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How did Sex Ed in the U.S. Become Such a Disaster?

Most people who went through middle or high school in the U.S. are well aware that sex ed can be… lacking, to put it mildly. I, for one, remember that scene in Mean Girls far better than I remember my own experience.

Still, you may be surprised by just how bad sex ed in this country continues to be. Only three states require comprehensive sex ed, which “seeks to equip young people with the knowledge, skills, attitudes, and values they need to determine and enjoy their sexuality — physically and emotionally, individually and in relationships.” Only 18 states require that the information being taught is medically accurate.

These statistics beg the question: What exactly are schools teaching in sex ed? Since there’s no national standardization of programming, it’s a mixed bag. And, as far as the Origin team knows, pelvic health — which goes beyond birth control and STIs to include basic pelvic anatomy and healthy sexual functioning — is largely, if not completely, missing.

To discover where we currently stand and how we got here, we dove into the research to learn about the long and complicated history of sex education in the U.S. You won’t be surprised to hear that it's steeped in sexism and racism — and has been shaped and reshaped by political agendas.

Let's start with what’s going on today.

By the Numbers: The Current State of Sex Ed

According to the Sexuality Information and Education Council of the United States (SIECUS), only California, Oregon, and Washington have laws that require schools to teach comprehensive sex ed, aka the kind that helps kids "determine and enjoy their sexuality."

In other states, the goals and content of sex ed differ widely, as revealed in a survey by the Guttmacher Institute.

Which states require sex ed?

Only half the states plus DC require both sex ed and HIV/AIDs education in schools. What's worse is that not all information taught in sex ed is required to be medically accurate, leaving students potentially misinformed about a topic that can already be confusing and embarrassing to learn about.

  • Only 3 states require that comprehensive sex ed be taught in public schools.
  • Only 10 states require HIV/AIDS education.
  • Only 18 states require that sex-ed and HIV/AIDS programming be medically accurate.
  • 26 states and DC require that instruction be age appropriate.
  • 40 states and DC require parental involvement in sex ed and/or HIV/AIDS education.

Are kids learning about birth control?

Many states continue to focus on abstinence rather than contraception, despite the fact that discussing contraception isn’t associated with increased risk of sexual activity, pregnancy, or STDs.

  • 20 states and DC require contraception information.
  • 29 states require programming that emphasizes and encourages abstinence.

Is sex ed getting more inclusive?

All youth, regardless of how they identify, deserve medically accurate, age-appropriate education that supports their sexual health — but the numbers make it clear that this isn’t happening.

  • Only 10 states require that programming is culturally responsive and unbiased.
  • Only 4 states require that programming does not promote religion.
  • Only 10 states and DC require programming to be inclusive in relation to sexual orientation.
  • Only 4 states require information about queerness to be negative or for information to emphasize straightness as positive.
  • And 1 state (Florida) prohibits any information on sexual orientation, gender identity, or gender expression.

What about education that goes beyond sex?

Most sex ed today has expanded to cover related issues in an effort to keep teens safe.

  • 35 states and DC require education around healthy romantic and sexual relationships.
  • 40 states and DC require that education cover teen dating and sexual violence.
  • Only 2 states, plus DC, have sex-ed programming that affirms abortion care.

Ok, but how do parents feel about all this?

As you'd imagine, opinions vary from county to county and state to state. That said, according to a recent national survey, American parents are overall very in favor of comprehensive sex education.

  • 70% of parents say comprehensive sex ed is important for the well-being of children
  • 70% of parents say that sex ed/reproductive health should be taught by certified instructors
  • 64% say sex ed should be a mandatory part of school curriculum
  • 51% say schools should spend more time covering topics related to sex ed

Based on all of these stats, it's clear that the current state of sex ed in America is inadequate. So how did sex ed get so messed up?

3 Dark Truths About the History of Sex Ed

The very first sex information lectures in the US were hosted by "social hygienists" in the 1900s. They sought to control sexual behavior by enforcing certain norms and leveraging shame and the threat of sexually transmitted disease. Much about sex education has changed from those early lectures, but three things have stayed true throughout.

