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ACLU is in support of decriminalizing sex work

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ACLU is in support of decriminalizing sex work

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Supporters of the American Civil Liberties union understand that sex work is often tied to the lack of sexual health education schools. The tweet suggests that sex work should be decriminalized and the money saved should go towards sexual health education instead. This tweet is an example of how people will take one statement as is, and make it connect to their own thoughts via Twitter.

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The ACLU of Southern California states that all California schools are required to teach sex education. The video shows multiple sex ed terms, and then states that it's the law, and encourages viewers to check their state's status at the listed website.

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The National Association of School Nurses is in Favor of Sexual Health Education

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The National Association of School Nurses is in Favor of Sexual Health Education

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The NASN state that sexual health education is more than preventing unplanned pregnancies and STI/STDs. From an analytical point of view the NASN describes the benefits of a successful sexual health education program in schools.

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Position Statement SUMMARY
It is the position of the National Association of School Nurses (NASN) that developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. NASN recognizes the role of parents and families as the primary source of education about sexual health. The registered professional school nurse (hereinafter referred to as school nurse) is a valuable resource to parents and educators in this area and supports the implementation of evidence-based sexual health education programs that promote healthy sexual development for all students.
BACKGROUND
The social and health risks of adolescent sexual activity are well known (Dee et al., 2017). While teen pregnancy and birth rates in the United States continue to decline, rates remain higher than in other industrialized countries; and racial, ethnic and geographic disparities persist (Centers for Disease Control and Prevention [CDC], 2016a). In addition, the rates of sexually transmitted infections (STIs) are at an unprecedented high in the United States, and more than half of newly acquired infections occur among adolescents and young adults (CDC, 2016b).

Sexual health as defined by the World Health Organization (WHO) is "... a state of physical, emotional, mental and social well-being in relation to sexuality..." (WHO, 2015, pp. 5), suggesting a whole child approach to sexual health education and not merely the absence of unplanned pregnancy or sexually transmitted infections. For decades, studies have shown that the majority of parents in the United States support sexual health education in schools. In addition, findings indicated that most parents supported abstinence-based rather than abstinence-only programs (Barr, Moore, Johnson, Forrest , Jordan , 2014). Finally, a May 2016 nationwide survey of middle and high school parents found that 70% believe sex education and pregnancy prevention should "definitely be covered" in sexual health education programs (Singer, 2016).

According to the 2014 School Health Policies and Practices Study (CDC, 2015a), 72% of high schools in the United States required students to receive education on pregnancy prevention, and 83.1% required instruction on STI prevention. Topics listed as part of required instruction by order of frequency included abstinence as the most effective method to avoid pregnancy and STIs, the relationship between alcohol or other drug use and risk for STIs and pregnancy, and resisting peer pressure to engage in sexual behavior. A worrisome trend is that the percentage of schools in which students are required to receive instruction on human sexuality, pregnancy, and STI prevention has steadily declined since 2000 (CDC, 2015a)

Healthy students are more likely to achieve academic success (CDC, 2014). Szydlowski (2015b) asserts that when teens receive accurate sexual health education information and skills, they can reduce health risk factors that may impact their success in school. Data from the 2015 Youth Risk Behavior Surveillance Survey (YRBSS) indicated that, among high school students, 41% have had sexual intercourse at least once; and 30% had sexual intercourse in the three months prior to participating in the survey, reflective of a decline from previous surveys (CDC, 2015b). Although teens may be having less sex, condom use and HIV testing are declining (CDC, 2015b). Of those who had intercourse in the past three months, 43% did not use a condom the last time they had sex; 14% did not use any method to prevent pregnancy; and 21% used substances before last sexual intercourse (CDC, 2015b).

For the first time, the CDC analysis of national data gathered from the 2015 YRBS included information on the health risks of lesbian, gay, and bisexual (LGB) high school students. These findings demonstrate that LGB youth report a higher incidence of bullying at school or online, physical and sexual dating violence, drug and alcohol use, and suicide-related behaviors than their straight peers (Kann, Olsen, & McManus, 2016). In the most recent Gay, Lesbian, and Straight Network (GLSEN) National School Climate Survey, over 31% of LGBTQ students reported missing at least one day of school during the past month due to safety concerns. Students who attended schools with LGBTQ-inclusive curriculum were less likely to miss school (18% vs. 35%) for safety reasons (Kosciw, Greytak, Giga, Villenas, & Danischewski, 2016). Although not a direct measure of school performance, absenteeism has been linked to low graduation rates, which can impact future success in life (CDC, 2014).

In addition to the disparities of risk for sexual minority youth, there are racial/ethnic differences. Black high school students are more likely to have had intercourse than white and Latino students; and more black high school students and Latino students initiated sex before the age of 13 compared to white students (Kaiser Family Foundation, 2014).

