When it Comes to Preventing Teen Pregnancy, Talk’s Not Cheap But Notification Laws Are

Dian Harrison

Dian Harrison is the President and CEO of Planned Parenthood Golden Gate. This is the first of a series of posts about California's Parental Notification Ballot Inititiative.
October is "Let's Talk Month." It's a great opportunity to let the young people in your life know that you are there for them and ready to help, even when they are facing issues that can be tough to talk about, like sexual health.

Research has shown that teens that have good communication with their families are more likely to delay becoming sexually active and are also more likely to be safe if they do become active. According to the National Campaign to Prevent Teen Pregnancy, "Teens who are close to their parents and feel supported by them are more likely to abstain from sex, wait until they are older to begin having sex, have fewer sexual partners, and use contraception more consistently."

Dian Harrison is the President and CEO of Planned Parenthood Golden Gate. This is the first of a series of posts about California's Parental Notification Ballot Inititiative.

October is "Let's Talk Month." It's a great opportunity to let the young people in your life know that you are there for them and ready to help, even when they are facing issues that can be tough to talk about, like sexual health.

Research has shown that teens that have good communication with their families are more likely to delay becoming sexually active and are also more likely to be safe if they do become active. According to the National Campaign to Prevent Teen Pregnancy, "Teens who are close to their parents and feel supported by them are more likely to abstain from sex, wait until they are older to begin having sex, have fewer sexual partners, and use contraception more consistently."

We counsel the teens who visit our health centers to talk with their parents about the issues they are facing, whether they are considering becoming sexually active, seeking birth control, or terminating an unintended pregnancy. Studies have shown that the vast majority of teens involve a parent when they are facing an unintended pregnancy.

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Parental Notification Laws, like California's Prop 85 and Oregon's Measure 43, Just Don't Work

Unfortunately, there are some teens that come from abusive homes where it's just not safe to discuss sensitive issues, like an unintended pregnancy. That's why laws that require parental notification before abortion, like Proposition 85 in California and Measure 43 in Oregon, are a bad idea.

Parents rightfully want to be involved in the lives of their teens, but not all teens come from supportive homes. Teens that don't turn to their parents usually have a very good reason for not doing so, such as fear for their physical safety. Rather than going to an abusive parent, some teens will seek an illegal back-alley abortion, try to self-abort, or even consider suicide.

These laws may look like a good communication tool at first glance, but don't be fooled! Notification laws don't help families communicate and they don't reduce teen pregnancy as proponents claim. All they do is put our most vulnerable teens in danger.

According to the American Academy of Pediatrics, "…mandating parental notification does not achieve the intended benefit of promoting family communication, but it does increase the risk of harm to the adolescent by delaying access to appropriate care."

A recent study by the N.Y. Times found that parental notification and consent laws have not reduced teen pregnancy in the states where they are enacted.

That's why the people who work with teens every day, such as the California Teachers Association, the California Medical Association, the American Academy of Pediatrics, and Planned Parenthood, all oppose Proposition 85.

The groups supporting 85 are all anti-choice groups that are furthering their political agenda at the expense of California's most vulnerable teens. Backers of 85 include Right to Life of Central California, the Traditional Values Coalition and Evangelicals for Social Action. The primary sponsor, Catholic publishing magnate James Holman, was also the main backer of last year's failed Proposition 73.

Family communication has to start at home and it has to start early, before an unintended pregnancy can take place. Combined with comprehensive, medically accurate sexuality education and access to contraception, it can work wonders when it comes to preventing teen pregnancy. In California, we have been able to reduce the teen pregnancy rate by 46% over the past decade without dangerous notification laws.

Help spread the word, good family communication starts with a conversation, not a law. Reject parental notification laws and help keep teens safe!

Commentary Sexual Health

Fewer Young People Are Getting Formal Sex Education, But Can a New Federal Bill Change That?

Martha Kempner

Though the Real Education for Healthy Youth Act has little chance of passing Congress, its inclusive and evidence-based approach is a much-needed antidote to years of publicly funded abstinence-only-until-marriage programs, which may have contributed to troubling declines in youth knowledge about sexual and reproductive health.

