News Contraception

Dispatches from Jackson: Teens Having Sex is a Fact, Not Fiction, In Mississippi

Robin Marty

Unintended pregnancies, especially teen pregnancies, are a large contributor to the many other challenges that plague the families in Mississippi, such as high rates of maternal and child mortality, a broader health crisis, and skyrocketing poverty levels.

They could almost be mother and daughter, not because of similar features as much as their matching look—their tailored suits, their genteel auras, even the pearls.

So when Carol Penick, Executive Director of the Women’s Fund of Mississippi, starts saying phrases like “sexual positions” and starts talking about the large boxes of condoms they carry to events or the keychain-sized flashlights that read “Don’t do it in the dark!” it’s jarring, to say the least.

“It’s our veneer of respectability that often gets us in the door,” Penick quips about herself and her colleague, Jamie Bardwell, the younger of the team and the Director of Programs.

The Women’s Fund has managed to get through a lot of doors, first as a Jackson organization addressing the needs of women in the city and now, expanding statewide to address a critical issue in Mississippi, the teen pregnancy rate.

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There is little doubt that the needs are unmet. Unintended pregnancies, especially teen pregnancies, are a large contributor to the many other challenges that plague the families in Mississippi, such as high rates of maternal and child mortality, a broader health crisis, and skyrocketing poverty levels. Even the governor, Republican Phil Bryant, recognized that teen pregnancy simply couldn’t be ignored, although his solution of  abstinence-only education classes and arsenal of increasingly strange bills meant to punish those who impregnate teens was an approach that left much to be desired.

Unlike abortion, it’s not difficult at all to get a discussion started about teen pregnancy or sex ed. Everyone is happy to discuss it, as long as their ideas that are being represented. For advocates of comprehensive, age-appropriate sex ed, increased knowledge of basic biology, of how to prevent pregnancy, and where to get the supplies to do so, are seen as the easiest means of addressing the problem (and, by extension, the issue of abortion).

Bryant and his “absolutely no sex before marriage” compatriots are at least somewhat open to ideas, especially after being pressured by the public. After all, as Penick notes, sex education is now mandatory in every classroom, something that would have been unthinkable up until recently.

“The media focused so much on the fact that, once schools had the chance to decide whether they wanted to provide abstinence-only sex ed classes or whether they wanted abstinence plus (abstinence education that also includes discussion about types of prevention as well), so many of them chose abstinence only,” explained Penick. “What they didn’t write about was the fact that nearly half of those schools chose abstinence plus. That was a huge victory for us.”

It’s the type of sex ed that is still a disappointment, and the lack of real information that is being provided, however, that made the Women’s Fund begin working with partners to embark on some education of their own. Abstinence plus, although a step up from straight abstinence only, still had no clear direction as to who would teach the classes, how long they would be or how often they would be offered. The groups would be separated by sex, continuing the appearance that the information was somehow mysterious or inappropriate. Plus, parents would need to opt in, rather than opt out. Many parents approved and would allow their children to participate, but how do you reach more?

These were many of the reasons that the Women’s Fund decided to begin a project of their own. They brought in talent to develop a website, “FactnotFiction,” that addresses many of the basics of biology, the issues of STIs and prevention, the truth about condoms and pregnancy and other information that students aren’t getting in the classroom. “We hope that this supplements not just their sex-ed classes, but also the information their parents would want them to have, too,” Bardwell told me. “If a child has a question that the parent feels too uncomfortable or uncertain to answer, they can say ‘Why don’t you go to that website and look there?'”

If the site itself doesn’t answer the question, there is also a page where the child can ask a question directly, and receive an answer from a medical professional. “It’s not real time, but it’s still a great resource that they didn’t have before.”

FactnotFiction provides the education, but more visionary is a program that the Fund is hoping to launch that addresses what they see as a more pressing root of teen pregnancy—the lack of ability to see a future for herself, especially once a teen girl has become pregnant and does have the child. According to recent numbers put out in the group’s latest executive report, only one in three teens mothers receive a high school diploma, a staggering statistic of lost potential.

