News Politics

House Republicans Propose a Massive Step Backwards in Sex Education and Women’s Health

Martha Kempner

In the name of fiscal responsibility, House Republicans suggest cutting teen pregnancy programs, the CDC budget, and Title X family planning.  But, interestingly, they're bringing back funding for abstinence-only-until-marriage programs. 

Last week, House Republicans released their version of the Fiscal Year (FY) 2012 Labor, Health and Human Services, and Education spending bill in an attempt to make their mark in Senate negotiations. (The Senate Appropriations Committee passed its version of the bill the week before.) While this version is not expected to be marked-up or voted on, it shows how House Republicans are thinking and that’s a little frightening. 

Using “fiscal responsibility” as a rallying cry, they propose gutting programs that help young people and women yet are willing to sink new money into abstinence-only-until-marriage programs that have been repeatedly proven ineffective. 

The proposed bill cuts funding for the Teen Pregnancy Prevention Initiative from $110 million to just $20 million.  The new initiative, according to the Sexuality Information and Education Council of the United States (SIECUS), funds a total of 102 grantees in 36 states and is set to reach over 800,000 young people annually.  It began in FY 2010 and was designed to support “medically accurate and age-appropriate programs to reduce teen pregnancy and underlying behavioral risk factors.”  Many saw this as the Obama Administration’s answer to the Bush-era investment in abstinence-only-until-marriage programs which did not work.  Not only would the cuts force the government to drastically reduce the number of grantees receiving money, the proposed bill also removes the important requirement that all programs be evidence-based, which disregards the intent of the initiative and makes room for abstinence-only programs to apply. 

But they might not have to because the bill also resurrects the Community-Based Abstinence Education (CBAE) grant program.  CBAE was always considered the strictest of the funding streams for abstinence-only programs in part because the money went straight from the Department of Health and Human Services to community-based organizations bypassing the states which were often more relaxed about the definition of what constitutes an abstinence-only program.  Funding for CBAE was finally eliminated in Fiscal Year 2010.  In this proposed bill, it once again would receive $20 million. 

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Of course, sex education was not the only target of House Republicans.  This proposed legislation also eliminates funding for Title X, which supports family planning services to low income women, and cuts funding for the Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention by $32.7 million.

Thankfully, the Senate version does not include these cuts and while such cuts will likely not make it into law as written, they do make it clear what Republicans really want.  As SIECUS points out, in the name of fiscal responsibility, they are once again cutting “programs that many ultra-conservative Members of Congress have been trying to get rid of for years,” while bringing back funding for a conservative pet project.  Sounds more like hypocrisy than responsibility. 

Commentary Sexual Health

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

Martha Kempner

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

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

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

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

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

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

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Less Sexuality Education Today

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

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

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

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

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

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

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

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

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

The Real Education for Healthy Youth Act

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

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

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

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

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

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

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

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

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

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

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

Commentary Law and Policy

The New McCarthyites: Lists, Lies, and the GOP’s Attacks on Women’s Health Care

Jodi Jacobson

McCarthyism is defined in the dictionary as the practice of making accusations unsupported by proof or based on slight, doubtful, or irrelevant evidence, and the practice of making unfair allegations or using unfair investigative techniques especially in order to restrict dissent or political criticism. I'd say today's radicalized GOP has them both down pat.

Watching last Tuesday’s congressional hearing on Planned Parenthood by the House of Representatives Oversight and Government Reform Committee felt less like viewing a bona fide hearing in the sense of fact-finding or rational questioning by capable public servants on issues of public import than it did, variously, like witnessing an inquisition, a series of performances in theater of the absurd, and raising Joe McCarthy from the dead.

Ostensibly, these hearings were called to investigate claims by an anti-choice group known as the Center for Medical Progress (CMP) that Planned Parenthood was profiting from the sale of fetal tissue. This in turn gave House Republicans a reason to call for “defunding” Planned Parenthood. But there has never been any actual evidence offered by CMP or anyone else to support the charges of profits from the sale of fetal tissue, which is widely used in critical health research and has long been regulated under federal law. No evidence was offered at the hearing either. None of the congresspeople had seen the full, unedited versions of these videos, which have yet to be publicly released by CMP, though they’d had months to ask for them. In fact, that same day, Missouri became the sixth in a list of states that have wasted taxpayer money on investigations that found the claims to be baseless. (Never mind that the Missouri Planned Parenthood clinic does not even offer fetal tissue donation, but you know, let’s investigate anyway.)

