specific topic about sex education

What is comprehensive sexuality education?

Comprehensive sexuality education  ( CSE ) 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 will empower 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.

[Source: UNESCO. 2017. International technical guidance on sexuality education,  pp.16-17.]

Depending on the country or region, CSE may go by other names. It may be referred to as ‘ life skills ’, ‘ family life ’, or ‘ HIV ’ education . It is sometimes called ‘holistic sexuality education’. It is important to confirm with ministries what they use to describe CSE, particularly as context-based terms can inform the most effective approach to take when partnering with and supporting these ministries.

• delivered in formal and non-formal settings , in school or out of school ;
• scientifically accurate , based on research, facts, and evidence;
• incremental , starting at an early age with foundational content and skills, with new information building upon previous learning, using a spiral-curriculum approach that returns to the same topics at a more advanced level each year;
• age- and developmentally appropriate , with content and skills growing in abstractness and explicitness with the age and developmental level of the learners; it also must accommodate developmental diversity, adapting for learners with cognitive and emotional development differences;
• curriculum-based , following a written curriculum that includes key teaching and learning objectives, and the delivery of clear content and skills in a structured way;
• comprehensive , and about much more than just sexual behaviours.

The comprehensive aspect of CSE refers to the breadth, depth, and consistency of topics, as opposed to one-off lessons or interventions. CSE addresses sexual and reproductive health issues, including, but not limited to:

• sexual and reproductive anatomy and physiology;
• puberty and menstruation;
• reproduction, contraception , pregnancy, and childbirth;
• STIs, including HIV and AIDS .

CSE also addresses the psychological, social, and emotional issues relating to these topics, including those that may be challenging in some social and cultural contexts. It supports learners’ empowerment by improving their analytical, communication, and other life skills for health and well-being in relation to:

• human rights,
• a healthy and respectful family life and interpersonal relationships,
• personal and shared values,
• cultural and social norms,
• gender equality,
• non-discrimination,
• sexual behaviour,
• gender-based and other violence,
• consent and bodily integrity,
• sexual abuse and harmful practices such as child , early, and forced marriage, and female genital mutilation/cutting.

Key values of CSE

CSE builds on and promotes universal human rights for all, including children and young people. It emphasizes all persons’ rights to health, education, information equality, and non-discrimination. It raises awareness among young people that they have their own rights, and that they must acknowledge and respect the rights of others, and advocate for those whose rights are violated.

Integrating a gender perspective throughout CSE curricula is integral to effective CSE programmes. CSE analyses how gender norms can influence inequality, and how inequality can affect the overall health and well-being of children and young people, as well as the efforts to prevent issues such as HIV, STIs, early and unintended pregnancies, and gender-based violence . CSE contributes to gender equality by building awareness of the centrality and diversity of gender in people’s lives; examining gender norms shaped by cultural, social and biological differences and similarities; and by encouraging the creation of respectful and equitable relationships based on empathy and understanding.

CSE must be delivered in the context of the range of values, beliefs, and experiences that exist even within a single culture. It enables learners to examine, understand, and challenge the ways in which cultural structures, norms, and behaviours affect their choices and relationships within a variety of settings.

CSE impacts whole cultures and communities, not simply individual learners. It can contribute to the development of a fair and compassionate society by empowering individuals and communities, promoting critical thinking skills, and strengthening young people’s sense of citizenship. It empowers young people to take responsibility for their own decisions and behaviours, and how they may affect others. It builds the skills and attitudes that enable young people to treat others with respect, acceptance, tolerance, and empathy, regardless of their ethnicity, race, social, economic, or immigration status, religion, disability, sexual orientation , gender identity or expression, or sex characteristics.

CSE teaches young people to reflect on the information around them in order to make informed decisions, communicate and negotiate effectively, and develop assertiveness rather than passivity or aggression. These skills foster the creation of respectful and healthy relationships with family members, peers, friends, and romantic or sexual partners.

[Source: UNESCO. 2017. International technical guidance on sexuality education,  pp 16-17.]

‘ Sexuality ’ is defined as ‘a core dimension of being human which includes: the understanding of, and relationship to, the human body; emotional attachment and love; sex; gender; gender identity; sexual orientation; sexual intimacy; pleasure and reproduction. Sexuality is complex and includes biological, social, psychological, spiritual, religious, political, legal, historic, ethical and cultural dimensions that evolve over a lifespan’.

[Source: UNESCO. 2017. International technical guidance on sexuality education,  p.17.]

The word ‘sexuality’ has different meanings in different languages and in different cultural contexts. Taking into account a number of variables and the diversity of meanings in different languages, the following aspects of sexuality need to be considered in the context of CSE:

• Sexuality refers to the individual and social meanings of interpersonal and sexual relationships, in addition to biological aspects. It is a subjective experience and a part of the human need for both intimacy and privacy.
• Simultaneously, sexuality is a social construct, most easily understood within the variability of beliefs, practices, behaviours and identities. ‘Sexuality is shaped at the level of individual practices and cultural values and norms’ (Weeks, 2011).
• Sexuality is linked to power. The ultimate boundary of power is the possibility of controlling one’s own body. CSE can address the relationship between sexuality, gender and power, and its political and social dimensions. This is particularly appropriate for older learners.
• The expectations that govern sexual behaviour differ widely across and within cultures. Certain behaviours are seen as acceptable and desirable, while others are considered unacceptable. This does not mean that these behaviours do not occur, or that they should be excluded from discussion within the context of sexuality education.
• Sexuality is present throughout life, manifesting in different ways and interacting with physical, emotional and cognitive maturation. Education is a major tool for promoting sexual well-being and preparing children and young people for healthy and responsible relationships at the different stages of their lives.

[Source: UNESCO. 2017. International technical guidance on sexuality education,  p. 17.]

When viewed holistically and positively: 

• Sexual health is about well-being, not merely the absence of disease. 
• Sexual health involves respect, safety and freedom from discrimination and violence. 
• Sexual health depends on the fulfilment of certain human rights. 
• Sexual health is relevant throughout the individual’s lifespan, not only to those in the reproductive years, but also to both the young and the elderly. 
• Sexual health is expressed through diverse sexualities and forms of sexual expression. 
• Sexual health is critically influenced by gender norms, roles, expectations and power dynamics.
• Sexual health needs to be understood within specific social, economic and political contexts.
• Characteristics of effective CSE programmes

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The Importance of Comprehensive K-12 Sexual Education Programs

Tatiana M. Smith, University of New Haven

The purpose of this paper is to discuss the current status of existing evidence-based health education programs designed for K-12 students. The content of well-informed K-12 health education programs is intended to clarify definitions and reduce future at-risk and criminal behaviors. This may include evidence-based curriculums encompassing such topics as mental health, sexual education, learning difficulties, sexuality, bullying, suicide, substance abuse, biological puberty, and more. However, the focus here will be on sexual education curriculums for K-12 health education programs. The goal is to evaluate whether existing health programs properly educate K-12 students about recognizing and practicing positive interactions within sexual situations. The intended audience includes legislators and school administrators who effect policy changes in K-12 academic public-school curricula (specifically sex education), with the expectation of enhancing course content to be more comprehensive and to decrease the likelihood of at-risk and criminal behavior in the future, both in the U.S. and perhaps globally (Leung, Shek, Leung, & Shek, 2019).

K-12 Sexual Health Education Programs

According to the Bureau of Justice Statistics (Morgan & Oudekerk, 2018), from 2017 to 2018, the rate of sexual assault among victims 12-years old or older increased from 1.4 to 2.7 per 1,000 persons. This increasing rate of victimization is in line with recent research from the Centers for Disease Control and Prevention (CDC, 2019). An updated release of the National Intimate Partner and Sexual Violence Survey (NISVS) data illustrates the risk to male and female victims, between ages 10-17, to be approximately 1 in 4 and 1 in 3 individuals, respectively (Smith, Zhang, Basile, Merrick, Wang, Kresnow, & Chen, 2018).

These data reveal the ongoing threat of sexual offending and violence among youth. The importance of this information is linked to sexual education programs for K-12 students, which is present in less than 30 states (Fay, 2019). Based upon state laws and corresponding education standards, existing sexual education programs discuss healthy relationships, sexual assault, and/or consent in only 11 states and the District of Columbia (Shapiro & Brown, 2018). In sum, the availability and standards of sex education programs in public schools are widely diverse.

The National Institute of Health reports that between 20 and 27 states only require sexual education on topics that include contraception, sex and/or HIV education, abstinence-only, and sexual activity only being acceptable within marriage (Shapiro & Brown, 2018; National Conference of State Legislatures (NCSL), 2020). Furthermore, states provide parental rights concerning the curriculum that public schools enact, including notification of parents, requiring parental consent, and/or allowing parents to opt-out of sexual education on behalf of their children (NCSL, 2020).

  Background

The history of sex education in the United States has been widely debated for decades, dating to the 1960s, on whether to become more restrictive or more comprehensive (NCSL, 2020; Planned Parenthood, 2016; Schmidt et al., 2015). Sex education has diverged into separate directions across U.S. schools, when it is present. Research has found that previous approaches intending to provide medically comprehensive information about sexual health are not the most successful at reducing risk-taking behaviors among youth (Planned Parenthood. 2016). Rather, studies have uncovered evidence indicating comprehensive programs are successful when they include health goals, preventive methods, physical/psychosocial risk and protective factors, fostering of safe environments, and the incorporation of active participation and multiple activities throughout the course (Planned Parenthood, 2016; Leung et al., 2019).

Sexual Health Education Curricula

The issue of a widely inconsistent and generally lacking sexual education curriculum, both nationally and internationally, is becoming more and more relevant. Rates of sexual violence victimization are not decreasing, but instead have been increasing, even in the context of substantial non-reporting (Smith et al., 2018; Morgan & Oudekerk, 2018; CDC, 2019). The purpose of drawing attention to the improvement of existing sexual education curricula is to decrease rates of sexual violence victimization in the future. The implementation of evidence-based comprehensive programs has shown positive results in prior studies, in that the risk-taking behaviors of youth decreased (Planned Parenthood, 2016). A review of current state legislation indicates, however, at least half of the nation receives limited to no sexual education in K-12 public schools (Planned Parenthood, 2016; Leung et al., 2019; NCSL, 2020).

This educational gap deprives K-12 students from learning about proper sexual health, healthy sexual interactions, the meaning and importance of consent, healthy relationships, sexuality, gender discussions, the significance of behavior, and more (Shegog, Baulmer, Addy, Peskin, & Thiel, 2017; Schmidt, Wandersman, & Hills, 2015; Shapiro & Brown, 2018; Leung et al., 2019; NCSL, 2020). The lack of action to enact new legislation, which could enhance sex education curricula, reduces the likelihood of declines in sexual victimization, including at the developmental stages for K-12 students (Mallet, 2017; CDC, 2019; Leung et al., 2019; NCSL, 2020; Shapiro & Brown, 2018; Smith, Park, Ireland, Elwyn, & Thornberry, 2013).

Pre-Existing K-12 Sexual Health Education Policies

The American public has been demanding an increased focus in schools on teen pregnancy and unhealthy relationships, but sex education standards vary significantly across states, preventing access to critical intervention tools that would provide more comprehensive sex education for students (Shapiro & Brown, 2018). This unbalanced focus creates vulnerability amongst K-12 students for increased risk of victimization and perpetration.

As previously discussed, sex education is not mandated nationwide, nor is the curriculum consistent across states that have implemented legislation. This disparity continues to impact young adults after graduation, placing them at a higher risk for a variety of social and health problems unknown to them (Fay, 2019). The benefit of updated legislation nationwide, in a comprehensive and uniform manner, would be in producing more informed students who will have the ability to make better decisions (Fay, 2019). Knowledge is power, and nearly half the nation does not have any form of sex education in their K-12 public schools, while the majority of those that have programs focus solely on abstinence, sex within marriage, contraception, and/or medically accurate information (Fay, 2019; Leung et al., 2019; NCSL, 2020).

Despite research showing these restrictive educational curricula to be ineffective, the movement to strengthen legislation on sex education requirements and make programs more comprehensive does not have strong traction nationwide (Fay, 2019; NCSL, 2020; Leung et al., 2019; Smith et al., 2013; Planned Parenthood, 2016). Lack of action by legislators in states with restrictive or non-existent programs suggests there is little desire to change or create policies, despite public health risks (CDC, 2019; Planned Parenthood, 2016; Shapiro & Brown, 2018).

Presently, there are no known specific programs that focus on non-heterosexual orientations, nor do existing sexual education courses give much attention to this topic (Schmidt et al., 2015). Although the majority of sexuality education programs in U.S. schools discuss sexually transmitted diseases, pregnancies, abstinence, and the use of contraception, there is a significant amount of content missing (Schmidt et al., 2015). For instance, such topics as what constitutes a healthy dating relationship, interpersonal violence, consent, and discussion of gender roles often are not included (Children & Families Directorate, 2019; Planned Parenthood, 2016; Schmidt et al., 2015; Shegog et al., 2017).

