Guidelines for the Sexual Health Education Component of Comprehensive Health Education

Overview of Sexual Health Education

In this section:

group of students embracing and laughing

All students should have the opportunity to be fit, healthy and ready to learn. Healthy children make better students, and better students make healthy communities. Education must address the needs of the whole child. Student’s physical, social and emotional development requires the same level of ongoing assessment and support as their academic development (CSDE, CSH Guidelines, 2007, p.5). Sexual health education is an essential component of students’ physical, social and emotional development. “Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs and values about such important topics as identity, relationships and intimacy” (SIECUS, Guidelines, 2004, p.11). The overall goal of sexual health education is to provide young people with the knowledge and skills to promote their health and well-being as they mature into sexually healthy adults (SIECUS, Guidelines, 2004). 

Sexual health education should be delivered within the context of a planned, ongoing and systematic health education curriculum. “School-based comprehensive sexuality education ideally begins in preschool or kindergarten, building upon key concepts each year until graduation from high school. It is best offered within the context of a comprehensive health curriculum and most effective when messages are reinforced by parents and the community” (Hedgepeth and Helmich, 1996, p. 2). In addition, sexual health education should be developmentally appropriate, medically accurate and use scientifically based approaches.

Medically accurate is defined as:

  • information relevant to informed decision-making based on the weight of scientific evidence; 
  • consistent with generally recognized scientific theory; 
  • conducted under accepted scientific methods; 
  • published in peer-reviewed journals;   
  • recognized as accurate, objective, and complete by mainstream professional organizations; and 
  • the deliberate withholding of information that is needed to protect life and health (and therefore relevant to informed decision-making) should be considered medically inaccurate (Santelli, 2008, p. 1791.).

Fundamental principles

The Sexuality Information and Education Council of the United States (SIECUS Guidelines, 2004) cites the following principles as fundamental to guide the development of sexual health education programs:

  • Parent and Community Involvement:  School-based programs must be carefully developed to respect the diversity of values and beliefs represented in the community. Parents, family members, teachers, administrators, community and faith-based leaders, and students should have an opportunity to provide input into sexual health education programs. 
  • Being a Component of a Comprehensive School Health Education Program:  Sexual health education should be offered as part of an overall health education program and can best address the broadest range of issues in the context of health promotion, social and gender equity, and disease prevention. Communities and schools should seek to integrate the concepts and messages in the Guidelines for a Coordinated Approach to School Health (CSH Guidelines) into their overall health education initiatives. 
  • A Focus on All Youth:  All children and youth will benefit from sexual health education regardless of gender, sexual orientation, gender identity, ethnicity, race, socioeconomic status, or disability. Programs and materials should be adapted to reflect the specific issues and concerns of the community as well as any special needs of the learners. In addition, curricula and material should reflect the cultural diversity represented in the classroom.
  • Well-Trained Teachers:  Sexual health education should be taught by specially trained teachers. Professionals responsible for sexual health education must receive training in teaching human sexuality, including the philosophy and methodology of sexuality education. While ideally teachers should attend academic courses or programs in schools of higher education, in-service courses, continuing education classes, and intensive seminars can also help prepare sexuality educators. 
  • A Variety of Teaching Methods:  Sexual health education is most effective when young people not only receive information but also are also given the opportunity to examine their own and society’s attitudes and values and to develop or strengthen social skills. A wide variety of teaching methods and activities can foster learning, such as interactive discussions, roleplaying, individual and group research, group exercises, and homework assignments (SIECUS Guidelines, 2004).

A more in-depth explanation of these fundamental principles is offered in Section 2 of the CT Guidelines.

Support for Sexual Health Education

There is broad public support for sexual health education. A vast majority of Americans support sexual health education that is medically accurate, age-appropriate and that includes information about both abstinence and contraception. They also believe that young people should be given information about how to protect themselves from unintended pregnancies and STDs (Kaiser Family Foundation, 2002). Repeated national, state and local surveys show that about 85 percent of parents support sex education in public schools (SIECUS, 2000). In Connecticut, 91 percent of the general public support sexual health education in high school and 79 percent support it in junior high. This support cuts across geography, race, ethnicity, age, income, and political and religious affiliations (Advocates for Youth and The Parisky Group, 2004).

The Guttmacher Institute reported that young people also want more information about sexuality than they are currently receiving in school. “Approximately half of students in Grades 7-12 report needing more information about what to do in the event of rape or sexual assault, how to get tested for HIV and other STDs, factual information on HIV/AIDS and other STDs, and how to talk with a partner about birth control and STDs” (Dailard, 2001). Among teenage males specifically, 30 percent do not receive any sexual health education before having sexual intercourse for the first time (Dailard, 2001).  

