The new document comes after ongoing calls for better sex education in schools, and in response to recommendations from the 2013 Health Select Committee which found "fragmented and uneven programmes" in schools were partly to blame for the high teen pregnancy rate.
The guidelines also have an added focus on consent, coercion and culture, but are not mandatory - meaning schools can choose to adopt the practices or not.
Sex education is a compulsory part of the health curriculum, however schools are free to decide how they teach it, in consultation with their school community.
Policy additions were based on research saying issues included the sexualisation of young people, particularly girls; the effects of pornography on young people's understanding of sexuality and relationships; and examining the bias that opposite sex relationships are normal.
Gender issues were also prevalent, with a nationally representative survey in 2012 finding that transgender students were a numerically small but important group. Around 1.2 per cent of students report as transgender and 2.5 per cent not sure.
The guidelines said: "School uniforms can reinforce gender norms, so schools may consider offering gender-neutral clothing choices when uniforms come up for review."
The deputy secretary for student achievement, Dr Graham Stoop, said the guide had been produced with the help of schools, education groups and professionals, and health experts.
"Research shows that when students feel their personal values are treated with respect by their peers and schools, they stay at school longer and achieve more."
Toni Duder, communications manager for lesbian, gay, transgender and bisexual group Rainbow Youth, welcomed the guidelines.
"It's based on facts, members of the young trans community were consulted, and it's awesome that it includes real life experiences," she said.
"It's great to see some schools taking a proactive approach."
Post-Primary Teachers' Association head Angela Roberts said the guidelines represented a huge social change.
"My only concern is that it's going to be left just to hang there unless there's support for boards on how to have the conversation with their community," she said.
Principal of the Catholic John Paul College, in Rotorua, Patrick Walsh, said his school was likely to adopt parts of the guidelines - around consent, for example. The school had a lot of input from students and parents about uniforms "and [gender-neutral uniforms have] never been requested".
Sexuality guidelines for schools
• Consider offering gender-neutral uniforms.
• Schools may also consider reviewing options around toilet facilities.
• All school extra-curricular activities should be inclusive of all students and encourage diverse participation.
• It is recommended that all students engage in sexuality education in years 11-13.
• Use of Pacific language terms in sexuality lessons is important.
• Include Maori world view.
• Decisions on contraceptive education should be considered during the consultation process.
See the full guidelines: health.tki.org.nz
