Saying No to Abstinence-Only Teaching: The History and Consequences of Sex Education in the United States

Image: Flickr

By Maura Masterson

Every American citizen becomes aware of reproductive topics at some point, most likely during adolescence. This is a simple statement, but when examined further, one realizes that although everyone has this fact in common, how and what one learns varies. Sex education in the United States has been a contentious topic, and has not experienced linear progress. Whether it be the appropriate age to learn about sex and bodily changes, whether or not sex-education has a place in public school curriculum, and what schools are allowed to teach are all points of debate surrounding sex-ed. Influenced by gender roles, state and federal governments, the HIV/AIDS epidemic, and religion – particularly Christianity – the U.S. has experienced many different phases of sex education. By analyzing sex education resources from different time periods, data on teen pregnancies and sexually transmitted diseases (STDs), and scholarly essays on consequences of different curricula, it becomes evident the most effective sex education leads to a better understanding of relationships, sexuality, and the human body. This form of education is known as “comprehensive sex education” and is generally more progressive and developed, since its curriculum covers the importance of contraception and consent – and does not rely on an abstinence-only curriculum. What children and teenagers learn is extremely important because it not only affects their sexual health, but also their views of their sexuality and role in society.

The concept of teaching a standardized sex education would have seemed asinine to a parent in the 19th century. Until the mid 20th century, biological topics were seen as a conversation to be had at home. Interestingly, the argument of what should be allowed to be taught in schools has continued into modern day. The current backlash against Florida’s “Don’t Say Gay” bill is a perfect example of sex education’s ebb and flow in public opinion. Whether to embrace a more liberal curriculum at school or leave such topics up to parents’ discretion has almost always been a juxtaposition for Americans. Besides Florida, many other states have rolled out their own “Don’t Say Gay” bills. Since Florida’s bill is receiving the most attention, it is easy to overlook the fact that the United States has been trending toward harsher restrictions on sex-education for a while. The public’s perception of sex education often reflects other societal issues which are concurring. Sex-ed does not exist in a vacuum, and it takes an examination of its history to see just how dynamic it can be. 

Children usually received some form of education from their parents because it was seen as only the parents’ job to tell their children about subjects like growth, sexual reproduction, etc.1 This is evident in a 1934 bulletin for homemakers published by Cornell: “Meet the child’s first questions, and if he doesn’t ask any, make an opportunity before he goes to school.”2 Most of the time, these conversations only consisted of basic information on sexual hygiene.3 After World War II, America went through the necessary cultural changes to accept the notion of sex education being taught in schools. Having seen the effects of soaring STD rates on their population, the dialogue surrounding sex education opened up. Six years after World War II ended, the first sexual education film for adolescents was shown to a seventh grade classroom in a public school in Oregon. It covered basic subjects like menstruation, growth experienced during adolescence, and sexual maturity. This was seen as an extraordinary milestone in public education, and was covered by Time, Newsweek, and Life. For the first time ever, the school had taken on the responsibility of educating youth on biological topics. This film, although only covering basic bodily functions, marks the official beginning of sex-ed in schools. Since then, hundreds of sex education films, pamphlets, and books for middle school aged children have been created, and now the concept of sex-ed in schools is standard. 

Not only is America’s youth deeply impressionable, they will also become the legislatures, leaders, and teachers who will decide how the next generation learns about sexual/reproductive health. Organization is required on a local level to ensure sex educators and teachers are able to implement budgeting, mandate medically accurate information, and seek a more well-rounded sex education.

The Progressive Era

The Progressive Era was invaluable in changing the way U.S. Americans perceived sexuality and reproduction. The escalation of venereal disease across the United States leading up to, and during, the 1900s was impossible to ignore. Urbanization, immigration, and industrialization led to a mess of overcrowding, poor housing conditions, and poverty––all of which created the perfect setting for a public health crisis. Public health campaigns regarding hygiene and sanitation became a common method implemented by the U.S. government to help stop the spread of disease. In 1920, the first ever sex education research survey was conducted by the U.S. Public Health Service and the U.S. Bureau of Education. The survey “sought information in three areas: the number of high schools teaching sex education, the content of sex education instruction, and the attitudes on sex education. Out of almost 6,500 responses, only two-fifths of the schools had any sort of sex education curriculum.” However, the respondents also answered they viewed sex education in schools as necessary in overwhelming numbers. The Progressive Era belief in the intelligent, informed citizen made sex education in schools seem more necessary than in previous eras. People in the United States were finally trying to come up with technical solutions to social problems. The endemic levels of venereal disease and the cultural shift toward safe hygienic practices created the conditions necessary for the United States to finally start considering sex education being taught in public schools.

