,i #aafth ,,congress #ast ,session ,h4 ,r4 #bgbj ,,in ,,the ,,house ,,of ,,representatives ,may #ad1 #bjai,ms4 ,lee of ,california 7for herself1 ,mr4 ,blumenauer1 ,ms4 ,norton1 ,ms4 ,bonamici1 ,ms4 ,omar1 ,ms4 ,wasserman ,schultz1 ,ms4 ,moore1 ,mr4 ,khanna1 ,mr4 ,tonko1 ,ms4 ,speier1 ,ms4 ,adams1 ,ms4 ,velzquez1 ,mr4 ,hastings1 ,mr4 ,serrano1 ,ms4 ,jayapal1 ,ms4 ,escobar1 ,ms4 ,roybal-,allard1 ,mr4 ,raskin1 ,mr4 ,schiff1 ,ms4 ,judy ,chu of ,california1 ,mrs4 ,torres of ,california1 ,mrs4 ,carolyn ,b4 ,maloney of ,new ,york1 ,ms4 ,del,bene1 ,ms4 ,clarke of ,new ,york1 ,mr4 ,larsen of ,washington1 ,mr4 ,mc,govern1 ,mr4 ,welch1 ,mr4 ,ryan1 ,mr4 ,aguilar1 ,ms4 ,de,gette1 ,mr4 ,evans1 ,ms4 ,de,lauro1 ,mr4 ,grijalva1 ,ms4 ,clark of ,massachusetts1 and ,mr4 ,pocan7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committee on ,education and ,labor1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to provide for the overall health and well-being of young people1 including the promotion of lifelong sexual health and healthy relationships1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,real ,education for ,healthy ,youth ,act of #bjai4 #b4 ,purposes2 finding2 sense of ,congress 7a7 ,purposes ,the purposes of this ,act are to provide young people with comprehensive sex education programs that-- 7#a7 promote and uphold the rights of young people to information in order to make healthy decisions about their sexual health2 7#b7 provide the information and skills all young people need to make informed1 responsible1 and healthy decisions in order to become sexually healthy adults and have healthy relationships2 7#c7 provide information about the prevention of unintended pregnancy1 sexually transmitted infections1 including ,,hiv1 dating violence1 sexual assault1 bullying1 and harassment2 and 7#d7 provide resources and information on topics ranging from gender stereotyping and gender roles and stigma and socio-cultural influences surrounding sex and sexuality4 7b7 ,finding on required resources ,in order to provide the comprehensive sex education described in subsection 7a71 ,congress finds that increased resources are required for sex education programs that-- 7#a7 substantially incorporate elements of evidence-based programs or characteristics of effective programs2 7#b7 cover a broad range of topics1 including medically accurate and complete information that is age and developmentally appropriate about all the aspects of sex1 sexual health1 and sexuality2 7#c7 are gender and gender identity-sensitive1 emphasizing the importance of equality and the social environment for achieving sexual and reproductive health and overall well-being2 7#d7 promote educational achievement1 critical thinking1 decision making1 self-esteem1 and self-efficacy2 7#e7 help develop healthy attitudes and insights necessary for understanding relationships between oneself and others and society2 7#f7 foster leadership skills and community engagement by-- 7,a7 promoting principles of fairness1 human dignity1 and respect2 and 7,b7 engaging young people as partners in their communities2 and 7#g7 are culturally and linguistically appropriate1 reflecting the diverse circumstances and realities of young people4 7c7 ,sense of congress ,it is the sense of ,congress that-- 7#a7 federally funded sex education programs should aim to-- 7,a7 provide information about a range of human sexuality topics1 including-- 7i7 human development1 healthy relationships1 personal skills2 7ii7 sexual behavior including abstinence2 7iii7 sexual health including preventing unintended pregnancy2 7iv7 sexually transmitted infections including ,,hiv2 and 7v7 society and culture2 7,b7 promote safe and healthy relationships2 7,c7 promote gender equity2 7,d7 use1 and be informed by1 the best scientific information available2 7,e7 be culturally appropriate and inclusive of youth with varying gender identities1 gender expressions1 and sexual orientations2 7,f7 be built on characteristics of effective programs2 7,g7 expand the existing body of research on comprehensive sex education programs through program evaluation2 7,h7 expand training programs for teachers of comprehensive sex education2 7,i7 build on programs funded under section #eac of the ,social ,security ,act 7#db ,u4,s4,c4 #gac7 and the ,office of ,adolescent ,health's ,teen ,pregnancy ,prevention ,program1 funded under title ,,ii of the ,consolidated ,appropriations ,act1 #bjaj 7,public ,law #aaa-aag2 #abc ,stat4 #cbec71 and on programs supported through the ,centers for ,disease ,control and ,prevention 7,,cdc72 and 7,j7 promote and uphold the rights of young people to information in order to make healthy and autonomous decisions about their sexual health2 and 7#b7 no ,federal funds should be used for health education programs that-- 7,a7 