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Biased Sex Education in the United States

After significant outbreaks of sexually transmitted diseases among soldiers in World War I, the federal government became involved and allocated money to educate soldiers about gonorrhea, syphilis and chlamydia. In 1919, the U.S. Department of Labor’s Children’s Bureau suggested that soldiers would have benefited from learning about STDs (sexually transmitted diseases) during school. As a result in the 1920s, sex education began to be taught in public schools.

Throughout the past century, sex education has become a hotly debated topic amongst legislators, public health officials, and state education boards. It is still a controversial subject, with people debating whether or not sex education mandates are constitutional, if sex education is appropriate for students, and what information should or should not be taught.

Each state has its own policies about sex education in schools. Although the American Medical Association and the Centers for Disease Control and Prevention both recommend that all students receive a comprehensive sex education, including information about how to prevent STDs and unwanted pregnancy.  Only 22 states and the District of Columbia mandate that schools provide sex education. In many states, the type of information that can be taught is biased with 17 not requiring instruction about HIV/AIDS; 19 requiring that information taught in sex education classes be medically, factually, or technically accurate; and eight have “no promo homo” laws which either prohibit gay-inclusive or sexual-orientation-neutral instruction or require that teachers provide anti-gay instruction.

Public Health Implications of Biased Sex Education


Currently, 27 states require an emphasis on an abstinence only approach to preventing pregnancy. The schools can discuss other birth control methods, but must stress that abstinence is the main method of protection. Abstinence may be the best way to prevent pregnancy, but abstinence-only education programs have been shown to be ineffective. Instead, they may deter teenagers from using contraceptives. Studies have shown that students who receive comprehensive education are 60% less likely to become pregnant or get someone else pregnant. Teen pregnancy rates in 2013 were highest in Mississippi and Arkansas, and both states have abstinence-only education.  The young women in these states are prone to experience the other consequences and health risks of teenage pregnancy, such as a higher likelihood of living in poverty or being in poor health. Their children have an increased risk of having health or cognitive disadvantages, and many become teen parents as well.

Additionally, schools with abstinence only education do not provide information for STD prevention. Often, students are not instructed about preventive methods, such as using condoms or receiving HPV vaccinations. This can lead to a higher risk of contracting and/or spreading STDs, including HIV/AIDS.

Inaccurate Information:

In 41 states and the District of Columbia, schools that teach sex education are not required to teach medically accurate information. They are allowed to- and often encouraged to- provide statistics that inflate the failure rate of contraceptives or emphasize only the risks of abortion. Exploiting the possible ineffectiveness of contraceptives can have devastating effects. Students who choose to engage in sexual activity may decide not to use protection, believing it will not make a difference. Without using protection, they can risk both pregnancy and contracting STDs. Teaching inaccurate information also sets a dangerous precedent for future health instruction. If students discover that they are not being given the truth, they may be reluctant to believe their teachers about other health issues and safety measures.

“No Promo Homo” Laws

These laws are present in Alabama, Arizona, Mississippi, North Carolina, Oklahoma, South Carolina, Texas, and Utah, and vary from state to state. In Alabama, teachers are required to emphasize, “in a factual manner and from a public health perspective, that homosexuality is not a lifestyle acceptable to the general public.” Arizona law requires that sex education cannot “promote a homosexual life-style,” or suggest that some methods of homosexual sex are safe. Such teachings can easily lead to an increase in stigma that many LGBT students already experience, as well as to an increase in bullying. Subsequently, they may be at a higher risk of developing anxiety or depression.

In many of the “No Promo Homo” states, instructors must emphasize that HIV/AIDS is generally transmitted through homosexual activity and that heterosexual activity is the best way to ensure protection. HIV/AIDS can be transmitted through any sexual activity, regardless of whether it is homosexual or heterosexual activity. By stressing that it is primarily a homosexual concern, non-LGBT students can have a lower risk perception and think they’re not at risk for contracting HIV/AIDS, and may be less likely to take protective measures.

Biased sex education can ultimately result in negative public health consequences, such as an unplanned pregnancy, the transmission of STDs, and poor mental health for LGBT students. Yet despite these consequences, many states still do not mandate a comprehensive sex education program.

To learn more about sex education laws throughout the U.S., visit the Guttmacher Institute’s website.

Sammi Gassel is a student in the MS in Health Communication Program at Tufts University School of Medicine and is also a James Hyde Newsletter Intern for the Tufts “Public Health Rounds” newsletter.


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