The most tangible origins of standardized sex education in the United States came in the form of pamphlets and videos released during and after World War II. The idea that any sex was being had outside of heterosexual, married relationships was taboo. However, by the 1940s the United States was experiencing the highest rates of STD transmission the country has ever seen. In 1943, there were a reported 575,593 cases of syphilis––the highest ever recorded between 1940 and 2018. This caused the U.S. government to step in with the first versions of standardized sex education. These pamphlets and sex-ed videos almost always focused on the STD crisis and were clearly written for/by men. For example, “Sex Hygiene and Venereal Disease”, a widely distributed pamphlet by the U.S. War Department says:

“It’s perfectly normal for you to want to go with girls––just as normal to get hungry or sleepy. […] You wouldn’t like to think that the girl you marry had been used by other men; or that your sweetheart or sister was letting herself be used by someone. If you want the girl you love and respect to keep her body pure and free from disease, you owe it to her to keep yours the same way.”4

This pamphlet taught thousands of soldiers it was normal to have sexual feelings, but it was NOT acceptable to act on them unless it was between two married people. It emphasizes the soldier’s duty to his own body, his future wife, and even the country not to get a venereal disease. Similarly, a 1941 sex hygiene training video from The Signal Corps along with the U.S. Surgeon General preaches the importance of avoiding sex as to avoid venereal disease. In the film’s opening there is a message from the War Department that labels any soldier who does not protect his body from venereal disease as a “shirker”. Similar to the other World War II information on sexual hygiene, this video places a personal responsibility to the country regarding sexual health. The film does not advocate for the use of contraception; instead, it embraces the abstinence-only approach: “In this connection continence is the best of all preventative measures.” It even goes on to back up these claims with “science”: “Medical science has definitely proved that a man can be healthy and actually stronger if he avoids sex relations.” During this period abstinence-only sex education becomes seen as the government standard. While abstinence is the only 100% guarantee against STDs and pregnancy, it cannot be the only option presented for contraception.

Sex Education and Religion

Understanding the United States’ proclivity for abstinence-only education has to do with a larger concept: morality. As seen in World War II era sex-ed, there is heavy emphasis on one’s duty to the country, as well as “doing the right thing”- i.e. not getting a venereal disease. Although intense definitions of morality were not unique to the United States, it is important to understand how they came to shape how U.S. Americans saw sex and sexuality. By the early 1900s, science had started to displace religion in the public sphere––especially regarding things like childbirth, sexual health, and illness. No longer were these topics considered too taboo for public discussion. However, this does not mean religion had zero influence on science. American Protestantism had long been the leading ideology regarding sexual promiscuity and what was considered socially acceptable. As science modernized, it was married with American Protestant ideals to be more digestible to the public. Early sex reformers pushed for more progressive topics to be available in sex education, but there was still heavy conservative pushback from liberal Protestants. Even though the United States was becoming a more medically advanced society, it was still heavily influenced by its Christian population:

“For sex educators in the United  States,  Christianity  offered  the  extra  advantage  of  shaping  cultural norms  about  sexuality  because  of  the  religion’s  dominance  within  society. Christian interpretations and symbols regarding love, marriage, monogamy, chastity, family, creation, motherhood, fatherhood, and sin influenced many Americans, including scientists.”

Even with the scientific advances of the early 20th century, Christian ideals were almost impossible for scientists to ignore. If the U.S. government wanted to mandate or standardize sex education it had to fall within parameters which would allow the United State’s sizable Christian population to remain comfortable. Science was able to attach itself to aspects of Christianity that made it more acceptable for sex educators to teach within a “moral” context. Had this symbiotic relationship not formed, it is possible sex education would have taken longer to enter public schools. 

Sexual Revolution

The sexual revolution of the 1960s not only resulted in sex education becoming contraception-friendly, it was a leap forward for standardized sex education in general. Created by former Planned Parenthood Director Mary Calderone in 1964, the Sexual Information and Education Council of the United States (SIECUS), “ was established as a values-neutral guide to comprehensive sex education through publishing books, journal articles, curriculums, and training workshops.” The council was intended to create sex education that presented students with factually correct information, then let them decide sexual morals for themselves. They even tasked The American Association for Sex Educators and Counselors and Therapists with creating training standards for professional sex educating––quite advanced from 70 years previous, when the only form of sex education was whatever was taught at home. New sexual norms and forms of birth control set the stage for a more comprehensive sex education in the United States. Defined by SIECUS, a comprehensive sex education puts less emphasis on common goals of sex education – preventing pregnancy and sexually transmitted disease – and more emphasis on understanding human sexuality. SIECUS describes this kind of understanding as, “the sexual knowledge, beliefs, attitudes, values, and behaviors of individuals. Its various dimensions involve the anatomy, physiology, and biochemistry of the sexual response system; identity, orientation, roles, and personality; and thoughts, feelings, and relationships.” The 1970s saw an explosion of comprehensive sex education films which covered topics like healthy relationships, homosexuality, sexual inadequacy, teenage pregnancy, and variation in sexual expression.5 This range of new topics and curricula represented progress. Finally, sex-ed curriculum had graduated from solely teaching functions of sexual organs, and now also offered students the chance to learn about the complexities of human sexuality. 

