For 40 years now, liberals and conservatives have waged war over sexual politics. Conservatives have fought bitterly against abortion, portrayals of sex in the media and sex education in public schools, castigating them as clear signs of national moral decay. They have promoted abstinence until marriage as the answer to everything from teen pregnancy to AIDS. With equal passion, liberals have championed women's right to abortion and teachers' right to discuss contraception and prevention of sexually transmitted diseases, insisting that such information is the answer to everything from teen pregnancy to AIDS.
The two groups' views appear diametrically opposed. But based on my five years of experience in family planning and teen sex education, and 25 years of writing about sexuality, it has become clear to me that the two sides are not the Hatfields and the McCoys. They're actually Romeo and Juliet, hailing from feuding clans but mainly in bed with each other. This may be a shock to readers with only a newspaper's-eye view of sexual politics, but when it comes to teens and sex, liberals and conservatives have very similar core values. Neither of their approaches to sex education makes sense (though the liberal view is a tad more realistic). And neither of their programs does much except create fear of sex.
Meanwhile, the best approach to teen sex education has been hiding in plain sight. It's the power of parents. Parents are by far teens' most effective sex educators. They're not perfect sex educators, but they're doing a better job than they did a decade or two ago, and a modest program of adult education could improve their effectiveness even more. Such an approach -- helping parents become better sex educators -- might even transcend the supposed liberal-conservative divide, and promote sexual responsibility to adolescents based on a concept completely foreign to both sides: the simple, elegant fact that contraception and STD prevention lead to better sex.
In the past few months, the nation's civil war over sex has taken two new turns. Both sides have won significant victories. Liberals triumphed in their 12-year battle to persuade the Food and Drug Administration to approve the French abortion pill known as RU-486. And conservatives notched a major win in sex education.
According to a recent report, in the 1990s school sex ed programs turned decisively away from "comprehensive" instruction, which includes contraceptives and STD prevention, and toward the conservatives' sexual panacea, abstinence until marriage. This news was published with great handwringing in the leading liberal journal Family Planning Perspectives, which is published by the Alan Guttmacher Institute, an ally of Planned Parenthood.
The Guttmacher report, released in September, was based on a survey of 3,754 sex education teachers in grades 7 to 12. It showed that in 1999, 23 percent of U.S. sex education programs taught abstinence until marriage as the only way to prevent pregnancy and STDs, compared with just 2 percent of sex ed programs that taught abstinence only in 1988. Moreover, many sex ed programs that do not insist on abstinence increasingly promote it: In 1988, 25 percent of teachers said abstinence was their "most important" message; by 1999, the figure had risen to 41 percent.
At the same time that the emphasis on abstinence-only sex education has risen, the rates of teen pregnancy and STD infection have fallen. According to the Centers for Disease Control and Prevention, the birth rate among teens has declined 18 percent since 1991, and the rates of chlamydia and gonorrhea infection (the two most prevalent STDs) in teens have fallen about 40 percent.
The result? Conservatives declare that their tunnel-vision approach to sex education is a big success. But this is a smug, delusional attitude. A closer look at the abstinence-only approach shows that it's about as effective in deterring teen pregnancy and STDs as a shredded condom.
Abstinence promotion began in earnest in 1997 with the $50 million in annual funding mandated by the 1996 Federal Welfare Reform Act. But teen STD rates have declined steadily since the late 1980s, and the teen birth rate began falling in 1991, years before the funding began, back when only a tiny fraction of sex ed programs preached abstinence.
There is also a great deal of evidence that abstinence promotion doesn't work. Abstinence-only sex ed is most deeply entrenched in the South, and less popular in the rest of the country. And guess where teens are most likely to become parents? In the South. According to the CDC, teen birth rates in Alabama, Georgia and South Carolina are two to three times the rates in Vermont, New York and Michigan.
Another recent report in Family Planning Perspectives addressed the results of an abstinence-only sex education program in New York that involved 312 middle schoolers. For four months, 125 of them participated in a daily small-group, 45-minute abstinence-promotion class. At the start of the study, there were no differences among the students in sexual experience, attitudes toward teen sex and likelihood of discussing sex with their parents. By the end of the course, however, key differences emerged: Compared with the students who did not take the class, those who did were more likely to discuss sex with their parents and more likely to disapprove of teen sex -- apparent support for conservative claims. However, one year later, those who had taken the class were just as likely to have become sexually active as those who had not. And participants in the abstinence-only class were more likely to have been involved in a pregnancy, though those results were not statistically significant.