Students with disabilities defined as "... a physical or mental impairment that substantially limits one or more major life activities" (Americans with Disabilities Act of 1990 [ADA], Title II Regulations, 2016, p. 187), and those with intellectual disabilities (ID) as characterized by "...signiﬁcant limitations both in intellectual functioning and in adaptive behaviour as expressed in conceptual, social, and practical adaptive skills" (Luckasson & Schalock, 2013, pp. 96) benefit from sexual health information. Low levels of knowledge can impede the recognition of sexual abuse situations, safe sex practices, and the development of positive attitudes toward sexuality (Schaafsma, Kok, Stoffelen, & Curfs, 2015). Szydlowski (2016) compiled general guidelines for sexual health educators for those with disabilities. Sexual health education needs to be tailored to the students with disabilities based on their ability, learning style, and maturity, in addition to parent values and beliefs (Szydlowski, 2016).
RATIONALE
School nurses support sexual health education that is accessible, inclusive, and developmentally and culturally appropriate for all students. Academic achievement is linked to student health (CDC, 2014). Health risk behaviors, such as early sexual initiation, are associated with lower grades and test scores, and lower educational attainment (CDC, 2016c). Evidence-based sexual health education provides accurate, complete, and developmentally appropriate information and skill development that allow young people to make decisions that are informed, responsible, and healthy (Szydlowski, 2015b). Evidence-based sexual health education can improve academic success; prevent dating violence, and bullying; help youth develop healthier relationships; delay sexual initiation; reduce unplanned pregnancy, HIV, and other STIs; and reduce sexual health disparities among LGBTQ youth (Szydlowski, 2015b). Evidence-based sexual health education reduces sexual risk behavior by delaying sexual initiation, reducing pregnancy and STIs, and increasing contraceptive use -- thereby protecting student health (Szydlowski, 2015b).

The National Sexuality Education Standards (Future of Sex Education Initiative [FOSE],2012) support a strategic and coordinated approach that includes family and community involvement, skill development and school health services. Furthermore, the Sexuality Information and Education Council of the United States (SIECUS) (2017) supports sexual health education that is appropriate to the student's age, developmental level, cultural background, and community values. SIECUS further advocates for sexual health education to augment the sexual health education provided by the family and their healthcare professionals. SIECUS specifies that sexual health education provided in an educational setting needs to be taught by an instructor trained on the principles, content and best practices of sexual health education. On behalf of Advocates for Youth, Szydlowski (2015a) emphasizes youth friendly sexual health education to assist with the positive development of sexual health, beginning in youth and continuing throughout adulthood.>

The National Sexuality Education Standards recommend that an evidence-based sexual health education program include the following characteristics (FOSE, 2012, p.9):

Focuses on specific behavioral outcomes;

Addresses individual values and group norms that support health‐enhancing behaviors;

Focuses on increasing personal perceptions of risk and harmfulness of engaging in specific health risk behaviors, as well as reinforcing protective factors;

Addresses social pressures and influences;

Builds personal and social competence;

Provides functional knowledge that is basic, accurate and directly contributes to health‐promoting decisions and behaviors;

Uses strategies designed to personalize information and engage students;

Provides age‐ and developmentally appropriate information, learning strategies, teaching methods and materials;

Incorporates learning strategies, teaching methods, and materials that are culturally inclusive;

Provides adequate time for instruction and learning;

Provides opportunities to reinforce skills and positive health behaviors;

Provides opportunities to make connections with other influential persons; and

Includes teacher information and plan for professional development and training to enhance effectiveness of instruction and student learning.

In addition, in terms of specific content, an emerging model for sexual health education is the rights-based approach, which employs a vast, comprehensive sexual education program with a focus on human rights, gender equality, access to healthcare services, and critical thinking (Constantine et al., 2015). Preliminary findings have supported that education based on theories of human rights, gender equality, and sexual development can positively impact healthy sexual behavior among adolescents (Constantine et al.).
CONCLUSION
Health education and promotion, disease prevention, and risk reduction are essential practice components for the 21st century school nurse to help students stay healthy, safe and ready to learn (NASN, 2016). School nurse leaders advocate for and support the delivery of evidence-based sexual health education that is "...medically accurate, developmentally appropriate, and ... provides students with the skills and resources that help them make informed and responsible decisions" (FOSE, 2012, p.8). School nurses -- working in collaboration with parents, students, health educators, curriculum specialists, and other school and community stakeholders -- strive to dismantle barriers and support access to evidence-based sexual health education that allows all students to make informed, responsible, and healthy decisions.
REFERENCES
Americans With Disabilities Act of 1990, Pub. L. No. 101-336, 104 Stat. 328 (1990), Title II Regulations. (2016). Part 35 Nondiscrimination on the Basis of Disability in State and Local Government Services (as amended by the final rule published on August 11, 2016). Retrieved from https://www.ada.gov/regs2010/titleII_2010/titleII_2010_regulations.htm

Barr E., Moore M., Johnson T., Forrest J., Jordan M. (2014). New evidence: Data documenting parental support for earlier sexuality education. Journal of School Health, 84(1), 10-17. doi:http://dx.doi.org/10.1111/josh.12112

