Keep the So-Cons Out of Sex Education

One of the cherished myths of the social conservatives is the one that says that the US, by "throwing God out of the schools" has been following in the path of godless, immoral cesspools of permissiveness like Sweden or the Netherlands. And in this context, I don't mean the good kind of myth, the kind of unifying historical narrative that brings a people together; I mean an outright falsehood. The truth is that by the US should be following the lead of such nations because, by almost any measure, they're doing a whole lot better than we are on issues like the breakup of the family, teen pregnancy, sexually transmitted diseases and so forth. So what does Europe do differently from the US when it comes to sex education? The Journal of Sex Research reports:

The Advocates of Youth--whose goal is to help young people make safe and responsible decisions about sex--and the University of North Carolina at Charlotte sponsored a study tour to learn about European approaches to adolescent sexual behavior (Berne & Huberman, 1999). Experts from the U.S. in adolescent health, teen journalists, and graduate students participated in the study tour and worked together to write a report of their findings. The three countries visited--The Netherlands, Germany, and France--all have significantly lower rates of STDs and teen pregnancy than does the U.S. In these countries teens are older, on average, than teens in the U.S. when they have their first sexual intercourse.

Adolescent sexual health in these countries is based on values of rights, responsibility, and respect. Government and the general society consider it not only a duty to provide accurate information and confidential contraceptive services to the young, but also that provision of such services and information to adolescents is part of their rights. There is no attempt to motivate behavior of teenagers through a collective effort to demand abstinence. Thus, the goal is not to prevent adolescents from having sex but to educate and thereby empower them to make responsible decisions. By respecting the independence and privacy of adolescents the expectation is that, in return, the majority will act responsibly to try to avoid pregnancy and STDs. The more tolerant attitude toward sexual expression of teenagers also makes it easier for them to get the services they need. Teenagers do not have to feel guilty or ashamed of using contraceptives. In fact, they will more likely feel they have been irresponsible if they fail to use it.

A similar approach has also been adopted in the Nordic countries, and it also has not led to promiscuity. In the Nordic countries as well as the previously mentioned study tour countries, public health policy is based on public health research and input from well-trained sex educators, not on political or religious definitions of moral behavior. In addition, these countries provide national health insurance that covers most of the costs of contraceptives and related services. The low cost and easy accessibility of services help adolescents take advantage of preventive health measures.

The Netherlands deserves attention, for it is the western country that has had the lowest rates of unplanned pregnancy, abortion, and teen pregnancy for quite some time (Jones et al., 1988; Ketting, 1994; Ketting & Visser, 1994; Singh & Darroch, 2000). In 1995 the teenage abortion and pregnancy rates in the U.S. were about seven times that of The Netherlands (29.2 vs. 4.0 and 83.6 vs. 12.2, respectively; Singh & Darroch, 2000). Dutch policy makers use research, pragmatism, and an ethics approach that tries to teach responsibility in sexual decision making as the basis for their sexual health programs. The goal is to allow an open discussion about sexual issues and encourage adolescents to talk about sex and topics that interest them. The attitude of the government is that both the public and families have a responsibility to help young people avoid unwanted pregnancies and STDs. The goal is to instill a sense of responsibility in the young and to give them the knowledge to act accordingly. It is also important that the general public is tolerant and accepting of teenage sexual experiences. The view is that it is impossible and quite ridiculous to try to prevent teenagers from having sex. Thus, the sensible action is to prepare them to act responsibly. Contrary to the view held by many in the U.S., this liberal attitude seems to be consistent with the findings that Dutch teenagers have fewer partners than their American counterparts and have their first sexual intercourse at an older age--15.8 for USA and 17.7 for The Netherlands (Berne & Huberman, 1999). Condom use does not vary greatly in the two countries but what distinguishes The Netherlands is that sexually active young adults use more effective contraception such as the pill at a much higher rate: 67% of sexually active female adolescents used the pill at their most recent intercourse in contrast to 20.5% in the U.S.(Berne & Huberman, 1999).

