State Profiles

Missouri’s Sex Education Snapshot

Advocates in Missouri have successfully made incremental advancements to Missouri’s sex education requirements and are now considering further efforts to revise the state’s current mandate. 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. Parkway School District and Lindbergh School District successfully amended their requirements to ensure students receive more comprehensive and inclusive instruction in 2016 and 2017 respectively, and two additional districts are currently in the process of updating their curriculum. Still, the patchwork nature of Missouri’s sex education curriculum requirements fail 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. Mandating 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. 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. 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 2020 state legislative session as well as bills that have been introduced thus far in 2021. 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, and HIV/AIDS, continue reading on to the “State Legislative Activity” section of Missouri’s profile.

2021 Legislative Session

House Bill 786 (pending): Aims 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.

2020 Legislative Session ​


House Bill 2200 (failed): Sought to require parents and guardians to provide their written consent for their children to participate in sex education.

Senate Bill 786 (failed): Sought to require any course materials related to sexual orientation or gender identity to be subject to the notice of parents and guardians and allow for their refusal, and removal of their children from such instruction.

House Bill 1565 (failed): Sought to clarify the ability of parents and guardians to remove their children from all or part of the district’s or school’s instruction relating to human sexuality or STDs.


More on sex ed in Missouri…


State Law

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. Attacks on the rights of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals, 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 2021 session convened on January 6, 2021. 

