II 

116TH CONGRESS 

1ST SESSION S. 1524 

To provide for the overall health and well-being of young people, including 

the promotion of lifelong sexual health and healthy relationships, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MAY 16, 2019 

Mr. BOOKER (for himself, Ms. HIRONO, Mr. BROWN, Mr. MURPHY, Ms. 

SMITH, Mr. MENENDEZ, Mr. BLUMENTHAL, Ms. WARREN, Ms. BALDWIN, Mr. MARKEY, Ms. DUCKWORTH, and Mrs. GILLIBRAND) introduced 

the following bill; which was read twice and referred to the Committee 

on Health, Education, Labor, and Pensions 

A BILL 

To provide for the overall health and well-being of young 

people, including the promotion of lifelong sexual health 

and healthy relationships, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Real Education for 

5 Healthy Youth Act of 2019’’. 


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1 SEC. 2. PURPOSES; FINDING; SENSE OF CONGRESS. 

2 (a) PURPOSES.—The purposes of this Act are to pro3 vide young people with comprehensive sex education pro4 grams that— 

5 (1) promote and uphold the rights of young 

6 people to information in order to make healthy deci7 sions about their sexual health; 

8 (2) provide the information and skills all young 

9 people need to make informed, responsible, and 

10 healthy decisions in order to become sexually healthy 

11 adults and have healthy relationships; 

12 (3) provide information about the prevention of 

13 unintended pregnancy, sexually transmitted infec14 tions, including HIV, dating violence, sexual assault, 

15 bullying, and harassment; and 

16 (4) provide resources and information on topics 

17 ranging from gender stereotyping and gender roles 

18 and stigma and socio-cultural influences surrounding 

19 sex and sexuality. 

20 (b) FINDING ON REQUIRED RESOURCES.—In order 

21 to provide the comprehensive sex education described in 

22 subsection (a), Congress finds that increased resources are 

23 required for sex education programs that— 

24 (1) substantially incorporate elements of evi25 dence-based programs or characteristics of effective 

26 programs; 


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1 (2) cover a broad range of topics, including 

2 medically accurate and complete information that is 

3 age and developmentally appropriate about all the 

4 aspects of sex, sexual health, and sexuality; 

5 (3) are gender and gender identity-sensitive, 

6 emphasizing the importance of equality and the so7 cial environment for achieving sexual and reproduc8 tive health and overall well-being; 

9 (4) promote educational achievement, critical 

10 thinking, decision making, self-esteem, and self-effi11 cacy; 

12 (5) help develop healthy attitudes and insights 

13 necessary for understanding relationships between 

14 oneself and others and society; 

15 (6) foster leadership skills and community en16 gagement by— 

17 (A) promoting principles of fairness, 

18 human dignity, and respect; and 

19 (B) engaging young people as partners in 

20 their communities; and 

21 (7) are culturally and linguistically appropriate, 

22 reflecting the diverse circumstances and realities of 

23 young people. 

24 (c) SENSE OF CONGRESS.—It is the sense of Con25 gress that— 


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1 (1) federally funded sex education programs 

2 should aim to— 

3 (A) provide information about a range of 

4 human sexuality topics, including— 

5 (i) human development, healthy rela6 tionships, personal skills; 

7 (ii) sexual behavior including absti8 nence; 

9 (iii) sexual health including preventing 

10 unintended pregnancy; 

11 (iv) sexually transmitted infections in12 cluding HIV; and 

13 (v) society and culture; 

14 (B) promote safe and healthy relation15 ships; 

16 (C) promote gender equity; 

17 (D) use, and be informed by, the best sci18 entific information available; 

19 (E) be culturally appropriate and inclusive 

20 of youth with varying gender identities, gender 

21 expressions, and sexual orientations; 

22 (F) be built on characteristics of effective 

23 programs; 


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1 (G) expand the existing body of research 

2 on comprehensive sex education programs 

3 through program evaluation; 

4 (H) expand training programs for teachers 

5 of comprehensive sex education; 

6 (I) build on programs funded under section 

7 513 of the Social Security Act (42 U.S.C. 713) 

8 and the Office of Adolescent Health’s Teen 

9 Pregnancy Prevention Program, funded under 

10 title II of the Consolidated Appropriations Act, 

11 2010 (Public Law 111–117; 123 Stat. 3253), 

12 and on programs supported through the Cen13 ters for Disease Control and Prevention (CDC); 

