Describe a fictional tv or movie character and analyze their sexual health using the SIECUS guidelines in 1,200-1,500 words.
Guidelines
for Comprehensive
Sexuality Education
3RD EDITION
NATIONAL GUIDELINES TASK FORCE
Kindergarten
through
12th Grade
Copyright © 2004 by the Sexuality Information and Education Council of the United States
No part of the Guidelines for Comprehensive Sexuality Education: Kindergarten-12th Grade,
Third Edition may be reproduced in any form without written permission.
Design and layout by Anna Raff
Proofing by Phil Banner and Beej Johnson
Printing by Fulton Press
Guidelines
for Comprehensive
Sexuality Education
3RD EDITION
NATIONAL GUIDELINES TASK FORCE
Kindergarten
through
12th Grade
Acknowledgements
For over a decade, SIECUS has published the Guidelines for Comprehensive Sexuality Education:
Kindergarten-12th Grade to help educators create new sexuality education programs and evaluate
already existing curricula. The Guidelines, developed by a national task force of experts in the fields
of adolescent development, health care, and education, provide a framework of the key concepts,
topics, and messages that all sexuality education programs would ideally include.
This Third Edition of the Guidelines is based on the work of the original National Guidelines Task
Force; the basic structure and content remain the same. Certain topics, messages, and age-levels,
however, have been changed to reflect new information and the reality that today’s young people
are facing. In addition, we have added a section on using the Guidelines that provides specific
advice, ideas, and resources to help educators implement this important framework into their efforts
to provide high-quality sexuality education to young people in their schools and communities.
Since they were originally developed 13 years ago, the Guidelines have become one of the most
influential publications in the field and a trusted resource for educators, curriculum developers, and
school administrators. SIECUS has distributed well over 100,000 copies of this publication. In fact,
the Guidelines are downloaded from SIECUS’ website by more than 1,000 people each month.
Given how popular and valuable this publication is, undertaking this revision was at the same time
exciting and daunting, and we have many people to thank for the success of the final product.
First we would like to thank the John M. Lloyd Foundation and Barbara Stanton whose generous
support made it possible for SIECUS to produce this vital resource.
We must also thank all of the members of the original task force for the enormity of the task they
took on. There is a phrase in the publishing world that asks “Where were you when the page was
blank?” Having worked for over a year to update and revise the Guidelines, we cannot imagine the
effort and patience it must have taken to start from scratch.
In addition, a number of former and present SIECUS staff members assisted us in updating messages
and adding new information and ideas including Myra Batchelder, Kate McCarthy, Jason Osher,
Ambika Panday, Coralie Meade Rodriguez, Darlene Torres, and Adrienne Verrilli. We give special thanks
to Amy Levine who spent a great deal of time helping us perfect messages. We would also like to
thank Joseph DiNoricia, Jr., SIECUS President and CEO, for his guidance and leadership on this project.
Finally, we must thank all of our reviewers. For this edition of the Guidelines, we assembled a panel
of experts in the field to review the concepts, topics, and messages. We owe a tremendous debt of
gratitude to Nora Gelperin, Eva Goldfarb, Joan Helmich, Maureen Kelly, Lis Maurer, Elizabeth Schroeder,
and Bill Yarber. Their comments and ideas were always insightful, often inspirational, and occasionally
humorous. This revision would not have been possible without their input.
It is our sincere hope that this edition of the Guidelines is a valuable resource for educators and
curriculum developers and that it ultimately helps to ensure that all young people receive the
comprehensive education about sexuality they need to become sexually healthy adults.
Sincerely,
Martha E. Kempner, M.A. Monica Rodriguez
Director of Public Information Vice President for Education and Training
Peggy Brick, M.Ed.
Planned Parenthood of Greater Northern
New Jersey
Maureen Corry, M.P.H.
March of Dimes Birth Defects Foundation
Brenda Green
National School Boards Association
Debra Haffner, M.P.H.
Sexuality Information and Education
Council of the United States
Marian Hamburg, Ed.D.
New York University
Carol Hunter Geboy
Independent Sexuality Education
Consultant
Richard Jimenez, M.Ed.
Centers for Disease Control and
Prevention
Robert Johnson, M.D.
New Jersey Medical School
Michael McGee, C.S.T.
Planned Parenthood Federation of
America
JoAnne Pereira
Sexuality Information and Education
Council of the United States
Martha Roper, M.S.
St Louis, Missouri Public Schools
Clair Scholz, M.A.
Irvington, New Jersey Public Schools
Robert Selverstone, Ph.D.
Westport, Connecticut Public Schools
Stanley Snegroff, Ed.D.
American School Health Association
Mary Lee Tatum, M.S.
Independent Sexuality Education
Consultant
Trish Moylan Torruella, M.S.
Planned Parenthood Federation of
America
Katherine Voegtle, Ph.D.
American Medical Association
James Williams
National Education Association
Pamela Wilson, M.S.W.
Independent Sexuality Education
Consultant
William L. Yarber, H.S.D
Indiana University
* 1991 affiliations, for identification purposes only.
Original Members of the National Guidelines Task Force*
Nora Gelperin
Director of Training and Education
Network for Family Life Education at
Rutgers University
Eva S. Goldfarb, Ph.D.
Associate Professor of Health and
Nutrition Science
Montclair State University
Joan Helmich, M.A.
Training Director,
Center for Health Training
Maureen A. Kelly
Vice President of Education and Training
Planned Parenthood of the Southern
Finger Lakes
Elizabeth Schroeder, MSW
Professional Trainer/Consultant
* Affiliations for identification purposes only.
Third Edition Review Panel*
Table of Contents
Background and Introduction ……………………………………………………………………………9
History of the Guidelines 12
Structure of the Guidelines 13
Goals, Values, and Fundamental Principles 17
Guidelines for Comprehensive Sexuality Education:
Kindergarten – 12th Grade ……………………………………………………………………………..21
Key Concept 1: Human Development 22
Key Concept 2: Relationships 31
Key Concept 3: Personal Skills 40
Key Concept 4: Sexual Behavior 48
Key Concept 5: Sexual Health 55
Key Concept 6: Society and Culture 68
Using the Guidelines ………………………………………………………………………………………77
Prioritizing Topics 79
Filling in the Gaps 80
Evaluating Existing Curricula and Lessons 84
Creating New Curricula and Lessons 98
Additional Resources …………………………………………………………………………………….101
Also Included
Life Behaviors of a Sexually Healthy Adult 14
Key Concepts and Topics 16
Curriculum Evaluation Tool 87
STDs/HIV Checklist 94
Background
and Introduction
Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs,
and values about such important topics as identity, relationships, and intimacy. The Sexuality
Information and Education Council of the United States (SIECUS) believes that all people have the
right to comprehensive sexuality education that addresses the socio-cultural, biological, psychological,
and spiritual dimensions of sexuality by providing information; exploring feelings, values, and attitudes;
and developing communication, decision-making, and critical-thinking skills.
While parents are – and ought to be – their children’s primary sexuality educators, they often need
help and encouragement. Faith-based institutions, community-based organizations, and schools can
play an important role.
SIECUS believes that comprehensive school-based sexuality education should be part of the education
program at every grade. Such programs should be appropriate to the age, developmental level, and
cultural background of students and respect the diversity of values and beliefs represented in the
community. Comprehensive school-based sexuality education complements and augments the
sexuality education children receive from their families, religious and community groups, and health
care professionals.
SIECUS is not alone in the belief that school-based sexuality education is vitally important to the
health and well-being of our nation’s youth. National, state, and local polls have consistently found
that a majority of parents want schools to provide comprehensive education about sexuality that
includes such topics as abstinence, sexually transmitted diseases (STDs), HIV/AIDS, contraception, and
disease prevention methods.1 In fact, many states mandate that some or all of these topics are cov-
ered in school curricula.2 Research also supports a comprehensive approach to sexuality education
with numerous studies finding that such programs can help young people delay intercourse, reduce
the frequency of intercourse, reduce the number of sexual partners they have, and increase their use
of condoms and other contraceptive methods when they do become sexual active.3
Educators and schools, however, are often left in the difficult position of trying to determine exactly
what their sexuality education courses should look like with little or no guidance. For over a decade,
SIECUS has published the Guidelines for Comprehensive Sexuality Education: Kindergarten-12th
Grade to provide such guidance and help educators create new sexuality education programs and
evaluate existing curricula. The Guidelines, created by a national task force of experts in the fields of
adolescent development, health care, and education, provide a framework of the key concepts,
topics, and messages that all sexuality education programs would ideally include.
Background and Introduction • 13
History of the Guidelines
As the 1980s drew to a close, in part because of the rapidly growing AIDS pandemic, there was
renewed interest in providing young people with the information and skills they needed to avoid
unintended pregnancy and STDs. In fact, at that point, a number of states began to mandate that
schools teach young people about STDs, HIV/AIDS, and other sexual health topics.
At the same time, however, debates were raging about whether young people should instead learn
solely about abstinence, if certain controversial topics such as masturbation and abortion could be
discussed in classrooms, and at what age other topics should be introduced.
This left many teachers confused and on their own. A 1989 study found that most sexuality education
teachers created their own curricular material, often without guidance from the state or local school
district.4 Other studies found that few of the teachers responsible for sexuality education had
received formal training in the subject.5
SIECUS realized that ultimately it would be the young people who suffered the most because they
would not receive the high-quality education they needed to become sexually healthy adults.
In 1990, SIECUS undertook a major effort to change this by convening the National Guidelines Task
Force, a group of leading educators, health professionals, and representatives from national organizations
who focused on adolescent development, education, and sexuality. Task force members included
representatives from the U.S. Centers for Disease Control and Prevention, the American Medical
Association, the National School Boards Association, the National Education Association, the March
of Dimes Birth Defects Foundation, and Planned Parenthood Federation of America, as well as school-
based sexuality education teachers, national program developers, and experienced trainers.
These experts were charged with the difficult task of creating an ideal model of comprehensive
sexuality education by developing a framework of the concepts, topics, skills, and messages young
people should learn and determining the age-level at which each should be introduced.
In 1991, the task force released the Guidelines for Comprehensive Sexuality Education: Kindergarten-
12th Grade. The Guidelines represented the first national model for comprehensive sexuality educa-
tion and helped educators evaluate existing curricula and create new programs. Since they were first
published, well over 100,000 copies have been distributed in both hard copy and electronic form. In
addition, the Guidelines have been adapted and translated into Spanish for use in Latino communities
in the U.S., and guidelines adaptation projects have produced national models in countries such as
Brazil, India, Iceland, Nigeria, and Russia.
This Third Edition is based on the work of the original task force; the basic structure and content
remain the same. Certain topics, messages, and age-levels, however, have been changed to reflect
new information, ongoing community dialogue about the appropriate content of sexuality education,
and the reality that today’s young people are facing.
14 • Guidelines for Comprehensive Sexuality Education
Structure of the Guidelines
The Guidelines are modeled after the landmark School Health Education Study (SHES) published in
the late 1960s. SHES developed an innovative approach to structuring health knowledge by identify-
ing broad concepts and related subconcepts and then arranging these in a hierarchy for students in
kindergarten through 12th grade.6
Using this model, the task force sought to create an organizational framework of the important
knowledge and skills related to sexuality and family living. To do this, the task force first determined
the life behaviors of a sexually healthy adult which serve as outcome measures of successful sexuality
education. They then compiled the information and determined the skills necessary to achieve these
life behaviors and organized them into key concepts, topics, subconcepts, and age-appropriate devel-
opmental messages.
Key Concepts: Key concepts are broad categories of information about sexuality and family living.
The Guidelines are organized into six key concepts, each of which encompasses one essential area of
learning for young people. They are:
Key Concept 1: Human Development. Human development is characterized by the
interrelationship between physical, emotional, social, and intellectual growth.
Key Concept 2: Relationships. Relationships play a central role throughout our lives.
Key Concept 3: Personal Skills. Healthy sexuality requires the development and use of specific
personal and interpersonal skills.
Key Concept 4: Sexual Behavior. Sexuality is a central part of being human, and individuals
express their sexuality in a variety of ways.
Key Concept 5: Sexual Health. The promotion of sexual health requires specific information
and attitudes to avoid unwanted consequences of sexual behavior.
Key Concept 6: Society and Culture. Social and cultural environments shape the way individ-
uals learn about and express their sexuality.
Life Behaviors: Life behaviors are essentially outcomes of instruction. For each of the broad
categories identified as a key concept, the Guidelines note several life behaviors of a sexually healthy
adult that reflect actions students will be able to take after having applied the information and skills.
For example, life behaviors under Key Concept 3: Personal Skills, include: “Identify and live according
to one’s values”; “Take responsibility for one’s own behavior”; and “Practice effective decision-making.”
(A complete list of life behaviors appears on page 14.)
Topics: Topics are the individual subjects that need to be discussed in order to sufficiently address
each key concept and help students achieve the desired outcomes or life behaviors. Each key concept
is broken down into a number of component topics.
Background and Introduction • 15
For example, Key Concept 2: Relationships, includes the following topics: families, friendship, love,
romantic relationships and dating, marriage and lifetime commitments, and raising children. Together,
the key concepts and topics create a simple outline for comprehensive sexuality education programs.
(A complete list of Key Concepts and Topics appears on page 16.)
Subconcepts: Subconcepts represent the essential message that young people need to learn about
each topic. The Guidelines begin the discussion on each topic by identifying a subconcept that
directly relates to the desired life behaviors.
For example, within Key Concept 1: Human Development, Topic 4 is Body Image. The subconcept
suggests that students learn that “People’s images of their bodies affect their feelings and behaviors.”
Subconcepts appear throughout the Guidelines.
16 • Guidelines for Comprehensive Sexuality Education
Life Behaviors of a Sexually Healthy Adult
A sexually healthy adult will:
• Appreciate one’s own body.
• Seek further information about reproduction as needed.
• Affirm that human development includes sexual development, which may or may not
include reproduction or sexual experience.
• Interact with all genders in respectful and appropriate ways.
• Affirm one’s own sexual orientation and respect the sexual orientations of others.
• Affirm one’s own gender identities and respect the gender identities of others.
• Express love and intimacy in appropriate ways.
• Develop and maintain meaningful relationships.
• Avoid exploitative or manipulative relationships.
• Make informed choices about family options and relationships.
• Exhibit skills that enhance personal relationships.
• Identify and live according to one’s own values.
• Take responsibility for one’s own behavior.
• Practice effective decision-making.
• Develop critical-thinking skills.
• Communicate effectively with family, peers, and romantic partners.
• Enjoy and express one’s sexuality throughout life.
• Express one’s sexuality in ways that are congruent with one’s values.
• Enjoy sexual feelings without necessarily acting on them.
Developmental Messages: Developmental messages are brief statements that contain the specific
information young people need to learn about each topic. For each topic, the Guidelines present develop-
mental messages appropriate for four separate age levels which reflect stages of development. The levels are:
Level 1: middle childhood, ages 5 through 8; early elementary school
Level 2: preadolescence, ages 9 through 12; later elementary school
Level 3: early adolescence, ages 12 through 15; middle school/junior high school
Level 4: adolescences, ages 15 through 18; high school
For example, within Key Concept 6: Society and Culture, Topic 5 is Diversity. Developmental messages
about diversity for Level 1 include: “Individuals differ in the way they think, act, look, and live,” and
“Talking about differences helps people understand each other better.” In contrast, developmental
Background and Introduction • 17
• Discriminate between life-enhancing sexual behaviors and those that are harmful to self
and/or others.
• Express one’s sexuality while respecting the rights of others.
• Seek new information to enhance one’s sexuality.
• Engage in sexual relationships that are consensual, non-exploitative, honest, pleasurable,
and protected.
• Practice health-promoting behaviors, such as regular check-ups, breast and testicular
self-exam, and early identification of potential problems.
• Use contraception effectively to avoid unintended pregnancy.
• Avoid contracting or transmitting a sexually transmitted disease, including HIV.
• Act consistently with one’s own values when dealing with an unintended pregnancy.
• Seek early prenatal care.
• Help prevent sexual abuse.
• Demonstrate respect for people with different sexual values.
• Exercise democratic responsibility to influence legislation dealing with sexual issues.
• Assess the impact of family, cultural, media, and societal messages on one’s thoughts,
feelings, values, and behaviors related to sexuality.
• Critically examine the world around them for biases based on gender, sexual orientation,
culture, ethnicity, and race.
• Promote the rights of all people to accurate sexuality information.
• Avoid behaviors that exhibit prejudice and bigotry.
• Reject stereotypes about the sexuality of different populations.
• Educate others about sexuality.
messages for Level 4 include: “Confronting one’s own biases and prejudices can be difficult,” and
“Workplaces benefit from having employees from diverse backgrounds.”
The developmental messages are introduced at the level when they should first be discussed. A
message introduced in Level 1 will not be listed again. This does not mean, however, that educators
working with older students should not reintroduce or reinforce earlier messages. All developmental
messages should be repeatedly reinforced at different age levels. In addition, in programs or communi-
ties where sexuality education does not start until middle school or junior high school (Level 3), it may
first be necessary to introduce students to the developmental messages suggested in earlier levels.
It is also important to note that while the developmental messages contain the age-appropriate information
that young people need to learn, they are not meant to simply be read or quoted verbatim in materials
or activities. Instead, they are intended for educators and other adults who are in a better position to
understand the best language and methods to use when sharing this information with young people.
