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National SexualityEducation StandardsCore Content and Skills, K–12

Special thanks to the following organizations for theirpartnership in developing and disseminating the NationalSexuality Education Standards: Content and Skills, K–12:The American Association of Health Education (www.aahperd.org/aahe) serves educators and other professionalswho promote the health of all people through educationand health promotion strategies.The American School Health Association (www.ashaweb.org) works to build the capacity of its members to plan,develop, coordinate, implement, evaluate and advocate foreffective school health strategies that contribute to optimalhealth and academic outcomes for all children and youth.The National Education Association – Health InformationNetwork (www.neahin.org) works to improve the healthand safety of the school community through disseminatinginformation that empowers school professionals andpositively impacts the lives of their students.The Society of State Leaders of Health and PhysicalEducation (www.thesociety.org) utilizes advocacy,partnerships, professional development and resources tobuild the capacity of school health leaders to implementeffective health education and physical education policiesand practices that support success in school, work and life.The Future of Sex Education (FoSE) Initiative is apartnership between Advocates for Youth, Answer andthe Sexuality Information and Education Council of theU.S. (SIECUS) that seeks to create a national dialogueabout the future of sex education and to promote theinstitutionalization of comprehensive sexuality educationin public schools. To learn more, please visitwww.futureofsexed.org.This publication was generously supported by a grant froman anonymous source and The George Gund Foundation.The partners wish to thank Danene Sorace, consultant to theFoSE Initiative for her hard work and dedication. 2011 the Future of Sex Education InitiativeSuggested citation: Future of Sex Education Initiative. (2012).National Sexuality Education Standards: Core Content andSkills, K-12 [a special publication of the Journal of SchoolHealth]. Retrieved from -fose-standards-web.pdf

Table of ContentsNational Sexuality Education Standards:Core Content and Skills, K–12 Advisory Committee4Additional Reviewers5Introduction and Background6Rationale for Sexuality Education in Public Schools7The National Sexuality Education Standards8Role of Education Standards8Goal of the National Sexuality Education Standards9Guiding Values and Principles9Theoretical Framework9Topics and Key to Indicators10Standards by Grade Level12Standards by Topic Area24National Resources37For Teachers36For School Administrators38For Parents38For Middle and High School Students38Glossary39References41

National Sexuality Education StandardsNational Sexuality Education Standards:Core Content and Skills, K–12 Advisory CommitteeLaurie Bechhofer, MPHHIV/STD Education ConsultantMichigan Department of EducationRobert McGarry, EdDDirector of Training and Curriculum DevelopmentGay, Lesbian and Straight Education Network (GLSEN)Nora Gelperin, MEdDirector of TrainingAnswerLinda MooreActing Executive DirectorAmerican Association for Health EducationEva Goldfarb, PhD, LHD (hon)ProfessorMontclair State UniversityLinda Morse, RN, NJ-CSN, MA, CHESPresident ElectAmerican School Health AssociationMal Goldsmith, PhD, MCHES, FASHA, FAAHEProfessor EmeritusSouthern Illinois UniversityBuzz Pruitt, EdDProfessorTexas A&M UniversityDebra Hauser, MPHExecutive Vice PresidentAdvocates for YouthMonica Rodriguez, MSPresident & CEOSexuality Information and Education Council of the UnitedStates (SIECUS)Nora L. Howley, MAManager of ProgramsNational Education Association–Health InformationNetworkDeborah Roffman, MS, CSESexuality Educator and ConsultantThe Park School of BaltimoreBarbara Huberman, RN, BSN, MEdDirector of Education and OutreachAdvocates for YouthElizabeth Schroeder, EdD, MSWExecutive DirectorAnswerLeslie M. Kantor, MPHDirector of National Education InitiativesPlanned Parenthood Federation of AmericaJennifer Heitel YakushDirector of Public PolicySexuality Information and Education Council of the UnitedStates (SIECUS)Kyle Lafferty, MPH, MST, CHESHIV Program DirectorThe Society of State Leaders of Health and PhysicalEducation4Danene Sorace, MPPConsultant, Future of Sex Education Initiative