A major component in the Dutch approach to sexual health is their mass media campaigns. According to Berne and Huberman (1999, pp. 13-14), these campaigns help to "keep sexual health on the public agenda, reduce stigma by emphasizing community responsibility for health problems, serve in educating youth by providing catalysts for discussion and reinforcing messages, reach higher risk groups not generally accessible through traditional channels, encourage intermediaries (teachers, youth workers, pharmacists) to draw attention to safer sex, and stimulate organizations to provide training and education to intermediaries." One of the media campaigns in The Netherlands popularized the use of the slogan "double dutch"--meaning to use the double protection of a condom (to lower STD risk) and the pill (for protection against pregnancy) when having sex. Media campaigns are well coordinated with the education and health sectors to ensure consistency and accuracy of messages to the young.

Additional strategies used by clinics that provide sexual health services to Dutch youth include (a) accept teen sexuality and sexual behavior, (b) guarantee anonymity or confidentiality, (c) waive PAP smear and pelvic exams as prerequisites for initial contraceptives, (d) provide nonjudgmental service, and (e) require minimal paperwork and no parental consent (Berne & Huberman, 1999).

Because The Netherlands has many port cities, STDs have been a major public health concern. To keep health risks minimal, accessible and government-funded STD clinics provide testing, treatment, education, pre- and posttest counseling, and contact tracing. National Public Health Insurance (which covers over 99% of the Dutch population) funds all reproductive health services except condoms. These include contraceptive pills and devices, emergency contraception, abortion, testing for pregnancy and HIV/STD, prenatal care, delivery, and all drug therapy associated with diagnosis and treatment of STD, HIV, and AIDS (Berne & Huberman, 1999). These authors also stress that the AIDS case rate per 100,000 is several times higher in the U.S. than in The Netherlands.

Compare that to the United States with our puritanical attitudes toward sex and federal funding for abstinence-only education. How bad is American sex ed? This bad:

Fewer than half of public schools in the U.S. now offer information on how to obtain birth control, and only a third include discussion of abortion and sexual orientation in their curricula. A large, nationally representative survey of middle school and high school teachers published in Family Planning Perspectives reported that 23 percent of teachers in 1999 taught abstinence as the only means of reducing the risk of sexually transmitted infections and pregnancy, compared with two percent in 1988.

The result is predictable. As those studies noted, the rates of teen pregnancy, teen abortion, and STD and AIDS infections in the US range from more than double the rates of these other nations to more than seven times their rates. While the social conservatives in the US want us to believe that the permissiveness of these societies is the source of immorality and rampant promiscuity, teenagers in those societies not only start having sex later on average than in the US, they also have fewer partners.

There is more than mere irony at work here, there is also tragedy. The US is the only Western nation where abortion is even an issue; in every other nation, it's virtually a given that a woman has the right to an abortion. Yet the US has the highest abortion rates in the western world by a huge margin. All the more bizarre, then, that the same voices who want an end to abortion also want an end to what little comprehensive sex education we do have in the United States. And can you imagine the reaction from the religious right if the government began airing regular public service announcements urging teenagers to use condoms and offering free and anonymous birth control and STD testing? They'd lose their minds over it. But the facts don't lie. Such policies dramatically reduce teen pregnancy and incidence of STDs and AIDS infections.

This is not just another battle in the culture war. This isn't a meaningless fight over religious symbols in a public square or who gives the opening invocation at a city council meeting. This is the health of our children on the line, and the reactionary prudishness from the religious right and their allies is damaging our children, and their own, at a rate unheard of in the rest of the civilized world. Their naive and childish view of human sexuality is destroying large parts of multiple generations of children, one after the other, and it must be stopped.

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"The view is that it is impossible and quite ridiculous to try to prevent teenagers from having sex."

Exactly - this is what seems so stupid about the americans fancy for abstinence programs. That you somehow encourage youths to have sex if you educate them on contraceptives etc. I'm 31 now, but I still remember being a teenager. You naturally think about sex - theres no stopping it. And unless teens in the US are somehow mentally retarded (now I'm being unfair to the mentally retarded), they do not need help in figuring out how to have sex.

So we have a bunch of horny teenagers, and what do you do? you say, hey lets NOT tell them how to protect themselves, and then they wont do naughty stuff?

In 8th grade I remember being sent to the school nurse with a small group of other boys, where we were encouraged to ask about anything. After talking about girls, periods, wet dreams, AIDs and condoms, we where supplied with a condom each and send back to class. And this was on top of the general sex ed, which took place in biology class.

