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"There is probably no subject that has posed greater headaches to teachers than sex education," writes NYU history and education professor Jonathan Zimmerman in his new book, Too Hot to Handle: A Global History of Sex Education. And no other topic illustrates the complexity and emotion that lies at the heart of the debates about parental, local, and federal control over education.

While every state offers some form of sex education, the substance and style of the given curriculum can range from comprehensive to significantly circumscribed, largely depending on local politics and beliefs. In many of America’s school districts, sex education looks a lot like the current "global norm," which is described by Zimmerman in his book as, "a smattering of information about their reproductive organs and a set of stern warnings about putting them to use."

The question of who should be teaching sex education, and what form that instruction should take, is increasingly problematic in this diverse and often ideologically divided nation. There’s little agreement on what should be included in sex education courses, let alone how, and at what ages it should be taught. The author Alice Dreger, writing for the Pacific Standard, pointed out that 44 percent of Americans mistakenly believe sex education is already covered by the Common Core  standard. So, she asks, "Why Isn’t Sex Education a Part of the Common Core?" On the other hand, sex-advice columnist and author Dan Savage suggests that if the country can’t offer effective sex education, maybe it should be looking to families, the Internet, or even independent sex instructors such as  Dr. Karen Rayne of Unhushed, or Amy Lang of Birds+Bees+Kids.

Whatever the issue, American adolescents need comprehensive sex education, well, because American adolescents have sex. According to the CDC, almost half—47 percent—of all U.S. high school students have had sexual intercourse, 34 percent of them during the previous three months. And 41 percent of those kids admit they did not use a condom the last time they had sex even though such contraception is highly effective against of pregnancy and the spread of sexually transmitted infections such as HIV. That statistic might help explain why the U.S. has the highest teen pregnancy rate in the developed world and why America’s adolescents account for nearly half of the 19 million new cases of STIs each year—even though, as the CDC indicates, teens represent only a fourth of the nation’s sexually active people.

It appears that America isn’t alone in neglecting the sexual education of its teens. That’s evidenced by findings from the U.K.’s third national Survey of Sexual Attitudes and Lifestyles, which was conducted among 4,000 adolescents and young adults and released today by the country’s Medical Research Council. The report reveals that in Britain, teens learn about sex from (in descending order of popularity) school, friends, the media, the Internet, and pornography. Despite access to these types of "information," approximately seven in 10 adolescents felt that they should have known more about sex before their first experience having intercourse. Specifically, they wished they knew more about contraception, how to reduce the health risks of sexual behavior, and "how to make sex more satisfying."

Meanwhile, the list of the most recently asked questions on, one of the most popular sex-education sites on the Internet, shows that these are the concerns of the 1 billion users (54 percent of whom are from the U.S.) who apparently visited the site since its launch in 2006:

(Scarleteen’s slogan? "Sex education for the real world: Inclusive, comprehensive and smart sexuality information and help for teens and 20s.")

The sex topics British teens want to know more about, and answers to the questions Scarleteen and Savage receive weekly, are inconsistently taught in U.S. schools—probably due to uneven requirements and the decentralization of policymaking. Because virtually every aspect of education, let alone that involving sex, does not fall under the control of the federal government, state, and more often local, entities decide what goes in—and what stays out—of the classroom. While every state engages in some form of sex education for public schoolchildren, only 13 of them have laws requiring that, if such a curriculum is offered, it must be medically accurate and based on scientific evidence. Meanwhile, just 18 states and the District of Columbia require that schools "provide instruction on contraception." While 26 states and the D.C. teach about healthy sexuality and decision-making, 19 states require that school-based sex education emphasize the importance of abstinence until marriage. Many of these standards, moreover, are open to interpretation.

Sex education takes three basic forms in the U.S.: comprehensive, abstinence-based, and abstinence-only. The comprehensive approach, according to the Sexuality Education and Information Council of the United States, provides "age- and developmentally appropriate sexual health information" that is medically accurate, informed by scientific evidence, and sensitive to the needs of all young people. Topics covered by such a curriculum include "human development, abstinence, contraception, disease and pregnancy prevention, as well as skill development for healthy relationships and decision-making."

Abstinence-based sex education, on the other hand, specifically promotes abstinence while providing some or all of the elements of the comprehensive approach; abstinence-only models, of course, teach only abstinence until marriage. Abstinence-only curricula don’t provide any information on contraception beyond its failure rates.

