High School Sex Education Programs

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What Works: Sexual Health Education
The Centers for Disease Control and Prevention’s Division of Adolescent and School Health (DASH) has established an evidence-based approach schools can implement to help prevent HIV, STDs, and unintended pregnancy among adolescents. It includes quality health education, systems that connect students to health services, and safer and more supportive school environments. This info brief focuses on delivering quality sexual health education—a systematic, effective way schools can provide adolescents the essential knowledge and critical skills needed to decrease sexual risk behaviors.
Quality sexual health education (SHE) provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted diseases (STD), and unintended pregnancy. A SHE curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development. 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.
Across states, fewer than half of high schools (43%) and less than one-fifth of middle schools (18%) teach key CDC topics for sexual health education.
Source: 2018 School Health Profiles
Quality sexual health education programs share many characteristics. These programs:
How can schools deliver sexual health education?
A school health education program that includes a quality SHE curriculum targets the development of critical knowledge and skills needed to promote healthy behaviors and avoid risks. It is important that SHE explicitly incorporate 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 HIV, STDs, and unintended pregnancy.
Broward County Public Schools in Florida has used CDC’s Health Education Curriculum Analysis Tool (HECAT) to improve their health education curricula.


We compared our current curriculum with HECAT and made changes and modifications and enhancements based on what we analyzed.
Quality sexual health education programs teach students how to:
What are the benefits of delivering sexual health education to students?
Promoting and implementing well-designed SHE programs positively impacts student health in a variety of ways. Students who participate in these programs are more likely to:
In addition to providing knowledge and skills to address sexual behavior, quality SHE programs 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 health and 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 SHE 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 SHE.
1. Implement policies that foster supportive environments for SHE.
Identify existing state, district, and school policies on health education and SHE for all students.
Establish a skills-based health education course requirement—which includes SHE content—for all middle and high school students.
2. Use health content that is medically accurate, developmentally appropriate, culturally inclusive, and grounded in science.
†A scope and sequence document outlines the key health topics and concepts to be learned across grade levels (scope), and the logical progression of health knowledge, skills, and behaviors to be addressed at each grade level (sequence)—from pre-kindergarten through 12th grade 7.
3. Equip staff with the knowledge and skills needed to deliver SHE.
Seek feedback from teachers, staff, students, and administrators within the school about what critical knowledge and skills are needed to effectively deliver SHE.
Identify a set of instructional competencies—the essential knowledge and teaching skills—that those delivering SHE should know and be able to demonstrate during instruction.
Use the identified instructional competencies to design, implement, and evaluate teacher and staff professional development and training. These trainings can improve teachers’ knowledge and comfort with the subject matter and use of effective teaching skills needed for SHE.
4. Engage parents and community partners.
Create School Health Advisory Councils (SHACs), or similar committees, that regularly provide district-level guidance on the school health program for students and staff. Within SHE, a SHAC can make valuable recommendations to strengthen curriculum or professional development and training opportunities for staff.
Use strategies to actively engage families and communities in school health programs, explicitly gaining their feedback on SHE curricula through participation on the SHACs.
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.
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.
CDC. PS18-1807 Program Guidance: Guidance for School-Based HIV/STD Prevention (Component 2) Recipients of PS18-1807 pdf icon[PDF – 120 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2019.
National Health Education Standards. CDC Division of Adolescent and School Health website. Accessed December 20, 2019.
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.
Basch CE. Healthier students are better learners: A missing link in school reforms to close the achievement gap. J Sch Health 2011;81(10):593–8.
CDC. Health-related behaviors and academic achievement among high school students—United States, 2015. MMWR 2017;66(35):921–927.
CDC. Developing a Scope and Sequence for Sexual Health Education [PDF – 17 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2016. .
CDC. Program guidance on the review of HIV-related educational and informational materials for CDC assistance programs pdf icon[PDF – 4 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2016.
CDC. Health Education Curriculum Analysis Tool (HECAT). Atlanta, GA: U.S. Department of Health and Human Services; 2012.
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Published by the PIT Journal: 
Cycle 7, 2016
Sex education permeates the public school system, but in its current form it is failing to adequately teach students about sex and sexuality. Rates of unwanted pregnancies and sexually transmitted infections are far too high, particularly among LGBT+ students. Teenagers are uninformed or misinformed about many issues concerning their bodies and turn to alternative forms of sex education, which are usually not very accurate or informative. There is not currently a nationwide standard for sex education. This article discusses the shortcomings of the United States’ present sex education norms—particularly as they relate to abstinence-only sex education programs and the ability of the programs already in place to include queer students—explores the opinions of advocates from multiple sides of the issue (from comprehensive sex education to abstinence-only programs to the complete abolishment of sex education in public schools), and ultimately presents the Sexuality Information and Education Council of the United States (SEICUS) and their National Sexuality Education Standards as a viable option for pushing toward the objective of nationwide, comprehensive, and inclusive sex education in public schools. The goal of this article is to start a conversation about the current state of sex education in public schools and the best way to reform sex education moving forward. Sex education permeates the public school system, but in its current form it is failing to adequately teach students about sex and sexuality. Rates of unwanted pregnancies and sexually transmitted infections are far too high, particularly among LGBT+ students. Teenagers are uninformed or misinformed about many issues concerning their bodies and turn to alternative forms of sex education, which are usually not very accurate or informative. There is not currently a nationwide standard for sex education. This article discusses the shortcomings of the United States’ present sex education norms—particularly as they relate to abstinence-only sex education programs and the ability of the programs already in place to include queer students—explores the opinions of advocates from multiple sides of the issue (from comprehensive sex education to abstinence-only programs to the complete abolishment of sex education in public schools), and ultimately presents the Sexuality Information and Education Council of the United States (SEICUS) and their National Sexuality Education Standards as a viable option for pushing toward the objective of nationwide, comprehensive, and inclusive sex education in public schools. The goal of this article is to start a conversation about the current state of sex education in public schools and the best way to reform sex education moving forward.
