In a country where 75% of youth have had sex by age 20, nearly 40% still receive no meaningful sexual health education at all.
Sexual health education in the U.S. remains inconsistent, fragmented, and often incomplete. At a recent sexuality conference, (where I kept running into SHA community members everywhere I looked!), I was reminded just how critical and urgent sexual health education remains.
Presentations highlighted the ongoing negative sexual health outcomes U.S. adolescents face; often at rates worse than their peers in many other high-income countries. If you’re curious about how the U.S. compares globally, I highly recommend exploring SHA’s study abroad programs, which offer powerful context.
This blog highlights two recent studies that, together, offer a meaningful snapshot of where we are and what young people need:
For sexual health professionals, understanding early adolescent experiences is essential to meeting the needs of our students and clients.
The State of Sex Education Today
There is enormous variation in what young people learn about sex and relationships in U.S. classrooms. Many students still receive abstinence-only or risk-based curricula, while a significant portion receives no sex education at all.
Why does this matter?
By age 17, around 40% of young people have had sex.
By age 20, around 75% have.
Across both studies, only 60%–70% of participants received school-based sex education, meaning many never received foundational sexual health information.
Of those who did receive sex education, 20% received abstinence-only instruction, while the majority received a curriculum focused primarily on the negative consequences of sex.
What Comprehensive Sex Education Should Include
Comprehensive sex education goes beyond pregnancy and STI prevention. A full curriculum includes:
Consent and communication
LGBTQ+ inclusion
Pleasure
Gender identity and expression
Healthy relationships
Skills, empowerment, and students’ rights within sexual decision-making
Countries like the Netherlands, France, and Iceland, to name a few (and where SHA went on amazing study abroad trips last year) are showing ways that more comprehensive sex education can be integrated into schools from an early age.
Research consistently shows that when adolescents receive instruction across these areas, they experience significantly better outcomes; not only medically, but socially, emotionally, and relationally.
And it’s not just young people asking for this. Adults across the lifespan are also seeking comprehensive, affirming sexual health education.
In a recent blog on older adults and sexuality, many adults shared that they never received the sex education they needed earlier in life and are now seeking it later. This reinforces a critical reality: sex education shouldn’t be something students receive once in eighth grade and never revisit. It is a lifelong need.
What LGBTQ+ Youth Say About Their Sex Education Experiences
A lack of comprehensive curriculum affects all students, but the impact is especially severe for youth whose identities are often not reflected or acknowledged in the classroom.
In one national study of LGBTQ+ youth, 30% reported that their schools either had no sex education or they were unsure if it existed. Instruction most commonly covered:
STIs
Biology and anatomy
Safer sex
Abstinence
Less than half of schools covered foundational topics such as:
Healthy relationships
Consent
Communication skills
The Glaring Gaps
Critical topics were rarely addressed:
Sexual orientation
Gender identity
Pronouns
LGBTQ+ sexual health concerns
Curricula were frequently cisnormative, heteronormative, and abstinence-based. When asked what they wanted more of, LGBTQ+ students consistently requested:
Gender-affirming care
Gender identity education
Diverse relationship models (e.g., nonmonogamy)
Emotional and Mental Health Consequences
Nearly one-quarter of LGBTQ+ students reported stigma or discrimination, often linked to sex education. As one participant said:
“Peers wouldn’t stop saying slurs… and laughing during lessons on LGBTQ subjects.”
Research has repeatedly shown that exclusionary sex education is associated with:
Greater anxiety and depression
Lower sense of belonging
Increased stigma and internalized shame
Reduced sense of safety
Importantly, some youth noted that including LGBTQ+ topics without safe facilitation led to increased bullying.
This is where sexual health professionals play a critical role, not only in what we teach, but in:
Setting classroom or group norms
Enforcing consequences for discrimination
Providing emotionally safe learning environments
Ensuring all students feel seen and respected
Where Youth Are Going Instead For Sex Education
When schools don’t provide inclusive information, young people seek answers elsewhere, including LGBTQ+ youth. In this study, researchers found that LGBTQ+ adolescents most often turned to:
Online resources
Friends
Personal experience
Young people overwhelmingly want reliable, accurate information from trusted educators so they don’t have to navigate alone.
Comprehensive Sex Education Matters
Another national study found that students who received comprehensive sex education, not just information, but skills and inclusion, had dramatically better outcomes as young adults. They were:
More likely to use condoms and engage in safer sex
More confident discussing sexual health with partners before sex
More likely to get tested for STIs
More sexually satisfied than peers who received no sex ed instruction
Empowered Youth
Participants described comprehensive programs as:
More inclusive
More validating
More effective in preparing them for real-world relationships
Interestingly, students also reported greater discomfort in more comprehensive programs, suggesting that growing capacity, and confronting gaps in understanding, can feel challenging. This signals a need for:
More research into what drives discomfort
Better educator preparation
Normalization of healthy learning discomfort without emotional harm
One key takeaway: adding more facts or contraception information alone is not enough. Skills-based, inclusive education produces better outcomes.
Sex Ed Inclusion Is Not Optional
LGBTQ+ inclusive sex education doesn’t only help LGBTQ+ youth; it improves outcomes for everyone.
Inclusive education:
Reduces stigma and discrimination
Strengthens empathy and emotional intelligence
Builds safer school climates
Supports healthier relationships
What Sexual Health Professionals Can Do
Assess Gaps in Your Own Training and Practice
From middle school classrooms to medical schools, many programs still lack comprehensive and inclusive sexual health preparation.
Ask yourself (or your school, clinic, or program):
Do we address:
Gender identity?
LGBTQ+ sexual health needs?
Consent applicable to diverse identities?
Pleasure, agency, and autonomy?
Communication and boundary-setting?
Deliver Content Beyond the Classroom
Young people aren’t waiting for institutions to catch up; they’re finding information wherever they can.
Professionals can support learning through:
Digital tools and apps
Online modules or accessible video learning
Peer-support spaces
Collaboration with community youth organizations
If you want an example of how sexual health professionals are innovating here, see Laura Widman’s development of an inclusive sexual health app, highlighted at SHA’s Business Summit.
Center Youth Voices
Professionals may bring expertise, but students are experts in their lived experiences.
Prioritize students interests:
What do you want to learn?
How do you want to learn it?
What makes a space feel safe?
When students lead, education becomes relevant, engaging, and inclusive.
Sex Education Takeaways
Comprehensive sexual health education is not a luxury; it is evidence-based public health. Research shows:
LGBTQ+ youth are asking to be included.
Inclusion improves outcomes for everyone.
Comprehensive curricula prepare students not only to avoid negative health outcomes, but to build healthy, empowered, joyful relationships across their lives.
Currently, as one student put it:
“If you are not straight, you don’t exist.”
We owe the next generation an educational experience where every young person feels seen, respected, and informed.
All students of all ages deserve sex education designed for all of them/us –and their/our sexual well-being across the lifespan.
Written by Emma Sell-Goodhand, MPH
Emma is a doctoral student and Global One Health Fellow at North Carolina State University studying adolescent sexual health. She brings prior experience as a Technical Advisor at the World Health Organization.
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