Commentary Sexual Health

High School Students Need Someone to Talk to About Sex Without Shame

Megan Carlson

A high school teacher speaks out about the pressing need for sexuality education among her students, who are literally begging for accurate information so they can make responsible decisions.

My side gig when I’m not being a professional blogger is teaching high school English at an inner city school in Philadelphia (well, maybe it’s the other way around, but let’s pretend). The other day, as a reward for finishing their state tests, I was letting my students talk quietly in groups and do word games. I sat next to three of my ninth graders (three girls and a boy) and quickly joined in on their discussion.

They were talking about teenage pregnancy, noticing the high number of girls in the school who were currently pregnant. The tone of the conversation started playful, but the students were asking some very serious questions.  The sole male student in our group directed the following question to me:

“Yo, Miss– who do you think is more responsible for getting pregnant—the boy or the girl?”

Before I could answer the girls quickly interjected their own opinions. It was the boy’s responsibility, because he was the one who needed to use a condom.  It was the girl’s responsibility because she shouldn’t be letting a boy go that far.  It was the parents’ responsibility because they should be monitoring their kids.

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Reeling the conversation back in, I answered, “First of all, I think it’s everyone’s responsibility because the consequences affect each person.  But I think that’s the wrong question.  My question is: why are teenagers getting pregnant, in the first place?  And I think the honest answer is that you guys just don’t receive a good sex education in school.”

To my surprise, the kids enthusiastically agreed. Many were quick to point out that they had had no sex education in their public schools.  And they were even quicker to insist that they needed it.

What followed was a barrage of basic sex-ed questions on topics from prophylactics to periods to pregnancy, some of which astonished me in their naïveté.  For example, one of my students asked if using condoms was even “worth it” because “a lot of times they don’t work.”  Astonished to find that several of my students were nodding in agreement, it dawned on me that this is a direct consequence of the misinformation spread with abstinence-only sex education.

In abstinence-only “sex education,” educators must emphasize abstinence as the only true method of birth control.  Information about prophylactics, disease, birth control, etc. gets spun to reflect the abstinence-only rhetoric.  Rather than facilitating a discussion about the importance of using condoms for safety, then, educators must state something like: “Condoms are only effective a certain percentage of the time and they can break.  The only 100% safe method is abstinence.”  While this information is technically true, it causes teens to believe that there are no other birth control options. This is a dangerous misconception that can lead teens to engage in risky behavior that they might otherwise have avoided with just some simple information.

What has been proven, time and time again, is that abstinencebased sex education is ineffective.  The reason is simple.  People have sex.  And I’m going to say something truly shocking to everyone:  teenagers have sex, too.   While this may affront our Puritan sensibilities, what should shock us is that teens are having sex without the necessary information to protect themselves, prevent unwanted pregnancy, and feel respected and safe at all times.  Furthermore, the scare-tactics used in abstinence-based sex education are making teens too afraid to ask appropriate questions about sex— something that perpetuates the ignorance that leads to high-risk behavior.

This is not to say that families cannot impart their particular moral values around sex to their children. Such values should be the basis of a youg person’s decision to have sex. But regardless of that decision, all young people should have all of the information necessary to be safe if they choose to have sex.

For my students, as part of my moral responsibility, I did my part to dispel any myths or misinterpretations they had been forming.  I told them the effectiveness rates for condoms when used correctly and incorrectly.  I gave them resources where they could go to find other age-appropriate information.  We talked about the subject maturely, objectively, and scientifically, and the students appreciated the candor.

As the discussion progressed, more and more students moved their desks toward our group.  All of this tells me that teens are crying out for information.  More than that, they want to be able to ask questions in an environment where they feel respected as the young adults they are and not judged for their curiosity.  It’s time that we stop shaming teens for trying to educate themselves and do our part to make sure they have the correct information so they are better prepared to make potentially life-altering decisions. 

