Healthy Youth Act FAQs

These Frequently Asked Questions (FAQs) are designed to help you understand sexuality education, requirements in North Carolina, and how to apply them as a parent, school administrator, or teacher. 

Submit a Question to Add to the FAQs Page!


The Basics

About Sexuality Education

Roles and Responsibilities


Content Requirements


Teaching Sexuality Education


The Basics

What is the Healthy Youth Act?

The Healthy Youth Act is a 2009 state law that updated North Carolina’s sexuality education to align more closely with parent opinion and public health best practices. Before the passage of the Healthy Youth Act, North Carolina schools were required to provide inaccurate and/or ineffective abstinence-only-until-marriage programs.

What is Reproductive Health and Safety Education?

Reproductive Health and Safety Education is the official name for education provided under the Healthy Youth Act.

When did the Healthy Youth Act go into effect?

School systems were required to implement the requirements of the Healthy Youth Act starting in the 2010-11 school year.

About Sexuality Education

What is sexuality education?

Sexuality education is another term for what is more commonly called sex education or sex ed. The name sexuality education is used because lessons often include aspects of sexual health that are not directly related to sex, such as relationships and decision-making skills.

Is sexuality education good for students?

Yes – as long as it’s the right kind. Students who complete sexuality education in general wait longer to have sex than students who have no sexuality education. Furthermore, when students do become sexually active, those who complete comprehensive sexuality education are more likely to use condoms and/or contraceptives and to have healthier relationships than students who have no sexuality education or who only receive abstinence-only education. In one well-regarded study, students who completed comprehensive sexuality education were 50% less likely to get pregnant as teens than students who completed abstinence-only education.

Does sexuality education encourage sex?

No. Research shows students who complete sexuality education wait longer to have sex than students who receive no sexuality education.

What is comprehensive sexuality education?

Comprehensive sexuality education is a loose term that commonly refers to sexuality education that includes instruction on both abstinence and on condoms and contraceptive methods. Comprehensive sexuality education has been widely researched and is proven to help students wait longer to have sex and be safer and more responsible when they do ultimately become sexually active.

What is abstinence-only education?

Abstinence-only education is a term for sexuality education that only focuses on sexual abstinence. Abstinence-only-until-marriage is a term for programs that focus on abstinence, and have an additional focus on saving sex until marriage. These programs are notorious for providing inaccurate and/or harmful information.

While some abstinence-only curricula are effective at helping teens delay having sex, they are not more effective at helping teens delay sex than comprehensive curricula. In addition, research shows that students who only receive abstinence-only education are less likely to use condoms and/or contraceptives, more likely to get pregnant, more likely to contract HIV or STIs, and more likely to enter unhealthy relationships.

Are any abstinence-only programs effective?

Two abstinence-only curricula have been shown to be effective at helping students delay sex. These two curricula are Making a Difference and Promoting Health Among Teens. Materials in these two programs are factually accurate and focus on delaying sex until ready (rather than delaying sex until marriage).  When considering these programs, schools should remember three key points:

  • These curricula are more effective at helping students delay sex than more comprehensive curricula, and should not be thought of as a preferred strategy to "promote abstinence"
  • Because these curricula do not directly address condom and/or contraceptive use, they are not effective at helping students use condoms and/or contraceptives when they become sexually active or if they already are sexually active
  • These curricula do not meet all the requirements of the Healthy Youth Act, and must be supplemented if used as part of a school curriculum

What is an evidence-based curriculum?

An evidence-based curriculum is a curriculum that has been evaluated against a control group and is proven to work. Most public health and education professionals and groups only consider this evidence of effectiveness valid if the evaluation results have been published in a peer-reviewed journal.

What is a promising curriculum?

A promising curriculum has been developed using the same processes and standards as an evidence-based program, and has undergone an initial evaluation. However, promising programs have either not been evaluated as rigorously as evidence-based programs or the evaluation has not been published in a peer-reviewed journal.

Roles and Responsibilities

What do school systems have to do according to the Healthy Youth Act?

Each local school system (LEA) in North Carolina is required to provide:

  • Reproductive Health and Safety Education that meets the guidelines set forth in the Healthy Youth Act and included in North Carolina’s Standard Course of Study for Comprehensive Health Education.
  • An opportunity for parents/guardians to review any materials and/or curricula used in Reproductive Health and Safety Education.
  • A mechanism for parents/guardians to withdraw their child from instruction or consent to their child’s participation.

What do school boards have to do according to the Healthy Youth Act?

Each school board is required to pass the appropriate local policies to ensure that the three requirements listed above are met. A sample school board policy is available from the North Carolina School Boards Association.

What is local control?

Local control is simply a term that indicates that most policy decisions and implementation procedures are determined by local school system officials. Local control is a key characteristic of North Carolina’s education system.

Is there a public hearing requirement?

