Electronic Journal of Human Sexuality, Volume 17, February 16, 2014


Teacher and Health Service Staff Values Regarding Sexuality Education in an Urban School District in Indiana

Patrick C. Herbert, PhD, CHES
Assistant Professor, Towson University
Department of Health Science

Dayna Henry, PhD
Assistant Professor, Southern Illinois University, Edwardsville
Department of Kinesiology and Health Education

Catherine M. Sherwood-Laughlin, HSD, MPH
Associate Clinical Professor, Indiana University
Department of Applied Health Science

Lisa K. Angermeier, PhD, MCHES
Clinical Assistant Professor IUPUI
Department of Kinesiology

Contact and Additional Information to be addressed to: Patrick Herbert, Towson University Department of Health Science, Linthicum Hall, 101E 8000 York Rd., Towson, Maryland 21252
phone: 410-704-4973 fax: 410-704-4670 pherbert(at)towson.edu


The purpose of this study was to explore the explicit and implicit values about sexuality education communicated by teachers and health services staff in a large, urban school district in Indiana.  A survey was used to collect quantitative and qualitative data from 159 staff members responsible for teaching sexuality education.  Results of this study strongly suggest that those teaching sexuality education classes were guided by their own values and beliefs. Sexuality educators also have very little guidance when it comes to teaching content and methodology.  The results could help influence the pre-service and professional training of school-based sexuality educators. In addition, this data could help educators to better meet the sexuality education health needs of middle and high school students.


With the recent creation of National Sexuality Education Standards, clear guidelines have been established for those responsible for teaching sexuality education in the schools (Future of Sex Education Initiative, 2012). These standards were designed to provide a rationale for teaching sexuality education that is evidence-based. Having sexuality standards are important for educators who are currently responsible for sexuality education in their school setting in addition to helping prepare future sexual health educators in teacher training programs in academic institutions. The standards provide sexuality educators with a plan for providing developmentally appropriate sexual health information. By having these standards, school administrators and teachers will now be able to provide parents and community members with a sequential approach to educating students which in turn, will hopefully reduce some of the fears and concerns about teaching sexuality education in school-based settings.   While these standards are still new to the field, there is an indication in research that health education teacher training programs are not adequate in preparing future sexuality educators. In fact, studies have shown that many teachers responsible for sexuality education have little formal training in sexuality education (Eisenberg, Madsen, Oliphant, Sieving, & Resnick, 2010) and would be interested in receiving more training (Dodge, et al., 2008). This lack of training in the field could interfere or create a bias toward accurate or evidence-based information. It has been found that a teacher’s personal experiences and beliefs influence his or her sexuality education teaching (Timmerman, 2009).

Although many researchers have studied the impact of sexuality education on students, not much is known about the values of the teachers related to how they deliver sexuality education content to their students. Moore and Rienzo (2000) examined sexuality topics taught in sexuality education classrooms and found that teachers were omitting topics in their curriculum based on what they felt was important to teach. Some teachers were uncomfortable with topics and thought they were controversial or difficult to teach to students. Topics that were reported as not important or were not taught by at least 50% of the teachers were abortion (39.8%), sexuality and religion (38.7%), sexuality and law (37.5%), shared sexual behavior (35.6%), diversity (31.8%), masturbation (28.0%), fantasy (24.9%), sexual dysfunction (24.1%) and sexuality and the arts (8.0%).  In this case, personal values directly influenced what each teacher included in his or her instruction. Woo and colleagues (2011) examined predictors of implementing sexuality education in a school system. Teachers in this study self-reported that their personal values had the greatest influence when it came to creating their sex education curriculum.  Milton (2001) explored qualities and attributes that Australian teachers found helpful for teaching sexuality education. She found that teachers valued being neutral, accepting and open-minded with regards to issues in sexuality education.

Understanding the values that teachers hold about sexuality education could help influence the pre-service and professional training of school-based sexuality educators. This study will attempt to fill in the gaps in the literature with regards to exploring teacher values regarding sexuality education by surveying sex educators in a large, urban school district in Indiana.