Analysis Abortion

‘Pro-Life’ Pence Transfers Money Intended for Vulnerable Households to Anti-Choice Crisis Pregnancy Centers

Jenn Stanley

Donald Trump's running mate has said that "life is winning in Indiana"—and the biggest winner is probably a chain of crisis pregnancy centers that landed a $3.5 million contract in funds originally intended for poor Hoosiers.

Much has been made of Republican Gov. Mike Pence’s record on LGBTQ issues. In 2000, when he was running for U.S. representative, Pence wrote that “Congress should oppose any effort to recognize homosexual’s [sic] as a ‘discreet and insular minority’ [sic] entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.” He also said that funds meant to help people living with HIV or AIDS should no longer be given to organizations that provide HIV prevention services because they “celebrate and encourage” homosexual activity. Instead, he proposed redirecting those funds to anti-LGBTQ “conversion therapy” programs, which have been widely discredited by the medical community as being ineffective and dangerous.

Under Pence, ideology has replaced evidence in many areas of public life. In fact, Republican presidential nominee Donald Trump has just hired a running mate who, in the past year, has reallocated millions of dollars in public funds intended to provide food and health care for needy families to anti-choice crisis pregnancy centers.

Gov. Pence, who declined multiple requests for an interview with Rewire, has been outspoken about his anti-choice agenda. Currently, Indiana law requires people seeking abortions to receive in-person “counseling” and written information from a physician or other health-care provider 18 hours before the abortion begins. And thanks, in part, to other restrictive laws making it more difficult for clinics to operate, there are currently six abortion providers in Indiana, and none in the northern part of the state. Only four of Indiana’s 92 counties have an abortion provider. All this means that many people in need of abortion care are forced to take significant time off work, arrange child care, and possibly pay for a place to stay overnight in order to obtain it.

This environment is why a contract quietly signed by Pence last fall with the crisis pregnancy center umbrella organization Real Alternatives is so potentially dangerous for Indiana residents seeking abortion: State-subsidized crisis pregnancy centers not only don’t provide abortion but seek to persuade people out of seeking abortion, thus limiting their options.

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“Indiana is committed to the health, safety, and wellbeing [sic] of Hoosier families, women, and children,” reads the first line of the contract between the Indiana State Department of Health and Real Alternatives. The contract, which began on October 1, 2015, allocates $3.5 million over the course of a year for Real Alternatives to use to fund crisis pregnancy centers throughout the state.

Where Funding Comes From

The money for the Real Alternatives contract comes from Indiana’s Temporary Assistance for Needy Families (TANF) block grant, a federally funded, state-run program meant to support the most vulnerable households with children. The program was created by the 1996 Personal Responsibility and Work Opportunity Reconciliation Act signed by former President Bill Clinton. It changed welfare from a federal program that gave money directly to needy families to one that gave money, and a lot of flexibility with how to use it, to the states.

This TANF block grant is supposed to provide low-income families a monthly cash stipend that can be used for rent, child care, and food. But states have wide discretion over these funds: In general, they must use the money to serve families with children, but they can also fund programs meant, for example, to promote marriage. They can also make changes to the requirements for fund eligibility.

As of 2012, to be eligible for cash assistance in Indiana, a household’s maximum monthly earnings could not exceed $377, the fourth-lowest level of qualification of all 50 states, according to a report by the Congressional Research Service. Indiana’s program also has some of the lowest maximum payouts to recipients in the country.

Part of this is due to a 2011 work requirement that stripped eligibility from many families. Under the new work requirement, a parent or caretaker receiving assistance needs to be “engaged in work once the State determines the parent or caretaker is ready to engage in work,” or after 24 months of receiving benefits. The maximum time allowed federally for a family to receive assistance is 60 months.

“There was a TANF policy change effective November 2011 that required an up-front job search to be completed at the point of application before we would proceed in authorizing TANF benefits,” Jim Gavin, a spokesman for the state’s Family and Social Services Administration (FSSA), told Rewire. “Most [applicants] did not complete the required job search and thus applications were denied.”

