Comprehensive Sexuality Education Adalah
Sexual education exemption
Just as teaching methods and curricula vary by state, excusal from sex education also varies by state. States may have an opt-out or opt-in policy. In some states, students can opt out of receiving sexual education without specifying a particular reason. In other states, students can only opt out for religious or moral reasons. In an opt-in provision, parents must actively agree to allow their children to receive sex education prior to the start of the sexual education.[5]
Abstinence Education Grant Program (AEGP)
Historically, funding for abstinence education has always been favored over CSE. In 1996, during Bill Clinton's presidency, legislation was passed to promote abstinence in education programs. Under Title V Section 510 of the Social Security Act, the Abstinence Education Grant Program (AEGP), was passed. AEGP has always been renewed before its expiration date, and each time funds gradually increase from fifty million dollars per year to seventy-five and as high as $6.75 million per state grant in 2015. The way the funds are disbursed are based on the proportion of low-income children in each state. So far, thirty-six states have been given AEGP funds.[5]
Part of Section 510(b) of Title V of the Social Security Act, contains the "A-H guidelines", which are the eight criteria that programs must abide by order to be eligible to receive federal funding.[42] They are as follows:
In addition to abiding by these 8 conditions, AEGP compliant programs cannot discuss contraception, STIs, or methods for protecting against STIs, except when describing failure rates.[5]
How are some legislators restricting CSE?
Despite the myriad benefits that CSE provides for people of all ages, lawmakers have been mounting increasingly frequent attacks meant to limit or outright ban various aspects of CSE. Florida’s notorious “Don’t Say Gay” bill, HB 1557, shone a spotlight on anti-CSE legislation when it prohibited “classroom discussion about sexual orientation or gender identity in certain grade levels or in a specified manner.” In May 2023, Florida legislators expanded on the Don’t Say Gay bill when they passed HB 1069, which prevents education on menstruation and other sex education topics in elementary school, including answering questions from students who have begun menstruating but have not yet entered middle school. This same bill requires educators to teach that “reproductive roles are binary, stable, and unchangeable” and students should abstain from sexual activity outside of heterosexual marriage. In April 2023, Florida’s education board also voted to ban education on gender identity and sexual orientation for grades four through 12 in all public schools, expanding on a 2022 ban that prohibited education on gender identity and sexual orientation from kindergarten through third grade.
Florida isn’t alone in its restrictive, regressive policies: Ohio HB 8, referred to the state senate in 2023, would permit parents to remove their children from CSE courses without the child’s input or consent. This bill also requires school employees to notify parents if their child requests to identify as a gender that does not align with the student’s biological sex, effectively mandating that school officials out students to families without the students’ consent—regardless of the danger being outed may pose to the student. And in some states, elected officials have advanced policies that would require students to watch biased and inaccurate content intended to support a particular ideological viewpoint and direct students’ future decisions about reproductive health care.
Policies that ban CSE or co-opt it to spread a particular ideology or demonize entire groups of people leave young people without the unbiased, scientifically accurate information necessary to understand and make informed choices about their bodies, gender, sexuality, and involvement in sexual activity and healthy relationships. Without CSE, children and young people may struggle to establish the framework for evaluating and understanding accurate information, science-based foundations of anatomy of reproductive and sexual health, and healthy social and emotional relationships. In an era in which misinformation proliferates about everything from how menstrual cycles work to how to avoid pregnancy to simple bodily anatomy and functions, providing children and young people with accurate, science-based information about their bodies and relationships with others is critical.
The Healthy Youth Act Massachusetts
An Act Relative to Healthy Youth, or the Healthy Youth Act, is a bill (HD.3454/SD.2178) that would require any public school in Massachusetts with a sex education curriculum to be fully comprehensive. This would include materials that are age-appropriate, medically-accurate, LGBTQ-inclusive, and consent-focused. Content would address how to build healthy relationships and how to prevent pregnancy and STIs when a person does have sex. The Healthy Youth Act was initially filed in January 2011 and has been revised multiple times since. This bill is a framework that does not mandate a particular curriculum, but does require that schools where sex education is already being taught fit this framework. Parents will be given 30 days-notice to review the material and opt-out.
