What Do American Kids Learn About Sex? It Depends Who You Ask.

When asked how many of her high school peers have a strong understanding of sexuality and reproductive health, Dorothy*, a 10th grader at a Dallas public school, says the answer is complicated. 

“There’s a big gap in knowledge and information. Some people have parents that read them all of the sex ed books. Some have had one conversation with their parents for half an hour when they grew body hair,” Dorothy says. “And there’s the people who learned everything from the internet.”

Some of her peers don’t understand how conception happens, or know where urine comes from, or they believe it’s impossible to get pregnant the first time they have sex. She recalls an 8th grade girl who didn’t know what rape was, until a group of boys explained it to her. 

“That was so disturbing to me,” she says—even more so because in Texas, lessons on consent—clear, mutual, and voluntary engagement sexual activity—arenʼt in the curriculum. The state has no sex ed requirements and is one of five states where parents must give written permission to opt in to those lessons. It’s also the only state with an opt-in policy for abuse prevention education, which encompasses child abuse, dating violence, and sex trafficking. 

In Texas, almost all abortions are banned, the teen birth rate towers 46% above the national average, and more teens give birth to multiple children than any other state. Teen STI rates are also on the rise in Texas, including for gonorrhea, chlamydia, and HIV, syphilis, and congenital syphilis. 

Given these figures, many Texas parents consider sex education a matter of basic health and safety. 

“We live in a place where people are very aware of what happens when kids don’t have a solid foundation in sexuality education,” says Emily Cabral, a mother and a program director at Wholly Informed Sex Ed (WISE). The Dallas-based nonprofit provides schools and community groups with comprehensive sexuality education (CSE)—a type of learning which incorporates complete and age-appropriate information about sexuality and sexual and reproductive health, including gender diversity and consent. 

‘A Chilling Effectʼ

For some CSE providers across the country, recent executive orders from the Trump administration are adding to that sense of vulnerability. 

While there have not been direct attacks on sex education, policy recommendations that target DEI, gender identity, and restroom access for trans people are already having a “chilling effect” on CSE providers, Allison Macklin, policy director at Sex Ed for Social Change (SIECUS), a leading nonprofit focused on advancing sex education, told GHN.

In the current political climate, “folks are afraid to talk about sexual orientation and gender identity in a school setting. Even though it’s not currently the law, they’re complying ahead of time.”

The federal government has no national requirements for teaching sex education, giving states, individual districts, and schools considerable leeway in whether, and how, sex education is taught. But federal grants provide funding for much of what students learn, Macklin says. 

The Teen Pregnancy Prevention Program (TPPP), which provides grants for sex education providers, is the “the closest thing we’ve got as a country” to a federal mandate for CSE, Macklin says. While it would take an act of Congress to rescind the program, the conditions for receiving that funding could change. 

Schools often outsource their programs to TPPP-funded organizations like WISE; others choose conservative and religious groups that also receive federal funding to teach an abstinence-only curriculum. 

And some schools, paradoxically, are teaching both abstinence-only programs and CSE lessons, says Macklin.

“So, one day theyʼre being told not to have sex ... Then, three days later, you have actual sex education coming in,” she says. “Itʼs the students that suffer from this confusion in information.”  

The Benefits of CSE

Over 90% of parents and guardians across the country—and the majority of those in Texas—support their children receiving CSE, according to SIECUS. The UN Population Fund and the CDC both endorse CSE for young people. 

And a broad base of research shows that it works. 

Young people with access to CSE experience improved mental health outcomes, especially among LGBTQ+ individuals; lower incidence of sexual violence and sexual assault; improved access to contraception and testing and treatment of STIs; and reductions in unplanned pregnancies.

Research also shows that starting CSE from as young as age 5 helps kids develop a healthy understanding of their bodies and boundaries, and the tools to protect themselves from potential harm. However, many programs favor a risk-based approach that focuses on outcomes like teen pregnancies, and neglect crucial “soft outcomes” like relationship skills and gender attitudes.

A Patchwork of Policies

While the U.S. federal government has previously acknowledged the importance of CSE, absent national requirements, what young people in the U.S. learn about sex, sexuality, consent, and relationships varies quite a bit. Only 38% of all high schools and 14% of middle schools in the U.S. provide all 16 priority topics identified by the CDC.

The Texas Board of Education reformed its health curriculum in 2020 for the first time since 1994, folding in optional instruction about STI protection and birth control at the high school level. But the reforms left out consent education, LGBTQ+ inclusion, and mention of anything other than heterosexual sex.

