Sex Education

Sex Education Running head:

1

Sex Education

Erin Boyle

Erica Ely

Christina Karanasos

Heidi Long

Jennifer Pena

Devyn Shook

Rebecca Waggoner

Pacific Lutheran University

2

Sex Education

3

The purpose of this paper is to explore the issue of sex education in the public school system. This is an important issue because teens are becoming sexually active at younger ages. The incidence of teenage sex and sexually transmitted diseases (STDs) is alarmingly high. By age seventeen, over 50 percent of teenagers have engaged in oral sex, between five percent and 30 percent of thirteen-year-olds have had sexual intercourse, and more than nine million new cases of STDs are contracted by Americans between the ages of fifteen and twenty-four every year (Shafer, 2006). The amount of teenage pregnancies is also very alarming. “The teen pregnancy rate in the U.S. is the highest among the most developed countries in the world… and despite recent declines in teenage pregnancy rates, 31 percent of American teens still experience pregnancy (Planned Parenthood, 2006)”. Sex education for kids and teens has been an extremely controversial topic, mostly due to the fact that there are many conflicting views between parents and educators. Most people agree that American school systems need to have some kind of sexual education program, and most do, the question is, what kind?

One part of a nurses’ role is to act as an educator. This means ensuring that their clients have proper information when it comes to sexual education. Nurses are currently seeing more and more young people presenting with sexual health issues that may potentially take a negative toll on the rest of their lives. It is frustrating for nurses to see these kids suffer because they had incorrect information, or no information on the consequences of sexual activity. School nurses play a large role in the sex education (sex ed) programs in schools. School personnel look to school nurses for providing accurate information to use in their programs.

Sex Education

4

There are currently two different types of sex ed programs being taught in the United States. Comprehensive sex education programs emphasize the importance of abstinence while also teaching kids about STDs and contraceptive devices. Abstinence only programs teach kids that the proper thing to do is to abstain from having sex until marriage. They do not teach about contraceptives or the consequences of having unprotected sex. Abstinence only programs are the only kind of programs being funded by the federal government, and the Bush administration spends approximately 200 million dollars on these programs every year (Robb, 2007). Planned Parenthood is encouraging states to refuse to accept federal funding so that they can continue or start to teach comprehensive programs, and states are doing so (Craig, 2007). Despite this fact, the majority of states are only teaching abstinence-only programs. We will now look further into the programs that are being taught in our schools, the content of these programs, parental viewpoints and the rights of parents in participating in their children’s sexual education.

Comprehensive Sex Education is one of the two major viewpoints that are associated with sex education in schools. By definition, Comprehensive Sex Education is an educational program that provides a balance of sex education by promoting abstinence in accordance with information on contraceptive devices and other birth control methods. The main goals of this educational teaching style is to reduce the number of teen pregnancies and sexually transmitted infections (STIs) and/or diseases. According to Advocates for Youth, “Comprehensive sex ed stresses abstinence and includes ageappropriate, medically accurate information about contraception. Comprehensive sex ed is also developmentally appropriate, introducing information on relationships, decision-

Sex Education

5

making, assertiveness, and skill building to resist social/peer pressure, depending on grade-level.” (“Comprehensive sex education,” n.d.). Furthermore, Advocates for Youth addresses the issue of teen pregnancies and STDs in regards to Comprehensive Sex Education by stating that “Comprehensive Sex Education teaches about abstinence as the best method for avoiding STDs and unintended pregnancy, but also teaches about condoms and contraception to reduce the risk of unintended pregnancy and of infection with STDs, including human immunodeficiency virus (HIV). It also teaches interpersonal and communication skills and helps young people explore their own values, goals, and options.” (“Sex education programs,” n.d.) Another source describes Comprehensive Sex Education in terms of “three key components: It provides complete, accurate, positive and developmentally appropriate information on human sexuality, including the risk reduction strategies of abstinence, contraception and STD protection; it promotes the development of relevant personal and interpersonal skills; and it includes parents or caretakers as partners with teachers” (Constantine, Jerman, & Huang, 2007). This definition provides a broader view of the topical outline and focus of comprehensive sex education as opposed to the definition commonly used by the media and politicians that merely refers to it as being an educational style which addresses “contraception and protection from those that strategically omit these topics” (Constantine et al., 2007).

