Are you considering how to offer sexuality education?
Regardless of your occupation, let's say you want to help children and young people:

• understand their own and others' rights
• develop respectful social and sexual relationships
• work toward their own health and well-being
• and acquire the knowledge, skills, attitudes, and values that will enable them to make solid choices throughout their lives.

　This is the learning encompassed by comprehensive sexuality education (CSE).

　This article offers practical suggestions for teachers and others who are hoping to implement this kind of sexuality education.

Step 1. Finding someone: a partner? a key person in the right position?

　The place to start is your own interest in providing sexuality education. This is going to be the place you always come back to, constantly questioning and revising your own position.

　Step 1 is expanding this interest from yourself alone to someone else.

　There is a big difference between thinking on your own and consulting with someone else. You won't get anywhere all on your own. There are any number of possibilities for that someone; it could be a colleague at school, an administrator, the school nurse, a P.E. and health teacher, a teacher handling health and human rights education, and so on. Depending on your occupation, it could be a colleague who has offered visiting classes at schools. It might be a PTA officer with whom you can speak candidly, or a local civil servant in charge of gender equality, health promotion, and so on. It could be a partner or a key person in a position of support, ideally both.

　The important thing is to exchange information with your "someone" and to be on the same page with them about the issues concerned. Along with that "someone," you will discuss potential handholds, footholds, and ways in to the practice of CSE in schools.

Step 2. Reappraising everyday interactions with children and young people: Are you actually doing CSE already?

　Reading various explanations and texts on CSE, you may reflect gloomily that you could never pull it off where you are. However, CSE is not always presented in its fullest form.

　Step 2 is focusing anew on this point.

　If you revisit your interactions and relations with children and young people, you will find that they include practice leading to CSE. CSE is something you are entirely capable of, perhaps even something you are doing already.

　Here are some examples.

◇ Dealing with elementary schoolers who keep shouting out sexual terms such as the names of sexual organs.

◇ Dealing with "pantsing," including underwear, when the perpetrators call it a game.

◇ Dealing with students who ask if daily masturbation is okay.

◇ Dealing with students who have missed a period and are worried about pregnancy.

◇ Dealing with students who object to the school rules and want to change them.

　And then some.

　In these contexts, your response must draw on important points within CSE such as the awareness that sexuality is a human right, accurate knowledge of the body, the significance of changing your own environment for the better, and so on. Even the briefest exchanges can leave students deeply impressed by words that seem designed directly for them. Everyday interactions and relationships must not be slighted.

Step 3. Various workable contexts for practice: Learning from experience here and there

　The state of implementation of sexuality education in Japanese schools is meager to a degree. The number of sexuality education classes in junior high schools averages no more than 8.62 hours over three years.^（1 This lamentable situation is due to the passivity of the Ministry of Education, Culture, Sports, Science and Technology (MEXT) with regard to sex education, in the context of the Japanese government's rejection of CSE. In response to the attitude evinced internationally^（2 that Japan should "[i]mplement comprehensive sexuality education inside and outside of schools," the government has responded with refusal, stating in conclusion that "[n]either comprehensive sexuality education (CSE) as a general term nor CSE as advocated by the UNESCO Guidance is acceptable to the Government." This stance has clearly been influenced by the right-wing separation of sexuality from human rights, addressing the issue of sexuality as one of morality and calling for "moral sexuality education" alone.

　In this situation, how can we wangle the practice of CSE?

　First, life safety education. This program, with guidelines clarified by MEXT for all Japanese public schools, is highly significant as the first thorough approach in the history of Japanese public education to "sexual violence and safety." However, the MEXT teaching materials and implementation guidelines avoid addressing any of the knowledge of what sexual behavior means to human beings and what constitutes sexual contact, essential in order to understand sexual violence, and thus simply end up calling for "moralistic regulation of behavior"; they fail to resolve the fundamental problem of "sexual safety education without sexuality education." Still, as this program is recommended for implementation at all public schools, it would be a shame not to make use of it. The MEXT teaching materials can be used while also working toward CSE through the use of individual "amendments" (permitted by MEXT). Of use here are the lesson plans and sample materials created by the Council for Education and Studies on Human Sexuality's Project on Converting Life Safety Education to Education on the Rights of the Body (to be found in Sexuality Vol. 115).

　Second, human rights education. The legal basis therefor is found in the Act on the Promotion of Human Rights Education and Human Rights Awareness-Raising, of which Article 3 stipulates that "[t]he human rights education and human rights awareness-raising provided by the national government and local governments shall be carried out ... at various places, including schools, communities, households, and workplaces." In addition, the latest Basic Plan on Human Rights Education and Awareness-Raising (Second Edition), which stipulates the specific content to be implemented, was adopted by the Cabinet in June of 2025. Chapter 5-2, "Initiatives on Human Rights Issues," includes "women, children, people with disabilities, people with infectious diseases, sexual minorities," and other subjects of learning within CSE. The implementation of human rights education can thus serve as a context for CSE.

