CONROE, Texas — For the first time in more than two decades, Texas’ Board of Education voted Friday to make major changes to the state’s sex education standards, expanding the teaching of birth control beyond abstinence-only education for middle school students.

Under the revision, public school educators will be allowed to teach students in seventh and eighth grades about birth control methods such as condoms and other contraceptives, and about their effectiveness in preventing pregnancy, S.T.D.s and S.T.I.s.

The revisions are set to go in effect in August 2022. High school health educators were already required to teach about different methods of birth control, but health education is an optional course at the high school level, unlike in elementary school and middle school.

“I know not everyone got what they wanted in this set of standards, but I would encourage them to compare this set of standards with what we began with and to see that there is a great deal of advancement,” said Marty Rowley, a Republican and the vice chair of the board.

Under the previous standards, in place since 1997, middle school educators were allowed to teach only about abstinence as birth control. Some health advocates said that rule put Texas out of step in its teaching about sex, and pointed to the state’s rate of teenage pregnancy, which is one of the highest in the nation, according to data from the Centers for Disease Control and Prevention.

Texas’ board of education wields significant influence over public school curriculums, both for millions of Texas students and outside the state, said Karen J. Rayne, an education professor at the University of Texas at Austin who researches the success of sexuality education programs.

“Textbook companies look to Texas to set their standards for the rest of the country because we are such a large textbook purchaser,” Dr. Rayne said. “So it’s not just a Texas issue. We have to consider the way the Texas State Board of Education policy is impacting education on a national level.”

State law does not require Texas public schools to teach sex education in their health courses. If a school district chooses to, however, it is required under state law to stress abstinence “as the preferred choice of behavior in relationship to all sexual activity for unmarried persons of school age.”

Leaving the choice to teach sex education in health courses to school districts in the state has led to a patchwork of sex education teaching across Texas.

During the 2015-16 school year, about 25 percent of school districts taught no sex education, about 17 percent taught abstinence in addition to information on contraception, and almost 60 percent taught an abstinence-only approach, according to the Texas Freedom Network, a nonpartisan organization that works on issues including religious freedom and public education.

Although some education advocates considered Friday’s vote a victory, others said the changes were not inclusive of L.G.B.T.Q. youth and did not do enough to expand students’ knowledge of consent.

Before Friday, amendments proposed to require that teaching around sex education define legal and affirmative consent, gender identity and sexual orientation had been defeated by the majority-Republican, 15-member board.

Ruben Cortez Jr., a Democratic board member, proposed multiple amendments that would have required students to define and differentiate between sexual orientation and gender identity. He also proposed amendments that would have required teaching about bullying based on sexual orientation or gender identity, a problem most L.G.B.T.Q. students in Texas have faced, according to the American Civil Liberties Union of Texas.

“We’ve heard the testimony,” Mr. Cortez said at a board meeting on Wednesday. “These students are out there. They talked to us in September, and they’re asking us to hear their voices. And it seems like only a few of us are listening to what they’re asking of us.”

Board members also defeated an amendment that would have required students to “analyze the similarities and differences between legal consent to sexual activity and affirmative consent to sexual activity.”

Mr. Rowley, the Republican vice chair of the board, said on Friday that he had voted down some of the proposed amendments to ensure decisions were left up to school districts.

“Texas is a very diverse state, obviously, and the 200-plus rural school districts that I represent, I wanted to give them the freedom and the latitude to include some of those items in their curriculum, in their teaching, if they choose to do so,” he said at Friday’s meeting.

More than 20 hours of public comment, from across the political spectrum, were heard in June and September over revisions of the state’s health education standards. Ricardo Martinez, the chief executive of Equality Texas, an L.G.B.T.Q. advocacy group, testified multiple times ahead of Friday’s vote and said that excluding language about gender identity, sexual orientation and consent hindered students’ ability to navigate the world.

“You change hearts and minds by educating people about the lived experiences of those around them,” he said in an interview. “Robbing folks, especially at this age, from receiving their vital information of how you can make other people feel included, you’re shortchanging them and their preparedness to go out into the world.”

Mary Elizabeth Castle, a policy adviser with the conservative organization Texas Values, said that the board’s rulings against language about consent and L.G.B.T.Q. identity were a clear signal to promote “sexual risk avoidance for children.”

“Leftist, political and personal ideologies have no place in science-based common-sense health education, which is why efforts to add sexual orientation and gender identity topics failed,” she said.

Dan Quinn, a spokesman and research director with the Texas Freedom Network, said most Texans are in favor of comprehensive sex education, despite what he called “fear tactics” by opponents.

A public opinion poll conducted by another nonpartisan group, The Texas Campaign to Prevent Teen Pregnancy, found that about 75 percent of respondents, including 68 percent of Republicans, were in support of education that covered abstinence and contraceptives.

“I think the state is changing,” Mr. Quinn said. “We’ve seen an increase in the percentage of school districts that are moving toward a comprehensive approach to sex education. And I think that, that over time is going to filter up to the state level. But it’s clear that the legislature and the state board of education are big stumbling blocks.”

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