In 2021, the Healthy Youth Act was cosponsored by Senator Sal N. DiDomenico and Representatives Christina A. Minicucci, Vanna Howard, and Jack Patrick Lewis of the 192nd General Court of the Commonwealth of Massachusetts. Bill SD.2178 has been advocated for over 10 years and has successfully passed the Massachusetts Senate, however it has yet to be passed by the Massachusetts House of Representatives[needs update].
Reactions to the Healthy Youth Act have been mixed, but it has gained increased support over the years. Some of its most dedicated supporters include Fenway Health, the Healthy Youth Coalition, The Massachusetts Healthy Youth Consortium, and Getting to Zero. The Planned Parenthood League of Massachusetts states that "comprehensive sex education is about more than just sex – it helps creates a culture of consent, recognizes and prioritizes LGBTQ youth health needs, and gives young people the tools to build healthy relationships... We can combat sexual assault at its roots by teaching young people how to build healthy, respectful relationships". In 2018, a poll of Massachusetts residents showed that 92% of people agree that students should receive comprehensive sex education in high school. In a testimony in support of the bill, supporters claim that "sex education is a perfect opportunity for youth to develop skills like communication, healthy relationships, decision-making, planning, and critical thinking. Such life skills can contribute to their positive development throughout adolescence and into adulthood".
The Massachusetts Family Institute (MFI), a conservative organization that promotes traditional Judeo-Christian values and the bill's main opponent, highlights the article "Pornographic 'Comprehensive Sexuality Education' in Massachusetts Public Schools" on the front page of their website. This article refutes Planned Parenthood's claims, stating that "it’s no wonder that Planned Parenthood is pushing it in our schools. Planned Parenthood administrators know that if they sexualize young people, they will create new customers who seek out their abortion services, sexually transmitted infection treatments, and transgender hormone therapies". Instead, MFI argues that the Healthy Youth Act would inappropriately expose underaged youth to "pornographic" content that would encourage youth to engage in sexual behaviors, concluding that "state education officials and local school administrators ought to reject Comprehensive Sexuality Education as the poisoner of children that it is".
Sexual Risk Avoidance (SRA) curricula has been promoted in direct opposition to the Healthy Youth Act. Advanced by Ascend, this curricula promotes an abstinence-only approach to sex education. Within SRA education programs "Ascend works with SRA educators, community organizations and more as they educate youth using a primary prevention health model".
Benefits of Pleasure-Inclusive Material
Though a focus on behavior change (i.e., increased condom use and delayed onset of sexual debut) is an important benefit and measure of outcomes associated with sex education, a pivot to exploring the mental health and well-being implications associated with shifting the narrative from a purely biological and procreative approach to a pleasure-inclusive and sex positive approach showcases a host of beneficial outcomes.[22] Two avenues hold particular interest when implementing a pleasure-based curricula: Benefits of CSE[23] and Benefits of Sexual Expression.[24]
Such avenues have been recognised by official organising bodies such as the World Association of Sexual Health (WAS). Indeed, their Sexual Pleasure Declaration outlines that the pursuit of pleasurable and safe sexual experiences, free from discrimination and coercion, is integral to sexual health and overall well-being. Recognising sexual pleasure as a fundamental aspect of human rights - which also holds its own declaration on Sexual Rights - its diverse expressions should be incorporated into global education, health promotion, research, and advocacy efforts, fostering comprehensive, immediate, and sustainable actions for individual well-being and contributing to global health and sustainable development.
Another notable organisation paving the way of pleasure-inclusive sex education curricula is The Pleasure Project. Which recently published a systematic review uncovering the distinct value added by embedding a pleasure-based lens within sexual health interventions.[22] The Pleasure Project also underscores seven guiding principles: Be Positive, Rights First, Think Universal, Be Flexible, Talk Sexy, Embrace Learning, and Love Yourself.
