[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1697 Introduced in Senate (IS)]

<DOC>






118th CONGRESS
  1st Session
                                S. 1697

   To provide for the overall health and well-being of young people, 
 including the promotion and attainment of lifelong sexual health and 
             healthy relationships, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 18, 2023

  Ms. Hirono (for herself, Mr. Booker, Mr. Blumenthal, Mr. Brown, Ms. 
   Duckworth, Mr. Markey, Mr. Menendez, Mr. Merkley, Mr. Murphy, Mr. 
  Padilla, Ms. Smith, Mr. Van Hollen, and Ms. Warren) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
   To provide for the overall health and well-being of young people, 
 including the promotion and attainment of lifelong sexual health and 
             healthy relationships, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Real Education and Access for 
Healthy Youth Act of 2023''.

SEC. 2. PURPOSE AND FINDINGS.

    (a) Purpose.--The purpose of this Act is to provide young people 
with sex education and sexual health services that--
            (1) promote and uphold the rights of young people to 
        information and services that empower them to make decisions 
        about their bodies, health, sexuality, families, and 
        communities in all areas of life;
            (2) are evidence-informed, comprehensive in scope, 
        confidential, equitable, accessible, medically accurate and 
        complete, age and developmentally appropriate, culturally 
        responsive, trauma-informed and resilience-oriented, and align 
        with the National Sex Education Standards of the Future of Sex 
        Ed Initiative;
            (3) provide information about the prevention, treatment, 
        and care of pregnancy, sexually transmitted infections, and 
        interpersonal violence;
            (4) provide information about the importance of consent as 
        a basis for healthy relationships and for autonomy in 
        healthcare;
            (5) provide information on gender identity and gender 
        expression;
            (6) provide information on the historical and current 
        condition in which education and health systems, policies, 
        programs, services, and practices have uniquely and adversely 
        impacted Black, Indigenous, Latine, Asian American, Native 
        Hawaiian, Pacific Islander, and other People of Color; and
            (7) redress inequities in the delivery of sex education and 
        sexual health services to marginalized young people.
    (b) Findings.--Congress finds the following:
            (1) Young people need and have the right to sex education 
        and sexual health services that are evidence-informed, 
        comprehensive in scope, confidential, equitable, accessible, 
        medically accurate and complete, age and developmentally 
        appropriate, culturally responsive, and trauma-informed and 
        resilience-oriented.
            (2) Currently, there is a gap between the sex education 
        that young people should be receiving based on expert standards 
        and the sex education many actually receive.
            (3) Only 38 States and the District of Columbia mandate sex 
        education or human immunodeficiency virus (HIV) education in 
        schools.
            (4) When there is sex education or instruction regarding 
        HIV or sexually transmitted infections (STI), 13 States do not 
        require the content to be evidence-informed, medically accurate 
        and complete, age and developmentally appropriate, or 
        culturally responsive.
            (5) Many sex education programs and sexual health services 
        currently available were not designed to and do not currently 
        meet the needs of marginalized young people. Some such programs 
        and services actually harm marginalized young people.
            (6) For marginalized young people, a lack of comprehensive 
        in scope, confidential, equitable, and accessible sex education 
        and sexual health services is not unfamiliar, but rather a 
        longstanding manifestation of white supremacy, which has 
        touched every aspect of our history, culture, and institutions, 
        including the education and healthcare systems.
            (7) The development and delivery of sexual health education 
        and sexual health services in the United States historically 
        has been rooted in the oppression of Black, Indigenous, Latine, 
        Asian American, Native Hawaiian, Pacific Islander, and other 
        People of Color.
            (8) The United States has a long history of eugenics and 
        forced sterilization. The sexual and reproductive rights and 
        bodily autonomy of specific communities deemed ``undesirable'' 
        or ``defective'' were targeted by our governments resulting in 
        state-sanctioned violence and generations of trauma and 
        oppression. These communities include--
                    (A) people with low incomes;
                    (B) immigrants;
                    (C) people with disabilities;
                    (D) people living with HIV;
                    (E) survivors of interpersonal violence;
                    (F) people who are incarcerated, detained, or who 
                otherwise have encountered the criminal-legal system;
                    (G) Black, Indigenous, Latine, Asian American, and 
                other People of Color;
                    (H) people who are lesbian, gay, bisexual, 
                transgender, and queer; and
                    (I) young people who are pregnant and parenting.
            (9) Black young people are more likely to receive 
        abstinence-only instruction. Research shows that abstinence-
        only instruction, also known as ``sexual risk avoidance'' 
