Skip to main content

Advertisement

SpringerLink
Log in

Sex Education for LGBTQ+ Adolescents

  • Published:
Current Sexual Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This paper summarizes the current research on the impact of abstinence-only sex education programs on LGBTQ+ adolescent health in the USA. We also seek to explore the current barriers to implementing comprehensive sex education, as well as discuss the future of LGBTQ+ adolescent health by outlining crucial components of LGBTQ+-inclusive sex education.

Recent Findings

The US sex education debate is centered on two approaches: abstinence-only and comprehensive. Abstinence-only sex education emphasizes risk reduction through abstaining from sexual behavior and has been found to be ineffective in promoting healthy sexual behavior among adolescents, compared to comprehensive sex education which centers on disseminating inclusive and medically accurate information. Abstinence-only sex education is taught through a heteronormative framework that excludes and devalues the experiences of LGBTQ+ adolescents. LGBTQ+ individuals are at increased risk for negative health outcomes as compared to their cisgender heterosexual counterparts. Lack of knowledge regarding safe sexual practices and consent, coupled with the shame and fear-based messaging promoted by abstinence-only sex education, further contributes to the health disparities experienced by LGBTQ+ youth.

Summary

The content and inclusivity of sex education has important implications for the health of LGBTQ+ youth. Abstinence-only sex education further compounds the health disparities experienced by LGBTQ+ adolescents by erasing LGBTQ+ representation and leaving out crucial information on diverse, non-heterosexual sex practices. Numerous barriers exist to implementing comprehensive, inclusive sex education including funding, policies, teacher training, and attitudes toward sex and LGBTQ+ individuals. To address these health disparities, we must listen to and amplify the voices of LGBTQ+ youth to promote safe, comprehensive, and LGBTQ+-inclusive content within our sex education system in the USA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Huber VJ, Firmin MW. A history of sex education in the United States since 1900. Int J Educ Reform. 2014;23:25–51.

    Article  Google Scholar 

  2. Alford S. Sex education programs: definitions & point-by-point comparison. Advocates for Youth, 2001. https://www.advocatesforyouth.org/resources/fact-sheets/sex-education-programs-definitions-and-point-by-point-comparison/. Accessed 23 Sept 2023

  3. Bodnar K, Tornello SL. Does sex education help everyone?: sex education exposure and timing as predictors of sexual health among lesbian, bisexual and heterosexual young women. J Educ Psychological Consult. 2019;29(1):8–26.

    Article  Google Scholar 

  4. Bruener CC, Mattson G. Committee on Psychosocial Aspects of Child and Family Health. Sexuality education for children and adolescents. Pediatrics. 2016;138:e1–e11.

    Google Scholar 

  5. Kramer AS. Framing the debate: the status of US sex education policy and the dual narratives of abstinence-only versus comprehensive sex education policy. Am J Sex Educ. 2019;14:490–513.

    Google Scholar 

  6. Kirby D. Emerging answers 2007: research findings on programs to reduce teen pregnancy and sexually transmitted diseases. Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy; 2007.

    Google Scholar 

  7. Santelli J, Grilo SA, Lindberg LD, Speizer I, Schalet A, Heitel J, et al. Abstinence-only-until-marriage policies and programs: an updated position paper of the Society for Adolescent Health and Medicine. J Adolesc Health. 2017;61:400–3.

    Article  PubMed Central  Google Scholar 

  8. Santelli JS, Kantor LM, Grilo SA, Heck CJ, Rogers J, Ott MA, et al. Abstinence-only-until-marriage: an updated review of U.S. policies and programs and their impact. J Adolesc Health. 2017;61:273–80.

    Article  PubMed  Google Scholar 

  9. Trenholm C, Devaney B, Fortson K, Quay K, Wheeler J, Clark M. Impacts of four Title V, Section 510 abstinence education programs. Final report. Princeton, NJ: Mathematica Policy Research, Inc.; 2007.

    Google Scholar 

  10. Kohler PK, Manhart LE, Lafferty WE. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. J Adolesc Health. 2008;42:344–51.

    Article  PubMed  Google Scholar 

  11. Rasberry CN, Condron DS, Lesesne CA, Adkins SH, Sheremenko G, Kroupa E. Associations between sexual risk-related behaviors and school-based education on HIV and condom use for adolescent sexual minority males and their non-sexual-minority peers. LGBT Health. 2017;5:69–77.

    Article  PubMed  Google Scholar 

  12. Rasberry CN, Lowry R, Johns M, Robin L, Dunville R, Pampati S, et al. Sexual risk behavior differences among sexual minority high school students - United States, 2015 and 2017. Morb Mortal Wkly Rep. 2018;67:1007–11.

    Article  Google Scholar 

  13. Kann L, Olsen EO, McManus T, Harris WA, Shanklin SL, Flint KH, et al. Sexual identity, sex of sexual contacts, and health-related behaviors among students in grades 9-12 - United States and selected sites, 2015. MMWR Surveill Summ. 2016;65:1–202.

