Authors: Caleb Campbell, Daniel Clifton, Sophia He, Abigail McNickle, Alexis Wallace
“Sexual Health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.”
-World Health Organization 2006
Introduction
In reviewing current legislation regarding sex education in Ohio and researching the efficacy of various sex education teaching strategies it has been determined that sex education in Ohio requires reexamination. For the purposes of this website, “sex education” refers to the education of seventh through twelfth graders and regards sexual interactions, sexual maturation, and sexual diseases. Ohio teachers should work to create a more inclusive and objective sex education curriculum. Extensive resources have been compiled below to support teachers who wish to create a more comprehensive curriculum. These resources cover six areas that are pertinent to the sexual education of teenagers in Ohio: puberty; relationship education; sex education for differently-abled persons; safe sex practices, including contraception education, teen pregnancy options, and STI education; scare tactics and sex myths, and resources for students and parents.
Why Improve Curriculum?
The outstanding research concedes that current archetypes of sex education are flawed and in need of reexamining for a changing generation.
Importance of Comprehensive Sex Education
The basis of abstinence-only education is to provide little to no information about contraception and condom use other than failure rate and often medically inaccurate information in hopes that teenagers will not have sex at all; however, comprehensive education, being transparent and open to the public, ensure the right for students to know about healthy sex (Stanger-Hall and Hall, 2011). On the contrary, teen pregnancy and birth rates have positive correlations with abstinence education (Stanger-Hall and Hall, 2011). In addition, comprehensive sex or HIV education including the discussion of abstinence, contraception and protection methods are more recommended in public schools biology classes taught by trained faculty (Stanger-Hall and Hall, 2011). Integrating sex education with the National Science Standards for U.S. middle schools and high schools with parents involved in the activities.. There are also 
great risks for women including maintaining a social life with loved ones, who conceive before the age of 15 or who do not seek prenatal care (Teen Pregnancy Issues and Challenges, 2019). For those who doesn’t have the ability to nourish a child, adoption can be a good choice. Being a birth mother cannot only reduce the stress for a teen and her family that accompanies raising a child, but can also help to complete the adopting family who have always wanted a child.
Comprehensive sexual education is relevant and applicable information for adolescents undergoing puberty to hear, therein lies the relationship between it and lower pregnancy and STD rates. A good comparison for not having adequate sexual education would be like playing a board game without the directions; it’s always better to understand the concepts and rules first. Adolescents face a multitude of challenges as they enter puberty. The combination of both biological and psychological changes that occur often puts them under stress as many are not prepared, and with the average age for female puberty continuing to decrease, these challenges can be even more profound (Greenspan & Deardorff 2014). Onset of menstruation, change in voice, development of secondary sexual characteristics, and psychological changes are all major life stages (Kar, 2015). As a adolescent develops sexually, family and society’s attitude, as well as any cultural influences on these changes, will play a major role in deciding the adolescent’s sexual behavior after puberty (Kar, 2015). The mysticism of puberty and sex can and is being broken down into a beneficial learning experience through comprehensive sexual education Schools not integrating some type of in-depth sexual education actively demonstrate a passive attitude over the matter; sexuality will and forever remain a major part of most people’s lives.
These are STD rates per county in Ohio. These rates can be lowered by converting to a comprehensive sex education program.
Relationship Education
Recent research has called for more comprehensive relationship education. Studies show that relationship education can greatly reduce sexual violence and intimate partner violence. (Antle 2011) Studies also show how creating an LGBTQ-inclusive sex education curriculum can be beneficial to LGBTQ students (Kosciw 2018). It can reduce poor mental health and bullying in sexual minority students (Proulx). A brief on the issue of LGBTQ-inclusive sex education endorsed by the sex education authorities of Advocates for Youth, Answer, GLSEN, Human Rights Campaign, Planned Parenthood, SIECUS details the lack of inclusive sex education in America and then calls for youth, parents, community members, educators, and policymakers to advocate for increased and improved LGBTQ-inclusive sex education. The brief describes the problem as being adverse sexual health effects felt by LGBTQ+ students due to minority stress factors and exclusionary sex education. It concludes the solution will be comprehensive, inclusive sex education.
