Sex Education In The United States Is Broken, But It Doesn’t Have To Be

Maddie* remembers walking into a sweaty, small practice gym one morning at Xavier High School, a private Catholic institution in Cedar Rapids, IA, for a unit on health. As she took a seat on the bleachers with her classmates, a teacher passed out brand new textbooks and permanent markers to everyone. For the first 20 minutes of class, the teacher instructed Maddie and the rest of the kids to turn to a specific chapter and black-out certain sections — ones that discussed topics such as sex, abortion, and birth control. “They said, ‘If you want to learn about this, do it on your own time, but we’re not going to cover it in class,’” remembers Maddie, who asked to be identified by her first name only for privacy reasons. “Who’s going to read up later, though? Looking back, it’s like, Holy cow, we didn't even have the opportunity to learn.” 

Meggie Gates also went to Xavier, though they graduated before Maddie, and remembers using sex ed textbooks in which entire paragraphs were redacted. Gates’ book was old; it was the same edition their sister, who’s seven years older, had used. Refinery29 contacted various current members of leadership at Xavier High School to ask about the books, but as of press time, has received no response. In an email, Tom Keating — who was the principal of Xavier from about 2004 to 2018, when Maddie and Gates were students, and now the executive director at the Iowa High School Athletic Association — said: “I don’t believe it would be appropriate for me to comment since I am no longer part of the Xavier administration”  

Maddie’s and Gates’ experiences aren’t unusual. Young people around the world go without access to comprehensive, medically accurate, and inclusive education about sex, sexuality, relationships, and health. In the U.S., only 28 states and the District of Columbia mandate that both sex education and “HIV education” be taught in schools, according to the Guttmacher Institute, a pro-choice research and policy organization. Even fewer states — 18 — mandate that the information taught be “medically accurate,” a term that is left up to individual states to define, but is generally understood to mean that the information is grounded in evidence-based, peer-reviewed scientific research.

States that don’t require sex ed information to be medically accurate are free to make unscientific, unproven, or even false claims about sexual health, such as conflating hormonal birth control or emergency contraceptives with abortion — and some curricula neglect these topics entirely. Federally, $110 million each year is spent on education that only covers abstinence, says Leah Keller, a policy manager at the Guttmacher Institute. Yet, research shows that abstinence-only education doesn’t reduce the likelihood that 15- to 19-year-olds will engage in sex, while comprehensive sex ed has been shown to significantly reduce reports of teen pregnancy. (Sexual activity and pregnancy are commonly used in research as markers of a program’s success, though those metrics are inadequate when it comes to providing a complete picture of meaningful sex education.) 

“There is this critically uneven patchwork of federal and state sex education policies,” Keller says. As a result, kids are left with different understandings of sex and sexuality, depending in large part on where they live, what kind of school they attend, and who they end up with for a teacher. What's more, ​​36 states and D.C. allow parents the option to remove their child from instruction entirely.

In an attempt to determine where traditional sex ed has fallen short, how that’s affected people, and how learning gaps can best be bridged, Refinery29 conducted a survey of 1,425 people in the U.S., U.K., and Canada. One key finding: Although 80% of the respondents received a formal sex education in high school or middle school, only 5% said sex ed fully prepared them for the real world. This impacted them in tangible ways. As Gates says: “What I didn’t learn shaped me.”

The R29 Sex Re-Education survey asked respondents about the subjects they wish had been covered more comprehensively in their sex education curricula. People had a lot to say, but three key areas bubbled up: sex, sexuality, and sexual health as it relates to the queer community; consent education; and pleasure. What was clear from the results was that these gaps meaningfully impacted people, leading them to associate sex and sexual wellness with fear, confusion, and shame, instead of confidence and empowerment. 

For far too long and in far too many schools, LGBTQ+ kids haven’t seen themselves reflected in curricula — to this day, five states still require that only negative information be provided about being queer, and another 12 require a positive emphasis on heterosexuality, the Guttmacher Institute notes. This has serious ramifications. “As a queer young person, I had a lot of conversations within romantic and platonic relationships about the validity of queer sex,” says Makayla (M.K.) Richards, a Georgia State organizer for the organization URGE: Unite for Reproductive & Gender Equity. “I was wondering, ‘Is this valid if it’s not penetrative penis-and-vagina, or cis-hetero-normative, sex? Does my pleasure matter if it’s outside of the scope of what society would deem as 'normal?'” But beyond a conversation about the topic in their general health elective, they received no explicit sex education, according to Richards.

Richards’ family helped them fill in the gaps in their education. “I was lucky to be having these conversations at home,” they say. “I was raised by a Black grandmother and aunt who were committed to ensuring we knew most of the things we needed to, to say no to things we didn’t want to do, and to know the value of expression.” Still, they add, “I had to do a lot of unlearning and figuring out the ways that queerphobia and transphobia taints our perceptions about what is really sex.”

