An Open Letter from the International Association for Adolescent Health (IAAH) about Comprehensive Sexuality Education

Gray, N., Pemde, H., Sawyer, S., et al., on behalf of the IAAH Council. (2023). An Open Letter from the International Association for Adolescent Health (IAAH) about Comprehensive Sexuality Education. International Association for Adolescent Health. Quebec, Canada. Doi:

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We need our children to grow and develop to become socially connected, productive adults who are able to engage and contribute to their communities. This process involves supporting their physical growth alongside their emotional, social, spiritual, and sexual development – starting at birth. Developing a positive and healthy understanding of sexuality is as central to children and young people as every other area of human development.

Now, more than ever, we need to support adolescents across the world to be informed and take control of their sexual health and wellbeing. Global health challenges, including the closure of many sexual health services because of the pandemic, national economic crises, and political/philosophical belief systems impeding human rights, collide with the rapid expansion of technologies that penetrate even the most private aspects of personal life. This means that our biggest ever global population of young people face more complex threats to sexual health and wellbeing than previous generations, with fewer resources to counter them. Comprehensive Sexuality Education (CSE) is vital for healthy development and schools are the right place to deliver this, alongside the efforts of families at home.

Since the beginning of the 21st century, international high-quality research has shown that school-based CSE programmes lead to: delayed initiation of sexual intercourse; decreased frequency of sexual intercourse; decreased number of sexual partners; reduced risk taking; increased use of condoms; and increased use of contraception. Moreover, CSE decreases gender-based violence, prevents sexual abuse of children, and decreases risk factors for depression and suicidality amongst youth. It allows children and adolescents to fully understand consent. The common-sense key concepts of CSE (Figure 1) show different aspects of sexual development that are vital to wellbeing.

From the members of its global network, IAAH has noted a surge in communications to Governments and the media that express concern about the teaching of CSE in schools. As the Council of an organisation that supports health and education professionals who serve adolescents and their families, we see danger in every effort to undermine CSE.

We believe that every parent wants their children to have fulfilling relationships that are free from harm. We also understand that, despite the best of intentions, many parents find it difficult to have the conversations that equip adolescents with the knowledge and skills to negotiate the complexity of contemporary relationships, including those online. School-based CSE ensures that students have the developmentally-appropriate, culturally-appropriate, evidence-informed and professionally supported information across their schooling that they need to counter the avalanche of inaccurate and exaggerated representations of sex and relationships in the media.

CSE is thus shared between school and other institutions including the family. School-based CSE does not replace the parental roles and responsibilities in educating children about their reproductive health, but rather augments it. It is important for educators to receive training that takes into account different ages, stages of development, sexual orientation and identity, and national context, in order to deliver accurate and suitable information with competence and confidence. In partnership with families and community leaders, this is how we equip and empower our children.

We believe that it is not a coincidence that a group of people are challenging national governments, UNESCO and WHO. We believe that this is an orchestrated attempt by a group of ideology-driven organizations, which are neither interested in the evidence nor the context, to undermine years of legislation and advocacy that both protect the rights of children and adolescents and also save lives.

It is not the right of adults to enforce ignorance on their own children, or other people’s children. It is important to see these challenges to CSE for what they are, an orchestrated attempt to undermine adolescents’ access to evidence-based, developmentally-appropriate and culturally-appropriate information.

We will rally behind those who are being challenged and encourage them to stand firm. Young people need us to do so. We hope that like-minded civil society organisations, academic leaders, community and faith-based organisations, political parties, and nations will join with us to denounce organised efforts to undermine CSE.