Recent High School Graduates’ Sex Education Experiences

Despite widespread support among parents and empirical support for comprehensive sex education (CSE; Eisenberg et al., 2022), sex education varies widely by state and school district, with five states not requiring any sex education. States without mandatory sex education cite a range of barriers, including fear of repercussions, inadequate funding and resources, limited class time, and ambiguous, fluctuating guidelines (Hall et al., 2016; Sexual Information and Education Council of the United States [SIECUS], 2022). According to SIECUS (2022), 28 states and the District of Columbia require sex education, while 22 states do not. Twenty-nine states stress abstinence until marriage while two states require CSE to be taught (SIECUS, 2022). Among those that offer sex education, only 10 states require the information to be evidence based and culturally appropriate, and 22 states require the information to be medically accurate (SIECUS, 2022).

Myths and misinformation contribute to legislation promulgating non-comprehensive programs lacking scientific and medically accurate information. Access to CSE has continued to decline over time (Brindis, 2022). Such restrictive legislation, related ideals, and resultant approaches to sex education have a detrimental impact on young people’s sexual wellness and psychological health and are associated with higher rates of teen pregnancy and sexually transmitted infections (STIs; Fox et al., 2019; Hobaica & Kwon, 2017; Paik et al., 2016). The needs and considerations of students of color and LGBTQ + students often go unmet in creating and executing curricula, which contributes to marginalized students being excluded and stigmatized (Roberts et al., 2020). Sex education is often provided from a white, westernized perspective, such that the values, beliefs, and experiences of students of color are not represented (Burnes, 2017). The lack of representation for students of color can hinder their ability to ask relevant questions about their sexual health and pleasure (Burnes, 2017). Understanding the connection of inadequate sex education with sexuality attitudes and knowledge is vital, particularly given the current political climate characterized by a regression in sexual and reproductive rights (Lieberman & Goldfarb, 2022).

Recent studies suggest young adults hold predominantly negative views toward their sexual education experiences, noting inadequate information, fear-based tactics, and a lack of coverage of diverse topics (Astle et al., 2021). However, the relation between type of sex education programs and sexuality attitudes and knowledge has not been extensively explored. Few studies explore outcomes based on comparisons between comprehensive and abstinence-only programs, and findings are largely derived from studies conducted solely with undergraduate students (Nurgitz et al., 2021; Seifen et al., 2022).

Purity Culture versus Sex Positivity

Proponents of purity culture, popularized by evangelical Christians, advocate teaching abstinence prior to heterosexual marriage, encourage traditional gender roles, and stress that a woman’s value is determined by her sexual modesty (Foster et al., 2021; Klement et al., 2022). Conservative Christian religious teachings uphold purity culture, resulting in feelings of sexual guilt, shame, and defectiveness, particularly among women of color and sexually marginalized people (Anderson & Koc, 2020; Natarajan et al., 2022). Beliefs espoused by purity culture adherents are consistent with those that characterize abstinence only until marriage (AOUM) sex education.

Purity beliefs have been linked to rape myth acceptance, including victim-blaming, inaccurately equating marital and acquaintance rape with consensual sex, and normalizing women’s oppression (Klement et al., 2022; Owens et al., 2021). Women who endorse high levels of purity beliefs show a decrease in HPV screening preventative care due to the sexual stigma associated with sexual activity, and they are less likely to pursue HPV preventative care for their children (Foster et al., 2021). We anticipated that young adults who experienced abstinence-based sex education would endorse more purity beliefs than those whose sex education was comprehensive.

In contrast, people who espouse sex-positive beliefs advance a perspective about sexuality based on wellness, strengths, and happiness, particularly “how people are, or can be, fulfilled with their unique sexualities and sexual expression, which contributes to their overall wellbeing and quality of life” (Williams et al., 2015, p. 7). Ivanski and Kohut (2017) surveyed 52 human sexuality experts and found consensus that sex positivity is characterized by acceptance, health and safety, autonomy, and consent. Researchers have also found that young people, those between ages 11 and 18, prefer sex-positive approaches to their sex education (Pound et al., 2017). We reasoned that recent high school graduates who received CSE would endorse more sex-positive and fewer purity culture beliefs and better sexual and reproductive health knowledge than those who experienced abstinence-based sex education.

