Abstract
Adolescents are experiencing a crisis of disconnection, potentially due to a lack of understanding their own and others’ sexualities and heightened difficulty with developing and maintaining intimate relationships. These challenges may undermine adolescents′ sense of belonging and persist into adulthood. To prevent these issues from emerging in the first place, comprehensive sex education may function as a structural intervention by providing accurate and affirming information about diverse sexual identities and intimate relationships. Namely, all youth should receive comprehensive sex education that is culturally relevant, such that the instruction not only should be medically accurate and developmentally appropriate but also should engage students’ lived experiences. Reviewing the empirical base illustrates that comprehensive sex education can help adolescents understand their own and others’ sexual identities, foster belonging across diverse social groups, and develop fulfilling intimate relationships. Finally, policymakers and relevant stakeholders should advocate for nationwide standards for comprehensive sex education that require core evidence-based topics across states while allowing districts and schools to adapt the language, examples, and delivery to the students they serve. Given its established benefits, culturally relevant comprehensive sex education represents a promising structural intervention for promoting healthy development, belonging, and well-being across the life span.
Social Media
The debate over sex education has focused on pregnancy and STIs. But what if the larger issue is belonging—or the lack thereof? We argue that culturally relevant comprehensive sex education may help adolescents understand identity, navigate relationships, and thrive across the life span.
Key Points
Sex education in the United States primarily follows an abstinence-only or abstinence-plus curricula rather than a comprehensive one, despite the overwhelming support American adolescents and parents report for comprehensive sex education.
As research shows, comprehensive sex education is associated with greater appreciation of sexual diversity and healthier relationships in adolescents.
Comprehensive sex education as an early-life structural intervention may be more cost-effective than abstinence-only programs to address the adolescent mental health crisis.
Policymakers should create the legal landscape for school administrators and educators to assess local needs and deliver culturally relevant, comprehensive sex education.
Sexual health education, hereafter referred to as sex education, in the United States generally falls into three broad categories: abstinence-only education, abstinence-plus, and comprehensive sex education (National Public Radio, 2004; YouGov, 2015). Abstinence-only education promotes traditional values surrounding sexuality and emphasizes refraining from sexual activity until marriage. Abstinence-plus education similarly prioritizes abstinence but also provides limited information regarding safe-sex practices to prevent human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and unintended teenage pregnancies. Comprehensive sex education acknowledges abstinence as one approach to sexual behavior while additionally providing education regarding safe-sex practices, sexual and gender identity development, awareness of diverse sexual orientations, and intimate and romantic relationships.
Among these approaches, comprehensive sex education appears to be the most effective in promoting public-health outcomes. In evaluation studies, comprehensive sex education programs were associated with increases in condom use and reduced teenage pregnancies (Leung et al., 2019; Mark & Wu, 2022; United Nations Population Fund, 2026). In contrast, evaluations of publicly funded abstinence-only programs in at least 13 states have shown no positive changes in youth sexual behaviors over time (Hauser, 2004, 2008). In addition, in a meta-analysis of 56 studies that assessed 9 abstinence-based programs and 48 comprehensive programs, two in three comprehensive sex education programs (versus three of nine abstinence-based programs) were associated with reductions in risky sexual behaviors, including delaying initiation of sex and increased condom and contraceptive use among adolescents (Kirby, 2008; Leung et al., 2019).
Despite the public-health benefits tied to comprehensive sex education, this form of education is politically controversial in the United States. While 41 states require the provision of sex education, HIV education, or both (Guttmacher Institute, 2025b), such education is not comprehensive. Specifically, 43 states require programs to cover and stress abstinence, and only 26 states require that such education be medically accurate (Guttmacher Institute, 2025b). With almost half of states potentially receiving sex education that is medically inaccurate, far fewer are offering sex education that is comprehensive. Although eight states require instruction that is inclusive of sexual and gender identities, seven states require framing sexual orientations other than heterosexuality as shameful, unacceptable, or illegal; and 10 states prohibit any discussion of sexual orientation (Guttmacher Institute, 2025b).
