This study examined 328 preservice educators' level of confidence in addressing four sexuality education domains and 21 sexuality education topics. Significant differences in confidence levels across the four domains were found for gender, academic major, sexuality education philosophy, and sexuality education knowledge. Preservice educators considered positive communication with family, physical/social changes with puberty, and abstinence as the most comfortable topics to address and masturbation, condom demonstration, and sexual orientation as the least comfortable topics to teach. Study results suggest the need for academic preparation in health education and sexuality education for individuals seeking teacher certification, regardless of grade level or specialized certification. Preservice training in sexual health education through teacher preparation programs can serve as the foundation for effective sexuality education in Grades K-12. (Contains 3 tables.)