College is too late to expose students to facts about their own anatomy or to introduce tools for informed, consensual decision-making. I began my career at a liberal arts university in South Carolina where I focused on social justice education and sexual assault prevention. I quickly realized that many undergraduate students were receiving information on consent, healthy relationships, and sexual health for the first time. Sexual assault prevention work will not be effective if a measurable percentage of the student body had no prior foundation of sex education. I began to explore the national landscape of sex education and found an urgent social justice issue.
The current state of sex education in the United States is inadequate and inequitable. Sexual health disparities on the basis of race and ethnicity are clear and alarming nationwide, especially in states that do not mandate sex education in any form or those that require an abstinence only curriculum. 26 states in this nation omit essential sex education from their curricula by mandating a stress on abstinence only information, (Lowen, 2019). We as a nation employ deficit-based thinking to blame teenagers for their choices and behavior, yet we fail to recognize the system that withholds the education students need to be informed and healthy young adults. When comprehensive, fact-based sexual health education is systematically withheld, we can see disproportionate rates of teenage pregnancy and HIV transmission in Black and brown youth.
Let’s examine what’s not working. Texas, for example, does not require HIV information or contraception in its sex education curriculum for public schools. If – and the key word is if – sexual health information on HIV or contraception is offered in Texas, it must be taught from an abstinence-only framework (Guttmacher Institute, 2019).
Like the 25 other states that stress the antiquated abstinence-only lens, Texas exacerbates the high national rates of teen pregnancy and HIV among youth. In 2016, for instance, the African American teen birth rate in Texas was 44.1 out of 1,000, compared to the national average of 29.4, (Jozkowski and Crawford, 2016). Latinx students exhibit even higher teen birth rates, with 62 out of 1,000. Meanwhile, white students had a birthrate of just 22.3 out of 1,000. Despite national declines in HIV transmission since 2016, the disparity between African-American and white teen HIV diagnosis (out of 100,000) is stark, with rates of 93.5 versus 9.8 respectively (Jozkowski and Crawford, 2016). Teen pregnancy rates and HIV transmission vary for many reasons, of course, but at the very least, we are failing to provide proper sex education in states where students need it most.
Modernizing sex education in this country would be a monumental undertaking, but there is hope. A model curriculum called Comprehensive Sexual Health Education (CSHE) could begin to address racial gaps. A CSHE curriculum is developmentally appropriate by grade and includes fact-based, medically accurate information on pregnancy prevention, HIV transmission and care, and sexually transmitted infections for heterosexual and queer youth. Beyond this basic information, the curriculum includes information on consent, healthy relationships, and sexual assault to equip students with the agency to make informed decisions. Contrary to critics’ claims, CSHE does not incentivize teens to engage in sexual activity. As students learn about bodily autonomy, consent, and healthy relationships, they become equipped with the knowledge and efficacy to make safer decisions about their health.
From a grassroots perspective, the first and foremost task would be the formation of coalitions of students, parents, teachers, and members of the medical community to advocate at the local district and state level for the adoption of the CSHE curriculum. In the face of resistance, advocates must rely on public health data as the impetus to push for equitable changes in curriculum. We know abstinence only sex education doesn’t work. Health outcomes say so.
Nationally, we must move beyond funding of abstinence only education outlined in Title V of the Personal Responsibility and Work Opportunity Reconciliation Act from the Clinton era. To address barriers to access and resulting gaps in teenage sexual health outcomes, national guidance on sex education could establish a new standard in American Education with far reaching public health implications. CSHE curriculum advances educational equity as one tool to address the racial gap in teen sexual health outcomes.
High quality comprehensive sexual health education is a social justice issue. We must remove barriers to access for all students, especially Black and brown youth, who are disproportionately affected by a lack of sex education needed to prevent pregnancy and HIV transmission. The implications of maintaining the inequitable status quo will perpetuate racial disparities in student health outcomes. It’s time to talk about sex education!