The data for this study were obtained from teachers, school counselors and social workers (n = 159) in a large, urban, school district in Indiana who were responsible for teaching sexuality education at the secondary school level (grades 7-10) during the 2008-2009 school year. The majority of the respondents indicated they were classroom/homeroom teachers (31%) and health or physical education teachers (26%). Only 7% were school counselors or social workers and the remaining were other types of teachers (less than 4%) who did not have specific responsibilities teaching health education or sexuality education. These types of teachers were self-identified as a regular/general education teacher, family and consumer science teachers, administrative staff, reading teacher, music teachers, language arts teachers, social science teacher, and guest to school. The wellness director did not participate in the study because she did not teach in the classroom at the time of data collection.


Prior to collection of data, the Indiana University Institutional Review Board approved this study. Following approval from the participating school district and the wellness director, an invitation to complete a self-administered, anonymous survey was emailed to all employees who were responsible for teaching sexuality education in the school corporation as well as those who may have responsibilities related to addressing sexual health issues with their students. Surveys were completed in March and April of 2009. The participants used a link to the web based survey tool, SurveyMonkey (SurveyMonkey.com, LLC) which was attached to the email. Of the 610 school district employees emailed, 173 completed the survey, for a response rate of almost 28.3%. All of the participants were contacted via their professional emails and they received three emails from the wellness coordinator inviting them to participate in this study.  Emails were sent in early March, at the beginning of April and again at the end of April.  All data were collected anonymously and analyzed in aggregate form and no incentives were given in this study. A total of 159 respondents completed all the questions in this study. All questions were analyzed utilizing the total sample size per question.


The survey that was used to collect quantitative and qualitative data in this study was based on a 39-item questionnaire used to assess sexuality education efforts of teachers and staff in the state of Florida (Dodge et al., 2008). For the Florida survey, a scientific advisory committee made up of six academics in the sexuality education field determined the validity and reliability of the research questions and survey format in conjunction with a community advisory committee.  The reliability scores were not reported.

Once the original questionnaire was revised, our questionnaire was reviewed and revised by qualified experts in the field of health education, sexuality education, and adolescent medicine. The jury of experts was comprised of academics from Indiana University who have extensive practical and research experience in sexuality education and teacher-training.  The team also consulted with a pediatrician who is an expert in adolescent health, the school wellness coordinator, and the HIV/STD Prevention Program Coordinator at the state department of education.  In addition to the jury of experts’ review of the questionnaire, the school district’s wellness committee also provided feedback.  The committee is comprised of school administrators, staff (e.g. social workers), teachers, parents, secondary-level student, and community members who are affiliated with health education (e.g. health educators from the county health department).

The final questionnaire implemented in this study  consisted of 36 questions about participants’ demographics, their role in teaching sexuality education in their school district, the nature of sexuality education taught in the schools, teaching materials, teaching strategies and topics covered in the classroom, professional training and support  and personal attitudes and beliefs about sexuality education. There was also an opportunity to provide additional comments with sentence prompts in an open ended format. Due to the fact that few teachers in the school district teach sexuality education and the stigma often faced by sexuality educators, the school board preferred that demographic questions were not asked to maintain anonymity of the survey respondents. Any identifying information that was included in the written responses was removed from the quotes.

Data Analysis

Frequencies were calculated for the close ended value questions.  Responses to the open- ended questions were analyzed using open coding (Carspecken, 1996), which organizes the results based on the implicit meaning in the respondents comments. Codes are then organized into families of themes based on content and summarized. For each theme, example quotations are given directly from the comments. The type of meaning examined in this study focused around normative claims which implied values. One peer debriefer, who was familiar with this method of coding and who is an expert in sexuality education examined the codes looking for systematic bias. No systematic bias was found. Member checks were completed to ensure accuracy of the interpretations by sending several coded comments with researcher interpretations to a health educator within the school corporation.


The focus of this paper was to report the explicit and implicit teacher values about sexuality education communicated through responses to closed and open-ended survey questions. The quantitative results regarding explicit values are summarized in table 1.  

