Controversy surrounding sex discrimination and sexual misconduct in higher education has existed now for over 50 years. Title IX is the federal law banning sex discrimination in schools receiving federal funds. This Report examines the evolving understanding of sex discrimination in higher education over the years, as well as the mechanisms that developed to find and punish it with Title IX. This Report starts with the background of Title IX--why it was enacted and how it was first implemented--and then shares findings from six campus visits and surveys made during the 2019-2020 academic year. It presents conversations with Title IX administrators and staff as well as with students, and it analyzes current university policies and practices to see what Title IX means in operation. Research for this Report was carried out at the very same time that the Trump Education Department's Office for Civil Rights ("OCR") began to review and revise federal Title IX policy. The Report therefore describes this initiative and the new Title IX regulations promulgated by Education Secretary Elisabeth DeVos, as well as subsequent court challenges to them. The Report ends with a discussion of findings and recommendations for the future.