Recent research from the Guttmacher Institute finds there have been significant changes in sexuality education during the last decade—and not for the better.

Fewer young people are receiving “formal sex education,” meaning classes that take place in schools, youth centers, churches, or community settings. And parents are not necessarily picking up the slack. This does not surprise sexuality education advocates, who say shrinking resources and restrictive public policies have pushed comprehensive programs—ones that address sexual health and contraception, among other topics—out of the classroom, while continued funding for abstinence-only-until-marriage programs has allowed uninformative ones to remain.

But just a week before this research was released in April, Sen. Cory Booker (D-NJ) introduced the Real Education for Healthy Youth Act (REHYA). If passed, REHYA would allocate federal funding for accurate, unbiased sexuality education programs that meet strict content requirements. More importantly, it would lay out a vision of what sexuality education could and should be.

Can this act ensure that more young people get high-quality sexuality education?

In the short term: No. Based on the track record of our current Congress, it has little chance of passing. But in the long run, absolutely.

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Less Sexuality Education Today

The Guttmacher Institute’s new study compared data from two rounds of a national survey in the years 2006-2010 and 2011-2013. It found that even the least controversial topics in sex education—sexually transmitted diseases (STDs) and HIV and AIDS—are taught less today than a few years ago. The proportion of young women taught about STDs declined from 94 percent to 90 percent between the two time periods, and young women taught about HIV and AIDS declined from 89 percent to 86 percent during the same period.

While it may seem like a lot of young people are still learning about these potential consequences of unprotected sex, few are learning how to prevent them. In the 2011-2013 survey, only 50 percent of teen girls and 58 percent of teen boys had received formal instruction about how to use a condom before they turned 18. And the percentage of teens who reported receiving formal education about birth control in general decreased from 70 percent to 60 percent among girls and from 61 percent to 55 percent among boys.

One of the only things that did increase was the percentage of teen girls (from 22 percent to 28 percent) and boys (from 29 to 35 percent) who said they got instruction on “how to say no to sex”—but no corresponding instruction on birth control.

Unfortunately, many parents do not appear to be stepping in to fill the gap left by formal education. The study found that while there’s been a decline in formal education, there has been little change in the number of kids who say they’ve spoken to their parents about birth control.

Debra Hauser, president of Advocates for Youth, told Rewire that this can lead to a dangerous situation: “In the face of declining formal education and little discussion from their parents, young people are left to fend for themselves, often turning to their friends or the internet-either of which can be fraught with trouble.”

The study makes it very clear that we are leaving young people unprepared to make responsible decisions about sex. When they do receive education, it isn’t always timely: It found that in 2011-2013, 43 percent of teen females and 57 percent of teen males did not receive information about birth control before they had sex for the first time.

It could be tempting to argue that the situation is not actually dire because teen pregnancy rates are at a historic low, potentially suggesting that young people can make do without formal sex education or even parental advice. Such an argument would be a mistake. Teen pregnancy rates are dropping for a variety of reasons, but mostly because because teens are using contraception more frequently and more effectively. And while that is great news, it is insufficient.

Our goals in providing sex education have to go farther than getting young people to their 18th or 21st birthday without a pregnancy. We should be working to ensure that young people grow up to be sexually healthy adults who have safe and satisfying relationships for their whole lives.

But for anyone who needs an alarming statistic to prove that comprehensive sex education is still necessary, here’s one: Adolescents make up just one quarter of the population, but the Centers for Disease Control and Prevention estimate they account for more than half of the 20 million new sexually transmitted infections (STIs) that occur each year in this country.

The Real Education for Healthy Youth Act

The best news about the REHYA is that it takes a very broad approach to sexuality education, provides a noble vision of what young people should learn, and seems to understand that changes should take place not just in K-12 education but through professional development opportunities as well.

As Advocates for Youth explains, if passed, REHYA would be the first federal legislation to ever recognize young people’s right to sexual health information. It would allocate funding for education that includes a wide range of topics, including communication and decision-making skills; safe and healthy relationships; and preventing unintended pregnancy, HIV, other STIs, dating violence, sexual assault, bullying, and harassment.