Table 1. Summary of Explicit Teacher Values (Quantitative Findings)   (n = 159)


Strongly Agree/Agree

% (n)


% (n)

Disagree/Strongly Disagree

% (n)

Sexuality education should not be taught in the school. 10.7 (17) 11.9 (19) 75.4 (123)
Students should be discouraged from asking sexuality-related questions. 9.5 (15) 5.7 (9) 84.8 (134)
Before a person should be allowed to teach sexuality education, they should meet certain criteria (i.e. certification). 70.5 (112) 18.9 (30) 10.6 (17)
Teachers who have strong religious beliefs about sexuality should teach those beliefs to their students. 12.7 (20) 13.3 (21) 74.1 (117)
Sexual play among adolescents is natural and harmless. 7.6 (12) 22.2 (35) 70.3 (111)

Many believed that sexuality education should be taught in school (75%) and that students should not be discouraged from sexuality-related questions in the school setting (85%).  However, the majority (71%) of the respondents also believed that the sexuality educators should be certified or trained to teach these topics. Seventy-four percent disagreed that teachers with strong religious beliefs about sexuality should teach those to students. When asked their beliefs about adolescent sexual behavior, 70% disagreed that sexual play among adolescents was natural and harmless. 

Forty-eight respondents out of 159 provided significant qualitative comments regarding many topics, including both explicit and implicit values. The qualitative analysis revealed several themes including the necessity for sexuality education, education as protection/solution to social problems, who is responsible for sexuality education and structure/content of sexuality education. Themes are summarized in table 2.  Due to the anonymity of the survey, it was not possible to determine what type of teacher provided the comments.  For each theme that emerged, example quotations from the comments are below.

Table 2. Summary of Implicit Teacher Values (Qualitative Themes)    (N = 48)
Necessity for sexuality education
    As prevention (teenage pregnancy and STI’s)
    Includes “real” issues affecting teens
    Teens are exposed to sexuality at younger ages than before
Information as protection
    Teens would use the information to make good decisions
    Protection from “dangers” of sexuality

Sexuality education as solution to social problems
     Child development/parenting
    Prevention of all types of problems (e.g. obesity, economic problems, family relationships, neglect and abuse)

Responsibility for sexuality education
    Parents vs. schools (teachers vs. external agencies)
    Specific sexuality education classes vs. incorporate into curriculum already taught
    Parents’ right to opt out
    School responsibility to educate parents as well

Structure/content of sexuality education
    Curriculum vs. single lesson/class
    Comprehensive content
    Age appropriate
    Who is equipped to teach it?

Necessity for Sexuality Education

Many of the teachers commented on the necessity for sexuality education in schools. In particular, the need for “real” information that addresses issues in students’ lives. This comment represents many of the participants’ beliefs about providing sexuality education

 “As a (former) teenage parent, I think that sexuality education is key in preventing teenage pregnancy and the transmission of STDs/HIV. I think that many lives can be positively affected with REAL and USEFUL information. Sexuality education is INEFFECTIVE if it is skirting the real issues which affect our teens. It needs to be straight and to the point. I think that the possibility of making some kids uncomfortable for a brief period of time is grossly outweighed by the positive effects we will experience in the population of kids which are/considering being sexually active.”[emphasis in original].

Of particular interest here is this participant’s acknowledgement of some of the common objections to sexuality education. Avoiding uncomfortability among the students and the teachers was mentioned by several teachers. In addition, the notion that sexuality education might cause students to engage in sexual behavior was mentioned as a false assumption by another participant:

“Teaching sex education is not going to make them rush out and explore on their own.”

Some participants noted that sexuality education was necessary because young people are being exposed to sexuality at younger ages than ever before.

 “Children are exposed to more and more younger and younger.”

Many also reported their belief that students were already sexually active and that this was happening at younger ages than ever before.

“Many teens are already sexually active” AND “our kids are sexually active.”

“We all know that children are becoming sexually active earlier.”     

“Our kids are sexually active way too young.”

Many participants pointed to the pregnancies observed at their schools as evidence for the need for sexuality education in school.

