Two types of sex education are generally offered in the United States: abstinence-only and comprehensive sex education. There is no clear scientific consensus over which approach minimizes the risk of unintended pregnancy and sexually transmitted diseases for teens. Policy debate surrounding school-based sex education in the United States has historically been cyclical in nature – with different approaches dominating the discussion in different decades – but has generally always been contentious. Due to growing concerns regarding teenage pregnancy and AIDS prevention in the 1970s and 1980s, sex education became more popular, and states began developing sex education policies (Boonstra, 2009).  The focus of the debate in recent decades then shifted to the content of sex education.  One difficulty is that while there have been studies that examine the (causal) relationship between the receipt of specific sex education and youth sexual behavior (Sabia, 2006), there is very little evidence about how state policies actually translate into the content of sex education in the classroom.  Of course, before state sex education policies can have any effect on the sexual behaviors of teens, they must first have an effect on actual sex education.

We estimate the impact of various state-level sex education policies on the content of sex education classes offered in the state use using data from six waves of the School Health Profiles from 18 to 36 states over the 2000 to 2010 time frame.  We characterized state requirements based on whether they require sexuality (sex and/or HIV/STD) education, whether they specify the content of the education, and whether the policies leave the actual content up to local districts.  We estimate models predicting whether the actual content is consistent with the state policies, taking the potential endogeniety of the policies into account.  Finally, we discuss the implications of our findings on the potential impact policies may have on teen sexual behaviors, rates of sexually transmitted infections, and unintended teen pregnancies, given the extant literature in those areas.