linguistic:voice_change
United States

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics in grades 5 or 6. However, what students learn varies widely, because curriculum decisions are decentralized. Many states have laws governing what is taught in sex education classes and contain provisions to allow parents to opt out. Some state laws leave curriculum decisions to individual school districts. In January 2022, a study found that a majority of US teens lack quality sexual education, a trend that has been worsening over years. Instruction on waiting until marriage to have sex declined from 73% to 67% among females (P = 0.005) and from 70% to 58% in males (P < 0.001).

Sex education is required in 30 states, 28 of which also require HIV education. 9 more states require just HIV education. Only 18 states require the information taught to be medically accurate by law. 37 states allow parents to opt their kids out of their Sex Ed. 19 states require instruction that sexual activity should only occur in marriage and 28 states require that abstinence be stressed. Contextually, 11 states must inclusively discuss sexual orientation and 5 legally must emphasize heterosexuality or provide negative information about homosexuality. A total of 6 states require LGBTQ+-inclusive sex education to be taught in school. Only 9 states require the importance of consent in a sexual situation.

For example, a 1999 study by the Guttmacher Institute found that most U.S. sex education courses in grades 7 through 12 cover puberty, HIV, STIs, abstinence, implications of teenage pregnancy, and how to resist peer pressure. Other studied topics, such as methods of birth control and infection prevention, sexual orientation, sexual abuse, and factual and ethical information about abortion, varied more widely.

Within the last decade, the US federal government has encouraged abstinence-only education by steering over a billion dollars to such programs. Some 25 states now decline the funding so that they can continue to teach comprehensive sexuality education. Funding for one of the federal government's two main abstinence-only funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that date. In 2007, a study ordered by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex (and use contraception) in their teenage years as those who did not. Abstinence-only advocates claimed that the study was flawed because it was too narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive effects.

Proponents of comprehensive sexuality education, which include the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the American Academy of Pediatrics, the American Public Health Association, and the American College Health Association, argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized; they also claim that denying teens such factual information leads to STIs and unwanted pregnancies.

A 2007 Centers for Disease Control and Prevention report showed a 3% increase in teenage pregnancies from 2005 to 2006, to nearly 42 births per 1,000. Apart from this, the rate of teen pregnancy has been declining consistently since 1991. Still, the U.S. has the highest teen birth rate and one of the highest rates of STIs among teens in the industrialized world.