Commentary Contraception

The Time Has Come: Free Condoms in Every High School

Amanda Marcotte

The American Academy of Pediatrics has issued a new set of recommendations encouraging schools, parents, and communities to focus on destigmatizing condoms and making them more available to teenagers. What was once a radical idea is quickly becoming normalized.

Making free condoms available in schools: It’s an idea that has long been bandied about on the right as evidence of the supposed excesses of liberal ideology. Take, for example, the hysterical coverage of “rubbers” in New York schools from conservative rag the New York Daily News, which breathlessly reported that “[t]he back-to-school collection includes ‘Rough Rider Studded’ condoms as well as ‘King XL,’ ‘Extra Strength,’ ‘Ultra Sensitive,’ ‘Ultra Thin,’ ‘Ribbed’ and ‘Assorted Flavors.’” You start to get the impression that the reason conservatives think high school students get sexually aroused at the mere sight of a condom is because they do themselves.

Well, the idea that condoms should be made available free to teenagers isn’t really a radical leftist idea anymore, if it ever was. Last week, the American Academy of Pediatrics (AAP)—hardly a subversive communist organization—issued a policy statement supporting the notion that kids who want condoms should be able to get them discreetly and affordably, preferably at no cost. “Schools should be considered suitable sites for condom distribution,” the statement read, adding that pediatricians should emphasize to parents the importance of educating their children about condom use.

The AAP knows some parents are afraid this will be read as “permission” to have sex, but as the group noted, kids who have access to condoms and condom education do not have sex sooner; in fact, nearly half of studies show that kids who have condom access have sex later than their peers who don’t have it. That may seem counter-intuitive at first, but it actually makes sense if you think about it. Kids who live in a more sexually liberated environment are more likely to have sex on their own terms rather than because of peer pressure or a desire to prove they’re rebellious. In addition, kids who live in an environment that is supportive of their sexuality instead of hostile to it may be more inclined to use oral sex and mutual masturbation in order to delay intercourse, whereas kids who don’t have a good idea that those are options might rush into intercourse first.

Not that facts will do much to stem the tide of disapproval from the right about the growing trend of schools, particularly in dense cities, making condoms available to students. “Sending a message” of disapproval about sex is clearly more important to many on the right than actually protecting the health and well-being of teenagers, and it appears to be more important even than making sure the message is received in the same spirit it was intended.

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But for those who really do put a priority on the health of teenagers, the AAP’s announcement is a big boost to efforts to get more condoms available to teenagers who need them. According to the AAP, rates of syphilis, gonorrhea, and chlamydia have been rising over the past decade, even as teenage pregnancy rates are falling. One in five new HIV infections is in someone age 13 to 24. Kids are getting smarter about preventing pregnancy, but when it comes to sexually transmitted infections, there’s clearly a gap.

The reason why shouldn’t be too hard to figure out. It can be difficult when you’re young to deal with the often delicate situation of explaining why you want to use condoms without causing an oversensitive partner to assume you’re accusing them of being “dirty.” No one is going to get bent out of shape because you believe their body plus your body could equal a pregnancy (if you’re straight, anyway), but sadly, some people, especially if they’re still inexperienced, think the desire to use a condom means a lack of trust.

One way to make that stigma disappear is to create as many opportunities as possible to communicate to young people that condoms are a normal, everyday part of sex and nothing to feel weird or ashamed about. Hiding condoms, or making students ask a nurse for them like they’re some kind of specialized medical device, does the opposite, creating stigma. Having condoms in big bowls or in free vending machines everywhere helps establish that sliding one on is normal, and it’s not a personal judgment on you or your health status to insist on wearing one. As with most things, frequent exposure to condoms will make them feel familiar and normal, instead of weird things you have to go out of your way to possess.

For example, think about how everyone went from not wearing seat belts to wearing seat belts. For those of us who are old enough to remember, when mandatory seat belt laws first started to be passed, a big obstacle was that a lot of people were offended by the idea, seeing it as a referendum on their driving skills rather than as a sensible safety precaution. There was a period when reaching for the seat belt was a fraught choice, a delicate situation in which you often had to make excuses to a driver who took it as an affront.