Approaches to Sex Education

Historically, AOUM has been the most prevalent type of sex education in the USA (Guttmacher Institute, 2021). AOUM programming asserts that sexual activity outside of heterosexual marriage has harmful psychological, physiological, and social effects (Advocates for Youth, 2018). Notably, AOUM is typically neither evidence based nor medically accurate and frequently omits important topics related to sexual well-being and reproductive rights, such as abortion, contraception, ways to access reproductive health services, and masturbation and pleasure (Advocates for Youth, 2018; The Society for Adolescent Health and Medicine [SAHM], 2017). AOUM approaches often contain misleading and harmful information and are largely ineffective at reducing sexual activity, STIs, unplanned pregnancies, or sexual risk-taking (Atkins & Bradford, 2021; SAHM, 2017). AOUM is situated in purity culture and links a person’s value and moral standing to modesty and sexual purity (O'Donnell & Cross, 2020).

Abstinence-plus forms of sex education stress abstinence but provide some attention to contraception and infection prevention (Miedema et al., 2020). McKay and colleagues (2021) stressed the importance of considering variations of sex education that provide relatively more attention to sexual health–promoting approaches, a strategy we also employed in the current investigation. As Miedema et al., (2020. p. 755) noted, “abstinence-plus… approaches do appear to resemble CSE, yet emphasis is still placed on abstinence, which CSE addresses but is not limited to.”

In contrast, CSE takes a holistic approach to teaching sex education with the intention of giving individuals the autonomy to make decisions about their body and relationships (United Nations Educational, Scientific and Cultural Organization [UNESCO], 2018). CSE utilizes developmentally appropriate and culturally sensitive frameworks to teach individuals about sexuality and relationships with scientific accuracy (UNESCO, 2018), empowering people to make informed choices about their bodies. CSE incorporates a wide range of safe sexual practices on contraceptives and teaches young people how to prevent STIs. CSE includes attention to relationships, consent, reproductive health services, information about sexual orientation and gender identity, and communication and decision-making skills (International Planned Parenthood Federation, 2023). CSE is LGBTQ + and gender inclusive, taking a non-heteronormative approach to sex education that provides all students with accurate information (Goldfarb & Lieberman, 2021). CSE considers how race, ethnicity, class, age, and disability status intersect with sexual development (Goldfarb & Lieberman, 2021).

High school graduates receive sex education from a variety of sources, with students' identities and backgrounds affecting the quality, quantity, and sources of sex education they may receive. Students who receive school-based sex education have more positive behavioral outcomes, such as using contraception, than those who report they primarily learn about sex through non-school sources (Pound et al., 2017). Sexual minority youth are more likely to report receiving no sex education compared to their heterosexual counterparts (McKay et al., 2021), particularly on how to say no to unwanted sex (Bloom et al., 2022). Adults are most likely to learn about sex from parents, peers, and media (White et al., 2023). Parents and caregivers can be essential sources of information, often sharing their values, expectations, and knowledge (White et al., 2023). Discussing sex and sexuality with peers provides validation, normalization, and space to discuss topics often considered as taboo (Astle et al., 2023; Jabareen & Zlotnick, 2023). Social media can likewise provide accessible information about sexuality and vital affirmation of identities and experiences related to sex (Olamijuwon & Odimegwu, 2021). Despite the potential benefit of receiving sex education from a variety of different sources, young people can internalize harmful messages when the information received is medically inaccurate and steeped in misinformation.

Researchers have found that students from marginalized groups who do not receive adequate school-based sex education often seek out information through peers, partners, and pornography, which can be biased, inaccurate, and harmful (Bloom et al., 2022; Currin et al., 2017). For example, Haley and colleagues (2019) studied transgender and non-binary youth, parents, and healthcare providers and found that negative messages resulted in harmful health consequences, such as unplanned pregnancies, STIs, unsafe binding, and unsanitary sex toy use. Youth who receive inadequate sex education are more likely to feel awkward discussing sex, have less understanding related to their identity and development, lack medically accurate information related to sexual health and well-being, and lack understanding of their bodily autonomy (Astle et al., 2021). In contrast, sex education that is inclusive of students from marginalized groups benefits not only students who are underrepresented but also majority group students. Proulx et al. (2019), for example, studied more than 47,000 students from 11 states and found that LGBTQ-inclusive sex education was associated with decreased reports of depressive symptoms and suicide and less bullying.