Well for once I can be glad I'm from Denmark ;)

By Soren Kongstad (not verified) on 08 Dec 2004 #permalink

How do you explain the success of abstinence education in Africa? I'm not in favor of abstinence-only education but I hear a lot about Africa when it is touted. Thanks.

By Matthew Phillips (not verified) on 08 Dec 2004 #permalink

Exactly - this is what seems so stupid about the americans fancy for abstinence programs. That you somehow encourage youths to have sex if you educate them on contraceptives etc. I'm 31 now, but I still remember being a teenager. You naturally think about sex - theres no stopping it. And unless teens in the US are somehow mentally retarded (now I'm being unfair to the mentally retarded), they do not need help in figuring out how to have sex.

So we have a bunch of horny teenagers, and what do you do? you say, hey lets NOT tell them how to protect themselves, and then they wont do naughty stuff?

In 8th grade I remember being sent to the school nurse with a small group of other boys, where we were encouraged to ask about anything. After talking about girls, periods, wet dreams, AIDs and condoms, we where supplied with a condom each and send back to class. And this was on top of the general sex ed, which took place in biology class.

Well for once I can be glad I'm from Denmark ;)

I think it's an idealistic goal, but what they hope for is just to eliminate pre-marital sex through the method of cold turkey. So it always comes back to wanting to roll society back "to the good ole days" with them. But what you wind up with is a country of people who suppress their natural sexual desires and then wind up molesting children.

By Matthew Phillips (not verified) on 08 Dec 2004 #permalink

How do you explain the success of abstinence education in Africa? I'm not in favor of abstinence-only education but I hear a lot about Africa when it is touted. Thanks.
This is the first I've heard of anyone claiming that abstinence-only education is successful in Africa. In what countries? Given the astonishing rate of STD and AIDS transmission in much of Africa, I find it highly doubtful that this claim has any support.

There is no relationship between repressing natural sexual desires and molesting children. Pediphiles are in a class by themselves, unrelated to any other sexual characteristics or practices.

This is the first I've heard of anyone claiming that abstinence-only education is successful in Africa. In what countries? Given the astonishing rate of STD and AIDS transmission in much of Africa, I find it highly doubtful that this claim has any support.

Uganda I believe is their primary example of a reduction of HIV. I will try and find some articles about it. It could be a complete fabricated claim for all I know, but I do recall hearing about it when the praises of abstinence are sung.

By Matthew Phillips (not verified) on 08 Dec 2004 #permalink

There is no relationship between repressing natural sexual desires and molesting children. Pediphiles are in a class by themselves, unrelated to any other sexual characteristics or practices.
I quite agree with this. I do think that there is a connection between, for example, priestly celibacy and pedophilia, but it's not the one most people tend to make. The celibacy does not cause pedophilia, it attracts pedophiles. And the reason it does so is because most pedophiles want to stop and can't. So there is a portion of them who view the celibate priesthood as a refuge from their troubled sexuality and hope that by denying their sexual urges all together, they'll go away. Unfortunately, this doesn't work, and all it really does is put them into easy contact with a lot of potential victims.

I did a google search of "Uganda abstinence" and came up with a variety of articles from religious websites. Here's one such article:

http://www.crosswalk.com/news/religiontoday/1180592.html

I feel I was most likely duped and that the programs in Uganda were not abstinence-only. A google news search revealed an ABC program, with the C standing for condoms.

By Matthew Phillips (not verified) on 08 Dec 2004 #permalink

From what I have read, Dutch society is actually quite conservative. Not in the wacky version that passes for conservatism in the US, but in a realistic

[quote]How do you explain the success of abstinence education in Africa? I'm not in favor of abstinence-only education but I hear a lot about Africa when it is touted. Thanks.[/quote]

Africa is a good example of the problem of abstinence-only education. From what I've heard women are to a high degree being abstinent and faithful to husbands, but are still contracting HIV at a high rate. This is because their husbands are not being faithful and the women have no education or power to protect themselves from their husbands' diseases.

Africa is actually a good example of how American puritanism is hurting the rest of the world. Since Bush policy refuses to fund any sex education program in the world that is even remotely connected with abortion. Thus many good, effective education and health programs in the third world are starved for funding. Yes, it is generous for the US to supply cash for such programs in other countries at all, but if it was done with more intelligence it would do far more good.

