Q: Do any elements of the sexual history need to be true?

A: No. It’s the statement/intention of the certificate authority for the certificate a person is on. But it can be investigated or challenged for non-compliance or some sort of out of band claim that it’s false.

If secret surveillance can be blocked and/or duped, then arranging for key people to have access to multiple ids, for use in alt. circumstances, will make compliance checking & enforcement much more difficult for the state mafia.