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health. (2014). Health and academic achievement. Retrieved from https://www.cdc.gov/healthyyouth/health_and_academics/pdf/health-academic-achievement.pdf

Centers for Disease Control and Prevention. (2015a). Results from the school health policies and practices study 2014. Retrieved from https://www.cdc.gov/healthyyouth/data/shpps/results.htm

Centers for Disease Control and Prevention. (2015b). Youth risk behavior surveillance system (YRBSS). Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/results.htm

Centers for Disease Control and Prevention. (2016a). About teen pregnancy: Teen pregnancy in the United States. Retrieved from http://www.cdc.gov/teenpregnancy/about/index.htm

Centers for Disease Control and Prevention. (2016b). Sexually transmitted diseases surveillance 2015. Retrieved from https://www.cdc.gov/std/stats15/default.htm

Centers for Disease Control and Prevention. (2016c). Adolescent and school health: Health and academics. http://www.cdc.gov/HealthyYouth/health_and_academics/

Constantine, N. A., Jerman, P., Berglasi, N. F., Angulo-Olaiz, F., Chou, C., & Rohrbach, L. A. (2015). Short-term effects of a rights-based sexuality education curriculum for high-school students: A cluster-randomized trial. BMC Public Health, 15(293),1-13. doi:10.1186/s12889-015-1625-5

Dee, D.L., Pazol, K., Cox, S., Smith, R.A., Bower, K., & Kapaya, M. (2017). Trends in repeat births and use of postpartum contraception among teens-United States, 2004-2015. Morbidity Mortality Weekly Report, 4/28/2017; 66(16), 422-426, 5. doi: http://dx.doi.org/10.15585/mmwr.mm6616a3

Future of Sex Education Initiative. (2012). National sexuality education standards: Core content and skills, K-12 [a special publication of the Journal of School Health]. Retrieved from http://www.futureofsexeducation.org/documents/josh-fose-standards-web.pdf

Kaiser Family Foundation. (2014). Sexual health of adolescents and young adults in the United States. Menlo Park, CA: Henry J. Kaiser Family Foundation. Retrieved from http://kff.org/womens-health-policy/fact -sheet/sexual-health-of-adolescents-and-young-adults-in-the-united-states/

Kann, L., Olsen, E.O., & McManus, T. (2016). Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9-12 - United States and selected sites, 2015. MMWR Surveillance Summary 2016,65(No. SS-9), 1-202. doi: http://dx.doi.org/10.15585/mmwr.ss6509a1

Kosciw, J. G., Greytak, E. A., Giga, N. M., Villenas, C. & Danischewski, D. J. (2016). The 2015 national school climate survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation's schools. New York: GLSEN.

Luckasson, R., & Schalock, R. L. (2013). What's at stake in the lives of people with intellectual disability? Part II: Recommendations for naming, defining, diagnosing, classifying, and planning supports. Intellectual and Developmental Disabilities, 51(2), 94-101. doi: 10.1352/1934-9556-51.2.094

National Association of School Nurses. (2016). Framework for 21st century school nursing practice. NASN School Nurse, 31(1), 45-53. doi: 10.1177/1942602X15618644

Schaafsma, D., Kok, G., Stoffelen, J. M. T., & Curfs, L. M. G. (2015). Identifying effective methods for teaching sex education to individuals with intellectual disabilities: A systematic review. Journal of Sex Research, 52(4), 412-432. doi: 10.1080/00224499.2014.919373.

Sexuality Information and Education Council of the United States. (2017). Human sexuality (Position Paper). Retrieved from http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&pageId=494

Singer, D.C. (Ed.). (2016). Beyond sex ed: Parents want more health topics covered in school. Retrieved from http://mottnpch.org/reports-surveys/beyond-sex-ed-parents-want-more-health-topics-covered-school

Szydlowski, M.B. (2015a). Sexual health education; research and results. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/storage/advfy/documents/school-health-equity/sexual-healthed-research-and-results.pdf

Szydlowski, M.B. (2015b). Sexual health education and academic success: Effective programs foster student achievement. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/school-health-equity-resources

Szydlowski, M. B. (2016). Sexual health education for young people with disabilities - Research and resources for educators. School Health Equity/Advocates for Youth. Retrieved from http://www.advocatesforyouth.org/publications/publications-a-z/2559

World Health Organization. (2015). Sexual health, human rights and the law. Retrieved from http://apps.who.int/iris/bitstream/10665/175556/1/9789241564984_eng.pdf?ua=1

Acknowledgement of Authors:
Lisa Kern MSN, RN, NCSN
Gina Emge MSN, RN
Kathy Reiner BSN, MPH, RN
Darla Rebowe BSN, RN

Adopted: October 2002
Revised: November 2005, June 2012, June 2017

(Formerly titled "School Health Education about Human Sexuality")

Suggested Citation: National Association of School Nurses. (2016). Sexual health education in schools (Position Statement). Silver Spring, MD: Author.
All position statements from the National Association of School Nurses will automatically expire five years after publication unless reaffirmed, revised, or retired at or before that time.

