Missouri’s Sex Education Snapshot
The State of Sex Education
Advocates in Missouri have successfully made incremental advancements to Missouri’s sex education requirements in the past seven years and are now considering further efforts to revise the state’s current mandate. Advocates are also actively working against legislative efforts to restrict sex education. In the current 2022 legislative session, three bills related to sex education have been introduced. One of these, House Bill 1752, seeks to change requirements in current sex education curriculum such as requiring medically accurate information on contraception while still emphasizing abstinence and stressing negative consequences associated with sexually transmitted infections. At the same time, Senate Bill 699 was introduced and, if enacted, would abolish abortion care in the state and also shift to a parental opt-in policy, from opt-out, for sex education.
In 2015, Representative Genise Montecillo successfully championed House Bill 501, which requires sex education instruction to include information on the dangers of sexual predators and how to remain safe on the internet. In 2018, the legislature passed House Bill 1601, sponsored by Representative Holly Rehder and written collaboratively with University of Missouri students, requiring sex education curriculum to include instruction on consent and sexual violence. Such efforts demonstrate consistent support to make sex education more comprehensive in Missouri and provide a framework that advocates may reference to make further advancements.
In addition to these statewide efforts, grassroots advocacy efforts have also focused on advancing local sex education requirements. Missouri advocates report that there are only a few schools that are providing comprehensive sex education, while the majority of districts provide abstinence-only or abstinence-plus instruction. The patchwork nature of Missouri’s sex education curriculum requirements fails to ensure that all students receive the same quality of sex education. Students report that their sex education curriculum continues to lack vital information related to reproductive health, including topics such as endometriosis and other uterine disorders. Further, an abysmal three percent of Missouri students reported receiving LGBTQ-inclusive sex education, according to GLSEN’s 2017 National School Climate Survey.
Since Missouri schools are not required to provide sex education to students, school districts are left to decide what type of sex education–if any at all–they provide to youth. Local control over sex education presents unique challenges that have resulted in a glaring disparity regarding the quality of sex education that students receive. Such discretion allows for the implementation of policies and curriculum that stigmatize marginalized youth, such as students of color and LGBTQ youth, and presents further challenges in ensuring that low income districts have access to the resources needed to implement comprehensive sex education.
To bridge the gaps in education, advocates recommend legislation that requires Missouri schools to include instruction on sexual orientation and gender identity in their sex education curriculum. To ensure more youth have access to comprehensive instruction, they also recommend that the Missouri legislature amend current provisions that prohibit Planned Parenthood educators from teaching sex education. House Bill 2591, introduced in the 2022 legislative session, seeks to repeal these specific provisions. Further, passing legislation that requires all schools to provide comprehensive sex education would ensure that every student in the state receives quality instruction.
Right now, advocates can take action to ensure young people in their community have access to quality sex education. After contacting their local school board, advocates can determine what topics are missing from sex education instruction, such as instruction on consent, sexual orientation and gender identity, and contraceptives. They can then vocalize the important need for advancing sex education requirements in their community. Advocates are encouraged to take action on pending legislation that seeks to advance or restrict the principles of comprehensive sex education. For a current overview of pending legislation, see table below. Additionally, reach out to EducateUs to get connected to local advocacy groups such as Teen Pregnancy and Prevention Partnership in Missouri. Further, advocates can contact their representatives to discuss the critical need for advancing comprehensive sex education requirements. Advocates are encouraged to use the SIECUS Community Action Toolkit to guide local efforts to advance sex education.
State Sex Education Policies and Requirements at a Glance
- Missouri schools are not required to teach sex education. However, they are required to teach health education, including HIV/AIDS prevention education.
- Curriculum is not required to be comprehensive.
- Curriculum must present abstinence as the preferred choice of behavior.
- If sex education is offered, curriculum is not required to include instruction on sexual orientation or gender identity.
- If sex education is offered, curriculum must include instruction on consent.
- Parents and guardians can remove their children from any part of their sex education instruction. This is referred to as an “opt-out” policy.
- All course materials related to HIV/AIDS, along with sex education curriculum if offered, must be medically accurate.
State House Highlights
This section highlights sex education bills that were introduced during the 2021 state legislative session as well as bills that have been introduced thus far in 2022. These proposed bills provide a brief overview of both recent and current legislative action taken to advance or restrict sex education. For a more comprehensive look at relevant legislation concerning sex education and related topics such as reproductive health care, LGBTQ rights, racial equity and justice, parental rights, bullying and harassment, mental health, assault and violence prevention, and HIV/STIs as it impacts youth, continue reading on to the “State Legislative Activity” section of Missouri’s profile.
