Sex Education Programs: Definitions, Funding, and Impact on Teen Sexual Health – KFF

Report on Adolescent Sexual and Reproductive Health Education in the Context of Sustainable Development Goals

Introduction: Challenges to Achieving SDGs 3, 4, and 5

Adolescents face significant barriers in accessing reliable health information, a challenge that directly impacts the achievement of several Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 5 (Gender Equality). The current landscape is complicated by the suppression of public health information, persistent policy changes, and widespread misinformation regarding reproductive health. While teen pregnancy rates have declined, rates of sexually transmitted infections (STIs) remain high, indicating a critical gap in health outcomes that effective education could address. This report analyzes the state of sex education, its funding, and its alignment with global development objectives.

State of Sex Education: A Barrier to Quality Education and Health (SDG 4 & SDG 3)

Sources of Information and the Risk of Misinformation

Adolescents obtain sexual health information from a variety of formal and informal sources, which impacts the quality and accuracy of their knowledge, a key component of SDG 4.7.

• Formal Sources: Schools and healthcare professionals are primary formal channels. However, fewer than half of adolescents report receiving school-based education on where to obtain birth control, a critical failure in providing actionable health information (SDG 3.7).
• Informal Sources: Parents, friends, and online media are significant sources. The heavy reliance on social media platforms like TikTok exposes youth to a high risk of misinformation, particularly concerning contraception, which undermines progress toward SDG 3.
• Parental Involvement: While most adolescents receive some information from parents, one in five do not. Furthermore, “opt-out” or “opt-in” policies in 45 states and D.C. can limit universal access to school-based education, creating inequalities in educational attainment (SDG 10).

Educational Models and Their Impact on Health Outcomes

The approach to sex education varies significantly, with differing impacts on achieving SDG 3 targets for adolescent health.

1. Sexual Risk Avoidance Education (SRAE): This model, which includes abstinence-only and abstinence-plus curricula, emphasizes abstaining from sexual activity. There is limited evidence that SRAE programs effectively reduce teen pregnancy or STIs, suggesting they are an insufficient strategy for meeting public health goals under SDG 3.
2. Comprehensive Sex Education (CSE): This evidence-based model provides medically accurate information on abstinence, contraception, and condoms. Research demonstrates that CSE is effective in delaying sexual initiation, increasing contraceptive use, and lowering pregnancy rates. It also addresses topics crucial for SDG 5 (Gender Equality) and SDG 16 (Peace, Justice and Strong Institutions), such as healthy relationships, consent, sexual orientation, and gender identity. Despite its proven effectiveness, 34 states still require an emphasis on abstinence.

Curriculum Content: Addressing Gender Equality and Reduced Inequalities (SDG 5 & SDG 10)

Gender and Sexual Diversity

The inclusion of sexual orientation and gender identity (SOGI) in curricula is vital for promoting gender equality (SDG 5) and reducing inequalities faced by LGBTQ+ youth (SDG 10). Inclusive education is associated with reduced victimization and improved mental health outcomes (SDG 3) for all students. However, progress is threatened:

• Only nine states and D.C. require SOGI instruction.
• Recent executive orders officially recognizing only two sexes and restricting federal funding for materials with “radical gender ideology” directly undermine efforts to create inclusive educational environments and threaten the well-being of gender-diverse youth.

Healthy Relationships and Violence Prevention

Education on healthy relationships and consent is fundamental to achieving SDG 5 (Gender Equality) and SDG 16 (Peaceful and Inclusive Societies). Dating violence is a significant issue for adolescents, particularly for female and LGBTQ+ teens. School-based programs that teach violence prevention have been proven to reduce dating violence. While 34 states and D.C. require curricula on healthy relationships, fewer than half (17 states and D.C.) mandate instruction on sexual consent, leaving a critical gap in education for violence prevention.

Abortion Knowledge and Reproductive Rights

Access to accurate information about abortion is a key component of SDG 3.7 (universal access to sexual and reproductive health-care services) and SDG 5.6 (ensuring reproductive rights). In the post-Dobbs landscape, accessing reliable information is increasingly difficult. Abortion is largely absent from school curricula, with only three jurisdictions requiring it be taught, while numerous states restrict or discourage its inclusion. This educational deficit hinders adolescents’ ability to make informed decisions about their reproductive health.

Federal Funding: Resource Allocation and Institutional Priorities (SDG 16)

Major Federal Funding Streams

Federal funding plays a crucial role in shaping sex education, but its allocation reflects conflicting institutional priorities that affect progress on the SDGs.

• Teen Pregnancy Prevention (TPP) Program: Funds evidence-based, comprehensive models aligned with achieving SDG 3.
• Personal Responsibility Education Program (PREP): Funds education on both abstinence and contraception for high-risk youth, supporting SDG 10.
• Title V Sexual Risk Avoidance Education (SRAE) & General Departmental (GD) SRAE: Fund programs focused on sexual risk avoidance and abstinence, which have limited evidence of effectiveness.

Misalignment of Funding with Evidence-Based Practices

In Fiscal Year 2024, of the $286 million in federal funding for these programs, $110 million (38%) was directed toward SRAE programs. This significant investment in less effective models represents a misallocation of resources that could be used to advance evidence-based strategies supporting SDG 3 and SDG 4. While funding for comprehensive programs has remained steady, funding for SRAE has more than doubled in the last decade.

