Analysis Sexual Health

Sex Ed in Texas? Perry’s Policies Result in High Rates of Teen Pregnancy and Disease

Martha Kempner

New research out of the University of Texas, Houston, confirms that young people in Texas are more likely to engage in risky sexual behaviors than their peers nationwide.  And, the researchers suggest that the state's conservative policies policies around sexuality education and reproductive heath are to blame. 

The sexual health of teens in Texas have become a central issue in Republican presidential debates, even if they remained largely unmentioned.  In pummeling Governor Rick Perry for having signed an executive order that mandated all young women in Texas receive the HPV vaccine before entering sixth grade, his opponents argued that he was stepping on parental authority, destroying the innocence of 11-year-olds, and giving a “license for promiscuity” to the young women of the Lone Star state.

What they seem not to discuss is how these young women (and their male peers) are now faring when it comes to their sexual health.

A new issue of the Journal of Applied Research on Children is dedicated to teen pregnancy and features a series of articles out of the University of Texas, Houston which focus on the issues young people in that state are facing.  One of the articles, “Adolescent Sexual Behavior: Examining Data from Texas and the United States,” provides a great comparison between young people in Perry’s home state and their peers nationwide.

We already know from myriad statistics that Texas teens are having a rough go of it:

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  • Texas has the third highest birth rate in the United States with 63.1 births per 1,000 females ages 15 to 19 compared to the national rate of 41.5 per 1,000.
  • The state’s teen pregnancy rate is fifth in the United States, with a rate of 88 pregnancies per 1,000 young women ages 15 to 19 compared to the national rate of 70 pregnancies per 1,000.
  • In 2008, there were 35,038 cases of Chlamydia, 9,592 cases of gonorrhea, and 142 cases of syphilis reported among young people ages 15 to 19 in Texas.
  • The state ranks 12th in the number of HIV cases diagnosed among young people ages 13 to 19.

The new research takes a closer look at the sexual behavior of Texas youth as well as other issues (such as poverty, restrictive laws, and education) that may account for these disparities.  The researchers looked at three sets of data.  First, they examined the Youth Risk Behavior Survey (YRBS), a nationally-representative survey conducted every two years by the Centers for Disease Control and Prevention (CDC) that looks at a range of risk behaviors such as drinking and drug use, violence, seatbelt use, and sexual behavior.  The data examined are from the 2009 YRBS.  They also looked at data from the 2009 Middle School YRBS which was conducted in 14 states but is not considered nationally representative. Since Texas did not participate in the study, the researchers used weighted data from five southern states with similar teen birth rates to estimate behavior of young teens in the Lone Star state.  Finally, they looked at All About Youth, a study conducted in a large urban district in Texas which included questions about sexual behaviors other than vaginal intercourse.

The findings are not surprising given what we already know about the sexual health of young people in the state:

  • Texas students are more likely to report having ever had sex (52 percent of 9thto 12th graders in Texas compared 46 percent of 9th to 12th graders nationwide).
  • When looked at by grade, 10th graders in Texas are more likely to report having ever had sex than their peers nationwide (52 percent compared to 41 percent) as are high school seniors (69 percent compared to 62 percent).
  • Texas students are more likely to report having had sex with four or more partners than young people nationwide (17 percent compared to 14 percent).
  • Texas students are also more likely to report being currently sexually active which is defined as having had sex in three months prior to the survey (38% compared to 34 percent).
  • Sexually active students in Texas are more likely to report not using a condom (42 percent compared to 39 percent) as well as not using birth control pills or Depo Provera (84 percent compared to 77 percent) the last time they had sex.

