State Profiles

Current Requirement

• North Carolina schools must teach sex education, also known as “reproductive health and safety education”
  • Curriculum is not required to be comprehensive and must emphasize the benefits of abstinence alongside instruction on contraception. 
  • Curriculum is required to include instruction on HIV/AIDS and STI prevention
• Curriculum is not required to include instruction on sexual orientation or gender identity. However, the curriculum must teach that a “faithful monogamous heterosexual marriage is the best lifelong means of avoiding STDs”. 
• Instruction on “gender identity, sexual activity, and sexuality” is prohibited in grades kindergarten through fourth grade
•  Curriculum is required to include instruction on consent and healthy relationships, according to the new health standards which will be required for implementation in the 2025-2026 school year.  
• Depending on the school district,  parents and guardians must either send a written notice to the school principal to excuse their children from any part of sex education instruction (an “opt-out” policy) or provide written permission for their children to take part in sex education instruction (an “opt-in” policy).  
• Curriculum must be medically accurate and evidence-based.

RECENT LEGISLATION SHAPING THE STATE LANDSCAPE

North Carolina schools are required to teach medically accurate reproductive health and safety education due to the passage of their Healthy Youth Act in 2009. Since then, North Carolina advocates have seen a steady increase in efforts to roll back progress and restrict sex education curriculum across the state in recent years.

Attacks on sex education have been on the rise in North Carolina under the umbrella of the “parental rights” movement. This movement led to the success of bills like Senate Bill 49 (2023). Senate Bill 49 (2023) has led to confusion among school districts as to whether sex education enrollment must be opt-in or opt-out. Although the law still leaves it up to local school districts to decide their policy, vague and confusing language is leading to some school districts, such as Charlotte-Mecklenburg Schools,  deciding to switch to an opt-in policy. This will lead to fewer young North Carolinans receiving sex education. This bill also prohibits instruction on gender identity, sexual activity, and sexuality in grades kindergarten through fourth, restricting content that can be taught as a part of health education in elementary school.

In the current session, House Bill 595 has been introduced and seeks to extend the ban on instruction of gender identity, sexual activity, and sexual activity to sixth grade and instead require human growth and development instruction only with a focus on puberty for grade fourth and fifth which parents must “opt” their child into. Further, it entirely would change reproductive health and safety education to opt in and prohibit its instruction prior to seventh grade. Lastly, it would require public hearings that anyone can attend when discussing health education curriculum changes. Thus far, this bill has not progressed; however, it represents some of the challenges advocates in North Carolina continue to face with providing quality and inclusive sex education.

In addition to attacks on inclusive sex education, the passage of House Bill 574 and House Bill 808, a transgender student athlete ban and medical care ban, has made North Carolina a more hostile place both within the school and healthcare system for transgender youth. LGBTQIA+ students deserve to be represented and affirmed both in the classroom, and outside the classroom. Existing North Carolina law that requires instruction on the importance of “faithful monogamous heterosexual marriage” further stigmatizes LGBTQIA+ students. 

North Carolina does require implementation of their Health Education Standards, which include abstinence, contraception, STI prevention, sexual violence prevention, healthy relationships, and more. These standards serve as a framework under which individual school districts can select the curriculum they want to use. Local decision-making over sex education curriculum presents unique challenges that have resulted in glaring disparities regarding the quality of sex education that students receive. Additionally, lack of enforcement of existing health standards remains an issue. For example, advocates report that many schools double-down on emphasizing abstinence by using fear mongering tactics erroneously linking suicide rates as an outcome of having premarital sex.

Right now, advocates can take action to ensure young people in their community have access to quality sex education. After contacting their  local education agencies (LEAs), advocates can determine what topics are missing from sex education instruction, such as instruction on sexual orientation and gender identity. They can then vocalize the important need for advancing sex education requirements in their community to make it more comprehensive. Advocates should also work to dispel myths and concerns regarding existing legislation to prevent local school districts from switching to opt-in policies. Advocates are encouraged to take action on pending legislation that seeks to advance or restrict the principles of sex education. Advocates are encouraged to take action on pending legislation that seeks to advance or restrict the principles of sex education. North Carolina’s 2025-2026 legislative session convened January 8th, 2025 and adjourned July 31st, 2026. Further, advocates can contact their representatives to discuss the need for strengthening the implementation of mandated reproductive health and safety education and the newest edition of state health education standards. Advocates are encouraged to use the SIECUS Community Action Toolkit to guide local efforts to advance sex education. For more information on getting involved in local and state advocacy for sex education, reach out to our State Policy Action Manager, Miranda Estes (mestes@siecus.org)