While CSE implementation is on the rise in the United States, it remains difficult for state officials to regulate what is and is not taught in the classroom. This is due in large part to the undefinability of CSE; CSE has the potential to comprise such a wide range of sexual information, and over-all focus varies widely between curricula.[25] Educators have also accused CSE of fundamentally operating as a form of "abstinence-plus", due to the reality that CSE often involves minimal body-related information and excessive promotions of abstinence.[26] "So-called Comprehensive Sex Ed" says Sharon Lamb, a professor at the University of Massachusetts Boston, "has been made less comprehensive as curricula are revised to meet current federal, state, and local requirements."[26]
The LGBT population experiences multiple health disparities which may be impacted by stigma, discrimination, and lack of provider cultural sensitivity.[27] This population is subject to systemic barriers to adequate healthcare services ultimately impacting their wellbeing and welfare negatively.[27] They often receive care from clinicians without specialty training in addressing the concerns of this population; which may hinder communication and trust, and ultimately influence the quality and adequate delivery of healthcare.[28] Discrimination and lack of cultural sensitivity may also contribute to the limited health-seeking behaviors experienced by this population.[27] This lack of health-seeking behavior both limits preventative services, and increases and prolongs illness and ailments. Research shows a higher risk of contracting HIV and other STDs; particularly in gay men of color.[27] Lesbian and bisexual females are less likely to obtain routine care like breast and cervical cancer screenings.[27] Gay men are at an increased risk of prostate, testicular, anal, and colon cancers, while lesbian and bisexual women have an increased risk of ovarian, breast, and endometrial cancers.[28] As a result of stigma, discrimination, victimization, and sexual abuse, LGBT youth are more likely to be involved in high-risk sexual behaviors at an earlier age.[28]
While comprehensive sex education exists in schooling, many programs do not address the needs of the LGBT community. This population faces different health disparities ultimately driven by discrimination, shortfalls of peers, the lack of parental support, community services, and school-based sex education.[29] The implementation of LGBT comprehensive sex education utilized as an intervention seeks to combat these health disparities, by informing the population of the importance of developing sexual health.[29] Sexual health involves not only preventing disease, but also a respectful approach to sexual relationships, sexuality, and accepting an individual's gender identity and sexual orientation.[29]
The term "comprehensive" is also often misleading because some comprehensive programs do not show the holistic picture of human sexuality.[30] LGBT advocates have long been critical of the ways in which comprehensive sex education generally promotes marriage as the end goal for students. LGBT advocates want to express other forms of relationships other than marriage. They advocate that students should have sex education that encompasses the different forms and should be allowed to exercise those forms in which they are most comfortable with. Even when curriculums claim to be inclusive of LGBT experiences, they often promote heteronormative lifestyles as "normal."[31] Inclusion of LGBT identities and health topics is necessary for LGBT students to feel safe and seen in their sex ed classrooms.[32] When sex education fails to include LGBT identities and experiences, LGBT youth can be vulnerable to risky sexual behaviors and experience negative sexual health outcomes. Due to the lack of LGBT sex education provided in schools, LGBT youth will look to peers and the internet, which can lead to misinformation.[33] When these students do not have access to or an interest in marriage they are practically erased from the CSE narrative.