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Position Statement SUMMARY It is the position of the National Association of School Nurses (NASN) that developmentally appropriate evidence-based sexual health education should be included as part of a comprehensive school health education program and be accessible to all students. NASN recognizes the role of parents and families as the primary source of education about sexual health.

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TIME explains parent concerns, but also shares voices of sexual health education supporters

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TIME explains parent concerns, but also shares voices of sexual health education supporters

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TIME is written extensively detailing the concerns of parents, but also dives in to why schools aren't doing enough for their sexual education programs to be effective. The voice that this is written in, does clearly favor one side over the other. Instead, it lays out both arguments for the viewer to decide.

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Here’s what kids need to know — and how parents can tell them

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The show on Netflix embraces and focuses on many topics often covered in Sexual Health Education classes, in an engaging way through the eyes of a young boy who's mother is a therapist. The protagonist becomes a sex therapist for his peers, realizing that sexual health is not just about his outer extremities.

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Sex Education Season 1 Trailer | Rotten Tomatoes TV

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Alexandria City Schools Curriculum Guide

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Alexandria City Schools Curriculum Guide

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Alexandria City Schools lists out an extensive curriculum guide for their sexual health education program. They provide the objective, outcomes, and activities for each lesson.

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In the article the writer explains the pros and cons of sexual education. She goes into details about what happens when it's lacking, but also if it's done poorly. Exposure at one point becomes the focus of the article, and readers are left to decide which side they agree with.

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Soaring rates of sexually transmitted diseases among teens are adding urgency to the debate over sex education. Conservatives claim the alarming statistics illustrate why abstinence should be the single mantra when it comes to sex ed. Liberals counter that the increase in disease is the strongest case for more detailed information. Caught in the middle are America's kids, who are more vulnerable than ever to potentially deadly diseases.

In the debate over sex education, one thing is undisputed: The average kid today is immersed in sexual imagery. A generation that has grown up on the sordid details of the Starr Report, watched thong-clad teens gyrate on Spring Break cable specials, or read the cover of nearly any women's magazine in the grocery check-out line is familiar with the facts of life.

But young people face a barrage of confusing messages. Along with titillating images from the media, some kids are told to "just say no" to sex. In school, others are taught how to put condoms on bananas in preparation for the real thing, and still other children receive no information whatsoever.

Transcending the cacophony of mixed messages is a host of alarming facts.

Kids are becoming more sexually active at an earlier age. Sixty-six percent of American high school students have had sex by their senior year.

And these same teens are paying the price by contracting dangerous - and sometimes deadly - sexually transmitted diseases.

According to the Centers for Disease Control and the Kaiser Family Foundation, approximately 65 percent of all sexually transmitted infections contracted by Americans this year will occur in people under 24. One in four new HIV infections occurs in people younger than 22.

"There's a disconnect somewhere. Someone's not getting the message. We need to find out why and help our kids be more responsible," said Dr. Ted Feinberg, assistant executive director of the National Association of School Psychologists.

But what message should be given to young people is the subject of intense debate.

How much to teach?
One side in the debate favors comprehensive sex education, including detailed information about sexually transmitted diseases, contraception and abstinence.

"Young people are going to learn about sex and our question has to be where do we want them to learn? From the media? From their friends? Or do we want them to learn from an educated, responsible adult?" said Tamara Kreinin, president of the Sexuality Information and Education Council of the United States, a leading advocate of comprehensive sex education.

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The opposing side pushes for an abstinence-only message that advises teens to wait until marriage.

Since there is no federal law that requires public schools to teach sex education, let alone one that specifies what should be taught, these decisions are left up to states and individual school districts.

Currently 18 states and the District of Columbia require schools to provide sex education and 32 do not. In some states, such as Louisiana, kids might learn about HIV/AIDS, but not about any other STDs or how to prevent pregnancy. In other states, like Washington, teens receive information on everything from birth control pills to homosexuality.

'Mixed signals'
A key issue in the battle over sex education is whether giving kids more information about sex actually leads to sexual activity.

In a study of 35 sex education programs around the world, the World Health Organization found there is no evidence that comprehensive programs encourage sexual activity.

The study also concluded that abstinence-only programs are less effective than comprehensive classes that include abstinence and safe-sex practices such as contraception and condom use.

Related nationwide studies by the Guttmacher Institute and Planned Parenthood came to similar conclusions.

But abstinence-only groups dismiss these studies as biased and skewed. They argue there is a fundamental flaw in giving kids more information about risky behaviors that they should simply be taught to avoid.

"We believe it's an inconsistent message," said Lori Cole, executive director of the Eagle Forum, a conservative lobby group founded by Phyllis Schlafly. "If you say, 'don't do it, it's not healthy for you, but if you're going to do it, do it this way,' that sends mixed signals to kids."

Cole argues that teaching teens about contraception and STDs only provides "a means for them to live an unhealthy lifestyle."

