Comprehensive sexuality education (CSE) enables children and young people to learn about the cognitive, emotional, physical, and social characteristics of sexuality.

However, teachers experience conflicts in teaching CSE due to different cultural and religious backgrounds. This qualitative systematic review aims to describe the conflicts experienced by teachers in the implementation of CSE in schools. The qualitative systematic review and thematic meta-synthesis highlighted several conflicts among teachers in CSE implementation. Despite teachers having a perception that sex education should be provided, traditional sex education has not yet transformed into CSE.

The thematic meta synthesis strongly reflects the context of Christianity in Europe and Africa. Thus, further research on the religious context in other regions is needed. Five themes on the causes of the conflict emerged from the thematic meta-synthesis. First, teachers are still hesitant to talk about sex education due to cultural and religious factors. Sexual and reproductive health remains to be a sensitive topic and it is difficult to make teachers interested in CSE. Second, traditional sex education has not been integrated into comprehensive sexuality education.  That is, the majority of official subjects on traditional sex education have not been incorporated into the curriculum.  Third, teachers are motivated to foster effective facilitation of CSE in school using old and new types of integrated sex education. Fourth, there is a need to determine the appropriate age to start sex education. Some teachers recommend providing sex education at early adolescence. But educational materials aimed at this age are lacking. Fifth, stakeholders outside of school should also be involved. Teachers recommend involving parents in counseling for students.

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