14 and 

15 (J) promote and uphold the rights of 

16 young people to information in order to make 

17 healthy and autonomous decisions about their 

18 sexual health; and 

19 (2) no Federal funds should be used for health 

20 education programs that— 

21 (A) withhold health-promoting or life-sav22 ing information about sexuality-related topics, 

23 including HIV; 

24 (B) are medically inaccurate or have been 

25 scientifically shown to be ineffective; 


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1 (C) promote gender or racial stereotypes; 

2 (D) are insensitive and unresponsive to the 

3 needs of sexually active young people; 

4 (E) are insensitive and unresponsive to the 

5 needs of survivors of sexual violence; 

6 (F) are insensitive and unresponsive to the 

7 needs of youth of all physical, developmental, 

8 and mental abilities; 

9 (G) are insensitive and unresponsive to the 

10 needs of youth with varying gender identities, 

11 gender expressions, and sexual orientations; or 

12 (H) are inconsistent with the ethical im13 peratives of medicine and public health. 

14 SEC. 3. GRANTS FOR COMPREHENSIVE SEX EDUCATION 

15 FOR ADOLESCENTS. 

16 (a) PROGRAM AUTHORIZED.—The Secretary, in co17 ordination with the Associate Commissioner of the Family 

18 and Youth Services Bureau of the Administration on Chil19 dren, Youth, and Families of the Department of Health 

20 and Human Services, the Director of the Office of Adoles21 cent Health, the Director of the Division of Adolescent 

22 and School Health within the Centers for Disease Control 

23 and Prevention and the Secretary of Education, shall 

24 award grants, on a competitive basis, to eligible entities 

25 to enable such eligible entities to carry out programs that 


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1 provide adolescents with comprehensive sex education, as 

2 described in subsection (f). 

3 (b) DURATION.—Grants awarded under this section 

4 shall be for a period of 5 years. 

5 (c) ELIGIBLE ENTITY.—In this section, the term ‘‘el6 igible entity’’ means a public or private entity that focuses 

7 on adolescent health and education or has experience 

8 working with adolescents. 

9 (d) APPLICATIONS.—An eligible entity desiring a 

10 grant under this section shall submit an application to the 

11 Secretary at such time, in such manner, and containing 

12 such information as the Secretary may require, including 

13 an assurance to participate in the evaluation described in 

14 section 6. 

15 (e) PRIORITY.—In awarding grants under this sec16 tion, the Secretary shall give priority to eligible entities 

17 that— 

18 (1) are State or local public entities; 

19 (2) are entities not currently receiving funds 

20 under— 

21 (A) section 513 of the Social Security Act 

22 (42 U.S.C. 713); 

23 (B) the Office of Adolescent Health’s Teen 

24 Pregnancy Prevention Program, funded under 

25 title II of the Consolidated Appropriations Act, 


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1 2010 (Public Law 111–117; 123 Stat. 3253), 

2 or any substantially similar successive program; 

3 or 

4 (C) the Centers for Disease Control and 

5 Prevention’s Division of Adolescent and School 

6 Health; and 

7 (3) address health inequities among young peo8 ple that face systemic barriers resulting in dis9 proportionate rates of not less than one of the fol10 lowing: 

11 (A) Unintended pregnancies. 

12 (B) Sexually transmitted infections, includ13 ing HIV. 

14 (C) Dating violence and sexual violence. 

15 (f) USE OF FUNDS.— 

16 (1) IN GENERAL.—Each eligible entity that re17 ceives a grant under this section shall use the grant 

18 funds to carry out an education program that pro19 vides adolescents with comprehensive sex education 

20 that— 

21 (A) is age and developmentally appro22 priate; 

23 (B) is medically accurate and complete; 

24 (C) substantially incorporates elements of 

25 evidence-based sex education instruction; or 


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1 (D) creates a demonstration project based 

2 on characteristics of effective programs. 

3 (2) CONTENTS OF COMPREHENSIVE SEX EDU4 CATION PROGRAMS.—The comprehensive sex edu5 cation programs funded under this section shall in6 clude instruction and materials that address— 

7 (A) the physical, social, and emotional 

8 changes of human development including, 

9 human anatomy, reproduction, and sexual de10 velopment; 

11 (B) healthy relationships, including friend12 ships, within families, and society, that are 

13 based on mutual respect, and the ability to dis14 tinguish between healthy and unhealthy rela15 tionships, including— 

16 (i) effective communication, negotia17 tion and refusal skills, including the skills 

18 to recognize and report inappropriate or 

19 abusive sexual advances; 