Ed claims that pedophiles have no free will. On what basis is this claim made? Because they say so? And if this claim is indeed true, why are pedophiles sent to prison? Isn't it cruel to punish someone for something they can't help?

By Mark D. Fulwiler (not verified) on 12 Dec 2004 #permalink

Mark wrote:
Ed claims that pedophiles have no free will. On what basis is this claim made? Because they say so? And if this claim is indeed true, why are pedophiles sent to prison? Isn't it cruel to punish someone for something they can't help?
No, I did not say that "pedophiles have no free will". I didn't say anything about free will (an infamously difficult thing to define) at all. What I said was that most pedophiles want to stop and can't, and the basis for that statement is a good deal of research I did on the subject many years ago. What I recall from that research is that a lot of pedophiles are tormented by their behavior and that they often will write in diaries or letters things like, "I wish someone would stop me". Many of them even leave behind obvious clues that allow them to be caught, perhaps as a result of this. It also is based on interviews I've read of a couple of former priests who had molested children, where they said that they entered the priesthood because they knew that their sexuality was toxic and dangerous and they hoped that by becoming celibate and just denying themselves any sexual outlet, it would prevent it from manifesting itself. They were wrong, of course.
None of that has anything to do with "free will", any more than the fact that someone has a drug addiction they can't shake means they don't have "free will". I was agreeing with Wilma that pedophilia is a unique sexual dysfunction, unrelated to any other type of sexuality. Pedophilia cannot be understood through the prism of heterosexuality or homosexuality, for instance, because it is independent of either. A homosexual pedophile and a heterosexual pedophile are the same, and in neither case is it related to either heterosexuality or homosexuality.
As far as the question of why we send pedophiles to prison, I don't think there's any connection at all between that question and what I said (because, again, I wasn't talking about free will). I would regard it as pretty much the definition of insanity if someone were to argue that pedophiles should not be imprisoned because they "can't help themselves" or any similar argument. In fact, I would argue the opposite. Because pedophilia is such a unique and immutable trait (thank goodness limited to a tiny minority of the species) and is, in my view, unchangable and incurable, imprisonment or capital punishment are the only sane ways to deal with it. Nothing short of that could possibly protect others from them. They cannot be rehabilitated, they can only be separated from any potential victims.

Sorry Ed, but if you say that someone ~cannot~ stop a behavior, that implies a ~total~ lack of free will. Do you think it is ~impossible~ for a pedophile to stop molesting children? If so, then they don't have any free will by my definition, and while it might be necessary to lock them up someplace for the protection of society, placing them in the prison system would seem to be cruel.

Let me give you an analogy. It is ~impossible~ for me to jump to the moon. Correct? The laws of physics won't allow it. But is it ~impossible~ for me to control my sexual behavior? Is it ~impossible~ for a pedophile to control his behavior? Do you really mean ~impossible~ (not possible, can't be done), or do you mean ~difficult~? There is a world of difference.

Why would it surprise anybody that people involved in a horrible, socially disapproved behavior would try to get sympathy by claiming that "they can't control themselves." It's sort of like the murderer claiming that the "devil" made him do it. The "insane" criminal we pity, the sane we loathe.

By Mark D. Fulwiler (not verified) on 13 Dec 2004 #permalink

Mark, you're overthinking this significantly. My statement wasn't really all that controversial. When I said that most pedophiles want to change but can't, I wasn't implying some metaphysical impossibility. To say someone can't do something might mean they don't have the will to do it, but in this case it means they don't have the ability. Now I don't pretend to know everything that goes on in the head of a pedophile by any means, I just know that many of the experts I've read on the subject in the past have said exactly what I said, that the typical pedophile is aware that they are sick and often behave as though they want to be caught because they know that's the only way they'll stop.
From that, you conclude that it would be cruel to punish them for their crimes, and I conclude the exact opposite. Because a pedophile cannot change his behavior, or have it changed by anyone else, the only thing you can do with them is imprison them so they can't victimize anyone else. You can call that cruel if you want, but it would be far more cruel to allow him to continue to ruin other people's lives. In the real world, there is ambiguity. Welcome to life.