Back To School: The Politics of Sex Education in the States

Robin Marty

A roundup of sex ed news as students across the country head back into the classroom.

Back to school time means many things: more homework, more juggling social events, and for many states facing a crisis of teen pregnancies and rising STI rates, it also means coming up with a better game plan for educating students about sex.

Both Minnesota and Virgina have been making big waves via their decisions to forego federal dollars for comprehensive sex education, while instead asking for funding for abstinence-only education programs that have been proven far less effective in protecting sexually active teens, and that also will cost the states matching grants from the federal government.

Florida, too, is going to have to make a choice on which funding path to go, and with its governor running for senate as an independent, the plan he picks may mean a lot, both to him politically, and to the children of the state.  Planned Parenthood of Southwest and Central Florida is urging Crist to commit to comprehensive sex education.

Via The Ledger:

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Gov. Crist has the opportunity to apply for PREP funds and reject failed abstinence-only-until-marriage funding, known as Title V. Over and over, programs taught under Title V have been discredited for their ineffectiveness, have been known to provide medical inaccuracies, and are taught using biased and fear-based tactics. Instead, PREP would offer sex education that is evidence-based, age-appropriate and medically accurate.

To date, millions of Florida’s taxpayer dollars have been wasted on failed abstinence-only-until-marriage programs. And as a result, many health outcomes among Florida teenagers continue to deteriorate.

Florida now ranks highest in the nation in cases of HIV infection diagnosed in the U.S. Florida also has the third-highest rate of AIDS cases nationwide. Additionally, Florida ranks 12th highest in the nation in teen births, rising by 7 percent in 2006 alone.

I urge all readers to contact Gov. Crist and urge him to join the growing number of states – by last count more than half the states – in applying for PREP funds. He must act by Monday.

For the state of Illinois, the choice was obvious, as they decisively went with the federal PREP funds.  Progress Illinois writes:

Tom Green, a spokesperson for the Illinois Department of Human Services, confirmed yesterday afternoon that state health officials did not apply for federal abstinence-only sex education funds made available through the federal health care reform package. Considering that Illinois would have had to fork over scarce state resources to qualify for the discredited Title V grants, it’s welcome news. As we wrote last week, the Quinn administration did seek out less restrictive and less costly Personal Responsibility Education Program (PREP) grants.

The debate on sex ed is always a hot one, and Montana is experiencing it as one side advocates for age-appropriate sexual information, and the other calls it propaganda and indoctrination.  And as always, the war always plays out on the opinion pages of newspapers.

One letter writer at the Helena Independent Record states:

Proposed is the naming of private body parts to kindergartners and an overly explicit explanation of different forms of sexual activity to fifth graders. Experts agree that teaching this will actually increase sexual activity in kids.

Sexually explicit “art” will be portrayed as acceptable. What one person might call “art,” another might call pornography. Is this appropriate for the classroom and who has the right to decide what to teach?

Why do we need to teach kids that it’s unkind to make fun of gay people? Don’t we need to teach them be kind to everyone? Tolerance can be taught without giving preferential treatment to gays.

Portraying abortion as birth control as well as redefining what a family is (in contradiction to the state law definition) has more to do with indoctrinating children on controversial issues than it does in promoting good health.

..

If the new curriculum is approved, many teachers may refuse to teach the material and large numbers of parents will refuse to let their children attend. The result will be that less sex education will actually be taught than before — unless you count second-hand discussion among peers.

If our true motives are to put the children first, the new curriculum should reflect high teaching standards without the influence of another agenda.

While another writes in that:

As it is now, few are well informed and many are misinformed. The misinformation spreads from peer to peer and that does not serve the purpose of good health. The aim should be to become comfortable with your body and knowledgeable about its functions as one develops. I often feel that those who are most strident in their opposition to basic sex education, and who are threatened by the thought of sex ed, are people who might themselves have benefited from an earlier and more honest sex education.

I applaud the curriculum committee, the school district and the school board as they step forward to do the right thing, which is to provide comprehensive health education and sex education to the students of Helena. We do not want our society to be ruled by those who shout the loudest, do the most name calling or send the most nasty e-mails. Nor should schools succumb to the very ignorance they are trying to dispel. I hope that the school board will stand firm on this issue and support the fine work which has been done.

And it’s not just letter writers in the state battling it out — the pro-abstinence side has even paid to bring an author to town to advocate against the new curriculum.  From the

Billings Gazette:

Miriam Grossman said she hopes her talks provide some clarity for the debate that surfaced in Helena after the curriculum committee presented the 62-page draft at a June meeting of the Helena School Board.

“I would not want my children exposed to what’s in there,” she said. “A child thinks different, experiences the world different than an adult. A child is not a miniature adult. Children are vulnerable in a way we as adults have forgot.”

Grossman, a child psychiatrist, medical doctor and author, spoke twice Wednesday after a group of opponents of the proposed curriculum funded her visit. About 600 people attended her afternoon talk at Carroll College and even more sat through the nearly two-hour evening event at Helena Middle School.

She said the proposal won’t help children understand their bodies and won’t empower them with information, but rather leave them misinformed and vulnerable.

Grossman addressed several specific parts of the draft curriculum. She said she would not teach third-graders that exchanging bodily fluids can give you deadly diseases, but would rather tell them that when they cough or sneeze they should cover their mouths not to spread germs.

