The importance of sexual education for students with disabilities cannot be overstated. The United Nations states that students with disabilities should have access to the same range and quality of sexual education as their nondisabled peers (Holmes, 2021). Despite this, students with disabilities, especially those with moderate to extensive support needs (MESN), are consistently denied access to sexual education in schools (Ailey et al., 2003; Collier, 2017; Waxman, 1994). To mitigate this historical and ongoing exclusion, the purpose of this multi-study dissertation was to create a research-based self-guided reflection tool that school-level special education departments and individual teachers can use to improve sexual education for students with MESN. As the dissertation evolved toward this purpose, it became evident that two studies were necessary to accomplish this task. In Study 1, a systematic literature and extant tool review on effective sexual education for students with MESN was used to develop a set of indicators and first draft of the self-reflection tool. In Study 2, the resulting tool draft from Study 1 was presented to two focus groups of experts in sexual education for people with MESN and/or tool development. Transcripts, analytical memos, rubrics, and simple numerical scores were analyzed and the resultant themes applied to a final version of a Toolkit for the Improvement of Sexual Education for students with Disabilities (TISED). The discussion section synthesizes the results of these two studies to answer the research questions and provides: (a) summary of findings, (b) discussion of findings, (c) implications for future research, practice, and policy, (d) limitations, and (e) conclusions. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]