In Canada, a federal report showed that the LGBT community has less access to health services and faces more comprehensive health challenges compared to the general population. As a result of the lack of support for the LGBT population, the Comprehensive Health Education Workers (CHEW) Project emerged in October 2014. Their goal is to educate the LGBT community about topics such as sexual and gender identity, sexually transmitted infections (STIs), healthy social relationships, and depression. They do this through workshops, arts‐based projects, and one‐on‐one meetings. The CHEW project is set exclusively for the LGBT community in order to establish a safe environment in which LGBT youth can gain resources for sex education.[34]
A cross-sectional study done in New York City analyzed the sexual behaviors of high school girls. Studies found that, "high school girls who identified as LGBT were more likely to report substance use such as: alcohol, marijuana, cocaine, heroin, meth, ecstasy and prescription drugs. They also had higher rates of contemplating and/or attempting suicide."[35] Another study found that "the LGBT youth accesses health information online five times more than the heterosexual population, and these rates are even higher for LGBT youth that identify as a person of color which stems from the fact that they lack health resources".[36] Rights, Respect, Responsibility includes an inclusive LGBT curriculum for grades K-12. By having a curriculum, such as the Right, Respect, Responsibility suggests, students will have accurate information about all identities as well as establishing a safe classroom for LGBT students.[37]
As of May 2018, only 12 states require discussion of sexual orientation and of these, only 9 states require that discussion of sexual orientation be inclusive (California, Colorado, Delaware, Iowa, New Jersey, New Mexico, Oregon, Rhode Island, and Washington).[38] Additionally, several states have passed legislation that bans teachers from discussing gay and transgender issues, such as sexual health and HIV/AIDS awareness.[36] As of 2022, five states require that heterosexuality be emphasized over homosexuality.[38]
Before the late 1800s, delivering sex education in the United States and Canada was primarily seen as a parent's responsibility.[36] Today, programs under the Sexuality Information and Education Council of the United States (SIECUS) begin comprehensive sex education in pre-kindergarten, drawing criticism related to the age at which it is appropriate to address sexual matters with children.[30]
What does comprehensive sexuality education do?
CSE imparts knowledge and skills that are critical to ensuring that children, adolescents, and young adults are equipped to make informed decisions about their bodies, their health, and their relationships. Its benefits are myriad: CSE can delay sexual initiation; increase the use of birth control, including condoms; and reduce sexual risk behaviors, sexually transmitted infections, and rates of unintended pregnancy. It also helps people recognize intimate partner violence, including among adolescents, and enables people to conceptualize sexuality, recognize and foster healthy relationships, understand consent, and make informed decisions about their health. A systematic literature review of three decades of research on school-based CSE programs showed that CSE led to “an appreciation of sexual diversity, dating and intimate partner violence prevention, development of healthy relationships, prevention of child sex abuse, improved social/emotional learning, and increased media literacy.”
CSE should be medically accurate, based in evidence, and appropriate for the age of the intended audience. ACOG guidance recommends that curricula include …
CSE also provides much-needed and timely education about sexuality, bodily autonomy, and personal boundaries in the digital age, safeguarding against the rise of behaviors such as sexting, which is associated with higher likelihood of reporting high-risk sexual behaviors, and online dating, which has been associated with dating violence among adolescents.
Comprehensive sexuality education (CSE) teaches about all aspects of human sexuality, such as anatomy, consent, sexual orientation, gender identity, and interpersonal relationships, to name just a few. Medically accurate, evidence-based, and age-appropriate education about anatomy, sexuality, gender, and relationships empowers and prepares children, adolescents, and young adults to make educated decisions about their health and their relationships. Despite the many benefits that CSE provides, CSE is largely unstandardized—and, in an increasing number of states, stymied or outright banned.
To ensure that children, adolescents, and young adults are equipped with the information they need to protect themselves, lead healthy and full lives, and distinguish fact from misinformation, they must have access to sexuality education that is truly comprehensive, inclusive, and based in science and evidence rather than education that is centered on a political viewpoint, promotes only abstinence, and excludes LGBTQ+ people.