As sex education encompassed more subjects, things like pregnancy, menstruation, and parenting were often pigeon-holed as women’s issues. One educational video from 1973 shows how pregnancy is often seen as a female-only consequence of sex. Episode #366 of Insight, powered by Paulist Productions, follows a high school girl named Ginny and her three friends on a ski trip where Ginny announces that she is pregnant. She and her friends discuss her options, and they acknowledge abortion, which makes sense given that Roe v. Wade was a high-profile Supreme Court decision the same year this film was released. Billy, the father, blames Ginny for not preventing the pregnancy herself. Throughout the episode it becomes clear Ginny’s pregnancy is her fault, and she will have to deal with the consequences more than Billy will. Although this story is fictional, it was seen by many young, impressionable people. Films like this one misrepresent abortion – which is a completely logical and safe procedure – or the emergency contraceptive pill which is often a woman’s only option. It is through subtle messages like the ones in this video that cause young men and women to believe untrue and sexist things about sex and pregnancy. Even if this was the only detrimental sex education film to ever be produced, it represents what was considered acceptable for children to learn at the time, and shows how flawed sex education was at this point. However, there were also more comprehensive films being produced as well. In the 1973 Film Resources for Sex Education, there are multiple examples of comprehensive curriculum. Such titles stand out like, “Sex is Not a Dirty Word”, a 1975 lecture that explains sexuality as an integral part of personality6, or “Methods of Family Planning”, a 1974 film on every method of contraception.7 This is one of many times progress in sex education is slightly paradoxical. Although there were abstinence-only education (AOE) supporters at the time, there were finally medically correct, unbiased educational materials being produced. Despite this progress, the cultural attitudes regarding sex and sexuality education were still steeped in the sexist undertones of early sexual cultural norms. 

The sex education created for the “modern” woman of the 1940s was not adequate for the women of the 1960s or 1970s. The idea of a sexually active, single woman was no longer taboo, and there were now many safe, affordable options to prevent pregnancy.

Besides abstinence, it was rare that any methods of preventing pregnancy were presented in earlier sex education curriculum. However, as it progressed, sex education soon encompassed more subjects than just basic bodily functions and anatomy. U.S. Americans were quickly growing into a need for more comprehensive sex education, as sexual culture and medical technology were progressing. The sex education created for the “modern” woman of the 1940s was not adequate for the women of the 1960s or 1970s. The idea of a sexually active, single woman was no longer taboo, and there were now many safe, affordable options to prevent pregnancy. By 1965, one out of every four married women had used the hormonal birth control pill by the time she was 45.8 Women were finally enjoying being liberated from unplanned pregnancies, which led to them being able to be sexual beings and enjoy more public and professional roles. As society was changing, sex education followed suit: curriculum distinguished sex hygiene from sexual reproduction less, and it became more acceptable to teach youth about contraception and preventing pregnancy. One of the earliest contraception-based sex education films intended for adolescent consumption was called Contraception, and was released in 1973. It is starkly different than any of the aforementioned sex-ed videos, with a simple yet powerful statement in the beginning: “Throughout the ages there have been powerful sentiments and powerful drives to have only wanted children. And there have been powerful drives to find other meanings in the act of love and reproduction alone.” These two sentences, along with illustrations of oral sex flashing on screen, represent powerful narrative: sex is not only meant for reproduction. Unlike older videos, which stipulate that sex only happens between two married people, this film acknowledges anyone can have sex, and that if someone chooses to do so, they have a duty to use contraception. It advocates for the use of the rubber condom, the vaginal diaphragm, spermicides, the rhythm method, the intrauterine device, surgical sterilization, and the hormonal birth control pill. A man and a woman, presumably medical experts, discuss the advantages and disadvantages of each method, and even rate them at the end. Multiple factors are taken into consideration, including effectiveness, convenience, and cost. The film even contains videos showing real people putting on condoms, inserting diaphragms and intrauterine devices, and there are videos of the various kinds of sterilization surgeries. Not once is abstinence mentioned in this film, nor is abortion.