Together, the evidence highlights the need to examine the influence of cultural ideas on sex education and the future implications of opposing sex education programs on the sexual and mental well-being of adults. In this investigation, we explored how the type of sex education recent high school graduates received related to their sexual knowledge and attitudes, as well as how prepared they felt for a healthy sexual life as adults given the sex education they received in high school. Recognizing that college students have often been oversampled in sexuality research (Wiederman, 1999), we also hoped to capture the experiences of young adults who had not begun and did not immediately plan to pursue additional education beyond high school.

Current Study

Our aims for the current study were to capture sex education experiences as they relate to recent high school graduates’ attitudes and knowledge about sexuality and reproduction. Given recent setbacks in sexual and reproductive health, particularly the overturning of Roe v. Wade, we hoped to gain insight into young adults’ experience with sex education during this vital point in time (Lieberman & Goldfarb, 2022). Based on the extant literature, we predicted:

  • H1: Compared to those who received comprehensive sex education, recent high school graduates who received AOUM sex education will endorse higher rates of purity culture beliefs (H1a), fewer sex-positive beliefs (H1b), less accurate sexual and reproductive health knowledge (H1c), and poorer ratings of their sex education (H1d).

  • H2: Among recent high school graduates, receiving abstinence-only sex education, having lower levels of sexual health knowledge, and having higher levels of purity culture beliefs will predict lower levels of sex positivity.

  • H3. Purity culture beliefs (H3a) and sexual health knowledge (H3b) will partially mediate the relationship between abstinence-only sex education and lower sex positivity.

  • H4: Students from marginalized groups (i.e., BIPOC [H4a]; LGBTQ + [H4b] students) will rate their sex education more poorly than their counterparts who are not marginalized (e.g., white; cisgender/straight students).

Method

Participants and Procedure

Participants were 1005 young adults who graduated from high school in 2023. Participants were recruited online through social media sites (e.g., Facebook, Reddit) with a focus on Class of 2023 groups for students. To be eligible for the study, participants had to (a) have graduated from a high school in the USA in 2023 and (b) be 18 years or older. The online survey was started by 1242 participants, some of whom were auto-routed to the end of the survey due to not meeting the eligibility criteria. Participants’ entries were also removed from the dataset if they completely skipped any of our main variable measures (e.g., skipped all items of the measures), if they missed more than one attention check item, if they “straightlined” both of the full measures (purity beliefs and sex positivity), or if they spent less than 2 min completing the survey, leaving us with our final participant count of 1005. Participants who met eligibility requirements provided their informed consent prior to beginning the survey and were eligible for a gift card drawing to win one of two $50 prizes at the conclusion of the study.

Demographics

Of the 1005 participants, 514 (51.1%) identified as women, 465 (46.3%) identified as men, and 18 (1.8%) identified as transgender or non-binary. Regarding their race or ethnicity, 50 (5%) participants were Asian American, 3 (0.3%) were Biracial/Multiracial, 200 (19.9%) were Black/African American, 32 (3.2%) were Latine/Hispanic, 27 (2.7%) were Native American/Indigenous, and 691 (68.8%) were white. The sample was primarily heterosexual (83.2%), with 64 (6.4%) identifying as gay or lesbian, 81 (8%) as bi + (i.e., bisexual, queer, or pansexual), and 15 (1.5%) as asexual. Participants also reported their religious affiliation; 321 (31.9%) were Christian (Protestant), 180 (17.9%) were Catholic, 148 (14.7%) were Atheist/Agnostic, and 107 (10.6%) described themselves as spiritual but not religious, 65 (6.5%) as Jewish, 64 (6.4%) as Hindu, 60 (6.0%) as Buddhist, and 51 (5.1%) as Muslim. On a scale of 0–100, students rated the importance of religion in their life at 61.49 on average (SD = 29.36). When asked about their plans after high school graduation, 391 (38.9%) reported that they were working full time, 354 (35.2%) were going to a 4-year college/university, 111 (11%) were attending a 2-year college, 106 (10.5%) were working part time, 35 (3.5%) were attending trade school, and 8 (0.8%) were taking a gap year. We categorized participants’ reported state-based location into regions using the CDC Health Statistics regions (U.S. Centers for Disease Control and Prevention [CDC], 2023), revealing that 352 (35%) were from the West, 262 (26.1%) were from the South, 170 (16.9%) were from the Northeast, 119 (11.8%) were from the Midwest, and 10 (1%) were from Puerto Rico or Guam, while 92 (9.2%) did not respond.