Why Scare Tactics Fail
It is clear that scare tactics are not an effective way to educate teens on STIs. They are also often used in conjunction with abstinence-only education, which is an unhealthy combination. Abstinence-only programs have been proven to not be effective at delaying the age that teens begin being sexually active (Gautam-Adhikary 2011), and scare tactics have been shown to only be effective “when people feel susceptible to the health problem and confident in their ability to take action to prevent it” (Lederer 2017). With this knowledge, the fact that abstinence-only education often views STIs as taboo and villanizes them through scare tactics means that they will likely be ineffective. A more comprehensive sex education curriculum that provides students with the information they need to understand the high risk of attaining an STI when not practicing safe sex habits as well as how to prevent and treat them will destigmatize these issues and promote healthy conversations. As an added bonus, Lerderer (2017) claims that this would allow educators to effectively utilize scare tactics without negatively impacting their students.
Teachers should restructure their sex education curriculum to ensure that teens are as prepared as possible to make informed decisions. There are five key points of a comprehensive sex education class that have been neglected in the past and should be considered when forming curriculum.
- Relationship Education → The current legislation requires that “grades seven through twelve, age-appropriate instruction in dating violence prevention education, which shall include instruction in recognizing dating violence warning signs and characteristics of healthy relationships” (Cafaro). Relationship education, which is not explicitly mentioned, refers to curriculum about consent, sexual and romantic relationships, intimate partner violence, sexual violence, and LGBTQ+ relationships. Teachers can inform the mandated sex education by including lessons about the importance of consent, how to form and maintain healthy romantic and/or sexual relationships, and the dangers of sexual violence. Comprehensive relationship education is encouraged in health class as students see a “reduction of multiple IPV outcomes” (Antle et al., 2011). To incorporate further inclusivity teachers may include LGBTQ+ information because “access to culturally competent, LGBTQ-affirming mental health providers… in school is essential to the well-being of LGBTQ teens” (Human Rights Campaign, 2018). This can be achieved by avoiding gendered or heteronormative terminology when teaching as acting as affirming the students identities.
- Sex Education for Persons with Varying Abilities → The broad spectrum of physical, mental, and learning disabilities requires unique styles of teaching depending on the needs of the student when it comes to sex education in particular. In Ohio, regardless of ability, all students at state-funded schools are mandated to receive “Venereal Disease” education (Hood, 2019). Intellectually disabled students encounter higher risks of sexual abuse compared to students without disabilities (Boehenning, 2006). With proper sex education to the disabled, studies have shown results of lowering sexual abuse, unplanned pregnancies, and sexual diseases (Boehenning, 2006). Currently, there is little legislation requiring training for educators on sexual education or the instruction of the disabled. For example; The Ohio State University’s bachelors in education does not even require a special education course to obtain the degree. Research shows positive correlation between proper sex education and better health throughout life. Curriculum may be altered at an instructor’s discretion but the necessary core information should be standardized across the state with individual teachers working to format the curriculum to best serve their students.
- Safe Sex Practices Education → Currently, Ohio requires that students are taught about the prevention of HIV/AIDs, and teachers should “stress abstinence”(House/Senate bill 101, 2015-2016) as it is an infallible method of preventing unplanned pregnancy and/or STIs. Condoms are mentioned once in House/Senate bill 101, requiring that educators state contraceptive success rates. Studies have shown that abstinence-only education is ineffective, (Stanger-Hall and Hall, 2011; Santelli et al., 2006) and does not adequately prepare students for sexual encounters. Ohio teachers are required to educate about the negative effects of STIs but they should also be willing to openly talk about sex and do examples like the classic “condom on a banana” demonstration. Teachers have responsibilities to provide objective information and resources about pregnancy options. For example, abortion or adoption are valid options to be explored way for pregnant teens, especially because studies have shown that there is greater risk for teens who conceive before the age of 15 (American Pregnancy Association). It is imperative that students are exposed to these scary situations with adults and resources to turn to in times of need.
- General Teaching Strategy → As scare tactics, a commonly utilized strategy to attempt to reduce sexual activity in teens, have been proven ineffective, teachers should work to improve their teaching strategies when it comes to sex education. Using scare tactics regarding sex education has been shown to increase stigma and therefore sexual activity, rather than achieveing the intended purpose of depleting it. Students who have been educated through abstinence-only sex education often resort to learning about sex and STIs through inaccurate rumors and experience, which can be physically or mentally detrimental. An objective warning about contraception and STIs is encouraged to be presented and should be accompanied by factual curriculum about how to prevent and treat them while maintaining a healthy sexual relationship. Common scare tactics utilize myths to frighten teens from sexual activity. Teachers should be cautious to correct and not perpetuate these myths. A few common myths teachers should be sure to bust are those regarding the effectivness of condoms, the use of lube, the logistics of LGBTQ sex, and the hymen’s connection to virginity.
