(VIDEO) California’s Sex Education Program: Ongoing Struggles Behind the Success Story

Phyllida Burlingame

California’s policies have undeniably made a positive impact on sex education in the state. But, unfortunately, sex education advocates can’t dust off our hands and move on. Many California public schools are still providing abstinence-only-until marriage programs, in spite of policies that forbid them.

California’s sex education policies are the envy of most other states. California is alone in having never accepted Title V federal abstinence-only-until-marriage funds, and state laws require that sex education in schools and state-funded community programs be comprehensive and bias-free. California’s laws have served as models for other states and the federal Responsible Education About Life (REAL) Act legislation. Recently, the Guttmacher Institute praised California as being way out front in preventing unintended pregnancy among teens, in part because of the state’s embrace of comprehensive sex education.

California’s sex education law requires that instruction:

  • Be medically accurate, science-based and age-appropriate
  • Include thorough information about condoms and contraception, as well as information about how, when and why to delay sexual activity
  • Be free of bias based on gender, sexual orientation, and race or ethnicity
  • Be accessible to English learner students and students with disabilities
  • Teach skills for making healthy decisions

California’s policies have undeniably made a positive impact on sex education in the state. But, unfortunately, sex education advocates can’t dust off our hands and move on. Many California public schools are still providing abstinence-only-until marriage programs, in spite of policies that forbid them.

In the six years since the sex education law was enacted, I’ve talked with countless parents complaining that outside agencies are coming into their schools to teach students about purity, condom ineffectiveness, and how their lives will be ruined if they engage in sex outside of marriage. How is this possible? 

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The gap between policy and practice in California reflects an ongoing challenge: implementation. In California, we have over 1,000 school districts and only one person at the California Department of Education who works on sex education. While the state does evaluate school districts for compliance with the law, its capacity is extremely limited: this year, only three districts have been reviewed. Without a powerful enforcement mechanism, school districts feel that they can ignore—or creatively misinterpret—the law with impunity.

Advocates for comprehensive sex education therefore can’t sit back and expect all school districts to implement the law on their own, or for the California Department of Education to force them to do it. To ensure that the instruction called for by law is actually presented to students, we need to keep working at the state level and in our communities.

While we still have our work cut out for us, California sex education advocates have made significant progress in leveraging the law to move school districts away from abstinence-only programs, through a combination of administrative advocacy, community organizing, and coalition building.

Getting State Agencies To Step Up

State agencies can seem like an impenetrable bureaucratic thicket, but finding a way through the thicket can be invaluable, since these agencies have extensive reach into local school districts and communities. They also play a key role in interpreting legislation and deciding how to incorporate it into their administrative processes, such as adopting state-approved textbooks, developing state standards for what students should learn, or establishing the criteria for grant programs.

If left to their own devices, most state agencies adopt a weak response to implementing comprehensive sex education. They see it as too controversial.  This is where the advocacy community can play a critical role. In California, we established relationships with key players, both public and private, and identified opportunities for strategic intervention. This approach has borne fruit in many ways:

  • California’s state superintendent sent a letter to all school districts specifying that abstinence-only education was not permitted in California public schools, and the Department of Education posted extensive information about the law on its website;
  • The California School Boards Association (CSBA) issued a more clear and robust model sex education policy for local school districts to adopt;
  • We successfully intervened in California’s adoption of standards for health education, insisting that the standards reflect the requirements of the sex education law and include clear messages regarding sexual orientation and condoms and contraception.
  • Since charter schools represent a growing segment of public schools in California, we partnered with the California Charter Schools Association to issue a statement in support of comprehensive sex education and educate their membership about California’s policies.

Taken together, these actions solidify and strengthen California’s embrace of comprehensive sex education. They also provide tools for local activists to use.

Engaging the Community

Many school districts simply won’t implement comprehensive sex education without being pressured by an organized group of parents, students and community members.

A case in point: As recently as 2008 here in the progressive Bay Area, the Fremont school district was using an agency that received federal Community Based Abstinence Education funds. The curriculum criticized unmarried couples who “mate” and have children, provided inaccurate information about condom effectiveness, and included anti-abortion bias.