        instruction, is ineffective in comparison to sex education.
            (10) Black, Indigenous, and Latine young people are 
        disproportionately more likely to be diagnosed with an STI, 
        have an unintended pregnancy, or experience sexual assault.
            (11) The framework of Reproductive Justice acknowledges and 
        aims to address the legacy of white supremacy, systemic 
        oppression, and the restrictions on sex education and sexual 
        health services that disproportionately impact marginalized 
        communities. Reproductive Justice will be achieved when all 
        people regardless of actual or perceived race, color, 
        ethnicity, national origin, religion, immigration status, sex 
        (including gender identity and sexual orientation), disability 
        status, pregnancy or parenting status, or age have the power to 
        make decisions about their bodies, health, sexuality, families, 
        and communities in all areas of life.
            (12) Increased resources are required for sex education and 
        sexual health services to reach all young people, redress 
        inequities and their impacts on marginalized young people, and 
        achieve Reproductive Justice for young people.
            (13) Such sex education and sexual health services should--
                    (A) promote and uphold the rights of young people 
                to information and services in order to make and 
                exercise informed and responsible decisions about their 
                sexual health;
                    (B) be evidence-informed, comprehensive in scope, 
                confidential, equitable, accessible, age and 
                developmentally appropriate, culturally responsive, and 
                trauma-informed and resilience-oriented;
                    (C) include instruction and materials that 
                address--
                            (i) puberty and adolescent development;
                            (ii) sexual and reproductive anatomy and 
                        physiology;
                            (iii) sexual orientation, gender identity, 
                        and gender expression;
                            (iv) contraception, pregnancy, and 
                        reproduction;
                            (v) HIV and other STIs;
                            (vi) consent and healthy relationships; and
                            (vii) interpersonal violence;
                    (D) promote gender equity and be inclusive of young 
                people with varying gender identities, gender 
                expressions, and sexual orientations;
                    (E) promote safe and healthy relationships; and
                    (F) promote racial equity and be responsive to the 
                needs of young people who are Black, Indigenous, and 
                other People of Color.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Age and developmentally appropriate.--The term ``age 
        and developmentally appropriate'' means topics, messages, and 
        teaching methods suitable to particular ages, age groups, or 
        developmental levels, based on cognitive, emotional, social, 
        and behavioral capacity of most young people at that age level.
            (2) Consent.--The term ``consent'' means affirmative, 
        conscious, and voluntary agreement to engage in interpersonal, 
        physical, or sexual activity.
            (3) Culturally responsive.--The term ``culturally 
        responsive'' means education and services that--
                    (A) embrace and actively engage and adjust to young 
                people and their various cultural identities;
                    (B) recognize the ways in which many marginalized 
                young people face unique barriers in our society that 
                result in increased adverse health outcomes and 
                associated stereotypes; and
                    (C) may address the ways in which racism has shaped 
                national health care policy, the lasting historical 
                trauma associated with reproductive health experiments 
                and forced sterilizations of Black, Latine, and 
                Indigenous communities, or sexual stereotypes assigned 
                to young People of Color or LGBTQ+ people.
            (4) Evidence-informed.--The term ``evidence-informed'' 
        means incorporates characteristics, content, or skills that 
        have been proven to be effective through evaluation in changing 
        sexual behavior.
            (5) Gender expression.--The term ``gender expression'' 
        means the expression of one's gender, such as through behavior, 
        clothing, haircut, or voice, and which may or may not conform 
        to socially defined behaviors and characteristics typically 
        associated with being either masculine or feminine.
            (6) Gender identity.--The term ``gender identity'' means 
        the gender-related identity, appearance, mannerisms, or other 
        gender-related characteristics of an individual, regardless of 
        the individual's designated sex at birth.
            (7) Inclusive.--The term ``inclusive'' means content and 
        skills that ensure marginalized young people are valued, 
        respected, centered, and supported in sex education instruction 
        and materials.
            (8) Institution of higher education.--The term 
        ``institution of higher education'' has the meaning given the 
        term in section 101 of the Higher Education Act of 1965 (20 
        U.S.C. 1001).
            (9) Interpersonal violence.--The term ``interpersonal 
        violence'' means abuse, assault, bullying, dating violence, 