20 (ii) bodily autonomy, setting and re21 specting personal boundaries, practicing 

22 personal safety, and consent; and 

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1 lying, harassment, and intimidation in re2 lationships; 

3 (C) healthy decision making skills about 

4 sexuality and relationships that include— 

5 (i) critical thinking, problem solving, 

6 self-efficacy, stress-management, self-care, 

7 and decision making; 

8 (ii) individual values and attitudes; 

9 (iii) the promotion of positive body 

10 images; 

11 (iv) developing an understanding that 

12 there are a range of body types and en13 couraging positive feeling about students’ 

14 own body types; 

15 (v) information on how to respect oth16 ers and ensure safety on the internet and 

17 when using other forms of digital commu18 nication; 

19 (vi) information on local services and 

20 resources where students can obtain addi21 tional information related to bullying, har22 assment, dating violence and sexual as23 sault, suicide prevention, and other related 

24 care; 


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1 (vii) encouragement for youth to com2 municate with their parents or guardians, 

3 health and social service professionals, and 

4 other trusted adults about sexuality and 

5 intimate relationships; 

6 (viii) information on how to create a 

7 safe environment for all students and oth8 ers in society; 

9 (ix) examples of varying types of rela10 tionships, couples, and family structures; 

11 and 

12 (x) affirmative representation of vary13 ing gender identities, gender expressions, 

14 and sexual orientations, including individ15 uals and relationships between same sex 

16 couples and their families; 

17 (D) abstinence, delaying age of first sexual 

18 activity, the use of condoms, preventive medica19 tion, vaccination, birth control, and other sexu20 ally transmitted infection prevention measures, 

21 and the options for pregnancy, including par22 enting, adoption, and abortion including— 

23 (i) the importance of effectively using 

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1 cable vaccinations to protect against sexu2 ally transmitted infections, including HIV; 

3 (ii) the benefits of effective contracep4 tive and condom use in avoiding unin5 tended pregnancy; 

6 (iii) the relationship between sub7 stance use and sexual health and behav8 iors; and 

9 (iv) information about local health 

10 services where students can obtain addi11 tional information and services related to 

12 sexual and reproductive health and other 

13 related care; 

14 (E) through affirmative recognition, the 

15 roles that traditions, values, religion, norms, 

16 gender roles, acculturation, family structure, 

17 health beliefs, and political power play in how 

18 students make decisions that affect their sexual 

19 health, using examples of various types of races, 

20 ethnicities, cultures, and families, including sin21 gle-parent households and young families; 

22 (F) information about gender identity, 

23 gender expression, and sexual orientation for all 

24 students, including— 


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1 (i) affirmative recognition that people 

2 have different gender identities, gender ex3 pressions, and sexual orientations; and 

4 (ii) community resources that can pro5 vide additional support for individuals with 

6 varying gender identities, gender expres7 sions, and sexual orientations; and 

8 (G) opportunities to explore the roles that 

9 race, ethnicity, immigration status, disability 

10 status, economic status, homelessness, foster 

11 care status, and language within different com12 munities affect sexual attitudes in society and 

13 culture and how this may impact student sexual 

14 health. 

15 SEC. 4. GRANTS FOR COMPREHENSIVE SEX EDUCATION AT 

16 INSTITUTIONS OF HIGHER EDUCATION. 

17 (a) PROGRAM AUTHORIZED.—The Secretary, in co18 ordination with the Secretary of Education, shall award 

19 grants, on a competitive basis, to institutions of higher 

20 education or consortia of such institutions to enable such 

21 institutions to provide young people with comprehensive 

22 sex education, described in subsection (e)(2). 

23 (b) DURATION.—Grants awarded under this section 

24 shall be for a period of 5 years. 


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1 (c) APPLICATIONS.—An institution of higher edu2 cation or consortia of such institutions desiring a grant 

3 under this section shall submit an application to the Sec4 retary at such time, in such manner, and containing such 

5 information as the Secretary may require, including an as6 surance to participate in the evaluation described in sec7 tion 6. 

8 (d) PRIORITY.—In awarding grants under this sec9 tion, the Secretary shall give priority to an institution of 

10 higher education that— 

11 (1) has an enrollment of needy students as de12 fined in section 318(b) of the Higher Education Act 

13 of 1965 (20 U.S.C. 1059e(b)); 

14 (2) is a Hispanic-serving institution, as defined 

15 in section 502(a) of such Act (20 U.S.C. 1101a(a)); 

16 (3) is a Tribal College or University, as defined 

17 in section 316(b) of such Act (20 U.S.C. 1059c(b)); 

18 (4) is an Alaska Native-serving institution, as 

19 defined in section 317(b) of such Act (20 U.S.C. 