Moreover, the data show ethnic and racial disparities among youth in Texas:

  • Black (63 percent) and Hispanic (54 percent) high school students in Texas are significantly more likely than non-Hispanic white students (45 percent) to have ever had sex.
  • Sexually active black (94 percent) and Hispanic (89 percent) students are also more likely to report not using birth control pills or Depo-Provera the last time they had sex compared to non-Hispanic white students (75 percent).
  • Black students (12 percent) are also more likely than Hispanic (6 percent) and non-Hispanic white (4 percent) students to report having had sex for the first time before age 13 and having had four or more lifetime partners (29 percent compared to 15 percent and 14 percent, respectively).

The authors go on to draw some conclusions as to why young people in Texas are engaging in riskier sexual behaviors and all of these conclusions point to the conservative policies of the state.  Perhaps most notably, young people in Texas are less likely to have learned about HIV and AIDS in school than other young people in the United States. The 2009 YRBS found that 83 percent of high school students in Texas reported having been taught about HIV and AIDS in school compared to 87 percent of high school students nationwide.

But the bigger issue might be what they were taught about that and other topics related to sexuality.

Texas does not require any classes on sexuality or STD prevention but according to the state’s education code, if such classes are provided, they must, among other things:

  • present abstinence from sexual activity as the preferred choice of behavior in relationship to all sexual activity for unmarried persons of school age;
  • devote more attention to abstinence from sexual activity than to any other behavior, and
  • direct adolescents to a standard of behavior in which abstinence from sexual activity before marriage is the most effective way to prevent pregnancy, STDs, and infection with HIV or AIDS.

Not surprisingly, Texas has a long history of promoting abstinence-only-until-marriage programming.  Before he helped pump millions of dollars into the nationwide abstinence-only industry, President George W. Bush promoted it through his Lone Star Leaders.  A 1998 Washington Post article described then-Governor Bush as “leading the pack,” when he initiated the program which included  “an aggressive abstinence program, backed up with more than $9 million for local efforts and a statewide media campaign to encourage young people to save sex for marriage.”  In the years since, the state saw a dramatic increase in the money for media campaigns, classroom lectures, and other programs designed to promote the same message. Between Fiscal Years 2001 and 2010, Texas received over $119 million in federal funding for abstinence-only-until-marriage programs.

The authors of the study also note that many school districts in Texas are using textbooks that omit medically accurate information on condoms and contraception.  As one of the largest states, the Texas State School Board has a great deal of power (specifically, purchasing power) over textbook publishers.  Over the years, the board has wielded this power to ensure that conservative views on everything from condoms to when the world began were represented in state-approved textbooks.  A 2009 report by the Texas Freedom Network notes “Seeking to avoid previous political battles over providing information on contraception and disease prevention in health textbooks, publishers simply self-censored the health education textbooks they submitted for the 2004 Texas adoption process.” As a result, only one of the four textbooks approved for the state’s schools mentions condoms as a way to prevent pregnancy and even in that book, the word condom appears “exactly once.”  

But it is not just the lack of good sexuality education that is putting Texas young people at a disadvantage; restrictive state policies regarding access to contraception and other reproductive health services are also to blame.  The authors note that with few exceptions, Texas requires parental consent for prescription contraception for anyone under 18.  Moreover, “health care providers are required to notify law enforcement officials of all patients under age 17 whom they suspect are sexually active.”  (Let’s not forgot the data mentioned earlier that found, among other things, that 52 percent of high school sophomores in Texas – who should be about 15 or 16 – reported having had sex.) This certainly creates an environment in which young people are at best reluctant to seek reproductive health care.

That may be fine with Governor Perry and the legislators in his state who recently cut funding for family planning clinics.  Though Texas politicians like to refer to them as “abortion clinics,” none of the state’s 71 clinics provide abortion.  Instead, they provide reproductive health care and family planning services, which ultimately prevent the unplanned pregnancies that lead to abortion. One study suggested that in 2006, contraceptive services provided by Title X funding averted 9,708 unintended pregnancies in girls ages 19 or younger in Texas.

