A Case for Sex Education about Older Adults in Gerontology and Geriatrics Programs

G Joseph Sample, PhD, MA, MPA

A responsive gerontological workforce is needed to address older adult sexual health as the U.S. population continues to age over the next 30 years. A case is made to include sex education as part of gerontological and geriatric education programs to counter older adult sexuality myths and ageism.

Always the Hopper, Never the Homie
Examination of Toxic Masculinity and Misogynoir in the Classroom

Dakota Ramppen, CSE
Mystkue Woods, MEd

This workshop will examine how toxic masculinity and misogynoir show up in the classroom and offer tools and sample lessons to dismantle these systems in real-time.

The goal of sex education is to empower students with the information and skills to become a sexually healthy adult. The exact details of how this looks and what this means will vary depending on age level and grade as well as where you’re teaching.

One of the best ways to teach sex education in a school is to implement an existing evidence-based curricula. If this is an option for you, keep the following in mind:

• The programs are not one size fits all. They vary in their approach, target population, setting, length, and desired outcome. Because of this, you should choose a program that is effective for the specific outcomes you want to achieve.
• Monitoring program fidelity and quality are important to ensuring you reach the desired outcomes of the curriculum.

For more advice around choosing and adapting a curriculum, click here.

If for some reason ‒ time, funding, location, etc ‒ you cannot implement an existing program, you can adapt or develop your own. A number of organizations have identified the characteristics of an effective sexuality curriculum. Essentially these are the pieces that programs effective at reducing STIs and teen pregnancy have in common. Characteristics of such curricula include:

1. A focus on clear health goals.
2. A focus on the specific behaviors that lead to these goals.
3. Information that is basic and age- and developmentally-appropriate.
4. Addressing social pressures and influences.
5. Create a safe environment for students to participate.
6. Include multiple activity and instructionally-sound, age-appropriate teaching methods.
7. Address and building self-efficacy around sexual psychosocial risk and protective factors.

For more details about these characteristics and additional ones that are effective you can check out the following resources:

• CDC – Characteristics of an Effective Health Education Curriculum
• The National Campaign – Characteristics of Effective Curriculum-Based Programs
• Kirby – Emerging Answers 2007

Lastly, the CDC has put together a guide to adapting and  developing curriculum-based programs in a way that continues to be effective.

When you learned about sex in school, you most likely were taught by a science teacher, nurse, or health/physical education (PE) teacher. This person may or may not have had the experience, training, or knowledge in this subject area. Though health/PE teachers are supposed to have specialized training in teaching students about a broad range of health topics including sex, only two-thirds of institutions require sexuality education courses for health education certification.^[1] Furthermore, because sex education is taught almost exclusively under the umbrella of another topic, states do not have licensure requirements or for sex education.The Future of Sex Education has put together seven teacher preparation standards to guide colleges and universities in better preparing health education teachers to teach sex education.

For those who did not benefit from the standards, there are many other ways to gain additional experience teaching sex education. The most comprehensive option is to become a certified sex educator through AASECT. Certification requires sizeable commitment; however, even completing some of the requirements will enhance individuals’ ability to teach sex education. Three popular programs to get AASECT-certified include:

1. Widener University’s Master of Education in Human Sexuality Studies is the only advanced degree program at an accredited institution. In addition to the degree, you will also fulfill all AASECT requirements.
2. The University of Michigan’s Sexual Health Certificate Program offers a Sexuality Education track for individuals who teach in schools and healthcare settings.
3. The Institute for Sexuality Education and Enlightenment offer both a certification program and a wide selection of workshops both online and in-person.

In addition, AASECT maintains a searchable database of education opportunities.

Another option for certification is to participate in the Planned Parenthood League of Massachusetts’ Sexuality Education Certification Series.^[2]

Not looking for certification? Many reputable organizations offer professional development workshops and trainings. Two reputable options include your closest Planned Parenthood affiliate and Answer. Google your local affiliate plus “professional training” for more information. Lastly, exploring options outside of academia can enhance your ability to teach. Feminist sex toy stores often offer workshops for free or a small fee.

The path to becoming a sex educator is as varied as the places where we work. To read others’ stories about how they got into sex education, check out How I Got Into Sex Ed.

For a comprehensive list of training opportunities, check out the lists made by the Kinsey Institute, Advocates for Youth, and the Society for the Scientific Study of Sexuality.

For an overview of ways to become a sex educator, click here.

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^[1] Future of Sex Education. National teacher preparation standards for sexuality education. http://www.futureofsexed.org/teacherstandards.html

^[2] This program is separate from AASECT but may provide some of the requirements.

As of 2013, 3.4% of individuals aged 18-64 identified as LGB or ‘other.’^[1] These individuals experience  significant health disparities ranging from increased rates of homelessness, mental health issues, and violence to decreased health care utilization. As a result, teaching students  about not only these identities but also about acceptance for them is vital.

The National Sex Education Standards identify the following learning objectives related to sexual orientation:

Most students, regardless of age, will have ideas about sexual orientation. These serve as a useful starting point for your lesson. To tap into students’ pre-existing knowledge and attitudes, Gareth Durrant, MPH a sex educator who teaches workshops for men who come out late in life and who currently works with Marie Stopes International, recommends an activity called an A-Z Race. Split the room into small groups and have them write down words related to sexual orientation next to each letter of the alphabet.

Beyond this ice-breaker, Gareth recommends one of the following three options depending on the age of your students and the amount of time you have with them to discuss sexual orientation.

1. Keep things simple! Most people need time to wrap their head around identity, attraction, sex, and gender expression. To guide your conversation, the Genderbread Person is hard to beat. If you only have one class period to discuss this topic, Genderbread is the resource to focus on.
2. Everybody comes out in some way or another. To normalize and celebrate this part of gay culture, have each student share a story about coming to self-acceptance. Provide an example to set the expectation for the type of information shared (e.g. accepting curly hair versus accepting a mental health diagnosis).
3. Expect questions and pushback. To keep things balanced and productive while challenging assumptions, use one of the following two strategies:
   1. Put the question back out to the group. “What do you think?” allows students to work through issues.
   2. Flip the question around and substitute ‘straight’ for ‘gay.’ For example, counter “Isn’t being gay just a phase?” with “Isn’t being straight just a phase?”

Additional Resources
Gay, Lesbian, and Straight Education Center
Planned Parenthood’s Sexual Orientation & Gender page
Lesson plans on Sexual Orientation and Gender Identity

Thank you to Gareth Durrant, MPH for his input on this article.

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^[1] Ward, B. W., Dahlhamer, J. M., Galinksy, A. M., & Joestly, S. S. (2014). Sexual orientation ant and health among US adults: National Health Interview Survey, 2013. National Health Statistics Reports, 77. http://www.cdc.gov/nchs/data/nhsr/nhsr077.pdf

While condoms remain the most commonly used contraceptive method among adolescents, their use is still inconsistent.^[1],[2]  Furthermore, the percentage of individuals using condoms at last intercourse has not increased in the last decade and there continue to be significant differences in use by age, gender, and race/ethnicity.^[3] This points to the need for better education on condom use and negotiation. The National Sexuality Education Standards provide the following learning objectives:

 
The basic steps for demonstrating condom use include:

While mastering these steps is important, the information can be overwhelming. Adjoa Tetteh, MA, CHES, a sex educator who teaches in clinical and community settings, has refined her key messages to two points:

1. For an external condom, place, pinch (the tip), and roll (down the erect penis). For an internal condom, pinch (the ring) and push (the ring and closed end as far back as you can).
2. Lubrication is essential for increasing sensation and making condoms less likely to break.

