Adolescence is a developmental period characterized by profound social, emotional, and cognitive growth, in addition to self-discovery, particularly concerning sexuality. However, misinformation or inadequate education can lead to detrimental decision-making, impacting both physical and emotional well-being. Inadequate sexual education contributes to risky behaviors such as unprotected sex or incorrect contraceptive use, heightening the risk of sexually transmitted infections (STIs) and unintended pregnancies. To address these challenges, sexual health education (SHE) emerges as a critical preventive measure. Despite significant federal funding, the United States still grapples with poor sexual health outcomes among adolescents compared to other industrialized nations, attributable in part to inconsistent and inequitable SHE programming. Furthermore, adolescents are seldom consulted in the development of SHE programs, highlighting the importance of understanding their perspectives to tailor interventions effectively. Consequently, this study aims to fill this gap by developing and piloting the "Sexual Health Education Experiences and Perceptions Questionnaire," a novel tool designed to measure adolescents' retrospective experiences and perceptions of SHE in North Carolina (NC) public high schools. By developing and piloting this questionnaire, findings from the present study inform further development of the questionnaire and provide insights to the sample's experiences and perceptions with SHE in their NC public high school. Using a cross-sectional, retrospective design, the presented study addressed three primary aims: (1) develop the questionnaire and examine its psychometric properties; (2) explore questionnaire responses and describe the extent to which participants' recalled experiences and perceptions aligned with standards outlined in the National Sexuality Education Standards (NSES); and (3) explore which variables have the greatest impact on the identified outcome (i.e., perceived positive impact). Overall, findings indicate that greater alignment with NSES yielded more positive perceptions of the adolescents' overall high school SHE. This this may serve as additional evidence that comprehensive sexuality education is associated with positive outcomes. Importantly, the outcomes measured in this study are ones that have been identified by adolescents themselves as most important to them (i.e., aligned with the literature on adolescent perceptions). The "Sexual Health Education Experiences and Perceptions Questionnaire" should be further refined to continue to elucidate these important relationships. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]