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Trends around sexual assault and dating violence are stagnant, rates of sexually transmitted infections STIs are increasing, and there are wide disparities between lesbian, gay, or bisexual LGB youth and their heterosexual peers. The bill does not require school districts to offer sex ed classes. If they do, however, the classes must be comprehensive — meaning that they include information on consent, the health needs of lesbian, gay, bisexual, transgender, or intersex Coloradans, and other issues that might not be covered in abstinence-only curricula.

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HB updates a law that some policymakers felt left gaps in the curriculum and resources for sex education. It was one of the most divisive bills of the session, with more than 20 hours of committee testimony and only two Republican votes across both chambers.

Download the PDF version of this report. Colorado is a local-control state, which means that the Colorado Department of Education creates comprehensive health education standards and supports school districts in aligning their curriculum with these standards. But the department does not require sex ed to be taught or monitor the extent to which the standards are implemented.

In fact, Colorado is the only state that does not require a health education course to graduate. That will not change under HB Districts will still determine whether to offer sex ed.

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Still, supporters of comprehensive sex ed hope that the stronger language will allow parents and students to hold their districts able for the quality and contents of the programs they do offer. Comprehensive sex ed and the standards included in HB are about much more than sex. An effective sexual health curriculum encourages students to maintain healthy relationships, be sexually abstinent, prevent or reduce sexually transmitted infections STIs and unintended pregnancies, and use appropriate health services to promote their sexual health.

Fewer — 83 percent — discussed contraception. And less than a third 31 percent of school districts in Colorado had a comprehensive sex ed policy on record in Moreover, students in schools with more low-income students were less likely to offer a sexual health component within their health education program.

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See Figure 4. HB addresses some of these disparities, because it provides funds that will go first to rural schools and schools without comprehensive sexual health programs. However, the initial grant is predicted to only reach 17 school districts. This report uses several acronyms when discussing lesbian, gay, bisexual, transgender, queer or questioning, and intersex Coloradans. The variation is due to an effort to accurately reflect the groups discussed in recent legislation and research. It does not look specifically at trans or intersex youth.

The following definitions, adapted from GLAAD 3can help illuminate the identities included in these definitions. Queer: An adjective used by some people whose sexual is not exclusively heterosexual.

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Fewer Colorado high school students are having sex than just a few years ago. The percentage of sexually active high school students has declined to 22 percent in from 29 percent inaccording the Healthy Kids Colorado Survey.

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An expanded view of youth sexual health, however, reveals a much more nuanced picture. While the percentage of sexually active Colorado students using some method of birth control has increased slightly, fewer students reported using a condom the last time they had sexual intercourse. At the same time, rates of STIs — which can be more effectively prevented by using condoms than by other commonly used forms of birth control — are increasing.

Chlamydia rates have gone up 24 percent sinceand gonorrhea rates have grown percent. Risk behaviors and STIs are just one part of sexual health. Healthy relationships are another important consideration, and Colorado has not made recent progress in this area.

Innearly one in 10 high schoolers in a relationship said they experienced dating violence, and more than one in 20 high schoolers experienced sexual assault see Figure 2. Both figures are close to their and values.

Comprehensive sex ed may also act as a protective factor against sexual assault later in life.

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About 2, students, or 5 percent of respondents, identified as unsure about their sexuality in the Healthy Kids Colorado Survey. Fewer students who were unsure about their sexual orientation reported having had sex and being currently sexually active. Like their LGB peers, however, they reported higher rates of intimate partner and sexual violence, poor mental health periods, and suicidal thoughts than their heterosexual peers.

These students cannot be grouped into either the heterosexual or LGBbut these disparities suggest that their needs be considered when developing curricula around healthy relationships and mental health for youth. InLGB youth were nearly two-and-a-half-times more likely than their heterosexual peers to report physical violence from a dating partner in the past year and four times more likely to report ever being physically forced to have sex, with nearly one in five LGB students reporting each of these events see Figure 3.

Sexuality-based discrimination and internalized homophobia have both been associated with increased likelihood of experiencing physical and sexual intimate partner violence among gay and bisexual men. While publicly available Healthy Kids Colorado Survey data does not have information on these outcomes for transgender youth specifically, a national survey found that nearly half 47 percent of transgender people have experienced sexual assault. It is likely that transgender high school students in Colorado experience higher rates of sexual violence than their cisgender peers.

