Rural communities like mine stand to be particularly harmed by the Trump administration’s efforts to eliminate key provisions of the Affordable Care Act (ACA). These changes come at a time when sexual health education has declined disproportionately in rural areas. A lack of comprehensive sexual health education, paired with the rolling back of ACA gains in rural communities, will exacerbate an already dire situation.
As reproductive rights advocates fight for expanded access to health-care services, we must also continue working to ensure that schools and community programs are providing education on contraceptive options and other sexual health issues. These issues are inextricable: Without equipping our community with knowledge about their own bodies, how will we move the needle forward in any way?
I am a mother of two children in Visalia, California, schools—the same system I attended as a kid. Our county, Tulare County, went 56 percent for Trump in the presidential election. At the same time, our county is home to a thriving community that supports, depends on, and could greatly benefit from expanded access to contraception, including young families, LGBTQ people, and women. We all have the right to decide if, when, and how we will parent.
And yet, sexual health education and other critical services are still hard to come by. Fewer than 10 percent of U.S. physicians practice in rural areas, according to Stanford eCampus Rural Health. Often rural residents need to travel significant distances just to reach a health-care provider, which can require us to take time off work and pay for transportation and other costs like child care. Once we reach a health center, rural residents are disproportionately dependent on Medicaid to get health coverage, which is under threat by congressional Republicans’ effort to defund Planned Parenthood and repeal the ACA.
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I volunteer in a group that informs the community about the Healthy Youth Act (which requires sex education in California schools) and school districts about the implementation of the law. As part of this group, we receive sexual health education, including anatomy lessons, in-depth contraceptive information, a condom demonstration, and more. I could plainly see how important and informative these lessons would be in schools. It might be the only time that adolescents receive sexual education of any kind. It cannot be assumed that each child is receiving supplemental sex education at home, or that what their parent or guardian teaches them is medically accurate and unbiased.
At one point it occurred to me that my fellow volunteers and I receive a more comprehensive sexual education experience in our meetings than what was offered to me in my public school, and not much has improved since I was a student.
The number of rural girls receiving birth control information actually has declined in recent years, from 71 percent to 48 percent, and among boys from 59 percent to 45 percent, according to the Guttmacher Institute. Although my district teaches Positive Prevention Plus, which abides by state guidelines, in some ways, a sex ed curriculum is only as good as the leadership that teaches and believes in it.
In my quest to learn more about what curriculum is implemented in Visalia schools, I contacted a health director by phone and a school principal in person. Appallingly, I was not only met with attitudes and tones of annoyance at any and all questions concerning sex education, but unapologetic carelessness about having the third-highest rate in the state for teen pregnancy, and sexually transmitted infection (STI) rates through the roof, in our county, with very few resources available for the most at-risk populations. The health director stated that “condom demonstrations are not proven to be effective,” and the principal said that “Planned Parenthood only served one agenda,” which I interpret to mean he believes health centers and organizations that provide reproductive and sexual health care have some kind of nefarious intent, rather than the simple truth that they provide some of the only resources to young people in our community.
Research and personal experience tell me the opposite of what school officials claim: You don’t just go to a reproductive and sexual health clinic for abortions, but to learn about birth control options, get screened for cancers and STIs, and learn about your body as a whole.
It is clear that people with these perceptions of reproductive health care will continue to be ineffective at helping to promote positive change in our community. They’ve left it up to community organizations—like the Source LGBT+ Center, and ACT for Women and Girls, which I participate in—to fill the void on sexual health education, contraceptive access, and reproductive justice as a whole.
Sexual health is a lifetime responsibility, and we need to equip young people with the tools they need.
Only as an adult have I come to understand that public health depends on health education, particularly sexual education. I would much prefer that my kids learn about the responsibility of having safer sex than learn the responsibility of being a reluctant teen parent. And no matter what choices my kids make, I want them to have the knowledge they need to make informed decisions, with confidence and resources.
Between a lack of quality sex education (which may only get worse with the help of the Department of Health and Human Services’s recent hire) and added barriers to contraception and reproductive health care coming out of Washington, rural America must fight back against both national and local barriers to women’s health and freedom. We need to put the pressure on our local lawmakers, and let school officials know that sexual health education and access to resources are priorities among parents as well as adolescents.
Knowledge is power, and I intend for my two kids to grow up to be powerful community leaders.