But Perry and his friend’s don’t seem to see, or at least care about, the irony here.  Nor do they seem to care that their policies and budget cuts are actually costing the state money.  One study estimated that the restrictive notification law (in which health care providers must report all those sophomores who are having sex) cost the state an extra $43.6 million in additional pregnancies, births, abortions, and sexually transmitted disease-related care for teenage girls using publicly funded health care systems.  The most recent rounds of cuts will have a similarly devastating effect on young women in Texas.  According to an NPR report, “The state estimates nearly 300,000 women will lose access to family planning services, resulting in roughly 20,000 additional unplanned births…In San Antonio alone, unplanned children born to teens would fill 175 kindergarten classrooms each year.”

That’s unforgivable, especially in a state where 24 percent of children live in poverty (compared to 20 percent of children nationally).  In fact, Texas is tied for first among states for the percentage of children living below 200 percent poverty.  As the authors of this study point out, “poverty, high unemployment, and residential instability have been associated with early sexual initiation and increased adolescent sexual risk behaviors.”  They believe that these “neighborhood effects” explain, at least in part, the differences in sexual behavior across racial/ethnic groups as black and Hispanic youth are disproportionally more likely to live in poverty.

So, essentially what we’re saying here is that not only are today’s Texas youth more likely to engage in risky sexual behavior than peers in other states, but Governor Perry and the lawmakers in his state are putting policies in place that will ensure the next generation of Lone Star teens fare no better.

I, for one, see irony in the fact that his since-rescinded HPV-vaccine mandate – for which he has gotten all sorts of flak – may be the only good thing Rick Perry has ever done when it comes to young people and sexual health.

Commentary Abortion

Losing My Lege: Lawmakers Pitched 32 New Abortion Bills in Texas This Year, and a Few Might Pass

Andrea Grimes

There are 30 days left in the regular session and a total of 32 filed bills dealing with the subject of abortion—most, but not all, of which would make comprehensive reproductive health care more costly and difficult to access.

Losing My Lege is a weekly column about the goings-on in and around the Austin capitol building during the 84th Texas legislature.

If Texas lawmakers wanted to take up one abortion-related bill per day in the time left in the regular legislative session, they could do it, although they’d have to double up a couple of times.

There are 30 days left in the regular session and a total of 32 filed bills dealing with the subject of abortionmost, but not all, of which would make comprehensive reproductive health care more costly and difficult to access. That’s the second-highest number of abortion-related legislation filed in regular sessions over the last decade—just two fewer than the 2011 regular legislative session, when lawmakers proposed 34 abortion-related bills and succeeded in passing Texas’ mandatory sonogram law. (Regular sessions run for 140 days from January through May, while special sessions are called by the governor during the summer to address legislation that lawmakers failed to pass earlier in the year. You’ll recall that Texas’ omnibus anti-abortion law, HB 2, was passed in a special summer session.)

Any one of those 32 bills could, conceivably, be passed in the next 30 days. The legislative process can be lengthy, but it needn’t be. And as we’ve seen with prior abortion-related legislation: If anti-choice lawmakers really put their minds to it, they can strip Texans of their reproductive rights quite quickly.

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The abortion-related bill with the best chance of passing is actually one that doesn’t do much, if anything, to restrict access to legal care for Texans. It’s SB 114, and it’s the only abortion-related bill to have crossed chambers—that is, it was passed by the senate, and now it’s made it all the way over to the house, where it’s been referred to a committee there. That referral is just the very first step, and it doesn’t guarantee a public hearing.

SB 114 relates to “adverse licensing,” and basically says that the state health officials can deny someone a license for an abortion clinic (or a birthing center, or a drug treatment program, or several other kinds of licensed facilities) if, in the past, they have had their license to run one of those other kinds of facilities revoked. In theory, it might create a hassle for someone who wanted to open an abortion clinic after they’d already had a license for a nursing home pulled, but it’s small potatoes in the grand scheme.