Since 1991, US teen pregnancy rates have seen a decrease in number (Hulton, 2007). Although one study found that “there was a substantial retreat from a comprehensive approach to sex education from 1995 to 2002” (Lindberg, Santelli, & Singh, 2006), another source stated that “[d]ramatic improvements in contraceptive use occurred between 1995 and 2002” (Santelli, Lindberg, Finer, & Singh, 2007). This same

Sex Education

6

study concluded that the “declining adolescent pregnancy rates in the United States between 1995 and 2002 were primarily attributable to improved contraceptive use. The decline in pregnancy risk among 18- and 19-year-olds was entirely attributable to increased contraceptive use. Decreased sexual activity was responsible for about one quarter (23 percent) of the decline among 15- to 17-year-olds, and increased contraceptive use was responsible for the remainder (77 percent)” (Santelli et al., 2007). Furthermore, this study stated that “[a]bstinence promotion is a worthwhile goal, particularly among younger teenagers; however, the scientific evidence shows that, in itself, it is insufficient to help adolescents prevent unintended pregnancies” (Santelli et al., 2007). Another source pointed out that “[b]ased on over 15 years of research, the evidence shows that comprehensive sexuality education programs for youth that encourage abstinence, promote appropriate condom use, and teach sexual communication skills reduce HIV-risk behavior and also delay the onset of sexual intercourse.” (“Based on the research”, 2005). It stands to reason, based on recent studies, that a continued reduction in the number of teen pregnancies would be promoted by teaching a balance of abstinence and contraception education.

The position of parents on the issue of sexuality education in America is a multifaceted topic. There is a wide spread agreement of the teaching of abstinence. The disagreement stems from whether it should be the only thing taught. Many parents would prefer their children remain abstinent until marriage; however, statistics show that they are realistic in understanding that this is not always likely. This is where the approval of comprehensive sexual education stems from; parents want their children to be as safe and well informed as possible if they do choose to have sexual intercourse. The Kaiser

Sex Education

7

Family Foundation conducted a survey of parents and the public regarding their opinions on sex education among other things. When asked how they, the parents surveyed, thought the funding for sex ed programs that come from the government should be used, 67 percent replied that, “The money should be used to fund more comprehensive sex education programs that include information on how to obtain and use condoms and other contraceptives.” (Kaiser Family Foundation, 2004) Among the topics that the survey asked parents about, 96 percent thought that the basic information of how babies come about, pregnancy and birth are appropriate for sex education programs. Ninety eight percent of parents agreed that AIDS, HIV and STD information is appropriate to include in such classes; 94 percent also wanted students to be taught how and where to be tested for such diseases. Ninety four percent wanted information on birth control and methods of preventing pregnancy to be included in school sex education classes and 87 percent wanted information included on where to get such resources; although only 71 percent wanted students made aware that they do not need parental permission to obtain such resources. Though parents also showed great support of topics other than just abstinence, they also highly supported teaching that emphasizes abstinence. Ninety five percent of those surveyed wanted teachings to include the idea of waiting until you are older to have sexual intercourse. Eighty two percent of respondents also stated that sexual education in school makes it easier for them to discuss sexual issues with their children. The legal rights of parents in such matters are complex. Laws on the issues of sexuality education vary from state to state. In some states, abstinence is the only thing that may be taught within public schools and much of the funding from the government goes only towards programs that teach abstinence. Sometimes parental permission is

Sex Education

8

required for a child’s participation in sex education and sometimes it is not. This is an issue that is still developing legally and does not yet have a clear set of guidelines on what is and what is not allowed, as well as what the rights of parents are. In 1996, the Welfare Reform Act was set up by congress. This act allocated 550 million dollars a year, for five years, to promote and teach abstinence as the only morally correct option for young adults to live by. In 1998, The Abstinence-Only Sexual Education programs were put into effect in schools all throughout the United States. The program is defined by Section 510(b) of Title V of the Social Security Act, P.L. 104-193. This act lists eight rules that outline exactly what the program teaches. “For the purposes of this section, the term "abstinence education" means an educational or motivational program which: 1. has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity; 2. teaches abstinence from sexual activity outside of marriage is the expected standard for all school-age children; 3. teaches that abstinence from sexual activity is the only certain way to avoid outof-wedlock pregnancy, sexually transmitted diseases, and other associated health problems; 4. teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity; 5. teaches that sexual activity outside the context of marriage is likely to have harmful psychological and physical side effects;

