What to include in sex education classes (or whether to have them at all) has been at the center of a heated debate for decades. There isn’t any real standard for sex education nationwide, but there’s data on what’s being done and what, of that, works well. Here’s a look at the forces that have shaped sex education, and how effective the curriculum really is.
Academics used to treat sex as all about reproduction
Up through the 18th and 19th centuries, academics mostly saw sex as solely an activity of procreation. "Let it be distinctly understood that Reproduction is the function of Man’s sexual nature," Frank Fowler, a physician, wrote in his very stern 1896 book, Life: How to Enjoy It and How to Prolong It. Fowler’s book, published by Harvard Medical School and marketed toward teens and adults, aimed to educate readers on the body and, in this particular passage, the purpose of sex. Talk of sex in America in the 19th century still echoed the ideas of respectability from Victorian England.
The first World War brought a big change to STD education
WWI was a turning point for sex education. It was the first time the government treated such a campaign as a public-health issue, as the army discharged more than 10,000 men ailing from STDs. Posters like this one from 1918 warned of venereal disease. And they created a tension between "social hygiene" reformers, who saw venereal disease as a moral issue, and medical officers, who wanted protocol for treating the diseases on military bases. This poster errs on the side of the social reformers’ argument, which aimed to convince soldiers to abstain from sexual activity altogether. It was part of a larger campaign to shape the role of a man as someone who was powerful, masculine, and moral.
Venereal diseases among World War II soldiers led to awareness programs
The military continued its campaign against venereal disease into WWII. By then, penicillin had hit the shelves, making many of the infections treatable. After Pearl Harbor, the military treated venereal disease as a matter of national security. The Office of War Administration pumped out awareness materials like this poster to the troops, 70 percent of whom were single.
The AIDS epidemic led to the surgeon general’s massive push for sex education
In 1986, Surgeon General C. Everett Koop released a bleak report on the spread of AIDS in the US. The chart shows a significant spike in AIDS diagnoses and deaths, which Koop referred to as an epidemic in dire need of attention. Some government officials opposed his message that condoms, rather than abstinence, were the way to stop the spread of AIDS — but Koop famously stood firm with his position. In his report, Koop also called for schools to step up their sex education programs. "There is now no doubt that we need sex education in schools and that it must include information on heterosexual and homosexual relationships," he wrote.
Contraceptives became a major point of conflict in the 1990s
In the 1990s, sex education had become a battleground, with parents fighting over the role of contraception in their kids’ lives as the government got involved with messages like this AIDS campaign. A Time magazine cover in 1993 captured the fight at a fever pitch. On Benicia High School’s prom night, students tried to give out condoms to their peers — but administrators confiscated them, "arguing that the school-sponsored event is no place for sex education," wrote Nancy Gibbs. The story is indicative of a larger trend toward teens having safer sex. New York City started making condoms available in public schools in 1991, and Fox Broadcasting Company began airing condom ads that year as well. By the end of the 1990s, contraception use among teens was more widespread than in the previous decade.
The majority of high schools mandate sex education
Seventy-one percent of school districts require human sexuality to be taught in high school, a 2012 government survey found. HIV prevention is mandatory high school curriculum in 82 percent of districts. Pregnancy prevention is mandatory teaching in 78 percent of school districts.
Some states let parents opt their kids out of sex education
Thirty-five states and the District of Columbia allow parents to opt out of having sex education taught to their children in schools. These opt-out provisions require public school districts to send parents written notification of upcoming sex education classes, and let them know they can opt their children out of the classes. Three states require parents to sign a consent form, or an opt-in, for their children to participate in sex education.
The HIV education movement spurred a push for sex education as a whole
The sex education movement was catalyzed by the HIV education movement after Surgeon General C. Everett Koop pressed for it to be taught nationwide. The conversation around Koop’s mandate echoed a contentious debate about what should be included in sex education programs. But the government saw HIV information as crucial to public health, and in 1988, a pamphlet explaining how the disease spreads was sent to every American household. Now, 33 states plus DC mandate that students take HIV prevention and education classes.
About half of schools teach about sexual identity and orientation
A recent study of health education programs conducted by the CDC’s Division of Adolescent and School Health looks at what’s being taught in sex education classes across the country. The study found that 48 percent of schools teach about sexual identity and sexual orientation. Right now, nine states require that sexual education classes be inclusive of sexual orientation. Three states — Alabama, South Carolina, and Utah — require that teachers tell students about the health hazards of homosexuality. (Alabama passed a law in 1992 requiring schools to emphasize homosexuality as an unacceptable lifestyle.)