20 1059d(b)); 

21 (5) is a Native Hawaiian-serving institution, as 

22 defined in section 317(b) of such Act (20 U.S.C. 

23 1059d(b)); 


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1 (6) is a Predominately Black Institution, as de2 fined in section 318(b) of such Act (20 U.S.C. 

3 1059e(b)); 

4 (7) is a Native American-serving, nontribal in5 stitution, as defined in section 319(b) of such Act 

6 (20 U.S.C. 1059f(b)); 

7 (8) is an Asian American and Native American 

8 Pacific Islander-serving institution, as defined in 

9 section 320(b) of such Act (20 U.S.C. 1059g(b)); or 

10 (9) is a minority institution, as defined in sec11 tion 365 of such Act (20 U.S.C. 1067k), with an en12 rollment of needy students, as defined in section 312 

13 of such Act (20 U.S.C. 1058). 

14 (e) USES OF FUNDS.— 

15 (1) IN GENERAL.—An institution of higher edu16 cation receiving a grant under this section shall use 

17 grant funds to integrate issues relating to com18 prehensive sex education into institution of higher 

19 education in order to reach a large number of stu20 dents, by carrying out one or more of the following 

21 activities: 

22 (A) Developing or adopting educational 

23 content for issues relating to comprehensive sex 

24 education that will be incorporated into student 

25 orientation, general education, or core courses. 


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1 (B) Developing or adopting, and imple2 menting schoolwide educational programming 

3 outside of class that delivers elements of com4 prehensive sex education programs to students, 

5 faculty, and staff. 

6 (C) Developing or adopting innovative 

7 technology-based approaches to deliver sex edu8 cation to students, faculty, and staff. 

9 (D) Developing or adopting, and imple10 menting peer-outreach and education programs 

11 to generate discussion, educate, and raise 

12 awareness among students about issues relating 

13 to comprehensive sex education. 

14 (2) CONTENTS OF SEX EDUCATION PRO15 GRAMS.—Each institution of higher education’s pro16 gram of comprehensive sex education funded under 

17 this section shall include instruction and materials 

18 that address the requirements under section 3(f). 

19 SEC. 5. GRANTS FOR PRE-SERVICE AND IN-SERVICE TEACH20 ER TRAINING. 

21 (a) PROGRAM AUTHORIZED.—The Secretary, in co22 ordination with the Director of the Centers for Disease 

23 Control and Prevention and the Secretary of Education, 

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1 ties to enable such eligible entities to carry out the activi2 ties described in subsection (e). 

3 (b) DURATION.—Grants awarded under this section 

4 shall be for a period of 5 years. 

5 (c) ELIGIBLE ENTITY.—In this section, the term ‘‘el6 igible entity’’ means— 

7 (1) a State or local educational agency; 

8 (2) a State or local department of health; 

9 (3) a tribe or tribal organization, as defined in 

10 section 4 of the Indian Self-Determination and Edu11 cation Assistance Act (25 U.S.C. 5304); 

12 (4) an educational service agency; 

13 (5) a nonprofit institution of higher education; 

14 (6) a national or statewide nonprofit organiza15 tion that has as its primary purpose the improve16 ment of provision of comprehensive sex education 

17 through training and effective teaching of com18 prehensive sex education; or 

19 (7) a consortium of nonprofit organizations that 

20 has as its primary purpose the improvement of pro21 vision of comprehensive sex education through train22 ing and effective teaching of comprehensive sex edu23 cation. 

24 (d) APPLICATION.—An eligible entity desiring a 

25 grant under this section shall submit an application to the 


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1 Secretary at such time, in such manner, and containing 

2 such information as the Secretary may require, including 

3 an assurance to participate in the evaluation described in 

4 section 6. 

5 (e) AUTHORIZED ACTIVITIES.— 

6 (1) REQUIRED ACTIVITY.—Each eligible entity 

7 receiving a grant under this section shall use grant 

8 funds for professional development and training of 

9 relevant faculty, school administrators, teachers, and 

10 staff, in order to increase effective teaching of com11 prehensive sex education students. 

