Blind and low-vision (BLV) youth have been excluded from technology-mediated learning in school for two decades due to the systemic inaccessibility of K-12 instructional technologies. Accessibility guidelines that address BLV youth’s needs would help schools address this systemic inequity. But such guidelines do not yet exist nor does the robust knowledgebase required to write them. Herein, I report three key findings from a mixed methods user study of BLV youth’s lived experiences learning with access technologies (AT) and instructional technologies in U.S. schools. First, these youth participants are using a broader range of AT than youth in previous studies. Second, the youth in this study frequently developed their AT literacy outside of school and most did not begin developing AT literacy in earnest until they were teens. Third, the youth defined accessible instructional technologies as those that are (1) easy to learn to use and (2) easy to use to learn and they used an inquiry process to evaluate accessibility. Building on the findings, I offer six preliminary design guidelines for accessible instructional technologies. Finally, I urge other scholars to study BLV youth’s digital access needs so that standards setting bodies eventually have sufficient data to write youth accessibility guidelines.