K-12 Sexual Health Education Policy Options

An initial policy proposal can be modeled after a study that associated professional development of teachers with increases in sexual education content coverage (Clayton, Brener, Barrios, Jayne, & Jones, 2018). This model acknowledges the efficacy of sexual health education for middle and high school students, which could be utilized for policies that provide guidance for K-12 sexual health education (Clayton et al., 2018). The positive impact uncovered in the study suggests that professional development of teachers is essential, as they are more likely to teach an expansive content of sexual health than are teachers without similar experience.

A second policy proposal may be constructed using the Reproductive Health Education (RHE) programs implemented and analyzed through a study focused on middle school students from Lebanon (Mouhanna, DeJon, Afifi, Asmar, Nazha, & Zurayk, 2017). These programs also found positive associations between expanded program content and student outcomes. Furthermore, this study developed a baseline for future research on this issue, to be used in informing future stakeholders and assessing the necessity and implementation of RHE programs in developing countries (Mouhanna et al., 2017).

A third and final policy proposal follows the structure of a peer education program known as Students with a Realistic Mission (SWARM; Butler, Jeter, & Andrades, 2002). This program model was found to be successful in integrating service learning and peer education within the health education curriculum (Butler et al., 2002). The original SWARM program included a focus on drugs, service learning, and healthy living-learning competencies. Additionally, it incorporated student feedback, which had been largely positive but included constructive criticism (Butler et al., 2002). Due to its earlier success and integration into an academic institution, a collaborative approach with education and community aspects likely would be an adaptable policy option for K-12 sexual health education.

Advantages of Each K-12 Sexual Health Education Policy Option

The advantages of the first policy proposal modeled after the combination of professional development of teachers and expanded content coverage in K-12 sexual health education (Clayton et al., 2018) may include:

 Focus on preventing adverse sexual behavior and subsequent consequences.  Professional development specifically targeted to teaching sexual health content.  Focus on teaching four domains (including several specific topics under each domain):

o Human sexuality o Pregnancy prevention o HIV prevention o Sexually transmitted diseases prevention.

 Middle and high school sexual education courses.  Reducing sexual risk behaviors and increasing adult/parental support for school-based sexual health education.  Teachers achieving expertise through preservice training.

The advantages of the second policy proposal, constructed using RHE programs with a focus on middle school students from Lebanon (Mouhanna et al., 2017), may include:

 Advocacy and effective implementations of RHE programs for greater numbers and types of youth.  Tailored interventions for the needs, concerns, and expectations of students.  Young people being educated to make informed decisions for their sexual health.  Expanded health education topics reviewed in school.

Finally, the advantages of the third policy proposal follow the structure of the SWARM program, which provides integrated service learning and peer education in the health education curriculum (Butler et al., 2002), and may include:

 Aspects of the community, peers, youth, and academic collaboration in the health education curriculum.  Primary focus on HIV/AIDS, STD prevention, alcohol, and drug education, with possible incorporation of sexual health education  Student feedback, including thoughtful and constructive criticism.

Disadvantages of Each K-12 Sexual Health Education Policy Option

The disadvantages of the first policy proposal (Clayton et al., 2018) may include:

 The preservice and ongoing educational training required may be a challenge due to issues with training, funding, and administrational support.  This could result in time management issues (i.e., overburdening teachers with requirements and little or no support).  Subjects such as mandating the use of condom instruction and discussing sexual orientation might be challenging.

The disadvantages of the second policy proposal (Mouhanna et al., 2017) may include:

 Lack of generalizability and replication of research on this program.  Variation in culture, attitudes, religion, and political orientation might impact implementation and effectiveness.

The disadvantages of the third policy proposal (Butler et al., 2002) may include:

 Limited research on the continued success of SWARM.  Little research on whether significant challenges have been identified since the initial analysis.

Recommendations for a K-12 Sexual Health Education Policy

An overall general recommendation would be to utilize an evidence-based program to restructure sexual health education in K-12 schools in the United States, with an emphasis on a collaborative approach at the micro and macro levels (Schmidt et al., 2015; Whillier, Spence, Giuriato, & Chiro, 2019). This could include, for instance, collaboration between academics, researchers, legislators, community leaders, and school personnel. Evidence-based curricula have been shown to be successful in U.S. school settings. However, for successful implementation, the curricula cannot be compromised by content and competing academic priorities (Shegog et al., 2017).

Based upon the three proposed policy options, the most effective and realistic option would likely be based on the first policy model. Research successfully associated ongoing professional development of teachers with a current, well developed curriculum in K-12 school-based sexual health education programs (Clayton et al., 2018). Ongoing professional development requirements for sexual health educators, combined with their educational pedigree upon entry into their position, could create a highly informed and comprehensive curricula in K-12 schools.

The addition of qualified sexual health educators and ongoing professional development requirements could aid in implementing K-12 school-based sexual health educational programs nationwide. This may be especially influential for policy legislators and in generating parental support, particularly in areas where sexual health education is presently limited or non-existent. The choice of this recommendation is intended to minimize at-risk behaviors, in addition to reducing both criminal victimization and perpetration.

Annotated Bibliography

Butler, K. L., Jeter, A., & Andrades, R. (2002). SWARMing for a solution: Integrating service learning and peer education into the health education curriculum. American Journal of Health Education, 33(4), 240-244. https://eric.ed.gov/?id=EJ854088 Butler, Jeter, & Andrades (2002) evaluated the program Students with a Realistic Mission (SWARM), which focused on health concerns such as drugs, alcohol, HIV/AIDS, and STD prevention. This article provides the framework for an integrated health education program that could be the basis for proposed legislation for comprehensive sexual education. This framework is especially resourceful as it has a successful history, and feedback had been both largely positive and constructive.

Centers for Disease Control and Prevention (CDC). (2019). CDC healthy school. National health education standards. https://www.cdc.gov/healthyschools/sher/standards/index.htm The Centers for Disease Control and Prevention provides an outline for National Health Education Standards (NHES) that pertain to education frameworks and curricula created for K-12 students. There are eight standards that discuss the required depth of ability students much reach at each stage. Furthermore, there is assistance provided to use characteristics associated with the creation of an effective health education curriculum.

Children and Families Directorate. (2019, May 17). Key messages for young people on healthy relationships and consent: A resource for professionals working with young people. Scottish Government. https://www.gov.scot/publications/key-messages-young-people-healthy-relationships-consent-resource-professionals-working-young-people/pages/3/ The Children and Families Directorate provides a resource for professionals to consult when creating well-informed curricula in sex education for young people. It provides a model created recently by the Scottish Government which is concise and informative, especially regarding legislation and/or curricula that may not have an existing framework to amend or build upon.

Clayton, H. B., Brener, N. D., Barrios, L. C., Jayne, P. E., & Jones, S. E. (2018). Professional development on sexual health education is associated with coverage of sexual health topics. Pedagogy in Health Promotion: The Scholarship of Teaching and Learning, 4(2), 115-124. doi: 10.1177/2373379917718562 This article examined sexual health education programs emphasizing the professional development of teachers with a focus on middle and high school health education courses. This study illustrates the importance of comprehensive sexual health education, as it is essential in the prevention of sexual behavior consequences. This structure for professional development associated with school-based sexual health education has proven to be effective, with a positive impact on both the health content covered and the students.

Fay, L. (2019, April 1). Just 24 states mandate sex education for K-12 students, and only 9 require any discussion of consent. See how your state stacks up. The 74 Media: The Big Picture. https://www.the74million.org/article/just-24-states-mandate-sex-education-for-k-12-students-and-only-9-require-any-discussion-of-consent-see-how-your-state-stacks-up/ Fay discusses the attention that sexual education programs in the United States are receiving, both in content and state education requirements. This article further states that during Sexual Assault Awareness Month, lawmakers have been considering legislation related to sex education for K-12 students. It is important to stress that the bills vary in whether the comprehensive nature of the sex education course requirements will be strengthened or restricted.

Leung, H., Shek, D. T. L., Leung, E., & Shek, E. Y. W. (2019). Development of contextually- relevant sexuality education: Lessons from a comprehensive review of adolescent sexuality education across cultures. International Journal of Environmental Research and Public Health, 16(4), 1-24. doi: 10.3390/ijerph16040621 The authors provide a comprehensive review of literature of sexuality education in the United States as well as abroad. This article reviews the policy, practice, training, evaluation, and research associated with the sex education programs in each of the evaluated countries. This highly comprehensive approach illustrates concern over the effectiveness of sexuality programs has been increasing globally, with youth specified as the target population. Furthermore, this review also supports the need for a more informed perspective and curricula that will enhance the effectiveness of these programs.

Mallett, C. A. (2017). The school-to-prison pipeline: Disproportionate impact on vulnerable children and adolescents. Education and Urban Society, 49(6), 563-592. doi: 10.1177/0013124516644053 Mallet presents the significant effect that a punitive school environment can have upon child and adolescent groups, specifically in urban schools. This study examines how certain traits may act as vulnerabilities such as their sexual orientation, socioeconomic class, race, disabilities, and more place these individuals at risk for what has become known as the school-to-prison pipeline. It is important to consider not only academics, but also the environmental factors that may increase an individual’s vulnerability to future criminal victimization or perpetration.

Morgan, R. E., & Oudekerk, B. A. (2019). Criminal victimization, 2018. The Bureau of Justice Statistics. U.S. Department of Justice: Office of Justice Programs. https://www.bjs.gov/content/pub/pdf/cv18.pdf This brief provides the most recently collected data from the Bureau of Justice Statistics regarding a range of criminal victimization, such as aggravated assault, sexual assault, robbery, and stranger violence. The authors provide data on the current rate of victimization regarding sexual assault victims from 2017 to 2018, which subsequently suggests a rise in victimization.

Mouhanna, F., DeJong, J., Afifi, R., Asmar, K., Nazha, B., & Zurayk, H. (2017). Student support for reproductive health education in middle schools: Findings from Lebanon. Sex Education, 17(2), 195-208. doi: 10.1080/14681811.2017.1280011 The authors present a study that acknowledges the critical developmental phase of youth can be more vulnerable to risky sexual behaviors and the associated negative health outcomes. This study is significant as it recognizes the importance of school-based health programs that are well-informed, as well as the significance of grade level and exposure to additional health education topics. This design would be a valuable model to replicate, as effective programs enhance positive attitudes and their implementation could be tailored to key interventions with specific individuals.

National Conference of State Legislatures (NCLS). (2020, April 1). State policies on sex education in schools. Why is sexual education taught in schools? https://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx The National Conference of State Legislators provides updated information as of March 1, 2020 regarding the sex education for public schools in all states. The brief includes summaries of state laws for the medical accuracy in sex or HIV education specifically. However, it does not include the same comprehensive summaries about other sex education programs and their content.

Planned Parenthood. (2016). History of sex education in the U.S. https://www.plannedparenthood.org/uploads/filer_public/da/67/da67fd5d-631d-438a-85e8-a446d90fd1e3/20170209_sexed_d04_1.pdf This Planned Parenthood brief reviews the history of sex education in the United States. This is significant brief, as it includes the World Health Organization’s (WHO) definition of sexual health, in addition to the curriculums and programs offered nationally and worldwide, including content evaluations, roles of the educators, agency roles, and parental roles. Furthermore, this brief acknowledges the concerns of this education curricula, the evolving differences in understanding sex education, as well as associated goals.

Schmidt, S. C., Wandersman, A., & Hills, K. J. (2015). Evidence-based sexuality education programs in schools: Do the align with the national sexuality education standards? American Journal of Sexuality, 10(2), 177-195. doi: 10.1080/15546128.2015.1025937 This article presents an evidence-based review of sexuality education programs in a sample of 10 schools from the Office of Adolescent Health (OAH). This analysis assesses whether the programs are following a comprehensive education model endorsed by the National Sexuality Education Standards. This review is essential, as it highlights pros and cons of the sexuality education programs based upon the level of comprehensiveness regarding the content.

Shapiro, S., & Brown, C. (2018, May 9). Sex education standards across the states. Center for American Progress. https://www.americanprogress.org/issues/education-k-12/reports/2018/05/09/450158/sex-education-standards-across-states/ Shapiro and Brown present a brief that discusses the importance of states moving towards a comprehensive sex education curriculum and current state sex education standards. This brief also highlights the significant diversity in state sex education standards in public schools nationally, but also cautions against focusing on limited topics like teen pregnancy and abstinence. The authors further emphasize the importance of consistent messaging as opposed to the current structure, which may produce inconsistent, confusing, and/or misleading information about sex education.

Shegog, R., Baumler, E., Addy, R. C., Peskin, M., & Thiel, M. A. (2017). Sexual health education for behavior change: How much is enough? Journal of Applied Research on Children: Informing Policy for Children at Risk, 8(1), 1-13. This article highlights the importance of an evidence-based program on sexual health curricula at the K-12 education levels. The authors discuss the significant impact of competing academic priorities, such as standardized testing schedules, which do not always enable students to receive effective sexual health curricula through both the quantity and quality of a program’s exposure.