The bill that’s made the second most progress so far is SB 575, sponsored by Sen. Larry Taylor (R-Friendswood), which would ban coverage for abortion care in health insurance exchanges under the Affordable Care Act (ACA). SB 575 has made it out of a senate committee and is scheduled on what’s called the “intent calendar” for Monday—which means lawmakers will debate it on the floor.

Versions of this bill have cropped up in the past few sessions, and the time is ripe for the Texas GOP to use this session to brag (again, which they do all the damn time) that they’re going to end taxpayer funding for abortion care (a thing they have already done). They hate the ACA anyway (it did, after all, significantly reduce the number of uninsured Texans, which means it’s obviously the absolute worst), so this bill has real potential. They’re basically saying that anybody who gets an abortion with the insurance they’ve purchased with their own money, for themselves, is forcing other folks to pay for their abortions because those folks also bought insurance and contributed to the same pool of money in the marketplace.

Yes, it is already illegal, in Texas, for public funds to be used for abortion care and no taxpayer funding for abortion care happens in Texas in the first place, but I’m just saying what they’re saying, here. Of course, the real deal is that anti-choice lawmakers don’t want people to get abortions ever for any reason and in fact would like to make it illegal and wholly overturn Roe v. Wade and keep everybody barefoot, pregnant, and fracking, but since they can’t do that, they will do literally anything to make abortion hard as hell to access.

Following those two, there’s HB 416, which requires abortion providers and anyone who works or volunteers with them that has contact with patients to take human trafficking education courses, and HB 635, which requires hospitals to release fetal remains to patients who request those remains. They’ve both been voted out of their issues-based committees and into the Calendars Committee, where our scheduling overlords have set them for floor debates next week.

Then there’s HB 723, which would basically end access to legal abortion care for abused and abandoned minors who need judicial bypasses to get abortions without a parent’s consent. It’s been sent to calendars but hasn’t yet been scheduled for a reading on the floor.

Sponsored by Rep. Phil King (R-Weatherford), HB 723 would have a direct and dire impact on teenage Texans who need abortion care but whose parents are not, for a variety of not-great reasons, available to consent to their teen’s abortion care—these parents might be in jail, or they’ve skipped town, or they’re dead, or they may be violent or abusive to the extent that a minor could be in danger if they told their parent they needed an abortion. A couple hundred teens use the judicial bypass process in Texas every year, usually with the help of Jane’s Due Process, a nonprofit legal aid organization.

King’s bill would raise the burden of proof for teens who need abortion care. Instead of proving just one tenet, they would have to prove all three of these: that they are “mature and sufficiently well informed” about their abortion decision, that notification of a parent would not be in the minor’s best interest, or that parental notification “may lead to physical, sexual or emotional abuse.”

King said, during testimony on the bill, that he would take out that language that forces teens to prove all three of those tenets, because it would basically be patently unconstitutional to place that level of burden on a teen, but he didn’t actually follow up on his word and do it, so ¯\_(ツ)_/¯.

There’s a four-way tie for fourth place among bills that have been passed favorably out of committee but not yet sent to calendars: another “adverse licensing” bill, another abortion insurance ban, another bill making it harder for minors to access judicial bypass, and a bill that would mandate some signage in abortion facilities.

Guess what? There’s a five-way tie for fifth place. Five bills have been heard, but not voted on (“left pending”) in committee. They’re SB 1873 (mandated trafficking training for abortion providers), HB 3765 (would require notarized parental consent for minors who need abortions), then HB 1648 (an “anti-coercion” bill), and HB 832 (increasing reporting requirements for physicians who provide abortion care). And, at long last, there’s HB 708, a bill that doesn’t restrict abortion access at all but which requires that abortion-seeking Texans be given scientifically and medically accurate information about abortion care, and strikes the requirement that Texas doctors tell their patients (falsely! wrongly! not a thing!) that abortion causes breast cancer.

In sixth place, a bill that would publicize the names of judges that grant judicial bypasses to minors who need abortions was, once upon a time in April, scheduled for a public hearing but was withdrawn from the agenda before it actually got heard.