The New York study is no fluke. In a 1997 report, researchers at the University of Nebraska at Lincoln evaluated outcomes of more than two dozen abstinence-only sex ed programs from 1985 to 1995. Their conclusion: The programs had no effect on teens' timing or amount of sexual activity.
Abstinence-only sex ed has become more popular as a political program, but as a formula for minimizing teen pregnancy and STDs it just doesn't work.
What about the liberal approach -- comprehensive sex education that includes information on birth control methods and STD prevention? As it happens, San Francisco, where I live, has one of the nation's most comprehensive sex ed programs. It runs from grades 5 through 8 and includes puberty issues, STD prevention (with a major emphasis on AIDS prevention) and all the contraceptive methods. In addition, middle school students do "the egg thing." They must carry a raw egg with them at all times for several days -- and not break it -- to drive home the point that caring for an infant takes over your life. (In my children's school, they now use dolls with computer-generated voices and timers that make them cry in the middle of the night.)
The kids get the point. By the time the egg (or the doll) thing is over, they're convinced they're not ready to become parents.
At my son's public middle school, the sex ed program culminated in the eighth grade with a visit from two 19-year-old women who'd had babies at 17. As part of a local program called the Teen-Age Parenting Project, these moms earn money visiting schools to discuss contraception and how parenthood has changed their lives.
My son's class hosted the young mothers last spring. Like so many teens, my son takes a dim view of adults telling him how to live his life. But he was impressed by the TAPP women. Six months after their visit, he still vividly recalls their regret over having become parents so young, their inability to afford cars or apartments of their own and their need to work to support their children, which has meant going to college at night and taking only one course per term. "They won't graduate for 12 years," my son explained. "That's almost as long as I've been alive." This is about as hard-hitting as school sex ed gets.
But if you scratch such "comprehensive" sex education programs, what you find is that they're not all that different from the abstinence-only programs. The fact is, "sex education" in this country is a misnomer. What we get from both sides of the social/political divide is dangers of sex education. Both liberals and conservatives agree on the dangers: sexual coercion, teen pregnancy and STDs. Both sides also agree that abstinence is the best defense against all those dangers. Then liberals weigh in with the mealy-mouthed notion that, gee, abstinence is just maybe a little unrealistic, so, kids, if you can't keep it zipped, please use contraception, particularly condoms, which prevent both pregnancy and STDs.
According to a survey of school superintendents published last year in Family Planning Perspectives, only 14 percent of school sex ed programs are "comprehensive," meaning that they give equal weight to abstinence and other birth control methods. Half (51 percent) promote "abstinence-plus," promoting abstinence as the best method while merely mentioning the others. Only 35 percent of sex ed programs are "abstinence only." In other words, two-thirds of school sex ed programs still discuss all birth control methods.
For all the handwringing over the recent rise of abstinence-only sex ed, abstinence-plus is the clear favorite in U.S. schools. Frankly, it's a mystery to me how comprehensive programs differ from abstinence-plus ones. As I mentioned, San Francisco's sex ed program is considered among the nation's most comprehensive, yet my son's teachers -- and the teen moms -- talked themselves hoarse promoting abstinence. My son was very clear on their message: "Abstinence is the only 100 percent effective birth control method. All the others can fail."
It's nonsense that abstinence is the only foolproof method of birth control. There's another way that's also 100 percent effective, not to mention popular, always available for free and enjoyable: lovemaking without intercourse. That is, mutual masturbation and oral sex. But even the most comprehensive sex education classes never mention those practices. Mentioning them would violate the fundamental axiom of American sex education, the principle that unites all sides far more than anything divides them, namely, that sex is basically dangerous for teens. To discuss mutual masturbation, fellatio and cunnilingus, sex educators would have to discuss sexual pleasure, which is absolutely verboten. A few years ago, Joycelyn Elders found out just how forbidden it is. She casually mentioned that because everyone masturbates, perhaps masturbation should be taught to children. Faster than you could say "spank the monkey," she was fired as surgeon general.