Looking for a balance
Despite all the disagreement, there is some middle ground in the debate.

Advocates of comprehensive sex education say the abstinence-only message ignores information critical for teens to protect their health. But they are not against the abstinence message itself.

"Programs in abstinence are very valuable," said Catherine Weiss, director of the ACLU's Reproductive Freedom Project. "It's programs that don't provide any information that we're against. ... It's as if you're trying to prevent kids from riding motorcycles by forbidding them to wear safety helmets."

Scott Phelps, a researcher and public speaker with the abstinence program Project Reality has heard the arguments of both sides and tried to find a balance.

Project Reality, which provides curriculum and support to districts across Illinois, including 140 public schools in the Chicago area, teaches teens about STDs and contraception, but tries to encourage abstinence by emphasizing the physical and emotional risks of teen sex.

"We recognize the problems of STDs and teen pregnancy, but there are also other risks, such as links to depression and suicide," said Phelps.

Not all comprehensive education proponents are pleased with Project Reality's approach. Some say it puts too much negative spin on sex and may frighten kids. But others say it is at least a step in the right direction.

Parents vs. public schools
While activists argue over the right balance, reports show that American parents want some sort of sex education taught in public schools.

A 1999 survey conducted by Hickman-Brown Research Inc. found that 93 percent of all Americans believe sex education should be taught in high schools, and 84 percent believe it should be taught in middle or junior high schools.

Jodi Hoffman, a Florida mother who successfully sued the Broward County public schools, claiming the district's sex education program was too explicit, represents the minority view among parents. Hoffman said information about sex should only be taught at home, where parents can impart their own values to their children.

She was outraged that the comprehensive sex education classes taught in her three children's schools included information about contraception, abortion and homosexuality.

Hoffman said the courses clash head-on with her religious values. Waiting until marriage to have sex "is the way God intended it to be. That's how it's taught in the Bible and those rules were not written for no reason," said Hoffman.

Fight brews over funding
With both sides so far apart, there are few signs that a compromise over sex education will be reached anytime soon. In fact, the battle is only likely to become more heated in the coming year.

In 1996, former President Clinton signed the Welfare Reform Act, which allocated $250 million over five years to be matched by state dollars - a total of $500 million - for abstinence-only programs. During the first year of the program, 48 states accepted the federal money.

The five-year program expires in 2002 and will once again be up for review. Both sides are revving up for an intense and bitter lobbying effort to lock in future financial support for their agendas.

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Soaring rates of sexually transmitted diseases among teens are adding urgency to the debate over sex education. Conservatives claim the alarming statistics illustrate why abstinence should be the single mantra when it comes to sex ed. Liberals counter that the increase in disease is the strongest case for more detailed information.

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This source lists out the different states in the US, and their stance on sex education (if they require the teaching of it or not). Instead of going in to detail about what makes up sex education, the information provided from this source lists statistics about sexual health.

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Why Is Sexual Education Taught in Schools?

A 2017 Centers for Disease Control and Prevention (CDC) survey indicates that nearly 40 percent of all high school students report they have had sex, and 9.7 percent of high school students have had sex with four or more partners during their lifetime. Among students who had sex in the three months prior to the survey, 54 percent reported condom use and 30 percent reported using birth control pills, an intrauterine device (IUD), implant, shot or ring during their last sexual encounter.

The birth rate for women aged 15-19 years was 18.8 per 1,000 women in 2017, a drop of 7 percent from 2016. According to CDC, reasons for the decline are not entirely clear, but evidence points to a higher number of teens abstaining from sexual activity and an increased use of birth control in teens who are sexually active. Though the teen birth rate has declined to its lowest levels since data collection began, the United States still has the highest teen birth rate in the industrialized world.

Certain social and economic costs can result from teen pregnancy. Teenage mothers are less likely to finish high school and are more likely than their peers to live in poverty, depend on public assistance, and be in poor health. Their children are more likely to suffer health and cognitive disadvantages, come in contact with the child welfare and correctional systems, live in poverty, drop out of high school and become teen parents themselves. These costs add up, according to The National Campaign to Prevent Teen and Unplanned Pregnancy, which estimates that teen childbearing costs taxpayers at least $9.4 billion annually. Between 1991 and 2015, the teen birth rate dropped 64%, resulting in approximately $4.4 billion in public savings in one year alone.

Sexually transmitted infections (STIs) disproportionately affect adolescents due to a variety of behavioral, biological and cultural reasons. Young people ages 15 to 24 represent 25 percent of the sexually active population, but acquire half of all new STIs, or about 10 million new cases a year. Though many cases of STIs continue to go undiagnosed and unreported, one in four sexually-active adolescent females is reported to have an STI.