Beyond demonstrating condoms it is also important to spend time building students’ confidence and skills with condom negotiation. Tetteh recommends the following activities:

1. Role plays. See examples here, here, and .
2. Have students think about why condom use is important to them and how it can be fun. Build a conversation based on their responses and anticipated partner responses.

Lastly, your demonstration may be the first time someone has seen a condom in real life. This is especially true for internal condoms. Therefore, the demonstration helps ease students into the idea of using condoms by allowing them to see and feel how the process works.

Additional Resources
How to Use an External Condom (video)
How to Use an Internal Condom (video)
Female Condom Fact Sheet
Male Condom Fact Sheet
Find a Family Planning Clinic

Thank you to Adjoa Tetteh for her input on this article.

 
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^[1] Martinez, G., Copen, C. E., and Abma, J.C. (2011). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, National Survey of Family Growth 2006-2010. National Center for Health Statistics. Vital and Health Statistics, 23(31). http://www.cdc.gov/nchs/data/series/sr_23/sr23_031.pdf

^[2] Data refers only to individuals who have had vaginal intercourse.

^[3] Child Trends Database. (2014). Condom use. http://www.childtrends.org/?indicators=condom-use

Though awareness around sexual violence continues to rise, incidents of abuse continue to pour in. Sexual abuse accounts for about 20% of all childhood maltreatment reports^[1] while about one in four women will experience some sort of sexual violence in their lifetime.^[2] Teaching about abuse is important not only to bring awareness of the issue but also to empower survivors of any age. The learning objectives were adapted from the National Sexuality Education Standards:

When teaching about abuse, it is important to clarify that this is not an “us versus them” problem but rather that it can happen to anyone regardless of race, gender, socioeconomic status, etc. Like when teaching HIV/AIDS , cultural competence is vital for this sensitive topic. Media is again a helpful tool to examine instances of abuse and start a discussion.

One of the best pieces of advice I’ve heard about teaching about exual violence is to assume all people are survivors. This mindset shift allows you to be more inclusive and compassionate in your teaching.

Lastly, it is important to note that abuse is a difficult topic to cover well. It is potentially triggering to student and therefore creating a safe classroom environment is vital. It can be helpful to familiarize yourself with the signs of child abuse, local support organizations, laws related to reporting. This varies by state and changes periodically. For more information, visit Not Alone.

Additional Resources
ChildHelp National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453)
ChildHelp Resources for Teachers
This fantastic guide to teaching younger children.
This CDC infographic on sexual violence.

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^[1] ChildHelp. (2014). Child abuse statistics & facts. https://www.childhelp.org/child-abuse-statistics/
^[2] National Coalition Against Domestic Violence. (2007). Domestic violence facts. http://www.ncadv.org/files/DomesticViolenceFactSheet%28National%29.pdf

One in six American adults will get herpes in their lifetime.^[1] Therefore, when teaching about herpes, it is important to stress that the disease is both common and manageable. The broad goals of teaching about herpes should include:

• Knowledge about the disease.
• An awareness of risky behaviors
• Prevention skills
• Information about accessing community resources.

The National Sexuality Education Standards break these broad goals into specific learning objectives depending on the age of your learners.^[2]

If working with adults, the larger goal is to ensure students are informed, know where to get tested and treated, and practice being responsible with their body and their partner’s. Key messages should also include information on managing herpes and communication skills to have open and empathetic conversations with partners.

Ashley Manta, a sex educator who teaches about living with herpes, stresses the importance of correcting misinformation and destigmatizing the disease from a young age. One way to do this is by using positive, non-stigmatizing language. “I tell groups, ‘When you ‘I’m clean’ when someone asks you about STIs, what you are implying is that people with STIs are ‘dirty.’ This is a big ‘a-ha’ moment for people.”

Additional Resources
Planned Parenthood’s Herpes page
ASHA’s Herpes Resource Center
Lesson plans on STIs

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^[1] CDC – STD Facts – Genital Herpes. http://www.cdc.gov/std/herpes/STDFact-herpes.htm
^[2] Adapted from: Future of Sex Education Initiative. (2012). National sexuality education standards: Core content and kkills, K-12 [a special publication of the Journal of School Health]. Retrieved from http://www.futureofsexeducation.org/documents/josh-fose-standards-web.pdf.
^[3] Includes abstinence and condom use.

Thirty three states and the District of Columbia currently require that schools teach about HIV.^[1] This is higher than the number of states mandating sex education. Even in states

requiring only HIV/AIDS education, class sessions may provide an opportunity to discuss other important sex-related topics including contraception. The National Sexuality Education Standards for this topic show how this can be the case.

Beyond meeting these learning objectives Kate McCombs, MPH a sex educator who has trained other public health professionals on this topic, stresses the importance of being culturally competent. “The epidemic is diverse,” she says and “stereotypes [like HIV/AIDS being a gay disease] have some utility but without context provide an incomplete picture.” Therefore, it’s important to learn what the epidemic looks like in the place you’re teaching and customize your lesson to best address that.

Stereotypes also provide good teaching moments for more nuanced conversations. McCombs cautions that this conversation can bring up hurtful statements about men who have sex with men, sex workers, injection drug users, and other populations among whom HIV rates are high. It’s important, therefore, to do a lot of work in advance to prepare responses that allow you to correct the misinformation while continue a productive conversation.

Lastly, McCombs stresses the importance of finding a balance between portraying HIV/AIDS as both something to be taken seriously and a manageable disease. “HIV/AIDS is no longer a death sentence” but ensuring students have accurate information about prevention and testing remains vital.

^[1] Guttmacher Instittue. (2015). Sex and HIV education. State Policies in Brief. http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf

Nearly half of all pregnancies in the US are unintended, a number the CDC hope to decrease by 10% by 2020.^[1] Teaching about pregnancy is one part of the strategy to reduce this number. Though such teaching is thought of as occurring primarily in the school setting, much education happens in medical clinics as well.

Teaching about pregnancy should cover three broad areas, regardless of age or setting:

1. Human reproduction
2. Pregnancy options including adoption and abortion.
3. Contraceptive methods including abstinence.

The National Sexuality Education Standards further refine these broad objectives^[2]:

If working with adults, do not assume they already have all of this information. Morgan Nuzzo, prenatal nurse and doula, recommends continually asking people if they have questions or concerns. She also cautions that patience is necessary, “Sometimes the best thing you can do is not say anything” while the person works through their thought. She highlights three key practices that have been invaluable to her patients.

• Know your state’s laws related to reproductive and sexual healthcare services. Are there waiting periods, do minors need consent, etc.
• Honor the autonomy of the pregnant person. “Women know almost immediately what they want to do with their pregnancies,” she says so honor that decision and provide information and resources related to that decision.
• Discuss birth control options after pregnancy. Many women mention abstinence as their preferred method going forward. This can be difficult, however, so finding a method that will allow the individual to enjoy sex and not worry about a second pregnancy is vital.

