Teaching comprehensive sexuality education in schools: A systematic review of educational approaches

Background: Comprehensive sexuality education plays a vital role in promoting adolescents’ informed decision-making, respectful relationships and sexual health. Although research on comprehensive sexuality education has expanded considerably, evidence remains fragmented across educational contexts and disciplines. This systematic review synthesises recent evidence to identify educational approaches shaping the implementation of comprehensive sexuality education in school settings. Method: This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Literature searches were conducted across Scopus, Web of Science and Education Resources Information Center databases for studies published between 2021 and 2026. A total of 1601 records were identified, and 22 studies met the inclusion criteria for qualitative synthesis. Results: Four major themes were developed from the synthesis: (1) teacher perspectives, training and professional practice; (2) implementation challenges and sociocultural influences; (3) student experiences, needs and outcomes; and (4) inclusive and whole-school approaches. The findings demonstrate that effective comprehensive sexuality education depends on teacher competence, inclusive curricula, institutional support and socioculturally responsive educational practices. Conclusion: The review highlights the importance of strengthening teacher preparation, institutional support and inclusive pedagogical approaches to improve the quality and sustainability of comprehensive sexuality education in schools. Future research should examine integrated educational strategies and policy frameworks that support effective comprehensive sexuality education implementation across diverse educational contexts.