IT IS, LITERALLY, not your father’s — or mother’s — sex ed standards.

The Board of Elementary and Secondary Education voted unanimously on Tuesday to update the curriculum framework for health and physical education, the first time the state’s sexual health standards have been updated in almost 25 years. 

Under the new guidelines, students should be receiving comprehensive health education that is inclusive of LGBTQ identities, emphasizes consent and safe sexual and personal boundaries, and highlights modern understandings of mental and emotional health, including the impacts of social media and increased usage of personal internet-connected devices.

“Since the 1999 framework was written, a lot has changed in the world,” said Michelle Soto with the Planned Parenthood League of Massachusetts in testimony before the vote. “This new framework reflects those updates in alignment, what young people are needing now. Personally, I attended Massachusetts public schools from kindergarten through college, and it is disheartening to think that my daughter would receive education under the same outdated, ineffective framework that I did. She along with everyone in her generation deserve better.”

State health standards, which are not specific curricula, offer guidance for students in four grade-level groups: pre-K through second grade, grades 3-5, grades 6-8, and grades 9-12.

“While the standards in each grade level build upon one another, they also differ significantly,” testified Greg Orpen, head of school at the Innovation Academy charter school. As an example, he said, students in grades pre-K to 2 will learn about personal boundaries, and students in grades 9 through 12 will learn about how to recognize abuse in a relationship. “Importantly, the framework empowers students to become critical thinkers when considering health related issues,” he said. “The framework supports the development of media literacy research and decision making skills, while also emphasizing the importance of dialogue with trusted adults, including parents and families.”

Since the draft framework was released in June, the state education department received, reviewed, and analyzed nearly 5,400 pieces of public comment. The vast majority of comments were from parents (71 percent of all comments) and community members, coming into the department through survey responses about the framework and through email.

These public comments were also largely in opposition to the new standards, which tread on the cultural third rail of appropriate sexual health standards for children.

“Under Massachusetts, law parents continue to have the right to opt their children out of lessons involving human sexuality education, which is a very small portion of this framework,” Commissioner Jeff Riley said as he recommended passage. “We believe it will be a helpful resource for districts, schools and families.”

According to the state education department, 2,780 of the 2,910 emails and mailed comments objecting to the revised draft were “a form email” that consisted of the same text, in several cases sent repeatedly from the same people, though some commenters included additional notes. About 270 emails expressed support for the draft, and about 70 emails offered suggestions for change.

Though opponents of the new standards have testified at past meetings, no one spoke against the new framework at Tuesday’s meeting.

There were changes made to the draft since June, tilting generally toward more inclusive and affirming language. For instance, one addition to the K-2 age group standards advises that they “discuss gender-role stereotypes and their potential impacts on people of all genders.” Another addition aimed at children in grades 3 to 5 says they should learn to “recognize and respect that all bodies are different.” 

As children age, the standards also become more advanced, delving into more complex explorations of consent and healthy relationships, sex and gender expression, substance use and misuse, and a more technical understanding of physical fitness and nutritional health.

Gov. Maura Healey cheered the updated framework after the vote. 

“Massachusetts is leading the way by providing a health and physical education framework that is inclusive, medically accurate and age-appropriate to help [students] make decisions that are right for their health and wellbeing,” Healey said in a statement. “We are grateful to the Board for approving the first update to the health education frameworks in more than two decades, and we appreciate the input we received from residents across the state.”

The decades-long slog to updating these standards was remarked upon by almost everyone who spoke at the Tuesday meeting. 

Education officials have taken a slow-roll approach to updating curriculum frameworks, “where we sat on them for decades,” said board member Michael Moriarty. “They should be works of continuous improvement, as just part of the culture of this department and of our entire educational system.”

To that end, Sen. Jason Lewis of Winchester and Rep. Jim O’Day of West Boylston offered comments at Tuesday’s meeting in support of their Healthy Youth Act legislation, which has withered on Beacon Hill for years and would require that state sex and health education standards for sex and health education are inclusive and be updated at least every 10 years. Beyond that, the legislation would require cities and towns to describe their sexual education curricula to the department each year, as well as report the number of students receiving that education. 

Many of the objections to the sexual health and sexual orientation standards “included concerns about age-appropriateness and implementation, religious objections, and concerns from parents about schools teaching values and beliefs,” the state found.

O’Day, who was a social worker for 24 years prior to his election to the Legislature, said accurate and comprehensive education is essential, especially for children.

“I can’t tell you how heartbreaking it would be to be in the living room or kitchen table with a family with a 12- or 13-year-old daughter, who was sitting at the table and saying, ‘I have no idea how I became pregnant,’” said O’Day. “That’s not a myth. Those conversations actually happened.”