Approaches to Sexual Health Education

According to Kirby 2002, “schools began developing programs to address adolescent sexuality during the 1970s when adolescent sexual behavior, unintended pregnancy, STDs, and their consequences were better measured and publicized. Schools responded far more dramatically when AIDS became a prominent problem in the latter part of the 1980s” (Kirby, 2002, np). 

Over the ensuing decades, sexual health education has had its share of debates.  Initially, critics charged that public schools were not the place for sexual health education and that it should be left to families and faith communities.  Today, there is less debate about whether schools should teach sexual health education.  A major national poll of the public and parents has shown that 93 percent of Americans think that sexual health education should be taught in schools (NPR/Kaiser Family Foundation/Kennedy School of Government, 2004).  Much of the discussion during the last two decades has focused on how sex education programs should best help teens avoid or reduce their sexual risk-taking behavior.  Proponents of sexual health education believe that programs should emphasize abstinence and also teach about methods of reducing sexual risks – contraception and condoms.  Proponents of ‘abstinence-only’ approaches believe that teaching abstinence until marriage is the only way to help teens reduce sexual risks (Kaiser Family Foundation, October 2002).

It is essential that local boards of education, parents/guardians and community members have a clear understanding of the different approaches to teaching sexual health education. An approach to sexual health education is a commitment to implementing best practice based on research that effectively addresses the needs of all students in a school community. Local boards of education have the responsibility to adopt policies that support research-based and medically-accurate sexual health education programs that are compatible with community values and needs. It is the district’s responsibility to implement developmentally-appropriate programs with fidelity in prekindergarten through Grade 12. The CSDE has published Guidelines for a Coordinated Approach to School Health (2007)to assist school districts in developing, implementing and evaluating policies, practices and programs, including comprehensive health education In addition, the Healthy and Balanced Living Curriculum Framework (CSDE, 2006), defines recommendations for content standards and performance indicators about what students should know and be able to do from prekindergarten to Grade 12. 

SIECUS (2010) identifies the following approaches to sexual health education:

  • Sexual Health Education: Sexual health education programs include age-appropriate, medically accurate information on a broad set of topics related to sexuality including human development, relationships, decision-making, abstinence, contraception, and disease prevention. They provide students with opportunities for developing skills as well as learning information. 
  • Abstinence-based: Programs that emphasize the benefits of abstinence. These programs also include information about sexual behavior other than intercourse as well as contraception and disease-prevention methods. These programs are also referred to as abstinence-plus or abstinence-centered.
  • Abstinence-only: Programs that emphasize abstinence from all sexual behaviors. These programs do not include information about contraception or disease-prevention methods. 
  • Abstinence-only-until-marriage: Programs that emphasize abstinence from all sexual behaviors outside of marriage. If contraception or disease-prevention methods are discussed, these programs typically emphasize failure rates. In addition, they often present marriage as the only morally correct context for sexual activity. 
  • Fear-based: Abstinence-only and abstinence-only-until-marriage programs that are designed to control young people’s sexual behavior by instilling fear, shame, and guilt. These programs rely on negative messages about sexuality, distort information about condoms and sexually transmitted diseases (STD), and promote biases based on gender, sexual orientation, marriage, family structure, and pregnancy options (SIECUS, Sexuality Education Q & A, 2010). 

Effectiveness of Different Approaches to Sexual Health Education 

According to Kirby (2007), research on comprehensive approaches to sexual health education has shown that:

  • sexual health education that at least provides information about abstinence and contraception can delay the onset of sexual activity among teens, reduce their number of partners, and increase safer sex practices and contraceptive use when they do become sexually active; and 
  • conversely, teaching young people about sex and contraception does not lead to early sexual activity or experimentation (Kirby, 2007, p.122-123). 

In 2005, Mathematica Policy Research, Inc., a highly regarded, private research organization, released a much-anticipated federally-funded evaluation of abstinence-only-until-marriage programs. The study found “that youth in the program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners and had initiated sex at the same mean age” (Trenholm et. al, 2007). 

In conclusion, evidence clearly demonstrates that sexual health education is an essential component of comprehensive health education in Connecticut schools. It is what students say they want and need, it is what teachers know their students need, it is what parents and the general public support, and it is what science says is effective.  By providing developmentally appropriate sexual health education in prekindergarten through Grade 12, Connecticut schools can lay an important foundation that:

  • will help young people grow up to be sexually healthy adolescents and adults; 
  • provides youth with the knowledge, skills, and attitudes they need to prevent HIV and other sexually transmitted infections; and 
  • increases young people’s ability to prevent unintended pregnancies during the teen years and beyond. 


