Best Practices for Sexual Health & Relationship Education

The school systems across Minnesota play an important role in the lives of the families that reside in each district. Sex education curriculum taught in Minnesota schools is likely the only type of relationship and sexual health learning that a student receives before moving on to the emerging adulthood stage of life. Research shows that when students do not have up-to-date and inclusive education, they are not as likely to succeed across a variety of outcomes as students who do receive comprehensive education that engages the school and the family (Frisco, 2008; Grossman, Tracy, Charmaraman, Ceder, & Erkut, 2014). Currently, the standards for sex education in Minnesota do not meet the needs of students and families, and ultimately put Minnesota students at a disadvantage as they start their careers or continue to higher education. Each district across the state must revise their curriculum standards to ensure that all students in Minnesota receive the best education that promotes relationship and sexual health.

The Minnesota school system plays a vital role in the health and wellbeing of its students, while overseeing their academic development. Teachers, staff, and administration all have a vested interest in ensuring that they see each student reach their potential and appreciate the many paths students take into adulthood. Primary and secondary education has made great advances in reaching the potential of each student to succeed. Research and training has provided teachers and administration the ability to design and implement new approaches to curriculum and diverse applications of teaching (Grossman et al., 2014). The future of education requires the continued collaborative effort that administrators and teachers have engaged in to promote student learning, their health, and their current and future relationships. Without comprehensive and inclusive sex education, Minnesota students are at a higher risk of STI’s, unplanned pregnancy, risky sexual behavior, and a host of relationship issues across their lifespan (e.g., intimate partner violence, divorce, and issues that translate into social and workplace relationships).

In Minnesota, the only requirements for sex education are that a sex education curriculum must be taught, it must be comprehensive, technically accurate, and updated. However, the statute also mandates that the curriculum must help students refrain from sexual activity until marriage (MINN. STAT. 121A.23, 2017). Minnesota allows for each school district to interpret this law in their own way, and provides parents the ability to remove their children from sex education courses with no consequence to students’ academic progress. This is problematic for Minnesota students because abstinence-only education has not shown effectiveness and is contradictory to comprehensive sex education. The statute indicates the need for technically correct (but not medically correct) sex education, and allows for schools to exclude sex education directed towards sexual & gender minority students. This means that schools do not need to teach up-to-date information on sexual health (i.e., school districts are free to withhold important information related to sexual health).

Abstinence-only sex education programs are widely used across the United States (including Minnesota) and receive more funding than any other type of sex education program. Abstinence-only sex education curriculums can be a highly polarizing topic for families and their school districts. However, there is mounting evidence that abstinence-only education is detrimental to all students, regardless of their family background (Kohler, Manhart, & Lafferty, 2008; Santelli et al., 2006). Abstinence-only education has been shown to increase the students’ knowledge of abstinence, beliefs about waiting until marriage, and intention to remain abstinent after receiving this education. However, the age at first sexual intercourse, condom use, and rate of STIs are not consistent with the aims of these programs for the students who receive this type of learning (Denny & Young, 2006; Kohler et al., 2008). Researchers across medical, public health, law, psychology, and social science have now begun to discuss abstinence-only and other non-comprehensive sex education programs for students as a human rights issues. This stems from the mounting evidence that comprehensive sex education protects students at the time of their education and throughout their lives (Santelli et al., 2006).

The pregnancy rate for adolescent females in Minnesota ages 15-19 was 20.4 pregnancies per 1,000 people and the actual birth rate was 15.5 per 1,000 people in 2014, which means that each day in Minnesota in 2014 10 girls become pregnant and 7 gave birth (Farris & McKye, 2016). Although this is below the national average (24.2 births per 1,000 people), certain areas of Minnesota are experiencing teen birth rates as high as 58.2 births per 1,000 people (Farris & McKye, 2016, Office of Adolescent Health, 2016). STI’s in Minnesota among adolescents increased by 15% in 2016 (Farris & Burt, 2017). Further, the rates of pregnancy and STD/I’s for racial & ethnic adolescents in Minnesota are triple those of white students. Sexual & gender minority adolescents in Minnesota are also at a greater risk for STI’s, pregnancy, and risky sexual behavior (Farris & McKye, 2016; Farris & Burt, 2017). Racial and ethnic minority students are much more likely to go to public schools where there might be a lack of comprehensive and medically accurate sex education programs, as opposed to a white student that is more likely to go to a private, charter, or magnet school where they may have adopted comprehensive and inclusive sex education. Sexual & gender minority students are faced with receiving no relevant sex education across the state, leaving them vulnerable to a host of negative experiences and outcomes as they navigate sexual relationships without proper education on their sexual health.

