Saying Goodbye to Ab-Only? Don’t Forget to Say Hello to Comprehensive Sex Ed

Amanda Marcotte

In a new administration, the real danger might not be that abstinence-only continues, but that it fails and nothing comprehensive replaces it.

The process
of writing obituaries for the fundamentalist brain child that has plagued
the nation for the past 8 years, known as "abstinence-only education," has already begun. 
Studies have repeatedly shown that abstinence-only fails at its purported public health
claims (though I suppose it succeeds amply at its unspoken aim of making
anti-choicers feel like their religious views are the official state
views). Just as importantly, abstinence-only has become a national
joke.  How could it not?  A bunch of dour scolds telling teenagers
to wait 10 or 15 years to have sex when they’re married makes as much
sense in an era when 95% of Americans have had premarital sex as square
dancing lessons.  In a nation with the highest rates of teen pregnancy
in the developed world, the people have come around to believing we
need something more than shaking a finger in the face of eye-rolling
teenagers.   

But what happens next? 

According to Newsweek, the writing’s on the wall for abstinence-only,
no matter who wins the election.  Both candidates have endorsed
the idea of contraception education in schools to various degrees, but
even if they hadn’t, the fact that the states are refusing federal abstinence-only
funds means the program might just die from lack of use.  Are we
looking at an inevitably brighter future in sex education?  Activists
who do this work day to day vehemently caution comprehensive sex ed
supporters not to grow complacent. VIDEO: Comprehensive Sex Ed vs. Abstinence-OnlyVIDEO: Comprehensive Sex Ed vs. Abstinence-Only

"It is far from the end game," says Bill Smith, the Vice President
of Public Policy at SIECUS, but "we are capitalizing on this momentum and using it to advance comprehensive
sex education. Specifically in Washington, it is SIECUS’ top priority
to establish the first-ever federal funding dedicated to comprehensive
sex education and our state work is similarly focused." 

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James Wagoner, the President
of Advocates For Youth, concurs, pointing out recent public opinion
victories (most recently, the McCain campaign’s failure at using comprehensive
sex education to scare the public), but notes that even if abstinence-only
funding is cut, that doesn’t necessarily mean we’ll see the funding
moved into comprehensive sex education.  Banking on a Democratic
Congress might be a mistake, he argues, pointing out that past resistance
from some House Democrats has to be overcome to achieve the comprehensive
sex education goals.   

Indeed, the real danger might
not be that abstinence-only continues, but that it fails and nothing
comprehensive would replace it, which Wagoner points out would do nothing
to change our high teenager pregnancy and STD rates.  So how should
sexual and reproductive health activists capitalize on the momentum and push for
a genuine, evidence-based, reality-oriented federal comprehensive sex
education program that might have a real effect on public health outcomes? 

We need to argue from a position
of strong values.  Right now, there’s a myth that anti-choicers
are the only ones who have values, and the mainstream media clings to
this myth even in the face of self-evident silliness.  This Newsweek
article is a good example: 

But spend time among the
folks of east Texas, folks you’ll find at the stadium on Friday night
and the sanctuary on Sunday morning, and you start to understand why
groups like Virginity Rules will not go quietly. This isn’t really about
sex. In the eyes of supporters, teaching abstinence to teenagers amounts
to teaching marriage to future adults. 

Teaching marriage?  I
live in Texas and can assure you that we don’t have a plague of teenagers
who are unaware of the existence of marriage, so I fail to understand
how you "teach" it. Presumably, reporter Laura Beil means teaching
young people to value marriage or to have good marriages.  In fact,
Beil seems to think that comprehensive sex education ignores marriage,
relationships, and values altogether.

The vast majority of public-health
experts, however, seldom discuss sex education and marriage in the same
sentence. They gauge success by pregnancies prevented, infections not contracted,
and kids who enter adulthood with a healthy view of sexuality. The public-health
community views a wait-until-marriage message as blind to the world
most teens inhabit.

It’s true that public health
advocates do tend to hold the very mainstream opinion that marrying
very young before you’ve seen much of the world isn’t a smart thing
to teach kids, but not because we’re cold, clinical people obsessed
with science over values, as Beil implies. (Even though it’s a statistical
reality that the younger you marry, the likelier you are to divorce.)
As Wagoner explains, comprehensive sex education is about teaching kids
about responsibility and conducting sexual relationships in healthy
ways, which is hardly anti-marriage.  "Good, solid, healthy relationships
are the foundation of good, healthy marriages," he argues.   

Not only do comprehensive sex
education proponents value responsibility and healthy relationships,
I’d add, but we also value maturity.  As the Newsweek article
demonstrates, abstinence-only proponents argue the best marriages are
made when the participants have the least amount experience and knowledge
about maintaining sexual relationships, a belief rooted firmly not in
the world of adults, but in children’s stories. 