18 • Guidelines for Comprehensive Sexuality Education
Guidelines for Comprehensive
Sexuality Education: Key Concepts
and Topics
Key Concept 1: Human Development
Topic 1: Reproductive and Sexual Anatomy
and Physiology
Topic 2: Puberty
Topic 3: Reproduction
Topic 4: Body Image
Topic 5: Sexual Orientation
Topic 6: Gender Identity
Key Concept 2: Relationships
Topic 1: Families
Topic 2: Friendship
Topic 3: Love
Topic 4: Romantic Relationships and Dating
Topic 5: Marriage and Lifetime
Commitments
Topic 6: Raising Children
Key Concept 3: Personal Skills
Topic 1: Values
Topic 2: Decision-making
Topic 3: Communication
Topic 4: Assertiveness
Topic 5: Negotiation
Topic 6: Looking for Help
Key Concept 4: Sexual Behavior
Topic 1: Sexuality Throughout Life
Topic 2: Masturbation
Topic 3: Shared Sexual Behavior
Topic 4: Sexual Abstinence
Topic 5: Human Sexual Response
Topic 6: Sexual Fantasy
Topic 7: Sexual Dysfunction
Key Concept 5: Sexual Health
Topic 1: Reproductive Health
Topic 2: Contraception
Topic 3: Pregnancy and Prenatal Care
Topic 4: Abortion
Topic 5: Sexually Transmitted Diseases
Topic 6: HIV and AIDS
Topic 7: Sexual Abuse, Assault, Violence,
and Harassment
Key Concept 6: Society and Culture
Topic 1: Sexuality and Society
Topic 2: Gender Roles
Topic 3: Sexuality and the Law
Topic 4: Sexuality and Religion
Topic 5: Diversity
Topic 6: Sexuality and the Media
Topic 7: Sexuality and the Arts
Goals, Values, and Fundamental Principles
Although the Guidelines are designed to be adaptable to the needs and beliefs of different communi-
ties, they are nonetheless based on certain specific values relating to sexuality and the nature of ideal
sexuality education. Before developing the concepts and messages in the Guidelines, the National
Guidelines Task Force agreed upon the goals of sexuality education, the values inherent in the Guidelines,
and a number of fundamental principles about the implementation of sexuality education.
The Goals of Sexuality Education The primary goal of sexuality education is to promote adult
sexual health. It should assist young people in developing a positive view of sexuality, provide them
with information they need to take care of their sexual health, and help them acquire skills to make
decisions now and in the future. The Guidelines recognize that the goals of sexuality education fall
into four areas:
Information: Sexuality education seeks to provide accurate information about human
sexuality, including growth and development, human reproduction, anatomy, physiology,
masturbation, family life, pregnancy, childbirth, parenthood, sexual response, sexual
orientation, gender identity, contraception, abortion, sexual abuse, HIV/AIDS, and other
sexually transmitted diseases.
Attitudes, Values, and Insights: Sexuality education seeks to provide an opportunity
for young people to question, explore, and assess their own and their community’s
attitudes about society, gender, and sexuality. This can help young people understand
their family’s values, develop their own values, improve critical-thinking skills, increase
self-esteem and self-efficacy, and develop insights concerning relationships with family
members, individuals of all genders, sexual partners, and society at large. Sexuality
education can help young people understand their obligations and responsibilities to
their families and society.
Relationships and Interpersonal Skills: Sexuality education seeks to help young people
develop interpersonal skills, including communication, decision-making, assertiveness,
and peer refusal skills, as well as the ability to create reciprocal and satisfying relationships.
Sexuality education programs should prepare students to understand sexuality effectively
and creatively in adult roles. This includes helping young people develop the capacity for
caring, supportive, non-coercive, and mutually pleasurable intimate and sexual relationships.
Responsibility: Sexuality education seeks to help young people exercise responsibility
regarding sexual relationships by addressing such issues as abstinence, how to resist
pressures to become involved in unwanted or early sexual intercourse, and the use of
contraception and other sexual health measures.
Background and Introduction • 19
Values Inherent in the Guidelines The Guidelines are based on a number of values about sexu-
ality, young people, and the role of families. While these values reflect those of many communities
across the country, they are not universal. Parents, educators, and community members will need to
review these values to be sure that the program that is implemented is consistent with their commu-
nity’s beliefs, culture, and social norms. The values inherent in the Guidelines are:
• Every person has dignity and self worth.
• All children should be loved and cared for.
• Young people should view themselves as unique and worthwhile individuals within the context
of their cultural heritage.
• Sexuality is a natural and healthy part of living.
• All persons are sexual.
• Sexuality includes physical, ethical, social, spiritual, psychological, and emotional dimensions.
• Individuals can express their sexuality in varied ways.
• Parents should be the primary sexuality educators of their children.
• Families should provide children’s first education about sexuality.
• Families should share their values about sexuality with their children.
• In a pluralistic society, people should respect and accept the diversity of values and beliefs
about sexuality that exist in a community.
• Sexual relationships should be reciprocal, based on respect, and should never be coercive or
exploitative.
• All persons have the right and obligation to make responsible sexual choices.
• Individuals, families, and society benefit when children are able to discuss sexuality with their
parents and/or trusted adults.
• Young people develop their values about sexuality as part of becoming adults.
• Young people explore their sexuality as a natural process in achieving sexual maturity.
• Early involvement in sexual behaviors poses risks.
• Abstaining from sexual intercourse is the most effective method of preventing pregnancy and
STD/HIV.
• Young people who are involved in sexual relationships need access to information about
healthcare services.
20 • Guidelines for Comprehensive Sexuality Education
Fundamental Principles While the Guidelines were created to be adaptable to a wide variety of
communities and settings, they are based on a number of fundamental principles about the nature
of ideal sexuality education programs. The task force believed that sexuality education programs
benefit from:
Being Part of a Comprehensive Health Education Program: Sexuality education should be
offered as part of an overall comprehensive health education program. Sexuality education
can best address the broadest range of issues in the context of health promotion, social and
gender equality, and disease prevention. Communities and schools should seek to integrate
the concepts and messages in the Guidelines into their overall health education initiatives.
Well-Trained Teachers: Sexuality education should be taught by specially trained teachers.
Professionals responsible for sexuality education must receive training in human sexuality,
including the philosophy and methodology of sexuality education. While ideally teachers
should attend academic courses or programs in schools of higher education, in-service courses,
continuing education classes, and intensive seminars can also help prepare sexuality educators.
Community Involvement: The community must be involved in the development and
implementation of sexuality education programs. School-based programs must be carefully
developed to respect the diversity of values and beliefs represented in the community.
Parents, family members, teachers, administrators, community and religious leaders, and
students should all be involved.
A Focus on All Youth: All children and youth will benefit from comprehensive sexuality
education regardless of gender, sexual orientation, ethnicity, socio-economic status, or
disability. Programs and materials should be adapted to reflect the specific issues and
concerns of the community as well as any special needs of the learners. In addition,
curricula and material should reflect the cultural diversity represented in the classroom.
A Variety of Teaching Methods: Sexuality education is most effective when young people
not only receive information but are also given the opportunity to explore their own and
society’s attitudes and values and to develop or strengthen social skills. A wide variety of
teaching methods and activities can foster learning such as interactive discussions, role plays,
demonstrations, individual and group research, group exercises, and homework assignments.
The Guidelines are a valuable tool for educators and community members wishing to develop and
analyze sexuality education programs, curricula, and textbooks. It cannot be said often enough,
however, that the Guidelines are not a curriculum nor are they lesson plans. They are designed as a
starting point for teachers and curriculum designers and can be used by local communities to plan
new programs, evaluate existing curricula, train teachers, educate parents, conduct research, and
write new materials. Ultimately, however, the community and school must determine which topics
and developmental messages will be included and the lessons plans and formats that will be utilized.
Background and Introduction • 21
K–12
Guidelines for
Comprehensive
Sexuality
Education
Human Development Life Behaviors:
Having applied the human development subconcepts at the
appropriate age, the learner will be able to:
• Appreciate one’s own body.
• Seek further information about reproduction as needed.
• Affirm that human development includes sexual development,
which may or may not include reproduction or sexual experience.
• Interact with all genders in respectful and appropriate ways.
• Affirm one’s own sexual orientation and respect the sexual
orientations of others.
• Affirm one’s own gender identities and respect the gender
identities of others.
Topic 1: Reproductive and Sexual Anatomy
and Physiology
Subconcept: The human body has the capability to reproduce as
well as to give and receive sexual pleasure.
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
24 • Guidelines for Comprehensive Sexuality Education
Key Concept 1:
Human Development
Human development is characterized
by the interrelationship between physical,
emotional, social, and intellectual growth.
Developmental Messages:
Level 1
• Each body part has a correct name and a specific function.
• A person’s genitals, reproductive organs, and genes determine whether the person is male or female.
• A boy/man has nipples, a penis, a scrotum, and testicles.
• A girl/woman has breasts, nipples, a vulva, a clitoris, a vagina, a uterus, and ovaries.
• Some sexual or reproductive organs, such as penises and vulvas, are external or on the outside of
the body while others, such as ovaries and testicles, are internal or inside the body.
• Both boys and girls have body parts that feel good when touched.
Level 2
• During puberty, internal and external sexual and reproductive organs mature in preparation for
adulthood.
• A young man’s ability to reproduce starts when he begins to produce sperm.
• A young woman’s ability to reproduce starts when she begins to menstruate.
Level 3
• The sexual response system differs from the reproductive system.
• Some sexual and reproductive organs provide pleasure.
Level 4
• Sexual differentiation, whether a fetus will be male or female, is determined largely by chromosomes
and occurs early in prenatal development.
• Some babies are born intersexed which means that they may have ambiguous genitals that are not
clearly male or female and/or that their chromosomes do not match their genitals.
• Hormones influence growth and development as well as sexual and reproductive functions.
• A woman’s ability to reproduce ceases after menopause; after puberty, a man can usually reproduce
for the rest of his life.
• Individuals may want to use a mirror to look closely at their external organs so they can note any
changes that may indicate health problems.
Topic 2: Puberty
Subconcept: Puberty is a universally experienced transition from childhood to adulthood that is
characterized by physical and emotional changes.
Key Concept 1: Human Development • 25
Developmental Messages:
Level 1
• Bodies change as children grow older.
• Puberty is a time of physical and emotional change that happens as children become teenagers.
• People are able to have children only after they have reached puberty.
Level 2
• Puberty begins and ends at different ages for different people.
• Everybody’s body changes at its own pace.
• Some people will not complete puberty until their middle or late teens.
• Girls often begin pubertal changes before boys.
• Most changes in puberty, such as the growth of body hair and an increase in body odor, are similar
for boys and girls.
• The sexual and reproductive systems mature during puberty.
• During puberty, girls begin to ovulate and menstruate, and boys begin to produce sperm and ejaculate –
once this occurs girls are physically capable of becoming pregnant and boys of getting a female pregnant.
• During puberty, some boys may ejaculate while they are asleep which is called a nocturnal emission
or “wet dream.”
• During puberty, emotional changes occur as a result of increased hormones.
• During puberty, many people begin to develop sexual and romantic feelings.
• Young teenagers sometimes feel uncomfortable, clumsy, and/or self-conscious because of the rapid
changes in their bodies.
Topic 3: Reproduction
Subconcept: Most people have the capability to reproduce; people also have the ability to choose
whether or not they wish to reproduce.
Developmental Messages:
Level 1
• Men and women have reproductive organs that enable them to have a child.
• Men and women have specific cells in their bodies (sperm cells and egg cells) that enable them to
reproduce.
• Reproduction requires that a sperm and egg join.
• Vaginal intercourse – when a penis is placed inside a vagina – is the most common way for a sperm
and egg to join.
26 • Guidelines for Comprehensive Sexuality Education
• When a woman is pregnant, the fetus grows inside her body in her uterus.
• A woman can be pregnant with more than one fetus at a time.
• Babies usually come out of a woman’s body through an opening called a vagina.
• Some babies are born by an operation called a Caesarian Section.
• A woman’s breasts can provide milk for a baby.
• Not all men and women have children.
• People who cannot have children may choose to adopt.
Level 2
• Decisions about having children are based on personal values, cultural beliefs, and other factors.
• Whenever vaginal intercourse occurs, it is possible for a woman to become pregnant.
• The union of a sperm and an egg is called conception or fertilization.
• The fetus begins to develop at fertilization.
• The fetus develops during pregnancy, a 40-week cycle that ends with birth.
• Sperm determine the biological sex of the fetus.
• Contraception can prevent fertilization and/or pregnancy.
Level 3
• People should use contraception during vaginal intercourse unless they want to have a child.
• Conception can occur once a woman has ovulated (released an egg).
• Ovulation is most likely to occur two weeks before a woman’s menstrual period.
• Predicting ovulation accurately can be difficult.
• A common sign of pregnancy is a missed menstrual period.
• Sexual intercourse during pregnancy usually will not harm the developing fetus.
Level 4
• Reproductive functioning is different from sexual functioning.
• Some people have fertility problems that make it difficult for them to conceive or carry a pregnancy.
• New reproductive technologies and medical procedures allow some people with fertility problems to
become pregnant.
• Some people who have fertility problems choose to adopt children or use a surrogate mother.
• Menopause is when a woman’s reproductive capacity ceases.
Key Concept 1: Human Development • 27
Topic 4: Body Image
Subconcept: People’s images of their bodies affect their feelings and behaviors.
Developmental Messages:
Level 1
• Individual bodies are different sizes, shapes, and colors.
• All bodies are equally special, including those that are disabled.
• Differences make us unique.
• Good health habits, such as eating well and exercising, can improve the way a person feels about
his or her body.
• Each person can be proud of his/her body.
Level 2
• A person’s appearance is determined by heredity, environment, and health habits.
• The way a body looks is mainly determined by the genes inherited from parents and grandparents.
• Most people do not look like what the media portrays as beautiful.
• Standards of beauty change over time and differ among cultures.
• What makes a body attractive is different for different people.
• People often feel pressure to change their bodies through gaining/losing weight, surgery,
or drugs.
• The value of a person is not determined by his/her appearance.
Level 3
• The size and shape of penises, breasts, and vulvas can vary significantly.
• The size and shape of sexual organs does not affect a person’s ability to reproduce or experience
sexual pleasure.
• The size and shape of a person’s body may affect how others feel about and behave toward that
person.
• Some people may develop disordered eating as a result of how they feel about their bodies.
• The media portrays beauty as a narrow and limited idea but beautiful people come in all shapes,
sizes, colors, and abilities.
• Although people stop growing once they reach adulthood, bodies change shape and size
throughout life.
28 • Guidelines for Comprehensive Sexuality Education
Level 4
• Many people of all shapes, sizes, and abilities have a positive image of their bodies.
• A person who accepts and feels good about his or her body may seem more likeable and attractive
to others.
• Physical appearance is only one factor that attracts one person to another.
• People are attracted to a variety of physical qualities.
• A person’s body image may impact his/her decision-making and behavior.
Topic 5: Sexual Orientation
Subconcept: As people grow and develop they may begin to feel romantically and/or sexually attracted
to people of the same and/or a different gender.
Developmental Messages:
Level 1
• Human beings can love people of the same gender and people of another gender.
• Some people are heterosexual, which means they can be attracted to and fall in love with someone
of another gender.
• Some people are homosexual, which means they can be attracted to and fall in love with someone
of the same gender.
• Homosexual men and women are also known as gay men and lesbians.
• People deserve respect regardless of who they are attracted to.
• Making fun of people by calling them gay (e.g. “homo,” “fag,” “queer”) is disrespectful and hurtful.
Level 2
• Sexual orientation refers to a person’s physical and/or romantic attraction to an individual of the
same and/or different gender.
• Some people are bisexual, which means they can be attracted to and fall in love with people of the
same or another gender.
• Gay men, lesbians, bisexuals, and heterosexuals are alike in most ways.
• Sexual orientation is just one part of who a person is.
• The origin of people’s sexual orientation is not known.
• Some people are afraid to share that they are gay, lesbian, or bisexual because they fear they will
be mistreated.
• People of all sexual orientations can have relationships that are equally fulfilling.
• Gay men, lesbians, and bisexual people can have their own children or adopt.
Key Concept 1: Human Development • 29
Level 3
• Gay, lesbian, bisexual, and heterosexual people come from all countries, cultures, races, ethnicities,
socio-economic backgrounds, and religions.
• People do not choose their sexual orientation.
• Understanding one’s sexual orientation can be an evolving process.
• There are many theories about what determines sexual orientation including genetics; prenatal,
social, and cultural influences; psychosocial factors; and a combination of all of these.
• Many scientific theories have concluded that sexual orientation cannot be changed by therapy or
medicine.
• Having discussions about sexual orientation can be difficult for some people.
• Teenagers who have questions about their sexual orientation should consult a trusted and
knowledgeable adult.
• People’s beliefs about sexual orientation are based on their religious, cultural, and family values.
• When a gay, lesbian, or bisexual person tells another person his/her sexual orientation, it is known
as “coming out.”
• Sometimes an individual’s sexual orientation is disclosed without his/her consent – this is known as
being “outed.”
• Coming out or being outed can be difficult because people may fear or experience negative reactions.
• Many of the sexual behaviors people engage in are the same regardless of their sexual orientations.
• There are people who have sexual thoughts and experiences with people of the same gender, but
do not consider themselves to be gay, lesbian, or bisexual.
• There are people who have sexual thoughts and experiences with people of another gender, but do
not consider themselves to be heterosexual.
• There are organizations that offer support services, hotlines, and resources for young people who
want to talk about sexual orientation.
• Some Internet sites offer gay, lesbian, bisexual, and heterosexual individuals the opportunity to join
a community and find friendship and support.
• While the Internet offers a wide range of information about sexual orientation, some of it is inaccurate.
• Although chatting or meeting people online can be fun, individuals should be cautious because it
can be unsafe.
Level 4
• Sexual orientation is determined by a combination of a person’s attractions, fantasies, and sexual
behaviors.
• The understanding and identification of one’s sexual orientation may change over the course of
his/her lifetime.
• Many states ban discrimination against people based on their sexual orientation.
• If an individual is being intimidated, harassed, or harmed because of a real or perceived sexual
30 • Guidelines for Comprehensive Sexuality Education
orientation, it is important to tell a trusted adult, school official, or law enforcement authority.
• This school’s bullying/harassment policy is _____________________.
• Civil rights for gay men and lesbian women are being debated in many states and communities
across the United States.
Topic 6: Gender Identity
Subconcept: People’s biological sex and gender identity play important roles in how they think, feel,
and behave.
Developmental Messages:
Level 2
• Biological sex refers to whether a person has male or female genitals and/or chromosomes.
• Gender identity refers to a person’s internal sense of being male, female, or a combination of these.
• Gender identity is just one part of who a person is.
• Gender roles refer to the way society expects people to behave based on their biological sex.
• Making fun of people for not acting the way society expects them to based on their biological sex
is disrespectful and hurtful.
Level 3
• For most people, biological sex and gender identity are the same.
• Some people’s gender identity differs from their biological sex.
• The origin of people’s gender identity is not known.
• Gender identity is different from sexual orientation.
• “Transgender” describes people whose internal sense of gender (gender identity) doesn’t match what
society expects of them based on their genitals and chromosomes (biological sex).
• Transgender is also used as a general term to describe many different identities that exist such as
“transsexual,” “drag king,” “drag queen,” “crossdresser,” “genderqueer,” “shapeshifter,”
“bigendered,” and “androgyne.”