Measures

We administered a demographic survey in two parts. In the initial part of the form, we asked participants for their race/ethnicity, age, gender, sexual orientation, plans for the year 2023–2024, state where they attended high school, and the kind of sex education they received in school. McKay et al. (2021) noted important distinctions between kinds of sex education beyond abstinence-only and comprehensive sex education. We provided participants with the following definitions: abstinence-only/abstinence until marriage sex education (if methods of contraception [birth control] were included, the emphasis was mostly on failure rates); abstinence-plus (abstinence was stressed, but there was some attention to contraception [birth control], too, and not just failure rates); and comprehensive sex education (sex education that included information about birth control, reproduction, safe sex, consent, healthy relationships, and/or sexual orientation). Participants completed a number of validated measures (described below). In the second part, administered after all other measures, we asked participants to specify their faith and how important it was in their lives. Finally, we asked participants to rate, on a scale from 0 (not at all well prepared) to 100 (extremely well prepared), how well prepared they felt for a healthy sexual life as an adult based on the sex education their high school provided them.

Sexual and Reproductive Health Knowledge

We used Kavanaugh and colleagues’ (2013) measure of sexual and reproductive health knowledge. The measure consists of 13 multiple choice questions designed to capture knowledge about sexual health risks pertaining to three subscale areas: pregnancy, contraception, and abortion. Due to an administrative error, we collected data for 12 of the questions. We were especially drawn to select this measure given that rates of sexual health risks are often exaggerated in AOUM programs (Santelli et al., 2017) and due to the increased abortion restrictions and legislation rooted in misinformation and myths about reproductive health (Mollen et al., 2018). Given that abortion rates have declined since Kavanaugh et al. (2013) designed their instrument, we reworded the correct response to the question, “What percentage of women in the United States will have had an abortion by the age of 45?” from 33 to 25% (Jones & Jerman, 2017). Another example item asks whether abortion or birth poses a greater health risk for the pregnant person. Each item was scored correct/incorrect; scores were summed to create an overall knowledge score and three subscale scores.

Purity Culture Beliefs Scale

Participants completed the Purity Culture Beliefs Scale (Ortiz, 2018), a 24-item scale that consists of three elements of purity culture: shame and guilt (i.e., “You should feel ashamed if you have sex outside of marriage”), gender roles (i.e., “Women are, by nature, more sexually pure than men”), and idealization (i.e., “Virginity is a gift to give your spouse on your wedding night”). Participants indicate their agreement of each item using a 5-point Likert scale, with higher scores reflecting greater endorsement of purity culture beliefs. The scale demonstrated very good internal reliability and convergent validity with measures assessing sexism, heterosexual intimacy, and heterosexual scripts (Ortiz, 2018). In the current study, the scale demonstrated good reliability, with a Cronbach’s alpha of 0.87.

Sex Positivity Scale

Participants completed the Sex Positivity Scale (Belous & Schulz, 2022), a 26-item scale using a 5-point Likert scale with subscales measuring sex-positive behaviors and attitudes about sex (i.e., “Just because I am not aroused by a specific sexual activity does not make it ‘wrong’”), talking about sex and communication (i.e., “Sex is not a taboo subject for discussion”), and personal beliefs, knowledge, and experience (i.e., “I like to learn new things about sex”). Higher scores indicate greater sex positivity. The instrument demonstrated adequate to good internal reliability and divergent and convergent validity. In the current study, a Cronbach’s alpha of 0.86 indicated good reliability.

Data Analysis

All analyses were completed in SPSS version 28, with the moderation/mediation analyses conducted using the PROCESS macro (Hayes, 2022). First, we completed a multivariate analysis of variance (MANOVA) to test for group differences between our three groups: students who received abstinence-only sex education, students who received abstinence-plus sex education, and students who received comprehensive sex education. Next, we ran a series of one-way ANOVAs to further explore H1a–d and a regression with mediation to test H2 and H3. We ran a set of t-tests to test H4, determining differences on preparedness ratings between students based on the type of sex education they received and their cultural identities.

