The necessity of comprehensive sex education in the United States

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In 2014, there were nearly 250,000 teen births in the United States, with an average of 24 births per 1000 girls. Billions of dollars are spent on costs associated with teen pregnancy each year – including health costs, child welfare costs, and many more costs with various social implications. Additionally, studies show that only 38% of teenage mothers graduate high school, and children born to teenage mothers are at higher risks of becoming teen parents and not finishing high school, themselves.

Though the number of teen pregnancies each year has recently dropped, significant improvements can still be made. One area that can have a great impact on these statistics is sexual education in public schools, at both primary and secondary levels. Studies performed by the Guttmacher Institute show that there are a number of discrepancies in the efficacy of sex education from state to state. For instance, while 21 states mandate sexual and HIV education, only 17 mandate education on contraceptive use, and 26 states stress abstinence-only education. The most alarming of these findings, however, is that only 13 states mandate that sex education (when provided) must be medically accurate, and 10 states have no requirements for sex or HIV education. This information is especially significant when taking into account the states with the highest teen pregnancy rates.

Image Credit: Kate Prengaman/XlyemBlog

Image Credit: Kate Prengaman/XlyemBlog

In order for these numbers to improve, the approach to sex education in public schools in the United States must change. Comprehensive, medically-based, and factual information should be taught, starting at a young age. Though some may argue that parents have the right and responsibility to teach their own children about sex, it is clear that current methods of sex education are not adequate. By strengthening comprehensive sex education to all children and teens, the teenage pregnancy rate will decrease, which will bring about a number of positive changes: more young women will have the chance to finish high school and will have more opportunities available to them, which will help protect against poverty, and can decrease child abuse and neglect rates, and will minimize the economic burden of teenage pregnancy, as well.

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7 Responses to “The necessity of comprehensive sex education in the United States”

  1. monicacmix Says:

    As a primary care physician, I see the effects of unintended adolescent pregnancies far too often. However, my location in Baltimore – a city where comprehensive sex education has been embraced – highlights for me that sex education is a necessary, but not sufficient step, in preventing unintended pregnancies. Knowledge must be combined with an ability to act on that knowledge through effective, affordable, and accessible contraception. Recent data from a program in Colorado that provided free long-acting, reversible contraceptive (LARC) methods, including IUDs and Nexplanon, demonstrated not only that adolescents were eager to use these methods, but that the provision of these methods led to a forty percent decrease in teenage pregnancies in the state in only four years (https://www.guttmacher.org/pubs/journals/46e1714.html). Improved sex education is important, but it can only have an impact if adolescent are also given the necessary tools to act.

  2. cgoh2 Says:

    The above graph has clearly highlighted the geographical relationship between abstinence only education and lower income as some of the socioeconomic factors that are related to high teenage pregnancy in the USA. Certainly, there are still inadequacy in the current methods of sex education. It will be interesting if more information can be obtained to understand if the incidence of pregnancy can be affected by the age which the sex education was introduced in class, whether at a much younger age, or at the age range which girls are experiencing puberty etc? This forms an important consideration in which different policies and specific campaigns can be better targeted.

    Agreed that the parents do play an pivotal role in providing the children the right values in sex education. More importantly, it will be useful to understand further if the cultural setting has played a crucial role in such trends. For example, certain ethnics groups or social upbringing may be more conservative and less forthcoming in sharing with the children on how they should behave and the use of contraception. In such community, the religious and local community leaders can help the health authorities to bridge with the local tradition and culture in advocating the right attitudes and responsibility towards sexuality in teenagers. Given the right buy-in, the community who may be of mixed position (due to differing opinions within the community) may work collaboratively in support of the policy.

    Also, any environmental setting, such as drinking pubs or where there are available contraceptive vending machines essentially creates opportunities for sexual interaction/behavior. Whilst this is arguably controversial, the strong support and involvement of the governmental bodies becomes necessary to reinforce the responsibility of teenagers towards sex while providing access to contraceptives.

  3. shanraym Says:

    As someone who works in family planning, a significant source of frustration for me comes from individuals who do not want comprehensive sex education taught in schools because they believe it promotes sex. Knowledge of a thing does not necessarily require positive feelings towards that thing. What springs to mind is all of the anti-smoking and/or anti-drug education that is done in our schools. The belief behind those programs is that if kids know about the dangers associated with the behavior, they are less likely to engage in that behavior. And while engaging in sex does not necessarily have the same direct negative health consequences as smoking, familiarity with the risks associated with sexual activity may in fact promote “better” behavior (condom use, LARC use, etc.). Therefore, we should be educating our kids about sex so that they can identify where the risks are, and who they can contact if they have questions or concerns. By not adequately addressing the subject in schools, we are leaving youth and teens to find answers from their equally inexperienced peers. That system of censorship and avoidance around sex results in inaccurate and dangerous information being passed around.