Gates also didn’t see themselves represented in their sex ed classes, something that had long-term repercussions. At Xavier, Gates says heteronormative marriage was held up as something of a gold standard — something that was not only aspirational, but was actually the only acceptable way and circumstance to have sex. “I never wanted that, and later on when I learned I was a lesbian, the stress and anxiety of having to live up to this thing I wasn’t — that was intense,” Gates says. “That permeates today. The compulsive heteronormativity was drilled into me. Sometimes I still question why I don’t want to have that perfect nuclear family. I’ll still have stress dreams where I’m questioning if my sexuality is valid: Should I be with a man? Is that the only way I can have stability?” 

Although Keating declined to comment on Xavier’s lack of LGBTQ+ inclusivity to Refinery29, Gates interviewed him for a 2018 article in the Iowa-based magazine Little Village. In a quote addressing LGBTQ+ youth suicide rates, he said, “It’s a fragile time in regards to where your life is going, and I don’t want to harm that. We can’t be in denial [that] there are LGBTQ students at Xavier, but at the same time we can’t be in denial of what Catholic teaching says and our responsibility to the Catholic Church as a Catholic school. That’s the challenge.” 

Yet, gender-inclusive and affirming sex ed can literally be life-saving, says Myeshia Price, a senior research scientist with The Trevor Project, a nonprofit focused on crisis and suicide prevention within the LGBTQ+ community. “We know that when LGBTQ+ youth find that their schools are affirming, they report lower rates of attempting suicide,” she says. That’s no small statement: 42% of LGBTQ+ youth and more than half of transgender and nonbinary youth have seriously considered attempting suicide in the past year, according to The Trevor Project’s 2021 National Survey on LGBTQ Youth Mental Health. 

But inclusive sex ed doesn’t mean just “covering” queer issues. “The biggest misconception when training adults is that they’ll think, And then on Thursday I’ll teach the LGBTQ+ lesson,” says Brittany McBride, MPH, the associate director of sex education at Advocates for Youth, a nonprofit organization and advocacy group dedicated to sexuality education, with whom Refinery29 partnered with for our Sex Re-Education program. “But this needs to be brought into every lesson.” When sex ed offers an accurate representation of what exists in the world, it’s easier for kids to relate to the information they’re being taught.

Too often, sex ed curricula glosses over consent. As one Sex Re-Education survey respondent said, “We were just told ‘just say no.’” Gates believes that their lacking consent education and the patriarchal narratives they were taught about relationships early on led to negative consequences. “The first time I was sexually assaulted, I didn’t want to [do anything sexual], but I did want to be near someone, and didn’t know how to just ask for that without making it transactional,” they explain, adding that they think more information about consent would help men, women, nonbinary people — everyone. 

Others wish consent education would include what to do after an assault. “Nowadays you might get an education about consent, but you don’t learn what to do if you end up in a situation where you are a victim,” points out Gigi Robinson, a body image and chronic illness advocate. “Nothing is saying here’s how to cope and how to report it and, importantly, that it’s not your fault.” 

“Not only did we not learn about consent for ourselves, but we didn’t learn how to be bystanders,” adds Renata Valquier Chavez, speaking about her experience as a freshman at the public Sidney High School in Sidney, IA, during the 2012/2013 school year. [Writer’s note: I was a senior at SHS when Valquier Chavez was a freshman.] “We weren’t really taught how to see signs. If we were all at a party and saw someone was being made uncomfortable by someone else, even though we grew up with that person, I feel like if we had learned what to look for, we would have felt a little more free to call someone out and say, ‘Hey, knock that shit off.’” She adds that she wishes alcohol had been mentioned in relation to consent, too. ”It’s frustrating to remember,” she says, especially because, “the culture of not asking for consent was considered normal.”

Aaron Misner, who was in the same health class as Valquier Chavez, also doesn’t recall consent being covered in the course, or learning how to practice safe sex. "The lack of adequate sex education definitely trickles down, causing rotting of the community, and it’s not creating a healthy and safe environment for everyone in the town,” he adds. 

Refinery29 reached out to administrators at SHS to comment on how they handled consent in their sex ed curriculum. “We cover these topics several times during Jr. High and High School,” current Sidney High School principal Kim Payne responded, in an email. She said all high school students are required to take health, but, “I cannot speak for what was taught in 2012/2013 as I was not associated with the district at that time.” Payne sent a link to the Health Literacy Standards taught in Iowa, and noted 21.9-12.HL.2 “is taught to help students make good choices and be active bystanders.” 