Status of Sexual Health Education in Connecticut

The Connecticut State Department of Education (CSDE) has a general picture of the health education topics that are taught in Connecticut middle and high schools. Results from the 2010 Connecticut School Health Profiles (SHP), a survey of middle and high school principals and lead health teachers supported by the Centers for Disease Control and Prevention (CDC), indicate that the vast majority of required health education courses in Grades 6-12 include instruction on HIV prevention (87 percent), human sexuality (88 percent), pregnancy prevention (78 percent) and STD prevention (87 percent) (SHP, 2008).  

three girls wispering to eachother in the hallway at school 

The SHP provides information about the specific content, quantity, or quality of HIV, STDs and pregnancy prevention instruction. With regard to HIV prevention, the survey found that 95 percent of high school health teachers and 75 percent of middle school health teachers taught abstinence as the most effective method to avoid HIV infection. Overall, schools are less likely to provide instruction on topics considered to be sensitive or controversial such as the importance of using condoms consistently and correctly (66 percent) and how to obtain condoms (56 percent). Middle school health teachers were generally less likely to teach specific HIV, STD and pregnancy prevention topics than high school health teachers.  

Specific guidance on sexual health education is included Section 3 of this document. 

Legislation Pertaining To Health Education Instructional Content

The following state mandates support the implementation of comprehensive school health education that includes sexual health education. There are several state statutes relating to health education instructional content. For full statutory language on health education content and family life education, refer to Appendix A .

The primary requirement is found in Section 10-16b of the Connecticut General Statutes (C.G.S.), which prescribes courses of study in public schools. A program of study in health and safety education must be offered in kindergarten through Grade 12 in a planned, ongoing and systematic fashion and include, at a minimum, human growth and development; nutrition; first aid; disease prevention; community and consumer health; physical, mental and emotional health, including youth suicide prevention, substance abuse prevention, safety, which may include the dangers of gang membership, and accident prevention. Health and safety education is included as a planned program of study and must be treated like any other content area with regard to quality of curriculum and instruction. 

C.G.S. Section 10-16c directs the CSDE to develop a curriculum guide to aid local and regional boards of education in developing family life education programs within the public schools. 

C.G.S. Section 10-16e says students are not required to participate in family life education programs. 

C.G.S. Section 10-19(a) requires instruction regarding the use of alcohol, nicotine, tobacco and drugs every academic year to all students in kindergarten through Grade 12 in a planned, ongoing and systematic fashion. Required content includes teaching about the knowledge, skills and attitudes required to understand and avoid the effects of alcohol, of nicotine or tobacco and of drugs on health, character, citizenship and personality development.

C.G.S. Section 10-19(b) requires that instruction in Acquired Immune Deficiency Syndrome (AIDS) be offered in kindergarten through Grade 12, during the regular school day in a planned, ongoing and systematic fashion. Parents/guardians have the right to opt their child out of such instruction. 

CSDE highly recommends that family life education be a component of sexual health education. As previously stated, sexual health education should be delivered within a comprehensive school health education planned program within the context of a coordinated approach to school health. This approach provides an opportunity for school, family and community involvement in addressing sexual health and well-being of children and youth.

Connecticut requires school districts to cover human growth and development, disease prevention and AIDS education. It does not mandate sexual health education. However, national and state data strongly support the need for the inclusion of sexual health education within school health programs. According to C.G.S. Section 10-16c, the State Board of Education (SBE) must develop family life education curriculum guidelines that “shall include, but not be limited to, information on developing a curriculum including family planning, human sexuality, parenting, nutrition and the emotional, physical, psychological, hygienic, economic and social aspects of family life, provided the curriculum guides shall not include information pertaining to abortion as an alternative to family planning.” Specific instruction for all curricula areas is left to the discretion of local or regional boards of education.  

Parents/guardians may submit a written notification to the local or regional board of education in order to exempt their child from instruction pertaining to HIV/AIDS and family life education. Local districts should clearly define which classroom lessons specifically address HIV/AIDS and family life education. If a student is exempt from these identified lessons, it is recommended that the local district offer an alternative health education related assignment during the time when HIV/AIDS and family life education is being taught. It is further recommended that districts provide an ongoing opportunity for parents/guardians to review curricular materials prior to classroom instruction in family life education, as well as, sexual health education.