- Mindfulness movements → Mindfulness involves focusing mental awareness to reflect on personal and external realities, it’s a technique that can be used and beneficial in practically every situation. This practice has become more common in Western Culture as more research and personal testimony’s supporting its positive benefits have come out; mindfulness used with adolescents undergoing puberty has been especially helpful (Greenspan 2015). In the classroom, mindfulness can be integrated with simple thoughtful questions that cause reflection. For example, asking students to close their eyes and begin to consciously focus on any physiological feelings or sensations as they inhale and exhale is a way of deepening the connection with one’s body (Blycher 2018). The purpose is to practice being present with oneself; slowing things down, and interrupt automatic reactions (Blycher 2018). In Dr. Greenspan’s book, “The New Puberty”, the decreasing average age of girls beginning puberty and negative effects this can onset is analyzed and assessed; many girls simply aren’t prepared enough for the challenges puberty brings. The changes in emotions, physical appearance, and bio-makeup are all new concepts and require correct understanding for proper sexual health (Blycher 2018). Dr. Greenspan’s and Dr. Deardorff’s research and personal experiences emphasize mindfulness learning for adolescents to engage in; these types of learning experience have indicated children with more positive self-imaging, lower rates of obesity, and other behavioral or sexual problems (Greenspan 2015). By favoring more self-awareness in a sexual education classroom, the supported hope is a more respect-based sexuality and mindful connections with peers (Blycher 2018)
- Classroom Resources → Teachers should prepare resources for both students and parents to further their knowledge of sex education if they so chose. Keeping a list of these resources in the classroom allows students to expand their knowledge on topics if they so choose. This encourages growth and healthy, well-informed decisions about their own sexual health. Sex education can be a difficult topic to approach with parents. Some parents may feel that sex education should be taught at home, rather than at school. By compiling resources to educate parents, teachers can lessen the stress of having to explain the importance of comprehensive sex education to each individual. These resources can also help parents to bolster their child’s growth and stay educated themselves.
How to Improve Curriculum
Recommended Resources
Resources for teachers to further their own knowledge about sex education.
Puberty and Body Image Resources
The new puberty: how to navigate early development in todays girls. Greenspan, L., & Deardorff, J. (2014)
Greenspan and Deardorff analyzed patterns of girls entering puberty earlier than the generational predecessors, particularly the environmental causes and negative effects it has on a child’s psychology. They argue that puberty education needs to start as early as possible, even going beyond sex education; mindfulness/movement programs in school are cited as a great method to integrate positive perspectives on puberty.
The separation solution?: single-sex education and the new politics of gender equality. Williams, J. (2016)
Williams states that sex education classes began to separate by sex after Brown v. Board of Education because of anxieties about black males and white females being taught in same health class. Studies show single sex-schooling can exacerbate stereotypes, and leading to a social separation of the sexes. This separated state can allow for a disparity between each sex’s level of education. Ignoring identity, intersectionality, ideology provides groundwork for power structures.
Relationship Education
This resource includes statistics regarding LGBTQ sex education in American schools in 2017. The survey allows insight into how students view their sex education and provides a good base of knowledge regarding LGBTQ-inclusive sex education.
https://www.tandfonline.com/doi/full/10.1080/10522158.2011.616482
This source was a study on the impact of a healthy relationship education program on IPV with at-risk individuals. It briefly discusses the epidemic of IPV and the traditional reactive approach to IPV as opposed to a preventive one. The paper describes the efforts being made to develop healthy relationship educational programs to prevent IPV. It then moves into current research being done through the Within My Reach classes. The study found that participants experienced a reduction in physical and emotional abuse. This source is a good example of a successfully implemented relationship education program.
https://www.sciencedirect.com/science/article/pii/S0190740910002926
This study provides background information about youth dating violence and an overview of statistics regarding sexual and emotional abuse among youths. It then describes the purpose of the study to be determining whether short term healthy relationship education programs, such as those usually implemented within high school sex education, are actually effective. The research concluded that, “…a brief relationship education program can produce significant gains in relationship knowledge, skills, and positive attitudes towards couple violence.” This is a good resource for teachers to learn about relationship education.
Sex Education for Differently Abled Persons
https://deldhub.gacec.delaware.gov/pdf/boehning%20sex%20education%20for%20students.pdf
Whether a student has a disability or not, by law they must receive the same/similar sex ed. This article emphasizes the importance of sexual education for disabled children to avoid teen-age pregnancies, sexual diseases, and specifically sexual exploitation of the disabled. The issue driving this article remains relevant today as the broad spectrum of disabilities makes creating meaningful lessons challenging. Ideally social workers and special educators in schools will have received some type of training or education on how to teach students with disabilities. Ultimately the parent/guardian should be the deciding and driving force over the child’s sex education recieved. The article points to many training based studies showing results of lower pregnancies and sexual abuse among disabled students; stricter requirements on sexual education for disabled could be made.
