Sexuality is a critical aspect of adolescent development and is often addressed through school-based sexuality education programs. While comprehensive sexuality education has strong evidence of effectiveness, it often lacks sufficient focus on gender-related issues and mental health, which leads to health inequities. This study evaluates the acceptability, feasibility, preliminary outcomes, and health equity of a comprehensive program. Using a mixed-methods experimental design, 179 students were assigned to control and experimental groups. The intervention was feasible and acceptable, though no significant changes were found in assessments. Case study findings revealed learning outcomes and health equity factors not captured by assessments. Lessons learned are discussed.