In the USA, there has been a nationwide call for comprehensive sexual health education programs to be LGBTQ+-inclusive. The Chicago Public Schools (CPS) K-12 curriculum was intentionally designed to align with the National Sexuality Education Standards and to be inclusive of lesbian, gay, bisexual, transgender, and questioning as well as other (LGBTQ+) identities (Chicago Public Schools, 2013). This case study of CPS's policy and curriculum implementation, with a focus on 9th grade, examines the extent to which this curriculum is truly experienced as inclusive by students and teachers. Twenty-nine ninth grade sex education class-periods were observed in 4 schools, 12 teachers were interviewed and 5 student focus groups were conducted to assess perceptions of the nature of inclusivity of the curriculum and ongoing needs to ensure inclusivity going forward. Students wanted a more LGBTQ+-inclusive curriculum defined by 1) including identity topics integrated throughout the curriculum; 2) more holistic discussion of sexuality; 3) more information about identity development, and 4) the creation of a safe space through an accepting, non-judgmental tone from teachers. Implications for the sexual health education field as well as for the larger public health field are discussed.