Formal school-based sex ed in the United States was born of the...
Allegra Kirkland at TPM:
Formal school-based sex ed in the United States was born of the turn of the century social hygiene movement, a hybrid medical and moral project that hoped to eradicate social ills of the day. These ills included sex work and “social diseases” — a euphemism for STIs — which were sweeping the nation. Made up of Christian reformers and medical idealists, this reform movement was populated by individuals who shared both a goal — reducing rates of STIs — and practical advice: don’t have sex until you get married, and then only have sex with that person. This was the soundest medical advice of the day for a nation that didn’t freely endorse the use of condoms nor even freely admitted the sexual practices of its citizens.
By the 1920s, social hygienists were convinced of the value of teaching “social hygiene” or “sex hygiene” to young people — ideally at home, perhaps through churches, and as a last resort, in schools. This was highly controversial, and the beginning of the fissure that would dictate the debates we are still having and that I explore in my new book, The Fight for Sex Ed: how much information are young people owed? Does teaching about sex — and how to make sex safer — lead to more sex? Who should teach young people and sex, and where, and when? This debate in its many iterations raged on through the decades, and two primary factions formed: the “abstinence-only” camp, which held — and still holds — that young people should be instructed to wait until marriage to have sex, and are given little information other than that; and what is now called “comprehensive sex ed,” which is most crucially marked by the inclusion of information about contraception (and today is marked by being medically accurate, age appropriate, and inclusive.)
By the 1980s, this debate had crystallized into a political, religious, legal, and educational firestorm, though one that not many know about. The religious right came to embrace the term and concept of “abstinence only” sex ed, which was branding itself as a new concept. In 1981, thanks to political machinations on behalf of the religious right, federal funding was made available for abstinence only sex ed through the “adolescent family life act,” (AFLA) which provided funding for “research on teen-age chastity” as well as “the prevention of promiscuity.” This excerpt recounts some of the outcomes of that AFLA funding.
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Mast and Benn, along with other abstinence-forward proponents gaining in popularity through the 1980s, argued that their positive emphasis on abstinence was a welcome change from the assumption that all young people would have sex, which they claimed was the foundation of “traditional” sex ed programs.
Not everyone bought their arguments. The Shreveport Journal reported that when the sex ed subcommittee in Caddo County, Louisiana, examined Sex Respect in July 1986, some members “said the program underestimated the sophistication of teens and took a negative approach.” A Louisiana State University Medical Center doctor on the committee was quoted as saying that it “promotes guilt, fear and self-hatred” and “doesn’t invite you to have self-respect and learn to make decisions.
But for many conservatives, programs like Teen-Aid and Sex Respect offered attractive alternatives to what they had long decried as amoral, or immoral, sex ed curricula. So now, when school boards were faced with decisions about sex ed—whether to implement it at all, what textbook to use, and so on—they could choose between “abstinence only” or traditional sex ed. And thanks to AFLA funding, abstinence-only programs now had the endorsement of the American government and the appearance of legitimacy.
The School-Based Clinic Model
While [some] young people were receiving government-funded platitudes about abstinence, other American students were getting government-funded sex ed and comprehensive care through school-based clinics. Although this model didn’t gain national momentum until the 1980s, one of the earliest school-based clinics had opened in 1973, in a junior-senior high school in Saint Paul, Minnesota. The city had been home to the Saint Paul Maternal and Infant Care (MIC) Project since 1968. An article in Family Planning Perspectives described the MIC Project as offering “comprehensive, multidisciplinary health care to adolescents.” By 1980, the MIC Project had established clinics in two “inner city” senior high schools. Each clinic was staffed with a family planning nurse practitioner, a clinic attendant, and a social worker, among others. There were on-site day-care programs affiliated with the clinics, meant to “give the adolescent parents an opportunity to complete high school, and at the same time learn good parenting skills.” Funding for the project came from a number of sources, including Title V Maternal and Child Health (MCH) block grants, Title XIX funds, and Title XX funds for the day-care facility. State funding came from the Minnesota Community Health Services Act.
The MIC Project set out to “address the total health care needs of adolescents” and also “developed a comprehensive medical and educational program.” The results seemed promising. After two years, Laura Edwards, the director of the MIC Project, reported that “the clinic was being used by about two-thirds of 12th grade students and by more than nine in 10 pregnant students,” and “fertility rates among female students fell by 56 percent between 1973 and 1976—from 79 to 35 births per 1000.” Subsequent research found that the dropout rate for student parents fell “from 45 percent in 1973 to 10 percent in 1976,” and further, that “no repeat pregnancies occurred among those students who delivered with the project and returned to school.”
The MIC Project served as a model for other clinic projects nationwide. By 1985, Joy Dryfoos in the journal Family Planning Perspectives noted that “in at least 14 American cities . . . comprehensive health services—including family planning services—are being offered in clinics located in or near public high schools and junior high schools.” These clinics, Dryfoos noted, served patients who tended to be “from low-income families, a reflection of the neighborhoods in which programs are located.” Dryfoos also reported that, in a study of nine school-based clinics, all surveyed provided not only general medical care, like treatment of “minor acute illnesses” and physical exams for sports and employment, but also “individual counseling about sexuality [and] gynecological examinations. . . . They either offer contraceptive prescriptions in the clinic or refer students to off-site birth control clinics. . . . They perform laboratory tests, screen for [STIs], provide nutrition education and refer students . . . to social service agencies.”
Other clinics varied school to school. Some served as classrooms for sex ed. Most provided pregnancy tests, and many provided prenatal care. Many offered referrals to abortions, although lack of public funding for abortions made it hard for low-income students to actually receive them. And clinics that received funding through AFLA were, of course, prohibited from providing abortion counseling. One researcher noted that while such clinics would refer pregnant students to information about adoption, “teenagers appear to have little interest.” Although there was no long-term data on the clinics, as they were still so new, Dryfoos noted that the “school-based programs [had] been credited with improving students’ health, lowering their birthrates, raising their levels of contraceptive use and improving their school attendance.” At last, here in the school-based clinic was an evidence-based, research-backed solution to reducing adolescent pregnancies—the avowed goal of so many programs, organizations, municipal officials, federal policymakers, public healthcare workers, medical professionals, educators, and parents. The clinics were meeting young people where they were, providing them with the active care they needed to address their specific situations. As such, it was only a matter of time before the religious right began to decry them.
The Christian Right’s influenced helped hijack the sex ed in schools debate, as explained in The Fight for Sex Ed: The Century-Long Battle Between Truth and Doctrine book.