No. North Carolina’s old abstinence-only-until-marriage law required LEAs to host a public forum in order to expand a curriculum. The public forum requirement – which proved burdensome for schools, health officials, and parents – was eliminated by the Healthy Youth Act.

Can schools opt out?

No. Individual public schools with grades 7, 8, and 9 must provide Reproductive Health and Safety Education.


What role do parents play?

Parental involvement is a part of any effective sexuality education curriculum, and the Healthy Youth Act mandates the promotion of parent-student communication and interaction. In addition, schools must make curricula/materials available for parents’ review.

Can a parent opt his or her child out of sexuality education?

Yes. All school districts must provide parents with an opportunity to withdraw their student from Reproductive Health and Safety Education through either an opt-out or opt-in process. Most school systems choose an opt-out process in accordance with general best practices for education. A parent/guardian can withdraw a student from any part of Reproductive Health and Safety Education or from all of it.

Can parents see a school’s sexuality education curriculum?

Yes. The Healthy Youth Act requires schools to let you view a curriculum. Many schools will simply keep a copy in the media center.

As a parent, what should I look for when I review a curriculum?

We recommend you look for the following:

  • Is the curriculum labeled “evidence-based” or “promising”? These will help you know if materials have been developed by trusted resources.
  • Does the curriculum follow a logical sequence? Most effective curricula will cover things like personal values or decision-making, then move on to abstinence and birth control methods.
  • Do materials focus too heavily on values? School-based curricula should let you provide values at home, and focus on facts in the classroom. Be wary of curricula that focus heavily on scare tactics or what makes someone a “good” person or “bad” person.

How do North Carolina parents feel about sexuality education?

A 2009 independent survey of parents of North Carolina public school students shows overwhelming support for school-based sexuality education. In all, 91.8% of parents think sexuality education should be provided in schools. These parents clearly indicated that they think sexuality education should be comprehensive and thorough:

  • Transmission and prevention of sexually transmitted diseases (99.6%)
  • What to do if one has been raped or sexually assaulted (99.4%)
  • The basics of reproduction or how babies are made, pregnancy, and birth (98.6%)
  • How to deal with pressure to have sex (99.4%) 
  • How to talk with parents about sex and relationship issues (98.7%)
  • How to talk with a girlfriend, boyfriend, or partner about birth control and sexually transmitted diseases (97.1%)
  • Abstinence until marriage (94%)
  • Waiting to have sex until after graduating from high school (96.2%)
  • Effectiveness and failure rates of birth control methods, including condoms (97.1%)
  • How to get tested for HIV/AIDS and sexually transmitted diseases (94.4%)
  • Risks of oral sex (92.9%)
  • How to use other birth control methods, such as birth control pills, or Depo-Provera (91%)
  • How to use condoms (91.3%)
  • Where to get birth control, including condoms (87%)
  • What sexual orientation means (86.9%)
  • A classroom demonstration of how to use a condom properly (76.7%)

Read the full results of the 2009 Parent Opinion Survey.

Since 2009, similar surveys have been conducted in conservative communities and found similar majority support for comprehensive and thorough sexuality education.

How should schools meet the parental involvement requirement?

Schools handle this requirement in different ways. Some curricula include parent-student activities like a take-home interview where a student interviews a parent about family values and expectations. Many schools choose to offer a parent education night to help parents talk to their children about sex. 

Content Requirements

What does sexuality education have to include?

Reproductive Health and Safety Education must teach the following points:

  1. Abstinence is the expected standard for school-aged children
  2. Strategies to deal with peer pressure
  3. Reasons, skills, and strategies for becoming or remaining abstinent
  4. Abstinence is the only certain means to prevent unintended pregnancy and diseases
  5. The best lifelong means of prevention is fidelity within marriage, including the value of monogamous, heterosexual marriage as an example of a healthy relationship
  6. The benefits of abstinence as compared to the risks of premarital sex
  7. Medically accurate information on HIV and STDs/STIs, including:
    1. How HIV/STIs are and are not transmitted
    2. Effectiveness and safety of all FDA-approved methods of risk reduction
    3. Available local resources for testing and treatment
    4. HIV/STI infection rates among youth and their effects
    5. Specific information about Human Papillomavirus (HPV) and its effects, including cancers like cervical cancer.
    6. The effectiveness and safety of all FDA-approved contraceptive methods
    7. Awareness of sexual assault, sexual abuse, and risk reduction:
      1. A focus on building healthy relationships
      2. What constitutes sexual assault and sexual abuse, the causes of those behaviors, and risk reduction
      3. Resources and reporting procedures if a student experiences sexual assault or abuse
      4. Common misconceptions about sexual assault and abuse

In addition, instruction must:

  1. Provide opportunities for parent/guardian-student interaction
  2. Provide factually accurate biological and pathological information
  3. Be objective and based upon scientific research that is peer reviewed and accepted by professionals and experts in the field of sexual health education

When is sexuality education taught?