• People’s understanding of their gender identity may change over the course of their lifetimes.
• Some transgender individuals may take hormones or have surgery to alter their bodies to better
match their gender identity.
• All societies and cultures have transgender individuals.
• Some cultures around the world recognize and have special roles for transgender individuals.
• Having discussions about gender identity can be difficult for some people.
• Teenagers who have questions about their gender identity should consult a trusted and knowledgeable
adult.
Key Concept 1: Human Development • 31
• Some organizations offer support services, hotlines, and resources for young people who want to
talk about gender identity.
• While the Internet offers a wide range of information about gender identity, some of it is inaccurate.
• Some Internet sites offer transgender individuals the opportunity to join a community and find
friendship and support.
• Although chatting or meeting people online can be fun, individuals should be cautious because it
can be unsafe.
• Some people are afraid to share that they are transgender because they fear they will be mistreated.
• Transgender individuals in this society commonly experience harassment and/or violence.
• If an individual is being discriminated against, intimidated, harassed, or harmed because of a
perceived gender identity, it is important to tell a trusted adult, school official, or law enforcement
authority.
• This school’s bullying/harassment policy is _____________________.
Level 4
• All people have the right to express their gender identity.
• As society builds a better awareness and understanding of gender identity, transgender individuals
may be more accepted and face less harassment and violence.
• Some cities have laws protecting transgender individuals from discrimination.
32 • Guidelines for Comprehensive Sexuality Education
Relationship Life Behaviors:
Having applied the relationships subconcepts at the appropriate
age, the learner will be able to:
• Express love and intimacy in appropriate ways.
• Develop and maintain meaningful relationships.
• Avoid exploitative or manipulative relationships.
• Make informed choices about family options and relationships.
• Exhibit skills that enhance personal relationships.
Topic 1: Families
Subconcept: Most people are raised in families and live in families
as adults.
Developmental Messages:
Level 1
• A family consists of two or more people who care for each
other in many ways.
Key Concept 2: Relationships • 33
Key Concept 2:
Relationships
Relationships play a central role
throughout our lives.
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
• There are different kinds of families.
• Children may live with one or more parents or caregivers including biological parents, step-parents,
foster parents, adoptive parents, grandparents, friends, or other combinations of adults.
• All members of a family may not live in the same place.
• The makeup of individual families may change over time.
• Each member of a family has something unique to contribute.
• Families have rules to help members live together.
• Family members take care of each other.
• Many adults may help care for children.
• Family members show love for each other.
• Change in a family may make its members happy or sad.
• When a baby is born or a child is adopted into a family, some parts of life will change for family
members.
Level 2
• Children may have a mother, a mother and a father, two mothers, two fathers, or any other
combination of adults who love and care for them.
• Family members have rights and responsibilities.
• Adult family members usually decide the children’s rights and responsibilities.
• Families help children learn values.
• Members of a family sometimes disagree but continue to love each other.
• Many life events, such as birth, adoption, separation, divorce, employment changes, moving,
disability, illness, or death, can change families.
• People in families can move away but they are still members of that family.
• Communication in families is important.
• For some families, raising children is a very important role.
• Families can influence individuals’ personalities.
Level 3
• Family members are individuals, each with a unique personality.
• The responsibilities of family members may change as they grow older.
• As children become more independent, they become more responsible for themselves and others.
• Teenagers are beginning a process of developing independence from their families and preparing to
be on their own.
• Love, cooperation, and mutual respect are necessary for good family functioning.
34 • Guidelines for Comprehensive Sexuality Education
• Family relationships may become difficult when the family structure changes.
• Different people may have different values and ideas about family life.
• Conflicts sometimes occur between parents and children, especially during adolescence.
• Families sometimes need counseling in order to function well.
• Community agencies and health professionals can assist families with problems.
• Sometimes families need to be broken up for the health and safety of the children.
• Relationships between parents and children often change as they all grow older.
Level 4
• When a family crisis occurs, family members need to support each other.
• One purpose of the family is to help its members reach their fullest potential.
• Many aspects of family life have changed during the past several generations.
Topic 2: Friendship
Subconcept: Friendships are important throughout life.
Developmental Messages:
Level l
• People can have many friends or just a few.
• A person can have different types of friends.
• Friends spend time together and get to know each other.
• Friendships depend on honesty.
• Friends respect and appreciate each other.
• Friends can feel angry with each other and still be friends.
• Friends sometimes hurt each other’s feelings.
• Friends forgive each other.
• Friends share feelings with each other.
• Friends can help each other.
• Friends can be male and female.
• Friends can be younger and older.
Level 2
• Friendships help people feel good about themselves.
Key Concept 2: Relationships • 35
• Many skills are needed to begin, continue, and end friendships.
• Choosing friends well is important.
Level 3
• Friends can influence each other both positively and negatively.
• It is important to support and help a friend when he/she has a problem.
• Friendships sometimes evolve into romantic relationships.
• People can be friends without being romantically involved.
Topic 3: Love
Subconcept: Loving relationships of many types are important throughout life.
Developmental Messages:
Level 1
• Love means having deep and warm feelings about oneself and others.
• People can experience different types of love.
• People express love differently to their parents, families, and friends.
• People can experience different loving relationships throughout their lives.
Level 2
• People are capable of giving and receiving love.
• A person can show love for another person in many ways.
• Feeling good about oneself enhances loving relationships.
Level 3
• Love is a difficult concept to define.
• Love is not the same as sexual involvement or attraction although it can happen at the same time.
• Knowing for sure if one is in love can be difficult.
• People may confuse love with other intense emotions such as sexual attraction, lust, infatuation,
jealousy, and control.
• The feelings of “falling in love” are often different from those in a continuing relationship.
• A person can “fall in love” many times in their life.
• “First love” is often one of life’s most intense experiences.
36 • Guidelines for Comprehensive Sexuality Education
• In a love relationship, people encourage each other to develop as individuals.
• Loving someone can involve taking risks and being vulnerable.
• Love is not always returned.
Level 4
• Love requires understanding oneself as well as others.
• Loving oneself improves one’s ability to love another person.
• Love often changes and grows during a long-term relationship.
• Loving another person can be one of life’s greatest joys.
• Loving relationships may involve shared values, commitment, and intimacy.
• Some love relationships involve sexual intimacy while others do not.
• Ending a loving relationship can be difficult and painful.
Topic 4: Romantic Relationships and Dating
Subconcept: Dating enables people to experience and learn about companionship and intimacy.
Developmental Messages:
Level 1
• Dating is when two people who are romantically attracted to each other spend their free time
together.
• When children become teenagers, they spend more time with their friends and may begin to date.
• Some adults, including single parents, may date.
Level 2
• Both teenagers and adults may have romantic relationships.
• Before people commit themselves to a relationship, they may want to be friends, spend time
together, and get to know each other well.
• Young people may use many different terms to describe dating and romantic relationships.
Level 3
• Readiness and interest in dating vary among individuals.
• Not all teenagers or adults date.
• Gay, lesbian, and bisexual youth, like heterosexual youth, may or may not date.
• Parents often decide the age at which their children may begin dating.
Key Concept 2: Relationships • 37
• Customs and values about dating differ among families and cultures.
• Families may have different standards for boys and girls about dating.
• People of different races, ethnic backgrounds, and religions sometimes date each other.
• People date for a variety of reasons such as companionship, to share an experience with someone,
friendship, intimacy, and love.
• Both girls/women and boys/men can show interest in a dating partner and initiate dating.
• Dating includes sharing recreational activities, learning about new things, and practicing social skills.
• People date in different ways such as couple dating, double dating, and group dating.
• What people consider a date can vary.
• Group activities allow teenagers to learn about others without dating.
• When dating involves expenses, either person or both people can pay.
• Paying for a date or giving gifts does not entitle someone to any type of sexual activity.
• When couples spend a lot of time together alone, they are more likely to become sexually involved.
• Sometimes people in dating relationships may be physically or emotionally abused by their partners
which is called “dating abuse.”
• There are organizations and counselors who can help teens and adults who are in an abusive
relationship.
• Ending a dating relationship can be painful.
Level 4
• Dating can be a way to learn about other people, about romantic and sexual feelings and
expressions, and about what it is like to be in an intimate relationship.
• Dating partners may choose not to follow traditional gender roles in their relationships.
• Dating relationships can be enhanced by honesty and openness.
• One person can not meet all of the needs of his/her dating partner.
• Responsibility for the quality of the relationship is shared by both dating partners.
Topic 5: Marriage and Lifetime Commitments
Subconcept: It is common for two people to make a commitment to share their lives with each other.
Developmental Messages:
Level 1
• Two people may decide to marry or make a lifetime commitment to each other because they love
each other and want to share their lives with each other.
• Many men and women will marry.
38 • Guidelines for Comprehensive Sexuality Education
• Many people live in lifetime committed relationships, even though they may not be legally married.
• Two people of the same gender can live in loving, lifetime committed relationships.
• Most people who marry intend the relationship to be lifelong.
• People who are married or committed to each other may get divorced or break up if they decide
they do not want to be together anymore.
• When parents divorce or break up, children may live with one or both parents or with other family
members.
• Divorce and break-ups are usually difficult for families.
• After a divorce or break-up, parents and children continue their lives in new ways and can be happy
again.
• Children are not able to get their separated or divorced parents back together regardless of how
much they want that to happen.
• Children are not to blame for their parents’ separations or divorces.
Level 2
• In the United States, people usually choose the person they want to marry or make a commitment to.
• In some cultures, parents choose marriage partners for their children.
• Different cultures and religions have varying values about marriage, lifetime commitments, living
together, sexual relationships before or outside of marriage, and divorce.
• Children dealing with separation or divorce may need to talk with an adult about their feelings.
Level 3
• Marriage is considered a commitment by two people to love, help, and support one another.
• Marriage is a legal contract between two people and the state.
• Marriage may include a religious or civil ceremony.
• Two people who live together without being married can have the same commitment and responsibility
toward one another as married people.
• Gay men, lesbians, bisexuals, and heterosexuals can establish lifelong committed relationships.
• Committed partners must decide how to share the roles and responsibilities in their lives.
• Marriage and lifetime commitments may benefit from characteristics such as friendship, shared
values, commitment, similar interests and goals, mutual support, and sexual attraction.
• In some families, there are different standards for men and women about sexual relationships
before marriage.
• Divorce is the legal ending of a marriage.
• In some religions and cultures, divorce is prohibited.
• Teenagers who marry are more likely to divorce than couples who marry when they are older.
Key Concept 2: Relationships • 39
• Couples with children have several options for child custody when they separate or divorce.
• In a divorce or separation, decisions about the family, including custody of children and financial
resources, may be made by the couple or the legal system.
• Marriage between two people of the same sex/gender is currently being debated in the United
States.
Level 4
• When two people are contemplating marriage or a lifetime commitment, they need to be realistic,
honest with one another, and accepting of their partner.
• Marriage and lifetime commitments require mutual effort.
• Marriage and lifetime commitments require understanding of extended family relationships.
• A marriage or committed relationship may change over time.
• Relationships change with parenthood.
• When married or committed partners have difficulty in their relationships, they can seek counseling.
Topic 6: Raising Children
Subconcept: Raising children is an enormous responsibility that can be one of life’s most rewarding roles.
Developmental Messages:
Level 1
• Many people want to be parents.
• Raising children is an adult role.
• Raising children requires great effort, resources, time, and patience.
• People who have children need to provide for them.
• Raising children can be a wonderful experience.
• Adults become parents in several ways: having biological children, adopting children, becoming a
step-parent, or becoming a guardian or foster parent.
• People who have or adopt children are responsible for loving and taking care of them.
• Parents who adopt, love their children as much as biological parents love theirs.
Level 2
• Children need a home, food, clothing, love, support, time, education, and caring adults to help
them grow and develop.
• Sometimes other family members or caring adults raise a child instead of her/his mother and/or
father.
40 • Guidelines for Comprehensive Sexuality Education
• Both men and women have important parental responsibilities.
• People with disabilities can have and care for children.
• People have different ideas about what makes a good parent.
• Sometimes parents may not be able to do a good job of raising children because they are having
difficulties in their own lives.
• Raising a child can be rewarding.
• Some couples do not have children.
• Adults can have happy lives without raising children.
Level 3
• Raising children is a full-time responsibility.
• Balancing job and parenting responsibilities can be difficult.
• Methods of raising children vary among cultures, but all parents must provide for their children’s
development.
• Children of different ages require different types of parenting.
• Family members and community agencies can help people to be better parents or to deal with
problems.
• Being a teenage parent can be extremely difficult.
• For a teenager, parenting responsibilities can interrupt schooling, employment plans, social
opportunities, and family life.
• The children of teenage parents often face more difficulties than the children of adults.
• Teenage parents may benefit from the support of their families and community services.
• Teenagers who become pregnant may receive financial and emotional support from their families
but this is not always the case.
Level 4
• As children grow, the nature of the parent/child relationship changes.
• Raising a child with special needs can be both rewarding and challenging.
• Deciding not to be a parent may be difficult because of societal and cultural pressures to have and
raise children.
Key Concept 2: Relationships • 41
42 • Guidelines for Comprehensive Sexuality Education
Personal Skills Life Behaviors:
Having applied the personal skills subconcepts at the appropriate
age, the learner will be able to:
• Identify and live according to one’s own values.
• Take responsibility for one’s own behavior.
• Practice effective decision-making.
• Develop critical-thinking skills.
• Communicate effectively with family, peers, and romantic partners.
Topic 1: Values
Subconcept: Values guide our behavior and give purpose and
direction to our lives.
Developmental Messages:
Level 1
• Values are strong feelings or beliefs about important issues.
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
Key Concept 3:
Personal Skills
Healthy sexuality requires
the development and use of specific
personal and interpersonal skills.
• Individuals and families have a variety of values.
• Children learn most of their values from parents, other family members, community, cultural and
religious teachings, and their peers.
Level 2
• Values help people decide how to behave and interact with others.
• Most parents want their children to develop values that are similar to their own.
• Parents and other adults teach values to children through explanation and example.
• While some values are universal, others differ among individuals, families, communities, religions,
and cultures.
Level 3
• Values are an important part of people’s lives.
• Values influence a person’s most important decisions about friends, sexual relationships, family,
education, work, and money.
• When people behave according to their values, they often feel better about themselves.
• A person who behaves contrary to his or her values may feel guilty or uncomfortable.
• Exploring one’s values can be confusing.
• Sometimes the values one learns in society conflict with the values one has learned from family,
religion, or culture.
• Values should be freely chosen after the alternatives and their consequences are evaluated.
• No one has the right to impose their values on others.
Level 4
• To behave according to one’s values can be difficult but satisfying.
• Knowing the consequences of behaving according to or against one’s values is important.
• Respecting the diversity of values and beliefs of other people is important.
• Having values different from one’s family can be difficult.
• A person may accept his/her family’s values and not always agree with all of them.
• Relationships are usually stronger if people share similar values.
• People who feel strongly about their values often share and affirm them publicly.
Topic 2: Decision-making
Subconcept: Making responsible decisions about sexuality is important because those decisions affect
individuals and the people around them.
Key Concept 3: Personal Skills • 43
Developmental Messages:
Level 1
• Everybody has to make decisions.
• Small children make many decisions, such as what clothes to wear, which toys to play with, or who
to be friends with.
• Children need help from adults to make some decisions.
• All decisions have consequences, positive and/or negative.
• Decision-making is a skill that can be improved.
Level 2
• People make decisions in different ways: by impulse, by making the same decision friends made, by
putting off making a decision, by letting someone else decide, and by testing the choices.
• To make a good decision one must consider all of the possible consequences, good and bad, and
choose the action that one believes will have the best outcome.
• Decisions often have more options than seem obvious at first.
• Parents and other adults can help with important decisions.
• Friends often try to influence each other’s decisions.
• Individuals should not make decisions based solely on what their peers are doing.
• Many decisions affect other people.
• Individuals are responsible for the consequences of their decisions.
Level 3
• People should carefully evaluate the consequences, advantages, and disadvantages of each possible
choice when they make a decision.
• To make wise decisions, people need accurate information about each choice.
• Evaluating past decisions can help individuals learn from experiences and not repeat mistakes.
• Talking to a close friend, parent, other family member, religious leader, or counselor during the
decision-making process can be helpful.
• The best decision is usually one that is consistent with one’s own values and does not involve
risking one’s health/safety, other people’s health/safety, or breaking the law.
• Barriers to implementing a decision may become evident after the decision is made.
• Barriers to acting on a decision can often be overcome with careful planning.
• People have the right to re-evaluate decisions and change their minds or their behavior accordingly.
• Some young people face difficult decisions about sexuality, including whether to have a sexual
relationship and the limits of the relationship.
44 • Guidelines for Comprehensive Sexuality Education
• Decisions about sexuality are sometimes difficult because of sexual feelings and pressure from
partners or peers.
• Teenagers who decide to engage in sexual behavior must also decide about pregnancy and STD/HIV
prevention.
• Alcohol and other drugs often interfere with clear, effective decision-making.
Level 4
• Some decisions have legal implications.
Topic 3: Communication
Subconcept: Communication includes sharing information, feelings, and attitudes with other people.
Developmental Messages:
Level 1
• People communicate in many ways.
• People speak, write, sign, or show how they feel with facial expressions and body language.
• Communication is necessary in human relationships.
Level 2
• People often communicate their feelings with nonverbal messages.
• Sometimes when two people talk they do not understand each other.
• Some disagreements in families and among friends may occur because of poor communication.
• People can learn to communicate more effectively.
• Depending on the situation, people may communicate differently or use different words.
• Some people speak more than one language.
• Speaking one language at home and another at school can be challenging.
Level 3
• Different people have different styles of communicating.
• People who have different styles of communicating may have a difficult time understanding each
other.
• Communication may be improved by: listening well; making eye contact; stating feelings; using
messages that start with “I” to indicate that the person is speaking for him/herself; trying to
understand the other person(s); offering possible solutions to problems; giving positive nonverbal
messages such as a smile or touch; asking for clarification.
• Communication may be impaired by: not listening; yelling; blaming, criticizing, or name calling;
Key Concept 3: Personal Skills • 45
making the other person feel guilty; giving negative nonverbal messages such as frowning or
scowling; and interrupting.
• Verbal and nonverbal communication do not always convey the same message.
• Verbal and nonverbal communication may have many meanings depending on the individual, family,
gender, cultural background, and situation.