Refinery29 also contacted Rev. Amy Johnson, who Valquier Chavez, Misner, and I all had as a health teacher at SHS. She said she touched on safe sex with an “abstinence is best” message at “the school board’s direction” during the years she taught health in Sidney, but said that she did teach about safe sex practices other than abstinence; touched on consent and the impact of alcohol and drugs on decision-making; and generally followed the Iowa academic standards. “We talked about no meaning no and that consent is something that is fluid, and you can say no at any point and either person can say no,” she said.

When told that two students had said they weren’t taught this sort of information, Johnson said that it was possible their parents had opted them out of taking the health class in which sex ed was a unit; later, both Valquier Chavez and Misner say they checked with their parents, who don’t remember this being the case.

But, Johnson said she hadn’t covered how to be an active bystander in class. “You know, [looking back] we should’ve, but we did not. We talked about peer pressure, but we didn’t talk a lot about how to keep one another safe, other than just the basic, don’t put yourself in that situation where you don’t feel comfortable being alone with someone and things like that,” she said, adding, “I think it’s really important for me that people know about their health and how to be safe and healthy.” Johnson, who has since moved away from Sidney, noted that she began working at SHS as an English teacher and aid, and only became certified to teach health and take over the courses after another teacher abruptly stopped teaching the class in 2007 or 2008. SHS administrators did not respond to Refinery29's question about this.

Ideally, the basics of consent should be taught to kids when they’re as young as two or three, so they know they don’t have to do things like hug relatives if they don’t want to, says Tina Schermer Sellers, PhD, a clinical sexologist and author. “It should be teaching kids to ask for what they want, to be able to say yes or no, and how to accept a ‘no’ graciously,” she explains. “It’s important to know that consent is complex, and that it’s okay to withdraw consent if you’ve already given it.”

But, "the consent focus is a pretty low bar, really, if what we want for young people is good, positive, sexual experiences,” says sexuality educator Greg Smallidge. “Having sex with someone? This is deeply layered, vulnerable, spiritual, messy stuff. And if sex ed isn’t willing to talk deeply about the mess, then it’s dishonest.”

Tied up with consent education is pleasure education, Dr. Schermer Sellers says. If you’re not taught that sex can feel good, it’s harder to identify it when something feels bad, she says. Even so, sex educators know that pleasure is one of the trickiest subjects to cover in their curricula. 

“​​We definitely see more backlash from parents and communities when discussing pleasure in sex ed, even though pleasure is an important part of sexuality,” says Caitlin Viccora, the program manager of healthy and supportive schools at Advocates for Youth. “Often, folks are more comfortable teaching about the risks related to having sex, such as unintended pregnancy and STIs, rather than the positive aspects of sex and sexuality.”

Perhaps because this area of sex education can be so fraught, many curricula simply leave out any discussion of sexual pleasure, or they focus on the male orgasm because it’s “productive,” neglecting to talk about women’s pleasure, our survey found. But ignoring the topic doesn’t mean kids will stop having questions about it — and treating these questions as though they’re shameful can cause folks to feel embarrassed or uncomfortable, often affecting them for years to come.

Maddie, for instance, remembers attending a school talk where a religious speaker came to tell her school about the sin of premarital sex: “They gave us a piece of tape, had us stick it on our arms, and then pass it to the next kid to do the same. As you got going, it wouldn’t stick as well. The implication was that when you met your future spouse, if you had sex with other people first, you’d be used up,” Maddie says. Gates recalls a similar exercise, in which a speaker taped two construction paper figures — one pink, and one blue — together, then ripped them apart to illustrate how if you have premarital sex, “you leave your soul behind.” This fed into a culture of judgement at the school, Maddie and Gates say. “After those classes, it was like, ‘Oh, Amy’s been having sex with so and so? She’s disgusting,’” Maddie says. Gates adds: “It was, if you have sex, you’re a slut and everyone will talk about you.” 

At Caelyn’s* Christian school in Tennessee, she remembers a guest speaker who came in to teach sex ed passing a cup around and asking each kid to spit in it. Then, he asked if anyone wanted to drink it, as a way of demonstrating the sanctity of virginity and the concept of “used goods.” “Even at the time I thought it was a pretty rotten thing to do,” says Caelyn, who asked for her last name to be withheld for privacy reasons.

Dr. Schemer Sellers says linking premarital sex — or any sex — to shame has myriad negative impacts, including making kids feel alone and like they can’t talk to anyone. “Research reveals that sexual shame impacts people’s ability to trust, communicate, and intimately or vulnerably attach emotionally or physically,” she adds. “It also causes people to doubt their sexual desire, and if they have the right to protect themselves in sexual encounters.”

When Maddie graduated high school, she didn’t feel she’d been fully prepared to have sex or relationships in college. “When I did later have sex, it was difficult for me at first to have conversations about it because I was so used to not talking about it,” she reflects. “Everything was always swept under the rug and it made it weird and difficult to talk about what you wanted and to have conversations like, ‘Do you like this? I like that.’ For so long, unless you were talking about having a baby with your spouse, talking about sex felt a little bit dirty and uncomfortable, like this mortal sin.” 