1. Most sex ed has primarily been driven by fear.

The social hygienists and those who came after them to shape sex ed were driven by fears of:

  • Promiscuity: From pushing the idea that sex work and sex outside of marriage was “risky” to “purity talks” in Chicago public schools in 1913 to abstinence-only messaging, the takeaway has long been that the natural urges and thoughts we have around sex are fundamentally “bad.”
  • STIs: When World War I increased fears about STIs, the government invested in sex-ed programs primarily designed to protect soldiers from sexually-transmitted disease.
  • Out-of-wedlock children: Family Life Education (FLE) programs in the ‘40s and ‘50s advised against premarital sex while promoting traditional gender roles.

2. Abstinence has dominated sex ed.

Since the start, sex ed has promoted the idea that withholding information about contraception and idealizing abstinence will stop people from engaging in sexual activities.

  • The WWI programs for soldiers equated abstinence with patriotism and upward mobility.
  • At the start of the Reagan administration, federal funding from the Adolescent Family Life Act (AFLA) went toward developing “chastity education” — the foundation for future abstinence-only sex-ed programs.
  • These programs gained a following in the 1990s, as the Christian Right claimed they would prevent HIV/AIDS and teen pregnancy, bring family values to sex ed, and fix societal issues like divorce, poverty, and crime.
  • Throughout the years, federal funding from various streams has flowed to support abstinence-only sex-ed programs. This despite research, starting in 2007, demonstrating that such programs were ineffective and potentially harmful.

3. Sex ed has been modeled on and aimed at the white middle class.

Social hygiene sex ed taught young white men that white, male, middle class sexuality was the norm — and anything else was unhealthy. According to Courtney Shah, author of Sex Ed, Segregated, sex education in the early to mid 20th century “was rife with eugenics language about improving the race… And it was used to justify existing political hierarchies.”

This white superiority has continued into the modern era. In the 1990s, “welfare reform” efforts led to a new channel for federal funding in support of abstinence-only sex-ed programs. That may sound innocent on the surface, but both “welfare reform” and abstinence-only sex-ed programs historically promoted racist and eugenic ideologies.

Today, “sexual risk avoidance” programs often include “poverty prevention” as a goal. In this context, though, “poverty prevention” puts all responsibility on the individual and their sexual behaviors and ignores systemic barriers to economic stability.

How Gaps in Sex Ed Harm Our Pelvic Health

Every year in the U.S., more than 40 million women suffer from symptoms of pelvic floor dysfunction that range from pain with intercourse to bladder and bowel issues. Due to little or no in-school education and lack of conversations about sex and anatomy at home, many adolescent and adult people assigned female at birth have major gaps in knowledge when it comes to pelvic health.

Open discussion of pelvic anatomy and health in any arena has been restricted by the stigmatization of female sexuality, the medical focus on disease rather than wellness, and the dearth of research investigating female bodies. One notable example is the general awareness of clitoral anatomy. It wasn’t until 2005 that Australian urologist Helen O’Connell identified, described, and published the complete structure of the clitoris.

There are countless benefits to knowing pelvic anatomy and how the muscles, connective tissues, and pelvic organs all work together to support bladder, bowel, and sexual health, including:

  • Understanding the mechanics of both pregnancy prevention and fertility.
  • Understanding how muscle and nerve function as well as blood flow enhance enjoyment of sex.
  • Recognizing the symptoms of pelvic floor dysfunction, from pain with intercourse, to constipation, to bladder leaks and chronic constipation.
  • Reducing the distress caused by symptoms of PFD and encouraging people to get care when they need it.

As advocates continue to push for standardized, comprehensive sex ed for all, we hope to see a stronger focus on pelvic anatomy and health. Although SIECUS’s Guidelines for Comprehensive Sexuality Education offer many important recommendations for more inclusive and affirming sex-ed instruction, there are several limitations from our perspective:

  • “Reproductive and sexual anatomy and physiology” is listed as a key concept, but neither “pelvic health” or the “pelvic floor” is mentioned.
  • There’s minimal focus on understanding sexual arousal and pleasure.
  • The section that discusses topics related to sexual dysfunction does not specify pelvic floor dysfunction.

Updating sexual education to include pelvic health — or, better yet, reimagining sex ed in a way that will allow us to move away from its sexist and racist history — has the potential to empower new generations with a more complete and positive relationship to their bodies.

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Sarah DuRivage-Jacobs
Sarah duRivage-Jacobs

Sarah duRivage-Jacobs is a reproductive health copywriter, editor, content strategist, and educator.

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