding of their bodies and sexuality. Sex education at schools should begin as early as possible, starting in grade 3 or 4, introducing the primary concepts of sexual development. In this way, sex education can help children be more confident in their sexual development and apply safety measures to avoid risks and negative effects of early sexual activity.

Works Cited

“When Is the Right Age to Teach a Child Sex Education.” Punch Newspapers, Punch Newspapers, 4 Feb. 2017, https://punchng.com/right-age-teach-child-sex-education/. Accessed 23 Jan 2019.

Walsh, Jenny. “Sex Education Needs to Begin Earlier.” Australian Federation of AIDS Organisations, Mar. 2013, https://www.afao.org.au/article/sex-education-needs-begin-earlier/. Accessed 23 Jan 2019.

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The Importance of Access to Comprehensive Sex Education

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

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

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

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

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

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

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

Comprehensive sex education programs have several common elements:

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

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

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

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

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

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

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

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

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

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

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

Benefits of comprehensive sex education programs

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

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

Education about condom and contraceptive use is needed:

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

STI prevention is needed:

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

Continued prevention of unintended pregnancy is needed:

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

Misinformation about sexual health is easily available online:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pediatric clinics provide a unique opportunity for comprehensive sex education.

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

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

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

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

Perspective

Karen Torres, Youth activist

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

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

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

Barriers to accessing comprehensive sex education include:

Misinformation, stigma, and fear of negative reactions:

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

Inconsistencies in school-based sex education:

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

Need for resources and training:

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

Lack of diversity and cultural awareness in curricula:

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

Disparities in access to comprehensive sex education.

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

Youth who are LGBTQ2S+:

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

Youth with disabilities or special health care needs:

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

Youth from historically underserved communities:

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

Youth from rural communities:

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

Youth from communities and schools that are low-income:

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

Youth who receive sex education in some religious settings:

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

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

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

Comprehensive sex education has significant benefits for children and adolescents.

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

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

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

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

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

Impacts of a lack of access to comprehensive sex education.

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

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

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

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

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

A lack of comprehensive sex education can harm young women.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What is sexual health education?

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

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

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

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

What does the research say about effective sex education?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Emily Bridges, MLS, and Debra Hauser, MPH

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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What Are the Goals of Sex Education?
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Sex education is designed to help young people gain the information and skills they need to make the best decisions for themselves about sex and relationships throughout their lives.

Does Sex Education Work?

Sex education gives young people the knowledge and skills they need for a lifetime of good sexual health. They learn how to have healthy relationships, make informed decisions about sex, think critically about the world, be a good ally to those who are marginalized, and love themselves for who they are.

Research shows that sex education that’s culturally responsive and inclusive helps young people develop the social and emotional skills they need to become caring and empathetic adults. This type of sex education early and often leads to 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. It also helps young people avoid unintended pregnancies and sexually transmitted infections (STIs).

Sex education works best when it’s:

Taught by trained professionals
Taught early and often throughout the lifespan
Includes both information and skill-building activities
Evidence-informed
Inclusive of LGBTQ+ youth
Rooted in anti-racism practices
Trauma-informed
Adapted to the needs of the community

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Home — Essay Samples — Education — Sex Education — Pros And Cons Of Sexual Education Being Taught In Schools