In addition, it would require all funded programs to be inclusive of lesbian, gay, bisexual, and transgender students and to meet the needs of young people who are sexually active as well as those who are not. The grants could also be used for adolescents and young adults in institutes of higher education. Finally, the bill recognizes the importance of teacher training and provides resources to prepare sex education instructors.

If we look at the federal government’s role as leading by example, then REHYA is a great start. It sets forth a plan, starts a conversation, and moves us away from decades of focusing on disproven abstinence-only-until-marriage programs. In fact, one of the fun parts of this new bill is that it diverts funding from the Title V program, which received $75 million dollars in Fiscal Year 2016. That funding has supported programs that stick to a strict eight-point definition of “abstinence education” (often called the “A-H definition”) that, among other things, tells young people that sex outside of marriage is against societal norms and likely to have harmful physical and psychological effects.

The federal government does not make rules on what can and cannot be taught in classrooms outside of those programs it funds. Broad decisions about topics are made by each state, while more granular decisions—such as what curriculum to use or videos to show—are made by local school districts. But the growth of the abstinence-only-until-marriage approach and the industry that spread it, researchers say, was partially due to federal funding and the government’s “stamp of approval.”

Heather Boonstra, director of public policy at the Guttmacher Institute and a co-author of its study, told Rewire: “My sense is that [government endorsement] really spurred the proliferation of a whole industry and gave legitimacy—and still does—to this very narrow approach.”

The money—$1.5 billion total between 1996 and 2010—was, of course, at the heart of a lot of that growth. School districts, community-based organizations, and faith-based institutions created programs using federal and state money. And a network of abstinence-only-until-marriage organizations grew up to provide the curricula and materials these programs needed. But the reach was broader than that: A number of states changed the rules governing sex education to insist that schools stress abstinence. Some even quoted all or part of the A-H definition in their state laws.

REHYA would provide less money to comprehensive education than the abstinence-only-until-marriage funding streams did to their respective programs, but most advocates agree that it is important nonetheless. As Jesseca Boyer, vice president at the Sexuality Information and Education Council of the United States (SIECUS), told Rewire, “It establishes a vision of what the government could do in terms of supporting sex education.”

Boonstra noted that by providing the model for good programs and some money that would help organizations develop materials for those programs, REHYA could have a broader reach than just the programs it would directly fund.

The advocates Rewire spoke with agree on something else, as well: REHYA has very little chance of passing in this Congress. But they’re not deterred. Even if it doesn’t become law this year, or next, it is moving the pendulum back toward the comprehensive approach to sex education that our young people need.

CORRECTION: This article has been updated to clarify Jesseca Boyer’s position at the Sexuality Information and Education Council of the United States.

Commentary Sexual Health

We’re Letting Schools Off the Hook on Sex Education

Martha Kempner

A report from the CDC shows that schools are failing to teach about STI and pregnancy prevention. But even if they were, students would still be left in the dark about many important issues.

Last month, the Centers for Disease Control and Prevention (CDC) released very disappointing data about sexuality education. Its School Health Profiles report, a survey of policies and practices across the country, found that fewer than half of all high schools and only a fifth of middle schools teach all 16 sexual health topics recommended by the CDC. Topics such as the importance of limiting the number of one’s sexual partners and the influences of peers, media, and family on sexuality are being left out by many schools. Particularly alarming were the findings about condoms, which showed that fewer than 60 percent of high schools tell students how to obtain condoms and only about half teach them how to use them correctly.

This is unconscionable in an era when half of all of sexually transmitted infections (STIs) occur in young people, and yet that is not what upsets me the most about the data. Based on my experience as a sex educator, I’m much more concerned about what agencies like the CDC don’t even expect schools to teach.

The CDC’s 16 sexual health topics, which largely focus on the prevention of STIs, HIV, and unintended pregnancy, are certainly important. As noted on the organization’s website, schools often use these guidelines and survey results to shape their future educational policies. But I would argue that even if 100 percent of schools in every state taught these topics, we would still be graduating students who don’t know some of the most basic information about sexuality. Based on what the CDC recommends exploring in depth, young people are certainly not prepared at this moment to think critically about more complicated issues—such as gender roles, relationships, sexual orientation, or sexual assault.