withhold health-promoting or life-saving information about sexuality-related topics1 including ,,hiv2 7,b7 are medically inaccurate or have been scientifically shown to be ineffective2 7,c7 promote gender or racial stereotypes2 7,d7 are insensitive and unresponsive to the needs of sexually active young people2 7,e7 are insensitive and unresponsive to the needs of survivors of sexual violence2 7,f7 are insensitive and unresponsive to the needs of youth of all physical1 developmental1 and mental abilities2 7,g7 are insensitive and unresponsive to the needs of youth with varying gender identities1 gender expressions1 and sexual orientations2 or 7,h7 are inconsistent with the ethical imperatives of medicine and public health4 #c4 ,grants for comprehensive sex education for adolescents 7a7 ,program authorized ,the ,secretary1 in coordination with the ,associate ,commissioner of the ,family and ,youth ,services ,bureau of the ,administration on ,children1 ,youth1 and ,families of the ,department of ,health and ,human ,services1 the ,director of the ,office of ,adolescent ,health1 the ,director of the ,division of ,adolescent and ,school ,health within the ,centers for ,disease ,control and ,prevention and the ,secretary of ,education1 shall award grants1 on a competitive basis1 to eligible entities to enable such eligible entities to carry out programs that provide adolescents with comprehensive sex education1 as described in subsection 7f74 7b7 ,duration ,grants awarded under this section shall be for a period of #e years4 7c7 ,eligible entity ,in this section1 the term eligible entity means a public or private entity that focuses on adolescent health and education or has experience working with adolescents4 7d7 ,applications ,an eligible entity desiring a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require1 including an assurance to participate in the evaluation described in section #f4 7e7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to eligible entities that-- 7#a7 are ,state or local public entities2 7#b7 are entities not currently receiving funds under-- 7,a7 section #eac of the ,social ,security ,act 7#db ,u4,s4,c4 #gac72 7,b7 the ,office of ,adolescent ,health's ,teen ,pregnancy ,prevention ,program1 funded under title ,,ii of the ,consolidated ,appropriations ,act1 #bjaj 7,public ,law #aaa-aag2 #abc ,stat4 #cbec71 or any substantially similar successive program2 or 7,c7 the ,centers for ,disease ,control and ,prevention's ,division of ,adolescent and ,school ,health2 and 7#c7 address health inequities among young people that face systemic barriers resulting in disproportionate rates of not less than one of the following3 7,a7 ,unintended pregnancies4 7,b7 ,sexually transmitted infections1 including ,,hiv4 7,c7 ,dating violence and sexual violence4 7f7 ,use of funds 7#a7 ,in general ,each eligible entity that receives a grant under this section shall use the grant funds to carry out an education program that provides adolescents with comprehensive sex education that-- 7,a7 is age and developmentally appropriate2 7,b7 is medically accurate and complete2 7,c7 substantially incorporates elements of evidence-based sex education instruction2 or 7,d7 creates a demonstration project based on characteristics of effective programs4 7#b7 ,contents of comprehensive sex education programs ,the comprehensive sex education programs funded under this section shall include instruction and materials that address-- 7,a7 the physical1 social1 and emotional changes of human development1 including human anatomy1 reproduction1 and sexual development2 7,b7 healthy relationships1 including friendships1 within families1 and society1 that are based on mutual respect1 and the ability to distinguish between healthy and unhealthy relationships1 including-- 7i7 effective communication1 negotiation1 and refusal skills1 including the skills to recognize and report inappropriate or abusive sexual advances2 7ii7 bodily autonomy1 setting and respecting personal boundaries1 practicing personal safety1 and consent2 and 7iii7 the limitations and harm of gender-role stereotypes1 violence1 coercion1 bullying1 harassment1 and intimidation in relationships2 7,c7 healthy decision making skills about sexuality and relationships that include-- 7i7 critical thinking1 problem solving1 self-efficacy1 stress-management1 self-care1 and decision making2 7ii7 individual values and attitudes2 7iii7 the promotion of positive body images2 7iv7 developing an understanding that there are a range of body types and encouraging positive feeling about students' own body types2 7v7 information on how to respect others and ensure safety on the internet and when using other forms of digital communication2 7vi7 information on local services and resources where students can obtain