Federal Funding for Sexual Education
Although there is no federal mandate that requires states to teach sexual education, there is federal funding available to assist with sexual education programs.[42]
Sexual content in the media
Since 1997, the amount of sexual content on TV has nearly doubled in the United States.[43] Additionally, a study done in 2008 showed that nearly 40% of popular music lyrics contained sexual references which were often sexually degrading. These lyrics were also often accompanied with mentions of other risk behaviors, such as substance use and violence.[43]
Teens (ages 13–15) in the United States, use entertainment media as their top source for education in regards to sexuality and sexual health. Additionally, a study found that 15–19-year-olds in the U.S use media far more than parents or schools to obtain information about birth control.[43] Some studies have found that, "very few teen television shows mention any of the responsibilities or risks (e.g., using contraception, pregnancy, STIs) associated with sex and almost none of the shows with sexual content include precaution, prevention, or negative outcomes as the primary theme."[43] Television shows 16 and Pregnant and its spin-off, Teen Mom, which first aired on MTV in 2009 received major disapproval from some parents as they thought the shows glamorized teen pregnancy and motherhood. However, 16 and Pregnant actually led to a 4.3 percent reduction in teen pregnancy, mostly as a result of increased contraceptive use.[5] In contrast, other data shows that exposure to high levels of sexual content on the television causes adolescents to have twice the risk of becoming pregnant in the following three years, compared to those who were exposed to low levels.[43]
The film Mean Girls, directed by Mark Waters shed light on the state sex education in some parts of the United States. In the film the health instructor states, "At your age, you're going to have a lot of urges. You're going to want to take off your clothes and touch each other. But if you do touch each other, you will get chlamydia and die." This line is meant to be satirical, but it illustrates common flaws within sex education in the U.S. It depicts simplistic descriptions of sexual activity and implementation of fear without any legitimate basis.[5]
Comprehensive sex education is the main topic in the documentary The Education of Shelby Knox (2005) about Lubbock, Texas, which has one of the highest teen pregnancy and STD rates in the nation; the "solution" to which is a strict abstinence-only sex education curriculum in the public schools and a conservative preacher who urges kids to pledge abstinence until marriage.
In 2013, How to Lose Your Virginity was released, a documentary that questioned the effectiveness of the abstinence-only sex education movement and observed how sexuality continues to define a young woman's morality and self-worth.[44][45] The meaning and necessity of virginity as a social construct is also examined through narration and interviews with notable sexuality experts, such as former Surgeon General Joycelyn Elders, "Scarleteen"[46] creator and editor Heather Corinna, historian Hanne Blank, author Jessica Valenti, and comprehensive sex education advocate Shelby Knox.
Not only have films portrayed sex education, but so has social media. Platforms such as YouTube, Facebook, and others are used as a tool to uplift the narratives of marginalized communities such as persons of color and LGBT persons in hopes to "strengthen sexual health equity for all."[36]
As a result of the mass amount of sex content in media, media literacy education (MLE) has emerged. It was created to address the influence of unhealthy media messages on risky health decisions, such as intention to use substances, body image issues, and eating disorders.[43] A study analyzed the effectiveness of a teacher-led MLE program, called Media Aware Sexual Health (MASH), which provides students with accurate health information and teaches them how to apply that information to critical analysis of media messages. This comprehensive sex education resulted in increased intentions to talk to a parent, partner and medical professional prior to sexual activity, and intentions for condom use.[43]
Due to knowledge gaps in most sex education curricula for teens, free online resources like Sex, Etc., Scarleteen.com, and teensource.org[47] have been created to promote comprehensive, inclusive, and shame-free sex education for teenagers.
This article incorporates text from a free content work. Licensed under CC-BY-SA IGO 3.0 (license statement/permission). Text taken from Emerging evidence, lessons and practice in comprehensive sexuality education: A global review 2015, 14, 15, 25, 29, UNESCO, UNESCO. UNESCO.