Smith, C. A., Park, A., Ireland, T. O., Elwyn, L., & Thornberry, T. P. (2013). Long-term outcomes of young adults exposed to maltreatment: The role of educational experiences in promoting resilience to crime and violence in early adulthood. Journal of Interpersonal Violence, 28(1), 121-156. doi: 10.1177/0886260512448845 This study examines whether educational experiences in adolescence may have any mitigating impact on exposure to maltreatment and/or violence in early adulthood. The authors found that while a high G.P.A. had the most positive association with resilience to crime and violence, that the study’s results were consistent with literature that associates promotion of school achievement to increase resilience in urban youth.

Smith, S. G., Zhang, X., Basile, K. C., Merrick, M. T., Wang, J., Kresnow, M., & Chen, J. (2018). The national intimate partner and sexual violence survey (NISVS): Data brief – Updated release. Atlanta: GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 1-25. The National Intimate Partner and Sexual Violence Survey (NISVS), originally collected in 2015 and recently updated in 2018, includes qualitative and quantitative data that relates to current victimization rates. These surveys provide rates that may not have been captured in other data sets to more accurately highlight the risk of sexual violence in the United States among different gender, age, and racial groups.

Whillier, S., Spence, N., Giuriato, R., & Chiro, G. D. (2019). A collaborative process for a program redesign for education in evidence-based health care. The Journal of Chiropractic Education, 33(1), 40-48. doi: 10.7899/JCE-17-31 The authors provide a perspective, not focused on sexual education curricula for K-12 students, which advocates for the importance of a restructured program created through a collaborative process. This supports the need for sexual education to be restructured nationally while acknowledging that this cannot be accomplished nor implemented successfully without collaboration. For instance, a program that is created with research experts, academics, professionals, community leaders, and state officials.

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What Works In Schools : Sexual Health Education

CDC’s  What Works In Schools  Program improves the health and well-being of middle and high school students by:

• Improving health education,
• Connecting young people to the health services they need, and
• Making school environments safer and more supportive.

What is sexual health education?

Quality provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted infections (STI) and unintended pregnancy.

A quality sexual health education curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development. 1

The curriculum is age-appropriate and planned across grade levels to provide information about health risk behaviors and experiences.

Sexual health education should be consistent with scientific research and best practices; reflect the diversity of student experiences and identities; and align with school, family, and community priorities.

Quality sexual health education programs share many characteristics. 2-4 These programs:

• Are taught by well-qualified and highly-trained teachers and school staff
• Use strategies that are relevant and engaging for all students
• Address the health needs of all students, including the students identifying as lesbian, gay, bisexual, transgender, queer and questioning (LGBTQ)
• Connect students to sexual health and other health services at school or in the community
• Engage parents, families, and community partners in school programs
• Foster positive relationships between adolescents and important adults.

How can schools deliver sexual health education?

A school health education program that includes a quality sexual health education curriculum targets the development of functional knowledge and skills needed to promote healthy behaviors and avoid risks. It is important that sexual health education explicitly incorporate and reinforce skill development.

Giving students time to practice, assess, and reflect on skills taught in the curriculum helps move them toward independence, critical thinking, and problem solving to avoid STIs, HIV, and unintended pregnancy. 5

Quality sexual health education programs teach students how to: 1

• Analyze family, peer, and media influences that impact health
• Access valid and reliable health information, products, and services (e.g., STI/HIV testing)
• Communicate with family, peers, and teachers about issues that affect health
• Make informed and thoughtful decisions about their health
• Take responsibility for themselves and others to improve their health.

What are the benefits of delivering sexual health education to students?

Promoting and implementing well-designed sexual health education positively impacts student health in a variety of ways. Students who participate in these programs are more likely to: 6-11

• Delay initiation of sexual intercourse
• Have fewer sex partners
• Have fewer experiences of unprotected sex
• Increase their use of protection, specifically condoms
• Improve their academic performance.

In addition to providing knowledge and skills to address sexual behavior , quality sexual health education can be tailored to include information on high-risk substance use * , suicide prevention, and how to keep students from committing or being victims of violence—behaviors and experiences that place youth at risk for poor physical and mental health and poor academic outcomes.

*High-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice involvement, school dropout, loss of life). This includes misuse of prescription drugs, use of illicit drugs (i.e., cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy), and use of injection drugs (i.e., drugs that have a high risk of infection of blood-borne diseases such as HIV and hepatitis).

What does delivering sexual health education look like in action?

To successfully put quality sexual health education into practice, schools need supportive policies, appropriate content, trained staff, and engaged parents and communities.

Schools can put these four elements in place to support sex ed.

• Implement policies that foster supportive environments for sexual health education.
• Use health content that is medically accurate, developmentally appropriate, culturally inclusive, and grounded in science.
• Equip staff with the knowledge and skills needed to deliver sexual health education.
• Engage parents and community partners.

Include enough time during professional development and training for teachers to practice and reflect on what they learned (essential knowledge and skills) to support their sexual health education instruction.

By law, if your school district or school is receiving federal HIV prevention funding, you will need an HIV Materials Review Panel (HIV MRP) to review all HIV-related educational and informational materials.

This review panel can include members from your School Health Advisory Councils, as shared expertise can strengthen material review and decision making.

For More Information

Learn more about delivering quality sexual health education in the Program Guidance .

Check out CDC’s tools and resources below to develop, select, or revise SHE curricula.

• Health Education Curriculum Analysis Tool (HECAT), Module 6: Sexual Health [PDF – 70 pages] . This module within CDC’s HECAT includes the knowledge, skills, and health behavior outcomes specifically aligned to sexual health education. School and community leaders can use this module to develop, select, or revise SHE curricula and instruction.
• Developing a Scope and Sequence for Sexual Health Education [PDF – 17 pages] .This resource provides an 11-step process to help schools outline the key sexual health topics and concepts (scope), and the logical progression of essential health knowledge, skills, and behaviors to be addressed at each grade level (sequence) from pre-kindergarten through the 12th grade. A developmental scope and sequence is essential to developing, selecting, or revising SHE curricula.
• Centers for Disease Control and Prevention. Health Education Curriculum Analysis Tool, 2021 , Atlanta: CDC; 2021.
• Goldfarb, E. S., & Lieberman, L. D. (2021). Three decades of research: The case for comprehensive sex education. Journal of Adolescent Health, 68(1), 13-27.
• Centers for Disease Control and Prevention (2016). Characteristics of an Effective Health Education Curriculum .
• Pampati, S., Johns, M. M., Szucs, L. E., Bishop, M. D., Mallory, A. B., Barrios, L. C., & Russell, S. T. (2021). Sexual and gender minority youth and sexual health education: A systematic mapping review of the literature.  Journal of Adolescent Health ,  68 (6), 1040-1052.
• Szucs, L. E., Demissie, Z., Steiner, R. J., Brener, N. D., Lindberg, L., Young, E., & Rasberry, C. N. (2023). Trends in the teaching of sexual and reproductive health topics and skills in required courses in secondary schools, in 38 US states between 2008 and 2018.  Health Education Research ,  38 (1), 84-94.
• Coyle, K., Anderson, P., Laris, B. A., Barrett, M., Unti, T., & Baumler, E. (2021). A group randomized trial evaluating high school FLASH, a comprehensive sexual health curriculum.  Journal of Adolescent Health ,  68 (4), 686-695.
• Marseille, E., Mirzazadeh, A., Biggs, M. A., Miller, A. P., Horvath, H., Lightfoot, M.,& Kahn, J. G. (2018). Effectiveness of school-based teen pregnancy prevention programs in the USA: A systematic review and meta-analysis. Prevention Science, 19(4), 468-489.
• Denford, S., Abraham, C., Campbell, R., & Busse, H. (2017). A comprehensive review of reviews of school-based interventions to improve sexual-health. Health psychology review, 11(1), 33-52.
• Chin HB, Sipe TA, Elder R. 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. Am J Prev Med 2012;42(3):272–94.
• Mavedzenge SN, Luecke E, Ross DA. Effective approaches for programming to reduce adolescent vulnerability to HIV infection, HIV risk, and HIV-related morbidity and mortality: A systematic review of systematic reviews. J Acquir Immune Defic Syndr 2014;66:S154–69.

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• Sexual health

Sex education: Talking to your teen about sex

Sex education is offered in many schools, but don't count on classroom instruction alone. Sex education needs to happen at home too. Here's help talking to your teen about sex.

Sex education basics may be covered in health class. But teens might not hear — or understand — everything they need to know to make tough choices about sex. That's where you come in.

It can be awkward, but sex education is a parent's job. By connecting with your teen early and often, you can set the stage for a lifetime of healthy sexuality.

Breaking the ice

Sex might be hard to talk about. But it's even harder to avoid. Sex seems to be everywhere — news, entertainment, social media, advertising. But you can use that to get the talk going and keep it going.

Here are some ideas:

• Seize the moment. When sex comes up in a show or song, use it as a way to start a talk. Everyday moments — such as riding in the car or putting away groceries — are often the best chances to talk.
• Talk early and often. A one-time "birds and the bees" talk isn't enough. Start talking to your teen about safe sex during the preteen years. Continue the talk into early adulthood. Change the talk to suit growth and development.
• Be honest. If you're uncomfortable, say so. But keep talking. If you don't know how to answer your teen's questions, offer to find the answers or look them up together.
• Be direct. Clearly state your feelings about sex. Give facts about risks such as emotional pain, sexually transmitted infections (STIs) and unplanned pregnancy. Explain that oral sex isn't a risk-free choice instead of intercourse.
• Think about your teen's point of view. Strict talks and scare tactics can stop connection and encourage rebellious, risky behavior. Instead, listen to your teen carefully. Understand the pressures, challenges and concerns that teens have.
• Move beyond the facts. Your teen needs to know the facts about sex. But it's just as important to talk about feelings, attitudes and values. Teens are more likely to adopt family values when they understand their parents and feel understood by them.
• Focus on well-being. The teen years are known as a time of risk-taking. But they're also the time when healthy self-care behaviors start. Besides talking about risks, model and express the value of healthy relationships and choices.
• Invite more talks. Let your teen know that it's OK to talk with you about sex when questions or concerns arise. Reward questions by saying, "I'm glad you came to me."

Addressing hard topics

Sex education for teens includes not having sex (abstinence), date rape, gender identity, sexual orientation and other hard topics. Be ready for questions such as:

• How will I know I'm ready for sex? Many issues, such as peer pressure, curiosity, and loneliness, might lead teens into early sexual activity. Reassure your teen that it's OK to wait. Sex is an adult behavior. But there are other ways to connect with someone. Explain that intimate talks, long walks, holding hands, listening to music, dancing, kissing, touching and hugging are safe ways to share affection.

What if my partner wants to have sex, but I don't? Be clear that no always means no. Sex should never be pressured or forced. Any form of forced sex is rape, whether it's done by a stranger or someone your teen has been dating.

Point out to your teen that alcohol and drugs can weaken peoples' decisions. And they can make people think less clearly. Date rape and other dangerous situations become more likely when alcohol and drugs are involved.

What if I'm questioning whether I'm lesbian, gay, bisexual, transgender or queer (LGBTQ)? Many teens wonder about their sexual orientation, gender identity or expression. Help your teen understand that teens are just beginning to explore sexual attraction. These feelings may change as time goes on. And if they don't, that's fine.

A negative answer to your teen's sexual orientation, gender identity or expression can have negative effects. LGBTQ youth have a higher risk of STIs, substance abuse, depression and attempted suicide. Family acceptance can protect against these risks.

Above all, let your teen know that your love is unconditional. Praise your teen for sharing their feelings. Listen more than you speak.

Healthy versus unhealthy relationships

Dating violence occurs more often than many teens or adults may think. About 1 in 12 teens has reported facing physical or sexual dating violence. So it's important to get the facts and share them with your teen.

Watch for warning signs of dating violence, such as:

• Alcohol or drug use
• Staying away from friends and social events
• Excusing a dating partner's behavior
• Acting scared around a dating partner
• Loss of interest in school or activities that were once fun
• Suspicious bruises, scratches or other injuries

Teens in abusive relationships have a higher risk of long-term effects. These include poor grades, binge drinking and suicide attempts. The emotional impact of early unhealthy relationships may also set the stage for future unhappy, violent relationships.

Talk with your teen now about the importance of healthy relationships. Model healthy relationships through the way you connect with your teen and others. The lessons your teen learns today about respect, boundaries, and understanding what is right and wrong will carry over into future relationships.

Responding to behavior

If your teen is sexually active, it may be more important than ever to keep the conversation going. Even if you don't think your teen is ready, be open yet honest in your approach. Remind your teen that you expect sex and its responsibilities to be taken seriously.

• Stress the importance of safe sex.
• Contraception. Make sure your teen understands how to get and use contraception such as condoms and birth control.
• Promote exclusivity. An exclusive sexual relationship supports trust and respect while lowering the risk of STIs.
• Set reasonable boundaries. Enforce curfews and rules about visits with friends. This is especially important if you notice sexual attraction between your teen and certain friends.