Whew. Okay. Well, we’ve still got 17 more bills to go—all of which were referred to their respective committees but not yet scheduled for public hearing there, and many of which are companion-type bills to other legislation in their opposite chamber. This list includes the four remaining “good” abortion bills. There’s SB 730, which would allow abortion providers who meet Medicare-determined operating standards (standards far less strict than HB 2, the omnibus anti-abortion law, requires), to open or reopen in Texas, effectively invalidating parts of HB 2. There’s also HB 709, which repeals Texas’ mandated 24-hour pre-abortion waiting period, HB 1210, which would exempt physicians from penalties if they fail to comply with abortion restrictions that go against their best medical judgment, and SB 1395, which would strike that mandated breast-cancer-causes-abortion language from pre-abortion medical counseling sessions in Texas.

The rest:

  • HB 113, a sex-selective abortion ban
  • HB 205, bans abortion providers or affiliates from teaching sex education in public schools
  • HB 1435, a ban on insurance coverage for abortion care
  • HB 1976, bans abortion care after 20 weeks for people who have non-viable pregnancies
  • HB 2531, requires “positive proof of age” for anyone seeking an abortion in Texas
  • HB 3447, prevents the state health department from allowing any exceptions to existing ambulatory surgical center regulations
  • SB 447, bans abortion providers or affiliates from teaching sex education in public schools
  • SB 831, an “anti-coercion” bill
  • SB 1564, requires “positive proof of age” for Texans seeking abortion care
  • SB 1869, creates pre-abortion “resource awareness” sessions about adoption and crisis pregnancy centers
  • SB 1872, a ban on insurance coverage for abortion care
  • HJR 126, puts a constitutional amendment on the statewide ballot in November asking Texans to vote to prohibit abortion “to the fullest extent authorized under federal constitutional law as interpreted by the United States Supreme Court.”

And then there’s my all-time favorite, SB 1870, from longtime Rio Grande Valley’s Sen. Eddie Lucio Jr., which requires literally all state agencies to operate under the belief that “life begins at conception.”

Heads up, Texas Lottery Commission—maybe y’all can replace the numbered balls in the lottery drawing with those little plastic fetuses they pass out at crisis pregnancy centers.

Analysis Sexuality

Sex Education in South Carolina Still Failing 25 Years After Passage of Comprehensive Law

Martha Kempner

South Carolina was ahead of the curve in adopting a mandate for health education, which includes a reproductive health component, in 1988. A new report suggests, however, that 25-years later many school districts aren't following the mandate and students are still not getting the education they should. 

In 1988, the South Carolina legislature passed the Comprehensive Health Education Act (CHEA) which was designed to standardize health education instruction in the state in order to “reduce substantially the amount of money the state spends to care for teenage mothers and their often sickly babies.” We can argue about the language and motives behind the legislation but the process of standardizing how young people learn about health is an important one that many states still have not undertaken.

South Carolina was certainly ahead of the curve passing such a bill so long ago (I was still in high school in 1988), but 25 years later there are questions as to how effective the law has been since sexual health statistics show South Carolina struggling with teen birth rates and sexually transmitted disease (STD) rates higher than the national average.   

A new report assesses the current status of health education with a focus on the reproductive health component. A Sterling Opportunity: 25 Years After the Comprehensive Health Education Act was conducted by Health Advocates LLC and the New Morning Foundation using a Department of Education survey of school districts in the state. The authors wanted to determine whether districts were following the parameters of the CHEA, what they were teaching, how well those teaching the subject were trained, and what materials they were using. The authors found a number of places where schools were failing to follow the law and providing inadequate—and in some cases inaccurate and outdated—information to students.

While the findings are not as outrageous as some found in other states, they shed important light on the situation in South Carolina which is struggling with a few issues: a law that has some good components and some highly restrictive ones, misunderstandings about what the law does and doesn’t require, and a complete lack of accountability.  