        domestic violence, harassment, intimate partner violence, or 
        stalking.
            (10) Local educational agency.--The term ``local 
        educational agency'' has the meaning given the term in section 
        8101 of the Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801).
            (11) Marginalized young people.--The term ``marginalized 
        young people'' means young people who are disadvantaged by 
        underlying structural barriers and social inequities, including 
        young people who are--
                    (A) Black, Indigenous, Latine, Asian American, 
                Native Hawaiian, Pacific Islander, and other People of 
                Color;
                    (B) immigrants;
                    (C) in contact with the foster care system;
                    (D) in contact with the juvenile justice system;
                    (E) experiencing homelessness;
                    (F) pregnant or parenting;
                    (G) lesbian, gay, bisexual, transgender, or queer;
                    (H) living with HIV;
                    (I) living with disabilities;
                    (J) from families with low-incomes; or
                    (K) living in rural areas.
            (12) Medically accurate and complete.--The term ``medically 
        accurate and complete'' means that--
                    (A) the information provided through the education 
                is verified or supported by the weight of research 
                conducted in compliance with accepted scientific 
                methods and is published in peer-reviewed journals, 
                where applicable; or
                    (B) the education contains information that leading 
                professional organizations and agencies with relevant 
                expertise in the field recognize as accurate, 
                objective, and complete.
            (13) Resilience.--The term ``resilience'' means the ability 
        to adapt to trauma and tragedy.
            (14) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (15) Sex education.--The term ``sex education'' means high 
        quality teaching and learning that--
                    (A) is delivered, to the maximum extent 
                practicable, following the National Sexuality Education 
                Standards of the Future of Sex Ed Initiative;
                    (B) is about a broad variety of topics related to 
                sex and sexuality, including--
                            (i) puberty and adolescent development;
                            (ii) sexual and reproductive anatomy and 
                        physiology;
                            (iii) sexual orientation, gender identity, 
                        and gender expression;
                            (iv) contraception, pregnancy, pregnancy 
                        options, and reproduction;
                            (v) HIV and other STIs;
                            (vi) consent and healthy relationships; and
                            (vii) interpersonal violence;
                    (C) explores values and beliefs about such topics; 
                and
                    (D) helps young people in gaining the skills that 
                are needed to navigate relationships and manage one's 
                own sexual health.
            (16) Sexual health services.--The term ``sexual health 
        services'' includes--
                    (A) sexual health information, education, and 
                counseling;
                    (B) all methods of contraception approved by the 
                Food and Drug Administration;
                    (C) routine gynecological care, including human 
                papillomavirus (HPV) vaccines and cancer screenings;
                    (D) pre-exposure prophylaxis or post-exposure 
                prophylaxis;
                    (E) substance use and mental health services;
                    (F) interpersonal violence survivor services; and
                    (G) other pregnancy and STI prevention, care, or 
                treatment services.
            (17) Sexual orientation.--The term ``sexual orientation'' 
        means an individual's romantic, emotional, or sexual attraction 
        to other people.
            (18) State educational agency.--The term ``State 
        educational agency'' has the meaning given the term in section 
        8101 of the Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801).
            (19) Trauma.--The term ``trauma'' means a response to an 
        event, series of events, or set of circumstances that is 
        experienced or witnessed by an individual or group of people as 
        physically or emotionally harmful or life-threatening with 
        lasting adverse effects on their functioning and mental, 
        physical, social, emotional, or spiritual well-being.
            (20) Trauma-informed and resilience-oriented.--The term 
        ``trauma-informed and resilience-oriented'' means an approach 
        that realizes the prevalence of trauma, recognizes the various 
        ways individuals, organizations, and communities may respond to 
        trauma differently, recognizes that resilience can be built, 
        and responds by putting this knowledge into practice.
            (21) Young people.--The term ``young people'' means 
        individuals who are ages 10 through 29 at the time of 
        commencement of participation in a project supported under this 
        Act.
            (22) Youth-friendly sexual health services.--The term 
        ``youth-friendly sexual health services'' means sexual health 
        services that are provided in a confidential, equitable, and 
        accessible manner that makes it easy and comfortable for young 
        people to seek out and receive services.