The 1970s and early 1980s served as a middle ground for sex education. No longer was abstinence the preferred method of contraception taught to teenagers and adolescents, and other forms had become socially acceptable and commonly used enough to be discussed in public schools. However, by the 1970s, sex education had not escaped the influence of Christianity. As well as abortion not being mentioned in Contraception, it also advocates for the risky “rhythm method”, which was the only form of contraception deemed acceptable by the Catholic Church at the time. This method, also commonly referred to as “Vatican Roulette”, entails a girl or woman tracking when she is fertile or infertile, and only having sex when she is infertile. This is extremely risky if being used to prevent pregnancy, because it presumes a regular menstrual cycle, of which many women do not experience. The two doctors in the film point out the ineffectiveness of this method, but they specify the reason they even included it is because it is the only form of birth control deemed acceptable by many religions. Once again, the influence of religion upon sex education is evident. Despite the flaws in this film, it contains a more factually correct, unbiased curriculum compared to earlier films of its kind. Finally, the sexual revolution, the break from Victorian values, and the rising popularity of the pill ushered in a new era for sex education: teaching about contraception. 

Challenges of the Modern Day

Sex education in public schools has long been a debated topic, and what is considered acceptable and effective has been shaped by varying philosophies, religions, and cultural norms. Despite evidence supporting comprehensive sexuality education, the United States experienced a backslide in sex-ed progress after the 1970s and through the 1990s. The 1980s AIDS epidemic evoked a fear and distrust of sex and made teaching comprehensive sexual education, particularly LGBTQ+ topics, a controversial topic. However, the AIDS crisis did create an unprecedented need for sex education in the United States, and leaders and educators were suddenly scrambling to design the optimal sex-ed curriculum. Sex education became a matter of life or death. In a 1987 press conference, U.S. Surgeon General C. Everett Coop declared:

“Education concerning AIDS must start at the lowest grade possible as part of any health and hygiene program — there is now no doubt that we need Sex Education in schools and that it must include information on heterosexual and homosexual relationships. The threat of AIDS should be sufficient to permit a Sex Education curriculum with a heavy emphasis on the prevention of AIDS and other sexually transmitted diseases.”

Sex education in public schools suddenly became necessary on a national scale. SIECUS and other pro-comprehensive sex education organizations benefitted from this, as there was less of an argument against any sex education in public schools, but there were also negative effects. Once it was realized that AIDS was transmitted sexually, there was an immediate leap in public opinion backwards to abstinent-only sex education. Sex educators were now tasked with creating a comprehensive sex education with a heavy anti-STD rhetoric, while resisting the public’s born-again proclivity for AOE. The country had regressed to only accepting sex education which taught America’s youth that sex was not only dirty, but also immoral. The sex education curriculua of the 1980s was more similar to sex hygiene education in the 1920s than the comprehensive topics that were beginning to be taught in the decade prior. Scare tactics in sex-ed videos were used to teach adolescents to avoid sex––especially homosexual experiences. Comprehensive sex education, which embraced portraying LGBTQ+ topics in a neutral way, had gone by the wayside. The AIDS epidemic allowed for a homophobic backlash which banished all mention of homosexuality in sex education. For the most part, all mention of an entire group had disappeared from public schools’ curriculum. The progress from the 1970s and Roe v. Wade was backsliding, and AOE gained massive popularity during this era. The cultural Christian Crusade of the 1980s, as well as misplaced fear from the AIDS epidemic, caused AOE curriculum to be standard well into the 1990s. Abstinence only until marriage (AOUM) was the name abstinence only education had adopted by the late 1990s. By that point, 49 out of 50 states had accepted federal funds to promote AOUM in public schools. Abstinence-only education, which had started to lose the public’s favor during the 1970s, was now stronger than ever. After this backslide in the development of American sex education, it has been slowly reattaching itself to the American classroom. And although a challenging process, it has been a worthwhile effort to provide adolescents with the best possible curriculum for their mental and physical well-being.

Just as the sexual revolution saw a joining of sex hygiene and reproductive topics in public school curriculum, the modern era has started to marry the concepts of sex education and comprehensive sexuality education.

Unfortunately, the modern era has also been challenging for pro-comprehensive sexual education (CSE) instructors. By the 2016 fiscal year, $85 million was going to abstinence only until marriage related curricula. Despite this, 2007-2014 saw a decline in adolescent birth rates, which might be indicative of today’s youth receiving much more information online. States and school districts are allowed to teach what they want regarding sex education on a local level, so the standards and methods implemented by school districts vary. Most do not put significant time or funding towards creating a truly beneficial, comprehensive sex education. A report by the Guttmacher Institute found that although 37 states require abstinence information be provided (25 that it be stressed), only 33 and 18 require HIV and contraceptive information. An even more dismal statistic is that only 13 states require information to be medically accurate. Much of sex education in public schools has not evolved since the 1980s and 1990s. However, the future holds so much potential for comprehensive sex-ed.