Nowadays, the opposite happens: Drivers not only expect everyone to buckle up, but as a matter of personal pride, most will insist on it. What happened? Legislation was part of it, but only because the law made wearing one ubiquitous. Once the stigma was gone, the whole sense that you were trying to “say” something by wearing a seat belt evaporated. Today it would seem ludicrous for a driver to say anything negative about seat belt usage.

The same thing can happen with condoms—and to an extent it already has for many communities. It’s just a matter of making condoms normal and mainstream so that the sight of them doesn’t cause people to fret or have weird feelings. Luckily, we now have the AAP’s recommendations to back up future attempts to make condoms more visible and accessible in high schools and other places teenagers congregate.

Commentary Sexual Health

Parents, Educators Can Support Pediatricians in Providing Comprehensive Sexuality Education

Nicole Cushman

While medical systems will need to evolve to address the challenges preventing pediatricians from sharing medically accurate and age-appropriate information about sexuality with their patients, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Last week, the American Academy of Pediatrics (AAP) released a clinical report outlining guidance for pediatricians on providing sexuality education to the children and adolescents in their care. As one of the most influential medical associations in the country, AAP brings, with this report, added weight to longstanding calls for comprehensive sex education.

The report offers guidance for clinicians on incorporating conversations about sexual and reproductive health into routine medical visits and summarizes the research supporting comprehensive sexuality education. It acknowledges the crucial role pediatricians play in supporting their patients’ healthy development, making them key stakeholders in the promotion of young people’s sexual health. Ultimately, the report could bolster efforts by parents and educators to increase access to comprehensive sexuality education and better equip young people to grow into sexually healthy adults.

But, while the guidance provides persuasive, evidence-backed encouragement for pediatricians to speak with parents and children and normalize sexual development, the report does not acknowledge some of the practical challenges to implementing such recommendations—for pediatricians as well as parents and school staff. Articulating these real-world challenges (and strategies for overcoming them) is essential to ensuring the report does not wind up yet another publication collecting proverbial dust on bookshelves.

The AAP report does lay the groundwork for pediatricians to initiate conversations including medically accurate and age-appropriate information about sexuality, and there is plenty in the guidelines to be enthusiastic about. Specifically, the report acknowledges something sexuality educators have long known—that a simple anatomy lesson is not sufficient. According to the AAP, sexuality education should address interpersonal relationships, body image, sexual orientation, gender identity, and reproductive rights as part of a comprehensive conversation about sexual health.

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The report further acknowledges that young people with disabilities, chronic health conditions, and other special needs also need age- and developmentally appropriate sex education, and it suggests resources for providing care to LGBTQ young people. Importantly, the AAP rejects abstinence-only approaches as ineffective and endorses comprehensive sexuality education.

It is clear that such guidance is sorely needed. Previous studies have shown that pediatricians have not been successful at having conversations with their patients about sexuality. One study found that one in three adolescents did not receive any information about sexuality from their pediatrician during health maintenance visits, and those conversations that did occur lasted less than 40 seconds, on average. Another analysis showed that, among sexually experienced adolescents, only a quarter of girls and one-fifth of boys had received information from a health-care provider about sexually transmitted infections or HIV in the last year. 

There are a number of factors at play preventing pediatricians from having these conversations. Beyond parental pushback and anti-choice resistance to comprehensive sex education, which Martha Kempner has covered in depth for Rewire, doctor visits are often limited in time and are not usually scheduled to allow for the kind of discussion needed to build a doctor-patient relationship that would be conducive to providing sexuality education. Doctors also may not get needed in-depth training to initiate and sustain these important, ongoing conversations with patients and their families.

The report notes that children and adolescents prefer a pediatrician who is nonjudgmental and comfortable discussing sexuality, answering questions and addressing concerns, but these interpersonal skills must be developed and honed through clinical training and practice. In order to fully implement the AAP’s recommendations, medical school curricula and residency training programs would need to devote time to building new doctors’ comfort with issues surrounding sexuality, interpersonal skills for navigating tough conversations, and knowledge and skills necessary for providing LGBTQ-friendly care.