The issue between technically correct sex education and medically correct information is the ability for individual districts to tailor their sex education programs to leave out pieces of information when teaching students. One example would be an abstinence-only curriculum teaching abstinence as the only 100% effective way to intentionally avoid an unplanned pregnancy, and leaving out education regarding appropriate condom use and other forms of sexual health practices in order to prevent increased sexual activity. However, the vast majority of health professionals argue that leaving out the information regarding condoms, STI vaccination options, and alternatives to intercourse is actually detrimental to the students. Comprehensive sex education has actually been found effective in preventing teen pregnancy, while abstinence-only programs show no effectiveness (Kohler et al., 2008). Kohler, Manhart, & Lafferty (2008) also found that comprehensive sex education does not increase sexual activity nor STI’s in students who received this education.

The goal of sex education is to provide students with information about puberty, pregnancy prevention, HIV/AIDS and STI prevention, consent, and appropriate birth control/contraceptive/prophylactic use. This parlays into student understanding of themselves and how to engage in healthy relationships. The state of Minnesota has a duty to do what is best for their students’ health and well-being, and is an opportune place to do so. Implementing a new standard of sex education requirements for schools across the state would significantly increase the positive outcomes for these students and provide a safer and healthier Minnesota. Because each school district has some autonomy over their curriculum, mandating comprehensive and inclusive sexual health and relationship education is vital in protecting students who are unable to advocate for themselves in most areas of their lives. This is also particularly important for the marginalized groups that live across the state. Implementing new standards for practice in the classroom would work to decrease the enormous health disparities Minnesota is working to reduce.

Many curriculums have been developed to provide a safe and effective way of teaching sex education. One example is the Our Whole Lives curriculum, which is a comprehensive and inclusive sex education program that gives the students a well-rounded education on sexual health and relationships. The unique aspect of this program is the incorporation of the parental system in the process. This curriculum engages parents and children in conversations about sexual health, which has been found to be another effective way of increasing positive outcomes and decreasing health risks for adolescents (Aspy et al., 2007; Campero, Walker, Atienzo, & Gutierrez, 2011). The University of MN produces some of the best teachers and educational researchers from around the world. Collaboration between teachers, researchers, and policy makers could help Minnesota become a leader in sexual health education for students, and help promote the overall well-being of the many families that live and work throughout the state.

Eugene L. Hall is a PhD candidate in the Family Social Science-Couple & Family Therapy program at the University of Minnesota. Broadly, his research focuses on sexual and gender minority relationships, as well as issues of diversity and social justice. His clinical work utilizes a narrative focus with couples and families.

Aspy, C. B., Vesely, S. K., Oman, R. F., Rodine, S., Marshall, L. D., & McLeroy, K. (2007). Parental communication and youth sexual behaviour. Journal of Adolescence, 30(3), 449–466.

Campero, L., Walker, D., Atienzo, E. E., & Gutierrez, J. P. (2011). A quasi-experimental evaluation of parents as sexual health educators resulting in delayed sexual initiation and increased access to condoms. Journal of Adolescence, 34(2), 215–223.

Denny, G., & Young, M. (2006). An evaluation of an abstinence-only sex education curriculum: An 18-month follow-up. Journal of School Health, 76(8), 414–422.

Farris, J., & Burt, J. (2017). 2017 Adolescent sexual health report. Minneapolis, MN: University of Minnesota Healthy Youth Development - Prevention Research Center.

Farris, J. & McKye, B. (2016). 2016 Minnesota Adolescent Sexual Health Report. Minneapolis, MN: University of Minnesota Healthy Youth Development - Prevention Research Center.

Frisco, M. L. (2008). Adolescents’ Sexual Behavior and Academic Attainment. Source: Sociology of Education, 81(3), 284–311. Retrieved from

Grossman, J. M., Tracy, A. J., Charmaraman, L., Ceder, I., & Erkut, S. (2014). Protective effects of middle school comprehensive sex education with family involvement. Journal of School Health, 84(11), 739–747.

Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy. Journal of Adolescent Health, 42(4), 344–351.

Minnesota Statutes 2017, section 121A.23. Programs to Prevent and Reduce the Risks of Sexually Transmitted Infections and Diseases.

Santelli, J., Ott, M. A., Lyon, M., Rogers, J., Summers, D., & Schleifer, R. (2006). Abstinence and abstinence-only education: A review of U.S. policies and programs. Journal of Adolescent Health, 38(1), 72–81.

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