Making Sex Ed And Pediatric Health Care LGBTQ+ Friendly

Much of what our children learn about sex and gender in the classroom is outdated. It’s important to understand why inclusive education is important for the health and development of all children and teens and how we as parents can improve what is taught in schools.

By Varuna Srinivasan, MBBS, MPH, FRSPH

In the United States, the sexual education your children and teens receive in school depends on where you live. While the American Medical Association, the American Academy of Pediatrics, and the Society for Adolescent Health and Medicine all support sex education in schools, only 29 states and the District of Columbia mandate it. And the type of education provided varies from state to state: According to a study by the Guttmacher Institute, a majority of teens do not receive information about birth control before they had sex for the first time. Access to sexual health information is even worse for LGBTQ+ teens, especially those who are Black, Indigenous, and other people of color.

Today, only seven states in the U.S. have policies that require instruction for sex ed in schools to include sexual health information for LGBTQ+ youth. A majority of southern states prohibit instruction on LGBTQ+ relationships and identities or require educators to emphasize negative associations with identifying within the community. In addition, 70 percent of states allow for parents to opt-out of sex education for their children altogether. Of the more than 12,000 LGBTQ+ students surveyed by the Human Rights Campaign and the University of Connecticut, only 20 percent of Black LGBTQ+ youth and 13 percent of Latinx LGBTQ+ youth said they received relevant sex information in schools. That percentage was down to 13 for bi youth and 10 for transgender and gender-expansive youth.

When LGBTQ+ relevant sexual health information is excluded from the curriculum, these children and teens are left to seek out information about sexuality, health, and STI’s on their own. “Unfortunately, much of the sexual health information online is neither age-appropriate nor medically accurate, leaving LGBTQ youth at a disadvantage and with a greater likelihood of being misinformed,” states a call to action report published by Unite for Reproductive and Gender Equity (URGE). In order for these systems to change, we need to let go of archaic systems that prioritize heteronormativity and the gender binary.

How We Got Here: The History of Gender and Sexuality

It’s very important to explore where our understanding of sex and gender comes from. For the most part, much of what we know around these topics is a result of settler colonialism. Many cultures, Indigenous tribes, for example, celebrated sexual freedom and gender fluidity. Two-spirit, transgender, and queer individuals were considered normal. The idea of gender binaries was a western concept that was established with the sole purpose of colonization. White supremacy created strict systems that centered on purity, heterosexuality, and monogamy. Anything outside of this was met with hostility and violence. Homosexuality, in particular, was made illegal, a practice still in place in many post-British colonies to this day.

Reframing the Conversation and Understanding the Basics

Unfortunately, white supremacy still influences the way we think about sex and gender. Sex education in many U.S. states is predominantly abstinence-only and more than 20 states are passing legislation affecting trans youth. The onus is often placed on parents and educators to deliver the “right” information. For this reason, it’s vital we use the right language when having conversations around sexuality to be more inclusive.

Research shows us that comprehensive sex education not only dismantles white supremacy but promotes LGBTQ+ equality and gender equity. In order to encourage inclusion in school curricula, we need to redefine some basic terms from an inclusive point of view. Emphasizing that sex and gender are very different and don’t necessarily influence each other is a start. Sex is a term assigned at birth, a decision made by health professionals mostly by anatomy (external genitalia) and sometimes chromosomes and hormones. Gender is always based on that binary, which then leads to stereotypes around roles, relationships, and types of sexual activity people experience. Understanding and affirming this can drastically change how kids think about their bodies. More importantly, we are including transgender and nonbinary students when it comes to conversations around sexual health.

School is where you learn about your body. Why not extend this conversation to include comprehensive know-how about sexual orientation, gender identity, and pronouns?

Making Health Care More Inclusive for Children and Teens

LGBTQ+ folks experience alarming rates of health disparities. In general, bisexual folks experience higher rates of HPV and sexual health issues as a result of not being able to come out to their health care providers. Transgender folks experience significant health disparities because of a lack of access to providers with significant knowledge on transgender-related health. These disparities can start young when children and teens don’t feel they can trust their health care providers to give them gender-affirming care. Health disparities are compounded by health care stigma and discrimination.

Like sex education, medicine centers around a cisgendered heteronormative experience and this can create a conscious or unconscious bias found on forms or signage, as well as during treatment. Bias can manifest in the following ways: assuming that only straight couples can have children, only cisgender women get pregnant; erasing transgender men and nonbinary people from gynecological health care information, refusing the use of correct pronouns and gender, insistence on using a person’s dead name or continuing to misgender someone despite being corrected.

These barriers to affirming health care stigmatize queer identities and bodies, which means many people put off the care they need. Health care facilities can move in the right direction by training their staff to be culturally competent in LGBTQ+ health issues, collecting gender identity, pronoun, and sexual orientation data on intake forms, and working with LGBTQ+ organizations in the community. Teaching LGBTQ+ youth and allies about inclusive health care and how to find supportive doctors and advocate for this care can make all the difference.

What Caregivers Can Do To Add Inclusive Sex Education in Schools

Parents and caregivers need to ask school administrations what sex education looks like in each grade. Ericka Burns, Ph.D., the founder of SACPOP, a Sacramento-based youth-led initiative that works to address sexual health issues in BIPOC communities, says that parents should include their kids in conversations about the sex-ed curriculum at school board meetings. “It’s so important for youth to speak for themselves and for parents to back them up,” she says.

Jess O’Reilly, Ph.D., a sexologist and TV personality, also recommends that straight parents show up for queer parents, students, and teachers. “This involves not only attending events that support gender and sexual diversity and justice but helping to spearhead and coordinate initiatives,” she says. “The labor of coordinating Pride events should not fall exclusively on queer folks.”

Dr. O’Reilly also recommends families donate supplies like books and resources that reflect a range of diverse genders, sexualities, and relationships to schools and use gender-neutral language when speaking to parents, kids, and teachers. She adds that you should not wait for queer students, parents, or teachers to be visible before you speak up in support of queer rights and justice.