Sex education involves the teaching of useful knowledge and related skills of critical issues related to sexuality, including intimacy, human relationships, sexual identity and gender roles, reproductive anatomy and body image, puberty and the reproductive process, emotional aspects of maturation, the value of continued abstinence among teens who are not sexually active, alternative methods of contraception and HIV/STD (sexually transmitted disease) prevention, and the health consequences of avoiding contraceptives and prevention methods among sexually active youth.

Studies show that adolescent sexuality is most influenced by parents, followed by peers, and finally, by what is learned in schools.

Sex education developed in response to various studies showing high rates of teen involvement in sexual activity (75 percent by the college years) and low rates of contraceptive use and knowledge about sexually transmitted diseases (STDs).

Risky Sexual Practices
Further, these studies showed that several situational factors contribute to risky practices among teens—especially failure to plan in advance for sexual activity (on the assumption that planning for sex damages spontaneity and romance) and use of alcohol and/or drugs prior to or during sex.

Also, less than complete ability to assess the potential consequences of one's actions has been found to be common among teenagers. All of these factors are associated with low levels of condom use among teens, and usually all are addressed in sex education programs.

The primary goal of school-based sex education is the promotion of sexual health. To achieve this goal, most programs seek to provide accurate information about human sexuality, an opportunity for value clarification, skills to improve interpersonal relationships, and assistance in exercising responsibility in one's sexual life, including acquiring healthy behaviors and attitudes regarding sexual behavior.

Effectiveness of Sex-Ed Mixed
Studies of the effectiveness of sex education in achieving its goals have been mixed. Consistently, sex education has been found to increase teenager knowledge about sexual issues, provide modeling and practice to enhance interpersonal skills relative to sexual behavior, and reinforce appropriate values, but most approaches have not had the desired impact on actual sexual behavior or contraceptive use.

Some of the best results are found in education programs that are linked to school-based health clinics. Studies show that sex education is most effective when it is implemented prior to the onset of sexual activity, and when it combines both abstinence and contraceptive information.

Studies have not found that sex education encourages sexual experimentation or increased involvement in sexual activity. Programs that only promote abstinence have not been found to be effective in controlling the onset of sexual activity.

Educational Videos
Limitations on the effectiveness of traditional classroom sex education approaches have led to the creation of alternative methods to communicate key sex education messages. One innovative approach is the use of specially produced educational videos. These videos often emphasize assertiveness and refusal skills (in responding to peer pressure), decision-making related to teen sexuality, and specific sex and health information (e.g., the symptoms of various sexually transmitted diseases).

Some videos also address the issue of mixing alcohol and sexual activity (a practice that has been found to lead to poor decision-making and riskier behavior). The rationale for sex education videos is that knowledge is not sufficient to lower the frequency of risky behavior.

Sex education videos commonly seek to address barriers to risk avoidance (e.g., pressure from a boy- or girlfriend to initiate sex or the widespread belief that condoms are ineffective in preventing pregnancy or infection with an STD or HIV).

Teen Theater Sex
Another innovative approach, which combines entertainment and peer communication of sex education information, is the use of teen theater. It began in 1973 at New York Medical College. Since its inception, teen theater sex education has been implemented in various locations around the U.S.

The expectation is that dramatic performances about critical sex education issues will decrease teen anxiety about sensitive issues, increase the willingness of teens to openly discuss sexual issues, increase the intention of sexually active teens to use birth control and protect themselves from STDs and HIV, and contribute to a delay in the onset of sexual activity among teens who are not already sexually active.

Research has shown that a key factor in avoidance of condom use among sexually active teenagers is embarrassment. In response, several teen theater performances have focused on decision-making around condom purchase and use. Evaluation of dramatic sex education has shown that this approach does lead to greater levels of sexual knowledge and increased willingness to talk freely about sex. However, it is has not been shown to significantly impact actual sexual practices.

No Uniform Support
Importantly, school-based teen sex education is not uniformly supported by all adults. Public opinion polls in the U.S. consistently find that the majority of parents want sex education at the high school level as a realistic response to demonstrated high rates of sexual activity among teens (as evidenced by pregnancy and STD rates among teenagers) and the potentially significant health and social consequences of uninformed teen sex.

Since the advent of AIDS, almost all states have implemented AIDS prevention curricula in their schools that, unavoidably, include sex education. Parental support for AIDS-related sex education has been found to top 90 percent of sampled parents. Even among parents who support sex education, however, there have been debates about what the curricula should include (e.g., should abstinence be emphasized, should birth control methods be discussed, does contraceptive knowledge lead to sexual experimentation) and at what age specific sex education information should be introduced. There also have been debates about whether schools should dispense condoms to sexually active students.

Some people believe that sexual education should only be conducted in the home, thereby insuring that parents will be free to transmit their own moral values regarding sexuality and sexual activity to their children. Some parent groups have been formed to protest the implementation of sex education and related programs (e.g., teen HIV prevention education) in public schools.

The Role of the Church
Although some groups opposed to sex education are religious in their orientation, studies have found that church attendance does not predict attitudes toward sex education. Less educated and older parents have generally been found to have less favorable attitudes toward sex education. In all states with school-based health education, parents have been given the right to remove their children from sex education programs.

The efforts to promote sex education have been supported by a national organization called the Sex Information and Education Council of the U.S. (SIECUS). SIECUS works closely with state and local education agencies to expand existing sex education programs and to implement new programs. SIECUS has developed Guidelines for Comprehensive Sexuality Education for implementation at all grade levels K-12. The Guidelines provide communities with a framework for developing and implementing a comprehensive sex education program in schools. Studies show that sex education is most effective when parents and schools reinforce similar messages about teen sexuality.