The sale of fetal tissue isn’t and never really was the point of this hearing nor in fact of the videos themselves. Rather this attack is yet another salvo in a very long, large, and well-organized campaign to destroy the single largest provider of reproductive and sexual health care in the United States. As noted by CMP founder David Daleiden in an interview with Politicohis agenda is to bring down Planned Parenthood by any means possible. Because after all, why worry about the lives and health of the three million people a year who get services at Planned Parenthood clinics when you have political points to score and a reputation to make.

But hearings were of course held anyway, because if there is anything the GOP hates more than gun regulations and immigrants, it’s the ability of women to get access to health care whether it be contraception, abortion, testing and treatment for sexually transmitted infections, or breast exams.

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Cecile Richards, president of the Planned Parenthood Federation of America (PPFA), appeared at the hearing voluntarily, but that did not prevent her from having to take five hours of abuse. Watching in real time, I quickly understood there were three reasons for this hearing. One was to try as much as possible to humiliate Richards, who, apart from being a political force in her own right, is also the daughter of former Texas Democratic Gov. Ann Richards, a Democrat herself, a former chief of staff for Nancy Pelosi, and the head of both a powerful health-care provider and a powerful political action committee. Attacking Richards covers a lot of bases for right-wing hate-mongers. Several House members appeared committed to doing anything possible to trip Richards up such that she said something, anything, they could perhaps later use as fodder for campaign ads and another round of attacks.

A second reason appeared to be to further obfuscate the issue of funding for reproductive health care such that the GOP could find “better” uses for that money.

Finally, and most insidiously, taking a page right out of the playbook of Sen. Joseph McCarthy, this hearing was about taking names and getting lists of providers, of clinics, of staff people and even of organizations providing family planning services abroad for the purposes of harassing and stigmatizing them, if not more.

The most aggressive tactics apparently meant to humiliate or trap Richards were used by Congressmen Trey Gowdy (R-SC) and Jim Jordan (R-OH). As the following videos show, they each asked leading questions of Richards, and, before she could even begin to reply they interrupted, answered for her, and then twisted what she had managed to say in reply. In fact, throughout the hearing, GOP congresspersons asked convoluted questions only to cut Richards off any time she tried to respond.

Gowdy didn’t bother with questions about fetal tissue, body parts, or funding. Instead he ran off the rails with irrelevant questions about whether or not Richards understood “how some of us may at a base level disagree with you on the origin of life?” He then went on to badger her about her opinions on abortion and on so-called partial birth abortion, neither of which were relevant to the stated purposes of the hearing and the latter of which does not exist.

Jordan focused on a Planned Parenthood video featuring Richards and made in response to the first release by CMP. He badgered Richards about this video, without allowing her to reply.

The effort to confuse the public around funding for Planned Parenthood was at first raised obliquely by House committee chairman Jason Chaffetz. He opened the hearing with a tearful though disconnected story about his personal family losses from cancer. Chaffetz said:

This is an important topic. The risk of getting a little—a little personal. My wife, Julie and I have been married some 24 years. Have our 25th wedding anniversary coming up in February.  I’m proud of my wife. She… she got her degree in psychology later in life after helping to raise three kids, some are still at home. She has just started to work [with] a plastic surgeon [who is] involved in helping women who are having to have their breast removed. And my wife (inaudible) helping these women. And I’m proud of her for doing that.

My mother—she passed away when I was 28 years old. She fought cancer for more than 10 years. She had breast cancer. And I miss her.  I lost my—I lost my father to cancer as well. Cancer, in this country, kills about 1,500 people a day. A day. And yet, our federal government only spends about $5 billion to fight it. If they were shooting 1,500 people a day, if there were rockets coming—we would be fighting this with everything we have got.

Then, Chaffetz continued:

And as I said before I came to Congress and I’m saying here today, as fiscally conservative as I can possibly be, we don’t spend enough on cancer. We don’t spend enough. We need to spend more. I would quadruple the amount of money if I had my chance to fight cancer and win. And the reason I’m passionate about the hearing today is we got a lot of health care providers, who, I think, in their hearts know that they’re trying to provide good.