2022 Legislative Session
House Bill 2591 (pending): Requiring menstrual hygiene products to be provided free of charge in middle and high schools and charter schools and repealing provisions prohibiting entities associated with abortion care from providing instruction on human sexuality or STIs
Senate Bill 699 (pending): Abolishes abortion entirely and establishes criminal penalties for abortion. It also changes from allowing parents to opt their child OUT of sex education to opt IN.
House Bill 1752 (pending): Requires curriculum to continue to emphasize abstinence and discourage adolescent sexual activity. Additionally, it would stress the negative consequences of sexually transmitted infections but require medically accurate information on contraception. It would also emphasize adoption as an alternative and allows for separation on the basis of gender for classroom instruction
2021 Legislative Session
House Bill 786 (failed): Sought to require parental notification if any curriculum, including sex education, includes instruction related to sexual orientation or gender identity and to make curriculum available for review.
More on sex ed in Missouri…
Missouri schools are required by Missouri Revised Statute § 170.015 to teach health education, including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) prevention education, beginning in elementary school. If a school chooses to provide additional sex education, Missouri law mandates that all instruction must be medically and factually accurate and “present abstinence from sexual activity as the preferred choice of behavior in relation to all sexual activity for unmarried pupils.” In addition, instruction must “advise students that teenage sexual activity places them at a higher risk of dropping out of school because of the consequences of sexually transmitted diseases [STDs] and unplanned pregnancy.”
Among other requirements, the instruction must also:
- Stress that [STDs] are serious, possible, health hazards of sexual activity. Pupils shall be provided with the latest medical information regarding exposure to [HIV], [AIDS], human papillomavirus [HPV], hepatitis, and other [STDs];
- Present students with the latest medically factual information regarding both the possible side effects and health benefits of all forms of contraception, including the success and failure rates for the prevention of pregnancy and [STDs]; or shall present students with information on contraceptives and pregnancy in a manner consistent with the provisions of the federal abstinence education law, 42 U.S.C. Section 510;
- Include a discussion of the possible emotional and psychological consequences of preadolescent and adolescent sexual activity and the consequences of adolescent pregnancy[iv]
The statute was first amended in 2015 to include instruction on “the dangers of sexual predators, including online predators when using electronic communication methods” and “the consequences, both personal and legal, of inappropriate text messaging.” Later, in 2018, the statute was amended again to include instruction on sexual harassment, sexual violence, and consent.
The specific content of human sexuality instruction must be determined by the school board of each school district or charter school. School districts and charter schools are prohibited from providing abortion services and allowing a person and/or entity that provides abortion services to “offer, sponsor, or furnish” course materials related to human sexuality and STDs.
Prior to instruction, school districts and charter schools must make all curriculum materials available for public inspection. Parents have the right to remove their child from any part of the district’s or school’s human sexuality instruction. This is referred to as an “opt-out” policy.
Missouri provides the Health Education Grade-Level Expectations to guide schools in developing a health education curriculum. Teen pregnancy, contraception, and the transmission, treatment, and prevention of sexually transmitted infections (STIs) are mentioned, as are “behaviors that could enhance HIV transmission.”
State Legislative Activity
State legislative activity related to sex education does not take place in isolation from the broader embroiled political and policy climate. Attacks on the rights of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals, attempts to restrict or prohibit instruction on “divisive concepts” such as Critical Race Theory, and efforts to limit access to abortion care and other reproductive health care services prevent students from receiving comprehensive sex education and accessing sexual and reproductive healthcare services. Below are highlights of current legislative activity related to these topics. Missouri’s 2022 session convened on January 5, 2022.
