Commentary Sexual Health

Yes, Camille Paglia, Let’s Put Sex Back in Sex Ed—But Not Fear, Shame, or Stereotypes

Martha Kempner

In a recent editorial, Paglia argues for moving toward a sex ed model in which young people learn reproductive biology in one class, study sexually transmitted diseases in another, and get a healthy dose of fear, shame, and gender stereotypes in yet another. But sexuality educators disagree.

In an editorial in TIME magazine’s Ideas Issue called “Put the Sex Back in Sex Ed,” writer Camille Paglia (a self-described “dissident feminist”) argues for moving toward a model in which young people learn reproductive biology in one class, study sexually transmitted diseases in another, and get a healthy dose of fear, shame, and gender stereotypes in yet another. What students should never get in school, according to Paglia, is “a political endorsement of homosexuality and gay rights causes” or a package of condoms.

Needless to say, as a sexuality educator, I disagree with most of her assertions here. And, not surprisingly, when I checked in with my colleagues in the field, they did too.  

In presenting her argument for separate classes, Paglia notes that sex ed classes are often taught by teachers without enough training and know-how. She writes, “Sex-ed teachers range from certified health educators to volunteers and teenage ‘peer educators’ with minimal training.” I agree that we need better training for those who teach young people about sex—a teacher who knows little more than his or her students will get nothing accomplished, nor will an embarrassed educator who blushes when trying to pronounce the word clitoris. I would argue, however, that peer educators are often the best trained, least embarrassed, and most informed class leaders around. I also question the wisdom of her solution, which seems to be dividing up the subject of sex into its core components, starting with reproductive biology. She writes:

First, anatomy and reproductive biology belong in general biology courses taught in middle school by qualified science teachers. Every aspect of physiology, from puberty to menopause, should be covered. Students deserve a cool, clear, objective voice about the body, rather than the smarmy, feel-good chatter that now infests sex-ed workbooks.

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I’ve reviewed a lot of sex education workbooks, as she calls them, and I’m wondering where she is finding all of this feel-good chatter. Personally, I’m more familiar with the ones that fail to draw external female genitalia, never label the clitoris, or describe the vagina as a sperm depository. But we can put that aside for the moment. Letting a biology teacher tackle the inner workings of the body is not unreasonable—some of the best sexuality courses I took in college and graduate school were straightforward biology courses, and I still refer to my notes from one of them some 20 years later. However, waiting until middle school—when biology teachers first appear—will mean the information about puberty is more of a history lesson for some students (the average age of breast buds, for example, is 9.96 for white girls and 8.87 for Black girls).

What Paglia misses are all of the things that we need to learn about our bodies that are not related to how they function, but instead encompass how we live with and in them for the rest of our lives. Sure, puberty education is going to tell young people where to find the vas deferens and how narrow fallopian tubes really are, regardless of whether it’s taught by a sex educator or a biology teacher. But without fail the biggest question young people of all ages have is “Am I normal?” And when they ask this, they are not talking about the plumbing and wiring systems hidden under their skin and between their legs. As Monica Rodriguez, president of the Sexuality Information and Education Council of the United States (SIECUS) told me, “Providing biological information without helping young people figure out their feelings and values related to body image, relationships, gender, and a whole host of other issues is so limited it loses much of its value.”

And yet, that what’s Paglia wants to continue doing when it comes to sexually transmitted diseases (STDs). She suggests that this portion of a teen’s sex life be taught by the same health educators “who advise children about washing their hands to avoid colds.” We could certainly treat STDs like colds—“This is chlamydia, it’s caused by a bacteria, it can infect the urethra and cervix”—though even this approach would fall short if Paglia has her way, since she says that schools have “no business” listing sexual behaviors like masturbation or oral or anal sex. Just as it would be tough to tell kids how to avoid a cold without mentioning handshakes, so would teaching them to avoid syphilis without discussing intercourse.

More importantly though, STDs are not like colds, and avoiding them is not just about washing one’s hands or even using a condom. Avoiding STDs requires decision making, communication, and negotiation skills, as well as an understanding of trust, and the ability to recognize and sustain healthy relationships. While I have no doubt that many health educators could take this on, that’s clearly not what Paglia has in mind. She’s talking just the facts, ma’am.

Well, just the facts, with a little fear and shame mixed in. She writes:

The liberal response to conservatives’ demand for abstinence-only sex education has been to condemn the imposition of “fear and shame” on young people. But perhaps a bit more self-preserving fear and shame might be helpful in today’s hedonistic, media-saturated environment.

I can almost get behind the idea of a healthy dose of fear. In fact, I credit a healthy dose of fear of herpes—obtained from a first-hand account of a woman living with outbreaks that was published in Cosmopolitan circa 1987—with my lifelong devotion to condoms. And I believe that an honest accounting of STDs does breed a healthy apprehension. What doesn’t work is exaggerating the consequences and suggesting STDs are the inevitable product of premarital sex, which is what most abstinence-only programs do.

