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Dr. Eva S. Goldfarb: Sex education

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While 29 states and the District of Columbia mandate some form of sex education, only 11 of those require that it be medically accurate, and 30 states demand that schools stress abstinence despite the lack of evidence to support this approach. Changes to sex education are proposed frequently at the state and local levels—including changes focused on LGBTQ+ issues.

On Wednesday, January 18, 2023, SciLine interviewed: Dr. Eva S. Goldfarb, a professor of public health at Montclair State University who studies K-12 sex education. She discussed topics including: the health impacts of sex education on students and communities beyond prevention of unintended pregnancies and sexually transmitted infections; public support for sex education; research on inclusive comprehensive sexuality education beginning in kindergarten; effects of policies that limit sex education or emphasize abstinence; and how sex education varies among U.S. states and localities.


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EVA GOLDFARB: My name is Eva Goldfarb. I’m a professor of public health at Montclair State University, and I’ve spent my career studying sex education and sexual health.


Interview with SciLine

Can you tell us about some of the outcomes of sex education?


EVA GOLDFARB: One of the most powerful and effective tools we have in public health is comprehensive sex education that’s taught in schools. And there’s decades of research that have demonstrated the effectiveness of sex education at preventing unintended pregnancies and sexually transmitted infections or STIs. And that’s great. That research is really important because it informs us on program development, policy development, etc. What we have known much less about until now are the other impacts that high quality sex education has. And along with my colleague, Dr. Lisa Lieberman, we conducted a comprehensive—what’s called a systematic literature review of the past 30 years of peer-reviewed research on the outcomes of sex education. And what we found is that sex education that is started early, as early as kindergarten, that is sequential, age-appropriate, and delivered—sometimes throughout the curriculum and throughout grades in a planned way—reduces child sex abuse, reduces intimate partner violence, reduces sexual harassment and bullying, including homophobic bullying and harassment, improves communication skills with peers, parents, medical providers, and partners. But it also develops important life skills that will help in many, many areas of a young person’s life. It improves things like compassion, empathy, agency—the sense that I have control over my own body—decision making skills. The ability to enter into and maintain healthy relationships. And on top of that, it also improves media literacy, and in today’s age when so much information about sex and sexuality is available on the internet, being able to discriminate between science-based, evidence-based, accurate websites and those that are misleading is really important. So what we found is that it also helps young people to feel safer, to stay in school longer—and this is especially true for LGBTQ young people and other marginalized young people—but that all young people feel safer and have greater sexual health.

What has research shown about public support for sex education?


EVA GOLDFARB: Small but vocal opposition to sex education portrays sex education as controversial. But that is not what the research tells us. There are decades of studies, of polls at the local, state, and national level that show that the overwhelming majority of adults—and voters by the way—support comprehensive sex education in middle and high school that includes topics such as pregnancy prevention, safer sex, STI prevention, birth control, including abstinence, but also sexual orientation, consent and healthy relationships. And this support goes across the political spectrum, is equally strong among Republicans and Democrats and across geographic location, regardless of a state’s political leanings or policies around sex education. So, it’s actually not controversial topic, if you look at the research.

What does comprehensive sex education look like?


EVA GOLDFARB: Comprehensive sex education is evidence-informed, science-based, medically accurate, age and developmentally appropriate and culturally appropriate formal education that begins early and that builds sequentially throughout a young person’s life. It takes a much more holistic view of sexual health and a much broader view than merely the absence of unintended pregnancy and disease. It really goes into the knowledge and skills that young people can develop to help them have healthier, safe, enjoyable, respectful relationships throughout their lifetime. And what the research tells us is that, just like every other education area, sex education is most effective when it started early with foundational concepts that set the stage for more challenging, difficult concepts and discussions in middle and high school. So, just as no one would ever suggest that we introduce math for the first time with eighth grade algebra, the same is true for sex education. So, the kinds of things that are taught in early years of elementary school are things like body integrity. Every child gets to decide what they do with their own body and who gets to hug them. And if I tell you, I don’t want to hug you, then you have to respect that. That sets the stage for later conversations about sexual consent.

What outcomes do researchers see in communities where policies limit sex education or stress abstinence?


EVA GOLDFARB: The research is very clear that in states that do not support high-quality sex education and those that use an abstinence-only approach have worse sexual health outcomes than those states that do. States that teach about contraception, and safer sex, and STI prevention have lower rates of pregnancies and STIs. And states and regions that take an abstinence-only approach have high rates of pregnancies. The research is very clear on that.

What does sex education currently look like in classrooms across the United States?


EVA GOLDFARB: The big story, as far as I’m concerned, is not that sex education is too invasive or inappropriate for young people, or that it’s too advanced for young people, it’s that in truth most sex education is not up to par, either in its quality, or its comprehensiveness, or the amount of time that’s spent on it. So, just about every state has some sort of guidance, or mandates, and policies around sex education, what can be taught, what should be taught, and some have curricula or suggestions, but for the most part, those kinds of decisions about what is actually taught are left to local school districts and communities. And so, what kind of sex education the young person receives can very often depend on where they live, and not only where they live, but what schools they go to. So, two different schools in the same school district may treat the topic very, very differently. So, it’s really—because there’s no national mandate or guidance, it’s really a patchwork of policies and programs. And as a result, it can be highly influenced by a few very loud voices at the local level. You know, who makes the most noise can have an impact on what gets taught, rather than the science and the research. So, that’s a broad 30,000 foot view of sex education in the United States. There are, I should say, there are national sex education standards that are available for school districts, but again, there’s no federal policy or mandate on teaching sex education.

What does research show about the impacts of inclusive sex education?


EVA GOLDFARB: What we also know from the research is that sex education, when it is limited in scope to abstinence only to heterosexual students—and, you know, very excluding all other topics—not only is not effective, but it also can really cause harm to young people. Someone once said that a curriculum should be a balance of mirrors and windows, and everyone should be able to see themselves reflected in a curriculum and be able to see other people that they may not know and learn about them. And to the extent that we exclude certain topics, we are enforcing that certain things are taboo. We’re also not only keeping young people from having life-saving information, but we are stigmatizing and harming young people who are already marginalized. That’s leading to a lot of harm.

How are reporters doing covering sex education issues?

[Posted January 18, 2023 | Download video]