As AAP explains in the report, sex education should come from many sources—schools, communities, medical offices, and homes. It lays out what can be a powerful partnership between parents, doctors, and educators in providing the age-appropriate and truly comprehensive sexuality education that young people need and deserve. While medical systems will need to evolve to address the challenges outlined above, there are several things I recommend parents and educators do to reinforce AAP’s guidance.

Parents and Caregivers: 

  • When selecting a pediatrician for your child, ask potential doctors about their approach to sexuality education. Make sure your doctor knows that you want your child to receive comprehensive, medically accurate information about a range of issues pertaining to sexuality and sexual health.
  • Talk with your child at home about sex and sexuality. Before a doctor’s visit, help your child prepare by encouraging them to think about any questions they may have for the doctor about their body, sexual feelings, or personal safety. After the visit, check in with your child to make sure their questions were answered.
  • Find out how your child’s school approaches sexuality education. Make sure school administrators, teachers, and school board members know that you support age-appropriate, comprehensive sex education that will complement the information provided by you and your child’s pediatrician.

School Staff and Educators: 

  • Maintain a referral list of pediatricians for parents to consult. When screening doctors for inclusion on the list, ask them how they approach sexuality education with patients and their families.
  • Involve supportive pediatricians in sex education curriculum review committees. Medical professionals can provide important perspective on what constitutes medically accurate, age- and developmentally-appropriate content when selecting or adapting curriculum materials for sex education classes.
  • Adopt sex-education policies and curricula that are comprehensive and inclusive of all young people, regardless of sexual orientation or gender identity. Ensure that teachers receive the training and support they need to provide high-quality sex education to their students.

The AAP clinical report provides an important step toward ensuring that young people receive sexuality education that supports their healthy sexual development. If adopted widely by pediatricians—in partnership with parents and schools—the report’s recommendations could contribute to a sea change in providing young people with the care and support they need.

Analysis Human Rights

Activists Seek Justice as Verdict Looms for Officer Involved in Freddie Gray’s Death

Michelle D. Anderson

Freddie Gray, 25, died from spinal cord injuries in April 2015, a week after police arrested and took him into custody. Last year, Baltimore City State's Attorney Marilyn J. Mosby brought criminal charges against six of the officers involved with his arrest. Since then, three officers' trials have been completed without convictions.

The bench trial of Lt. Brian Rice, the highest-ranking Baltimore Police Department officer involved in the 2015 death of Freddie Gray, began on Thursday, July 7. Rice faces involuntary manslaughter, second-degree assault, and reckless endangerment; the state dropped a misconduct charge after acknowledging Rice was not directly involved in Gray’s arrest. The closing arguments in his trial are scheduled for this Thursday; the judge is expected to share his verdict Monday.

The Rice trial started just as the public began grappling with the deaths of Philando Castile and Alton Sterling—and the subsequent murder of five police officers at a Dallas protest.

Castile and Sterling, both Black men, died during encounters with police in Falcon Heights, Minnesota, and Baton Rouge, Louisiana, triggering nationwide protests against police brutality and implicit racial bias that have continued into this week.

And just like the days following Gray’s death, social media sites like Twitter and Facebook were flooded with images, videos, and hashtags demanding justice.

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Gray, 25, died from spinal cord injuries in April 2015, a week after police arrested and took him into custody. Activists and some Maryland legislators accused police of giving Gray an intentional “rough ride,” when inmates or persons in custody are transported in police vans without a seat belt and subjected to frantic driving, ultimately causing them injury. Last year, Baltimore City State’s Attorney Marilyn J. Mosby brought criminal charges against six of the officers involved with his arrest. Since then, three officers’ trials have been completed without convictions—and as activists on the ground in Baltimore wait for more verdicts, they are pushing for reforms and justice beyond the courtroom.

The first police trial, which involved charges against Officer William Porter of involuntary manslaughter, second-degree assault, reckless endangerment, and misconduct in office, ended in a mistrial in December 2015 after jurors failed to reach a verdict.