Unspent money from the block grant can be carried over to following years. Indiana receives an annual block grant of $206,799,109, but the state hasn’t been using all of it thanks to those low payouts and strict eligibility requirements. The budget for the Real Alternatives contract comes from these carry-over funds.

According to the U.S. Department of Health and Human Services, TANF is explicitly meant to clothe and feed children, or to create programs that help prevent “non-marital childbearing,” and Indiana’s contract with Real Alternatives does neither. The contract stipulates that Real Alternatives and its subcontractors must “actively promote childbirth instead of abortion.” The funds, the contract says, cannot be used for organizations that will refer clients to abortion providers or promote contraceptives as a way to avoid unplanned pregnancies and sexually transmitted infections.

Parties involved in the contract defended it to Rewire by saying they provide material goods to expecting and new parents, but Rewire obtained documents that showed a much different reality.

Real Alternatives is an anti-choice organization run by Kevin Bagatta, a Pennsylvania lawyer who has no known professional experience with medical or mental health services. It helps open, finance, and refer clients to crisis pregnancy centers. The program started in Pennsylvania, where it received a $30 million, five-year grant to support a network of 40 subcontracting crisis pregnancy centers. Auditor General Eugene DePasquale called for an audit of the organization between June 2012 and June 2015 after hearing reports of mismanaged funds, and found $485,000 in inappropriate billing. According to the audit, Real Alternatives would not permit DHS to review how the organization used those funds. However, the Pittsburgh Post-Gazette reported in April that at least some of the money appears to have been designated for programs outside the state.

Real Alternatives also received an $800,000 contract in Michigan, which inspired Gov. Pence to fund a $1 million yearlong pilot program in northern Indiana in the fall of 2014.

“The widespread success [of the pilot program] and large demand for these services led to the statewide expansion of the program,” reads the current $3.5 million contract. It is unclear what measures the state used to define “success.”

 

“Every Other Baby … Starts With Women’s Care Center”

Real Alternatives has 18 subcontracting centers in Indiana; 15 of them are owned by Women’s Care Center, a chain of crisis pregnancy centers. According to its website, Women’s Care Center serves 25,000 women annually in 23 centers throughout Florida, Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin.

Women’s Care Centers in Indiana received 18 percent of their operating budget from state’s Real Alternatives program during the pilot year, October 1, 2014 through September 30, 2015, which were mostly reimbursements for counseling and classes throughout pregnancy, rather than goods and services for new parents.

In fact, instead of the dispensation of diapers and food, “the primary purpose of the [Real Alternatives] program is to provide core services consisting of information, sharing education, and counseling that promotes childbirth and assists pregnant women in their decision regarding adoption or parenting,” the most recent contract reads.

The program’s reimbursement system prioritizes these anti-choice classes and counseling sessions: The more they bill for, the more likely they are to get more funding and thus open more clinics.

“This performance driven [sic] reimbursement system rewards vendor service providers who take their program reimbursement and reinvest in their services by opening more centers and hiring more counselors to serve more women in need,” reads the contract.

Classes, which are billed as chastity classes, parenting classes, pregnancy classes, and childbirth classes, are reimbursed at $21.80 per client. Meanwhile, as per the most recent contract, counseling sessions, which are separate from the classes, are reimbursed by the state at minimum rates of $1.09 per minute.

Jenny Hunsberger, vice president of Women’s Care Center, told Rewire that half of all pregnant women in Elkhart, LaPorte, Marshall, and St. Joseph Counties, and one in four pregnant women in Allen County, are clients of their centers. To receive any material goods, such as diapers, food, and clothing, she said, all clients must receive this counseling, at no cost to them. Such counseling is billed by the minute for reimbursement.

“When every other baby born [in those counties] starts with Women’s Care Center, that’s a lot of minutes,” Hunsberger told Rewire.