Comprehensive programs are slowly gaining ground in the U.S. Still, abstinence-only programs have been well-funded over the years, beginning with the Reagan Administration and the federal block grant for maternal and child health services under Title V of the Social Security Act—despite evidence that these programs are ineffective when it comes to better sexual health. According to multiple peer-reviewed studies, abstinence-only programs do not delay the average age of the first time a person has sexual intercourse, nor do they prevent the spread of STIs or reduce the number of sexual partners someone has during adolescence. The peer-reviewed Journal of Adolescent Health came out against abstinence-only education in a 2006 position paper, stating that while abstinence is a healthy choice for teens, "Providing ‘abstinence only’ or ‘abstinence until marriage’ messages as a sole option for teenagers is flawed from scientific and medical ethics viewpoints."

Many advocates and experts agree. As Savage, a longtime critic of abstinence-only education, recently told me in a phone interview, he supports having sex education in schools but believes "[the country] should stop pretending what passes for sex education is sex education." Savage has been commentator and sex advice columnist since 1991, both in his Savage Love column and his extremely popular "Savage Love" podcast. He’s thus familiar with the full range of questions Americans have about sex. Savage agrees that the topics most school programs cover, such as reproductive biology, are important emphasized that curricula often ignore topics such as consent, pleasure, and effective communication about sex.

So I asked Savage to elaborate on what a comprehensive sex-education curriculum should cover:

We should be teaching the real things that can trip people up, things that can ruin people's lives or traumatize them, like what is and isn't consent, and what is and isn't on the menu, and what are you or are you not comfortable with, and how do you advocate for yourself, and how do you draw someone out and solicit their active consent so that you don't accidentally traumatize someone? We need to talk about sex for pleasure, which is 99.99 percent of the sex that people have, and that's 99.99 percent of what's not covered in even what liberals and progressives would look at and say, "Oh, look at that good sex ed!"

Savage claims that despite the nation’s outward appearance of progress on matters such as marriage and gender equality, "Sex education has gone backwards. When it comes to our children, there is more information and more truthfulness out there about sex, sexuality, gender identity, everything, than there has ever been. Social conservatives know they can't undo the sexual revolution, or unmake gay people, or roll back women’s empowerment—but they have it in their heads that they can reverse engineer the future by raising today's children in ignorance."

To illustrate the consequences of such ignorance, Savage analogized the state of sex education today to a driver’s education class that focuses exclusively on the mechanics of the internal combustion engine, with no mention of brakes, steering, red lights, and stop signs. "That’s sex ed in America. We hand kids the keys to the car, and when they drive straight into walls, we say, ‘See? See? If we’d only kept them a little more ignorant, this wouldn’t be happening!’"

But for Zimmerman, conservatives aren’t the only culprits responsible for the country’s failure to progress on sex education: "Dan is right to be sanguine about any kind of real substantial change, but it’s actually because of our country’s diversity. The more diverse the world becomes, and the more it globalizes, the faster people and ideas move across borders, the more difficult [agreeing how to teach] sex ed becomes."

Even proponents of progressive, comprehensive sex education disagree about what phenomena are hindering its development. While some advocates may like the idea of a comprehensive national standard for the subject, such as Alice Dreger’s vision of sex education as a Common Core standard, Zimmerman believes allowing schools to experiment with content or format would be key to promoting innovation.

The United States might be one of the places where we will see a little bit more variation and experimentation, and that’s because we don’t have a national system. There are compelling reasons to think about national standards and national curriculum, but where sex ed is concerned, you have to think about some of the downsides of that, too, which is how it might inhibit experimentation and variation.

That experimentation and variation flourishes in independent sex-education classes around the country, such as those that Rayne teaches at the Austin-based Unhushed. Rayne, an author, sex educator, and the chair of the National Sex Ed Conference, is doggedly optimistic in her predictions about the future of sex education in America, largely because she knows firsthand about the demand for progressive, comprehensive curricula. "I do think we’ve come a long way," she said in a phone interview. "I’ve seen a lot of change that’s happened since I started in sex education [in 2007]. People are much more open to it. The laws are improving—I would not say that they are great—but they are improving. The Texas Freedom Network does really good research on sex education in Texas and its findings show a clear trajectory toward openness, honesty, and fact-based information, so I do see that happening here and also nationally."

Zimmerman doubts a comprehensive national sex ed curriculum will ever happen. To him, the U.S. is simply too diverse for one solution to fit all. As he concludes in Too Hot to Handle, sex education serves as "a mirror, reflecting all the flux and diversity—and the confusion and instability—of sex and youth in our globalized world." No matter how rapidly sex education evolves, he believes, it will always be playing catch-up—to the media, to the Internet, and to everything adolescents talk about when adults are not around.