The question before us is, does this organization—does Planned Parenthood really need federal subsidy? Does it need federal dollars? Every time we spend a federal dollar, what we’re doing is pulling money out of somebody’s pocket and we’re giving it to somebody else. What I don’t like, what I don’t want to tolerate, what I don’t want to become numb to is wasting those taxpayer dollars.

It is not at all unusual for congresspeople to use personal stories in hearings. Normally, however, such stories are relevant to the subject of the hearing itself. Cancer research was not relevant. It is funded through the National Institutes of Health, the budget of which was cut by Republicans in March of this year.

This hearing was about the federal funds that support services delivered by Planned Parenthood, which come through two avenues, either reimbursement of services for patients who qualify for Medicaid, or through funding to support Title X family planning services. To suggest funds for cancer research have anything to do with funding for these services reveals either that Chaffetz did not know his facts, or he was playing on sympathy as a guise for suggesting there was a choice to be made between the two. In the same way that the GOP either truly does not get it or purposefully misunderstands the actual process women go through to get mammograms (first a primary caregiver provides a referral, then you go to a radiologist), they seem bent on pretending that switching funds from Planned Parenthood to other purposes is a better use of money. We’ll have to watch for these comparisons to be made later.

But what was perhaps the most insidious aspect of the hearing were the “lists.” As the hours wore on, there were repeated requests for Richards to send the committee lists of everything from the organizations to which Planned Parenthood provides funding overseas to the names and contact info for clinics and providers. In the 1950s, former Sen. Joe McCarthy touted lists he claimed proved communists had infiltrated the U.S. government. He used those purported lists (which did not actually exist) to create fear and intimidate people throughout the country, and to haul them in front of Congressional committees. He ruined many lives. And it appears his spirit lives on in the contemporary GOP now in power.

Reproductive health providers know about lists. A number of organizations in the anti-choice movement have been known to make and publish lists online, including the names of doctors and service providers of abortion care, the names and addresses of clinics, and the home addresses of those who work at clinics. These lists are used to intimidate, target, follow, and sometimes harm or murder abortion providers and staff. Some state attorneys general have tried to use their power to obtain the records of women who have had abortions, and in at least one case, that of former Kansas State Attorney General Phill Kline, information gathered by his office was shared publicly and with anti-choice groups. And now, since CMP released its videos, there have been a number of attacks on clinics throughout the country.

Chaffetz started taking names and making lists almost immediately. He began with a question about the Democratic Republic of Congo (yes, you read that right, straight from fetal tissue to the DRC):

CHAFFETZ: Ms. Richards, Planned Parenthood has sent 32-plus million dollars in grants overseas. Does any of the funds go to the Democratic Republican of the Congo?

RICHARDS: Congressman, let me…

CHAFFETZ: No, no, no. We don’t have time for a narrative. I just want to know…

(CROSSTALK)

CHAFFETZ: Yes or no.

RICHARDS: You asked me a question. Any of the money that is — Planned Parenthood raises and is given by foundations and individuals to support family planning services is in Africa and Latin America, and they go to individual organizations.

I’m happy to provide you a list of those organizations, but I did not bring them with me.

CHAFFETZ: If you could give us a list of those organizations.

Chaffetz then asked for a list of Planned Parenthood’s “ownership in foreign companies,” a somewhat strange request to a nonprofit, but…

CHAFFETZ: Does Planned Parenthood have any ownership in foreign companies?

RICHARDS: I don’t believe so. I don’t know what you mean by ownership.

CHAFFETZ: Well, in your 2013 tax return, it lists $3.3 million marked as, quote, “investment,” unquote in Central America and the Caribbean. I’m just asking if that investment was an actual investment?

RICHARDS: We don’t own anything in those countries. What…

CHAFFETZ: OK. Let me keep going. I have to keep going. I need to — I would appreciate a list. You have been very cooperative so far.

Congresswoman Cynthia Lummis (R-WY) picked up this thread by asking for a list of affiliates that “receive the majority of their revenue from abortion.” Lummis insinuated that there must be something wrong with Planned Parenthood’s data on the share of services for abortion, given revenues from abortion appear higher than those from other services. Her line of questioning was wholly misleading. Surgical abortion is more costly than other services, and those services are not reimbursable by Medicaid or other government funds, so the revenue stream is not relevant to the share of services provided. It’s like asking a dentist why she brings in more money for root canals than teeth cleanings.