We used a linear regression to check the outlier and normality assumptions for the MANOVA with sex education type as our dependent variable and purity beliefs, sex positivity, and knowledge as our independent variables. We found a maximum Mahalanobis distance of 13.58, under the critical value of 18.47 for MANOVAs with three dependent variables (Penny, 1996). We utilized the Shapiro–Wilk test of normality to determine which of these three variables were normally distributed; all were found to be non-normally distributed, with ps < 0.01. To test assumptions of multicollinearity, we used bivariate analyses and determined that none of our variables were correlated at a level exceeding r = 0.9. We used Box’s test of equality of variables and found that we did not meet this criterion, with p < 0.001; however, this result was expected given the large sample size of our study. Using Levene’s test of equality of error variances, we determined that the purity beliefs variable violated this assumption with p = 0.001. Finally, because group sizes were unequal and did not meet assumptions regarding equality of variances, we utilized Dunnet’s T3 as a post hoc test in place of Tukey. In addition, due to our variables’ violations of normality, we used Pillai’s Trace in place of Wilk’s Lambda.

Results

Scores on our four outcome variables based on type of sex education received are displayed in Table 1. Participants reported that, on a scale from 0 to 100, they felt that the sex education they received prepared them effectively (M = 70.49, SD = 21.31). However, their scores on the sexual and reproductive health knowledge measure were relatively low across all subscales. Specifically, participants answered an average of 4 of the total 12 items correctly, with only 39 participants (3.8%) answering 8 or more items correctly (a score of 66% or better). Average scores were similar across the three subscales, with participants scoring a mean of 30% correct on the pregnancy and birth subscale, a mean of 36% correct on the contraceptive subscale, and a mean of 34% correct on the abortion subscale.

Table 1 Means and standard deviations of dependent variables based on sex ed type
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A MANOVA revealed a statistically significant difference across sex education types, given a linear combination of sex positivity, purity beliefs, and sexual knowledge (F(3,1940) = 17.23, p < 0.001, partial η2 = 0.050), suggesting a small-to-medium effect size. Between-subjects effects demonstrated that type of sex education significantly affected both sex positivity (F(2,6614) = 42.54, p < 0.001, partial η2 = 0.081), suggesting a medium effect size, and purity beliefs (F(2,6614) = 6.68, p = 0.001, partial η2 = 0.014), suggesting a small effect size, but did not have a significant effect on knowledge (F(2,6614) = 1.20, p = 0.30 1, partial η2 = 0.00), meaning that we found preliminary support for H1a and H1b (see below) and did not find support for H1c.

Post hoc ANOVA tests demonstrated significant differences on sex positivity and purity beliefs, but not knowledge (see Table 2). There were significant differences between students who received abstinence-plus sex education and abstinence-only sex education (p < 0.001, 95% CI = 0.09 to 0.38) and between students who received abstinence-plus sex education and comprehensive sex education (p = 0.01, 95% CI = 0.03 to 0.19) on purity beliefs, whereby those who received abstinence-plus sex education had beliefs less aligned with purity culture than the other two groups, partially supporting H1a. There were no significant differences between abstinence and comprehensive sex education on purity beliefs. There were significant differences on sex positivity between students who received comprehensive sex education and abstinence-only sex education (p < 0.001, 95% CI = 4.94 to 9.83) and between students who received comprehensive sex education and abstinence-plus sex education (p < 0.001, 95% CI = 5.20 to 10.28), whereby those who received comprehensive sex education were more sex positive than the other two groups, supporting H1b. There were no significant differences between the abstinence-only and abstinence-plus groups on sex positivity.

Table 2 Post hoc comparisons of ANOVAs comparing sex positivity, purity beliefs, and preparedness scores based on sex ed type
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We also ran a linear regression model to determine the effects of purity beliefs, sex education type, and knowledge on sex positivity R2 = 0.12, F(3, 974) = 43.35, p < 0.001 (see Table 3). Results indicated that both purity beliefs (b =  − 3.92, p < 0.001) and type of sex education (b = 4.01, p < 0.001) predicted sex positivity, while the effect of sexual knowledge was insignificant (b = 0.23, p = 0.28) on sex positivity, mostly confirming H2 (with the exception of sexual health knowledge). Finally, we ran a simple mediation model using the PROCESS macro, using abstinence-only sex education as our predictor variable, purity beliefs as our mediator, and sex positivity as our dependent variable. The indirect effect through our mediator was shown to be significant (B =  − 0.62, SE = 0.23, 95% CI =  − 1.01 to − 0.22), such that those who reported having abstinence-only sex education were more likely to have high levels of purity beliefs and therefore less sex positivity, confirming H3a. We did not run a model with sexual knowledge as a mediator (H3b), given that knowledge was an insignificant predictor in the linear regression.

