Adolescent sexual health programs often frame needs assessments using risk-taking, disease, or fertility data, fostering a narrow perspective of sexual health and limiting scopes of related programs. We address the gap between traditional measures and the socioecological lens used by many in the field. Using Washington State as an example, we report methods for developing and mapping an index of sex education needs that integrates social determinants of health (SDH) to reflect the complex, interrelated influences affecting adolescents. The generated index and maps support a holistic approach to assessing inequity, resource allocation gaps, and specific programmatic needs of young people. This case study demonstrates that it is possible and important to align adolescent sexual health measurement strategies with more holistic adolescent sexuality development frameworks. We recommend that public health professionals consider a broader range of data on SDH in their sex education policy and program decision making.