|House Bill 1371||Requires all students to receive mental health awareness training from grades 5-8||Introduced (2023)||Mental Health||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2611H.02I.pdf|
|House Bill 1217||Requires school districts to excuse students with mental or behavioral health concerns from attendance at school||Introduced (2023)||Mental Health||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2550H.01I.pdf|
|House Bill 1258||Prohibits school employees from using students pronouns if it differs from biological sex unless parent permission received, school employees don't have to use pronouns if it contradicts their religious or moral convictions||Introduced (2023)||Sexual Orientation and Gender Identity||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2598H.01I.pdf|
|House Bill 1110||Requires any organization providing pregnancy related services or counseling to provide medically accurate and unbiased information on reproductive health options to receive state funding||Introduced (2023)||Reproductive Health care||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/0197H.01I.pdf|
|Senate Bill 598||Prohibits gender affirming care on minors and prohibits interstate referrals||Introduced (2023)||Sexual Orientation and Gender Identity||https://senate.mo.gov/23info/pdf-bill/intro/SB598.pdf|
|Senate Bill 39||Restricts participation in school sports on the basis of biological sex||Introduced (2023)||Sexual Orientation and Gender Identity||https://senate.mo.gov/23info/pdf-bill/intro/SB39.pdf|
|House Bill 950||Requires school districts to provide "period products" at no cost in middle schools and high schools and charter schools and repeals provisions prohibiting abortion services providers from providing instruction on human sexuality or sexually transmitted diseases||Introduced (2023)||Health Disparities & Menstrual Equity||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/1032H.01I.pdf|
|House Bill 916||Prohibits gender affirming care on minors||Introduced (2023)||Sexual Orientation and Gender Identity||https://www.house.mo.gov/billtracking/bills231/sumpdf/HB0916I.pdf|
|House Bill 883||Requires the department of elementary and secondary education to convene a work group to develop and recommend academic performance standards relating to health education required by the state board of education. The group shall include, but not be limited to, educators providing instruction in health education and family and consumer science in grades nine to twelve, representatives from the department of elementary and secondary education, and nonprofit organizations that focus on public health, parenting, and social services.||Introduced (2023)||Sex Education||https://house.mo.gov/billtracking/bills231/hlrbillspdf/2038H.01I.pdf|
|House Bill 507||Allows school districts to teach students information on the roles and contributions of LGBT people in the history of the United States. Also allowed to familiarize students with the history of LGBT social movements, persecution of LGBT people, current issues of LGBT inequality and progress, and the influence of the LGBT community on law, history, government, literature, art, music, values, and culture.||Introduced (2023)||Sexual Orientation and Gender Identity||https://legiscan.com/MO/text/HB507/2023|
|House Bill 463||Prohibits a physician or other health care provider from providing gender transition procedures to any individual under eighteen years of age or referring any individual under eighteen years of age to any health care provider for gender transition procedures. Defines as "coercing" a minor to undergo surgical or hormonal treatment for gender transition as child abuse or neglect.||Introduced (2023)||Sexual Orientation and Gender Identity||https://legiscan.com/MO/text/HB463/2023|
|House Bill 634||Prohibits classroom instruction by school personnel or third parties relating to sexual orientation or gender identity||Introduced (2023)||Sex Education||https://legiscan.com/MO/text/HB634/2023|
|House Bill 337||No school district or charter school shall allow any student to compete in an athletics competition that is designated for the biological sex opposite to the student's biological sex as correctly stated on the student's official birth certificate. A school district or charter school may allow a female student to compete in an athletics competition that is designated for male students if no corresponding athletics competition designated for female students is offered or available.||Introduced (2023)||Sexual Orientation and Gender Identity||https://legiscan.com/MO/text/HB337/2023|
|House Bill 627||Establishes Parents Bill of Rights||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/1433H.01I.pdf|
|Senate Joint Resolution 6||Asserts that parents have right to participate ion and direct their child's education, transparency in curriculum materials, the right of the legislature to enforce this as legislation||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://senate.mo.gov/23info/pdf-bill/intro/SJR6.pdf|
|House Bill 137||Sex ed bill that includes parental consent aspects related to sex ed instruction and surveys.||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://house.mo.gov/billtracking/bills231/hlrbillspdf/0110H.01I.pdf|
|House Bill 170||Prohibits transgender athletes from playing on schools sports teams aligned with their gender by only allowing designation based on biological sex||Introduced (2023)||Sexual Orientation and Gender Identity||https://house.mo.gov/billtracking/bills231/hlrbillspdf/0501H.01I.pdf|
