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August 11, 2023 NASPAG Position Statement: Comprehensive Sexual Education for Adolescents Created by Swetha Naroji MD and Kristl Dorschner Tomlin MD In collaboration with NASPAG Advocacy Committee members: Shelby Davies MD, Rachel Goldstein MD, Megan Harrison MD FRCPC, Olga Kcuik MD, Andrew Lupo MD, Megan McCracken MD, Mary Romano MD, Ellen Rome MD, Lauryn Roth MD, Kathryn Stambough MD, Megan Sumida MD Approved by the NASPAG Board of Directors July 2023 NASPAG asserts that comprehensive sexual education (CSE) is vital to improving the physical and reproductive health of adolescents worldwide while also promoting the development of self-esteem and healthy interpersonal relationships. CSE is an approach to sex education that provides accurate, age and developmentally appropriate, unbiased comprehensive information about sexuality and reproductive health. It aims to equip individuals with knowledge, skills, attitudes, and culturally appropriate values necessary to make informed decisions about sexual and reproductive health (1-4). It also recognizes the intersectionality of human sexuality in aspects of society such as religion and media and serves to counteract inaccurate sexual health information found in contemporary media sources such as the internet and pornography (9,10). Benefits of CSE include (1-5, 8, 10): NASPAG supports local, national, and international efforts aimed at improving both the quality of and access to CSE. NASPAG endorses the following key elements of CSE (1-5,8,10): 1. Age and developmentally-appropriate information: Sexual health information tailored to the developmental stage and understanding of the individual. Over time, this should include information about sexual and reproductive anatomy, puberty, relationships, contraception and abstinence, sexually transmitted infections (STI), sexual behaviors, decision-making skills, gender identity, sexual orientation. This is true for all adolescents of all backgrounds, including those with chronic illness and/or physical or developmental disabilities. 2. Parental communication and open dialogue: Recognition of the importance of involving parents and caregivers in the education process. It encourages open and respectful communication between young people and their parents or guardians, providing support for discussing sensitive topics at home. 3. Holistic approach: Addressing the spectrum of physical, emotional, social, and psychological aspects of human sexuality as well as recognizing the intersection of sexuality with society in religion (including faith-based CSE), media, and other areas. 4. Life skills development: Development of life skills such as communication, negotiation, critical thinking, problem-solving, and decision-making. These skills empower young people to navigate relationships, resist peer pressure, set boundaries, and make informed choices regarding their sexual health. 5. Inclusive and non-judgmental approach: Recognition of the diverse needs and experiences of all individuals, regardless of background, ability, sexual orientation, or gender identity. It promotes inclusivity, respect for diversity, and non-discrimination within a community-centered context appropriate for the population. 6. Reproductive justice: CSE is based on human rights principles and recognizes that individuals have the right to accurate information, autonomy over their bodies, and the ability to make choices about their sexual and reproductive health. 7. Gender equality and social norms: CSE promotes gender equality and challenges harmful gender stereotypes and discriminatory norms, emphasizing the importance of mutual respect, consent, and healthy relationships based on equality and shared decision-making. NASPAG endorses the American Academy of Pediatrics statement that “when children and adolescents lack access to CSE, they do not get the information they need to make informed, healthy decisions about their lives, relationships, and behaviors (5,6).” Despite proven efficacy in promoting sexual health and well-being, CSE is not provided equally across populations (7). Opponents of CSE have cited reasons including moral or religious objections to sexual teaching, concern about controversial topics, and parental discomfort. NASPAG believes comprehensive sexuality education is an essential component of public health. It is imperative that educational institutions, policymakers, and communities embrace and implement comprehensive sexuality education to empower youth for a healthier future. References: 1. United Nations Education Scientific and Cultural Organization (UNESCO), Joint United Nations Programme on HIV/AIDS, United Nations Population Fund, United Nations Children’s Fund, United Nations Entity for Gender Equality and the Empowerment of Women, World Health Organization (WHO). International technical guidance on sexuality education: An evidence-informed approach. 2nd Revised Edition. Paris: UNESCO; 2018. Open access book available at (accessed 6/2023): https://cdn.who.int/media/docs/default-source/reproductive-health/sexual-health/international-technical-guidance-on-sexuality-education.pdf?sfvrsn=10113efc_29&download=true |