State Profiles

North Carolina’s Sex Education Snapshot

North Carolina advocates have seen a steady increase in efforts to restrict sex education curriculum across the state in recent years. In light of the coronavirus pandemic, advocates report that the irregularity between virtual and in person learning has caused concern regarding the quality of sex education young people are receiving. Efforts are currently underway to advance sex education for youth in custody, but have been partially stalled due to the North Carolina Juvenile Justice system being focusing on coronavirus relief initiatives.

In 2019, the state legislature considered legislation to increase opportunities for parents to object to sex education being taught in schools and remove their children from instruction. These efforts include the recent attempt to pass House Bill 196, sponsored by Representative Michael Speciale, Representative Julia Howard, and Representative Larry Pittman. Had it been successful, this bill would implement an “opt-in” policy to require parents and guardians to provide written permission for their children to participate in sex education instruction. “Opt-in” requirements present an unnecessary barrier to receiving sex education. Similarly, Senate Bill 318, introduced by Senator Norman Sanderson, Senator Joyce Krawiec, and Senator Ralph Hise, sought to establish a 60-day notice for parents and guardians regarding sex education instruction materials in which parents can object to curriculum.

Opposition groups including the North Carolina Values Coalition and North Carolina Protect our Students have participated in fundraising and “get out the vote” efforts to restrict local and state sex education efforts since the passage of the Healthy Youth Act in 2009, which mandates medically accurate sex education. While the passage of this bill was a small step in the right direction, the Healthy Youth Act of 2009 contains glaring issues that need to be updated, including maintaining an emphasis on abstinence as the expected standard for young people and its failure to include instruction on consent.

As a result of their coordinated efforts to restrict sex education curriculum in schools, both Onslow County and Cumberland County rolled back their sex education programs in 2016 and 2018 respectively. Despite these significant setbacks, advocates are working tirelessly to advance sex education curriculum across the state. A coalition of advocates including Sexual Health Initiatives for Teens (SHIFT NC), NC Pediatric Society, NC Child, ACLU of NC, Planned Parenthood South Atlantic, and NC AIDS Action Network monitor legislation related to sex education and oppose attempts to roll back the Healthy Youth Act. Advocates are also working with the Department of Public Instruction and the Department of Health and Human Services to address opponents’ efforts to restrict sex education in North Carolina schools.

State law requires students in grades 7-9 to receive medically accurate sex education that includes instruction on abstinence, contraceptives, STD prevention, and sexual assault. Despite these mandates, advocates report that the sex education instruction is varied and unreliable. Instruction ranges from evidence-based curriculum to abstinence only or “sexual risk avoidance” programs–in direct violation of North Carolina statute. 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. In an attempt to address these gaps in education, organizations, including SHIFT NC, have trained teachers in school systems–serving more than 300,000 young people–on how to provide effective sex education.

When school districts lack resources to provide sex education instruction, they may turn to community partners to provide their expertise. While local health departments may provide satisfactory sex education curriculum, crisis pregnancy centers, (CPCs) are also invited into schools to provide abstinence only or “sexual risk avoidance” instruction. CPCs, also known as fake clinics, are invited into schools where they offer abstinence only or “sexual risk avoidance” programming. These centers provide false, manipulative information about abortion care. Unfortunately, crisis pregnancy centers have increasingly received federal funding to deliver abstinence-only instruction nationwide.

Advocates note that increased school accountability, culturally responsive instruction geared towards youth of color, inclusion of topics concerning sexual orientation and gender identity, and a defined comprehensive approach to teaching sex education must be implemented. Additionally, increased community support and an increased ability to address myths and concerns regarding comprehensive sex education is needed to advance sex education curriculum statewide. Right now, advocates can take action to ensure young people in their community have access to quality sex education. After contacting their  local education agencies (LEAs), 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.  While advocating for improved policies, it is also essential to raise awareness about the misinformation spread by those who oppose advancing sex education. Further, advocates can contact their representatives to ensure that the Healthy Youth Act stays intact, additional accountability measures are implemented, and that legislators work to advance requirements for sex education curriculum in North Carolina. 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