    [The beauty queens] were,
    each one, card-carrying virgins, declaring, "We Are Waiting for
    Our Prince Charming." 

In that, you really see the
difference in worldviews.  Abstinence-only is about telling teenage
girls to hold out for a character that only exists in fiction. 
Comprehensive sex education is about understanding that people have
relationships in the real world, and those relationships shouldn’t
be devalued because they aren’t in storybooks or animated by Disney.

Commentary Contraception

The Double Standard of Military Pregnancy: What Contraceptive Access Won’t Fix

Stephanie Russell-Kraft

Unique military gender politics that make it hard for some servicewomen to ask for birth control also stigmatize them if they get pregnant—especially when that happens at an overseas post or on a deployment. Any effort to increase birth control availability can only be understood against that particular cultural backdrop.

At the beginning of May, pharmaceutical giant Allergan announced that, in partnership with nonprofit Medicines360, it would begin offering its new intrauterine device (IUD) Liletta at a reduced price to military treatment facilities and veterans hospitals across the United States. The company would also support “an educational effort to raise contraception awareness among healthcare providers treating U.S. military service women,” according to its press release.

Military personnel and medical professionals agree Allergan’s initiative represents an important step toward expanding access to the IUD, which along with other long-acting reversible contraceptives (like injections) are particularly well suited to the demands of military training and deployment schedules. But this push to increase IUD use can’t be fully understood outside the context of the unique challenges and stigmas facing women of reproductive age in the U.S. military (who numbered just under 200,000 as of 2011, the latest available data obtained via FOIA by Ibis Reproductive Health).

Despite theoretically having access to a wide variety of contraceptive options, women in the military still report higher rates of unplanned pregnancy than their civilian peers, and it remains somewhat of a mystery exactly why. What is clear is that the unique military gender politics that make it hard for some women to ask for birth control also stigmatize them if they get pregnant—especially when that happens at an overseas post or on a deployment. Any effort to increase birth control availability, including Allergan’s, can only be understood against that particular cultural backdrop.

Nearly every time a U.S. military branch changes policies to include more women, critics raise the old argument that allowing women into the service, particularly in combat roles, will lead to sex between soldiers and thereby distract from the mission. Because of that, the military generally prohibits sex during deployments between service members not married to each other (exact policies vary across the branches and across units, and some are less strict). Taken as a whole, the U.S. military’s policy basically amounts to an abstinence-only approach, with women shouldering nearly all of the risk and blame when soldiers do decide to have sex on deployment.

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Bethany Saros, who enlisted in the Army as an 18-year-old in 2002, faced this blame head-on when she became pregnant by a fellow soldier during a 2007 tour in Iraq.

Although condoms were available to soldiers at her deployment site, Saros did not use birth control. Her decision not to end the pregnancy meant her deployment was over, and Saros recalls meeting several other pregnant women in Kuwait while they all waited to get shipped back. “I felt like a pariah, and I think the other girls did too,” she said.

“It’s not like anyone does this on purpose,” Saros explained. “The fathers of these babies, they don’t get any problems, and they were screwing around just as we were.”

Across all branches of service, pregnant women are typically not allowed to serve on deployments, and, though the length of time varies by branch, women are not allowed to deploy in the six to 12 months after they give birth. According to spokespeople from each of the branches, the reasoning behind the policies is to protect servicewomen and give them the time they need to recover from birth. All of the women I spoke with for this piece told me that soldiers—both male and female—often believe a woman who gets pregnant right before or during a deployment is simply trying to avoid her work.

“The first thing someone talked about when a woman got pregnant was that she was trying to get out of a deployment,” said Lauren Zapf, a former Naval officer, mental health clinician, and fellow with the Service Women’s Action Network. “Whereas if men announce that they’re going to have a baby, there’s a lot of backslapping and congratulations.”

According to Ibis Reproductive Health’s analysis of Department of Defense data, about 11 percent of active-duty military women reported an unintended pregnancy in 2008 and 7 percent reported an unintended pregnancy in 2011—in both years, this was far more than the general population. Younger, less educated, nonwhite women were much more likely to become pregnant unintentionally, as were those who were married or living with a partner, according to Ibis. Contrary to military lore, the pregnancy rates did not differ between those women who had deployed and those who didn’t during that time, the study found.

It remains unclear why exactly military women have higher reported rates of unplanned pregnancy than their civilian counterparts, but one reason has likely been their inconsistent access to birth control and limited access to abortion services. As with most institutions, there’s a difference between official policy and what happens on a day-to-day basis on military bases and in medical exam rooms. Just because most military branches officially require routine birth control consultations doesn’t mean women will always get them, according to Ibis researcher Kate Grindlay, who is one of very few independent researchers looking into this issue.