Pros and Cons of Sexual Education Being Taught in Schools

Categories: Public School Sex Education

About this sample

Words: 655 |

Published: Dec 16, 2021

Words: 655 | Page: 1 | 4 min read

Works Cited

Chin, H. B., Sipe, T. A., Elder, R., Mercer, S. L., Chattopadhyay, S. K., Jacob, V., ... & Community Preventive Services Task Force. (2012). The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the Guide to Community Preventive Services. American Journal of Preventive Medicine, 42(3), 272-294.
Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42(4), 344-351.
Lindberg, L. D., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents’ receipt of sex education, 2006–2013. Journal of Adolescent Health, 58(6), 621-627.
Morgan, M., Gibbs, S., Maxwell, K., & Britten, N. (2015). Hearing children’s voices? Including children’s perspectives on their experiences of living with parental alcohol problems in assessments and reviews. Child Abuse Review, 24(2), 92-104.
Planned Parenthood Federation of America. (2021). Sex education: Get real. Retrieved from https://www.plannedparenthood.org/learn/for-educators/sex-education
Santelli, J. S., Kaiser Family Foundation, & American Association of Sexuality Educators, Counselors and Therapists. (2017). Sex education in America: A view from inside the nation’s classrooms. Journal of Adolescent Health, 61(3), 297-304.
Schalet, A. T. (2011). Not under my roof: Parents, teens, and the culture of sex. University of Chicago Press.
SIECUS: Sexuality Information and Education Council of the United States. (2021). Comprehensive sexuality education. Retrieved from https://siecus.org/what-we-do/sexuality-education/
UNESCO. (2018). International technical guidance on sexuality education: An evidence-informed approach. Retrieved from https://unesdoc.unesco.org/ark:/48223/pf0000263037
World Health Organization. (2010). Developing sexual health programmes: A framework for action.

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Essay on Onam for Students and Children

Updated on
Sep 14, 2024

We all have heard of the Onam festival. It is an important festival celebrated in South India, especially for the people of Kerala. This is a harvest festival which is celebrated in various parts of the country with different names. In Kerala, this festival is celebrated with great enthusiasm for ten days. Each day of the festival has its own significance. In this section, we will look at some samples of essay on Onam that will help you learn the celebration in depth. It will also help children understand their cultural diversity and richness. So, if you want to know more about the festival, keep reading.

Table of Contents

1 Long Essay on Onam (500 words)
2 Short Essay on Onam (250 words)
3 Facts About Onam

Long Essay on Onam (500 words)

Onam is the festival of Kerala and it is considered as one of the most important festivals in India. This festival is celebrated by Malayalees not just in India but all around the world. The festival highlights Kerala’s vibrant culture, traditions and history. This ten-day festival includes big feasts, folk dances, music, boat races and floral decorations.

Onam festival is deeply roted in Hindu mythology with the story of King Mahabali. The story of onam revolves around the legendar figure of Kerala, King Mahabali. According to Hindu mythology, Mahabali was the king of Kerala, and his rule was marked by peace and equality. However, the gods were worried by his growing popularity and requested Lord Vishnu’s help. Lord Vishnu, in the form of Vamana, went to Mahabali and requested three paves of land. Mahabli agreed and Vamana grew to a large size, covering both the earth and the heavens in two steps. For the third step, Mahabali respectfully surrendered his head, and he was sent to Patalalok. Impressed by Mahabali’s devotion, Lord Vishnu granted him the blessing of visiting his kingdom once a year. This annual visit is celebrated as Onam and symbolizes the spirit of sacrifice and the promise of hope and renewal.

The Onam festival begins in the Malayalam month of Chingam, which usually falls in August or September. This festival lasts for ten days and each day of Onam has its own traditions and significance. The first day of the festival marks the beginning of the festival, with people preparing for the major celebration. The making of a flower rangoli begins today and rises in size each day, symbolising the arrival of King Mahabali. The second day is spent visiting temples, and on the third day, people begin shopping for new clothes and gifts. The fourth day is known as Vishakam, and it marks the beginning of the beautiful Onam Sadhya (feast). The fifth day is known for the Vallamkali, or boat race. On the sixth and seventh day, people start preparing for the festival which is followed by many traditional games and performances. The eighth day is dedicated to creating idols of King Mahabali. The ninth day, also known as Uthradam is considered as the eve of onam and the tenth day is the most important day of the festival, marked by the grand Onam Sandhya.

The Onam festival is celebrated with prayers, feasts and traditional traditional games. The Vallamkali, commonly known as the Snake Boat Race, is one of the festival’s most stunning events. Another unique feature of Onam is the folk dance Pulikali, in which men dress up as tigers and leopards and dance to traditional music. Kaikottikali or Thiruvathirakali, is a graceful dance done by women in a circle around a lit lamp to express joy and unity. Kummattikali is another dance form in which performers use colourful costumes and wooden masks that represent mythological characters. Onam Sandhya, which is the grand feast followed by this festival is the highlight of this celebration. It includes over 26 dishes on the banana leaves and represents the distinct flavour of the Kerala.