Additional ReviewersAdditional ReviewersDrafts of the sexuality education core content and skillsdocument were reviewed by a diverse group of professionals with expertise in sexuality, public education, publichealth, child and adolescent medicine, and psychology. Wewish to thank these individuals for their work:Nancy Hudson, RN, MS, CHES, Council of Chief StateSchool OfficersJeNeen Anderson, MPH, National Association of StateBoards of EducationEmily Kitchen, Indiana University StudentDeborah Arrindell, American Social Health AssociationElissa M. Barr, PhD, University of North FloridaHeather Boonstra, Guttmacher InstituteDiane Brown, EdD, Widener UniversityKim Robert Clark, DrPH, San Bernardino CountySuperintendent of Schools, CALinda Juszczak, National Assembly on School-BasedHealth CareMaureen Kelly, Planned Parenthood of the SouthernFinger LakesDouglas Kirby, PhD, ETR AssociatesCynthia Lam, Sex, Etc. Teen Editorial StaffJessica Lawrence, MS, Bogli Consulting, Inc.Konstance McCaffree, PhD, CFLE, CSE, Widener UniversityRonna Popkin, MS, Columbia UniversityValerie Rochester, Black Women’s Health ImperativeStephen Conley, PhD, American School Health AssociationJohn Santelli, MD, MPH, Columbia UniversitySam Dercon, Sex, Etc. Teen Editorial StaffDebra Shapiro, Society for Public Health EducationBonnie J. Edmondson, EdD, Connecticut State Departmentof EducationSamantha Shinberg, Advocates for Youth InternBarb Flis, Parent Action for Healthy Kids, MIVeronica Bayetti Flores, National Latina Institute forReproductive HealthElizabeth Gallun, MA, Prince George’s County PublicSchools, MDMelissa Grigal, East Brunswick School District, NJThe Rev. Debra W. Haffner, MPH, M.Div., Religious InstituteBonni C. Hodges, PhD, State University of New York Collegeat CortlandHeather Holaday, District of Columbia Public SchoolsSusan Telljohann, HSD, CHES, University of ToledoMelanie Tom, Asian Communities for Reproductive JusticeAl Vernacchio, MSEd, Friends’ Central School, PAJenna Weiss, University Middle School, NJDavid Wiley, PhD, Texas State UniversityKelly Wilson, PhD, CHES, Texas State UniversityPam Wilson, MSW, Sexuality Educator and TrainerSusan N. Wilson, MSEd, Sexuality Education ConsultantMichael Young, PhD, FAAHB, New Mexico State UniversityMark Huffman, MTS, Independent Trainer and ConsultantPete Hunt, MPH, MEd, Centers for Disease Control andPrevention (CDC),Division of Adolescent and School HealthThe reviewers above provided many valuable commentsto the draft documents. Organizational affiliations areincluded for identification purposes only.5

National Sexuality Education StandardsIntroduction and BackgroundThe goal of the National Sexuality Education Standards:Core Content and Skills, K–12 is to provide clear, consistentand straightforward guidance on the essential minimum,core content for sexuality education that is developmentally and age-appropriate for students in grades K–12.Thedevelopment of these standards is a result of an ongoinginitiative, the Future of Sex Education (FoSE). Forty individuals from the fields of health education, sexuality education, public health, public policy, philanthropy and advocacy convened for a two-day meeting in December 2008to create a strategic plan for sexuality education policy andimplementation. A key strategic priority that emerged fromthis work was the creation of national sexuality educationstandards to advance the implementation of sexualityeducation in US public schools. Provide a clear rationale for teaching sexuality education content and skills at different grade levels thatis evidence-informed, age-appropriate and theorydriven. Support schools in improving academic performanceby addressing a content area that is both highly relevant to students and directly related to high schoolgraduation rates. Present sexual development as a normal, natural,healthy part of human development that should be apart of every health education curriculum. Offer clear, concise recommendations for school personnel on what is age-appropriate to teach studentsat different grade levels. Translate an emerging body of research related toschool-based sexuality education so that it can be putinto practice in the classroom.Specifically, the National Sexuality Education Standardswere developed to address the inconsistent implementation of sexuality education nationwide and the limited timeallocated to teaching the topic. Health education, whichtypically covers a broad range of topics including sexualityeducation, is given very little time in the school curriculum. According to the School Health Policies and PracticesStudy, a national survey conducted by the Centers forDisease Control and Prevention’s Division of AdolescentSchool Health to assess school health policies and practices, a median total of 17.2 hours is devoted to instruction inHIV, pregnancy and STD prevention: 3.1 hours in elementary, 6 hours in middle and 8.1 hours in high school.1The National Health Education Standards2 (NHES) heavily influenced the development of the National SexualityEducation Standards. First created in 1995 and updated in2007, the NHES were developed by the Joint Committee onNational Health Education Standards of the American Cancer Society and widely adopted by states and local schooldistricts. The NHES focus on a student’s ability to understand key concepts and learn particular skills for using thatcontent. These standards were developed to serve as theunderpinning for health education knowledge and skillsstudents should attain by grades 2, 5, 8 and 12. The NHESdo not address any specific health content areas, including content for sexuality education.Given these realities, the National Sexuality EducationStandards were designed to: Outline what, based on research and extensive professional expertise, are the minimum, essential contentand skills for sexuality education K–12 given studentneeds, limited teacher preparation and typically available time and resources. Assist schools in designing and delivering sexuality education K–12 that is planned, sequential and part of acomprehensive school health education approach.The National Sexuality Education Standards were furtherinformed by the work of the CDC’s Health Education Curriculum Analysis Tool (HECAT)3; existing state and international education standards that include sexual health content;the Guidelines for Comprehensive Sexuality Education:Kindergarten – 12th Grade4; and the Common Core StateStandards for English Language Arts and Mathematics5,recently adopted by most states.6