12 (2) PERMISSIBLE ACTIVITIES.—Each eligible 

13 entity receiving a grant under this section may use 

14 grant funds to— 

15 (A) provide research-based training of 

16 teachers for comprehensive sex education for 

17 adolescents as a means of broadening student 

18 knowledge about issues related to human devel19 opment, healthy relationships, personal skills, 

20 and sexual behavior, including abstinence, sex21 ual health, and society and culture; 

22 (B) support the dissemination of informa23 tion on effective practices and research findings 

24 concerning the teaching of comprehensive sex 

25 education; 


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1 (C) support research on— 

2 (i) effective comprehensive sex edu3 cation teaching practices; and 

4 (ii) the development of assessment in5 struments and strategies to document— 

6 (I) student understanding of 

7 comprehensive sex education; and 

8 (II) the effects of comprehensive 

9 sex education; 

10 (D) convene national conferences on com11 prehensive sex education, in order to effectively 

12 train teachers in the provision of comprehensive 

13 sex education; and 

14 (E) develop and disseminate appropriate 

15 research-based materials to foster comprehen16 sive sex education. 

17 (3) SUBGRANTS.—Each eligible entity receiving 

18 a grant under this section may award subgrants to 

19 nonprofit organizations that possess a demonstrated 

20 record of providing training to faculty, school admin21 istrators, teachers, and staff on comprehensive sex 

22 education to— 

23 (A) train teachers in comprehensive sex 

24 education; 


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1 (B) support internet or distance learning 

2 related to comprehensive sex education; 

3 (C) promote rigorous academic standards 

4 and assessment techniques to guide and meas5 ure student performance in comprehensive sex 

6 education; 

7 (D) encourage replication of best practices 

8 and model programs to promote comprehensive 

9 sex education; 

10 (E) develop and disseminate effective, re11 search-based comprehensive sex education 

12 learning materials; 

13 (F) develop academic courses on the peda14 gogy of sex education at institutions of higher 

15 education; or 

16 (G) convene State-based conferences to 

17 train teachers in comprehensive sex education 

18 and to identify strategies for improvement. 

19 SEC. 6. IMPACT EVALUATION AND REPORTING. 

20 (a) MULTI-YEAR EVALUATION.— 

21 (1) IN GENERAL.—Not later than 6 months 

22 after the date of the enactment of this Act, the Sec23 retary shall enter into a contract with a nonprofit 

24 organization with experience in conducting impact 

25 evaluations, to conduct a multi-year evaluation on 


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1 the impact of the grants under sections 3, 4, and 5, 

2 and to report to Congress and the Secretary on the 

3 findings of such evaluation. 

4 (2) EVALUATION.—The evaluation conducted 

5 under this subsection shall— 

6 (A) be conducted in a manner consistent 

7 with relevant, nationally recognized professional 

8 and technical evaluation standards; 

9 (B) use sound statistical methods and 

10 techniques relating to the behavioral sciences, 

11 including quasi-experimental designs, inferential 

12 statistics, and other methodologies and tech13 niques that allow for conclusions to be reached; 

14 (C) be carried out by an independent orga15 nization that has not received a grant under 

16 sections 3, 4, or 5; and 

17 (D) be designed to provide information 

18 on— 

19 (i) output measures, such as the num20 ber of individuals served under the grant 

21 and the number of hours of instruction; 

22 (ii) outcome measures, including 

23 measures relating to— 

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1 gram have gained in each of the fol2 lowing age and developmentally appro3 priate areas— 

4 (aa) growth and develop5 ment; 

6 (bb) relationship dynamics; 

7 (cc) ways to prevent unin8 tended pregnancy and sexually 

9 transmitted infections, including 

10 HIV; and 

11 (dd) sexual health; 

12 (II) the age and developmentally 

13 appropriate skills that individuals par14 ticipating in the grant program have 

15 gained regarding— 

16 (aa) negotiation and commu17 nication; 

18 (bb) decision making and 

19 goal-setting; 

20 (cc) interpersonal skills and 

21 healthy relationships; and 

22 (dd) condom use; and 

23 (III) the behaviors of adolescents 

24 participating in the grant program, 

25 including data about— 


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1 (aa) age of first intercourse; 

2 (bb) condom and contracep3 tive use at first intercourse; 

4 (cc) recent condom and con5 traceptive use; 

6 (dd) substance use; 

7 (ee) dating abuse and life8 time history of sexual assault, 

9 dating violence, bullying, harass10 ment, stalking; and 

11 (ff) academic performance; 

12 and 

13 (iii) other measures necessary to 

14 evaluate the impact of the grant program. 