Onam is now celebrated all across the world which helps to preserve Malayalee traditions. This celebration promotes inclusivity and unity across communities. Its mythological roots represent values such as equality, humility and devotion. Onam brings together individuals from every phase of life and it is the true symbol of social harmony.

Also Read: 5 and 10 Lines on Onam Festival in English for Students

Short Essay on Onam (250 words)

Onam is a festival that is celebrated in India’s southern state, Kerala. It is a harvest festival that crosses all religious and social borders. It takes place during the Malayalam month of Chingam, which is generally between August and September. This celebration lasts around ten days and is considered one of India’s most important festivals. Onam celebrations are deeply rooted in Hindu mythology and are associated with King Mahabali.

According to mythology, Mahabali was a generous king whose popularity scared the gods. Lord Vishnu took the form of Vamana, a dwarf Brahmin, and demanded three paces of land from the king. King Mahabali’s generosity pleased Lord Vishnu, who granted him the boon of visiting his kingdom and people once a year. This annual visit is known as Onam and this festival represents humility and hope for a better future.

Onam is celebrated with various traditional activities, including Pookalam, the floral rangoli, and Onam Sandhya, a large feast served on banana leaves. These traditions reflect Kerala’s cultural heritage and richness. The highlights of Onam include many cultural performances like as the snake boat races known as Vallamkali, the folk dance Pulikali, in which men dress as tigers, and the graceful Kaikottikali, a group dance performed by women. Onam is a celebration that promotes inclusivity and community harmony. Onam is more than just a harvest festival; it is a celebration of Kerala’s rich cultural traditions and a hope for peace.

Also Read: Why is Onam Celebrated: The Festival of Joy in Kerala

Facts About Onam

Here we have mentioned some of the interesting facts about ONam which will give you a better learning about this festival.

Onam celebrates the legendary return of King Mahabali, whose rule was regarded as a golden age.
The festival is connected with Lord Vishnu’s Vamana avatar.
Onam Snadhya is a grand feast of more than 26 Kerala foods served on banana leaves.
The Aranmula Uthrattathi Vallamkali is one of the oldest and most famous snake boat races which held during Onam.
Kerala’s Tourism Department organises Onam Week to celebrate the state’s rich culture and attract visitors.
Onam is one of the oldest festivals in Kerala which dates back thousands of years.
Archery competitions were originally part of Onam celebrations.
The Thrikkakara Temple in Kochi is the centre of Kerala’s Onam celebrations.
Onathallu is a traditional martial art performed during Onam, especially in rural Kerala.
Various countries, including the Gulf countries, the United States, the United Kingdom and Australia, celebrate Onam with great zeal.

Onam Sandhya, which is te grand feast served on the banana leaves is the main highlight of the onam.

Onam festival is deeply roted in Hindu mythology with the story of King Mahabali. The festival is connected with Lord Vishnu’s Vamana avatar.

Onam takes place during the Malayalam month of Chingam, which is generally between August and September. This celebration lasts around ten days and is considered one of India’s most important festivals.

Bhumika Sharma

A writer with a fresh perspective on thoughts, I have an year of experience in writing the blogs on various topics. Here, you will find my blogs for the students and education purpose.

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Commentary | Jens Ludwig: Sexual assault is the most…

Commentary | Jens Ludwig: Sexual assault is the most important problem in higher education that no one is talking about

The first time I heard the 1-in-3 figure, I didn’t realize how shocking this is because I didn’t realize exactly how serious these events are that the campus survey data is capturing. Half are what used to be called rape. The rest involve force and coercion and everything right up to rape. Many women simply aren’t the same afterward. Fully a third consider suicide. This is not what parents hoped for when they heard that college would be a life-changing experience for their daughter.

This is the most important problem in higher education that no one is talking about, one that’s rampant at some of the biggest-name schools.

The problem is so big one might worry it’s too big to fix. But that’s what lots of people thought about street crime in the early 1990s, too, at the peak of the nationwide crack cocaine epidemic. Yet 30 years later, homicide rates in the U.S. plummeted by fully 40%. How did we do that?

