The State of Sex Ed in the U.S.

Teens may be having sex with the lights off, but millions are in the dark on sexual education and sexuality, mostly due to the education they receive in high schools across the U.S.

In the United States, the sex-ed “beacon” for adolescents takes the form of abstinence-only education, where the focus is on pregnancy and disease as unavoidable consequences of teen sex. In its many forms, this type of education remains ineffective in actually promoting sexual health.

According to the March 2016 Guttmacher Report on Sex and HIV Education, 21 states in America have mandated that all teens receive both sex and HIV education, and only 13 of these need to provide medically-accurate information. Material on contraception is only required in 18 states. And the focal point of 19 states’ sex education coverage is that sex should only occur in a marriage, with the majority of these states stressing the “effectiveness” of abstinence.

To top it off, most adolescents do not receive any sort of sexuality education. Sadly, six of the states that require education on sexualities deviating from heterosexuality demand that queer identities be covered negatively and inaccurately. Lastly, only 20 states require any sort of life skills instruction for ways to avoid sexual coercion, make healthy decisions, and communicate with family members.

One study, conducted by Dr. Amy Schalet and based on observed comparisons between the outcomes of sex education programming in the U.S. and the Netherlands, found that Dutch teens are far less likely to contract an STI or get pregnant. Dutch teens also tend to use contraceptives effectively and have fewer sex partners than U.S. teens. Researchers believe that this difference in sexual expression might be linked to how these societies reacted to the introduction of oral contraceptives.

Once the pill was introduced in 1964 and became widely-adopted by 1974, sentiment in the Netherlands on premarital sex changed—it could be deemed moral if those involved were in love. This shift toward acceptance of sexuality complimented by the efforts of healthcare professionals, media, clergy, and academics, transformed Dutch teen culture, giving adolescents the responsibility and right to make informed decisions regarding their sexual and reproductive health. Almost immediately, they saw a dramatic decrease in teen pregnancy rates.

Contrary to the Netherlands and other western countries, Americans tend to associate their teens' sexuality with raging hormones, a lack of self-control, and a feeling of invincibility that can lead to risky outcomes. They distrust their adolescents to make informed and responsible decisions regarding sex. The Dutch, instead, target this potential issue through normalization of sexuality and sexual health. They accept that teens can fall in love. They believe that teens are capable of creating strong, intimate relationships. And this is what Schalet attributes to the lack of sexual dysfunction, teen pregnancy, and STI infections.

In the United States, research conducted by Lindberg, Maddow-Zimet, and Boonstra points to a significant decline in the amount of adolescent formal sexual education on crucial topics, especially among teen women. It is even worse for rural white girls, where sex education tends to be highly limited in its educational value. The consequences of this growing divide include higher teen birth rates, lower rates of contraceptive use, and less access to reproductive services compared to their metropolitan peers.

Sex education is supposed to promote sexual health and help develop the skills necessary to make informed decisions during intimate negotiations. Students should walk away from these programs knowing how to postpone sex and resist unwanted sex. They should know the facts of physiology, STI transmission, and masturbation. Finally, they should have positive attitudes and values in regard to their individual sexuality in the context of their community, family, and personal attitudes.

When the formal means of learning about sexual health and sexuality are taken away from teens, they often look to other sources for the information, usually from the Internet; these resources tend to be unregulated, with outdated and incorrect information.

For the good of the public's health, we should call on legislators and school boards across the nation to fund and allow our educators to provide holistic and effective sex education to our teens. We should call on our nation’s parents, guardians, and healthcare providers to overcome their anxiety about having difficult and awkward conversations with adolescents about sex and provide an open and supportive environment for them to learn more about their sexual health.

Our adolescents should be empowered to learn about their sexuality and sexual health, so that if and when the time comes to use this knowledge, they will do so with confidence. We do a monumental disservice to future generations by deflecting and avoiding this topic.

Almost all adolescents will, at some point in their lives, engage in some form of sex. It is our duty as public health practitioners to provide just enough light for adolescents to engage in safer and smarter sex.

By Kittu Pannu, Department of Sociomedical Sciences, MPH '17

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