California Health Youth Act: Reflections on Mandated Comprehensive Sexual Health Education

By: The Adolescent Sexual Health Policy Work Group

The California Healthy Youth Act (EC sections 51930–51939) took effect on January 1, 2016. If you’re not familiar, the law requires school districts to provide students with integrated, comprehensive, accurate, and inclusive comprehensive sexual health education and HIV prevention education, at least once in middle school and once in high school.

The California Healthy Youth Act (CHYA) updated the California Comprehensive Sexual Health and HIV Prevention Education Act of 2003 to provide clear guidance to local education authorities (LEAs) that had requested additional clarity and support for teaching comprehensive sexual health education. The law requires instruction on pregnancy (including prevention, prenatal care, and pregnancy options); sexually transmitted infections (STI) (including prevention, treatment, and the nature of HIV/AIDS); healthy relationships and threats to young people from adolescent relationship abuse and sex trafficking, sexual orientation, gender, including gender identity and the harm of negative gender stereotypes, young people’s health rights, and local healthcare resources.

Decades of public health research has demonstrated the importance of comprehensive sexual health education in preventing unintended pregnancy and STIs. Since over six million young people in California attend public school , classrooms are an ideal venue for providing them with the medically accurate information they need. Students miss valuable instruction when having to attend to reproductive health concerns that could have been avoided by practicing preventive health behaviors, which are addressed in CHYA-compliant instruction.

While the teen birth rate has decreased significantly over the last 25 years, California has seen an increase in the rate of STIs, underscoring the urgent need to ensure young people receive accurate, timely, complete information about sexual health and prevention strategies, including delaying the onset of sexual activity. Nationally, young people are at a higher risk than older adults for acquiring STIs, with 15-24 year-olds acquiring half of the estimated new 20 million STIs diagnosed each year according to the Centers for Disease Control and Prevention. Most STIs do not have obvious symptoms; when undetected and untreated, they can lead to increased risk for serious preventable health conditions, including potential infertility and HIV. A critical element of CHYA is educating students on the importance of STI testing and youth access to reproductive health care.

While schools represent a necessary venue for comprehensive sexual health education, CHYA also emphasizes the important role parents and guardians play in providing information and guidance to students when it comes to sexual health decision-making. CHYA encourages students to communicate with their parents, guardians and other trusted adults about human sexuality, recognizing that the knowledge and skills students learn in class are complemented by discussions at home about cultural, religious, and familial beliefs about sexuality. If parents or guardians do not want their students to participate in sexual health education in school, CHYA provides clear direction for how to opt out of instruction.

CHYA not only incorporates best practices in adolescent sexual health education from a broad public health research base; it also can be an integrated part of school districts’ Local Control Accountability Plan (LCAP). Of the eight California educational priorities, CHYA instruction addresses at least five of those priorities, directly or indirectly: implementation of state content standards, parent engagement, student engagement (graduation rates and chronic absenteeism), and school climate. School climate, in particular, is addressed by CHYA, thanks to a significant emphasis on inclusiveness for LGBTQ+ youth, communication skills, healthy relationships, and sexual safety. With the newly-released California School Dashboard, which includes school climate indicators, CHYA provides a valuable tool for schools.

Recognizing that every community is different, and to further help school districts comply with the law, ASHWG constituted an ad-hoc sub-committee to review the most commonly used curriculum for middle and high schools in California. The sub-committee was comprised of eight adolescent sexual health experts from the California Department of Education, California Department of Public Health, and nonprofit organizations from around the state. The sub-committee provided detailed feedback to all curriculum developers and posted the reviews of each curriculum here. This review process provides some assurance to LEAs that the reviewed curricula meet the extensive CHYA requirements. It also provides several options to school districts to find a sexual health curriculum that meets their local needs.

The passage of the California Healthy Youth Act was a critical first step in ensuring young people have access to the information and skills they need to protect their health and have positive, healthy relationships throughout their lifetime. However, it is only the first step. It’s essential to support parents and schools in their efforts to ensure that all young people have a safe place to learn and trusted adults to talk to. ASHWG looks forward to continuing to support parents and schools to implement effective, legally-compliant sexual health education and to share what works throughout the state and nationally.