• It may be difficult for individuals who feel that they have less power in a relationship to communicate
effectively.
• Some cultures teach that it is disrespectful to make eye contact with a person in authority or to ask
for more information.
• Talking openly about sexuality can enhance relationships.
• People are sometimes uncomfortable discussing sexuality in an open manner.
Level 4
• Good communication is essential to personal and work relationships.
• Communication about sexual feelings, desires, and boundaries can improve sexual relationships.
• Communication is necessary to assure consent for a sexual relationship and any sexual behavior.
• There are several types of communication including assertive, aggressive, passive, and passive-
aggressive.
• Assertive communication is most effective for stating one’s needs without hurting or overpowering
others.
Topic 4: Assertiveness
Subconcept: Assertiveness is communicating feelings and needs while respecting the rights of others.
Developmental Messages:
Level 1:
• Everyone, including children, has rights.
• Telling trusted people about one’s feeling and needs is acceptable.
• Asking is often the first step to getting what one wants or needs.
• Children sometimes have to do things they do not want to do because their parents or other adults
say so.
Level 2
• Being assertive means expressing what one wants or saying how one feels without hurting or over-
powering others.
• Assertiveness is a skill that can be learned and improved.
46 • Guidelines for Comprehensive Sexuality Education
• Being assertive may include repeating one’s position, offering a compromise, and/or walking away.
• Being assertive does not ensure that people will always get what they want.
• Being assertive is different from being aggressive, which interferes with the rights of others.
Level 3
• People have the right to express how they feel; disagree with others; refuse a request; and expect
to be treated fairly and not be intimidated.
• Being assertive can help people choose between the actions they believe are best and behaviors
their friends pressure them to do.
• Behaviors that help people be more assertive include: being honest; being direct; communicating
feelings and needs as they come up instead of waiting; using assertive body language; speaking for
oneself; and taking responsibility for one’s feelings and needs.
• Failure to be assertive may cause one to feel angry or ashamed and, as a result, to act aggressively.
• People may choose not to be assertive in certain situations.
• Behavior that is viewed as assertive and appropriate in one culture may be viewed as aggressive or
passive in others.
• In some cultures, asking directly for what one wants is considered disrespectful or inappropriate.
• Some cultures and families teach women not to be assertive within the family or with men.
• Girls and women and boys and men can be assertive.
• It may be difficult for individuals who feel that they have less power in a relationship to be assertive.
• Being assertive in sexual situations may be especially difficult.
• Individuals always have the right to refuse any person’s request for any type of sexual behavior.
Level 4
• It may be difficult always to be assertive.
• Assertiveness skills can be practiced and improved throughout one’s life.
• Adults may be assertive in their personal and work relationships.
• Sexual partners may need to assertively communicate their needs and limits.
Topic 5: Negotiation
Subconcept: Negotiation allows people to solve a problem or resolve a conflict.
Developmental Messages:
Level 1
• Negotiation requires give and take on the part of all people involved.
Key Concept 3: Personal Skills • 47
• Good negotiation can enhance relationships and friendships.
• Sharing is a type of negotiation.
Level 2
• Negotiation is a way to compromise with others without using guilt, anger, or intimidation.
• There are many different negotiation techniques.
• Effective negotiation requires certain skills including: careful observation of other people; use of
open body language; good verbal communication; imagining oneself in other people’s positions;
identifying all the options in a situation; and reaching mutual agreement.
• Negotiation works best when a problem or conflict is addressed in its early stages.
Level 3
• To negotiate one must decide what trade-offs can be accepted and what issues cannot be
compromised.
• Teenagers who date need to learn to negotiate decisions about sexual behaviors and limits.
• It may be difficult for individuals who feel that they have less power in a relationship to negotiate
effectively.
• Many relationship and sexual concerns can be resolved through negotiation.
• If people fail to reach an acceptable compromise even after negotiation, they may decide to walk
away from the situation.
Level 4
• Manipulation, trying to unfairly control someone’s decision or behavior without consideration of
their feelings or needs, is different from negotiation.
• Negotiations that involve ultimatums or threats are often less effective.
Topic 6: Looking for Help
Subconcept: People can seek help from family, friends, or professionals.
Developmental Messages:
Level 1
• Family members and friends usually try to help one another.
• If parents cannot help, one can ask another family member, a teacher, religious leader, guidance
counselor, a friend’s parent, or another trusted adult.
48 • Guidelines for Comprehensive Sexuality Education
Level 2
• Children may be able to help someone who has a problem.
• Sometimes the best help comes from someone who is a good listener.
• Asking for help is usually a wise decision.
• Families might need outside help to deal with problems involving alcohol, drugs, money, violence,
health, and abuse.
• Community agencies and other people can provide help to families and individuals.
• Many problems need time to resolve.
Level 3
• People often have difficulty admitting they need help.
• Teenagers sometimes need to talk with an adult other than their parents.
• In order to find the best source of help, individuals should consider the nature of their problem and
the questions they need answered.
• People who can help include family members, counselors, religious leaders, health/mental healthcare
providers, and teachers.
• Some agencies specialize in working with young people and provide services for teenagers that do
not require parental permission, are confidential, and cost little or no money.
• Most communities have a telephone crisis line so people can talk to someone about a problem; the
local crisis line phone number is ____________________.
• While the Internet can provide information and support about a variety of topics and problems,
some sites may be inaccurate and/or biased.
Level 4
• Sometimes people need to work through their problems themselves.
• Sometimes people need professional help.
• Seeking professional help can be a sign of strength.
• While the Internet can be a source of information and referrals, it cannot replace the support of
family, friends, or professionals.
Key Concept 3: Personal Skills • 49
Sexual Behavior Life Behaviors:
Having applied the sexual behavior subconcepts at the appropriate
age, the learner will be able to:
• Enjoy and express one’s sexuality throughout life.
• Express one’s sexuality in ways that are congruent with one’s
values.
• Enjoy sexual feelings without necessarily acting on them.
• Discriminate between life-enhancing sexual behaviors and
those that are harmful to self and/or others.
• Express one’s sexuality while respecting the rights of others.
• Seek new information to enhance one’s sexuality.
• Engage in sexual relationships that are consensual, non-
exploitative, honest, pleasurable, and protected.
Topic 1: Sexuality Throughout Life
Subconcept: Sexuality is a natural and healthy part of life.
50 • Guidelines for Comprehensive Sexuality Education
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
Key Concept 4:
Sexual Behavior
Sexuality is a central part of being
human, and individuals express their sexuality
in a variety of ways.
Developmental Messages:
Level 1
• Most children are curious about their bodies.
• Bodies can feel good when touched.
Level 2
• People become more curious about their sexuality as they become older.
• Talking to parents and other trusted adults about sexuality can be helpful.
Level 3
• All people, regardless of biological sex, gender, age, ability, and culture, are sexual beings.
• Sexuality is experienced in a variety of ways at different stages and points in people’s lives.
• Sexual feelings, fantasies, and desires occur throughout life.
• Sexual feelings, fantasies, and desires are natural.
• Sexual feelings, fantasies, and desires do not need to be acted upon.
Level 4
• Sexuality is multifaceted, having biological, social, psychological, spiritual, ethical, and cultural dimensions.
• Sexuality is a natural part of being human.
• Sexuality is one component of total well-being to be expressed in harmony with other life needs.
• Healthy sexuality enhances total well-being.
• Sexuality can be more rewarding and positive when expressed in a sharing, enhancing, and non-
exploitative way.
• People’s interest in sexual activity and expression may change as they age.
• Elderly people can be sexually active and have intimate relationships.
• Sexual expression is not a significant part of some people’s lives.
Topic 2: Masturbation
Subconcept: Masturbation is one way human beings express their sexuality.
Developmental Messages:
Level 1
• Touching and rubbing one’s own genitals to feel good is called masturbation.
Key Concept 4: Sexual Behavior • 51
• Some boys and girls masturbate and others do not.
• Masturbation should be done in a private place.
Level 2
• Masturbation is often the first way a person experiences sexual pleasure.
• Many boys and girls begin to masturbate for sexual pleasure during puberty.
• Some boys and girls never masturbate.
• Masturbation does not cause physical or mental harm.
• Some families, religions, and cultures believe that masturbation is wrong.
Level 3
• Most people have masturbated at some time in their lives.
• How often a person masturbates varies for every individual.
• A person worried about masturbation might talk to a trusted adult.
• It may be difficult for some people to talk about masturbation.
• Masturbation, either alone or with a partner, is one way people can enjoy and express their sexuality
without risking pregnancy or an STD/HIV.
• Many negative myths exist about masturbation.
Level 4
• People who are single, married, or in a committed relationship may masturbate.
• Masturbation may be an important part of a couple’s sexual relationship.
• Being sexual with another person does not mean that masturbation must or should stop.
Topic 3: Shared Sexual Behavior
Subconcept: Individuals express their sexuality with a partner in diverse ways.
Developmental Messages:
Level 1
• People often kiss, hug, touch, and engage in other sexual behaviors with one another to show caring
and to feel good.
Level 2
• Couples have varied ways to share sexual pleasure with each other.
52 • Guidelines for Comprehensive Sexuality Education
• Being sexual with another person usually involves more than sexual intercourse.
Level 3
• Some sexual behaviors shared by partners include kissing; touching; talking; caressing; massaging;
and oral, vaginal, or anal intercourse.
• Many pleasurable sexual behaviors do not put an individual at risk for an unintended pregnancy or
STDs/HIV.
• The majority of people, regardless of biological sex, gender, ability, sexual orientation, gender identity,
and culture, have sexual feelings and the need for love, affection, and physical intimacy.
• Sexual relationships are enhanced when a couple communicates with one another about what
forms of sexual behavior they like or dislike.
• Sexual relationships are enhanced when partners make a commitment to respect each other’s
boundaries and do what they can to avoid STDs and unintended pregnancy.
• Sexual relationships can be more fulfilling in a loving relationship.
• A person has the right to refuse any sexual behavior.
• At any point during sexual activity a person has the right to ask a partner to stop and to expect
that his/her request will be respected.
• A person should not pressure a partner to engage in any sexual behavior that he/she is
uncomfortable with.
• Some sexual behaviors are prohibited by law and/or disapproved of by certain religions, cultures, or
families.
• Both men and women can give and receive sexual pleasure.
Level 4
• For many people, sharing a sexual experience with a partner is a satisfying way to express sexuality.
• Couples and individuals need to decide how to express their sexual feelings.
• As people get older, they may continue to discover new forms of sexual expression to share with a partner.
• Individuals can learn what gives them sexual pleasure and communicate that to partners in order to
enhance their sexual relationships.
Topic 4: Sexual Abstinence
Subconcept: Abstinence from sexual intercourse is the most effective method of preventing pregnancies
and sexually transmitted diseases, including HIV.
Developmental Messages:
Level 2
• Children are not physically or emotionally ready for sexual intercourse and other sexual behaviors.
Key Concept 4: Sexual Behavior • 53
Level 3
• Abstinence means voluntarily choosing not to engage in certain behaviors.
• Sexual abstinence means not engaging in any sexual behavior that can result in a pregnancy or
STD, including HIV.
• People may have different ideas about what constitutes abstinence, from no sexual contact of any
kind including kissing, to only abstaining from sexual intercourse, and all points in-between.
• People of all ages, genders, and sexual orientations can choose to be abstinent.
• Sexual partners should discuss what they mean by abstinence.
• Abstinence from intercourse has benefits for teenagers and adults.
• Sexual abstinence is the best method to prevent pregnancy and STDs/HIV.
• Young teenagers are not mature enough for a sexual relationship that includes intercourse.
• Many adults believe school-age teenagers should not have sexual intercourse.
• Some religions teach that sexual intercourse should only occur in marriage.
• There are many ways to give and receive sexual pleasure without having intercourse.
• Teenagers in romantic relationships can express their feelings without engaging in sexual
intercourse.
• Teenagers who date need to discuss sexual limits with their dating partners.
• Individuals need to respect the sexual limits set by their partners.
• Teenagers considering sexual activity should talk to a parent or other trusted adult about their
decisions, contraception, and disease prevention.
• Teenagers who have already had sexual intercourse can choose to be abstinent in that same
relationship and/or in future relationships.
Level 4
• Many teenagers have had sexual intercourse and many have not.
• Sexual intercourse is not a way to achieve adulthood.
• Many adults experience periods of abstinence.
Topic 5: Human Sexual Response
Subconcept: Female and male bodies respond both similarly and differently to sexual stimulation.
Developmental Messages:
Level 1
• Both girls and boys may discover that their bodies feel good when touched.
54 • Guidelines for Comprehensive Sexuality Education
Level 2
• Human beings have natural, physical responses to sexual stimulation.
• During puberty, boys and girls may become more aware of their responses to sexual stimulation.
Level 3
• Women and men may be sexually aroused by thoughts, feelings, sights, smells, sounds, and touches.
• Boys/men get erections and girls/women experience vaginal lubrication during sexual arousal.
• Sexual response is experienced differently by different individuals.
• Sexual response varies from experience to experience and throughout life.
• Orgasm is an intense pleasurable release of sexual feelings or tension experienced at the peak of
sexual arousal.
Level 4
• Most women need some clitoral stimulation to reach orgasm.
• Most couples do not experience simultaneous orgasm.
• As two sexual partners become more comfortable with each other, the nature of their sexual
responses may change and may become more rewarding.
• Middle age may bring some changes in physiological sexual responses, but most men and women
still desire sexual contact and experience orgasm.
• Women and men have the capacity to respond sexually throughout life.
Topic 6: Sexual Fantasy
Subconcept: Sexual fantasies are common.
Developmental Messages:
Level 3
• Many people experience sexual and erotic thoughts called fantasies.
• Fantasies are one type of sexual expression.
• People may fantasize while they are alone or with a partner.
• People do not need to act on their sexual fantasies.
Level 4
• People can have sexual fantasies about individuals of all genders without it necessarily affecting
their understanding of their sexual orientation.
Key Concept 4: Sexual Behavior • 55
• Some people use erotic photographs, movies, art, literature, or the Internet to enhance their sexual
fantasies when alone or with a partner.
• Some sexual fantasies involve mysterious or forbidden things.
• Many people’s sexual fantasies include behaviors not actually acted upon or even desired in real life.
Topic 7: Sexual Dysfunction
Subconcept: Sexual dysfunction is the inability to express, experience, and/or enjoy sexuality.
Developmental Messages:
Level 3
• The way people feel about themselves and sexuality affects their ability to function sexually.
• Some people have sexual problems, commonly called sexual dysfunction.
• People of all genders and sexual orientations can experience sexual dysfunction.
Level 4
• What is perceived as sexual dysfunction varies among individuals.
• Common sexual dysfunctions include lack of desire, inadequate lubrication, erectile difficulties, and
difficulties attaining orgasm.
• Sexual dysfunctions may result from guilt, fear, anger, stress, anxiety, depression, medical problems,
medication, or relationship difficulties.
• Some sexual dysfunctions may indicate undiagnosed medical problems or relationship difficulties.
• Most sexual dysfunctions can be effectively managed through treatment or therapy with a specially
trained professional.
• For some couples, honest communication can solve sexual problems.
• At one time or another, nearly everyone will experience a sexual concern or dysfunction.
• A person concerned about sexual functioning can talk to a trusted adult or health care provider.
• There are mental health professionals, including sex therapists, who can help individuals and
couples deal with sexual dysfunction.
56 • Guidelines for Comprehensive Sexuality Education
Sexual Health Life Behaviors:
Having applied the sexual health subconcepts at the appropri-
ate age, the learner will be able to:
• Practice health-promoting behaviors, such as regular check-ups,
breast and testicular self-exam, and early identification of
potential problems.
• Use contraception effectively to avoid unintended pregnancy.
• Avoid contracting or transmitting a sexually transmitted disease,
including HIV.
• Act consistently with one’s own values when dealing with an
unintended pregnancy.
• Seek early prenatal care.
• Help prevent sexual abuse.
Topic 1: Reproductive Health
Subconcept: Men and women must care for their reproductive
health.
Key Concept 5: Sexual Health • 57
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
Key Concept 5:
Sexual Health
The promotion of sexual health requires
specific information and attitudes to avoid
unwanted consequences of sexual behavior.
Developmental Messages:
Level 1
• Girls and boys need to take care of their bodies during childhood and adolescence.
• Like other body parts, the genitals need care.
Level 2
• Boys and girls should keep their genitals clean, healthy, and free from injury.
Level 3
• After a girl’s breasts have developed, she needs to examine them each month using the correct
breast self-examination procedure.
• After puberty, a boy needs to examine his testicles regularly using the correct testicular self-
examination procedure.
• Young women should begin to receive regular gynecological exams, including pap smears, breast
examinations, and/or STD testing, when they begin to engage in oral, vaginal, or anal intercourse or
turn 18, whichever happens first.
• Young men should begin to receive regular sexual health exams from a general practitioner or
urologist that include testicular exams and/or STD testing when they begin to engage in oral,
vaginal, or anal intercourse or turn 18, whichever happens first.
• Individuals who suspect something is wrong with their sexual or reproductive organs, such as genital
discomfort or itching or a lump in a breast or testicle, should seek medical attention immediately.
• Untreated STDs during adolescence can be especially dangerous to a boy’s or girl’s future reproductive
capability.
• Drug use during adolescence can be especially dangerous to a boy’s or girl’s future reproductive capability.
Level 4
• Older men and women need to be regularly tested for such health issues as prostate cancer or
breast cancer.
• Women and men in the workplace should be informed regarding any environmental hazards that
could harm their reproductive system and the precautions necessary to avoid those hazards.
Topic 2: Contraception
Subconcept: Contraception enables people to have sexual intercourse and avoid unintended pregnancy.
Developmental Messages:
Level 1
• Some people have children and others do not.
58 • Guidelines for Comprehensive Sexuality Education
• Each family can decide how many children to have, if any.
Level 2
• When a man and a woman want to have vaginal intercourse without having a child, they can use
contraception to prevent pregnancy.
• Some religions and cultures teach that contraception is acceptable while others do not approve of
using contraception.
• Decisions about using contraception are based on personal values, comfort with one’s body, cultural
traditions, availability of methods, and other factors.
Level 3
• Young people who are considering sexual intercourse should talk to a parent or another adult
about their decision and about contraception.
• There are many different methods of contraception.
• Some contraceptive methods require a visit to a healthcare provider and a prescription while others
are available “over-the-counter.”