Sexual pleasure has no place in American sex education. It's the sole province of the mass media -- and the media is more sex-drenched than ever. Network programs directed at teens, among them "Friends" and "Dawson's Creek," are filled with sexual allusions, jokes and activity. Cable TV is even more sexually explicit, notably "Sex and the City," whose career-women characters don't waste their money on panties and wouldn't be caught dead without a vibrator in their purses. Teen-oriented popular music is equally sex-soaked. My 10-year-old daughter likes the song "Bad Touch" by the Bloodhound Gang, a hit on pop radio: "Put your hands down my pants and I bet you feel nuts. Yes, I'm Siskel, yes I'm Ebert, and you're getting two thumbs up. You and me baby ain't nothing but mammals. So let's do it like they do on the Discovery Channel ... You show me yours, and I'll show you mine. And we'll do it doggie style, so we both can watch 'X-Files.'"
Pornography is more mainstream than ever. Almost every video store stocks it. You may have to be 18 to rent it, but any kid can wander into the adult section and see hardcore action shots on the box covers. And the Internet has brought pornography into more homes than ever before. My Web-surfing teenage son has downloaded photos that would make Hugh Hefner's hair curl.
Compared with teachers tediously droning their way through sex ed curricula, sex in the media is much more compelling -- and arousing. In addition, time spent in school sex ed programs is a mere drop in the bucket compared with the amount of time kids spend tuned in to the media. Sex ed classes typically run for 45 minutes a day for a few months. But according to a recent analysis in the Journal of Adolescent Health, the typical teen spends more than six hours a day plugged into some form of mass media. The JAH found that about 9 percent of sex-laced TV shows mention contraception and STDs -- the rest ignore the risks of pregnancy and STDs.
For years, conservatives were alone in excoriating the media for promoting reckless sex. Recently, however, liberals -- including Vice President Al Gore and Sen. Joseph Lieberman -- have embraced a similar view. The real divide is between the sex-fearing liberal-conservative alliance and the sex-without-consequences media.
In addition to unprecedented access to sex-promoting media, today's teens also have more opportunity than previous generations did to "do it." When today's parents were growing up, most of their mothers stayed home, making private access to sofas and bedrooms logistically difficult. Today, however, most mothers work outside the home and many teens spend after-school hours at home without an adult in sight. Recently, I attended a party for a friend's 18-year-old daughter, who was going off to college, and the subject of teen sex came up. I waxed nostalgic about the back seat of my old '54 Plymouth. The teenager looked at me incredulously: "A car? Why didn't you just go to someone's house?"
Teenagers have more opportunity than ever to let their hormones get the better of them. No wonder the adult world is so nervous. No wonder school boards and teachers face so much community pressure about sex ed. And no wonder Gov. George W. Bush and Dick Cheney touted abstinence-only sex ed in their campaign while the Gore-Lieberman campaign wagged its finger at Hollywood.
Oddly, however, despite our sex-soaked culture, empty homes after school and the raging hormones of horny teens, the teen birth rate has fallen 18 percent over the past decade. The teen STD rate has fallen about 40 percent. And other CDC figures round out a reassuring picture: Intercourse among teens has fallen (from 54 percent in 1991 to 50 percent last year), and regular condom use among sexually active teens has increased considerably (from 46 percent in 1991 to 58 percent in 1999).
So, parents: Exhale. The sexual sky isn't falling. Despite all the cultural changes that could have teens humping like bunnies on espresso, today's adolescents are actually rather conservative sexually.
Why is this? Conservatives have rushed to take the credit, but as has been demonstrated, their program has proved worthless. Liberals have also rushed to take the credit. When the CDC announced that the teen birth rate had fallen in the 1990s, Planned Parenthood released a self-congratulatory press release. Not so fast. A cornerstone of liberal sex ed is promotion of abstinence, which is a proven bust. To believe Planned Parenthood, you'd have to believe that a few hours of exposure to contraceptives and STD prevention tips have had an impact greater than six hours a day of much more entertaining sex in the media. Unlikely. Bruce Springsteen put it well in "No Surrender": "We learned more from a three-minute record than we ever learned in school."
Some argue that legal abortion deserves credit. No way. According to the CDC, teens accounted for 33 percent of abortions in 1972 but just 20 percent of them in 1997.
