Real Education and Access for Healthy Youth Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 3583 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 HOUSE OF REPRESENTATIVES MAY 22, 2023 Ms. LEE of California (for herself, Ms. ADAMS, Ms. JAYAPAL, Mr. CASTEN, Ms. DEAN of Pennsylvania, Mr. DOGGETT, Mr. SWALWELL, Ms. GARCIA of Texas, Mr. PAYNE, Ms. NORTON, Ms. BROWNLEY, Ms. CASTOR of Florida, Ms. SCHAKOWSKY, Mr. DAVIS of Illinois, Ms. PINGREE, Ms. WILSON of Florida, Ms. BONAMICI, Ms. TOKUDA, Mr. POCAN, Ms. BUSH, Mr. QUIGLEY, Mr. THANEDAR, Mr. TRONE, Mr. GOMEZ, Ms. CLARKE of New York, Ms. CHU, Ms. DEGETTE, Mr. DESAULNIER, Ms. STRICK- LAND, Mr. BEYER, Mr. GRIJALVA, and Ms. CROCKETT) introduced the following bill; which was referred to the Committee on Education and the Workforce, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 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 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3583 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Real Education and 2 Access for Healthy Youth Act of 2023’’. 3 SEC. 2. PURPOSE AND FINDINGS. 4 (a) PURPOSE.—The purpose of this Act is to provide 5 young people with sex education and sexual health services 6 that— 7 (1) promote and uphold the rights of young 8 people to information and services that empower 9 them to make decisions about their bodies, health, 10 sexuality, families, and communities in all areas of 11 life; 12 (2) are evidence-informed, comprehensive in 13 scope, confidential, equitable, accessible, medically 14 accurate and complete, age and developmentally ap- 15 propriate, culturally responsive, and trauma-in- 16 formed and resilience-oriented, and align with the 17 National Sex Education Standards of the Future of 18 Sex Ed Initiative; 19 (3) provide information about the prevention, 20 treatment, and care of pregnancy, sexually trans- 21 mitted infections, and interpersonal violence; 22 (4) provide information about the importance of 23 consent as a basis for healthy relationships and for 24 autonomy in health care; 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3583 IH (5) provide information on gender identity and 1 gender expression; 2 (6) provide information on the historical and 3 current condition in which education and health sys- 4 tems, policies, programs, services, and practices have 5 uniquely and adversely impacted Black, Indigenous, 6 Latine, Asian American, Native Hawaiian, Pacific 7 Islander, and other People of Color; and 8 (7) redress inequities in the delivery of sex edu- 9 cation and sexual health services to marginalized 10 young people. 11 (b) FINDINGS.—Congress finds the following: 12 (1) Young people need and have the right to sex 13 education and sexual health services that are evi- 14 dence-informed, comprehensive in scope, confiden- 15 tial, equitable, accessible, medically accurate and 16 complete, age and developmentally appropriate, cul- 17 turally responsive, and trauma-informed and resil- 18 ience-oriented. 19 (2) Currently, there is a gap between the sex 20 education that young people should be receiving 21 based on expert standards and the sex education 22 many actually receive. 23 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3583 IH (3) Only 38 States and the District of Colum- 1 bia mandate sex education or human immuno- 2 deficiency virus (HIV) education in schools. 3 (4) When there is sex education or instruction 4 regarding HIV or sexually transmitted infections 5 (STI), 13 States do not require the content to be 6 evidence-informed, medically accurate and complete, 7 age and developmentally appropriate, or culturally 8 responsive. 9 (5) Many sex education programs and sexual 10 health services currently available were not designed 11 to and do not currently meet the needs of 12 marginalized young people. Some such programs and 13 services actually harm marginalized young people. 14 (6) For marginalized young people, a lack of 15 comprehensive in scope, confidential, equitable, and 16 accessible sex education and sexual health services is 17 not unfamiliar, but rather a longstanding manifesta- 18 tion of White supremacy, which has touched every 19 aspect of our history, culture, and institutions, in- 20 cluding the education and health care systems. 