SEC. 4. GRANTS FOR SEX EDUCATION AT ELEMENTARY AND SECONDARY SCHOOLS 
              AND YOUTH-SERVING ORGANIZATIONS.

    (a) Program Authorized.--The Secretary, in coordination with the 
Secretary of Education, shall award grants, on a competitive basis, to 
eligible entities to enable such eligible entities to carry out 
projects that provide young people with sex education.
    (b) Duration.--Grants awarded under this section shall be for a 
period of 5 years.
    (c) Eligible Entity.--In this section, the term ``eligible entity'' 
means a public or private entity that delivers health education to 
young people.
    (d) Applications.--An eligible entity desiring a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary may 
require.
    (e) Priority.--In awarding grants under this section, the Secretary 
shall give priority to eligible entities that are--
            (1) State educational agencies or local educational 
        agencies; or
            (2) Indian Tribes or Tribal organizations, as defined in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act (25 U.S.C. 5304).
    (f) Use of Funds.--Each eligible entity that receives a grant under 
this section shall use the grant funds to carry out a project that 
provides young people with sex education.

SEC. 5. GRANTS FOR SEX EDUCATION AT INSTITUTIONS OF HIGHER EDUCATION.

    (a) Program Authorized.--The Secretary, in coordination with the 
Secretary of Education, shall award grants, on a competitive basis, to 
institutions of higher education or consortia of such institutions to 
enable such institutions to provide students with age and 
developmentally appropriate sex education.
    (b) Duration.--Grants awarded under this section shall be for a 
period of 5 years.
    (c) Applications.--An institution of higher education or consortium 
of such institutions desiring a grant under this section shall submit 
an application to the Secretary at such time, in such manner, and 
containing such information as the Secretary may require.
    (d) Priority.--In awarding grants under this section, the Secretary 
shall give priority to an institution of higher education that--
            (1) has an enrollment of needy students, as defined in 
        section 318(b) of the Higher Education Act of 1965 (20 U.S.C. 
        1059e(b));
            (2) is a Hispanic-serving institution, as defined in 
        section 502(a) of such Act (20 U.S.C. 1101a(a));
            (3) is a Tribal College or University, as defined in 
        section 316(b) of such Act (20 U.S.C. 1059c(b));
            (4) is an Alaska Native-serving institution, as defined in 
        section 317(b) of such Act (20 U.S.C. 1059d(b));
            (5) is a Native Hawaiian-serving institution, as defined in 
        section 317(b) of such Act (20 U.S.C. 1059d(b));
            (6) is a Predominantly Black Institution, as defined in 
        section 318(b) of such Act (20 U.S.C. 1059e(b));
            (7) is a Native American-serving, nontribal institution, as 
        defined in section 319(b) of such Act (20 U.S.C. 1059f(b));
            (8) is an Asian American and Native American Pacific 
        Islander-serving institution, as defined in section 320(b) of 
        such Act (20 U.S.C. 1059g(b)); or
            (9) is a minority institution, as defined in section 365 of 
        such Act (20 U.S.C. 1067k), with an enrollment of needy 
        students, as defined in section 312 of such Act (20 U.S.C. 
        1058).
    (e) Uses of Funds.--An institution of higher education or 
consortium of such institutions receiving a grant under this section 
shall use grant funds to develop and implement a project to integrate 
sex education into the institution of higher education in order to 
reach a large number of students, by carrying out 1 or more of the 
following activities:
            (1) Adopting and incorporating age and developmentally 
        appropriate sex education into student orientation, general 
        education, or courses.
            (2) Developing or adopting and implementing educational 
        programming outside of class that delivers age and 
        developmentally appropriate sex education to students.
            (3) Developing or adopting and implementing innovative 
        technology-based approaches to deliver age and developmentally 
        appropriate sex education to students.
            (4) Developing or adopting and implementing peer-led 
        activities to generate discussion, educate, and raise awareness 
        among students about age and developmentally appropriate sex 
        education.
            (5) Developing or adopting and implementing policies and 
        practices to link students to sexual health services.

SEC. 6. GRANTS FOR EDUCATOR TRAINING.

