For most people, middle and high school sex education classes are not fond memories. But most sex ed isn’t just cringeworthy and awkward, it’s also ineffective, new research shows.
In a survey of 1,500 Americans ages 18 to 44, 90% of respondents said that their sex education had not prepared them for real-world sexual experiences. Specifically, more than 40% of women and 47% of men reported feeling unprepared for their first sexual experiences and 41% of both genders said they felt unprepared for communication with sexual partners.
Subpar sex education leads to gaps in knowledge for women about their own reproductive health. For example, 38% of women said they felt unprepared for changes in their menstrual cycle. One-third said the same about fertility and conception (34%) and birth and postpartum (33%). More than one-quarter (27%) said they weren’t prepared for perimenopause, a finding consistent with other recent surveys.
“I see a major gap in modern sex education,” Sylvia Kang, CEO and founder of Mira, a women’s health company that sponsored the survey, said in a statement. “Women often lack knowledge about their cycles, hormones, and fertility. Many Mira customers spend much time searching for answers they should’ve learned in school.”
Younger women were even less prepared. Nearly half (46%) of Gen Z female respondents said that sex ed hadn’t prepared them for changes during their menstrual cycle, compared with 38% overall. Another 37% weren’t prepared to find out that getting pregnant can be difficult.
Men were similarly ill-informed. About one-quarter of men surveyed said they didn’t feel sex ed had prepared them adequately about unplanned pregnancy (24%), fertility and conception (24%), or sexually transmitted infections (21%). Nearly one in five men (19%) said that sex ed hadn’t prepared them for birth or the postpartum period.
One thing that men are learning about more than women: sexual pleasure. About half (51%) of men surveyed said formal sex ed classes taught them about sexual pleasure compared to just 32% of women.
Only one in five (21%) survey respondents said that they had learned that sex can be painful and 40% hadn’t learned anything formally about consent and respect in the context of sexual experiences.
Fewer than half (45%) rated their knowledge of sexual health as “good.”
Overall, 30% of respondents said they hadn’t learned anything about sex hormones. Thirty-seven percent of female respondents said their sex education hadn’t prepared them for hormone imbalances, which can cause irregular periods, weight gain, acne, and medical conditions such as diabetes or thyroid disease.
“Reproductive hormones are central to reproductive and sexual health,” Kara McElligott, MD, MPH, MMCI, an obstetrician/gynecologist and medical advisor at Mira said in a statement. “Failing to educate women leads to unnecessary anxiety, frustration, delayed care, preventable disease, unnecessary office visits, health disparity and increased health costs.”
McElligott said that women may not recognize certain health risks if they don’t know what to expect or what to consider abnormal. Specifically, she said that women with infrequent periods are at higher long-term risk of endometrial cancer and women with heavy periods are at higher risk of anemia, which could require emergency care. Women who are unaware of perimenopause symptoms may not know what is going on and needlessly suffer without treatment as a result.
Where people turn for sex education
Healthcare professionals and formal classes were the most trusted sources for sex education, as rated by 42% and 35% of participants, respectively. But that doesn’t mean that’s where people turn for information, especially young people.
Among Gen Z and Millennial respondents, 48% said their primary source for sex education was online sources (48%) while 32% look to friends and one-quarter cited porn (26%) or social media (25%). Healthcare professionals (37%) and formal sex education (33%) also made the list of primary sources.
When asked which information sources have had the biggest impact on their perceptions of sex and relationships, as many people (26%) cited porn as formal sex ed classes. Fewer pointed to the influence of family (16%), healthcare professionals (21%), and friends (23%).
Improving sex education
Survey respondents had ideas about how sex education could better prepare people for real-life situations.
More than half of participants said sex ed should address building healthy relationships and communication with a sexual partner (57%) and exploring emotional and psychological aspects of sexual wellness (52%). Nearly half (46%) suggested that sex ed should teach people how to avoid misinformation and debunk stigmas relating to sex.
Forty-five percent of women suggested that sex ed should address self-esteem and body image and 43% said it should include hormonal imbalances.
According to McElligott, less than half of high schools and less than one-quarter of middles schools teach all the topics recommended by the CDC guidelines on formal sexual education.
Worse, she said that the guidelines themselves barely touch hormone health, leaving out sufficient information on how reproductive hormones (estrogen and progesterone) affect women and specifically how they affect mental health, cognition, bone health, and other systems.
To improve formal sex education, McElligott suggests including more content on the menstrual cycle, contraception, fertility, and major reproductive milestones such as perimenopause and menopause.
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