Americans are being misled on comprehensive sex ed. Here is what it actually does.

America is at an inflection point on sex education.

In June, the U.S. Supreme Court overturned the constitutional right to an abortion, sparking a conversation about which states teach students how to prevent pregnancy (never mind consent, boundaries or bodily autonomy). Opponents of sex ed are ramping up attacks, exploiting parental fears and accusing proponents of pushing education that introduces sexually inappropriate material to young kids too early, grooming them for abuse (studies show comprehensive sex ed reduces child sexual abuse). At the same time, the proliferation of "Don't Say Gay" bills further complicates sex ed in schools, eliminating the possibility of LGBTQ-inclusive education on topics critical to young people's health and well-being.

Advocates see the attack on sex ed as backlash against an uptick in states implementing more robust sex ed across the country, a response in part to the conversations around consent catalyzed by #MeToo. In the last several years, more states have enacted state-based standards for comprehensive sex education and are implementing curricula that is not only comprehensive in terms of teaching medically accurate information, but is also responsive to LGBTQ youth, youth of color, youth with disabilities, that is trauma-informed, and that includes teaching on healthy relationships.

Since #MeToo, four more states require consent to be taught, two more states require that curriculum is taught in a culturally responsive way and two more states have policies that now include more affirmative instruction on sexual orientation in LGBTQ communities. These changes are even taking place in conservative states like Alabama, which in 2021 passed a sex ed bill to remove LGBTQ discrimination from its curriculum, and Oklahoma, which in 2019 passed a bill requiring schools teaching sex education to include information about consent.

Sex ed: Many parents wouldn't recognize it today

"You do see this push and pull that's happening," says Christine Soyong Harley, president and chief executive officer of SIECUS, a nonprofit that advocates for universal comprehensive sex ed. "Attacking sex education, attacking LGBTQ instruction in schools is both a reaction to that progress as well as this headwind that the Christian nationalist movement is really experiencing with the overturning of the Dobbs decision."

'Set them up for failure': Sex education not required in many states where abortion is or will be banned

While 2018 polling from SIECUS shows that 89% of likely voters believe it's important to have sex education in middle school and 98% believe it's important to have sex education in high school, there is less acceptance of sex education curriculum that begins in elementary school. One of the greatest challenges advocates of comprehensive sex education must overcome are misbeliefs among parents that sex ed is solely about sex.

"Comprehensive sexuality education has to do with everything in the world that's connected meaningfully to issues of sex, gender and reproduction," says Deborah Roffman, a human sexuality educator and author of "The Science of Babies: A Little Book for Big Questions About Bodies, Birth and Families." "If you think deeply enough about that, that is everything in the world. We take this enormous subject and we pass it through a funnel to focus on sex. No, this is intricately woven into the fabric of human life."

Researchers say comprehensive sex education may be a misnomer, as this type of education seeks to do far more than reduce the teen birth rate. A meta-analysis published in 2020 in the Journal of Adolescent Health reviewing three decades of research on comprehensive sex ed found it 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." It concluded there is substantial evidence to support sex education beginning in elementary school.

"You're teaching kids from the beginning that all of us are equal and how to respect each other and treat each other as co-equal human beings," says Jaclyn Friedman, founder and executive director of the nonprofit EducateUS, which works to advance progressive sex education policy in K-12 schools. "If we had a whole generation of kids who all had these skills in common, it could be transformational."

Sex in the USA: No universal standard, no federal funding

According to SIECUS, sex ed has a long history in the U.S., and was pushed initially by people concerned about the perception of loosening sexual morals. It has been positioned as an antidote to various social ills concerning sex and relationships, a response to everything from a fear of sexually transmitted infections among WWI soldiers to the rise of the sexual revolution to the HIV epidemic. But advocates for comprehensive sex ed say its utility is well beyond pregnancy and STI prevention. They view it as a tool for social change.

There has never been federal funding for comprehensive sex education and there is no universal standard. To fill that gap, SIECUS and the Future of Sex Ed Initiative developed the National Sex Ed Standards, which gives schools and administrators guidance on what experts say is the best approach for providing comprehensive sex education that is medically accurate, age-appropriate and inclusive of young people's needs.

Currently, 29 states and the District of Columbia require sex education, five states have laws requiring comprehensive sex education, and of those, three require it to be taught in all schools while two require the curriculum be comprehensive if it is taught in schools.

There has been federal funding for abstinence-only programs, but they have proven less effective. A 2017 review of abstinence-only programs in the Journal of Adolescent Health called them "scientifically and ethically problematic."