15 (3) REPORT.—Not later than 6 years after the 

16 date of enactment of this Act, the organization con17 ducting the evaluation under this subsection shall 

18 prepare and submit to the appropriate committees of 

19 Congress and the Secretary an evaluation report. 

20 Such report shall be made publicly available, includ21 ing on the website of the Department of Health and 

22 Human Services. 

23 (b) SECRETARY’S REPORT TO CONGRESS.—Not later 

24 than 1 year after the date of the enactment of this Act, 

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1 retary shall prepare and submit to the appropriate com2 mittees of Congress a report on the activities to provide 

3 adolescents and young people with comprehensive sex edu4 cation and pre-service and in-service teacher training 

5 funded under this Act. The Secretary’s report to Congress 

6 shall include— 

7 (1) a statement of how grants awarded by the 

8 Secretary meet the purposes described in section 

9 2(a); and 

10 (2) information about— 

11 (A) the number of eligible entities and in12 stitutions of higher education that are receiving 

13 grant funds under sections 3, 4, and 5; 

14 (B) the specific activities supported by 

15 grant funds awarded under sections 3, 4, and 

16 5; 

17 (C) the number of adolescents served by 

18 grant programs funded under section 3; 

19 (D) the number of young people served by 

20 grant programs funded under section 4; 

21 (E) the number of faculty, school adminis22 trators, teachers, and staff trained under sec23 tion 5; and 

24 (F) the status of the evaluation required 

25 under subsection (a). 


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1 SEC. 7. NONDISCRIMINATION. 

2 Programs funded under this Act shall not discrimi3 nate on the basis of actual or perceived sex, race, color, 

4 ethnicity, national origin, disability, sexual orientation, 

5 gender identity, or religion. Nothing in this Act shall be 

6 construed to invalidate or limit rights, remedies, proce7 dures, or legal standards available under any other Fed8 eral law or any law of a State or a political subdivision 

9 of a State, including the Civil Rights Act of 1964 (42 

10 U.S.C. 2000a et seq.), title IX of the Education Amend11 ments of 1972 (20 U.S.C. 1681 et seq.), section 504 of 

12 the Rehabilitation Act of 1973 (29 U.S.C. 794), the Amer13 icans with Disabilities Act of 1990 (42 U.S.C. 12101 et 

14 seq.), and section 1557 of the Patient Protection and Af15 fordable Care Act (42 U.S.C. 18116). 

16 SEC. 8. LIMITATION. 

17 No Federal funds provided under this Act may be 

18 used for health education programs that— 

19 (1) withhold health-promoting or life-saving in20 formation about sexuality-related topics, including 

21 HIV; 

22 (2) are medically inaccurate or have been sci23 entifically shown to be ineffective; 

24 (3) promote gender or racial stereotypes; 

25 (4) are insensitive and unresponsive to the 

26 needs of sexually active young people; 


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1 (5) are insensitive and unresponsive to the 

2 needs of pregnant or parenting young people; 

3 (6) are insensitive and unresponsive to the 

4 needs of survivors of sexual abuse or assault; 

5 (7) are insensitive and unresponsive to the 

6 needs of youth of all physical, developmental, or 

7 mental abilities; 

8 (8) are insensitive and unresponsive to individ9 uals with varying gender identities, gender expres10 sions, and sexual orientations; or 

11 (9) are inconsistent with the ethical imperatives 

12 of medicine and public health. 

13 SEC. 9. AMENDMENTS TO OTHER LAWS. 

14 (a) AMENDMENT TO THE PUBLIC HEALTH SERVICE

15 ACT.—Section 2500 of the Public Health Service Act (42 

16 U.S.C. 300ee) is amended by striking subsections (b) 

17 through (d) and inserting the following: 

18 ‘‘(b) CONTENTS OF PROGRAMS.—All programs of 

19 education and information receiving funds under this sub20 chapter shall include information about the potential ef21 fects of intravenous substance abuse.’’. 

22 (b) AMENDMENTS TO THE ELEMENTARY AND SEC23 ONDARY EDUCATION ACT OF 1965.—Section 8526 of the 

24 Elementary and Secondary Education Act of 1965 (20 

25 U.S.C. 7906) is amended— 


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1 (1) by striking paragraph (3); 

2 (2) by redesignating paragraphs (4) and (5) as 

3 paragraphs (3) and (4), respectively; 

4 (3) in paragraph (4), by inserting ‘‘or’’ after 

5 the semicolon; 

6 (4) in paragraph (5), by striking ‘‘; or’’ and in7 serting a period; and 

8 (5) by striking paragraph (6). 