LGB students are also more likely than non-LGB students to report ever having had sex, having sex before age 13, and being currently sexually active. These students had much higher rates of poor mental health and suicidal feelings see Figure 3.

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These disparities between heterosexual and LGB youth were one source of motivation for supporters of HBwhich emphasizes that sexual health education cannot explicitly or implicitly exclude the health needs of LGBTI individuals. There is limited quantitative research on the impact of comprehensive sex ed on sexual health outcomes of non-heterosexual students.

Colorado occupies an odd place among the states when it comes to sex ed. It has some of the strongest curriculum standards, but it does not require schools to offer sex ed at all. The law made Colorado one of eight states that require sex ed to be culturally appropriate and unbiased, one of nine requiring it to be inclusive of all sexual orientations, and one of 13 requiring it to be medically accurate. However, Colorado is the only state without a health education mandate 25 and it is one of 26 states without a sex ed mandate.

Comparing Colorado to a handful of states with various sex ed policies see Figure 5 provides a sense of which policies seem to be associated with certain health outcomes see Figures 6 and 7. A sex ed mandate on its own is not enough to drive change in sexual health outcomes, but sex ed policy still influences these outcomes.

New Mexico, which mandates sex ed but does not require the curriculum to be medically accurate, has the highest STI and teen pregnancy rates among these five states see Figure 7 — in line with the evidence that comprehensive sex ed is correlated with better health outcomes. In Colorado, LGB youth experience concerning levels of sexual and dating violence.

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Mandating sex ed for all school districts on its own, however, does not seem to be associated with reducing inequity in these markers. Public health research suggests that the expansion of comprehensive sex ed could positively impact youth sexual health. However, any expansion is likely to be contentious. Public health studies often contrast comprehensive sex ed with approaches such as abstinence-only, abstinence-only-until-marriage AOUMand sexual risk avoidance SRAwhich teach that sex should be delayed until marriage and limit discussion of birth control methods to descriptions of its ineffectiveness.

A systematic review of comprehensive sexuality education programs found that these programs increased abstinence and use of protection and decreased the of sexual partners, frequency of sexual activity, STIs, and pregnancy. Many abstinence-only programs focus exclusively on heterosexual relationships and describe homosexuality as deviant and unnatural.

Many abstinence-only programs state that all premarital sexual activity is shameful and le to guilt about sex.

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Supporters of HB also often cite less tangible benefits to comprehensive sex ed. For these supporters, the benefits of comprehensive sex ed go beyond health outcomes that can be demonstrated by quantitative data.

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As the lengthy debate over HB during the legislative session makes clear, however, many people who oppose comprehensive sex ed in schools have a different vision of what these policies and curricula should look like. Many frame their concerns as a moral issue grounded in values, arguing that providing too much information on contraception endorses premarital sex, of which they do not approve. Some worry that the discussion of homosexuality and transgender identities in the classroom discredits their belief systems and promotes sexual activities they oppose, tacitly endorsing one view of sex and sexuality over another.

Other opponents of HB are concerned that it takes some local control away from schools. Other policy options may further the goals of improving sexual health outcomes.

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For example, Colorado could consider adding a teacher certification program, reaching out to local school districts to inform them of existing resources, or expanding the Comprehensive Human Sexuality Grant Program. A teacher certification program would allow instructors to get trained on how to teach sexual health more effectively. The CDC recommends professional development programs for health education instructors.

However, such a program would require funding. While it would likely be an optional program, it could raise the same concerns around usurping local control as HB For supporters of comprehensive sex education, encouraging their school district to apply for the grant program could be one way to expand sexual health education in their area.

Each school district would be able to decide for itself if its leadership wished to access existing resources for expanding sex education programs. Conversations about this issue at the local level would allow both opponents and supporters of comprehensive sex ed to be heard. With or without the grant money, though, schools that offer sex ed will have to follow the new comprehensive standards in HB Finally, expanding the grant program would give more schools the resources to update their curricula.

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CDPHE, which runs the grant program, will collect data on the effectiveness of the initial appropriation. Lawmakers can use this data to inform next steps for the program, including future funding. At the same time, Colorado youth are experiencing concerning rates of STIs and dating violence.

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