Baltimore City Circuit Court Judge Barry Glenn Williams acquitted Officer Edward M. Nero of all charges in May. Mosby had charged Nero with misconduct, second-degree assault, and reckless endangerment for putting Gray into the police van without a seat belt.

But many viewed the trial of Caesar R. Goodson Jr., who drove the van, as the most critical of the six. Last month, Judge Williams announced that Goodson, too, had been acquitted of all charges—including second-degree depraved-heart murder, the most serious of those brought against the officers.

Kwame Rose, a Baltimore activist, told Rewire he was not surprised.

“The judicial system of America shows that police are never held accountable when it comes to the death of Black people,” said Rose, who was arrested in September and December during peaceful protests related to Gray’s death.

During Goodson’s trial, Williams said there were several “equally plausible scenarios,” that could have transpired during Gray’s arrest. He also rejected the state’s argument that police intentionally gave Gray a “rough ride,”according to a New York Times account.

Ray Kelly, community relations director for the No Boundaries Coalition of West Baltimore grassroots group and a community interviewer for the West Baltimore Community Commission on Police Misconduct, said he was disappointed by the Goodson verdict. However, he noted that he was heartened by Mosby’s decision to bring criminal charges against the officers in the first place. “It’s a small change, but it is a change nonetheless,” Kelly said in a recent interview with Rewire.

In addition to the charges, Gray’s death eventually sparked a major “pattern or practice” investigation by the U.S. Department of Justice (DOJ). Local activists, including the No Boundaries Coalition, which issued in March a 32-page report that detailed police misconduct in Baltimore and helped to trigger the DOJ, expected the findings of the DOJ investigation in late June.

However, the document has yet to be released, said Kelly, who is a native of the same West Baltimore neighborhood where Gray was detained.

Kelly is expecting a consent decree—similar to the ones in Ferguson, Missouri, and Cleveland, Ohio—and a continued partnership with federal officials in the near future.

For Kelly, the trials—and the lack of convictions—have proved what leaders in groups like the No Boundaries Coalition have been saying in their advocacy. One of those messages, Kelly said, is that the community should continue to focus less on the judicial process for theoretically punishing officers who have committed wrongdoing and more on initiating policy changes that combat over-policing.

Baltimore Bloc, a grassroots group, seemed to echo Kelly’s sentiment in a statement last month. Two days after the Goodson verdict, Baltimore Bloc activists said it was a reminder that the judicial system was not broken and was simply doing exactly what it is designed to do.

“To understand our lack of faith in the justice system, you must first recognize certain truths: the justice system works for police who both live in and out of the city; it works against Black people who come from disinvested, redlined Black communities; and it systematically ruins the lives of people like Keith Davis Jr., Tyrone West and Freddie Gray,” Baltimore Bloc leadership said, referencing two other Baltimore residents shot by police.

The American Civil Liberties Union, citing the U.S. Supreme Court decision in Illinois v. Wardlow, said in a May blog post that police had legal case for stopping and arresting Gray, but also said the action constituted racially biased policing and diminished rights for Black and Latino citizens.

“The result is standards of police conduct that are different in some places than other places. It is a powerful example of institutionalized and structural racism in which ostensibly race-neutral policies and practices create different outcomes for different racial groups,” ACLU leaders said.

Right before issuing its statement in May, ACLU released a briefing paper that said at least 21 individuals had been killed in police encounters across Maryland in 2015. Of those fatal encounters, which included Gray, 81 percent were Black and about half were unarmed.

The ACLU said it was impossible for the agency to determine whether any officers were disciplined for misconduct in most cases because the police refused to release crucial information to the public.

The ACLU began compiling information about police custody deaths after learning that Maryland officials were not tracking those cases. In 2015, state politicians passed a law mandating law enforcement agencies to report such data. The first set of statistics on police custody deaths is expected in October, according to the ACLU. It is unclear whether those will include reports of officer discipline.

In line with those efforts, activists across Maryland are working to bring forth more systemic changes that will eliminate over-policing and the lack of accountability that exist among police agencies.