|Senate Bill 381||Creates "health and family education" which consists of many concepts including sexual health AND parenting education competency development, changes health education one half unit credit to be named "health and family education", requires the creation of a working group under the DoE that will develop academic standards and written curriculum for health and family education with emphasis on "behavioral health relating to morbidity and mortality of youth, chronic disease management, and parenting skills"||Introduced (2023)||Sex Education||https://senate.mo.gov/23info/pdf-bill/intro/SB381.pdf|
|Senate Bill 451||Creates Parents Bill of Rights which entail rights in education and health, curriculum transparency||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://senate.mo.gov/23info/pdf-bill/intro/SB451.pdf|
|Senate Bill 165||Prohibits transgender athletes from playing on schools sports teams aligned with their gender by only allowing designation based on biological sex||Introduced (2023)||Sexual Orientation and Gender Identity||https://senate.mo.gov/23info/pdf-bill/intro/SB165.pdf|
|Senate Bill 89||Creates internet-based tool for curriculum transparency in Missouri's public education system and provides citizens access to every school district's curriculum, source materials, and professional development materials. Creates Parents Bill of Rights of 2023||Introduced (2023)||Parental Rights & Curriculum Transparency||https://www.senate.mo.gov/23info/BTS_Web/Bill.aspx?SessionType=R&BillID=44666|
|Senate Bill 390||Prohibits instruction by school personnel or third parties on gender identity or sexual orientation in K-3 or in a manner that is not age appropriate or developmentally appropriate for students in accordance with state standards.||Introduced (2023)||Sexual Orientation and Gender Identity||https://senate.mo.gov/23info/pdf-bill/intro/SB390.pdf|
|Senate Bill 134||Prohibits any school nurse, counselor, teacher, principal, or other personnel at a public or charter school from discussing gender identity or sexual orientation with a student unless such person is a licensed mental health provider with prior parental permission||Introduced (2023)||Sexual Orientation and Gender Identity||https://www.senate.mo.gov/23info/BTS_Web/Bill.aspx?SessionType=R&BillID=44406|
|Senate Bill 172||Prohibits divisive concepts in schools||Introduced (2023)||Racial Equity and Justice||https://senate.mo.gov/23info/pdf-bill/intro/SB172.pdf|
|Senate Joint Resolution 29||Resolution that establishes parents have exclusive control over minor's lives||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://senate.mo.gov/23info/pdf-bill/intro/SJR29.pdf|
|Senate Bill 318||"Empowering Missouri Parents Act" establishing parental rights and curriculum transparency, similar to the other parental rights bills||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://s3.amazonaws.com/fn-document-service/file-by-sha384/5955315684fd2d53811c0201c5f4775591389ee154761d4e6b2b983b43531292a0fb5e86c4c82b304da76644e79d78f9|
|Senate Bill 158||Establishing the "The Parents' Bill of Rights for Student Well Being" including all the the rights encompassed in other bills + divisive concepts||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://s3.amazonaws.com/fn-document-service/file-by-sha384/24ed6eff012e04e67694bfa37e0cf2e24f194cb16721091398fbcd369efc1af1c78051bb7bd90fee4ac18fd0c50a8ad3|
|Senate Bill 42||Prohibiting instruction on "divisive concepts", "critical race theory", "The 1619 Project", restricts any training for school employees involving "racial stereotyping", establishes " "Sunlight in Learning Act" which calls for EXTENSIVE procedures for curriculum transparency and established the "Parental Bill of Rights Act of 2023", require a joint committee to study participation of student athletes and what the impact of a policy restricting transgender athletes would be||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://s3.amazonaws.com/fn-document-service/file-by-sha384/719ac2218aad9d577c85b5ca1c4b29f4d544dc0007d290ca1cac7b9880eee5c65f47395d33bc66f4333bad76ac28266d|
|Senate Bill 4||Adds "Parents Bills of Rights of 2023" requiring school districts to develop procedures for increased parental notification, consent, and accessibility to curriculum; embeds "divisive concepts" language; bans instruction on "critical race theory" in K-12, may restrict implicit bias and racial sensitivity training of employees and students; however gives additional context that this statue won't limit teaching on segregation and racial oppression.||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://s3.amazonaws.com/fn-document-service/file-by-sha384/127e5b8c1e29a3a2e4acda0bc2e2edb734a6f956a905e2f57616c49393b9793cf9bb36b4be422beb3313bddefe3750ed|
|House Bill 482||Adds "Parents Bills of Rights of 2023" requiring school districts to develop procedures for increased parental notification, consent, and accessibility to curriculum; embeds "divisive concepts" language||Introduced (2023)||Parental Rights, Curriculum Transparency, and Book Bans||https://s3.amazonaws.com/fn-document-service/file-by-sha384/a47ba46e4f54eedd3d4dcd746d8f5ab7299af04a43b68ca022454e33b492afee6c6255465c061c0a58b8ea41745bb97b|
|Senate Bill 497||Prohibits instructional materials on gender identity and gender reassignment procedures||Introduced (2023)||Sexual Orientation and Gender Identity||https://senate.mo.gov/23info/pdf-bill/intro/SB497.pdf|
Youth Sexual Health Data
Young people are more than their health behaviors and outcomes. While data can be a powerful tool to demonstrate the sex education and sexual health care needs of young people, it is important to be mindful that these behaviors and outcomes are impacted by systemic inequities present in our society that affect an individual’s sexual health and well-being. To learn more about Missouri’s Youth Risk Behavior Survey (YRBS) results, click here.