Your teen's health care provider can help too. A routine checkup can give your teen the chance to talk about sexual health to only the provider in private. The provider can help your teen learn about contraception and safe sex. The provider can also help you build your skills to teach your teen about safe sex.

The provider may also stress the importance of routine human papillomavirus (HPV) vaccination. This vaccine protects people of all genders against genital warts and cancers of the cervix, anus, mouth and throat, and penis. People can usually get the vaccine between ages 9 and 26. But it is sometimes available for people older than age 26.

Looking ahead

Your guidance is key to helping your teen become a sexually responsible adult. Be honest and speak from the heart. If your teen doesn't seem interested in what you have to say about sex, say it anyway. Your teen is probably listening.

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• Talking with your teens about sex: Going beyond "the talk." Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/protective/factsheets/talking_teens.htm. Accessed May 26, 2022.
• Youth connectedness is an important protective factor for health and well-being. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/protective/youth-connectedness-important-protective-factor-for-health-well-being.htm. Accessed May 26, 2022.
• Positive parenting tips: Young teens (12-14 years of age). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/adolescence.html. Accessed June 23, 2022.
• Positive parenting tips: Teenagers (15-17 years of age). Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/adolescence2.html. Accessed June 23, 2022.
• Monitoring your teen's activities: What parents and families should know. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/protective/factsheets/parental_monitoring_factsheet.htm. Accessed June 28, 2022.
• Fast facts: Preventing teen dating violence. Centers for Disease Control and Prevention. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/teendatingviolence/fastfact.html. Accessed June 22, 2022.
• Teen health services and one-on-one time with a healthcare provider: An infobrief for parents. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/protective/factsheets/OneonOnetime_FactSheet.htm. Accessed June 28, 2022.
• Forcier F. Adolescent sexuality. https://www.uptodate.com/contents/search. Accessed June 12, 2022.
• Chacko MR. Contraception: Overview of issues specific to adolescents. https://www.uptodate.com/contents/search. Accessed May 26, 2022.
• Human papillomavirus (HPV): Questions and answers. Centers for Disease Control and Prevention. https://www.cdc.gov/hpv/parents/questions-answers.html. Accessed June 12, 2022.
• Ford CA, et al. Effect of primary care parent-targeted interventions on parent-adolescent communication about sexual behavior and alcohol use: A randomized clinical trial. JAMA Network Open. 2019; doi:10.10.01/jamanetworkopen.2019.9535.
• Be an askable parent. American Sexual Health Association. https://www.ashasexualhealth.org/parents/. Accessed June 24, 2022.
• Lissaurer T, et al. Adolescent medicine. In: Illustrated Textbook of Paediatrics. 6th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 25, 2022.
• FAQs for teens: You and your sexuality. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/you-and-your-sexuality. Accessed June 27, 2022.
• FAQs for teens: Healthy relationships. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/healthy-relationships. Accessed June 16, 2022.
• FAQs for teens: Lesbian, gay, bisexual, transgender, and queer (LGBTQ) teens. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/lgbtq-teens. Accessed June 16, 2022.
• FAQs for teens: Health care for transgender teens. The American College of Obstetricians and Gynecologists. https://www.acog.org/womens-health/faqs/health-care-for-transgender-teens. Accessed June 16, 2022.
• Hunt, Kristen E. Teen dating violence victimization: Associations among peer justification, attitudes toward gender inequality, sexual activity, and peer victimization. Journal of Interpersonal Violence. 2022; doi:10.1177/08862605221085015.
• Health Education & Content Services (Patient Education). Your options for birth control. Mayo Clinic; 2021.
• Padilla-Walker LM, et al. Is there more than one way to talk about sex? A longitudinal growth mixture model of parent-adolescent sex communication. Journal of Adolescent Health. 2020; doi:10.1016/j.jadohealth.2020.04.031.
• McKay EA, et al. Parent-adolescent sex communication with sexual and gender minority youth: An integrated review. Journal of Pediatric Health Care. 2020; doi:10.1016/j.pedhc.2020.04.004.
• Miller, E, et al. Adolescent relationship abuse including physical and sexual teen dating violence. https://www.uptodate.com/contents/search. Accessed July 15, 2022.
• Wiemann, CM. Date rape: Identification and management. https://www.uptodate.com/contents/search. Accessed July 15, 2022.
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Sexuality Education

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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

Advocates for Youth © May 2014

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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Sex Education: 4 Questions and Answers About the Latest Controversy

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The perennially touchy issue of sex education has erupted again—this time in states not known for being especially prudish about the topic.

Both Illinois and New Jersey rolled out changes to health and sex education standards this school year. And in both states, the revisions have sparked complaints—often specifically about what the standards say about LGBTQ issues and on sexual identity.

Here are some answers to common questions about the latest flare-ups.

Hasn’t sex ed. always been controversial?

For sure. It’s frequently the subject of intense local debates, in part because sexuality education is probably the most local of all curriculum topics in schools: Sex education is not mandatory in all of the states, which means it’s often up to school districts to decide whether—and how—to offer it.

Many states do set some parameters for sex ed., usually in legislation, but these guidelines are still pretty sketchy—often framed in terms of what educators can’t mention (abortion, same-sex relationships) than what they should mention. And it’s still left up to school districts to craft teaching materials or to hire outside organizations to provide curriculum and training.

There are no national sex education mandates, but historically, federal funding for health education has shaped what’s covered in the classes. Abstinence continues to be a core theme of this programming.

One common thread in the evolution of sex education has been risk avoidance and prevention, which have driven the emphasis of specific topics over the years: sexually transmitted infections in the 1970s, teen pregnancy in the 1970s and 1980s, and HIV/AIDS beginning in the 1980s.

Now, health researchers and practitioners have tried to shift away from trying to frighten kids away from behavior that carries any risk. Instead they favor an approach that emphasizes informed decisionmaking, risk management, and self-advocacy.

“Because when kids feel confident in their skills, they’ll act in more healthy ways,” said Judy LoBianco, the supervisor of health and physical education for the Livingston public schools in New Jersey.

What’s ‘comprehensive sex education’ anyway?

This is basically the term of art for a more holistic approach towards sex education that goes beyond abstinence or risk prevention. It includes topics like gender roles and identity, consent, healthy relationships, and sexual diversity presented in the context of social and emotional skills.

This is the approach taken by the groups that have crafted the National Sex Education Standards, last updated in 2020. Despite their name, these are not mandated. States use them to inform their own guidelines. (Illinois adopted these guidelines, but allows districts to opt out of using them, and many have.)

Counter to popular claims, the guidelines do not introduce specific sexual practices in early grades. In 2nd grade, for instance, the national standards require that students can list medically accurate names for the body parts, including genitals, and that students can define “bodily autonomy” and personal boundaries.

How are national politics affecting the sex-ed. discussion?

Despite polling that generally shows that adults favor the tenets of comprehensive sex education, many of the new complaints about sex education echo national political discourse that casts schools as the sites of indoctrination about gender identity.

In New Jersey, whose new standards draw on but aren’t identical to the National Sex Education Standards, opponents have claimed that they show young children “sexually explicit” material and are “indoc t rinating” kids into “woke ideology.”

Some of these complaints cite purported materials and lesson plans in use, claiming they are required by the state. But the state does not pick what curriculum, lesson plans, or training teachers receive; districts select those.

In general, sex-ed. advocates say, these complaints are linked to wider moves to censor what happens in classrooms. About 17 states have restricted lessons about race and gender—and some of them, like a Florida law that forbids talk about sex or sexuality in grades K-3 , have led to the accusations that teachers are “grooming” students. Sociologists and health experts say conflating grooming—in which an adult inappropriately develops a close relationship with a child to facilitate abuse—with sex education puts both teachers and students at risk.

Is the U.S. Supreme Court’s decision in the ‘Dobbs’ case affecting sex ed.?

Surprisingly, abortion is not a common theme in most states’ sex-ed. guidelines . Only nine states and the District of Columbia direct whether or how to discuss abortion in sex education, according to a 2022 policy review from the Sexuality Information and Education Council of the United States, or SIECUS, a nonprofit.

Six of those states prohibit discussing abortion, while Vermont, Colorado, and the District of Columbia affirm abortion as an option.

More states—about 15—include abortion in the context of social studies classes, where it’s often taught in lessons about interpretations of the U.S. Constitution, the 14th Amendment, and the expansion of civil liberties.

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Youngsters using porn to learn with sex education 'failing young people'

The Women and Equalities Committee said there was an "unacceptable risk of harm" from online information about sex and described NHS services as being at "breaking point".

By Dylan Donnelly, news reporter

Tuesday 26 March 2024 05:38, UK

Young people are learning about sex from online pornography because conventional sex education is "failing" them, MPs have said, amid a surge of sexually transmitted infections.

The Women and Equalities Committee said that there is an "unacceptable risk of harm" from online information about sex and sexual health because of an "absence of authoritative advice".

MPs said there is "compelling evidence that relationships and sex education is failing young people" and the benefits of condom use "must be a key part of the curriculum".

They also criticised the government for "failing to heed warnings", with funding for sexual health services reducing year-on-year.

In their report, the committee found that gonorrhoea cases rose to 82,592 in 2022 - the highest number since records began in 1918.

Read more from Sky News: 'I'm going to ruin your life': Inside the Revenge Porn Helpline Porn websites may have to use photo ID and credit card checks US state bans children under 14 from social media

They also found infectious syphilis diagnoses increased to 8,692 in 2022 - the largest annual number since 1948 - and that overall, there were 392,453 diagnoses of new sexually transmitted infections (STIs) in England in 2022, more than 1,000 a day.

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Caroline Nokes MP, chair of the Women and Equalities Committee, called the figures a "red flag" and said: "Sexual health services are at breaking point. They are underfunded and in many cases unable to provide the services their local area needs.

"It is not sustainable and an obvious false economy to substantially reduce funding for sexual health services during a period of increasing demand upon them."

Keep up with all the latest news from the UK and around the world by following Sky News

A government spokesperson said: "In 2020 we made it compulsory for all secondary schools to offer relationships and sex education to ensure that young people are equipped to make safe, informed and healthy choices.

"Content includes information about safer sex and contraception and how these can reduce STIs.

"This year we have allocated more than £3.5bn to local authorities in England to fund public health services, including sexual health services, and this funding will increase in each of the next three years."

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Pre-teen pregnancies are rising in the Philippines – critics blame the Catholic Church

K essa was just 13 years old when she became pregnant with her daughter. A “taboo topic” in the Philippines, she hadn’t felt able to ask anyone about sex and received no education about it in school. 

A year later she had another child, a son, and today, at 17, has forfeited her studies in order to provide for her children. “It’s hard to be a young mum because you need to sacrifice everything for them,” she says.

Kessa’s story isn’t unusual. The Philippines’ teenage pregnancy rates are among the highest in Asia , with more than 500 adolescents becoming pregnant and giving birth every day. The rate is rising among girls aged 10 to 15; data from the Philippine Statistics Authority revealed a 35 per cent hike between 2021 and 2022.

It’s hard to pinpoint the exact reason for this increase, said Mary Racelis, a social anthropologist and sociologist from the Philippines, adding that while many cases are likely a result of abuse, children are possibly becoming sexually aware at a younger age.

However, experts are increasingly theorising that the Catholic Church – and the culture of “prevailing conservatism” it’s created in the Philippines – could be partly responsible, by erecting barriers to contraception and sex education.

Almost 90 per cent of the population adhere to a form of Christianity, including Catholicism, which discourages sex before marriage and the use of condoms or the pill.

This has made it very difficult for schools and campaigners to educate young children about sex and emphasise the need for protection, such is the Church’s hold and influence on civic life in the Philippines.

If a local chief executive is “very Catholic” they may opt against allocating funding to reproductive health, said Amina Evangelista Swanepoel, executive director of Roots of Health, a reproductive, maternal and sexual health non-profit in Puerto Princesa. 

Felie Mae Ferman, an adolescent health and development coordinator with the local government in General Santos City, meanwhile told of how her team has to censor sex education in certain schools, removing any mention of contraception. 

“They [the Church] are pro-life and they are discouraging us from promoting using contraceptives to their students,” she said. “But how can we promote the prevention of teenage pregnancy here in the Philippines if they will not embrace the change?”

Church-led misinformation

Such censorship is likely to feed into the fact that only 1.1 million students in the Philippines have access to sex education, out of 32 million, according to United Nations Population Fund estimates.

There is also the issue of Church-led misinformation. Pro-life local authorities in Manila banned contraceptives for 11 years based on claims from the Church that they caused abortions and immorality. Prominent bishops have meanwhile purported that condoms are ineffective.

“There’s a lot of people who for years, from the Catholic Church, would hear that contraception causes cancer, that contraception kills,” said Swanepoel.

“Thousands of young people think that jumping up and down after sex will prevent pregnancy and a similar [amount] believe that if it’s your first time having sex you won’t get pregnant.”  

