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Sexuality education is a controversial and contested issue that has evoked wide debate on the question of its aims, contents, methods, pedagogy and desired outcomes. This editorial aims to provide a brief commentary, positioning the contributions to this Special Issue of Health Education within the research landscape concerning sexuality education in schools internationally.

The idea for this Special Issue was born in Odense, Denmark, in October 2012, during the 4th European Conference of Health Promoting Schools. The Conference Programme and the debates during the sessions demonstrated the need for a wider discussion of sexuality education, particularly within the framework of the health-promoting school. There was recognition of the need to endorse positive and wide socio-ecological views of health, including sexual health and a critical educational approach to sexuality education. The conference delegates and the members of the Schools for Health in Europe Research Network were invited to submit a paper for the Special Issue, and the invitation was also sent through other networks and research communities globally. The invitation resulted in papers being submitted beyond Europe and the Special Issue took an interesting global turn. This networking process also resulted in the identification of a number of key international subject-specific experts who took on the role of independent reviewers.

Following the review and editorial process six papers were accepted for the Special Issue. The papers highlight contrasts, tensions, potentials and barriers embedded in the ways sexuality education is delivered to children and young people internationally. Examples are drawn from Russia, Wales, China and the USA; they identify historical and structural issues related to the implementation of comprehensive progressive approaches. Topics discussed include the importance of appropriate content, theoretical/conceptual frameworks, modes of delivery, timing, attitudes from key stakeholders and the need for comprehensive evaluation of innovative approaches to the delivery of sexual education.

The Special Issue provides a unique blend of evaluations of practical examples of pioneering programmes, research using qualitative, quantitative and mixed method designs, and critical conceptual discussions related to sexuality education and factors that influence it. The Special Issue addresses sexuality education from a life course perspective; some of the individual papers focus on young children and some on lifelong learning. All the papers point to the importance of understanding structural, socio-historical, political and cultural factors influencing sexuality education.

The purpose of this paper is to examine how school-based sexuality education has had a long and troubled history of exclusionary pedagogical practices that have negatively affected such populations as lesbian, gay, bisexual, trans, queer (LGBTQ) individuals, people of color, and the disabled. The social ecological model is introduced as a way of offering sexuality educators and school administrators a way of thinking more broadly about how to achieve sexual health through sexuality education efforts inside and outside of the school environment.

This paper uses critical analysis of current and historical school-based sexuality education methods and curricula used in the USA. Authors use both academic journals and their own expertise/experience teaching sexuality education in the USA to analyze and critique the sources of sexuality education information and curricula used in schools.

Historically, sexuality education in school settings in the USA has been biased and has generally not offered an educational experience fostering sexual health for all students. There are now welcome signs of reform and movement toward a more inclusive and progressive approach, but there is still some way to go. Sexuality education programs in schools need to be further and fundamentally reformed to do more to foster sexual health particularly for LGBTQ individuals, students of color, and people with disabilities.

This paper offers sexuality educators ways of addressing structural issues within the sexuality education curriculum to better serve all students to increase the quality of their sexual health. Integrating critical pedagogy and anti-oppressive education can increase students’ sexual health along physical, social, emotional, intellectual, and spiritual dimensions.

This paper provides historical analysis along with the identification of structural difficulties in the sexuality education curriculum and proposes both critical pedagogy and anti-oppressive education as ways of addressing sex and relationships education.

Parents are sometimes perceived as barriers to providing comprehensive and inclusive sexuality education to young people. However, little is known about parents’ actual attitudes towards providing such broad information to young people. The purpose of this paper is to examine two different approaches to measuring parents’ attitudes towards sexuality information, a programme title approach and a topic-centred approach.

Illinois parents of adolescents (n=301) indicated their knowledge about and attitudes towards sexuality education programmes and 18 sexual health topics via online survey. Confirmatory factor analysis was used to examine whether parents’ attitudes were more consistent with a programme-centred (i.e. abstinence-only, comprehensive) or a topic-centred (i.e. physical health, sexual and gender identity, pleasure, and relationships) approach.

Parents were uncertain about what form of sexuality education was offered but most were equally comfortable with both abstinence-only and comprehensive programmes. Parents’ ratings of topics grouped significantly better by the topic-centred than the programme-centred approach. Parents rated all four subjects as important, with the highest mean ratings given to physical health topics. Further, parents’ ratings of importance by subject matter were largely independent of their reported programming preference. Together these findings provide evidence that parents believe it is important for their children to have access to a broad range of sexual health education information.

This study is one of the first to document parents’ support for information for young people that goes beyond being comprehensive to include topics such as identities and pleasure. In addition, parents’ lack of knowledge about sexuality education programming may obscure their support for sexual health information. Measuring support by specific topics, however, can help to overcome issues due to parents’ lack of knowledge about programming.

The purpose of this paper is to describe the development of new interactive, bi-lingual Sex and Relationships Education (SRE) resources called Tyfu i Fyny/Growing Up, suitable for students aged between five and 12 years. It also discusses the evidence used to support the development of the resources, the support provided for teachers and parents and an initial evaluation following their use.

Tyfu i Fyny/Growing Up are interactive bi-lingual (Welsh and English) SRE teaching resources for primary schools suitable for students aged five to 12 years. These resources comprise of two components, an interactive electronic web-based programme and a floor mat illustrating a naked boy and girl. The electronic web-based programme is used to introduce puberty changes, loving relationships, conception, pregnancy and birth and is suitable for students aged nine to 12 years. The floor mat is suitable to be used with students aged between five and 12 years. Teaching activities can include naming body parts, discussing gender differences, personal safety, distinguishing between appropriate and inappropriate touching, discussing puberty changes and other health promotion activities as well as delivering aspects of the National Curriculum for Wales.

