There is now experimental evidence for Higgs boson decay into a pair of muons, and significant constraints on the Higgs boson decay into a charm quark-antiquark pair. The data on Higgs boson decays into second generation fermions probes various extensions of the Standard Model. We analyze the implications for the Standard Model effective field theory (SMEFT), without and with minimal flavor violation (MFV), for two Higgs doublet models (2HDM) with natural flavor conservation (NFC), for models with vector-like fermions, and for specific models that predict significant modifications of the Yukawa couplings to the light generations.