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Re-Examining the Evidence for School-Based Comprehensive Sex Education: A Global Research Review

Affiliations.

• 1 Senior Research Analyst, The Institute for Research & Evaluation, Salt Lake City, Utah, U.S.A.
• 2 Founder & Director, The Institute for Research & Evaluation, Salt Lake City, Utah, U.S.A.
• PMID: 33950605

Purpose: To evaluate the global research on school-based comprehensive sex education (CSE) by applying rigorous and meaningful criteria to outcomes of credible studies in order to identify evidence of real program effectiveness.

Methods: We examined 120 studies of school-based sex education contained in the reviews of research sponsored by three authoritative agencies: the United Nations Educational, Scientific and Cultural Organization, the U.S. federal Teen Pregnancy Prevention Program, and the Centers for Disease Control and Prevention. Their reviews screened more than 600 hundred studies and accepted only those that reached a threshold of adequate scientific rigor. These included 60 U.S. studies and 43 non-U.S. studies of school-based CSE plus 17 U.S. studies of school-based abstinence education (AE). We evaluated these studies for evidence of effectiveness using criteria grounded in the science of prevention research: sustained positive impact (at least 12 months post-program), on a key protective indicator (abstinence, condom use-especially consistent use, pregnancy, or STDs), for the main (targeted) teenage population, and without negative/harmful program effects.

Results: Worldwide, six out of 103 school-based CSE studies (U.S. and non-U.S. combined) showed main effects on a key protective indicator, sustained at least 12 months post-program, excluding programs that also had negative effects. Sixteen studies found harmful CSE impacts. Looking just at the U.S., of the 60 school-based CSE studies, three found sustained main effects on a key protective indicator (excluding programs with negative effects) and seven studies found harmful impact. For the 17 AE studies in the U.S., seven showed sustained protective main effects and one study showed harmful effects.

Conclusions: Some of the strongest, most current school-based CSE studies worldwide show very little evidence of real program effectiveness. In the U.S., the evidence, though limited, appeared somewhat better for abstinence education.

Keywords: Abstinence Education; Comprehensive Sex Education; Sex Education; Sex Education Effectiveness; Teenage Pregnancy.

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Article Contents

Introduction, purpose of the study, literature search and selection criteria, coding of the studies for exploration of moderators, decisions related to the computation of effect sizes.

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The effectiveness of school-based sex education programs in the promotion of abstinent behavior: a meta-analysis

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Mónica Silva, The effectiveness of school-based sex education programs in the promotion of abstinent behavior: a meta-analysis, Health Education Research , Volume 17, Issue 4, August 2002, Pages 471–481, https://doi.org/10.1093/her/17.4.471

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This review presents the findings from controlled school-based sex education interventions published in the last 15 years in the US. The effects of the interventions in promoting abstinent behavior reported in 12 controlled studies were included in the meta-analysis. The results of the analysis indicated a very small overall effect of the interventions in abstinent behavior. Moderator analysis could only be pursued partially because of limited information in primary research studies. Parental participation in the program, age of the participants, virgin-status of the sample, grade level, percentage of females, scope of the implementation and year of publication of the study were associated with variations in effect sizes for abstinent behavior in univariate tests. However, only parental participation and percentage of females were significant in the weighted least-squares regression analysis. The richness of a meta-analytic approach appears limited by the quality of the primary research. Unfortunately, most of the research does not employ designs to provide conclusive evidence of program effects. Suggestions to address this limitation are provided.

Sexually active teenagers are a matter of serious concern. In the past decades many school-based programs have been designed for the sole purpose of delaying the initiation of sexual activity. There seems to be a growing consensus that schools can play an important role in providing youth with a knowledge base which may allow them to make informed decisions and help them shape a healthy lifestyle ( St Leger, 1999 ). The school is the only institution in regular contact with a sizable proportion of the teenage population ( Zabin and Hirsch, 1988 ), with virtually all youth attending it before they initiate sexual risk-taking behavior ( Kirby and Coyle, 1997 ).

Programs that promote abstinence have become particularly popular with school systems in the US ( Gilbert and Sawyer, 1994 ) and even with the federal government ( Sexual abstinence program has a $250 million price tag, 1997 ). These are referred to in the literature as abstinence-only or value-based programs ( Repucci and Herman, 1991 ). Other programs—designated in the literature as safer-sex, comprehensive, secular or abstinence-plus programs—additionally espouse the goal of increasing usage of effective contraception. Although abstinence-only and safer-sex programs differ in their underlying values and assumptions regarding the aims of sex education, both types of programs strive to foster decision-making and problem-solving skills in the belief that through adequate instruction adolescents will be better equipped to act responsibly in the heat of the moment ( Repucci and Herman, 1991 ). Nowadays most safer-sex programs encourage abstinence as a healthy lifestyle and many abstinence only programs have evolved into `abstinence-oriented' curricula that also include some information on contraception. For most programs currently implemented in the US, a delay in the initiation of sexual activity constitutes a positive and desirable outcome, since the likelihood of responsible sexual behavior increases with age ( Howard and Mitchell, 1993 ).

Even though abstinence is a valued outcome of school-based sex education programs, the effectiveness of such interventions in promoting abstinent behavior is still far from settled. Most of the articles published on the effectiveness of sex education programs follow the literary format of traditional narrative reviews ( Quinn, 1986 ; Kirby, 1989 , 1992 ; Visser and van Bilsen, 1994 ; Jacobs and Wolf, 1995 ; Kirby and Coyle, 1997 ). Two exceptions are the quantitative overviews by Frost and Forrest ( Frost and Forrest, 1995 ) and Franklin et al . ( Franklin et al ., 1997 ).

In the first review ( Frost and Forrest, 1995 ), the authors selected only five rigorously evaluated sex education programs and estimated their impact on delaying sexual initiation. They used non-standardized measures of effect sizes, calculated descriptive statistics to represent the overall effect of these programs and concluded that those selected programs delayed the initiation of sexual activity. In the second review, Franklin et al . conducted a meta-analysis of the published research of community-based and school-based adolescent pregnancy prevention programs and contrary to the conclusions forwarded by Frost and Forrest, these authors reported a non-significant effect of the programs on sexual activity ( Franklin et al ., 1997 ).

The discrepancy between these two quantitative reviews may result from the decision by Franklin et al . to include weak designs, which do not allow for reasonable causal inferences. However, given that recent evidence indicates that weaker designs yield higher estimates of intervention effects ( Guyatt et al ., 2000 ), the inclusion of weak designs should have translated into higher effects for the Franklin et al . review and not smaller. Given the discrepant results forwarded in these two recent quantitative reviews, there is a need to clarify the extent of the impact of school-based sex education in abstinent behavior and explore the specific features of the interventions that are associated to variability in effect sizes.

The present study consisted of a meta-analytic review of the research literature on the effectiveness of school-based sex education programs in the promotion of abstinent behavior implemented in the past 15 years in the US in the wake of the AIDS epidemic. The goals were to: (1) synthesize the effects of controlled school-based sex education interventions on abstinent behavior, (2) examine the variability in effects among studies and (3) explain the variability in effects between studies in terms of selected moderator variables.

The first step was to locate as many studies conducted in the US as possible that dealt with the evaluation of sex education programs and which measured abstinent behavior subsequent to an intervention.

The primary sources for locating studies were four reference database systems: ERIC, PsychLIT, MEDLINE and the Social Science Citation Index. Branching from the bibliographies and reference lists in articles located through the original search provided another source for locating studies.

The process for the selection of studies was guided by four criteria, some of which have been employed by other authors as a way to orient and confine the search to the relevant literature ( Kirby et al ., 1994 ). The criteria to define eligibility of studies were the following.

Interventions had to be geared to normal adolescent populations attending public or private schools in the US and report on some measure of abstinent behavior: delay in the onset of intercourse, reduction in the frequency of intercourse or reduction in the number of sexual partners. Studies that reported on interventions designed for cognitively handicapped, delinquent, school dropouts, emotionally disturbed or institutionalized adolescents were excluded from the present review since they address a different population with different needs and characteristics. Community interventions which recruited participants from clinical or out-of-school populations were also eliminated for the same reasons.

Studies had to be either experimental or quasi-experimental in nature, excluding three designs that do not permit strong tests of causal hypothesis: the one group post-test-only design, the post-test-only design with non-equivalent groups and the one group pre-test–post-test design ( Cook and Campbell, 1979 ). The presence of an independent and comparable `no intervention' control group—in demographic variables and measures of sexual activity in the baseline—was required for a study to be included in this review.

Studies had to be published between January 1985 and July 2000. A time period restriction was imposed because of cultural changes that occur in society—such as the AIDS epidemic—which might significantly impact the adolescent cohort and alter patterns of behavior and consequently the effects of sex education interventions.

Five pairs of publications were detected which may have used the same database (or two databases which were likely to contain non-independent cases) ( Levy et al ., 1995 / Weeks et al ., 1995 ; Barth et al ., 1992 / Kirby et al ., 1991 /Christoper and Roosa, 1990/ Roosa and Christopher, 1990 and Jorgensen, 1991 / Jorgensen et al ., 1993 ). Only one effect size from each pair of articles was included to avoid the possibility of data dependence.

The exploration of study characteristics or features that may be related to variations in the magnitude of effect sizes across studies is referred to as moderator analysis. A moderator variable is one that informs about the circumstances under which the magnitude of effect sizes vary ( Miller and Pollock, 1994 ). The information retrieved from the articles for its potential inclusion as moderators in the data analysis was categorized in two domains: demographic characteristics of the participants in the sex education interventions and characteristics of the program.

Demographic characteristics included the following variables: the percentages of females, the percentage of whites, the virginity status of participants, mean (or median) age and a categorization of the predominant socioeconomic status of participating subjects (low or middle class) as reported by the authors of the primary study.

In terms of the characteristics of the programs, the features coded were: the type of program (whether the intervention was comprehensive/safer-sex or abstinence-oriented), the type of monitor who delivered the intervention (teacher/adult monitor or peer), the length of the program in hours, the scope of the implementation (large-scale versus small-scale trial), the time elapsed between the intervention and the post-intervention outcome measure (expressed as number of days), and whether parental participation (beyond consent) was a component of the intervention.

The type of sex education intervention was defined as abstinence-oriented if the explicit aim was to encourage abstinence as the primary method of protection against sexually transmitted diseases and pregnancy, either totally excluding units on contraceptive methods or, if including contraception, portraying it as a less effective method than abstinence. An intervention was defined as comprehensive or safer-sex if it included a strong component on the benefits of use of contraceptives as a legitimate alternative method to abstinence for avoiding pregnancy and sexually transmitted diseases.

A study was considered to be a large-scale trial if the intervention group consisted of more than 500 students.

Finally, year of publication was also analyzed to assess whether changes in the effectiveness of programs across time had occurred.

The decision to record information on all the above-mentioned variables for their potential role as moderators of effect sizes was based in part on theoretical considerations and in part on the empirical evidence of the relevance of such variables in explaining the effectiveness of educational interventions. A limitation to the coding of these and of other potentially relevant and interesting moderator variables was the scantiness of information provided by the authors of primary research. Not all studies described the features of interest for this meta-analysis. For parental participation, no missing values were present because a decision was made to code all interventions which did not specifically report that parents had participated—either through parent–youth sessions or homework assignments—as non-participation. However, for the rest of the variables, no similar assumptions seemed appropriate, and therefore if no pertinent data were reported for a given variable, it was coded as missing (see Table I ).

Once the pool of studies which met the inclusion criteria was located, studies were examined in an attempt to retrieve the size of the effect associated with each intervention. Since most of the studies did not report any effect size, it had to be estimated based on the significance level and inferential statistics with formulae provided by Rosenthal ( Rosenthal, 1991 ) and Holmes ( Holmes; 1984 ). When provided, the exact value for the test statistic or the exact probability was used in the calculation of the effect size.

Alternative methods to deal with non-independent effect sizes were not employed since these are more complex and require estimates of the covariance structure among the correlated effect sizes. According to Matt and Cook such estimates may be difficult—if not impossible—to obtain due to missing information in primary studies ( Matt and Cook, 1994 ).

Analyses of the effect sizes were conducted utilizing the D-STAT software ( Johnson, 1989 ). The sample sizes used for the overall effect size analysis corresponded to the actual number used to estimate the effects of interest, which was often less than the total sample of the study. Occasionally the actual sample sizes were not provided by the authors of primary research, but could be estimated from the degrees of freedom reported for the statistical tests.

The effect sizes were calculated from means and pooled standard deviations, t -tests, χ 2 , significance levels or from proportions, depending on the nature of the information reported by the authors of primary research. As recommended by Rosenthal, if results were reported simply as being `non-significant' a conservative estimate of the effect size was included, assuming P = 0.50, which corresponds to an effect size of zero ( Rosenthal, 1991 ). The overall measure of effect size reported was the corrected d statistic ( Hedges and Olkin, 1985 ). These authors recommend this measure since it does not overestimate the population effect size, especially in the case when sample sizes are small.

The homogeneity of effect sizes was examined to determine whether the studies shared a common effect size. Testing for homogeneity required the calculation of a homogeneity statistic, Q . If all studies share the same population effect size, Q follows an asymptotic χ 2 distribution with k – 1 degrees of freedom, where k is the number of effect sizes. For the purposes of this review the probability level chosen for significance testing was 0.10, due to the fact that the relatively small number of effect sizes available for the analysis limits the power to detect actual departures from homogeneity. Rejection of the hypothesis of homogeneity signals that the group of effect sizes is more variable than one would expect based on sampling variation and that one or more moderator variables may be present ( Hall et al ., 1994 ).

To examine the relationship between the study characteristics included as potential moderators and the magnitude of effect sizes, both categorical and continuous univariate tests were run. Categorical tests assess differences in effect sizes between subgroups established by dividing studies into classes based on study characteristics. Hedges and Olkin presented an extension of the Q statistic to test for homogeneity of effect sizes between classes ( Q B ) and within classes ( Q W ) ( Hedges and Olkin, 1985 ). The relationship between the effect sizes and continuous predictors was assessed using a procedure described by Rosenthal and Rubin which tests for linearity between effect sizes and predictors ( Rosenthal and Rubin, 1982 ).

Q E provides the test for model specification, when the number of studies is larger than the number of predictors. Under those conditions, Q E follows an approximate χ 2 distribution with k – p – 1 degrees of freedom, where k is the number of effect sizes and p is the number of regressors ( Hedges and Olkin, 1985 ).

The search for school-based sex education interventions resulted in 12 research studies that complied with the criteria to be included in the review and for which effect sizes could be estimated.

The overall effect size ( d +) estimated from these studies was 0.05 and the 95% confidence interval about the mean included a lower bound of 0.01 to a high bound of 0.09, indicating a very minimal overall effect size. Table II presents the effect size of each study ( d i ) along with its 95% confidence interval and the overall estimate of the effect size. Homogeneity testing indicated the presence of variability among effect sizes ( Q (11) = 35.56; P = 0.000).

An assessment of interaction effects among significant moderators could not be explored since it would have required partitioning of the studies according to a first variable and testing of the second within the partitioned categories. The limited number of effect sizes precluded such analysis.

Parental participation appeared to moderate the effects of sex education on abstinence as indicated by the significant Q test between groups ( Q B(1) = 5.06; P = 0.025), as shown in Table III . Although small in magnitude ( d = 0.24), the point estimate for the mean weighted effect size associated with programs with parental participation appears substantially larger than the mean associated with those where parents did not participate ( d = 0.04). The confidence interval for parent participation does not include zero, thus indicating a small but positive effect. Controlling for parental participation appears to translate into homogeneous classes of effect sizes for programs that include parents, but not for those where parents did not participate ( Q W(9) = 28.94; P = 0.001) meaning that the effect sizes were not homogeneous within this class.

Virginity status of the sample was also a significant predictor of the variability among effect sizes ( Q B(1) = 3.47 ; P = 0.06). The average effect size calculated for virgins-only was larger than the one calculated for virgins and non-virgins ( d = 0.09 and d = 0.01, respectively). Controlling for virginity status translated into homogeneous classes for virgins and non-virgins although not for the virgins-only class ( Q W(5) = 27.09; P = 0.000).

The scope of the implementation also appeared to moderate the effects of the interventions on abstinent behavior. The average effect size calculated for small-scale intervention was significantly higher than that for large-scale interventions ( d = 0.26 and d = 0.01, respectively). The effects corresponding to the large-scale category were homogeneous but this was not the case for the small-scale class, where heterogeneity was detected ( Q W(4) = 14.71; P = 0.01)

For all three significant categorical predictors, deletion of one outlier ( Howard and McCabe, 1990 ) resulted in homogeneity among the effect sizes within classes.

Univariate tests of continuous predictors showed significant results in the case of percentage of females in the sample ( z = 2.11; P = 0.04), age of participants ( z = –1.67; P = 0.09), grade ( z = –1.80; P = 0.07) and year of publication ( z = –2.76; P = 0.006).

All significant predictors in the univariate analysis—with the exception of grade which had a very high correlation with age ( r = 0.97; P = 0.000)—were entered into a weighted least-squares regression analysis. In general, the remaining set of predictors had a moderate degree of intercorrelation, although none of the coefficients were statistically significant.

In the weighted least-squares regression analysis, only parental participation and the percentage of females in the study were significant. The two-predictor model explained 28% of the variance in effect sizes. The test of model specification yielded a significant Q E statistic suggesting that the two-predictor model cannot be regarded as correctly specified (see Table IV ).

This review synthesized the findings from controlled sex education interventions reporting on abstinent behavior. The overall mean effect size for abstinent behavior was very small, close to zero. No significant effect was associated to the type of intervention: whether the program was abstinence-oriented or comprehensive—the source of a major controversy in sex education—was not found to be associated to abstinent behavior. Only two moderators—parental participation and percentage of females—appeared to be significant in both univariate tests and the multivariable model.