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The Law

The CHEA is very prescriptive in what is required as well as what is prohibited in health education including reproductive health education and teen pregnancy prevention. For example, it requires that each year students in grades nine through 12 receive comprehensive health education that includes at least 750 minutes of reproductive health education and pregnancy prevention education. Sixth through eighth graders are also supposed to receive reproductive health education which must include STD information. It may also include information on contraception, though this is up to the local school board. 

The law does restrict sexuality education to a certain extent. It requires an emphasis on abstinence, says that contraception information must be provided in the context of future planning, and directs schools to present adoption as a “positive alternative.” In addition, schools cannot provide any information about abortions, distribute contraception of any kinds, or show films that portray actual or simulated sexual activity. Finally (and I’d argue most disturbingly), the law states that “health education classes may not include discussions of alternate sexual lifestyles from heterosexual relationships” except in the context of STDs.

Despite these conservative aspects, the sexuality education component of the law has been controversial since the law was passed. In fact, there have been a number of attempts to change that part of the law. The report notes one amendment to the law proposed in 1998 that sought to change the purpose of the CHEA from “promote responsible sexual behavior,” to “the goal of this act is to reduce the incidence of sexual activity among school aged youth.” In 2004, there was an attempt to reduce the amount of sex education instruction from a minimum of 750 minutes per year to a maximum of 200 minutes. These challenges have failed.

The law also has administrative aspects such as teacher training requirements; an “opt-out” provision that allows parents to remove their children from the reproductive health portion of the course; and a requirement that districts assemble an advisory board of parents, teachers, and clergy to review materials.

Even though the law remains in place, according to the report many school districts are not following it. In fact, the study found that 75 percent of the districts surveyed were out of compliance with some piece of the reproductive health portion of the CHEA.

The Findings

Schools were out of compliance on issues related to time spent on reproductive health, teacher training, and administration. For example:

  • 66 percent of districts that responded did not teach STD and HIV prevention in all three middle school grades.
  • 23 percent of districts that responded did not have the appropriate community members on their advisory boards.
  • 12 percent of districts that responded did not provide the required teacher training.

Interestingly, 96 percent of districts that responded reported teaching all 750 required minutes of reproductive health in high school. 

Districts reported other issues that showed they were either not understanding the law or deliberately defying it. A number of districts, for example, seem to have misinterpreted the “opt out” provision which essentially says that students will be enrolled in the class unless their parents choose to exempt them. Many school districts, 26 of the 69 that responded, were using a much more strict “opt-in” policy which requires parents to sign permission slips before a child can attend the course or the sexuality education portion of the course. Opt-in requirements put an administrative burden on the school and can result in young people missing out on a course not because their parents object but because they forgot to sign the permission slip or it never made it out of the kid’s backpack. 

The most disturbing finding, however, was that eight districts were using materials that were out of compliance with the law, including abstinence-only-until-marriage curricula and outdated programs. 

What Kids Are Learning

A few months ago, the New York Civil Liberties Union undertook a similar review of sex education in their state and we learned that some districts were defining vaginas as sperm depositories and reminding kids that HIV leads to AIDS and certain death within three months. The South Carolina findings were somewhat less outrageous but inadequate nonetheless.

Only one of the high school textbooks used provides information about condoms or other forms of contraception. Some give lessons on abstaining from sex until marriage instead while others leave out vital information or just get it wrong. For example, one mentions “unprotected sex” but never defines it. Another inaccurately says that “barrier protection” is “not effective against HPV-human papilloma virus.” In fact, there is a great deal of research to suggest that condoms reduce the risk of contracting HPV as well as the risk of HPV-associated health issue such as cervical cancer. 

And then there is Holt Lifetime Health, which was part of a controversy in Texas, mentioned in the New York report, and is the subject of a California lawsuit. It famously says that the way to avoid STDs is to “get plenty of rest.”

