Only a third of US states require sexual education in schools to be medically accurate

Only just over a third of U.S. states require sexual education in public schools to be medically accurate, researchers said on Friday, potentially preventing tens of millions of students from receiving crucial information about sexual health.
While 42 states ask students to take a course that covers at least one “sex ed” topic between kindergarten and high school, just 19 mandate that the information be evidence-based and supported by the medical community, according to a new analysis from the Boston University School of Public Health. And five of those states require accuracy for specific topics, which may include sexually transmitted diseases and HIV/AIDS, unwanted pregnancies, and unhealthy relationships.
“While many students in the U.S. are required to get some form of sexual education, our study shows that substantially fewer students are likely to be getting the comprehensive sexual education that public health and medical associations recommend,” Dr. Kimberly Nelson, an associate professor at the school, said in a statement.
More than 65 million students were enrolled in public schools in 2021, according to a U.S. Census Bureau survey.
Now, only 58 percent of students live in a jurisdiction that requires sex ed to be medically accurate, Nelson noted, and many jurisdictions have content mandates that extend only to a few topics.
“This means that many U.S. students are living in jurisdictions where they are unlikely to receive the accurate and comprehensive information that we know will help them make informed, healthy choices about their sexual behaviors and relationships,” she explained.
No federal law requires schools in the U.S. to teach sex ed, leaving decisions to the states or school districts.
Dozens of the 42 states that mandate sex ed courses – 34 – require instruction on abstinence, which the researchers say has consistently proven to be ineffective or harmful to adolescent sexual health. The same number of states mandate instruction about HIV, while only 32 require education about sexually transmitted infections, and 31 mandate instruction on child abuse prevention. Even fewer states require instruction about healthy relationships and dating or intimate partner violence.
Just 24 states require education about sexual assault, even though one in five American women has experienced completed or attempted rape during their lifetime. Nearly a quarter of men have experienced some form of contact sexual violence in their lifetime, according to federal health officials.
In addition, only 20 states require instruction related to contraception, and nine states mandate instruction about consent to sex.
The analysis also found just 12 states mandate instruction about sexual orientation, with Oklahoma and Texas requiring the use of messaging the researchers called “stigmatizing” or “negative.”

State mandates also varied by region, with all Northeast states requiring school-based sex ed for at least one topic. The same was true for 88 percent of states in the South, 83 percent of states in the Midwest, and 62 percent of states in the West.
The researchers said 34 states have allowed parents to opt their children out of receiving sex ed instruction, and five states require parents to opt in.
The findings were based on an examination of state statutes, administrative regulations, state court decisions, sex ed content requirements, and parental notice and consent policies.
Although more research is necessary to fully understand the extent to which parental policies limit the effect of state sex ed mandates, the researchers said current policies may stop students from receiving vital information about sexual health.
“Because policy decisions about sexual education curricula happen at the state-level, state-level sociopolitical forces exert substantial influence on sexual education,” said Nelson.