Table 3 Regression analysis with sex positivity as outcome variable
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A simple one-way ANOVA demonstrated a significant difference in self-reported preparedness rating scores based on type of sex education received (F(2,881) = 30.39, p < 0.001; see Table 2). Post hoc tests indicated that students who received comprehensive sex education reported that their sex education prepared them more than students who received abstinence-only sex education (p < 0.001, 95% CI = 4.24 to 13.83) as well as than students who received “abstinence-plus” sex education (p < 0.001, 95% CI = 7.81 to 17.02), supporting H1d. There were no observed differences between those who received abstinence-only and those who received abstinence-plus. In an exploratory analysis, another simple one-way ANOVA revealed a significant difference in sex education rating scores based on geographic location (F(4,869) = 5.43, p < 0.001). Post hoc tests indicate that students who lived in the Midwest rated their sex education more poorly than those who lived in the Northeast (p = 0.01, 95% CI =  − 15.42 to − 1.17) as well as students who lived in the West (p < 0.001, 95% CI =  − 15.59 to − 2.90).

An independent samples t-test showed a significant difference between students of color (M = 74.38, SD = 18.61) and white students (M = 68.58, SD = 22.28) on sex education preparedness rating t(905) =  − 4.12, p < 0.001, such that students of color reported more favorable ratings of their sex education, the opposite of H4a. Another independent samples t-test did not show a significant difference between LGBTQ + students (M = 70.82, SD = 19.30) and straight, cisgender students (M = 70.43, SD = 21.74) on their preparedness ratings of their sex education t(897) =  − 0.21, p = 0.84, overall suggesting no support for H4b.

An independent samples t-test showed a significant difference between students of color (M = 4.39, SD = 2.03) and white students (M = 3.87, SD = 1.81) on sexual health knowledge t(1001) =  − 3.90, p < 0.001, such that students of color had more sexual health knowledge than white students. Specifically, students of color scored higher on the pregnancy and birth and contraception subscales (as well as the overall scale), with no significant differences on the abortion subscale.

Another independent samples t-test showed a significant difference between LGBTQ + students (M = 4.53, SD = 1.89) and straight, cisgender students (M = 3.94, SD = 1.89) on their sexual health knowledge t(993) =  − 3.62, p < 0.001, such that LGBTQ + students had more sexual health knowledge than cisgender, straight students. Specifically, LGBTQ + students scored higher on the pregnancy and birth subscales (as well as the overall scale), with no significant differences on the contraception subscale.

Given that prior research on sex education has focused primarily on undergraduate students and has not included students who are not college bound, we ran a series of exploratory analyses comparing students who planned to attend higher education (i.e., immediately going to a 4-year university, a 2-year college, or those taking a “gap year” before college) to those who did not (i.e., those who planned to work or attend trade school). An independent samples t-test showed a significant difference between students who planned to attend a college or university (M = 91.88, SD = 10.60) and those who planned to work or attend trade school (M = 84.69, SD = 13.99) on sex positivity t(1003) = 9.24, p < 0.001, such that students who planned to attend a college or university were more sex positive than students who planned to work or attend trade school. Another independent samples t-test showed a significant difference between students who planned to attend a college or university (M = 2.81, SD = 0.80) and those who planned to work or attend trade school (M = 3.04, SD = 0.63) on purity beliefs t(1003) =  − 5.01, p < 0.001, such that students who planned to attend a college or university had fewer purity culture beliefs than students who planned to work or attend trade school.

Finally, a subsequent independent samples t-test showed a significant difference between students who planned to attend a college or university (M = 72.6, SD = 20.89) and those who planned to work or attend trade school (M = 68.38, SD = 21.55) on their ratings of how effectively the sex education they received prepared them, t(907) = 2.99, p < 0.001, such that students who planned to attend a college or university were more prepared than students who planned to work or attend trade school. There were no significant differences on sexual and reproductive health knowledge between students based on their plans to work, attend trade school, or pursue higher education.

