Associations Between Sex Education Types and Sexual Behaviors Among Female Adolescents: a Secondary Data Analysis of the National Survey of Family Growth 2011–2019

Introduction: Sex education is important to support healthy sexual development/behaviors among heterosexual and sexual minority youth. Efforts to assess the efficacy of different sex education programs have been complicated by the lack of an established and detailed way to characterize overall sex education content. Methods: This study delineates seven different types of sex education and compares the impact of education types on the probability of sexual intercourse and contraceptive method use among a nationally representative sample of females aged 15–19 years. Data were obtained from four National Survey of Family Growth surveys (2011–2019). Multinomial logistic regression was used to examine associations and calculate predicted probability values. Results: Among youth in this analysis (N = 3952), 14.9% identified as a sexual minority and 72% reported sex education including refraining from sex, contraception, and STIs/HIV. Compared to their heterosexual peers, sexual minorities were more likely to report no sex education and less likely to report receipt of abstinence-only education. All types of education, except education solely focused on refraining from sex and contraception methods, had a statistically significant effect on sexual behavioral outcomes (intercourse in the past 12 months and type of contraceptive use) as compared to no sex education. Conclusions: Findings highlight the need for consideration of the specific/total content of sex education, benefits/drawbacks of sex education types, and the needs of sexual minority youth. Policy Implications: Research is needed to further explore outcomes associated with specific curricular content. Specific content of sex education should be considered prior to making curricular policies decisions.