State Profiles

MISSOURI’S STATE OF SEX ED

Current Requirements At Glance – Missouri schools are not required to teach sex education. However, they are required to teach health education, including HIV/AIDS prevention education. 

  • 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.

RECENT LEGISLATION SHAPING THE STATE LANDSCAPE

Advocates in Missouri have successfully made incremental advancements to Missouri’s sex education requirements in the past seven years, particularly by expanding curriculum to include instruction on sexual harassment, sexual violence, and consent, and are now considering further efforts to revise the state’s current mandate. In 2022, advocates introduced House Bill 1752, which sought to require medically accurate information on contraception while still emphasizing abstinence and stressing negative consequences associated with sexually transmitted infections. 

Unfortunately, advocates are also actively working against legislative efforts to restrict sex education. In the 2022 legislative session,  Senate Bill 699 was introduced and would have abolished abortion care in the state and also shift to a parental opt-in policy, from opt-out, for sex education. Fortunately, this bill along with similar efforts were ultimately unsuccessful. In 2023, advocates expect additional aggressive legislative attacks on sexual and reproductive rights in a state that is gaining national notoriety for its treatment of transgender youth and their families, as well as banning access to abortion care. One such bill is Senate Bill 42 which, if enacted, would hinder racially informed education, establish a “parental bill of rights”, and create a committee to explore policies to restrict the participation of transgender students in school sports. This is one of many regressive pieces of legislation that have been introduced in this session and reflect the current legislative landscape in Missouri.

Missouri advocates report that there are only a few schools that are providing quality 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.  Further, an abysmal three percent of Missouri students reported receiving LGBTQAI+-inclusive sex education, according to GLSEN’s 2019 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 LGBTQAI+ youth, and presents further challenges in ensuring that low income districts have access to the resources needed to implement sex education.

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 sex education. For a current overview of pending legislation, see table below. 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 and to reach out to EducateUs to get connected to local advocacy groups, such as Teen Pregnancy and Prevention Partnership in Missouri.


More on sex ed in Missouri…


State Law: A Closer Look

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.

State Standards

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. In 2022, a national wave of attacks on the rights of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQAI+) individuals, attempts to restrict or prohibit instruction on “divisive concepts” such as “Critical Race Theory” (which is not taught in public schools), and efforts to limit access to abortion care and other reproductive healthcare services swept the country in an effort to prevent students from receiving sex education and accessing sexual and reproductive healthcare services. Below are highlights of current legislative activity related to these topics. Missouri’s 2024 annual session convenes on January 3, 2024.