Although parental participation in interventions appeared to be associated with higher effect sizes in abstinent behavior, the link should be explored further since it is based on a very small number of studies. To date, too few studies have reported success in involving parents in sex education programs. Furthermore, the primary articles reported very limited information about the characteristics of the parents who took part in the programs. Parents who were willing to participate might differ in important demographic or lifestyle characteristics from those who did not participate. For instance, it is possible that the studies that reported success in achieving parental involvement may have been dealing with a larger percentage of intact families or with parents that espoused conservative sexual values. Therefore, at this point it is not possible to affirm that parental participation per se exerts a direct influence in the outcomes of sex education programs, although clearly this is a variable that merits further study.

Interventions appeared to be more effective when geared to groups composed of younger students, predominantly females and those who had not yet initiated sexual activity. The association between gender and effect sizes—which appeared significant both in the univariate and multivariable analyses—should be explored to understand why females seem to be more receptive to the abstinence messages of sex education interventions.

Smaller-scale interventions appeared to be more effective than large-scale programs. The larger effects associated to small-scale trials seems worth exploring. It may be the case that in large-scale studies it becomes harder to control for confounding variables that may have an adverse impact on the outcomes. For example, large-scale studies often require external agencies or contractors to deliver the program and the quality of the delivery of the contents may turn out to be less than optimal ( Cagampang et al ., 1997 ).

Interestingly there was a significant change in effect sizes across time, with effect sizes appearing to wane across the years. It is not likely that this represents a decline in the quality of sex education interventions. A possible explanation for this trend may be the expansion of mandatory sex education in the US which makes it increasingly difficult to find comparison groups that are relatively unexposed to sex education. Another possible line of explanation refers to changes in cultural mores regarding sexuality that may have occurred in the past decades—characterized by an increasing acceptance of premarital sexual intercourse, a proliferation of sexualized messages from the media and increasing opportunities for sexual contact in adolescence—which may be eroding the attainment of the goal of abstinence sought by educational interventions.

In terms of the design and implementation of sex education interventions, it is worth noting that the length of the programs was unrelated to the magnitude in effect sizes for the range of 4.5–30 h represented in these studies. Program length—which has been singled out as a potential explanation for the absence of significant behavioral effects in a large-scale evaluation of a sex education program ( Kirby et al ., 1997a )—does not appear to be consistently associated with abstinent behavior. The impact of lengthening currently existing programs should be evaluated in future studies.

As it has been stated, the exploration of moderator variables could be performed only partially due to lack of information on the primary research literature. This has been a problem too for other reviewers in the field ( Franklin et al ., 1997 ). The authors of primary research did not appear to control for nor report on the potentially confounding influence of numerous variables that have been indicated in the literature as influencing sexual decision making or being associated with the initiation of sexual activity in adolescence such as academic performance, career orientation, religious affiliation, romantic involvement, number of friends who are currently having sex, peer norms about sexual activity and drinking habits, among others ( Herold and Goodwin, 1981 ; Christopher and Cate, 1984 ; Billy and Udry, 1985 ; Roche, 1986 ; Coker et al ., 1994 ; Kinsman et al ., 1998 ; Holder et al ., 2000 ; Thomas et al ., 2000 ). Even though randomization should take care of differences in these and other potentially confounding variables, given that studies can rarely assign students to conditions and instead assign classrooms or schools to conditions, it is advisable that more information on baseline characteristics of the sample be utilized to establish and substantiate the equivalence between the intervention and control groups in relevant demographic and lifestyle characteristics.

In terms of the communication of research findings, the richness of a meta-analytic approach will always be limited by the quality of the primary research. Unfortunately, most of the research in the area of sex education do not employ experimental or quasi-experimental designs and thus fall short of providing conclusive evidence of program effects. The limitations in the quality of research in sex education have been highlighted by several authors in the past two decades ( Kirby and Baxter, 1981 ; Card and Reagan, 1989 ; Kirby, 1989 ; Peersman et al ., 1996 ). Due to these deficits in the quality of research—which resulted in a reduced number of studies that met the criteria for inclusion and the limitations that ensued for conducting a thorough analysis of moderators—the findings of the present synthesis have to be considered merely tentative. Substantial variability in effect sizes remained unexplained by the present synthesis, indicating the need to include more information on a variety of potential moderating conditions that might affect the outcomes of sex education interventions.

Finally, although it is rarely the case that a meta-analysis will constitute an endpoint or final step in the investigation of a research topic, by indicating the weaknesses as well as the strengths of the existing research a meta-analysis can be a helpful aid for channeling future primary research in a direction that might improve the quality of empirical evidence and expand the theoretical understanding in a given field ( Eagly and Wood, 1994 ). Research in sex education could be greatly improved if more efforts were directed to test interventions utilizing randomized controlled trials, measuring intervening variables and by a more careful and detailed reporting of the results. Unless efforts are made to improve on the quality of the research that is being conducted, decisions about future interventions will continue to be based on a common sense and intuitive approach as to `what might work' rather than on solid empirical evidence.

References marked with an asterisk indicate studies included in the meta-analysis.

Description of moderator variables

Effect sizes of studies

Tests of categorical moderators for abstinence

Weighted least-squares regression and test of model specification

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• least-squares analysis
• sex education

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REVIEW article

A systematic review of the provision of sexuality education to student teachers in initial teacher education.

• 1 School of Languages, Law and Social Sciences, Technological University of Dublin, Dublin, Ireland
• 2 School of Human Development, Institute of Education, Dublin City University, Dublin, Ireland
• 3 Department of Psychology, Faculty of Science & Engineering, Maynooth University, Kildare, Ireland

Teachers, and their professional learning and development, have been identified as playing an integral role in enabling children and young people’s right to comprehensive sexuality education (CSE). The provision of sexuality education (SE) during initial teacher education (ITE) is upheld internationally, as playing a crucial role in relation to the implementation and quality of school-based SE. This systematic review reports on empirical studies published in English from 1990 to 2019. In accordance with the PRISMA guidelines, five databases were searched: ERIC, Education Research Complete, PsycINFO, Web of Science and MEDLINE. From a possible 1,153 titles and abstracts identified, 15 papers were selected for review. Findings are reported in relation to the WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of core competencies for sexuality educators . Results revealed that research on SE during ITE is limited and minimal research has focused on student teachers’ attitudes on SE. Findings indicate that SE provision received is varied and not reflective of comprehensive SE. Recommendations highlight the need for robust research to inform quality teacher professional development practices to support teachers to develop the knowledge, attitudes and skills necessary to teach comprehensive SE.

Introduction

Sexuality education.

Our understanding of sexuality education is ever evolving, and differences exist in the terminology, definitions and criteria employed across various international documentation relating to SE (cf. Iyer and Aggleton, 2015 ; European Expert Group on Sexuality Education, 2016 ). While the term comprehensive sexuality education (CSE) has, in the last decade or so, come to be widely employed ( WHO Regional Office for Europe and BZgA, 2017 ; United Nations Educational Scientific and Cultural Organisation [UNESCO], 2018 ), given its more recent common usage, for the purpose of this paper, sexuality education (SE) is the broader term employed.

An international qualitative review of studies which report on the views of students and experts/professionals working in the field of SE ( Pound et al., 2017 ) provides recommendations for effective SE provision. According to that review, effective SE provision should include: The adoption of a “sex positive,” culturally sensitive approach; education that reflects sexual and relationship diversity and challenges inequality and gender stereotyping; content on topics including consent, sexting, cyberbullying, online safety, sexual exploitation, and sexual coercion; a “whole-school” approach and provide content on life skills; non-judgmental content on contraception, safer sex, pregnancy and abortion; discussion on relationships and emotions; consideration of potentially risky sexual practices and not over-emphasize risk at the expense of positive and pleasurable aspects of sex; and the production of a curriculum in collaboration with young people. Similarly, Goldfarb and Lieberman’s (2021) systematic review provides support for the adoption of comprehensive SE that is positive, affirming, inclusive, begins early in life, is scaffolded and takes place over an extended period of time.

Teachers as Sexuality Educators

While there are a variety of sources from which students access information for SE, and diversity in respect of students expressed preferences with regards to SE sources ( Turnbull et al., 2010 ; Donaldson et al., 2013 ; Pound et al., 2016 ), the formal education system remains a significant site for universal, comprehensive, age-appropriate, effective SE. Teachers are particularly well-positioned to provide comprehensive SE and create a climate of trust and respect within the school ( World Health Organisation [WHO]/Regional Office for Europe & Federal Centre for Health Education BZgA, 2010 , 2017 ; Bourke et al., 2022 ). Qualities of the teacher and classroom environment are associated with increased knowledge of health education, including SE, for students. Murray et al. (2019) found that the teacher being certified to teach health education, having a dedicated classroom, and having attended professional development training were associated with greater student knowledge of this subject. Inadequate training, embarrassment and an inability to discuss SE topics in a non-judgmental way have been cited as explanations provided by students as to why they would not consider teachers suitable or desirable to teach SE ( Pound et al., 2017 ).

Walker et al. (2021) in their systematic review of qualitative research on teachers’ perspectives on sexuality and reproductive health (SRH) education in primary and secondary schools, reported that adequate training (pre-service and in-service) was a facilitator that positively impacted on teachers’ confidence to provide school-based SRH education. These findings highlight the importance of quality teacher professional development, commencing with initial teacher education (ITE), for the provision of comprehensive SE. Consequently, ITE has increasingly been proposed as key in addressing the global, societal challenge of ensuring the provision of high-quality SE.

Initial Teacher Education

Teacher education provides substantial affordances to respond to the opportunities and challenges presented in the area of SE ( WHO Regional Office for Europe and BZgA, 2017 ). Furthermore, a research-informed understanding of teacher education is emphasized to better support teacher educators in their work with student teachers ( Swennen and White, 2020 ).

Quality ITE provides a strong foundation for teachers’ delivery of comprehensive SE and the creation of safe and supportive school climates. Research has found that teacher professional development in SE is a significant factor associated with the subsequent implementation of school-based SE ( Ketting and Ivanova, 2018 ). A recent Ecuadorian study reported that student teachers held a relatively high level of confidence in terms of their perceived ability to implement SE and to address specific CSE topics. Furthermore, favourable attitudes toward CSE, strong self-efficacy beliefs to implement CSE, and increased confidence in the ability to implement CSE were significantly associated with positive intentions to teach CSE in the future. Insufficient mastery of CSE topics, however, may temper student teachers’ intentions to teach CSE ( Castillo Nuñez et al., 2019 ). Internationally, research suggests there is inconsistency in the provision of SE in ITE and that access to professional development in SE in ITE, and after qualification, needs substantial development ( United Nations Educational Scientific and Cultural Organisation [UNESCO] , 2009 , 2018 ; Ketting et al., 2018 ; O’Brien et al., 2020 ).

Research is thus warranted to explore aspects at the institutional, programmatic and student-teacher level at ITE to address issues regarding the provision, and barriers to SE provision during ITE. Contemporaneous to the current review, O’Brien et al. (2020) undertook a systematic review of teacher training organizations and their preparation of student teachers to teach CSE. They found that teacher training organizations are often strongly guided by national policies and their school curricula, as opposed to international guidelines. They also found that teachers are often inadequately prepared to teach CSE and that CSE provision during ITE is associated with greater self-efficacy and intent to teach CSE in schools. The importance of ITE with regards to the provision of SE cannot be underestimated. Teachers are in an optimal position to provide age-appropriate, comprehensive and developmentally relevant SE to all children and young people.

The current systematic review will assess the provision of SE to student teachers in ITE and how this relates to the relevant knowledge, attitudes and skills required of sexuality educators as proposed by the international guidelines produced by the WHO Regional Office for Europe and BZgA (2017) . The WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of core competencies for sexuality educators adopts a holistic definition of core competencies, espousing an understanding of teacher competencies as “…overarching complex action systems” and as multi-dimensional, made up of three components: attitudes, skills and knowledge ( WHO Regional Office for Europe and BZgA, 2017 , p. 20). This framework outlines a set of general competencies, together with more specific attitudes, skills and knowledge competencies for sexuality educators. Attitudes, which may be explicit or implicit, are understood as a factor pertaining to the influencing and guiding of personal behaviour. Skills are understood in terms of the abilities educators can acquire which enables them to provide high-quality education. While knowledge is understood as professional knowledge (pedagogical knowledge, content knowledge and pedagogical subject knowledge) in all relevant areas required to deliver high-quality education. Overall, the framework endorses a holistic and multi-dimensional approach which focuses on sexuality educators and the inter-related competencies, in relation to the knowledge, attitudes, and skills that they should have, or need to develop to become effective teachers of SE.

Aims and Objectives

The current study aimed to systematically review existing empirical evidence on the provision of SE for student teachers in the context of ITE.

The objectives were:

• To review the existing peer-reviewed, published literature on SE provision during ITE.

• To synthesize the research on SE provision at ITE institutional/programmatic level.

• To synthesize the research on individual level student teachers’ knowledge, attitudes, and skills in relation to SE during ITE.

Materials and Methods

The systematic review was completed in accordance with PRISMA guidelines ( Liberati et al., 2009 ). A descriptive summary and categorization of the data is reported ( Khangura et al., 2012 ).

Eligibility Criteria

Articles were included in the review subject to adherence to specific inclusion criteria. An overview of inclusion criteria is outlined in Table 1 .

Table 1. Screening and selection tool.

Information Sources

A three-reviewer process was employed. Searches were conducted in August 2019 on five databases selected for their ability to provide a focused search within the disciplines of education (ERIC and Education Research Complete), psychology (PsycINFO), and multi-disciplinary research in the disciplines of health/public health (Web of Science and MEDLINE).

Screening and Study Selection

Reviewers’ selected keywords from two domains, namely ITE and SE as outlined in Table 2 , for the searches. Search terms for each domain were combined using the Boolean search function “AND.”

Table 2. Overview of Systematic Review search terms.

Where possible, limits were applied to include articles from peer reviewed journals as outlined in Table 3 .

Table 3. Overview of database searches and limits applied.

In accordance with Boland et al. (2017) , a pilot screening of a sample of titles and abstracts were completed by two reviewers to assess the inclusion and exclusion criteria. All titles and abstracts were then screened using Abstrackr software ( Abstrackr, 2010 , accessed 2019; Wallace et al., 2010 ). A selection of abstracts were then cross checked by two reviewers. The final selection involved a three reviewer process. Duplicates and references which did not meet the eligibility criteria were removed at this stage. Full text papers of the remaining articles were obtained, where possible. All three reviewers blindly screened the texts of the remaining articles. Consensus was reached that 15 articles met the criteria for this review. Two experts in the field of SE reviewed the list of 15 articles to ensure there were no outstanding papers for consideration within the parameters of the review. No additional papers were identified.

Data Collection Process

A data extraction template was devised in accordance with Boland et al.’s (2017) recommendations. Information was collected on each study regarding: participant characteristics (data on participant gender, age, programme and institution of study, ethnicity, socio-economic status and religion were extracted, where provided); whether the studies examined programmatic input and if so the duration/extent of input; theoretical and conceptualization of SE within the programme; topics covered; whether this was a compulsory or elective programme; and whether the study addressed the WHO-BZgA competencies of knowledge, attitudes and skills of student teachers during ITE ( WHO Regional Office for Europe and BZgA, 2017 ). One lead author was contacted for the purpose of data collection and provided further information regarding their study.

Synthesis of Results

A qualitative synthesis was conducted; the purpose of which was to provide an overview of the evidence identified regarding research on the provision of SE in the ITE context. The findings of the reviewed studies were synthesized following consideration of the key learnings and recommendations from the studies and consideration of the WHO Regional Office for Europe and BZgA (2017) competencies of knowledge, attitudes, and skills necessary for the provision of SE at ITE. The WHO Regional Office for Europe and BZgA (2017) framework was selected to support the categorization and analysis of findings as it was developed by global experts in the field and is thus, an international standard for SE. While there are limitations to the use of this framework, it offered the ability to categorize and analyze findings through a multi- dimensional lens of knowledge, attitudes, and skills.

Quality Appraisal

The Mixed Methods Appraisal Tool (MMAT) ( Pluye et al., 2009 ; Hong et al., 2018 ) was used to appraise the quality of papers by two reviewers. This tool has been found to be reliable for the appraisal of qualitative, quantitative and mixed methods studies ( Pace et al., 2012 ; Taylor and Hignett, 2014 ) and has been successfully used in previous systematic reviews (e.g., McNicholl et al., 2019 ). For each paper, the appropriate study design was selected (i.e., 1. Qualitative, 2. Quantitative randomized controlled trials, 3. Quantitative non-randomized, 4. Quantitative descriptive, and 5. Mixed methods). Next, the paper was assessed using the checklist associated with the study design (see Appendix A for overview of checklist). For example, if the study was categorized as 4. Quantitative descriptive, the study was assessed against the five criteria (4.1–4.5) associated with this study design. An example of a question on the checklist includes “Are the measurements appropriate?” criteria were reported as “met,” “not met,” “cannot tell if criteria were met” or “criteria not applicable.” The results of the quality appraisal are presented in Table 4 . The same numbering as the methodological quality criteria of Hong et al.’s (2018) study was used.

Table 4. MMAT quality appraisal.*

Study Selection

Fifteen articles reporting on thirteen empirical studies were included in the review (see Figure 1 ). Harrison and Ollis (2015) and Ollis (2016) articles are derived from the same dataset, as are Sinkinson and Hughes (2008) and Sinkinson (2009) articles. Given, however, that these articles refer to unique aspects of the particular studies, they have been described and discussed as separate studies in this review. An overview of the process of screening and study selection is outlined in Figure 1 .

Figure 1. Flow diagram of systematic review process.

Study Characteristics

Six qualitative, five quantitative, and four mixed methods studies were reviewed. Where information was available, the research studies were identified as having been conducted predominantly in Australia, New Zealand, and South Africa. The studies were published between 1996 and 2016. Data was most frequently collected from one source; student teachers ( n = 10) and teacher educators/course providers ( n = 3). One study collected data from both student teachers and teacher educators/course providers ( Johnson, 2014 ). The samples size of studies varied from three to 478 participants but were generally small (eight of the studies had fewer than 90 participants: Vavrus, 2009 ; Carman et al., 2011 ; Goldman and Coleman, 2013 ; Johnson, 2014 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ).

