Real Education and Access for Healthy Youth Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1689 To provide for the overall health and well-being of young people, including the promotion and attainment of lifelong sexual health and healthy rela- tionships, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 18, 2021 Mr. BOOKER (for himself, Ms. HIRONO, Mr. MARKEY, Mr. MENENDEZ, Ms. WARREN, Mr. BROWN, Ms. BALDWIN, Mr. BLUMENTHAL, Ms. SMITH, Ms. DUCKWORTH, and Mr. MERKLEY) introduced the following bill; which was read twice and referred to the Committee on Health, Edu- cation, Labor, and Pensions A BILL To provide for the overall health and well-being of young people, including the promotion and attainment of life- long sexual health and healthy relationships, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Real Education and 4 Access for Healthy Youth Act of 2021’’. 5 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 1689 IS SEC. 2. PURPOSE AND FINDINGS. 1 (a) PURPOSE.—The purpose of this Act is to provide 2 young people with sex education and sexual health services 3 that— 4 (1) promote and uphold the rights of young 5 people to information and services that empower 6 them to make decisions about their bodies, health, 7 sexuality, families, and communities in all areas of 8 life; 9 (2) are evidence-informed, comprehensive in 10 scope, confidential, equitable, accessible, medically 11 accurate and complete, age and developmentally ap- 12 propriate, culturally responsive, and trauma-in- 13 formed and resilience-oriented; 14 (3) provide information about the prevention, 15 treatment, and care of pregnancy, sexually trans- 16 mitted infections, and interpersonal violence; 17 (4) provide information about the importance of 18 consent as a basis for healthy relationships and for 19 autonomy in healthcare; 20 (5) provide information on gender roles and 21 gender discrimination; 22 (6) provide information on the historical and 23 current condition in which education and health sys- 24 tems, policies, programs, services, and practices have 25 uniquely and adversely impacted Black, Indigenous, 26 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 1689 IS Latinx, Asian, Asian American and Pacific Islander, 1 and other People of Color; and 2 (7) redress inequities in the delivery of sex edu- 3 cation and sexual health services to marginalized 4 young people. 5 (b) FINDINGS.—Congress finds the following: 6 (1) Young people need and have the right to sex 7 education and sexual health services that are evi- 8 dence-informed, comprehensive in scope, confiden- 9 tial, equitable, accessible, medically accurate and 10 complete, age and developmentally appropriate, cul- 11 turally responsive, and trauma-informed and resil- 12 ience-oriented. 13 (2) Currently, there is a gap between the sex 14 education that young people should be receiving 15 based on expert standards and the sex education 16 many actually receive. 17 (3) Only 29 States and the District of Colum- 18 bia mandate sex education in schools. 19 (4) When there is sex education or instruction 20 regarding human immunodeficiency virus (HIV) or 21 sexually transmitted infections (STI), 15 States do 22 not require the content to be evidence-informed, 23 medically accurate and complete, age and develop- 24 mentally appropriate, or culturally responsive. 25 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 1689 IS (5) Many sex education programs and sexual 1 health services currently available were not designed 2 to and do not currently meet the needs of 3 marginalized young people. Some such programs and 4 services actually harm marginalized young people. 5 (6) For marginalized young people, a lack of 6 comprehensive in scope, confidential, equitable, and 7 accessible sex education and sexual health services is 8 not unfamiliar, but rather a longstanding manifesta- 9 tion of white supremacy, which has touched every 10 aspect of our history, culture, and institutions, in- 11 cluding the education and healthcare systems. 12 (7) The development and delivery of sexual 13 health education and services in the United States 14 historically has been rooted in the oppression of 15 Black, Indigenous, Latinx, Asian, Asian American 16 and Pacific Islander, and other People of Color. 