The ACLU of Northern California and Bay Area Communities for Health Education (BACHE, a parent-founded organization that mobilizes other parents around sex education) began organizing local community members and launched an effort to replace the abstinence-only provider with comprehensive sex education. Using the law as leverage and relying on tools such as the CSBA model policy and the letter from the state Department of Education, Fremont parents, students, teachers and community members spoke at school board meetings, gained a majority on the district’s sex education oversight committee, and presented the district with a concrete list of problems and proposed solutions.

The Fremont school district had long been in the sway of a small group of ardent abstinence-only supporters, but faced with overwhelming community opposition to the abstinence-only-until-marriage program and the reality that it was breaking the law, the district changed course and adopted comprehensive sex education in both middle and high schools. The ACLU and BACHE are now teaming up on a similar effort in Sonoma County, north of San Francisco. Watch a video featuring Renee Walker, the parent founder of BACHE, talking about the value of community-based work.

Organizing local communities is labor-intensive, but the rewards are great. School districts often hide behind perceived community opposition as a reason not to improve their sex education instruction. “This is a conservative community,” district officials will say. “People here won’t support teaching anything other than abstinence.” That argument is quickly deflated when they’re faced with a mobilized, representative cross-section of the community arguing persuasively about why they support comprehensive sex education and demanding accountability from their local schools.

Organizing also increases the chances that change will be sustainable over time, since the community is both invested in the outcome and still on site to monitor the situation and make sure no back-sliding occurs. Also, once community members connect with each other in support of comprehensive sex education, they can also turn their energy in support of other important causes. The Fremont group, for example, after having achieved their sex education victory over a year ago, have now re-energized to push the district to recognize Harvey Milk Day, recently adopted by the state to honor the gay rights leader.

The fact that community members in Fremont who organized in support of sex education are now fighting to recognize an LGBTQ civil rights day demonstrates a key truth about sex education: it stands at the intersection of many issues and can serve as a bridge between them.

In its most narrow conception, sex education advocacy is about implementing programs that prevent teen pregnancy or sexually transmitted infections. But when approached from a reproductive justice perspective that recognizes all the factors that can negatively affect young people’s health—including racism, sexism, homophobia, poverty, immigration status, and language barriers—the goal of sex education advocacy expands from preventing unintended  pregnancy and disease to promoting a holistic vision of well-being for young people. By connecting with parents’ deeply held desire for healthy children and healthy communities, this approach has the potential to bring together a much wider cross-section of the community, and to engage them on a wider range of issues.

Making Connections Across Communities

Back in 2002, when we were contemplating sex education legislation, the ACLU of Northern California and Planned Parenthood Affiliates of California brought together educators, researchers, policy advocates and community-based organizations to discuss problems with the sex education then being taught in schools, and to strategize policy solutions.

Now called the California Sex Education Roundtable, and additionally convened by California Latinas for Reproductive Justice, this group promotes networking, cross-fertilization of ideas, and collaborative action. For example, the Public Health Institute, a research organization, conducted a survey of California parents’ support for comprehensive sex education, the results of which were widely used by other Roundtable members in their local efforts. California Latinas for Reproductive Justice and Asian Communities for Reproductive Justice have created toolkits for working on sex education with the Latina/o and Asian communities, respectively, and have brought  the voices of communities of color into statewide administrative and legislative advocacy efforts.

By developing a network that informs work at both the state and local levels and includes the perspectives of members from a range of disciplines and contexts, the Sex Education Roundtable has played a key role in furthering sex education implementation in California.

In It to Win It

Before implementation comes into play, of course, a policy must be enacted. Many states are still struggling to achieve this goal.  But it’s worth remembering that policy change, while incredibly important, is only the first step.  Ahead lies the long road to policy implementation, which is challenging, creative and rewarding.  With a long-term commitment and creative advocacy rooted in the community, progress becomes not just necessary, but attainable.

News Law and Policy

Texas Lawmaker’s ‘Coerced Abortion’ Campaign ‘Wildly Divorced From Reality’

Teddy Wilson

Anti-choice groups and lawmakers in Texas are charging that coerced abortion has reached epidemic levels, citing bogus research published by researchers who oppose legal abortion care.

A Texas GOP lawmaker has teamed up with an anti-choice organization to raise awareness about the supposed prevalence of forced or coerced abortion, which critics say is “wildly divorced from reality.”

Rep. Molly White (R-Belton) during a press conference at the state capitol on July 13 announced an effort to raise awareness among public officials and law enforcement that forced abortion is illegal in Texas.