    (a) Program Authorized.--The Secretary, in coordination with the 
Secretary of Education, shall award grants, on a competitive basis, to 
eligible entities to enable such eligible entities to carry out the 
activities described in subsection (e).
    (b) Duration.--Grants awarded under this section shall be for a 
period of 5 years.
    (c) Eligible Entity.--In this section, the term ``eligible entity'' 
means--
            (1) a State educational agency or local educational agency;
            (2) an Indian Tribe or Tribal organization, as defined in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act (25 U.S.C. 5304);
            (3) a State or local department of health;
            (4) an educational service agency, as defined in section 
        8101 of the Elementary and Secondary Education Act of 1965 (20 
        U.S.C. 7801);
            (5) a nonprofit institution of higher education or a 
        consortium of such institutions; or
            (6) a national or statewide nonprofit organization or 
        consortium of nonprofit organizations that has as its primary 
        purpose the improvement of provision of sex education through 
        training and effective teaching of sex education.
    (d) Application.--An eligible entity desiring a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary may 
require.
    (e) Authorized Activities.--
            (1) Required activity.--Each eligible entity receiving a 
        grant under this section shall use grant funds for professional 
        development and training of relevant teachers, health 
        educators, faculty, administrators, and staff, in order to 
        increase effective teaching of sex education to young people.
            (2) Permissible activities.--Each eligible entity receiving 
        a grant under this section may use grant funds to--
                    (A) provide training and support for educators 
                about the content, skills, and professional disposition 
                needed to implement sex education effectively;
                    (B) develop and provide training and support to 
                educators on incorporating anti-racist and gender 
                inclusive policies and practices in sex education;
                    (C) support the dissemination of information on 
                effective practices and research findings concerning 
                the teaching of sex education;
                    (D) support research on--
                            (i) effective sex education teaching 
                        practices; and
                            (ii) the development of assessment 
                        instruments and strategies to document--
                                    (I) young people's understanding of 
                                sex education; and
                                    (II) the effects of sex education;
                    (E) convene conferences on sex education, in order 
                to effectively train educators in the provision of sex 
                education; and
                    (F) develop and disseminate appropriate research-
                based materials to foster sex education.
            (3) Subgrants.--Each eligible entity receiving a grant 
        under this section may award subgrants to nonprofit 
        organizations that possess a demonstrated record of providing 
        training to teachers, health educators, faculty, 
        administrators, and staff on sex education to--
                    (A) train educators in sex education;
                    (B) support internet or distance learning related 
                to sex education;
                    (C) promote rigorous academic standards and 
                assessment techniques to guide and measure student 
                performance in sex education;
                    (D) encourage replication of best practices and 
                model programs to promote sex education;
                    (E) develop and disseminate effective, research-
                based sex education learning materials; or
                    (F) develop academic courses on the pedagogy of sex 
                education at institutions of higher education.

SEC. 7. AUTHORIZATION OF GRANTS TO SUPPORT THE DELIVERY OF SEXUAL 
              HEALTH SERVICES TO MARGINALIZED YOUNG PEOPLE.

    (a) Program Authorized.--The Secretary shall award grants, on a 
competitive basis, to eligible entities to enable such entities to 
provide youth-friendly sexual health services to marginalized young 
people.
    (b) Duration.--Grants awarded under this section shall be for a 
period of 5 years.
    (c) Eligible Entity.--In this section, the term ``eligible entity'' 
means--
            (1) a public or private youth-serving organization; or
            (2) a covered entity, as defined in section 340B of the 
        Public Health Service Act (42 U.S.C. 256b).
    (d) Applications.--An eligible entity desiring a grant under this 
section shall submit an application to the Secretary at such time, in 
such manner, and containing such information as the Secretary may 
require.
    (e) Uses of Funds.--Each eligible entity that receives a grant 
under this section may use the grant funds to--
            (1) develop and implement an evidence-informed project to 
        deliver sexual health services to marginalized young people;
            (2) establish, alter, or modify staff positions, service 
        delivery policies and practices, service delivery locations, 
        service delivery environments, service delivery schedules, or 
        other services components in order to increase youth-friendly 
        sexual health services to marginalized young people;
            (3) conduct outreach to marginalized young people to invite 
        them to participate in the eligible entity's sexual health 
        services and to provide feedback to inform improvements in the 
        delivery of such services;
            (4) establish and refine systems of referral to connect 
        marginalized young people to other sexual health services and 
        supportive services;
            (5) establish partnerships and collaborations with entities 
        providing services to marginalized young people to link such 
        young people to sexual health services, such as by delivering 
        health services at locations where they congregate, providing 
        transportation to locations where sexual health services are 
        provided, or other linkages to services approaches;
            (6) provide evidence-informed, comprehensive in scope, 
        confidential, equitable, accessible, medically accurate and 
        complete, age and developmentally appropriate, culturally 
        responsive, and trauma-informed and resilience-oriented sexual 
        health information to marginalized young people in the 
        languages and cultural contexts that are most appropriate for 
        the marginalized young people to be served by the eligible 
        entity;
            (7) promote effective communication regarding sexual health 
        among marginalized young people; and
            (8) provide training and support for eligible entity 
        personnel and community members who work with marginalized 
        young people about the content, skills, and professional 
        disposition needed to provide youth-friendly sex education and 
        youth-friendly sexual health services.

