Table 1.

Review of Studies Related to Inclusive Sexual Health Education

Author	Purpose/Topic	Type of Study/Sample	Key Findings/recommendations
Arbeit et al. 2016 Arbeit, M. R., Fisher, C. B., Macapagal, K., & Mustanski, B. (2016).	To analyze bisexual female perspectives of their experiences accessing sexual health information and services provided by schools and health providers.	Mixed methods; n= 40 cisgender sexual minority females divided into 6 focus groups	Practitioners should include nonjudgmental questions regarding bisexuality into contraceptive and sexual health practices involving young females. Schools need to provide inclusive sex education.
Bodnar, K., & Tornello, S. L. (2019)	To explore how exposure and timing of sex education were associated with sexual health outcomes.	Quantitative; 2002 to 2013 collections of the National Survey of Family Growth n=5, 141 young women	Exposure to sex education resulted in poorer outcomes for sexual minority women. Sex education should be presented earlier and be inclusive.
Gowen, L. K., & Winges-Yanez, N. (2014).	To investigate the sexual health education experiences of LGBTQ youth and gather suggestions for improving the inclusiveness of sexuality education. curricula.	Qualitative; n=5 semi-structured focus groups containing 30 LGBTQ adolescents	LGBTQ youth see current sex education as exclusive, not inclusive. Schools and policymakers need to make sure inclusive education is available to all youth.
Haley, S. G., Tordoff, D. M., Kantor, A. Z., Crouch, J. M., & Ahrens, K. R. (2019)	To use information from transgender and nonbinary youth and their parents to understand deficits in sexual health education and give recommendations for a comprehensive inclusive curriculum.	Qualitative; n=21 (n=11 transgender/nonbinary youth, n=5 parents of transgender/nonbinary youth; n=5 healthcare providers)	Most information taught in schools was irrelevant to transgender/nonbinary youth. Education needs to be inclusive and gender-affirming.
Hall, K. S., McDermott Sales, J., Komro, K. A., & Santelli, J. (2016)	To analyze the content of school-based sex education policies in the United States.	Commentary	There were no consistent policies regarding sex education in schools. Abstinence-only education was the prominent form of education taught. Few states mandated inclusive teaching and some mandated only negative information on homosexuality be taught. Sex education should be evidence-based.
Hobaica, S., & Kwon, P. (2017).	To explore sex-education policies and curriculum to determine if they could be adapted for sexual minority students.	Qualitative; n=12 sexual minority individuals who received sex education in school	Sex education was heteronormative and did not address the needs of sexual minority individuals potentially causing poorer physical and mental health outcomes. Education should be inclusive and be taught earlier.
Hobaica, S., Schofield, K., & Kwon, P. (2019).	To explore the experiences of trans students in sex education.	Qualitative; n=11 transgender individuals who received sex education in school	Most information taught in schools was cisgender and irrelevant to transgender/nonbinary youth. Education needs to be offered earlier and be gender-affirming to help prevent risky sexual behavior and gender dysphoria.
McCarty-Caplan, D. (2015).	To explore policy limitations and demonstrate how comprehensive sex education perpetuates the heteronormative nature of sex education in a way that continues to marginalize and harm LGB individuals.	Commentary	Comprehensive sex education programs do not provide substantial support for lesbian, bisexual, and gay individuals.
Pingel, E. S., Thomas, L., Harmell, C., & Bauermeister, J. (2013).	To investigate the sexual health education experiences of sexual minority young men and gather suggestions for improving the inclusiveness of sexuality education. curricula.	Qualitative; n=30 young gay, bisexual and questioning men who had experience with school-based sex education.	Most information on sexual minorities was excluded from the sex-education taught in school. Many youths looked to the internet for sexual health information to fill the gap. Sexual health education should be inclusive.
Proulx, C. N., Coulter, R. W. S., Egan, J. E., Matthews, D. D., & Mair, C. (2019)	To explore whether LGBTQ inclusive sex education is associated with adverse mental health and school-based victimization.	Quantitative; 2015 Youth Risk Behavior Survey and 2014 School Health Profiles n=47,730 sexual minority youth.	Inclusive sex education had a protective effect against suicidal thoughts and plans. LGBTQ youth had lower odds of being bullied as the percentage of schools in the state offered inclusive education. States should offer inclusive education.
Rasberry, C. N., Condron, D. S., Lesesne, C. A., Adkins, S. H., Sheremenko, G., & Kroupa, E. (2017).	The purpose of this study was to help inform the development of school-centered strategies for connecting sexual minority young men with HIV and STD prevention services.	Mixed methods; n=415 web-based questionnaires and n=32 interviews of Black and Latino young sexual minority men.	School nurses were the people youth most talked to about STIs, HIV, or condom use but they would not talk to them about personal attraction. Many youths felt school staff lacked knowledge on LGBT issues. School nurses and staff need additional training on LGBT issues.
Roberts, C., Shiman, L. J., Dowling, E. A., Tantay, L., Masdea, J., Pierre, J., Lomax, D., & Bedell, J. (2019)	To conceptualize the barriers LGBTQ+ students of color face in learning about sexual health education in school.	Qualitative; n=27 LGBTQ students of color between the ages of 15–19	Students reported receiving heteronormative sex education that was inadequate to their needs and left them feeling unrepresented, unsupported, stigmatized, and, bullied. Students filled these gaps by seeking information from external sources. Schools need to provide inclusive information.
Steinke, J., Root-Bowman, M., Estabrook, S., Levine, D. S., & Kantor, L. M. (2017).	To better understand what young people want from digital sexual health interventions.	Qualitative; n=92 gender and sexual minority youth	Education taught in schools was inaccurate and insufficient. Most participants looked for information online. Content and delivery of online sexual health information should be inclusive.