『保健医療科学』 2026 Vol.75 No1 p.66-76（2026年2月）
Topics：Recent topics in public health in Japan 2026
＜ Review / 総説 ＞
The current state and challenges of comprehensive sexuality education in Japan
KODAMA Tomoko1），YUKAWA Keiko2），WATARAI Mutsuko3）
1） Department of International Health and Collaboration, National Institute of Public Health
2）Department of Epidemiology and Statistics, National Institute of Public Health
3）Department of Nursing, Faculty of Healthcare, Tokyo Healthcare University
国内における包括的性教育の現状と課題
児玉知子1），湯川慶子2），渡會睦子3）
1）国立保健医療科学院公衆衛生政策研究部
2）国立保健医療科学院疫学・統計研究部
2）東京医療保健大学医療保健学部看護学科
Abstract
Comprehensive sexuality education (CSE) has been internationally recognized as a critical component of health promotion, gender equality, and human rights for children and adolescents. United Nations Educational, Scientific and Cultural Organization (UNESCO)’s International Technical Guidance on Sexuality Education emphasizes a curriculum that is age-appropriate, evidence-based, and grounded in scientific research.It also highlights the importance of fostering healthy relationships, promoting gender equality, and preparing young people to make informed decisions about their sexual and reproductive health. Recent updates to global CSE guidelines further incorporate ducation on sexual diversity as well as the challenges posed by the digital era, such as online safety, consent in digital communication, and privacy protection.
In Japan, sexuality education has traditionally been limited in scope and shaped by cultural, political, and institutional factors. While public health initiatives have addressed issues such as HIV prevention and reproductive health, comprehensive approaches to sexual education remain ontested. Curriculum guidelines issued by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) outline basic health and hygiene instruction, but more sensitive topics—including contraception, sexual iversity, and sexual rights—have often been restricted. At the same time, grassroots efforts by educators, medical professionals, and non-governmental organizations have introduced innovative practices, including pilot programs inspired by UNESCO’s CSE framework. This review provides an overview of the current state of CSE in Japan, analyzing both institutional policies and emerging practices. Key themes include the integration of gender equality and human rights perspectives, the inclusion of sexual diversity, strategies for preventing sexually transmitted infections and unintended pregnancies, and the role of digital literacy in fostering safe and respectful relationships. In conclusion, expanding evidence-based and inclusive sexuality education in Japan is essential not only for improving adolescent health outcomes, but also for advancing gender equality and supporting young people to navigate complex interpersonal and digital environments in the 21st century.
keywords : Comprehensive Sexuality Education (CSE), adolescent health, gender equality, sexual diversity, digital literacy
＜抄録＞
ユネスコの包括的性教育（Comprehensive Sexuality Education: CSE）ガイドラインは，科学的根拠に基づく年齢別カリキュラムを基盤とし，ジェンダー平等，人権，健康的な人間関係の形成を重視している．近年の国際的なCSE枠組みでは，性的多様性への配慮に加え，性感染症予防，デジタル環境における同意，オンライン安全やプライバシー保護といった課題も重要な要素として位置づけられている．
日本における性教育は，歴史的に文化的・政治的・制度的要因の影響を受け，比較的限定的な範囲で展開されてきた．学習指導要領に基づく学校教育では基礎的な健康・衛生教育が中心となり，避妊，性的多様性，性的権利といったテーマについては慎重な運用が続いてきた．一方で，近年は教育者，医療専門職，非政府組織（NGO）などによる実践を通じ，国際的なCSEの理念を参照した試行的な取り組みもみられる．本稿では，日本における包括的性教育の制度的枠組みと実践の動向を概観し，その特徴と課題を整理する．あわせて，CSEが制度的に定着している各国との比較を通じ国際的文脈を踏まえて検討する．日本におけるエビデンスに基づく包括的性教育の充実は，青少年の健康と福祉の向上に加え，ジェンダー平等の推進や，複雑化する対人関係・デジタル環境への適応を支える上で重要な意義を有すると考えられる．
キーワード：包括的性教育（CSE），思春期保健，ジェンダー平等，性的多様性，デジタルリテラシー
The current state and challenges of comprehensive sexuality education in Japan