“We have so many pregnant girls at our school”

“At any time in [the school district] there are 250-300 pregnant girls”

“…especially in [the school district] where we have pregnant 5th graders”

 “We have many children in middle school pregnant”

 “TOO many 10th grade students are having babies!”

Finally, one participant mentioned the rates of sexually transmitted infections in the school district as a reason to have sexuality education.

“According to [STI prevention organization], we are having an outbreak of STDs in the [the school] district involving 15 to 19 year olds.”

Information as protection

One of the common beliefs regarding sexuality education refers to the protective effects of information. The notion that if given accurate information, students would make good decisions was commonly mentioned among participants.

“Knowledge is power and can save a student's life as well as saving them from becoming teen parents. Students do not have accurate information to make sound decisions. [the school district] needs to have a better program in place.”

“I hope that abstinence as well as safe sex/birth control options are given. This way, the students are given an informed choice.”[Emphasis added]

Participants also commented on the many dangers they perceived of sexual activity. They noted that students should be taught or warned about the dangers, likely because they endorse the notion that having this information would affect student decision-making about sexuality. In particular, they may endorse the belief that emphasizing the negative aspects of sexuality would scare students from engaging in sexual behaviors.

“…need to know more about the dangers (disease, pregnancy, emotional turmoil) that come with sex.”

“More time should be spent with these students [5th and 6th graders] so that they are aware of the dangers and risks of having sex.”

“I don't think kids are given accurate information about the failure rate of condoms and other birth control. The students I know think that if you use a condom, then the girl will be protected from STD's and pregnancy. Plus, nobody talks about the emotional side of having sex. They don't talk about broken hearts.”

“HIV, and AIDS is killing our youth because of their lack of knowledge.”

One participant mentioned the issue of low self-esteem as affecting decision making. She/he suggested classes on self-esteem.

“You should include classes on self-esteem. So many want a baby because it will love them. They forget the baby grows up.”

Sexuality Education as Solution to Social Problems

Underlying several of the comments was the notion that sexuality education was a solution to wide-spread social problems.

“I believe that child development/parenting should be a required class to graduate from high school.... It seems like all the big problems our country faces... obesity, economic problems, the breakdown of the family, child neglect and abuse... all could be covered in a well taught food and fitness class (Family and Consumer Science teacher co teach with P.E.) and child development/parenting class and consumer education/career class (it used to be called independent living)”

“It [sex education] gave them [my adult children] a better understanding about themselves and the people around them.”

Responsibility for Sexuality Education

Many of the participants used the comment section to give their opinion regarding who should take responsibility for providing sexuality education. There was disagreement among the participants regarding whether this was the domain of parents or the school.

 “I believe that sex education is the responsibility of the parents and not the school”

“It is not our place to provide birth control or discuss the options regarding it”

Those who felt the school should provide sexuality education also provided advice on where it could be incorporated.

“…should incorporate sex education into the regular health and science curriculum… They already have the questions and it's our responsibility to education them before someone else does.”

“I think [the school district] has to jump on the topic of sex education and make it a responsibility of all students to be informed”

“We really need to address the sexual activities of our students as part of educating the whole child.”

Some participants felt parents should have the right to choose whether the school provides sexuality education. However, one participant also acknowledged that many parents are ill equipped to provide adequate information.

“I feel parents should be given the right to choose whether or not their children are taught about it in school. However, I realize that vast numbers of my students never hear about sexuality and development from their families, and they should not learn on their own."

One other teacher agreed with this and suggested the school also teach parents how to talk to their children about sexuality.

“I personally think you should have a parent class on how to talk to your child about sex at any age.”

Among those who felt sexuality education was the responsibility of the school, there was disagreement about whether the teachers or external agencies should provide the classes. 

“I would like to continue having outside agencies teach our students about human growth and development through the 8th grade at least.”

“I think that there should be some involvement on the part of classroom teachers. By having outside sources do it for us, it may help teachers feel less awkward, but then it makes it seem like some topic that is forbidden. Students feel most comfortable with us and although it does make me a little uneasy, I do think that classroom teachers in grades 5 and up need to be trained and should incorporate sex education into the regular health and science curriculum.”