SEC. 8. REPORTING AND IMPACT EVALUATION.

    (a) Grantee Report to Secretary.--For each year a grantee receives 
grant funds under section 4, 5, 6, or 7, the grantee shall submit to 
the Secretary a report that includes--
            (1) the use of grant funds by the grantee;
            (2) how the use of grant funds has increased the access of 
        young people to sex education or sexual health services; and
            (3) such other information as the Secretary may require.
    (b) Secretary's Report to Congress.--Not later than 1 year after 
the date of the enactment of this Act, and annually thereafter for a 
period of 5 years, the Secretary shall prepare and submit to Congress a 
report on the activities funded under this Act. The Secretary's report 
to Congress shall include--
            (1) a statement of how grants awarded by the Secretary meet 
        the purpose described in section 2(a); and
            (2) information about--
                    (A) the number of grantees that are receiving grant 
                funds under sections 4, 5, 6, and 7;
                    (B) the specific activities supported by grant 
                funds awarded under sections 4, 5, 6, and 7;
                    (C) the number of young people served by projects 
                funded under sections 4, 5, and 7, in the aggregate and 
                disaggregated and cross-tabulated by grant program, 
                race and ethnicity, sex, sexual orientation, gender 
                identity, and other characteristics determined by the 
                Secretary (except that such disaggregation or cross-
                tabulation shall not be required in a case in which the 
                results would reveal personally identifiable 
                information about an individual young person);
                    (D) the number of teachers, health educators, 
                faculty, school administrators, and staff trained under 
                section 6; and
                    (E) the status of the evaluation required under 
                subsection (c).
    (c) Multi-Year Evaluation.--
            (1) In general.--Not later than 6 months after the date of 
        the enactment of this Act, the Secretary shall enter into a 
        contract with a nonprofit organization with experience in 
        conducting impact evaluations to conduct a multi-year 
        evaluation on the impact of the projects funded under sections 
        4, 5, 6, and 7 and to report to Congress and the Secretary on 
        the findings of such evaluation.
            (2) Evaluation.--The evaluation conducted under this 
        subsection shall--
                    (A) be conducted in a manner consistent with 
                relevant, nationally recognized professional and 
                technical evaluation standards;
                    (B) use sound statistical methods and techniques 
                relating to the behavioral sciences, including quasi-
                experimental designs, inferential statistics, and other 
                methodologies and techniques that allow for conclusions 
                to be reached;
                    (C) be carried out by an independent organization 
                that has not received a grant under section 4, 5, 6, or 
                7; and
                    (D) be designed to provide information on output 
                measures and outcome measures to be determined by the 
                Secretary.
            (3) Report.--Not later than 6 years after the date of 
        enactment of this Act, the organization conducting the 
        evaluation under this subsection shall prepare and submit to 
        the appropriate committees of Congress and the Secretary an 
        evaluation report. Such report shall be made publicly 
        available, including on the website of the Department of Health 
        and Human Services.

SEC. 9. NONDISCRIMINATION.

    Activities funded under this Act shall not discriminate on the 
basis of actual or perceived sex (including sexual orientation and 
gender identity), age, parental status, race, color, ethnicity, 
national origin, disability, or religion. Nothing in this Act shall be 
construed to invalidate or limit rights, remedies, procedures, or legal 
standards available under any other Federal law or any law of a State 
or a political subdivision of a State, including the Civil Rights Act 
of 1964 (42 U.S.C. 2000a et seq.), title IX of the Education Amendments 
of 1972 (20 U.S.C. 1681 et seq.), section 504 of the Rehabilitation Act 
of 1973 (29 U.S.C. 794), the Americans with Disabilities Act of 1990 
(42 U.S.C. 12101 et seq.), and section 1557 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18116).