TitleDescriptionStatusLegislative Topic
House Bill 1371Requires all students to receive mental health awareness training from grades 5-8Introduced (2023)Mental Healthhttps://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2611H.02I.pdf
House Bill 1217Requires school districts to excuse students with mental or behavioral health concerns from attendance at schoolIntroduced (2023)Mental Healthhttps://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2550H.01I.pdf
House Bill 1258Prohibits 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 convictionsIntroduced (2023)Sexual Orientation and Gender Identity https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/2598H.01I.pdf
House Bill 1110Requires any organization providing pregnancy related services or counseling to provide medically accurate and unbiased information on reproductive health options to receive state fundingIntroduced (2023)Reproductive Health care https://www.house.mo.gov/billtracking/bills231/hlrbillspdf/0197H.01I.pdf
Senate Bill 598Prohibits gender affirming care on minors and prohibits interstate referralsIntroduced (2023)Sexual Orientation and Gender Identity https://senate.mo.gov/23info/pdf-bill/intro/SB598.pdf
Senate Bill 39Restricts participation in school sports on the basis of biological sexIntroduced (2023)Sexual Orientation and Gender Identity https://senate.mo.gov/23info/pdf-bill/intro/SB39.pdf
House Bill 950Requires 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 diseasesIntroduced (2023)Health Disparities & Menstrual Equityhttps://www.house.mo.gov/billtracking/bills231/hlrbillspdf/1032H.01I.pdf
House Bill 916Prohibits gender affirming care on minorsIntroduced (2023)Sexual Orientation and Gender Identityhttps://www.house.mo.gov/billtracking/bills231/sumpdf/HB0916I.pdf
House Bill 883Requires 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 Educationhttps://house.mo.gov/billtracking/bills231/hlrbillspdf/2038H.01I.pdf
House Bill 507Allows 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 463Prohibits 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 634Prohibits classroom instruction by school personnel or third parties relating to sexual orientation or gender identityIntroduced (2023)Sex Educationhttps://legiscan.com/MO/text/HB634/2023
House Bill 337No 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 627Establishes Parents Bill of RightsIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://www.house.mo.gov/billtracking/bills231/hlrbillspdf/1433H.01I.pdf
Senate Joint Resolution 6Asserts 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 legislationIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://senate.mo.gov/23info/pdf-bill/intro/SJR6.pdf
House Bill 137Sex ed bill that includes parental consent aspects related to sex ed instruction and surveys.Introduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://house.mo.gov/billtracking/bills231/hlrbillspdf/0110H.01I.pdf
House Bill 170Prohibits transgender athletes from playing on schools sports teams aligned with their gender by only allowing designation based on biological sexIntroduced (2023)Sexual Orientation and Gender Identityhttps://house.mo.gov/billtracking/bills231/hlrbillspdf/0501H.01I.pdf
Senate Bill 381Creates "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 Educationhttps://senate.mo.gov/23info/pdf-bill/intro/SB381.pdf
Senate Bill 451Creates Parents Bill of Rights which entail rights in education and health, curriculum transparencyIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://senate.mo.gov/23info/pdf-bill/intro/SB451.pdf
Senate Bill 165Prohibits transgender athletes from playing on schools sports teams aligned with their gender by only allowing designation based on biological sexIntroduced (2023)Sexual Orientation and Gender Identity https://senate.mo.gov/23info/pdf-bill/intro/SB165.pdf
Senate Bill 89Creates 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 2023Introduced (2023)Parental Rights & Curriculum Transparencyhttps://www.senate.mo.gov/23info/BTS_Web/Bill.aspx?SessionType=R&BillID=44666
Senate Bill 390Prohibits 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 134Prohibits 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 permissionIntroduced (2023)Sexual Orientation and Gender Identity https://www.senate.mo.gov/23info/BTS_Web/Bill.aspx?SessionType=R&BillID=44406
Senate Bill 172Prohibits divisive concepts in schoolsIntroduced (2023)Racial Equity and Justicehttps://senate.mo.gov/23info/pdf-bill/intro/SB172.pdf
Senate Joint Resolution 29Resolution that establishes parents have exclusive control over minor's livesIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://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 billsIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://s3.amazonaws.com/fn-document-service/file-by-sha384/5955315684fd2d53811c0201c5f4775591389ee154761d4e6b2b983b43531292a0fb5e86c4c82b304da76644e79d78f9
Senate Bill 158Establishing the "The Parents' Bill of Rights for Student Well Being" including all the the rights encompassed in other bills + divisive conceptsIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://s3.amazonaws.com/fn-document-service/file-by-sha384/24ed6eff012e04e67694bfa37e0cf2e24f194cb16721091398fbcd369efc1af1c78051bb7bd90fee4ac18fd0c50a8ad3
Senate Bill 42Prohibiting 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 beIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://s3.amazonaws.com/fn-document-service/file-by-sha384/719ac2218aad9d577c85b5ca1c4b29f4d544dc0007d290ca1cac7b9880eee5c65f47395d33bc66f4333bad76ac28266d
Senate Bill 4Adds "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 Banshttps://s3.amazonaws.com/fn-document-service/file-by-sha384/127e5b8c1e29a3a2e4acda0bc2e2edb734a6f956a905e2f57616c49393b9793cf9bb36b4be422beb3313bddefe3750ed
House Bill 482Adds "Parents Bills of Rights of 2023" requiring school districts to develop procedures for increased parental notification, consent, and accessibility to curriculum; embeds "divisive concepts" languageIntroduced (2023)Parental Rights, Curriculum Transparency, and Book Banshttps://s3.amazonaws.com/fn-document-service/file-by-sha384/a47ba46e4f54eedd3d4dcd746d8f5ab7299af04a43b68ca022454e33b492afee6c6255465c061c0a58b8ea41745bb97b
Senate Bill 497Prohibits instructional materials on gender identity and gender reassignment proceduresIntroduced (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. At the time of publication, the 2021 YRBS data was not made available yet.

Missouri School Health Profiles Data 

In 2022, the Centers for Disease Control and Prevention (CDC) released the 2020 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 22 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 2019–2020 school year. 

Reported teaching all 22 critical sexual health education topics

  • 11.1% of Missouri secondary schools taught students all 22 critical sexual health education topics in a required course in any of grades 6, 7, or 8.
  • 29.8% of Missouri secondary schools taught students all 22 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

  • 69.9% 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. 
  • 92.6% 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

  • 65.7% 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.
  • 92.6% 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

  • 71.8% 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. 
  • 93.4% 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

  • 57.3% 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. 
  • 84.9% 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 9, 10, 11, or 12. 

Reported teaching how to correctly use a condom

  • 16.4% of Missouri secondary schools taught students how to correctly use a condom in a required course in any of grades 6, 7, or 8. 
  • 43.7% 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

  • 40.6% 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.
  • 74.4% 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 and gender identity

  • 28.6% of Missouri secondary schools taught students about sexual orientation in a required course in any of grades 6, 7, or 8.
  • 56.8% 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 how gender roles and stereotypes affect goals, decision-making, and relationships

  • 39.3% of Missouri secondary schools taught students about gender roles and stereotypes in a required course in any of grades 6, 7, or 8.
  • 68.0% of Missouri secondary schools taught students about gender roles and stereotypes  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

  • 46.5% 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.

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