• Nonprescription (“over-the-counter”) methods include male and female condoms, foam, gels, and
suppositories.
• Young people can buy nonprescription contraceptives in a pharmacy, grocery store, market, or
convenience store.
• Prescription methods include birth control pills, birth control injections, the birth control patch, the
birth control ring, the diaphragm, cervical cap, and intrauterine devices (IUD).
• In most states, young people can get prescriptions for contraception without their parents’ permission.
• Other methods of preventing pregnancy include abstinence, withdrawal, and natural family planning.
• Male and female sterilization are permanent methods of contraception.
• Each method of contraception has advantages and disadvantages.
• Certain contraceptive methods may not be appropriate for individuals with specific health issues.
• Some methods of contraception, such as withdrawal, are not as effective as others.
• Some methods of contraception, such as condoms, can also prevent the transmission of STDs/HIV.
• The most effective methods of contraception, such as the Pill, injection, and the birth control patch,
do not help prevent the transmission of STDs/HIV.
• Couples who want to reduce their risk for both pregnancy and STDs/HIV need to use male or
female condoms along with another effective method of contraception.
• Any method of contraception, in order to be effective in preventing pregnancy and STDs/HIV, must
be used consistently and correctly.
• Although most contraceptive methods are made for the female body, men and women should
make decisions about methods together.
Key Concept 5: Sexual Health • 59
Level 4
• A person whose religious or cultural teachings prohibit contraception may have to decide between
those teachings, the risk of unintended pregnancy or STDs/HIV, and his/her decision to have vaginal,
oral, or anal intercourse.
• When choosing contraception, people must weigh the advantages and disadvantages of a particular
method as well as its effectiveness in preventing pregnancy and STDs/HIV.
• People should choose a method that they will use effectively and consistently.
• People can find creative and sensual ways to integrate contraception into their sexual relationships.
• Emergency contraception is a high dose of birth control pills that when taken shortly after vaginal
intercourse can prevent pregnancy.
• Women who have had unprotected vaginal intercourse or whose contraceptive method failed can
obtain emergency contraception from their health care provider or pharmacist.
• Emergency contraception should not be used as a primary method of birth control.
Topic 3: Pregnancy and Prenatal Care
Subconcept: Women who are pregnant or considering becoming pregnant should take care of their
reproductive health and seek prenatal care.
Developmental Messages:
Level 1
• A pregnant woman must take extra care of her health with exercise, healthy foods, and frequent
visits to her healthcare provider.
• Most babies are born healthy.
• Smoking, drinking alcohol, and using other drugs can hurt a fetus before it is born.
Level 2
• Birth defects may cause lifetime health or developmental problems.
• Pregnancy can happen anytime a girl/woman has unprotected vaginal intercourse with a boy/man.
Level 3
• When a woman decides to try to become pregnant or becomes pregnant, she should begin routine
prenatal care; follow nutrition guidelines; avoid tobacco, alcohol, and other drugs; and consider
being tested for STDs/HIV.
• If a woman suspects she is pregnant, she should consult a healthcare provider.
• Whether a woman decides to terminate a pregnancy or carry it to term, early discussions and
medical care are important.
• STDs/HIV during pregnancy can result in birth defects.
60 • Guidelines for Comprehensive Sexuality Education
• Men and women should be examined for STDs/HIV prior to conception.
• Pregnant teenagers need special medical care and support.
• Childbirth is a natural process that is usually safe for the pregnant woman and the baby.
• A woman can choose to have certain individuals, such as the father of the baby or family members,
present during labor and delivery.
• Miscarriages may result from a maternal infection but most often occur because of genetic
abnormalities in the fetus.
• Regardless of the mother’s or father’s age, health status, diet, or genetic background, some babies
are born with medical problems or die in infancy.
• Some genetic disorders can cause birth defects or infant death.
• Men and women should find out if there are genetic disorders in their family before attempting a
pregnancy.
• Some genetic disorders are so serious that men and women who are carrying them often decide to
adopt a child instead of risking having a baby with the disorder.
• Most major medical centers have genetic counselors who can help people with family genetic
disorders make decisions about having children.
• Parents whose baby dies or is born with birth defects can get special counseling to help them cope.
Level 4
• Women and couples who unsuccessfully attempt to become pregnant can seek infertility counseling,
diagnosis, and treatment.
• Same gender couples have a number of pregnancy options available to them including alternative
fertilizations, surrogacy, and shared parenting arrangements.
• Couples with genetic disorders or infertility problems who desire to have children have several
medical options.
• Some women with serious diseases may decide not to become pregnant or continue a pregnancy
because of the risk to the fetus or to themselves.
Topic 4: Abortion
Subconcept: When a woman becomes pregnant and chooses not to have a child, she has the option
of having an abortion.
Developmental Messages:
Level 1
• Sometimes women become pregnant when they do not want to be or are unable to care for a child.
Key Concept 5: Sexual Health • 61
Level 2
• A woman faced with an unintended pregnancy can carry the pregnancy to term and raise the baby,
place the baby for adoption, or have an abortion to end the pregnancy.
• Abortion is legal in the United States up to a certain point in a pregnancy.
• Abortion must be performed by a physician or other licensed healthcare provider.
• A legal abortion is very safe.
• People have a variety of beliefs about the ethics and morality of abortion.
Level 3
• People’s beliefs about abortion are based on their religious, cultural, and family values.
• Some religions support the right to an abortion while others oppose abortion.
• Deciding whether or not to have an abortion can be difficult.
• Teenagers with an unintended pregnancy can talk with their parents, other family members, religious
leaders, counselors, healthcare providers, or other trusted adults.
• The right of a woman to have a legal abortion is guaranteed by the Supreme Court, although there
are restrictions in some states.
• State laws vary on teenagers’ rights to obtain an abortion.
• Some states require teenagers to observe a waiting period, notify their parents, obtain parental
permission, or obtain a judge’s permission before having an abortion.
• The law regarding teenagers and abortion in this state is_______________.
• No one can force a woman to have an abortion against her will – not even her parents or her partner.
• Abortions are safest when performed in the first 12 weeks of pregnancy.
• After 24 weeks of pregnancy, an abortion is only done when the woman’s life is in danger or the
fetus has extreme medical problems.
• An abortion can be done in a clinic, doctor’s office, or hospital.
• Having a legal abortion rarely interferes with a woman’s ability to become pregnant or give birth in
the future.
Level 4
• Women can choose to have surgical abortions or medical abortions, which involve taking prescrip-
tion medication under the supervision of a healthcare provider.
• Emergency contraception (the “morning after pill”) is not a method of abortion.
• Abortion is not a method of contraception.
• Men who are the sexual partners of women considering abortion can express their feelings and desires.
• Women have the legal right to make the final decision about whether or not to choose abortion.
• The right of women to have legal abortions is being challenged in a variety of ways in the United States.
62 • Guidelines for Comprehensive Sexuality Education
Topic 5: Sexually Transmitted Diseases
Subconcept: Sexually transmitted diseases (STDs) can be avoided by individual preventative behaviors.
Developmental Messages:
Level 1
• Sexually transmitted diseases are caused by germs such as bacteria and viruses.
• There are many types of sexually transmitted diseases.
• People who do not engage in certain behaviors do not get STDs.
• A small number of children are born with STDs that they get from their mothers during pregnancy
or birth.
• The most common ways for a person to get an STD is to participate in sexual behavior or share a
needle with another person who is already infected with an STD.
• Children who find needles on the ground should not touch them and should tell an adult.
Level 2
• STDs are sometimes referred to as sexually transmitted infections or STI’s.
• STDs include diseases such as gonorrhea, syphilis, HIV infection, Chlamydia, genital warts, and herpes.
• The viruses and bacteria that cause STDs are usually found in the semen, vaginal fluids, and blood
of an infected person.
• STDs are most commonly passed during sexual contact, but some can also be passed by sharing
unsterilized needles or from a mother to child during pregnancy, birth, or breastfeeding.
• Abstinence from sexual activity is an effective way to avoid STDs.
• STDs can be passed during vaginal, oral, or anal intercourse.
• STDs can be transmitted even if the person does not have signs of infection.
• Anyone, regardless of age or sexual orientation, can get STDs if they have sexual contact with an
infected person.
• Uninfected individuals who engage in sexual behavior cannot get an STD from each other.
• A person can have more than one STD at a time and can get an STD more than once.
• Those STDs caused by bacteria, such as gonorrhea, Chlamydia, or syphilis, can be cured with
prescription medication.
• Those STDs caused by viruses, such as HIV, Human Papilloma Virus (HPV – genital warts), herpes,
and hepatitis, can be treated but not cured.
Level 3
• Many teenagers who have vaginal, oral, or anal intercourse will become infected with an STD.
Key Concept 5: Sexual Health • 63
• The major symptoms of most STDs include genital discharge, sores on the genitals or mouth,
abdominal pain, painful urination, skin changes, genital itching, or sore throat.
• The symptoms of STDs can be hidden, absent, or unnoticed, especially in women.
• One cannot determine who has an STD by just looking at that person or at that person’s genitals.
• The only sure way to know if someone is infected with an STD is from testing and a medical exam.
• Individuals suspecting that they have an STD should stop having sexual intercourse, promptly go to
a healthcare provider for testing, and refer sexual partners to a healthcare provider as well.
• Individuals who have been sexually assaulted should be tested for STDs.
• Public STD clinics, private doctors, family planning clinics, and hospitals are places for STD testing,
treatment, and counseling.
• STDs can be detected through blood tests; urine tests; or vaginal, penile, or throat swabs.
• Routine medical exams do not typically check for STDs: therefore, individuals wishing to be tested
must ask their healthcare provider.
• Persons infected with STDs should encourage their partner(s) to seek medical care.
• Sexual partners can reinfect each other with an STD unless both get proper treatment.
• Untreated STDs can lead to serious health problems, including infertility.
• Teenagers can get confidential testing and treatment for STDs without parental consent.
• Some communities have support groups for people with STDs.
• Professional counseling and support can be helpful for persons infected with an STD.
• Persons infected with STDs can lead satisfying and productive lives.
• Hepatitis B is the only STD that can be prevented by a vaccine.
• Proper use of latex condoms, along with water-based lubricants, can greatly reduce but not eliminate
the chance of getting an STD.
• Dental dams, latex barriers used during oral sex, can reduce but not eliminate the risk of STD transmission.
• An uninfected couple can avoid STDs by practicing mutual monogamy.
• Individuals should discuss concerns about STDs with their sexual partner(s).
• In this community, call ______________ for STD information and medical services.
Level 4
• Individuals can help fight STDs by serving as an accurate source of information, by being a responsible
role model, and by encouraging others to protect themselves.
Topic 6: HIV and AIDS
Subconcept: HIV infection can be avoided by individual preventative behavior.
64 • Guidelines for Comprehensive Sexuality Education
Developmental Messages:
Level 1
• HIV stands for Human Immunodeficiency Virus.
• Once a person gets HIV, he/she will have it for the rest of his/her life.
• HIV causes AIDS, which stands for Acquired Immune Deficiency Syndrome.
• People who have HIV or AIDS are more at risk of getting infections, diseases, and other illnesses.
• People with HIV who work hard to stay healthy can live for a very long time.
• There are medicines that people with HIV or AIDS can take to help them stay healthier and live longer.
• People who do not engage in certain behaviors do not get HIV or AIDS.
• A small number of children are born with HIV that they get from their mothers during pregnancy,
birth, or breastfeeding,
• The most common ways for a person to get HIV is to participate in sexual behavior or share a needle
with another person who is already infected with HIV.
• A person cannot become infected with HIV by being around, touching, or hugging someone who
has HIV or AIDS.
• HIV is found in the blood of infected people; it is never a good idea to touch another person’s blood.
• Children who find needles on the ground should not touch them and should tell an adult.
Level 2
• HIV is usually found in the blood, semen, vaginal fluids, and breast milk of an infected person.
• HIV can be transmitted even if the person does not have signs or symptoms of infection.
• Anyone can get HIV.
• Individuals who avoid blood, semen, vaginal fluids, and breast milk of other people by abstaining
from sexual activity and not sharing needles greatly lower their risk of HIV infection.
• HIV is not spread by casual, social, or family contact, by insects, or by donating blood.
• HIV attacks an infected person’s immune system, making it much harder for her/him to fight off infections.
• To have AIDS means that HIV has done enough damage to the body that the immune system is
weak and certain serious diseases have developed.
• Some children may have parents, family members, or friends who have HIV or AIDS.
• People who have HIV or AIDS can enjoy happy and productive lives.
• People who have HIV or AIDS need the support of family and friends.
Level 3
• Some sexual behaviors that do not involve exposure to another person’s semen, vaginal fluid, or
blood (such as masturbation and hugging) pose no risk for HIV infection.
Key Concept 5: Sexual Health • 65
• HIV can be transmitted by vaginal, oral, or anal intercourse regardless of the gender(s) of the partners.
• Latex condoms can greatly reduce, but not eliminate, the risk of HIV transmission during intercourse.
• Dental dams, latex barriers used during oral sex, can reduce but not eliminate the risk of HIV
transmission.
• Exposure to blood by sharing needles for drug use, piercing, or tattooing can put an individual at
risk for HIV infection.
• People infected with HIV may look and feel healthy and not be aware that they are infected.
• People infected with HIV are sometimes referred to as being HIV positive.
• The only way to know for sure that one is infected with HIV is to be tested by a healthcare provider.
• Healthcare providers test for the presence of HIV antibodies by an oral swab or blood test.
• Teenagers are usually able to get tested for HIV without parental permission; to learn more about
HIV testing in this community call _______________________.
• HIV attacks specific cells in one’s immune system called CD4 cells that defend the body against
infection and disease.
• Individuals with weaker immune systems because of HIV are more susceptible to common illnesses.
• The common illnesses that affect people with HIV or AIDS who have weakened immune systems
are often referred to as opportunistic infections.
• AIDS is a diagnosis that healthcare providers make when a person infected with HIV has a lowered
CD4 cell count and/or opportunistic infections.
• It can take several years after becoming infected with HIV for symptoms of AIDS to appear.
• Teenagers who become infected with HIV will probably not develop AIDS until they are much older.
• The first symptoms of AIDS are similar to common minor illnesses and can include one or more of
the following: fatigue, swollen lymph glands, fever, loss of appetite and weight, diarrhea, persistent
yeast infections, and night sweats.
• There are medicines to help treat individuals infected with HIV or diagnosed with AIDS.
• There is no cure for HIV or AIDS.
• Many communities have support groups for people with HIV or AIDS.
Level 4
• Healthcare providers and other professionals who may be exposed to patients’ blood, semen,
vaginal fluids, or breast milk should observe universal precautions, including avoiding bodily fluids
and using latex gloves.
• People can always reduce their risk of HIV infection by abstaining from certain behaviors, using
condoms and other latex barriers, and using only clean or sterilized needles.
• HIV/AIDS is a global pandemic, affecting almost every country in the world.
• Certain regions of the world, such as sub-Saharan Africa and southeast Asia, are particularly hard
hit by the HIV/AIDS pandemic and often lack the resources needed to prevent and treat this disease
and deal with its lasting impact.
66 • Guidelines for Comprehensive Sexuality Education
• Individuals with HIV or AIDS are often discriminated against and may fear letting people know their status.
• There are laws in the United States to protect individuals with HIV or AIDS from discrimination.
• Individuals with HIV or AIDS need help, love, and support from family, friends, and community.
• By taking precautions and preventing the spread of HIV/AIDS whenever possible, individuals can
contribute to stemming the impact of the pandemic.
• Individuals can make a difference in the global AIDS pandemic by donating money, time, or resources
to increase awareness, improve prevention education, and help individuals infected with HIV or AIDS.
Topic 7: Sexual Abuse, Assault, Violence, and Harassment
Subconcept: Individuals have the right to maintain boundaries that will help prevent or stop sexual
abuse, assault, violence, and harassment; no one should coerce, abuse, or assault another person.
Developmental Messages:
Level 1
• One’s body belongs to oneself.
• There are parts of one’s body that are considered to be private, including one’s mouth, nipples,
breasts, chest, penis, scrotum, vagina, vulva, and buttocks.
• No one should touch the private parts of a child’s body except for health reasons or to clean them.
• Children should not touch the private parts of other people’s bodies.
• Child sexual abuse is when someone touches the private parts of a child’s body without a health or
hygiene reason.
• Sexual abuse can also occur when someone asks a child to touch the private parts of his/her body.
• Both boys/men and girls/women can be sexually abused.
• Everyone, including children, has the right to tell others not to touch their body when they do not
want to be touched.
• If a child experiences unwanted or uncomfortable touching, he/she should tell a trusted adult, even
if he/she was told to keep it a secret.
• Children can be sexually abused by a stranger or by someone they know.
• A child is never at fault if a person – even a family member – touches him/her in a way that is
wrong or uncomfortable.
• If a stranger tries to get a child to go with him/her, the child should run and tell a parent, teacher,
neighbor, or other adult.
• Most people would never abuse children.
Level 2
• Sexual abuse is very common, even though many people do not want to talk about it.
• Sexual abuse is most often committed by someone the child knows.
Key Concept 5: Sexual Health • 67
• An abuser can be an adult, a teenager, or child, and can be male or female.
• Most sexual abuse involves some kind of secrecy, bribery, trickery, threat, or force.
• If a child experiences unwanted or uncomfortable touching, he/she should tell a trusted adult; if
that adult doesn’t believe or help him/her, the child should tell another adult, and keep telling until
someone helps.
• Sexual abuse may or may not involve touch.
• When people are sexually abused they can have many conflicting emotions including feeling con-
fused, angry, scared, guilty, ashamed, alone, worthless, depressed, and helpless, or feeling special,
wanted, loved, needed, and cared for.
• There are many people who can help young people who have been abused, including school coun-
selors, teachers, doctors, religious leaders, and police.
• Although chatting or meeting people online can be fun, individuals should be cautious because it
can be unsafe.
• Some people use the Internet to trick young people into sexually abusive situations.
• Sexual harassment is unwanted and uninvited sexual attention such as teasing, touching, or taunting.
• Sexual harassment is against the law.
• This school’s sexual harassment policy is _______________________.
Level 3
• Sexual abuse involving touch can include kissing, an abuser touching “private parts,” touching the
abusers “private parts,” being asked to touch one’s own “private parts,” or engaging in vaginal,
oral, or anal intercourse.
