High school students across the country often struggle to get the health information they need. The federal government does not require schools to teach sex education or set standards for what it should include. Only 36 states and the District of Columbia require schools to teach sex education at all. And amongst the remaining states, requirements are wide-ranging.
For example, in states like Texas, schools aren’t required to offer sex education past middle school. When they do, parents or guardians must give written permission first. This “opt-in” policy, advocates say, creates another barrier to accessing medically accurate information.
To better understand how these policies and other challenges affect young people in Texas and beyond, Public Good News spoke with Sarah McQueen, chief mission officer at Healthy Futures of Texas. She shared how her organization and community partners work to expand access to sexual health information, care, and resources—especially for young people in rural areas, in foster care, or involved in the juvenile justice system.
Here are five key takeaways from the conversation:
[Editor’s note: The contents of this interview have been edited for length and clarity.]
It’s rarely lack of interest that stops people… it’s life.
“The vast majority of states across the country do what’s called an opt out policy. [But] in Texas, sexual health education in schools often requires a signed form. For households where guardians are juggling jobs, or where kids are in foster care or juvenile justice settings, that form might never reach school. Small barriers like this can have big consequences. Those young people that maybe most need that information are least likely to… get that permission slip signed and return it. Because of this, we really try to seek out those community-based partners to provide that wraparound support for young people, so we can help close that gap.”
Peer-to-peer engagement works
“For our peer-to-peer work on college campuses, we really do try to embed that because it’s such a successful method. Young people want to hear information from their peers—people who are sharing the same experience at that moment in time. Our program, Campus Conversations, really becomes that voice on campus. They’re helping to recruit their peers, sharing that information, and we just work with campus departments to help get recruitment going. Sometimes it’s just word of mouth as well.”
Adults need this information too
“What we also find, especially when partnering with a community-based organization, is that staff of the organization will come to us after a session and say, ‘I never even learned this information.’ Adults need this too. So we provide both the basic content—like contraception, pregnancy, STI prevention, anatomy— and training on skills: how to navigate sensitive topics, answer questions, remain values-neutral.”
Listen to your frontline workers
“Health educators are the backbone of our organization. They’re the first to hear where students are getting information, and they hear all the misinformation out there. They pick up on trends. What myths are circulating… and bring that back to us. That feedback informs our programs and helps us respond to what young people actually need to know.”
Bring humanity into health work
“We often think of health work as delivering services. But young people need someone who understands their life and challenges. Someone who treats them like humans, not case files.
Young people are inquisitive and they’re smart and they’re trying to be discerning, but there’s so much noise out there. Healthy Futures really aims to cut through that noise and provide accurate, age-appropriate information that they can then share out.”
A correction was made on Dec. 15, 2025: An earlier version of this article published that Texas did not have state requirements to provide sex education, instead of specifying that it is required in middle school, but not beyond it.