Sex Education

9

6. teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child's parents, and society; 7. teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances, and 8. teaches the importance of attaining self-sufficiency before engaging in sexual activity” (Advocates for Youth, 2007) The program usually forces teachers to censor information about condoms and birth control, as well as any information about other methods of contraceptives and/or protection against STDs. This means that if a student asks a question regarding any of these subjects, the teacher is not permitted to answer. The only acceptable form of information regarding the use of condoms, is listing the failure rates. Abstinence-Only Education also teaches that there can be harmful physical, social, and psychological consequences for individuals who engage in pre-marital sexual activity. It does not discuss certain controversial issues like masturbation, sexual orientation or abortion. It also suggests that STDs are inevitable if an individual engages in pre-marital sexual activity. Although this is a very controversial issue, there are some who say that positive effects have come out of this program. In 2005, a study was done on seventh, eighth, and ninth graders in a south metro Atlanta school, to compare the effects of the past sexual health textbook versus the new abstinence-only “Choosing the Best” textbook program. Over a one-year period, the study showed that there was a 47 percent decrease in the initiation of teen sex. Another study was performed from 1995 to 1996 by Northwestern University Medical School. “Graduates” evaluated 2,541 Illinois public school students

Sex Education

10

from the age of 13-16. After one year of the “Choosing the Best” program, 54 percent of the students were no longer sexually active. The number is believed to have dropped due to the changes in curriculum. (Choosing the Best, 2007). The abstinence-only programs were formed due to the idea that if children are taught ways to prevent pregnancy or protect against STDs, that this is promoting, and encouraging pre-marital sex. It has never been doubted that abstinence is truly the only way to protect oneself 100 percent of the time against STDs or unwanted pregnancy. The choice we now have to make is how do we decide, as a nation, which way is “the right way” for our children to learn to learn about sex. In 1990, Sexuality Information and Education Council of the United States (SIECUS) started a task force aimed chiefly at creating a curriculum framework or guideline used to create new sexual education programs and evaluate existing ones. The task force was comprised of 20 individuals in the fields of medicine, education, youth services and sexuality. These guidelines are outlined in a 112 page document. These guidelines do not only cover the sex part of sexual education, but many other areas such as puberty, self esteem, body image, and development issues. These issues are just the tip of the iceberg of what is covered within the program guidelines. The guidelines set up by SIECUS for sexual education are based first upon four different age levels. Next, the recommended curriculum is based on six key concepts consisting of five to seven topics within each concept. Within each topic is a listed curriculum guide for what should be covered according to the age appropriateness within each of the age levels designed.

Sex Education

11

Before the curriculum itself, the task force says “The educators must be educated” (Sexuality and Education Council of the United States, 2004). What does this mean? Educating the educators means that those teaching the curriculum must know the subject matter well and be able to communicate it effectively. Teachers must be confident that the message they are relaying makes a difference. Very few educators called to teach sexual education will have had professional preparation thus making pre- and in-service training invaluable. It is a must that sexual education teachers feel comfortable teaching the content outlined within their school’s program. Determining sexual education content can be a challenging process. The following is a small portion of the guidelines created by the National Guidelines task force. First and foremost, the task force defined the age groups for which they would focus each of the key concepts and topics. The following tables explain the age groups and curriculum used. Table 1 Age levels as defined by SIECUS, 2004 Level 1 Middle childhood Ages 5 through 8 (early elementary school) Level 2 Preadolescence Ages 9 through 12 (upper elementary school) Level 3 Early Adolescence Ages 12 through 15 (middle/junior high school) Level 4 Adolescence Ages 15 through 18 (high school) Table 2 Recommended Curriculum as defined by SIECUS, 2004 Key Concept 1: Human Development Topic 1: Reproductive and sexual Anatomy and Physiology