Resources to Share
Backline Talkline
National Abortion Federation Find a Provider or 1-877-257-0012
Planned Parenthood Find a Clinic or 1-800-230-PLAN
Faith Aloud

Thank you to Morgan Nuzzo, RN, BS(N) for her input for this article.

^[1] Guttmacher Institute. (2013). Fact sheet: Unintended pregnancy in the United States. http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html

Nearly half of all sexual assault and rape victims are under the age of 18 while 80% are under the age of 30.^[1] The highest risk years are from 12-34 with girls age 16-19 being four times more likely than the general population  to be victims of rape, attempted rape, or sexual assault.^[2] Given that the majority of existing sex education occurs in middle and high school, this topic is particularly relevant. Below are learning objectives adapted from the National Sexuality Education Standards.
 

In a face-to-face interview, Leslie Kantor, Planned Parenthood Federation of America’s (PPFA) vice president of education, recommends focusing on what students really need when teaching about sex.  This includes:

• A definition of consent that is nuanced and goes beyond “yes means yes” or “no means no.”
• An understanding of gender scripts and how these contribute to problems related to consent.
• Skills about navigating sex and alcohol.
• An understanding of bystander intervention.

For example, if watching a video in which a bystander did not step up, you can ask students questions like, “What would have been helpful in the situation? What could s/he have said or done to prevent this? What are some barriers to speaking up or acting?” Processing in this way allows you to cover many different themes including causes of rape, rape myths, victim blaming, and the important role of bystanders.

Lastly, it is important to note that sexual violence is a difficult topic to cover well. It is potentially triggering to student and therefore creating a safe classroom environment is vital. Some ideas for doing this include:

• Creating ground rules or community agreements including confidentiality.
• Passing out identical sheets of paper and having all students write questions, even if it is just “I have no questions.”
• Being prepared to respond to hostile, offensive or victim blaming comments and questions. Brainstorm potential statements and your responses. Use these steps as a guide: stop the offensive behavior, name the behavior and describe why it is harmful or triggering, and ask for a change.^[3]
• Believing students who confide in you and offering to connect them to additional services if they desire. Take some time to research support organizations in your area.

Beyond the support organizations near you, it is vital you know your legal responsibility to report information shared with you. This varies by state and changes periodically. For more information, visit Not Alone.

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^[1] Rape, Abuse, & Incest National Network. (2014). Who are the victims? Breakdown by gender and age. https://www.rainn.org/get-information/statistics/sexual-assault-victims

^[2] Rape, Abuse, & Incest National Network. (2014).

^[3] Adapted from Girl’s Best Friend Foundation and Advocates for Youth. (2005). Creating safe space for GLBTQ youth: A toolkit. http://www.advocatesforyouth.org/storage/advfy/documents/safespace.pdf

When it comes to sex education, you’ve got a big job to do. It goes beyond identifying body parts and defining consent. The Sexuality Information and Education Council of the United States (SIECUS) defines comprehensive sex ed as that which “addresses the socio-cultural, biological, psychological, and spiritual dimension of sexuality […].”

Luckily, community is important in this field. Colleagues are invaluable for brainstorming, feedback, and support. To get you started, I’ve gathered tips from incredible sex educators via in-person, telephone, and email interviews. You’ll find tools to use, things they wish they had known, and advice for doing the best teaching possible.

Leslie Kantor, MPH Planned Parenthood Federation of America

• Facilitate a lesson in front of a few peers who will give you honest feedback about your body language, tone of voice, clarity, and other facilitation skills. Highlight what went well and what needs improvement.
• Define very clear learning objectives and continually steer the lesson back to these. Choose content and activities that will meet these objectives. In other words – you need to have a roadmap and be a good driver.

Sexuality Information and Education Council of the United States

• Give your students both information and the “opportunity to explore their own and society’s attitudes and values and to develop or strengthen social skills.”^[1]

Adjoa Tetteh, MA CHES

• Push yourself to continue learning how to be more engaging, inclusive, affirming, and thoughtful of how social justice issues intersect with people’s ability to express, learn, and explore their sexuality.

Linda Kirkman, MHS,  La Trobe University

• Use concepts and language that support sex, gender and sexuality diversity rather than the binary.

Christopher Hook, Johns Hopkins Bloomberg School of Public Health

• Talk to kids like they are adults […] Play an empowering role by acknowledging the sensitivity and awkwardness that comes with addressing these topics while confidently moving forward and normalizing them.

Liore Klein, Johns Hopkins Bloomberg School of Public Health

• Answer all questions respectfully, straightforwardly, and factually. The student probably desperately needs the answer. If you don’t know, admit it, find out, and report back.

Andrea Renae, www.andrearenae.net

• Provide an easy way for students to apply the information you’ve given them as soon as possible after class. Handout with key points and/or exercised are a great option and can be printed or emailed.

Bianca Laureano, www.BiancaLaureano.com

• To have a community member call you out/hold you accountable it is a gift. When you are wrong, and you are held accountable, corrected, and have the opportunity to apologize and learn, take it!
• Don’t be afraid of the silence. Thinking is hard work especially as it is connected to un/learning! When your students sit quietly in class after you’ve asked a question and you give them time to think, that is ok.

Kate McCombs, MPH www.katemccombs.com

• The emotional container you create in a room is more important than knowing all the answers. Focus your energy on creating safe space and finding answers together.

Perhaps the most important thing you can do is be open to learning new concepts and teaching techniques. The sex ed community is always available for guidance and support so don’t be afraid to reach out. At the end of the day, providing accurate information and a safe space to explore these often still taboo topics is the best thing you can do in your role.

Parents play a critical role in the overall health of their children, including adolescents’ sexual health. Most major sexual health promotion organizations agree that parents should be the primary sexuality educators for their children because research shows that teens who feel they can talk to their parents are less likely to engage in risky behaviors^[1].

Most parents (82%) are already having some conversation with their kids about sex.^[2] What exactly this looks like varies drastically in both form and content. For example, parents may convey their values about sex outside of marriage but not talk about birth control. Alternatively, parents may rely on a single conversation to convey information as opposed to a series of talks throughout their child’s life.

If working with parents, encourage them to do the following:

• Keep the conversation ongoing. Ongoing conversations provides three major benefits. First, parents can reinforce and build upon the information they give. Secondly, it gives children the opportunity to integrate things they are learning elsewhere, whether in school or from peers, into the framework their parents have promoted. Lastly, it identifies the parent as a trusted person to talk to and ask questions of.^[3]

• Don’t shy away from the tougher conversations. Media provides a rich source of examples to tie into the sex conversations. It also lets parents be more in touch with the messages their children are receiving. To use two obvious examples, ‘Blurred Lines’ provided parents a perfect jumping point to talk about consensual sex while Teen Mom is a conversation starter about unintended pregnancy and safe sex.

• Educate themselves. Parents need to know the facts before sharing them with their students. Three great resources for parents are Planned Parenthood’s Tools for Parents, Alberta’s Parent Portal, and books by Sol Gordon.

