Survey highlights inadequate sexual health education for LGBTQ+ adolescents

Children across the United States who identify as LGBTQ+ say the sexual health education curricula they receive is leaving them without essential information to make informed decisions about their sexual health – which could force them to seek potentially dangerous advice elsewhere. 

The results of a new, national, peer-reviewed survey, show that these young people – aged 13 to 17 – believe crucial topics surrounding sexual orientation and gender identity are being omitted from sexual health education programs.

Experts who led the study – published today in The Journal of Sex Research, as people around the world celebrate Pride month – say the addition of key items in the curricula could be "life-saving". 

"The exclusion of LGBTQ+ students from the curricula may contribute to poor health outcomes in LGBTQ+ youth, with some research beginning to document these experiences and provide recommendations for curricula changes," explains lead author Steven Hobaica, a clinical psychologist and Research Scientist at The Trevor Project, whose mission is to end suicide among LGBTQ+ young people. 

"Addressing this negligence is urgent and could be life-saving.

"Given the current political climate, with legislation attempting to exclude LGBTQ+ information in schools, we encourage policymakers to continue fighting for LGBTQ+ inclusion in curricula as a means to prevent health problems for a vulnerable group."

Of more than 800 respondents to the survey, most participants reported a lack of LGBTQ+ content in their sexual health education experiences. In order to be educated on sexual health, most were using extracurricular sources including online spaces, friends, and personal experiences with sexual exploration. The authors found that these extracurricular sources are frequently preferred by LGBTQ+ youth; but may lack accuracy and reliability.

Overall, participants described feeling marginalized by curricula that were based on abstinence-only approaches, religious principles, or contained oppressive and suppressive elements – such as negative remarks about LGBTQ+ individuals or skipping required LGBTQ+ content altogether. 

"LGBTQ+ youth expressed a strong desire to learn more about topics related to their sexual orientation and gender identity, highlighting a critical gap in existing curricula," says co-author Dr. Erica Szkody, who is a Postdoctoral Research Associate, at the Lab for Scalable Mental Health, at Northwestern University.

"Despite the well-known benefits of comprehensive sexual health education, the majority of school sexual health education curricula in the U.S. is non-comprehensive and excludes LGBTQ+ students.

"Our analyses underscore the extent of this exclusion."

The survey also provided LGBTQ+ young people the opportunity to openly share on their experiences, as well as recommendations for change, in regard to sexual health education:

These suggestions included:

• More LGBTQ+ content in sexual health education curricula, as well as more detail on healthy and diverse relationships (e.g., non-monogamy, polyamory), consent, safety in relationships, and communication skills.
• Creating safe and supportive spaces, while considering legitimate fears due to a possible increase in bullying, as they had heard students make fun of the material or use discriminatory language during past implementation.
• Updating sexual health education materials to reflect LGBTQ+ lived experiences, history, and risk factors.
• Creating sexual health interventions focused on LGBTQ+ experiences and concerns.
• Improving access to reliable sexual health information.
• Creating more accessible sexual health information via other avenues, such as online and through mobile applications.

Summarizing their experiences of sexual health curricula in the U.S., LGBTQ+ study participants left heartfelt responses:

"I wish I was taught about gay sex, sexual orientation, and all the other controversial topics that [are deemed] 'grooming.' When kids aren't taught good sex ed, they learn how to do it in an unhealthy way from other sources like the internet or word of mouth. If we teach children about these topics, they'll be safer when they become teenagers," one said.

Another added: "I wish others understood that while the anatomy-related knowledge is important, we need sexual [health] education that is relevant to today's world. This involves sexual [health] education [about] dangers and safety on the Internet, [same-sex/gender] relations, and education geared towards attraction and feelings rather than a lesson only [regarding] heterosexual procreation. I wish they took our real-life experiences and insecurities into account."

One more exclaimed: "It is NOT HARMFUL to talk about gender identity and sexuality with high schoolers. It SAVES LIVES."

The authors hope that their findings contribute to a "critical" policy shift toward including LGBTQ+ young people in sexual health education, a community that is "often underserved". 

"By including the voices of LGBTQ+ young people in curricula design, we can not only provide the necessary knowledge for youth to engage in healthy relationships and health behaviors, but also can contribute to a more accepting and equitable society for years to come," states Hobaica.

Although this study incorporated quantitative and qualitative analyses with a large national sample of LGBTQ+ youth, it had limitations. "Given sample size constraints, we could not draw conclusions regarding recommendations from students with specific identities," explain the authors who state future work could collect similar data from even larger samples for further generalizability and comparisons.