1. Professor and Chair, Dept of Urban-Global Public Health
Sex Education
Leslie M. Kantor, PhD, MPH
Professor and Chair, Dept of Urban-Global Public Health
May 5, 2019
@LeslieKantor

2. Sex Education Defined
Sex Education in high quality teaching and learning about a broad variety of topics related to sex and sexuality, exploring values and beliefs about those topics and gaining the skills that are needed to navigate relationships and manage one’s own sexual health.
Sex Education in the United States

3. Key Concepts in Sex Education
Sexual Behavior
Human Development
Relationships
Personal Skills
Sexual Health
Society & Culture
Sex Education in the United States

4. Topic Examples Reproduction Body Image Gender Identity Friendships
Communication
Abstinence
Contraception
Decision-Making
Sex Education in the United States

5. Characteristics of Effective Programs
Experiential learning;
Theories of behavior change;
Taught by trained teachers.
Sex Education in the United States

6. Federal Policy on Sex Education

7. Mandates are mainly at the state level -- some cities/districts have established policies.
At the federal level there is some funding for evidence-based teen pregnancy prevention.

8. Sex Education Guidance
Almost every state provides some guidance around sex education
Mandates: Sex education must be taught.
Content Requirements: If sex education is taught, then it must/must not address certain topics.

9. Sex Education Mandates
24 States + DC

10. HIV Education Mandates
33 States + DC
Mandate
No Mandate

12. Not All Mandates are Created Equal
Utah Mandate
California Mandate
Must cover abstinence
Requires information on contraception and condoms
All information about sexual orientation and gender identity/expression must be affirming and inclusive
Must stress abstinence
Must stress the importance of sex only within the context of marriage
Does not require information on contraception or condoms

13. What Schools Provide & What Young People Receive

14. School-based sex education
In most states, fewer than half of high schools and a quarter of middle schools teach all CDC essential health topics.
In high school health classes, 25% don’t include information on condom use.
CDC School Health Profiles, 2014:

15. Percentage of Schools Requiring Health Education, by Grade%
Elementary Schools
Middle Schools
High Schools
Here, we look at WHEN sex education occurs, by examining the share of elementary, middle and high schools reporting that they require instruction on the same sex education topics. There were four sex ed topics that the SHPPS survey measured across grades—abstinence in the orange line, decision making related to sexual behaviors, resisting peer pressure about sex, and instruction in how to correctly use a condom, which is shown in purple.
In general, as we move from left to right on this graph, we see that elementary schools are less likely to require instruction than middle schools, and high schools are the most likely.
What we also see in this graph is that declines in sex education are occurring AT EVERY GRADE Level
Elementary schools –on the left side of this graph– had especially large declines… by 2014 fewer than 10% of elementary schools offered instruction on each of these sex ed topics, as compared to 30-40% in 2000.
Now I want to switch to focus on the experiences of adolescents directly…

16. Percentage of females 15-19 who received formal sex education, by topic
Here is trend data from the National Survey of Family Growth. I published recently on trends through 2012…. Today you are getting the first view of the newest data which extends through 2014.
The NSFG interviews adolescents at home and asks them if they ever received what they refer to as “formal instruction “ on a range of sex ed topics
This instruction probably occurs primarily in schools, but also could be at health centers, community centers or other settings
Of course, what we have here is what teens SAY they learned and may not reflect all their experiences. But what they remember being taught may be the most important measure!
This graph focuses on the experiences of adolescent girls. We see that since 1995, there have been declines in two important sex ed topics: Not surprisingly, there has been a decline in instruction about birth control. This decline was particularly sharp from 1995 to 2002, as abstinence only policies and funding were put in place. We also had another drop in recent years, falling to 60% in But the 2014 data show an increase, with 70% of girls now report having received formal instruction about birth control. This suggests that the Obama administrations changes to sex ed policy and funding in 2010 took a few years to be reflected in students experiences.
The second set of bars tells us about instruction in “how to say no to sex”—which is how the NSFG asks about what we interpret as abstinence education. Ever here there have been declines over time, which is part of the larger pull back from health education that we saw in the previous slides.
The Patterns of adolscent males are similar, and indeed in recent periods there is little gender difference overall

17. Beyond School-Based Sex Education
Sex Education in the United States

18. Digitally-Native Youth

19. Digital Tools for Sex Education
Sex Education in the United States

20. Planned Parenthood Chat/Text
Over 1 million chats since September 2010
20 educators, 6 monitors
Available 93 hours/week
Average chat is over 15 minutes
83% of chatters (who complete the post-survey) agree that Chat/Text is helpful
Almost 1/3 of chatters come back to ask new questions
Chat/Text introduces the most effective birth control methods to a large percentage of users
Sex Education in the United States

21. Sex Ed for the YouTube Generation

22. Creating AMAZE

23. AMAZE is available in 10 languages

24. Consent Videos
Sex Education in the United States

25. Hi! Meet Roo
Chey

26. POPULAR QUESTIONS What's the right age to have sex for the first time?
What will happen to me if I masturbate too much?
How do I tell someone I like them?
When are you no longer a virgin?
Is my vagina normal?
Chey starts here

27. Sex Ed in the News

28. Sex Ed in the News: Colorado

29. Sex Ed in the News: California