Sex Education

12

Developmental Message examples: Level 1: Each body part has a correct name and specific function a boy/man has nipples. A penis, scrotum, and testicles Level 2: During puberty, internal and external sexual and reproductive organs in preparation for adulthood. Level 3: Some sexual and reproductive organs provide pleasure Level 4: Hormones influence growth and development as well as sexual and reproductive functions. Topic 2: Puberty Developmental Message examples: Level 1: Puberty is a time of physical and emotional change that happens as children become teenagers. Level 2: Everybody’s body changes at it’s own pace. Topic 3: Reproduction Topic 4: Body Image Topic 5: Sexual Orientation Topic 6: Gender Identity Key Concept 2: Relationships Topic 1: Families Topic 2: Friendship Topic 3: Love Developmental Message examples: Level 1: People can experience different types of love Level 2: Feeling good about oneself enhances loving relationships Level 3: Love is not the same as sexual involvement, but it can happen at the same time. Level 4: Loving another person can be one of life’s greatest joys Topic 4: Romantic Relationships and Dating Topic 5: Marriage and Lifetime Commitments Topic 6: Raising Children Key Concept 3: Personal Skills Topic 1: Values Topic 2: Decision-making Topic 3: Communication Topic 4: Assertiveness Developmental Message examples: Level 1: Telling people about one’s feelings and needs is acceptable Level 2: Assertiveness is a skill that can be learned and improved Level 3: Being assertive in sexual situations may be especially difficult. Level 4: Sexual partners may need to assertively communicate their needs and limits. Topic 5: Negotiation Topic 6: Looking for help

Sex Education

13

Key Concept 4: Sexual Behavior Topic 1: Sexuality throughout life Topic 2: Masturbation Developmental Message examples: Level 1: Touching and rubbing one’s own genitals to feel good is called masturbation. Level 2: Some boys and girls never masturbate Level 3: Many negative myths exist about masturbation Level 4: People who are single, married, or in committed relationship may masturbate. Topic 3: Shared sexual behavior Topic 4: Sexual Abstinence Topic 5: Human Sexual Response Topic 6: Sexual Fantasy Topic 7: Sexual Dysfunction Key Concept 5: Sexual Health Topic 1: Reproductive Health Topic 2: Contraception Developmental Message examples: Level 1: Each family can decide how many children to have, if any Level 2: When a man and a woman want to have vaginal intercourse without having a child, they can use contraception to prevent pregnancy. Level 3: Young people can buy non-prescription contraception in a pharmacy, grocery store, market, or convenience store. Level 4: People can find creative and sensual ways to integrate contraception into their sexual relationships. Topic 3: Pregnancy and prenatal care Topic 4: Abortion Topic 5: Sexually Transmitted Diseases Topic 6: HIV and AIDS Developmental Message examples: Level 1: Once a person gets HIV, he/she will have it for the rest of his/her life Level 2: HIV is not spread by casual, social, or family contact, by insects, or by donating blood. Level 3: Some sexual behaviors that not involve exposure to another person’s semen, vaginal fluid, or blood (such as masturbation or hugging) pose no risk for HIV infection. Level 4: People can always reduce their risk of HIV infection by abstaining from certain behaviors, using condoms and other latex barriers, and using only clean or sterilized needles. Topic 7: Sexual Abuse, Assault, Violence and Harassment. Key Concept 6:

Society and Culture

Sex Education

14

Topic 1:

Sexuality and Society There is no Level 1 Curriculum for this topic Topic 2: Gender Roles Topic 3: Sexuality and the Law There is no level 1 or 2 Curriculums for this topic Topic 4: Sexuality and Religion Topic 5: Diversity Topic 6: Sexuality and the Media Developmental Message examples: Level 1: Some movies, TV programs and websites are not appropriate for children. Level 2: Parents have the right to decide what appropriate viewing material for their own children is. Level 3: Some television shows and movies provide positive models of relationships and sexuality. There is no level 4 curriculum for this topic Topic 7: Sexuality and the Arts There is no level 1 or level 2 curriculums for this topic. The previous is a very small portion of the guidelines presented by the guidelines task force. Each topic goes into much more detail within each age appropriate level. Sexual education is as important for the parents at home as it is for the students who receive it. As much as possible, parents need to be involved with their student’s sex education at school. Parents can be involved by participating in parent night. Most often schools offer a parent night where the curriculum that will be taught to their children can be previewed. This preview may include videos, handouts, and activities that will be used during the sexual education process. Often times, parents come away learning something they didn’t know previously and feeling more comfortable knowing their children will be taught age appropriate material. As a group, we feel that comprehensive sex education is better than abstinenceonly programs. Although both programs have advantages, we feel that in the long run children and teens will have more positive outcomes with comprehensive information.