I draw a hard line when it comes to shame, however. This is something we should never want our children or young adults to experience in association with their sexuality. Activities that suggest sexually experienced teens are less worthy of our love, trust, or respect—by likening them to a mint that has been passed around the room, a petal-less rose, or a pitcher of spit—run counter to all efforts to promote sexual health. (See reviews of the abstinence-only programs that invented these shame-based activities on SIECUS’s Community Action Kit website.)

As Lucinda Holt, director of communications for Answer, pointed out, “At Answer’s teen website, we have seen over and over again that fear and shame do not serve young people. Fear and shame prevent young people from talking to their partners before they have sex about safer sex, whether they’re even ready for sex, sexual histories, and if they’ve been tested. Fear and shame prevent young people from getting tested for STDs or pregnancy. Fear and shame prevent young people from talking to their parents or other adults in their lives who care about them and want the best for them.”

SIECUS’s Monica Rodriguez adds that “today’s hedonistic, media-saturated environment” of which Paglia writes is exactly why we can’t rely on fear and shame: “I would argue that precisely because young people are growing up in a time where everything is sexualized we need to give them more information, not less and we need to help them practice looking at sexuality and the sexualized messages that they are getting with a critical eye.”

But Paglia does not want young people to be taught to use a critical eye in sexuality education. She seems to believe that there is too much liberal ideology in sex ed today, and some discussions are not appropriate:

The issue of homosexuality is a charged one. In my view, antibullying campaigns, however laudable, should not stray into political endorsement of homosexuality or gay rights causes. While students must be free to create gay-identified groups, the schools themselves should remain neutral and allow society to evolve on its own.

Acknowledging the existing of different sexual orientations is not political, nor is it an endorsement; it is an inarguable truth. Remaining neutral has meant ignoring sexual orientation—operating under the false assumption that all the students in the class, all of their parents, and everyone they know and will ever know are heterosexual. This is a political statement—one that dashes the hopes of some students for a happy, healthy relationship in the future, invalidates families, and perpetuates bullying.

Then there’s Paglia’s discussion of gender differences. Though she starts strong on this topic—suggesting young women should think about their future fertility and career aspirations at a young age—she quickly falls into stereotypes worthy of the most sexist abstinence-only programs. Women, she says, have far more to lose from casual sex and need to be taught that their fertility is fleeting while they are busy being “propelled along a career track devised for men.”

“Boys need lessons in basic ethics and moral reasoning about sex (for example, not taking advantage of intoxicated dates), while girls must learn to distinguish sexual compliance from popularity,” she writes.

“Where do I even begin?” said Monica Rodriguez. “Her attitude is so disrespectful of young people and promotes the very stereotypes that limit both girls and boys as they make their way in the world and in their romantic and sexual relationships. And, I would argue, that this attitude directly contributes to rape culture.”

What’s more, without giving any reason, Paglia suggests that schools should not distribute condoms, leaving that to hospitals and social service agencies. This is the opposite of what the American Academy of Pediatrics (AAP) suggested in a recent policy in which the group argues that all obstacles to condom access for teens should be removed and that schools are a good place for condom availability programs. The AAP came to this conclusion after reviewing a great deal of evidence that suggests condoms prevent both STDs and pregnancy, and making them available to teens does not increase sexual activity but does increase condom use. (Speaking of pregnancy prevention, Paglia derides current liberal sex education programs for defining pregnancy as “a pathology for which abortion is the cure.” Yet her model of sex ed does not seem to make room for teaching about contraception at all.)

All of the sex educators I spoke with agreed with Paglia on one (and only one) point: “A national conversation is urgently needed for curricular standardization and public transparency.”

Sexuality education will never be completely standardized, because local school districts are and will remain in charge of what gets taught, but nonetheless there is a movement to improve programs across the country. As Advocates for Youth President Debra Hauser said, “The National Sexuality Education Standards, published in January of 2012, provide schools with a guide to the minimum essential content and skills young people need at each grade level to take personal responsibility for their sexual health as they mature. Schools across the country have begun using the standards to improve the sexuality education they provide to their students.”

In fact, all of the groups I spoke with for this article—Advocates for Youth, Answer, and SIECUS—along with other experts in the field, have worked on these standards for many years.

But my guess is that Paglia is not going to like what they came up with, because the standards certainly don’t follow her guidelines of separating boys and girls, sticking to the facts, adding shame and stereotypes, and withholding information about sexual orientation. Instead, the standards offer a guide to creating a comprehensive sexuality education program that can help young people develop critical thinking skills to help them navigate sexuality throughout their lives.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

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.