There have been previous attempts to mandate sex education in the Philippines but these have been slow to materialise. 

In 2012, a reproductive health law was passed, providing free access to contraceptives and mandating government schools to teach sex education. The Church and a number of Catholic groups openly challenged it, which sent the legislation to the Supreme Court. 

At the time, the late Father Melvin Castro, a leading Catholic official in the Philippines, said the legislation risked “opposing God’s will to procreate”.

The Supreme Court upheld the law in 2014, but it has still been slow to roll out, said Shebana Alqaseer, Save the Children Philippines’ technical adviser for adolescent sexual and reproductive health. 

The Supreme Court also introduced a provision that only allows those over 18 to access contraceptives unless they have parental consent – yet another barrier to safe sex.

“With religion, culture, the dynamics of a family in the Philippines, you can’t just go to your parents and ask them,” Alqaseer said. Kessa shared she was worried she’d be seen as “promiscuous.”

Although the conservatism of the Philippines doesn’t look to be fading anytime soon, there are signs that the country is softening its stance on teenage pregnancy.

Last September, a prevention bill, which proposes the creation of a dedicated council tasked with rolling out programmes designed to reduce teen pregnancies, was approved by the House of Representatives. It’s expected to be passed into law later this year by the Senate.

Campaigners meanwhile point to the progress that has been made in getting the topic of teenage pregnancies into the public domain.

“I do think that talking about these things more, collecting the data and having it out in the mainstream is one of the ways to normalise discussions around sex, to make them a little less taboo,” said Swanepoel. “But we still have a lot of issues.”

One such issue is the physical health of the girls falling pregnant, some of whom are as young as 10. It is a side of the debate that often gets overlooked.

Mothers under 15 are twice as likely to die from complications in pregnancy or childbirth as women between the ages of 20 and 30, according to Save the Children . 

“The consequences of early childbearing can be devastating, affecting not only young mothers but also their children, families, and the broader society,” said Alqaseer. 

Although the Catholic Church is held responsible by many for the Philippines’ teenage pregnancy crisis, more research ultimately needs to be conducted to understand the driving factors behind the recent rise.

Until recently, national demographic health surveys only published data on those aged 15 and over. That has since changed; the survey now captures child pregnancies from 10 years old.

The expanded and improved data collection methods on younger age groups could mean “we’re seeing trends or things that we were not seeing before,” said Swanepoel. “Maybe they were always there but just weren’t being recorded.”

But whether the 35 per cent increase in pregnancies of those under 15 is due to improved reporting or a genuine surge, there were 815 more mothers aged 10 to 14 in 2022 compared to the previous year, said Alqaseer. “Even a single birth from a 10 year-old is cause for concern.”

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Community event organized to promote Latinas in higher education coming to Houston

HOUSTON, Texas (KTRK) -- A new event coming to Houston this week will focus on Latinas in higher education. The goal is to increase the number of Latinas earning their diplomas.

According to organizer Anjelica Cazares, unique social and cultural barriers keep this demographic from earning a degree. She says she had a child early on in life, and becoming a young mom kept her from thinking she could stay in college full-time.

Cazares is now using her personal story, her passion, and her platform with the Latina Leadership Podcast to come up with community solutions to stop Latinas from dropping out of college at higher rates than other demographic groups.

SEE ALSO: Work and Learn program providing 6-week paid training course for young adults

"Say you have 100 Latinas signing up. Only 20-30 will graduate from that program. This is dedicated to Latinas in higher education and helping them understand maybe they can go back at 40 years old, or they can go back to full-time education as opposed to part-time," Cazares said.

The Latinas in Higher Education event will feature a panel of successful Latinas who have graduated from local colleges, universities, and training programs.

The event is free for the community on Thursday from 10 a.m. to 2 p.m. at Houston Community College's southeast campus on Rustic Street.

For updates on this story, follow Briana Conner on Facebook , X and Instagram .

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‘It is our duty:’ Understanding Parents’ Perspectives on Reproductive and Sexual Health Education

Amanda cameron.

a South Carolina Clinical and Translational Research Institute, Medical University of South Carolina, Charleston, SC, USA

Ellie Smith

b College of Public Health and Human Sciences, Oregon State University, St. Corvallis, OR, USA

Nicholas Mercer

c Department of Political Science, College of Charleston, Charleston, SC, USA

Beth Sundstrom

d Department of Communication, College of Charleston, Charleston, SC, USA

South Carolina ranks 16 th in the USA for highest rates of teenage pregnancy. The South Carolina Comprehensive Health Education Act (CHEA) does not require medically accurate, unbiased, culturally appropriate materials, and varies greatly in compliance and implementation. This study aimed to better understand parents’ perspectives in one county in South Carolina regarding reproductive and sexual health education. A total of 484 parents responded to a qualitative questionnaire, collectively representing 798 students. Researchers conducted a thematic analysis to organise data. Main themes identified include comprehensive reproductive and sexual health education as a duty; dispelling the myth of abstinence-only education; and the value of comprehensive reproductive and sexual health education. Parents described teaching reproductive sexual health education in public schools as a ‘duty.’ Furthermore, parents rejected the idea that abstinence-only education is effective and believed reproductive and sexual health education should be taught without the influence of religion. Parents valued inclusive reproductive and sexual health education, covering a robust set of topics. Findings from the study provide evidence for the need to update current reproductive and sexual health education materials and legislation to meet parental demands and reduce youth sexual and reproductive health disparities.

Teenage pregnancy often results in negative outcomes for women, infants and communities including poorer educational, behavioural and health outcomes compared to children born to older parents ( Hoffman and Maynard 2008 ). Despite recent declines in teenage pregnancy, including an eight percent decrease from 2014 to 2015, the USA faces higher rates of teenage pregnancy than other high-income nations ( CDC 2016 ; Finer and Zolna 2016 ). Lower socioeconomic status and education levels for teenagers and parents may contribute to increased incidence of teenage pregnancies ( Penman-Aguilar et al. 2013 ). In 2015, teenage pregnancy cost US taxpayers 3.7 billion dollars, including costs for publicly funded nutrition, health care, and childcare assistance programmes ( Frost et al. 2014 ). Furthermore, teenage pregnancy contributes to increased rates of incarceration, a cycle of lower educational attainment, and unemployment for teenage parents and their children ( CDC 2016 ; Hoffman and Maynard 2008 ).

South Carolina, USA

In South Carolina, the teenage birth rate decreased by nine percent from 2015 to 2016. However, South Carolina ranks 16 th in the USA for highest rates of teenage pregnancy ( Martin et al. 2018 ). The public burden of teenage pregnancy costs South Carolina taxpayers an estimated $166 million annually ( SC Campaign to Prevent Teen Pregnancy 2018 ). Further, South Carolina reports high rates of sexually transmitted infections (STIs), ranking 7 th in the nation for rates of Chlamydia and 9 th for gonorrhoea, and over half of all South Carolina high school students (aged 14-18 years) reported having sex in 2017 ( CDC 2017 ; South Carolina Department of Education 2017 ).

South Carolina, along with 36 other states, mandates HIV or reproductive health education ( South Carolina Legislature 1988 ). The South Carolina Comprehensive Health Education Act (CHEA), Title 59 Chapter 32, requires comprehensive reproductive and sexual health education be taught in public schools. The CHEA mandates that grades Kindergarten to 5 (i.e children aged 5-10 years) receive comprehensive health education; grades 6-8 (aged 11-13 years) receive comprehensive health education, including instruction on STIs; and at least seven hundred and fifty minutes of reproductive health and pregnancy prevention education be taught at least one time during the four years of high school. According to CHEA, ‘reproductive health education’ is defined as ‘instruction in human physiology, conception, prenatal care and development, childbirth, and postnatal care, but does not include instruction concerning sexual practices outside marriage or practices unrelated to reproduction except within the context of the risk of disease’ ( South Carolina Legislature 1988 ). Furthermore, abstinence must be ‘strongly emphasized.’ ( South Carolina Legislature 1988 ).

However, CHEA remains outdated by not requiring medically accurate, culturally appropriate and unbiased health information, the exclusion of information on gender and sexual minorities (i.e., non-heterosexual), and previously purposed amendments fail sufficiently to incorporate these requirements ( Orekoya et al. 2016 ; South Carolina Legislature 1988 ). For example, proposed amendments advocate for the inclusion of defining ‘medically accurate’ health information, but not ‘culturally appropriate’ or ‘unbiased’ health information (e.g., without the influence of religion). Furthermore, large variations persist in materials and implementation of education curricula across the state and school districts ( Orekoya et al. 2016 ).

The most recent state-wide survey on reproductive and sexual health education, conducted in 2005 among registered voters of South Carolina, found over three quarters of participants believed reproductive and sexual health education should emphasise abstinence-only education. Nearly all (88.4%) of the participants indicated the responsibility to teach reproductive and sexual health education falls on parents ( Alton, Oldendick, and Draughon 2005 ). However, half of all participants indicated the number of reproductive and sexual health education should increase, and 70% believed the number of teenage pregnancy prevention programmes should increase in South Carolina ( Alton, Oldendick, and Draughon 2005 ). A more recent focus-group study involving parents found parents desire a collaborative process, including a larger role from schools, to implement teenage pregnancy prevention programmes in South Carolina public schools ( Rose et al. 2014 ).

Despite these previous findings, no changes have been made to CHEA since its introduction in 1988. CHEA’s outdated and limited standards, coupled with a conservative culture, may contribute to higher rates of poor health outcomes for South Carolina’s youth ( Guttmacher Institute 2018 ; Orekoya et al. 2016 ). Research indicates parents may not be equipped with accurate, comprehensive knowledge to teach reproductive and sexual health education solely in the home ( Elliott 2010 ; Heller and Johnson 2010 ; Johnson-Motoyama et al. 2016 ), therefore implementing medically accurate, unbiased school-based sexual education curricula may improve adolescent sexual and reproductive health outcomes.

Comprehensive School-Based Reproductive and Sexual Health Education

Parents of adolescents indicate a need for comprehensive school-based sexual education in order to reduce teenage pregnancies and empower youth ( M. E. Eisenberg et al. 2008 ; Howard et al. 2017 ; Johnson-Motoyama et al. 2016 ; Tortolero et al. 2011 ). Previous studies describe the benefits of comprehensive sexual education policies, including decreased incidence of teenage pregnancy, ( Kohler, Manhart, and Lafferty 2008 ) delay of sex initiation, ( Kirby 2008 ) increased condom and contraceptive use, ( de Castro et al. 2018 ; Kirby 2008 ) and more accurate sexual health knowledge ( Grose, Grabe, and Kohfeldt 2014 ). Current school-based sexual education policies are often outdated ( Greslé-Favier 2010 ), vary largely by state ( Santelli et al. 2017 ), and emphasise abstinence-only sex education, which does not decrease incidence of teenage pregnancy ( Carr and Packham 2017 ). Moreover, studies suggest abstinence-only reproductive and sexual health education does not delay initiation of sexual debut, ( Kirby 2008 ; Kohler, Manhart, and Lafferty 2008 ) and may contribute to higher rates of teenage pregnancy due to lack of contraceptive counseling ( Stanger-Hall and Hall 2011 ). This necessitates a comprehensive, inclusive understanding of stakeholders’ (i.e., parents of students) perspectives and opinions regarding school-based reproductive and sexual health education.

Survey data from previous studies indicate parents of children and young people overwhelmingly value school-based comprehensive reproductive and sexual health education that includes information on contraception, ( Alton, Oldendick, and Draughon 2005 ; M. E. Eisenberg et al. 2008 ; Grose, Grabe, and Kohfeldt 2014 ; Tortolero et al. 2011 ) relationships and gender identity ( M. E. Eisenberg et al. 2008 ; Simovska and Peter 2015 ). Focus group studies, including those with parents, teachers and school stakeholders, found reproductive and sexual health education curricula and teenage pregnancy prevention programmes should detail the ‘real life,’ honest consequences associated with sexual activity, include age appropriate materials, and should be standardised in delivery ( M. Eisenberg et al. 2012 ; Johnson-Motoyama et al. 2016 ; Murray et al. 2014 ). Furthermore, parents detail how their own lack of sexual health knowledge creates an impetus for schools to teach these subjects ( Elliott 2010 ; Heller and Johnson 2010 ; Johnson-Motoyama et al. 2016 ). Not only should reproductive and sexual health education address the needs and wants of parents, but also diverse groups of individuals, including gender non-conforming, lesbian, gay bisexual, transgender, queer and questioning (LGBTQ) community members who otherwise remain marginalised from heteronormative reproductive and sexual health education materials ( Hobaica and Kwon 2017 ).

Purpose of the Study

This study was conducted in Charleston County on behalf of the Charleston County Teen Pregnancy Prevention Council (CCTPPC). CCTPPC is a nonprofit organisation aiming to reduce teenage pregnancy and improve the quality of life in the Charleston community. To achieve its mission, the council provides teen age pregnancy data, community resources, contraceptive access, and effective teenage pregnancy prevention programmes ( CCTPPC 2019 ). Community events held by CCTPPC found a common theme that parents felt their voices were not heard and frustration regarding the lengthy and late timing school board meetings, making it difficult to even attend.

