Sexuality Education:

Birds, Bees, and Scientific Evidence

Marla Eisenberg, Sc.D., M.P.H.
Healthy Youth Development Prevention Research Center
Department of Pediatrics,
Division of Adolescent Health and Medicine
University of Minnesota
Overview
What is school-based sexuality
education?

Review of the scientific research
Effectiveness of different programs
Parental support for different programs
Teachers views on teaching sex ed
Sexuality Education Lingo
Abstinence-only education
Initiated with 1998 Social Security Act,
$50 million in annual grants
Recently renewed, $250 million as part of
Health Care Reform legislation
8 requirements
Developed by Heritage Foundation
Designed to clarify what counts as
abstinence for funding purposes

Abstinence-only
requirements
a) Health gains of abstinence
b) Abstinence outside of marriage is the
expected standard
c) Only certain way to avoid pregnancy,
STIs and other health problems
d) Mutually faithful monogamous
marriage is the expected standard for
sexual activity
Abstinence-only
requirements
e) Sex outside of marriage is likely to
have harmful psychological, physical
effects
f) Out-of-wedlock childbearing is
harmful to child, parents and society
g) How to reject sexual advances, role
of alcohol and drug use
h) Importance of attaining self-
sufficiency before engaging in sex

Comprehensive Sexuality
Education
Abstinence, AND
Prevention of pregnancy and sexually
transmitted infections (STIs)
And more..

Anatomy
Puberty
Healthy
Relationships

Decision-
making
Interpersonal
communication
Adoption
Abortion
Sexual
orientation
Media
Sexual violence,
dating violence
Comprehensive Sexuality
Education
Medically accurate
Based on scientific evidence, not
ideology

Age-appropriate
Other approaches
Abstinence-based, Abstinence-plus
Focus on abstinence, with some
prevention messages
Poorly defined, very common
Other abstinence
Does not adhere to abstinence-until-
marriage guidelines
Increase in abstinence-only messages
over time
Review of scientific research
Effective sexuality education programs

What parents want for school-based
sexuality education

Teachers experiences with sexuality
education
What is rigorous scientific research?
Not all studies are
created equal
Peer review the
hallmark of scientific
studies
Two reviews of sexuality education
programs
Effective sex education
Effective sex education
Emerging Answers; Kirby, 2007
Conducted in U.S., 1990-2007
>100 teens ages 12-18
Impact on behavior and health outcomes
Experimental or quasi-experimental
design
Sufficient longitudinal follow-up
Appropriate statistical analysis
Impacts of abstinence-only education
programs; Trenholm, et al, 2007
Effective sex education
Comprehensive programs (Kirby, 2007)
Improved sex-related factors
Knowledge about risks, consequences
Values, beliefs, attitudes about sex,
condoms, contraception
Confidence to say no, insist on condoms,
use condoms
Intention to avoid sex or unprotected sex
Communication with adults about sex

Effective sex education
Comprehensive programs (Kirby, 2007)
Improved sexual behaviors
Delayed sexual initiation
Reduced number of partners, frequency of
sex
Increased condom or contraceptive use
Did NOT lead to earlier or more frequent sex
Worked for wide variety of participants,
in different settings, communities

Effective sex education
Abstinence-only until marriage (Maynard et
al, 2005; Trenholm et al, 2007)
Improved sex-related factors
Views of abstinence
Perceptions of adverse consequences
Expectations of abstinence

BUT increased inaccurate information about
condoms

Effective sex education
Abstinence-only until marriage (Trenholm et
al, 2007)
Did not delay sexual initiation
Did not decrease number of partners
But did NOT have negative impacts on
condom, contraceptive use
Effective sex education
Other abstinence-only programs (Kirby,
2007)
Improved sex-related factors
Values, beliefs, attitudes favoring abstinence
Intentions to abstain from sex
Sexual behaviors
Did not delay sexual initiation
Did not increase secondary abstinence
Did not decrease number of partners
But did NOT have negative impact on
condoms, contraceptives


Effective sex education
Jemmott et al, 2010
Scientifically rigorous
Tested abstinence-only program against
safer-sex and combined models
Key findings re: abstinence-only program
Reduced sexual initiation
Reduced recent sexual activity
No effect on condom use

Effective sex education
Jemmott et al, 2010
Abstinence content
NOT abstinence-until-marriage
No inaccurate/disparaging information, esp.
regarding condoms
Sample
African American students, 12 years old
Volunteer participants
Setting, structure
Not school-based
Weekends, 8-1 ratio, follow-up counseling


Effective sex education
Conclusions
Several effective comprehensive
programs
Abstinence-only-until-marriage
programs, not effective for behavior
change
Some promising abstinence programs

Review of scientific research
Effective sexuality education programs

What parents want for school-based
sexuality education

Teachers experiences with sexuality
education
Parents on sex ed.
What parents want
Study of Minnesota parents (Eisenberg et al,
2008)
Telephone survey of parents, 2006 2007
Sampling frame stratified by
congressional district
Survey based on existing instruments
2,546 contacts with eligible households
child age 5-18
English or Spanish speaking parent
1605 parents, 63% participation rate

What parents want
Overall views on sexuality education
12 specific sexuality education
topics
Earliest grade level
Demographic/personal
characteristics

What parents want
Characteristics of the sample, n=1605
What parents want
Thinking about sex education classes, do you think teenagers
should be taught
What parents want
Sex education should include information about abstinence and
prevention of pregnancy and STDs
What parents want
What parents want
Should this topic be taught? What is the earliest grade level?
What parents want
Conclusions
Minnesota parents overwhelmingly
support comprehensive sex ed
Consistent support across demographic
categories, geographic regions
Variety of topics, mostly by middle-school
Findings are consistent with several other
peer-reviewed studies
What parents want
Other research shows strong support for
abstinence-only education (Zogby Intl, 2007)
National sample, 1002 parents of 10-16 y.o.
Find strong support for abstinence
education
BUT, defined abstinence education as:
permitting an age-appropriate discussion of
contraceptives within the context of
promoting abstinence as the healthiest
choice


Review of scientific research
Effective sexuality education programs

What parents want for school-based
sexuality education

Teachers experiences with sexuality
education




Teachers experiences
Qualitative study, focus groups
42 sexuality educators, diverse group
Discussion questions
Supports and barriers in teaching sex ed
What they would like to teach and what
prevents them from teaching what
they would like
Teachers experiences
Thinking about the sex education
curricula or content you use, what
grade would you give it in terms of
how well it prepares students to be
sexually healthy adults and why?

Teachers experiences
I would give it a C. Just because it is
general. And we cant say, or we are not
supposed to talk about gay, lesbian,
unless of course somebody asks you can
answer, or oral sex.
I dont think we should have to rely on
the kids to have to ask to get a
comprehensive education.
Teachers experiences
If it were totally up to you what would
you teach your students? What
prevents you from teaching the way
youd like to?
We could probably do better if we had
more control over what we could present.
Teachers experiences
Other barriers
Restrictive policies
Time available to teach content
Timing of programming
Poor curricula and lack of resources to
purchase/get trained on a new one

Teachers experiences
Additional content to teach
Healthy relationships
The emotional component of sexual
relationship
STI and pregnancy prevention
Sexual orientation and sexual identity
Media

Teachers experiences
Conclusions
Teachers want to teach more content
but face numerous barriers

More research to come..


Some concluding thoughts
Strong alignment
Evidence of effective programs
What parents want
What teachers think students need
School-based sexuality education can
be part of sexual violence prevention