Nearly everyone who attended public high school suffered through some form of sex education. The image of a little old lady or a football coach standing at the front of a classroom and struggling over the words “penis” and “vagina” is seared into our brains, if we haven’t suppressed the memories entirely. But how much did we really learn and retain in sex education? How many of us walked away feeling completely confident in our understanding of the human body and how sex worked, not just biologically but socially? I would argue not many. Currently, sex education in public schools is failing to adequately teach students about sex and sexuality. While most people agree that sex education needs to be improved, not many can agree on how that should happen. This article will discuss two main shortcomings of public school sex education, briefly explore several differing opinions on how sex education should be taught in schools, and present SIECUS’ National Sexuality Education Standards as a viable option for sex education reform moving forward.
Sex education in public schools across America is largely abstinence-only. According to the Guttmacher Institute, an organization funded in part by Planned Parenthood and claiming to “advance sexual and reproductive health and rights,” nineteen states’ laws require abstinence-only sex education in public schools. The Guttmacher Institute further reports that twenty-nine states do not require sex education at all, and thirty-seven do not require sex education curriculum to be medically accurate. This means that a large portion of American students is not receiving formal sex education; they are forced to rely on what their parents may or may not teach them and what they learn from the Internet. Of the students who do receive sex education in schools, a large number are getting inaccurate information about their bodies. In nearly half of US states—the ones that require abstinence-only sex education—students are not getting any information on contraception or how to stay safe when they eventually do have sex (Guttmacher).
Abstinence-only sex education programs are meant to delay the age at which teenagers start having sex in order to reduce teenage pregnancy. However, according to Advocates for Youth—an organization that strives to help young people make informed decisions about sex and their bodies largely through sex education programs—they do not work. The organization cites several studies throughout America that have conclusively shown that abstinence-only sex education programs do not delay the age at which teenagers start having sex, but they do decrease the regularity with which students correctly use contraception, increasing their risk for sexually transmitted infection and unwanted pregnancy (“The Truth”). Advocates for Youth claims that 95 percent of American adults between the ages of eighteen and forty-four reported having sex before marriage, indicating that abstinence-only-until-marriage sex education is not only ineffective but irrelevant to the majority of Americans.
Another obsolescence of sex education in American public schools is its inability to include every student—specifically the queer ones. Many states do not discuss gender identity or sexual orientation in their sex education programs, and Texas, Alabama, and South Carolina go so far as to require only negative information about same-sex relationships to be taught in schools, if they are mentioned at all (Guttmacher). Because they do not have access to accurate sex education, LGBT+ students are only half as likely to use birth control during sexual intercourse compared to their straight peers, and lesbian and gay teenagers are defying expectations by being three times as likely to have been pregnant or gotten someone pregnant than their straight peers, and there is not a solid explanation as to why. LGBT+ students are also much more likely to use alcohol or drugs before sexual encounters (Kattari). Queer students do not know and are not being taught how to have sex at all, much less safe sex, leading to higher rates of sexually transmitted infection and unwanted pregnancy—the very things sex education is meant to prevent in the first place.
The lack of queer representation in public school sex education leads to several negative social effects, including increased harassment of LGBT+ students. Robert McGarry, director of the Gay, Lesbian, and Straight Education Network (GLSEN), discusses ways in which sex education programs typically exclude LGBT+ students. Most commonly, he says, their existence is simply ignored. These programs “[present] heterosexuality as the absolute norm and the only conceivable option for students” (McGarry 28). This refusal of public school curriculums to acknowledge queer people in sex education leads to LGBT+ students’ inability to have healthy sexual relationships or to stay safe within relationships. Tanya McNeill, a faculty member of Wellesley College, argues that, by ignoring or even demonizing queer people, sex education programs are promoting a damaging heteronormativity in schools. She claims that they are encouraging straight students to hold a negative view of their queer peers or to fear them (840). This stigmatization also leads to a greater degree of bullying outside the classroom.
According to the GLSEN National School Climate Survey, 63 percent of queer teenagers said that they did not feel safe at school because of their sexual orientation (qtd in “Sex and Schools” 32). Almost all queer teens reported regularly hearing “gay” used as a pejorative. Eighty-two percent of LGBT+ teens reported being verbally harassed, nearly 40 percent reported being physically harassed, and nearly 20 percent of queer teens reported being physically assaulted at school in the past year (“Sex and Schools” 33). Fortunately, students felt much safer at schools with inclusive sex education; less than half of queer students felt unsafe at schools with inclusive curriculum, compared to two thirds at other schools (McNeill 840). Schools should be safe environments for all students to learn in without fearing for their physical safety, and while inclusive sex education will not completely eliminate social inequality for queer people, it can be a step toward safer schools.
Most people would agree that sex education in its current state is not ideal. One would be hard-pressed to find anyone who thinks that sex education is perfect exactly the way it is. Arguments form when solutions are presented to the current state of sex education in schools. Everyone has differing opinions, from taking sex education out of public schools entirely to reforming the process to be included at every grade level. Much of the debate seems to be a clash between proponents of abstinence-only sex education and advocates of comprehensive sex education, with a small section of people with seemingly radically different ideas.
For example, blogger and parent Matt Walsh believes that sex education should be taken out of schools entirely. In Walsh’s view, “Sex is just too big a topic. There’s too much there. It’s too important. The schools cannot handle it,
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