Chaffetz, however, did not want to let that point go by, and so he reiterated the request when Lummis was done. “[A]s a point of clarification, Ms. Richards, I want to make sure there’s no ambiguity here. The gentlewoman from Wyoming asked for a listing of affiliates where the majority of revenue comes from abortion services. You said you’d talk to your team. Will you actually provide us that list?”

Like Joseph McCarthy, GOP members of the hearing panel then went on to suggest some sort of guilt by association with President Obama and the Department of Justice.

JORDAN: Since the videos have surfaced have you had any conversations with the President of the United States?

RICHARDS: No I have not.

JORDAN: Since the videos have surfaced have you been to the White House?

RICHARDS: No I have not.

JORDAN: How many times have you been to the White House?

RICHARDS: During what period of time?

JORDAN: Since Mr. Obama’s been president.

RICHARDS: I don’t know that’s been I think seven years, so I would have to get back to you on that.

JORDAN: Our count shows that you, your board members and senior staff have been to the White House 151 times in six and a half years. I’m just curious, that’s why I ask the question if you’ve been to the White House or you talked to the President since these videos have surfaced?

RICHARDS: And I said I have not.

JORDAN: And you’ll get back with me on if the Justice Department has contacted you since these videos have surfaced?

RICHARDS: Well I think you listed several folks, so I’m happy to work with the committee and find out what all you need to know.

JORDAN: CMS, HHS, Inspector General, Justice Department; Justice Department’s the most important.

Was President Obama featured in the CMP videos? I don’t think so either.

Chaffetz then once again stepped in and reiterated the list of lists being requested, and added a couple more.

CHAFFETZ: We are looking for the amount of revenue by affiliate for abortion services. So you have the — that should be pretty straightforward. We would like to know which affiliate provides which services.

RICHARDS: I believe you have that, but we’re happy to provide that.

CHAFFETZ: We’re still—we want to make sure we’ve it crystal. I think we have portions of it, but we don’t have all of it.

RICHARDS: OK.

CHAFFETZ: The names of organizations and the countries that Planned Parenthood gives funds to overseas. So based on the tax returns and reports, you’re sending money to overseas. Some of them have been listed as investments, so as other things, we’d like to get some details and specificity as to how much is going to which country and what those are for. Is that fair?

RICHARDS: I really have to talk to my team about that but I will.

And:

CHAFFETZ: We obviously, have some concerns about the Planned Parenthood Action Fund. So we’re trying to get to the duties performed and compensation received for all Planned Parenthood or affiliate employees. This could either by for the Planned Parenthood Action Fund or for either of the — I believe there are two, 5207 organizations. One of our concerns, is that the shared services and the sharing of employees between political actives and non-political activities and we would like to understand how broad based that is.

CHAFFETZ: [And] the cost of reimbursement for both contraception, and abortion, and abortion obviously breaks down into in clinic as well as the pill.

RICHARDS: Actually, there’s a lot of kinds of contraception too.

CHAFFETZ: Yes, contraception, I left it as broad as I could. But for the abortion services…

RICHARDS: I’m just saying, I think it’s important, I’m not sure we got into much of that conversation about how birth control—how many different kinds of birth control there are now because that’s one of our specialties.

CHAFFETZ: Help us understand and what services and money you’re allocated and what the costs of that are. There were some points that should be helping to drive down those costs and we’re just not understanding the ratio…

RICHARDS: That’s why…

CHAFFETZ: It needs clarification. I’m not asking…

RICHARDS: It was clear that folks weren’t aware of the various costs of different kind of contraceptions..

CHAFFETZ: Exactly, and that’s where we need help. Not right now, just as a follow up.

And:

CHAFFETZ: A list of political organizations, Planned Parenthood collarbones, including the names in compensation of received of shared employees.

I think I covered that in general, but I’ll keep going.

Yes, it seems they will keep going, as one means of spreading fear and intimidation.

There are two definitions of McCarthyism in the dictionary:

  • the practice of making accusations unsupported by proof or based on slight, doubtful, or irrelevant evidence.
  • the practice of making unfair allegations or using unfair investigative techniques especially in order to restrict dissent or political criticism.

I’d say today’s radicalized GOP has them both down pat.

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