These policies are in direct contrast with adolescents’ and their parents’ needs. Adolescents want comprehensive sex education, as documented in one focus-groups study of 46 racially/ethnically diverse students enrolled in Chicago Public Schools. Participants agreed with one another about the need for more LGBTQ + inclusive curricula, defined by them as one with greater inclusion of identity topics integrated throughout the school curriculum, more holistic discussions of sexuality, and more information about identity development (Jarpe-Ratner, 2020). In addition, in a nationally representative survey of parents conducted by Planned Parenthood (2023), most participants believed it important to teach sex education in middle school (84%) and in high school (96%). These parents also supported sex education covering a wide range of topics, including sexual orientation, gender identity and healthy relationships (Planned Parenthood, 2023). Uniquely, more parents of color support comprehensive sex education than White American parents, as the fight for bodily autonomy has been viewed as part of liberation and the Black empowerment movement (Walsh, 2024).
Nonetheless, parents who identify as conservatives in today's political system in the United States support comprehensive sex education at high rates. According to one politically diverse sample of 1,633 parents of children aged 9 to 21 years, over 78% of these parents supported a wide range of topics in sex education, including puberty, healthy relationships, abstinence, STIs, and birth control in middle school (Kantor & Levitz, 2017). The rate of support for including these topics in high school was even higher (i.e., over 89%), which was comparably high among both Republican and Democrat parents (Kantor & Levitz, 2017). Additionally, in a state-representative survey of 500 North Carolina parents, 90% of Democrats and 81% of Republicans favored schools providing comprehensive sex education (Kershner et al., 2013). Altogether, empirical data reveal a conundrum in which comprehensive sex education garners bipartisan support among individuals while remaining politically contentious at the policy level.
To contribute to ongoing policy discussions regarding sex education, available evidence suggests a need for comprehensive sex education to not only be mandated but also be designed in a way that is culturally relevant. Culturally relevant education engages students’ lived experiences and encourages them to question the status quo to improve the classroom environment, while also optimizing students’ engagement in the classroom (Arons & Laughter, 2016). Culturally relevant education, when applied to comprehensive sex education, can strengthen connections between curricula and students’ lived experiences (Kaley, 2020). This approach may enhance students’ comprehension of and access to course material, addressing criticisms that comprehensive sex education is culturally insensitive (Hodder-Shipp, 2026).
To understand the utility of culturally relevant, comprehensive sex education, the current review illustrates the challenges youth are experiencing today. These challenges relate to their understanding of their own and others’ sexualities and romantic contexts. Many of these challenges are connected to racism, sexism, and heterosexism that disadvantage minoritized groups, including sexual minoritized youth color, and socially privileged groups of youth, including cis-gender heterosexual White boys. Highlighting these youth's unique and universal challenges recognizes both difference and commonality (Cole, 2009; Crenshaw, 1991), which is critical for understanding how culturally relevant sex education can support adolescents broadly. Whereas existing arguments emphasize how sex education can improve the experiences of girls of color (Jerald & Romanovska, 2026), the current review extends this perspective and demonstrates that comprehensive sex education is associated with better functioning in three psychosocial domains: sexual-identity exploration, attitudes toward sexual minorities, and romantic-relationship formation. Tangible recommendations for policy follow.
Addressing Adolescent Developmental Challenges Through Culturally Relevant Comprehensive Sex Education
Adolescents face challenges related to sexual identity development, stigma toward sexual minority youth, and romantic relationships. These challenges are not reserved for minoritized youth but are also detrimental for youth of all demographic backgrounds (Goldfarb & Lieberman, 2021). These challenges underscore an instrumental rational for relevant stakeholders, including policymakers: Effectively addressing adolescents’ challenges may require replacing abstinence-only education with culturally relevant comprehensive sex education. As empirical evidence suggests, equity-oriented school-based interventions centering marginalized youth leave majority-group students no worse off and, in some cases, better off (Stephens et al., 2012; Umaña-Taylor et al., 2018; Wang et al., 2023).
Sexual Minority Identities
Sexual minority youth reflect a larger population now than ever before. In a meta-analysis of 30 studies conducted between 1987 and 2015 with 26,706 participants, sexual minoritized youth, on average, questioned their sexual orientations at age 13 and, on average, “came out” at age 20 (Hall et al., 2021). Relative to then, more sexual minority youth today are disclosing their sexual identities at earlier ages. In 2021, a nationally representative survey of 17,232 teenagers ages 14 to 18 revealed that 26% of youth identified as sexual minorities, which is an increase from an 11% observed in 2015 (Mpofu, 2023). With roughly one-in-four youth self-identifying as sexual minorities, this diversity within the youth population suggests a need for adolescents to receive information to understand their sexual identities and preferences.