As a sex educator, you also can give students homework assignments that involve their parents. This may not take away all of the awkwardness for families, but it will give students an excuse to broach the topic, for the first or the fiftieth time.

Remember: many parents support sex education in both school and the home. These tools help you as an educator guide the information they provide and pass along ‘best practices’ so they can have more effective and meaningful conversations, and relationships, with their children.

For another look at parents and sex ed, check out this article from Time.

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^[1]  Martino, S. C., Elliott, M. N., Corona, R., Kanouse, D. E., & Schuster, M. A. (2008). Beyond the “Big Talk”: The roles of breadth and repetition in parent-adolescent communication about sexual topics.

Pediatrics, 121(3): 612–618.

^[2] Planned Parenthood Federation of America. (2011). Let’s talk: Are parents tackling crucial conversations about sex? Poll finding fact sheet, New York: Planned Parenthood Federation of America and the Center for Latino Adolescent and Family Health, conducted by Knowledge Network.

^[3] Martino, et. al (2008).

As a sex educator, your learning is ongoing. Its important to stay on top of the latest policy, research, and teaching methods, particularly as they relate to the state where you teach and the age group you work with. Below are some important readings to supplement your knowledge and guide your sex education work.

Sex Education Articles and Reports
Emerging Answers 2007, Douglas Kirby
FreezeFrame: A Snapshot of America’s Teens, Allison Stewart and Kelleen Kaye
The Health Benefits of Sexual Expression, Planned Parenthood
A History of Birth Control Methods, Planned Parenthood
Identifying Programs That Impact Teen Pregnancy, Sexually
Transmitted Infections, and Associated Sexual Risk Behaviors, Mathematica and Child Trends
Masturbation: From Stigma to Sexual Health, Planned Parenthood
The Pleasure Deficit: Revisiting the ‘‘Sexuality Connection’’, Jenny A. Higgins and Jennifer S. Hirsch
Programs to Reduce Teen Pregnancy, Sexually Transmitted
Infections, and Associated Sexual Risk Behaviors: A Systematic Review, Mathematica and Child Trends
Sex Education in the United States, Planned Parenthood
Unlocking the Contraception Conundrum, James Jaccard

Policy, Advocacy, and Current Events
Introducing Intersectionality:The Matrix of Oppression and Gendered Violence, Oregon Sexual Assault Task Force
Sex and HIV Education, Guttmacher Institute
Sex Stories, Sexual Health Rankings
WOSCHN at the National Sex Ed Conference 2014, Women of Color Sexual Health Network

Facilitation/Pedagogy
Teaching About Sexuality and HIV: Principles and Methods for Effective Education. Evonne Hedgepeth and Joan Helmich.
Facilitating Reflection. Julia Reed and Christopher Koliba.
Ask Me About Sex Activity Booklet^[1]

Collections of Articles
These websites maintain continually updated resources related to sex education. They allow you to search by topic, keyword, etc to identify exactly what you need.

Guttmacher Institute Resources List
The National Campaign Resources
Planned Parenthood Fact Sheets and Reports
SIECUS Publications

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^[1] Best for adult learners.

When teaching adult sex education, it is important to remember that many adults feel embarrassed to talk about sex and have many questions. Therefore, creating a safe space is vital. What works with adults is engagement in abstract thinking and conversations that go beyond sound bites. You also can focus on pleasure in addition to or as part of sexual health.

Because no guidelines exist for teaching adults^[1], using SMART learning objectives can help you teach them. Use the National Sexuality Education Standards as a starting point. To provide the most valuable and effective experience for adult students, familiarize yourself with learning theories that have been shown to be successful with adults. Here are some tips:^[2]

• Focus on process not content. What do the learners need to do to acquire the desired knowledge and skills. Only include content and activities that get you to your objectives.
• Tell them your why. Why are you teaching them this? What benefits do they gain?
• Give them a say in what and how they learn and let them work independently if possible. This gives a sense ownership over the material.
• Honor their experience. Draw on this experience to meet your learning objectives. Additionally, brainstorm potential biases that may come from their experiences and create a game plan for managing them so you can stay on track.
• Connect your activities to students’ lived experiences. Identify their existing knowledge and tie your lesson and activities into it.
• Keep activities active, constructive, and collaborative. We process a lot through our bodies. Movement allows for both muscles memory and cognitive recall.
• Keep your lesson timely and relevant. Pull in information from current events, the media, and life experiences that are common to your learners.
• Provide extra direction and support. Make your instructions extremely clear, honor everyone’s responses with a ‘thank you,’ and continually drive the lesson in the direction you need it to go to meet your learning objectives.
• Focus on tasks and problems. Contextualize your lesson and take students through the experiential learning cycle (experience, observe and reflect, generalize, and apply).
• Provide motivation to learn. For adults, these motivations tend to be intrinsic (e.g. enjoyment, self-satisfaction, value, etc). Making your lesson fun and engaging helps.

Additional Resources
Adult Learning (journal)
8 Important Characteristics of Adult Learners
17 Tips To Motivate Adult Learners

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^[1] Our Whole Lives offers an adult education program.

^[2] Finlay, J. (2010). Adragogy (Adult learning). https://www.youtube.com/watch?v=vLoPiHUZbEw

Though sex education for younger children (under nine years old) has not been widely adopted in the United States, there have been a number of studies^[1] in recent years in support of starting sex education during preschool. In addition, both SIECUS’ Guidelines for Comprehensive Sexuality Education and the National Sexuality Education Standards provide guidelines for teaching this population. Even if you do not work with this age group, understanding the best practices for teaching them will help you respond to parents, guardians, and caretakers’ concerns about their children’s inevitable questions about where babies come from.

Sex education for younger children looks very different from the discussions that are encouraged for middle and high schoolers. For this age group one of the most important things you can do is teach them the rules about appropriate sexual expression.^[2] Examples of these rules include:

• Where they can touch themselves (e.g. We Don’t Touch Our Vulvas at the Table).
• Asking before touching anyone else.
• Respecting ‘no’ as an answer.
• Not harming anyone else.
• Not putting objects in your body.
• Using the proper terms for body parts.

Modeling these rules is equally important. For example, say a child has come out of time-out and you ask for a hug as an apology. If the child says, “No,” it is important to respect that response. You also may offer an alternative (e.g. a high five) as a way to begin modeling negotiation skills.

When answering children’s questions, provide correct, age-appropriate information.  Both Planned Parenthood and the Mayo Clinic provides specific questions and answers that children of different ages may ask. Lastly,  and  are useful to explain different concepts.

Additional Resources^[3]
Age-Appropriate Sex Education for Children
Sex Education for Pre-Schoolers
Questions and Answers about Sex
The Hormone Factory (children 10-12)

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^[1] Igras, S. M., Maciera, M., Murphy, E., & Lundgren, R. (2014). Investing in very young adolescents’ sexual and reproductive health. Global Public Health: An International Journal for Research, Policy, and Practice, 9(5): 555-569.

^[2] Appropriate, in this case, from the perspective that sexuality is a healthy and innate part of everyone from birth.

^[3] Most of these resources are geared towards parents; however, the concepts and key messages are useful for educators.

