Introduction

Although sexuality has gained increasing attention, there is still a significant gap in understanding the role of sexuality education in adolescent character development, particularly in terms of moral values, ethical decision-making, and social responsibility. Although few studies discuss the impact of sexuality education on long-term identity formation, most of the remaining studies highlight health-related outcomes. To fill the gap in the existing literature, this study presents a bibliometric analysis that systematically maps existing research trends and explores existing gaps in the literature. In doing so, this study aims to provide a holistic understanding of the role of sexuality education in adolescent development and to guide policy and future research efforts.

Given the psychological impact of sexuality education and adolescent development, it is important to understand how sexuality education influences self-identity formation. While previous studies have examined how sexuality education contributes to adolescent identity formation, these studies have been largely unsystematic, and no previous studies have examined sexuality education using bibliometric analysis. In addition, current studies tend to be cross-sectional in design, have specific cultural settings, or do not capture the interactive nature of social-emotional issues, thus limiting the comprehensive understanding gained from these studies.

To address these gaps, this study aims to conduct a bibliometric analysis that maps key themes and trends in modern sexuality education. By utilizing VOSviewer for visualization, this study seeks to: (a) identify the evolution of major themes such as "sexual health" and "young adults," (b) highlight emerging developments in contemporary sex education, and (c) encourage the integration of digital platforms for sexual counseling and education. Through this analysis, we aim to provide insights into the role of sexuality education in shaping adolescent identity and offer recommendations for future interventions.

Through this analysis, we aim to provide insights into the role of sexuality education in shaping adolescent identity and offer recommendations for future interventions. The structure of this paper is as follows: the next section presents the research methodology, followed by the results and discussion, which highlight key findings and their implications. Lastly, suggestions for further study and policy formation are included in the paper's conclusion.

Methodology

The Scopus database was chosen as the primary data source since it includes peer-reviewed articles across various fields. Due to its detailed metadata, such as citation linkages, author affiliations, and keyword trends, Scopus is widely used for bibliometric studies. A sensitive “Sex Education” AND “Adolescent” keyword search across the abstract, title, and keyword fields was performed on 2 September 2024 at 21:18 Western Indonesian Time (WIB). The timeframe for this bibliometric analysis spans from 1939 to 2024. The year 1939 was chosen as the starting point because it represents the earliest recorded publication on 'Sex Education' and 'Adolescent' indexed in the Scopus database. This selection ensures that the analysis captures the full historical development of research on this topic, allowing for a comprehensive understanding of how scholarly discussions, trends, and methodologies have evolved over time. Additionally, including the earliest available data helps identify foundational works, shifts in academic focus, and the impact of socio-cultural changes on research in this field. The endpoint, 2024, reflects the most current data available at the time of this study, ensuring that the findings remain relevant and up to date.

Scopus returned 20,107 records after the initial search. The dataset was refined through a rigorous inclusion–exclusion process to ensure the relevance of the literature included. Studies that specifically addressed sexuality education and its impact on teenage identity formation, health-related behaviors, or psychological outcomes were included. Only English-language conference and peer-reviewed journal publications with complete metadata were included. Duplicates, non-peer-reviewed sources, and research focusing on adults or sexuality education that did not take place in the teenage context were excluded. After applying these limitations, a total of 15,874 studies remained in the dataset for further bibliometric analysis.

We performed bibliometric analysis using VOSviewer (version 1.6.17, Leiden University, Netherlands), a popular program for the visualization of bibliometric networks. It involved three aspects of analysis, namely co-authorship analysis, co-occurrence analysis, and citation analysis. With the use of network maps to visualize author collaboration, co-authorship analysis was performed to determine the most-frequent authors and institutions contributing to the field. The co-occurrence analysis assessed the number of times the occurrences of certain keywords to find the dominant themes of research, and the related terms were clustered into thematic clusters. Citation analysis was used to determine the extent of this influence through citation counts for individual papers along with acknowledgement of influence by other papers. The data exported and cleaned and preprocessing to ensure of correct format. The CSV file consisting of abstracts, keywords, citation information, and bibliographic details was stringently validated for structural consistency. Repetitive or redundant terms were filtered out manually, and duplicate terms were eliminated. For example, to assure the accuracy of the keyword analysis, commonly used words which were less specific to the nature of the work (e.g., “study,” “review,” and “education”) were also removed. The results were presented using network visualization, where interlocking circles represented relationships between terms. The distance between circles indicated the strength of association, while different colors denoted thematic clusters, and circle size corresponded to frequency of occurrence. To improve clarity, terms that were unrelated or excessively common were manually removed from the visualizations.

