Comprehensive sexuality education

Comprehensive sexuality education (CSE) gives young people accurate, age-appropriate information about sexuality and their sexual and reproductive health, which is critical for their health and survival.

While CSE programmes will be different everywhere, the United Nations’ technical guidance – which was developed together by UNESCO, UNFPA, UNICEF, UN Women, UNAIDS and WHO – recommends that these programmes should be based on an established curriculum; scientifically accurate; tailored for different ages; and comprehensive, meaning they cover a range of topics on sexuality and sexual and reproductive health, throughout childhood and adolescence.

Topics covered by CSE, which can also be called life skills, family life education and a variety of other names, include, but are not limited to, families and relationships; respect, consent and bodily autonomy; anatomy, puberty and menstruation; contraception and pregnancy; and sexually transmitted infections, including HIV.

Sexuality education equips children and young people with the knowledge, skills, attitudes and values that help them to protect their health, develop respectful social and sexual relationships, make responsible choices and understand and protect the rights of others. 

Evidence consistently shows that high-quality sexuality education delivers positive health outcomes, with lifelong impacts. Young people are more likely to delay the onset of sexual activity – and when they do have sex, to practice safer sex – when they are better informed about their sexuality, sexual health and their rights.

Sexuality education also helps them prepare for and manage physical and emotional changes as they grow up, including during puberty and adolescence, while teaching them about respect, consent and where to go if they need help. This in turn reduces risks from violence, exploitation and abuse.

Children and adolescents have the right to be educated about themselves and the world around them in an age- and developmentally appropriate manner – and they need this learning for their health and well-being.

Intended to support school-based curricula, the UN’s global guidance indicates starting CSE at the age of 5 when formal education typically begins. However, sexuality education is a lifelong process, sometimes beginning earlier, at home, with trusted caregivers. Learning is incremental; what is taught at the earliest ages is very different from what is taught during puberty and adolescence.

With younger learners, teaching about sexuality does not necessarily mean teaching about sex. For instance, for younger age groups, CSE may help children learn about their bodies and to recognize their feelings and emotions, while discussing family life and different types of relationships, decision-making, the basic principles of consent and what to do if violence, bullying or abuse occur. This type of learning establishes the foundation for healthy relationships throughout life.

Many people have a role to play in teaching young people about their sexuality and sexual and reproductive health, whether in formal education, at home or in other informal settings. Ideally, sound and consistent education on these topics should be provided from multiple sources. This includes parents and family members but also teachers, who can help ensure young people have access to scientific, accurate information and support them in building critical skills. In addition, sexuality education can be provided outside of school, such as through trained social workers and counsellors who work with young people. 

Well-designed and well-delivered sexuality education programmes support positive decision-making around sexual health. Evidence shows that young people are more likely to initiate sexual activity later – and when they do have sex, to practice safer sex – when they are better informed about sexuality, sexual relations and their rights.

CSE does not promote masturbation. However, in our documents, WHO recognizes that children start to explore their bodies through sight and touch at a relatively early age. This is an observation, not a recommendation. 

The UN’s guidance on sexuality education aims to help countries, practitioners and families provide accurate, up-to-date information related to young people’s sexuality, which is appropriate to their stage of development. This may include correcting misperceptions relating to masturbation such as that it is harmful to health, and – without shaming children – teaching them about their bodies, boundaries and privacy in an age-appropriate way.

There is sound evidence that unequal gender norms begin early in life, with harmful impacts on both males and females. It is estimated that 18%, or almost 1 in 5 girls worldwide, have experienced child sexual abuse.

Research shows, however, that education in small and large groups can contribute to challenging and changing unequal gender norms. Based on this, the UN’s international guidance on sexuality education recommends teaching young people about gender relations, gender equality and inequality, and gender-based violence. 

By providing children and young people with adequate knowledge about their rights, and what is and is not acceptable behaviour, sexuality education makes them less vulnerable to abuse. The UN’s international guidance calls for children between the age of 5 and 8 years to recognize bullying and violence, and understand that these are wrong. It calls for children aged 12–15 years to be made aware that sexual abuse, sexual assault, intimate partner violence and bullying are a violation of human rights and are never the victim’s fault. Finally, it calls for older adolescents – those aged 15–18 – to be taught that consent is critical for a positive sexual relationship with a partner. Children and young people should also be taught what to do and where to go if problems like violence and abuse occur.

Through such an approach, sexuality education improves children’s and young people’s ability to react to abuse, to stop abuse and, finally, to find help when they need it. 

There is clear evidence that abstinence-only programmes – which instruct young people to not have sex outside of marriage – are ineffective in preventing early sexual activity and risk-taking behaviour, and potentially harmful to young people’s sexual and reproductive health.

CSE therefore addresses safer sex, preparing young people – after careful decision-making – for intimate relationships that may include sexual intercourse or other sexual activity. Evidence shows that such an approach is associated with later onset of sexual activity, reduced practice of risky sexual behaviours (which also helps reduce the incidence of sexually transmitted infections), and increased contraception use.

On sexuality education, as with all other issues, WHO provides guidance for policies and programmes based on extensive research evidence and programmatic experience.

The UN global guidance on sexuality education outlines a set of learning objectives beginning at the age of 5. These are intended to be adapted to a country’s local context and curriculum. The document itself details how this process of adaptation should occur, including through consultation with experts, parents and young people, alongside research to ensure programmes meet young people’s needs.