Textbooks are a multimillion dollar publishing business in the United States. Even as twenty-first century classrooms become more multimodal, digital and hardcopy textbooks remain a key feature of American education. Consequently, classroom textbooks have been shown to control knowledge dissemination across the content areas. In particular, health texts have been uniquely shown to communicate values that validate or marginalize students and encourage healthy or harmful activity. Thus, what textbook makers choose to include as worthy of study, and how they portray various groups of people with regard to race, gender, sexuality, and ability has societal implications. Employing quantitative and qualitative content analysis methods, the authors of this study analyzed 1,468 images across elementary and middle school health textbooks to examine the portrayal of race, gender, and sexuality. They found that, while gender and racial diversity are well-represented in texts, women and people of color were frequently portrayed in stereotypical roles. For example, girls were depicted daydreaming about heterosexual marriage. Furthermore, this analysis revealed limited representations of sexuality. Findings suggest that focusing on the numerical representation of marginalized groups is not enough to address issues of equity and power in classroom curricula. Instead, the authors argue, educators must consider the ways in which people are positioned in curricular materials, and ask if portrayals perpetuate or challenge traditional stereotypes.