    PubMed  Google Scholar 

  14. Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Queen B, et al. Youth risk behavior surveillance — United States, 2017. MMWR Surveill Summ. 2018;67:1–114.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Heels SW. The impact of abstinence-only sex education programs in the United States on adolescent sexual outcomes. Perspectives. 2019;11:3.

    Google Scholar 

  16. Hoefer SE, Hoefer R. Worth the wait? The consequences of abstinence-only sex education for marginalized students. Am J Sex Educ. 2017;12:257–76.

    Google Scholar 

  17. Naser SC, Clonan-Roy K, Fuller KA, Goncy EA, Wolf N. Exploring the experiences and responses of LGBTQ+ adolescents to school based sexual education. Pyschol Sch. 2022;59:34–50.

    Article  Google Scholar 

  18. Kosciw JG, Greytak EA, Zongrone AD, Clark CM, Truong NL. The 2017 National School Climate Survey: the experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation’s schools. New York: GLSEN; 2018.

    Google Scholar 

  19. Evans R, Widman L, Goldey K. The role of adolescent sex education in sexual satisfaction among LGB+ and heterosexual young adults. Am J Sex Educ. 2020;15:310–35.

    Google Scholar 

  20. Estes ML. “If there’s one benefit, you’re not going to get pregnant”: the sexual miseducation of gay, lesbian and bisexual individuals. Sex Roles. 2017;77:615–27.

    Article  Google Scholar 

  21. Hobaica S, Kwon P. “This is how you hetero:” sexual minorities in heteronormative sex education. Am J Sex Educ. 2017;12(4):423–50.

    Google Scholar 

  22. Hobaica S, Schofield K, Kwon P. “Here’s your anatomy…good luck”: transgender individuals in cisnormative sex education. Am J Sex Educ. 2019;14:358–87.

    Google Scholar 

  23. Ozata B, Yuksel S, Noyan H, Avayu M, Yildizhan E. EPA-0185 - effects of sex reassignment surgery on quality of life and mental health in transsexuals. Eur Psychiatry. 2014;29:1–1.

    Article  Google Scholar 

  24. Heer B, Brown M, Cheney J. Sexual consent and communication among the sexual minoritized: the role of heteronormative sex education, trauma, and dual identities. Fem Criminol. 2021;16:701–21.

    Article  Google Scholar 

  25. Tabaac AR, Johns MM, Zubizarreta D, Haneuse S, Tan ASL, Austin SB, et al. Associations between sexual orientation, sex education curriculum, and exposure to affirming/disaffirming LGB content in two US-based cohorts of adolescents. Sex Educ. 2022; https://doi.org/10.1080/14681811.2022.2072286.

  26. Keller L. Adolescents deserve better: what the Biden-Harris administration and congress can do to bolster young people’s sexual and reproductive health. Guttmacher Pol Rev. 2021;24:8–13.

    Google Scholar 

  27. Proulx CN, Coulter RWS, Egan JE, Matthews DD, Mair C. Associations of lesbian, gay, bisexual, transgender, and questioning–inclusive sex education with mental health outcomes and school-based victimization in U.S. high school students. J Adolesc Health. 2019;64:609–14.

    Article  Google Scholar 

  28. Mata D, Korpak AK, Sorensen BL, Dodge B, Mustanski B, Feinstein BA. A mixed methods study of sexuality education experiences and preferences among bisexual, pansexual, and queer (bi+) male youth. Sex Res Soc Policy. 2022;19:806–21.

    Article  Google Scholar 

  29. Crowell C. Anti-gay sex education: a lasting tool for discrimination? Law Sex. 2019;28:45–57.

    Google Scholar 

  30. Epps B, Markowski M, Cleaver K. A rapid review and narrative synthesis of the consequences of non-inclusive sex education in UK schools on lesbian, gay, bisexual, transgender and questioning young people. J Sch Nurs. 2021:10598405211043394.

  31. Kanuga M, Rosenfeld WD. Adolescent sexuality and the internet: the good, the bad, and the URL. J Pediatr Adolesc Gynecol. 2004;17:117–24.

    Article  PubMed  Google Scholar 

  32. Kaczkowski W, Cooper AC, Li J, Robin L. The association of LGBTQ-supportive school health policies and practices with sexual health outcomes. LGBT Health. 2022;9:384–92.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sondag KA, Johnson AG, Parrish ME. School sex education: teachers’ and young adults’ perceptions of relevance for LGBT students. J LGBT Youth. 2020;19:247–67.

    Article  Google Scholar 

  34. Donovan MK. The looming threat to sex education: a resurgence of federal funding for abstinence-only programs? Guttmacher Pol Rev. 2017;20:44–7.

    Google Scholar 

  35. Sexuality Information and Education Council of the United States. A history of abstinence-only-until-marriage (AOUM) funding. SIECUS Sex Ed for Social Change, 2019. https://siecus.org/wp-content/uploads/2019/05/AOUM-Funding-History-Report-5.2019.pdf. Accessed 23 Sept 2023

  36. Feldman Farb A, Margolis AL. The teen pregnancy prevention program (2010–2015): synthesis of impact findings. Am J Public Health. 2016;106:S9–S15.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Fox AM, Himmelstein G, Khalid H, Howell EA. Funding for abstinence-only education and adolescent pregnancy prevention: does state ideology affect outcomes? Am J Public Health. 2019;109:497–504.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Guttmacher Institute. Sex and HIV education, 2022. https://www.guttmacher.org/state-policy/explore/sex-and-hiv-education. Accessed 23 Sept 2023

  39. Kantor LM, Santelli JS, Teilte J, Balmer R. Abstinence-only policies and programs: an overview. Sex Res Soc Pol. 2008;5:6–17.

