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The Benefits and Barriers of Teaching Comprehensive Sex Education in American and Japanese

Public Schools

Christina Zendzian

Global Connections

Gregory Falls

December 2016







History of Sex Education in the U.S. 6

Issues Surrounding Sex Education in the U.S. 8

The Demonization of Sex and Sexuality 12

The Rise in Teen Pregnancy and STIs 13

Japanese Sex Education 14

Comprehensive Sex Education 16





The battle for sex education in public schools is a global concern. From government funding of

abstinence-only-until-marriage sex education to societal norms, critical information about sex

and sexual health is lost. There are multiple factors that contribute to the lack of comprehensive

sex education in public schools. This in-depth research paper will explain why abstinence-only-

until-marriage sex education is not effective in the education of adolescents about their own

sexual health and identity. American and Japanese sex education systems will be compared on

topics such as lack of comprehensive sex education and its affects on teen pregnancy, rates of

sexually transmitted infections, and how we perceive sexuality.


Despite the idealization and romanticization of sex across the globe, sex education is

often overlooked. When first introduced in the U.S., the primary focus of sex education was to

promote sexual health. The World Health Organization defined sexual health as the capacity to

enjoy and control sexual and reproductive behavior in accordance with a social and personal

ethic, freedom from fear, shame, guilt, false beliefs, and other psychological factors inhibiting

sexual response and impairing sexual relationship, freedom from organic disorders, diseases, and

deficiencies that interfere with sexual and reproductive functions (Knowles. 2012).

Furthermore, the purpose of sexual health care should be to enhance lives and personal

relationships rather than minimal counseling and care related to procreation or sexuality

transmitted diseases (Knowles, 2012). It wasnt until the HIV/AIDS epidemic in the late 1980s

and early 1990s that the American sex education curriculum changed. In response, condoms

were taught as the most effective way to combat HIV. In protest, religious groups, which became

influential during the mid-1990s, would advocate for an anti-condom curriculum. The pivotal

change in American sex education that would create barriers for comprehensive sex education

came in 1996 when the federal government got involved. President Bill Clinton passed multiple

acts that stated the federal government would grant $50 million a year to state governments that

taught abstinence-only-until-marriage (Malone, 2011).

This paper will dive into the benefits and barriers of teaching comprehensive sex

education in American and Japanese public schools as well as explore a secondary option to

abstinence-only education. Sex education is vital, and abstinence-only-until-marriage sex

education doesnt cover the whole story. Critical information is left out of the abstinence-only-

until-marriage curriculum, which produces risky and unsafe sexual practices and misinformed

individuals, both nationally and internationally.


Abstinence-Only Sex Education. The debate of comprehensive sex education vs.

abstinence-only sex education is simply what is thought of as age or school appropriate.

Psychiatrist, Dr. Keith Ablow, discusses a few of many conservative values, such as: kids should

learn about sex from their parents. Fox News Insider leans strongly towards conservative values

and ideas, which explains Dr. Ablows opinions on sex education in public schools

(Outnumber, 2014) . Likewise, Kim argues that teenage sex leads to serious health risks.

Many of these risks are avoidable if teens choose to abstain from sexual activity. Abstinence is

the surest way to avoid the risk of STDs and unwed childbearing. The data shown in this article

is fairly dated and heavily biased; however, it does show a clear outlook on why abstinence-only

sex education is prevalent in the U.S (2010).

Comprehensive Sex Education. Klein emphasizes the multiple loopholes that the

American sex education system has created, which is only the beginning with the barriers of

teaching comprehensive sex education in the U.S.. There is nothing concrete in national law that

truly dictates what should and shouldnt be taught in public schools, which makes the barriers

more difficult to overcome (Klein, 2014). Alford makes a strong point on how ineffective

abstinence-only sex education is on American youth and the consequences of such. She

advocates for reform, questions federal funding of abstinence-only-until-marriage programs, and

discusses how the need for comprehensive sex education hasnt changed since the 1950s. Alford

states that abstinence-only programs did not achieve later sexual initiation or lower rates of

pregnancy or STIs and considerable scientific evidence...about both abstinence and

contraception can work to help teens delay sexual activity, have fewer sexual partners and

increase contraceptive use when they begin having sex (Alford, 2011).