Seven studies assessed SE educational inputs at ITE, and three conducted content analysis of content covered on SE educational input at ITE. As the studies were predominantly descriptive and explorative in design, specific outcome variables were often neither defined nor addressed. Educational input studies were classified as examples of research which assessed a particular course, module, or lecture on SE at ITE. With regards to theoretical approaches that may have informed the educational input studies reviewed, three did not report a specific theoretical approach ( Sinkinson, 2009 ; Gursimsek, 2010 ; MacEntee, 2016 ), and the remaining four reported that a critical approach was adopted ( Vavrus, 2009 ; Harrison and Ollis, 2015 ; Brown, 2016 ; Ollis, 2016 ). An overview of study characteristics are presented in Table 5 .

Table 5. Overview of characteristics of reviewed studies.

Quality Appraisal Results

An overview of the results of the MMAT are presented in Table 4 . All the papers in the review were empirical studies and therefore could be appraised using the MMAT. Predominantly the studies reviewed employed the use of qualitative methods, and of the mixed methods studies there was often an emphasis on the qualitative data. Generally, the quality of the mixed methods studies was varied with only a minority of these studies providing a rationale for the use of mixed methods and reporting on divergences between the qualitative and quantitative findings.

The rigour and quality of the qualitative research was also varied. An explicit statement of the epistemological stance adopted and detail of the analytical process were reported in a minority of studies. With regards to educational input studies, data was often collected only after the educational input was completed and thus behavioral change as a result of engagement in the educational input could not be ascertained (e.g., Harrison and Ollis, 2015 ; MacEntee, 2016 ; Ollis, 2016 ). Only one study employed a quasi-experimental design ( Gursimsek, 2010 ), and in this case a purposive sample of student teachers who did not complete the SE course was selected as the control group. Within the remaining 14 studies there were no control groups, randomization, or concealment.

Findings are reported in relation to (a) institutional/programme level and (b) individual student teacher level aligned with the World Health Organisation ( WHO Regional Office for Europe and BZgA, 2017 ) Training Matters: Framework of Core Competencies for Sexuality Educators . An awareness of the interaction of these aspects of student teachers’ development was informative in terms of structuring the findings.

The research studies reviewed predominantly focused on examining a particular educational input on SE during ITE ( Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ) or investigating the SE content covered during ITE ( Rodriguez et al., 1997 ; McKay and Barrett, 1999 ; Carman et al., 2011 ). Fewer of the reviewed studies focused on student teachers’ skills to teach SE (e.g., Sinkinson, 2009 ; Vavrus, 2009 ; Harrison and Ollis, 2015 ; Goldman and Grimbeek, 2016 ; MacEntee, 2016 ) or student teachers’ attitudes regarding SE (e.g., Sinkinson and Hughes, 2008 ; Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Johnson, 2014 ; Brown, 2016 ). The findings of the studies were synthesized and categorized in relation to institutional/programmatic level or individual student teacher level. Findings which reflected responses and perceptions of student teachers were categorized as individual student teacher level. Institutional/Programme level related to studies assessing particular modules or comparing course content across programmes, and institutional level studies were categorized as studies where data was collected from multiple institutions. Individual student teacher level findings were reported in relation to the knowledge, attitudes, and skills competency areas required of sexuality educators. These competency domains, however, are not discrete entities or mutually exclusive. In taking a systemic approach, it is, therefore, acknowledged that they are dynamically interconnected, and influence and interact.

Institutional/Programme Level Findings

At a programmatic level, studies revealed variance in the type of SE provision (core/mandatory and elective), student teachers receive during ITE. May and Kundert (1996) found that coursework on SE was reported as part of a mandatory course by 66% of respondents and as part of an elective course by 14% of respondents. While McKay and Barrett (1999) reported that only 15% of the health education programmes in their study offered mandatory SE training with 26% of programmes offering an elective component. With regards to the provision of skill development and training for SE that student teachers received during ITE, Rodriguez et al. (1997) found that of a potential 169 undergraduate programmes, the majority (i.e., 72%) offered some training to student teachers in health education: A minority offered teaching methods courses in SE (i.e., 12%) and HIV/AIDS prevention education (i.e., 4%). Two of the reviewed studies also investigated programme time allocated to SE and found that time spent on SE varied from 3.6 hours ( May and Kundert, 1996 ) to between 9.6 and 36.2 hours ( McKay and Barrett, 1999 ). While at an institutional level, Carman et al. (2011) found that eight of 45 teacher training institutions did not offer any training in SE and of those that did, 62% offered mandatory, and 38% elective inputs.

Findings indicate the paucity of SE topics covered across ITE programme curricula. Rodriguez et al. (1997) reported that 90% of the courses they reviewed listed a maximum of three SE topic areas. The top three SE topics reported in terms of coverage were human development, relationships, and society and culture. Somewhat consistently, McKay and Barrett (1999) found that the topics least emphasized on courses were masturbation, sexual orientation, human sexual response, and methods of sexually transmitted disease prevention. Johnson (2014) sought to examine coverage of, what they defined as, “lesbian, gay, bisexual, transsexual and intersexual (LGBTI)” (p. 1249) issues on ITE courses and reported that of the three ITE institutions examined, none specifically reference LGBTI issues. Finally, one study reported that the provision of SE was found to be contingent on the interest and expertise of the university teacher educators ( Carman et al., 2011 ). Collectively, these findings bring to light the variance in mandatory and/or elective SE provision during ITE, as well as the diverse content covered and the role of teacher educators on its provision.

Individual Student Teacher Level Findings

Factors associated with student teachers’ attitudes regarding sexuality education topics.

Gender, geographical location, religious beliefs, and family background were identified as factors associated with student teachers’ attitudes regarding SE ( Sinkinson and Hughes, 2008 ; Gursimsek, 2010 ; Johnson, 2014 ). Attending a SE course may have positive implications for student teachers’ attitudes as Gursimsek (2010) found that students who had not attended the SE course reported more conservative and prejudiced views toward sexuality than those who had attended the SE course. Given that this was an elective course, however, it is important to consider self-selection bias regarding those who may have opted to take the course.

Student teachers in Johnson’s (2014) study reported that, through engagement in educational inputs which discussed sexuality issues in an open and inclusive way, greater awareness of student teachers’ own and others’ biases was developed. So, too, was knowledge to better understand sexuality issues. Student teachers did, however, acknowledge difficulty integrating these new learnings with their family backgrounds, and belief systems. MacEntee’s (2016) study also brought to light tensions between student teachers’ intentions to teach, and their own attitudes to SE topics and norms within schools. Since the educational input, however, none had used the participatory visual methods when teaching about HIV and AIDS during their teaching practice. Student teachers’ responses indicated that external factors made it difficult to independently continue to integrate participatory visual methods and HIV and AIDS topics into their teaching practice experiences in schools. The findings from Johnson (2014) , and MacEntee (2016) studies indicate that student teachers’ intentions and the realities of teaching subjects and using pedagogical approaches in schools do not always align.

Critical Consciousness

The WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework outlines the objectives of SE, including “open-mindedness and respect for others” (p.26). Although SE courses during ITE may be student teachers’ first exposure to issues of sexual and gender equality, for example, critiques of hetero-normativity ( Vavrus, 2009 ) and introductions to critical feminist discourses ( Harrison and Ollis, 2015 ), findings from several of the studies ( Sinkinson, 2009 ; Vavrus, 2009 ; Harrison and Ollis, 2015 ), indicated that the SE programmes offered during ITE may be insufficient in developing student teachers’ critical consciousness—the ability to recognize and analyze wider social and cultural systems of inequality and the commitment to take action to address such inequalities.

Vavrus (2009) found student teachers expressed varying degrees of critical consciousness as a result of completing a multi-cultural curriculum and assignment. While Harrison and Ollis’s (2015) examination of micro-teaching lessons indicated that completion of an educational input on SE from a feminist, post-structuralist perspective did not suffice in increasing student teachers’ understanding of gender/power relations but rather brought to light the challenges of employing such a perspective. Similarly, Sinkinson (2009) reported a noticeable lack of development of criticality regarding socio-cultural perspectives of SE from the completion of an introductory health education course (2004, first year) to the completion of a specialist health education course (2006, third year). Finally, albeit difficult to generalize given the study’s small sample size, Brown (2016) reported that experiential pedagogical approaches, through inclusion of a guest speaker living with HIV, and employment of a critical, creative arts-based pedagogical strategy offered a critical lens through which student teachers moved from a position of stigmatization toward one of understanding and compassion.

Factors Associated With Student Teachers’ Skills Regarding Sexuality Education Topics

With regards to student teachers’ skills, or potential skill development during ITE, several aspects of ITE were identified as significant in relation to the acquisition of the required skills to teach SE. These included the pedagogical approaches adopted during ITE; the learning environment; opportunities for practical teaching experience, and critical self- reflection.

Pedagogical Approaches and Practical Teaching Experiences

Seven of the studies reviewed examined aspects of pedagogical approaches to teaching SE ( Rodriguez et al., 1997 ; Sinkinson and Hughes, 2008 ; Sinkinson, 2009 ; Carman et al., 2011 ; Goldman and Coleman, 2013 ; Johnson, 2014 ; Goldman and Grimbeek, 2016 ). Goldman and Coleman (2013) reported that their small sample of six student teachers indicated that they learned very little regarding knowledge and pedagogical approaches specific to SE during ITE. Sinkinson (2009) , however, found that student teachers identified co- constructivist pedagogical approaches as being important when teaching SE. Student teacher participants in MacEntee’s (2016) study indicated that the use of participatory visual methods was a novel and thought-provoking way to learn about HIV and AIDS.

Several of the studies indicated the need for opportunities for student teachers to teach and develop the skills to teach SE. Harrison and Ollis (2015) article was the sole study to report on the evaluation of the potential pedagogical skills student teachers had acquired following the completion of SE input. Their examination of micro-teaching lessons indicated the value in examining student teachers teaching of SE. Through this experience, they identified that the educational input had been insufficient in providing student teachers with the opportunity to reflect on a critical approach to gender and sexuality, and to develop the pedagogical skills to teach SE from a critical perspective.

Vavrus (2009) suggested that, given the level of fear acknowledged by student teachers around teaching SE, interventions and programmes should provide structured opportunities for student teachers to construct lesson plans that critically address gender identity and sexuality in developmentally appropriate ways. Vavrus (2009) further suggests that instruction on conducting discussions related to gender identity and sexuality, and strategies to respond to homophobic and sexist discourse should also be provided. Participants in Brown’s (2016) study similarly reported that they would have liked to have had more opportunities to familiarize themselves with facilitating visual participatory methods when teaching about SE topics such as HIV and AIDS.

Learning Environment

MacEntee’s (2016) study provides provisional support for the use of workshops in learning about HIV and AIDS. Student teachers ( Goldman and Grimbeek, 2016 ) and course providers ( Johnson, 2014 ), indicated preferences for the use of tutorial groups, small group face-to-face discussion, and case studies when teaching about SE. In both studies, these approaches were associated with creating less threatening, and more comfortable environments for student teachers to engage with topics on a personal level. Across studies, student teachers remarked that respect and acceptance of other people’s views and opinions were critical to ensure that the environment in which SE provision takes place is safe. These views are aligned with two of the overarching skills outlined by the WHO Regional Office for Europe and BZgA (2017) ; the “ability to use interactive teaching and learning approaches” and the “ability to create and maintain a safe, inclusive and enabling environment” (p. 28). In relation to assessment of SE at ITE, Goldman and Grimbeek (2016) found that student teachers had a preference for group-based assessments, independent research, and self-assessment.

Consistent with the WHO Regional Office for Europe and BZgA (2017) Training Matters: Framework of Core Competencies for Sexuality Educators , sexuality educators should “be able to use a wide range of interactive and participatory student-centered approaches” (p. 28). These findings indicate that the creation of interactive and participatory learning environments is conducive to SE at ITE level. The opportunity to engage in these types of learning environments and student teachers’ positive perceptions of these learning environments may have consequences for the classroom environment which student teachers subsequently create.

Critical Self-Reflection

The ability of sexuality educators to reflect on beliefs and values is a vital skill, according to WHO Regional Office for Europe and BZgA (2017) . The reviewed studies consistently cited the importance of self-reflection in SE provision during ITE. Vavrus (2009) found that self-reflection was critical to the development of a more understanding, and empathetic, approach to teaching. Harrison and Ollis (2015) emphasized the need to support teachers in the development of reflective practices. Ollis (2016) concluded that the opportunity for self-reflection would impact on student teachers’ intention to include pedagogies of pleasure in their practice. Johnson’s (2014) study indicated that engagement in reflection regarding the self and others, helped students to develop a better understanding of their own beliefs and assumptions. The findings from Johnson’s study, however, also show that increased opportunity for self-reflection, and exposure to critical interpretations of content, do not necessarily transfer to teaching behaviours. Gursimsek (2010) recommended the inclusion of critical self-reflection components on future SE courses as it was suggested that components would assist student teachers in clarifying their own social and sexual values, life experiences, and learning histories. This clarification then assists, and supports, maturation in terms of attitudes, beliefs, knowledge as they relate to sexuality. Collectively, these findings indicate that teaching in ITE needs to provide safe spaces for self-reflection on the part of student teachers—and honest engagement with others.

Factors Associated With Student Teachers’ Knowledge Regarding Sexuality Education Topics

Two of the reviewed studies explored the topics student teachers perceived as important for school students to learn about, and the topics they themselves would like to study during ITE. Sinkinson and Hughes (2008) found that, of the aspects of health education student teachers prioritized for school students, the most important were mental health (62%); aspects of sexuality (61.2%); and drugs and alcohol (46.8%). Mental health included “personal development, relationships, emotional health and essential skill development such as decision making” (p. 1079). Student teachers’ responses indicate that they saw personal and interpersonal topics as important aspects of health education. Goldman and Grimbeek (2016) reported that, during ITE on SE, student teachers would most prefer to have social, psychological, and developmental factors associated with student/learner puberty and sexuality addressed. Older student teachers—those in the 22–48 year-old age range—were significantly more likely than their younger student teachers to strongly rate preferences for knowledge about wider socio-cultural contextual factors.

Student Teachers’ Confidence and Comfort to Teach Sexuality Education

Four of the studies reviewed reported student teachers’ comfort and confidence in teaching SE ( Sinkinson, 2009 ; Vavrus, 2009 ; Johnson, 2014 ; Ollis, 2016 ). Student teachers in Sinkinson’s (2009) study suggested that increases in knowledge and learning about SE topics increased comfort levels and intention to teach SE. Student teachers suggested that the opportunity to listen, learn, and discuss topics in an open environment reduced their embarrassment in discussing SE issues. These opportunities increased their comfort for answering pupils’ questions, and using language that they had previously considered taboo ( Sinkinson, 2009 ). Vavrus (2009) reported that having completed the educational input on SE, all student teachers felt they would create an open and safe space for students. Some student teachers reported confidence in their ability to create content, and think of topics to cover, relating to sexuality and gender identity. Responses also indicated challenges for student teachers regarding empathy; fears on how to respond to issues of sexuality and gender identity; lack of experience; feeling unprepared; and fear of reprisal for working outside traditional norms. Cognitive dissonance between the knowledge student teachers acquired about sexuality issues during ITE, and their personal and familial belief system in Johnson’s (2014) study was associated with discomfort for student teachers. Thus, findings from Vavrus’s (2009) and Johnson’s (2014) studies indicate that, although ITE had provided student teachers with knowledge on SE topics, wider socio-cultural/systemic factors may influence student teachers’ confidence or comfort to integrate or apply this knowledge outside of the ITE context.

A lack of student teacher knowledge about SE topics, especially with regards to “non- normative” areas, such as HIV/AIDS, was reported by Brown (2016) as associated with “othering” and discomfort regarding teaching SE content. Ollis (2016) reported the discomfort student teachers’ experience with topics on sexual pleasure and observed that engagement in teaching a 20-minute lesson on a positive sexual development theme—such as pleasure—resulted in increased confidence and skill to discuss sexual pleasure, orgasm, and ethical sex. The topic of student teachers’ comfort and confidence provides a prime example of the interaction of all three competency areas; knowledge, attitudes, and skills in relation to SE. Furthermore, the findings highlight that a more systemic consideration of these competency areas and teachers’ comfort and confidence to teach SE beyond the ITE context to the lived experience of school contexts, is warranted.

Overview of Findings

This systematic review sought to investigate the empirical literature on SE provision with student teachers during ITE. Fifteen articles, reporting on thirteen studies, from predominantly Western, English-speaking contexts met the criteria for review. The findings reveal the varied nature of the provision of SE during ITE for student teachers ( Rodriguez et al., 1997 ; McKay and Barrett, 1999 ; Carman et al., 2011 ). This is consistent with the findings of O’Brien et al.’s (2020) systematic review which similarly found variability in the provision of SE for student teachers. The current reviewed studies document an examination of SE provision at institutional/programme level, and individual student teacher level. The latter studies, in the main, reflected student teachers’ experiences regarding a particular educational input on SE, and to a lesser extent related to an examination of student teachers’ general knowledge, attitudes, or skills regarding SE.

