Health Youth Survey 2023 Exemptions

For HYS 2023, schools can request a special exemption from asking one or both of the following sets of questions on the secondary survey (for 8th graders and older)

  • Sexual behavior questions
  • Sexual violence questions

How does collecting information on these questions benefit school districts? 

Having data about behavior and violence can assist districts and schools in understanding their students’ experiences. We know that negative experiences during childhood and young adulthood can lead to lifelong consequences for physical and mental health. Learning more about what students are experiencing can help schools and districts to reshape social norms, establish new programming, or develop support structures that best meet the needs of students.

Information on sexual behavior could be useful when talking to school boards and community members about the need for sexual health education. For districts that already offer sexual health education, data could provide support for continuing or modifying the program to most effectively meet the needs of students. If, for example, data suggests that many students begin sexual intercourse in ninth grade, the district may decide to include lessons on abstinence, contraceptives, STDs, HIV, and sexual decision making in middle school.

Combining information from these questions with other Healthy Youth Survey data can show how sexual behavior and violence intersect with other health-related behaviors. These relationships can give districts a better sense of how and where to direct appropriate interventions with limited resources. Research shows that intervening with youth at highest risk benefits not only those youth, but all youth who participate.

Asking questions about sexual behavior also provides information on students who have NOT had sex. This information can be used to educate students. According to the 2021 Healthy Youth Survey, of the students who responded to these questions, 86 percent of 10th grade students and 63 percent of 12th grade students have never had sexual intercourse. Unfortunately, students often operate on the inaccurate perception that most of their peers have had sexual intercourse. 

Information from these questions can also be used to boost or restructure student support services for sexually active youth and those engaging in risky health behaviors and for youth who have been sexually abused who are at increased risk of a variety of psychological and behavioral problems. 

Questions eligible for exemption

Sexual behavior questions:

  • How old were you when you had sex for the first time? (I have never had sex; 11 years or younger; 12, 13, 14, 15, 16, 17 years old or older).
  • During your life, with whom have you had sexual contact? Select all that apply. (I have not had sexual contact; Females; Males; Other)
  • With how many people have you had sex? (I have never had sex; 1 person; 2 people, 3 people, 4 people, 5 people; 6 or more people)
  • The last time you had sex, what method(s) did you or your partner use to prevent pregnancy and/or sexually transmitted infections? (Select all that you used): (I have never had sex; No method was used; Birth control pills; Condoms; Dental dams; An IUD or implant (such as Mirena or ParaGard; Implanon or Nexplanon); A shot (such as Depo-Provera); Patch or birth control ring (such as Xulane; NuvaRing); Withdrawal; Some other method; Not sure) 

Sexual violence questions:

  • Have you ever been in a situation where someone made you engage in kissing, sexual touch or having sex when you did not want to? (No, Yes).
  • Have you ever seen someone about your age pressure someone else to kiss, touch, or have sex when they did not want to? (No; Yes).

Where do these questions come from?

The sexual behavior questions are from the national Youth Risk Behavioral Survey (YRBS) sponsored by the Centers for Disease Control and Prevention (CDC). In 2019, 36 of the 47 states and 31 of the 43 large urban school districts that administered the YRBS asked these questions. The sexual violence questions were adapted from a Sexual Experiences Survey designed to assess sexual victimization among high school students. 

Have these questions been asked previously?

The sexual behavior questions have been on the Healthy Youth Survey since 2010 and the sexual violence questions have been asked since 2014. A majority of schools have asked these questions, and, there have been no adverse reports from having administered these questions.

What about the Index that measures adverse experiences among students?

Only schools who administer the questions on sexual violence will receive results for the Washington HYS Adverse Childhood Experiences (WAH-ACEs) index because the index includes a question on sexual violence. This index was developed in 2021 in response to Washington Senate Bill 6191 and is based on extensive research led by the Centers for Disease Control and Prevention around adverse childhood experiences (ACEs). More than half of the students reported 1 or more ACEs. This index will give schools and districts a clearer picture of the negative experiences that their students are facing, and how they can better support them in the classroom, with special programming, and with other resources. This index can also help highlight the importance of protective factors like safe and stable relationships at home and at school.

Will sexual behavior increase if we ask about it?

Research shows that asking youth about sexual behavior does not increase this behavior. Additionally, if there were large-scale negative effects of Healthy Youth Survey questions on health-risk behaviors, in general, we would expect to see increases over time in behaviors that we have measured repeatedly, such as violence and substance use. We do not, however, see increases in these behaviors. 

Nationally, even though most states ask youth about sexual behavior, the percent of sexually active adolescents is dropping.

Please contact Washington State Department of Health at if you would like to discuss an exemption for your school.


Additional Information about the opt in for new gender question on the elementary survey. 

Every year on the HYS, students are asked the following question: What sex were you assigned at birth? Female or Male. 

For 2023, schools can select if they want to ask the new gender question for 6th graders (and 7th graders in small school districts) on their registration form. 

The new gender question is: 

What is your gender?

  • Boy
  • Girl
  • Something else fits better

The U.S. Department of Education emphasizes the importance of collecting high quality data on both sex and gender. Gender diverse youth are at increased risk of adverse experiences. Collecting both sex and gender on student surveys allows communities to better understand and meet the needs of all youth.