• Sexual abuse not involving touch can include being shown pornographic movies, magazines,
websites, or other materials; taking photos, videos, or other recordings; or watching sexual acts.
• Sexual coercion is when a person uses threats or force in order to engage in sexual behavior with
another person.
• No one should coerce another person into engaging in any type of sexual behavior.
• Sexual assault is a person forcing another person to have any type of intimate sexual contact.
• Sexual assault can occur with physical or psychological force.
• When sexual assault involves penetration of the vagina or anus it is called rape.
• Both boys/men and girls/women can be sexually assaulted, although it is more commonly reported
by girls/women.
• People who are sexually assaulted are never at fault.
• Sexual assault by an acquaintance, a friend, or a date is often called acquaintance rape or date rape.
• One should never force another person to engage in any type of sexual behavior.
• Sexual assault is a crime.
• A person who is sexually assaulted can report the assault to the police who may start an investigation.
68 • Guidelines for Comprehensive Sexuality Education
• Tools that can help protect individuals in potential sexual assault situations include learning self-
defense techniques, assessing whether a situation may be dangerous, avoiding alcohol and other
drugs, and developing assertiveness skills.
• Not all sexual abuse, assault, violence, and harassment can be prevented.
• Domestic violence is psychological, physical, and/or sexual abuse between people in an intimate
relationship who are dating, living together, or married.
• Psychological, physical, and/or sexual abuse between people who are dating is also known as
dating violence.
• Many people who commit sexual abuse, assault, or domestic violence experienced abuse at some
point in their lives.
• Many community resources can help individuals who have survived sexual harassment, assault, or
other forms of violence, including counselors, teachers, doctors, religious leaders, rape crisis centers,
domestic violence organizations, and the police.
• Sexual harassment can occur in a variety of settings including schools, the workplace, and extracurricular
programs.
• In this community, you can call _______________ for information on sexual abuse, sexual assault,
domestic violence, or sexual harassment.
Level 4
• People who have been sexually abused or assaulted may benefit from support, counseling, and
medical care.
• Whether or not to report sexual abuse, assault, violence, or harassment, is a personal decision that
can be difficult for survivors to make.
• The investigation and/or trial resulting from reported sexual abuse, assault, violence, or harassment
can be a difficult experience for survivors.
Key Concept 5: Sexual Health • 69
Society and Culture Life Behaviors:
Having applied the society and culture subconcepts at the
appropriate age, the learner will be able to:
• Demonstrate respect for people with different sexual values.
• Exercise democratic responsibility to influence legislation dealing
with sexual issues.
• Assess the impact of family, cultural, media, and societal messages
on one’s thoughts, feelings, values, and behaviors related to
sexuality.
• Critically examine the world around them for biases based on
gender, sexual orientation, culture, ethnicity, and race.
• Promote the rights of all people to accurate sexuality
information.
• Avoid behaviors that exhibit prejudice and bigotry.
• Reject stereotypes about the sexuality of different populations.
• Educate others about sexuality.
70 • Guidelines for Comprehensive Sexuality Education
Level 1
middle childhood,
ages 5 through 8;
early elementary school
Level 2
preadolescence,
ages 9 through 12;
upper elementary school
Level 3
early adolescence,
ages 12 through 15;
middle school/
junior high school
Level 4
adolescence,
ages 15 through 18;
high school
Key Concept 6:
Society and Culture
Social and cultural environments
shape the way individuals learn about
and express their sexuality.
Topic 1: Sexuality and Society
Subconcept: Society influences what people believe and how they feel about sexuality.
Developmental Messages:
Level 2
• Boys and girls get messages early in their life about how they are supposed to act, dating, and
sexual behaviors.
• Individuals should not make decisions based solely on what their peers are doing.
Level 3
• Every culture communicates norms and taboos about sexuality.
• Different cultures may have widely varying views about sexuality.
• In a pluralistic society, an individual’s right to hold different opinions is valued.
• The messages one receives about sexuality may vary depending on his/her age or gender.
• Societal messages about sexuality are often confusing and contradictory.
• Messages received about sexuality from one’s family and culture may be different from general
societal messages.
• It can be difficult to sort through and understand conflicting messages about sexuality.
• Individuals need to critically evaluate messages received from different sources and establish
guidelines for their own behavior.
• Holding values that are different from one’s family and culture is often difficult.
• In most schools, there are unwritten norms about sexuality for teenagers.
Level 4
• Because of the wide range of sexual values and beliefs, people need to communicate their
views to their friends and partners in order to negotiate behaviors that are acceptable to
everyone involved.
• Understanding the diversity of views about sexuality is important.
Topic 2: Gender Roles
Subconcept: Cultures teach what it means to be a man or a woman.
Developmental Messages:
Level 1
• Girls and boys have many similarities and a few differences.
Key Concept 6: Society and Culture • 71
• Some people may expect or demand that boys and girls behave in certain ways, but this is
beginning to change.
• Both women and men can be involved and caring parents.
• Boys and girls can do the same chores at home.
• Men and women are capable of doing almost all the same jobs.
• Some men and women may be told that certain jobs and tasks are only for women or only for
men, but this is beginning to change.
Level 2
• Boys and girls receive messages about how they should behave from their families, friends, the
media, and society.
• The belief that all people of the same gender should behave the same way is called a stereotype.
• People often expect girls and boys to behave stereotypically.
• Some families have different expectations for their boy and girl children.
• Sometimes people receive unequal or negative treatment because of their gender.
• Certain laws and rules protect women’s and men’s rights.
• Boys and girls can have equal talents, characteristics, strengths, and hopes for their future.
• Girls and boys can be friends and respect each other.
Level 3
• Attitudes about proper behavior for men and women differ among families, cultures, and individuals.
• Some families and cultures have different expectations and rules about sexual practices for females
and males.
• Accepting gender role stereotypes can limit a person’s life.
• Individuals should be allowed to make their own choices about appropriate roles for themselves as
men and women.
• The way a person expresses his/her gender does not necessarily have anything to do with whether
that person is heterosexual, gay, lesbian, or bisexual.
• Young men and young women should be given the same opportunities.
• Laws protect young women’s and men’s rights to participate equally in athletic activities.
• Laws protect women’s and men’s rights to hold jobs.
Level 4
• Gender role stereotypes can lead to problems for both men and women such as poor body image,
low aspirations, low paying jobs, relationship conflict, stress-related illness, anxiety about sexual
performance, sexual harassment, and date rape.
72 • Guidelines for Comprehensive Sexuality Education
• Gender role stereotypes are harmful to both men and women.
• Some people, primarily women and girls, are still denied equal treatment on the basis of gender
even though laws prohibit discrimination.
• In a sexual relationship, both partners, regardless of gender, have equal rights and responsibilities.
Topic 3: Sexuality and the Law
Subconcept: Certain laws govern sexual and reproductive rights.
Developmental Messages:
Level 3
• The Supreme Court has ruled that, to a certain extent, people have the right to make personal
decisions concerning sexuality and reproductive health matters, such as abortion, sterilization, and
contraception.
• State laws govern the age of consent for sexual behaviors.
• Age of consent laws are gender neutral.
• The law in this state concerning the age of consent is__________________.
• Sexual abuse, assault, and harassment are illegal in all states.
Level 4
• Many states have laws requiring HIV prevention and sexuality education.
• Some states and cities have passed laws banning discrimination on the basis of sexual orientation.
• Some cities and municipalities have passed or are considering laws banning discrimination on the
basis of gender identity.
• Laws are currently being developed to govern new reproductive technologies.
• Courts across the United States are currently debating legal issues concerning same-sex marriage.
• The Supreme Court recently ruled that state laws restricting certain types of sexual behavior
between consenting adults were unconstitutional.
• Court cases have provided guidelines for determining what is obscene, including whether the mate-
rial portrays sexual conduct in an offensive way, is without value, and if a “reasonable” person
would find the work to possess no social value.
• Public nuisance behavior, such as exhibitionism and voyeurism, are illegal in most states.
• Prostitution is illegal in all states except Nevada.
• Child pornography is illegal.
Topic 4: Sexuality and Religion
Subconcept: Religions’ views about sexuality affect people’s sexual attitudes and behaviors.
Key Concept 6: Society and Culture • 73
Developmental Messages:
Level 1
• Some families go to a church, mosque, or synagogue to worship; some families do not.
• Religions teach people how to love each other, how to behave, and what is right and wrong.
• Different religions may promote similar or different values.
Level 2
• Some people consider themselves spiritual without necessarily belonging to a particular religion.
• Many religions teach that sexual intercourse should occur only in marriage.
Level 3
• All world religions have views about sexuality and its place in the human experience.
• Some religions have more liberal and moderate views on sexuality, while others are more conservative.
• One’s religious values can play an important role in sexual decision-making.
• When people’s values about sexuality differ from those taught by their religion, they may experi-
ence conflict.
Level 4
• Some people continue to respect their religion’s teaching and traditions but believe that some
specific views are not personally relevant.
• Partners with very different religious backgrounds may have difficulty reaching agreements about
their sexual relationship.
• Contemporary religions struggle with many issues related to sexuality and reproduction.
• A growing number of congregations openly welcome gay, lesbian, bisexual, and transgender people.
Topic 5: Diversity
Subconcept: Our society has a diversity of sexual attitudes and behaviors; some people are unfairly
discriminated against because of the way they express their sexuality.
Developmental Messages:
Level 1
• Individuals differ in the way they think, act, look, and live.
• Talking about differences helps people understand each other better.
• The belief that all members of a group will behave the same way is called a stereotype.
74 • Guidelines for Comprehensive Sexuality Education
• Stereotypes can hurt people.
• All people should receive fair and equal treatment.
• People who are different are often treated negatively or unequally, which is unfair.
Level 2
• Culture, race, ethnicity, religion, biological sex, sexual orientation, gender identity, physical ability,
and age all play a role in how individuals appear, think, and behave.
• People are sometimes discriminated against because of race, culture, ethnicity, language, socio-
economic class, age, and disability.
• People are sometimes discriminated against because of biological sex, appearance, sexual orienta-
tion, gender identity, family, and living arrangements.
• Discrimination can lead to lower self-esteem, unequal opportunities, and physical and emotional
problems.
• Discrimination has negative consequences for the individual, family, community, and society.
• Discrimination limits a society’s ability to utilize the full potential of all its members.
• Discrimination is illegal.
• Young people who believe they are being discriminated against should tell a parent or other adult.
Level 3
• People’s lives are enriched when they understand and celebrate diversity.
• Societies work best when different groups respect each other’s views.
• People have the right to speak up when they encounter discrimination and when they see others
being discriminated against.
• Laws, policies, and procedures can help individuals fight discrimination.
Level 4
• Examining one’s views about diversity occurs throughout life.
• Confronting one’s own biases and prejudices can be difficult.
• Workplaces benefit from having employees from diverse backgrounds.
Topic 6: Sexuality and the Media
Subconcept: The media has a profound effect on sexual information, values, and behavior.
Key Concept 6: Society and Culture • 75
Developmental Messages:
Level 1
• Some information on television, in the movies, in books and magazines, on the radio, and on the
Internet is true and some is not.
• Some commercials, television shows, movies, and magazines make people and things look different
or better than they really are.
• Some television programs, movies, and websites are not appropriate for young children.
Level 2
• The media can influence the way people think and behave.
• The media often presents an unrealistic image of what it means to be male or female, what it
means to be in love, and what parenthood and marriages are like.
• No one looks as perfect in real life as certain actors and actresses appear in the media.
• The media sometimes negatively portrays groups of people by using stereotypes.
• A parent or trusted adult can help when media messages are confusing.
• Parents have the right to determine what is appropriate viewing material for their own children.
• Young people may need to ask a parent or trusted adult for help in determining what information
in the media is accurate and what is not.
• People can refuse to watch, read, and/or listen to anything that offends them.
Level 3
• The media usually does not portray sexuality realistically.
• Soap operas, talk shows, and movies may give inaccurate and unrealistic information and portrayals
of sexuality.
• Real relationships require more effort than is often portrayed in the media.
• The media sometimes portrays stereotypes about the sexuality of certain groups.
• The media primarily depicts and focuses on heterosexual people and relationships.
• Some television shows and movies provide positive models of relationships and sexuality.
• People who recognize that the images in the media may be stereotypical and unrealistic are less
likely to be negatively affected by them.
• Teens and adults have a responsibility to help younger children avoid or deal effectively with media
influences.
• Although chatting or meeting people online can be fun, individuals should be cautious because it
can be unsafe.
• Communicating one’s reactions to the media about the portrayal of sexual issues is important.
76 • Guidelines for Comprehensive Sexuality Education
Topic 7: Sexuality and the Arts
Subconcept: Sexual and erotic images are common themes in art.
Developmental Messages:
Level 3
• Sexual images are often depicted in the arts, such as music, films, drama, and literature.
Level 4
• The nature of sexual images in art changes throughout history.
• What one person might consider to be erotic art another person may not.
• Erotic images in art reflect society’s views about sexuality and help people understand sexuality.
• Art with sexual images that reflect one culture’s norms may be considered obscene in another culture.
• Some people try to regulate or eliminate sexual images in art.
Key Concept 6: Society and Culture • 77
Using the
Guidelines
The Guidelines were designed as a framework for comprehensive sexuality education; as such,
they can be used to create new programs or evaluate existing curricula and material. SIECUS believes
that the Guidelines are an excellent starting point for both experienced sexuality education teachers
and educators new to this topic. The following section is designed to give educators additional infor-
mation, ideas, and encouragement for turning the Guidelines into a high-quality, comprehensive
sexuality education program for young people in their school or community.
Prioritizing Topics
The task force designed the Guidelines to include all of the concepts and topics that young people
need to learn in order to become sexually healthy adults. Ideally, all sexuality education programs
would cover all of the concepts, topics, and developmental messages included in the Guidelines.
SIECUS realizes, however, that due to constraints on time, staff, and other resources, many programs
will not be able to tackle every topic in the Guidelines.
Educators and curriculum developers who find themselves in this position may need to start by
choosing the topics they will cover. Decisions about topics are most often based on the amount of
time and resources that can be devoted to a program as well as the needs of the young people
involved.
Educators can use the key concepts and topics as a jumping off point and then work with staff,
parents, and/or young people to narrow down and prioritize this list. Many educators prioritize topics
based on their personal observations of the needs of the young people they work with. For example,
after hearing young people spread misinformation about reproduction or demonstrate a lack of
information about anatomy, an educator may choose to focus a program or lesson on Key Concept 1:
Human Development. It can also be helpful to ask young people directly for their input in determining
which topics will be covered.
The following exercise is designed to be conducted in a group setting—with educators, administrators,
parents, or young people. Whether educators are evaluating an existing curriculum or creating a new
one, this exercise can help them choose topics and determine priorities.
Using the Guidelines • 81
Filling in the Gaps
While the Guidelines contain the key concepts, topics, and messages for a comprehensive
program, they are not a curriculum; therefore, specific information is often left out. For example,
the Guidelines suggest that students in early elementary school learn that “Each body part has a
correct name and a specific function,” and that “A girl/woman has breasts, nipples, a vulva, a
clitoris, a vagina, a uterus, and ovaries.” They do not, however, explain the specific function of
each of these parts to students or educators. It is the responsibility of educators to fill in this
information when necessary.
Whether educators are using the Guidelines to evaluate existing curricula or create new materials,
it is important to have basic, accurate information about sexuality. Such background information
can help individuals determine if the curriculum they are reviewing contains accurate, unbiased
information and can be an essential base for any lessons that are developed. Numerous books
and other resources are available to help educators review basic information and share it with
young people.
82 • Guidelines for Comprehensive Sexuality Education
Prioritizing Topics Activity
On a sheet of paper, the facilitator should list all 39 topics suggested in the Guidelines,
with a blank space in front of each for a score. Make one copy of this sheet for each
participant and save one sheet to tally the final scores at the end of the activity. Also
recreate this list on a large piece of newsprint so the whole group can view the final
results.
Give each person a sheet with the 39 topics and explain that each individual has 15
points that he/she can assign to the topics listed. They can assign the points any way they
want—i.e., he/she can give one topic 15 points, 15 topics one point each, or three topics
five points each—however, no one can exceed 15 points total. Explain that ultimately
the topics that get the most points will be considered the top priorities.
After giving each person 5–7 minutes to decide on their totals, have them share their
score sheets with the whole group. Ask people to explain why they distributed their
points in the way that they did. As each person presents, the facilitator should keep a
tally of how the points are distributed and note the similarities and differences in the
scores given.
After all the participants have shared their individual scores and the results have been
tallied, note which topics received the highest scores. These are the ones the whole
group has decided are most important. Allow the group an opportunity to negotiate
and reprioritize based on the discussion.
Resource Manuals
There are a number of books and manuals that can serve as excellent reference sources for educators
to review basic information, confirm facts or figures, and seek answers to questions they may have.
Educators may want to invest in a college-level human sexuality textbook, many of which provide
introductory information in a straightforward manner and can serve as a valuable resource for both
new and experienced teachers. Educators may also be interested in reference manuals that provide
more in-depth information on specific topics such as women’s health or contraception. Some available
textbooks and resource manuals include:
• Exploring the Dimensions of Human Sexuality, by Jerrold S. Greenberg, Clint E. Bruess, and Debra
Haffner; Jones and Bartlett; 40 Tall Pine Drive, Sudbury, MA, 01776; 978/443-5000; www.jbpub.com.
• Our Sexuality, by Robert Crooks and Karla Baur; Wadsworth Publishing/Thompson Learning; P.O.
Box 6904, Florence, KY, 410022; 800/354-9706; www.wadsworth.com.
• Our Bodies, Ourselves; Our Bodies Ourselves; 34 Plympton Street, Boston, MA 02118; 617/451-
3666; www.ourbodiesourselves.org.
• Contraceptive Technology, by Robert A. Hatcher, et al; Ardent Media; Box 286, Cooper Station P.O.,
New York, NY, 10276; 800/218-1535; www.managingcontraception.com.
For additional resources see SIECUS’ Annotated Bibliography: Resources for Professionals (available
online at www.siecus.org) or contact SIECUS’ Mary S. Calderone Library at 212/819-9770.
