New research appears to confirm what’s apparent to most anyone who’s taken sex ed in school: it’s largely terrible. Scientists at Boston University led the study, which examined state laws and regulations governing sexual education in public schools. They found that a majority of states mandate schools to teach flawed and ineffective abstinence-based programs, while only some truly require schools to provide medically accurate information. The findings suggest that kids, by and large, aren’t getting adequate sex ed before they reach adulthood. “While many students in the US are required to get some form of sexual education, our study shows that substantially fewer students are likely to be getting the comprehensive sexual education that public health and medical associations recommend,” said lead study researcher Kimberly Nelson, an associate professor of community health sciences at BU, in a statement from the university. The dismal state of sex ed in America The federal government doesn’t mandate that public schools teach sex ed nor what it should look like. That means states and cities are left to decide whether sex ed should exist in their schools as well as the curricula included in such programs, allowing for plenty of variability. The researchers found that 42 states mandate that at least one sexual education course be taught to children between kindergarten and senior year of high school. That said, shortfalls in sex ed weren’t evenly spread across the U.S. While all states in the northeastern U.S. mandated sex ed in schools, for instance, just 62% of states in the western U.S. did the same. Importantly, only 19 states (37%) mandate that the information taught in these courses be medically accurate, and five of these states only require medically accurate information for specific topics, not in general. What’s worse, 34 states (68%) are still forcing schools to teach their children abstinence-based sex ed. Although abstaining from sex entirely is 100% effective at preventing pregnancy and (most) sexually transmitted infections, sex ed programs emphasizing abstinence—especially abstinence-only-until-marriage programs—typically fail at their stated goal. Not only do children taught with these programs have sex as early as everyone else, but they’re also less knowledgeable about how to have it safely. Research has consistently shown that these programs do not reduce the rate of teen pregnancy or sexually transmitted infections among young people and may even raise the risk of both. By contrast, children taught comprehensive sex ed have lower rates of teen pregnancy and are less likely to practice unprotected or otherwise risky sex. Too many gaps The researchers found plenty of other gaps in sex ed classes. Only 34 states mandate that schools teach children about HIV, 32 states mandate STI education, 31 states mandate discussion about how to prevent child abuse, and only 20 states actually require schools to include lessons about contraception. Thirty-four states also allow parents to have their children opt out of these classes altogether, and five states have an opt-in system (generally, opt-in programs are likely to have less participation). The team’s findings were published this month in the American Journal of Public Health. “Only 58% of students reside in a jurisdiction that requires sexual education to be medically accurate, and many jurisdictions have content mandates that extend only to a few topics,” said Nelson. “This means that many US students are living in jurisdictions where they are unlikely to receive the accurate and comprehensive information that we know will help them make informed, healthy choices about their sexual behaviors and relationships.” Among other things, the poor quality of sex ed in America may help explain why the country has faced increasing rates of STIs in recent years.