The controversial Pono Choices sex education program can again be taught in public middle schools, the Department of Education announced Thursday, saying several revisions have made by the program’s developers at the University of Hawaii at Manoa to improve the curriculum and address public concerns.

Pono Choices, billed as a “culturally responsive” program to help reduce teen pregnancies and prevent sexually transmitted infections, has been under fire since last year’s special legislative session on gay marriage amid criticisms that it’s medically inaccurate — classifying the anus as genitalia, for example — and includes explicit lessons inappropriate for students as young as 11 years old.

The DOE halted the program for a second time in June, when it asked UH Manoa’s Center on Disability Studies, which developed and owns Pono Choices, to revise the curriculum using recommendations made by a stakeholder review panel.

The review panel focused on 15 parts of the curriculum that were identified as controversial, including the teaching material’s definition of sex, anus, pono and abstinence; a condom demonstration; relationship scenarios that included same-sex couples; and images of sexual and reproductive anatomy parts.

The DOE said a total of 10 changes have been made by the university, including no longer grouping grouping anus under the term genitals; new emphasis on the dangers of unprotected anal sex; and elimination of confusing language about condom effectiveness rates. 

Changes also have been made to the script and materials for the required parent informational night to give parents more information about the language and scenarios used in the curriculum, the DOE said.

Pono Choices is one of seven approved programs for middle schools to use for sexual health education. The DOE over the summer changed its policies to make sex ed optional and require that parents to opt their children in to participate.

“No student is required to participate in sexual health education,” the department said in a statement. “The DOE strengthened the role of parents in this decision by changing its policy from an opt-out to an opt-in. Beginning in the 2014-15 school year, all parents must sign an opt-in form permitting their children to participate in sexual health education.”

The DOE briefly halted the program in November 2013 to review the content and address concerns, and reinstated it two weeks later.