In 2015, despite unanimous approval from the health advisory committee, the Charleston County school board rejected a new Making Proud Choices! comprehensive sex education curriculum. In 2016, the Charleston County School Board rejected a curriculum that would have allowed seventh and eighth graders to learn about pregnancy prevention techniques, including birth control methods and effective condom use, with their parents’ permission ( Pan 2016 ). Most recently, parents were upset to find out that the health advisory committee (mandated by CHEA) is required to have three clergy members, as compared to only two health professionals, two parents, two teachers, two students and two other persons not employed by the local school district ( Schiferl 2019 ).

Few existing studies exploring views on school-based reproductive and sexual health education offer qualitative or open-ended data from parents alone, thus limiting the representation and understanding of parents’ perspectives, opinions and values regarding school-based reproductive and sexual health education ( Elliott 2010 ; Heller and Johnson 2010 ; Johnson-Motoyama et al. 2016 ; Murray et al. 2014 ). Furthermore, updated findings are needed in order to address the modern desires of South Carolina parents that may not be properly represented in older studies. Qualitative research provides in-depth insight into participants’ understandings. Against this background, the purpose of this study was to better understand the parental opinions related to sexual health education in Charleston County, South Carolina public schools. We expect findings to identify practical opportunities to meet the needs of parents and ultimately improve adolescent and teenage sexual health outcomes.

This qualitative study was part of a larger research project investigating the opinions of parents in Charleston County about preferred reproductive health education topics. A qualitative questionnaire was developed with open-ended questions designed to elicit in-depth and rich responses. Through the strategic use of open-ended questions, researchers elicited robust responses and stories from participants suitable for qualitative analysis ( O’Cathain and Thomas 2004 ). Further, scholars suggest that web-based surveys offer the potential to increase participation from diverse, hard-to-access, and marginalised populations, who are often understudied ( McInroy 2016 ; Wright 2005 ). Open-ended text responses were analysed using thematic analysis ( Braun & Clarke, 2006 ). The University of South Florida institutional review board (IRB) approved this study.

Data collection

Eligible participants included parents and caregivers with at least one child attending a Charleston County public school. Potential respondents were recruited through email, web-based listservs, social media (i.e., Facebook and Twitter) and word of mouth. Examples of the different social media pages and listservs included local churches, the Ryan White Program, the South Carolina Coalition Against Domestic Violence and Sexual Assault, the YWCA, Communities in Schools, multiple Charleston Mom Facebook groups and many other social media pages parents might frequent (posted by individual accounts as well as those of relevant organisations).

Recruitment materials included unbiased language to encourage participation: ‘Do you have a child attending Charleston County Public Schools? We want to hear from you! Please take 3 minutes to complete this survey on parental opinions related to reproductive health education in public schools.’ There was no compensation provided to participants. Researchers encouraged participants to share the survey with other parents in Charleston County, creating a ‘snowball’ sampling approach, meaning current study participants recruit additional participants to ‘keep the ball rolling’ and facilitate ongoing recruitment ( Berg and Lune 2012 ). Participants completed an anonymous, self-administered, online questionnaire through REDCap, a secure web application. espondents provided brief demographic details to ensure responses represented a diverse segment of the population. Computer IP addresses were limited to one submission to minimise multiple attempts from the same participant during the data collection period. Participants provided informed consent to proceed to the questionnaire, which respondents completed in approximately 5-15 minutes.

Exploratory open-ended questions were developed in collaboration with the Charleston County Teen Pregnancy Prevention Council and a review of the literature to facilitate inductive qualitative data analysis. . Sample questions included “The South Carolina Comprehensive Health Education Act requires that reproductive health in public schools emphasise abstinence as the first and best option for youth. Do you think that public schools should also teach youth about contraception and condoms as methods to prevent unwanted pregnancy and/or sexually transmitted diseases (including how to use these methods correctly)? Why or why not?”, and “Which of these topics (e.g., male and female reproductive anatomy, abstinence, parenting responsibilities, physical changes associated with puberty, STIs, HIV/AIDS, sexual abuse/rape, negotiation skills, contraception, condoms, pregnancy and childbirth, sexual orientation/gender identity) do you believe should be part of school-based sex education programmes, and what do you think is the earliest grade level at which it should be taught?”

In addition, participants were reminded that researchers were interested in parental opinions related to reproductive health education in public school and were encouraged to use as much space as they needed to share relevant details.

Data analysis

Thematic analysis methodology was used to offer a robust, thick description of these data, meaning a detailed and complex description of participants’ subjective experiences with appropriate context ( Braun and Clarke 2006 ). Thematic analysis offered a recursive process to identify, analyse and report themes. Qualitative data analysis software HyperRESEARCH 3.7.3 was used to assist the analysis. Researchers followed Braun and Clarke’s (2006) six phases of analysis, including (1) familiarisation with the data, (2) generating initial codes, (3) searching for themes, (4) reviewing themes, (5) defining and naming themes, and (6) producing the report. This process involved seeking repeated patterns of meaning across the open-ended textual responses ( Braun and Clarke 2006 ). Initially, the analytic process included description and organisation to reveal patterns in the data. Similar to a codebook, researchers defined and refined a thematic map, which provides a visual conceptualisation of patterns in the data, including the relationships between codes ( Braun & Clarke, 2006 ). Figure 1 shows the final three main themes and subthemes.

Design based on Braun & Wilkinson, 2003

A total of 484 participants responded to the survey. Participants reported an average age of 41.25 ± 15.97 and overwhelmingly self-identified as female (n = 438, 90.5%) and white (n = 412, 85.1%), which is considerably larger than the 48% of white students represented in Charleston County School District. A smaller portion of the respondents self-identified as Black/African American (n = 43, 8.9%), much lower than the 38% of black students in Charleston County School District ( Charleston County School District 2019 ).

Most participants self-reported an Associate’s Degree or higher for level of education obtained (n = 450, 93%), while the remaining participants reported an education level of a GED or lower (n = 29, 6%), reflective of Charleston County where 91% of adults report their education level as higher than a high school diploma ( US Census Bureau 2018 ). The majority of participants indicated they had one child (n = 236, 48.8%) enrolled in a Charleston County public school, followed by two children (n = 194, 40.1%), three children (n = 44, 9.1%), four children (n = 8, 1.7%), and five children (n = 2, 0.4%). Participants represented 496 (62.1%) elementary school students, 163 (20.5%) middle school students, and 112 (14%) high school students. Overall, the sample represented a total of 798 students enrolled in Charleston County School District, which serves 49,820 students. See Table 1 for all participant demographic characteristics.

Demographic Characteristic

Note. Frequencies that do not sum due to “prefer not to answer” response.

Three themes, with related subthemes were identified regarding parental attitudes toward sex education in Charleston County public schools: 1) Comprehensive Reproductive and Sexual Health Education as a Duty: Right, Obligation, Duty; Effective, Evidence-Based, Age-Appropriate Education; and Not Always Taught at Home; 2) Dispelling the Myth of Abstinence-only Education: Religion; ‘Real World;’ and Stigma; and 3) The Value of Comprehensive Reproductive and Sexual Health Education: Male and Female Reproductive Anatomy; Bodily Autonomy, Consent, and Health Relationships; and Gender Identity and Sexual Orientation. Results include representative quotes chosen to best reflect patterns and themes in the data as well as to honor the unique voices of participants, therefore each comment is from a different participant.

Comprehensive Reproductive and Sexual Health Education as a Duty

Right, obligation, and duty.

Participants viewed teaching comprehensive sex education as a public school’s obligation to students. One 38-year-old mother with a graduate degree said, ‘we have an obligation to inform youth of the options available.’ Many participants indicated that students had the right to knowledge about their bodies and withholding education was not only a disservice, but also harmful. According to another 63-year-old mother with a graduate degree, ‘not telling [students] about contraception and sexually transmitted disease (STD) prevention is pure negligence.’ Most participants believed that providing knowledge about sexual health-related topics can empower students to take control of their health.

Participants also invoked duty as a reason to provide comprehensive sex education. According to one participant, a 45-year-old mother with a bachelor’s degree, ‘South Carolina ranks in the top #5 out of 50 states with the highest incidence of Chlamydia and gonorrhoea. We need to educate our youth.’ Another 43-year-old mom with a graduate degree noted the correlation that ‘the states with abstinence-only sex education have the highest rates of pregnancy.’ Participants understood comprehensive reproductive and sexual health education as a student’s right, which could reduce rates of STIs and teen pregnancy.

Effective, Evidence-based, Age-appropriate Education

In addition to the right to education, parents suggested comprehensive sex education should comprise effective, scientific, evidence-based and age-appropriate material. According to one 32-year-old mother with a bachelor’s degree, ‘data show that comprehensive sex education is more effective than an abstinence-only approach at reducing the rates of teen pregnancy and STIs.’ Parents regularly reaffirmed that comprehensive sex education is proven effective in reducing rates of STIs and teenage pregnancy.

Overall, participants favoured comprehensive sex education, but some had concerns about its implementation. For example, one 39-year-old mother with a graduate degree, although comfortable with comprehensive sex education, warned ‘all of these topics should be approached in a developmentally appropriate way.’ In addition to concerns about age-appropriateness, some participants were concerned about the qualifications of instructors teaching sex education. According to one 34-year-old mother with a graduate degree, ‘anything related to medicine (like contraception) should not be taught in schools by teachers that have NO medical background to be able to discuss the risk factors associated with different types of medicine.’ Although participants expressed concerns, parents also recognised the benefits of comprehensive sex education as effective when appropriately implemented.

Not always taught at home

Many participants expressed the importance of teaching evidence-based, comprehensive sex education because it is not always taught at home. One 41-year-old mother with a bachelor’s degree stated, ‘I would guess that a lot of children might not have the benefit of a responsible adult helping them become properly educated in this area.’ According to one 39-year-old mother with a bachelor’s degree, ‘although I think abstinence is best, there are some who will be sexually active, and parents may not be teaching proper methods at home.’ Regardless of personal views on abstinence, participants felt an obligation to implement comprehensive sex education as part of the public-school curriculum because students may not receive this education at home.

Dispelling the Myth of Abstinence-Only Education

Participants viewed the religious beliefs of others as a barrier to comprehensive sex education in schools. Some participants were frustrated by what they viewed as an encroachment of religion concerning the inclusion of sex education in schools. One 42-year-old mother with a bachelor’s degree said, ‘keep religion out of our public institutions and teach children about the human body, biology, reproduction and STDs.’ According to a 54-year-old mother with a graduate degree, ‘our kids and teens deserve better than religious lies that are not based on evidence or facts.’ For these participants, religion played a disproportionate role in the conversation around sex education in schools.

On the other hand, many participants cited their personal religious views as the basis for their support of comprehensive sex education. One 43-year-old mother with a graduate degree said:

As a Christian parent, I hold the view that the tension of ‘freedom and responsibility’ is the best way to raise children, but the natural consequence of sex is likely conceiving a baby, so in my view prevention and education is in order for a healthy society.

Many participants recognised the tension between religious teachings of abstinence, and the practical responsibility of creating a ‘healthy society,’ which requires comprehensive sex education.

In addition to religion, participants described the impact of media and popular culture as a reason for comprehensive sex education in schools. One 35-year-old mother with a graduate degree said, ‘the reality is that teens have sex, and I prefer my son understand how to protect himself and his partner from pregnancy and diseases.’ Many participants viewed sex as an inevitability for teenagers, and abstinence-only education depended on the myth that teenagers do not engage in sexual activity. Another 47-year-old mother with a graduate degree cited the media as a reason for comprehensive sex education in schools, stating ‘teens are sexually active. Promiscuity is all over mainstream television, magazines and the internet.’ Most participants recognised abstinence as unrealistic for students, and abstinence-only education as ineffective.

Participants described the need to diminish the stigma surrounding sex education. According to one 40-year-old mother with a bachelor’s degree, ‘we have to stop making sex a taboo topic. Kids are full of false ideas because no one is providing them with accurate information.’ Many participants advocated for comprehensive sex education in schools to correct misinformation and address the stigma around sexual health-related topics. Other participants discussed stigma and the need for education in the context of their own histories. One 36-year-old mother with a bachelor’s degree described how they, ‘grew up in an upper-class religious household, as did my friends. I started having sex at 14. My friends were all having sex around me.’ Despite an upbringing in a conservative environment, this same participant engaged in sexual activity as a young person and advocated for comprehensive sex education in schools in order to teach safe practices and help young people make better decisions.

The Value of Comprehensive Reproductive and Sexual Health Education

Male and female reproductive anatomy.

