Editorial: Sexuality education that prioritizes sexual well-being: initiatives and impact

A key theme across this issue is the imperative to move from risk-avoidance paradigms to frameworks that center pleasure, agency, and respect. While harm reduction remains essential, an exclusive focus on danger obscures the positive dimensions of sexuality. Balliet and Ford's pornography-literacy curriculum integrates media literacy with consent and safer-sex skills, while O'Kane and colleagues' MisconSEXions campaign and Power and colleagues' work on digital sexual literacy show how online spaces can be harnessed to build confidence and critical awareness rather than fear. Kang et al. and Pantaleo et al. demonstrate that youth-led and codesigned programs generate expansive, strength-based, and impactful content. Finally, studies on teacher attitudes (Adekola) and inclusive education (Touloupis & Pnevmatikos) underscore the need to move beyond moralistic or fear-driven framings. Together, these contributions affirm that sexuality education should not only prevent harm but also empower young people to experience sexuality as a source of joy, connection, and self-determination.The most powerful innovations in sexuality education emerge when young people are empowered to co-design or deliver the learning that directly shapes their lives. When youth help design the lessons meant for them, education becomes anchored in their realities, their voices, and their vision for the future. Several contributions in this special issue illustrate this shift: Pantaleo and colleagues, including their consortium of student co-researchers, outlined a protocol for the authentic co-design of a healthy relationships intervention suitable for senior secondary school students (aged 15-18); Kang and colleagues evaluate Consent Labs, a youthled consent and healthy relationships education initiative delivered by peers in secondary and tertiary settings in Australia that significantly improved knowledge and confidence; and Balén and colleagues show how participatory evaluation strategies can make research itself more inclusive of LGBTQIA+ youth, using the U.S.-based SafeSpace curriculum as a case study. Together, these studies demonstrate that centering youth voices not only strengthens the relevance and impact of educational content but also fosters a deeper sense of ownership and agency.For sexuality education to be effective and transformative, the workforce that delivers it must be well-prepared, well-supported and valued. Several papers in this issue spotlight the pivotal but often precarious role of educators. Macleod & du Plessis frame South African Life Orientation teachers as frontline sexual, reproductive, and mental health workers, especially in traumatized school environments. Teachers report encountering sexual abuse, HIV, neglect, and suicidal behavior among students, but lack training in trauma-sensitive pedagogy and referral practices. Adekola highlights how educator attitudes, beliefs, age differences, health status and personal discomfort can directly undermine classroom implementation. Touloupis & Pnevmatikos extend this focus to primary education, showing how educators' and parents' own prejudices can shape whether inclusive curricula are embraced or resisted. Collectively, these studies remind us that teacher preparation, professional development, and well-being are central to delivering sexuality education that truly advances sexual well-being.Sexuality education is also widely shaped and constrained by the broader systems of community, culture and health services in which it operates. Kwok & Kwok examine sexual health access among young female migrant workers in Hong Kong, mapping various individual, interpersonal, community, and sociopolitical factors that create both risks and opportunities for sexual wellbeing. Roux and colleagues demonstrate how a whole-school, health-promoting approach can normalize menstrual literacy and challenge stigma, while Tibebu and colleagues extend this systems perspective into health services, finding that satisfaction with comprehensive abortion care in Ethiopia remains suboptimal; underscoring the vital links between education, rights, and the quality of sexual and reproductive health care. These contributions show that advancing sexual well-being requires not only innovative curricula and well-prepared teachers, but also supportive institutions, equitable policies, and accessible, respectful health systems.Equally transformative are the contributions that reimagine sexuality education for the digital age. Young people are already learning about sex and relationships online, often through exploratory "rabbit holes" of peer-shared content that foster critical reflection as much as they transmit information, as Power and colleagues demonstrate. O'Kane and colleagues illustrate how social media can be harnessed to effectively debunk pervasive myths, though engagement and adoption require careful strategy. Balliet and Ford take this work further with their pornography-literacy curriculum, Navigating Realities, which integrates media literacy, consent, relationships, and safer-sex skills into a rights-based, sex-positive framework. Together, these papers make clear that digital spaces are not simply a challenge to sexuality education-they are a central site for cultivating the literacies young people need to navigate an increasingly sexualized media landscape with agency, critical awareness, and confidence. As governments make policies to restrict young people's access to digital spaces, efforts are needed to ensure we can reach young people where they are with evidence-based and engaging sexuality information.The contributions in this special issue highlight clear priorities for advancing sexuality education policy and practice. Together, they point to a whole-of-society approach that empowers youth, equips educators, embraces digital realities, embeds inclusion, and connects classrooms to care systems. Important action points include:• Frame sexuality education as a rights-based, equity-driven commitment. Embed in national curricula and policies that affirm all young people, including LGBTQIA+ youth, youth with disability, and other marginalized groups. • Invest in workforce capacity. Provide educators with ongoing professional development in trauma-sensitive, pleasure-affirming, rights-based pedagogy, and ensure systemic support for their well-being. • Center youth perspectives in program development. Co-design curricula and evaluations with young people to ensure programs reflect their lived realities. • Leverage digital platforms responsibly. Use social media and online spaces as vital tools for literacy-building, myth-busting, and engagement. • Advance inclusion and challenge stigma. Design programs and evaluations that explicitly affirm and support marginalized communities. • Strengthen health system linkages. Connect sexuality education to accessible, respectful sexual and reproductive health services, embedding it within broader sexual and reproductive rights agendas.This collection of twelve articles presents a compelling vision: sexuality education rooted in well-being, rights, inclusion, and meaningful participation. Together, they map out scalable practices, expose persistent barriers, and celebrate youth-led innovation. Spanning contexts from primary classrooms to digital platforms, and from community programs to clinical services, these studies demonstrate both the urgency and the feasibility of reimagining sexuality education globally. They do not merely anticipate future directions for the field-they are actively charting them.

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