Making information about sex-related preferences publicly accessible can dismantle social barriers to youth interested in exploring their sexual identities. Exploring and identifying with a sexual minority identity can be conceptualized as a privilege, as research illustrates associations between minoritized sexual orientations and indicators of high socioeconomic status (e.g., high educational attainment). In one 2020 study conducted by the Pew Research Center, countries with higher gross domestic products per capita (GDPs) were associated with greater country-level aggregates of individuals’ self-reported acceptance of homosexuality (Poushter & Kent, 2020). Even at the individual level within the United States, a similar phenomenon emerged: in a study of 11,868 early adolescents, sexual minority adolescents were more likely than their same-aged heterosexual peers to live in households where parents had more advanced levels of education (Del Toro et al., 2026a). Thus, conceptualizing sexual identity exploration as a privilege and an outcome of economic equity corroborates the central thesis that everyone has a right to explore and learn about their sexual preferences.
In addition to intersecting with socioeconomic status, sexual orientation intersects with race/ethnicity, illustrating that sexual identity exploration is shaped not only by individual predispositions but also by broader sociocultural contexts. Puberty may serve as one developmental precursor to sexual identity exploration, as adolescents become increasingly aware of sex-related preferences and are more likely to be perceived by others as romantically or sexually eligible (Del Toro et al., 2026a; Dorn & Susman, 2019). Consistent with this perspective, earlier pubertal timing has been associated with earlier self-identification as a sexual minority (Papke et al., 2025). Yet, despite evidence that Black youth tend to experience puberty earlier than White youth (Carter & Seaton, 2025; Osinubi et al., 2022), Black youth are less likely than White youth to self-identify as a sexual minority during early adolescence (Del Toro et al., 2026a). Altogether, these patterns suggest that sexual identity development is shaped not only by biological maturation, but also by racialized sociocultural contexts that influence whether adolescents feel able, safe, or supported in exploring and disclosing sexual minority identities.
These racial/ethnic group differences in puberty and sexual orientation may reflect group differences in access to comprehensive sex education. Due to socioeconomic status, racial/ethnic groups differ in their access to comprehensive sex education. According to a report by the Sexuality Information and Education Council of the United States (SIECUS), young people who received no sex education, on average, tended to be Black and from low-income families, whereas young people who received comprehensive sex education, on average, tended to be White and from higher-income families (SIECUS, 2008). These group differences in the quality of education between predominantly Black schools (that are relatively under-resourced) and predominantly White schools (that are more socioeconomically affluent) has been attributed to racial-economic segregation (Martz et al., 2024). Low-income schools, where Black youth are disproportionately over-represented, receive less state and local funding, directly hindering the implementation of comprehensive sex education. Thus, conceptualizing comprehensive sex education as a structural resource that is inequitably distributed should further corroborate the need to have it more equitably distributed.
Attitudes Toward Sexual Minorities
While increased rates of sexual minorities in today's adolescent population relative to prior generations of adolescents can be attributable to progress in societal acceptance toward sexual minorities, this may be faltering. Drawing on data from 7.1 million Americans collected from 2007 to 2020, one study found that anti-gay biases decreased throughout this period, on average, by roughly 65% to 75% (Charlesworth & Banaji, 2022). However, using similar sources of data collected from 2.5 million Americans from 2021 to 2024, anti-gay biases reversed and rose by around 10% (Charlesworth & Finkel, 2026). To the researchers’ surprise, these increases in anti-gay biases were observed in Americans ages 25 years and under, whose anti-gay biases rose more sharply than those of older Americans. Thus, a comprehensive sex education that reviews sexual identities may be needed now more than ever, as exposure to and familiarity with sexual diversity is linked to lower biases (Kesler et al., 2023; Pettigrew & Tropp, 2006).
