State Profiles

Current Requirement

• Missouri schools are not required to teach sex education. However, they are required to teach health education, including HIV/AIDS prevention education.
  • If sex education is offered, curriculum must present abstinence as the preferred choice of behavior.
  • If sex education is offered, curricula must teach about contraceptives within a curriculum that promotes abstinence.  
• All course materials related to HIV/AIDS, along with sex education curriculum if offered, must be medically accurate.

• 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. 
• Schools are required to provide trauma-informed, developmentally appropriate sexual abuse training to students in 6th grade and up.
• Parents and guardians can remove their children from any part of their sex education instruction. This is referred to as an “opt-out” policy.

RECENT LEGISLATION SHAPING THE STATE LANDSCAPE

Advocates in Missouri have successfully made incremental advancements to Missouri’s sex education requirements in the past several  years, particularly by expanding curriculum to include instruction on sexual harassment, sexual violence, and consent in 2018 through House Bill 1606.  Further efforts to revise the state’s current mandate have been attempted, in 2022 HB 2591 would have provided free menstrual products in public and charter schools and repeal the current statute that prevents abortion providers from teaching on human sexuality or sexually transmitted infections. There have been numerous other attempts to provide free menstrual products in public schools and ban conversion therapy on minors. Despite these efforts, advocates are forced to focus their efforts combating attempts to codify sweeping “parental rights,” outlaw diversity, equity, and inclusion (DEI) initiatives in public schools, and restrict access to abortion and gender affirming care for minors.

Year after year, legislation is introduced in Missouri under the guise of “parental rights”. In 2021, House Bill 786 specifically targeted “parental rights” related to human sexuality instruction and had it not died would have required schools to notify parents if any curriculum, sex ed or otherwise, includes instruction on sexual orientation or gender identity and remind parents of their right to remove the student from the instruction as well as make the materials available for public inspection. These bills force advocates to continuously push back against legislation that, under the misleading banner of ‘parental rights,’ undermines inclusive education, stigmatizes LGBTQIA+ students, and creates hostile environments for teachers and schools striving to serve all students equitably. During the following session Missouri legislators unsuccessfully attempted to pass the “Parents Bill of Rights Act of 2022” which would have made sweeping requirements to notify parents about instruction content, teacher and speakers, individuals and organizations that have contracts with the school, any collection/transmission of their child’s data, and other assertions of parents rights to intervene and direct their child’s education. In 2023, lawmakers attempted to replicate their 2022 attempt by introducing the “Parental Bill of Rights Act of 2023”, “The Parents’ Bill of Rights for Student Well Being”, and the “Empowering Missouri Parents Act” all of which were unsuccessful. More attempts were made to allow parents access to instructional materials in 2024 through Senate Bill 728, House Bill 1739, and Senate Bill 1203 but were again unsuccessful. During the 2025 session, lawmakers are attempting to use a new tactic to advance parents’ rights as well as outlaw diversity, equity, and inclusion initiatives and any instruction on Critical Race Theory, Senate Joint Resolution 6 and House Joint Resolution 81 propose a constitutional amendment. Passage would require approval by both legislative chambers before being placed on a statewide ballot for voter approval. Despite repeated failures, these efforts persist in Missouri.

Over the last several years, Missouri has also gained national notoriety for its attacks on LGBTQIA+ individuals, especially transgender and gender non-conforming youth. Beginning with attacks on school sports, like 2022’s Senate Bill 781 titled the “Save Women’s Sports Act,” these bills target transgender students and attempt to conflate safety concerns and protection of women and girls to exclude trans youth from participating in school sports. These attempts were successful during the 2023 legislative session when Senate Bill 39, which ‘prohibits a private school, public school district, public charter school, or public or private institution of postsecondary education from allowing any student to compete in an athletic competition that is designated for the biological sex opposite to the student’s biological sex as stated on the student’s official birth certificate’, passed and was signed into law. During the 2023 legislative session, the ‘Missouri Save Adolescents from Experimentation (SAFE) Act’ was also enacted and prohibits health care providers from performing gender transition surgeries on minors nor prescribing HRT or puberty blockers for new minor patients. Legislation like this creates a hostility in the state towards LGBTQIA+ youth and with an abysmal three percent of Missouri students report receiving LGBTQIA+-inclusive sex education, according to GLSEN’s 2019 National School Climate Survey, there is an uphill fight for advocates in the state when it comes to inclusion.  

Advocates in Missouri have been pushing for legislation to require free menstrual products in public schools for years with little success. In 2023, had it passed, House Bill 950 would have required school districts to provide free period products as well as repealing Missouri’s ban on abortion service providers teaching sex education in schools. This bill is similar to House Bill 2422  and House Bill 2370, which were introduced in 2024 but unfortunately failed. During the 2025 legislative session, there have been multiple progressive attempts to provide free menstrual products in schools- Senate Bill 342 would mandate all public, private, and charter schools to provide at least one type of ‘feminine hygiene product’ in each school building and House Bill 429 which seeks to require free period products in the bathrooms of all 6 – 12th grade bathrooms. Additionally, this bill seeks to remove current statute language that bars abortion providers from providing sex education in schools. Lacking access to menstrual products is defined as period poverty, which research links to poor education, missed days, urinary tract infections, and depression. Providing these products for free at school would help to reduce period poverty in Missouri and reduce period stigma.

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 attacks on sex education comes through attempting to require disinformation in instruction. House Bill 461 introduced in 2025, seeks to require a 3-minute ultrasound video from early fetal development and a “Meet Baby Olivia” video created by the anti-abortion extremist group LiveAction. Advocates successfully defeated similar “Baby Olivia” legislation in 2024, but these regressive attempts have been a national trend. 

Right now, advocates can take action to ensure young people in their community have access to quality sex education. Particularly, advocates can invest in local school board races to elect strong advocates who support sex education. Advocates can also contact their local school board to determine what topics are missing from sex education instruction, such as instruction on healthy relationships, sexual orientation and gender identity, and menstrual health education. They can then vocalize the important need for advancing instruction requirements in their community or push for a state mandate of sex education. Advocates are encouraged to take action on pending legislation that seeks to advance or restrict the principles of sex education. Missouri’s 2025 legislative session convened January 8th, 2025, and adjourns May 30th, 2025.

Further, advocates can contact their representatives to discuss the critical need for a statewide sex education mandate. Advocates are encouraged to use the SIECUS Community Action Toolkit to guide local efforts to advance sex education. For more information on getting involved in local and state advocacy for sex education, reach out to our State Policy Action Manager, Miranda Estes (mestes@siecus.org)

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 referrals to 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.

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.

State Standards

While Missouri does not have or require state standards to be followed, the Missouri Department of Elementary and Secondary Education has released Health Education Grade Level Expectations (GLE’s). These expectations represent content that Missouri students are expected to know at each grade level. Content standards outlined are: reproductive system, adolescent health issues and sexually transmitted infections, HIV/AIDS prevention education, abstinence, and teen pregnancy prevention behaviors.

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. In recent years, there has been an increase in legislative attacks on the implementation of CDC’s Youth Risk Behavior Survey (YRBS) which tracks six categories of health risk behaviors including sexual health behaviors. To learn more about Missouri’s 2023 YRBS results, click here.

Missouri School Health Profiles Data 

In 2024, the Centers for Disease Control and Prevention (CDC) released the 2022 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. To view Missouri’s results from the 2022 School Health Profiles Survey, visit CDC’s School Health Profiles Explorer tool.

Visit the CDC’s School Health Profiles 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.