STIs, Firearm Safety, Mental Health Among Revised Public School Curriculum Standards
By David Doolittle


For the first time since 1997, Texas is overhauling health education in public school. 

After the State Board of Education took a major step this month toward finalizing new health education curriculum standards, Texas public school students – roughly 5 million per year and growing – are on track to receive more comprehensive and medically accurate instruction on multiple health-related topics. 

During recent public meetings, the board preliminarily approved new draft standards on vaping, firearm safety education, mental health, suicide, and sexual health. 

Thanks to an organized push from Texas Medical Association members, the board also enhanced standards requiring public schools to teach the importance of immunizations, including the effectiveness of human papillomavirus (HPV) vaccines, beginning in seventh grade

The board is expected to vote on final approval, along with other public-school curriculum standards, in November. 

TMA advocated for much of the revised Texas Essential Knowledge and Skills (TEKS), the state standards for knowledge and skills every Texas public school student must demonstrate before advancing to the next grade or graduating. 

Many of the topics in the revised standards are not covered in the current TEKS, including contraception, vaping, and suicide prevention. 

Because health is an elective class in Texas high schools – and not offered at some high schools – TMA focused particularly on revisions in elementary and middle school grades, where all students receive the information. 

Below are some of the key changes in the TEKS by topic: 

Sexually transmitted infections

Throughout the new standards, the medically preferred term “sexually transmitted infections” (STIs) will be taught alongside “sexually transmitted diseases.” In addition, middle school students will be taught to define STIs as infections that are spread through sexual activity using medically accurate terms. 

Students in grades 7, 8, and into high school will learn:

  • The signs, symptoms, and long-term health effects of various STIs;
  • Various ways STIs can be transmitted;
  • Effectiveness of prevention methods, including contraception and HPV vaccinations;
  • The importance of testing and early treatment; and
  • Minors’ right to consent to testing and treatment under certain conditions. 

Students will continue to learn that abstinence is the only 100% effective method to prevent STIs. 

Reproductive health  

Certain standards on puberty and adolescent development have been moved to earlier grades, so more students will receive information before or around the time changes begin to happen. 

The menstrual cycle and puberty will now be introduced in fourth grade, and fifth-grade students will be expected to identify the role of hormones and their effect on secondary sex characteristics. 

In middle school, students still will be expected to describe the processes of cellular fertilization and sexual intercourse as well as the physical signs of pregnancy. However, new standards were added on the importance of early pregnancy testing, and early prenatal care. 

Seventh- and eighth-grade students also will receive instruction on the effectiveness of various contraceptive methods at preventing pregnancy. Students will continue to learn that abstinence is the only 100% effective method to prevent pregnancy. 

Firearm safety

Currently, elementary school lessons on environmental hazards list loaded guns in the home as an example that may be taught. New safety and injury prevention standards now call for all students in second and third grades to specifically discuss hazards of unsupervised and improper handling of guns and other weapons. 

Mental health and wellness  

Currently, elementary school students are not expected to be able to identify mental health symptoms and conditions, or signs someone may need help. That changes under the new standards. 

Beginning in kindergarten, students at all grade levels will be expected to:

  • Discuss and differentiate various emotions;
  • Practice self-management strategies for dealing with difficult emotions, like anxiety or depression;
  • Identify signs that someone may need mental health support and how to seek help; and
  • Identify sources of stress and discuss healthy and unhealthy strategies for managing stress. 

Beginning in sixth grade, students will be expected to identify warning signs of suicide and how to respond. 

Medically accurate information about eating disorders is now included within the mental health and wellness TEKS. Previously, eating disorders were discussed in lessons on healthy dietary choices. 

Healthy eating  

Key additions on healthy eating include new standards to address excess sugar consumption, the importance of choosing water over sugary beverages, and how to select healthier choices when ordering from fast food and restaurant menus. 

The standards on food groups, essential nutrients, appropriate portion sizes, and interpreting nutrition labels are substantially stronger and will expect students to apply more of their knowledge in real-world situations, TMA believes. 

Tobacco and other Drugs  

Revised standards will also require schools to teach about the harmful effects of vaping alongside the effects of tobacco products, beginning in first grade and continuing through high school. 

Lessons on proper use of over-the-counter and prescription medications will be introduced beginning in first grade, rather than fourth grade in the current TEKS, and continue through elementary school. 

New TEKS in middle school and high school will ensure students learn how to properly store and dispose of medications, and will teach students to recognize and respond to accidental poisoning and overdose.

Photo: Getty Images

Last Updated On

September 21, 2020

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David Doolittle


(512) 370-1385

Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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