In addition to bibliometric analysis, a meta-analysis was performed on selected high-impact studies (i.e., the top 10% of cited papers). This meta-analysis aimed to synthesize findings related to the impact of sexuality education on adolescent identity development, sexual behavior, and psychological well-being. Effect sizes were calculated using Cohen’s d, Odds Ratios (OR), and Confidence Intervals (CI) to measure the magnitude of educational interventions. Heterogeneity across studies was assessed using I² statistics, and Egger’s test was applied to detect potential publication bias. A funnel plot was generated to visually assess symmetry, ensuring the validity of the synthesized results.

To better explain the research procedure, here are the stages of work carried out:

Keyword Determination: We defined the keywords “Sex Education” AND “Adolescent” and various synonyms and related terms to ensure broad and comprehensive coverage.

Data Mining: We collected data from the Scopus database on September 2, 2024, covering the period of 1939 to 2024. Only articles, research papers, conference papers, and reviews were included.

Data Cleaning: Exported data in “tab-delimited” format was checked for completeness and accuracy. Repetitive or irrelevant terms are manually removed.

Data Processing: Data were analyzed using VOSviewer software. This analysis included co-authorship and co-occurrence, which allowed us to generate a network map of authors, countries, and keywords.

Data Analysis: We conducted citation analysis to create a network map of scientific journals. The results are displayed on interlocking circles, where the proximity of the terms’ circles can imply a strong relationship of the terms. Different colors once again indicate groups of terms, while the sizes of the circles show how frequently the terms occur.

Figure 1. Flowchart of Research Stages

A systematic bibliometric approach was taken in this study to summarize and carry out a comprehensive review of the literature on sexuality education and adolescent identity formation. These big data analytics generated useful insights, offering valuable information on key contributors, highlight recurring themes and identify gaps in current knowledge regarding research directions in the field which can also help in future policy formation.

Findings/Results

The bibliometric data collected showed that there was a growing number of publications on adolescent sex education between 1939 to 2024 (Figure 2) in total, there were 780 publications from 149 journals. 2020 showed the highest number of publications with nine publications. The rise in publications demonstrates that it is an increasing trending topic, as the growing relevance of the issue across disciplines including the psychological, the social, the medical needs a more interdisciplinary approach. Since 160 authors from 66 nations contributed to these publications, it is clear that sex education for teenagers is a global topic that is examined from a variety of social and cultural angles. This wide distribution also shows strong international collaboration and a multidisciplinary approach to research on adolescent identity.

Figure 2.Documents per Year

Furthermore, Figure 3 shows that publications related to sex education for adolescents have a total of 20,107 citations. In Table 1, it can be seen that the publication entitled “Sexual Abuse in a National Survey of Adult Men and Women: Prevalence, Characteristics, and Risk Factors,” written by David Finkelhor, Gerald Hotaling, I. A. Lewis, and Christine Smith, has the highest number of citations (1,154 at time of data collection).

Figure 3.Citations per Year

Table 1. Top 5 Publications Based on Citations

Figure 4.Visualization of Bibliometric Maps and Keyword Clusters

Figure 5.Visualization of Bibliometric Maps Based on Year

Figure 5 shows the development of research topics on sex education for adolescents based on the average year of publication for each keyword. Keywords such as ‘Sexual Health’ (average year: 2018), ‘Procedures’ (2017), ‘Young Adult’ (2019), ‘High Risk Behavior’ (2019), ‘Unsafe Sex’ (2019), ‘Unwanted Pregnancy’ (2020), ‘Transgender’ (2020), and ‘Sexual and Gender Minority’ (2020) are displayed in bright yellow, indicating that research related to these topics is relatively recent. This yellow color represents newer research trends, as shown on the color scale at the bottom of the figure, which spans from 1990 to 2020. Meanwhile, keywords with darker colors, such as ‘Population’ (2005), ‘Behavior’ (2008), and ‘Programs’ (2007), indicate older research topics that have been studied for a longer period and have strong links within the research network on sex education for adolescents. This indicates a shift in research focus, from general population studies and behavior analysis in earlier years, towards more specific and emerging issues such as gender identity, high-risk sexual behaviors, and the inclusion of marginalized groups in recent years.