Several participants noted the importance of teaching anatomy, including the use of scientifically accurate language, as a key component of comprehensive sex education curricula. One 38-year-old mother with a bachelor’s degree said, ‘I think that it is super important for kids to know their anatomy and what happens with it. The correct terms are so important.’ Another 42-year-old mother with a bachelor’s degree said, ‘I think it is important to also teach children that what they are feeling and how their body is changing is normal [emphasis by participant].’

Bodily Autonomy, Consent, and Healthy Relationships

Participants expressed support for a variety of topics in comprehensive sex education curricula regarding individual bodily autonomy. According to one 36-year-old mother with a graduate degree, ‘I believe sexual abuse prevention should be taught to all ages in a developmentally appropriate way.’ Participants also supported teaching about healthy relationships, ‘I believe sex ed should also include a HUGE [emphasis by participant] component about consent.’ Participants who expressed concerns over comprehensive sex education in schools were also in favour of topics related to bodily autonomy, according to a 45-year-old mother with a graduate degree: ‘abstinence should be promoted in a way that does not reinforce gender norms but rather emphasises respect between individuals.’ Despite different viewpoints about comprehensive sex education, participants believed that students should be taught about their right to control their own body.

Contraception and STIs

Another topic addressed by participants included contraception and STIs. Participants expressed interest in comprehensive sex education including discussions about birth control. According to one 51-year-old mother with a bachelor’s degree, ‘we must…educate our children on the proper birth control methods to prevent unwanted pregnancies.’ This sentiment was echoed by another 51-year-old mother with a bachelor’s degree saying, ‘I wish all girls could receive free birth control implants at age 13! They should at least be given as much information as possible about sex and birth control.’

Support for contraceptive information was stressed regardless of gender, ‘I have a teenager and stress the importance of using condoms to him…It would be nice to have this advice reinforced at school.’

STIs were also noted as an important topic to be included in comprehensive sex education in order to address misinformation. According to one 46-year-old mother with a bachelor’s degree, ‘I’ve heard friends of my kids say they didn’t know they could get oral herpes from just kissing or other STIs from just “touching.”‘ One 39-year-old father with a bachelor’s degree explicitly outlined the need for this information stating, ‘knowledge is power, and a formalised curriculum including effectiveness and application of various birth control and STI prevention methods empowers our children.’

Gender Identity and Sexual Orientation

Participants varied in their opinions regarding gender identity and sexual orientation being taught in schools. Despite differing viewpoints, participants discussed reducing stigma as a reason for discussing these topics. According to one 31-year-old mother with a bachelor’s degree:

Teaching about sexual orientation and gender [identity] at a young age can help destigmatise and de-mystify it all, making it easier for children…to speak to their peers and transition when they’re ready.

Some participants had mixed feelings about gender identity and sexual orientation being taught in school. According to one 35-year-old mother with an associate degree:

Not sure how I feel about school addressing sexual orientation or gender identity, but I realise it is a conversation one must have. My kids are still very young, so I am still grappling with how to handle this on the most basic level for such discussions.

For most participants, there was a tension between recognising that students should learn about gender identity and sexual orientation and the need for the conversation to be developmentally appropriate.

Even participants who were uncomfortable with schools teaching about gender identity and sexual orientation expressed support and inclusion for LGBTQ students. According to one 52-year-old mother with a bachelor’s degree, ‘sexual orientation should not be a school topic, it should be taught by parents…That being said, sexual orientation should not be a putdown in any school setting, nor should such bullying be tolerated.’ This same participant was opposed to gender identity and sexual orientation being taught in schools while wanting to ensure students with non-normative identities were included and not subjected to bullying.

Four hundred and eighty-four parents, representing a total of 798 students, responded to a questionnaire aimed at understanding parental attitudes toward sex education in local public schools. Participants believed public schools have a duty to teach comprehensive reproductive and sexual health education. Findings show that reproductive and sexual health education curricula should be effective, evidence-based, science-based, age-appropriate and taught by trained teachers or instructors. Many participants perceived a lack of reproductive and sexual health education being taught at home, resulting in an obligation to include reproductive and sexual health education in a school setting. Participants rejected the idea of abstinence-only as an effective approach to reproductive and sexual health education. Many participants cited the impact of religious beliefs, the reality of adolescent sexual activity, sexual content in media, and stigma on discussions of sexual and reproductive health topics. Finally, most parents agreed that reproductive and sexual health education should include a robust set of topics including reproductive anatomy, bodily autonomy and consent, contraception and gender identity and sexual orientation.

Reproductive and Sexual Health Education as a Duty

Parents believed schools are obligated to provide effective, evidence-based, and age-appropriate reproductive and sexual health education. This reinforces previous research suggesting parents believe schools need to ‘do more,’ including teaching about STI prevention, condom use and contraceptive methods ( Tortolero et al. 2011 ). This finding also supports research suggesting parents lack the necessary, in-depth knowledge to effectively teach myriad sexual health topics to their children at varying ages within the home ( Elliott 2010 ; Heller and Johnson 2010 ; Johnson-Motoyama et al. 2016 ).

This assertion by parents for trained sexual health education instructors in schools coupled by lack of adequate in-home instruction from parents establishes an imperative, or ‘duty,’ for school-based sexual health educators to deliver effective, age-appropriate sexual health education. It offers an updated perspective on findings from a 2005 survey of South Carolina residents, of a similar demographic composition (72% white, and 59% female), that indicated parents and/or legal guardians should hold the responsibility to teach reproductive and sexual health education ( Alton, Oldendick, and Draughon 2005 ). Mandating the comprehensive coverage of sexual health topics in public schools through policy may close the knowledge gap created by limited or absent in-home instruction, protect students and reduce sexual health disparities experienced by youth across age groups. This finding also supports the updating of CHEA to create a more standardised administration of comprehensive sexual and reproductive health education to ensure students receive adequate information regardless of parents’ teaching.

Effective Abstinence-Only is a Myth

Parents perceived effective abstinence-only reproductive and sexual health education as a myth. This finding supports research that indicates abstinence-only education does not reduce teenage pregnancy rates ( Carr and Packham 2017 ). Curricula should be comprehensive, developed without the influence of religious beliefs, recognise the reality of media influence on adolescent sexual behaviour, and attempt to normalise sexual and reproductive health discussions. This finding extends previous research indicating parents believe school-based reproductive and sexual health education should cover the ‘realities’ and the potential consequences of risky sexual behaviours among adolescents ( Murray et al. 2014 ; Tortolero et al. 2011 ). Research suggests equipping adolescents with the necessary skills to navigate and communicate sexual health decision making and sexual encounters contributes to healthier relationships ( Decker, Berglas, and Brindis 2015 ; Elliott 2010 ; Orekoya et al. 2016 ). Incorporating ‘real world’ influences and consequences into reproductive and sexual health education may normalise sexual health discussions and empower youth to make positive sexual and reproductive health decisions.

Parents’ stated need for unbiased reproductive and sexual health education (i.e., without the influence of religion) demonstrates that South Carolina’s reproductive and sexual health education legislation (CHEA) requires further reform in order to meet the modern desires of South Carolina parents. Stimulating policy change by improving CHEA via standardising and mandating the provision of unbiased school-based reproductive and sexual health education holds the potential to optimise educational materials and instructor time and efforts in order to ameliorate adolescent sexual health disparities. It is imperative, however, that updated amendments to CHEA not only define ‘unbiased’ health information, but also include training for reproductive and sexual health educators to ensure unbiased, culturally appropriate delivery of education materials.

Reproductive and Sexual Health Education is Inclusive

Parents value inclusive, comprehensive reproductive and sexual health education. Reproductive and sexual health education curricula should include age-appropriate discussions of male and female reproductive anatomy, bodily autonomy, consent, healthy relationships, contraception, and gender identity and sexual orientation. This finding mirrors previous research showing that parents value comprehensive reproductive and sexual health education beyond abstinence-only, including information on contraception, relationships and gender identity ( M. E. Eisenberg et al. 2008 ; Johnson-Motoyama et al. 2016 ; Simovska and Peter 2015 ; Tortolero et al. 2011 ).

Beyond this, these qualitative findings provide novel insight to specific topics parents value in reproductive and sexual health education materials that may not be covered in previous survey studies, including gender identity and sexual orientation, bodily autonomy and consent. Parents believed including information on gender identity and sexual orientation can destigmatise these topics, challenging previous survey data that indicate over half of South Carolina residents surveyed do not want information on ‘homosexuality’ included in school-based reproductive and sexual health education ( Alton, Oldendick, and Draughon 2005 ). This further revidences the evolving views of South Carolina. CHEA should be updated to not exclude information on ‘alternative sexual lifestyles’ in order to address materials that parents of children within the public-school system desire to be taught.

Parents expressed concern that they lack comprehensive understanding of issues related to gender identity and sexual orientation, emphasising that these topics should be covered in school-based reproductive and sexual health education. Participants suggested addressing these topics may reduce misunderstandings and bullying and contribute to creating a safe space in public schools. This parental perspective contributes to previous research among sexually diverse youth who believed inclusive reproductive and sexual health education may contribute to a better sense of community and potentially safer sex practices ( Hobaica and Kwon 2017 ; Snapp et al. 2015 ). In-depth understanding of parents’ values and reasoning for the inclusion of specific topics demands reproductive and sexual health education materials be complete, including sexual orientation and gender identity, to ensure the wellbeing and safety of all students.

Limitations

Several limitations exist in the present study. Survey data obtained includes insights from South Carolina parents from within one county, therefore generalisability to other regions of South Carolina and the USA i limited. Although the study surveyed a select group of Charleston County residents (i.e., parents with children in public schools), participant demographics (e.g., race and gender) may not fully represent or reflect those of all Charleston County residents. Future research should seek to include more diverse participants, including men and parents of colour. In addition, qualitative data obtained via surveys may not address parents’ thoughts and opinions as comprehensively as other qualitative methodologies. Future studies should employ other qualitative methodologies including in-depth interviews or focus groups to add more in-depth understanding of parental perspectives of reproductive and sexual health education.

Future Implications

Study findings offer novel and updated insights to the perspectives, opinions, and values among parents for school-based reproductive and sexual health education materials, topics and implementation. In particular, they evidence the critical need to increase oversight and documentation of the reproductive and sexual health taught to youth in schools to ensure realisation of current and future policies. Abstinence-only and other outdated sexual and reproductive health policies and curricula do not contribute to lower rates of teenage pregnancy ( Carr and Packham 2017 ). The 1988 CHEA policy is 31 years old and, as indicated in previous studies and the current study, the perspectives and needs of parents and students evolve over time, therefore CHEA must be updated. For example, CHEA currently requires information that is ‘age-appropriate,’ but allows the school board to determine what is deemed age-appropriate, without consideration of parental perspectives. This study provides insight to parental views of ‘age-appropriate’ sexual and reproductive health topics and explicit information parents wish to be included in updated school-based reproductive and sexual health education policies.

Future research should also examine the qualifications and training of reproductive and sexual health education teachers and instructors to ensure effective presentation of updated curricula. These results should guide the Charleston County School Board, and potentially South Carolina legislation, to ensure the needs of parents and students are met to reduce sexual and reproductive health disparities faced by South Carolina youth.

Acknowledgements

The authors would like to thank members of the Women’s Health Research Team at the College of Charleston and the Charleston County Teen Pregnancy Prevention Council for their support and collaboration on the project.

This project was supported, in part, by the National Center for Advancing Translational Sciences of the US National Institutes of Health under Grant Number UL1 TR001450. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Declaration of Interests

The authors have no conflicts of interests to report.