additional information related to bullying1 harassment1 dating violence and sexual assault1 suicide prevention1 and other related care2 7vii7 encouragement for youth to communicate with their parents or guardians1 health and social service professionals1 and other trusted adults about sexuality and intimate relationships2 7viii7 information on how to create a safe environment for all students and others in society2 7ix7 examples of varying types of relationships1 couples1 and family structures2 and 7x7 affirmative representation of varying gender identities1 gender expressions1 and sexual orientations1 including individuals and relationships between same sex couples and their families2 7,d7 abstinence1 delaying age of first sexual activity1 the use of condoms1 preventive medication1 vaccination1 birth control1 and other sexually transmitted infection prevention measures1 and the options for pregnancy1 including parenting1 adoption1 and abortion1 including-- 7i7 the importance of effectively using condoms1 preventive medication1 and applicable vaccinations to protect against sexually transmitted infections1 including ,,hiv2 7ii7 the benefits of effective contraceptive and condom use in avoiding unintended pregnancy2 7iii7 the relationship between substance use and sexual health and behaviors2 and 7iv7 information about local health services where students can obtain additional information and services related to sexual and reproductive health and other related care2 7,e7 through affirmative recognition1 the roles that traditions1 values1 religion1 norms1 gender roles1 acculturation1 family structure1 health beliefs1 and political power play in how students make decisions that affect their sexual health1 using examples of various types of races1 ethnicities1 cultures1 and families1 including single-parent households and young families2 7,f7 information about gender identity1 gender expression1 and sexual orientation for all students1 including-- 7i7 affirmative recognition that people have different gender identities1 gender expressions1 and sexual orientations2 and 7ii7 community resources that can provide additional support for individuals with varying gender identities1 gender expressions1 and sexual orientations2 and 7,g7 opportunities to explore the roles that race1 ethnicity1 immigration status1 disability status1 economic status1 homelessness1 foster care status1 and language within different communities affect sexual attitudes in society and culture and how this may impact student sexual health4 #d4 ,grants for comprehensive sex education at institutions of higher education 7a7 ,program authorized ,the ,secretary1 in coordination with the ,secretary of ,education1 shall award grants1 on a competitive basis1 to institutions of higher education or consortia of such institutions to enable such institutions to provide young people with comprehensive sex education1 described in subsection 7e77#b74 7b7 ,duration ,grants awarded under this section shall be for a period of #e years4 7c7 ,applications ,an institution of higher education or consortia of such institutions desiring a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require1 including an assurance to participate in the evaluation described in section #f4 7d7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to an institution of higher education that-- 7#a7 has an enrollment of needy students as defined in section #cah7;b7 of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajei;e7b772 7#b7 is a ,hispanic-serving institution1 as defined in section #ejb7;a7 of such ,act 7#bj ,u4,s4,c4 #aaja;a7a772 7#c7 is a ,tribal ,college or ,university1 as defined in section #caf7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;c7b772 7#d7 is an ,alaska ,native-serving institution1 as defined in section #cag7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;d7b772 7#e7 is a ,native ,hawaiian-serving institution1 as defined in section #cag7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;d7b772 7#f7 is a ,predominately ,black ,institution1 as defined in section #cah7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;e7b772 7#g7 is a ,native ,american-serving1 nontribal institution1 as defined in section #cai7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;f7b772 7#h7 is an ,asian ,american and ,native ,american ,pacific ,islander-serving institution1 as defined in section #cbj7;b7 of such ,act 7#bj ,u4,s4,c4 #ajei;g7b772 or 7#i7 is a minority institution1 as defined in section #cfe of such ,act 7#bj ,u4,s4,c4 #ajfgk71 with an enrollment of needy students1 as defined in section #cab of such ,act 7#bj ,u4,s4,c4 #ajeh74 7e7 ,uses of funds 7#a7 ,in general ,an institution of higher education receiving a grant under this section shall use grant funds to integrate