Real Education and Access for Healthy Youth Act of 2023

II 118TH CONGRESS 1ST SESSION S. 1697 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, 2023 Ms. HIRONO (for herself, Mr. BOOKER, Mr. BLUMENTHAL, Mr. BROWN, Ms. DUCKWORTH, Mr. MARKEY, Mr. MENENDEZ, Mr. MERKLEY, Mr. MUR- PHY, Mr. PADILLA, Ms. SMITH, Mr. VAN HOLLEN, and Ms. WARREN) 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 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 2023’’. 5 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1697 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, trauma-informed 13 and resilience-oriented, and align with the National 14 Sex Education Standards of the Future of Sex Ed 15 Initiative; 16 (3) provide information about the prevention, 17 treatment, and care of pregnancy, sexually trans- 18 mitted infections, and interpersonal violence; 19 (4) provide information about the importance of 20 consent as a basis for healthy relationships and for 21 autonomy in healthcare; 22 (5) provide information on gender identity and 23 gender expression; 24 (6) provide information on the historical and 25 current condition in which education and health sys- 26 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1697 IS tems, policies, programs, services, and practices have 1 uniquely and adversely impacted Black, Indigenous, 2 Latine, Asian American, Native Hawaiian, Pacific 3 Islander, and other People of Color; and 4 (7) redress inequities in the delivery of sex edu- 5 cation and sexual health services to marginalized 6 young people. 7 (b) FINDINGS.—Congress finds the following: 8 (1) Young people need and have the right to sex 9 education and sexual health services that are evi- 10 dence-informed, comprehensive in scope, confiden- 11 tial, equitable, accessible, medically accurate and 12 complete, age and developmentally appropriate, cul- 13 turally responsive, and trauma-informed and resil- 14 ience-oriented. 15 (2) Currently, there is a gap between the sex 16 education that young people should be receiving 17 based on expert standards and the sex education 18 many actually receive. 19 (3) Only 38 States and the District of Colum- 20 bia mandate sex education or human immuno- 21 deficiency virus (HIV) education in schools. 22 (4) When there is sex education or instruction 23 regarding HIV or sexually transmitted infections 24 (STI), 13 States do not require the content to be 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1697 IS evidence-informed, medically accurate and complete, 1 age and developmentally appropriate, or culturally 2 responsive. 3 (5) Many sex education programs and sexual 4 health services currently available were not designed 5 to and do not currently meet the needs of 6 marginalized young people. Some such programs and 7 services actually harm marginalized young people. 8 (6) For marginalized young people, a lack of 9 comprehensive in scope, confidential, equitable, and 10 accessible sex education and sexual health services is 11 not unfamiliar, but rather a longstanding manifesta- 12 tion of white supremacy, which has touched every 13 aspect of our history, culture, and institutions, in- 14 cluding the education and healthcare systems. 15 (7) The development and delivery of sexual 16 health education and sexual health services in the 17 United States historically has been rooted in the op- 18 pression of Black, Indigenous, Latine, Asian Amer- 19 ican, Native Hawaiian, Pacific Islander, and other 20 People of Color. 21 (8) The United States has a long history of eu- 22 genics and forced sterilization. The sexual and re- 23 productive rights and bodily autonomy of specific 24 communities deemed ‘‘undesirable’’ or ‘‘defective’’ 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1697 IS were targeted by our governments resulting in state- 1 sanctioned violence and generations of trauma and 2 oppression. These communities include— 3 (A) people with low incomes; 4 (B) immigrants; 5 (C) people with disabilities; 6 (D) people living with HIV; 7 (E) survivors of interpersonal violence; 8 (F) people who are incarcerated, detained, 9 or who otherwise have encountered the crimi- 10 nal-legal system; 11 (G) Black, Indigenous, Latine, Asian 12 American, and other People of Color; 13 (H) people who are lesbian, gay, bisexual, 14 transgender, and queer; and 15 (I) young people who are pregnant and 16 parenting. 