Safe Sex Practices
Galligan found that “emotional concerns of destroying romance and fear of negative implications have a major impact on sexual behavior” regarding condom use and the pressure against it, particularly in the case with young women. There is a stigma around condom use that pressures sexual novices into agreeing to unprotected sexual contact for fear of “killing the mood.” Wether students are mature enough or knowledgeable enough to be ready for sex is a moot point. About half of high school students claim to have had sex at least once before graduating (Planned Parenthood), regardless of their preparation. Teachers cannot control the sexual activities of their students but they can educate their students in consent and safety so that they can better avoid STDs, unplanned pregnancies, IPV, and have the tools for healthier relationships.
http://www.center4research.org/preventing-teen-pregnancy-impact-dolls-abstinence-sex-education/
This article discussed indirect ways to prevent teen pregnancy rates. It mentioned both abstinence programs and sex education programs conducted in schools/communities and discussed which program is better by questioning educators to think critically. Besides these two major programs currently running in the state, the author also mentions other teen pregnancy prevention programs financially supported by The federal government’s Office of Adolescent Health. This is a good source to reveal different adolescent programs. These programs running in schools and communities shows that the government is lending support for adolescent sexual health, paying careful attention to adolescents’ growing path.
Classroom Resources
Resources regarding the six main areas of sex education for use in the classroom.
Puberty Resources
https://classroom.kidshealth.org/classroom/6to8/personal/growing/puberty.pdf
KidsHealth.org is a CDC and National Health Education Standard backed program/resource for teachers. The website offers useful lessons and techniques for teaching puberty effectively to students along with many other external resources on sexual health. The website’s lessons utilize a combination of critical thinking, comprehension, and multimedia for students to engage in sexual education in a more stimulating way.
Relationship Education
https://www.gse.harvard.edu/news/uk/18/11/sex-education-goes-beyond-sex
This article discusses the idea of focusing on more than just physical health when it comes to sex education, emphasizing the importance of relationship education. It is a good resource for teachers to explore what ideas, such as consent, mutuality, and healthy relationships should be included in their relationship education curriculum. The article explains that sex education should take an ethical approach to sex, developing relationship-building and communication skills from a young age.
Sex Education for Differently Abled Persons
https://sites.ed.gov/idea/topic-areas/#Assessment-Early-Childhood
Under IDEA, disabled students have the right to be evaluated by the school to determine an efficient individualized plan if needed. This applies to all aspects of a student’s learning, so ultimately it is up to the instructor and parents to find the best way for the student to learn. There are thousands of informal books, videos, and websites analyzing specific disabilities; which not only break the disability down but offer advice on how to best work with the disabled person. Once an evaluation is complete a more thorough lesson plan should be made to best meet the students needs.
https://www.specialeducationguide.com/disability-profiles/
This website offers insight to all 13 categories of disabilities covered by IDEA.
Safe Sex Practices
https://www.plannedparenthood.org/learn/pregnancy/pregnancy-options
While one of the main purposes of comprehensive sex education is to reduce teen pregnancy, students should be aware of their options, should they become pregnant.
https://www.hopkinsmedicine.org/health/wellness-and-prevention/safer-sex-guidelines
Johns Hopkins hospital states that “there really is no such thing as safe sex. They believe the only way to be truly safe is not to have sex because all forms of sexual contact carry some risk.” This fact, based on sexual activity rates in teens, is not enough to prevent sexual congress in students. It is recommended that people limit their sexual partners, always use condoms, check regularly for signs of infection, and maintain an open communication with their partner or partners to protect against STDs.
Helpful guidelines for practicing safe sex.
Scare Tactics and Sex Myths
https://link.gale.com/apps/doc/EJ3010603221/OVIC?u=colu44332&sid=OVIC&xid=5701d89
Discusses the effects that abstinence-only education, and its employment of scare tactics, has on the students that are exposed to it. It discusses a controversy surrounding a rape victim and denounces abstinence-only education and the shame that it puts on women. The article creates a metaphor of a woman who has sex before marriage being as useless as a chewed piece of gum. The shame that scare tactics cause in teens is concluded not only be ineffective in preventing teens from engaging, but also ineffective in educating them about safe sex practices in the first place.
https://scholars.org/contribution/why-use-scare-tactics-promote-sexual-health-youth-may-backfire
Argues that scare tactics are not beneficial for the education of children when it comes to sexual health. It talks specifically about how the teaching of sexually transmitted infections are often taught with the utilization of fear tactics. The article also discusses what research tells us about the pros and cons of the implementation of fear tactics.
https://www.advocatesforyouth.org/wp-content/uploads/storage//advfy/documents/cse-myths-adfacts.pdf
Debunks common myths that surround sex education. It lists many good myths and utilizes copious amounts of respected research that debunks them. It covers frequently spread myths about topics such as contraceptives, comprehensive sex education, abstinence-only education, and more.