Rewire was unable to verify exactly what is said in those counseling sessions, except that they are meant to encourage clients to carry their pregnancies to term and to help them decide between adoption or child rearing, according to Hunsberger. As mandated by the contract, both counseling and classes must “provide abstinence education as the best and only method of avoiding unplanned pregnancies and sexually transmitted infections.”

In the first quarter of the new contract alone, Women’s Care Center billed Real Alternatives and, in turn, the state, $239,290.97; about $150,000 of that was for counseling, according to documents obtained by Rewire. In contrast, goods like food, diapers, and other essentials for new parents made up only about 18.5 percent of Women’s Care Center’s first-quarter reimbursements.

Despite the fact that the state is paying for counseling at Women’s Care Center, Rewire was unable to find any licensing for counselors affiliated with the centers. Hunsberger told Rewire that counseling assistants and counselors complete a minimum training of 200 hours overseen by a master’s level counselor, but the counselors and assistants do not all have social work or psychology degrees. Hunsberger wrote in an email to Rewire that “a typical Women’s Care Center is staffed with one or more highly skilled counselors, MSW or equivalent.”

Rewire followed up for more information regarding what “typical” or “equivalent” meant, but Hunsberger declined to answer. A search for licenses for the known counselors at Women’s Care Center’s Indiana locations turned up nothing. The Indiana State Department of Health told Rewire that it does not monitor or regulate the staff at Real Alternatives’ subcontractors, and both Women’s Care Center and Real Alternatives were uncooperative when asked for more information regarding their counseling staff and training.

Bethany Christian Services and Heartline Pregnancy Center, Real Alternatives’ other Indiana subcontractors, billed the program $380.41 and $404.39 respectively in the first quarter. They billed only for counseling sessions, and not goods or classes.

In a 2011 interview with Philadelphia City Paper, Kevin Bagatta said that Real Alternatives counselors were not required to have a degree.

“We don’t provide medical services. We provide human services,” Bagatta told the City Paper.

There are pregnancy centers in Indiana that provide a full range of referrals for reproductive health care, including for STI testing and abortion. However, they are not eligible for reimbursement under the Real Alternatives contract because they do not maintain an anti-choice mission.

Parker Dockray is the executive director of Backline, an all-options pregnancy resource center. She told Rewire that Backline serves hundreds of Indiana residents each month, and is overwhelmed by demand for diapers and other goods, but it is ineligible for the funding because it will refer women to abortion providers if they choose not to carry a pregnancy to term.

“At a time when so many Hoosier families are struggling to make ends meet, it is irresponsible for the state to divert funds intended to support low-income women and children and give it to organizations that provide biased pregnancy counseling,” Dockray told Rewire. “We wish that Indiana would use this funding to truly support families by providing job training, child care, and other safety net services, rather than using it to promote an anti-abortion agenda.”

“Life Is Winning in Indiana”

Time and again, Bagatta and Hunsberger stressed to Rewire that their organizations do not employ deceitful tactics to get women in the door and to convince them not to have abortions. However, multiple studies have proven that crisis pregnancy centers often lie to women from the moment they search online for an abortion provider through the end of their appointments inside the center.

These studies have also shown that publicly funded crisis pregnancy centers dispense medically inaccurate information to clients. In addition to spreading lies like abortion causing infertility or breast cancer, they are known to give false hopes of miscarriages to people who are pregnant and don’t want to be. A 2015 report by NARAL Pro-Choice America found this practice to be ubiquitous in centers throughout the United States, and Rewire found that Women’s Care Center is no exception. The organization’s website says that as many as 40 percent of pregnancies end in natural miscarriage. While early pregnancy loss is common, it occurs in about 10 percent of known pregnancies, according to the American Congress of Obstetricians and Gynecologists.

Crisis pregnancy centers also tend to crop up next to abortion clinics with flashy, deceitful signs that lead many to mistakenly walk into the wrong building. Once inside, clients are encouraged not to have an abortion.