issues relating to comprehensive sex education into the institution of higher education in order to reach a large number of students1 by carrying out one or more of the following activities3 7,a7 ,developing or adopting educational content for issues relating to comprehensive sex education that will be incorporated into student orientation1 general education1 or core courses4 7,b7 ,developing or adopting1 and implementing schoolwide educational programming outside of class that delivers elements of comprehensive sex education programs to students1 faculty1 and staff4 7,c7 ,developing or adopting innovative technology-based approaches to deliver sex education to students1 faculty1 and staff4 7,d7 ,developing or adopting1 and implementing peer-outreach and education programs to generate discussion1 educate1 and raise awareness among students about issues relating to comprehensive sex education4 7#b7 ,contents of sex education programs ,each institution of higher education's program of comprehensive sex education funded under this section shall include instruction and materials that address the topics described in section #c7;f77#b74 #e4 ,grants for pre-service and in-service teacher training 7a7 ,program authorized ,the ,secretary1 in coordination with the ,director of the ,centers for ,disease ,control and ,prevention and the ,secretary of ,education1 shall award grants1 on a competitive basis1 to eligible entities to enable such eligible entities to carry out the activities described in subsection 7e74 7b7 ,duration ,grants awarded under this section shall be for a period of #e years4 7c7 ,eligible entity ,in this section1 the term eligible entity means-- 7#a7 a ,state educational agency2 7#b7 a local educational agency2 7#c7 a tribe or tribal organization1 as defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act 7#be ,u4,s4,c4 #ecjd72 7#d7 a ,state or local department of health2 7#e7 a ,state or local department of education2 7#f7 an educational service agency2 7#g7 a nonprofit institution of higher education2 7#h7 a national or statewide nonprofit organization that has as its primary purpose the improvement of provision of comprehensive sex education through training and effective teaching of comprehensive sex education2 or 7#i7 a consortium of nonprofit organizations that has as its primary purpose the improvement of provision of comprehensive sex education through training and effective teaching of comprehensive sex education4 7d7 ,application ,an eligible entity desiring a grant under this section shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require1 including an assurance to participate in the evaluation described in section #f4 7e7 ,authorized activities 7#a7 ,required activity ,each eligible entity receiving a grant under this section shall use grant funds for professional development and training of relevant faculty1 school administrators1 teachers1 and staff1 in order to increase effective teaching of comprehensive sex education to students4 7#b7 ,permissible activities ,each eligible entity receiving a grant under this section may use grant funds to-- 7,a7 provide research-based training of teachers for comprehensive sex education for adolescents as a means of broadening student knowledge about issues related to human development1 healthy relationships1 personal skills1 and sexual behavior1 including abstinence1 sexual health1 and society and culture2 7,b7 support the dissemination of information on effective practices and research findings concerning the teaching of comprehensive sex education2 7,c7 support research on-- 7i7 effective comprehensive sex education teaching practices2 and 7ii7 the development of assessment instruments and strategies to document-- 7,i7 student understanding of comprehensive sex education2 and 7,,ii7 the effects of comprehensive sex education2 7,d7 convene national conferences on comprehensive sex education1 in order to effectively train teachers in the provision of comprehensive sex education2 and 7,e7 develop and disseminate appropriate research-based materials to foster comprehensive sex education4 7#c7 ,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 faculty1 school administrators1 teachers1 and staff on comprehensive sex education to-- 7,a7 train teachers in comprehensive sex education2 7,b7 support internet or distance learning related to comprehensive sex education2 7,c7 promote rigorous academic standards and assessment techniques to guide and measure student performance in comprehensive sex education2 7,d7 encourage replication of best practices and model programs to promote comprehensive sex education2 7,e7 develop and disseminate effective1 research-based comprehensive sex education learning materials2 7,f7 develop academic courses on the pedagogy of sex education