In the United States, sex education in schools varies significantly across districts. Many schools operate without state-guided health education curricula, leaving decisions up to individual districts. The purpose of this study was to explore what type of sex education is being offered in U.S. high schools in addition to assessing the frequency of condom access and contraceptive referral. A total of 772 high school superintendents were surveyed with a response rate of 40.4% (n = 297). Data show most districts teach comprehensive sex education (63%), while only 7% of districts offer condoms to high school students. Twenty-nine percent of superintendents reported their district refers out for contraceptive services to a variety of agencies. School nurses can use this information to inform health policy discussions in their district as well as advocate for awareness among district officials regarding existing health service offerings.