Despite the well-known benefits of comprehensive sexual health education, the majority of school sexual health education curricula in the United States (U.S.) is non-comprehensive and excludes LGBTQ+ students. This exclusion may contribute to poor health outcomes in LGBTQ+ youth, with some research beginning to document these experiences and provide recommendations for curricula changes. Using a sample of LGBTQ+ youth across the U.S. (ages 13-17; N = 809), this study characterizes youths' sexual health education experiences and provides curricula recommendations using a mixed methods approach. Quantitative analyses revealed that LGBTQ+ content is often excluded from sexual health education, particularly topics surrounding sexual orientation and gender identity, which youth wanted to learn more about. Furthermore, participants identified several extracurricular sources of sexual health education, including online spaces, friends, and personal experiences, which were often preferred. Qualitative analyses suggested that LGBTQ+ youth described their sexual health education as exclusive of LGBTQ+ content, often being based in abstinence, religious principles, or described as oppressive (e.g. hearing LGBTQ+ negative remarks) or suppressive (e.g. skipping required LGBTQ+ content). LGBTQ+ youth also provided recommendations for future curricula. Findings can inform curricula development and implementation, as well as policy change, to ascertain that all youth have access to inclusive and comprehensive sexual health education.