Along with the acknowledged need to provide educational input on SE in ITE, the findings reflect that SE is perceived of as more than a stand-alone curriculum subject. Recommendations from the reviewed studies in respect of educational input provide some support for a more embedded and intersectional approach to SE provision during ITE. Similarly, O’Brien et al.’s (2020) systematic review emphasized the need for greater collaboration, integration and consistency in provision of SE at ITE. ITE in SE is typically seen within the realm of student teachers who are going to qualify as health educators, however, there is a strong argument to make that all pre-service teachers require a fundamental understanding of SE. With regards to the current review, for example, Vavrus (2009) concluded that there is a need for teacher education programmes that extend curricular attention to gender identity formation and sexuality, beyond specific SE modules, as it was suggested that this will help student teachers better understand socio-cultural factors that influence their teacher identities. Harrison and Ollis (2015) acknowledged that—as student teachers may not have engaged with critical approaches to material previously and may not have been provided with adequate time to consider these interpretations of gender and power—programmes over an extended period of time and engagement with these topics across the curriculum may facilitate increased engagement and reflection on this content. The findings provide some support that more time invested in educational input programmes may be beneficial. Courses covered over a semester ( Sinkinson, 2009 ; Gursimsek, 2010 ), for example, may be more beneficial than those covered over much shorter periods ( Harrison and Ollis, 2015 ; Ollis, 2016 ).

The WHO Regional Office for Europe and BZgA (2017) states that an important pre-requisite to teaching SE is the ability and willingness of teachers to reflect on their own attitudes toward sexuality, and social norms of sexuality. Sexual Attitudes Reassessment or values clarification has been an integral part of sexology education and training since the 1990s ( Sitron and Dyson, 2009 ). Indeed, many accreditation bodies set a minimum number of hours in this process-orientated exploration as a requirement for sexology or sexuality education work ( Areskoug-Josefsson and Lindroth, 2022 ). This involves a highly personal internal exploration that is directed toward helping participants to clarify their personal values and provides opportunities for participants to explore their attitudes, values, feelings and beliefs about sexuality and how these impact on their professional interactions ( Sitron and Dyson, 2009 ). This type of input would be valuable in the ITE space. The current findings indicate that educational inputs which facilitate self-reflection and the development of critical consciousness may be particularly beneficial and necessary in supporting student teachers to teach SE. Having the space and time to engage with one’s own belief systems, and experiences, can provide student teachers with insights regarding factors that shape identity and human interaction, which are fundamental to comprehensive SE. This is an important task for teachers and previously has been identified as a gap within existing teacher education programmes ( Kincheloe, 2005 , as cited in Vavrus, 2009 ).

With regards to pedagogical approaches for teaching SE during ITE, the findings indicate that the use of tutorial groups, small group face-to-face discussions, case studies, participatory visual methods, and the inclusion of guest speakers sharing their lived experiences may create less threatening, and more comfortable, environments for student teachers to engage with SE topics on a personal level ( Johnson, 2014 ; Brown, 2016 ; Goldman and Grimbeek, 2016 ; MacEntee, 2016 ). These findings are somewhat consistent with existing evidence that supports experiential and participatory learning techniques for SE (e.g., United Nations Educational Scientific and Cultural Organisation [UNESCO], 2018 ; Begley et al., 2022 ). A lack of practical teaching experience was acknowledged by student teachers as a barrier to teaching SE topics (e.g., Vavrus, 2009 ; MacEntee, 2016 ). Given the reported ( Ollis, 2016 ), and potential ( Vavrus, 2009 ) benefits from engaging in the practice of teaching SE the inclusion of skills-based and practical teaching experience of SE or its proxy as a minimum, within the ITE context may be warranted.

There were some notable absences from the literature reviewed. Although there are examples of research in this review which refer to positive SE topics such as pleasure, sexual orientation, and gender identity, the studies in the main do not reflect an examination of topics fundamental to a CSE curriculum. Studies did not consider or examine the impact of the Internet and social media in relation to SE. Apart from May and Kundert’s (1996) study, the research did not reflect consideration of the provision of SE for students with diverse learning abilities and needs. Some studies considered correlational factors pertaining to student teachers’ attitudes regarding SE. These included gender, geographical location of upbringing ( Gursimsek, 2010 ), and student teachers’ previous school experiences of SE ( Sinkinson and Hughes, 2008 ; Vavrus, 2009 ). Overall, in the studies reviewed there was a dearth of research on student teachers’ attitudes about SE, and the inter-dependence of factors that may influence student teachers’ attitudes.

Given that this field of research is in its relative infancy, the findings which may be inferred from the educational input studies ( Sinkinson, 2009 ; Vavrus, 2009 ; Gursimsek, 2010 ; Harrison and Ollis, 2015 ; Brown, 2016 ; MacEntee, 2016 ; Ollis, 2016 ), are tentative. These studies are generally informative regarding a particular topic or educational input but tend not to shed light on student teachers’ experiences. Furthermore, the findings from Carman et al.’s (2011) and Johnson’s (2014) studies, highlight the role of teacher educators in relation to SE provision being taught during ITE. Teacher educators provide vital support and facilitate new understandings and guidance in the context of SE and teacher professional development. Consistent with O’Brien et al. (2020) , this review highlights the need to promote greater shared learning and evidence-based resources among teacher educators and ITE institutions.

Limitations

This systematic review should be considered in light of its limitations. There is inherent risk of bias across studies given that only peer reviewed articles written in English were reported on. Consequently, a wealth of potential research may have been precluded from review and the findings of the studies will pertain to and potentially reflect the experiences of those in the global north and/or a Westernized view. The exclusion of grey literature such as dissertations and theoretical papers is indicative of publication bias. The very process of selecting inclusion and exclusion criteria is subjective and may facilitate the exclusion of minority voices, or creative methodologies for conducting and or presenting research. Through the exclusion of position papers or articles that do not make reference to empirical data, important voices to this conversation may have been limited/excluded.

Findings were discussed in relation to the competencies outlined by the WHO Regional Office for Europe and BZgA (2017) . Although an international standard for SE, there are limitations to these guidelines. Our understanding of the provision of SE is continuously developing. In 2019, the Sex Information and Education Council of Canada (SIECCAN) updated their guidelines to include an emphasis on changing demographics in relation to sexual health, the need for sexual health educators to demonstrate awareness of the impact of colonialism on the sexual health and well-being of indigenous people, to recognize the impact of technology on sexual health education, to meet the needs of young people of all identities and sexual orientations, and the need to address the topic of consent within sex education. These aspects of SE are not reflected in the WHO Regional Office for Europe and BZgA (2017) guidelines, nor are they reflected in the studies reviewed. This is indicative of the dynamic and complex nature of the field of SE and specifically in ITE.

Given the design of the studies we cannot conclude that ITE experiences translate to teachers’ SE teaching practice. Some studies provided examples of the barriers student teachers can face in the translation of ITE experiences to classroom experiences (e.g., MacEntee, 2016 ). However, other than MacEntee (2016) , examples of research with both student teachers and in-service teachers were not identified nor were longitudinal studies examining the progression from ITE to classroom experiences. Notably, upon screening the abstracts, the literature tended to assess SE received by medical and health care professionals, and there were far less examples regarding research with teachers in general and as may be garnered from this systematic review, a very limited amount of research conducted with student teachers in ITE. As ITE programmes do not routinely publish their course content, there is also a chance that such professional learning and development is being provided but not being reported. Furthermore, given that research on SE within an ITE context is a relatively novel field, diverse methodological approaches have been adopted and there appears to be limited reporting of the theoretical basis informing on this work which has implications for cross-study synthesis of findings. The studies included in this systematic review, predominantly employed qualitative designs and consequently were more idiosyncratic in their selected methodological approach.

Recommendations

Drawing on the findings from the systematic review the overarching recommendation is for more quality research on teacher professional development in the context of SE during ITE. Aspects which require further research attention are outlined below.

Along with the provision of educational input on SE at ITE, an embedded and intersectional approach to SE at ITE programme-level requires further exploration. If student teachers are to meet their future school students’ SE needs, a foundational element of teacher preparation must involve actively addressing issues that are linked to teacher confidence and comfort for delivering SE. The reviewed studies broadly indicate that opportunities for critical self-reflection, practice-oriented and small-group, dialogical, inclusive and participatory pedagogical approaches may be beneficial to adopt with regards to the provision of SE during ITE, however, further robust research is required to support this.

Larger scale, multi-dimensional, integrative studies employing rigorous methodologies to assess inter alia student teachers’ knowledge, attitudes, and skills, regarding sexuality during ITE including student teachers’ knowledge, comfort, confidence and preparedness to teach sexuality are warranted. Furthermore, research which is inclusive of both student teachers’ and teacher educators’ voices, is needed.

Adoption of a systemic approach examining individual-level and contextual factors relating to SE provision during ITE is needed to develop theoretically derived, research-informed, and evidence-based SE programmes at ITE. In order to improve the provision of SE at ITE an evaluation of provision must be in place for best practice to be achieved.

ITE provision needs to adopt a holistic approach when supporting teacher development. As documented by the WHO Regional Office for Europe and BZgA (2017) guidelines, this involves supporting the development and acquisition of relevant knowledge, attitudes and skills pertaining to SE. Although ITE in SE often focuses on student teachers who will qualify as health educators, it can be argued that all pre-service teachers require a fundamental understanding of SE. Furthermore, the SE provided during ITE should be nuanced to support LGBTI students, students with special educational needs and/or from diverse racial and cultural backgrounds ( Whitten and Sethna, 2014 ; Ellis and Bentham, 2021 ; Michielsen and Brockschmidt, 2021 ). A series of indicators to assess the relevant factors pertaining to SE provision and how these indicators relate to the knowledge, attitudes, and skills required for sexuality educators would be helpful. Monitoring and evaluation of structural indicators such as the designated SE components of course programmes, whether courses are elective or core, whether practice elements are provided etc. would provide a baseline from which system change and improvements could be measured. This systematic review has provided tentative suggestions as to what may work to ensure best practice of SE during ITE. Further research is required to evaluate the outcomes associated with their implementation.

Author Contributions

AC, CM, CC, and AB were responsible for the development and design of the study and final decisions regarding the reviewed articles. AC and CM completed the initial pilot searches. AC completed the final searches and wrote the first draft of the manuscript. AC, CM, and CC reviewed the articles. AC and AB developed the data extraction template. All authors contributed to manuscript revision, read, and approved the submitted version.

This work was supported by the Irish Research Council IRC Coalesce Research Award (Strand 1E—HSE—Sexual Health and Crisis Pregnancy Programme) for the research study TEACH-RSE Teacher Professional Development and Relationships and Sexuality Education: Realizing Optimal Sexual Health and Wellbeing Across the Lifespan (Grant No. IRC COALESCE 2019/147).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords : systematic review, sexuality education, student teacher, initial teacher education, comprehensive sexuality education, sex education

Citation: Costello A, Maunsell C, Cullen C and Bourke A (2022) A Systematic Review of the Provision of Sexuality Education to Student Teachers in Initial Teacher Education. Front. Educ. 7:787966. doi: 10.3389/feduc.2022.787966

Received: 01 October 2021; Accepted: 08 February 2022; Published: 07 April 2022.

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The State of Sex Education in the United States

Kelli stidham hall.

Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia

Jessica McDermott Sales

Kelli a. komro, john santelli.

Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York

For more than four decades, sex education has been a critically important but contentious public health and policy issue in the United States [ 1 – 5 ]. Rising concern about nonmarital adolescent pregnancy beginning in the 1960s and the pandemic of HIV/AIDS after 1981 shaped the need for and acceptance of formal instruction for adolescents on life-saving topics such as contraception, condoms, and sexually transmitted infections. With widespread implementation of school and community-based programs in the late 1980s and early 1990s, adolescents’ receipt of sex education improved greatly between 1988 and 1995 [ 6 ]. In the late 1990s, as part of the “welfare reform,” abstinence only until marriage (AOUM) sex education was adopted by the U.S. government as a singular approach to adolescent sexual and reproductive health [ 7 , 8 ]. AOUM was funded within a variety of domestic and foreign aid programs, with 49 of 50 states accepting federal funds to promote AOUM in the classroom [ 7 , 8 ]. Since then, rigorous research has documented both the lack of efficacy of AOUM in delaying sexual initiation, reducing sexual risk behaviors, or improving reproductive health outcomes and the effectiveness of comprehensive sex education in increasing condom and contraceptive use and decreasing pregnancy rates [ 7 – 12 ]. Today, despite great advancements in the science, implementation of a truly modern, equitable, evidence-based model of comprehensive sex education remains precluded by sociocultural, political, and systems barriers operating in profound ways across multiple levels of adolescents’ environments [ 4 , 7 , 8 , 12 – 14 ].

At the federal level, the U.S. congress has continued to substantially fund AOUM, and in FY 2016, funding was increased to $85 million per year [ 3 ]. This budget was approved despite President Obama’s attempts to end the program after 10 years of opposition and concern from medical and public health professionals, sexuality educators, and the human rights community that AOUM withholds information about condoms and contraception, promotes religious ideologies and gender stereotypes, and stigmatizes adolescents with nonheteronormative sexual identities [ 7 – 9 , 11 – 13 ]. Other federal funding priorities have moved positively toward more medically accurate and evidence-based programs, including teen pregnancy prevention programs [ 1 , 3 , 12 ]. These programs, although an improvement from AOUM, are not without their challenges though, as they currently operate within a relatively narrow, restrictive scope of “evidence” [ 12 ].

At the state level, individual states, districts, and school boards determine implementation of federal policies and funds. Limited in-class time and resources leave schools to prioritize sex education in competition with academic subjects and other important health topics such as substance use, bullying, and suicide [ 4 , 13 , 14 ]. Without cohesive or consistent implementation processes, a highly diverse “patchwork” of sex education laws and practices exists [ 4 ]. A recent report by the Guttmacher Institute noted that although 37 states require abstinence information be provided (25 that it be stressed), only 33 and 18 require HIV and contraceptive information, respectively [ 1 ]. Regarding content, quality, and inclusivity, 13 states mandate instruction be medically accurate, 26 that it be age appropriate, eight that it not be race/ethnicity or gender bias, eight that it be inclusive of sexual orientation, and two that it not promote religion [ 1 ]. The Centers for Disease Control and Prevention’s 2014 School Health Policies and Practices Study found that high school courses require, on average, 6.2 total hours of instruction on human sexuality, with 4 hours or less on HIV, other sexually transmitted infections (STIs), and pregnancy prevention [ 15 ]. Moreover, 69% of high schools notify parents/guardians before students receive such instruction; 87% allow parents/guardians to exclude their children from it [ 15 ]. Without coordinated plans for implementation, credible guidelines, standards, or curricula, appropriate resources, supportive environments, teacher training, and accountability, it is no wonder that state practices are so disparate [ 4 ].

At the societal level, deeply rooted cultural and religious norms around adolescent sexuality have shaped federal and state policies and practices, driving restrictions on comprehensive sexual and reproductive health information, and service delivery in schools and elsewhere [ 12 , 13 ]. Continued public and political debates on the morality of sex outside marriage perpetuate barriers at multiple levels—by misguiding state funding decisions, molding parents’ (mis)understanding of programs, facilitating adolescents’ uptake of biased and inaccurate information in the classroom, and/or preventing their participation in sex education altogether [ 4 , 7 , 8 , 12 – 14 ].

Trends in Adolescents’ Receipt of Sex Education

In this month’s Journal of Adolescent Health , Lindberg et al. [ 16 ] provide further insight into the current state of sex education and the implications of federal and state policies for adolescents in the United States. Using population data from the National Survey of Family Growth, they find reductions in U.S. adolescents’ receipt of formal sex education from schools and other community institutions between 2006–2010 and 2011–2013. These declines continue previous trends from 1995–2002 to 2006–2008, which included increases in receipt of abstinence information and decreases in receipt of birth control information [ 17 – 19 ]. Moreover, the study highlights several additional new concerns. First, important inequities have emerged, the most significant of which are greater declines among girls than boys, rural-urban disparities, declines concentrated among white girls, and low rates among poor adolescents. Second, critical gaps exist in the types of information (practical types on “where to get birth control” and “how to use condoms” were lowest) and the mistiming of information (most adolescents received instruction after sexual debut) received. Finally, although receipt of sex education from parents appears to be stable, rates are low, such that parental-provided information cannot be adequately compensating for gaps in formal instruction.

Paradoxically, the declines in formal sex education from 2006 to 2013 have coincided with sizeable declines in adolescent birth rates and improved rates of contraceptive method use in the United States from 2007 to 2014 [ 20 , 21 ]. These coincident trends suggest that adolescents are receiving information about birth control and condoms elsewhere. Although the National Survey of Family Growth does not provide data on Internet use, Lindberg et al. [ 16 ] suggest that it is likely an important new venue for sex education. Others have commented on the myriad of online sexual and reproductive resources available to adolescents and their increasing use of sites such as Bedsider.org, StayTeen.org, and Scarleteen. [ 2 , 14 , 22 – 24 ].

The Future of Sex Education

Given the insufficient state of sex education in the United States in 2016, existing gaps are opportunities for more ambitious, forward-thinking strategies that cross-cut levels to translate an expanded evidence base into best practices and policies. Clearly, digital and social media are already playing critical roles at the societal level and can serve as platforms for disseminating innovative, scientifically and medically sound models of sex education to diverse groups of adolescents, including sexual minority adolescents [ 14 , 22 – 24 ]. Research, program, and policy efforts are urgently needed to identify effective ways to harness media within classroom, clinic, family household, and community contexts to reach the range of key stakeholders [ 13 , 14 , 22 – 24 ]. As adolescents turn increasingly to the Internet for their sex education, perhaps school-based settings can better serve other unmet needs, such as for comprehensive sexual and reproductive health care, including the full range of contraceptive methods and STI testing and treatment services. [ 15 , 25 ].

At the policy level, President Obama’s budget for FY 2017 reflects a strong commitment to supporting youths’ access to age-appropriate, medically accurate sexual health information, with proposed elimination of AOUM and increased investments in more comprehensive programs [ 3 ]. Whether these priorities will survive an election year and new administration is uncertain. It will also be important to monitor the impact of other health policies, particularly regarding contraception and abortion, which have direct and indirect implications for minors’ rights and access to sexual and reproductive health information and care [ 26 ].