Japanese Sex Education. The Economist article about Japanese sex education makes a

strong point about how the Japanese government is tiptoeing around the topic of sex.

Throughout the article, it is apparent that the government guidelines barely cover the minimum

and remains unchanged since the 1990s. The Economist also plainly states different attitudes

towards commercialised sex and formal sex education, which creates bias within the Japanese

culture. While the Economist is usually unbiased, this article leaned toward the favor of teaching

comprehensive sex education (No sex, 2016). This is the gateway to discovering the answer to

the question of what aspects of Japanese culture is preventing comprehensive sex education from

being taught in Japan.

Similarly, Brasor answers the questions on why Japan has two different opinions toward

sex. The root of the problem concerning sex education in schools is the education ministry

while giving reasons like, the Japanese government as squeamish towards teaching conception.

Brasor strongly pointed out the multiple barriers in Japanese culture and politics (Brasor, 2015).


Original survey bias and inaccuracies. The original student survey was implemented

with proper sampling methods, such as obtaining an approximately normal sample; however,

there is a possible sampling fallacy with convenience sampling. Also, the use of qualitative

responses may lead to response bias, causing an inaccurate representation of the sex education

curriculum. The free version of Surveymonkey was used for the questionnaire has a limit of a

hundred responses that can be viewed. Over a hundred responses were collected and due to lack

of funds, only the first hundred can be considered. Despite the fallacies and bias in research, the

study can be taken as credible source of experience.

Sources. Information regarding sex education in the U.S. tend to be dated. Updated sex

education is not the top priority; therefore, old information is recycled and taught in schools.

Crucial sources that were used multiple times go as far back as 2007 and 2011.

Geographical constraints. Original surveys were implemented mainly within the

Virginia Beach City Public School district. Questionnaires were not sent to any form of private

school; meanwhile, mainly high school seniors participated in the original student survey. This

excludes groups of students and skews the data. Although, there are some international

viewpoints included in the survey results (mainly high school juniors from Sweden and China).

Despite the international focus of the paper being on Japan, no students from from that country



History of Sex Education in the U.S.

In present day America, education is a state right; therefore, the federal government has

no mandate, whatsoever, over what the states teach. Although general education of American

youth is required by federal law, sex education is not. Therefore, states individually have the

responsibility to create their own sex education policies. This responsibility also tends to fall into

the hands of individual school districts, which can result in two schools in the same district to be

teaching sex education in two completely different ways (Malone, 2011). As a result, heated

debates occur over what is the appropriate type of sex education that should be taught in

American public schools: comprehensive or abstinence-only-until-marriage.

The Advocates for Youth Publications of Sex Education Programs defines comprehensive

sex education as education that teaches about abstinence as the best method for avoiding

sexually transmitted infection (STIs) and unintended pregnancy, but also teaches about condoms

and contraception to reduce the risk of unintended pregnancy and of infection with STIs,

including HIV. It also teaches interpersonal and communication skills and helps young people

explore their own values, goals, and options. Comprehensive sex education is more holistic than


Furthermore, it is important to take into account that the dominating sex education

program in American public schools is abstinence-only. Religion's relationship, specifically

Christianity, with politics plays a key role in the reason why sex education is a political issue and

why abstinence-only sex education dominates American public schools. With the majority of

policymakers being Christian, this leads to a clash of opinions due to Americas diversity.

In the 1970s and 80s, sex education in public schools became a hot topic due to the

HIV/AIDS epidemic and rising teen pregnancy rates. The federal government, under President

Clinton, began funding conservative abstinence-only programs through three sources: the Title

XX of the Public Health Service Act within the Adolescent Family Life Act (AFLA), Title V of

the 1996 Social Security Act, and Title XI, Section 110 of the Social Security Act, known as the

Community Based Abstinence Education program (CBEA).

Although sex education is state run, public schools could still receive funding from the

government. Federal funding made the push for abstinence-only sex education greater because it

showed what the government wanted. At the time, the states received approximately $88 million

annually from the federal government (Cadwell, 2015), and from 1982, the federal government

spent approximately $1.87 billion on abstinence-only programs that intentionally withheld

information about contraceptives and other topics. The federal government has since stopped all

funding of all federal abstinence-only programs under President Obama (Punjabi, 2015).

