Abstract
Objectives. To assess state laws and regulations mandating sexual education in US public schools in 2025. Methods. We identified and analyzed state statutes, administrative regulations, and state court decisions that mandated sexual education in public schools in every US state and the District of Columbia. We coded content requirements, attributes (e.g., "age-appropriate"), and parental notice and consent policies. Results. Forty-two US states required sexual education in at least 1 content area in K‒12 public schools. Most required education to cover abstinence (34 states), HIV (34 states), sexually transmitted infections (32 states), and child abuse prevention (31 states). Five states required opt-in parental consent; 34 allowed parents to opt children out. Nineteen states mandated medically accurate content for any topic. Conclusions. Although many states mandated sexual education, few required content beyond sexual abstinence, HIV, sexually transmitted infections, and child abuse prevention. Laws that make content optional or facilitate opt-outs can undermine access to this education. Public Health Implications. This detailed accounting of the law will enable researchers and policymakers to identify opportunities to support the implementation of medically accurate, evidence-based sexual education in school settings. (Am J Public Health. 2025;115(10):1723-1733. https://doi.org/10.2105/AJPH.2025.308199).