White said in a statement that she is proud to work alongside The Justice Foundation (TJF), an anti-choice group, in its efforts to tell law enforcement officers about their role in intervening when a pregnant person is being forced to terminate a pregnancy. 

“Because the law against forced abortions in Texas is not well known, The Justice Foundation is offering free training to police departments and child protective service offices throughout the State on the subject of forced abortion,” White said.

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White was joined at the press conference by Allan Parker, the president of The Justice Foundation, a “Christian faith-based organization” that represents clients in lawsuits related to conservative political causes.

Parker told Rewire that by partnering with White and anti-choice crisis pregnancy centers (CPCs), TJF hopes to reach a wider audience.

“We will partner with anyone interested in stopping forced abortions,” Parker said. “That’s why we’re expanding it to police, social workers, and in the fall we’re going to do school counselors.”

White only has a few months remaining in office, after being defeated in a closely contested Republican primary election in March. She leaves office after serving one term in the state GOP-dominated legislature, but her short time there was marked by controversy.

During the Texas Muslim Capitol Day, she directed her staff to “ask representatives from the Muslim community to renounce Islamic terrorist groups and publicly announce allegiance to America and our laws.”

Heather Busby, executive director of NARAL Pro-Choice Texas, said in an email to Rewire that White’s education initiative overstates the prevalence of coerced abortion. “Molly White’s so-called ‘forced abortion’ campaign is yet another example that shows she is wildly divorced from reality,” Busby said.

There is limited data on the how often people are forced or coerced to end a pregnancy, but Parker alleges that the majority of those who have abortions may be forced or coerced.

‘Extremely common but hidden’

“I would say that they are extremely common but hidden,” Parker said. “I would would say coerced or forced abortion range from 25 percent to 60 percent. But, it’s a little hard be to accurate at this point with our data.”

Parker said that if “a very conservative 10 percent” of the about 60,000 abortions that occur per year in Texas were due to coercion, that would mean there are about 6,000 women per year in the state that are forced to have an abortion. Parker believes that percentage is much higher.

“I believe the number is closer to 50 percent, in my opinion,” Parker said. 

There were 54,902 abortions in Texas in 2014, according to recently released statistics from the Texas Department of State Health Services (DSHS). The state does not collect data on the reasons people seek abortion care. 

White and Parker referenced an oft cited study on coerced abortion pushed by the anti-choice movement.

“According to one published study, sixty-four percent of American women who had abortions felt forced or unduly pressured by someone else to have an unwanted abortion,” White said in a statement.

This statistic is found in a 2004 study about abortion and traumatic stress that was co-authored by David Reardon, Vincent Rue, and Priscilla Coleman, all of whom are among the handful of doctors and scientists whose research is often promoted by anti-choice activists.

The study was cited in a report by the Elliot Institute for Social Sciences Research, an anti-choice organization founded by Reardon. 

Other research suggests far fewer pregnant people are coerced into having an abortion.

Less than 2 percent of women surveyed in 1987 and 2004 reported that a partner or parent wanting them to abort was the most important reason they sought the abortion, according to a report by the Guttmacher Institute.

That same report found that 24 percent of women surveyed in 1987 and 14 percent surveyed in 2004 listed “husband or partner wants me to have an abortion” as one of the reasons that “contributed to their decision to have an abortion.” Eight percent in 1987 and 6 percent in 2004 listed “parents want me to have an abortion” as a contributing factor.

‘Flawed research’ and ‘misinformation’  

Busby said that White used “flawed research” to lobby for legislation aimed at preventing coerced abortions in Texas.

“Since she filed her bogus coerced abortion bill—which did not pass—last year, she has repeatedly cited flawed research and now is partnering with the Justice Foundation, an organization known to disseminate misinformation and shameful materials to crisis pregnancy centers,” Busby said.  

White sponsored or co-sponsored dozens of bills during the 2015 legislative session, including several anti-choice bills. The bills she sponsored included proposals to increase requirements for abortion clinics, restrict minors’ access to abortion care, and ban health insurance coverage of abortion services.

White also sponsored HB 1648, which would have required a law enforcement officer to notify the Department of Family and Protective Services if they received information indicating that a person has coerced, forced, or attempted to coerce a pregnant minor to have or seek abortion care.

The bill was met by skepticism by both Republican lawmakers and anti-choice activists.