“One of the challenges that we found [in our research] was that these things were not being done in a consistent way,” Grindlay said. “Some providers having these conversations in a routine way, some weren’t.”

Access to birth control—and the conversations that lead up to it—has improved greatly for military women in the past 20 years. Elizabeth McCormick, a former Black Hawk pilot who served in the Army from 1994 to 2001, recalled that “no one talked about birth control” in any of her pre-deployment medical events in the 1990s. By contrast, some of the women I spoke with who served more recently said they didn’t have issues getting the care they needed.

However, in a 2010 Ibis survey of deployed women, 59 percent of respondents said they hadn’t discussed contraception with a military health-care provider before deployment and 41 percent said they had difficulty obtaining the birth control refills they needed while away from home. Servicewomen also reported being denied an IUD because they had not yet had children, even though nulliparous women can use the devices.

These inconsistencies are part of the problem Allergan says it hopes to address with its education efforts for military health-care providers. The company hasn’t explicitly said what those efforts will look like.

Another part of the problem, according to former Marine Corps officer and Cobra helicopter pilot Kyleanne Hunter, might be cultural. Conversations with military medical providers likely present another major barrier to proper contraceptive care because most military doctors are not only men, but also officers, who, outside the context of a hospital exam room, can give orders that must be respected.

Young female enlisted service members who have internalized the military’s rigid power structures might be reluctant to speak honestly and openly about reproductive care, posited Hunter, who’s currently a University of Denver PhD candidate studying the national security impact of integrating women into western militaries. She said the same dynamic often prevents women from coming forward after they have been sexually assaulted by a fellow service member.

“It adds one more layer to what’s already an uncomfortable conversation,” Hunter said.

When Bethany Saros returned to Fort Lewis, Washington, after leaving Iraq for her pregnancy, a conversation with a male doctor solidified her decision to quit the Army altogether.

“I had to go through a physical, and there was a Marine doctor, and he said, ‘Was there enough room on the plane for all the pregnant ladies that came back?’” she told me, still taken aback by the incident.

Grindlay said efforts like Allergan’s to increase the use of IUDs in the military are “very beneficial” to servicewomen. She also applauded a provision in the 2016 National Defense Authorization Act to require standardized clinical guidelines for contraceptive care across the armed forces. Under the new provisions, women in the armed forces must receive counseling on the “full range of methods of contraception provided by health care providers” during pre-deployment health care visits, visits during deployment, and annual physical exams.

But there’s still work to be done in order for the military to provide full access to reproductive health care, particularly when it comes to abortion. Tricare, the military’s health and insurance provider, only covers abortions “if pregnancy is the result of rape or incest or the mother’s life is at risk,” and certain countries in which the military operates ban the procedure altogether.

In a sampling of 130 online responses for a medication abortion consultation service reviewed by Ibis in 2011, several military women reported considered using “unsafe methods” to try to terminate a pregnancy themselves, according to Grindlay. One of the women, a 23-year-old stationed in Bahrain, said she had been turned away by five clinics and had contemplated taking “drastic measures.”

According to the 2011 Ibis report, many women sought abortions so that they could continue their military tour. Others feared a pregnancy would otherwise ruin their careers.

Virginia Koday, a former Marine Corps electronics technician who left the service in 2013, said in a phone interview that women can face losing their rank or getting charged for violating military policy if they become pregnant overseas. “Getting pregnant in Afghanistan is good cause to terminate your own pregnancy without anyone finding out,” she said.

“The unspoken code is that a good soldier will have an abortion, continue the mission, and get some sympathy because she chose duty over motherhood,” wrote Bethany Saros in a 2011 Salon piece about her unplanned pregnancy.

For these women, one act of unprotected sex had the potential to derail their career. For the men, it was just a night of fun.

Kyleanne Hunter said that while she doesn’t have a “whole lot of sympathy” for women who become pregnant on deployments (they’re not supposed to be having sex in the first place, she argues), she disagrees with the double standard that allows the men involved to escape punishment.

“Both parties need to be held exactly to the same accountability standards,” said Hunter. “If the woman is punished, then whoever she is involved with should be punished a well, because it takes two. She’s not alone in it. There’s no immaculate conception going on there.”

Analysis Law and Policy

The Issue of Trans Student Rights Inches Closer to the Supreme Court

Jessica Mason Pieklo

With several cases in the legal pipeline, it's becoming a question of when—not whether—the Roberts Court will step into the fight over transgender rights and bathroom access.