  • North Carolina schools are required to teach sex education. Curriculum must include instruction on pregnancy prevention, STDs, and HIV.
  • Curriculum is not required to be comprehensive.
  • Curriculum must explain the benefits of abstinence.
  • Curriculum is not required to include instruction on sexual orientation or gender identity. However, curriculum must teach that a faithful monogamous heterosexual marriage is the best lifelong means of avoiding STDs.
  • Curriculum is not required to include instruction on consent.
  • Parents and guardians must have the ability to either exempt their children from any portion of sex education instruction through written notification to the school principal or to give written permission for their children to participate in sex education instruction, depending on the school district. These are referred to as “opt-out” and “opt-in” policies, respectively.
  • Curriculum 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 North Carolina’s profile.

2021 Legislative Session

No bills have been introduced concerning sex education to date.

More on sex ed in North Carolina…


State Law

North Carolina General Statutes § 115C-81.25 and 115C-81.30 require schools to teach a comprehensive health education program, which includes instruction on the prevention of pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Schools must stress the importance of parental involvement and teach refusal skills and strategies to handle peer pressure. Comprehensive health education must include “reproductive health and safety education” beginning in seventh grade. Such instruction must teach “that abstinence from sexual activity outside of marriage is the expected standard for all school-age children” and “that a mutually faithful, monogamous, heterosexual relationship in the context of marriage is the best lifelong means of avoiding [STDs], including HIV/AIDS,” among other stipulations. With respect to contraception and family planning, the law requires instruction to teach:

  • “… how [STDs] are and are not transmitted, the effectiveness and safety of all federal Food and Drug Administration (FDA)-approved methods of reducing the risk of contracting [STDs], and information on local resources for testing and medical care for [STDs] …; and
  • The effectiveness and safety of all FDA-approved contraceptive methods in preventing pregnancy.”

The information included in reproductive health and safety education must be age-appropriate, objective, and based upon scientific research that is peer reviewed and accepted by professionals in the field of sexual health education. Students may receive information about where to obtain contraceptives and abortion referral services only in accordance with a local board’s policy regarding parental consent. Contraceptives, including condoms and other devices, shall not be made available or distributed on school property. Instruction must also teach “awareness of sexual assault, sexual abuse, and risk reduction” and focus on healthy relationships.

The State Board of Education shall make available a list of reviewed materials, any approved textbooks and other approved materials for discussion regarding pregnancy and STDs, including HIV prevention, to parents and legal guardians at least 60 days before such instruction is provided in the classroom.

North Carolina law also requires local school boards to “adopt policies to provide opportunities either for parents and legal guardians to consent or for parents and legal guardians to withhold their consent for the students’ participation in any or all of these programs.” These are referred to as “opt-in” and “opt-out” policies, respectively.

State Standards

The North Carolina Department of Public Instruction provides Healthful Living: Health Education Essential Standards, which offers model policies and content outlines. Essential standards in this guideline include the skill to “evaluate abstinence from sexual intercourse as a positive choice for young people” and to “create strategies that develop and maintain reproductive and sexual health,” such as “illustrat[ing] skills related to safe and effective use of methods to prevent STDs, as well as access resources for testing and treatment.”

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 health care services. Below are  highlights of current legislative activity related to these topics. North Carolina’s 2021 session convened January 13, 2021.