State affairs committee chairman Rep. Byron Cook (R-Corsicana) told White during a committee hearing the bill needed to be revised, reported the Texas Tribune.

“This committee has passed out a number of landmark pieces of legislation in this area, and the one thing I think we’ve learned is they have to be extremely well-crafted,” Cook said. “My suggestion is that you get some real legal folks to help engage on this, so if you can keep this moving forward you can potentially have the success others have had.”

‘Very small piece of the puzzle of a much larger problem’

White testified before the state affairs committee that there is a connection between women who are victims of domestic or sexual violence and women who are coerced to have an abortion. “Pregnant women are most frequently victims of domestic violence,” White said. “Their partners often threaten violence and abuse if the woman continues her pregnancy.”

There is research that suggests a connection between coerced abortion and domestic and sexual violence.

Dr. Elizabeth Miller, associate professor of pediatrics at the University of Pittsburgh, told the American Independent that coerced abortion cannot be removed from the discussion of reproductive coercion.

“Coerced abortion is a very small piece of the puzzle of a much larger problem, which is violence against women and the impact it has on her health,” Miller said. “To focus on the minutia of coerced abortion really takes away from the really broad problem of domestic violence.”

A 2010 study co-authored by Miller surveyed about 1,300 men and found that 33 percent reported having been involved in a pregnancy that ended in abortion; 8 percent reported having at one point sought to prevent a female partner from seeking abortion care; and 4 percent reported having “sought to compel” a female partner to seek an abortion.

Another study co-authored by Miller in 2010 found that among the 1,300 young women surveyed at reproductive health clinics in Northern California, about one in five said they had experienced pregnancy coercion; 15 percent of the survey respondents said they had experienced birth control sabotage.

‘Tactic to intimidate and coerce women into not choosing to have an abortion’

TJF’s so-called Center Against Forced Abortions claims to provide legal resources to pregnant people who are being forced or coerced into terminating a pregnancy. The website includes several documents available as “resources.”

One of the documents, a letter addressed to “father of your child in the womb,” states that that “you may not force, coerce, or unduly pressure the mother of your child in the womb to have an abortion,” and that you could face “criminal charge of fetal homicide.”

The letter states that any attempt to “force, unduly pressure, or coerce” a women to have an abortion could be subject to civil and criminal charges, including prosecution under the Federal Unborn Victims of Violence Act.

The document cites the 2007 case Lawrence v. State as an example of how one could be prosecuted under Texas law.

“What anti-choice activists are doing here is really egregious,” said Jessica Mason Pieklo, Rewire’s vice president of Law and the Courts. “They are using a case where a man intentionally shot his pregnant girlfriend and was charged with murder for both her death and the death of the fetus as an example of reproductive coercion. That’s not reproductive coercion. That is extreme domestic violence.”

“To use a horrific case of domestic violence that resulted in a woman’s murder as cover for yet another anti-abortion restriction is the very definition of callousness,” Mason Pieklo added.

Among the other resources that TJF provides is a document produced by Life Dynamics, a prominent anti-choice organization based in Denton, Texas.

Parker said a patient might go to a “pregnancy resource center,” fill out the document, and staff will “send that to all the abortionists in the area that they can find out about. Often that will stop an abortion. That’s about 98 percent successful, I would say.”

Reproductive rights advocates contend that the document is intended to mislead pregnant people into believing they have signed away their legal rights to abortion care.

Abortion providers around the country who are familiar with the document said it has been used for years to deceive and intimidate patients and providers by threatening them with legal action should they go through with obtaining or providing an abortion.

Vicki Saporta, president and CEO of the National Abortion Federation, previously told Rewire that abortion providers from across the country have reported receiving the forms.

“It’s just another tactic to intimidate and coerce women into not choosing to have an abortion—tricking women into thinking they have signed this and discouraging them from going through with their initial decision and inclination,” Saporta said.

Busby said that the types of tactics used by TFJ and other anti-choice organizations are a form of coercion.

“Everyone deserves to make decisions about abortion free of coercion, including not being coerced by crisis pregnancy centers,” Busby said. “Anyone’s decision to have an abortion should be free of shame and stigma, which crisis pregnancy centers and groups like the Justice Foundation perpetuate.”

“Law enforcement would be well advised to seek their own legal advice, rather than rely on this so-called ‘training,” Busby said.

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.