“Having an outside agency present family life topics provides students with a sense of comfort. Students know this is a professional and feel safe with their information…It does bring comfort to me as the teacher to know that is not my responsibility to teach the family life curriculum.”

The previous comment from a participant expressed relief that sexuality education would not be his/her responsibility. This speaks to the sense that teachers feel ill-equipped or uncomfortable teaching this topic.

Structure/Content of Sexuality Education

The comments provided by teachers were also directed at those who they believed would have power in deciding how and what was taught in sexuality education. They gave specific advice regarding structuring sexuality education as part of the entire curriculum, rather than a single class or lesson.

“I think the fact that I introduce or discuss the topic as it relates to human safety and also in part of the violence curriculum, etc., keeps it going throughout the year and not just in a topic of human anatomy or SEX class. I touch on it as it relates in other curriculum pertaining to Health, without dwelling on it all in one session.”

“…it comes up throughout my curriculum in various lessons, or even as subtopics within a lesson.”

Participants also described what topics should be included in sexuality education. They were particularly concerned that the school go beyond “don’t do it” as evidenced by these comments.

“We most definitely need a comprehensive sex education, relationship, abuse program.”

“Information needs to be current and relevant.”

“Many teens are sexually active and need to be aware of contraceptive methods that cannot be discussed in the classroom. Abstinence is the right message but many teens are already sexually active and they tune out everything when they hear abstinence.”

“Not only do the physical aspects of sexuality need to be covered, but also the emotional aspects as well. Too many of our students believe that sex is no big deal until it's too late. Too many teens are experiencing sex when they are not ready to handle the that come with it.”

“…students becoming more knowledgeable of their bodies and how the body functions sexually, mentally, developmentally, psychologically, and culturally.”

“Students need information about birth control and more information on STIs. Students also need information about relationships and handling sexuality within those relationships.”

None of the participants mentioned including anything about the positive aspects of sexuality, for example, consensual sexual activities that encourages sexual pleasure, sexual expression can be healthy,  or the notion of taking personal responsibility for one’s own sexual health. Two participants touched specifically on issues of values and morality as part of sexuality education. This participant felt this was a good opportunity to express her/his religious/spiritual beliefs:

“Homosexuality as an acceptable life style choice is immoral and should be stated as such. Keep morality in our schools!”

In contrast, this teacher wished that sexuality education was more tolerant of diversity and less about what an individual teacher believes.

“At my school, a guest presenter does something called Family Life. It teaches that sex happens only AFTER marriage. Many of my students came from parents who were never married. I think this says to those children that their parents did something bad by producing them. I think this is bad message for today and for our specific population. I agree that we need a more modern, tolerant approach in [the school district].”

Many participants mentioned the idea that sexuality education information should be “age appropriate”, although none of them described what this means, meaning that either they expected the school board and readers of their responses to understand what they meant, or they themselves do not know what this means, only that it sounds like a good idea to them.

“…give input depending on the age of their child. By high school students must be given appropriate information and feel comfortable enough to ask questions.”

“I believe that the material covered for each grade level should vary so that it is appropriate for the age.”

Two participants specifically advised that social workers should teach human sexuality since it’s a sensitive subject. The assumption was that social workers had better training or by virtue of their profession, would be comfortable teaching human sexuality. None of the teachers identified themselves as social workers and thus more willing or able to teach human sexuality.

“This subject should only be taught by a health teacher not any classroom teacher. Social workers are usually more equipped to teach this sensitive topic. It should be taught in small same sex classes.”

“Social Workers should be allowed to discuss sexuality issues with students. That discussion should include birth control. It should be supported by the school board and not be something done in secret or at the worker's personal risks.”

Note that in this last quotation the participant reiterates that the school board should support teaching and those who teach sexuality education. They noted personal risks associated with talking about controversial topics.