When it comes to sex, the teen years are full of changes, pressures, and excitement. While the average age of first intercourse is 17, by the time students reach their teen years they’ve most likely heard something about sex.^[1] Therefore much of the work with teens is correcting misinformation and guiding them to make the right decisions for themselves.

The National Sexuality Education Standards for high schoolers focus on analyzing, comparing and contrasting, and applying basic sexuality information. Obviously, the ability to do this depends on the type of education teens have already received. Opening activities that allow you to assess current knowledge are extremely useful. For example, you can have students categorize contraception options based on effectiveness to prevent pregnancy. This allows you to see what they already know and build off of that.

As with all sex education, what you teach should be age-appropriate with regards to both content and how it’s taught. Developmentally, teens are strengthening their abstract and critical thinking skills; however, their perception of risk often varies from adults.^[2] Additionally, research shows that most students are concerned with the pleasurable and social aspects of sex while most curricula focus almost exclusively around pregnancy and disease prevention.^[3] Finding a way to address these concerns is important. Two strategies for doing so include

1. Using TV shows, songs, and other popular media to teach and process ideas around sex, relationships, body image and more is particularly poignant for this age group. Doing so gives them permission to explore their thoughts and feelings related to these topics.
2. Focusing on values. What are your students’ values around sex? How do these play out in their relationships? Why do they hold these values? Do they differ from their parents/guardians? How and why?

Lastly, while teens have the reputation for being reckless, they often are grappling with a bit of insecurity as well. They want to fit in while simultaneously develop their independent identities. Finding ways to balance these needs and structure messages accordingly can help guide your teaching.

_____________________

^[1] CDC – Key Statistics from the National Survey of Family Growth – Vaginal Intercourse. (2013). http://www.cdc.gov/nchs/nsfg/key_statistics/s.htm#vaginalsexual

^[2] Larsman, P., Eklof, M., & Torner, M. (2012). Adolescents’ risk perceptions in relation to risk behavior with long-term health consequences; antecedents and outcomes: A literature review. Safety Science, 50(9) 1740-1748.

^[3] Guilamo-Ramos, V., Jaccard, J., Dittus, P., Bouris, A., Holloway, I. & Casillas, E.  (2007). Adolescent Expectancies, Parent-Adolescent Communication and Intentions to Have Sexual Intercourse Among Inner-City, Middle School Youth. Annals of Behavioral Medicine: 34(1).

As sex educators, it is on us to state up-to-date on the latest policies, information, and resources. Luckily, there are a number of resources that make this task easier. Below you will find a select list of these resources, starting with education standards that can guide your work and links to evidence-based curricula.

Education Standards
Provide an overview of the types of content and skills that should be taught from K-12.

National Sexuality Education Standards (Answer)

Education Resources
The specific tools you need to teach sex education including evidence-based curricula.

Curricular Organizer for Reproductive Health Education
ETR
GLSEN Resources for Educators
ReCAPP
Sex Ed Store
Sexuality Education for Youth with Chronic Disability or Illness
TPP Resource Center – Evidence-Based Programs

Organizations
Get support, information, and training.

American Association for Sex, Educators, Counselors, and Therapists (AASECT)
American Sexual Health Association
Answer (Rutgers University)
Association of Reproductive Health Professionals (ARHP)
Gay Lesbian, & Straight Education Network (GLSEN)
The Guttmacher Institute
Institute for Sexuality Education and Enlightenment
International Society for the Study of Women’s Sexual Health
Kinsey Institute
Planned Parenthood
Sexuality Information and Education Council of the United States (SIECUS)
The Association for Black Sexologists and Physicians
The Center for Sex Education (CSE)
The Center for Sexual Pleasure and Health (CSPH)
Power to Decide
The National Coalition for Sexual Health
The Society for the Scientific Study of Sexuality
Women of Color Sexual Health Network (WocSHN) 

Websites
Further your own knowledge or share these accurate and user-friendly sites to students.

Alice!
Bedsider
Scarleteen
Sex, Etc
SexPlanations

Conferences
Invaluable training and networking opportunities

AASECT
ARHP Annual Meeting
CatalystCon
ISSWSH Meeting
SSSS Annual Meeting
The National Sex Ed Conference

Journals

AIDS Education and Prevention
American Journal of Sexuality Education
Contraception
Journal of Black Sexuality and Relationships
Journal of School Health
Journal of Sex Research

 

For a more comprehensive list of journals, click here.

Teaching sex education in schools comes with its own set of challenges. Many school districts have restrictions and/or strict guidelines regarding sex education curricula. To guide your work in schools, Liore Klein, a sex educator who’s worked with a variety of non-profits, recommends you keep the following tips in mind. They will help you not only do the best work possible but also avoid getting in trouble with the school or your organization.

1. Always ask the teacher if there are restrictions on the presentation. Examples of restrictions include no condom demonstrations, only teaching specific birth control methods, or using fingers for condom demonstrations instead of a dildo. Even if you talked with a school administrator ahead of time, double check with the teacher.

2. Read up on mandatory reporting laws in your state and find out if/how you are mandated to report.

3. Read up on minor’s reproductive rights for abortion and contraception in your state, especially regarding birth control and abortion. They vary widely and your students will most likely have questions.

4. Clarify how to handle discussion about abortion. Ask your supervisor, school administration, and the classroom teacher (see #1). You may be restricted in what you can teach or you may need training on dealing with anti-abortion advocates.

5. Don’t make assumptions about students’ knowledge. Additionally,, don’t treat them as ignorant. Young people respond best when treated like adults whose opinions matter.

6. Know the language and literacy needs of the class before you go teach. Ensure translation is available and/or adjust lesson plans accordingly.

7. Avoid heteronormative language as much as possible. This both makes lessons more inclusive and reaches young people who are having sex but not using commitment-heavy language like boyfriend/girlfriend to describe their sex partners.

8. There are no stupid questions. No matter how “out-there” a question may be, if a student risked embarrassment to ask it, they most likely need the answer.

9. Don’t be afraid to say, “I don’t know.” Then find the answer and follow-up at the next class session. Only with this group once? Provide an age-appropriate resource.

10. Master your poker face. Some question will get under your skin. Answer it factually then do some internal work on your own time to understand why this bothered you.

The good news is that teen birth rates, formally known as the adolescent fertility rate, are dropping throughout the world.^[1] Nevertheless, the majority (95%) of teen births among girls aged 15-19 still occur in low- and middle-income countries.^[2] The highest rates are found in sub-Saharan Africa, south-central, and south-eastern Asia. Rates for teen births among girls younger than 15 vary drastically by country.

When comparing the teen pregnancy rates of different countries, it is important to keep in mind that some do not collect this data. Instead, the rates are a combination of data from vital registration systems, birth , censuses, sample surveys, and extrapolation from earlier data. The rates, therefore, vary in both their accuracy and recency. Additionally, unlike the  , which includes all pregnancies regardless of their outcome in birth, abortion, or miscarriage, the statistic used worldwide looks only at births to teen mothers.