There are three lessons to take away.

The first lesson is to find exemplars. For street crime, the exemplars everyone points to are Los Angeles and New York City. They were early and rapid adopters of data-driven policing and investing in community violence intervention groups . Mayors across the country sent their people out there to get new ideas.

For campus sexual assault, the exemplars include places such as Rice University. One thing Rice did was to ban fraternities . The survey data shows that in general, schools without fraternity systems tend to have lower rates of sexual assault. We also see that men who do and don’t join fraternities behave similarly before college, but once in college, the men in fraternities commit sexual assault three times as often. This suggests fraternities don’t just happen to be home to people who would behave horribly no matter what; the fraternities seem to be cultivating horrible behavior.

A second lesson is to pay attention to data and do things that actually work. Universities currently do countless trainings that have no evidence whatsoever of effectiveness. At the same time, few of the trainings that have been proved to work are widely used.

For example, while most training programs are fairly short, the research-based Enhanced Assess, Acknowledge, Act (EAAA) training program engages people for fully 12 hours. It covers, among other things, risk cues in the situation and in the man’s behavior, overcoming the emotional obstacles to prioritizing the woman’s own safety over the man’s entreaties (given most offenders are acquaintances), and practical verbal and physical strategies to get out of a situation. A randomized controlled trial published in the New England Journal of Medicine showed the program cut sexual assaults in half. Why isn’t every college doing that training?

A third lesson is to think outside the box. With street crime, the numbers seemed overwhelming. In Chicago, for example, we reportedly have more than 100,000 gang members in more than 700 gang factions. The few thousand officers that the city has out on patrol at any given time can’t be everywhere. A key innovation was to prioritize the police department’s limited resources on the small number of gangs that were most violent. The hope was that the threat of police crackdown would reorient the gang’s internal norms from supporting to discouraging violence. The evidence suggests this so-called “ focused deterrence ” strategy reduces crime.

If fraternities are the campus version of street gangs that university presidents just can’t get rid of altogether, why not think out of the box and apply focused deterrence to the fraternities? Tell them that the next time the victim of a sexual assault mentions your fraternity in any capacity — even if she was “just” served alcohol there earlier in the night — the campus police will make sure every future party that fraternity throws receives hyperenforcement, and every noise complaint leads to a police visit that (while inside) includes carding everyone who’s drinking.

For a long time in America, we thought high rates of street crime and gun violence were inevitable. By being more thoughtful and data-driven, that pessimistic view of things was proved wrong. Too many people today think of campus sexual assault as similarly inevitable. It’s time — perhaps long past time — to prove that pessimistic view wrong, too.

Editor’s note: A graph included in this piece misstated the percent of 4th year Ohio State female undergraduates who have experienced sexual assault by force or inability to consent. The Tribune regrets the error.

Jens Ludwig is the Edwin A. and Betty L. Bergman distinguished service professor at the University of Chicago, Pritzker director of the University of Chicago Crime Lab and an elected member of the National Academy of Medicine. He also serves on the Committee on Law and Justice of the National Academy of Sciences.

Submit a letter, of no more than 400 words, to the editor here or email [email protected] .

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1. Introduction

2. Methodology

2.2. Methods

2.3. Search Strategy

2.4. Inclusion Criteria

2.5. Exclusion Criteria

2.6. Risk of Bias and Assessment of Study Quality

2.7. Data Synthesis

3.1. Results of Search

3.2. Risk of Bias in Included Studies

3.3. Reviews Included

3.3.1. Setting

3.3.2. Population

3.3.3. Interventions/Types of Study

3.3.4. Outcomes

3.3.5. Country of Review

3.3.6. Year of Last Paper Included

3.3.7. Search Tools

3.3.8. Multicenter Studies and Number of Studies Included

3.3.9. Number of Reviews Covered That Include Meta-Analysis

3.4. Effectiveness

3.4.2. Online Platforms

3.4.3. Blended Learning

4. Discussion

4.1. Interventions Reviewed

4.2. Effectiveness

4.3. Limitations

5. Conclusions

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