“Of the teens who get pregnant, only 35 percent of them are younger teens,” said Penick. “The rest are 18 or 19 years old. They have dropped out of high school. They won’t be heading to college. We have to find a way to help them still get an education, to be able to obtain real, meaningful employment with living wages, to keep them out of poverty and give them a future that is more than just getting pregnant again.

Penick refers to this as a  “two-generational approach,” one that cares for both the teen mother and her child. It’s a program that helps the teen mother get her GED, helps her find Pell grants, opening the door to community college—one that also provides quality daycare for her child, including Early Learning education programs. “It is education for her, and for her child,” she explained. “Mom goes to school, child goes to ‘school.’ Mom comes home and studies, her child gets to read books with her.”

It’s a way to break the poverty cycle, and one that the group is anxious to find even more groups interested in it so they can launch. “We hope to have many partners, soon.”

It seems like such a logical idea, and such an efficient used of money. An analysis from the Mississippi Economic Policy Center shows that in 2009, unintended pregnancies cost the state  $155 million. This is just examining low wages for teen parents and the lost tax revenue associated with those wages, and not even considering the additional health care costs, which would continue to add up.

The analysis clearly shows that committing funding towards real, effective solutions is a fiscally sound policy. So why is a non-profit like Women’s Fund forced to spearhead such an effort, rather than the state? “Well, obviously we’d like to ask the same question,” Penick said with a wry smile.

Apart from reducing teen pregnancy rates overall, it is hoped that these programs will help teen mothers avoid a second birth before they are ready, improve their ability to care for the child they already have, and improve their own chances for the future. In a state where the government is eager to avoid the “sex” talk and also force women to carry pregnancies no matter their own desires, these may be the best outcomes that can be hoped for at the moment.

Commentary Politics

No, Republicans, Porn Is Still Not a Public Health Crisis

Martha Kempner

The news of the last few weeks has been full of public health crises—gun violence, Zika virus, and the rise of syphilis, to name a few—and yet, on Monday, Republicans focused on the perceived dangers of pornography.

The news of the last few weeks has been full of public health crises—gun violence, the Zika virus, and the rise of syphilis, to name a few—and yet, on Monday, Republicans focused on the perceived dangers of pornography. Without much debate, a subcommittee of Republican delegates agreed to add to a draft of the party’s 2016 platform an amendment declaring pornography is endangering our children and destroying lives. As Rewire argued when Utah passed a resolution with similar language, pornography is neither dangerous nor a public health crisis.

According to CNN, the amendment to the platform reads:

The internet must not become a safe haven for predators. Pornography, with its harmful effects, especially on children, has become a public health crisis that is destroying the life [sic] of millions. We encourage states to continue to fight this public menace and pledge our commitment to children’s safety and well-being. We applaud the social networking sites that bar sex offenders from participation. We urge energetic prosecution of child pornography which [is] closely linked to human trafficking.

Mary Frances Forrester, a delegate from North Carolina, told Yahoo News in an interview that she had worked with conservative Christian group Concerned Women for America (CWA) on the amendment’s language. On its website, CWA explains that its mission is “to protect and promote Biblical values among all citizens—first through prayer, then education, and finally by influencing our society—thereby reversing the decline in moral values in our nation.”

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The amendment does not elaborate on the ways in which this internet monster is supposedly harmful to children. Forrester, however, told Yahoo News that she worries that pornography is addictive: “It’s such an insidious epidemic and there are no rules for our children. It seems … [young people] do not have the discernment and so they become addicted before they have the maturity to understand the consequences.”

“Biological” porn addiction was one of the 18 “points of fact” that were included in a Utah Senate resolution that was ultimately signed by Gov. Gary Herbert (R) in April. As Rewire explained when the resolution first passed out of committee in February, none of these “facts” are supported by scientific research.

The myth of porn addiction typically suggests that young people who view pornography and enjoy it will be hard-wired to need more and more pornography, in much the same way that a drug addict needs their next fix. The myth goes on to allege that porn addicts will not just need more porn but will need more explicit or violent porn in order to get off. This will prevent them from having healthy sexual relationships in real life, and might even lead them to become sexually violent as well.

