Teenagers Think Abstinence Is Cool?

Tyler LePard

As Scott mentioned when he introduced this series yesterday, I attended a conference in Chicago last weekend titled "Contraception Is Not the Answer." You may be wondering who would oppose an essential part of many Americans' lives - one that protects people from disease and helps them plan if, when, and how many children to have. Ian provided an insightful preview to the event with background information in Friday's blog. In this series I will address the main themes of the conference and provide a much-needed reality check on their arguments.

As Scott mentioned when he introduced this series yesterday, I attended a conference in Chicago last weekend titled "Contraception Is Not the Answer." You may be wondering who would oppose an essential part of many Americans' lives – one that protects people from disease and helps them plan if, when, and how many children to have. Ian provided an insightful preview to the event with background information in Friday's blog. In this series I will address the main themes of the conference and provide a much-needed reality check on their arguments.

The multi-faceted, no-holds-barred attack on all contraception began with a session called "Comprehensive Failure: The Harm Done by Pro-Contraception Sex Ed," presented by Libby Gray Macke, Director of Project Reality. Macke gave a high-energy lecture using material that she presents to teenagers in an abstinence-only education program.

Macke cheerfully started with "Facts about Teen Sexual Activity," which described the risks of STDs and teen pregnancy. (Both sides often start in the same place and then move on to different solutions; the difference is that comprehensive sex ed has proven to affectively address these problems, while abstinence-only ed has not.) Macke's next step was to examine the changes in our culture in the past 20 years – blaming it on… the sexual revolution of the 60s and 70s.

According to Macke, "Young people are suffering because of previous generations." Hold the phone – really? The monsters in the closet are advances in women's rights, civil rights, and technology? Young people are in trouble because of their parents (or because of what their parents did)? Well, I guess I can see her logic – after all, the conferees want women to stay home and pop out lots of babies, which fits in with the idealized vision of returning to "the good old days" of restrictive social norms. But I'm getting ahead of myself. This was the first, but not the last, reference to the cultural change that apparently destroyed American morals.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Then she moved on to examine the teenage brain. Macke has come up with two characters to illustrate the main players in an adolescent's head: the caveman (which represents the amygdala) and the professor (representing the pre-frontal cortex). Supposedly, comprehensive sex ed addresses the amygdala portion of the brain by assuming teenagers cannot control their sexual urges. In contrast, Macke says that abstinence-only education helps teenagers develop their pre-frontal cortexes by talking about hopes and dreams.

Let's step back for a second to examine an underlying assumption that giving teenagers information about contraception encourages them to be promiscuous. This argument is incorrect. What is correct is that delaying sexual activity decreases the risks of disease and pregnancy – and while abstinence education may contribute to that goal, it does not actually prevent sexual activity. Comprehensive sex ed delays sexual activity AND gives teens the information needed to protect themselves when they do eventually have sex.

And appealing to kids' hopes and dreams to teach them about sex sounds nice, but we've seen what happens when schools teach abstinence and withhold information about contraception. Macke told the audience that "condom-based sex ed" requires kids to repress feelings of embarrassment about condoms, which is an interesting twist to the reality: abstinence-only education tries to keep teenagers from having sex by using tactics based on fear and shame.

To put a positive spin on her message, Macke says that she tells teenagers: "I am not here to tell you what to do. I can't make your decision for you. I am here to give you the information to make choices." But the truth is that she doesn't give them enough information; she only gives them a small piece of the overall picture. She acknowledges that teens have free will and can make their own decisions, but she doesn't give them the knowledge they need to be safe when they do make the choice to have sex. Abstinence may work for some, but realistically, not everyone is going to choose to wait for marriage to have sex. So if a teenager makes what Macke would consider to be the wrong choice, they're screwed.

What makes Macke a serious threat to sexuality education and reproductive health is that she presents misinformation in an entertaining, dynamic bundle targeted towards teenagers. Behind her friendly, upbeat demeanor is the belief that this issue isn't "just a side issue from pro-life, it's the heart of the issue" and that "abstinence stops abortion." Despite her protestations, contraception has been proven to effectively prevent unwanted pregnancy, therefore preventing abortion, and – like it or not – is in sync with reality.

Check out more facts about sexuality education for additional information. Check back tomorrow for another reality check on the conservatives attack on contraception.

Commentary Sexual Health

Parents, Educators Can Support Pediatricians in Providing Comprehensive Sexuality Education

Nicole Cushman

While medical systems will need to evolve to address the challenges preventing pediatricians from sharing medically accurate and age-appropriate information about sexuality with their patients, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Last week, the American Academy of Pediatrics (AAP) released a clinical report outlining guidance for pediatricians on providing sexuality education to the children and adolescents in their care. As one of the most influential medical associations in the country, AAP brings, with this report, added weight to longstanding calls for comprehensive sex education.

The report offers guidance for clinicians on incorporating conversations about sexual and reproductive health into routine medical visits and summarizes the research supporting comprehensive sexuality education. It acknowledges the crucial role pediatricians play in supporting their patients’ healthy development, making them key stakeholders in the promotion of young people’s sexual health. Ultimately, the report could bolster efforts by parents and educators to increase access to comprehensive sexuality education and better equip young people to grow into sexually healthy adults.

But, while the guidance provides persuasive, evidence-backed encouragement for pediatricians to speak with parents and children and normalize sexual development, the report does not acknowledge some of the practical challenges to implementing such recommendations—for pediatricians as well as parents and school staff. Articulating these real-world challenges (and strategies for overcoming them) is essential to ensuring the report does not wind up yet another publication collecting proverbial dust on bookshelves.