Table 2. Top 5 Research Topics Related to Anatomical Terminology

Table 2 shows that the most frequently researched topics associated with sex education for adolescents in the Scopus database are psychology with 780 publications (48.4%), followed by social science with 353 publications (21.9%), medicine with 314 publications (19.5%), arts and humanities with 115 publications (7.1%), and neuroscience with 17 publications (1.1%).

Table 3.Top 5 Journals Based on Publication Counts

Table 3 shows that the journal with the most publications related to sex education for adolescents is Adolescence with 90 publications. It is followed by Archives of Sexual Behavior with 50 publications, Journal of Sex Research with 40 publications, AIDS Care: Psychological and Socio-Medical Aspects of AIDS/HIV with 36 publications, and Journal of Adolescence with 25 publications.

Figure 6.Documents by Country

Based on Figure 6, there are 10 countries with the largest number of publications. The United States leads with 401 publications, followed by the United Kingdom with 77 publications, Canada with 36 publications the Netherlands with 26 publications, Germany with 22 publications, the Australia with 20 publications. South Africa with 20 publications, China with 19 publications, Spain with 17 publications, Prance with 15 publications. It can be concluded that the United States is the most dominant country in publications related to sex education for adolescents.

Figure 7.Documents by Author

Figure 7 shows that the most productive authors writing publications related to sex education for adolescents are P. B. Smith with six publications, D. Kirby with five publications, and the following authors each with three publications: P. Aggleton, L. Armistead, R. S. Buzi, S. Choukas-Bradley, K. Dawson, J. A. Diniz, J. P. Espada, and T. D. Fisher.

Figure 8. Co-Citation (Cited Authors)

The co-citation map (Figure 8) shows that Kirby D. emerges as the most frequently co-cited author, indicating his significant impact on the development of school-based sex education programs. Other key influential authors include Bandura A., whose Social Learning Theory underpins many behavioral interventions, and DiClemente R.J., known for his work on HIV prevention strategies. The analysis further reveals distinct research clusters: education program evaluation, theoretical frameworks, behavioral interventions, and online safety in adolescent sexual health. This comprehensive analysis highlights the core contributors and thematic areas shaping current research in this domain.

Figure 9.Documents by Affiliation

Figure 8 shows the ten institutions with the most significant number of publications on sex education for adolescents. The University of North Carolina at Chapel Hill (United States) leads with 14 publications, followed by The University of Texas at Austin (United States) with 11 publications. Emory University, Johns Hopkins Bloomberg School of Public Health, Centers for Disease Control and Prevention (CDC), University of California-Los Angeles, and Columbia University each contributed 9 publications. Meanwhile, the University of Glasgow (United Kingdom), the University of Washington, and Indiana University Bloomington each produced 9 publications as well.

Of the top 10 institutions, nine are located in the United States, while only one, the University of Glasgow, represents the United Kingdom. Notably, there is a lack of representation from institutions in other regions, such as Asia, Africa, and Latin America. This indicates that research on adolescent sex education is largely concentrated in Western countries, particularly in the United States. The limited contribution from other regions suggests a potential research gap and highlights the need for broader international collaboration and representation in future studies.

Conclusion

This bibliometric study reveals the main trends in research on adolescent sex education from 1939 to 2024. The data show a fairly steady increase in the number of publications, especially between 2000 and 2010. Although classic topics such as sexual behavior, contraceptive use, and HIV prevention still dominate, since 2015, there has been a greater focus on new issues, such as gender identity, psychosexual development, and self-esteem. However, despite the growth of research in this area, there are still some gaps that need to be addressed. One of them is the lack of an approach that involves families, as seen from the minimal occurrence of keywords such as "parental involvement" and "family relationships." This suggests that although the role of families in sex education has been recognized, its integration into academic studies is still limited. In addition, discussions on digital-based sex education and gender inclusivity are also still rare in the existing literature. Therefore, further research is needed to understand how online resources and the diversity of adolescent identities can influence the effectiveness of sex education.

The co-occurrence and overlay analyses show an increasing focus on family dynamics, as reflected in the presence of terms such as “parental involvement,” “parent-child communication,” and “family relationships.” Although these terms appear in the network visualization, their node sizes are relatively small and located on the periphery of the main cluster (Figure 4). This suggests that while family-based approaches are gaining attention, they are not as prominent as more individual-based interventions, such as “adolescent behavior,” “HIV infection,” and “sexually transmitted diseases,” which have larger and more central nodes in the research network. Similarly, terms such as “internet,” “sexting,” and “sexual and gender minorities” are emerging in academic discussions, but remain on the periphery of the network visualization with small node sizes (Figure 4). From a bibliometric perspective, this suggests that the frequency of these terms is still low and their association with the main themes, such as “sexual education” and “adolescents” is still weak. This marginalized position further emphasizes that research on digital behavior, online sexual activity, and gender diversity is still in the early stages of academic exploration. This gap indicates the need for more in-depth research to understand how digitalization and gender inclusivity can shape adolescent experiences and contribute to the design of more comprehensive and relevant sex education programs.