Sex Education Teens are going to do what they want to do despite what we teach them. Hopefully, having more knowledge will lead them to make smarter choices whether they chose to remain abstinent until marriage or become sexually active before.

15

Sex Education

16

References

Advocates for Youth. (n.d.) Comprehensive sex education. Retrieved November 1, 2007, from http://www.advocatesforyouth.org/sexeducation.htm Advocates for Youth. (2007). The History of Abstinence-Only Funding. Retrieved November 9, 2007. (http://www.advocatesforyouth.org/rrr/definitions.htm) Advocates for Youth. (n.d.). Sex education programs: Definitions & point-by-point comparison, Retrieved November 1, 2007, from http://www.advocatesforyouth.org/rrr/definitions.htm American Psychological Association (2005). Based on the research, comprehensive sex education is more effective at stopping the spread of HIV infection, says APA committee Research shows that abstinence-only programs have a limited effectiveness and unintended consequences. Washington, D.C. Retrieved November 1, 2007, from http://www.apa.org/releases/sexeducation.html

Choosing the best. (2007). Research results. Retrieved November 9, 2007. (http://www.choosingthebest.org/research_results/index.html Constantine, N.A., Jerman, P., & Huang, A.X. (2007) California parents’ preferences and beliefs regarding school-based sex education policy. Perspectives on Sexual and Reproductive Health, 39 (3). Retrieved October 27, 2007, from http://proquest.umi.com.ezproxy.plu.edu/ Craig, Tim - Washington Post Staff Writer (2007, November 21). Va. GOP Assails Kaine on Sex-Ed; Abstinence-Only Funding at Issue. The Washington

Sex Education

17

Post,p. B.1. Retrieved November 21, 2007, from National Newspapers(5) database. (Document ID: 1386075251). Drolet, Judy C., & Clark, Kay. (Eds.). (1994). The Sexuality Education Challenge, Promoting Healthy Sexuality in Young People. Santa Cruz: ETR Associates. Hulton, L.J. (2007). An evaluation of a school-based teenage pregnancy prevention program using a logic model framework. The Journal of School Nursing, 23(2). Retrieved October 27, 2007, from http://proquest.umi.com.ezproxy.plu.edu/ Lindberg, L.D., Santelli, J.S., & Singh, S. (2006). Changes in formal sex education: 1995-2002. Perspectives on Sexual and Reproductive Health, 38 (4). Retrieved October 27, 2007, from http://proquest.umi.com.ezproxy.plu.edu/ National Public Radio/Kaiser Family Foundation/Harvard University Kennedy School of Government 2004 Poll “Sex Education in America”. Retrieved November 12, 2007. www.plannedparenthood.org Pregnancy and Childbearing Among U.S. Teens. (2006, January 1). Updated on 2007, September 18. Retrieved November 21, 2007, http://www.plannedparenthood.org/news-articles-press/politics-policyissues/teen-pregnancy-6239.htm Robb, Amanda (2007, October 18). Abstinence 1, S-Chip 0 :[Op-Ed]. New York Times(Late Edition (east Coast)), p. A.31. Retrieved November 21, 2007, from National Newspapers (5) database. (Document ID: 1367420201). Santelli, J.S., Lindberg, L.D., Finer, L. B., & Singh, S. (2007). Explaining recent declines in adolescent pregnancy in the United States: The contribution of

Sex Education

18

abstinence and improved contraceptive use. American Journal of Public Health, 29 (1). Retrieved October 27, 2007. http://proquest.umi.com.ezproxy.plu.edu/ Sexuality Information and Education Council of the United Dtates. (2004). Guidelines for Comprehensive Sexuality Education. Retrieved October 26, 2007. http://www.siecus.org/pubs/guidelines/guidelines.pdf Schafer, Ethan D (2006, May). Training Your Staff to Manage the Challenges of Adolescence. The Camping Magazine, 79(3), 32-37. Retrieved November 21, 2007,

from Research Library database. (Document ID: 1035897761).