The results from the initial evaluation undertaken with year six students and teachers demonstrates how the resources have impacted on the teaching and learning experiences of primary teachers and students. It also demonstrates how the teacher training sessions and using the Tyfu i Fyny/Growing Up resources have increased teachers’ confidence in delivering SRE.

The learning experiences of students and their enjoyment of using the Tyfu i Fyny/Growing Up resources were significantly high. The implementation of teacher training improved teaching practice and increased teachers’ confidence in the subject. The resources have facilitated the delivery of effective whole school comprehensive SRE programmes for primary schools. These factors confirm the value of the investment given to their development. The resources could easily be customised in line with diverse ethnic, cultural, linguistic and religious requirements.

This paper demonstrates how the Tyfu i Fyny/Growing Up interactive SRE resources have influenced the teaching and learning experiences of primary school teachers and students.

Sexual education in adolescence may represent the only formal sexual information individuals ever receive. It is unclear whether this early educational experience is sufficient to promote lifelong sexual health literacy. The purpose of this paper is to examine the influence of the timing and source of sexual knowledge on current safe sex knowledge and risky sexual behaviours among middle-aged and older adults in the USA.

Participants (n=410, mean age=53.9, 50.7 per cent female) reported whether and when they received sexual knowledge from various sources. They were asked about their current safe sex knowledge and their lifetime sexual risk behaviours.

Most of the participants (61.5 per cent) received formal sexual education in adolescence and 20.2 per cent reported formal sexual education post-adolescence. Across the life span, friends were the most common source of sexual information. The sample scored in the upper mid-range on the scale indexing safe sex knowledge (M=6.69, SD=1.64, range=0-8). Participants reported engaging in an average of approximately four (out of 16) risky sexual behaviours across their lifetime. Those with formal sex education in adolescence scored significantly higher on safe sex knowledge. However, they also engaged in more risky sex behaviours.

This study is among the first to situate the normative, formal sexual education experience of adolescence within a life span context that not only accounts for time, but also multiple sources of influence. It would appear that there are more things to learn about the long-term influence of sexual education programmes during the formative years by studying adult sexual health and knowledge.

The purpose of this paper is to study the effectiveness of the international volunteer programme’s dance4life (D4L) in Russia. The programme aims to address taboos, stigma, discrimination, HIV/AIDS prevention and the promotion of sexual reproductive health and rights (SRHR) and a healthy lifestyle among adolescents. The programme uses an “edutainment” model that involves young people through music, dance and youth icons. Educated volunteers provide schoolchildren with comprehensive information on SRHR and demonstrate the practical application of life and leadership skills. The programme ends with a celebration event.

Qualitative and quantitative methods were used. Only those who got as far as stage three of the process, 20 per cent of those who begun, were sampled. The qualitative research involved youth aged 13-19 (20 interviews, six focus groups), teachers (eight interviews), volunteer team members (eight interviews) and programme managers in four project regions and in Moscow (five interviews). In the quantitative research 105 respondents took part, of whom 48 per cent were 13-16 years old, 44 per cent were 17-19 years old and 8 per cent were 20-23 years old. Both boys and girls were included in the sample.

Young people’s participation in D4L had a significant positive impact on perceptions of SRHR and knowledge levels, changed some misconceptions about HIV/AIDS and helped develop social and healthy lifestyle skills. The programme contributed to the growth of voluntary activity and the organizational skills of participants. Teachers’ perceptions of SRHR changed positively after their participation in the programme.

The fact that the sample is only those who completed all stages of the programme, 20 per cent of the overall population who began it, is clearly a source of bias. The size of the quantitative research sample (n=105) does not allow disaggregation of data by region nor by gender: this limitation was minimized by choosing four regions with relatively comparable socio-economic status, and through quota sampling in equal proportions for boys and girls. This is the first time such a study has been conducted, so it is not possible to draw conclusions about the long-term impact of the programme.

The short implementation period allows for the dissemination of information and training to large numbers despite limited funding.

The D4L approach provides information on SRHR to youth, which arouses their interest, and is perceived as relevant and important. Programme participants use this information themselves and share it with their friends, parents and other adults.

The D4L programme is unique in Russia: there is no regular sexual education in Russian schools. School programmes are rarely evaluated with the methods used in this study.

The purpose of this paper is to examine the type and quality of sexuality education received by college students in Hangzhou, China. Their attitudes towards sex and sexuality were also explored. To set the broader context the regulations and laws governing the provision of sexuality education in China have also been examined.

A cross-sectional survey of 132 college students was conducted in Hangzhou, China in 2013. The aim was to explore their experience of and attitudes towards their sexuality education.

Most respondents lacked formal sexuality education. Neither schools nor parents were reported to be the major providers of sexuality education. The students reported that their main sources of knowledge and information relating to sex were their fellow schoolmates and the internet. Participants reported insufficient or inaccurate sexual knowledge as a key factor in their participation in unprotected sex. Attitudes towards premarital sex and cohabitation, and homosexual relationships were reported to be more open and tolerant than those of the older generation.

The data from this study suggest that reluctance amongst parents and schools to provide formal and comprehensive sexuality education has resulted in unsatisfactory sexuality education in Hangzhou. The lack of sexuality education among college students may have had an influence on their unsafe sexual behaviours which is potentially damaging to both their physical and psychological health. Implications for improving the quality of sexuality education for young people in China are discussed.