    Article  Google Scholar 

  40. Hammig B, Ogletree R, Wycoff-Horn MR. The relationship between professional preparation and class structure on health instruction in the secondary classroom. J Sch Health. 2011;81:513–9.

    Article  PubMed  Google Scholar 

  41. Price JH, Dake JA, Kirchofer G, Telljohann SK. Elementary school teachers’ techniques of responding to student questions regarding sexuality issues. J Sch Health. 2003;73:9–14.

    Article  PubMed  Google Scholar 

  42. Rhodes DL, Kirchofer G, Hammig BJ, Ogletree RJ. Influence of professional preparation and class structure on sexuality topics taught in middle and high schools. J Sch Health. 2013;83:343–9.

    Article  PubMed  Google Scholar 

  43. Montana Office of Public Instruction. Montana health enhancement standards model curriculum guide for K-12 health and physical education. Health Enhancement and Safety Division. 2016; https://opi.mt.gov/Portals/182/Page%20Files/Health%20%26%20Physical%20Education/HE_ModelCurriculumGuide.pdf. Accessed 23 Sept 2023

  44. Kennedy C, Covell K. Violating the rights of the child through inadequate sexual health education. Int J Child Rights. 2009;17:143–54.

    Article  Google Scholar 

  45. Boushka B. Homosexuality should be discussed in high schools. In: Wells KR, editor. Teenage sexuality: opposing viewpoints. Detroit, MI: Greenhaven Press; 2006. p. 183–92.

    Google Scholar 

  46. Feinstein B, Thomann M, Coventry R, Macapagal K, Mustanski B, Newcomb M. Gay and bisexual adolescent boys’ perspectives on parent-adolescent relationships and parenting practices related to teen sex and dating. Arch Sex Behav. 2018;47:1825–37.

    Article  PubMed  Google Scholar 

  47. Mustanski B, Greene G, Ryan D, Whitton S. Feasibility, acceptability, and initial efficacy of an online sexual health promotion program for LGBT youth: the Queer Sex Ed intervention. J Sex Res. 2015;52:220–30.

    Article  PubMed  Google Scholar 

  48. Atkins DN, Bradford WD. The effect of state-level sex education policies on youth sexual behaviors. Arch Sex Behav. 2021;50:2321–33.

    Article  PubMed  Google Scholar 

  49. Roffman DM. A model of helping schools address policy options regarding gay and lesbian youth. J Sex Educ Ther. 2000;25:130–5.

    Article  Google Scholar 

  50. Haley SG, Tordoff DM, Kantor AZ, Crouch JM, Ahrens KR. Sex education for transgender and non-binary youth: previous experiences and recommended content. J Sex Med. 2019;16:1834–48.

    Article  PubMed  Google Scholar 

  51. Olson-Kennedy J, Cohen-Kettenis PT, Kreukels BP, Meyer-Bahlburg HF, Garofalo R, Meyer W, et al. Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes. Curr Opin Endocrinol Diabet Obes. 2016;23:172–9.

    Article  Google Scholar 

  52. Rabbitte M. Sex education in school, are gender and sexual minority youth included?: a decade in review. Am J Sex Educ. 2020;15:530–42.

    PubMed  PubMed Central  Google Scholar 

  53. Minnesota Student Survey Interagency Team. Minnesota Student Survey 2019, 2022. Roseville, MN: Minnesota Department of Education, 2019, 2022.

  54. Herbenick, D. Sex, love, intimacy, and orgasm: integrating Sex Ed and new findings from the National Survey of Sexual Health Behavior. Presented at: National Sex Ed Conference; December 5, 2014; New Jersey.

  55. Koepsel ER. The power in pleasure: practical implementation of pleasure in sex education classrooms. Am J Sex Educ. 2016;11(3):205–65. https://doi.org/10.1080/15546128.2016.1209451.

    Article  Google Scholar 

  56. Bradford NJ, DeWitt J, Decker J, Berg DR, Spencer KG, Ross MW. Sex education and transgender youth: ‘trust means material by and for queer and trans people’. Sex Educ. 2019;19:84–98.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Minnesota Medical School, Minneapolis, MN, USA

    Ceili Charley, Annika Tureson & Linzie Wildenauer

  2. Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA

    Kristen Mark

Authors
  1. Ceili Charley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annika Tureson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linzie Wildenauer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kristen Mark
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristen Mark.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Charley, C., Tureson, A., Wildenauer, L. et al. Sex Education for LGBTQ+ Adolescents. Curr Sex Health Rep 15, 180–186 (2023). https://doi.org/10.1007/s11930-023-00361-2

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11930-023-00361-2

Keywords

Search

Navigation