17 (8) The United States has a long history of eu- 18 genics and forced sterilization. The sexual and re- 19 productive rights and bodily autonomy of specific 20 communities deemed ‘‘undesirable’’ or ‘‘defective’’ 21 were targeted by our governments resulting in state- 22 sanctioned violence and generations of trauma and 23 oppression. These communities include— 24 (A) people with low incomes; 25 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 1689 IS (B) immigrants; 1 (C) people with disabilities; 2 (D) people living with HIV; 3 (E) survivors of interpersonal violence; 4 (F) people who are incarcerated, detained, 5 or who otherwise have encountered the crimi- 6 nal-legal system; 7 (G) Black, Indigenous, and other People of 8 Color; 9 (H) people who are lesbian, gay, bisexual, 10 transgender, and queer; and 11 (I) young people who are pregnant and 12 parenting. 13 (9) Black young people are more likely to re- 14 ceive abstinence-only instruction. Research shows 15 that abstinence-only instruction, also known as ‘‘sex- 16 ual risk avoidance’’ instruction, is ineffective in com- 17 parison to sex education. 18 (10) Black, Indigenous, and Latinx young peo- 19 ple are disproportionately more likely to be diag- 20 nosed with an STI, have an unintended pregnancy, 21 or experience sexual assault. 22 (11) The framework of Reproductive Justice ac- 23 knowledges and aims to address the legacy of white 24 supremacy, systemic oppression, and the restrictions 25 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 1689 IS on sex education and sexual health services that dis- 1 proportionately impact marginalized communities. 2 Reproductive Justice will be achieved when all people 3 regardless of actual or perceived race, color, eth- 4 nicity, national origin, religion, immigration status, 5 sex (including gender identity and sexual orienta- 6 tion), disability status, pregnancy or parenting sta- 7 tus, or age have the power to make decisions about 8 their bodies, health, sexuality, families, and commu- 9 nities in all areas of life. 10 (12) Increased resources are required for sex 11 education and sexual health services to reach all 12 young people, redress inequities and their impacts 13 on marginalized young people, and achieve Repro- 14 ductive Justice for young people. 15 (13) Such sex education and sexual health serv- 16 ices should— 17 (A) promote and uphold the rights of 18 young people to information and services in 19 order to make and exercise informed and re- 20 sponsible decisions about their sexual health; 21 (B) be evidence-informed, comprehensive in 22 scope, confidential, equitable, accessible, age 23 and developmentally appropriate, culturally re- 24 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 1689 IS sponsive, and trauma-informed and resilience- 1 oriented; 2 (C) include instruction and materials that 3 address— 4 (i) puberty and adolescent develop- 5 ment; 6 (ii) sexual and reproductive anatomy 7 and physiology; 8 (iii) sexual orientation, gender iden- 9 tity, and gender expression; 10 (iv) contraception, pregnancy, and re- 11 production; 12 (v) HIV and other STIs; 13 (vi) consent and healthy relationships; 14 and 15 (vii) interpersonal violence; 16 (D) promote gender equity and be inclusive 17 of young people with varying gender identities, 18 gender expressions, and sexual orientations; 19 (E) promote safe and healthy relationships; 20 and 21 (F) promote racial equity and be respon- 22 sive to the needs of young people who are 23 Black, Indigenous, and other People of Color. 24 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 1689 IS SEC. 3. DEFINITIONS. 1 In this Act: 2 (1) AGE AND DEVELOPMENTALLY APPRO- 3 PRIATE.—The term ‘‘age and developmentally appro- 4 priate’’ means topics, messages, and teaching meth- 5 ods suitable to particular ages, age groups, or devel- 6 opmental levels, based on cognitive, emotional, so- 7 cial, and behavioral capacity of most young people at 8 that age level. 9 (2) CHARACTERISTICS OF EFFECTIVE PRO- 10 GRAMS.—The term ‘‘characteristics of effective pro- 11 grams’’ means the aspects of evidence-informed pro- 12 grams, including development, content, and imple- 13 mentation of such programs, that— 14 (A) have been shown to be effective in 15 terms of increasing knowledge, clarifying values 16 and attitudes, increasing skills, and impacting 17 behavior; and 18 (B) are widely recognized by leading med- 19 ical and public health agencies to be effective in 20 changing sexual behaviors that lead to sexually 21 transmitted infections, unintended pregnancy, 22 and interpersonal violence among young people. 23 (3) CONSENT.—The term ‘‘consent’’ means af- 24 firmative, conscious, and voluntary agreement to en- 25 gage in interpersonal, physical, or sexual activity. 