The AAP report does lay the groundwork for pediatricians to initiate conversations including medically accurate and age-appropriate information about sexuality, and there is plenty in the guidelines to be enthusiastic about. Specifically, the report acknowledges something sexuality educators have long known—that a simple anatomy lesson is not sufficient. According to the AAP, sexuality education should address interpersonal relationships, body image, sexual orientation, gender identity, and reproductive rights as part of a comprehensive conversation about sexual health.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The report further acknowledges that young people with disabilities, chronic health conditions, and other special needs also need age- and developmentally appropriate sex education, and it suggests resources for providing care to LGBTQ young people. Importantly, the AAP rejects abstinence-only approaches as ineffective and endorses comprehensive sexuality education.

It is clear that such guidance is sorely needed. Previous studies have shown that pediatricians have not been successful at having conversations with their patients about sexuality. One study found that one in three adolescents did not receive any information about sexuality from their pediatrician during health maintenance visits, and those conversations that did occur lasted less than 40 seconds, on average. Another analysis showed that, among sexually experienced adolescents, only a quarter of girls and one-fifth of boys had received information from a health-care provider about sexually transmitted infections or HIV in the last year. 

There are a number of factors at play preventing pediatricians from having these conversations. Beyond parental pushback and anti-choice resistance to comprehensive sex education, which Martha Kempner has covered in depth for Rewire, doctor visits are often limited in time and are not usually scheduled to allow for the kind of discussion needed to build a doctor-patient relationship that would be conducive to providing sexuality education. Doctors also may not get needed in-depth training to initiate and sustain these important, ongoing conversations with patients and their families.

The report notes that children and adolescents prefer a pediatrician who is nonjudgmental and comfortable discussing sexuality, answering questions and addressing concerns, but these interpersonal skills must be developed and honed through clinical training and practice. In order to fully implement the AAP’s recommendations, medical school curricula and residency training programs would need to devote time to building new doctors’ comfort with issues surrounding sexuality, interpersonal skills for navigating tough conversations, and knowledge and skills necessary for providing LGBTQ-friendly care.

As AAP explains in the report, sex education should come from many sources—schools, communities, medical offices, and homes. It lays out what can be a powerful partnership between parents, doctors, and educators in providing the age-appropriate and truly comprehensive sexuality education that young people need and deserve. While medical systems will need to evolve to address the challenges outlined above, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Parents and Caregivers: 

  • When selecting a pediatrician for your child, ask potential doctors about their approach to sexuality education. Make sure your doctor knows that you want your child to receive comprehensive, medically accurate information about a range of issues pertaining to sexuality and sexual health.
  • Talk with your child at home about sex and sexuality. Before a doctor’s visit, help your child prepare by encouraging them to think about any questions they may have for the doctor about their body, sexual feelings, or personal safety. After the visit, check in with your child to make sure their questions were answered.
  • Find out how your child’s school approaches sexuality education. Make sure school administrators, teachers, and school board members know that you support age-appropriate, comprehensive sex education that will complement the information provided by you and your child’s pediatrician.

School Staff and Educators: 

  • Maintain a referral list of pediatricians for parents to consult. When screening doctors for inclusion on the list, ask them how they approach sexuality education with patients and their families.
  • Involve supportive pediatricians in sex education curriculum review committees. Medical professionals can provide important perspective on what constitutes medically accurate, age- and developmentally-appropriate content when selecting or adapting curriculum materials for sex education classes.
  • Adopt sex-education policies and curricula that are comprehensive and inclusive of all young people, regardless of sexual orientation or gender identity. Ensure that teachers receive the training and support they need to provide high-quality sex education to their students.

The AAP clinical report provides an important step toward ensuring that young people receive sexuality education that supports their healthy sexual development. If adopted widely by pediatricians—in partnership with parents and schools—the report’s recommendations could contribute to a sea change in providing young people with the care and support they need.

Roundups Law and Policy

Gavel Drop: Republicans Can’t Help But Play Politics With the Judiciary

Jessica Mason Pieklo & Imani Gandy

Republicans have a good grip on the courts and are fighting hard to keep it that way.

Welcome to Gavel Drop, our roundup of legal news, headlines, and head-shaking moments in the courts.

Linda Greenhouse has another don’t-miss column in the New York Times on how the GOP outsourced the judicial nomination process to the National Rifle Association.

Meanwhile, Dahlia Lithwick has this smart piece on how we know the U.S. Supreme Court is the biggest election issue this year: The Republicans refuse to talk about it.

The American Academy of Pediatrics is urging doctors to fill in the blanks left by “abstinence-centric” sex education and talk to their young patients about issues including sexual consent and gender identity.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Good news from Alaska, where the state’s supreme court struck down its parental notification law.

Bad news from Virginia, though, where the supreme court struck down Democratic Gov. Terry McAuliffe’s executive order restoring voting rights to more than 200,000 felons.

Wisconsin Gov. Scott Walker (R) will leave behind one of the most politicized state supreme courts in modern history.

Turns out all those health gadgets and apps leave their users vulnerable to inadvertently disclosing private health data.

Julie Rovner breaks down the strategies anti-choice advocates are considering after their Supreme Court loss in Whole Woman’s Health v. Hellerstedt.   

Finally, Becca Andrews at Mother Jones writes that Texas intends to keep passing abortion restrictions based on junk science, despite its loss in Whole Woman’s Health.