Modern sex education falls short in many other ways besides these. Notably, racism and classism pervade sex education curricula. “Lots of sexuality education isn’t culturally responsive, and there’s no understanding of the historical context with Black and brown bodies,” says Tanya Bass, PhD, a sex educator in North Carolina. Dr. Bass also notes that, with the ongoing prevalence of systemic and medical racism, it’s essential for people to be informed about the choices available to them, specifically when it comes to issues such as birth control methods. “People aren’t learning about the history surrounding the coercive use of LARCs,” Dr. Bass says, referring to long-acting reversible contraceptives such as IUDS. There’s a history of medical professionals disproportionally “offering LARCs as contraceptives [to Black and brown people] instead of giving people all the options and information," she says.   

Our systems, including educational institutions, “have historically been touched and influenced by white supremacy culture and were built on the oppression of marginalized communities,” says Sara C. Flowers, DrPH, the vice president of education and training at the Planned Parenthood Federation of America. “In order to work to disrupt that and work towards reproductive freedom and justice, it’s key to ensure that sex education is comprehensive, anti-racist, and accessible and inclusive of the needs and realities of all young people.” 

Many sex ed lesson plans also neglect discussions around how to treat STIs, or about health issues such as polycystic ovary syndrome (PCOS) or vaginismus, gaps that could delay diagnosis and treatment and leave people in pain. According to our Sex Re-Education survey, people left sex ed feeling “nervous” and “embarrassed,” with unanswered questions about anatomy, STIs, pregnancy, and general sexuality. That’s a far cry from how the advocacy and policy organization SIECUS: Sex Ed For Social Change imagines sex ed in their guidelines: as “a lifelong process of acquiring information and forming attitudes, beliefs, and values about such important topics as identity, relationships, and intimacy.” 

Learning accurate, inclusive information about sex and sexuality early on is affirming for young people. McBride says proper sex education can be compared to teaching a kid about water safety. “Say, you’re alone in a room, listening to your friends swim in a pool outside, something you’ve never done before. You hear people having fun, and it sounds amazing,” she says. “If I take the time to explain that you have to take swimming lessons and wear sunscreen and have to reapply before you go in, there's less likelihood of you wanting to get in yourself without being equipped." If kids are left without guidance, they’re more likely to just jump in the pool — maybe even right into the deep end without knowing how to swim. All sex education does is "remove the mystique that comes with sex,” McBride says.

There’s no simple remedy to this problem. But “it’s 100% worth working on, because when it's done intersectionally and comprehensively, health education is life-saving work,” says Justine Ang Fonte, M.Ed, MPH, an intersectional health educator. And schools are a good place to start, since they are still a top source of information for people: 45% of respondents in the Refinery29 2021 Sex Re-Education survey said they first learned about sex in school. Nearly as many — 44% — said they learned through friends, while 31% reported learning about sex through TV and movies, 27% cited their parents as resources, and 26% cited pornography. 

School curricula can be analyzed, overhauled, and changed for the better, according to advocates such as McBride. Many people who spoke to Refinery29 see The Real Education and Access for Healthy Youth Act, which is in Congress now and aims to fund comprehensive sex education for students, as a positive step forward. Some, like Keller, hope to defund abstinence-only sex ed entirely. A few advocates who spoke to R29 were skeptical that meaningful advancements could happen in classrooms within their lifetimes. 

In the meantime, generations of young people are seeking out important, sometimes urgent, information through the internet, their peer groups, and medical professionals. When asked what they’d like to see covered in sex education, our survey respondents asked for science-backed answers to questions they found themselves asking the internet, such as how to react to a positive STI test or how to have safe oral sex. They also reported wanting to know whether the experiences they were facing, including something that had happened during sex, were “okay,” or a cause for concern. They asked for more information regarding consent, pleasure, and sex ed as it relates to the LGBTQ+ community. And if they don’t get that information from their schools and parents, they’ll look for it elsewhere; most often on Google, where 60% of survey respondents and 70% of Gen Z respondents get their sex information. 

And so, we listened. Based on what we learned, Refinery29 is hoping to bridge the gap between what schools currently offer and what young people desperately need, with two series of short videos that offer up answers to the questions people actually have. “Is It Okay?” delivers science- and expert-backed answers to common sexual health-related questions, and “What I Wish I Had Known” allows well-known people to speak directly about, well, everything they wish they’d known when they were younger.

Our hope is that Sex Re-Education can provide help to the 95% of people who don’t feel that their school — or their parents or their friends or the internet — adequately prepared them for the real world and their experiences in it. 

If you are an LGBTQ person thinking about suicide, please call the Trevor Lifeline at 1-866-488-7386.