Human papillomavirus is the most common STI and some estimates find that up to 35 percent of teens ages 14 to 19 have HPV. The rate of reported cases of chlamydia, gonorrhea, and primary and secondary syphilis increased among those aged 15-24 years old between 2017-2018. Rates of reported chlamydia cases are consistently highest among women aged 15-24 years, and rates of reported gonorrhea cases are consistently highest among men aged 15-24 years. A CDC analysis reveals the annual number of new STIs is roughly equal among young women and young men. However, women are more likely to experience long-term health complications from untreated STIs and adolescent females may have increased susceptibility to infection due to biological reasons.

The estimated direct medical costs for treating people with STIs are nearly $16 billion annually, with costs associated with HIV infection accounting for more than 81% of the total cost. In 2017, approximately 21 percent of new HIV diagnoses were among young people ages 13 to 24 years.

Sex Education and States

All states are somehow involved in sex education for public schoolchildren.

As of October 1, 2020:

Thirty states and the District of Columbia require public schools teach sex education, 28 of which mandate both sex education and HIV education.

Thirty-nine states and the District of Columbia require students receive instruction about HIV.

Twenty-two states require that if provided, sex and/or HIV education must be medically, factually or technically accurate. State definitions of "medically accurate" vary, from requiring that the department of health review curriculum for accuracy, to mandating that curriculum be based on information from "published authorities upon which medical professionals rely." (See table on medically accuracy laws.)

Many states define parents' rights concerning sexual education:

Twenty-five states and the District of Columbia require school districts to notify parents that sexual or HIV education will be provided.

Five states require parental consent before a child can receive instruction.

Thirty-six states and the District of Columbia allow parents to opt-out on behalf of their children.

Each school district may provide instruction on HIV/AIDS. At minimum the instruction shall be medically accurate, age-appropriate, promote abstinence, discourage drug abuse and dispel myths regarding the transmission of HIV.

Establishes the Colorado comprehensive health education program. Human sexuality instruction is not required, but a school district that offers a human sexuality curriculum shall be comprehensive and maintain content standards for the curriculum that are based on scientific research. Curriculum content standards shall be age-appropriate, medically accurate, encourage parental involvement and family communication, and promote the development of healthy relationships.

Human growth and development and family life responsibilities, including evidence-based and medically accurate information regarding sexual abstinence until marriage and prevention and control of disease, including instruction in grades 6 through 12 on the prevention, transmission and spread of AIDS is included as a major educational area as a basis for curricula in all elementary and secondary schools in the state. All schools that provide sex education courses are required to be developmentally and age appropriate, medically accurate, evidence-based and complete. Comprehensive sex education offered in grades six through 12 must include instruction on both abstinence and contraception for the prevention of pregnancy and diseases. Parents can opt out.

Any public elementary school or secondary school in Louisiana may, but is not required to, offer instruction in subject matter designated as "sex education". "Sex education" shall mean the dissemination of factual biological or pathological information that is related to the human reproductive system and may include the study of sexually transmitted disease, pregnancy, childbirth, puberty, menstruation and menopause, as well as the dissemination of factual information about parental responsibilities under the child support laws of the state.

Any course materials and instructions related to human sexuality and STIs shall be medically and factually accurate. The department of health and senior services shall prepare public education and awareness plans and programs for the general public, and the department of elementary and secondary education shall prepare educational programs for public schools, regarding means of transmission and prevention and treatment of the HIV virus. Beginning with students in the sixth grade, materials and instructions shall also stress that STIs are serious, possible health hazards of sexual activity. The educational programs shall stress moral responsibility in and restraint from sexual activity and avoidance of controlled substance use whereby HIV can be transmitted. Students shall be presented with the latest medically factual and age-specific information regarding both the possible side effects and health benefits of all forms of contraception.

Family life education curriculum must be aligned with the most recent version of the New Jersey Core curriculum Content Standards which requires that instructional material be current, medically accurate and supported by extensive research.

The State Department of Education shall develop curriculum and materials for AIDS prevention education in conjunction with the State Department of Health. A school district may also develop its own AIDS prevention education curriculum and materials. Any curriculum and materials developed for use in the public schools shall be approved for medical accuracy by the State Department of Health. The State Department of Health and the State Department of Education shall update AIDS education curriculum material as newly discovered medical facts make it necessary.

Requires local education agencies to develop and implement a family life education program if the teen pregnancy rate in any county exceeds 19.5 pregnancies per 1,000 females aged 11 through 18. Requires curriculum be age-appropriate and provide factually and medically accurate information. Prohibits instruction and distribution of materials that promote "gateway sexual activity." Requires that parents or guardians be notified in advance of a family life program, allowed to examine instruction materials, and provide written consent for a student to opt-out of family life education.

The State Office of Education must approve all sexuality education programs through the State Instructional Material Commission. Programs must be medically accurate.

Virginia***
A local curriculum plan shall use as a reference the Family Life Education Standards of Learning objectives approved by the Board of Education and shall provide age-appropriate, medically-accurate instruction in relation to students' developmental stages and abilities, and reproduction-related topics.

*Medical accuracy is not specifically outlined in state statue, rather it is required by the New Jersey Department of Education, Comprehensive Health and Physical Education Student Learning Standards.

