State Profiles

Current Requirement

• 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.

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.