Below is a list of the countries with the highest and lowest teen birth rates.^[3]

____________________________________

^[1] The World Bank. (2014). Adolescent pregnancy. http://www.who.int/mediacentre/factsheets/fs364/en/

^[2] The World Bank. (2014). Adolescent pregnancy. http://www.who.int/mediacentre/factsheets/fs364/en/

^[3]The World Bank. (2014). Adolescent fertility rate (Births per 1000 women ages 15-19). http://data.worldbank.org/indicator/SP.ADO.TFRT

Teen pregnancy rates have been on the decline in recent decades, hitting an all-time low in 2010.^[1] Despite the fact that declines have occurred across all states and racial/ethnic groups, there continue to be large health disparities by age, geographic region, race/ethnicity, and socioeconomic status. Specifically:

• The majority of teen pregnancies occur among girls aged 18 to 19. This corresponds to the average age of sexual debut, which is 17.^[2]
• Rates among black and Hispanic teens are at least twice those among Non-Hispanic Whites. Similar trends are seen for both teenage birth and abortion rates.^[3]
• Pregnancy rates for Non-Hispanic White teens is the highest in Southern states.
• States with the highest number of teens had the highest rates of teen pregnancy.^[4]

In addition to the decline in teen pregnancy rates, states are also seeing the proportion of pregnancies that end in abortion decline.

Below you will find a list of the states with the highest and lowest teen pregnancy rates. The rates include births, abortions, and miscarriages among teenage girls ages 15 to 19. Data is drawn from birth records as well as estimates of miscarriages and abortion numbers.

10 States with the Lowest Teen Pregnancy Rate 

10 States with the Highest Teen Pregnancy Rate^[6]

____________________________________________

^[1] The National Campaign to Prevent Teen and Unintended Pregnancy. (2010). Teen Pregnancy Rate Comparison, 2010. http://thenationalcampaign.org/data/compare/1678

^[2] Kost, K. & Henshaw, S. (2014). US Teenage Pregnancies, Births, and Abortions, 2010: National and State Trends by Age, Race, and Ethnicity. Guttmacher Institute. http://www.guttmacher.org/pubs/USTPtrends10.pdf

^[3] Kost, K. & Henshaw, S. (2014).

^[4] Kost, K. & Henshaw, S. (2014).

^[5] Kost, K. & Henshaw, S. (2014).

^[6] Kost, K. & Henshaw, S. (2014).

Earlier this year, the media buzzed with news of the “mysterious” decline in teen pregnancy rates^[1]. While theories about the true cause abounded, sex educators understood that a variety of factors played a role.These ranged from MTV’s teen pregnancy shows to broader implementation of effective comprehensive sex education programs. All of the factors had a few characteristics in common. Specifically they:

1. Increased awareness of teen pregnancy and its consequences.
2. Increased awareness about safe(r) sex options.
3. Encouraged research and conversation about pregnancy, contraception, and sex.

The impact of comprehensive sex education programs go beyond these broad ones. Such programs increase knowledge about contraception and reduce risky sexual behaviors including early sexual initiation, sex with multiple partners, and increased sexual activity. Other content of comprehensive sex education curricula that likely helped reduce the teen pregnancy rate include:

• how to use contraception more effectively
• alternatives to vaginal intercourse (e.g. oral sex) that do not carry a risk of pregnancy^[2]
• involvement of parents and other trusted adults

By doing all of this, sex education fills an important gap. Research shows that teens not only want more information about using condoms, the different types of contraception, and emergency contraception but also that they need it desperately.^[3]

• 36% of teens say they know “a little” or “nothing” about condoms.^[4]
• Half have not heard of emergency contraception.^[5]
• 36% know “a lot” or “everything” about birth control pills and how to use them. ^[6]

The answer to how much of an impact comprehensive sex education has on teen pregnancy rates is a complicated one. However, research is able to tease out a number of important connections.

• More effective contraceptive use accounts for up to 86% of the reduction.^[7]
• Teens receiving comprehensive sex education are half as likely to get pregnant as those in abstinence-only programs.^[8]
• The most effective programs may reduce risky sexual behaviors by one-third.^[9]

Milwaukee provides a great case study for how sex education can drastically impact teens. An ambitious campaign involving evidence-based curricula helped reduce the city’s teen pregnancy rate by half in just five years.

For more information on reducing teen pregnancy, check out these articles by Planned Parenthood and the CDC.
__________________________________________

^[1] In the US, the teen pregnancy rate include births, abortions, and miscarriages among teenage girls ages 15 to 19.

^[2] Weiss, D., & Bullough, V. L. (2004). Adolescent American sex. Journal of Psychology & Human Sexuality, 16(2/3): 43–53.

^[3] Kaiser Family Foundation. (2003). National survey of adolescents and young adults: Sexual health knowledge, attitudes and experiences. Menlo Park, CA: Kaiser Family Foundation. [Online]. http://www.kff.org/youthhivstds/3218-index.cfm.

^[4] Albert, B. (2012). With one voice 2012: America’s adults and teens sound off about teen pregnancy. Washingon, DC: National Campaign to Prevent Teen and Unintended Pregnancy. [Online]. http://thenationalcampaign.org/sites/default/files/resource-primary-download/wov_2012.pdf

^[5] Albert, B. (2012).

^[6] Albert, B. (2012).

^[7] Santelli, J. S., Lindberg, L. D., Finer, L. B., & Singh, S.. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of abstinence and improved contraceptive use. American Journal of Public Health, 97(1): 150 –156.

^[8] Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42(4): 344–351.

^[9] Kirby, D. (2007). 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. [Online]. http://www.thenationalcampaign.org/EA2007/EA2007_Full.pdf.

Traditionally, sex education was thought to be exclusively the responsibility of family and religion. While this view is no longer universally held in the US, there continues to be two divergent views on sex education: 1) medically-accurate and comprehensive information about sexual health decreases risk-taking behaviors; and 2) medically-accurate, comprehensive information increases risk-taking behaviors.^[1] While research has shown the former to be correct, scare tactics, stigma, and shame continue to be a hallmark of much sexuality education, both formal and informal.

To better understand why this is so, it helps to take a look at the origins of today’s sex education.

Sex Education Timeline^[2],[3]
1918: The Chamberlain-Kahn Act mandates soldier education on syphilis and gonorrhea .

1919 – The U.S. Department of Labor’s Children’s Bureau releases a report suggesting sex education during school could have better protected soldiers from STIs.

1920s- Sex education is introduced in high schools.

1930s- The US Office of Education first publishes sex education materials and trains teachers.

1930s-1940s: Human sexuality courses appear in colleges.

1964: Sexuality Information and Education Council of the US (SIECUS) is founded.

1968: The US Department of Education gives NYU a grant to develop graduate programs for training sex education teachers.

1960s-1970s: Sex education becomes a political issues; parents start protesting it in schools.

1980s: The AIDS crisis strengthens sex ed advocates’ case.

1981- 1981: Adolescent Family Life Act passed; funds “chastity” and abstinence-only education

mid-1990s: Every state has a mandate for AIDS education

1990 – SIECUS convenes National Guidelines Task Force.

1991- The first Guidelines for Comprehensive Sexuality Education – Kindergarten-12th Grade is published.

1993- SCOTUS rules that federally-funded sex education programs must delete direct references to religion

1994: US Surgeon General Joceyln Elders endorses teaching about masturbation and subsequently is forced to resign

1996: The Welfare Reform Act includes a provision that provides tens of millions of dollars to abstinence-only programs

2000: The Special Projects of Regional and National Significance–Community-Based Abstinence Education adds $31 million to the federal funding stream for abstinence-only programs.