Missouri School Health Profiles Data
In 2019, the Centers for Disease Control and Prevention (CDC) released the School Health Profiles, which measure school health policies and practices and highlight which health topics were taught in schools across the country. Since the data were collected from self-administered questionnaires completed by schools’ principals and lead health education teachers, the CDC notes that one limitation of the School Health Profiles is bias toward the reporting of more positive policies and practices. In the School Health Profiles, the CDC identifies 20 sexual health education topics as critical for ensuring a young person’s sexual health. Below are key instruction highlights for secondary schools in Missouri as reported for the 2017–2018 school year.
Reported teaching all 20 critical sexual health education topics
- 17.6% of Missouri secondary schools taught students all 20 critical sexual health education topics in a required course in any of grades 6, 7, or 8.
- 26.1% of Missouri secondary schools taught students all 20 critical sexual health education topics in a required course in any of grades 9, 10, 11, or 12.
Reported teaching about the benefits of being sexually abstinent
- 76.7% of Missouri secondary schools taught students about the benefits of being sexually abstinent in a required course in any of grades 6, 7, or 8.
- 94.7% of Missouri secondary schools taught students about the benefits of being sexually abstinent in a required course in any of grades 9, 10, 11, or 12.
Reported teaching how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy
- 66.9% of Missouri secondary schools taught students how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy in a required course in any of grades 6, 7, or 8.
- 91.6% of Missouri secondary schools taught students how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy in a required course in any of grades 9, 10, 11, or 12.
Reported teaching how to create and sustain healthy and respectful relationships
- 76.7% of Missouri secondary schools taught students how to create and sustain healthy and respectful relationships in a required course in any of grades 6, 7, or 8.
- 92.9% of Missouri secondary schools taught students how to create and sustain healthy and respectful relationships in a required course in any of grades 9, 10, 11, or 12.
Reported teaching about preventive care that is necessary to maintain reproductive and sexual health
- 64.9% of Missouri secondary schools taught students about preventive care that is necessary to maintain reproductive and sexual health in a required course in any of grades 6, 7, or 8.
- 89.0% of Missouri secondary schools taught students about preventive care that is necessary to maintain reproductive and sexual health in a required course in any of grades 9, 10, 11, or 12.
Reported teaching how to correctly use a condom
- 24.5% of Missouri secondary schools taught students how to correctly use a condom in a required course in any of grades 6, 7, or 8.
- 37.4% of Missouri secondary schools taught students how to correctly use a condom in a required course in any of grades 9, 10, 11, or 12.
Reported teaching about methods of contraception other than condoms
- 44.9% of Missouri secondary schools taught students about methods of contraception other than condoms in a required course in any of grades 6, 7, or 8.
- 69.9% of Missouri secondary schools taught students about methods of contraception other than condoms in a required course in any of grades 9, 10, 11, or 12.
Reported teaching about sexual orientation
- 35.7% of Missouri secondary schools taught students about sexual orientation in a required course in any of grades 6, 7, or 8.
- 46.7% of Missouri secondary schools taught students about sexual orientation in a required course in any of grades 9, 10, 11, or 12.
Reported teaching about gender roles, gender identity, or gender expression
- 34.5% of Missouri secondary schools taught students about gender roles, gender identity, or gender expression in a required course in any of grades 6, 7, or 8.
- 49.3% of Missouri secondary schools taught students about gender roles, gender identity, or gender expression in a required course in any of grades 9, 10, 11, or 12.
Reported providing curricula or supplementary materials relevant to lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth
- 44.3% of Missouri secondary schools provided students with curricula or supplementary materials that included HIV, STD, or pregnancy prevention information relevant to LGBTQ youth.
(Visit the CDC’s School Health Profiles report for additional information on school health policies and practices.)
***The quality of sex education taught often reflects funding available for sex education programs. To learn more about federal funding streams, click here.Back to the SIECUS State Profiles