17 (9) Black young people are more likely to re- 18 ceive abstinence-only instruction. Research shows 19 that abstinence-only instruction, also known as ‘‘sex- 20 ual risk avoidance’’ instruction, is ineffective in com- 21 parison to sex education. 22 (10) Black, Indigenous, and Latine young peo- 23 ple are disproportionately more likely to be diag- 24 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1697 IS nosed with an STI, have an unintended pregnancy, 1 or experience sexual assault. 2 (11) The framework of Reproductive Justice ac- 3 knowledges and aims to address the legacy of white 4 supremacy, systemic oppression, and the restrictions 5 on sex education and sexual health services that dis- 6 proportionately impact marginalized communities. 7 Reproductive Justice will be achieved when all people 8 regardless of actual or perceived race, color, eth- 9 nicity, national origin, religion, immigration status, 10 sex (including gender identity and sexual orienta- 11 tion), disability status, pregnancy or parenting sta- 12 tus, or age have the power to make decisions about 13 their bodies, health, sexuality, families, and commu- 14 nities in all areas of life. 15 (12) Increased resources are required for sex 16 education and sexual health services to reach all 17 young people, redress inequities and their impacts 18 on marginalized young people, and achieve Repro- 19 ductive Justice for young people. 20 (13) Such sex education and sexual health serv- 21 ices should— 22 (A) promote and uphold the rights of 23 young people to information and services in 24 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1697 IS order to make and exercise informed and re- 1 sponsible decisions about their sexual health; 2 (B) be evidence-informed, comprehensive in 3 scope, confidential, equitable, accessible, age 4 and developmentally appropriate, culturally re- 5 sponsive, and trauma-informed and resilience- 6 oriented; 7 (C) include instruction and materials that 8 address— 9 (i) puberty and adolescent develop- 10 ment; 11 (ii) sexual and reproductive anatomy 12 and physiology; 13 (iii) sexual orientation, gender iden- 14 tity, and gender expression; 15 (iv) contraception, pregnancy, and re- 16 production; 17 (v) HIV and other STIs; 18 (vi) consent and healthy relationships; 19 and 20 (vii) interpersonal violence; 21 (D) promote gender equity and be inclusive 22 of young people with varying gender identities, 23 gender expressions, and sexual orientations; 24 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1697 IS (E) promote safe and healthy relationships; 1 and 2 (F) promote racial equity and be respon- 3 sive to the needs of young people who are 4 Black, Indigenous, and other People of Color. 5 SEC. 3. DEFINITIONS. 6 In this Act: 7 (1) AGE AND DEVELOPMENTALLY APPRO- 8 PRIATE.—The term ‘‘age and developmentally appro- 9 priate’’ means topics, messages, and teaching meth- 10 ods suitable to particular ages, age groups, or devel- 11 opmental levels, based on cognitive, emotional, so- 12 cial, and behavioral capacity of most young people at 13 that age level. 14 (2) CONSENT.—The term ‘‘consent’’ means af- 15 firmative, conscious, and voluntary agreement to en- 16 gage in interpersonal, physical, or sexual activity. 17 (3) CULTURALLY RESPONSIVE.—The term ‘‘cul- 18 turally responsive’’ means education and services 19 that— 20 (A) embrace and actively engage and ad- 21 just to young people and their various cultural 22 identities; 23 (B) recognize the ways in which many 24 marginalized young people face unique barriers 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1697 IS in our society that result in increased adverse 1 health outcomes and associated stereotypes; and 2 (C) may address the ways in which racism 3 has shaped national health care policy, the last- 4 ing historical trauma associated with reproduc- 5 tive health experiments and forced sterilizations 6 of Black, Latine, and Indigenous communities, 7 or sexual stereotypes assigned to young People 8 of Color or LGBTQ+ people. 