9 SEC. 10. DEFINITIONS. 

10 In this Act: 

11 (1) ADOLESCENTS.—The term ‘‘adolescents’’ 

12 means individuals who are ages 10 through 19 at 

13 the time of commencement of participation in a pro14 gram supported under this Act. 

15 (2) AGE AND DEVELOPMENTALLY APPRO16 PRIATE.—The term ‘‘age and developmentally appro17 priate’’ means topics, messages, and teaching meth18 ods suitable to particular age, age group of children 

19 and adolescents, or developmental levels, based on 

20 cognitive, emotional, social, and behavioral capacity 

21 of most students at that age level. 

22 (3) APPROPRIATE COMMITTEES OF CON23 GRESS.—The term ‘‘appropriate committees of Con24 gress’’ means the Committee on Health, Education, 

25 Labor, and Pensions of the Senate, the Committee 


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1 on Appropriations of the Senate, the Committee on 

2 Energy and Commerce of the House of Representa3 tives, the Committee on Education and the Work4 force of the House of Representatives, and the Com5 mittee on Appropriations of the House of Represent6 atives. 

7 (4) CHARACTERISTICS OF EFFECTIVE PRO8 GRAMS.—The term ‘‘characteristics of effective pro9 grams’’ means the aspects of evidence-based pro10 grams, including development, content, and imple11 mentation of such programs, that— 

12 (A) have been shown to be effective in 

13 terms of increasing knowledge, clarifying values 

14 and attitudes, increasing skills, and impacting 

15 upon behavior; and 

16 (B) are widely recognized by leading med17 ical and public health agencies to be effective in 

18 changing sexual behaviors that lead to sexually 

19 transmitted infections, including HIV, unin20 tended pregnancy, and dating violence and sex21 ual assault among young people. 

22 (5) COMPREHENSIVE SEX EDUCATION.—The 

23 term ‘‘comprehensive sex education’’ means instruc24 tion part of a comprehensive school health education 

25 approach which addresses the physical, mental, emoVerDate Sep 11 2014 05:34 May 23, 2019 Jkt 089200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\S1524.IS S1524

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1 tional, and social dimensions of human sexuality; de2 signed to motivate and assist students to maintain 

3 and improve their sexual health, prevent disease and 

4 reduce sexual health-related risk behaviors; and en5 able and empower students to develop and dem6 onstrate age and developmentally appropriate sexu7 ality and sexual health-related knowledge, attitudes, 

8 skills, and practices. 

9 (6) CONSENT.—The term ‘‘consent’’ means af10 firmative, conscious, and voluntary agreement to en11 gage in interpersonal, physical, or sexual activity. 

12 (7) CULTURALLY APPROPRIATE.—The term 

13 ‘‘culturally appropriate’’ means materials and in14 struction that respond to culturally diverse individ15 uals, families and communities in an inclusive, re16 spectful and effective manner; including materials 

17 and instruction that are inclusive of race, ethnicity, 

18 languages, cultural background, religion, sex, gender 

19 identity, sexual orientation, and different abilities. 

20 (8) EVIDENCE-BASED.—The term ‘‘evidence21 based’’, when used with respect to sex education in22 struction means a sex education program that has 

23 been proven through rigorous evaluation to be effec24 tive in changing sexual behavior or incorporates eleVerDate Sep 11 2014 05:34 May 23, 2019 Jkt 089200 PO 00000 Frm 00029 Fmt 6652 Sfmt 6201 E:\BILLS\S1524.IS S1524

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1 ments of other programs that have been proven to 

2 be effective in changing sexual behavior. 

3 (9) GENDER EXPRESSION.—The term ‘‘gender 

4 expression’’, when used with respect to a sex edu5 cation program, means the expression of one’s gen6 der, such as through behavior, clothing, haircut, or 

7 voice, and which may or may not conform to socially 

8 defined behaviors and characteristics typically asso9 ciated with being either masculine or feminine. 

10 (10) GENDER IDENTITY.—Except with respect 

11 to section 7, the term ‘‘gender identity’’, when used 

12 with respect to a sex education program, means the 

13 gender-related identity, appearance, mannerisms, or 

14 other gender-related characteristics of an individual, 

15 regardless of the individual’s designated sex at birth 

16 including a person’s deeply held sense or knowledge 

17 of their own gender; such as male, female, both or 

18 neither. 