Political Threats to Comprehensive Education

Recent administrative actions threaten the institutional framework (SDG 16) supporting comprehensive sex education. Efforts to cancel PREP grants, impose restrictions on content related to gender identity, and eliminate funding for the TPP program reflect a policy agenda that contradicts evidence-based public health. These actions, which align with Project 2025’s goals, directly challenge the nation’s ability to meet its commitments under the Sustainable Development Goals for health, education, and equality for all adolescents.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article is fundamentally about adolescent health, focusing on sexual and reproductive health. It discusses issues like teen pregnancy, sexually transmitted infections (STIs), access to contraception, and the impact of education on health outcomes.

• SDG 4: Quality Education

  The core of the article evaluates the content, quality, and accessibility of sex education in schools. It contrasts different educational models (“comprehensive” vs. “sexual risk avoidance”) and discusses how curricula are shaped by state and federal policies, directly addressing the quality and nature of education provided to adolescents.

• SDG 5: Gender Equality

  The article addresses gender equality by discussing universal access to sexual and reproductive health information and rights. It highlights the specific challenges faced by female adolescents and LGBTQ+ youth, and examines how policies related to gender identity (e.g., the executive order recognizing only two sexes) impact education and health services.

• SDG 10: Reduced Inequalities

  The article points to significant inequalities in health education and outcomes. It notes that LGBTQ+ youth face higher rates of victimization and adverse mental health outcomes, which can be mitigated by inclusive curricula. It also mentions that federal programs like PREP are designed to target vulnerable populations, including those in foster care or from minority groups, acknowledging existing disparities.

• SDG 16: Peace, Justice and Strong Institutions

  This goal is relevant through its focus on access to information and the role of policies and institutions. The article details how legislative actions, executive orders, and legal challenges (“post-Roe landscape”) create an environment where “publicly available health information on government webpages continue to be suppressed” and misinformation is widespread, hindering public access to reliable information.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
     • The article directly addresses this by examining adolescents’ access to “reliable health information and education” on topics like contraception, STIs, and abortion. It analyzes various “programmes” (e.g., TPP, PREP, SRAE) that constitute national strategies for adolescent reproductive health.

2. SDG 4: Quality Education

   • Target 4.7: By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development, including, among others, through education for… gender equality, promotion of a culture of peace and non-violence…
     • The article discusses how “comprehensive sex education” provides knowledge on “healthy relationships,” “sexual consent,” and “gender and sexual diversity.” This education is shown to reduce “dating violence,” thereby promoting a “culture of peace and non-violence” and “gender equality.”

3. SDG 5: Gender Equality

   • Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights…
     • The article highlights barriers to this target, such as the suppression of information on abortion, restrictive state policies on curricula, and federal actions that limit education on gender identity. It notes that “fewer than four in ten [adolescents] say they are confident in their ability to get information about abortion services.”

4. SDG 10: Reduced Inequalities

   • Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex… or other status.
     • The article connects to this target by showing how LGBTQ-inclusive curricula can lead to “reduced victimization among sexual minority youth” and better mental health for all students. It also discusses how recent executive orders threaten this inclusion by officially recognizing “only 2 sexes: male and female,” which excludes “gender expansive identities.”

5. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.10: Ensure public access to information and protect fundamental freedoms…
     • The article’s discussion of “suppressed” government health information, the spread of “mis- and dis- information about health,” and policy changes that make “accessing reliable and accurate information on abortion difficult” directly relates to the challenge of ensuring public access to information.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For SDG 3 (Good Health and Well-being)

   • Indicator 3.7.2 (Adolescent birth rate): The article explicitly states that “teen pregnancy and birth rates have fallen,” which is a direct measure for this indicator.
   • Implied Indicator (STI rates): The article mentions that “rates of sexually transmitted infections (STIs) remain high among teens and young adults.” This serves as a key health outcome measure to evaluate the effectiveness of sex education programs.
   • Implied Indicator (Contraceptive use): The article notes that comprehensive sex education can “increase the use of contraceptives, including condoms, among sexually active youth.” The rate of contraceptive use is an implied metric for progress.

2. For SDG 4 (Quality Education)

   • Indicator 4.7.1 (Extent to which… gender equality and human rights are mainstreamed in… (b) curricula): The article provides data on this by stating how many states require, allow, or ban instruction on topics like “sexual orientation and/or gender identity (SOGI),” “healthy relationships,” and “sexual consent” in their curricula. For example, “instruction on SOGI is required in only nine states and D.C.”

3. For SDG 5 (Gender Equality)

   • Indicator 5.6.2 (Number of countries with laws and regulations that guarantee full and equal access… to sexual and reproductive health care, information and education): While focused on the US, the article’s detailed analysis of varying state laws and federal policies serves as a qualitative measure for this indicator. It shows how “34 states require schools to stress abstinence” and how federal executive orders restrict access to information on gender diversity.

4. For SDG 10 (Reduced Inequalities)

   • Implied Indicator (Prevalence of dating violence and victimization): The article cites statistics on dating violence (“1 in 12 teens… report experiencing physical DV”) and notes that comprehensive education is associated with “lower rates of DV” and “reduced victimization among sexual minority youth.” These rates are implied indicators of inclusion and safety for vulnerable groups.

5. For SDG 16 (Peace, Justice and Strong Institutions)

   • Indicator 16.10.2 (Number of countries that adopt and implement… policy guarantees for public access to information): The article’s content can be used to assess this indicator qualitatively. It describes policies that both hinder (suppression of information, “Baby Olivia” laws) and support (mandates for comprehensive education) public access to health information, reflecting the status of policy implementation.

4. SDGs, Targets, and Indicators Analysis

Source: kff.org