TitleDescriptionStatusLegislative Topic
House Bill 31Prohibits abortion after a fetal heartbeat is detected. Referred to the House Committee on Health (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/bfbef83b285f822aacf7ffc15a513c99da6e6f88b1d91ce40960ee256d9b4c666a893d4084e9e7d6f6cf484190e63ef2
House Bill 149 Prohibits telehealth from being used for any health care services related to abortion. Referred to the Senate Committee on Rules and Operations (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/5377ceaf80e6df6e2839269b85e1fd1c449ed1428dc1b3819c5a368dc1106ceb483f3228494fec6d07e5deb67cce29ef
House Bill 452Prohibits health providers from engaging in conversion therapy with minors. Referred to the House Committee on Rules, Calendar, and Operations (2021)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/5eb100dd8228398842e5800a25f8387b8f17b707369212821cef4c0011ac118f09c1001d08824566620c0f805a9933c3
House Bill 453Prohibits abortion based upon the presence or presumed presence of Down syndrome in the fetus. Vetoed (2021) Reproductive Health Care https://s3.amazonaws.com/fn-document-service/file-by-sha384/5f921e191aa6762df0f86b9e29e118e5ee984752776d142956dbc6e9311ee2ece0c1d2407b536180c31ba5a136804568
House Bill 450Adds sexual orientation and gender identity as protected classes from discrimination. Passed first reading in the House Committee on Rules, Calendar, and Operations (2021)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/da7cea490568edbb3cf2e928209272c2b3966c0294ad7fdcc48f9f9328659f86e111fa52af6bcaa4f1b8410cdc5ae947
Senate Bill 396Adds sexual orientation and gender identity as protected classes from discrimination. Referred to the Senate Committee on Rules and Operations (2021) Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/5a5d5c2883afbb09f5b668a20e23b51432d2aa398c5ab14b32a9c4524aca9782d9530a722b039cb13fc90e4978f390e6
Senate Bill 577Establishes the North Carolina Black Women and Girls Task Force to, among other goals, study the health and wealth disparities of Black women and their impact, review educational justice principles for Black girls and the impact of trauma to learning, and examine the effect of disparate health factors of Black girls and women.Re-referred to the Senate Committee on Appropriations on Base Budget. If favorable, re-referred to the Senate Committee on Rules and Operations (2021) Reproductive Health Care https://www.ncleg.gov/BillLookUp/2021/S577/True
Senate Bill 392Prohibits health providers from engaging in conversion therapy with minors. Referred to the Senate Committee on Rules and Operations (2021)Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/2e86384736f39343e1bd6a6cc247fe258581303aa9ab941e4bc727568e5c501e9b609e001012eb19af31f8f8444ad2d0
Senate Bill 514Prohibits health providers from providing gender affirming care to minors. Referred to the Senate Committee on Rules and Operations (2021) Sexual Orientation and Gender Identityhttps://s3.amazonaws.com/fn-document-service/file-by-sha384/3cbeb69f8a85d443359ae0ca3c3ee44ded253ead6d9fca683749821b77dd76077cdcd04b90ceb76a3f52b80bf2ef642a

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 North Carolina’s Youth Risk Behavior Survey (YRBS) results, click here.

North Carolina 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 (state) as reported for the 2017–2018 school year.

Reported teaching all 20 critical sexual health education topics

  • 31.6% of North Carolina secondary schools taught students all 20 critical sexual health education topics in a required course in any of grades 6, 7, or 8.
  • 42.8% of North Carolina 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

  • 85.8% of North Carolina secondary schools taught students about the benefits of being sexually abstinent in a required course in any of grades 6, 7, or 8.
  • 92.4% of North Carolina 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

  • 79.3% of North Carolina 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.
  • 87.6% of North Carolina 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

  • 84.0% of North Carolina 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.
  • 91.5% of North Carolina 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

  • 73.7% of North Carolina 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.
  • 85.3% of North Carolina 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

  • 56.0% of North Carolina secondary schools taught students how to correctly use a condom in a required course in any of grades 6, 7, or 8.
  • 56.0% of North Carolina 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

  • 74.3% of North Carolina secondary schools taught students about methods of contraception other than condoms in a required course in any of grades 6, 7, or 8.
  • 80.9% of North Carolina 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

  • 41.1 % of North Carolina secondary schools taught students about sexual orientation in a required course in any of grades 6, 7, or 8.
  • 57.8% of North Carolina 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

  • 43.6% of North Carolina secondary schools taught students about gender roles, gender identity, or gender expression in a required course in any of grades 6, 7, or 8.
  • 59.6% of North Carolina 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

  • 40.3% of North Carolina 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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