26 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 1689 IS (4) CULTURALLY RESPONSIVE.—The term ‘‘cul- 1 turally responsive’’ means education and services 2 that— 3 (A) embrace and actively engage and ad- 4 just to young people and their various cultural 5 identities; 6 (B) recognize the ways in which many 7 marginalized young people face unique barriers 8 in our society that result in increased adverse 9 health outcomes and associated stereotypes; and 10 (C) may address the ways in which racism 11 has shaped national health care policy, the last- 12 ing historical trauma associated with reproduc- 13 tive health experiments and forced sterilizations 14 of Black, Latinx, and Indigenous communities, 15 or sexual stereotypes assigned to young People 16 of Color or LGBTQ+ people. 17 (5) EVIDENCE-INFORMED.—The term ‘‘evi- 18 dence-informed’’ means incorporates characteristics, 19 content, or skills that have been proven to be effec- 20 tive through evaluation in changing sexual behavior. 21 (6) GENDER EXPRESSION.—The term ‘‘gender 22 expression’’ means the expression of one’s gender, 23 such as through behavior, clothing, haircut, or voice, 24 and which may or may not conform to socially de- 25 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 1689 IS fined behaviors and characteristics typically associ- 1 ated with being either masculine or feminine. 2 (7) GENDER IDENTITY.—The term ‘‘gender 3 identity’’ means the gender-related identity, appear- 4 ance, mannerisms, or other gender-related character- 5 istics of an individual, regardless of the individual’s 6 designated sex at birth. 7 (8) INCLUSIVE.—The term ‘‘inclusive’’ means 8 content and skills that ensure marginalized young 9 people are valued, respected, centered, and sup- 10 ported in sex education instruction and materials. 11 (9) INSTITUTION OF HIGHER EDUCATION.—The 12 term ‘‘institution of higher education’’ has the 13 meaning given the term in section 101 of the Higher 14 Education Act of 1965 (20 U.S.C. 1001). 15 (10) INTERPERSONAL VIOLENCE.—The term 16 ‘‘interpersonal violence’’ means abuse, assault, bul- 17 lying, dating violence, domestic violence, harassment, 18 intimate partner violence, or stalking. 19 (11) MARGINALIZED YOUNG PEOPLE.—The 20 term ‘‘marginalized young people’’ means young peo- 21 ple who are disadvantaged by underlying structural 22 barriers and social inequities, including young people 23 who are— 24 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 11 •S 1689 IS (A) Black, Indigenous, and other People of 1 Color; 2 (B) immigrants; 3 (C) in contact with the foster care system; 4 (D) in contact with the juvenile justice sys- 5 tem; 6 (E) experiencing homelessness; 7 (F) pregnant or parenting; 8 (G) lesbian, gay, bisexual, transgender, or 9 queer; 10 (H) living with HIV; 11 (I) living with disabilities; 12 (J) from families with low-incomes; or 13 (K) living in rural areas. 14 (12) MEDICALLY ACCURATE AND COMPLETE.— 15 The term ‘‘medically accurate and complete’’ means 16 that— 17 (A) the information provided through the 18 education is verified or supported by the weight 19 of research conducted in compliance with ac- 20 cepted scientific methods and is published in 21 peer-reviewed journals, where applicable; or 22 (B) the education contains information 23 that leading professional organizations and 24 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with BILLS 12 •S 1689 IS agencies with relevant expertise in the field rec- 1 ognize as accurate, objective, and complete. 2 (13) RESILIENCE.—The term ‘‘resilience’’ 3 means the ability to adapt to trauma and tragedy. 4 (14) SECRETARY.—The term ‘‘Secretary’’ 5 means the Secretary of Health and Human Services. 6 (15) SEX EDUCATION.—The term ‘‘sex edu- 7 cation’’ means high quality teaching and learning 8 that— 9 (A) is delivered, to the maximum extent 10 practicable, following the National Sexuality 11 Education Standards of the Future of Sex Ed 12 Initiative; 13 (B) is about a broad variety of topics re- 14 lated to sex and sexuality, including— 15 (i) puberty and adolescent develop- 16 ment; 17 (ii) sexual and reproductive anatomy 18 and physiology; 19 (iii) sexual orientation, gender iden- 20 tity, and gender expression; 21 (iv) contraception, pregnancy, and re- 22 production; 23 (v) HIV and other STIs; 24 VerDate Sep 11 2014 03:55 Jun 03, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1689.IS S1689 pbinns on DSKJLVW7X2PROD with [Text truncated for display. Full text available on Congress.gov.]