The absence of comprehensive sex education can perpetuate stereotypes of and biases against sexual minorities. In a qualitative study of 191 sexual minoritized adults, one-in-four adults recalled the school-based sexuality education experiences that they received during their adolescent years (Bishop et al., 2021). In their recollections, participants described receiving misinformation about HIV/AIDS, including information that perpetuated stereotypes linking a high prevalence of acquiring HIV/AIDS with sexual minoritized populations and people of color (Bishop et al., 2021). In addition, participants recollected that sex education in their schools used scare-tactics that invoked shame and prejudice toward youth's curiosity regarding sexual minority identities (Bishop et al., 2021). Another qualitative study of 12 sexual minoritized adults recollected similar shame-based scare tactics during their adolescent years that left them afraid of sex-related experiences (Hobaica & Kwon, 2017).
Misinformation and shame-based curricula regarding sexual minorities perpetuates stigma affecting both sexual minority and heterosexual youth alike, uniquely for cis-gender heterosexual boys. Extensive qualitative work with secondary-school aged heterosexual boys reveals that participants in middle adolescence learn to dismiss their close friendships with other boys to avoid being mislabeled as a sexual minority, even though participants continued to want close friendships with other boys (Way, 1997, 2011). These qualitative results with adolescents were recently replicated in a study with 3,215 adults (Xue et al., 2025). Here, men, more than women, avoided shared experiences (e.g., going to the movies and sharing food) with others of the same gender, and this pattern was driven by men feeling more apprehensive about signaling same-gender romance in platonic relationships, compared to women (Xue et al., 2025). Even after controlling for how hedonic, enjoyable, and feminine the activities were, these results persisted (Xue et al., 2025). Such robustness suggests that men's reluctance to share experiences with other men reflects broader masculine norms rather than merely individual preferences (Xue et al., 2025). This distance from same-gendered peers is thought to contribute to men's experienced loneliness, as one nationally representative survey conducted by the Survey Center on American Life found: almost one-in-five (17%) men have zero close friends (Graham-Felsen et al., 2025). Thus, destigmatizing sexual minority identities via comprehensive sex education can expand such education's beneficiaries from not only sexual minority youth but also their heterosexual peers. Moreover, from a developmental perspective, comprehensive sex education can be an early-life intervention to destigmatize sexual minority identities and dismantle societal narratives around masculinity, ultimately allowing boys (who will eventually age into adulthood) to pursue and maintain close same-sex relationships.
Romantic Relationships
With fewer youth making friendships, then it comes as no surprise that fewer youth today are developing romantic partnerships. According to a nationally representative sample of 5,055 adults ages 18 and up in the United States, 46% of Gen Z adults reported having had a boyfriend or girlfriend as a teenager, and this rate for having had a partner as a teenager was true for 69% of millennials, 76% for Generation Xers, and 78% of baby boomers (Cox et al., 2023). These generational differences can be explained by many factors, such as the role of technology that detracts youth from formulating meaningful in-person contact with others (Cox et al., 2023). Implications are discussed regarding the lack of romantic partnerships in adolescence and how these partnerships are inequitably distributed across intersecting racial/ethnic and gender groups.
Experiences in adolescence can have downstream implications for outcomes in adulthood (Giordano et al., 2015; Manning et al., 2014). For example, in the aforenoted nationally representative sample of 5,055 adults in the United States, 62% of Americans who had a steady partner during adolescence were married as adults, but this rate held for only 46% of Americans who did not have a steady partner during adolescence (Cox et al., 2023). Additionally, in one longitudinal study surveying a random sample of 324 adolescents from Ohio at ages 18–19 and again five years later, the number of dating partners with whom the individual was sexually active with was associated with an increased odds of intimate partner violence and relationship churning (i.e., breaking up and getting back together with the same partner) in adulthood (Manning et al., 2014). Among these same 324 adolescents, sexual non-exclusivity in adolescence was associated with lower relationship quality in adulthood (Manning et al., 2014). Collectively, these findings underscore that adolescent romantic experiences may carry long-term implications for adult relational well-being, positioning comprehensive sex education as a developmental context for promoting healthier relationship trajectories.