In Colorado, sex ed is not required but if it is taught, then it must be comprehensive. In Florida, rules focus on what cannot be taught, rather than what must be taught. In California, CSE and HIV prevention are required for 7th through 12th graders. But even in states that require CSE, compliance is inconsistent and difficult to enforce in budget-strapped school systems, especially those serving low-resource communities. 

“There’s a mountain of problems that [teachers and schools] are struggling with … they are feeding kids or clothing kids. They’re the mental health safety net,” says Macklin. “Unfortunately, complying with certain laws around sex education may not be top of mind.”

These gaps have an impact. A 2022 study in the Journal of Adolescent Health warned that inequities in the delivery of sex education may leave young Americans vulnerable to health problems and deprive them of accurate and developmentally appropriate information—with particularly large gaps for young people of color. The study found that, compared to their white peers, young men of color were less likely to learn about key sex ed topics, and Black females were less likely to receive information on where to get birth control before they became sexually active.

In conservative states like Texas, there’s also fear of blowback from school boards and from a vocal minority of families who oppose CSE, so many teachers don’t push to teach the topic.

“Teachers are in such a climate of fear right now … so it’s just much easier just not to do it,” saysCabral. 

Meanwhile, pressure from religious conservatives to promote abstinence-only sex education has gained momentum in Washington, even though, according to research compiled by the Guttmacher Institute, it has been shown to be ineffective at delaying initiation of sex, preventing teen pregnancies, promoting safe sex, and preventing STIs. In 1996, Congress authorized $50 million annually for five years to states for abstinence education programs, and in 2005, allocated an additional $13 million to grantees providing abstinence education—and these funding streams increased substantially in the 2010s. 

“Conservative religious groups have been huge opponents of CSE, and they really believe that withholding info on things like sex and reproduction is going to help young people avoid certain problems,” says John Santelli, a leading CSE advocate and a professor of Population and Family Health and Pediatrics at Columbia University’s Mailman School of Public Health.

Such concerns about sexuality education by religious groups sets the U.S. apart from its peers. The U.S. is “the most vociferous among developed countries of promoting abstinence-only sex ed,” says Santelli. 

Separation of Church and State: The Dutch Model

The Netherlands—a society with a relatively clear delineation between church and state—takes a different approach. 

Since 2012, sexuality education has been mandatory in Dutch primary through lower secondary schools, and in special education. These lessons must include diversity and sexual diversity. 

Headlines touting that the Dutch start sex ed in kindergarten have led to some backlash based on misinformation about what these programs really teach. 

“We’re not teaching four year-olds to put condoms on. We’re teaching them basic autonomy of their body, and consent,” clarifies Evelien Spek, a senior project officer at Soa Aids, a government-funded sexual health advocacy organization. 

The benefits of these lessons play out in the data, says Spek. Most 12 to 25-year-olds in the Netherlands report having “wanted and fun” first sexual experiences. At 2.1 births per 1,000 women ages 15–19, the Netherlandsʼ teen birth rate is the lowest in the EU, where that average is 6.8 births per 1,000.

The U.S. teen birth rate towers above these figures, at 13.2 births per 1,000 females. Additionally, 1 in 16 U.S. women say their first sexual experience was forced, according to research published in JAMA Internal Medicine.

Still, there are gaps in the Dutch system, too. “Most schools in Holland do pay attention to [sex ed], but there’s a very big divide between what schools do,” Spek says. But a clear separation between religion and state education, a relatively progressive view of sexuality across Dutch society, and a broad understanding of its health implications, helps CSE remain a priority, she says. 

The Path Forward

Advocates in the U.S. are pushing for a similar narrative.

SIECUS has proposed federal legislation that would provide a mandate for the U.S. to say that sex education is valued and important, make it available in public schools, and support teachers in offering it. 

In the meantime, advocacy groups like WISE—which was founded out of a Dallas church that helped launch Roe v. Wade—are filling the gaps in CSE themselves, offering 7th–9th graders 90-minute lessons on a wide range of topics. One of their top priorities is expanding access not just in Texas, but nationwide—but they “need more information on what works,” says WISE executive director Sherri Cook, who wants to see more research on the correct “dosage” of sex ed across all ages. 

While promoting sex ed and reproductive health in Texas can be challenging, Cabral says that experiencing impacts of the state’s abortion ban, its high HIV rates, and other poor health outcomes motivate her work.

“The urgency that people feel to make sure their kids have vital, life-saving information, that is driving a real commitment to making sure kids get this information,” she says. “It takes pressure to make a diamond.”

*In this story, Dorothyʼs name has been changed to protect her identity. 

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