Additional Resources for Parents and Students
Uses easy to understand digital media to provide teens with age-appropriate individualized information about the subjects that they want to learn about. Also provides resources for their parents, teachers, and even younger children.
Gives in depth information and additional resources for parents, younger kids, teens, and educators. Each group has topics that range from sex education to general health.
Provides information for both men’s and women’s sexual health, as well as a guide to having a healthy sexual relationship. Also has information for both teachers and parents to read to guide their child or student to being a healthy human being.
Glossary
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Sex Education – Sex education helps people gain the information, skills, and motivation to make healthy decisions about sex and sexuality.
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Unprotected Sex – an act of sexual intercourse performed without the use of a condom, thus involving the risk of sexually transmitted diseases.
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Sexually Transmitted Illness (STI) – Sexually transmitted infections (STIs) are also called sexually transmitted diseases, or STDs. STIs are usually spread by having vaginal, oral, or anal sex.
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HIV – Human Immunodeficiency Virus.
LGBTQ+ – Lesbian, Gay, Bisexual, Transgender, Queer; + Represents all other members of the community that do not fall under the aforementioned categories.
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Relationship Education – efforts or programs that provide education, skills, and principles that help individuals (a person not in a relationship or a person without his or her partner) and couples (both partners participating) increase their chances of having healthy and stable relationships.
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Intimate partner violence (IPV) – is abuse or aggression that occurs in a close relationship. “Intimate partner” refers to both current and former spouses and dating partners.
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Abstinence/Abstinence-only Education – Also called “Sexual Risk Avoidance.” Teaches that abstinence is the expected standard of behavior for teens. Usually excludes any information about the effectiveness of contraception or condoms to prevent unintended pregnancy and STIs.
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Development of sexuality – A bio-psycho-social development tending to take place during puberty. The process are individual’s thoughts and perceptions containing sexual understanding/motivation. Puberty is an important landmark of sexuality development.
Mindfulness – focusing mindful awareness to explore the body, feelings, mind (thoughts, images, stories, judgments, beliefs, etc.), and the dharma [truth, elements, principles and laws that contribute to experiences)
Related Legislation
The Sexuality Information and Education Council of the United States completes yearly state profiles which provide an overview of federally funded sexual education programs in the United States. The most recent Ohio State Profile details the legislation surroun
ding sex education in Ohio, which does not mention LGBTQ topics or the topic of healthy relationships. A figure from the CDC identifying “19 Critical Sexual Education Topics” is included as a comparison to the Ohio legislation. The state profile also provides data regarding Ohio students’ experiences. This data includes statistics about sexual and relationship violence, as well as statistics on teaching about healthy, respectful relationships and LGBTQ topics. The resource is particularly helpful as it is a comprehensive guide to Ohio state sex education legislation.
https://siecus.org/wp-content/uploads/2019/03/Ohio-FY18-Final.pdf
Sex education is not required by Ohio but a “health curriculum” must be integrated within schools. Ohio Revised Code Sections 3313.60 and 3313.6011: Venereal diseases is one sex-ed topic required to be in that curriculum, abstinence education is emphasized. Cleveland school in 2002 adopted Comprehensive school health program. New sex-ed approach through 4 goals (opposite of abstinence education) with positive results.
https://siecus.org/wp-content/uploads/2015/03/OHIO09.pdf
Senate Bill 101 for the Ohio house and senate sponsored by Senator Cafaro. This most recent version includes requirements for education on STIs/AIDS in health classes in accordance with the revised bill 3313.6011. The “instruction should stress abstinence but shall not exclude other instruction and material on sexually transmitted illnesses.”
https://www.legislature.ohio.gov/legislation/legislation-summary?id=GA131-SB-101
Revised bill 3313.6011 of the 128th general assembly 2009-2010. Made to amend sections of the Revised Code to establish statutory standards for comprehensive sexual health education and HIV/AIDS prevention education
http://archives.legislature.state.oh.us/bills.cfm?ID=128_HB_316
The Individuals with Disabilities Act is a series of legislation making it law for all disabled students to have access to free public schooling with an evaluation of their needs and individualized education plan if needed. Public Law 101-476, enacted by 101st United States Congress.
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