9 (4) EVIDENCE-INFORMED.—The term ‘‘evi- 10 dence-informed’’ means incorporates characteristics, 11 content, or skills that have been proven to be effec- 12 tive through evaluation in changing sexual behavior. 13 (5) GENDER EXPRESSION.—The term ‘‘gender 14 expression’’ means the expression of one’s gender, 15 such as through behavior, clothing, haircut, or voice, 16 and which may or may not conform to socially de- 17 fined behaviors and characteristics typically associ- 18 ated with being either masculine or feminine. 19 (6) GENDER IDENTITY.—The term ‘‘gender 20 identity’’ means the gender-related identity, appear- 21 ance, mannerisms, or other gender-related character- 22 istics of an individual, regardless of the individual’s 23 designated sex at birth. 24 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 10 •S 1697 IS (7) INCLUSIVE.—The term ‘‘inclusive’’ means 1 content and skills that ensure marginalized young 2 people are valued, respected, centered, and sup- 3 ported in sex education instruction and materials. 4 (8) INSTITUTION OF HIGHER EDUCATION.—The 5 term ‘‘institution of higher education’’ has the 6 meaning given the term in section 101 of the Higher 7 Education Act of 1965 (20 U.S.C. 1001). 8 (9) INTERPERSONAL VIOLENCE.—The term 9 ‘‘interpersonal violence’’ means abuse, assault, bul- 10 lying, dating violence, domestic violence, harassment, 11 intimate partner violence, or stalking. 12 (10) LOCAL EDUCATIONAL AGENCY.—The term 13 ‘‘local educational agency’’ has the meaning given 14 the term in section 8101 of the Elementary and Sec- 15 ondary Education Act of 1965 (20 U.S.C. 7801). 16 (11) MARGINALIZED YOUNG PEOPLE.—The 17 term ‘‘marginalized young people’’ means young peo- 18 ple who are disadvantaged by underlying structural 19 barriers and social inequities, including young people 20 who are— 21 (A) Black, Indigenous, Latine, Asian 22 American, Native Hawaiian, Pacific Islander, 23 and other People of Color; 24 (B) immigrants; 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 11 •S 1697 IS (C) in contact with the foster care system; 1 (D) in contact with the juvenile justice sys- 2 tem; 3 (E) experiencing homelessness; 4 (F) pregnant or parenting; 5 (G) lesbian, gay, bisexual, transgender, or 6 queer; 7 (H) living with HIV; 8 (I) living with disabilities; 9 (J) from families with low-incomes; or 10 (K) living in rural areas. 11 (12) MEDICALLY ACCURATE AND COMPLETE.— 12 The term ‘‘medically accurate and complete’’ means 13 that— 14 (A) the information provided through the 15 education is verified or supported by the weight 16 of research conducted in compliance with ac- 17 cepted scientific methods and is published in 18 peer-reviewed journals, where applicable; or 19 (B) the education contains information 20 that leading professional organizations and 21 agencies with relevant expertise in the field rec- 22 ognize as accurate, objective, and complete. 23 (13) RESILIENCE.—The term ‘‘resilience’’ 24 means the ability to adapt to trauma and tragedy. 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS 12 •S 1697 IS (14) SECRETARY.—The term ‘‘Secretary’’ 1 means the Secretary of Health and Human Services. 2 (15) SEX EDUCATION.—The term ‘‘sex edu- 3 cation’’ means high quality teaching and learning 4 that— 5 (A) is delivered, to the maximum extent 6 practicable, following the National Sexuality 7 Education Standards of the Future of Sex Ed 8 Initiative; 9 (B) is about a broad variety of topics re- 10 lated to sex and sexuality, including— 11 (i) puberty and adolescent develop- 12 ment; 13 (ii) sexual and reproductive anatomy 14 and physiology; 15 (iii) sexual orientation, gender iden- 16 tity, and gender expression; 17 (iv) contraception, pregnancy, preg- 18 nancy options, and reproduction; 19 (v) HIV and other STIs; 20 (vi) consent and healthy relationships; 21 and 22 (vii) interpersonal violence; 23 (C) explores values and beliefs about such 24 topics; and 25 VerDate Sep 11 2014 21:13 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S1697.IS S1697 kjohnson on DSK79L0C42PROD with BILLS [Text truncated for display. Full text available on Congress.gov.]