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Comprehensive Sexuality Education

Issue Brief

Overview

Comprehensive sexuality education (CSE) teaches about all aspects of human sexuality, such as anatomy, consent, sexual orientation, gender identity, and interpersonal relationships, to name just a few. Medically accurate, evidence-based, and age-appropriate education about anatomy, sexuality, gender, and relationships empowers and prepares children, adolescents, and young adults to make educated decisions about their health and their relationships. Despite the many benefits that CSE provides, CSE is largely unstandardized—and, in an increasing number of states, stymied or outright banned.

To ensure that children, adolescents, and young adults are equipped with the information they need to protect themselves, lead healthy and full lives, and distinguish fact from misinformation, they must have access to sexuality education that is truly comprehensive, inclusive, and based in science and evidence rather than education that is centered on a political viewpoint, promotes only abstinence, and excludes LGBTQ+ people.

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What does comprehensive sexuality education do?

CSE imparts knowledge and skills that are critical to ensuring that children, adolescents, and young adults are equipped to make informed decisions about their bodies, their health, and their relationships. Its benefits are myriad: CSE can delay sexual initiation; increase the use of birth control, including condoms; and reduce sexual risk behaviors, sexually transmitted infections, and rates of unintended pregnancy. It also helps people recognize intimate partner violence, including among adolescents, and enables people to conceptualize sexuality, recognize and foster healthy relationships, understand consent, and make informed decisions about their health. A systematic literature review of three decades of research on school-based CSE programs showed that CSE led to “an 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.”

CSE should be medically accurate, based in evidence, and appropriate for the age of the intended audience. ACOG guidance recommends that curricula include …

CSE also provides much-needed and timely education about sexuality, bodily autonomy, and personal boundaries in the digital age, safeguarding against the rise of behaviors such as sexting, which is associated with higher likelihood of reporting high-risk sexual behaviors, and online dating, which has been associated with dating violence among adolescents.

How are some legislators restricting CSE?

Despite the myriad benefits that CSE provides for people of all ages, lawmakers have been mounting increasingly frequent attacks meant to limit or outright ban various aspects of CSE. Florida’s notorious “Don’t Say Gay” bill, HB 1557, shone a spotlight on anti-CSE legislation when it prohibited “classroom discussion about sexual orientation or gender identity in certain grade levels or in a specified manner.” In May 2023, Florida legislators expanded on the Don’t Say Gay bill when they passed HB 1069, which prevents education on menstruation and other sex education topics in elementary school, including answering questions from students who have begun menstruating but have not yet entered middle school. This same bill requires educators to teach that “reproductive roles are binary, stable, and unchangeable” and students should abstain from sexual activity outside of heterosexual marriage. In April 2023, Florida’s education board also voted to ban education on gender identity and sexual orientation for grades four through 12 in all public schools, expanding on a 2022 ban that prohibited education on gender identity and sexual orientation from kindergarten through third grade.

Florida isn’t alone in its restrictive, regressive policies: Ohio HB 8, referred to the state senate in 2023, would permit parents to remove their children from CSE courses without the child’s input or consent. This bill also requires school employees to notify parents if their child requests to identify as a gender that does not align with the student’s biological sex, effectively mandating that school officials out students to families without the students’ consent—regardless of the danger being outed may pose to the student. And in some states, elected officials have advanced policies that would require students to watch biased and inaccurate content intended to support a particular ideological viewpoint and direct students’ future decisions about reproductive health care.

Policies that ban CSE or co-opt it to spread a particular ideology or demonize entire groups of people leave young people without the unbiased, scientifically accurate information necessary to understand and make informed choices about their bodies, gender, sexuality, and involvement in sexual activity and healthy relationships. Without CSE, children and young people may struggle to establish the framework for evaluating and understanding accurate information, science-based foundations of anatomy of reproductive and sexual health, and healthy social and emotional relationships. In an era in which misinformation proliferates about everything from how menstrual cycles work to how to avoid pregnancy to simple bodily anatomy and functions, providing children and young people with accurate, science-based information about their bodies and relationships with others is critical.

What can ob-gyns do?

  • Ask parents about their adolescents’ reproductive development and sexual education, HPV vaccination status, and contraceptive needs
  • Provide support to the parents and caretakers of adolescents by encouraging them to be actively involved in their children’s sexuality education
  • Support and assist in sexuality education by developing evidence-based curricula that focus on clear health goals and providing health care that optimizes sexual and reproductive health and development

What can policy makers and elected officials do?

  • Hold meetings with community members in their district to educate them about CSE
  • Introduce policies that protect access to CSE in schools
  • Invite experts to discuss the importance of CSE with colleagues
  • Actively combat misinformation and use their platforms as public officials to elevate evidence-based information about CSE