Conservative ideals concerning sex education in public schools were not controversial at the time

since the conservatives controlled most policy making jobs; however the benefits and

effectiveness of the abstinence-only on sexual health started to be questioned.

Issues Surrounding Sex Education in the U.S.

The main issue surrounding abstinence-only-until-marriage sex education is that it creates

a narrow view and can facilitate the spread fallacies concerning sex and sexual health. The

curriculum often censors information about contraceptives, which are vital in preventing STIs,

HIV, and pregnancy.


According to liberals, American sex education would ideally be unbiased, medically

accurate, up-to-date, and teach safe and healthy sexual health practices with or without

abstinence; however many states do not uphold to this ideal. Only 24 out of 50 states, including

D.C., require public schools to teach sex education . From those 24 states, 21 of them also

require HIV/AIDS education, and only 20 states require medically accurate sex and/or HIV

education. Topics covered in sex education can either be factually or technically accurate, which

varies from state to state because a law mandating that all sex education topics be 100%

medically accurate doesnt exist. Therefore, the Department of Health is required to review

curriculum, mandating that curriculum to be based on information from published authorities

upon which medical professionals rely (State, 2016). The variations of definitions for medical

accuracy can lead to risky sex practices and unhealthy sexual health. For example, if pregnancy

is effectively explained, students might believe that pregnancy cannot occur through anal sex

(which is possible).

Another issue surrounding sex education in the U.S. is single-sex lessons, which

separates males and females in different classroom during lessons. Single-sex lessons are

harmful because they promote archaic and harmful sex stereotypes. Sex education typically

begins in 5th grade, the average age that puberty begins. During topics like puberty and anatomy,

single-sex lessons cause gender stereotypes to be more salient. Since students are only taught one

side of puberty and anatomy stereotypes, the opposite sex confuses them. Stereotypes such as

girls are only mad because they're on their period or periods are disgusting become

embedded into American culture due to the lack of understanding between sexes (Bohm, 2012).

In addition to single-sex lessons, abstinence-only programs promote more subliminal

messages regarding gender roles and ideals. If rape and sexual assault are taught and discussed

in the classroom, the impression that only females get pressured into unwanted sex is made,

which is false. These subliminal messages create benevolent sexism, which occurs throughout

abstinence-only programs. Benevolent sexism is subjectively positive but patronizing in tone

and reflects the desire to protect and idealize women. Students are taught that women are not to

be respected because they are human beings, but they are respected because they are someones

future wife. Abstinence-only programs also promote female passivity and male sexual

aggression (Caldwell, 2015). This is an issue because it can teach students that sex makes women

dirty, but makes men powerful.

To emphasize benevolence sexism and the inaccuracy of abstinence-only sex education,,

another study was conducted in 2004 by Rep. Henry Waxman on thirteen abstinence-only

programs. Waxman reported that those thirteen programs tended to be inaccurate and sometimes

dishonest, and that eleven of the thirteen curricula contained errors, distortions, and misleading

information about the effectiveness of contraception, HIV and STI prevention, and the risks of

abortion. The curricula studied from these programs also blurred religious belief with science,

and stated stereotypes about girls and boys as scientific fact. Blurring religion and science

contributes to the fallacies concerning sex and sexual health. Waxman stated that abstinence-only

programs often taught students benevolent sexism (Knowles, 2012).

Sex education teachers within the Virginia Beach City Public Schools (VBCPS) took a

student survey concerning their opinions and thoughts on the VBCPS sex education curriculum,

which has not been updated in eighteen years. Approximately 62% of teachers felt that the sex

education curriculum was not helpful for all students. The top two responses when asked what

changes they would like made about current sex education laws or curriculum were


More current topics/update the curriculum more

frequently, and
To teach away from abstinence-only.

Approximately 75% teachers believed that LGBTQ+ topics should be included, or at least

mentioned in the curriculum because majority of teacher wanted students to learn to embrace

students with different sexual/gender identities.

