Abstract
INTRODUCTION: Comprehensive sexuality education (CSE) is central to the healthy development of young people and, promoting healthy relationships and gender equality. Since the publication of the WHO Standards in 2010, the evidence base has expanded considerably and new discourses have gained importance. The aims of this study are to provide a systematic overview of the evidence on school-based CSE published since 2010 and to identify emerging thematic developments. METHODS: As part of a scoping review, structured literature searches were carried out in PubMed, Google Scholar, and the journal Sex Education. Search terms combined variations of "comprehensive sexuality education," "sex education," "school-based," "adolescence," "sexual development," and "Europe" as well as terms related to child and adolescent sexual development. The search period covered 1 January 2010 to 25 February 2025. To strengthen European representation, additional references were solicited from members of the expert group. This was followed by screening, evidence extraction, and validation of the synthesis. RESULTS: The evidence demonstrates positive effects of CSE on social-emotional learning, healthy relationships, gender equality, and violence prevention. Increasing emphasis is placed on rights-based, inclusive, and diversity-sensitive approaches as well as on addressing digital realities. At the same time, growing societal resistance is evident. DISCUSSION: The analysis highlights a substantive evolution of CSE that should be considered in the evidence-based revision of the Standards to ensure their relevance and applicability within the European context.