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Only 13 States Require Sex Ed to Be Medically Accurate

And half the country is pushing abstinence-only, which, STD rates have shown us, is not exactly effective.

Letizia Adams

Emilio Santoyo

It starts at birth. Your parents, flustered and too focused on not dropping you to worry about how this may affect you, used terms such as "privates," "hoo-hoo," or "weenie" to refer to human genitalia. While psychologists wanted them to use the actual words, comfort trumps psychology any day. No harm done—you eventually acquired the terms "cooch" and "dong" later in life anyway, so technically, they prepped you right. But at some point, sex ed has to get medically accurate. Or does it?

Regarding our educational system: Since there's no national standard in the US on who gets taught what (or when they get taught), kids get a range of information depending on where they live. Some of it accurate, some of it too prim to be of much practical help, and some of it just downright reckless.

That's what Michigan mom Alice Dreger discovered when she sat in on her freshman son's high-school class. Michigan is one of several US states that permit parents to attend sex ed classes if they want to vet what their kids are being taught. In Dreger's case, she went in expecting the worst—and was not disappointed. As the instructors alternately slut-shamed sexually active girls and warned of dire consequences for boys, she live-tweeted her shock and horror.

"You'll find a good girl. If you find one that says 'no,' that's the one you want." HE ACTUALLY JUST SAID THAT," Dreger wrote about a male teacher's message to the class.

"I can't stand this…The whole lesson here is 'sex is part of a terrible lifestyle.' Drugs, unemployment, failure to finish school—sex is part of the disaster," Dreger tweeted from inside her son's East Lansing classroom.

"I need a drink," she added, as the class ended.

Dreger's reactions brought home the significant and serious flaws in America's sex education system, such as it is. Twenty-five states in the US mandate that some form of sexual education be taught in public schools. In other states, such as Alaska or Arizona, school districts can choose to teach sex ed if they wish, but it's not required by law. In Alaska, the state doesn't offer any specific guidelines to those districts that decide to teach it, while in Alabama, if classes are given, they must stress abstinence, according to the Kaiser Family Foundation, a non-profit health organization.

In fact, 37 states insist that abstinence be part of the curriculum. Of those, 26 mandate that classes "must stress" abstinence (the rest only say that it must be covered). The role of abstinence in sex-ed classes can be really damaging if not presented as just one of many options open to students, says Laura Lindberg from the Guttmacher Institute. Putting too much emphasis on "saying no" and waiting for marriage can do more harm than good. "Programs and policies that promote abstinence until marriage…have repeatedly been shown to be ineffective and actually harmful to young people," Lindberg says. "The programs are stigmatizing and some have even been shown to have negative sexual impact. And if they don't teach about contraception, they are withholding medically important information and that can be very damaging."


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Lindberg was one of several medical professionals to partner on a collaboration of two different studies released by Columbia University last month that showed that abstinence-only-until-marriage programs and did little to delay sexual initiation or reduce sexual risk behaviors. "As a position paper…it emphasizes that providing ethical medical care to young people means you can't withhold information from them because of their age," Lindberg says.


Yet across America, there's a huge range in what kids are taught and how detailed the information is, research has shown. The patchwork approach has left gaps, particularly in Red states in the Bible Belt, Lindberg says. "Policies are generally set within the school district. The state might set laws on whether there should be sex ed, but it's up to the school districts to decide how those classes should be implemented. It can be a very divisive issue," she says.

There do exist federal guidelines and expert opinion on what details and materials should be introduced at specific ages—an attempt to give some structure to finding an "age-appropriate" curriculum, Lindberg adds, "but one of the points I like to emphasize is that in many school systems, sex ed is provided too late. It's reaching teens after they have already had sex. It misses the boat and young people need a full set of information before they reach the age of sexual activity."

There are in fact only 13 states in the US, including California, Colorado and (surprise!) North Carolina, that require sex ed classes to include information that is medically, factually and technically accurate, but state definitions of what is medically accurate can vary widely. Some might require that lessons be reviewed by a state department of health; others simply say that information must be drawn from "published authorities." In a whopping 36 states, parents can sign waivers to have their kids removed from sex ed classes. Only two states, California and Louisiana, specifically prohibit sex ed classes from promoting religion as part of the program.

Horror stories from sex ed class are everywhere on the internet, and at least one awkward or side-splitting moment seems to be a universal requirement for high school graduation (e.g., that time a student confidently informed another that women have orgasms from using tampons, or when one teen asked if jerking off to a picture of their own dick is gay). Yet in some states—even when prohibited by law—there are teachers trying to do it right.

When Mississippi passed a 2011 sex-education law that forced schools to give abstinence-based education and banned the use of condoms for in-class demonstrations, Sanford Johnson, a deputy director for Mississippi First, an education non-profit, started teaching students about the best way to don a sock for anyone about to engage in "shoe activity." Johnson posted a video to show kids how to "pinch the air out of the tip of the sock" and then "roll the sock all the way down your foot." At the time he made his video, which never once mentions the word condom, Mississippi had the second-highest rate of teen births. While Johnson's video has been viewed 1.5 million times, we probably can't give him full credit for the fact that the state has now fallen from second to third, behind Arkansas and Oklahoma. It's innovative teaching methods like his, though, that have been a big part of the positive shift.

A new push among educators for a more comprehensive and holistic approach to sex ed has brought some parts of the US in line with how kids are taught about sex in northern Europe, which has long been considered by medical experts as far more advanced in its approach. Pregnancy rates continue to be higher in the US than in most European nations, and that's due in part to early exposure to comprehensive sex ed in the latter, Lindberg says. "Some sex ed here is very good, and there's an increased emphasis in the field on using evidence-based approaches that have been shown to have positive results, so that's the better side of this," she adds.

Thanks to increased research that's traced the failings of abstinence-heavy teaching, educators in the US are talking now about developing the "softer skills" of sex ed. "Programs tend to overemphasize the plumbing aspect of sex. What we would like to see more inclusion of is the decision-making and communicating that is a big part of having a healthy approach to sex. We want kids to have the skills they need to do that," Lindberg notes. "In Europe, sex ed begins early and is integrated as health information. We in the US, on the other hand, save it all up for one 60-minute lecture in the 11th grade. It's unreasonable and unrealistic to think we can meet young people's needs with a 60-minute presentation."

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