at institutions of higher education2 or 7,g7 convene ,state-based conferences to train teachers in comprehensive sex education and to identify strategies for improvement4 #f4 ,impact evaluation and reporting 7a7 ,multi-,year evaluation 7#a7 ,in general ,not later than #f months after the date of the enactment of this ,act1 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 grants under sections #c1 #d1 and #e1 and to report to ,congress and the ,secretary on the findings of such evaluation4 7#b7 ,evaluation ,the evaluation conducted under this subsection shall-- 7,a7 be conducted in a manner consistent with relevant1 nationally recognized professional and technical evaluation standards2 7,b7 use sound statistical methods and techniques relating to the behavioral sciences1 including quasi-experimental designs1 inferential statistics1 and other methodologies and techniques that allow for conclusions to be reached2 7,c7 be carried out by an independent organization that has not received a grant under section #c1 #d1 or #e2 and 7,d7 be designed to provide information on-- 7i7 output measures1 such as the number of individuals served under the grant and the number of hours of instruction2 7ii7 outcome measures1 including measures relating to-- 7,i7 the knowledge that individuals participating in the grant program have gained with respect to-- 7aa7 growth and development2 7bb7 relationship dynamics2 7cc7 ways to prevent unintended pregnancy and sexually transmitted infections1 including ,,hiv2 and 7dd7 sexual health2 7,,ii7 the age and developmentally appropriate skills that individuals participating in the grant program have gained regarding-- 7aa7 negotiation and communication2 7bb7 decision making and goal-setting2 7cc7 interpersonal skills and healthy relationships2 and 7dd7 condom use2 and 7,,iii7 the behaviors of adolescents participating in the grant program1 including data about-- 7aa7 age of first intercourse2 7bb7 condom and contraceptive use at first intercourse2 7cc7 recent condom and contraceptive use2 7dd7 substance use2 7ee7 dating abuse and lifetime history of sexual assault1 dating violence1 bullying1 harassment1 stalking2 and 7ff7 academic performance2 and 7iii7 other measures necessary to evaluate the impact of the grant program4 7#c7 ,report ,not later than #f years after the date of enactment of this ,act1 the organization conducting the evaluation under this subsection shall prepare and submit to the appropriate committees of ,congress and the ,secretary an evaluation report4 ,such report shall be made publicly available1 including on the website of the ,department of ,health and ,human ,services4 7b7 ,secretary's report to congress ,not later than #a year after the date of the enactment of this ,act1 and annually thereafter for a period of #e years1 the ,secretary shall prepare and submit to the appropriate committees of ,congress a report on the activities to provide adolescents and young people with comprehensive sex education and pre-service and in-service teacher training funded under this ,act4 ,the ,secretary's report to ,congress shall include-- 7#a7 a statement of how grants awarded by the ,secretary meet the purposes described in section #b7;a72 and 7#b7 information about-- 7,a7 the number of eligible entities and institutions of higher education that are receiving grant funds under sections #c1 #d1 and #e2 7,b7 the specific activities supported by grant funds awarded under sections #c1 #d1 and #e2 7,c7 the number of adolescents served by grant programs funded under section #c2 7,d7 the number of young people served by grant programs funded under section #d2 7,e7 the number of faculty1 school administrators1 teachers1 and staff trained under section #e2 and 7,f7 the status of the evaluation required under subsection 7a74 #g4 ,nondiscrimination ,programs funded under this ,act shall not discriminate on the basis of actual or perceived sex1 race1 color1 ethnicity1 national origin1 disability1 sexual orientation1 gender identity1 or religion4 ,nothing in this ,act shall be construed to invalidate or limit rights1 remedies1 procedures1 or legal standards available under any other ,federal law or any law of a ,state or a political subdivision of a ,state1 including the ,civil ,rights ,act of #aifd 7#db ,u4,s4,c4 #bjjj;a et seq471 title ,,ix of the ,education ,amendments of #aigb 7#bj ,u4,s4,c4 #afha et seq471 section #ejd of the ,rehabilitation ,act of #aigc 7#bi ,u4,s4,c4 #gid71 the ,americans with ,disabilities ,act of #aiij 7#db ,u4,s4,c4 #abaja et seq471 and section #aeeg of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahaaf74 #h4 ,limitation ,no ,federal funds provided under this ,act may be used for health education programs that-- 7#a7 withhold health-promoting or life-saving information about