“That’s enough,” she said.

Grossman said the document is not abstinence-based, which state standards require. She said it instead leaves it up for discussion, with the sentence “teenagers who decide to engage in sexual behaviors must also decide about pregnancy and STI/HIV prevention.”

In elementary school the proposed draft document teaches students “that barrier methods of contraception can … greatly reduce but not prevent sexually transmitted infections.” Grossman said diseases like herpes live in the skin not covered by condoms. She said the protection from condoms is 20 to 50 percent.

“Anyone who believes condoms will greatly reduce risk is living in la-la land,” she said.

Grossman also spent a lot of time talking about the biology of the cervix, and how until a female is in her 20s, the organ is susceptible to diseases because the cells have yet to build up in the transformation zone. Once girls are older, these cells thicken and provide females with natural protection against diseases, such as human papillomavirus, or HPV.

She said this is biological proof that young girls are not physically ready for sexual relations.

Still, some school systems are embracing comprehensive sex ed programs enthusiastically, like in Cleveland, where the state’s new Healthy Youth Act will be implemented this school year.  Much like its predecessor in Wisconsin, the Healthy Youth Act will bring age appropriate, comprehensive, fact based sexual education to the classrooms.  The Shelby Star has details, straight from the director of secondary ed.

JUST THE FACTS

John Goforth, director of secondary education, assuaged potential concerns about what will and will not be presented in the classroom.

“The policy specifically says what will be taught and specifically says contraceptives shall not be available or distributed on school property,” he said.

Goforth said abstinence is always their foremost message.

“We won’t be talking about abortion, we won’t be talking about lifestyles; we won’t be talking about a person’s partner choices…that’s not part of our curriculum,” he said.

Goforth said instruction will be limited to the facts.

“Here’s STDs, here’s how you get them and here’s how you avoid them,” he said. “We don’t demonstrate the use of contraceptives. We won’t demonstrate anything.”

PARENTS HAVE CHOICES

Another point officials want to emphasize is the parents’ choice to opt out and have their children excluded from the instruction.

“They’re welcome to opt out…we respect that for sure,” Goforth said.

Administrators said all of the material that will be taught is available for viewing at each middle and high school’s media center.

Students who opt out of the program will be given alternate health assignments.

Goforth said parents will be sent a consent form and will have 60 days from the time a notice is sent home to make their decision.

Wisconsin schools should be receiving final approval from the schoolboard this month.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

News Abortion

Study: United States a ‘Stark Outlier’ in Countries With Legal Abortion, Thanks to Hyde Amendment

Nicole Knight Shine

The study's lead author said the United States' public-funding restriction makes it a "stark outlier among countries where abortion is legal—especially among high-income nations."

The vast majority of countries pay for abortion care, making the United States a global outlier and putting it on par with the former Soviet republic of Kyrgyzstan and a handful of Balkan States, a new study in the journal Contraception finds.

A team of researchers conducted two rounds of surveys between 2011 and 2014 in 80 countries where abortion care is legal. They found that 59 countries, or 74 percent of those surveyed, either fully or partially cover terminations using public funding. The United States was one of only ten countries that limits federal funding for abortion care to exceptional cases, such as rape, incest, or life endangerment.

Among the 40 “high-income” countries included in the survey, 31 provided full or partial funding for abortion care—something the United States does not do.

Dr. Daniel Grossman, lead author and director of Advancing New Standards in Reproductive Health (ANSIRH) at the University of California (UC) San Francisco, said in a statement announcing the findings that this country’s public-funding restriction makes it a “stark outlier among countries where abortion is legal—especially among high-income nations.”

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The researchers call on policymakers to make affordable health care a priority.

The federal Hyde Amendment (first passed in 1976 and reauthorized every year thereafter) bans the use of federal dollars for abortion care, except for cases of rape, incest, or life endangerment. Seventeen states, as the researchers note, bridge this gap by spending state money on terminations for low-income residents. Of the 14.1 million women enrolled in Medicaid, fewer than half, or 6.7 million, live in states that cover abortion services with state funds.

This funding gap delays abortion care for some people with limited means, who need time to raise money for the procedure, researchers note.

As Jamila Taylor and Yamani Hernandez wrote last year for Rewire, “We have heard first-person accounts of low-income women selling their belongings, going hungry for weeks as they save up their grocery money, or risking eviction by using their rent money to pay for an abortion, because of the Hyde Amendment.”

Public insurance coverage of abortion remains controversial in the United States despite “evidence that cost may create a barrier to access,” the authors observe.

“Women in the US, including those with low incomes, should have access to the highest quality of care, including the full range of reproductive health services,” Grossman said in the statement. “This research indicates there is a global consensus that abortion care should be covered like other health care.”

Earlier research indicated that U.S. women attempting to self-induce abortion cited high cost as a reason.

The team of ANSIRH researchers and Ibis Reproductive Health uncovered a bit of good news, finding that some countries are loosening abortion laws and paying for the procedures.

“Uruguay, as well as Mexico City,” as co-author Kate Grindlay from Ibis Reproductive Health noted in a press release, “legalized abortion in the first trimester in the past decade, and in both cases the service is available free of charge in public hospitals or covered by national insurance.”