Websites
The Internet can also be a valuable source of basic information and statistics on such topics as contraceptive
methods, STDs, and HIV. Scientific information and statistics on these topics frequently change and
educators will need to continually update their information. Websites can be particularly useful on
such topics as they are reviewed and revised more often than printed publications. At the same time,
there is a great deal of inaccurate and biased information available on the Internet and it is important
to use only reliable sources. Some reliable websites include:
STDs
• Centers for Disease Control and Prevention, Division of Sexually Transmitted Diseases
www.cdc.gov/std
• Centers for Disease Control and Prevention, National Prevention Information Network, a service
of the CDC National Center for HIV, STD, and TB Prevention
www.cdcnpin.org
• The American Social Health Association
www.ashastd.org
HIV
• Centers for Disease Control and Prevention, Division of HIV and AIDS Prevention
www.cdc.gov/hiv/dhap.htm
• Centers for Disease Control and Prevention, National Prevention Information Network,
a service of the CDC National Center for HIV, STD, and TB prevention
www.cdcnpin.org
Using the Guidelines • 83
• University of California at San Francisco, Center for AIDS Prevention Studies
www.caps.ucsf.edu
Contraception and Pregnancy
• Planned Parenthood Federation of America
www.ppfa.org
• United States National Library of Medicine and National Institutes of Health
www.nlm.nih.gov/medlineplus/birthcontrol.html
• Not-2-Late.com; The Emergency Contraception Website
www.not-2-late.com
For links to additional websites, see SIECUS’ website at www.siecus.org.
Books for Young People
While the Guidelines present age-appropriate messages, these are not meant to be read verbatim or
incorporated into lesson plans word-for-word. One of the challenges for educators may be determining
the best language to use when presenting information to students. Numerous books have been
developed for young people of various ages that explain many of the topics recommended in the
Guidelines including puberty, relationships, sexual orientation, and contraception. Educators may find
that such books help them develop the most appropriate and effective language for their students.
Some available books for young people include:
• It’s So Amazing: A Book About Eggs, Sperm, Birth, Babies, and Family, by Robie H. Harris,
Penguin Putnam; 405 Murray Hill Parkway, East Rutherford, NJ 07073; 800/788-6262;
www.penguinputnam.com.
• It’s Perfectly Normal: Changing Bodies, Growing Up, Sex and Sexual Health, by Robie H. Harris;
Penguin Putnam; 405 Murray Hill Parkway, East Rutherford, NJ 07073; 800/788-6262;
www.penguinputnam.com.
• The What’s Happening to My Body? Book for Boys: A Growing Up Guide for Parents and Sons
The What’s Happening to My Body? Book for Girls: A Growing Up Guide for Parents and
Daughters, by Lynda Madaras and Area Madaras; New Market Press; 18 E. 48th Street, Suite
1501, New York, NY, 10017; 212/832-3575; www.newmarketpress.com.
• The Underground Guide to Teenage Sexuality, by Michael Basso; Fairview Press;
2450 Riverside Avenue, Minneapolis, MN, 55454; 800/544-8207; www.fairviewpress.org.
• The “Go Ask Alice” Book of Answers: A Guide to Good Physical, Sexual, and Emotional Health,
by Columbia University’s Health Education Program; Owl Books; 16365 James Madison
Highway, Gordonsville, VA, 22942; 888/330-8477;
www.henryholt.com/owlbooks.htm.
For additional books for young people see SIECUS’ Annotated Bibliography: Facts on Sexuality-
Related Issues for Young People and SIECUS’ Annotated Bibliography: Sexuality Education in the
Home (available online at www.siecus.org) or call SIECUS’ Mary S. Calderone Library at 212/819-9770.
84 • Guidelines for Comprehensive Sexuality Education
Community Information
The Guidelines include a number of messages that are meant to be customized for individual schools
and communities such as “This school’s sexual harassment policy is __________________,” and “Most
communities have a telephone crisis line so people can talk to someone about a problem; the local
crisis line phone number is ____________________.”
These messages are especially important in helping young people identify resources and access available
services in their community. Educators may want to complete these messages for their community before
a course begins or use these messages as a launching point for a research project in which students
investigate the available resources and services.
Teaching Methods
SIECUS believes that sexuality education is best taught using a variety of teaching methods that allow
students to gain knowledge, acquire skills, and explore their values. The Guidelines, however, do not
recommend teaching methods or provide ideas on matching available techniques with topics.
Whether educators are creating their own program or evaluating existing materials, familiarity with a
wide variety of methods for teaching about sexuality can be helpful. Some available resources on
teaching methods include:
• Teaching About Sexuality and HIV: Principles and Methods for Effective Education, by Evonne
Hedgepeth and Joan Helmich; New York University Press; Washington Square, New York, NY
10003; 212/998-2575, www.nyupress.edu.
• Sexuality Education: Theory and Practice, Clint Bruess and Jerrold Greenberg; Jones and
Bartlett; 40 Tall Pine Drive, Sudbury, MA, 01776, 978/443-5000; www.jbpub.com.
For additional resources see SIECUS’ Annotated Bibliography: Resources for Professionals (available
online at www.siecus.org) or contact SIECUS’ Mary S. Calderone Library at 212/819-9770.
Using the Guidelines • 85
Evaluating Existing Curricula and Lessons
Many sexuality education resources already exist, from complete pre-packaged curricula, to lesson
plans that cover one topic, to time-tested activities that have been frequently used with young people,
to videos and other classroom materials.
More often than not, there is no need to reinvent the wheel. Sexuality education professionals have
already created activities on almost every sexuality-related topic and these lessons can be easily modified
and adapted to fit a variety of settings and age-groups.
Not all lesson plans or curricula, however, are created equal. Educators need to review all materials
closely to ensure that the important topics and concepts are covered, that the information is accurate
and age-appropriate, and that the resource does not rely on fear or shame. In addition, educators
will want to look at whether a wide variety of teaching strategies are employed, whether the curricu-
lum is culturally appropriate, and whether it encourages parental involvement. Finally, educators will
want to make sure that the curriculum or lessons plans are based on theories and techniques that
have been proven effective.
These simple questions, based on the Guidelines and available research, are a great place to begin.
Reviewing Topics and Messages
The Guidelines can help educators evaluate curriculum or lesson plans by providing a framework of
suggested concepts, topics, and messages.
• Which of the six key concepts does this curriculum/lesson address?
• Which topics suggested for these key concepts are included?
• Which topics suggested for these key concepts are not included?
• Are the messages included in the curriculum/lesson similar to those suggested by the Guidelines?
• Are the messages included in the curriculum/lesson age-appropriate according to the Guidelines?
• Are there important key concepts, topics, or messages suggested in the Guidelines that have been
left out?
Ensuring Skills Are Addressed
In addition to providing information, the best curriculum and lessons on sexuality provide young people
with opportunities to learn and practice a number of important skills.
• Does the curriculum/lesson help young people build self-esteem?
• Does the curriculum/lesson help young people identify other sources of information/help?
• Does the curriculum/lesson help young people learn critical analysis skills?
• Does the curriculum/lesson help young people identify risk factors?
• Does the curriculum/lesson help young people practice decision-making and negotiation skills?
• Does the curriculum/lesson help young people practice communication skills?
86 • Guidelines for Comprehensive Sexuality Education
Checking Accuracy and Appropriateness
It is also important to make sure that the information included in the curriculum/lesson is accurate,
up-to-date, and appropriate for the students in the program.
• Is the information in the curriculum/lesson scientifically and medically accurate?
• Is the information up-to-date?
• Is the information presented in a way that is appealing to young people?
• Is the curriculum/lesson, including graphics, materials, and examples, culturally appropriate for the
age, race, ethnicity, and sexual orientation of all the young people in the program?
Weeding Out Fear and Shame
Some sexuality education curricula and lessons rely on messages of fear and shame to try to control
young people’s sexual behavior. There is no evidence that using fear will help young people delay
sexual activity, and such messages may negatively affect their views on sexuality. These questions can
help educators identify and avoid fear-based materials.
• Does the curriculum/lesson indicate that pre-marital sexual behavior inevitably leads to pregnancy,
STDs, guilt, bad relationships, or other negative consequences?
• Does the curriculum/lesson portray students who have engaged in sexual behavior as troubled or
less worthy of respect?
• Does the curriculum/lesson portray sexuality/sexual behaviors as a force that young people cannot control?
• Does the curriculum/lesson assert that STDs and unintended pregnancy are never an issue for
married people?
But Does It Work?
As with any education program, it is important to continually assess whether a program is successful.
Research has shown that programs that teach young people about both abstinence and other pregnancy
and disease prevention methods can help young people delay intercourse, reduce the frequency of
intercourse, reduce the number of partners they have, and increase condom and contraceptive use
among sexually active teens. Although the types of programs that have been found to be effective vary,
noted researcher Doug Kirby has identified 10 characteristics that these programs have in common.7
Educators evaluating curricula or lesson plans may want to keep these in mind as well.
Effective programs:
• Focus on reducing one or more sexual behaviors that lead to unintended pregnancy or HIV/STD
infection.
• Are based on theoretical approaches that have been demonstrated to influence other health-
related behavior and identify specific important sexual antecedents to be targeted.
• Deliver and consistently reinforce a clear message about abstaining from sexual activity and/or
using condoms or other forms of contraception. This appears to be one of the most important
characteristics that distinguish effective from ineffective programs.
• Provide basic, accurate information about the risks of teen sexual activity and about ways to
avoid intercourse or use methods of protection against pregnancy and STDs.
Using the Guidelines • 87
• Include activities that address social pressures that influence sexual behavior.
• Provide examples of and practice with communication, negotiation, and refusal skills.
• Employ teaching methods designed to involve participants and have them personalize the
information.
• Incorporate behavioral goals, teaching methods, and materials that are appropriate to the age,
sexual experience, and culture of the students.
• Last a sufficient length of time (i.e., more than a few hours).
• Select teachers or peer leaders who believe in the program, and provide them with adequate
training.
There are many existing curricula and compilations of lesson plans that meet the criteria set forth
above. It is often just a matter of matching the right curriculum to the students and the program.
For a list of available sexuality education curricula and lesson plans see SIECUS’ Annotated
Bibliography: Sexuality Education Curricula or contact SIECUS’ Mary S. Calderone Library at
212/819-9770.
88 • Guidelines for Comprehensive Sexuality Education
Using the Guidelines • 89
CURRICULUM EVALUATION TOOL
Often, educators or curriculum review committees are charged with evaluating extensive
programs or comparing the strengths and weaknesses of a number of available curricula.
These individuals may need to examine each curriculum in greater detail. To help them with
this sometimes daunting task, SIECUS has created the following evaluation tool based on the
Guidelines that may be photocopied and filled in as a curriculum is read and discussed.
Curriculum……………………………………………………………………………………………………………….
Publisher/Distributor …………………………………………………………………………………………………..
Address……………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Phone…………………………………………………….. Fax……………………………………………………
E-mail ……………………………………………………..
Cost ……………………………………………………….
Date Published…………………………………………. Date of Revisions/Updates…………………….
Grade Levels Included………………………………..
Number of Lessons ……………………………………
CONCEPTS AND TOPICS COVERED
Key Concept 1 2 3 4 5
major emphasis addressed but not not addressed
a major focus /
major emphasis
HUMAN DEVELOPMENT
Reproductive and
Sexual Anatomy 1 2 3 4 5
and Physiology
Puberty 1 2 3 4 5
Reproduction 1 2 3 4 5
Body Image 1 2 3 4 5
Sexual
Orientation 1 2 3 4 5
Gender Identity 1 2 3 4 5
Key Concept 1 2 3 4 5
major emphasis addressed but not not addressed
a major focus /
major emphasis
RELATIONSHIPS
Families 1 2 3 4 5
Friendship 1 2 3 4 5
Love 1 2 3 4 5
Romantic
Relationships 1 2 3 4 5
and Dating
Marriage and
Lifetime 1 2 3 4 5
Commitments
Raising Children 1 2 3 4 5
PERSONAL SKILLS
Values 1 2 3 4 5
Decision-making 1 2 3 4 5
Communication 1 2 3 4 5
Assertiveness 1 2 3 4 5
Negotiation 1 2 3 4 5
Looking for Help 1 2 3 4 5
SEXUAL BEHAVIOR
Sexuality
throughout Life 1 2 3 4 5
Masturbation 1 2 3 4 5
Shared Sexual
Behavior 1 2 3 4 5
Sexual
Abstinence 1 2 3 4 5
Human Sexual
Response 1 2 3 4 5
Sexual Fantasy 1 2 3 4 5
Sexual
Dysfunction 1 2 3 4 5
90 • Guidelines for Comprehensive Sexuality Education
Key Concept 1 2 3 4 5
major emphasis addressed but not not addressed
a major focus /
major emphasis
SEXUAL HEALTH
Reproductive
Health 1 2 3 4 5
Contraception 1 2 3 4 5
Pregnancy and
Prenatal Care
Abortion 1 2 3 4 5
STDs 1 2 3 4 5
HIV and AIDS 1 2 3 4 5
Sexual Abuse
Assault, Violence 1 2 3 4 5
and Harassment
SOCIETY AND CULTURE
Sexuality
and Society 1 2 3 4 5
Gender Roles 1 2 3 4 5
Sexuality and
the Law 1 2 3 4 5
Sexuality and
Religion 1 2 3 4 5
Diversity 1 2 3 4 5
Sexuality and
the Media 1 2 3 4 5
Sexuality and
the Arts 1 2 3 4 5
Using the Guidelines • 91
ABSTINENCE AND SAFER SEX
❏ Curriculum explores benefits of abstinence.
❏ Curriculum presents abstinence without relying on fear or shame.
❏ Curriculum reaches a balance between abstinence and safer sex messages.
❏ Curriculum discusses abortion when pregnancy, parenthood, and adoption are included.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
FEAR OR SHAME-BASED MESSAGES
Curriculum indicates that sexual behavior almost always or always leads to:
❏ STDs
❏ Pregnancy
❏ Bad relationships
❏ Guilt
❏ Other ………………………………………………………..
❏ Curriculum uses derogatory terms for students who have engaged in sexual behavior.
❏ Curriculum portrays sexuality as a force that young people cannot control.
❏ Curriculum asserts that STDs and unintended pregnancy are never issues for married couples.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
ACCURACY AND RELEVANCE
❏ Information is scientifically accurate.
❏ Information is up-to-date.
❏ Information is presented in a way that appeals to young people.
❏ Information, graphics, and materials represent target populations.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
92 • Guidelines for Comprehensive Sexuality Education
Using the Guidelines • 93
TEACHING STRATEGIES
Which teaching strategies are used? (check all that apply)
❏ case study ❏ small group activity
❏ brainstorming ❏ role play
❏ whole group processing/
large group discussion ❏ homework
❏ journals ❏ worksheets
❏ lecture ❏ anonymous question box
❏ audio-visual materials ❏ community speakers/involvement
❏ peer education component ❏ parent/guardian involvement
❏ other ……………………………………………………………………………………………………………
Which skills are addressed/taught? (check all that apply)
❏ self-esteem building ❏ identifying other sources of information/help
❏ critical analysis ❏ risk factor identification
❏ decision-making ❏ communication
❏ negotiation ❏ sexual limit setting
❏ peer refusal ❏ handling peer pressure
❏ handling partner pressure ❏ handling media pressure
❏ media literacy ❏ obtaining contraception/condoms
❏ use of contraception/condoms
❏ other ……………………………………………………………………………………………………………
❏ Curriculum reaches a balance between helping young people gain knowledge, examine
their attitudes, and develop healthy behaviors
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
CULTURAL SENSITIVITY
❏ Curriculum is inclusive of many racial and ethnic groups in examples, pictures, and illustrations.
❏ Curriculum takes into account the cultural and ethnic values, customs, and practices of
the target community.
❏ Curriculum contains stereotypic references or images regarding gender.
❏ Curriculum contains stereotypic references or images regarding race/ethnicity.
❏ Curriculum contains stereotypic references or images regarding family types.
❏ Curriculum contains stereotypic references or images regarding sexual orientation.
❏ Curriculum contains stereotypic references or images regarding age.
❏ Curriculum contains stereotypic references or images regarding ability.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
PARENTAL INVOLVEMENT
❏ Curriculum encourages students to discuss sexuality with their parents.
❏ Curriculum provides parallel curriculum for parents.
❏ Curriculum provides homework assignments for students that include home discussions.
❏ Curriculum suggests other responsible adults to talk with if parents are not an option.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
94 • Guidelines for Comprehensive Sexuality Education
OTHER CONSIDERATIONS
❏ Curriculum explicitly presents the values underlying the curriculum.
❏ Messages are age-appropriate.
❏ Curriculum recommends appropriate supplemental materials.
❏ Curriculum includes an evaluation component.
❏ Curriculum provides guidance for integrating topic into other subject areas.
❏ Curriculum encourages social action/volunteerism.
❏ Curriculum reinforces clear values against unprotected sexual activity.
❏ Curriculum includes information on recognizing social influences on behavior.
❏ Curriculum includes exercises on changing group norms.
❏ Curriculum employs active learning methods.
Comments: ………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
Using the Guidelines • 95
96 • Guidelines for Comprehensive Sexuality Education
STDs/HIV CHECKLIST
It may also be helpful for educators to create simple evaluation tools or checklists to review
lessons on specific topics that they have chosen to cover. Checklists can be based on subconcepts
and developmental messages in the Guidelines as well as additional information that educators
have found in their research.
The following is a checklist on STDs/HIV. It is adapted from a larger checklist created by
William Yarber to help educators and school officials evaluate their existing STD/HIV prevention
programs or create new curricula and materials on the topic. Dr. Yarber is a professor of
Applied Health Science at Indiana University and the senior director of the Rural Center for
AIDS/STD Prevention. Dr. Yarber was also a member of the National Guidelines Task Force.
The checklist includes essential topics for STD/HIV prevention curricula and provides a basic
concept for each topic. Specific developmental messages are not included. It is based on the
Guidelines as well as other research on STDs/HIV. Educators evaluating STD/HIV prevention
curricula can use this checklist along with the messages in the Guidelines to ensure that
programs their community is using or considering are complete and accurate.
The STD/HIV Problem
❏ The “Hidden” STD Epidemic
Although STDs are the most commonly reported infection disease in the United States, they
are often hidden and the prevalence underestimated which can cause negative outcomes for
individuals and society.
❏ STDs
There are over 25 STDs, including HIV/AIDS, many of which have a particular impact on teenagers.
❏ Size of Problem
STDs are prevalent in both the United States and around the world.
❏ People with STDs/HIV
STD infections occur in all communities and population groups although individuals in under-
served communities and communities of color are disproportionately affected by STDs and HIV.