At the state and local program level, models of sex education that are grounded in a broader interdisciplinary body of evidence are warranted [ 4 , 11 – 14 , 27 – 29 ]. The most exciting studies have found programs with rights-based content, positive, youth-centered messages, and use of interactive, participatory learning and skill building are effective in empowering adolescents with the knowledge and tools required for healthy sexual decision-making and behaviors [ 4 , 11 – 14 , 27 – 29 ]. Modern implementation strategies must use complementary modes of communication and delivery, including peers, digital and social media, and gaming, to fully engage young people [ 14 , 22 , 23 , 27 ].

Ultimately, expanded, integrated, multilevel approaches that reach beyond the classroom and capitalize on cutting-edge, youth-friendly technologies are warranted to shift cultural paradigms of sexual health, advance the state of sex education, and improve sexual and reproductive health outcomes for adolescents in the United States.

Acknowledgments

Funding Sources

K.S.H. is supported by the National Institute of Child Health and Human Development #1K01HD080722-01A1.

Contributor Information

Kelli Stidham Hall, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Jessica McDermott Sales, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

Kelli A. Komro, Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.

John Santelli, Department of Population & Family Health, Mailman School of Public Health, Columbia University, New York, New York.

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New research: quality sex education has broad, long-term benefits for young people’s’ physical and mental health.

An extensive review finds that in addition to helping to prevent teen pregnancy and STIs, sex education can help prevent child sexual abuse, create safer school spaces for LGBTQ young people, and reduce relationship violence

Washington, DC – New research published in the Journal of Adolescent Health has identified a wide variety of benefits of comprehensive, quality sex education. 

For Three Decades of Research: The Case for Comprehensive Sex Education , Eva S. Goldfarb, Ph.D. and Lisa D. Lieberman, Ph.D. examined studies from over three decades of research on sex education and found “evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality.”

From the authors: 

“We undertook this research because of the glaring lack of work that examines the impact  of sex education on all aspects of sexual health, rather than limiting the scope to pregnancy and STI prevention. Our research found that sex education has the potential do so much more. The impact of quality sex education that addresses the broad range of sexual health topics extends beyond pregnancy and STIs and can improve school success, mental health, and safety. As with all other areas of the curriculum, building an early foundation and scaffolding learning with developmentally appropriate content and teaching are key to long-term development of knowledge, attitudes, and skills that support healthy sexuality.

Further, if students are able to avoid early pregnancy, STIs, sexual abuse and interpersonal violence and harassment, while feeling safe and supported within their school environment, they are more likely to experience academic success, a foundation for future stability.”

The paper found that sex education efforts can also succeed in classrooms outside of  the health education curriculum. Given that most schools have limited time allotted to health or sex education, a coordinated and concerted effort to teach and reinforce important sexual health concepts throughout other areas of the curriculum is a promising strategy.

Members of the Future of Sex Education Initiative, a coalition of organizations working to ensure all students in grades K–12 receive comprehensive, quality sex education which developed the National Sex Education Standards, welcomed the research: 

Debra Hauser, President, Advocates for Youth:

“This paper confirms what educators and young people see every day in classrooms and school communities: sex education helps young people have healthier, safer lives and more affirming environments. We owe it to every young person to make sure they not only have the information and skills they need to protect their health, but that they are safe in their schools and their homes.”

Chris Harley, President & CEO, SIECUS:

“At SIECUS: Sex Ed for Social Change, we have been asserting that individual and social benefits of sex education extend far beyond simply decreasing rates of unintended pregnancies and sexually transmitted infections among young people. This new wealth of research is just the start of illuminating that the power and importance of comprehensive, inclusive sex education is in it’s ability to do so much more. The findings are clear: sex education helps all of our young people lead happier, healthier, safer lives—no matter who they are or how they identify. ”

Dan Rice, Executive Director, Answer:

“When it comes to most topics taught in school, the motto is often “ Knowledge is Power ;” but there’s often a double standard when it comes to sex education. This paper provides the evidence that access to comprehensive sex education is not only empowering to all students, but can also help to improve their emotional and social development.”

Eva S. Goldfarb, Ph.D. , and Lisa D. Lieberman, Ph.D. are available for comment; please reach out to [email protected] .

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Perspectives in Primary Care

Published by the harvard medical school center for primary care, comprehensive sex education as violence prevention.

May 29, 2020

By Rebekah Rollston, MD, MPH

It’s #SexEdForAll month, yet most people still believe sex education is just about sex. But it’s so much more than that. As a young woman from rural Appalachia, I’m well aware that until people learn what sex education truly is, it won’t be widely accepted in our society. That’s why I created the Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators story map, in conjunction with the Robert Graham Center . The story map explores sexuality education legislation and policies by state, compared to each state’s respective health indicators, including teen birth rate, contraceptive prevalence rate, sexually transmitted infection (STI) rate, sexual violence, physical dating violence, bullying/harassment, and suicide. This story map can be used as a visually accessible advocacy tool to demonstrate the breadth of health indicators impacted by comprehensive sex education. In addition to the sexual and reproductive health benefits of comprehensive sex education, it is a powerful tool for violence prevention.

• Sexual violence

Consent is a core topic taught in sex education , which is vitally important since our society has failed to teach people what consent actually means. Before we touch, hug, kiss, cuddle, or touch someone’s body in any way, we must ask consent . We can teach this from a young age… for example, when a 4-year-old kid says they don’t want a hug from their aunt, then we respect that. This shows children it’s their body, and they decide who touches them. The same goes for adolescents (and all people, really)… before hugging or kissing someone at the end of a romantic date, we must ask first, saying “Hey, is it okay if I hug you?” If they verbally say “yes,” then it’s time to hug! Teaching consent is key to preventing sexual violence.

• Physical dating violence

Healthy relationships are another primary theme in sex education . Students learn positive ways to express intimacy and affection, communicate personal boundaries, and develop strategies to avoid or end unhealthy relationships. Just like consent, our society has failed to teach people what it means to be a healthy partner. Further, perpetrators of dating violence often have poor self-esteem , and importantly, sex education provides students with the tools needed to develop positive self-worth as well as ways to serve as a healthy partner. Sex education also teaches gender equality from a young age, thereby reducing risk for gender-based violence .

• Bullying & harassment

Comprehensive sex education offers robust curricula on bullying prevention. People bully for many reasons , including low self-esteem, emotional neglect, and some bullies may be victims of violence themselves. Sex education teaches students that bullying is wrong as well as how to respond if they are being bullied. Further, sex education guides students in identity development, healthy self-esteem, and body confidence, all of which influence one’s sense of self, thereby decreasing risk for students to bully or be bullied.

Though it may not seem readily apparent, comprehensive sex education is a powerful vehicle for addressing youth risk factors for depression and suicide. Sex education teaches students to build healthy self-esteem and body confidence, normalizes the full spectrum of gender identity and sexual orientation, encourages mutually respectful and equitable relationships based on empathy and open communication, teaches personal safety, including how to respond to bullying and harassment, and ultimately, promotes tolerance. These life skills act as protective factors against depression and suicide.

In addition to violence prevention, comprehensive sex education is a powerful vehicle for addressing reproductive justice, gender equity, LGBTQ+ equality, and power and oppression. Within the United States, sex education is not standardized across states, counties, or even school systems, and a large proportion of sex education programs are not evidence-based or medically accurate. #SexEdForAll month highlights that all young people deserve developmentally and culturally responsive, science-based, and medically accurate life skills education. Sexuality Education Legislation and Policy: A State-by-State Comparison of Health Indicators , presented as an interactive story map, can be used as a visually accessible advocacy tool to demonstrate that sex education is about more than just sex… instead, comprehensive sex education is a powerful vehicle for social change .

This blog post was originally published by Healthy Teen Network .

About the author

Rebekah L. Rollston, MD, MPH, is a Family Medicine Physician at Cambridge Health Alliance, Clinical Associate at Tufts University School of Medicine, and Resident Affiliate at the Harvard Medical School Center for Primary Care. She earned her Medical Degree from East Tennessee State University James H. Quillen College of Medicine and her Master of Public Health from The George Washington University Milken Institute School of Public Health. Her professional interests focus on social influencers of health & health disparities, gender-based violence, sexual & reproductive health, self-esteem development, addiction medicine, rural health, homelessness & supportive housing, and immigrant health.

**Feature photo by Alexis Brown on Unsplash

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Federal Policy Snapshots

Federally Funded Sex Education: Strengthening and Expanding Evidence-Based Programs

Reproductive rights are under attack. Will you help us fight back with facts?

All young people should have access to comprehensive sexual and reproductive health information that is medically accurate, LGBTQ inclusive, and culturally and age appropriate so that they can make informed decisions about their sexual behavior, relationships and reproductive choices. Sex is already part of many adolescents’ lives , and they deserve to receive high-quality information to inform their decision-making. Unfortunately, just 30 states and the District of Columbia require sex education to be taught in schools, and fewer states require that the school curricula include key sex education topics or even medically accurate information. The federal government also wastes $110 million per year on misleading and harmful programs that only cover abstinence. Federal policymakers have an opportunity to strengthen existing sex education programs by funding them at adequate levels and to create a new comprehensive sex education funding stream through the Real Education and Access for Healthy Youth Act.

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How federally funded sex education programs work

There are currently two federal funding streams for evidence-based and medically accurate sex education: the Teen Pregnancy Prevention Program (TPPP) and the Personal Responsibility Education Program (PREP).

Teen Pregnancy Prevention Program

• TPPP supports the implementation and evaluation of evidence-based programs and innovative approaches to reducing pregnancy among adolescents. Its primary purpose is to build an evidence base of effective sex education programs.
• The program was established in 2010. Since 2014, it has been funded at $101 million each year. Ten percent of funding goes to training, technical assistance, evaluation and other forms of program support. Of the remaining funds, 75% goes to grantees that replicate effective programs (Tier 1) and 25% goes to grantees that test innovative strategies to reduce adolescent pregnancy rates (Tier 2). Both Tier 1 and Tier 2 programs are evaluated as part of TPPP.
• The program currently supports Tier 1 grants in 29 states and Puerto Rico and Tier 2 grants in 13 states. Grantees include for-profit and nonprofit organizations, clinics, hospitals, state and local governments, schools and universities.

Personal Responsibility Education Program

• PREP supports a variety of evidence-based programs that aim to prevent pregnancy and STIs among adolescents by emphasizing abstinence and contraception.
• The program focuses on young people aged 10–19 who are homeless, in or aging out of foster care, living with HIV or AIDS, victims of human trafficking or living in areas with high adolescent birth rates. It also focuses on people younger than 21 who are pregnant or parenting.
• The program was established in 2010 and has been funded at $75 million per year.
• PREP currently supports three types of grantees— state , tribal and nongovernmental —across 50 states , the District of Columbia and seven territories or countries.
• PREP-funded curricula are not required to be comprehensive, but the majority incorporate elements of comprehensive sex education: healthy relationships (98%), healthy life skills (81%) and adolescent development (73%).

Comprehensive sex education

• There are currently no federal programs dedicated to funding and expanding access to comprehensive sex education, which is considered the gold standard of sex education.
• Comprehensive sex education covers a broad range of topics, including human development, relationships, communication and decision-making skills, sexual behavior, sexual health, and cultural representations of sexuality and gender. These curricula frame sexuality as a normal part of life and are medically accurate, LGBTQ inclusive, and culturally and age appropriate.

Impact of sex education programs

• To date, HHS has identified 48 programs funded by TPPP that meet criteria for program effectiveness, including one or more favored outcomes in increased contraceptive use or reduced sexual activity, number of sexual partners, STIs or pregnancy.
• These programs and their evaluations provide useful information about where, when and with whom programs are most effective, allowing program organizers to design curricula that best fit their context and audience.
• Curricula funded by PREP fulfill the goals of the program by changing behaviors related to pregnancy risk. For example, after taking part in PREP-funded curriculum in 2016–2017, half of participants said they were more likely to abstain from sex for the next six months. Among those who said they might have sex, 70% reported they were more likely to use birth control and 77% were more likely to use a condom than before participating.
• PREP curricula also resonate with young people: About 70% of participants expressed interest in the content, 87% felt respected by the program, and more than 70% said that PREP helped them prepare for adulthood.
• A 2018 review of curricula from around the world, commissioned by the United Nations, found that comprehensive sex education programs contribute to numerous outcomes for adolescents, including delayed initiation and decreased frequency of sexual intercourse, fewer sexual partners and increased use of condoms and other contraceptives.
• Research indicates that comprehensive sex education programs also can reduce homophobia, expand students’ understanding of gender and gender norms, decrease intimate partner violence and improve communication skills.

What policymakers can do

Congress and the Biden-Harris administration should take the following steps:

• Pass the Real Education and Access for Healthy Youth Act , which would—among other provisions—eliminate funding streams for abstinence-only-until-marriage programs and establish five-year grants for comprehensive sex education programs. Curricula funded through these grants must follow standards established by experts and cover a variety of sex and sexuality topics, including puberty and adolescent development; anatomy and physiology; sexual orientation, gender identity and gender expression; contraception, pregnancy and reproduction; STIs, including HIV; healthy relationships; and interpersonal violence.
• Increase annual TPPP funding to $150 million to help the Biden-Harris administration restore program integrity, high-quality evaluation and adequate technical support after years of damage under the Trump-Pence administration. Notably, the prior administration halted funding to the Teen Pregnancy Prevention Evidence Review , which informs TPPP grantmaking by systematically reviewing teen pregnancy prevention research.
• Increase PREP funding to $150 million for five years, which would allow the program to double the number of young people served, from 110,000 to 220,000 annually. Guaranteed funding for five years would enable grantees to develop programs that best fit their communities’ needs as they recover from the pandemic .
• Eliminate abstinence-only programs. Abstinence-only programs are not sex education—they are misinformation campaigns that fail to meet the needs of young people. Congress must stop funding programs that stigmatize sex, ignore or bully LGBTQ children and reinforce harmful gender norms.

Adolescents' Receipt of Sex Education in a Nationally Representative Sample, 2011–2019

The path ahead: restoring and advancing sexual and reproductive health and rights, sex and hiv education, adolescents deserve better: what the biden-harris administration and congress can do to bolster young people’s sexual and reproductive health, assessing state-level variations in high school students’ sexual and contraceptive behavior: the 2019 youth risk behavior surveys, adolescent sexual and reproductive health in the united states, united states.

• Northern America : United States

Summary State Policies on Sex Education in Schools

Why is sexual education taught in schools.

A 2017 Centers for Disease Control and Prevention (CDC)  survey  indicates that nearly 40 percent of all high school students report they have had sex, and 9.7 percent of high school students have had sex with four or more partners during their lifetime. Among students who had sex in the three months prior to the survey, 54 percent reported condom use and 30 percent reported using birth control pills, an intrauterine device (IUD), implant, shot or ring during their last sexual encounter.

The birth rate for women aged 15-19 years was  18.8 per 1,000 women  in 2017, a drop of 7 percent from 2016. According to CDC, reasons for the decline are not entirely clear, but evidence points to a higher number of teens abstaining from sexual activity and an increased use of birth control in teens who are sexually active. Though the teen birth rate has declined to its lowest levels since data collection began, the United States still has the highest teen birth rate in the industrialized world.

Certain social and economic costs can result from teen pregnancy. Teenage mothers are less likely to finish high school and are more likely than their peers to live in poverty, depend on public assistance, and be in poor health. Their children are more likely to suffer health and cognitive disadvantages, come in contact with the child welfare and correctional systems, live in poverty, drop out of high school and become teen parents themselves. These costs add up, according to The National Campaign to Prevent Teen and Unplanned Pregnancy, which estimates that teen childbearing costs taxpayers at least $9.4 billion annually. Between 1991 and 2015, the teen birth rate dropped 64%, resulting in approximately  $4.4 billion  in public savings in one year alone.

Sexually transmitted infections (STIs) disproportionately affect adolescents due to a variety of behavioral, biological and cultural reasons. Young people ages 15 to 24 represent  25 percent  of the sexually active population, but acquire half of all new STIs, or about 10 million new cases a year. Though many cases of STIs continue to go  undiagnosed and unreported , one in four sexually-active adolescent females is reported to have an STI.

Human papillomavirus  is the most common STI and some estimates find that up to 35 percent of teens ages 14 to 19 have HPV. The rate of reported cases of chlamydia, gonorrhea, and primary and secondary syphilis increased among those aged 15-24 years old between 2017-2018. Rates of reported chlamydia cases are consistently highest among women aged 15-24 years, and rates of reported gonorrhea cases are consistently highest among men aged 15-24 years. A CDC analysis reveals the annual number of new STIs is roughly equal among young women and young men. However, women are more likely to experience long-term health complications from untreated STIs and adolescent females may have increased susceptibility to infection due to biological reasons.

The estimated direct medical costs for treating people with STIs are nearly $16 billion annually, with costs associated with HIV infection accounting for more than 81% of the total cost. In 2017, approximately  21 percent  of new HIV diagnoses were among young people ages 13 to 24 years.

Sex Education and States

All states are somehow involved in sex education for public schoolchildren.

As of October 1, 2020:

• Thirty states and the District of Columbia require public schools teach sex education, 28 of which mandate both sex education and HIV education.
• Thirty-nine states and the District of Columbia require students receive instruction about HIV.
• Twenty-two states require that if provided, sex and/or HIV education must be medically, factually or technically accurate. State definitions of “medically accurate" vary, from requiring that the department of health review curriculum for accuracy, to mandating that curriculum be based on information from “published authorities upon which medical professionals rely.” (See table on medically accuracy laws.)

Many states define parents’ rights concerning sexual education:

• Twenty-five states and the District of Columbia require school districts to notify parents that sexual or HIV education will be provided.
• Five states require parental consent before a child can receive instruction.
• Thirty-six states and the District of Columbia allow parents to opt-out on behalf of their children.

*Medical accuracy is not specifically outlined in state statue, rather it is required by the New Jersey Department of Education, Comprehensive Health and Physical Education Student Learning Standards.

** Medical accuracy requirement is pursuant to rule R277-474 of the Utah Administrative Code.

***Medical accuracy is not outlined in state statute, rather it is included in the Virginia Department of Education Standards of Learning Document for Family Life Resources.