21 (7) The development and delivery of sexual 22 health education and services in the United States 23 historically has been rooted in the oppression of 24 Black, Indigenous, Latine, Asian American, Native 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 3583 IH Hawaiian, Pacific Islander, and other People of 1 Color. 2 (8) The United States has a long history of eu- 3 genics and forced sterilization. The sexual and re- 4 productive rights and bodily autonomy of specific 5 communities deemed ‘‘undesirable’’ or ‘‘defective’’ 6 were targeted by our governments resulting in state- 7 sanctioned violence and generations of trauma and 8 oppression. These communities include— 9 (A) people with low incomes; 10 (B) immigrants; 11 (C) people with disabilities; 12 (D) people living with HIV; 13 (E) survivors of interpersonal violence; 14 (F) people who are incarcerated, detained, 15 or who otherwise have encountered the crimi- 16 nal-legal system; 17 (G) Black, Indigenous, Latine, Asian 18 American, and other People of Color; 19 (H) people who are lesbian, gay, bisexual, 20 transgender, and queer; and 21 (I) young people who are pregnant and 22 parenting. 23 (9) Black young people are more likely to re- 24 ceive abstinence-only instruction. Research shows 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 3583 IH that abstinence-only instruction, also known as ‘‘sex- 1 ual risk avoidance’’ instruction, is ineffective in com- 2 parison to sex education. 3 (10) Black, Indigenous, and Latine young peo- 4 ple are disproportionately more likely to be diag- 5 nosed with an STI, have an unintended pregnancy, 6 or experience sexual assault. 7 (11) The framework of reproductive justice ac- 8 knowledges and aims to address the legacy of White 9 supremacy, systemic oppression, and the restrictions 10 on sex education and sexual health services that dis- 11 proportionately impact marginalized communities. 12 Reproductive justice will be achieved when all people 13 regardless of actual or perceived race, color, eth- 14 nicity, national origin, religion, immigration status, 15 sex (including gender identity and sexual orienta- 16 tion), disability status, pregnancy or parenting sta- 17 tus, or age have the power to make decisions about 18 their bodies, health, sexuality, families, and commu- 19 nities in all areas of life. 20 (12) Increased resources are required for sex 21 education and sexual health services to reach all 22 young people, redress inequities and their impacts 23 on marginalized young people, and achieve reproduc- 24 tive justice for young people. 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 3583 IH (13) Such sex education and sexual health serv- 1 ices should— 2 (A) promote and uphold the rights of 3 young people to information and services in 4 order to make and exercise informed and re- 5 sponsible decisions about their sexual health; 6 (B) be evidence-informed, comprehensive in 7 scope, confidential, equitable, accessible, age 8 and developmentally appropriate, culturally re- 9 sponsive, and trauma-informed and resilience- 10 oriented; 11 (C) include instruction and materials that 12 address— 13 (i) puberty and adolescent develop- 14 ment; 15 (ii) sexual and reproductive anatomy 16 and physiology; 17 (iii) sexual orientation, gender iden- 18 tity, and gender expression; 19 (iv) contraception, pregnancy, and re- 20 production; 21 (v) HIV and other STIs; 22 (vi) consent and healthy relationships; 23 and 24 (vii) interpersonal violence; 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 3583 IH (D) promote gender equity and be inclusive 1 of young people with varying gender identities, 2 gender expressions, and sexual orientations; 3 (E) promote safe and healthy relationships; 4 and 5 (F) promote racial equity and be respon- 6 sive to the needs of young people who are 7 Black, Indigenous, and other People of Color. 8 SEC. 3. DEFINITIONS. 9 In this Act: 10 (1) AGE AND DEVELOPMENTALLY APPRO- 11 PRIATE.—The term ‘‘age and developmentally appro- 12 priate’’ means topics, messages, and teaching meth- 13 ods suitable to particular ages, age groups, or devel- 14 opmental levels, based on cognitive, emotional, so- 15 cial, and behavioral capacity of most young people at 16 that age level. 17 (2) CHARACTERISTICS OF EFFECTIVE PRO- 18 GRAMS.