Students, ranging from high school sophomore to high school/college graduate from

Virginia, also took a student survey on how they felt about sex education. Out of 100, 93% of

participants were from the U.S, and 7% of participants were from Sweden and China. 97% of all

participants did participate in a form of formal sex education, and the majority felt that the

current sex education curriculum in their nation was not doing all that it could be teaching about

sex and sexual health. Based on the student survey, 75% learned about HIV/AIDS and STI

prevention, 90% learned about anatomy, 77% learned about pregnancy, 74% learned about the

negative outcomes of teen sex, 58% learned about abstinence-only and the importance of sex

only within marriage, and 73% learned about menstruation. These are typical topics students

learn nationwide. 53% learned about condoms and other contraceptives, 32% learned about

consent, rape, and avoiding coercion, 8% learned about sexual orientations and gender identity.

The results show that there is a huge emphasis on abstinence-only topics and little emphasis on

comprehensive topics (Zendzian, 2016).

Moreover, parents play a vital role in the education of their children since parents tend to

want their children to share their beliefs. Parents are allowed to opt-out of children from their

schools sex education classes in 35 states, including D.C., and four states require parental

consent in order for a child to receive sex education in public schools (State, 2016).

Conservatives argue that sex education should be taught at home instead of in school. For


example, a father in Kansas became upset with a poster in his childs school that showed

examples of platonic and romantic ways to express attraction, such as holding hands or having

sex. The father stated that the poster was outrageous for 13-year-old children (Parents, 2014).

A valid opinion, however children begin becoming interested and understanding sex as early as

the age of six (Understanding, 2016). Parents are responsible for educating their children about

sex and sexual health topics; however, sex education is taught in public schools for a reason.

There are children that are opted-out of their schoolss sex education and dont have

parents or a trusted adult to not give them the talk or access to the Internet or books regarding

sexual health. There are children who are questioning their sexuality and gender identity and do

not have access to that kind of information because they do not have the resources or they are not

taught about those topics in school. Abstinence-only-until-marriage excludes those who do not fit

into societys norms, which creates a demonization of sex and sexuality, as well as a shame


The Demonization of Sex and Sexuality

America has built a culture of shame and guilt around sex, sexuality, and sex education.

Abstinence-only programs teach that the only proper way to have sex is vaginal-penis

intercourse between a married male and female that have only had sex with each other (Caldwell,

2016). Those that have had sex with one or more partner before marriage, have gotten pregnant

outside of wedlock, or are not heterosexual are shamed.

There is no room for the LGBTQ+ community in the sex education classroom. In 11 out

of 50 states allow open discrimination against lesbian, gay, bisexual, transgender, queer and

questioning LGBTQ+ students by restricting or prohibiting discussion of LGBTQ+ topics in

school sex education instruction. Based on the 2015 Youth Risk Behavior Survey, 11% of high


school students identified as lesbian, gay, bisexual, or not sure (Punjabi, 2015). The spectrum of

sexuality and gender is ignored as if they are non-existent; however when it is taught, only

homosexuality is mentioned during HIV/AIDs discussion or to mention that homosexuality is

deviant and immoral. Abstinence-only ignores the emotional and health needs of LGBTQ+

youth, and consequently, destroys safe spaces by giving them a small range of choicespretend

to be straight, remain abstinent forever, or risk their health (Alford, 2007).

These negative lessons in sex education makes homophobia in the U.S. more prominent

due to both members of the LGBTQ+ community and heterosexuals learning to believe being

anything but heterosexual is bad. Additionally, since sexual orientations and gender identity are

not taught at all or in a good light, LGBTQ+ youth are at an increased risk for mental health

concerns like depression, low self-esteem and suicide. This is concerning because this kind of

hatred should not be taught in publics schools (Goodman, 2016). The Universal Declaration of

Human Rights, which was mentioned previously, states in Article 26: Education shall...promote

understanding tolerance and friendship among all nations, racial or religious groups, and shall

further the activities of the United Nations for the maintenance of peace. Students have the right

to an education free of discrimination (Caldwell, 2015). Comprehensive sex education programs

would fulfill Article 26 and teach students that all sexual orientations are equally valid, while

abstinence-only adds fuel to bullies hate speech by showing that its acceptable to have negative

attitudes toward LGBTQ+ people (Goodman, 2016).

Due to the shame of sex out of marriage, pregnant teens are ostracized. Its not odd when

a pregnant teen suddenly disappears from school; no one questions it. There are a few reasons

why she is gone: she either dropped out or moved to a family member or special program that

would help her. Most likely, the former will occur. According to the American Civil Liberties


Union of Washington State, teen pregnancy is the the #1 reason why teenage girls leave school

(Mangel, 2010). Abstinence-only programs dont teach that it is normal to have sex before

marriage. There is too much of an emphasis on not having sex as a teenager that it enforces the

exclusion of pregnant teen girls. In reality, the average American female has at least 8.6 sexual

partners by the time they reach age 40 (Britt, 2006).