The Healthy Youth Act only covers education in grades 7, 8, and 9. In addition, North Carolina’s Standard Course of Study includes Comprehensive Health Education in all grades, which includes subjects like puberty. LEAs can elect to provide more education in more grades.

Is there anything schools cannot teach?

Any prohibition on teaching certain subjects is determined at the local level. In addition, schools are required to provide information that is factually accurate – which could be interpreted as a prohibition on providing inaccurate information, a common flaw in abstinence-only-until-marriage materials.

Do schools teach about abstinence?

Yes. Schools are required to teach about abstinence. All effective curricula include information about abstinence.

Do schools have to teach about birth control or condoms?

Yes. Instruction must cover all FDA-approved contraceptive methods and FDA-approved devices for HIV/STD prevention. All curricula that are effective for pregnancy prevention include information about contraceptive methods. 

Are condom demonstrations required?

The Healthy Youth Act does not require or prohibit condom demonstrations. Many evidence-based curricula include a condom demonstration as a skill-building activity because it is one of the best ways to reinforce correct and consistent condom use as a means of preventing pregnancy and HIV/STIs. 91.8% of North Carolina parents of public school children want schools to provide sexuality education. Of these parents, 76.7% want sexuality education to include a condom demonstration. 

Will schools distribute condoms to students?

No. North Carolina law prohibits schools from distributing condoms or contraceptive devices on school grounds.

Do schools have to teach about Emergency Contraception?

Yes. Emergency Contraception (also called Plan B or the morning-after pill) is an FDA-approved contraceptive method. While lots of misinformation exists, Emergency Contraception is not considered an abortifacient by the medical community.

Do schools have to teach about abortion?

Any decision to provide information on abortion is a local decision. Most school systems choose not to address this topic.

Do schools have to use a specific curriculum?

No. Information must be factually accurate and objective, and meet all the requirements of the Healthy Youth Act. However, no specific curriculum is recommended or required.


Is there a review period for materials?

Not for local school systems. The only requirement for a materials review period applies at the state level. If the state school board or Department of Public Instruction requires or recommends a curriculum or text book, then they must offer a 60 day review period.

How do we make materials available to parents?

Most school systems simply place materials in each school’s media center. This is a common practice for any instructional material, and is not unique to sexuality education.

Should we create an opt-in or opt-out policy?

We recommend an opt-out policy for two reasons. First, since the implementation of the Healthy Youth Act, many schools report having very few parents withdraw a child from sexuality education. Therefore, an opt-out process defaults to what most parents would choose. Second, most schools seem to prefer opt-out processes because it places less administrative onus on teachers, parents, and school personnel to track permission slips from every student, and allows the school to be more responsive to the small number of objecting parents.

How do we choose a curriculum?

Many great resources exist to help you select a curriculum. We recommend the following strategies:

Do you offer training for teachers?

Yes. We offer teacher training in general teaching skills and on specific curricula. Please visit our Training & Events section for more information.

How can we help teachers feel comfortable teaching sexuality education?

Great question! We recognize that a great many sexuality education teachers did not enter the teaching profession with the goal of teaching sexuality education. A few ways to increase teacher comfort include:

  • Provide your teachers with training on the selected curriculum
  • Make sure teachers know they have support from their principal, school board, and superintendent
  • Help teachers clearly understand your school system’s policy on Reproductive Health and Safety Education, answering questions, providing referrals, and any specific local policies

How do we create a referral policy?

Each school system must have a system for providing referrals for HIV/STD testing and treatment. School systems can also elect to include contraceptive resources in their referral list. You can use our Clinic Locator tool to find a list of nearby clinics that provide sexual health services, including low-cost and/or teen friendly services.

Teaching Sexuality Education

As a teacher, what should I cover?

Please refer to the Content section of this page for specific content that must be covered.

As a teacher, is there anything I can’t talk about?

The Healthy Youth Act does not explicitly bar talking about any subject, and only sets baseline content standards. Please consult your local school system policies to see if there are any local restrictions.

As a teacher, what do I do if I disagree with a lesson’s content or with a question a student asks?

With the exception of basic universal values – respect, responsibility, health – school-based sexuality education is designed to help students learn facts and learn ways to apply their own family’s beliefs to real world situations. Part of a teacher’s role is to leave personal feelings or experiences out of the classroom.

As a teacher, how to I answer tough questions? What do I do if a student asks me about sexual orientation?

With facts. With the exception of basic universal values – respect, responsibility, health – school-based sexuality education is designed to help students learn facts and learn ways to apply their own family’s beliefs to real world situations. Offer the student basic medical facts about their situation.

As a teacher, what do I do if I don’t know an answer to a question?

It’s perfectly okay to tell a student you will find an answer and get back to them later.