Rationale for Sexuality Education in Public SchoolsRationale for SexualityEducation in Public SchoolsFor years, research has highlighted the need to provideeffective, comprehensive sexuality education to youngpeople. The US has one of the highest teen pregnancyrates in the industrialized world.6 Each year in the US,more than 750,000 women ages 15–19 become pregnant,7with more than 80 percent of these pregnancies unintended.8 Furthermore, while young people in the US ages15–25 make up only one-quarter of the sexually activepopulation, they contract about half of the 19 million sexually transmitted diseases (STDs) annually. This equates toone in four sexually active teenagers contracting a sexuallytransmitted disease each year.9 And young people ages13–29 account for about one-third of the estimated 50,000new HIV infections each year, the largest share of any agegroup.10There is also a pressing need to address harassment, bullying and relationship violence in our schools, which havea significant impact on a student’s emotional and physicalwell-being as well as on academic success. According tothe 2009 National School Climate Survey, nearly 9 out of10 lesbian, gay, bisexual or transgender (LGBT) studentsreported being harassed in the previous year. Two-thirds ofLGBT students reported feeling unsafe and nearly one-thirdskipped at least one day of school because of concernsabout their personal safety. LGBT students who reportedfrequent harassment also suffered from lower grade pointaverages.11Similarly, teen relationship violence continues to be apressing problem. Although frequently under-reported, tenpercent of teens are physically harmed by their boyfriendor girlfriend in a given year.12Studies have repeatedly found that health programs inschool can help young people succeed academically.The most effective strategy is a strategic and coordinatedapproach to health that includes family and communityinvolvement, school health services, a healthy schoolenvironment and health education, which includes sexuality education.13 14 15 In fact, an extensive review of schoolhealth initiatives found that programs that included healtheducation had a positive effect on overall academic outcomes, including reading and math scores.15Evaluations of comprehensive sexuality education programs show that many of these programs can help youthdelay the onset of sexual activity, reduce the frequency ofsexual activity, reduce the number of sexual partners, andincrease condom and contraceptive use.16 17 Researchersrecently examined the National Survey of Family Growth todetermine the impact of sexuality education on sexual risktaking for young people ages 15-19, and found that teenswho received comprehensive sexuality education were 50percent less likely to report a pregnancy than those whoreceived abstinence-only education.18The CDC has also repeatedly found that student healthbehaviors and good grades are related, stating: “ studentswho do not engage in health-risk behaviors receive highergrades than their classmates who do engage in health-riskbehaviors.”19Further, studies show that physical and emotional healthrelated problems may inhibit young people from learningby reducing their motivation to learn; diminishing theirfeelings of connectedness to school; and contributing toabsenteeism and drop out.13 20An example related to sexuality education is teen pregnancy.Teen pregnancy often takes a particular toll on school connectedness for both partners, representing a major disruption in many teens’ lives and making it difficult to remainin and/or engaged in school. Many pregnant and parentingteens experience lower grades and higher dropout ratesthan their non-parenting peers. In fact, research showsthat only 51 percent of pregnant and parenting teensgraduate from high school as compared to 89 percent oftheir non-pregnant and parenting peers.21Given the evidence that connects lower risk behaviorsto academic success, schools clearly have as vested aninterest in keeping students healthy as do parents andother community members. In providing comprehensivesexuality education programs, schools support studenthealth and as such further foster young people’s academicachievement.Parents overwhelmingly favor comprehensive sexuality education in public school at the national and state7