Furthermore, the rates of adolescents entering romantic partnerships are not equitably distributed across groups at the intersection of race/ethnicity and gender. Specifically, in adolescent-aged samples, particularly nationally representative data from the National Longitudinal Survey of Adolescent to Adult Health (i.e., Add Health), Black American girls were less likely to be in a romantic relationship than White American girls, but the inverse was true for boys, among whom Black American boys were more likely to be in a romantic relationship than White American boys (Raley & Sullivan, 2010). This intersectional finding is the opposite among Asian American adolescents, who were the least likely to be currently dating and having ever dated than all other racial/ethnic groups (Cutri et al., 2025), and this was uniquely the case for Asian American boys (Balistreri et al., 2015; Dryburgh et al., 2026).
These intersectional patterns persist into adulthood. In a study of adults, Black women and Asian men were the least pursued in romantic partnership formation (Rudder, 2014). Specifically, in an analysis of online dating profiles, users were less likely to positively evaluate as possible eligible partners and directly engage with Black women and Asian men relative to Black men and Asian women, respectively (Rudder, 2014).
The psychology driving the intersecting racial/ethnic and gender group differences is tied to how different racial/ethnic groups are sexualized. Specifically, Black Americans are viewed by society as more hypermasculine than other racial/ethnic groups, whereas Asian Americans are viewed by society as more effeminate relative to other racial/ethnic groups (Hughes et al., 2017; Way, 2011). This societal lens of hypermasculinity toward Black Americans disadvantages Black American girls, and how Asian Americans are effeminized by society disadvantages Asian American boys. These stereotypes shape how others approach these intersectional groups, as 12% of Black American women have a spouse of a different racial/ethnic group relative to 24% of Black American men, whereas 36% of Asian American women have a spouse of a different racial/ethnic group relative to 21% of Asian American men, according to a nationally representative survey of 1,778 adults (Livingston & Brown, 2017). These inter-racial relationships are more likely to be with White partners (Belot & Fidrmuc, 2010; Livingston & Brown, 2017). These findings underscore how racialized standards of attractiveness may differentially position adolescents within the romantic landscape, suggesting that comprehensive sex education may promote more inclusive and egalitarian comprehensions of beauty, desirability, and relationships.
Discussing the observed romantic-partnership involvement across racial/ethnic and gender groups is not intended to discourage inter-racial dating but rather to call attention to inequities experienced in romantic-relationship involvement. Specifically, the American adolescent population is a majority-minority demographic, in which White American adolescents are now the numerical minority (Witherspoon & Stein, 2023). For this reason, by sheer numbers alone, adolescents of color regardless of race/ethnicity and gender should be in similar rates of, if not more, romantic relationships than their White American counterparts, especially considering the possible role of racial/ethnic homophily. Because racial/ethnic homophily does not appear to sufficiently explain observed patterns of romantic-relationship involvement across intersections of race/ethnicity and gender, structural and sociocultural influences—particularly media messages that reinforce White standards of beauty—may better account for these disparities (Roberts & Rizzo, 2021). Thus, explicit messaging within comprehensive sex education that promotes inclusive and egalitarian representations of beauty (Nagoski, 2015) may help reduce racialized disparities in perceptions of attractiveness and romantic desirability.
Recommendations for Policy
The positive outcomes linked to comprehensive sex education are unequivocal. According to a systematic review of 80 empirical studies, comprehensive sex education was associated with greater awareness and appreciation of sexual diversity and the development of healthy relationships (Goldfarb & Lieberman, 2021). Given that empirical studies have revealed promising outcomes associated with comprehensive sex education, policymakers and relevant stakeholders should consider the following two policy recommendations.
Recommendation #1: Implement Nationwide Comprehensive Sex Education Standards
Comprehensive sex education should be conceptualized and implemented as a structural intervention. Much of the existing literature frames sex education as an individual- or school-level program; however, the inequities described throughout this manuscript suggest that access to high-quality sex education is itself structured by broader policy and socioeconomic conditions. States vary widely in whether sex education is mandated, medically accurate, or inclusive of sexual and gender diversity (Guttmacher Institute, 2025b), thereby reproducing inequities in adolescents’ access to critical developmental resources. As such, policy efforts should focus on establishing nationwide standards that require comprehensive, medically accurate, and culturally relevant sex education across all schools.