I say this based in large part on my years teaching college students in the great state of New Jersey, which, according to the School Health Profiles, does the best job covering prevention issues of any state. Here in the Garden State, 89.5 percent of high schools teach all 16 topics. Compare that to the worst-performing state, Arizona, where only 21 percent of high schools teach them all. This is great news for my home, to be sure. And yet, the recent graduates of New Jersey high schools who sit in my sociology of sexuality class each semester bemoan a lack of sex education—and what they don’t know may shock you.

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As expected, those who say they got any sex education (and some swear they did not), are most likely to report learning about STIs. The quality of the lessons, however, which the CDC’s “yes-or-no” survey questions do not measure, may leave something to be desired. A surprising number of students say this information revolved around a slide show of infected genitals and fallopian tubes injected with dye to show a blockage caused by untreated STIs. I have never seen the value in this method of teaching about STIs. It’s shocking, to be sure, but beyond that what do students learn? The pictures included are almost always of advanced infections, meaning they do nothing to help students identify the tiny sores and bumps that should have sent the people in the photographs running to the doctor months, if not years, before the pictures were taken.

Moreover, these slides are often the only time that young people see pictures—even illustrations—of genitals. There seems to be a belief that pictures of healthy genitals are inappropriate for a classroom, but once you add disease, they are educational. This just perpetuates the idea that these are dirty and shameful parts of our bodies.

This might be why I was met with a sea of confused faces when I began to discuss labiaplasty and the trend among young women to surgically alter their genitals to look more “normal.” It quickly became clear that many of my students did not know what labia were. So, even though my course is not supposed to be about the basics of human sexuality or anatomy, I put up a drawing of female genitalia and explained what was where and what function it served. One woman stared closely at the screen and admitted that she had not known women had three holes—the vagina, the urethra, and the anus. She was 20 years old and had always believed urine came out of her vagina.

I’m not suggesting that most schools in New Jersey fail to teach the basics of human anatomy. In fact, this young woman’s school may even have done so, she may have just been absent or not paying attention that day. What I do believe, however, is that if we keep focusing our attention on preventing negative consequences, our schools will never teach more than the basics. While it’s understandable that the CDC sticks to its mission of preventing pregnancy and disease, we cannot use that as the ultimate goal for sex education: policymakers, teachers, advocates, and parents have to demand something more of our schools, and provide them with the support and resources to do more.

SIECUS’ Guidelines for Comprehensive Sexuality Education—which many educators see as a framework for the ideal sexuality education program—suggest young people learn from kindergarten through 12th grade 39 topics related to sexuality. Of course, the prevention of STIs, HIV, and pregnancy are among these topics, but the list goes far beyond that. This model of sexuality education, which I totally support (I co-authored the third edition of the Guidelines when I was at SIECUS) wants young people to learn about families, friendships, love, romantic relationships, and marriage and lifetime commitment. It tries to help students understand their values and practice communication, negotiation, and assertiveness skills so as to stick to these values. It informs young people about sexual behavior, masturbation, sexual response, and fantasy. It actually tells them that sex feels good. And it begins the conversations about gender, sexual orientation, society, the media, and the law that I try to take on in my college course.

It is this well-rounded type of education that can get young people to think critically about the sexuality issues that set up the world around them, affect how they interact with that world, and directly impact the decisions they will make throughout their lives. Unfortunately, the vast majority of schools do not have the time or resources to devote to such teaching models, even when they are not limited by restrictive local policies mandating “abstinence-only education.” Most adults want young people to grow up to have a happy and healthy sex life, and yet schools are often limited to discussing the negative consequences of sex. This leaves young people uninformed and confused.

We know that almost two-thirds of high school students have had sex by their senior year. We know that although teen pregnancy and birth rates in this country are at an all-time low, there are still more than 270,000 babies born to teens each year. And we know that nearly half of the 20 million new STIs each year are diagnosed among young people between the ages of 15 to 24. It is sad that in this environment, our schools are failing to provide even the most basic prevention education.

Even so, what I think is truly pathetic is that we’ve evidently given up on the idea that schools can, and should, strive for more than that.