Learning, Agency, and Diffusion: How Adolescents Become Sexuality Educators Through a Cascade Model in Ghana

School-based sexuality education in sub-Saharan Africa remains constrained by moral regulation, limited dialogue, and uneven pedagogical implementation, limiting adolescents’ access to meaningful sexual and reproductive health learning. Although peer-led approaches are widely promoted, less is known about adolescents’ experiences of becoming credible sexuality education facilitators. This study examined an expert-to-peer cascade model implemented across five Ghanaian senior high schools, focusing on adolescents’ reports of acquiring knowledge, building facilitation confidence, and circulating sexual and reproductive health information through peer networks. Using a multi-site interpretive qualitative design informed by phenomenological sensitivity, data were generated through forty in-depth interviews with trained peer educators and student beneficiaries, five focus group discussions, and twenty hours of participant observation. Findings indicate that expert-led training clarified sexual and reproductive health concepts, modeled respectful communication, and bolstered peer educators’ confidence. Participants reported that peer-led sessions created more open spaces for questioning, clarification, and respectful engagement with sensitive topics. They also described ongoing conversations in dormitories, friendship circles, and other school spaces. The study highlights the importance of structured preparation, ethical facilitation, privacy protection, and ongoing supervision in peer-led sexuality education.