School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education. Methods: Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving 39. In the next phase, researchers expanded criteria to studies outside the U.S. to identify evidence reflecting the full range of topic areas. Eighty articles constituted the final review. Results: Outcomes include appreciation of sexual diversity, dating and intimate partner violence prevention, development of healthy relationships, prevention of child sex abuse, improved social/ emotional learning, and increased media literacy. Substantial evidence supports sex education beginning in elementary school, that is scaffolded and of longer duration, as well as LGBTQeinclusive education across the school curriculum and a social justice approach to healthy sexuality. Conclusions: Review of the literature of the past three decades provides strong support for comprehensive sex education across a range of topics and grade levels. Results provide evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality. Findings strengthen justification for the widespread adoption of the National Sex Education Standards.

The National Teacher-Preparation Standards for Sexuality Education represent an unprecedented unified effort to enable prospective health education teachers to become competent in teaching methodology, theory, practice of pedagogy, content, and skills, specific to sexuality education. Higher education will play a key role in ensuring the success of these standards.

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Seventy-four first-and second-year students, participating in focus groups at a northeastern U.S. university, discussed recollections of messages received at home, prior to sexual debut, about sex and sexuality. Responses were categorized as Characteristics of Communication (nature of interactions participants had at home about sexuality) and Major Message Content (actual themes of those conversations). Commonly reported characteristics were trouble talking with parents; most conversations happened with mothers; participants feared parents' reactions; and among lesbian, gay, bisexual groups, feared parents' discovering their nonheterosexual orientation. Commonly reported message content included use protection and, among women, wait. Women reported messages that were at best, mixed, and at worst, threatening or moralistic. Men reported fewer conversations, and those recalled were more neutral or encouraging, especially from fathers. Parental messages to males and females differed qualitatively, reflected stereotypical assumptions about gender roles, desire, and appropriate conditions under which to have sex, and lacked support for nonheterosexual orientations.

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