In the midst of a generalised HIV and AIDS epidemic in southern Africa, the argument for more coordinated and comprehensive youth sexual health interventions is intensifying. Yet the crucial question of "how best" to provide young people with these skills and knowledge remains a key challenge for policy-makers, researchers and practitioners in our region. Moreover, amongst the available literature on sex education in southern Africa, few authors have taken an applied perspective, to look at fresh approaches and tools with the potential to be implemented more broadly. This paper argues for a greater focus on concepts of masculinity and sexuality in the development of sexual health efforts in southern Africa. It aims to bridge theory and practice by advancing six promising approaches with the potential to create a suitable space and environment for participants to engage with these issues. Approaches include methods and tools currently being implemented in existing programmes, as well as ideas emerging from recent literature. Our paper is ultimately a call for further "out-of-the-box" thinking to find more effective and creative practical ways of providing the sexual health education our region's youth urgently needs. It is also a call for more applied research, to better inform future sex education programmes in southern Africa. (Contains 1 table.)