TitleDescriptionStatusLegislative Topic
House Bill 33 Prohibits medical professionals from providing gender affirming care to minors. Motion to Do Pass Failed(2021) Sexual Orientation and Gender Identity https://s3.amazonaws.com/fn-document-service/file-by-sha384/93cccd9338150bc7ba74c0271725dd6f7e0e10aa279692808479221404cd9069f94650dec6ea5b6bf13927ea0eaab637
House Bill 225 Requires schools to provide period products in the restrooms of each school at no charge to students. Died in the House Committee on Elementary and Secondary Education (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/ca8676fe37f98515e2a357a1868c931300f535d34f7192518ce12d03fcef65ed381f8e293c29590d100cd0866ca764b5
House Bill 468Prohibits "dismemberment" abortion. Died in the House Committee on Children and Families (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/3ba3cf8de35c5a29d1e182db738b9631031c0af52bba362af5870acc148fbbd07e84910ae36299b0d6f8bcbfbe611830
House Bill 786Requires parental notification if any curriculum, including sex education, includes instruction related to sexual orientation or gender identity and to make curriculum available for review.Died in the House Committee on Elementary and Secondary Education (2021) Sex Education https://s3.amazonaws.com/fn-document-service/file-by-sha384/f32fb63fe01fd175940d04a6a50e7dfada77449f0fc574c454f587e1726d3a5f9d456a825860bc6b200342f0dc733f61
House Bill 831Requires the state to protect a woman's right to terminate a pregnancy prior to viability of the fetus or if necessary to protect a woman's life or health. Died in the House Committee on Children and Families (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/a40e4e5aef25d12f5006bba2d5f139ce357007082078928e4ac7ce518cd75d7b5ecc62363bb6f6ce41ded5413225c051
House Bill 1269Prohibits health providers from engaging in conversion therapy with a minor. Died in the House Committee on Children and Families (2021) Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/fd9f9e496eb80929e395591ca7ba95791d4e03fd2611621481688dc2dfef636798024ca436f7d01de22062a9289cb24c
Senate Bill 207Prohibits mental health providers from engaging in conversion therapy with minors. Died in the Senate Committee on Professional Registration (2021) Sexual Orientation and Gender Identity https://s3.amazonaws.com/fn-document-service/file-by-sha384/0915aecc2dff1e9fba51e437851462350b37c515933264b8f59a4a3f50bfa29f1c7e06e169dc3e26b5a36fefe5f6cf2f
Senate Bill 391 Prohibits abortion, defining human life as beginning at conception and classifying the procedure as murder. Died in the Senate Committee on Health and Pensions Committee (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/0915aecc2dff1e9fba51e437851462350b37c515933264b8f59a4a3f50bfa29f1c7e06e169dc3e26b5a36fefe5f6cf2f
Senate Bill 442Prohibits medical professionals from providing gender affirming care to minors. Died in the Senate Committee on Seniors, Families, Veterans & Military Affairs (2021) Sexual Orientation and Gender Identity https://s3.amazonaws.com/fn-document-service/file-by-sha384/09ee31f1b99ba949d929f23c53b4fec527a5944e81b9933ab027032440f1cec658b8a0268cc2d822cc293f247912381a
Senate Bill 450Prohibits abortion once a fetal heartbeat is detected. Died in the Senate Committee on Health and Pensions (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/78b0dba6ab8298189bd271478e177bb5fa03c813c5b683667e224a9c71119119b1e40322cfaad2921904b997bc06057e
Senate Bill 458 Prohibits "dismemberment" abortion. Died in the Senate Committee on Health and Pensions (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/58e9bbaf6062aa33d24e46786feac92d78416a78424d203f36e6bbd57441a2878248160fa19241dc1339cba8d8281b2b
House Bill 1070Prohibits abortion except in the case of a medical emergency. Died in the House Children and Families Committee (2020)Reproductive Health Carehttps://s3.amazonaws.com/fn-document-service/file-by-sha384/fd2cce65eccb98765753fa62f6e6deeb6f0941cd9e15311c25ad4b5843b1c19a89ec1ef682831c002b325f7125997393
House Bill 964Prohibits abortion if a fetal heartbeat is detected except in the case of a medical emergency. Died in the House Children and Families Committee (2020)Reproductive Health Carehttps://s3.amazonaws.com/fn-document-service/file-by-sha384/4f85c170456c10b43f4405cb25d8ec61c478b02569843c7d99e90321059687b7109f764725cda7601c8af169a776dddb
House Bill 1565Clarifies the ability of parents and guardians to remove their children from all or part of the district’s or school’s instruction relating to human sexuality or STDs. Died in the House Committee on Elementary and secondary Education (2020)Sex Educationhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/e4497e1afe22e0a5e629e14733d6d7ae0d7491444d1b76b377e13718dad60d882e8bf959bccf9de7a93627216dbe602f
House Bill 1574Prohibits Missouri from denying the right to obtain an abortion and protects the right to terminate a pregnancy prior to viability or if necessary to protect the life or health of the pregnant person. Died in the House Committee on Children and Families (2020)Reproductive Health Carehttps://s3.amazonaws.com/fn-document-service/file-by-sha384/6cbf8c20fab8aecc207376411f2ca62571332bc0d6a71361ebbfd3bb06bda6c23728fe7197e7523ede2c307fa578ac2e
House Bill 1721Prohibits physicians and surgeons from providing gender affirming surgery or hormone therapy for a minor. Died in the House Committee on Judiciary (2020)Sexual Orientation and Gender Identity https://s3.amazonaws.com/fn-document-service/file-by-sha384/604d37d536bd5f22f9e96e3a87c8df66dac68d404baa670904f2a9d31a90d3e3e007792510be11f829faae1704596077
House Bill 2200Requires parents and guardians to provide their written consent for their children to participate in sex education. Died in the House Committee on Elementary and Secondary Education (2020)Sex Educationhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/ba0ff1483b101c796be9bffa6c842e8e52fc6fe36289b8ec78cd20050d03a6a0f4ce1ef7520e39da900f3974c3226a52
House Bill 2051Prohibits assisting, coercing, or providing a minor with gender affirming medical procedures or hormonal treatment.Died in the House Committee on Judiciary (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/008bfb265b95881841e40943618981c87b988789273421f98adab8f6cfe964016627013544092562f22ecdf7d679c17a
House Bill 2448Prohibits individuals from transporting a minor across state lines to obtain an abortion without the consent of the minor and a parent or guardian unless the minor is emancipated.Died in the House Committee on Children and Families (2020)Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/77535918a85aa5cdd66ca8c78b0b2afe92405deb3ed37085573958597361814014dbd50343a409e2352157b5b775a97c
House Bill 2718Requires students who attend public funded secondary schools and participate in athletics to participate in athletic contests organized for persons of the same "biological sex" included on the student's original birth certificate. Permits transgender students to participate in athletics aligned with their gender identity. Died in the House Committee on General Laws (2020)Sexual Orientation and Gender Identity https://s3.amazonaws.com/fn-document-service/file-by-sha384/0322fb0bb62547c3d81a44646b21298bdc92a53e2ae02f782be44d4dea5221553e3e98a974330794937d03b0c2fa0408
House Bill 2283Prohibits healthcare providers from performing conversion therapy on minors.Died in the House Committee on Children and Families (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/2457876128c0eff0f631d867646541b5e2f1685a198b4a8dc396791724e8dec1b2504d9eee62dd0f4e5134f6b1983b8c
House Bill 2285Prohibits abortion in all cases with no exceptions.Died in the House Committee on Children and Families (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/2457876128c0eff0f631d867646541b5e2f1685a198b4a8dc396791724e8dec1b2504d9eee62dd0f4e5134f6b1983b8c
House Joint Resolution 82Prohibits transgender athletes from competing in school athletics unless they join the team which correlates with their sex assigned at birth.Died in the House Committee on General Laws (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/05eac732df451a5be17b952c2e6810eb508317f64605a462e4deff87844c38299f6b2122ce24fd5521e58315082fb94d
Senate Bill 658Prohibits any licensed professional from engaging in conversion therapy with a minor. Died in Senate Professional Registration Committee (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/809341e90a66629d7748372e118fd819bd2a39f187eb15ed8429796d33e6b5faa2735850ec4c48ba73ed58d133d7c9dc
Senate Bill 786Requires any course materials related to sexual orientation or gender identity to be subject to the notice of parents and guardians and allow for their refusal, and removal of their children from such instruction.Died in the Senate Committee on Education (2020)Sex Educationhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/727f609a3820d8808e5957d7b915a9c06b4e5f8a28516dd41626785590ed566a66e20d8d3afc9689afb69f9191511f19
Senate Joint Resolution 50Prohibits transgender athletes from competing in school athletics unless they join the team which correlates with their sex assigned at birth.Died in the Senate Committee on Education (2020)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/c6e0fcee2c2241741e8724f2189f3695e8f2f6940e2c77efdb401ee2ec771b09653f017385534771b592fe5676312e2f

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.

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