A Content Analysis of State Policy on School-Based Sex Education Focused on Sexual Behaviors, Relationships, and Identities

Background and Purpose: Adolescents face crucial sexual health issues, including sexually transmitted infections and diseases (STIs/STDs), teenage pregnancy, and sexual violence.  Youth who are lesbian, gay, bisexual, or transgender (LGBT) are disproportionately affected by these sexual health issues.  Given the sexual health risks facing adolescents, education that advances students’ knowledge, skills, and attitudes about sexual health is imperative in order to prevent STIs/STDs, unwanted pregnancy, and sexual violence as well as to promote individual well-being and healthy relationships.  Schools play a major role in educating adolescents about sexuality, which is guided by policy.  State policies about sex education in K-12 schools shape what is taught to students about sexual behaviors, relationships, and identities.  In this study, a content analysis of the school-based sex education policies of all 50 states was completed.

Methods: Searches for state policies occurred in June 2016 and were based on policy information provided by the Sexuality Information and Education Council of the United States, which is a national, nonprofit organization that provides education and information about sexuality and sexual and reproductive health.  Policy documents included state statutes, state board of education policies, and state department of education or public instruction curriculum standards.  Policy data were analyzed using a qualitative content analysis approach aimed at thematic description.  A team of five coders approached the data using a social-behavioral science perspective and focused on content related to sexual behaviors, relationships, and identities.  A coding scheme was established based on open coding of a pilot sample of policy documents.  Next, double independent coding was used to code the policy documents of all 50 states.  Disagreements were resolved between pairs of coders.  Several strategies for rigor were used to help ensure that the findings were valid and trustworthy: triangulation, peer debriefing and support, and audit trail. 

Results: Most state policies emphasized abstinence from sexual behavior and did not require education about contraceptive and barrier methods.  Few policies required detailed information about contraceptive and barrier methods to prevent pregnancy and STIs/STDs.  Around half of states addressed sexual relationship issues (i.e., healthy relationships, sexual decision-making, and sexual violence); however, few states included content about communication about sexual consent.  Eight state policies explicitly stigmatized homosexuality.  Conversely, 12 states were inclusive of diverse sexual orientations and 7 states were inclusive of diverse gender identities. 

Conclusions and Implications: Many state policies are not informed by evidence on adolescent sexual health.  Sex education policy content should be evidence-based and inclusive of sexual diversity.  Policies without comprehensive information to prevent pregnancy and STIs/STDs, practical information about healthy relationships, and inclusiveness regarding sexual orientation and gender diversity may contribute to high rates of adolescent pregnancy and STIs/STDs, sexual violence, and health disparities for youth who are LGBT.