    In addition, abstinence-only education has been proven time and time again to be ineffective. Oftentimes these abstinence programs promote abstinence by way of shaming teens who have had sex. For a great piece on the (awful) state of sex education in the US, I recommend that people check out John Oliver’s piece from Last Week Tonight (note: this show is on HBO and some language may be considered offensive)– https://www.youtube.com/watch?v=L0jQz6jqQS0. The main takeaway from this video for me is that yes, adolescents and teens need sex education which provides them with the medically accurate information on pregnancy, STIs, and other risks associated with sexual activity; however, we should also be educating our children on the existence of sex as a normal part of many adult lives, and that it is perfectly normal and acceptable to have sex as a consenting adult. Children need to be taught that sex can be a part of a healthy adult lifestyle, but that there are very real and very serious risks associated with sex including pregnancy, STIs and HIV, herpes, and HPV.

  4. nikettaw Says:

    It will be interesting to observe the response that teenagers and adolescents have on the various approaches to sex education in a school setting. Having a focus group to test out some of the tools currently available along with some new approaches will provide a better idea on how well it is received. We often force new ideas and policies onto teens without first receiving their input on what is most comfortable for them and in what settings. Learning about sex around adults and parent figures can maybe make some teens uncomfortable with the subject matter. Most parents push for abstinence so a teen that is sexually activity may shy away from openly discussing sex with teachers or staff in the school setting. Sex education in school is definitely a better approach than none at all, but I wonder how much more effective it will be in an off-campus setting.

    I was once a part of a cohort study during my undergraduate studies that was conducted through my health insurance company that focused on safe sex education. During each meeting/visit we were tested for sexually transmitted diseases (STDs) and then educated on the various types of contraceptives and ways to discuss safe sex and STDs with your partner. At the end of each session, the instructors provided goodie bags with condoms, pamphlets, and other new gadgets to encourage safe sex. We once received a condom case that looked like a mirror, so really addressed the embarrassment that some young women had in purchasing or carrying condoms. The course was conducted in a very comfortable and intimate setting that allowed for great exchange of experiences and open discussion amongst my peers.

    I share this information to state that we possible implement sex education into the school systems similar to driver’s education, where it’s conducted at a different facility away from the school and maybe a more comfortable environment in which the students can openly ask questions and discuss sex without having the image of their teachers and parents. I think this will reenforce the “coolness” of safe sex and not only focus on the educational aspect but will increase the actually change in behavior for the students.

  5. magbailon Says:

    As a parent and a healthcare professional, I could not agree more on this issue. I see the detrimental results of the lack of a medically accurate sexual education for our children every day. At my daughters school, for instance, a health course is offered once in middle school and once in high school and that’s just not enough for preventing pregnancy. As a matter fact, our county has the second highest rate of teenage pregnancy in the state of Washington. Let’s us not forget that our kids will receive sexual education, without exception. If they don’t get it from parents and schools, they will get it from TV, the internet, and their friends. We live in a media saturated world in which sexual behavior is frequent and increasingly explicit. Children in the United States spend 6-7 hours a day, on average, with some form of media. So the question is not if we want sexual education or not, the real question is whether we want education to come from people who are prepared for that role and actually care about the children, or whether we want to leave it up to mass media and other children.

  6. woolleyliz Says:

    I completely agree that sex education should be mandated in all US schools. Not only is this key for reducing teenage pregnancy, but is also an important component of HIV/STI prevention. Everyone deserves to know what places them at risk and methods for reducing risk, and this starts at school age. Sex education and HPV vaccines are also clearly politically charged topics in the US, so that even as strides are made in some areas or with certain administrations, those often become erased when administrations change. I wonder if there are strategies to reduce politicization of sex ed, HPV, and even free contraception options (as was done in Colorado). This would probably require changing where or when sex education is provided, or where it can be regulated. Clearly there have been some successes – perhaps these can be used to inform initiates.

  7. atrueb Says:

    I was very excited to read your posting as this topic hits close to home for me. In college I participated in a club that would teach sexual education to Boston high school students who did not receive any from their curriculum. It was not just the lack of information, but the misinformation that was most shocking. Topics that I thought were straightforward, such as rape, would be surrounded with misconception and uncertainty that truly startled me. I think a huge component of sexual education that is incredibly important for youth and that all policy makers can stand behind is education on communication skills and relationship building. Focus on these topics provides students with life skills in building respectful relationships free of coercion or intimidation, and in making healthy decisions about their sexuality.

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