In this article, we consider what would happen if the resources and energy devoted to formal, school-based sex education were redirected into a syndemic sex education approach that centres the individual, social, and structural conditions that shape adolescents' sexual and reproductive health (SRH). Drawing on a case study of youth in Malawi, we argue that sex education in its current form fails to broadly prevent negative SRH outcomes and meaningfully improve wellbeing. Yet it, and the (female) sexuality it seeks to prevent, remain the subjects of considerable attention and moral anxiety. We call to move beyond sex as a focus for institutionalised teaching and learning, replacing it with holistic efforts to support the wellbeing of young people living in syndemic conditions.