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Over the past two decades, formal sexual education rates among children in the United States have substantially declined in areas such as contraception and how to say no to sex. An influx of state legislation restricting sexual education in the past two years has further affected its availability in schools.

Since the Supreme Court overturned Roe v. Wade in 2022, revoking the federal right to abortion, there’s been a drastic rise in state legislatures nationwide introducing bills to restrict sexual education. A CNN analysis of Sexuality Information and Education Council of the United States (SIECUS) data found that in the first half of 2024, at least 135 bills regarding sexual education were introduced in state legislatures—the highest number since at least 2018.

Eighty-one of those bills sought to restrict sexual education. This is a stark contrast to 2018, when only 12 of the at least 106 sex education bills introduced in state legislatures were restrictive, according to CNN.

Advocates say the consequences are likely to be dire for children. Leslie Kantor, chair of the Rutgers University School of Public Health’s department of urban-global public health, worked as an AIDs educator in the mid-1980s and sexual education advocate in the 1990s. She said that while doing this work, she used to tell people that sexual education was “a matter of life and death.”

When more testing, prevention, and treatment options became available for HIV, Kantor said she thought the days of describing sex education as life-or-death were over. Since the fall of Roe, that’s changed.

“We have to say that now since—incredibly—becoming pregnant can be a death sentence in many areas of this country,” Kantor said.

Attacks on sexual education

Rates of formal sexual education among children increased across the U.S. in the 1990s due to the AIDs epidemic. However, a 2022 study Kantor co-authored found sexual education declined in several key areas between 1995 and 2019.

Adolescents continue to learn about sexually transmitted infections (STIs), including HIV, but instruction on birth control methods declined by approximately 18 percent among adolescent males and 23 percent among adolescent females. Additionally, fewer girls reported being taught how to say no to sex and a majority of adolescents reported being told to wait until marriage to have sex, though this number has decreased since 1995.

According to Kantor, several arguments against comprehensive sexual education have remained the same between the 1990s and today.

“The center of the debate was really on, ‘Is any kind of teen sexual behavior okay?’” Kantor said. “[It] was about teaching only about abstinence compared to providing any information on protection from pregnancy, STDs, and then related topics like navigating relationships and seeking health care.”

Today, SIECUS reports that 35 states emphasize abstinence-based sexual education curricula. But the current push against comprehensive sexual education differs from the 1990s in “anxieties related to gender identity,” Kantor said.

The CNN analysis found that beginning in 2021, there was a sharp increase of sexual education bills aiming to ban discussions around gender identity or sexual orientation. Several high-profile examples included Florida’s 2023 ban and Missouri’s 2024 bill. These bans have cultivated stressful environments for teachers, sexual education advocates say.

Elissa Barr, president of the Florida Healthy Youth Alliance and health science professor at the University of North Florida, told RNG that most students in Florida went without sex education in the 2023-24 academic year because of a delay in the Florida Department of Education’s approval of sexual education curricula.

“Teachers were fearful,” Barr said. “They felt threatened that if they moved ahead without approval, they could lose their job, or there could be complaints to the administrator.”

According to Barr, Florida’s education department began calling the lead health teachers in districts across that state at the beginning of the year “letting them know what they can and can’t do.” Barr said some big changes to curricula included removing contraception, emphasizing abstinence, not using the terms “consent” and “sexual abuse” for certain age groups, and prohibiting educators from showing pictures of reproductive anatomy.

But Barr noted the communication was “very inconsistent from one district to the next.”

“Other words they were told to take out includes ‘rape,’ ‘abuse,’ and ‘domestic violence’ along with ‘consent,’” Barr continued. “So it’s almost like this current push is so much more dangerous than even an abstinence only-curriculum. It’s like they’re taking away just the basic protection for kids when we know that kids should hear about consent, dating violence, and other child abuse, because [studies show] they’re more likely to report it.”

According to LOOKOUT, a similar situation occurred in Arizona in the same academic year, and schools have used the politicization of LGBTQ+ issues “as an excuse for denying students the curriculum.”

Comprehensive sexual education is important—but it’s heavily politicized

Comprehensive sexual education (CSE)—which the World Health Organization defines as programs giving young people “accurate, age-appropriate information about sexuality and their sexual and reproductive health”—leads to better physical and mental health outcomes for children, youth advocates say. This can include information about birth control methods, gender and sexuality, abortion, pregnancy, and more.

Several studies show CSE has proven physical and mental health benefits. It can reduce the spread of STIs and provide students with tools to navigate romantic and sexual relationships, reducing their risk of being sexually assaulted and experiencing emotional distress as a result of sex. CSE can also mitigate the risk of succumbing to misinformation about sex online while seeking information students otherwise wouldn’t receive at school.

“We have years of data to show that comprehensive sex ed changes behaviors,” Barr said. “Kids wait longer [to have sex], they reduce the number of partners. They’re more likely to use contraceptives, and so the health outcomes are documented that we have less unplanned pregnancy, which ultimately is fewer abortions. Comprehensive programs have shown to reduce STIs and HIV and reduce teen dating violence. So we can’t we can’t ignore this data.”

But in the U.S., abstinence-only-until-marriage (AOUM) programs and curricula remain popular and well-funded.

“It really short changes our youth,” Giokazta Molina-Schneider, vice president of education and training for Planned Parenthood of Greater New York, said. “At the end of the day, what they do is give a limited amount of information so young people don’t have the tools they need to make decisions for their lives.”

Sexual education has become more politicized now than in previous decades, but Kantor believes it is more important than ever.

“Certainly we are in a more conservative moment and a more difficult moment from the perspective of even availability of health care,” Kantor said. “I mean, we’re in a moment that we never thought we would ever see again in the United States in terms of access to abortion.”

Several states that have abortion bans in place are less likely to teach youth about accessing birth control in schools. Kantor referenced Florida as an example.

“In a state where there’s not very much sex ed happening, and now there’s extraordinarily limited access to abortion, you’ve got to see that as kind of a mixed message,” Kantor said.

‘Their body belongs to them’

Barr said sexual education has bipartisan support in Florida but that there is a “very loud and organized” minority who don’t want CSE in the state.

“As an advocate and as somebody who serves other advocates, it’s been really challenging because we’re going up against people who are not making data-driven decisions,” Barr said. “You have people making these decisions based on what they think or feel, and not what the data says.”

Barr also said that “political and religious agendas” made advocating for sexual education more difficult.

“It’s really difficult when you’re up against these people who are so extreme and can’t even come back to see the middle road,” she said.

Sriya Srinivasan, a high school junior in California who proposed the now-passed Know Your Period bill mandating comprehensive menstrual health education in California schools, said that she sees CSE as essential to not only understanding sexual health, but health overall.

“Comprehensive sex education provides clarity for a lot of youth and eases the burden on many of us,” Srinivasan said. “If I had received menstrual education earlier on, comprehensive menstrual education … I wouldn’t have to have felt restricted or stressed out because I just didn’t understand how my body worked.”

Students of color and LGBTQ+ students disproportionately receive less CSE compared to their peers. This does these youth a disservice, Molina-Schneider said, because CSE can help youth with “the idea of understanding their bodies and feeling comfortable in their bodies and not feeling shame.”

“We are coming into an environment where young people, and actually bodily autonomy in general, is going to be challenged,” Molina-Schneider said. “I think it is crucial now for young people to understand that their body belongs to them.”