Teachers don’t always agree with the curriculum
The curriculum of sex education classes in US public schools has prompted debate for decades. But what teachers have to instruct their students about doesn’t match up, necessarily, with what they think they should be teaching students about sex. In this study, 18 percent of sex education teachers (whose actual job titles range from physical education instructor to school nurse) reported that their biggest challenge in instructing students about sex was the pressure they faced about what they covered in class. Some subjects, like condom use and sexual orientation, are given less focus in the curriculum than teachers would like.
Classes don’t always teach what parents would like them to
In 2004, a study reviewed sex education in the US and, among other things, examined what parents thought their kids should be learning in sex education classes. Nearly all parents surveyed wanted their children to learn about sexually transmitted diseases in classes. But what the majority of parents want taught isn’t being taught in the majority of sex education classes. Only 48 percent of classes address sexual identity, though 73 percent of parents would like the subject taught.
Abstinence education rose during the Bush administration
The Bush administration prioritized abstinence-only curriculum as the best means of sex education in the 2000s. There were significant spending increases for more conservative sex education during George W. Bush’s two terms. The president’s administration shelled out $1.5 billion on abstinence education programs for teens. In a 2004 USA Today article, Bush administration official Wade Horn defended the spending: "We don't need a study, if I remember my biology correctly, to show us that those people who are sexually abstinent have a zero chance of becoming pregnant or getting someone pregnant or contracting a sexually transmitted disease."
States can choose if and how to promote abstinence
For decades now, the role of abstinence in sex education has been at the center of a heated debate. Twenty-five states mandate that if sex education is taught, it must stress abstinence as the best choice to prevent pregnancy and sexually transmitted diseases and infections. Twelve other states mandate presenting abstinence as one of several options for doing so. A 2007 policy report found that teens who had abstinence-only sex education were just as likely to have sex as their peers who didn’t get abstinence-only education.
The Obama administration still funds abstinence education
Obama supported contraception as part of sex education in his 2008 campaign, and his 2010 budget left out funding for abstinence-only education. But in an effort to appease some conservative House members in health-reform negotiations, the Affordable Care Act provided additional abstinence-only funds. The Obama administration now spends about one-third of what the Bush administration did on sex education that does not include information on contraceptives.
Lower-income kids are more likely to receive abstinence education
One study looking at the sociodemographic side of sex education classes showed that who learns about what varies widely. Students who didn’t receive any sex education were more likely to be black and from rural areas, low-income families, and single-parent homes. Students who said they learned only about abstinence were more likely to be from low-income and middle-class homes with parents who were still together. Students who’d had comprehensive sex education were more likely to be white and from urban areas and higher-income families, the study found.
States that emphasize abstinence have higher teen pregnancy rates
Researchers at the University of Georgia looked at the relationship between what kids learn and pregnancy rates. In data published in 2012, they found a correlation between states that emphasize abstinence and those that have more teen births. This is a correlational relationship, rather than causal: states that tend to lean toward abstinence-education also have lower-income residents.
Some controlled trials don’t show a difference between comprehensive and abstinence programs
One controlled study in 2012 of the effects of sex education on the sexual behavior of teens found that there are some similarities in outcomes between comprehensive sex education and abstinence-education programs. In many of the outcomes studied, such as the likelihood a teen would use contraception or a condom, there was no significant difference between abstinence education and sex education that included information about birth control. The study did find that teen girls who received information about birth control were more likely to use a condom during the first time they had sex than teen girls who received abstinence-only education.
Most teens use contraceptives
The majority of teens (78 percent of females, 85 percent of males) say they used contraceptives the first time they had sex. Teens have gotten better at contraceptive use over time. In 1982, only 48 percent of females ages 15 to 19 used contraceptives during the first time they had sex. From 2006 to 2010, the use of contraceptives by females ages 15 to 19 was up to 78 percent. Condoms are the most common choice for contraception for the first time a teen has sex.
The teen birth rate is falling significantly
America’s teen birth rate has dropped dramatically over the past five years, falling 38.4 percent between 2007 and 2013. Fewer girls are getting pregnant, and researchers can’t decide on a clear reason for why that’s happening. Vox's Sarah Kliff explains: "The recent and rapid decline in the teen birth rate is largely a mystery. It makes it difficult to implement policies to further reduce teen births when nobody knows what’s working so well right now."
HIV/AIDS education is growing less common in schools
The percentage of students learning about HIV infection and AIDS in schools has remained mostly steady over the past two decades. There was a drop in the number of students being taught about HIV and AIDS in the late '90s, which coincided with the time the spread of AIDS in the US started to slow.
History of sex education
What students get taught today
The rise of abstinence-only education
What students are learning in sex ed
- Editor: Sarah Kliff
Developer: Yuri Victor
Lead image: Shutterstock