Co-citation analysis reveals that several influential authors, such as Kirby D., Bandura A., and DiClemente R.J., still play a significant role in shaping the theoretical foundations of this field. However, most of the frameworks they have developed tend to focus on individual behavioral change, while family- or community-based approaches have received less attention. In addition, geographical analysis shows that research in this area is still dominated by the United States and the United Kingdom, with relatively limited contributions from Asia, Africa, and Latin America. This disparity highlights the need for more geographically diverse research so that the developed sex education models are more appropriate to different cultural contexts. This lack of global representation also poses challenges in the implementation of sex education policies, given that cultural and regulatory differences across countries can affect the effectiveness of designed interventions.

Therefore, more contextualised and up-to-date approaches should be used, taking into account the social and cultural background of adolescents. Access to factual information about how puberty affects their bodies and comprehensive sexuality education has a significant impact on their physical, emotional, and social development. Sound sexuality education not only helps adolescents make responsible choices about their sexual and reproductive health, but also contributes significantly to their self-esteem and physical health and well-being. Sex education teaches more than just the biological act of sex; it also focuses on relationship-building skills, gender identity, consent and boundaries. This understanding is crucial for young people as they face normative and relational issues in their everyday lives.

Implications and Future Research

The implications of these findings are significant for research, policy, and practice. First, there is an urgent need to develop and test parent-inclusive adolescent sexual health interventions. Such programmes also need to address cultural diversity, particularly in geographical areas under-represented in the existing literature. Second, the growing role of digital technology in adolescent sexual activity highlights the need to integrate digital literacy, online safety, and responsible digital engagement into sexuality education curricula. Innovative delivery methods and novel aspects of digital interventions should therefore be explored in future studies and their potential to improve sexual outcomes. Thirdly, the low representation of sexual and gender minorities in the literature highlights the immediate need for equitable and inclusive models of sex education. Future research should explore how sex education can best support students with diverse gender identities and sexual orientations, so that all adolescents receive relevant and affirming information.

The study has one limitation: there were no articles from 1939 to 1963 (Figure 2). Conservative attitudes, limited policy initiatives, and a lack of structured sex education programs were present during this time. The lack of visibility of earlier works may have been caused by research indexing practices. Since the 1960s, Publications have increased in wider cultural shifts, the rise of public health initiatives, and greater governmental involvement in education.

Another limitation is sex education citations become more prevalent after 1976 (Figure 3). Social, political and health concerns influenced an increasing interest in sex education during the 1970s from country to country.1.xviii. While sex education programs were becoming more popular, challenges relating to ideological debates and responses to health crises remained significant. Various methods, such as peer education and popular culture, were used to introduce or adapt the concept of sex education during this period.

While these limitations are significant, they don't diminish the importance of the study. Some non-indexed sources, policy documents, or other academic discourse on sex education have previously contained earlier discussions that weren't included in this dataset. Archives or other databases could be used to provide a more comprehensive historical account of the development of sex education in future research.

Overall, this bibliometric study not only illustrates the development map of research on adolescent sex education but also reveals important gaps and emerging areas of study. To strengthen research in this field, efforts are needed to address these gaps through family involvement, utilization of digital technology, and the application of a more inclusive approach. However, this study has several limitations. First, the use of literature that only comes from the Scopus database has the potential to ignore valuable insights from other sources that are not indexed or included in the gray literature category. Second, the bibliometric approach focuses more on mapping trends and the influence of a study but does not evaluate the quality of the content or the effectiveness of the interventions implemented. Third, the meta-analysis in this study only considered the 10% of the most frequently cited studies, so there is a possibility of citation bias that emphasizes works that have been influential for a long time compared to newer studies.

Generative AI Statement

The author has not used generative AI or AI-supported technologies.

Authorship Contribution Statement

Purwati: Writing, supervision, final approval. Japar: Analysis, data acquisition. Hadli: Editing/reviewing, statistical analysis. Aryani: Data analysis, admin. Nikmah: Drafting manuscript, critical revision of manuscript. Pratama: Securing funding, technical or material support. Sari: Conceptualization, design.