The Rise in Teen Pregnancy and STIs

Another issue that revolves around the abstinence-only programs in the U.S., is teen

pregnancy and STIs. Among all developed nations, the United States is ranked first in both

teenage pregnancy and STI rates. While the teen pregnancy rates have decreased nationwide by

8% from 2014 to 22.3 births per 1,000 females ages 1519 (Hamilton, 2015), data shows the

progress is uneven (Stanger-Hall, 2011). Teen pregnancy rates are relatively low in northern

states, while rates are highest in southern states like New Mexico, Mississippi, and Arkansas

(Teen, 2011), where abstinence-only is deeply rooted in sex education.

Furthermore, American adolescents are disproportionately affected by STIs, especially

gay and bisexual adolescents (State, 2016; 2015 STD, 2016). The American youth (ages 15-

24) represent 25% of the sexually active population; however they catch more than 50% of all

STIs, which according to the National Conference of State Legislature , the cases of adolescent's

acquiring STIs amounts to 9.8 million a year (2016). Socio-demographic differentials also show

the need for comprehensive sex education. Studies show that nearly one-third of young men of

color did not receive instruction on either abstinence or birth control methods before first sex.

People of color who were among those who were from a lower-income group, had lower

maternal education, or were black or Hispanic tended to have higher rates of STIs and teen


pregnancy, which highlights the need for formal comprehensive sex education. (Lindberg, 2012).

Correlation does not mean causation; however, there are clear patterns.

Japanese Sex Education

Compared to the U.S., Japan has virtually no sex education within its public schools. Sex

education was basically outlawed due to the rise of neo-conservatives. Government guidelines

for sex education has gone almost completely unchanged since the 1990s (Tashiro, 2011). In

2002, the Japanese education ministry instructed elementary and junior high school health

teachers to teach students about contraception without explicitly talking about sex (Tiptoeing,

2016). Implicitly teaching sex education is not only tough on the teacher, but it can also cause

confusion amongst students. In an interview about Japanese sex education, J. Satoh who grew

up in Japan and is currently the Japanese language teacher at Tallwood High School said, It is

not as open as here. I do not know the current curriculum for sex education in Japan, but I did not

receive it when I was in school. We learned just about period and body changes. Due to Mrs.

Satoh not receiving any form of sex education, she is, to this day, confused about sex and sexual

health (J. Satoh, Personal interview, Dec. 2, 2016).

When sex education is taught in Japan, 45 minutes to two hour is spent discussing topics

like child-rearing, STIs, contraception, and Japans abortion law (Ishiwata, 2011; Tashiro, 2011).

Thus, Japanese youth have to turn to the media for sex education since the government has made

it virtually impossible to get useful information from a reliable source (Brasor, 2015). This is not

helpful to the sexual health of Japanese youth because the media is unreliable. Japanese media

creates an image of sex that is inaccurate and distorted, which causes Japanese youth to believe

everything they see to be accurate (Tiptoeing, 2016). Without some form of formal sex

education, Japanese youth grow up not knowing how to practice healthy and safe sexual health.


As a result, STI rates are high (Ishiwata, 2011); however, it is important to take into account

culture when openly discussing sex in Japan. The Japanese are conservativethey get

embarrassed about the topic of sex. It is not something that is talked about in public, yet sex is

everywhere in Japan. Its gleefully commercialised, from explicit manga comics to Tokyos

red light district with rows of love hotels where rooms are rented by the hour (Brasor, 2015).

Japans contradictory views towards sex contributes to the demonization of sex and sexuality.

Similar to the U.S., LGBTQ+ topics are not mentioned, which results in stereotypes and

bullying, which is a major issues in Japan, especially towards members of the LGBTQ+


Comprehensive Sex Education

Comprehensive sex education is an umbrella term, which addresses the socio-cultural,

biological, psychological, and spiritual dimensions of sexuality by providing information;

exploring feelings, values, and attitudes; and developing communication, decision-making, and

critical-thinking skills (Guidelines, 2001). and is medically accurate, unbiased, and science-

based. It includes topics as puberty, conception, contraceptives, abstinence, and more. The

primary goal of comprehensive sex education is to assist young people in developing a positive

view of sexuality, provide them with information they need to take care of their sexual health,

and help them acquire skills to make decisions now and in the future (Guidelines, 2001).