National Sexuality Education Standardslevels.22 23 24 25 In 2004, National Public Radio (NPR), theKaiser Family Foundation and the Kennedy School of Government released a poll that indicated: Ninety-three percent of parents of junior high schoolstudents and 91 percent of parents of high school students believe it is very or somewhat important to havesexuality education as part of the school curriculum. Ninety-five percent of parents of junior high schoolstudents and 93 percent of parents of high schoolstudents believe that birth control and other methodsof preventing pregnancy are appropriate topics forsexuality education programs in schools. Approximately 75 percent of parents believed thatthe topic of sexual orientation should be included insexuality education programs and “discussed in a waythat provides a fair and balanced presentation of thefacts and different views in society.” Eighty-eight percent of parents of junior high schoolstudents and 85 percent of parents of high school students believe information on how to use and where toget contraceptives is an appropriate topic for sexualityeducation programs in schools.26The National Sexuality Education Standards set forth minimum, essential sexuality education core content and skillsresponsive to the needs of students and in service to theiroverall academic achievement and sexual health. Theyfulfill a key recommendation of the White House Office ofNational AIDS Policy’s National HIV and AIDS Strategy forthe United States, which calls for educating all Americansabout the threat of HIV and how to prevent it. This recommendation includes the goal of educating young peopleabout HIV and emphasizes the important role schools canplay in providing access to current and accurate information. The strategy notes that it is important to provideaccess to a baseline of information that is grounded in thebenefits of abstinence and delaying or limiting sexual activity, while ensuring that youth who make the decision tobe sexually active have the information they need to takesteps to protect themselves.27In addition, the National Sexuality Education Standards satisfy a key recommendation of the Office of the SurgeonGeneral’s National Prevention and Health PromotionStrategy, which calls for the provision of effective sexualhealth education, especially for adolescents. This strategynotes that medically accurate, developmentally appropriate, and evidence-based sexual health education providesstudents with the skills and resources that help them makeinformed and responsible decisions.28National SexualityEducation StandardsThe Role of Education StandardsEducational standards are commonplace in public education and are a key component in developing a rich learningexperience for students. The purpose of standards in general is to provide clear expectations about what studentsshould know and be able to do by the conclusion of certaingrade levels. Other equally important components of thestudent learning experience include pre-service teachertraining, professional development and ongoing supportand mentoring for teachers, clear school policies that support sexuality education implementation and the teacherswho deliver sexuality education, a sequential, age-appropriate curriculum that allows students to practice key skillsand assessment tools for all of these elements.Standards are an important part of the educational process, but they do not provide specific guidance on how atopic area should be taught. They also generally do notaddress special needs students, students for whom Englishis their second language, or students with any of the otherunique attributes of a given classroom or school setting.In addition, although recommendations made here arebased on grade level, children of the same age often8develop at different rates and some content may need tobe adapted based on the needs of the students.Sexuality education standards specifically should accomplish the following: Provide a framework for curriculum development,instruction and student assessment. Reflect the research-based characteristics of effectivesexuality education. Be informed by relevant health behavior theories andmodels. Focus on health within the context of the world inwhich students live. Focus on the emotional, intellectual, physical andsocial dimensions of sexual health. Teach functional knowledge and essential personaland social skills that contribute directly to healthysexuality. Focus on health promotion, including both abstinencefrom and risk reduction pertaining to unsafe sexualbehaviors. Consider the developmental appropriateness of material for students in spec

National Sexuality Education Standards Introduction and Background The goal of the National Sexuality Education Standards: Core Content and Skills, K–12 is to provide clear, consistent and straightforward guidance on the essential minimum, core content for sexuality education that is developmen-

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