The timely emergence of the National Teacher Preparation Standards for Sexuality Education in the United States will transform preparation of future educators and provide guidance for professional development training of current sexuality educators. This article focuses on identifying factors that affect sexuality education by examining perceptions and experiences held by certified Rhode Island public school health educators. Study participants were asked to respond to questions addressing their confidence in teaching sexuality education topics, ability to plan and implement sexuality lessons with the National Health Education Standards, and ability/proficiency in the National Teacher Preparation Standards for Sexuality Education. The topic of identity (36%), which addresses people’s understanding of who they are, was the only topic identified by the National Sexuality Education Standards that teachers were uncomfortable teaching. The majority of the educators felt very confident in their abilities to teach lessons integrated with four of the six National Health Education Standards. Less than half of the educators felt very confident with integrating communication and advocacy skills. The educators surveyed also believed to be very confident in meeting all seven National Teacher Preparation Standards for Sexuality Education. This article concludes that gauging current teacher’s confidence and proficiency with these standards can isolate factors that either impede or enhance quality sexuality education for youth. Expanding the understanding of these factors can influence professional development and provide meaning as to what confident and proficient sexuality educators look like in practice.