Discussion

Our findings help inform and extend the existing scholarship on the relation between the kind of sex education recent high school graduates received and its relation to their attitudes toward sexuality (Zori et al., 2023), as well as young adults’ evaluation of the quality of the sex education they received regarding how well they felt their school-based sex education prepared them for a healthy sexual life as an adult. Specifically, results revealed that participants who received abstinence-plus sex education endorsed fewer purity beliefs than those who received abstinence-only sex education. Previous research has demonstrated that young people who receive abstinence-plus sex education engage in healthier sexual behaviors and have better sexual health outcomes (Lindberg & Maddow-Zimet, 2012); results from the current investigation provide additional evidence that having some coverage of birth control may help attenuate purity beliefs, which have been linked to rape myth acceptance and sexual assault victim blaming (Klement et al., 2022; Owens et al., 2021).

We also found support for our prediction that young adults who received comprehensive sex education endorsed more sex-positive beliefs than those whose sex education was abstinence-only. Given the importance of sexual wellness across the lifespan (Syme et al., 2019), particularly among marginalized people (i.e., Black women; see Townes et al., 2021), ensuring that students receive scientifically accurate sex education can help foster more positive outlooks that yield in better sexual experiences. Scholars have recommended that schools embrace a sex-positive approach to sex education (Burton et al., 2023), echoing the wishes of students themselves (Pound et al., 2017). Educators should honor each individual’s relationship with sexuality and expression, employing a multicultural, global perspective that promotes inclusivity (Burnes, 2017). Educators can infuse discussions of how race, ethnicity, gender, and other identities might impact sexual expression (Burnes, 2017).

Our results also supported our predictions that recent high school graduates who report having received abstinence-only sex education were more likely to endorse higher levels of purity culture beliefs and less sex positivity. Results from the current investigation also complement and extend the work of scholars who have raised concern about the lack of accuracy in abstinence-only sex education programs (Santelli et al., 2017), which may also help explain participants’ dissatisfaction when they received this kind of sex education.

In contrast, inconsistent with our predictions, sexual knowledge was unrelated to sex-positive beliefs, and those from marginalized groups (students of color, LGBTQ + students) demonstrated higher scores on the knowledge measure than cisgender, heterosexual, and white participants. One possible explanation for these findings is the tendency for LGBTQ people to compensate for the lack of sex education they receive in school by seeking out information for themselves (Bloom et al., 2022; Currin et al., 2017). Of note, however, sexual health knowledge was generally poor across the sample, with more than 88% of participants answering 50% or more of the knowledge questions incorrectly. As such, we surmise that high school–based sex education may not be adequately preparing young adults for the sexual health knowledge needed for adults to pursue and enjoy healthy sexual lives.

We were also particularly interested in attitudes about sex education and sex among non–college-bound students who have been understudied in the literature as sexuality scholars have historically sought the experiences and perspectives of college students (Wiederman, 1999). While education status and social class are not equivalent, college trajectory often follows along the lines of socioeconomic class and can represent class-based cultural differences (McDonough, 1997). We examined these differences via exploratory analyses. Among our sample, those who planned to work or pursue trade school reported endorsed more purity culture beliefs, fewer sex-positive beliefs, and reported that their high school sex education had not prepared them as well for a healthy adult sexual life compared to adults planning to attend college, university, or take a gap year. Non–college-attending adults also scored more poorly than college-bound and gap-year adults on the sexuality and reproductive health knowledge measure.

Other sexuality researchers who have included adults who do not attend college in their investigations have found some equivocal findings. For example, Hawkins et al. (2023) found that, contrary to expectations, non-college adults expressed greater anticipation of participating in casual sexual relationships compared to college students. In a study examining sexual risk behaviors, Renfro et al. (2022) found that young adults not in college reported earlier sexual debut, less likelihood of using condoms, and more lifetime sexual partners than the college students in their sample. In contrast, Olmstead and their colleagues (2021) found no difference in the meaning ascribed to sex and commitment among their mixed sample of college and non–college-attending adults. Taken together, socioeconomic class and educational/career trajectory are important variables that should be considered regarding helping students who do not plan on attending college develop healthy, positive attitudes toward sexuality with an aim toward empowering them to pursue fulfilling sexual experiences in adulthood.