2004: The Content of Federally Funded Abstinence-Only Education Programs (The Waxman Report) is released and shows such programs contain inaccurate and misleading information.

2006: The Government Account Office (GAO) releases a report showing that most abstinence-only programs were not reviewed for scientific accuracy before funding and implementation.

2007 – The Trenholm study finds four federally-funded abstinence programs are ineffective at changing young people’s sexual behaviors

2007- UNAIDS/WHO evaluation finds 13 abstinence-only programs for HIV prevention are ineffective

2007- Emerging Answers published; evaluates 56 programs

2008- President Bush requests $242 million for abstinence-only funding; Congress approves $176.83

2009- Obama administration budgets $114.5 million to support evidence-based programs. The majority of the funds are earmarked for replicating these programs.

2011- Polling shows 90% of US parents support sex education in high school while 75% support it in middle school.

2014: 22 states and the District of Columbia mandate sex education while 11 more mandate HIV education.^[4]

___________________________________________

^[1] Planned Parenthood Federation of America, Inc. (2012). Sex education in the United States. http://www.plannedparenthood.org/files/3713/9611/7930/Sex_Ed_in_the_US.pdf

^[2] Cornblatt, J. A. (2009). Brief history of sex ed in America. Newsweek. http://www.newsweek.com/brief-history-sex-ed-america-81001

PPFA, 2012.

^[3] Future of Sex Education. (2014). History of sex education. http://www.futureofsexed.org/background.html

^[4] Guttmacher Institute. (2014). State policies in brief: Sex and HIV education. http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf

Myths surrounding what sex education is and isn’t abound throughout both the US and abroad. Words that come to mind as people reflect on their own sex education experiences often include “awkward” and “scary.” As a result, teaching in this field requires both the basic knowledge of sexual health and the ability to navigate a multitude of emotions and experiences that can color one’s views of sexuality.

SIECUS defines sexuality education as “a lifelong process of acquiring information and forming attitudes, beliefs, and values about such important topics as identity, relationships, and intimacy.” Such education should address “the socio-cultural, biological, psychological, and spiritual dimensions of sexuality by providing information; exploring feelings, values, and attitudes; and developing communication, decision-making, and critical-thinking skills.”^[1]

In other words: sex education should be broad and go beyond the birds and bees. Based on this definition, the ideal sex education program should include information on all of the following:

• Development. This includes anatomy, physiology, puberty, sexuality, and identity.
• Healthy relationships. Different familial structures, personal and interpersonal skills, communication, boundaries, and sexual negotiation.
• Sexual health. Pregnancy, STI, and HIV prevention,
• Sexual behavior. Aligning sexual activity with one’s values.
• Society and culture. Tech use, personal safety, inclusivity.^[2]

Like other topics under the health education umbrella, sex education’s goal is to create sexually healthy adults. Defining what this means and ensuring one’s lesson plans align with this definition are vital.

That being said, such ideal sex education is not often taught. Currently, programs can be broken down into one of the following three categories:

1. Abstinence-Only or Abstinence-Centered Education. Also called “chastity education,” this teaches abstinence as the only morally correct option of sexual expression for unmarried persons.
2. Abstinence-Plus Education. Strongly focuses on abstinence but also provides information about contraception and condoms.
3. Comprehensive Sex Education.^[3] Teaches abstinence as the safest choice while also providing information about contraception and condoms, building interpersonal and communication skills, and helping students define and explore their own values goals, and options related to sex.

Advocates for Youth has compiled a detailed comparison of abstinence-only versus comprehensive sexuality education.

How does the US currently stand on these programs? As of November 2014,

• 22 states and DC mandate sex education
• 33 states and DC mandate HIV education
• 19 states must stress the importance of having sex only within marriage.
• More than 37 states^[4] require abstinence be either stressed or covered.
• More than 15 states require information on condoms or contraception
• 13 states must cover the negative outcomes of teen sex and pregnancy
• 26 states and DC skills-building around healthy sexuality and decision-making.

For more information on the state of sex education in the US today, read the Guttmacher Institute’s brief on Sex and HIV Education.

Though many strides have been made in school-based sex education  and most parents support it^[5], there is still a lot of work to be done towards reaching SIECUS’ ideal curriculum.

_____________________________________

^[1]Sexuality Information and Education Council of the United States. (2004). Guidelines for comprehensive sexuality education.

^[2]Sexuality Information and Education Council of the United States. (2004). Guidelines for comprehensive sexuality education.

^[3] Some educators have called for a new model titled ‘Comprehensive-Plus Sexuality Education.’

^[4] The precise number depends on whether sex education or HIV education is taught. See the report for specific details.

^[5]Kaiser Family Foundation & Kennedy School of Government. (2004). Sex Education in America: General Public/Parents Survey. Washington, DC: National Public Radio.

As it stands now, the average age of first sex is around 17, a number that indicates teens are waiting longer to have sex. Puberty begins much earlier, on average at 10.5 for girls and between 11.5 and 12 for boys,^[1] while sexual development begins at birth. When it comes to sex education,the earlier, the better.

Sex education for young adolescents looks vastly different for that of adolescents  yet it is just as necessary . A recent study from Georgetown concludes that sex education for “very young adolescents” aged 10-14 “is imperative to lay foundations for future health relationships and positive [sexual and reproductive health].”^[2] Sex education among young adolescents is useful because they are still developing their sexual and gender identity.

Beyond this benefit, beginning sex education earlier ensures that young adolescents will receive the information they need to protect themselves from STIs and unintended pregnancy before they begin experimenting sexually. That is not currently the case, with a majority of teen females reporting that they did not receive sex education until after their first intercourse.^[3] The study did not ask about other sexual activities but it would be an educated conclusion that it therefore did not capture the true percentage of individuals who engaged in sexual behaviors of some sort before their sex education class.

Waiting until after teens have begun sexual activity also means that prevention messages may not be as effective. This is partially due to the fact that  young adolescents process risks differently than adults. Specifically, they use more primitive parts of their brain as compared to those devoted to reasoning, planning and complex thought. As a result, prevention messaging after the initiation of sex may be a moot point. If the teen hasn’t gotten a disease or pregnant yet, then they must be safe.

Taken together, this leads to one conclusion: sex education should coincide with individuals’ sexual development and age. It can begin as early as pre-school by teaching the proper names for body parts, respect for “yes means yes,” and the rules about touching one’s own genitals as a private activity. By being age-appropriate and medically accurate, such comprehensive sex education will decrease sexual risk taking, sexual shame, and sexual and reproductive health problems.

_________________________________________________

^[1] Adkins, D. (2013). When is puberty too early? Duke Medicine. http://www.dukemedicine.org/blog/when-puberty-too-early

^[1] Igras, S. M., Maciera, M., Murphy, E., & Lundgren, R. (2014). Investing in very young adoelscents’ sexual and reproductive health. Global Public Health: An International Journal for Research, Policy, and Practice, 9(5): 555-569

^[1] Cox, S., Pazol, K., Warner, L., Romero, L., Spitz, A., Gavin, L., & Barfield, W. (2014). Vital Signs: Births to Teens Aged 15-17 Years – United States, 1991-2012. Morbidity and Mortality Weekly, 63.