sexuality-related topics1 including ,,hiv2 7#b7 are medically inaccurate or have been scientifically shown to be ineffective2 7#c7 promote gender or racial stereotypes2 7#d7 are insensitive and unresponsive to the needs of sexually active young people2 7#e7 are insensitive and unresponsive to the needs of pregnant or parenting young people2 7#f7 are insensitive and unresponsive to the needs of survivors of sexual abuse or assault2 7#g7 are insensitive and unresponsive to the needs of youth of all physical1 developmental1 or mental abilities2 7#h7 are insensitive and unresponsive to individuals with varying gender identities1 gender expressions1 and sexual orientations2 or 7#i7 are inconsistent with the ethical imperatives of medicine and public health4 #i4 ,amendments to other laws 7a7 ,amendment to the public health service act ,section #bejj of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;ee7 is amended by striking subsections 7b7 through 7d7 and inserting the following3 7b7 ,contents of programs ,all programs of education and information receiving funds under this subchapter shall include information about the potential effects of intravenous substance abuse4 4 7b7 ,amendments to the elementary and secondary education act of #aife ,section #hebf of the ,elementary and ,secondary ,education ,act of #aife 7#bj ,u4,s4,c4 #gijf7 is amended-- 7#a7 by striking paragraph 7#c72 7#b7 by redesignating paragraphs 7#d7 and 7#e7 as paragraphs 7#c7 and 7#d71 respectively2 7#c7 in paragraph 7#d71 by inserting or after the semicolon2 7#d7 in paragraph 7#e71 by striking 2 or and inserting a period2 and 7#e7 by striking paragraph 7#f74 #aj4 ,definitions ,in this ,act3 7#a7 ,adolescents ,the term adolescents means individuals who are ages #aj through #ai at the time of commencement of participation in a program supported under this ,act4 7#b7 ,age and developmentally appropriate ,the term age and developmentally appropriate means topics1 messages1 and teaching methods suitable to particular age1 age group of children and adolescents1 or developmental levels1 based on cognitive1 emotional1 social1 and behavioral capacity of most students at that age level4 7#c7 ,appropriate committees of congress ,the term appropriate committees of ,congress means the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 the ,committee on ,appropriations of the ,senate1 the ,committee on ,energy and ,commerce of the ,house of ,representatives1 the ,committee on ,education and the ,workforce of the ,house of ,representatives1 and the ,committee on ,appropriations of the ,house of ,representatives4 7#d7 ,characteristics of effective programs ,the term characteristics of effective programs means the aspects of evidence-based programs1 including development1 content1 and implementation of such programs1 that-- 7,a7 have been shown to be effective in terms of increasing knowledge1 clarifying values and attitudes1 increasing skills1 and impacting upon behavior2 and 7,b7 are widely recognized by leading medical and public health agencies to be effective in changing sexual behaviors that lead to sexually transmitted infections1 including ,,hiv1 unintended pregnancy1 and dating violence and sexual assault among young people4 7#e7 ,comprehensive sex education ,the term comprehensive sex education means instructional part of a comprehensive school health education approach which addresses the physical1 mental1 emotional1 and social dimensions of human sexuality2 designed to motivate and assist students to maintain and improve their sexual health1 prevent disease and reduce sexual health-related risk behaviors2 and enable and empower students to develop and demonstrate age and developmentally appropriate sexuality and sexual health-related knowledge1 attitudes1 skills1 and practices4 7#f7 ,consent ,the term consent means affirmative1 conscious1 and voluntary agreement to engage in interpersonal1 physical1 or sexual activity4 7#g7 ,culturally appropriate ,the term culturally appropriate means materials and instruction that respond to culturally diverse individuals1 families and communities in an inclusive1 respectful and effective manner2 including materials and instruction that are inclusive of race1 ethnicity1 languages1 cultural background1 religion1 sex1 gender identity1 sexual orientation1 and different abilities4 7#h7 ,evidence-based ,the term evidence-based1 when used with respect to sex education instruction means a sex education program that has been proven through rigorous evaluation to be effective in changing sexual behavior or incorporates elements of other programs that have been proven to be effective in changing sexual behavior4 7#i7 ,gender expression ,the term gender expression1 when used with respect to a sex education program1 means the expression of one's