On August 29, the Gloucester County School Board in Virginia will file a request asking the U.S. Supreme Court to step into the fight over whether transgender student Gavin Grimm can use the bathroom that aligns with his gender identity. Grimm’s case is not the first of its kind, but it has become one of the most high-profile.

At this point, it’s not a question of whether the Roberts Court is likely to take a case concerning what rights transgender students have under Title IX. It’s more a question of when.

Title IX of the Education Amendment Act of 1972 is a federal civil rights law that prohibits discrimination on the basis of sex in any federally funded education program or activity. Historically, civil rights advocates have used Title IX to guarantee female students access to equal classes, facilities, and educational opportunities. It’s also recently become an important, if flawed tool in addressing campus sexual assault.

“Basically anything distinguishing between boys and girls or men and women is prohibited under Title IX, unless there is a specific exception in the statute or regulations allowing it to happen,” Joshua Block, senior staff attorney with the America Civil Liberties Union’s LGBT & HIV Project and one of the lawyers on Grimm’s case, explained to Rewire in an interview.

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Title IX has some small carve-outs for when and under what conditions schools may discriminate on the basis of sex, Block noted. “The Department of Education has passed very detailed regulations saying when you do and don’t have to integrate a sports team,” he explained. “It’s passed detailed regulations on under what conditions a school [can] offer sex-segregated classes. Those would otherwise be prohibited unless … authorized by the regulation,” he said.

Among the carve-outs for allowable sex-segregation under Title IX is a regulation dealing with restroom and locker room access, which is at the heart of cases like Grimm’s. And it’s that carve-out that has sparked the legal fight over trans rights at school.

“There is a long-standing regulation that says schools can have separate restrooms and can have locker rooms divided by sex,” said Block. “Now fast forward 40 years later and you have school districts saying that this regulation not only gives them permission to have boys’ and girls’ rooms, but it gives them permission to essentially banish transgender kids from those restrooms by saying they can’t use a restroom consistent with their gender identity.”

The legal landscape of trans student rights to access restrooms and locker rooms consistent with their gender identity has been shifting well before Grimm’s lawsuit. Since as early as 2009, schools in places like Maine and Illinois have faced lawsuits for prohibiting students from accessing restrooms and locker rooms consistent with their gender identity. Meanwhile, states like California and Colorado have provided affirmative protections for transgender students in the form of nondiscrimination laws so students can use restrooms and locker rooms consistent with their gender identity. But that means transgender students across the country are subject to a patchwork of legal protections that are not uniform across the country: A trans student in California has, at least in theory, more legal protections against discrimination at school than one in Mississippi. So for many trans students, Title IX is the only legal protection against discrimination they have.

Through a series of administrative actions, the Department of Education (DOE) since 2013 has tried to nudge reluctant school administrators toward understanding the difference between providing for sex-segregated facilities and using those facilities as justification for discriminating against transgender students. It has notified federally funded schools that failing to allow transgender students access to restrooms and locker rooms consistent with their gender identity will subject those schools to litigation and risk their federal funding. In other words, the DOE made explicit its interpretation of federal law: Schools may have sex-segregated facilities like restrooms, but they cannot determine on the basis of gender identity which students have access to which facilities.

Significantly, the Obama administration filed a friend-of-the-court brief in Grimm’s case, urging the federal appeals court to follow its lead on interpreting Title IX to protect against gender identity discrimination in schools. So far, both the district court and the Fourth Circuit Court of Appeals have listened to the administration, deferring to the federal agency on how best to interpret the regulations that agency publishes. Those rulings have been temporarily put on hold while the Gloucester School Board files its request to have the Roberts Court step in.

This brings us to the conservative Fifth Circuit Court of Appeals and the lawsuit filed by more than 20 states in May arguing that the Obama administration has overstepped its authority on this matter. It’s similar to the argument raised by Gloucester County in the Grimm case and rejected by the Fourth Circuit.

Raising those arguments in the conservative Fifth Circuit, the same federal appeals court that blocked the Obama administration’s executive action on deportations, is a strategic bet by conservatives that they can get a ruling in their favor. Such a ruling would create a likely circuit split, or disagreement, in the appellate courts—which is exactly the kind of situation the Supreme Court is set up to resolve.

Once again, Justice Anthony Kennedy is poised as the swing vote, the justice each side needs to rule in its favor. And while Kennedy has emerged as a moderate but leading voice in the jurisprudential recognition of LGBTQ rights, he has also been critical of some Obama administration agency action. Cases like Grimm’s, or whichever transgender rights case the Court eventually takes up, will present the ultimate test for Kennedy: Which matters more, his desire to see the “dignity” of the LGBTQ community advance in the law, or his distrust of executive authority—even if that executive authority advances LGBTQ dignity?

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