A Google search for “abortion” and “Indianapolis” turns up an ad for the Women’s Care Center as the first result. It reads: “Abortion – Indianapolis – Free Ultrasound before Abortion. Located on 86th and Georgetown. We’re Here to Help – Call Us Today: Abortion, Ultrasound, Locations, Pregnancy.”

Hunsberger denies any deceit on the part of Women’s Care Center.

“Clients who walk in the wrong door are informed that we are not the abortion clinic and that we do not provide abortions,” Hunsberger told Rewire. “Often a woman will choose to stay or return because we provide services that she feels will help her make the best decision for her, including free medical-grade pregnancy tests and ultrasounds which help determine viability and gestational age.”

Planned Parenthood of Indiana and Kentucky told Rewire that since Women’s Care Center opened on 86th and Georgetown in Indianapolis, many patients looking for its Georgetown Health Center have walked through the “wrong door.”

“We have had patients miss appointments because they went into their building and were kept there so long they missed their scheduled time,” Judi Morrison, vice president of marketing and education, told Rewire.

Sarah Bardol, director of Women’s Care Center’s Indianapolis clinic, told the Criterion Online Edition, a publication of the Archdiocese of Indianapolis, that the first day the center was open, a woman and her boyfriend did walk into the “wrong door” hoping to have an abortion.

“The staff of the new Women’s Care Center in Indianapolis, located just yards from the largest abortion provider in the state, hopes for many such ‘wrong-door’ incidents as they seek to help women choose life for their unborn babies,” reported the Criterion Online Edition.

If they submit to counseling, Hoosiers who walk into the “wrong door” and “choose life” can receive up to about $40 in goods over the course their pregnancy and the first year of that child’s life. Perhaps several years ago they may have been eligible for Temporary Assistance for Needy Families, but now with the work requirement, they may not qualify.

In a February 2016 interview with National Right to Life, one of the nation’s most prominent anti-choice groups, Gov. Pence said, “Life is winning in Indiana.” Though Pence was referring to the Real Alternatives contract, and the wave of anti-choice legislation sweeping through the state, it’s not clear what “life is winning” actually means. The state’s opioid epidemic claimed 1,172 lives in 2014, a statistically significant increase from the previous year, according to the Centers for Disease Control and Prevention. HIV infections have spread dramatically throughout the state, in part because of Pence’s unwillingness to support medically sound prevention practices. Indiana’s infant mortality rate is above the national average, and infant mortality among Black babies is even higher. And Pence has reduced access to prevention services such as those offered by Planned Parenthood through budget cuts and unnecessary regulations—while increasing spending on anti-choice crisis pregnancy centers.

Gov. Pence’s track record shows that these policies are no mistake. The medical and financial needs of his most vulnerable constituents have taken a backseat to religious ideology throughout his time in office. He has literally reallocated money for poor Hoosiers to fund anti-choice organizations. In his tenure as both a congressman and a governor, he’s proven that whether on a national or state level, he’s willing to put “pro-life” over quality-of-life for his constituents.

Analysis LGBTQ

Fourth Circuit Rejects Request to Rehear Ruling in Favor of Transgender High School Student

Imani Gandy

In late April, a three-judge panel of the Fourth Circuit Court of Appeals ruled in Gavin Grimm’s favor, signaling that the high school’s anti-trans bathroom policy is a violation of Title IX of the U.S. Education Amendments of 1972, a federal law that prohibits sex discrimination at schools that receive federal funding.

A federal appeals court on Tuesday refused to rehear a case involving transgender student Gavin Grimm’s battle with his school board for the right to use the boys’ bathroom and locker room facilities at his high school in Gloucester County, Virginia.

In late April, a three-judge panel of the Fourth Circuit Court of Appeals ruled in Grimm’s favor, signaling that the high school’s anti-trans bathroom policy is a violation of Title IX of the U.S. Education Amendments of 1972, a federal law that prohibits sex discrimination at schools that receive federal funding.

