California’s implementation of AB 329 is an opportunity to lead
More than six years after its passage, the California Healthy Youth Act continues to face challenges to its implementation. The significance of this legislation reaches new heights in the wake of the Supreme Court’s decision in Dobbs v. Jackson—a new era that underscores the need for comprehensive and inclusive sexual health education. As a result, California is at a critical point in its journey of sexual health reform. After addressing implementation concerns, the State has a unique opportunity to continue to spearhead the movement and create a model for sexual health programs across the nation.
Legislation’s Requirements and Restrictions
The California Healthy Youth Act (AB 329) took effect in January 2016. The California Healthy Youth Act (CHYA) mandates comprehensive sexual health education and HIV prevention education in California public schools. In 2018, California extended the application to include charter schools. Under the Act, students are required to receive sexual health instruction at least once in junior high or middle school and at least once in high school. The legislation lays out specific requirements for the curriculum. In short, the instruction and materials must be age-appropriate, medically accurate; unbiased; inclusive of the LGBTQ+ community; and appropriate for use with students of all races, ethnic and cultural backgrounds, and students with disabilities. Additional requirements include addressing gender identity and expression; sexuality; HIV and other sexually transmitted infections (STIs); contraceptives; legally available pregnancy outcomes and options—including abortion; sexual harassment and assault; and other forms of relationship abuse and violence. Notably, the law requires that students are informed about local resources for sexual health and reproductive health services and care.
In addition to content requirements, the CHYA imposed some restrictions on sexual health instruction. First, parents may opt their student out of participating in the program in its entirety. However, the legislation does not allow parents to request that their child receive information about certain topics and not others. Second, the legislation prohibits instruction that promotes (1) religious doctrine; (2) bias against any student based on any protected category (gender expression; race; sexuality; disability; etc.); or (3) “abstinence-only” sex education.
Sexual Education in the Dobbs era
After CHYA’s passage in 2016, most school districts in California updated their board policies and sexual health programs to satisfy the requirements under the Act. However, two years later, parents and community members in Orange County, San Diego, and other smaller districts across California voiced their opposition to the mandated curriculum. In 2019, 28 of 130 responding school districts failed to provide inclusive policies and curriculum. Community opposition to sexual health reform encourages local school districts to remain out of compliance with the law and restricts students’ access to comprehensive sexual health information. The effects of the opposition to sexual education reform are further exacerbated by the status of reproductive health care post-Roe.
In Dobbs v. Jackson Women’s Health Organization, the Supreme Court overturned Roe v. Wade and Planned Parenthood v. Casey and removed the constitutional right to abortion, returning the decision to permit access to abortion to the states. Since then, 22 states have laws restricting the legal status of abortion. Because of these laws, student access to comprehensive and accurate sexual health education is critical. The nation’s youth must understand the options available to them in order to make informed decisions and protect their sexual and reproductive health.
Declining teen birth rates offer a glimmer of hope. In fact, the CDC reports that the “birth rate for teenagers ages 15–19 declined by 6% in 2021.” Advocates say the decline could be in part due to increased access to improved sexual health education. A 2021 study supports this assertion by finding that “counties that received federal funding for more comprehensive sex education led to a 3 percent reduction in the overall rate of teen births.” Another study found that comprehensive sexual education encouraged teens to delay intercourse and helped avoid unplanned pregnancy. Dobbs threatens this progress by restricting teens’ access to reproductive healthcare and stands to reverse declines in teen birth rates. This effect will be further exacerbated since abortion rates are higher among teens than older people. Teens are also more likely to find out that they are pregnant at a later stage of their pregnancies. Additionally, due to their age and status as minors, teens have to comply with further regulations in order to receive an abortion. These factors directly threaten the health and safety of teens because pregnant people in this age group are at a greater risk of medical complications such as high-blood pressure as well as further financial and psychological stressors of raising a child.
An increased focus on sexual health education provides a solution. In addition to contributing to a reduction in teen births, the CHYA’s mandated shift towards comprehensive sexual education is supported by a study that shows that abstinence-only instruction does not delay initiation of sexual intercourse or change other sexual risk behaviors. Increased access to comprehensive sexual education will play an integral role in mitigating the effects of Dobbs. Students deserve to be armed with un-biased, inclusive information in order to make choices that are the healthiest for them.
A promising start to sexual health reform suffers due to opposition and lack of enforcement
California remains at the front of the movement for sexual education reform in the United States as one of only seven states that “mandate sex education, HIV/STI education, and comprehensive healthy relationship content.” However, implementation of the California Healthy Youth Act has slowed in response to parent opposition and religious opposition to the reformed curricula. A 2019 report found that 28 out of the 130 responding school districts failed to comply with the California Healthy Youth Act because they used materials that were not inclusive of the needs of LGBTQ youth. This lack of compliance is partially due to lack of enforcement of the legislation.
Further, school districts maintain a significant amount of discretion over the manner in the schools comply with the law. School districts, school boards, and teachers all have considerable influence over the content and method by which the information is presented. As a result, there is substantial variation in sexual health programs across districts. Although California adopted a Healthy Education Framework, schools are not required to follow its guidelines, thus limiting its adherence. This undermines students’ access to consistent, comprehensive sexual education across school districts.
What happens next?
The Dobbs decision urges California to address compliance issues. This new era of reproductive health emphasizes the need for students to receive reproductive healthcare. California needs to address these issues by (1) increasing funding for training of teachers entrusted with teaching sexual education; (2) providing mandatory instructional materials for sexual health programs; and (3) improving enforcement tools to ensure adherence with CHYA.
The Supreme Court’s decision has also ignited the dialogue surrounding reproductive health. This presents an opportunity to expand the conversation to include sexual education reform in the face of growing opposition. This is critical because stigma surrounding these conversations continues to threaten the nation’s youth. Stigma surrounding HIV and other STIs has been shown to reduce sexual health seeking behaviors and remains a significant “barrier to building healthy young people and communities.” Through continued progress and support of CHYA, schools across California can actively confront this stigma.
Finally, the requirements of the California Health Youth Act deserve credit as innovative, inclusive, comprehensive, medically accurate, and un-biased. California needs to remedy the pitfalls in its implementation in order to set the standard for successful sexual health reform that other states can follow. California must become the model for comprehensive sexual education and effectively continue the sexual health reform movement that is desperately needed in the aftermath of Dobbs.