Modern-day has the advantage of hindsight to see the overwhelming benefits of a comprehensive sex education, especially compared to its abstinent-only alternative. No longer does sex education have to be only about reproductive topics. Just as the sexual revolution saw a joining of sex hygiene and reproductive topics in public school curriculum, the modern era has started to marry the concepts of sex education and comprehensive sexuality education. Not only are adolescents and teens learning medically correct information, they are also becoming more aware of the complexity of human sexuality, consent, healthy boundaries, and more inclusive notions of gender. According to the Journal of Adolescent Health, “Curricula designed specifically to reduce homophobia have been found to be successful across grade levels using a variety of approaches both formally within sexuality education and throughout other areas of the curriculum,” and a better understanding of sexuality, gender, and other modern topics has been proven to result in less prejudice and violence. Teaching about human sexuality is paramount in creating healthy adolescent self esteem and awareness. Sex education is not just about preventing teenage pregnancies and STDs anymore: the United States has the funding and duty to form a better approach to sex-ed that strengthens society as a whole––there just needs to be the proper effort and use of resources.

However, many schools are still teaching outdated and potentially detrimental curricula. Abstinence-only education has no effect on birthrates. There is no reason ineffective sex-ed should still be receiving so much federal funding. Barack Obama’s administration pledged more money to more comprehensive programs with medically accurate information, and even proposed elimination of AOUM funding, but all of those efforts were reversed after Donald Trump took office. Sex education has become deeply entrenched in politics, with Democrats overwhelmingly supporting CSE, and Republicans tending to support AO. Having become a popular campaign issue, sex education in public schools is once again in the spotlight. According to the Guttmacher Institute, 2021 was the most devastating year for abortion legislation, with 561 abortion restriction and 165 abortion ban bills being introduced. Texas famously outlawed abortion at six weeks, with other states following suit by passing restrictive bills of their own. Arizona, Arkansas, Indiana, Kentucky, and Oklahoma all passed harsh restrictions on abortion clinics and providers. With the recent overturn of Roe v. Wade, sexual issues are at the forefront of society’s agenda again. Although it may seem minuscule, what young people learn about these topics has an important role in reproductive rights. As discussed earlier, a comprehensive sex-ed curriculum shapes people to have a medically accurate, unbiased view of such topics and issues. Not only is America’s youth deeply impressionable, they will also become the legislatures, leaders, and teachers who will decide how the next generation learns about sexual/reproductive health. Organization is required on a local level to ensure sex educators and teachers are able to implement budgeting, mandate medically accurate information, and seek a more well-rounded sex education. The attitudes and curricula surrounding reproductive topics which children are exposed to have deeper consequences than choices individuals make later in life. Rather, they shape how an entire generation will protect themselves and others. A scientifically accurate, comprehensive sex education gives people the choice to conduct their bodies how they so choose, with as few ramifications as possible. As it has become evident, nothing is more inefficient than a society of people who cannot agree upon basic reproductive facts.Although its progress has not been linear, comprehensive sex-ed is still in a rut. Between 2008 to 2018, reported cases of syphilis doubled along with every other “common” sexually transmitted disease almost doubling as well. U.S. Americans are either not receiving the messages of sexual education, or sex education needs to be improved –– and it is most likely both. Adapting a comprehensive sexuality education and figuring out how to translate it to today’s youth is the next step in America’s history of sex education. The future holds possibilities of local school districts having access to contraceptives for students, pleasure-based sex-ed, and a more inclusive curriculum. Whether or not that will happen depends on the resources and efforts allocated to sex education in the next ten years, as well as the general public becoming more aware of the benefits of CSE.

1 Edith D. Dixon, “Part V, Number 293 – Sex Education: [Cornell Bulletin for Homemakers 1934]” Cornell University, 2
2 Ibid, 7
3 Ibid, 5
4 United States War Department, “Sex Hygiene and venereal disease,” 1942
5 Derek L. Burleson and Gary Barbash, Film Resources for Sex Education, 1976th ed. (New York, NY: Sex Information and Education Council of the U.S., 1976).
6 Ibid., 35
7 Ibid, 28
8 “The Birth Control Pill a History – Planned Parenthood,” Planned Parenthood (Planned Parenthood Federation of America, 2015),, 4.