—The term ‘‘characteristics of effective pro- 19 grams’’ means the aspects of evidence-informed pro- 20 grams, including development, content, and imple- 21 mentation of such programs, that— 22 (A) have been shown to be effective in 23 terms of increasing knowledge, clarifying values 24 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 3583 IH and attitudes, increasing skills, and impacting 1 behavior; and 2 (B) are widely recognized by leading med- 3 ical and public health agencies to be effective in 4 changing sexual behaviors that lead to sexually 5 transmitted infections, unintended pregnancy, 6 and interpersonal violence among young people. 7 (3) CONSENT.—The term ‘‘consent’’ means af- 8 firmative, conscious, and voluntary agreement to en- 9 gage in interpersonal, physical, or sexual activity. 10 (4) CULTURALLY RESPONSIVE.—The term ‘‘cul- 11 turally responsive’’ means education and services 12 that— 13 (A) embrace and actively engage and ad- 14 just to young people and their various cultural 15 identities; 16 (B) recognize the ways in which many 17 marginalized young people face unique barriers 18 in our society that result in increased adverse 19 health outcomes and associated stereotypes; and 20 (C) may address the ways in which racism 21 has shaped national health care policy, the last- 22 ing historical trauma associated with reproduc- 23 tive health experiments and forced sterilizations 24 of Black, Latine, and Indigenous communities, 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 3583 IH or sexual stereotypes assigned to young People 1 of Color or LGBTQ+ people. 2 (5) EVIDENCE-INFORMED.—The term ‘‘evi- 3 dence-informed’’ means incorporates characteristics, 4 content, or skills that have been proven to be effec- 5 tive through evaluation in changing sexual behavior. 6 (6) GENDER EXPRESSION.—The term ‘‘gender 7 expression’’ means the expression of one’s gender, 8 such as through behavior, clothing, haircut, or voice, 9 and which may or may not conform to socially de- 10 fined behaviors and characteristics typically associ- 11 ated with being either masculine or feminine. 12 (7) GENDER IDENTITY.—The term ‘‘gender 13 identity’’ means the gender-related identity, appear- 14 ance, mannerisms, or other gender-related character- 15 istics of an individual, regardless of the individual’s 16 designated sex at birth. 17 (8) INCLUSIVE.—The term ‘‘inclusive’’ means 18 content and skills that ensure marginalized young 19 people are valued, respected, centered, and sup- 20 ported in sex education instruction and materials. 21 (9) INSTITUTION OF HIGHER EDUCATION.—The 22 term ‘‘institution of higher education’’ has the 23 meaning given the term in section 101 of the Higher 24 Education Act of 1965 (20 U.S.C. 1001). 25 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 3583 IH (10) INTERPERSONAL VIOLENCE.—The term 1 ‘‘interpersonal violence’’ means abuse, assault, bul- 2 lying, dating violence, domestic violence, harassment, 3 intimate partner violence, or stalking. 4 (11) MARGINALIZED YOUNG PEOPLE.—The 5 term ‘‘marginalized young people’’ means young peo- 6 ple who are disadvantaged by underlying structural 7 barriers and social inequities, including young people 8 who are— 9 (A) Black, Indigenous, Latine, Asian 10 American, Native Hawaiian, Pacific Islander, 11 and other People of Color; 12 (B) immigrants; 13 (C) in contact with the foster care system; 14 (D) in contact with the juvenile justice sys- 15 tem; 16 (E) experiencing homelessness; 17 (F) pregnant or parenting; 18 (G) lesbian, gay, bisexual, transgender, or 19 queer; 20 (H) living with HIV; 21 (I) living with disabilities; 22 (J) from families with low incomes; or 23 (K) living in rural areas. 24 VerDate Sep 11 2014 21:16 Jun 08, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3583.IH H3583 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 3583 IH (12) MEDICALLY ACCURATE AND COMPLETE.— 1 The term ‘‘medically accurate and complete’’ means 2 that— 3 (A) the information provided through the 4 education is verified or supported by the weight 5 of research conducted in compliance with ac- 6 cepted scientific methods and is published in 7 peer-reviewed journals, where applicable; or 8 (B) the education contains information 9 that leading professional organizations and 10 agencies with relevant expertise in the field rec- 11 ognize as accurate, objective, and complete. 12 (13) RESILIENCE.—The term ‘‘resilience’’ 13 means the ability to adapt to trauma and tragedy. 14 (14) SECRETARY.—The term ‘‘Secretary’’ 15 means the Secreta [Text truncated for display. Full text available on Congress.gov.]