As a sex educator, you can probably cite facts about the state of the US’ sexual health without thinking twice. For example, you know that:

• Half of all births are unplanned.
• Adolescents receive half of the new STI diagnoses each year despite the fact that they only make up a quarter of the population.
• It is estimated that one in four women and one in ten men hve experienced unwanted sexual contact during their lifetime.
• LGBTQIA individuals experience higher rates of harassment, bullying, homelessness, and mental health issues.

These statistics serve as motivation to continue advocating for comprehensive sex education throughout the lifespan. They also identify the unmet needs that such programs address. As familiar as you are with the above statistics you probably also know that comprehensive sex education can have the following impacts:

• Delay sexual debut.
• Reduce the frequency of sexual activity.
• Reduce the number of sexual partners.
• Increase use of various contraceptive methods.

In other words, comprehensive sex education programs reduce sexual risk taking. This, in turn, helps decrease the rates of unintended pregnancies and STIs. This is not news. In fact, part of the motivation to bring sex education into schools was research showing that soldiers would have been better off had they learned about venereal disease in school.

Evidence-based comprehensive programs also go beyond traditional sexual health topics like STIs, puberty, reproduction, and contraception. As a result they have the potential to make much broader impacts. For example, the prevalence of eating disorders has been on the rise over the last several decades and they have a disproportionately high mortality rate.Comprehensive sex education programs help address this need by covering topics such as body image, beauty standards, and gender roles.

If these reasons were not enough, consider this: health education programs may also be linked to improved academic performance.

The US suffers from a general lack of information about and comfort with sex. Any sex educator can tell you a time that they received a question about basic facts. While infuriating, sex education in schools addresses this lack of knowledge while promoting sexual and overall health.

Further Reading
Sex Education in the US is Screwing Our Kids

Condoms  are known to help greatly reduce the transmission of STIs. Yet condom use among adolescents continues to be inconsistent and use decreases with age. When it comes to teaching about using condoms, the following learning objectives have been adapted from the  National Sexuality Education Standards.

Kate McCombs, MPH a sex educator who teaches about safer sex, stresses the importance of including pleasure in your conversation about using condoms. “The activities that lead people to practice safer sex or not are about pleasure.” It doesn’t help to respond to pleasure focused questions such as, “Won’t a condom ruin sex?” with a response about preventing STIs and pregnancy. Instead, rely on the research showing that while condoms may diminish sensation, they do not negatively impact individuals’ overall experience of sex.

If using a stricter curriculum, she recommends the following two strategies to address pleasure.

1. Talk about lube. “You can talk about lube without talking about pleasure because it increases the efficacy of condoms and decreases the likelihood they’ll break.” In other words, you’re providing students with a pleasurable solution without using pleasure as the selling point.
2. Focus on communication skills building, particularly around negotiating sex acts. The conversations, she stresses, must go beyond “Yes means yes” or “No means no.”

Finally, McCombs stresses the importance of normalizing condom-use. One way of doing this is simply by discussing what they are, their use, and why people might want to use them. When it comes to skills building, it is also important to include examples of these in role plays, sexual communication exercises, etc.

For additional resources on teaching this topic, check out the CSE’s resources: Teaching Safer Sex and Positive Images.

One thing is for certain: teens are curious about sex. I can still remember my own experiences reading Are You There God? It’s Me, Margaret, asking my mom about boners, and giggling with my best friend as we discussed the sex scene in our favorite sci-if novel.

Despite the fact that society uses sex to sell everything, finding accurate and age-appropriate sex education resources for teens that also align with parents’ values can feel difficult. Below is a list of books on sexual and reproductive health that are specifically written for adolescents.

This list is a subset of those maintained by SIECUS and Advocates for Youth.

Younger Teens (Middle School)

The Guy Book:  An Owner’s Manual, Mavis Jukes.

It’s Perfectly Normal: Changing Bodies, Growing Up, Sex and Sexual Health, Robie Harris^[1] and Michael Emberley

Period. A Girl’s Guide, JoAnn Loulan and Bonnie Worthen

Sex is a Funny Word: A Book about Bodies, Feelings, and YOU, Cory Silverberg

What’s Happening to My Body? Book for Girls and What’s Happening to My Body? Book for Boys, Lynda Madaras, Area Madaras, and Simon Sullivan

What’s Happening to Me? A Guide to Puberty, Peter Mayle, Arthur Robbins

Older Teens (High School)

Being a Teen: Everything Teen Girls & Boys Should Know About Relationships, Sex, Love, Health, Identity & More, Jane Fonda

Caution: Do Not Open Until Puberty!: An Introduction to Sexuality for Young Adults with Disabilities, Rick Enright, B.A., M.S.W

From Your Doctor to You: What Every Teenage Girl Should Know About Her Body, Sex, STDs, and Contraception, Dr. Fatu Forna

GLBTQ: The Survival Guide for Queer & Questioning Teens, Kelly Huegel

The Go Ask Alice Book of Answers: A Guide to Good Physical, Sexual, and Emotional Health, Columbia University’s Health Education Program

S.E.X.: The All-You-Need-To-Know Progressive Sexuality Guide to Get You Through High School and College, Heather Corinna

___________________________

^[1] Look for other books by this author too.

The average age of first menstruation in the US is 12, though it is healthy to start menstruating between ages 8 and 15.^[1] Therefore, it is ideal to discuss this aspect of puberty before this time.

The good news it that by the time girls get their period, most have heard something about periods, sex, and babies. This is a good place to start your lesson: ask students what they have already heard about periods and make a list of student responses on the board.This allows you to correct misinformation and ensure they receive the facts.

Use the list generated by students as a jumping off point for discussing menstruation and the monthly cycle. The following learning objectives are adapted from the National Sexuality Education Standards.

Learning Objectives

1. Describe the female reproductive system including body parts and their functions
2. Explain how the timing of the first period varies considerably and can still be healthy.
3. Describe how puberty prepares human bodies for the potential to reproduce.
4. Identify parents or other trusted adults of whom students can ask questions about their period or turn to if something happens in school.
5. Explain ways to manage the physical and emotional changes associated with the menstrual cycle.
6. Identify medically-accurate information about female reproductive anatomy and puberty.

If a student, or her parent, wants additional information, these great books discuss both the first period and other changes during puberty:

1. It’s Perfectly Normal by Robie Harris
2. The Care and Keeping of You: The Body Book for Younger Girls by Valorie Schaefer (ages 8+)
3. The Care and Keeping of You 2: The Body Book for Older Girls by Cara Natterson (ages 10+

The Office of Women’s Health maintains a stellar website for girls that are a great resource to refer to students and families. Girls’ Health includes information on all aspects of adolescence and puberty including getting one’s period. Kids Health also maintains a library of resources for both children and parents.

Additional Resources
Changes, Changes, Changes: Great Methods for Puberty Education
Lesson plans on puberty

____________________________________

^[1] McDowell, M. A., Brody, D. J., & Hughes, J. P. (2007). Has age at menarche changed? Results from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. Journal of Adolescent Health, 40(3) 227-231.