Results of this study strongly suggest that those teaching sexuality education classes were guided by their own values. A large majority (80%) of the respondents surveyed reported that they believed students should be provided with medically accurate information and 74% believed that providing this information would not encourage sexual activity. These results mirror the work of the Illinois Campaign for Responsible Sex Education (Lindau, Tetteh, Kasza, & Gilliam, 2008) which focused on predictors of comprehensive sexuality education in public schools. Researchers found that 92% of teachers believed that students should be given accurate information and that 83% of these teachers also believe that giving students accurate information about contraception and safe sex does not cause them to engage in sexual activity.

Personal values and access to curriculum were found to influence teachers the most when it came to creating their sexuality education curriculum. This implies that the sexuality teachers of this school corporation have very little guidance when it comes to teaching content and methodology. The teachers develop their own methods and choose their own topics based on what they believe to be important; therefore, there is not a consistent approach towards sexuality education in the schools.  Teachers with more conservative values will be less likely to teach topics beyond the abstinence-only models.  One teacher mentioned that he/she would like more oversight and responsibility on the part of the school board in determining who teaches sexuality education and the topics that should be taught in the curriculum.  This concern shows the desire for the administration to become more involved in guiding the teachers in a direction that supports a comprehensive approach to sexuality education.  The perceived controversial nature of the subject matter seems to open the content up to interpretation. Strong leadership is needed from school district health education coordinators.

Nationally only 25% of health education teachers receive staff development, including sexual education content (Kahn, Telljohann, & Wooley, 2006). The teachers in the present study have expressed the same desire.

These findings suggest several points of possible intervention. Providing a values clarification professional development seminar for sexuality education teachers could provide a starting point for consistency across a school district. Developing trainings with local higher education institutions and state education agencies could also be vital to professional development. The literature supports professional development for educators before teaching specific curricula (Herbert & Lohrmann, 2011). Teachers who attend in-service trainings are more likely to be successful in their teaching (Parillio, Lehman, Blake, Lohrmann, & Ledsky, 2000). More specifically, professional development can influence attitudes about sexuality education. In a study of high school health-education teachers’ perceptions related to teaching about HIV, teachers with the least training and experience teaching sexuality education, had the least supportive attitudes toward teaching about HIV (Herr, Telljohann, Price, Dake, & Stone, 2012).

Data from the School Health Policies and Programs Study (Kahn, Telljohan, Wooley, 2006) revealed that only 37% of teachers responsible for teaching health possessed a degree in health education. Since, these are most likely the same teachers who are teaching sexuality education, it can be surmised that around two-thirds of sexuality education teachers had no formal training in the content area. In our study, it was found that 74% of sexuality education was taught by someone other than a health education teacher in the school district and that 80% never had any formal training in sexuality education. School leaders should focus on hiring educators who have received additional training in sexuality education teaching methods. However, since sexuality educator competencies have yet to be released, it is difficult to find qualified sexuality educators, therefore, school administrators must become more proactive and provide teacher trainings to be offered on-site during teacher professional development days.  By allowing the teachers to learn and develop these skills, which are supported by their administrators, perhaps more teachers will feel comfortable because they have received training.

This study has several potential limitations. The study results were collected using a self-report survey and are subject to bias by the participants. We were unable to collect demographic information due to fear of teacher identification and potential repercussions. This limited our ability to describe the sample. The participants, who included only teachers, were from one large, urban school district in Indiana and the results may not be generalizable across the United States, nor to other school staff who may be responsible for making decisions about sexuality education. Also, those who chose to complete the survey were probably more likely to actually approve of sexuality education and perhaps want their administrators to know they are supportive of additional sexuality education training. This is particularly true for the smaller sub-set who provided comments that were the basis of the qualitative analysis.

Despite the limitations of this study, the results have important implications for the training of sexuality education teachers. Understanding both the explicit and implicit values that teachers hold about sexuality education is important for the professional development of current school-based sexuality educators and for the pre-service university training of future school-based sexuality educators. School leaders need to be aware of the potential pitfalls that will arise of sexual education teachers are not given training or not provided the opportunity to stay current in the field through professional development. These problems could include teachers who are not providing current, unbiased, medically accurate content to students.

Future research is needed on the impact of pre-service sexuality education training and professional development on those who teach sexuality education. This data may also help researchers and educators to better meet the sexuality education health needs of middle and high school students.

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