This is a scary story, for sure, but it is not supported by research. Yes, porn does activate the same pleasure centers in the brain that are activated by, for example, cocaine or heroin. But as Nicole Prause, a researcher at the University of California, Los Angeles, told Rewire back in February, so does looking at pictures of “chocolate, cheese, or puppies playing.” Prause went on to explain: “Sex film viewing does not lead to loss of control, erectile dysfunction, enhanced cue (sex image) reactivity, or withdrawal.” Without these symptoms, she said, we can assume “sex films are not addicting.”

Though the GOP’s draft platform amendment is far less explicit about why porn is harmful than Utah’s resolution, the Republicans on the subcommittee clearly want to evoke fears of child pornography, sexual predators, and trafficking. It is as though they want us to believe that pornography on the internet is the exclusive domain of those wishing to molest or exploit our children.

Child pornography is certainly an issue, as are sexual predators and human trafficking. But conflating all those problems and treating all porn as if it worsens them across the board does nothing to solve them, and diverts attention from actual potential solutions.

David Ley, a clinical psychologist, told Rewire in a recent email that the majority of porn on the internet depicts adults. Equating all internet porn with child pornography and molestation is dangerous, Ley wrote, not just because it vilifies a perfectly healthy sexual behavior but because it takes focus away from the real dangers to children: “The modern dialogue about child porn is just a version of the stranger danger stories of men in trenchcoats in alleys—it tells kids to fear the unknown, the stranger, when in fact, 90 percent of sexual abuse of children occurs at hands of people known to the victim—relatives, wrestling coaches, teachers, pastors, and priests.” He added: “By blaming porn, they put the problem external, when in fact, it is something internal which we need to address.”

The Republican platform amendment, by using words like “public health crisis,” “public menace” “predators” and “destroying the life,” seems designed to make us afraid, but it does nothing to actually make us safer.

If Republicans were truly interested in making us safer and healthier, they could focus on real public health crises like the rise of STIs; the imminent threat of antibiotic-resistant gonorrhea; the looming risk of the Zika virus; and, of course, the ever-present hazards of gun violence. But the GOP does not seem interested in solving real problems—it spearheaded the prohibition against research into gun violence that continues today, it has cut funding for the public health infrastructure to prevent and treat STIs, and it is working to cut Title X contraception funding despite the emergence of Zika, which can be sexually transmitted and causes birth defects that can only be prevented by preventing pregnancy.

This amendment is not about public health; it is about imposing conservative values on our sexual behavior, relationships, and gender expression. This is evident in other elements of the draft platform, which uphold that marriage is between a man and a women; ask the U.S. Supreme Court to overturn its ruling affirming the right to same-sex marriage; declare dangerous the Obama administration’s rule that schools allow transgender students to use the bathroom and locker room of their gender identity; and support conversion therapy, a highly criticized practice that attempts to change a person’s sexual orientation and has been deemed ineffective and harmful by the American Psychological Association.

Americans like porn. Happy, well-adjusted adults like porn. Republicans like porn. In 2015, there were 21.2 billion visits to the popular website PornHub. The site’s analytics suggest that visitors around the world spent a total of 4,392,486,580 hours watching the site’s adult entertainment. Remember, this is only one way that web users access internet porn—so it doesn’t capture all of the visits or hours spent on what may have trumped baseball as America’s favorite pastime.

As Rewire covered in February, porn is not a perfect art form for many reasons; it is not, however, an epidemic. And Concerned Women for America, Mary Frances Forrester, and the Republican subcommittee may not like how often Americans turn on their laptops and stick their hands down their pants, but that doesn’t make it a public health crisis.

Party platforms are often eclipsed by the rest of what happens at the convention, which will take place next week. Given the spectacle that a convention headlined by presumptive nominee (and seasoned reality television star) Donald Trump is bound to be, this amendment may not be discussed after next week. But that doesn’t mean that it is unimportant or will not have an effect on Republican lawmakers. Attempts to codify strict sexual mores are a dangerous part of our history—Anthony Comstock’s crusade against pornography ultimately extended to laws that made contraception illegal—that we cannot afford to repeat.

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

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Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.