Source: NCSL, 2019; Guttmacher Institute, 2019; Powered by StateNet

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U.S. Department of Education

Single-sex education refers most generally to education at the elementary, secondary, or postsecondary level in which males or females attend school exclusively with members of their own sex. This report deals primarily with single-sex education at the elementary and secondary levels. Research in the United States on the question of whether public single-sex education might be beneficial to males, females or a subset of either group (particularly disadvantaged youths) has been limited. However, because there has been a resurgence of single-sex schools in the public sector, it was deemed appropriate to conduct a systematic review of single-sex education research.

A number of theoretical advantages to both coeducational (CE) and single-sex (SS) schools have been advanced by their advocates, a subset of whom have focused specifically on the potential benefits of SS schooling for disadvantaged males who have poor success rates in the educational system. The interpretation of results of previous studies in the private sector or the public sectors of other countries has been hotly debated, resulting in varying policy recommendations based on the same evidence. However, no reviews on this topic have been conducted using a systematic approach similar to that of the Campbell Collaboration (CC) or the What Works Clearinghouse (WWC). Thus, the objective of this review is to document the outcome evidence for or against the efficacy of single-sex education as an alternative form of school organization using an unbiased, transparent, and objective selection process adapted from the standards of the CC and WWC to review quantitative studies.

Concurrently with this review of the quantitative literature, we conducted a review of the qualitative literature on the subject of single-sex schooling using parallel coding techniques. Unlike quantitative studies, qualitative studies are not viewed by WWC as appropriate methodology when determining causal relationships. Rather, they contribute to theory building and provide direction for hypothesis testing. Few qualitative studies satisfied the criteria for inclusion. Therefore, the primary focus of this paper is the systematic review of quantitative research.

The following are the major research questions addressed by the systematic quantitative review:

• Are single-sex schools more or less effective than coeducational schools in terms of concurrent, quantifiable academic accomplishments?
• Are single-sex schools more or less effective than coeducational schools in terms of long-term, quantifiable academic accomplishment?
• Are single-sex schools more or less effective than coeducational schools in terms of concurrent, quantifiable indicators of individual student adaptation and socioemotional development?
• Are single-sex schools more or less effective than coeducational schools in terms of long-term, quantifiable indicators of individual student adaptation and socioemotional development?
• Are single-sex schools more or less effective than coeducational schools in terms of addressing issues of procedural (e.g., classroom treatment) and outcome measures of gender inequity?
• Are single-sex schools more or less effective than coeducational schools in terms of perceptual measures of the school climate or culture that may have an impact on performance?

As in previous reviews, the results are equivocal. There is some support for the premise that single-sex schooling can be helpful, especially for certain outcomes related to academic achievement and more positive academic aspirations. For many outcomes, there is no evidence of either benefit or harm. There is limited support for the view that single-sex schooling may be harmful or that coeducational schooling is more beneficial for students.

The Systematic Review Process

The systematic review of the literature consisted of the following steps:

An exhaustive search of electronic databases for citations, supplemented by other sources. This search strategy yielded 2,221 studies.

An initial Phase I exclusion of sources whose subject matter falls outside the defined scope of the study. Criteria used for exclusion in Phase I included:

Population -To be included, the students had to be enrolled in a full-time school. They had to be in elementary, middle, or high school as opposed to college and beyond. Finally, the schools being studied had to be in English-speaking or Westernized countries somewhat comparable to American public-sector schools.

Intervention -The single-sex school had to be one in which students were either completely segregated by sex or were completely segregated for all classes, even if co-located in the same building (i.e., dual academies). Studies of single-sex classes in a coeducational school were excluded from review. This initial screening yielded 379 publications that fit the initial inclusion criteria.

A Phase II exclusion based on obvious methodological considerations (e.g., nonstudy, weak study). On the basis of titles and abstracts, citations that appeared to be essays, reviews, opinion pieces, and similar items were excluded, and only qualitative and quantitative studies that were likely to be codable in Phase III were retained. During Phase II, 114 citations were culled from the 379 items and coded as appropriate for review as quantitative (88) or qualitative (26) studies. Of the 26 qualitative studies, 4 met the criteria for final inclusion and were reviewed separately.

A Phase III evaluation and coding of the remaining quantitative articles. According to the guidelines of the WWC, all studies other than randomized controlled trials, quasi-experimental designs (QED) with matching, or regression discontinuity designs would be excluded prior to Phase III. Under the WWC criteria for inclusion, virtually all single-sex studies would have been eliminated from the review process because of the lack of experimental research on this topic. Therefore, for this review, a conscious decision was made to relax these standards and include all correlational studies that employed statistical controls. By relaxing the WWC standards, the number of candidate studies to be screened in Phase III was greatly increased. A more streamlined and efficient checklist was developed requiring dichotomous responses rather than descriptive responses in order to facilitate rater decision making. To be included in the quantitative review, a study had to use appropriate measurement and statistical principles. A primary criticism of previous single-sex literature has been the confounding of single-sex effects with the effects of religious values, financial privilege, selective admissions, or other advantages associated with the single-sex school being studied. Therefore, in particular a study had to include statistical controls to account for individual differences (e.g., socioeconomic status [SES], individual ability, and age) as well as school and class differences that might account for the differences between single-sex and coeducational schools. Even so, many studies that included at least one covariate lacked other important covariates such as ethnic or racial minority status, socioeconomic status, and grade level or age. Also, it is important to note that the inclusion of covariates cannot control for important unobservable differences between the groups, such as motivation. Because correlational studies cannot adequately address the issue of differences in unobservables (or selection bias), the studies in this review may over or understate the true effects of SS schooling.

The Quantitative Review

Two reviewers coded each study independently, using a quantitative coding guide. A quantitative study was coded for its treatment of the following broad issues: sample characteristics, psychometric properties, internal validity, effect, and bias. Each of these categories had several criteria by which they were coded. To be retained, a study did not have to meet all criteria.

Of the 88 quantitative studies, 48 were eliminated after further review using the coding guide, and 40 studies met the inclusion criteria and were retained. The reasons for the exclusion of these articles were 1) failure to operationalize the intervention properly; 2) failure to apply statistical controls during the analyses; 3) work that was actually qualitative in nature rather than quantitative; 4) work performed in a non-Westernized country and therefore not comparable; 5) work written in a foreign language and therefore not codable by the researchers; 6) failure to draw comparisons between SS and CE schools; and 7) participants not of high school, middle, or elementary school age. In all, 40 studies met the inclusion criteria and were retained in the quantitative review. The following table shows results of each study according to the seven broad questions listed above and is broken into specific criteria within each larger category. Because some studies addressed multiple criteria, the total number of findings is greater than 40. Specifically, there are 112 findings considered in the 40 quantitative studies.

A table summarizing the findings is below . In each row, one of the 32 outcome categories is listed, as well as the total number of studies related to that outcome category and the raw number and percent of findings that either support SS schooling, support CE schooling, are null, or mixed (supporting both CE and SS schooling). While eight of the outcome categories have four or more studies, others have as few as one or two studies. For any outcome category, the percentage of studies falling in any of the dispositions (supporting SS, supporting CE, null, or mixed) and the confidence with which one can use the findings will increase with the number of studies. Therefore, the percentages in the summary table should be treated with caution when only one or two studies appear for that outcome category.

As shown in the Summary Table, every study falls into one of four categories: Pro-SS, Pro-CE, Null, or Mixed. If a study's findings all supported SS schooling for a given outcome variable, it was coded as "Pro-SS". If the study's findings all supported CE for a given outcome variable, it would be coded "Pro-CE". A study was coded "Null" if for all findings regarding that outcome variable, there were no differences between the SS and CE schools. A study was coded "Mixed" if the study had significant findings in opposite directions for different subgroups on the same variable. For example, a study would be coded "Mixed" if on a specific outcome, support was found for single-sex schooling in the case of boys and support was found for coeducation in the case of girls. Another example would be a finding favoring single-sex in a 10th-grade sample and coeducation in a 12th-grade sample for the same outcome variable within a single study. If a study had findings that were both pro-SS and null, it was coded a pro-SS; if the study had findings that were both pro-CE and null, it was coded as pro-CE. Only studies with findings favoring both single-sex and coeducation were coded as mixed. It should also be kept in mind that some researchers evaluated multiple outcome variables in their research; therefore, it is possible that a single published study would yield information that appears in multiple rows of the Summary Table.

Implications of Review

Summary of Findings in Each Domain

Concurrent, quantifiable academic accomplishments

In general, most studies reported positive effects for SS schools on all-subject achievement tests. Studies examining performance on mathematics, science, English, and social studies achievement tests found similar findings with one caveat. Within each of these subject-specific categories, roughly a third of all studies reported findings favoring SS schools, with the remainder of the studies split between null and mixed results. This minimal to medium support for SS schooling applies to both males and females and in studies pertaining to both elementary and high schools. The overall picture is split between positive findings for SS schooling and no differences or null findings, with little support for CE schooling. The one study that found advantages for CE schooling found advantages for white females but not for Asian or black females. Males continue to be underrepresented in this realm of research.

Long-term, quantifiable academic accomplishment

As opposed to concurrent indicators of academic achievement, any positive effects of SS schooling on longer-term indicators of academic achievement are not readily apparent. No differences were found for postsecondary test scores, college graduation rates, or graduate school attendance rates. However, all the findings in this domain came from a pair of studies, indicating the lack of high-quality research on these important criteria. Although some studies favor single-sex education in the case of postsecondary test scores, there is a dearth of recent studies using controls. There has been a similar lack of research on other potential criteria in this domain, such as college grade point average, meritorious scholarships or funding attained, postgraduate licensure test scores, and any career achievement that could ostensibly be tied to quality of schooling.

Concurrent, quantifiable indicators of individual student adaptation and socioemotional development

This category includes a range of outcomes that are not easily grouped together, and the results are mixed. Regarding self-concept and locus of control, the studies are split between those showing positive effects for SS schooling and those showing no differences. In the case of self-esteem, a third of the studies supported CE schooling while half found no difference. Given a recent extensive review concluding that self-esteem's relationship to school success, occupational success, better relationships, leadership, delinquent behavior, and other desirable outcomes is modest to nonexistent, the implications of findings regarding self-esteem appear complementary. Furthermore, CE schooling only had a positive impact on the self-esteem of males.

Findings regarding school track and subject preferences were mixed, with the overall weight of the findings lying somewhere between pro-SS findings and no differences. A majority of studies favored SS schools on the outcome of higher educational aspirations, as evidenced by SS students showing more interest in and taking more difficult courses. SS schools fostered higher educational and career aspirations for girls. More studies emphasized the positive effect of SS schools on career aspirations than CE schools for boys, but evidence regarding their educational aspirations was mixed. A category called "attitudes toward school" showing mixed results was actually a combination of single studies using somewhat different outcome variables, thus reducing the meaningfulness of the category. In terms of actual behaviors, a few studies focused on delinquency, reporting differences in favor of SS schools that were moderated by individual developmental differences. What is lacking is a conceptual framework to tie together the myriad academic-attitude outcome measures used in this realm so that studies will be more directly comparable.

Long-term, quantifiable indicators of individual student adaptation and socioemotional development

The outcomes in this domain generally do not appear in more than one or two studies that made it to Phase III review. Therefore, one must be cautious in generalizing from these results. Having said that, the results still suggest the potential that SS schooling could be associated with a number of post-high school, long-term positive outcomes. These include postsecondary success or participation in collegiate activities while maintaining full-time enrollment for a four-year period, reduced unemployment (males and females), reduced propensity to drop out of high school (males and females), the choice of a nontraditional college major (for females), and political activism (for females). The sole exception is eating disorders; one study found more SS students to have eating disorders than CE students.

Procedural (e.g., classroom treatment) and outcome measures of gender inequity

This question could not be addressed because of a lack of any quantitative studies that used gender equity as an outcome variable at the school level. Any studies that compared SS and CE classrooms within a CE school were outside the purview of this study and were not reviewed.

Perceptual measures of the school climate or culture that may impact performance

This category includes a number of disparate, single-study results. One of the two studies addressing leadership opportunities found more opportunities for both males and females in SS schools; however, the statistical significance of this finding depended on what other variables had been controlled for. The other found that both males and females in SS schools put more value on grades and leadership and less on attractiveness and money. However, there remains a dearth of high-quality empirical studies using this class of outcome variables as criteria.

A final category of outcomes examined as a subset of culture was the realm of subjective satisfaction of students, parents, and teachers with the school environment. The one study in this review that found the social environment more appealing in CE schools is a good case in point in that the same study found that SS students are more interested in grades and leadership and less interested in money and looks. Some qualitative studies have looked at why certain parents prefer SS schooling, and studies in other cultures have found mixed results regarding teacher satisfaction with CE versus SS schooling. However, no empirical studies comparing current parental satisfaction in equivalent SS and CE schools were available for review using the stated guidelines. There remains a lack of research both on this class of criteria and on the relationship of subjective satisfaction to other more critical criteria.

Expected Outcomes Not Seen in the Review

Teenage pregnancy, college performance, differential treatment by teachers, parental satisfaction, bullying in school, and teacher satisfaction were among the many outcomes that we expected to see in the review or that should be addressed but were not found in any included study.

General Trends

A few trends are apparent across all outcomes. The preponderance of studies in areas such as academic accomplishment (both concurrent and long term) and adaptation or socioemotional development (both concurrent and long term) yields results lending support to SS schooling. A limited number of studies throughout the review provide evidence favoring CE schooling. It is more common to come across studies that report no differences between SS and CE schooling than to find outcomes with support for the superiority of CE. In terms of outcomes that may be of most interest to the primary stakeholders (students and their parents), such as academic achievement test scores, self-concept, and long-term indicators of success, there is a degree of support for SS schooling.

The overwhelming majority of studies employ high school students, with a small minority using elementary school students. The preponderance of SS research has been conducted in Catholic SS schools in which students are separated by sex only when entering adolescence. Therefore, opportunities to study SS elementary or middle schools in either the public or private sector have been limited.

There is also a pronounced tendency to study girls' schools more than boys' schools: 76 studies compared SS and CE girls, and 20 of those focused exclusively on girls. Of those 20, 18 were split evenly between support for SS schooling and no differences (nine pro-SS and nine no differences). The other two studies resulted in findings supporting CE schooling. SS and CE schooling for boys was compared in 55 studies, of which only three were studies exclusively devoted to boys' schools.

There is a dearth of quality studies (i.e., randomized experiments or correlational studies with adequate statistical controls) across all outcomes. Even using the more relaxed criterion of allowing correlational studies, each outcome has only limited candidate studies. Too few researchers report descriptive statistics or effect sizes. Mathematics achievement test scores, English achievement test scores, and school subject preference were the only outcomes to have 10 or more qualifying studies. Even within these three categories, the studies differ in the criteria they use and the statistical controls they use to compare SS and CE schooling. This somewhat limits the arguments that can be built and extended from this quantitative review and renders it nearly impossible to conduct a meta-analysis on any outcome area. Many of the remaining studies have other conceptual or interpretive flaws. Many of the studies lacked well-developed hypotheses, and the hypotheses were often not linked directly to the outcomes being studied.

The list of outcomes of interest needs to be expanded in future research and defined more clearly. For example, outcomes such as teenage pregnancy and bullying in school did not appear in a single study of sufficient quality to be reviewed. Other outcomes that are implicit in arguments for and against SS schooling need to be addressed explicitly. These include work-related long-term outcomes such as job performance, leadership performance, mixed-sex work team performance, performance and leadership in volunteer associations, job involvement, and organizational commitment. Few studies address important moderators, that is, variables that may have differential effects for single-sex schooling. For example, a number of authors have proposed that SS schools are particularly effective for students of lower socioeconomic status and perhaps specifically for those who are members of minority or disadvantaged communities. Unfortunately, only three studies addressed this moderator.

This review should not be interpreted as a condemnation of the work of the dedicated researchers who have chosen to study SS-CE differences, as they may not have been in a position to conduct a randomized experiment on this topic. Such a study has yet to be conducted. However, it could be argued that instead of trying to conduct only all-or-nothing studies of whether SS schooling is better or worse than CE schooling, more careful specification of hypotheses and direct linkage of hypotheses to specific outcomes may show ways to also conduct smaller studies that prove whether certain aspects of SS or CE schooling are beneficial.

Finally, there are limits to what a systematic review can accomplish when an intervention is being judged by multiple criteria and all stakeholders do not share the hierarchy of these criteria. Some issues cannot be resolved by any type of research, even randomized experiments, because they involve issues of philosophy and worldview and represent the relative priorities of dueling stakeholders. There is no way to resolve whether an outcome that is important to one stakeholder group, such as parents, students, civil libertarians, and feminists on both sides of the issue, should be accorded more weight than an outcome valued by another group. What is possible is to separate out fact in the form of evidence from fiction by converting as many claims as possible to testable hypotheses and performing the necessary research. In this way, the two parallel debates can be separated from each other. "Does SS schooling benefit or harm the students, and in what ways?" can be separated from "Is it worth it for society regardless of the benefits or costs?" with each debated on its own merits.

These general implications of the review provide a stepping-stone for future research through the continuation of quality research on extant outcomes, the refinement of methodology, better statistical reporting, and the expansion of the theoretical domain. If heeded, these implications can improve the generalizations made about single-sex schooling and coeducation.