Others credit AIDS for scaring teens celibate with the threat of death. Those who advance this view have clearly never parented teenagers. To be a teen is to believe utterly, totally and completely in your own immortality. Health educators have trotted out the death threat in anti-smoking campaigns since the 1960s. It hasn't worked. Teens have been much more responsive to cigarette price hikes and advertising campaigns depicting smokers as losers.
No one really knows why teen birth, abortion and STD rates have fallen so far so fast. But I think parents deserve the credit. They have been talking more with their children about sex -- and getting through to them.
Studies going back 25 years show that when parents discuss sex openly and frankly, teens listen and take what they hear to heart. They delay sexual activity and, when they become sexually active, are more likely to use condoms. The most recent evidence comes from a 1998 CDC survey of 372 sexually active teens around the country. Compared with those whose mothers did not discuss sex, the teens whose moms did were three times more likely to use condoms during their first sexual experience and 20 times more likely to use condoms subsequently. These numbers are much more impressive than the results of any school sex ed follow-up study. Indeed, they're large enough to account for the significant drop in teen births, abortions and STDs over the past decade.
Sex educators of all political stripes moan that many parents have trouble discussing sex with their children or refuse to do so. Hence the major push for sex education in schools. Clearly, some parents can't or won't discuss sex, and many are not very articulate on the subject. But I contend that to be effective sex educators, parents don't have to be all that good at it. They just have to try, even if it involves admitting their own discomfort with the subject. And baby boom parents are trying; they are discussing sex more than their own parents did -- even if they don't want to.
Events have forced the subject on them. During the 1950s, newspapers were virtually devoid of sex news. Today, it's difficult to open a newspaper or turn on the TV news and not see a story with sexual content: AIDS, other STDs, abortion, breast implants, homosexuality, pornography, Viagra, sex-change surgery, the Miss Nude America pageant and President Clinton's use of cigars. Some recent sex news has been amazingly graphic. AIDS forced the country to acknowledge the existence of anal intercourse.
While both sides continue to clash over the content of sex education -- mostly over how much to emphasize abstinence -- a survey released in October by the Kaiser Family Foundation found that most American parents want their children to receive more sex education than even the most "comprehensive" programs currently provide. The Kaiser survey of 4,000 parents and students found that in addition to information about STDs (supported by 98 percent of parents) and contraceptives (90 percent), 97 percent of parents wanted instruction on how to talk with kids about sex, 88 percent wanted teens to learn to negotiate safe sex with a partner, 79 percent wanted more information on abortion and 76 percent wanted discussion of homosexuality. The students said these subjects are rarely, if ever, addressed in school sex ed. No kidding.
Given the state of American sexual politics, the chances are slim to none that sex education in schools will ever provide what the parents in the Kaiser survey requested. If that's what parents want their kids to learn, they'll have to teach it themselves.
School sex education programs have focused on the wrong group. Schools should offer classes to parents on how to discuss sex with their children, especially since parents apparently make a much bigger impression on young people than even the most comprehensive sex ed program. As the Kaiser survey makes clear, parents want coverage of subjects that school programs won't touch. And since the students in the classes for parents would be adults, many conservatives' objections to sex education would vanish. From the perspectives of both public health and sexual politics, the most strategic approach to teen pregnancy and STDs is thus to help parents do a better job of discussing these issues at home.
If parents want to emphasize abstinence when they talk to their kids, that's their prerogative. But personally, I would present a much different perspective -- and have with my kids. I would focus on that wonderful gift from God, sexual pleasure. (I tell my children that sex is one of the greatest pleasures in life but that, like other pleasures -- for example, downhill skiing -- you have to do it carefully and responsibly.)
Every parent who has ever enjoyed lovemaking knows that the best sex emerges from mutual trust and deep relaxation. Who can trust a lover who doesn't care about contraception? Who can relax with a lover who isn't willing to take the minimal precautions necessary to prevent STDs? Contraception and safe sex are much more than just public health initiatives. Along with leisurely, playful, whole-body sensuality, they are the foundation of great sex.
This country sells everything with sex. Why not use sex to sell sexual responsibility -- one of the few places where a "sex sell" is truly appropriate. I suspect we'd have even fewer teen pregnancies and STDs if parents offered a sex-positive message: Embrace responsible sex because it enhances sexual pleasure. Such a message would not only further reduce our steadily falling rates of teen births, abortions and STDs but help our children grow up to be something they all want to be -- good lovers.
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