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Background: The recent ‘Sexuality, Consent and Relationships’ subject integrated curriculum in Swedish schools has posed socio-ecological challenges for teachers across individual, community, institutional, and policy levels. For example, at the individual level, teachers may avoid or minimise topics they feel uncomfortable teaching. This avoidance may contribute to 50% student engagement in CSE classes and lower migrant student health outcomes at the community level. Nevertheless, teachers’ voices remain unheard.

Aim: To explore the perceptions, attitudes and challenges comprehensive sexeducation teachers in Sweden experience at the years 7-9 secondary school level.

Method: The qualitative focus group discussion (FGD) study included current teachers in Sweden who have taught sex education for at least one year at the years 7-9 secondary school level. Nine participants were included in a total of two FGDs, held via Zoom. The FGDs were transcribed from Swedish and translated into English before an inductive content analysis using NVivo.

Results: Teachers perceived three key themes; Diffuse Sex Education without an Aim; Fostering Engagement with Trust-based Curiosity; and Slipping Through the Cracks within an overarching theme of Navigating Multi-level Complexity in Comprehensive Sex Education.

Conclusion: Multi-level accountability is needed to increase cross-subject planning and support for teachers so that teachers with high self-efficacy may encourage an increase in student engagement.