More on sex ed in North Carolina…

State Law: A Closer Look

North Carolina General Statutes § 115C-81.25 and 115C-81.30 require schools to teach a comprehensive health education program, which includes instruction on the prevention of pregnancy and sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Schools must stress the importance of parental involvement and teach refusal skills and strategies to handle peer pressure. Comprehensive health education must include “reproductive health and safety education” beginning in seventh grade. Such instruction must teach “that abstinence from sexual activity outside of marriage is the expected standard for all school-age children” and “that a mutually faithful, monogamous, heterosexual relationship in the context of marriage is the best lifelong means of avoiding [STDs], including HIV/AIDS,” among other stipulations. With respect to contraception and family planning, the law requires instruction to teach:

• “… how [STDs] are and are not transmitted, the effectiveness and safety of all federal Food and Drug Administration (FDA)-approved methods of reducing the risk of contracting [STDs], and information on local resources for testing and medical care for [STDs] …; and
• The effectiveness and safety of all FDA-approved contraceptive methods in preventing pregnancy.”

Reproductive health and safety education must be age-appropriate, objective, and based on scientific research that is peer-reviewed and accepted by professionals in the field of sexual health education. Instruction must include information on healthy relationships, awareness of sexual assault, sexual abuse, and risk reduction. Students may receive information about where to obtain contraceptives and abortion referral services only in accordance with the local board’s policy regarding parental consent; however, contraceptives, including condoms and other devices, shall not be made available or distributed on school property. Instruction is also required to include stigmatizing information about the risks associated with “preterm birth,” including those linked to “induced abortion.”

The State Board of Education is required to make a list of reviewed materials, any approved textbooks and other approved materials regarding pregnancy and STDs, including HIV prevention, available to parents and legal guardians at least 60 days before such instruction is provided in the classroom. Additionally, as a result of Senate Bill 49 (2023), General Statutes 115C-76.55 prohibits instruction on gender identity, sexual activity, and sexual activity in kindergarten through fourth grade.North Carolina law also requires local school boards to “adopt policies to provide opportunities either for parents and legal guardians to consent or for parents and legal guardians to withhold their consent for the students’ participation in any or all of these programs.” These are referred to as “opt-in” and “opt-out” policies, respectively.

State Standards

The North Carolina Department of Public Instruction provides Healthful Living: Health Education Essential Standards, which offers model policies and content outlines, the most recent edition released in 2024 for implementation in the 2025-2026 school year. Essential standards in this guideline include the skill to “evaluate abstinence from sexual intercourse as a positive choice for young people” and to “create strategies that develop and maintain reproductive and sexual health,” such as “illustrat[ing] skills related to safe and effective use of methods to prevent STDs, as well as access resources for testing and treatment.” In the most recent edition, instruction on consent and physical boundaries was added. These standards serve as a framework for local school districts to base their curriculum on.

Youth Sexual Health Data

Young people are more than their health behaviors and outcomes. While data can be a powerful tool to demonstrate the sex education and sexual health care needs of young people, it is important to be mindful that these behaviors and outcomes are impacted by systemic inequities present in our society that affect an individual’s sexual health and well-being. In recent years, there has been an increase in legislative attacks on the implementation of CDC’s Youth Risk Behavior Survey (YRBS) which tracks six categories of health risk behaviors including sexual health behaviors. To learn more about North Carolina’s 2023 YRBS results, click here. In 2023, North Carolina participated in high school and middle school YRBS data collection.

North Carolina School Health Profiles Data 

In 2024, the Centers for Disease Control and Prevention (CDC) released the 2022 School Health Profiles, which measure school health policies and practices and highlight which health topics were taught in schools across the country. Since the data were collected from self-administered questionnaires completed by schools’ principals and lead health education teachers, the CDC notes that one limitation of the School Health Profiles is bias toward the reporting of more positive policies and practices. In the School Health Profiles, the CDC identifies 22 sexual health education topics as critical for ensuring a young person’s sexual health. To view North Carolina’s results from the 2022 School Health Profiles Survey, visit CDC’s School Health Profiles Explorer tool.

Visit the CDC’s School Health Profiles for additional information on school health policies and practices.

The quality of sex education taught often reflects funding available for sex education programs. To learn more about federal funding streams, click here.