Thursday, September 17, 2009

Cristina Page

 

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.

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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 Politics

Ted Cruz Is No Moderate: Meet Some of His Most Extreme Allies

Ally Boguhn

The presidential candidate has lined up supporters who have suggested that marriage equality may usher in a second civil war and compared Planned Parenthood workers to perpetrators of clinic violence.

In his quest to secure conservative votes, Sen. Ted Cruz (R) has embraced extremists across the country, many of whom have well-documented histories of anti-choice, anti-LGBTQ, and racist rhetoric. As more moderate Republicans flock to Cruz in a push to block Donald Trump from winning their party’s nomination, Cruz’s support of these extremists sheds light on his future policy making, should he be elected president.

Though hardly an exhaustive list of the radicals with whom Cruz has aligned, here are some of the most reactionary characters in his playbook.

Troy Newman

Cruz and activist Troy Newman, head of the radical anti-choice group Operation Rescue, have spent months on the campaign trail praising each other’s extreme stances on abortion.

Operation Rescue moved to Wichita, Kansas, in 2002 to continue its campaign to intimidate abortion provider Dr. George Tiller, whom it had nicknamed “Tiller the Killer.” Before Newman came on as president, the group had previously targeted Tiller as part of its 1991 “Summer of Mercy,” when it led protesters to physically block and verbally intimidate those entering abortion clinics in Wichita, holding signs that, among other things, read “Tiller’s Slaughter House.”

Although Newman issued a statement on behalf of Operation Rescue condemning Scott Roeder when he murdered Tiller in 2009, a 2010 Ms. investigation reported that, according to Roeder, Newman had once told him that “it wouldn’t upset” him if an abortion provider was killed. (Newman denied meeting Roeder.) Roeder also had the phone number of Operation Rescue’s Cheryl Sullenger on a note on the dashboard of his car when he murdered Tiller. Sullenger, the senior vice president of the group, had been sentenced to prison time in 1988 for attempting to bomb an abortion clinic.

Newman co-founded anti-choice front group Center for Medical Progress (CMP) in 2013, whose widely discredited videos alleged that Planned Parenthood was illegally profiting from fetal tissue donations. Multiple ensuing investigations at both the state and federal level produced no evidence of wrongdoing, and one of the group’s other founders, David Daleiden, was later indicted in connection to the videos. Newman later separated from the group.

Despite the extremism of Newman’s groups, Cruz lauded the anti-choice activist upon receiving his endorsement in November, saying in a statement, “We need leaders like Troy Newman in this country who will stand up for those who do not have a voice.”

Cruz announced in late January that Newman would co-chair his coalition of anti-choice advisers, “Pro-Lifers for Cruz,” listing Newman’s book co-authored with Sullenger, Their Blood Cries Out, among his accomplishments. As Right Wing Watch noted, however, the text argues women who have abortions should be treated like murderers, and that abortion doctors should be executed. The book, now out of print, read: “[T]he United States government has abrogated its responsibility to properly deal with the blood-guilty. This responsibility rightly involves executing convicted murderers, including abortionists, for their crimes in order to expunge bloodguilt [sic] from the land and people,” according to Mother Jones.

Tony Perkins

Troy Newman isn’t the only radical in “Pro-Lifers for Cruz”—the group’s chair, Tony Perkins, is an anti-LGBTQ activist with a history of aiding extremist anti-choice groups.

Since 2003, Perkins has led the Family Research Council (FRC), classified by the Southern Poverty Law Center (SPLC) as a “hate group” for its anti-LGBTQ record.

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Recounting Perkins’ biography, the SPLC noted that although he claimed to have left a police force position over a disagreement about containing an anti-choice protest, “the reality is quite different.” The SPLC pointed to a report from the Nation finding that Perkins “failed to report an illegal conspiracy by anti-abortion activists” Operation Rescue during the group’s 1992 “Summer of Purpose,” while he worked dual roles as a reserve police officer in Baton Rouge and reporting for a conservative television station:

According to Victor Sachse, a classical record shop owner in the city who volunteered as a patient escort for the clinic, Perkins’ reporting was so consistently slanted and inflammatory that the clinic demanded his removal from its grounds.

In order to control an increasingly tense situation, the police chief had a chain-link fence erected to separate anti-abortion activists from pro-choice protesters, and he called in sheriff’s deputies and prison guards as extra forces. Perkins publicly criticized the department and the chief. Then, after learning about plans for violent tactics by anti-abortion activists to break through police lines and send waves of protesters onto the clinic’s grounds, he failed to inform his superiors on the force. As a result of his actions, Perkins was suspended from duty in 1992, and he subsequently quit the reserve force.

Perkins also has ties to white supremacist groups and is well known as a vocal opponent of LGBTQ equality, having suggested, among other things, that there is “a correlation between homosexuality and pedophilia,” and that lawmakers who supported the repeal of the military’s “Don’t Ask, Don’t Tell” policy had “the blood of innocent soldiers on their hands.”