Notably, the present call for standardized comprehensive sex education should not be interpreted as advocating for a rigid, one-size-fits-all curriculum implemented uniformly across the country. Rather, this call refers to ensuring that core topics (e.g., healthy romantic relationships) are consistently addressed, while allowing the language, framing, and delivery of content to remain relevant to the cultural and contextual needs of specific communities. The present call for comprehensive sex education to be standardized as a culturally relevant pedagogical practice leads us to our next recommendation for policymakers.
Recommendation #2: Curtail Anti-Critical Race Theory Legislation
Comprehensive sex education should be culturally relevant. However, thirty states have imposed policies banning discussions about race/ethnicity in K-12 education (e.g., Stop Wrongs to Our Kids and Employees, WOKE, Act in Florida). The basis for these bans stem from beliefs, like those reflected in Executive Order 13950, that school-based lessons about race/ethnicity may foster stereotypes among youth and create divisions among them based on group differences (Watkins, 2021). These bans target Critical Race Theory (CRT; i.e., the ideology that race is a social construct and racism is the product of individual, institutional, and political prejudices) and were driven by families’ and policymakers’ concerns that CRT in schools may ostracize White students following the period of racial unrest in 2020. In 2025, United States President Donald J. Trump released Executive Order #14190, Ending Radical Indoctrination in K-12 Schools, threatening to cancel federal funds in the event that a K-12 school promotes equity-focused ideology. These policies have sparked fear among educators who now avoid discussions of any issues even closely related to CRT (PEN America, 2024), including culturally relevant education (Najarro, 2022), which universally benefits adolescents (Bardach et al., 2024; Del Toro et al., 2026b; Gay, 2018; Ladson-Billings, 1995).
Absence of culturally relevant education may perpetuate existing racial/ethnic inequities in youth's relational and sexual development. Recall that youth's sexual identity development, attitudes toward sexual minorities, and romantic relationship experiences are unevenly distributed across social groups and reflect structural inequities. To address these inequities, curricula should explicitly acknowledge how youth's experiences with sexuality are shaped by intersecting systems of racism, sexism, and heterosexism. Comprehensive sex education should incorporate materials that reflect diverse racial/ethnic, gender, and sexual identities; challenge narratives that privilege whiteness, heteronormativity, and traditional gender roles; and provide opportunities for youth to critically engage with how societal structures shape their experiences.
Conclusion
Policymakers should create the legal landscape for school administrators and educators to assess local needs and deliver culturally relevant comprehensive sex curricula. Implementation will require coordinated action from state legislators, state departments of education, school districts, administrators, educators, and community stakeholders, including parents and students. Although developing culturally relevant curricula and providing educator training require upfront investments, these costs are relatively modest compared with the potential societal benefits of improved developmental outcomes that matter for all adolescents: for example, reduced risky sexual behaviors (Leung et al., 2019), healthier platonic and romantic relationships (Rice et al., 2017), and better overall mental health (Proulx et al., 2019). These developmental outcomes may otherwise worsen with each successive generation of youth via abstinence-only curricula, which the federal government spends up to $110 million per year on (Guttmacher Institute, 2025a). Redirecting these federal funds from abstinence to comprehensive sex education will not only follow a moral rationale of fostering healthy adolescent development but will also represent a more cost-effective use of public resources.
Adolescents’ sexual development does not occur in a vacuum; it unfolds within a social and structural ecology shaped by intersecting systems of racism, sexism, and heterosexism that differentially constrain opportunities to explore identity, form relationships, and experience belonging. Across psychosocial outcomes, such as sexual-identity development, attitudes toward sexual minorities, and romantic relationships, the evidence reviewed in this article underscores both the unique and shared challenges adolescents face—and how these challenges are patterned by structural inequities rather than individual deficits. Comprehensive sex education that is culturally relevant offers a promising, yet underutilized, structural intervention to address these disparities at scale. By providing accurate information, affirming diverse identities, and challenging harmful social norms, such education has the potential not only to improve individual-level health and psychosocial outcomes but also to shift broader cultural narratives that reproduce inequities. Moving forward, aligning policy, research, and practice around the implementation of nationwide, standardized, and culturally relevant comprehensive sex education is not simply a matter of improving curricula—it is a matter of advancing equity, fostering healthy development, and promoting liberty and justice for all adolescents.
Footnotes
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