In response, the Gloucester County School Board asked all 15 judges who sit on the Fourth Circuit to rehear the case “en banc”, meaning before the full court. In papers filed with the court, the school board argued that the Title IX ban on sex discrimination does not protect transgender students; that the court did not answer the fundamental question of whether the school board’s restroom and locker policy violated Title IX; and that the court’s decision “undermined the constitutional privacy rights of other students.”

In a five-page order Tuesday, the court denied the Gloucester County School Board’s request.

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Grimm’s lawsuit alleges that the school board’s decision to ban him from using the bathroom that aligns with his gender identity is unconstitutional under the 14th Amendment and violates Title IX. Grimm seeks an injunction blocking the school board’s policy.

A lower court initially sided with the school board, ruling that its policy of requiring that students use bathrooms consistent with their “biological sex” rather than their gender identity does not violate Title IX, and that Grimm’s schoolmates’ “bodily privacy” outweighed any potential harm to Grimm in using a different bathroom.

A three-judge panel of the Fourth Circuit disagreed: It held that the lower court relied on the wrong legal standard in failing to issue the injunction. In backing Grimm, the court deferred to recent guidance issued by the U.S. Department of Education that denying transgender students access to school bathrooms of their choice is a violation of Title IX. It remanded the case back to the lower court for a new hearing, with instructions to include consideration of the Department of Education’s guidance.

The Fourth Circuit’s rulings in Grimm’s case do not bode well for North Carolina. The state is currently embroiled in a pair of lawsuits against the United States regarding whether a provision in HB 2, which mandates that access to restroom facilities in schools and publicly owned buildings be restricted to the gender on a person’s birth certificate, is a violation of both Title IX and Title VII of the Civil Rights Act of 1964.

North Carolina filed a lawsuit against the Obama administration in federal court regarding the administration’s “radical reinterpretation” of Title VII, which prohibits sex-based discrimination in employment. That lawsuit is notably silent on Title IX.

The United States’ lawsuit against North Carolina, however, is not: In addition to mentioning Title VII, it alleges that HB 2 constitutes “discrimination on the basis of sex in an education program receiving federal funds in violation of Title IX.”

Since North Carolina sits in the Fourth Circuit and given Grimm’s success before that court, the United States will likely be successful in its Title IX claim. And given that Title VII and Title IX cases are analyzed using similar legal principles, it is likely that North Carolina faces a similar uphill battle in its own Title VII case.

In his dissent from the Court’s order rejecting Gloucester County School Board’s request for a rehearing, Fourth Circuit Judge Paul Niemeyer wrote that “bodily privacy is historically one of the most basic elements of human dignity and individual freedom. And forcing a person of one biological sex to be exposed to persons of the opposite biological sex profoundly offends this dignity and freedom.” His comments obscure the fact that the courts have frequently ignored the right to bodily privacy: In pushing anti-choice laws, for example, conservatives have leveraged the state’s interest in the “health of the fetus” over a pregnant person’s right to bodily privacy.

Niemeyer further wrote that the Obama administration has “redefin[ed] sex to mean how any given person identifies himself or herself at any given time, thereby, of necessity, denying all affected persons the dignity and freedom of bodily privacy.”

The Obama administration disagrees, and believes that—due to a legal principle sometimes referred to as the Auer/Seminole Rock doctrine—the Department of Education (DOE) is entitled to interpret its own implementing regulations as it sees fit.

Title IX regulations provide for the separation of restrooms, showers, locker rooms, and dorms on the basis of sex, but the regulations are silent as to where transgender students fit when it comes to sex segregation in bathrooms and locker rooms. According to court documents filed by the Obama administration, because there’s no legislative history regarding what Congress meant by “sex,” in Title IX, the DOE can rightfully expand its protection to include transgender people.

It remains to be seen whether the lower court will rehear Grimm’s case as instructed by the Fourth Circuit, or whether Gloucester County School Board will immediately appeal the Fourth Circuit’s ruling to the Supreme Court. In either event, it is expected that the Supreme Court will soon be called to weigh in on the interpretation of Title IX and whether transgender people fall within its protection.