Frank Gaffney

Cruz’s list of national security advisers, meanwhile, includes Frank Gaffney Jr. Even in the face of criticism, Cruz has defended his pick, telling CNN’s Wolf Blitzer that “Frank Gaffney is a serious thinker who has been focused on fighting jihadists, fighting jihadism across the globe.”

Gaffney, a former Reagan administration official, is the founder and president of the Center for Security Policy (CSP). In this year’s Intelligence Report, which documents extremist groups, the SPLC categorized CSP as an anti-Muslim hate group.

The CSP’s primary focus in recent years “has been on demonizing Islam and Muslims under the guise of national security” by promoting conspiracy theories, according to SPLC. The Center for American Progress’ 2011 report, The Roots of the Islamophobia Network in America, featured Gaffney as a key player in promoting anti-Muslim rhetoric in the United States, writing that he often “makes unsubstantiated claims about ‘stealth jihad,’ the ‘imposition of Sharia law,’ and the proliferation of ‘radical mosques.'”

Gordon Klingenschmitt

Cruz announced in early April that his Colorado Leadership Team included state Rep. Gordon Klingenschmitt (R-Colorado Springs), asserting he was “honored” to have the support of the politician and 24 other conservatives from the the state.

The previous week, Klingenschmitt had made headlines for claiming transgender people are “confused about their own identity” during an appearance on Comedy Central’s The Daily Show.

Klingenschmitt had been previously stripped of his position on the Colorado House of Representatives’ House Health, Insurance and Environment Committee in early 2015 after claiming on his television program that a violent attack on a pregnant woman in the state was the result of “the curse of God upon America for our sin of not protecting innocent children in the womb.”

“Part of that curse for our rebellion against God as a nation is that our pregnant women are ripped open,” claimed Klingenschmitt at the time before going on to pray for an “end to the holocaust which is abortion in America.”

In the wake of the deadly shootings at a Colorado Springs Planned Parenthood in November 2015, Klingenschmitt claimed that “Planned Parenthood executives” have the “same demonic spirit of murder” as the alleged killer, Robert Lewis Dear Jr.

Earlier in 2015, the Colorado state representative said that Planned Parenthood executives have “demons inside of them, you can see the blood dripping from their fangs. These people are just evil.” That June, he criticized Wisconsin Gov. Scott Walker (R) for signing a measure forcing those seeking abortions to receive medically unnecessary forced ultrasounds, claiming that the law didn’t go far in enough because it didn’t ban abortion entirely
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James Dobson

Focus on the Family (FoF) founder and chairman James Dobson played a starring role in a February ad released by the Cruz campaign, which praised the candidate for defending “the sanctity of human life and traditional marriage.” That same month, he rolled out a robocall for a super PAC supporting the candidate after giving Cruz his endorsement last year.

Dobson’s FoF has spent millions promoting its anti-choice and anti-LGBTQ extremism, even dropping an estimated $2.5 million in 2010 to fund an anti-choice Super Bowl ad featuring conservative football player Tim Tebow. Dobson also founded the aforementioned Family Research Council, now headed by Tony Perkins.

Dobson’s own personal rhetoric is just as extreme as the causes his organization pushes. As extensively documented by Right Wing Watch,

Dobson has:

Other Notable Extremists Working With Cruz

Conservative radio host Steve Deace, a member of the Cruz campaign’s Iowa leadership team, is “virulently anti-LGBT, having repeatedly attacked supporters of LGBT equality as being part of a ‘Rainbow Jihad,'” according to media watchdog organization Media Matters for America.

In October Cruz announced he was “thrilled” to receive the endorsement of Sandy Rios, a conservative radio host and official at the American Family Association-yet another organization classified by the SPLC as a hate group. Rios gained notoriety during the 2015 Amtrak crash in Philadelphia after claiming the conductor’s sexuality may have played a role in the accident.

Cruz and several other Republican presidential candidates spoke alongside far-right, anti-LGBTQ pastor and Christian radio host Kevin Swanson in November at the National Religious Liberties Conference. Swanson is featured in GLAAD’s Commentator Accountability Project, which highlights figures who “represent extreme animus towards the entire LGBT community.”

A&E’s Duck Dynasty star Phil Robertson has been a fierce Cruz supporter, and in February the presidential candidate pitched the idea of making him an ambassador to the United Nations should he be elected. Just weeks earlier, Robertson had called same-sex marriage “evil” during a Cruz rally. This statement came as little surprise given the reality television star’s previous comments condemning homosexuality and linking it to bestiality.

Cruz was also “thrilled” in March to win an endorsement from “Ohio’s top conservative leaders”—a list that included activist Linda Harvey, who once wrote that LGBTQ youth may be possessed by “demonic spirits.”