How Do I Find... Student loans, forgiveness College accreditation Every Student Succeeds Act (ESSA) 1098, tax forms Information About... Transforming Teaching Family and Community Engagement Early Learning Student Loans Grants & Programs Laws & Guidance Data & Research Privacy Policy Accessibility Information quality Inspector General Whitehouse.gov Benefits.gov Regulations.gov Color Scheme Use system setting Light theme State superintendent challenged by three opponents in race to oversee public education Three challengers seek to head public education in Washington, vying for the role of superintendent of public instruction held by incumbent Chris Reykdal since 2017. The elected state superintendent position pays around $166,000 yearly and the term lasts four years. It is a nonpartisan position. Reykdal has served two terms, tasked with overseeing state public school budgets and K-12 educational policies at the Legislative level. He’s proud to have made strides in early learning, free meal access and graduation rates that he hopes will spur voters to select him for a third term. Reykdal said his eight years as superintendent of public instruction, time as a state Legislator, a school board member and teacher give him a nuanced perspective with which to guide public education, or “the greatest tool of democracy we’ve ever created,” as he called it. “We grow this idea that together every child has this democratic opportunity to accelerate,” Reykdal said. “We invest even more if you’re high poverty, if you have a disability, if you have a nutritional need, so we also lean into the progressive idea that some students need a little bit more, but doing it together is what makes it public.” Reykdal isn’t the only name on the ballot with experience; each of his challengers also work in public education roles. Challenger Reid Saaris is a former teacher, substitute and founder of nonprofit Equal Opportunity Schools that consults with districts on how to bridge “opportunity gaps” and ensure challenging classwork is available for kids of all backgrounds, he said. He seeks to apply his 10 years leading his nonprofit in advancing equity to leading state education, coordinating with schools who’ve seen success in different areas, like college or career readiness to mirror the successes across the state. “We’re not doing a great job of matching people with careers or post secondary opportunities, and there’s places within the states that are very successful with this work, but it’s just not systemic,” he said. “That’s back to my core motivation in my whole career, how do we make these things work consistently for kids from all backgrounds and all parts of the state?” State Republican party-endorsed candidate David Olson has sat on the board of the Peninsula School District in Gig Harbor for more than a decade. He said he’s seen students perform poorly over time in areas like math, reading and science. Under Reykdal’s leadership, he said school districts have lost much of their local control through state-level mandates. “The current superintendent over the past five or six years has not been super friendly to school boards,” Olson said. “He’s sort of telling us, ‘It’s my way or the highway, if you don’t do this, I’m gonna take your state funding.’ ” Libertarian-leaning candidate John Patterson Blair’s experience lies in teaching, curriculum development and four years on the Vashon Island School Board. It’s also his fifth run for the state superintendent position, but not because he wants the job, he said. “In fact, as I jokingly have told friends, the first thing I would do if I won was demand a recount,” he said. “My goal is to just put out an idea and so people are aware of it.” Blair’s campaign is based entirely around his proposed “new foundation” in the schooling system where each student receives a trust account with the amount the state would pay for their education based on their apportionment in state’s funding model. Last year, the state paid an average $18,000 per pupil, with different allocations if a student was in special education or low income, for example. Their parents could then use this trust to pay tuition at a registered school of their choice, allowing for more freedom in their child’s schooling, whether it be home-school, a project-based alternative school or a public school. “There’s a real advantage to studying on your own,” Blair said. “Say you want to do violin, you hire a violin teacher for an hour or two a week at 200 bucks an hour, and you’re getting really great training. The idea is to give individuals control and they aren’t penalized for failure.” His plan also includes districts with locally elected advisers to oversee progress of students in their neighborhoods and one to maintain facilities. Here’s where each of the candidates stand on other issues facing education. On state funding Education consistently receives the largest apportionment from the state budget, with around 1.1 million students enrolled in Washington public schools. Candidates differed on how they would urge lawmakers to direct these funds. All six bonds on August ballots failed in Spokane County last year; some regional levies also failed. Freeman’s capital levy, intended to pay for construction and technology, failed twice, in August and February. Moses Lake School District’s educational programs and operations levy failed twice , resulting in upcoming staffing reductions and extracurricular cuts. Olson said the state fails to fund public education sufficiently, eyeing transportation needs and “unfair” models that put too much burden on local property taxes to fund schools through levies and bonds. Taxpayers in rural districts with less property value than larger districts, like Seattle, end up having to pay more toward their schools, he said. As such, these districts struggle to pass levies and bonds. Levies are used to pay for student needs beyond basic education and bonds for school construction needs. “I want to make sure that we’re being fair and that school districts that are having a tough time passing their levies and bonds, what can we do to help them?” he said. If elected, he said he’d solicit advice from a team of financial experts and completely reimagine funding formulas and urge the Legislature to implement his findings. Bonds, which authorize districts to borrow money to pay for major construction, require 60% voter support to pass, while levies need a simple majority. Reykdal said he supports a bond threshold reduction to a simple majority and would continue advocating to lower the “undemocratic” threshold. Reykdal said the state’s funding formula hasn’t kept up with inflation and estimates schools need an additional $1 billion, at least. He advocates for funding adjustments in formulas that fund transportation, school construction and special education. While state allocations for special education have increased during his terms, he said many school districts are supplementing special education through levy taxes, contrary to the state’s obligation to fund basic education. He estimates an additional $400-$500 million in special education investments are needed. “The places we have to really double down on are all those wrap-around supports for kids,” Reykdal said. “Things that aren’t necessarily obviously in the classroom, but they really make for successful students: mental health, physical safety, nutrition.” Mental health improvement is a priority in Saaris’ campaign, he cited declining mental health in youths and plans to address the state comprehensively with universal access to mental healthcare for students. “We had a mental health crisis and it was declared a state of emergency, the mental health of adolescents and we are having real challenges around academics. So to me, the opportunity for leadership at OSPI is to really be that thought partner with folks.” Saaris said there are gaps in Washington’s education funding formula that create disparities between high poverty districts and their more affluent counterparts. He looked to other states that have revamped funding formulas and proposed funneling 30% more resources into schools with more low-income students. Blair’s proposal provides for parents’ independence in how their apportionment is spent, but doesn’t alter the formula that allots more dollars to some students, like those in special education or low income. Chronic absenteeism The rate of regular attendance has plummeted across the nation emerging from pandemic-era school closures. A chronically absent student is one who missed at least 10% of the school year for any reason, averaging out to two days absent per month. In Washington, the proportion of chronically absent students doubled from 15% to 30% between the 2018-19 school year, the last full one before the pandemic, and 2022-23, the latest year with available data. Students suffer academically when they miss class, Olson said, especially in advanced math classes. His school district is above the state average in regular attendance by about 7%, to which he credits schools engaging parents to determine the underlying causes of absent students, perhaps illness or social or academic stressors. He’d advise districts to start with similar inquiries with families. “I’d like to know, working with parents as much as they’re able to work with the school district, to find out what’s the cause of the absentee kid and try and get them to be back in school,” he said. Blair similarly advocated for starting by asking students why they miss school. He reasoned many families are removing students from school in favor of homeschooling. To bring kids back to the classroom, Saaris proposed enticing them with engaging schoolwork and opportunities for connection to school. He referenced phones and social media contributing to disengagement. Teachers fight an uphill battle for their students’ attention against tech giants whose algorithms are designed to distract, he said. If elected, Saaris said he would partner with the governor and state attorney general and the trio of office newbies could collaborate to restrict social media use for kids, enforcing age minimums for using social media. “Part of it is probably related to the purview of the attorney general and others to say, ‘You know, we really need to hold companies responsible for following the law on these things,’ ” Saaris said. “Then schools can support parents and students in awareness and age verification in ways that are privacy protected,” he said. Reykdal said attendance has been improving post-pandemic, crediting school districts that intervene early when they notice early attendance patterns. He said parents are increasingly excusing their students for illness-related reasons, something he expects to persist especially as new COVID variants develop. “As long as we have a virus that’s knocking people out, you’re gonna see slightly elevated absences compared to pre-pandemic, but it is improving,” he said. Sex education Reykdal and Saaris said they supported the current system surrounding sex education that provides districts to select their own curriculum as long as it’s in line with state policy and OSPI learning standards. Olson said he’d advocate for an “opt-in” approach to sex education where parents deliberately select the class for their student, rather than the current approach that allows parents to opt their child out. The opt-out option applies to any curriculum. Parents can easily miss opt-out notifications, he said. A change in model would prevent a situation in which a student receives a lesson their parent disapproves of. “They’re busy and they come home, maybe they missed the email from the school district or the backpack note or whatever that says their kid’s going to have a curriculum and they miss the opportunity to opt out,” Olson said. While he’s not sure exactly how it would work, Blair idealized a more personalized approach to sex education where parents could select from different curriculum options for their child. “This is a libertarian idea that the individual family should have this say of what goes on with their kid,” Blair said. Saaris, who has racked up the most campaign contributions and spent the most, is endorsed by the Seattle Times and Mike Wiser, Spokane Public School board member, according to his campaign website . Incumbent Reykdal has the endorsements of the state teacher’s union, the Washington Education Association; and Spokane County Democrats. Spokane-area Legislators Marcus Riccelli, Andy Billig and Timm Ormsby support Reykdal, according to his website . The state Republican Party endorsed Olson, as did Central Valley School School Board members Pam Orebaugh and Anniece Barker and Mead School Board members Jennifer Killman and Michael Cannon, according to his website . Unleashing the power of career readiness programs As the new school year begins, local juniors and seniors in the Greater Spokane area find themselves standing at the precipice of their future. Election 2024 Entertainment Photography AP Buyline Personal Finance AP Buyline Shopping Press Releases Israel-Hamas War Russia-Ukraine War Global elections Asia Pacific Latin America Middle East Election Results Delegate Tracker AP & Elections Auto Racing 2024 Paris Olympic Games Movie reviews Book reviews Financial Markets Business Highlights Financial wellness Artificial Intelligence Social Media California is 1st state to ban school rules requiring parents get notified of child’s pronoun change FILE - Parents, students, and staff of Chino Valley Unified School District hold up signs in favor of protecting LGBTQ+ policies at Don Antonio Lugo High School, in Chino, Calif., June 15, 2023. California Gov. Gavin Newsom signed a law Monday, July 15, 2024, barring school districts from passing policies that require schools to notify parents if their child asks to change their gender identification. (Anjali Sharif-Paul/The Orange County Register via AP, File) Copy Link copied SACRAMENTO, Calif. (AP) — California became the first U.S. state to bar school districts from requiring staff to notify parents of their child’s gender identification change under a law signed Monday by Gov. Gavin Newsom. The law bans school rules requiring teachers and other staff to disclose a student’s gender identity or sexual orientation to any other person without the child’s permission. Proponents of the legislation say it will help protect LGBTQ+ students who live in unwelcoming households. But opponents say it will hinder schools’ ability to be more transparent with parents. The legislation comes amid a nationwide debate over local school districts and the rights of parents and LGBTQ+ students. “This law helps keep children safe while protecting the critical role of parents,” Brandon Richards, a spokesperson for Newsom, said in a statement. “It protects the child-parent relationship by preventing politicians and school staff from inappropriately intervening in family matters and attempting to control if, when, and how families have deeply personal conversations.” The new law comes after several school districts in California passed policies requiring that parents be notified if a child requests to change their gender identification. That led to pushback by Democratic state officials , who say students have a right to privacy. But Jonathan Zachreson, an advocate in California who supports the so-called parental notification policies , opposes the law and said telling parents about a student’s request to change their gender identification is “critical to the well-being of children and for maintaining that trust between schools and parents.” States across the country have sought to impose bans on gender-affirming care , bar transgender athletes from girls’ and women’s sports, and require schools to out trans and nonbinary students to their parents. Some lawmakers in other states have introduced bills with broad language requiring that parents are told of any changes to their child’s emotional health or well-being. The California law led to heated debate in the state Legislature. LGBTQ+ lawmakers have shared stories about how it was difficult for them to decide when to come out to their families, arguing that transgender students should be able to share that part of their identity on their own terms. State Assemblymember Bill Essayli, a Republican representing part of Riverside County, is an outspoken opponent of the law. He has criticized Democratic leaders for preventing a bill he introduced last year — that would have required parents to be told of their child’s gender identification change — from receiving a hearing. In Northern California, the Anderson Union High School District board approved a parental notification policy last year. But the teachers union recommended that teachers not enforce the rule while the union is involved in a labor dispute with the district over the policy, said Shaye Stephens, an English teacher and president of the teachers association at the district. The notification policies put teachers in an unfair position, Stephens said. “It’s kind of a lose-lose situation for teachers and administrators or anybody that’s being asked to do this. I don’t think it’s safe for students,” she said. “I do not think that we are the right people to be having those conversations with a parent or a guardian.” Austin is a corps member for The Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Austin on X: @sophieadanna California becomes first state to ban forced outing of LGBTQ+ students According to the progressive think tank the movement advancement project, eight states, including idaho and north dakota, legally force the outing of transgender youth in schools.. California Gov. Gavin Newsom, a Democrat, signed a first-of-its-kind state law Monday aimed at protecting LGBTQ+ students from having their sexual orientation, gender identity or gender expression revealed by schools without consent. The SAFETY Act prohibits schools from enforcing policies that forcibly out a student and shields teachers and other school staff from retaliation if they refuse to obey such policies.  The new law makes California the first state to ban outing policies, according to the California Legislative LGBTQ Caucus. Chris Ward, a San Diego Democrat who first introduced the bill in the California Legislature, said in a statement Monday that the SAFETY Act combats a rise in politically motivated attacks on queer and transgender students nationwide.  "While some school districts have adopted policies to forcibly out students, the SAFETY Act ensures that discussions about gender identity remain a private matter within the family,” Ward said. “As a parent, I urge all parents to talk to their children, listen to them, and love them unconditionally for who they are." The law’s enactment came nearly a year after Tony Thurmond, the state superintendent of public instruction, said he was forcibly removed from a local school board meeting where he was opposing a district's proposed outing policy, which was eventually blocked in court .  “Our teachers can now focus on teaching the critical academic skills that our students need to succeed, not on policing the gender identities of children,” Thurmond said in a statement Monday.  According to the progressive think tank the Movement Advancement Project, eight states, including Idaho and North Dakota, legally force the outing of transgender youth in schools. Five others, including Florida and Kentucky, promote the practice, though it’s not required.  Zachary Schermele covers education and breaking news for   USA TODAY. You can reach him by email at [email protected]. Follow him on X at @ZachSchermele . Politics | New California law prohibits schools from… Share this:. Click to share on Facebook (Opens in new window) Click to share on Twitter (Opens in new window) Click to share on Reddit (Opens in new window) Click to print (Opens in new window) Investigative Reporting Environment Politics | New California law prohibits schools from disclosing students’ gender identities without consent Gov. Gavin Newsom signed into law a bill that prohibits districts from enacting what’s been dubbed parental notification policies, requirements for school employees to disclose information related to a student’s sexual orientation, gender identity or gender expression without the student’s consent. With this decision, California became the first state in the nation to prohibit these types of mandates, commonly referred to as “outing policies.” The newly approved legislation, known as the “Support Academic Futures and Educators for Today’s Youth Act,” or “SAFETY Act,” will take effect on Jan. 1, 2025. Assemblymember Chris Ward, D-San Diego, said the signage of this bill is a “significant step forward in ensuring that all students, regardless of their gender identity, have a supportive and safe environment to learn and grow.” “Politically motivated attacks on the rights, safety and dignity of transgender, nonbinary and other LGBTQ+ youth are on the rise nationwide, including in California,” said Ward, who authored the bill. “While some school districts have adopted policies to forcibly out students, the SAFETY Act ensures that discussions about gender identity remain a private matter within the family. As a parent, I urge all parents to talk to their children, listen to them and love them unconditionally for who they are.” Several districts in California, including in Orange and Riverside counties, enacted versions of a parental notification policy in the past year. “Teachers should not be the gender police and violate the trust and safety of the students in their classrooms,” said Ward, who identifies as LGBTQ+. “Parents should be talking to their children, and the decision for a student to come out to their family members should be on their own terms.” Hate crimes against the LGBTQ+ community in California increased 86.4% last year, from 81 in 2022 to 151 in 2023, according to data from the state Department of Justice. Republicans in the state legislature opposed the bill, saying parents should be involved in every aspect of their student’s lives. Assemblymember Bill Essayli, R-Corona, one of the most ardent critics of the bill, said it “defied parents’ constitutional and God-given right to raise their children.” “AB 1955 endangers children by excluding parents from important matters impacting their child’s health and welfare at school,” Essayli said. As the Assembly was preparing to vote on the bill last month, Essayli was part of a kerfuffle with Assemblymember Corey Jackson , D-Perris. Essayli had his mic cut during his floor comments but still said remarks that angered Jackson. The Perris Democrat had to be physically restrained by his colleagues. Legislators formed a wall between Essayli and Jackson for the rest of the debate on the bill. The bill’s signage also drew the attention of Elon Musk, CEO of Tesla and owner of various companies including X (formerly Twitter) and spacecraft manufacturer SpaceX. “This is the final straw,” Musk said in a tweet , vowing to move SpaceX’s headquarters from Hawthorne to Starbase, Texas. “I did make it clear to Governor Newsom about a year ago that laws of this nature would force families and companies to leave California to protect their children,” he added. The bill also directs the California Department of Education to develop new resources or update existing ones to support parents, guardians and families of LGBTQ+ students. What does this mean for districts that have already adopted the policy? Once it becomes law early next year, school districts that have already implemented such policies are prohibited from enforcing them. Chino Valley Unified School District was one of the first in California to adopt such a policy in July 2023. The original policy required notifying parents within three days if their child requested changes related to their gender identity, such as using a different name or pronoun or accessing sex-segregated facilities not aligned with their biological sex listed on official records. Attorney General Rob Bonta sued the district , and a judge halted the policy . CVUSD revised the policy to say parents are only notified when there’s a request to change official records. It no longer specifies gender-related matters or pronouns. The new law is an “egregious attack on the constitutional rights of parents and the raising of their children,” said Sonja Shaw, CVUSD’s board president. “This legislation weaponizes the system against those who know and care for their children the most,” Shaw said. “This legislation prevents parents from exercising their rights as legal guardians. Every parent is now aware of this betrayal and will rise to challenge it.” The district plans to sue to challenge the new law, said attorneys with the Liberty Justice Center, a