AAP Voices Blog

Reinforcing the Importance of Comprehensive Sex Education in Schools 

To this day, one child’s story replays in my mind. Only 12 –years old, a girl was receiving counseling on what it meant to be pregnant. She had been intimate with a boy as they replicated something they had seen on TV without fully understanding the implications of their actions. As a result, this child was pregnant.

It made me wonder how many other kids were in the same position merely because they lacked information they needed.

There are numerous teenage pregnancies every year with the most recent data showing a national teen birth rate of 13.6 births per 1,000 adolescents between the ages of 15-19, which is about 1 out of every 75 teen girls. Of those births, approximately 14% were repeat teen births. However, the risk of teen pregnancies is unevenly distributed, with adolescents from minority racial or ethnic backgrounds and those of lower socioeconomic status experiencing higher rates of teen births relative to their peers.

The concern comes when we look at the implications of teen pregnancy for both mother and child. Pregnancy at an early age is associated with increased risk of low birth weight, perinatal mortality, developmental delays, and other health issues for the baby, along with negative effects on education attainment, employment opportunities, and future income for the mother. There is also an increased risk for sexually transmitted infection (STI) acquisition. The Centers for Disease Control and Prevention estimates that even though young people ages 15 to 24 make up only a quarter of the population, they account for half of the 20 million new STI infections that occur in the U.S. annually. It is imperative that we do not fail the adolescents in our community and rather, equip them with the knowledge and resources to make the best decisions for themselves.

With sexual education curricula varying wildly from state to state, this can quickly become a challenging task. There are currently 9 states that do not mandate sex education at school with only 26 states that do require that that information be medically accurate. For the states that do mandate sex education, there have been evolving legislative changes that guide the curriculum. One of the most concerning changes is the opt-in policy. As of June 2025, Texas became one of 7 states that are known to have implemented a state-wide policy which requires parents to actively consent to sexual health education at school, meaning that they now must sign and return a permission slip for their child to participate in the course.

Studies on active versus passive consent show that opt-in policies tend to result in reduced responses from parents. This, however, does not reflect the attitudes or preferences of most parents across the country, over 75% of whom believe that sex education should be offered in both middle school and high school. Rather, it could represent external obstacles that parents face, including lack of time from working multiple jobs or language barriers that make it difficult to understand the form itself. In fact, research shows that when parents do not return a signed permission slip where active consent is required, most of the time it does not indicate refusal for their child to participate. When parents who didn’t actively consent were contacted for follow up, about 87% of them stated that they did want their children to participate.

Clearly, mandating an opt-in policy adds an extra step for busy or uninformed parents and can serve as a barrier to children receiving this necessary education.  This barrier may place the burden of difficulty in accessing this education more heavily on the adolescents who would benefit most from it. 

We, as a nation, need to do better for our children. It is their fundamental right to learn about their bodies so they can make informed decisions about their health.

I urge you to get involved with your local school board to learn what the policies are in place in your state and district. If your child’s school has an opt-in policy for sex education, please reach out to your local representatives to advocate for a more inclusive opt-out policy. 

We all have a responsibility to use our voices for the children in our community and advocate for comprehensive sexual health education that can be easily accessible by all. 

*The views expressed in this article are those of the author, and not necessarily those of the American Academy of Pediatrics.