❏ Problems Caused by STDs/HIV
STDs/HIV impact lives and relationships, finances, research and healthcare priorities, and prevention
efforts.
❏ Reasons for the STD/HIV Epidemics
The STD/HIV epidemics are exacerbated by inadequate education, health care, and support, as well
as social, economic, and emotional barriers that prevent some people from getting treatment.
Using the Guidelines • 97
Transmission of STDs/HIV
❏ STD Organisms
STDs/HIV are usually found in body fluids and individuals can have more than one STD
infection at a time.
❏ Sexual Transmission of STDs/HIV
STDs/HIV are contracted during contact with an infected person; vaginal, anal, and oral sex all
involve risk.
❏ Sexual Relationships
Partner choice can increase risk for STDs/HIV.
❏ Blood Transmission of STDs/HIV
Blood-to-blood transmission is the second-most common way STDs/HIV are contracted and
people who share needles, people who have their bodies tattooed or pierced, and healthcare
workers are at increased risk.
❏ Mother-to-Child Transmission
STDs/HIV are sometimes passed from mother to child during pregnancy or breast-feeding but
medical treatment is available to reduce a child’s risk of contracting STDs/HIV from his/her mother.
❏ Increased HIV Risk with STD Infection
People with an STD are at increased risk of contracting HIV and people with HIV and an STD
are at increased risk of transmitting HIV.
❏ STD Transmission without Sex or Injection Drug Use
STDs/HIV are not transmitted through casual non-sexual contact.
STD/HIV Prevention
❏ Sexual Abstinence
While sexual feelings are natural, there are benefits to sexual abstinence and delaying sexual
intercourse.
❏ Mutual Sexual Exclusivity
There are benefits to mutual sexual exclusivity; exclusive relationships other than marriage exist.
❏ Condom Use
Condoms can be effective in preventing the spread of STDs/HIV; individuals should learn
when and how to use condoms.
❏ Careful Partner Selection
Carefully selecting partners can help individuals avoid sexual contact with people who might
be at high risk for STDs/HIV.
98 • Guidelines for Comprehensive Sexuality Education
❏ Avoid Injection and Other Drugs
Injection drug use involves risk for STDs/HIV; individuals can identify and resist the pressure to
use drugs.
❏ Vaccines
Hepatitis B is the only STD with a vaccine but efforts are underway to create vaccines for HIV
and Human Papilloma Virus.
❏ Other Prevention Methods
There are many things individuals can do to help prevent the transmission of STDs/HIV includ-
ing engaging in lower risk behaviors; avoiding contact with blood, semen, or vaginal fluids;
and seeking appropriate prenatal care.
❏ Communicating Prevention to Others
Communication is a valuable and necessary component of prevention and individuals can
suggest ways to improve communication about sexuality-related issues.
❏ Choosing Friends Wisely
Friends who support preventive and risk-reduction behaviors are important.
❏ Help Avoiding STDs/HIV
Individuals need to know who might help them avoid STDs/HIV; teenagers may want to talk with
their parents or other supportive adults about sexuality, growing up, and STD/HIV prevention.
❏ Taking Responsibility for Personal Health and the Health of Others
Individuals can make efforts to control the spread of STDs/HIV by serving as responsible role
models, accurate sources of information, and supportive friends.
RECOGNIZING STDs/HIV
❏ STD/HIV Symptoms
STDs/HIV may have no symptoms or may have symptoms similar to those of other infections;
individuals can become alert to the symptoms of STDs/HIV and seek prompt medical attention
if they suspect they may be infected.
❏ What to Do After Suspecting an STD/HIV
Individuals who suspect STD/HIV symptoms can stop having sexual contact, stop using and
sharing needles, seek prompt medical attention, and encourage partners to seek testing and
treatment as well.
SEEKING STD/HIV TESTS AND TREATMENT
❏ STD/HIV Tests and Counseling
People who have practiced any STD/HIV risk behaviors may want to seek STD/HIV counseling/testing.
Using the Guidelines • 99
❏ Confidential Testing and Treatment of Minors
Young people facing health issues may want to talk to parents or other trusted adults, but
can often receive testing and treatment without parental consent.
❏ The Medical Visit
Many different types of testing and treatment exist; individuals should talk to their healthcare
provider about what is best for them.
❏ STD/HIV Treatment
Although some STDs, such as HIV, have no cure, a number of STD treatments exist.
❏ Support for People with STDs/HIV
Individuals who are infected with an STD/HIV need the support of family and friends and may
also be able to find support groups or other resources that can help.
PARTNER STD/HIV TESTING AND TREATMENT
❏ Importance of Asking Partner to See a Health Care Provider
Encouraging a partner to seek testing and treatment can protect his/her health, prevent
reinfection, and reduce the spread of STDs/HIV.
❏ Ways of Getting Partners to Testing and Treatment
Public health professionals and healthcare providers can help individuals determine the best
way to approach their partner(s) about the need for testing and treatment.
For more information or a copy of the complete STD/HIV checklist, please contact SIECUS at
212/819-9770.
Creating New Curricula and Lessons
Some educators or curriculum developers may prefer to create there own curricula or lessons. The
Guidelines can help them do this as well. The first task is determining what topics the program will
address based on the needs of the students and the available time, staff, and resources. (See the
Prioritizing Topics section on page 79 for specific ideas on how to do this.)
The number of topics selected as well as the number of sessions and amount of time available will
determine how many lessons educators or curriculum developers will need to create. It is important
to remember that students can only absorb a limited amount of information in any given session;
trying to cram too many topics into one session is not effective.
Goals and Learning Objectives
The next step is to develop goals and learning objectives for each lesson that is planned. Goals
provide a framework for the topic and the general direction for the lesson. Goals describe what the
lesson will teach about, explain, discuss, or demonstrate. The subconcepts listed for each topic in the
Guidelines can serve as starting point for developing goals. For example, in Key Concept 3: Personal
Skills, Topic 4 is Assertiveness. An educator creating a lesson plan on assertiveness may decide that
his/her goal is to explore assertiveness and teach that “assertiveness is communicating feelings and
needs, while respecting the rights of others.”
Once goals have been finalized, educators need to develop specific learning objectives that focus on
what young people will learn from the lesson. Many educators find it helpful to think of learning
objectives as falling into four basic categories. In a given lesson, students may acquire new knowledge,
enhance thinking skills, develop psychomotor skills, or change attitudes, values, and/or feelings.8
The life behaviors listed for each key concept can help educators create broad outcome measures.
Life behaviors are essentially outcomes of instruction that reflect actions students will be able to take
after having applied the information and skills.
In addition, the developmental messages in the Guidelines can help educators create learning
objectives for lessons on specific topics. For example, in Key Concept 3: Personal Skills, Topic 3 is
Communication. An educator creating a lesson plan for middle school or junior high school students
(Level 3) on communication might generate the following learning objectives using the Guidelines’
developmental messages:
By the end of this session:
• Students will be able to identify three behaviors that can enhance communication.
• Students will be able to identify three behaviors that can impair communication.
• Students will be able to reflect on how verbal and nonverbal communication may have a different
meaning depending on the individual, family, gender, cultural background, and situation.
Not all of the developmental messages in the Guidelines should or will become learning objectives.
Educators and curriculum planners will once again have to prioritize the information and skills they
want to convey to young people in their community. In addition, many of the developmental
100 • Guidelines for Comprehensive Sexuality Education
messages build on each other and educators may find that it is easier and more effective to cover a
number of related messages in one learning objective.
Teaching Methods
The final step to creating a lesson plan involves deciding which teaching methods will work best for
each topic. Again, this decision depends on the time and resources available, the comfort level of the
educator, and the needs and abilities of the students in the course. SIECUS believes that sexuality
education is most effective when young people not only receive information but are also given the
opportunity to explore their own attitudes and values and to develop or strengthen social skills. A
wide variety of teaching methods and activities can foster learning such as interactive discussions, role
plays, demonstration, individual and group research, group exercises, and homework assignments.
Evaluation
Even when educators and curriculum planners have developed their own lessons, it is helpful to
review these lessons once they are written to ensure that they cover the important topics and
concepts, are accurate and age-appropriate, and do not rely on fear or shame. Educators will also
want to make sure that the curriculum or lessons are based on theories and techniques that have
been proven effective. (See the Evaluating Curricula section on page 84 for specific ideas on how to
do this.)
Using the Guidelines • 101
Additional
Resources
104 • Guidelines for Comprehensive Sexuality Education
There are numerous organizations dedicated to sexuality, education, and the health and well-
being of our nation’s youth. These organizations provide information, guidance, and support to
educators looking to create, evaluate, or implement sexuality education in their community. The
following list includes organizations who conduct research, develop curricula, and provide advocacy
tools for educators, policymakers, and parents.
Academy for Educational Development
Committed to solving social health problems in the United States and throughout the world through
education, training, social marketing, policy analysis, and innovative program design.
1255 23rd Street N.W. Phone: 202/884-8700
Washington, DC 20037 Fax: 202/884-8701
Website: www.aed.org
Advocates for Youth
Dedicated to promoting policies which help young people make informed and responsible decisions
about their sexual health.
2000 M Street, N.W., Suite 750 Phone: 202/419-3420
Washington, DC 20036 Fax: 202/419-1448
Website: www.advocatesforyouth.org
Alan Guttmacher Institute
Working to provide research data and policy analysis on reproductive health issues, both domestic
and international.
120 Wall Street, 21st Floor Phone: 212/248-1111
New York, NY 10005 Fax: 212/248-1951
Website: www.agi-usa.org
American Psychological Association – Healthy Lesbian, Gay, and Bisexual Students Project
Working to strengthen the capacity of the nation’s schools to prevent the behavioral health risks of
lesbian, gay, and bisexual students through knowledge development, dissemination, and application
by working with and through national organizations of school stakeholders.
750 First Street, NE Phone: 202/336-5977
Washington, DC, 20002 Fax: 202/336-6130
Website: www.apa.org/ed/hlgb/ TDD/TTY: 202/336-6123
American School Health Association
Dedicated to protecting and promoting the health of children and youth by supporting coordinated
school health programs as a foundation for school success.
P.O. Box 708 Phone: 330/678-1601
Kent, Ohio 44240 Fax: 330/678-4526
Website: www.ashaweb.org
American Social Health Association
Dedicated to improving the health of individuals, families, and communities, with a focus on prevent-
ing sexually transmitted diseases and their harmful consequences.
P.O. Box 13827 Phone: 919/361-8400
Research Triangle Park, NC 27709 Fax: 919/361-8425
Website: www.ashastd.org
Centers for Disease Control and Prevention (CDC)
Promoting health and quality of life by preventing and controlling disease, injury, and disability.
Public Inquiries/MASO F07
1600 Clifton Road Phone: 800/311-3435
Atlanta, GA 30333 Fax: 404/639-3880
Website: www.cdc.gov
Child Trends
Dedicated to improving the lives of children by conducting research and providing
science-based information to improve the decisions, programs, and policies that affect children.
4301 Connecticut Avenue, N.W., Suite 100 Phone: 202/362-5580
Washington, DC 20008 Fax: 202/362-5533
Website: www.childtrends.org
Comprehensive Health Education Foundation
Promoting health and quality of life through education by providing the skills, information, and
resources people need to live safe and healthy lives.
22419 Pacific Highway South Phone: 206/824-2907
Seattle, WA 98198 Fax: 206/824-3702
Website: www.chef.org
ETR Associates
Dedicated to enhancing the well-being of individuals, families, and communities by providing leader-
ship, educational resources, training, and research in health promotion with an emphasis on sexuality
and health education.
P.O. Box 1830 Phone: 831/438-4060 or 800/321-4407
Santa Cruz, CA 95061-1830 Fax: 831/438-4284 or 800/435-8433
Website: www.etr.org
Additional Resources • 105
Gay, Lesbian & Straight Education Network
Working to ensure that each member of every school community is valued and respected regardless
of sexual orientation or gender identity/expression.
121 West 27th Street, Suite 804 Phone: 212/727-0135
New York, NY 10001 Fax: 212/727-0254
Website: www.glsen.org
Girls Incorporated
Dedicated to inspiring all girls to be strong, smart, and bold by providing educational programs to
American girls, particularly those in high-risk, underserved areas.
120 Wall Street, 3rd Floor Phone: 212/509-2000
New York, NY 10001 Fax: 212/509-8708
Website: www.girlsinc.org
The Henry J. Kaiser Family Foundation
An independent philanthropic organization focusing on the major health issues facing the nation.
2400 Sand Hill Road Phone: 800/656-4533
Menlo Park, CA 94025 Fax: 650/854-4800
Website: www.kff.org
National Association of State Boards of Education
Working to strengthen state leadership in educational policymaking, promote excellence in the
education of all students, advocate equality of access to educational opportunity, and assure
continued citizen support for public education.
277 S. Washington Street, Suite 100 Phone: 703/684-4000
Alexandria, VA 22314 Fax: 703/836-2313
Website: www.nasbe.org
National Campaign to Prevent Teen Pregnancy
Working to improve the life prospects of this generation and the next by influencing cultural values
and building a more effective grassroots movement.
2100 M Street, N.W., Suite 300 Phone: 202/261-5655
Washington, DC 20037 Fax: 202/331-7735
Website: www.teenpregnancy.org
National Education Association – Health Information Network
Improving the health and safety of school personnel and students by providing the school community
with vital and timely health information that will increase teacher and education support professional
(ESP) quality and student achievement.
1201 16th Street, N.W. Phone: 202/822-7570
Washington, DC 20036 Fax: 202/822-7775
Website: www.neahin.org
106 • Guidelines for Comprehensive Sexuality Education
National Minority AIDS Council
Developing leadership within communities of color to address the challenges of HIV/AID by providing train-
ing opportunities, promoting sound HIV/AIDS and public health policy, and producing informative resources.
1931 13th Street, N.W. Phone: 202/483-6622
Washington, DC 20009 Fax: 202/483-1135
Website: www.nmac.org
National School Boards Association
Fostering excellence and equity in public education through school board leadership by representing
the school board perspective before federal government agencies and with national organizations
that affect education.
1680 Duke Street Phone: 703/838-6722
Alexandria, VA 22314 Fax: 703/683-7590
Website: www.nsba.org
National Information Center for Children and Youth with Disabilities
Dedicated to providing information on disabilities and disability-related issues.
P.O. Box 1492 Phone: 800/695-0285
Washington, DC 20013 Fax: 202/884-8441
Website: www.nichcy.org
National Network for Youth
Dedicated to ensuring that young people can be safe and lead healthy and productive lives, particu-
larly those with less opportunity to become contributing members of their communities.
1319 F Street, N.W., Suite 401 Phone: 202/783-7949
Washington, DC 20004 Fax: 202/783-7955
Website: www.nn4youth.org
National Organization on Adolescent Pregnancy, Parenting and Prevention
Dedicated to providing general leadership, education, training, information, advocacy, resources, and
support to individuals and organizations in the field of adolescent pregnancy, parenting, and prevention.
1319 F Street, N.W., Suite 400 Phone: 202/783-5770
Washington, DC 20004 Fax: 202/783-5775
Website: www.noappp.org
Network for Family Life Education
Dedicated to providing young people with honest, medically accurate, and balanced information
about sexuality in schools, homes, and communities.
Rutgers University Center for Applied Research Phone: 732/445-7929
41 Gordon Road, Suite A Fax: 732/445-7970
Piscataway, NJ 08854
Website: www.sexetc.org
Additional Resources • 107
Parents, Families and Friends of Lesbians and Gays
Promoting the health and well-being of gay, lesbian, bisexual, and transgender persons, and their
families and friends through support, education, and advocacy.
1101 14th Street, N.W., Suite 1030 Phone: 202/638-4200
Washington, DC 20005 Fax: 202/638-0243
Website: www.pflag.org
Planned Parenthood Federation of America
Dedicated to the principles that every individual has a fundamental right to decide when or whether
to have a child and that every child should be wanted and loved.
443 West 33rd Street Phone: 212/541-7800 or 800/829-PPFA
New York, NY 10001 Fax: 212/245-1845
Website: www.plannedparenthood.org
The Rape, Abuse & Incest National Network (RAINN)
Leading the national efforts to improve services to victims and ensure that rapists are brought to justice
by operating the National Sexual Assault Hotline and educating the public about sexual assault.
635-B Pennsylvania Avenue, S.E. Hotline: 800/656-HOPE (free, confidential, and available 24 hours)
Washington, DC 20003 Phone: 202/544-1034
Website: www.rainn.org Fax: 202/544-3556
Sexuality Information and Education Council of the United States
Advocating for the right of all people to accurate information, comprehensive education about sexuality,
and sexual health services, and working to create a world that ensures social justice and sexual rights.
130 West 42nd Street, Suite 350 Phone: 212/819-9770
New York, NY 10036 Fax: 212/819-9776
Web site: www.siecus.org
(For additional organizations and resources, see SIECUS’ website at www.siecus.org or call SIECUS at
212/819-9770.)
108 • Guidelines for Comprehensive Sexuality Education
References
1. Issues and Answers: Fact Sheet on Sexuality Education, (New York, NY: SIECUS, September 2001).
2. SIECUS State Profiles: A Portrait of Sexuality Education and Abstinence-Only-Until-Marriage
Programs in the States (Washington, DC: SIECUS, 2004).
3. D. Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy
(Washington, DC: The National Campaign to Prevent Teen Pregnancy, May 2001).
4. P. Donovan, Risk and Responsibility: Teaching Sex Education in America’s Schools Today, (New
York, NY: Alan Guttmacher Institute, 1989), pp. 5-6.
5. Teaching Our Teachers To Teach (New York, NY: SIECUS, 1996).
6. School Health Education Study. Health Education. A Conceptual Approach to Curriculum Design,
(Minnesota: 3M Education Press, 1967).
7. D. Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy.
8. R. S. Cafferella, Planning Programs for Adult Learners: A Practical Guide for Educators, Trainers and
Staff Developers (San Francisco, CA: Jossey-Bass Publishers, 1994).
Additional Resources • 109
SIECUS affirms that sexuality is a fundamental
part of being human, one that is worthy of dignity
and respect. We advocate for the right of all people to
accurate information, comprehensive education about sexuality,
and sexual health services. SIECUS works to create a world
that ensures social justice and sexual rights.
S
IEC
U
S
130 West 42nd Street, Suite 350
New York, NY 10036.7802
phone: 212 819.9770
1706 R Street, NW
Washington, DC 20009
phone: 202 265.2405
www.siecus.org
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