California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act
In January 2016, the California Healthy Youth Act amended the California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act to include minority groups and expand health education. Before, it authorized schools to provide comprehensive sex education and required all materials to be made accessible to students with a variety of needs; it also focused solely on marital relationships. It now mandates that schools provide comprehensive sex education and states that "materials cannot be biased and must be appropriate for students of all races, genders, sexual orientations, and ethnic and cultural backgrounds, as well as those with disabilities and English language learners." Additionally, education must now include "instruction about forming healthy and respectful committed relationships," regardless of marital status. Furthermore, it is now required to have discussions about all FDA-approved contraceptive methods in preventing pregnancy, including the morning-after pill.[5]
In conclusion now requires that all sex education programs promulgated in the state should:[5]
Some critics state that young people's access to CSE is grounded in internationally recognized human rights, which require governments to guarantee the overall protection of health, well-being and dignity, as per the Universal Declaration on Human Rights, and specifically to guarantee the provision of unbiased, scientifically accurate sexuality education.[16]
These rights are protected by internationally ratified treaties, and lack of access to sexual and reproductive health (SRH) education remains a barrier to complying with the obligations to ensure the rights to life, health, non-discrimination and information, a view that has been supported by the Statements of the Committee on the Rights of the Child, the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) Committee, and the Committee on Economic, Social and Cultural Rights.[16]
The commitment of individual states to realizing these rights has been reaffirmed by the international community, in particular the Commission on Population and Development (CPD), which – in its resolutions 2009/12 and 2012/13 – called on governments to provide young people with comprehensive education on human sexuality, SRH and gender equality.[16]
Other analysis show that comprehensive sex education is not an international right nor a human right because it not clearly stated in either a treaty or custom. By international law, states are required to provide access to information and education about reproductive health, but this does not require a sex education curriculum. It may take different forms such as mandating that local school districts create a system for providing information to students, or mandating that health clinics and practitioners dispense information to patients.[30]
As CSE gains momentum and interest at international, regional and national levels, governments are increasingly putting in place measures to scale-up their delivery of some form of life skills-based sexuality education, as well as seeking guidance on best practice, particularly regarding placement within the school curriculum. Sexuality education may be delivered as a stand-alone subject or integrated across relevant subjects within the school curricula. These options have direct implications for implementation, including teacher training, the ease of evaluating and revising curricula, the likelihood of curricula being delivered, and the methods through which it is delivered.[16]
Within countries, choices about implementing integrated or stand-alone sexuality education are typically linked to national policies and overall organization of the curricula. The evidence base on the effectiveness of stand-alone vs. integrated sexuality education programming is still limited. However, there are discernible differences for policy-makers to consider when deciding the position of CSE within the curriculum.[16]
As a stand-alone subject, sexuality education is set apart from the rest of the curriculum, whether on its own or within a broader stand-alone health and life skills curriculum. This makes it more vulnerable to potentially being sacrificed due to time and budget constraints, since school curricula are typically overcrowded.[16]
However, a stand-alone curriculum also presents opportunities for specialized teacher training pathways, and the use of non-formal teaching methodologies that aim to build learners' critical thinking skills. The pedagogical approaches promoted through sexuality education – such as learner-centred methodologies, development of skills and values, group learning and peer engagement – are increasingly being recognized as transformative approaches that impact on learning and education more widely. As a standalone subject, it is also significantly easier to monitor, which is crucial in terms of evaluating the effectiveness of programming, and revising curricula where it is not delivering the desired learning outcomes.[16]
When sexuality education is integrated or infused, it is mainstreamed across a number of subject areas, such as biology, social studies, home economics or religious studies. While this model may reduce pressure on an overcrowded curriculum, it is difficult to monitor or evaluate, and may limit teaching methodologies to traditional approaches.[16]
Apart from the different teaching methods, terminology also differs. Abortion, homosexuality and abstinence have connotations and definitions that vary by state and by nationality. For example, the word "abstinence" may refer to disengaging from all forms of sexual activities until marriage or may refer to only disengaging from sexual intercourse. Furthermore, the degree of sexual activity that "abstinence" connotes is often unclear, because sexual behavior that is not sexual intercourse may or may not be included in its definition. As a result, students are left confused about what activities are risky and teachers do not know what they can and cannot teach.
The term "comprehensive", is also falls on spectrum, therefore can be considered an umbrella term. CSE means something radical for some institutions while it can mean something moderate and even conservative for others.[25]
According to the Sexuality Information and Education Council of the United States (SIECUS), the guidelines for comprehensive sexuality education are as follows:[42]