　Third, preconception care. While this initiative, launched as a countermeasure for the falling birthrate, is all too closely entwined with the pressure on young people to marry and procreate, the Preconception Care Promotion 5-Year Plan produced in May of 2025 by a council of the Children and Families Agency includes the following notable points. "With regard to gender equality, diverse sexualities, respect for the body, and so on, information must be provided with suitable timing, bestowing not only knowledge but the ability for sufficient consideration in everyday life," "...enriching a curriculum in which students study a human-rights approach in stages," "...referring to the structure of comprehensive sex education" (Promotion 5-Year Plan, Chapter 2 Section 1). It is rare for "comprehensive sex education" to appear with a positive inflection in Japanese official documents. In response to these "expectations," one option is to render preconception care a context for the practice of CSE.

　Fourth, creating contexts through various forms of collaboration.

　In Uwajima City, Ehime, the Uwajima Hearts Together (kokoro majiwau) Project was launched based on a comment from a junior high school principal, who had been attending a research group led by school nurses, to the effect that "sexuality education lectures will be presented to all class years at all city junior high schools, led by the city principals' association." The school nurses' long-standing, tenacious learning and practice resulted in this initiative upon encountering an administrator with understanding. Budget acquisition is taking place, along with the creation of a "package" including leaflets for parents and lesson plans, through the collaboration of staff on the ground, administrators, and local government.

　At the Saitama Prefectural Fujimi Special Support School, the practice of sexuality education started in the high school division and has since been implemented in the elementary and junior high divisions as well. This initiative went from the school's administrators to the City Board of Education, which launched a "Comprehensive Sexuality Education" project team for discussion, including administrators from elementary schools, junior high schools, and special support schools, staff in charge of morality and human rights education, school nurses, and so on.

Conclusion: Keep on Learning

　Even given the various sample approaches above, some readers may still be feeling the difficulty of creating a space for the practice of sexuality education. There is a line in Kenji Miyazawa's poetry collection Introduction to Agrarian Art: An Outline that goes "Seeking the way is the way itself." I understand this to mean that "learning is practice." Learning is the foundation of all sexuality education practice, and is at the same time an irreplaceable form of sexuality education practice in itself.

[Reference]

　Children and Families Agency Council on the Provision of Preconception Care, "Toward the Spread of Correct Knowledge on Sex and Health" https://www.cfa.go.jp/councils/preconception-care (Japanese)

1）According to a survey of 724 junior high schools of a certain size around Japan (Noriko Hashimoto, Terunori Motegi et al., 2017)

2）United Nations Human Rights Council, "Report of the Working Group on the Universal Periodic Review: Japan" (2023)

　How would you respond if someone asked you what SRHR (Sexual and Reproductive Health and Rights) means? According to the SRHR Survey of a Hundred Million White Paper 2025^（1, implemented in April 2025 by SRHR for Japan, 24.7% of respondents answered "Familiar with SRHR" and 9.2% "Understand what they consist of." SRHR are spreading steadily within the Japanese context. On the other hand, the survey also found that while 56.5% of respondents called SRHR "Important," only 35.4% felt that they were "Respected in daily life," revealing the current wide disparity between awareness and actuality. Results indicated that the gap was particularly severe with regard to access to healthcare and information and to understanding of sexual consent. This article discusses the status and issues of contraception and abortion in Japan in particular, while providing an overview of SRHR and reflecting on the progress made so far.

　SRHR were first approached in the context of population control policy, as "reproductive health"; clarified as a human rights issue at the 1994 Cairo Conference, they are also reflected in the SDGs in fields including medical care, health, and gender. They have developed into a wider concept including sexual and bodily autonomy, no longer limited to reproduction alone. The Guttmacher-Lancet Commission, jointly established by the Guttmacher Institute (which conducts SRHR research) and the British medical journal Lancet, issued the following new definition of SRHR^（2 in 2018.

　Sexual and reproductive health is a state of physical, emotional, mental and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction or infirmity. Therefore, a positive approach to sexuality and reproduction should recognize the part played by pleasurable sexual relationships, trust and communication in promoting self-esteem and overall well-being. All individuals have a right to make decisions governing their bodies and to access services that support that right.

　Achieving sexual and reproductive health (SRH) relies on realizing sexual and reproductive rights (SRR), which are based on the human rights of all individuals to:

• have their bodily integrity, privacy and personal autonomy respected
• freely define their own sexuality, including sexual orientation and gender identity and expression
• decide whether and when to be sexually active
• choose their sexual partners
• have safe and pleasurable sexual experiences
• decide whether, when and whom to marry
• decide whether, when and by what means to have a child or children, and how many children to have
• have access over their lifetimes to the information, resources, services and support necessary to achieve all the above, free from discrimination, coercion, exploitation and violence

　According to the new definition, SRHR have been reconfirmed to refer not simply to the state of being free of disease but to the realization of individual well-being in all aspects through sexuality. The package of services essential for SRHR is defined as including science-based comprehensive sexuality education (CSE) as well as information and care with regard to sexual functions and sexual satisfaction, prevention of sexual and gender-based violence, contraception, childbirth, abortion, infertility, prevention of sexually transmitted diseases, and prevention of reproductive cancers. In addition, the definition notes that people requiring support may include youth and the elderly, sex workers, refugees and immigrants, indigenous ethnic communities, sexual and gender minorities, people with disabilities, people with addictions, and those in disadvantaged situations; it states that everyone is entitled to access and to be able to pay the costs required.

