Global Lessons for Sex Education in America
By Ryan Villarreal
The health, wellbeing, and rights of women in America hang in the balance this November, with the U.S. presidential candidates Hillary Clinton and Donald Trump offering vastly different federal agendas on sex education. “Clinton has been a lifelong advocate for women, children, and family health,” said Dr. Leslie Kantor, Vice President of Education at Planned Parenthood Federation of America, which has officially endorsed Clinton for president. “Donald Trump has made it very clear that he is no friend of Planned Parenthood—he has vowed to defund us. Sex education is certainly part of the key work that we do. Beyond that, I have not heard Mr. Trump make particular statements about sex education.”
Kantor expects that Clinton would continue supporting funding for evidence-based sex education programs. While it remains unclear what Trump’s position is on the issue, the GOP platform states, “We renew our call for replacing ‘family planning’ programs for teens with sexual risk avoidance education that sets abstinence until marriage as the responsible and respected standard of behavior.”
The candidates are entering an already fraught sex education environment.
Resistance to evidence-based approaches and cultural taboos around discussing sex have kept the United States from instituting nationwide progressive sex education. At the federal level, President Barack Obama has pushed to promote funding for comprehensive sex education (CSE) programs, but resistance in Congress among Republicans who support abstinence-only programs remains entrenched. In his 2017 proposed budget, President Obama cut federal funding for abstinence-only programs and increased funding for more comprehensive programs, though the budget must be approved by Congress.
“The importance of leadership from the White House can’t be understated,” said Heather Boonstra, Director of Public Policy at the Guttmacher Institute, a research organization focused on advancing reproductive health and rights in the United States and globally. “We saw that in the shift from [former president George W.] Bush to Obama. Under Bush, funding for abstinence-only programs grew and grew.” According to the Siecus Institute, a sexuality and sexual health research organization, Congress has spent over $1.5 billion on abstinence-only programs since 1981, under both Republican and Democratic administrations, though Siecus said the largest increase occurred under President Bush.
Currently in the United States, sex-ed policies vary from state to state, which has allowed for the implementation of socially conservative programs that promote abstinence-until-marriage as the primary method of avoiding unintended pregnancies and sexually transmitted infections (STIs). “Many of the more conservative, especially the abstinence-only, approaches depend on this paradigm of heterosexual marriage and reinforce retrograde gender norms,” said Boonstra. Such norms stigmatize female sexuality, hindering women’s access to sexual health information and contraceptives, which Boonstra said are major factors in issues ranging from unintended pregnancies to sexual assault.
Only 24 states and the District of Columbia mandate sex education, according to the Guttmacher Institute. When sex education is taught, whether mandatory or not, 26 states require that abstinence be stressed. Texas, for example, refers to its state-funded sex-ed program as “Abstinence Education” and does not require students to learn about contraception and STI prevention in the likely event they do become sexually active.
Boonstra believes that CSE is a more effective approach to informing young people about sexual health and behavior. CSE, as it is implemented in California and New York, for example, generally involves introducing medically accurate and age-appropriate information about sex and related issues to young people over time to promote a better understanding of responsible sexual behavior with an emphasis on avoiding unintended pregnancies and STIs. Boonstra pointed to California as an example of what is needed in a sex education policy. In 2016, comprehensive sex-ed became mandatory for grades 7 through 12 in public schools across the state.
Still, CSE advocates believe that programs should begin much earlier. “In the U.S., very few young people live in areas where they’re getting anything at the elementary school level,” Kantor said.
As the United States Debates Sex-Ed, the World Moves Forward
While the United States is caught in a partisan divide over sex education, other countries are taking the lead. Perhaps America should take instruction from them.
In western and northern European countries, CSE programs are typically the standard. In the Netherlands, for example, sex-ed programs can begin as early as kindergarten and are mandatory for all primary school students. Sex is not discussed explicitly with younger children, but concepts such as love and relationships are introduced. By age 11, sexual orientation and contraceptives are addressed, according to a PBS NewsHour report. Boonstra said such programs operate on the assumption “that you will become sexually active as a young person, and therefore the focus is how to best prepare you.”
These policies on sex education are well established in developed nations, but efforts are being made where they are truly needed in the developing world. With public health crises such as HIV/AIDS and the Zika virus, governments in the most affected regions have been pushing for more comprehensive sex education that could stem the spread of these sexually transmitted diseases.
Antón Castellanos Usigli, a public health advocate who has worked with the UN Population Fund (UNFPA), International Planned Parenthood Federation (IPPF), and other organizations to promote CSE globally, said the response to Zika in Latin America must go beyond prevention and change attitudes around gender roles and sexual consent. “It’s not only about condom use; you have to examine unequal power relationships where women aren’t able to speak up when it comes to having sex and to understand the implications of that.” Usigli said that progress is being made on that front throughout Latin America, and points to a 2008 conference where governments from the region met in Mexico City and agreed to ramp up CSE in their respective countries. IPPF has been monitoring efforts in the region to expand CSE and published its findings in a 2014 report.
In 2012, Costa Rica adopted a national sex education program for the first time, which IPPF highlighted as a sign of progress. “The curriculum approaches human sexuality in a comprehensive way, including lessons on human rights and gender equality, power and interpersonal communications, respect for diversity, and even pleasure,” the report said.
According to Usigli, cooperation with organizations like IPPF and the UNFPA were important in holding governments accountable and providing educational resources, but that involvement of civil society organizations within countries has been crucial in the process. “Mexico City was the first city to actually develop a handbook that contained a very comprehensive understanding of human sexuality,” he said. “It’s all been because of movements from civil society.”
Usigli pointed to a 2013 agreement between 20 countries in eastern and southern Africa as another example of a regional push for CSE. “Its success will depend on a very strong civil society movement monitoring the development of these commitments,” he said.
Empowerment Through Education
America’s debate over sex education could draw upon the lessons learned by other countries dealing with the consequences of a lack of sex education. Sexually transmitted diseases spread and endanger the population at large. Unwanted pregnancies contribute to inequitable societies in which women have outsized dangers and demands. They also prevent all of humankind from reaping the benefits of educated, consenting relationships.
“Sex education is such an incredible opportunity, when done correctly, to give people personal skills, critical thinking skills, chances to talk about what they’re experiencing in their lives,” said Kantor. “When we don’t have sex education, young people are not getting a chance to explore healthy relationships.”