** Medical accuracy requirement is pursuant to rule R277-474 of the Utah Administrative Code.

***Medical accuracy is not outlined in state statute, rather it is included in the Virginia Department of Education Standards of Learning Document for Family Life Resources.

Source: NCSL, 2019; Guttmacher Institute, 2019; Powered by StateNet

Additional Resources

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national conference of state legislatures

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State Policies on Sex Education in Schools

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A 2017 Centers for Disease Control and Prevention (CDC) survey indicates that nearly 40 percent of all high school students report they have had sex, and 9.7 percent of high school students have had sex with four or more partners during their lifetime.

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WRAL News Article: Announces Partnership between Poe Center and North Carolina Schools  

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WRAL News Article: Announces Partnership between Poe Center and North Carolina Schools  

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The news article provides a Q & A layout by covering common questions asked by parents. The language of the answers, is in favor of sex education.

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LGBTQ Inclusive Sex Education is a requirement in England

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LGBTQ Inclusive Sex Education is a requirement in England

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The news article gives information about the new mandate for high schools in England. The article pulls from supporters as well as the concerns of those who are not in favor of the new requirement. The article does not sway the reader to be in favor of a particular view point.

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LGBTQ-inclusive sex education is now mandatory in all of England's high schools. Starting this month, all English teenagers will learn about lesbian, gay, bisexual, transgender and queer sexual health and positive relationships.

"We want to support all young people to be happy, healthy and safe," a Department for Education spokesperson said in an email to NBC News.

The inclusive sex-ed mandate is part of a broader set of new guidelines rolled out by the department that seek to teach high school students "what makes a good friend, a good colleague and a successful marriage," as well as provide information on contraception, consent and online safety. The curriculum aims to "teach young people to understand human sexuality and to respect themselves and others."

Rather than explored in only one lesson, the guidelines call for information on sexual orientation and gender identity to be integrated into the curriculum so all pupils "understand the importance of equality." It also requests teachers approach the topics sensitively because some students may be discovering their identities.

In the new relationships education curriculum for elementary school children - focusing on healthy families and friendships, not intimate relationships - educators are strongly encouraged to include LGBTQ examples.

"This is a landmark step forward," Josh Bradlow, the policy manager at Stonewall, a United Kingdom-based LGBTQ organization, said. "For me, it would have been life-changing to receive this education."

The Morning Rundown

Bradlow said if the curriculum reflects LGBTQ students' lives, they will better absorb information about healthy relationships and safe sex. As a victim of bullying and someone who struggled with his sexual orientation as a teen, Bradlow also said this inclusive approach to sex education will also encourage heterosexual and cisgender students to view their gay and trans peers as equals.

"This teaching will have just as strong an impact on LGBT people as non-LGBT people," he said. "I think this plays a tremendous and decisive role in helping to tackle bullying."

He also encouraged the curriculum to share examples of same-sex couples in "healthy relationship[s]," which he said would help "normalize" LGBTQ relationships and hopefully spare some students from the discomfort he felt as a gay teen.

Bradlow, who is concerned teachers have not received enough guidance, said his organization has already helped 1,500 schools across England. Stonewall is planning to start virtual lessons that aim to help teachers develop curricula that are inclusive of all students, LGBTQ and straight.

England's new guidelines are a 180 from the curriculum less than two decades ago. It was only in 2003 that the country repealed a 1988 measure, commonly known as Section 28, that prevented educators at state-funded schools from teaching or publishing material relating to homosexuality.

"It had a massive negative impact because of that lack of visibility of LGBT people," said Rachel Williams, a manager at The Proud Trust, an LGBTQ youth organization in northern England. "Growing up knowing you're LGBT, it was just terrifying and frightening."

The new guidelines mandating LGBTQ-inclusive sex education were overwhelmingly supported by English members of Parliamanet, who voted 538-21 in favor of them last year. As for the British public, 60 percent supported elementary school teachers including examples of LGBTQ families in their lessons, and 68 percent of British young people ages 16 to 24 were in favor of LGBTQ-inclusive teaching in all schools, according to research commissioned by Stonewall last year.

While support for the new LGBTQ-inclusive measure has been widespread, it is not without critics. A group of parents in the city of Birmingham that protested lessons on same-sex relationships made international news late last year when they were permanently banned from demonstrating at the school.

As for parents who do not support the LGBTQ-inclusive lessons - or sex education in general - they are able to withdraw their children from the high school sex-ed program until they are 16, the age of consent in England.

"If there's nervousness around this, then seek out what those resources look like," Williams said, adding that many parents who are against the new guidelines don't really understand what their children will be taught.

"It's very gentle and nothing inappropriate," they said of the curriculum.

England is not the first country to offer nationwide LGBTQ-inclusive sex and relationship education. Denmark, Sweden and the Netherlands give their students a comprehensive curriculum that covers sexual diversity.

While the U.S. does not have a countrywide program mandating LGBTQ-inclusive sex education, at least two states - California and New Jersey - have passed and started to implement such measures in their public schools.