Rivka Vizcardo-Lichter, 15, is a student in Fairfax County, Virginia, a state which this year saw the introduction of a number of regressive sex education bills, including one which allowed parents to object to curriculum and another which pushed to include a video recording of an ultrasound of a fetus. Vizcardo-Lichter, co-founder of the Pride Liberation Project, a student-led organization advocating for LGBTQIA+ rights, says she went to a private elementary school and didn't receive sex education until she entered public school in fifth grade. She says that education was woefully inadequate.

"A lot of the sex ed that I got was from my parents and not from school," Vizcardo-Lichter says. "They don't even begin to cover what they need to ... and the sex education ends in 10th grade."

Vizcardo-Lichter says there was never explicit discussion of contraception or abortions, and there was little to no mention of consent. At home, Vizcardo-Lichter says her mother talked to her about topics she wishes were part of her school's curriculum, including boundaries, grooming and digital safety.

Keara Banks is a 16-year-old student in Midland, Michigan, a state which does not require sex education. Many students who do receive sex education in the state report that it rarely teaches about consent or includes information on sexual orientation and gender identity, and at times it uses fear tactics to promote abstinence, according to SIECUS, who says there have also been reports that children have brought home virginity pledge cards.

Banks advocates for comprehensive sex ed through the Michigan Organization on Adolescent Sexual Health (MOASH).

"Comprehensive sex ed is really about making sure that everyone has a way to learn what's safe and healthy, and how to be themselves," she says.

Advocates say state disparities underscore the need for federal support.

Let's talk about (queer) sex: The importance of LGBTQ-inclusive sex education in schools

Parental fears a barrier to comprehensive sex ed

While advocates argue comprehensive sex education should begin in kindergarten, they say many elementary schools refuse to teach it for fear of parent backlash.

Roffman says the anxieties about too much too soon stem from a misunderstanding that the concept of "sex" is the only thing that defines the subject matter. Children have universal questions about reproduction as they develop a better understanding of concepts such as time, geography and spatial relationships. When they understand time and separateness, they can understand that they weren't always here. They want to know where they were before, and how they arrived.

"These questions are about science, not sex," she says.

Roffman says that parents and schools are protective factors in children's lives, but children must have open, honest communication about complex topics at the earliest ages in order to think critically about a variety of subjects.

"If we're not actively engaging children around these subjects by third grade, almost everything after that is going to be remedial because they're not living in a vacuum," she says.

The benefits of comprehensive sex education: healthier relationships, less violence

Research shows comprehensive sex education is most effective when it begins early and uses a scaffolding approach, which breaks the subject matter up into developmentally appropriate concepts that build upon one another.

In elementary school, for example, comprehensive sex ed looks like children learning the names of their body parts, how to say no to being touched, or that every living thing reproduces. In high school, it's learning what actions to take when a partner isn't respecting boundaries. Roffman says it's ineffective to only begin talking about these subjects when children are experiencing puberty, or on the verge of it.

"We don't teach anything else that way," she says.

Research shows when young children, especially, are provided with high-quality comprehensive sex ed, it can lead to increased empathy, improved communication skills, help managing feelings, positive self-image and healthier relationships, sexual or otherwise, throughout their lives.

Friedman, who was sexually assaulted in college, says she wishes she had better sex education. But more than that, she wishes the person who assaulted her had better sex education.

"I wish that not because he was confused about whether or not he had consent, but because he was under the impression that it didn't matter," she says.

To transform communities, advocates say all children need access to high-quality comprehensive sex ed

Advocates say some parental fears stem from the poor sex education many of them got when they were growing up, if they received sex education at all. It's understandable that they would have some anxieties around what their children are learning in programs today. Friedman also says at least some of the hangups may be linguistic.

"I don't like to say the phrase 'comprehensive sex education,' because I think it is confusing," she says. "One of the main things that people don't understand when we're talking about what is commonly called 'comprehensive sex ed' is that it's not just sex ed. And how could you blame them for not knowing, when you're saying 'sex' over and over again?"

Friedman says she uses the term "relationships and sexuality education," to better reflect a curriculum that teaches kids how to respect one another and navigate emotional conflict.

To transform society, advocates say, these are skills every child must learn.

"So many of our problems today stem from the fact that there isn't enough comprehensive sex ed," Vizcardo-Lichter says. "In order to be healthy, functioning, knowledgeable adults, students need to be able to be educated about their bodies, and about others' bodies as well."

This article originally appeared on USA TODAY: Sex education: Americans misled on what 'comprehensive' means