Other school districts are using strict abstinence-only-until-marriage curriculum including Heritage Keeper’s and Worth the Wait. These are both fear-based programs that focus exclusively on saving sex for heterosexual marriage. Heritage Keeper’s, for example, tells young people:

“Sex is like fire. Inside the appropriate boundary of marriage, sex is a great thing! Outside of marriage, sex can be dangerous.”

Worth the Wait has this to say:

“Teenage sexual activity can create a multitude of medical, legal, and economic problems not only for the individuals having sex but for society as a whole.”  

And both programs include a slew of gender stereotypes and biases. 

Unfortunately, the report found that some districts that are not using these commercially-available curricula are nonetheless giving students similar messages. One district, for example, created a worksheet entitled “Protection Against Date Rape,” which explained:

 “A female may dress and act ‘sexy’ because she wants the male to find her attractive… The male may misinterpret her dress and actions as wanting more. This type of miscommunication sets up problems.”

This age-old idea that boys will be boys and girls should not “ask for it” has been used for years to blame rape victims for what happened to them. The authors note that this victim-blaming is misguided and dangerous:

“Instead of putting the brunt of responsibility on females to protect themselves against sexual assault, we should instead teach our youth—both women and men—that healthy relationships foster open communication, understanding, respect, and freedom of choice.”

One positive finding of the report is that despite the law’s assertion that schools cannot discuss “alternative lifestyles” to heterosexuality, the report did not find many materials that actively discriminated against LGBTQ students or their families. The authors write:

“Fortunately, blatantly discriminatory or homophobic materials are relatively rare in South Carolina sexuality education instruction and there has been more of an effort to make schools safer, more welcoming environments for all students, regardless of sexual orientation.“

Still, they acknowledge that the CHEA statute ignores non-heterosexual students and that this can contribute to a homophobic environment in schools.     

Multi-Prong Remedy

The CHEA is important in that it mandates that young people receive health education that includes reproductive health components but the law itself is not without its flaws. This means that there needs to be a multi-pronged approach to improving sex education in South Carolina.

In general there needs to more accountability; though the law directs the Department of Education to oversee compliance, there is even disagreement as to whether the survey it created to do so is required of all districts. Elizabeth Schroeder of Answer, a national sexuality education organization, points out that few laws of this kind have any teeth: “Just saying that our state has a sex education mandate isn’t the answer.” She noted research she had done years ago in a northern state with one of the best mandates in which she discovered that many districts were simply ignoring the law because there were no consequences of doing so. 

In a potential move to boost compliance, the authors of the South Carolina report suggest that health education become a requirement for graduation arguing that this would force schools to be more accountable in providing it. In addition, the report focuses on teacher training and recommends that health education only be taught by certified teachers and that health teachers be required to get periodic updated training on sexuality related topics. As Kathryn Zenger, a research analyst at New Morning Foundation who contributed to the report, put it: “We require math teachers to be certified in math and science teachers to be certified in science, health is no different.”  Zenger also noted that it’s important to change the law and its enforcement in ways that will be most effective for students. Having the information delivered by trained teachers, she said, is one of those changes that will have a direct effect in the classroom.

Other important changes recommended in the report speak to the law’s current restrictions on content. For example, the authors think that the law should be changed to remove the requirement that contraception education be provided only in the context of future planning. They note that given that almost 60 percent of high school seniors in South Carolina are sexually active this context isn’t realistic. Schroeder adds that many teens are still concrete thinkers who cannot think in terms of future planning. She notes that this is why course requirements should be crafted by educators and people with child development experience rather than policymakers.

The CHEA has now been in place for 25 years but it has clearly not met its goals even when we remember that those goals were written in terms of cost. The report’s authors note that birth to teen mothers cost the state $197 million each years.

This report is the first step for taking a multi-prong approach to fixing sex education in South Carolina. It also should serve as a reminder to advocates in other states that a law is a first step but we have to stay vigilant.