gender1 such as through behavior1 clothing1 haircut1 or voice1 and which may or may not conform to socially defined behaviors and characteristics typically associated with being either masculine or feminine4 7#aj7 ,gender identity ,except with respect to section #g1 the term gender identity1 when used with respect to a sex education program1 means the gender-related identity1 appearance1 mannerisms1 or other gender-related characteristics of an individual1 regardless of the individual's designated sex at birth including a person's deeply held sense or knowledge of their own gender2 such as male1 female1 both or neither4 7#aa7 ,inclusive ,the term inclusive1 when used with respect to a sex education program1 means curriculum that ensures that students from historically marginalized communities are reflected in classroom materials and lessons4 7#ab7 ,institution of higher education ,the term institution of higher education has the meaning given the term in section #aja of the ,higher ,education ,act of #aife 7#bj ,u4,s4,c4 #ajja74 7#ac7 ,medically accurate and complete ,the term medically accurate and complete1 when used with respect to a sex education program1 means that-- 7,a7 the information provided through the program is verified or supported by the weight of research conducted in compliance with accepted scientific methods and is published in peer-reviewed journals1 where applicable2 or 7,b7 7i7 the program contains information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate1 objective1 and complete2 and 7ii7 the program does not withhold information about the effectiveness and benefits of correct and consistent use of condoms and other contraceptives4 7#ad7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7#ae7 ,sexual development ,the term sexual development means the lifelong process of physical1 behavioral1 cognitive1 and emotional growth and change as it relates to an individual's sexuality and sexual maturation1 including puberty1 identity development1 socio-cultural influences1 and sexual behaviors4 7#af7 ,sexual orientation ,except with respect to section #g1 the term sexual orientation1 when used with respect to a sex education program1 means an individual's attraction1 including physical or emotional1 to the same or different gender4 7#ag7 ,young people ,the term young people means individuals who are ages #aj through #bd at the time of commencement of participation in a program supported under this ,act4 #aa4 ,funding 7a7 ,appropriation ,for the purpose of carrying out this ,act1 there is appropriated #ge1jjj1jjj for each of fiscal years #bjbj through #bjbe4 ,amounts appropriated under this subsection shall remain available until expended4 7b7 ,reservations of funds 7#a7 ,the ,secretary shall reserve #ej percent of the amount appropriated under subsection 7a7 for the purposes of awarding grants for comprehensive sex education for adolescents under section #c4 7#b7 ,the ,secretary shall reserve #be percent of the amount appropriated under subsection 7a7 for the purposes of awarding grants for comprehensive sex education at institutes of higher education under section #d4 7#c7 ,the ,secretary shall reserve #bj percent of the amount appropriated under subsection 7a7 for the purposes of awarding grants for pre-service and in-service teacher training under section #e4 7#d7 ,the ,secretary shall reserve #b percent of the amount appropriated under subsection 7a7 for the purpose of carrying out the impact evaluation and reporting required under section #f7;a74 7c7 ,secretarial responsibilities ,the ,secretary shall reserve #c percent of the amount appropriated under subsection 7a7 for each fiscal year for expenditures by the ,secretary to provide1 directly or through a competitive grant process1 research1 training1 and technical assistance1 including dissemination of research and information regarding effective and promising practices1 providing consultation and resources1 and developing resources and materials to support the activities of recipients of grants4 ,in carrying out such functions1 the ,secretary shall collaborate with a variety of entities that have expertise in adolescent sexual health development1 education1 and promotion4 7d7 ,reprogramming of abstinence only until marriage program funding ,the unobligated balance of funds made available to carry out section #eaj of the ,social ,security ,act 7#db ,u4,s4,c4 #gaj7 7as in effect on the day before the date of enactment of this ,act7 are hereby transferred and shall be used by the ,secretary to carry out this ,act4 ,the amounts transferred and made available to carry out this ,act shall remain available until expended4 7e7 ,repeal of abstinence only until marriage program ,section #eaj of the ,social ,security ,act 7#db ,u4,s4,c4 #gaj et seq47 is repealed4