19 (11) INCLUSIVE.—The term ‘‘inclusive’’, when 

20 used with respect to a sex education program, means 

21 curriculum that ensures that students from histori22 cally marginalized communities are reflected in 

23 classroom materials and lessons. 

24 (12) INSTITUTION OF HIGHER EDUCATION.— 

25 The term ‘‘institution of higher education’’ has the 


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1 meaning given the term in section 101 of the Higher 

2 Education Act of 1965 (20 U.S.C. 1001). 

3 (13) MEDICALLY ACCURATE AND COMPLETE.— 

4 The term ‘‘medically accurate and complete’’, when 

5 used with respect to a sex education program, means 

6 that— 

7 (A) the information provided through the 

8 program is verified or supported by the weight 

9 of research conducted in compliance with ac10 cepted scientific methods and is published in 

11 peer-reviewed journals, where applicable; or 

12 (B)(i) the program contains information 

13 that leading professional organizations and 

14 agencies with relevant expertise in the field rec15 ognize as accurate, objective, and complete; and 

16 (ii) the program does not withhold infor17 mation about the effectiveness and benefits of 

18 correct and consistent use of condoms and 

19 other contraceptives. 

20 (14) SECRETARY.—The term ‘‘Secretary’’ 

21 means the Secretary of Health and Human Services. 

22 (15) SEXUAL DEVELOPMENT.—The term ‘‘sex23 ual development’’ means the lifelong process of phys24 ical, behavioral, cognitive, and emotional growth and 

25 change as it relates to an individual’s sexuality and 


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1 sexual maturation, including puberty, identity devel2 opment, socio-cultural influences, and sexual behav3 iors. 

4 (16) SEXUAL ORIENTATION.—Except with re5 spect to section 7, the term ‘‘sexual orientation’’, 

6 when used with respect to a sex education program, 

7 means an individual’s attraction, including physical 

8 or emotional, to the same or different gender. 

9 (17) YOUNG PEOPLE.—The term ‘‘young peo10 ple’’ means individuals who are ages 10 through 24 

11 at the time of commencement of participation in a 

12 program supported under this Act. 

13 SEC. 11. FUNDING. 

14 (a) APPROPRIATION.—For the purpose of carrying 

15 out Act, there is appropriated 75,000,000 for each fiscal 

16 years 2020 through 2025. Amounts appropriated under 

17 this subsection shall remain available until expended. 

18 (b) RESERVATIONS OF FUNDS.— 

19 (1) The Secretary shall reserve 50 percent of 

20 the amount appropriated under subsection (a) for 

21 the purposes of awarding grants for comprehensive 

22 sex education for adolescents under section 3. 

23 (2) The Secretary shall reserve 25 percent of 

24 the amount appropriated under subsection (a) for 

25 the purposes of awarding grants for comprehensive 


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1 sex education at institutes of higher education under 

2 section 4. 

3 (3) The Secretary shall reserve 20 percent of 

4 the amount appropriated under subsection (a) for 

5 the purposes of awarding grants for pre-service and 

6 in-service teacher training under section 5. 

7 (4) The Secretary shall reserve 2 percent of the 

8 amount appropriated under subsection (a) for the 

9 purpose of carrying out the impact evaluation and 

10 reporting required under section 6(a). 

11 (c) SECRETARIAL RESPONSIBILITIES.—The Sec12 retary shall reserve 3 percent of amount appropriated 

13 under subsection (a) for each fiscal year for expenditures 

14 by the Secretary to provide, directly or through a competi15 tive grant process, research, training, and technical assist16 ance, including dissemination of research and information 

17 regarding effective and promising practices, providing con18 sultation and resources, and developing resources and ma19 terials to support the activities of recipients of grants. In 

20 carrying out such functions, the Secretary shall collabo21 rate with a variety of entities that have expertise in adoles22 cent sexual health development, education, and promotion. 

23 (d) REPROGRAMMING OF ABSTINENCE ONLY UNTIL

24 MARRIAGE PROGRAM FUNDING.—The unobligated bal25 ance of funds made available to carry out section 510 of 


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1 the Social Security Act (42 U.S.C. 710) (as in effect on 

2 the day before the date of enactment of this Act) are here3 by transferred and shall be used by the Secretary to carry 

4 out this Act. The amounts transferred and made available 

5 to carry out this Act shall remain available until expended. 

6 (e) REPEAL OF ABSTINENCE ONLY UNTIL MAR7 RIAGE PROGRAM.—Section 510 of the Social Security Act 

8 (42 U.S.C. 710 et seq.) is repealed. 

Æ 


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