Limitations and Future Research

Our findings should be considered within the limitations inherent in our study. First, because we administered our study online, those without internet access were ineligible to participate. Second, by administering our study online, we were unable to control participants’ ability to access information to help them answer the items in the instrument used to measure sexual and reproductive health knowledge, although notably, overall participants scored poorly on this measure. Third, more than two-thirds of our sample were white and well over three-quarters were heterosexual, limiting our ability to examine the experiences of participants from specific marginalized racial, ethnic, and sexual identity groups. We also did not ask about disability status, which would have been important to include. We had no way of verifying the kind of sex education participants received; while it is possible that participants misremembered the kind of education they had, our decision to recruit recent high school graduates gives us some confidence that participants were able to recall their school-based sex education accurately. Lastly, we did not collect data about sexual behavior or wellness; although this decision was intentional to allow us to focus on attitudes and knowledge, we cannot ascertain the role sex education type has on sexual behavior.

Future researchers can extend our work by continuing to examine the relationship between kind of sex education and concomitant sexuality attitudes, behaviors, and knowledge. Surveying adults across the lifespan and generational cohorts would allow for potentially important intergenerational comparisons, particularly given the ubiquity of abstinence-only sex education in the southern United States in the past three decades and the recent Dobbs’ decision (2022). Mixed-method approaches including qualitative methods would allow for more depth of the findings, such that participants could provide important context for their answers. We encourage future researchers to continue ensuring the perspectives of those who are often absent from similar studies, such as non–college-bound adults, are included. We likewise urge scholars to continue studying the sex education experiences of people of color, queer people, and those with disabilities.

Implications and Policy Recommendations

Results from the current investigation can serve as an important guide for educators, policymakers, and others who teach and mentor high school students and design and implement sexuality curricula. Given the role of high school–based sex education in informing students’ attitudes about sexuality, we encourage those involved with young people to advocate for and implement sex-positive comprehensive sex education. Sex education that is scientifically accurate, age and developmentally responsive, and grounded in both a human rights and gender equality framework is most likely to lay the foundation for a healthy sexual life into adulthood (Guttmacher, 2023; UNESCO, n.d.). Moreover, sex-positive curricula include the importance of pleasure in sexuality, which is also commensurate with what young people want (Kantor & Lindberg, 2020; Pound et al., 2017).

Recent high school graduates in our study generally scored poorly on the measure of sexual and reproductive health knowledge, indicating that many young adults are ill-prepared to navigate their sexual lives as adults. Kavanaugh et al. (2013) similarly found poor sexual and reproductive health knowledge among a random sample of adults. Given ongoing threats to reproductive healthcare, including access to both contraception (Smith et al., 2022) and abortion (Fuentes, 2023), inadequate sexual and reproductive health knowledge is likely to continue to have profound consequences for emerging adults.

We urge policymakers to take action in our communities in alignment with existing research and our current study through the implementation of policies that prioritize sexuality education as a basic human right. In the 2023 legislative session, SIECUS tracked 496 bills across the USA that sought to restrict access to comprehensive and affirming education, including sex education, access to sexual and reproductive services, and infringing on the rights of LGBTQIA + youth (SIECUS, 2023). We call upon policymakers to consider decades of evidence-based research that have established the importance of comprehensive sex education as contributing to people's well-being and development (SIECUS, 2023). We advocate for the deconstruction of policies that restrict access to comprehensive sex education and for policymakers to increase funding for classroom and community educator training to provide current and accurate sexuality information, curriculum, and materials (SIECUS, 2024). Our findings support the prioritization of age-appropriate, scientifically accurate, inclusive sexual education programs focused on sexual health, pregnancy and STI prevention, and sexual autonomy, which includes information for marginalized communities (SIECUS, 2022).

Conclusion

Findings from the current investigation provide an important window into the state of high school–based sex education among a diverse group of recent high school graduates. Abstinence-only sex education was related to the endorsement of more purity culture beliefs and fewer sex-positive beliefs, and participants who experienced abstinence-only sex education were less likely than those who experienced comprehensive sex education to rate their sex education as having adequately prepared them for healthy sexual lives as adults. Comprehensive sex education can provide integral exposure to sex-positive perspectives, grounded in science and inclusive of pleasure, to prepare young people to be sexually informed, responsible, and knowledgeable.