• Alton Forrest, Oldendick Robert, and Draughon Katherine. 2005. “ The Sex Education Curriculum in South Carolina’s Public Schools: The Public’s View .” Public Policy & Practice 4 ( 1 ): 1–14. http://www.ipspr.sc.edu/ejournal/ejmay05/sexrev3.htm [ Google Scholar ]
• Berg Bruce L, and Lune Howard. 2012. Qualitative Research Methods for the Social Sciences . Boston: Pearson. [ Google Scholar ]
• Braun Virginia, and Clarke Victoria. 2006. “ Using Thematic Analysis in Psychology .” Qualitative Research in Psychology 3 ( 2 ): 77–101. [ Google Scholar ]
• Braun Virginia, and Wilkinson Sue. 2003. “ Liability or Asset? Women Talk about the Vagina .” Psychology of Women Section Review 5 ( 2 ): 28–42. [ Google Scholar ]
• Carr Jillian B., and Packham Analisa. 2017. “ The Effects of State-Mandated Abstinence-Based Sex Education on Teen Health Outcomes .” Health Economics 26 ( 4 ): 403–20. [ PubMed ] [ Google Scholar ]
• Castro Filipa de, Rojas-Martínez Rosalba, Villalobos-Hernández Aremis, Allen-Leigh Betania, Breverman-Bronstein Ariela, Billings Deborah Lynn, and Uribe-Zúñiga Patricia. 2018. “ Sexual and Reproductive Health Outcomes Are Positively Associated with Comprehensive Sexual Education Exposure in Mexican High-School Students .” Edited by Dalby Andrew R.. PLOS ONE 13 ( 3 ). 10.1371/journal.pone.0193780. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
• CCTPPC. 2019. “ Charleston County Teen Pregnancy Prevetion Council: About Us .” Charleston County Teen Pregnancy Prevention Council; November 2019. https://www.cctppc.com . [ Google Scholar ]
• CDC. 2016. “ About Teen Pregnancy | Teen Pregnancy | Reproductive Health | CDC .” April 26, 2016. http://www.cdc.gov/teenpregnancy/about/index.htm
• ———. 2017. “ Sexually Transmitted Disease Surveillance 2016 .” Atlanta, GA: US Department of Health and Human Services; https://www.cdc.gov/std/stats16/CDC_2016_STDS_Report-for508WebSep21_2017_1644.pdf [ Google Scholar ]
• Charleston County School District. 2019. “ Fast Facts .” Charleston County School District Schools; 2019. https://www.ccsdschools.com . [ Google Scholar ]
• Decker Martha J., Berglas Nancy F., and Brindis Claire D.. 2015. “ A Call to Action: Developing and Strengthening New Strategies to Promote Adolescent Sexual Health .” Societies (2075-4698) 5 ( 4 ): 686. [ Google Scholar ]
• Eisenberg Marla E., Bernat Debra H., Bearinger Linda H., and Resnick Michael D.. 2008. “ Support for Comprehensive Sexuality Education: Perspectives from Parents of School-Age Youth .” Journal of Adolescent Health 42 ( 4 ): 352–59. [ PubMed ] [ Google Scholar ]
• Eisenberg Marla, Madsen Nikki, Oliphant Jennifer A., and Resnick Michael. 2012. “ Policies, Principals and Parents: Multilevel Challenges and Supports in Teaching Sexuality Education .” Sex Education 12 ( 3 ): 317–29. [ Google Scholar ]
• Elliott Sinikka. 2010. “ ‘If I Could Really Say That and Get Away with It!’ Accountability and Ambivalence in American Parents’ Sexuality Lessons in the Age of Abstinence .” Sex Education 10 ( 3 ): 239–50. [ Google Scholar ]
• Finer Lawrence B., and Zolna Mia R.. 2016. “ Declines in Unintended Pregnancy in the United States, 2008-2011 .” The New England Journal of Medicine , no. 9 : 843. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Frost Jennifer J., Sonfield Adam, Zolna Mia R., and Finer Lawrence B.. 2014. “ Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program: US Publicly Funded Family Planning Program .” Milbank Quarterly 92 ( 4 ): 696–749. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Greslé-Favier Claire. 2010. “ The Legacy of Abstinence-Only Discourses and the Place of Pleasure in US Discourses on Teenage Sexuality .” Sex Education 10 ( 4 ): 413–22. [ Google Scholar ]
• Grose Rose Grace, Grabe Shelly, and Kohfeldt Danielle. 2014. “ Sexual Education, Gender Ideology, and Youth Sexual Empowerment .” Journal Of Sex Research 51 ( 7 ): 742–53. [ PubMed ] [ Google Scholar ]
• Guttmacher Institute. 2018. “ Sex and HIV Education .” Guttmacher Institute; 01 2018. https://www.guttmacher.org/state-policy/explore/sex-and-hiv-education . [ Google Scholar ]
• Heller Janet R., and Johnson Helen L.. 2010. “ What Are Parents Really Saying When They Talk With Their Children About Sexuality? ” American Journal of Sexuality Education 5 ( 2 ): 144–70. [ Google Scholar ]
• Hobaica Steven, and Kwon Paul. 2017. “ ‘This Is How You Hetero:’ Sexual Minorities in Heteronormative Sex Education .” American Journal of Sexuality Education 12 ( 4 ): 423–50. [ Google Scholar ]
• Hoffman Saul D., and Maynard Rebecca A.. 2008. Kids Having Kids: Economic Costs and Social Consequences of Teen Pregnancy . Second edition Washington, D.C: Rowman & Littlefield Publishers. [ Google Scholar ]
• Howard Tiffany R., Larkin Lauri J., Ballard Michael D., McKinney Molly A., and Gore Jonathan S.. 2017. “ Parental Views on Sexual Education in Public Schools in a Rural Kentucky County Eastern Kentucky University .” KAHPERD Journal 54 ( 2 ): 32–43. [ Google Scholar ]
• Johnson-Motoyama Michelle, Moses Mindi, Kann Tiffany, Mariscal E, Levy Michelle, Navarro Carolina, Fite Paula, Koloroutis Kann Tiffany, Mariscal E Susana, and Fite Paula J. 2016. “ Parent, Teacher, and School Stakeholder Perspectives on Adolescent Pregnancy Prevention Programming for Latino Youth .” Journal of Primary Prevention 37 ( 6 ): 513–25. [ PubMed ] [ Google Scholar ]
• Kirby Douglas B. 2008. “ The Impact of Abstinence and Comprehensive Sex and STD/HIV Education Programs on Adolescent Sexual Behavior .” Sexuality Research & Social Policy 5 ( 3 ): 18. [ Google Scholar ]
• Kohler Pamela K., Manhart Lisa E., and Lafferty William E.. 2008. “ Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy .” Journal of Adolescent Health 42 ( 4 ): 344–51. [ PubMed ] [ Google Scholar ]
• Martin Joyce A., Hamilton Brady E., Osterman Michelle J.K., Driscoll Anne K., and Patrick Drake. 2018. “ Births: Final Data for 2017 .” National Vital Statistics Reports 67 ( 8 ): 50. [ PubMed ] [ Google Scholar ]
• McInroy Lauren B. 2016. “ Pitfalls, Potentials, and Ethics of Online Survey Research: LGBTQ and Other Marginalized and Hard-to-Access Youths .” Social Work Research 40 ( 2 ): 83–94. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Murray Ashley, Ellis Monica U., Castellanos Ted, Gaul Zaneta, Sutton Madeline Y., and Sneed Carl D.. 2014. “ Sexual Health Discussions between African-American Mothers and Mothers of Latino Descent and Their Children .” Sex Education 14 ( 5 ): 597–608. [ Google Scholar ]
• O’Cathain Alicia, and Thomas Kate J.. 2004. “ ‘Any Other Comments?’ Open Questions on Questionnaires – a Bane or a Bonus to Research? ” BMC Medical Research Methodology 4 ( 1 ): 25. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Orekoya Olubunmi, White Kellee, Samson Marsha, and Robillard Alyssa G.. 2016. “ The South Carolina Comprehensive Health Education Act Needs to Be Amended .” American Journal of Public Health 106 ( 11 ): 1950–52. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Pan Deanna. 2016. “ Charleston County School Board Nixes Part of Sex Education Curriculum .” Post and Courier , October 24, 2016, Online edition. https://www.postandcourier.com/news/charleston-county-school-board-nixes-part-of-sex-education-curriculum/article_7e6f1846-9a09-11e6-b4df-e32fc56b9b8d.html .
• Penman-Aguilar Ana, Carter Marion, Snead M. Christine, and Kourtis Athena P.. 2013. “ Socioeconomic Disadvantage as a Social Determinant of Teen Childbearing in the U.S .” Public Health Reports (Washington, D.C.: 1974) 128 Suppl 1 (April): 5–22. [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Rose India, Prince Mary, Flynn Shannon, Kershner Sarah, and Taylor Doug. 2014. “ Parental Support for Teenage Pregnancy Prevention Programmes in South Carolina Public Middle Schools .” Sex Education 14 ( 5 ): 510–24. [ Google Scholar ]
• Santelli John S., Kantor Leslie M., Grilo Stephanie A., Speizer Ilene S., Lindberg Laura D., Heitel Jennifer, Schalet Amy T., et al. 2017. “ Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact .” Journal of Adolescent Health 61 ( 3 ): 273–80. [ PubMed ] [ Google Scholar ]
• SC Campaign to Prevent Teen Pregnancy. 2018. “ On Taxpayers | SC Campaign to Prevent Teen Pregnancy .” 2018. https://www.teenpregnancysc.org/issue/taxpayers
• Schiferl Jenna Schiferl. 2019. “ Charleston Parents Slam SC Sex Ed Law Giving Clergy Members More Say than Health Experts .” Post and Courier , July 19, 2019, Online edition. https://www.postandcourier.com/news/charleston-parents-slam-sc-sex-ed-law-giving-clergy-members/article_1cbf7396-92a6-11e9-acbd-dbb5b801180f.html
• Simovska Venka, and Peter Christina R.. 2015. “ Parents’ Attitudes toward Comprehensive and Inclusive Sexuality Education : Beliefs about Sexual Health Topics and Forms of Curricula .” Health Education , no. 1 : 71. [ Google Scholar ]
• Snapp Shannon D., McGuire Jenifer K., Sinclair Katarina O., Gabrion Karlee, and Russell Stephen T.. 2015. “ LGBTQ-Inclusive Curricula: Why Supportive Curricula Matter .” Sex Education 15 ( 6 ): 580–96. [ Google Scholar ]
• South Carolina Department of Education. 2017. “ SC Youth Risk Behaviors Survey (YRBS) - South Carolina Department of Education .” 2017. https://ed.sc.gov/districts-schools/school-safety/health-safety-surveys/sc-youth-risk-behaviors-survey-yrbs/
• South Carolina Legislature. 1988. Title 59: Comprehensive Health Education Program. Act Vol. 437 . [ Google Scholar ]
• Stanger-Hall Kathrin F., and Hall David W.. 2011. “ Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S .” PLOS ONE 6 ( 10 ). [ PMC free article ] [ PubMed ] [ Google Scholar ]
• Tortolero Susan R., Johnson Kimberly, Cuccaro Paula M., Markham Christine, Hernandez Belinda F., Addy Robert C., Shegog Ross, Li Dennis H., and Peskin Melissa. 2011. “ Dispelling the Myth: What Parents Really Think about Sex Education in Schools .” Journal of Applied Research on Children 2 ( 2 ): 1. [ Google Scholar ]
• US Census Bureau. 2018. “ Charleston County, South Carolina .” United States Census Bureau; July 1, 2018. https://www.census.gov/quickfacts/fact/table/charlestoncountysouthcarolina/PST045217 [ Google Scholar ]
• Wright Kevin B. 2005. “ Researching Internet-Based Populations: Advantages and Disadvantages of Online Survey Research, Online Questionnaire Authoring Software Packages, and Web Survey Services .” Journal of Computer-Mediated Communication 10 ( 3 ). 10.1111/j.1083-6101.2005.tb00259.x [ CrossRef ] [ Google Scholar ]

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• Facilitating Generic Drug Product Development through Product-Specific Guidances - 04/25/2024

Virtual | Virtual

Event Title Facilitating Generic Drug Product Development through Product-Specific Guidances April 25, 2024

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ABOUT THIS EVENT

FDA’s Office of Generic Drugs (OGD) publishes product-specific guidances (PSGs), which describe the agency’s current thinking and expectations on how to develop generic drug products that are therapeutically equivalent to reference listed drugs.

The purpose of this webinar is to provide current and prospective generic drug applicants insight on how PSGs are developed, revised, and published, and how PSGs may be used to improve the efficiency of generic drug development. FDA publishes PSGs to give applicants seeking to develop generic drugs a better opportunity to efficiently allocate resources and clarity of FDA's expectations on the evidence needed to support an abbreviated new drug application (ANDA) approval, and ultimately promote generic drug product availability.

The event will include a panel discussion on topics pertinent to PSGs and a live Q&A session with FDA .

INTENDED AUDIENCE

• Members of the generic drug industry, including current and prospective applicants who are interested in submitting an ANDA
• Regulatory reviewers for generic drug assessments
• Consultants focused on bioequivalence
• Clinical research coordinators

TOPICS COVERED

• General Principles of PSGs
• PSG Lifecycle Overview
• Utility of PSGs
• Updates on PSG Program

FDA RESOURCES

• FDA Product-Specific Guidances
• Upcoming Product-Specific Guidances for Generic Drug Product Development
• Product-Specific Guidance Snapshot
• Bioequivalence Recommendations for Specific Products Final Guidance (June 2010)
• Product-Specific Guidance Meetings Between FDA and ANDA Applicants Under GDUFA Draft Guidance (February 2023)

CONTINUING EDUCATION

Real-time attendance is required for the certificate of attendance which can be used in support of CEs for the following professional organizations. Certificates are only available during the two weeks post-event.

This course has been pre-approved by:

• RAPS as eligible for a maximum of 12 credits for a two-day event (appropriate to real-time attendance) towards a participant’s RAC recertification upon full completion.
• SOCRA who accepts documentation of candidate participation in continuing education programs for re-certification if the program is applicable to clinical research regulations, operations or management, or to the candidate's clinical research therapeutic area.
• SQA as eligible for 1 non-GCP or non-GLP unit for every 1 hour of instructional time towards a participant’s RQAP re-registration.
• ACRP for continuing education in clinical research. ACRP will provide 1 ACRP contact hour for every 45-60 minutes of qualified material.

TECHNICAL INFORMATION

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