SEC. 10. LIMITATION.

    No Federal funds provided under this Act may be used for sex 
education or sexual health services that--
            (1) withhold health-promoting or life-saving information 
        about sexuality-related topics, including HIV;
            (2) are medically inaccurate or incomplete;
            (3) promote gender or racial stereotypes or are 
        unresponsive to gender or racial inequities;
            (4) fail to address the needs of sexually active young 
        people;
            (5) fail to address the needs of pregnant or parenting 
        young people;
            (6) fail to address the needs of survivors of interpersonal 
        violence;
            (7) fail to address the needs of young people of all 
        physical, developmental, or mental abilities;
            (8) fail to be inclusive of individuals with varying gender 
        identities, gender expressions, and sexual orientations; or
            (9) are inconsistent with the ethical imperatives of 
        medicine and public health.

SEC. 11. AMENDMENTS TO OTHER LAWS.

    (a) Amendment to the Public Health Service Act.--Section 2500 of 
the Public Health Service Act (42 U.S.C. 300ee) is amended by striking 
subsections (b) through (d) and inserting the following:
    ``(b) Contents of Programs.--All programs of education and 
information receiving funds under this subchapter shall include 
information about the potential effects of intravenous substance 
use.''.
    (b) Amendments to the Elementary and Secondary Education Act of 
1965.--Section 8526 of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7906) is amended--
            (1) by striking paragraphs (3), (5), and (6);
            (2) by redesignating paragraph (4) as paragraph (3);
            (3) in paragraph (3), as redesignated by paragraph (2), by 
        inserting ``or'' after the semicolon; and
            (4) by redesignating paragraph (7) as paragraph (4).

SEC. 12. FUNDING.

    (a) Authorization.--For the purpose of carrying out this Act, there 
is authorized to be appropriated $100,000,000 for each of fiscal years 
2024 through 2029. Amounts appropriated under this subsection shall 
remain available until expended.
    (b) Reservations of Funds.--
            (1) In general.--The Secretary--
                    (A) shall reserve not more than 30 percent of the 
                amount authorized under subsection (a) for the purposes 
                of awarding grants for sex education at elementary and 
                secondary schools and youth-serving organizations under 
                section 4;
                    (B) shall reserve not more than 10 percent of the 
                amount authorized under subsection (a) for the purpose 
                of awarding grants for sex education at institutions of 
                higher education under section 5;
                    (C) shall reserve not more than 15 percent of the 
                amount authorized under subsection (a) for the purpose 
                of awarding grants for educator training under section 
                6;
                    (D) shall reserve not more than 30 percent of the 
                amount authorized under subsection (a) for the purpose 
                of awarding grants for sexual health services for 
                marginalized youth under section 7; and
                    (E) shall reserve not less than 5 percent of the 
                amount authorized under subsection (a) for the purpose 
                of carrying out the reporting and impact evaluation 
                required under section 8.
            (2) Research, training, and technical assistance.--The 
        Secretary shall reserve not less than 10 percent of the amount 
        authorized under subsection (a) for expenditures by the 
        Secretary to provide, directly or through a competitive grant 
        process, research, training, and technical assistance, 
        including dissemination of research and information regarding 
        effective and promising practices, providing consultation and 
        resources, and developing resources and materials to support 
        the activities of recipients of grants. In carrying out such 
        functions, the Secretary shall collaborate with a variety of 
        entities that have expertise in sex education and sexual health 
        services standards setting, design, development, delivery, 
        research, monitoring, and evaluation.
    (c) Reprogramming of Abstinence Only Until Marriage Program 
Funding.--The unobligated balance of funds made available to carry out 
section 510 of the Social Security Act (42 U.S.C. 710) (as in effect on 
the day before the date of enactment of this Act) are hereby 
transferred and shall be used by the Secretary to carry out this Act. 
The amounts transferred and made available to carry out this Act shall 
remain available until expended.
    (d) Repeal of Abstinence Only Until Marriage Program.--Section 510 
of the Social Security Act (42 U.S.C. 710 et seq.) is repealed.
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