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High schools must teach LGBTQ-inclusive sex ed in England

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LGBTQ-inclusive sex education is now mandatory in all of England's high schools. Starting this month, all English teenagers will learn about lesbian, gay, bisexual, transgender and queer sexual health and positive relationships. "We want to support all young people to be happy, healthy and safe," a Department for Education spokesperson said in an email to NBC News.

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Parents in California against the new sexual education curriculum

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Parents in California against the new sexual education curriculum

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The article is in clear support of the parents who are against the "new" sexual health curriculum in California public schools. The article is filled with quotes, and pictures from those speaking out, but lack the balance of the "pro" argument. Since there is a lack, this article is considered to be against rather than neutral.

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California school districts are teaching more detailed descriptions of body parts, sexual acts and sexual diversity.

That's brought a dozen parents outside State Senator Connie Leyva's office one recent afternoon. She leads the Senate Education Committee, which makes decisions about sex ed in public schools.

Many of those parents share an active disdain for California's sex education.

One of them is Michelle New. She pulled her 12-year-old daughter out of public school after learning about the curriculum there.

She says it's not the same lessons she learned when she was in school.

"Sex education taught safety, it taught reproductive, it taught puberty, it did teach condoms and birth control and things like that. But it didn't go over and beyond sexual beliefs, and this curriculum does," she says. "You don't see anything that doesn't have an agenda. It's all agenda-driven."

The new curriculum was passed in 2016 under the Child Healthy Youth Act . It requires that students receive comprehensive sex education at least once in middle school, and once in high school. Parents can opt their kids out. But unless they formally make that request in writing, students are automatically enrolled.

Concern over the curriculum found new life after California approved resources and textbooks in May 2019. So this is the first school year since those recommendations came out.

Stephanie Yates' son is a freshman in high school this year, but she put him in private school to avoid the curriculum.

She pulls out one of the books that was originally recommended to teachers, and reads a bookmarked page. "It's like, do you laugh or cry? This is how bad it is. It says ... 'body fluid blood play.' Not only that, it says, 'what is it, and how do you do it?' "

She goes on to read detailed, explicit explanations of how to engage in types of manual stimulation and oral sex.

But that's only one of the pieces that parents are upset about.

There's also the new focus on diversity. Teachers are encouraged to use more LGBTQ-inclusive language. Children learn about gender identity, sexual orientation, and sexuality across different schools subjects. Parents can't opt out of that.

Linda Liu was angry after she discovered one of her son's assignments. He had drawn several scenes that promoted tolerance of the LGBTQ+ community. She says she discovered that he had been learning about gender identity and expression for a month without her notice.

She says the diversity and inclusion curriculum shouldn't be taught before puberty: "It's most important to understand themselves. Too much complicated information to the 10-year-old kid. It's not age appropriate."

Parents blame the new focus on diversity and inclusion for some of the more explicit information in sexual education. Since educators are teaching about gay and straight couplings, they're also explaining more than procreative, vaginal sex. Recommended resources show illustrations of oral and anal sex as well.

But politicians like Leyva disagree with the parents who protest outside her office. She has two adult daughters who went through public school sex education.

"I did not feel that it was not age appropriate. I had the opportunity as a parent to review the material if I went into the school and asked for it, which I believe all parents have that right now. There's nothing in there that is not age appropriate."

As for administrators, most declined to comment or did not respond to requests. More than half a dozen school districts were contacted for this story, and none of them agreed to speak.

LAUSD provided a written statement. A spokesperson said, " Before this legislation passed, Los Angeles Unified already had a program in place that met these new requirements. Los Angeles Unified has a long history of providing a comprehensive health curriculum, and has been a model in this work throughout the nation."
What do you want to know more about?

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Parents on California sex ed: Too graphic, too detailed, too much LGBTQ talk

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California school districts are teaching more detailed descriptions of body parts, sexual acts and sexual diversity. That's brought a dozen parents outside State Senator Connie Leyva's office one recent afternoon. She leads the Senate Education Committee, which makes decisions about sex ed in public schools.

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Connections between Sexual Education and Lives are Made

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Connections between Sexual Education and Lives are Made

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In this interview, Actor and UN Goodwill Ambassador Dia Mirza discusses the negative mindset about gender equality and how sexual education is important to teach the correct views of gender. She discusses how sex education is important when achieving a respectful environment for all genders.

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India https://t.co/KHQlxEoKEX

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India pic.twitter.com/KHQlxEoKEX
— NDTV (@ndtv) September 5, 2020

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India https://t.co/KHQlxEoKEX

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India https://t.co/KHQlxEoKEX

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#LifesavingConversations | "Unfortunately sex education is not a part of our education": Actor and UN Goodwill Ambassador Dia Mirza (@deespeak) on sex education in India

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My Stance and Why My Sources Against Sexual Health are Limited

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My Stance and Why My Sources Against Sexual Health are Limited

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My Stance and Why My Sources Against Sexual Health are Limited