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In the spheres of education and public health, sex education is often discussed in terms of content and outcomes. Policy makers, advocates, parents, and educators want to know: Does it teach about contraceptive methods? Is there a condom demonstration? Does it lead to young people delaying sex? Does it reduce rates of STI transmission? And certainly content and outcomes are of vital importance. But great sex education must also address the context of young people’s lives. And that requires that sex education support young people in building the knowledge, skills, and self-efficacy to create and navigate healthy relationships throughout their lives.

For too long, in reaction to years of federally-subsidized medically-inaccurate, misleading, and stigmatizing abstinence-only-until-marriage programs, advocates and educators in favor of comprehensive sex education have concentrated on a relatively small component of this topic. The work for comprehensive sex education has often focused narrowly on ensuring that young people can learn accurate and age-appropriate information about their bodies, about sexual decision-making and negotiation, and about reducing the risk of STI transmission and unintended pregnancy. And as a result, there have been positive shifts in sex education in recent years. Federal funding initiatives like the Teen Pregnancy Prevention Initiative (TPPI) and the Personal Responsibility Education Program (PREP) have increased the resources available in states, communities, and schools to implement evidence-based programs.

But too many of these programs and curricula focus narrowly on specific changes in youth risk behavior—such as delayed initiation of sex, reduced frequency of sex, and increased condom use—and not nearly enough on healthy relationships. This is a missed opportunity and an incomplete representation of comprehensive sex education.

Healthy relationships education is an integral component of truly comprehensive sex education. Released last year, the National Sexuality Education Standards outline the minimum, essential content and skills that is age-appropriate for children and youth in grades K-12, and healthy relationships is one of seven major topic areas (page 32). These standards outline the baseline of healthy relationship knowledge and skills that students should have after completing sex education coursework. For example, students should be able to:

  •  “Identify healthy ways for friends to express feelings to each other” by the end of 2nd grade.
  • “Compare positive and negative ways friends and peers can influence relationships” by the end of 5th grade.
  • “Describe the potential impacts of power differences such as age, status, or position within relationships” by the end of 8th grade.
  • “Demonstrate effective ways to communicate personal boundaries as they relate to intimacy and sexual behavior” by the end of 12th grade.

It is not a coincidence that healthy relationships are a key component of comprehensive sex education, because comprehensive sex education is the best vehicle for healthy relationship education. The information and skills that it takes to create and navigate healthy relationships are best taught in the context of the non-judgmental, honest, and inclusive classrooms that comprehensive sex education fosters.

Because while some abstinence-only-until-marriage programs do purport to teach information and skills related to healthy relationships, these programs are full of flawed, incomplete, and harmful messages. These programs make false promises to youth that they will necessarily avoid heartache, regret, and “baggage” by pursuing relationships and avoiding sex. They teach young people that relationships that involve sexual activity can only chip away at a finite “self:” that youth have a certain amount of love and affection to give, and they will be diminished and depleted if they give it away “too soon” or to the “wrong” person. They often assume that (heterosexual) marriage is an inevitable and/or universally desired goal. This is a wildly limiting way to think about people’s personal and interpersonal capacity. Relationships—including young people’s relationships—can be opportunities for learning and growth, and we are much better off helping young people pursue mutually respectful and satisfying relationships than we are feeding them dishonest guarantees.

For many young people, part of pursuing and maintaining healthy relationships may mean delaying sex. For many others, it may not. Either way, a real understanding of communication, power, consent, sexual negotiation, and risk reduction is of vital importance. To fully meet young people’s rights and needs, we must take an inclusive and non-judgmental approach to relationship education. A sole focus on sexual refusal skills—as is the case in many abstinence-only-until-marriage programs—is just not sufficient. We must work with youth as they learn to form and maintain healthy relationships. This includes being truly inclusive of GLBTQ youth and families. It includes respecting and trusting young people with the knowledge and skills to negotiate relationships and sexuality on their own terms.

Healthy relationships education is not a “middle-ground” between comprehensive sex education and abstinence-only-until-marriage programs. If we don’t look closely, some programs may use the guise of healthy relationships education to reinforce the same old gender stereotypes and compulsory heterosexuality that we see in abstinence-only-until-marriage programs.

Rather, healthy relationships education is part and parcel of comprehensive sex education. Sex education programs that teach youth to reduce their risk of unintended pregnancy and STI transmission are incomplete if they neglect to build in youth the knowledge, skills, and self-efficacy to negotiate healthy relationships. And programs that purport to teach relationship skills but fail to do so in a way that represents the full range of experiences in young people’s lives are limiting and ultimately harmful.

We must take the strides we’ve made and move forward to ensure that sex education for young people is truly meeting their rights and needs and that healthy relationships education is integrally tied to the respect, honesty, and inclusivity of comprehensive sex education.