Furthermore, comprehensive sex education is beneficial because it is inclusive. It allows

students to choose what they want to believe and approach early sexual encounters with caution.

By having more comprehensive sex education, teachers and parents can empower youth to

make responsible choices that protect their health, well-being and provide support for academic

achievement. Data shows that comprehensive sex education is effective in reducing risky sexual


behaviors. The National Survey of Family Growth took a recent examination to determine the

impact of sexuality education on sexual risk-taking for young people ages 15-19, and they

revealed that teens who received comprehensive sex education were 50% less likely to report a

pregnancy than those who received abstinence-only education (Why, 2013). Oregon has been

noted for mandating comprehensive and medically accurate sex education in public schools

among four other states, which further shows the benefits of comprehensive sex education.

Oregon public schools can openly discuss HIV prevention, the different methods of

contraception and abstinence. Thus, Oregons 46% teen pregnancy rate is close to the Healthy

People 2020 objective of 44% (Frazier, 2016).

Unlike abstinence-only sex education, comprehensive sex education doesnt impede on

the right of free speech. Due to censorship, young people's right to have access to much-needed

health information is impeded. As a result, sex education teacher and students operate under a

gag order that censors the communication of vital sexual health information (Alford, 2011).

According to the Review of Key Findings of Key Findings of Emerging Answers 2007 Report

on Sex Education (2007), comprehensive sex education has improved factors such as knowledge

about risks and consequences of pregnancy and STD; values and attitudes about having sex and

using condoms or other contraceptives; perception of peer norms about sex and contraception;

confidence in the ability to say no to unwanted sex, to insist on using condoms or

contraception, or to actually use condoms or contraception; intention to avoid sex or use

contraception; and communication with parents or other adults about these topics. In part by

improving these factors, the programs changed behavior in desired directions.




Abstinence-only sex education has been proven ineffective in preventing sexual relations

among teenagers. As a result, I believe it is important for adolescents to receive a well rounded

sex education, which comes in comprehensive sex education because students have the right to

the information withheld by abstinence-only programs. Despite their differences, the U.S. and

Japan are similarly affected by the lack of comprehensive sex education in their teenage

populations. In the U.S., religion and conservatism are key reasons why abstinence-only sex

education has deep roots within the public school system. On the other hand, culture and

conservatism are the reasons why sex education remains obsolete in Japan. The goal of sex

education should not be to stop or delay sexuality; instead, it should promote healthy sexual

practices, such as condom usage and understanding consent. Sex education is not black and

white; rather, the purpose of education is to foster to minds of students and allow them to make

their own opinions. While the future of sex education is foggy, the shift to a more comprehensive

curriculum is needed.


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I. What is your gender?

Female: 64% Other: 3%

Male: 33%

II. What grade are you in?

High school College

freshman: 0% sophomore: 7%
High school College

sophomore: 3% junior: 3%
High school College

junior: 13% senior: 1%

High school Fifth

senior: 56% year/Other: 1%

College Graduated:

freshman: 6% 10%

III. In what country do you currently reside?

United States: Other

93% (Sweden & China): 7%



IV. Have you ever been given "the talk" by your parents/guardians?

Yes: 34% No. I know

No: 32%
what I know because of the

Internet: 34%

V. Did you participate in sex ed/family life in school?

Yes: 97% No. My school

No. I was
doesnt provide sex ed/family
opted-out by my parents: 1%
life: 2%

VI. Were you taught these topics during sex ed?

HIV/STI Consent.

prevention: 75% Rape, & Avoiding Coercion:

90% Pregnancy:
73% LGBTQ+: 8%
Condoms & Negative

Other Contraceptives: 53% Outcomes of Teen Sex: 74%

Abstinence & Nothing: 3%

Importance of Sex Only

Within Marriage: 58%

VII. Do you think religious opinions should be included during sex ed?

Yes: 15% No: 85%

VIII. Do you think the sex ed curriculum should be medically accurate and




es: 96% o: 4%