Elizabeth Alex, the regional director for CASA Baltimore, a grassroots group that advocates on behalf of local, low-income immigrant communities, told Rewire many activists are spending less energy on reforming the judicial process to achieve police accountability.

“I think people are looking at alternative ways to hold officers and others accountable other than the court system,” Alex said.

Like the No Boundaries Coalition, CASA Baltimore is part of the Campaign for Justice, Safety & Jobs (CJSJ), a collective of more than 30 local community, policy, labor, faith, and civil rights groups that convened after Gray’s death. CJSJ members include groups like the local ACLU affiliate, Baltimore United for Change, and Leaders of a Beautiful Struggle.

CJSJ leaders said the Goodson verdict underlined the critical need for “deep behavioral change” in the Baltimore Police Department’s culture. For the past year, the group has pushed heavily for citizen representation on police trial boards that review police brutality cases. Those boards make decisions about disciplining officers. For example, the city’s police commissioner might decide to discipline or fire an officer; that officer could go to the trial board to appeal the decision.

This spring, recent Baltimore City mayoral candidate and Maryland Sen. Catherine Pugh (D-Baltimore), helped pass an omnibus police accountability law, HB 1016. Part of that bill includes a change to Maryland’s Law Enforcement Officer’s Bill of Rights (LEOBR) giving local jurisdictions permission to allow voting citizens on police trial boards. Republican Gov. Larry Hogan signed the changes into law in May.

That change can only happen in Baltimore, however, if the Baltimore Fraternal Order of the Police union agrees to revise its contract with the city, according to WBAL TV. The agreement, which expired on June 30, currently does not allow citizen inclusion.

In light of the current stalled negotiations, Baltimore Bloc on July 5 demanded Baltimore City Council President Bernard C. “Jack” Young instead introduce an amendment to the city charter to allow civilian participation on trial boards. If Young introduced the amendment before an August deadline, the question would make it onto the November ballot.

Kelly, in an interview with Rewire, cited some CJSJ members’ recent meeting with Baltimore Police Commissioner Kevin Davis as a win for Baltimore citizens. During that meeting, held on June 29, Davis outlined some of his plans for implementing change on the police force and said he supported local citizens participating on police trial boards, Kelly said.

This year, the Baltimore Police Department has also implemented a new use-of-force policy. The policy emphasizes de-escalation and accountability and is the first rewrite of the policy since 2003, according to the Sun.

The ACLU has welcomed the policy as a step in the right direction, but said the new rules need significant improvements, according to the Sun.

For example, the policy requires reporting to the department when an officer flashes or points a weapon at a suspect without shooting; the data will be reviewed by the police commissioner and other city officials. However, it doesn’t require the same from officers who use deadly force.

Notably, the policy requires officers to call a medic if a person in custody requests medical assistance or shows signs that they need professional help. Gray had requested a medic, but officers were skeptical and didn’t call for help until he became unresponsive, according to various news reports.

Rose, who recently received legal assistance from the ACLU to fight criminal charges related to his arrests last year, said citizens should continue to demand accountability and “true transparency” from law enforcement.

In the meantime, with four trials—including Rice’s case—remaining and no convictions, many are looking to see if Mosby will change her prosecution strategy in the upcoming weeks. Roya Hanna, a former Baltimore prosecutor, has suggested Mosby showed poor judgment for charging the six officers without “adequate evidence,” according to the Sun.

Meanwhile, Baltimore City’s police union has urged Mosby to drop the remaining charges against officers.

The trial of Officer Garrett E. Miller is slated to begin July 27; Officer William Porter, Sept. 6, and Sgt. Alicia D. White, Oct. 13. All officers charged pleaded not guilty.

Baltimore Bloc, citing its dissatisfaction with her performance thus far, demanded Mosby’s removal from office last month.

Kelly, who counts Baltimore Bloc among his allies, has a different outlook. Calling’s Mosby’s swift decision to charge the six officers last year  “groundbreaking,” the Baltimore activist said the ongoing police trials are justified and help give attention to police misconduct.

“She should follow through on the charges ….We need that exposure,” Kelly said. “It keeps the debate open and sparks the conversation.”