NC is revising its sex education standards. LGBTQ+ advocates want them to be more inclusive

North Carolina officials are revising standards on how the state’s public schools should teach reproductive health to young people — changes that come as political fights rage over the discussion of sexual orientation and gender in classrooms.

State leaders so far aren’t planning to make fundamental changes to the 12-year-old standards. But some reproductive health education experts and LGBTQ+ advocates see room for improvement.

A new state law has caused school districts to review their sexual education policies. The law, which Republican sponsors call the Parents' Bill of Rights, came after a long debate amid a national culture war over whether LGBTQ+ discussions were happening in schools or should happen in schools.

State standards on sex ed, which are only for fifth grade and up, don’t mention sexual orientation or gender identity.

State law requires that reproductive health and safety education heavily emphasize abstinence and promote the idea that “a mutually faithful monogamous heterosexual relationship in the context of marriage is the best lifelong means of avoiding sexually transmitted diseases, including HIV/AIDS.”

That language is alienating to non-heterosexual people who will also be taking sex education lessons, some advocates argue. Experts say education about sex — in addition to access to health care products — is a major way to reduce sexual health risks and should be considerate of everybody, regardless of sexuality or identity.

Sex education curriculum varies widely by state. Some groups, including Planned Parenthood, have called for sex education to be inclusive of LGBTQ+ students, but some states outright forbid such an approach, according to the Associated Press.

Sex education is largely about risk reduction, said Robin Pittman, family life director at the Alice Aycock Poe Center for Health Education in Raleigh

“We tell the kids ‘knowledge is power,’ whether we're talking about math, or science, English, or reproductive and sexual health,” Pittman said. “The more we know, the better off we're going to be, and you're going to be able to make a better informed decision and make healthy choices.”

Nationwide, 13 states and the District of Columbia explicitly require instruction that is LGBTQ-inclusive, according to the Guttmacher Institute.

Adrian Parra became HIV-positive at 20 years old and wishes they’d known about PrEP (pre-exposure prophylaxis) or PEP (post-exposure prophylaxis), medication regimens to prevent HIV transmission, when they were younger.

“That was a gap for me, personally,” said Parra, executive director of Youth OUTright, an Asheville nonprofit focused on queer and transgender young people.

PrEP is now FDA-approved, meaning schools would be required to teach students about it, while PEP only has emergency use authorization from the FDA.

In recent years, about 40% of North Carolina high school students reported having sexual intercourse, according to the biennial Youth Risk Behavior Survey conducted by the U.S. Centers for Disease Control and Prevention in most states. That’s roughly 200,000 students. About 40% of them report not using a condom. About a three-quarters of them say they are heterosexual. About one in eight say they have been the victim of an attack, verbal or physical, for identifying as LGBTQ+. About 8% of high school students report being the victim of sexual assault.

Not using a condom can increase the risk of sexually transmitted infections or pregnancies. Both can have life-long consequences.

Rethinking standards

The first draft of the proposed revision to healthful living standards contains increased detail on teaching consent, sexual violence prevention, infection prevention and resources for help, among other things.

Initial suggestions from educators and other stakeholders were to keep the existing health standards framework but to expand on the standards for clarity and detail, according to the North Carolina Department of Public Instruction.

People largely favor teaching comprehensive sex education, national polls show. They also show people favor including instruction on sexual orientation and gender identity at the high school level.

While stakeholders consider new state health standards, educators must follow several requirements — namely, that the standards must emphasize abstinence from sexual activity first and foremost and promote heterosexual relationships.

“That completely eliminates education about people who might be bisexual or homosexual,” said Clayton Alfonso, a gynecologist at Duke University Hospital.

That could be 10% to 20% of North Carolina teenagers, according to the Youth Risk Behavior Survey.

“We're leaving them out of the educational sphere without arming them with the tools necessary to have responsible sex,” Alfonso said.

Education about condoms is particularly important at a time when fewer men are using them, according to federal surveys.

Some teenagers feel comfortable accessing contraceptives or other barriers and know where to get them for free, Alfonso said. However, “I do see teens on the opposite end of that, that said, ‘I didn't think I could get this because my partner said this isn't how you got an STI,’ or ‘I didn't realize I could get an STI from just one sexual encounter.’”

Helping young people, regardless of their sexual orientation or gender identity, feel more comfortable with their bodies is part of puberty and sex education.

Research also shows that teaching growth and development to kids empowers them to have more confidence in their changing bodies, Pittman said, and they’ll talk to their parents more about it.

“They'll feel better about themselves,” Pittman said. “They'll understand the changes.”

Some children, she said, especially girls, can lose self-esteem when their bodies change and they don’t completely understand why.

Requirements of sex education

The North Carolina State Board of Education updates its course standards every few years to reflect new knowledge, learning techniques or priorities for what kids should master in each subject area.

The standards determine how the state’s more than 1.5 million public school children will learn about reproductive health in the classroom.

When it comes to health classes and other non-core courses, the standards often guide curricula and lesson planning.

School systems often form their health curricula around the state’s standards and often don’t purchase third-party curricula. That’s unlike in core subject areas, like reading and math. So the template the state offers for health class is largely what’s used.

North Carolina state law lists out two pages of requirements for reproductive health education. The State Board of Education and the state Department of Public Instruction take those requirements, combine them with established research, and form the reproductive health education standards.

The state law’s requirements on sexual education don’t get deep into specifics. Schools could spend differing amounts of time talking about each topic or approach each topic using differing lesson plans or texts.

But the law outlines many things standards must include. Among them:

• Schools can, but don’t have to, start reproductive health education before 7th grade. They are required to teach reproductive health beginning in 7th grade.
• School boards can choose either an opt-in or opt-out method for families to decide whether their child should receive reproductive health education.
• Families must be able to review instructional materials before instruction begins.
• Instruction must be medically accurate.
• Reproductive health and safety education heavily emphasizes abstinence and promotes the idea that “a mutually faithful monogamous heterosexual relationship in the context of marriage is the best lifelong means of avoiding sexually transmitted diseases, including HIV/AIDS.”
• Schools are required to teach about all U.S. Food and Drug Administration-approved methods for preventing pregnancy and sexually transmitted infections. That includes condoms, birth control pills and other tools.
• Schools are required to teach about sexual assault and sexual abuse, including what it is, common misconceptions and stereotypes of sexual assault and abuse, ways to report it and what healthy relationships look like. Schools are also required to teach about “causes of those behaviors” and reducing the risk of becoming a victim. Consent, and how it is given, is not mentioned.
• Schools are required to teach about sex trafficking and prevention.