An Inclusive Approach to Sex Education

Comprehensive sex ed isn’t just about being physical. It’s also about helping teens form healthy relationships, according to experts

The type of sex education each of us received as a teenager depended a lot on the place we grew up. In the U.S., for example, requirements for sex education in schools vary widely by state. Cultural practices and our parents’ beliefs likely also played a role in what we learned, as did our friends and the internet. 

“The sources where people get sex information is very variable and the quality ranges quite a lot,” said Eileen Crehan, an assistant professor in the Eliot-Pearson Department of Child Study and Human Development at Tufts University.

In many cases, school-based sex education programs have focused primarily on the medical aspects, such as learning the names of body parts or understanding different sexually transmitted infections (STIs). But research has shown that age-appropriate, comprehensive sex education—which focuses on interpersonal connections as well as physical health—can do more than simply reduce pregnancy rates and prevent STIs. It helps young people develop healthy relationships, improves social and emotional learning, expands understanding of gender and sexual diversity, and reduces dating and intimate partner violence. 

“The medical aspects are obviously important to know, but before you get to the point of potentially contracting an STI, a lot of social stuff has to happen. How do you flirt with someone? How do you navigate consent?” Crehan said. 

Crehan’s research centers around improving access to effective sex education and developing better measurement tools to study it, particularly in relation to people with autism. One of her studies, which used an evidence-based sex education program developed in the Netherlands, focuses in large part on the social aspects of relationships, breaking down the sort of ‘unwritten rules’ about dating and sexuality. 

“There’s this stigma that autistic people don’t want relationships or aren’t social and those ideas are false,” Crehan said. “A lot of times, people with disabilities aren’t given information about sex ed because people don’t think they need it, and that creates a very unsafe and unhealthy landscape for these relationships.”

Crehan is building the knowledge and tools to ensure that autistic people aren’t overlooked in sex education. But she has noted that discussing the nuances of different communication styles and body language is really useful for neurotypical people as well.

“We went into this thinking about walking through the unwritten rules about dating and sexuality in ways that match the communication profile of lots of autistic people,” Crehan said. “But it turns out that breaking this stuff down is helpful for everyone.”

It’s not just neurodivergent people who have been historically left out of sex education. Programs have typically ignored anyone that didn’t fit the stereotypical idea of a “normal” relationship—one healthy, straight, able-bodied man with one healthy, straight, able-bodied woman.

“I went to a school that had a sex education curriculum, but I was aware that they weren't talking about me,” said Mikey Cox, A25, a sex health representative (SHR) and former SHR coordinator with Tufts’ Center for Awareness, Resources, and Education (CARE). “The curriculum and the lesson plans that were being taught weren't reflective of how I was feeling or what I was thinking about. I felt ignored and it made me really upset and I have talked to other LGBTQIA+ people who have had very similar experiences.”

Tufts student Mikey Cox, A25, wearing a gray T-shirt that says, "Sex education is health care"

Mikey Cox, A25, is a sex health representative (SHR) and former SHR coordinator with Tufts’ Center for Awareness, Resources, and Education (CARE). Photo: Courtesy of Mikey Cox

Cox channeled that frustration into action, getting involved with a sex education nonprofit in his home state of Rhode Island while he was still in high school and becoming a peer educator and sex health representative with CARE as soon as he got to Tufts. 

CARE’s mission centers around providing support for Tufts students impacted by sexual misconduct—including harassment, stalking, assault, and other forms of intimate partner violence—and creating a culture that reduces these incidents. In addition to providing consultations, confidential support, and bystander intervention training, they run programming that encourages open and fun conversations about relationships and sexual health.

If I'm too embarrassed to even say what we are going to do, how am I asking for consent about it?” said Alexandra Donovan, the director of CARE. “We have to reduce the shame around these topics, and we do that by making it fun, by making it something that’s entertaining.”

Cox and his fellow sex health representatives run a podcast, an Instagram account, and on-campus events to provide approachable resources and answer questions from other students, discussing everything from queer sex to the history of prostitution in the Middle Ages. 

“We’re very strongly focused on peer-to-peer education because with a lack of knowledge and understanding, people turn to porn or TikTok or anonymous forums to ask questions and get the most ridiculous, harmful answers,” Donovan said. “We want to be a resource that can counter that.”

Cox has also been working with younger teens—8th and 9th graders—through Our Whole Lives, a sexuality education program offered outside of school. He has been able to bring in fellow Tufts students for LGBTQ+ panels and provide the kind of educational experiences that he wishes he had at the same age. 

“The people on the panel had all these different identities that perhaps some of the students in the room had never even heard of before,” Cox said. “Incorporating these aspects into traditional sex education opens a dialogue and increases awareness of different experiences that exist in the world. It reduces stigma and starts conversations about different identities and interactions and relationships.”

It’s not the kind of sex education that many of us remember receiving, and that’s a good thing. Broadening the idea of sex education to represent the diversity of human experience and relationship types and focusing on communication and empathy, in addition to the medical aspects, provides young people with the skills to create healthy relationships, romantic or not, in the future. 

“There are so many avenues for change that can be introduced through sex education,” Cox said. “My passion for sex education and equity and health care has blossomed at Tufts, and has turned into something concrete that I feel like I can make a career and a future out of.” 

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