public-interest law firm based in Texas, which is representing the district. Meanwhile, Orange Unified School District adopted a policy in September 2023 requiring school employees and principals to inform parents if their child, who is under the age of 12, requests to use a different name or pronounces or asks to change sex-segregated programs. If the student is older, it is up to the discretion of a school counselor or psychologist to decide if it is appropriate to report the information to the family. In accordance with AB 1955, OUSD is “reviewing current board policies and practices” and will “recommend to the Orange Unified Board of Education any necessary modifications to policies in order to be compliant with the law,” Superintendent Ernie Gonzalez said. Temecula Valley Unified and Murrieta Valley Unified also adopted similar policies last year. Placentia-Yorba Linda Unified’s policy said it is focused on mental health. A designated school counselor must notify a student’s family “when they have reasonable cause to believe that doing so will avert a clear and present danger to the health, safety or welfare” of students, it says. The policy does not include any language related to LGBTQ+ or gender expression. However, Superintendent Alex Cherniss said during a board discussion about the policy that there could be instances when a teacher or school staff member would notify parents when they become aware that a student desires or starts to transition genders, requests to go by a different pronoun or experiences distress because their gender expression does not match their gender identity. Cherniss said the district will not be changing its policy once the new law is in place. “As usual, our district was incorrectly labeled and assigned to a specific political agenda which carries with it this ridiculous assumption that we require gender parental notification,” said Cherniss. “This couldn’t be further from the truth.” LGBTQ+ activists praise the new law Proponents of the bill say this legislation aids in students’ safety, both inside and outside the classroom. “Today marks a significant step in ensuring California’s LGBTQ+ youth can thrive in supportive and safe learning environments,” said Brock Cavett, advocacy director of Riverside Pride. “We’re delighted that Gov. Newsom signed this critical legislation and extend our deepest gratitude to the legislators, advocates and citizens that worked to pass these vital protections for trans youth, from forced outing policies.” Gabriel Maldonado, CEO and founder of TruEvolution, which advocates for health equity for LGBTQ+ people, said the new law will be “vital to ensuring that LGBTQ+ students can feel safe at school.” “This vital legislation affirms the rights and dignity of LGBTQ+ youth, particularly in the Inland Empire where forced outing policies have been disproportionately enacted,” said Maldonado. “We have witnessed firsthand the profound harm forced outing policies have caused, especially to transgender youth.” The bill also had support from State State Superintendent of Public Instruction Tony Thurmond, who called it a “major step forward for the rights of students and families.” “All of our students deserve to be safe at school in order to learn and thrive,” Thurmond, who is running for governor in 2026, said. “Our LGBTQ+ youth need to be protected from bullying and harassment at school, and the families of our LGBTQ+ youth deserve privacy and dignity to handle deeply personal matters at home, without the forced intervention of school employees.” “Our teachers can now focus on teaching the critical academic skills that our students need to succeed, not on policing the gender identities of children.” Newsroom Guidelines Report an Error More in Politics California News | Ex-Trump adviser Navarro released from prison, headed to RNC Politics | Rep. Adam Schiff calls on Biden to drop out of race, says ‘it’s time to pass the torch’ National Politics | The stepped-up security around Trump is apparent, with agents walling him off from RNC crowds National Politics | Biden plans to propose Supreme Court reforms, including term limits More From Forbes What does project 2025 actually plan for education. Share to Facebook Share to Twitter Share to Linkedin Here's a hint. Word has spread about Project 2025 and its Mandate for Leadership: The Conservative Promise , some of it accurate, some of it not. That’s not surprising; nobody really wants to read an entire 900-page policy document, and some of that document hints at more than it explicitly says. What does the document actually have to say about education? Let’s take a deep breath and read carefully. Education in the Foreword Some of the broadest promises are laid out by Kevin Roberts (Heritage Foundation) in the foreword, where the first promise is to “restore the family as the centerpiece of American life and protect our children.” Roberts calls for “deleting” a list of terms starting with “sexual orientation and gender identity” as well as “diversity, equity and inclusion,” “reproductive rights,” and a host of similar terms. It’s not clear how he proposes that “deleting” would occur, but through the 900 pages it becomes clear that the federal government would stop using them. Roberts also calls for the criminalization of pornography and the imprisonment of any person who produce and distribute it; “Educators and public librarians who purvey it should be classed as registered sex offenders.” No specific definition of pornography is included. BlackRock CEO Issues ‘Massive’ Warning After Crypto Flip That Powered A Bitcoin, Ethereum And XRP Price Boom Ingrid andress’ national anthem at 2024 home run derby draws criticism online, trump signs posted outside attempted assassin’s home, neighbors say: what we know about thomas matthew crooks. Roberts demands that “parents’ rights” are non-negotiable and that “States, cities and counties, school boards, union bosses, principals, and teachers who disagree should be immediately cut off from federal funds.” He declares “parental authority” central to policy, and in that context makes the call for vouchers clear, calling it “a goal all conservatives and conservative Presidents must pursue.” The Chapter on Education The education chapter was written by Lindsey Burke , chief of the Heritage Center’s Center for Education Policy. She’s also works at EdChoice, a school choice advocacy group formerly named after Milton Friedman, and she was part of Governor Glenn Youngkin’s transition team in 2021. Burke leads off with some broad goals, including the elimination of the Department of Education and the goal that “families and students should be free to choose from a diverse set of school options and learning environments.” She salutes Friedman’s ideal, with education publicly funded but “education decisions are made by families.” She points to state leadership where the “future of education freedom and reform is bright and will shine brighter when regulations and red tape from Washington are eliminated.” Federal money comes with federal rules and regulations attached. Burke proposes that federal dollars come to the states as block grants with no rules or regulations attached. She nods to the characterization of the department that runs through the whole document—a department born of a deal between Jimmy Carter and the National Education Association, attractive because it gave certain people a way to extend their influence via federal power and “continuously expand federal expenditures.” The federal education infrastructure has been “[b]olstered by an ever-growing cabal of special interests that thrive off federal largesse.” Burke proposes several core principles to guide the next administration. Advancing education freedom. The administration could give more families more options by way of “portability of existing federal education spending to fund families.” In other words, take the money DC sends to the states and distribute it to families as vouchers. Burke suggests federal tax credit scholarships, the same voucher program unsuccessfully pushed by Betsy DeVos during her tenure as education secretary. Burke also notes that the federal government could immediately put universal vouchers in place for “federal” children (i.e. military families, DC residents, and members of sovereign tribes. Turn federal funding into grants to the states “over which they have full control.” Let the states use the funds for “any lawful educational purpose,” regardless of what the original federal intent might have been. College loans should be handled by private lenders and treated as investments. Students should pay the loans back, and politicians must not be allowed to interfere just to score some political points. Civil rights must be safeguarded, which in this case means rights “based on a proper understanding of those laws, rejecting gender ideology and critical race theory.” Policy should be set by Congress, and neither the President (through executive orders) nor agencies (through regulation and guidance). Burke also suggests some reforms. She wants to address administrative “bloat,” arguing that the federal Department of Education has spawned a “shadow” department of state-level education employees through the “labyrinthian nature of federal education programs.” She calls for a Department of Education Reorganization Act to “reform, eliminate, or move” programs. (That name calls back to the Department of Education Organization Act that established the department.) Title I is the program that sends federal dollars to buttress lower-income school districts. Burke recommends that these dollars to be turned into block grants that the states should use to fund vouchers. By the end of the decade, the federal program should be eliminated and “states should assume decision-making control over how to provide a quality education to children from low-income families.” In other words, Title I would disappear and states would have to figure out how to replace the funding and pick up the slack themselves. Individual with Disabilities Education Act (IDEA) funds, like Title I funding, should become a no-strings block grant to states. IDEA is supposed to cover 40% of states’ special education costs. The various offices of the departments should either be eliminated or be moved into a different department. For instance, the department’s Office of Civil Rights should have its work moved to the Department of Justice. Burke also has a list of rules and regulations that she wants to see eliminated. The Biden administration tightened the rules for giving grants to charter schools; Burke would like to reverse that. She would like the Office of Civil Rights to stop collecting gender data that includes “nonbinary” as a category. She would like to undo loan forgiveness. And while the Biden changes to Title IX hadn’t taken place yet when this document was written, Burke wanted to roll back what changes had started to recognize anything other than gender as anything other than gender at birth. The Project also wants to undo the shift in Title VI that looked at school discipline for “disparate impact” (i.e. considering if a school disproportionately punished minority students). Burke characterizes school meal programs as “some of the most wasteful federal programs in Washington.” But she especially objects to the feds withholding those funds from schools that insist on holding to “gender at birth” rather than “sexual orientation and gender identity” language. Other recommendations. Burke calls on Congress to rescind the National Education Association’s charter, and members should hold hearings to see how much federal taxpayer money the NEA has used for radical causes. And she has a whole assortment of recommendations for keeping critical race theory out of classrooms. Burke argues that parental rights are treated as “second-tier,” and she would like to see them legislated into a “top-tier” position with rights like free speech and free exercise of religion. Every proposed rule should undergo strict scrutiny to make sure it doesn’t infringe on parental rights. Burke calls for a private right of action, so that parents who think institutions have violated their rights may sue. She recommends a federal law similar to those already passed in some states such as Florida and Oklahoma. Federal law should require school staff to out LGBTQ students to their parents, and no school staff should be allowed to address a student by anything other than the gender and name on their birth certificate without parental approval. However, if staff member objects, those parents do not have the right to insist their child be addressed by their chosen name or gender. No mention here of students’ rights. States should be free to opt out of any federal education program, but still collect the funds as a grant they can use as they please. Outside the chapter. In the chapter for the Department of Defense, there is a proposal that all students in schools that receive federal funding be required to take the Armed Services Vocational Aptitude Battery; this to improve recruiter “access” to candidates. The Department of Agriculture chapter advocates for making it harder for schools to qualify for free school meals, and resist attempts to create universal free meal programs. So what do we have here. There are several major threads when it comes to K-12 education. Vouchers, vouchers, vouchers. Eliminate the federal Department of Education, and turn the money for Title I and IDEA into block grants that states can use for anything education-adjacent (but Heritage is hoping it will be for vouchers), with Title I ending within a decade. That is no small potatoes. In 2022, Title I amounted to over $16 billion . IDEA is underfunded according to the targets set by law, but it still accounts for roughly $13 billion . Project 2025 is also deeply concerned about LGBTQ issues as well as other culture war issues. In discussion of virtually all issues, they make certain to demand an end to so much as mentioning Certain Terms. Project 2025 is deeply committed to reinforcing the traditional nuclear family and a government that treats that family as the only proper way to live. Such policies would have large implications for a public school system that is unavoidably diverse. Heritage published their first Mandate for Leadership in 1981 and has made many similar attempts since ; this is the 9th edition. If implemented, it would visit considerable disruption to our public education system, which is, of course, the point. We will have to wait another six months to see if ninth time’s a charm. Editorial Standards Reprints & Permissions Join The Conversation One Community. 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Please read the full list of posting rules found in our site's  Terms of Service. 302 IMAGES 21+ Pros and Cons of Sex Education (explained) Reasons Why Sex Education is Important and should be Taught in Schools How Should Sex Education Be Taught in Schools? by Hal Marcovitz Shaping A Future: Pros and Cons of Sex Education in Schools Sex Education in Schools: Here's What Your Kid Is Learning The Right to a Comprehensive Sex Education COMMENTS School-based Sex Education in the U.S. at a Crossroads: Taking the School-based sex education in the U.S. is at a crossroads. The United Nations defines sex education as a curriculum-based process of teaching and learning about the cognitive, emotional, physical, and social aspects of sexuality [1]. Over many years, sex education has had strong support among both parents [2] and health professionals [3-6], yet the receipt of sex education among U.S ... Three Decades of Research: The Case for Comprehensive Sex Education School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education. Sex Education in the Spotlight: What Is Working? Systematic Review This study represents the first review of reviews, as far as we are aware, in which the effectiveness of sex education programs in different settings (school-based, digital and blended learning) is evaluated, using a rich methodology and providing interesting conclusions. Three Decades of Research: The Case for Comprehensive Sex Education This review summarizes the evidence for comprehensive sex education from three decades of research and highlights the benefits for sexual health and well-being. Sex Education in School, are Gender and Sexual Minority Youth Included The purpose of this review was to examine sexual health education programs in schools in the United States for the inclusion of information on gender identity and sexual orientation. The review provides information on current programs offered in schools and suggestions to make them more inclusive to gender and sexual minority youth. Full article: Assessing the role of school-based sex education in School-based sex education interventions can be effective in promoting positive sexual health behaviours. The findings of this review provide understanding of such interventions in shaping sexual health behaviours. These also offer evidence-based knowledge for researchers, educators and policy makers in understanding how they can support future development of school-based sex education programmes. Re-Examining the Evidence for School-Based Comprehensive Sex Education Purpose: To evaluate the global research on school-based comprehensive sex education (CSE) by applying rigorous and meaningful criteria to outcomes of credible studies in order to identify evidence of real program effectiveness. Methods: We examined 120 studies of school-based sex education contained in the reviews of research sponsored by ... Three decades of research: The case for comprehensive sex education Abstract. Purpose: School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based ... What else can sex education do? Logics and effects in classroom This article contributes to understanding sexuality education beyond health effects or critique, through exploring sex education in school spaces. It does so through analysing sex education in practice in classrooms, in the Netherlands, a country that is often ascribed a guiding role in issues of youth sexuality ( Naezer et al., 2017 ). The effectiveness of school-based sex education programs in the This review presents the findings from controlled school-based sex education interventions published in the last 15 years in the US. The effects of the interventions in promoting abstinent behavior reported in 12 controlled studies were included in the meta-analysis. A Systematic Review of the Provision of Sexuality Education to Student An international qualitative review of studies which report on the views of students and experts/professionals working in the field of SE ( Pound et al., 2017) provides recommendations for effective SE provision. According to that review, effective SE provision should include: The adoption of a "sex positive," culturally sensitive approach; education that reflects sexual and relationship ... Comprehensive Sex Education—Why Should We Care? Comprehensive sex education (CSE) is preferred over abstinence-only sex education for obvious reasons. CSE is much more than just "how we have babies" and "birth control"; it focuses on healthy decision-making, respect for the opposite gender, safe sex, ability to consent, and sexual rights. The United Nations Educational, Scientific ... The State of Sex Education in the United States At the state level, individual states, districts, and school boards determine implementation of federal policies and funds. Limited in-class time and resources leave schools to prioritize sex education in competition with academic subjects and other important health topics such as substance use, bullying, and suicide [ 4, 13, 14 ]. The Role of Policy on Sexual Health Education in Schools: Review The purpose of this review was to examine the role of policy on sexual health education, which can have an impact on the health and well-being of adolescents. The review provides school nurses with information to help them educate parents and administrators to the negative repercussions of AOE, so they can advocate for policy change. New research: Quality sex education has broad, long-term benefits for The paper found that sex education efforts can also succeed in classrooms outside of the health education curriculum. Given that most schools have limited time allotted to health or sex education, a coordinated and concerted effort to teach and reinforce important sexual health concepts throughout other areas of the curriculum is a promising strategy. UNESCO The UNESCO International Technical Guidance on Sexuality Education provides an evidence-informed approach to sexuality education. Comprehensive Sex Education as Violence Prevention Sex education also teaches gender equality from a young age, thereby reducing risk for gender-based violence. Comprehensive sex education offers robust curricula on bullying prevention. People bully for many reasons, including low self-esteem, emotional neglect, and some bullies may be victims of violence themselves. PDF Pros and Cons of Sex Education in School Children: Review Sex education is commonly taught in high school health classes or guidance programs. Education on sexuality is controversial because some parents and educators believe it's up to parents to teach kids on this subject. Additionally, debate around sex education centers on the approaches to teaching including abstinence-only, preventative or health-centered coaching [6]. Studies have shown that ... Three Decades of Research: The Case for Comprehensive Sex Education School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education. Federally Funded Sex Education: Strengthening and Expanding Evidence Unfortunately, just 30 states and the District of Columbia require sex education to be taught in schools, and fewer states require that the school curricula include key sex education topics or even medically accurate information. The federal government also wastes $110 million per year on misleading and harmful programs that only cover abstinence. Summary State Policies on Sex Education in Schools All states are somehow involved in sex education for public schoolchildren. As of October 1, 2020: Thirty states and the District of Columbia require public schools teach sex education, 28 of which mandate both sex education and HIV education. PDF Importance of sex education in schools: literature review Sex education in high schools helps young people to be more prepared for life changes such as puberty, menopause and aging. Sex education can develop skills and self-esteem to help students enter adolescence. It helps them in knowing that the sudden few changes are okay and normal. Single-Sex Versus Coeducation Schooling: A Systematic Review Executive Summary. Single-sex education refers most generally to education at the elementary, secondary, or postsecondary level in which males or females attend school exclusively with members of their own sex. This report deals primarily with single-sex education at the elementary and secondary levels. Research in the United States on the ... House passes measure to block Biden's Title IX rule House Republicans passed a measure Thursday that would bar the Biden administration from enacting new standards for sex-based misconduct in schools. State superintendent challenged by three ... Three challengers seek to head public education in Washington, vying for the role of superintendent of public instruction held by incumbent Chris Reykdal since 2017. California is 1st state to ban school rules requiring parents get California Gov. Gavin Newsom has signed a law barring school districts from passing policies requiring schools to notify parents if their child asks to change their gender identification. California bans forced outing of LGBTQ+ students, in a first for US California Gov. Gavin Newsom, a Democrat, signed a first-of-its-kind state law Monday preventing schools from enacting forced outing policies. A Scoping Review of School-Based Sexuality Education for Children With Individuals with disabilities often have limited access to school-based sexuality education (SE). This scoping review identified the characteristics of school-based SE intervention programs implemented for students with disabilities. New California law prohibits schools from disclosing students' gender The bill also directs the California Department of Education to develop new resources or update existing ones to support parents, guardians and families of LGBTQ+ students. What Does Project 2025 Actually Plan For Education? The Department of Agriculture chapter advocates for making it harder for schools to qualify for free school meals, and resist attempts to create universal free meal programs. So what do we have here. assignment essay homework phd report resume review speech thesis