Sexual Education in Schools: The Harm of Exclusion

We teach our children about the birds and the bees, but for some, this talk is as foreign as the metaphor. Today, as a consequence of the growing awareness, knowledge, and acceptance of the nature of sexuality, recent polls in Gallup estimate that seven percent of the United States population identifies as LGBTQ+. This statistic suggests that in the average classroom, one to two children will identify as LGBTQ+ at some point in their lives, if they do not already. So why, in the same classrooms, is a sexual education curriculum taught that neglects these children as if they do not exist? It is imperative to include LGBTQ+ representation in the sexual education curriculum, in accordance with our ethical principles, to support the health and well-being of our communities.

Sexual education (sex-ed) has a disappointingly contentious history in the US. The effort to provide young students with information about sex, gender, and sexuality began in public schools in 1912 with the distribution of vague pamphlets, which were largely ignored until 1940 when the Public Health Service called attention to the “urgent need” for its inclusion in the curriculum. By 1953, the American School Health Association had created and nationally distributed a base sex-ed curriculum. The implementation of sex-ed was quickly met with backlash, and the decades between the 1960s and 1980s were riddled with attempts to ban any version of it from schools. These movements were backed by misinformation and fear-mongering, spread through the conduit of religious values that crudely shamed the program and blocked comprehensive sex-ed from entering schools. However, a devastating viral infection changed the debate irrevocably in the 1980s. The HIV/AIDS epidemic provoked serious research into the efficacy of sex education and prompted Surgeon General C. Everett Koop to announce, “There is now no doubt that we need sex education in schools and that it [should] include information on heterosexual and homosexual relationships…The need is critical and the price of neglect is high.” His endorsement of science propelled the issue into popular public view, and the last two decades have been characterized by a political battle of funding between comprehensive and abstinence-only sex-ed.

A general understanding of the need for sex-ed for children has not been accepted universally, nor has it been extended to those who may have experiences outside of the heteronormative curriculum. Currently, only ten states require information to be provided for LGBTQ+ children. This is not an oversight or an accident; it is blatant discrimination, overtly displayed by the seven states with “no promo homo” laws that require teachers to present monogamous heterosexual relationships as the only acceptable option and to actively demean LGBTQ+ lifestyles. This prejudice cuts deeper than verbal offense.

Depriving the LGBTQ+ community of comprehensive and medically accurate sex-ed inflicts lifelong adverse health effects. According to a study in the American Journal of Sexuality Education, students who did not receive sex-ed relevant to their sexuality “reported increased sexual partners, earlier sexual debut, the use of alcohol or drugs before sex, and decreased condom and contraceptive use than their heterosexual peers.” LGBTQ+ students are at greater risk for HIV/AIDS infection, unwanted pregnancies, drug use, suicidal thoughts, sexual violence, and domestic violence, which comprehensive sex-ed could ameliorate. These factors all contribute to a poor lifetime health prognosis for LGBTQ+ children, but the harm is not all delayed. According to Jennifer Driver, vice president of policy and strategic partnerships at SIECUS: Sex Ed for Social Change, LGBTQ+ kids in the states that ignore or outwardly shame them are “more likely to feel unsafe at school, more likely to skip class, and experience higher levels of harassment and victimization because of their sexual orientation or gender identity.” On the other hand, schools with inclusive sex-ed have lower rates of bullying and greater peer acceptance. Whether intentionally or implicitly, teachers who fail to include and normalize sexual identities in sex-ed empower hateful rhetoric and the psychological abuse LGBTQ+ children endure as a result. However, the bulk of the fault cannot be placed on teachers. Sex-ed is funded by the state under specific guidelines and written into legislation; therefore, it is the responsibility of all constituents to instigate change.

Scientists, health professionals, and educators’ valiant efforts highlight the importance of sex-ed in schools and demand for national attention to provide heterosexual children with the information they need to stay healthy. The same must be done for the LGBTQ+ community. Continuously neglecting their sexual safety is a threat to their well-being and stands in direct conflict with the bioethical principle of non-maleficence. With modern knowledge of the harm children will incur without this knowledge, refusing to provide it can only be interpreted as complicit participation, and in more extreme states, an intentional act of harm.

While religious beliefs constitute one common objection to the facilitation of comprehensive sex-ed, the right to freedom of religion allows children to express religious beliefs in school, as long as they are not disruptive or discriminatory; it does not give people the right to restrict the education of others to align with their religion. Doing so would be both disruptive and discriminatory to the sexual education of others. Additionally, the opt-out option exists for anyone who has a religious objection to informing their children about different sexual orientations. The opt-out system creates a slew of other ethical questions surrounding LGBTQ+ children of religious parents, but parents currently reserve the right to opt their children out of sex-ed for any reason.

Non-maleficence is not the only ethical principle disregarded if we don’t advocate for the implementation of sex-ed for the LGBTQ+ community. Withholding sexual information from LBGTQ+ students while providing a full curriculum for their heterosexual peers violates their right to justice. Every child deserves the same access to lifesaving and life-improving information. Denying certain students this opportunity, thus subjecting them to health risks based on sexual orientation, constitutes a breach of justice. Furthermore, imposing heteronormative values on children and attempting to “shame away the gay” undermines their autonomy, which often pressures students to hide their true desires and live their lives masquerading as “straight-passing” to avoid negative attitudes or physical harm. Strictly heterosexual sex-ed also affects autonomy by stripping away young LGBTQ+ people’s capacity to make informed decisions about their sexual health. Many do not have access to a trusted adult with the knowledge they require and are forced to turn to notoriously untrustworthy sources like the Internet for advice. Lastly, and most simply, the absence of sex-ed for LGBTQ+ students represents a lack of beneficence. Including all children in the curriculum is an act of pure kindness and provides a necessary resource to reduce the prevalence of negative health effects. Therefore, the inadequacy of sex-ed for LGBTQ+ students in American schools is an explicit offense to all four principles of bioethics.

We know the consequences of poor sexual education. We have acknowledged the scientific evidence and enacted the necessary change to protect our children. But we have become complacent. We have decided that we have done enough, but we have not. Thousands of students are still victimized by the issue we deemed urgent enough to fix for some, yet somehow passive enough to forget about the others and the risks they still face. These are difficult conversations, and they have often been met with a history of discrimination and prejudice, but that cannot represent sufficient reason to quit. Why are we allowing our discomfort to rob children of an education and consequently their health? We must continue to apply pressure and insist on meaningful legislative change at the state and local levels. The birds and the bees are only a fraction of nature’s beauty. It is time to celebrate the rest.

Featured image caption: A teacher points to a diagram of female reproductive organs projected on a screen in a classroom in a scene from Human Growth, an education film on sex education shown to students in Oregon junior high schools beginning in 1948. (Courtesy Tullio Saba)

Grace Wilsey

Grace Wilsey is a University of Virginia alumna and a 2023 graduate of the Columbia University Master of Bioethics program. She is passionate about the clinical applications of ethics, particularly surrounding access to care for disadvantaged populations, language barriers, and sports medicine. Grace intends to continue pursuing her clinical education in medical school next fall.

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