　The World Association for Sexual Health (WAS) positions SRHR as a means of realizing gender equality and social justice, through its Declaration on Sexual Rights, Declaration on Sexual Pleasure (which defines pleasure as an essential element of SRHR), and Declaration on Sexual Justice (which calls for rectification of socially structural and institutional discrimination and inequality).

Issues in Japan

　While Japan, with its universal health insurance, has been globally recognized for the excellence of its perinatal care, it remains faced with numerous issues concerning SRHR. Among the issues coming to light are the inability to apply health insurance to contraception or abortion, scarcity of access and options for contraception, need for access to safe abortion, financial burdens of infertility treatment, lack of comprehensive sexual education, failings in criminal law and the legal system regarding sexual violence, insufficient support for victims, need to guarantee LGBTQ+ rights, period poverty, and more.

　For example, even now emergency contraception requires a doctor's diagnosis and a prescription, costing as much as six thousand to twenty thousand yen. Approximately 90 countries around the world provide emergency contraception at low prices or free of charge at pharmacies, without a prescription; the Japanese system lags far behind the international standard. The Project to Realize Emergency Contraception at Pharmacies, a citizens' organization, has gathered approximately 180,000 signatures to lobby the government; experimental sales at some pharmacies began in 2023, but as of August 2025 there is still no prospect of full implementation. Also, contraception in Japan is still largely based around the use of condoms, with limited options and availability for modern contraception methods permitting women's active choice (low-dose pills, IUS/intra-uterine contraceptive systems, contraceptive implants, etc.). The number of induced abortions performed in 2023 was some one hundred and thirty thousand, with the highest rates among women in their twenties in particular, and also including about ten thousand abortions for women in their teens. The oral abortion pill was first approved in April 2023, but the drug in question is usable only during the first nine weeks of pregnancy, a short period even by the international standard; it also costs some hundred thousand yen, comparable to surgery. According to a survey on the first six months of its availability^（3, it was used in just 1% of all abortions. Even now surgical methods such as vacuum aspiration or dilatation and curettage are the norm; the system requiring spousal consent for abortion also restricts the right to self-determination of the person receiving the abortion.

　In addition, the context includes the deeply rooted gender role awareness and gender norms of Japanese society, such as the taboo on women speaking out about sex or the tendency to assume that men will take the lead in sexual relations. In relationships involving economic dependence, these imbalanced power relations are even more prominent. Further, the scarcity of women and LGBTQ+ people in politics, where social system designs are determined, is also a factor in the lack of progress toward SRHR policy.

　Elsewhere, while the government has been passive regarding the promotion of comprehensive sexual education, it is working toward preconception care in the form of organizing "information provision and consultation systems required for life design." However, the focus of this initiative is on "enabling women's physical readiness for pregnancy," suggesting that it risks steering women in the direction of having children rather than respecting their own intentions and choices. Preconception care in the true sense must, in the future, be effective for people with various life courses in mind, including LGBTQ+ people, those who prefer not to marry or to have children, and so on. Similarly, while "life safety education," introduced as a measure against sexual violence, has been implemented throughout Japan, it does not touch on genuine content such as consent, sexual and bodily autonomy, or gender equality, only providing abstract guidance such as "keep an appropriate distance"; this issue likewise requires reexamination.

　To achieve SRHR, reform of these gender-related social norms is called for along with that of the structures of society itself, such as the systems and laws which create gender inequality. To realize SRHR for every single individual, we must focus on the complex and intersectional discrimination involving gender, sexual orientation, race, dis/ability, nationality, and so on, with every member of society taking action toward realizing SRHR.

【Author's note (added in May 2026)】

　In February 2026, Japan introduced non-prescription pharmacy access to emergency contraception. However, barriers remain, including the requirement to take the pill in front of a pharmacist, its high cost (around 7,500 JPY, approximately 50-55 USD), and regional disparities in access.

[Footnotes]

1）SRHR for Japan, SRHR Hundred-Million-Person Survey White Paper 2025
　 https://srhrforjapan.com/whitepaper/2025whitepaper_1.pdf
　 Accessed August 1, 2025

2）IPPF, Technical Brief: New Definition of Sexual and Reproductive Health and Rights
　 https://www.ippf.org/jp/resources/IPPF_technical_brief_SRHR_japanese
　 Accessed July 30, 2025

3）Ministry of Health, Labour and Welfare, Status Survey of Orally Induced Abortions and Study
　 on the Provision of Appropriate Information
　 FY2023 Report on Comprehensive and Shared Research (May 2024)
　 https://www.mhlw.go.jp/content/11121000/001308189.pdf
　 Accessed July 30, 2025