This paper investigates the relationship between school-based sex education policies and sexual health-related statistics of young people in four developed countries: the Netherlands, France, Australia, and the United States of America. Drawing upon literature searches in relevant CD-ROM databases, Internet websites, government reports and libraries, school-based sex education policies and a range of sexual health indicators for young people are described for each country. While the average age of first intercourse is approximately the same for each country, the analysis indicates that those countries with pragmatic and sex positive government policies (France, Australia and especially the Netherlands) have better sexual health-related statistics than the one country with a primarily sexual abstinence-based policy (the United States). The findings suggest that abstinence-based policies do not necessarily result in improved sexual health outcomes for young people. Furthermore, liberal policies do not necessarily "promote" sexual activity and may serve to better equip young people with skills that enable sexual health sustaining behaviours. Although a causal relationship between school-based sex education policies and sexual health outcomes cannot be proved, the analysis does suggest that young people's reproductive and sexual health is best served when sex between young people is acknowledged, accepted and regulated rather than proscribed in all contexts outside marriage. (Contains 3 tables and 2 notes.)