Across the nation, students have vastly different experiences learning about a somewhat taboo but super important health topic: sexual health education, or sex ed.

According to Sex Ed for Social Change, or SIECUS, 29 states and D.C. mandate sex ed as of July 2022. But 17 of those states require that abstinence be stressed, and only 11 of them require the curriculum to be medically accurate. Some states choose to leave discussions around healthy relationships, contraception and sexual orientation out of the conversation entirely.  

“Due to the lack of guidance and policy implementation at the federal level, the United States has a patchwork of laws that vary, which determine what and if sex education is being taught,” said Michelle Slaybaugh, director of social impact and strategic communications at SIECUS. “When it comes to education, policy, decisions have largely been left to local control, So we’re talking very local at the school board level, not even the city or state level. It’s very, very local.” 

Currently at the federal level, SIECUS is one group working to get the Real Education and Access for Healthy Youth Act passed. This legislation promotes comprehensive sex ed, which means giving young people the knowledge and skills they need to make healthy choices about their sexual lives, and the act makes sure access to this education is protected.

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In March, Congress passed the Consolidated Appropriations Act of 2022, but funding for comprehensive sex ed programs is not included.

On the state level, according to the SIECUS mid-year report, the number of bills introduced this year aimed at restricting sex ed was almost equal to the number of bills introduced advancing sex ed. But more regressive bills were passed in states this legislative session than progressive ones.

“I think there is this big myth that if we teach young people about sex, that they’re going to go and have it,” Slaybaugh said. “The evidence does not show that. Additionally, I think it is very important for us to understand that age appropriate or developmentally appropriate sex education is key.”

A Georgetown University study shows that sex ed helps with a lot of things, like preventing unplanned pregnancy, maternal death, unsafe abortions and sexually transmitted diseases. But a survey from the Public Religion Institute found that nearly a quarter of millennials were not taught sex ed in middle or high school.

There is also a big gap in sex ed that’s inclusive and talks about LGBTQ+ identities. Less than 10% of LGBTQ+ students say their school’s sex ed is inclusive. When talking about gender identity and orientation, this is sometimes where curriculum can become “medically inaccurate.” 

“Medically accurate sex education is vital to promoting long term health outcomes, and a part of that, which I think is really where we’re seeing the rub, is this idea of gender norms, gender stereotypes and orientation,” Slaybaugh said. 

Florida in particular has become a bit of a hotspot when it comes to sex ed and what can or should be taught. New laws there, like what critics dubbed the “Don’t Say Gay” bill, limits discussion of sexuality and gender identity for some elementary students.

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Katie Lagrone, a correspondent at Newsy’s sister station in Tampa, Florida explains a confusing mix of standards on whether the new laws are altering old policies on sex ed.

“In Florida, while laws mandate health education include teen dating and disease control, we discovered there’s actually no statewide curriculum for sex education,” Lagrone said. “What and how students are taught about sexual and reproductive health is left to individual school boards who approve policies, principals who interpret them and instructors who ultimately drill it down for students. What’s more… we found about a one-third of Florida’s 67 school districts are teaching students, even high schoolers, abstinence only.”

Studies show abstinence-only instruction doesn’t prevent teens from having sex. In fact, a 2019 study by the CDC found by the 12th grade, more than half of Florida teens surveyed have already engaged in sexual intercourse, with some STD rates among teens in Florida being four times higher than the national average.

In some counties that have adopted this abstinence-only teaching method in Florida, teen birth rates are actually higher. One district spokesperson told Newsy these limits are because they “are respectful of parents rights.”

Elsewhere in the world, some countries have been recognized for comprehensive sex ed programs that help combat these issues, especially in Europe.

In the Netherlands, it’s required by law that all primary school students are taught sex ed. It starts as early as 4-years-old, but they’re not talking about the full birds and the bees at that age. They are simply covering the basics of healthy relationships.

In the U.S., some people argue that that is too young to be teaching sex ed, but three decades of research shows that sex ed can help prevent child abuse.

On average, teens in the Netherlands are also waiting longer to have sex when compared to Europe or the U.S. Researchers found that most young people in the Netherlands had “wanted and fun” first sexual experiences, while many American teens said they wished they waited longer to have sex for the first time.

The Netherlands has one of the lowest teen pregnancy rates in the world. Dutch teens are some of the most likely to use birth control pills, though part of that could be because contraception is easily accessible.

The Netherlands also works to educate parents on how to talk to their kids about sex to help get everyone on the same page.

In Denmark, for a long time, their sex ed program emphasized preventing unplanned pregnancy and promoting safe sex. In 2015, the country’s birth rate fell below the rate necessary to maintain population, and Danish officials went as far as actually encouraging people to have babies at a younger age. At the time, only point 5% of teen girls in Denmark had a baby. That rate was six times higher in the United States.

In recent years, the birth rate has started to rise again. While neither Denmark nor any country has a perfect system, they experienced some outcomes that other places could learn from.  

This highlights good models for comprehensive sex ed, but there are also other countries, like the U.S., where it isn’t widely taught, there are inconsistencies or it’s not available at all. Experts stress the importance of making sure students have the information necessary to live healthy lives.  

“We really need to push for something that is rooted in age-appropriate, medically-accurate and affirming content that is taught by trained educators to be able to deliver the most comprehensive and age-appropriate education around sexuality as possible,” Slaybaugh said.