Sex Education 1

Running head:
 Sex Education 2

Erin Boyle

Erica Ely

Christina Karanasos

Heidi Long

Jennifer Pena

Devyn Shook

Rebecca Waggoner

Pacific Lutheran University

 Sex Education 3

The purpose of this paper is to explore the issue of sex education in the public

school system. This is an important issue because teens are becoming sexually active at

younger ages. The incidence of teenage sex and sexually transmitted diseases (STDs) is

alarmingly high. By age seventeen, over 50 percent of teenagers have engaged in oral

sex, between five percent and 30 percent of thirteen-year-olds have had sexual

intercourse, and more than nine million new cases of STDs are contracted by Americans

between the ages of fifteen and twenty-four every year (Shafer, 2006). The amount of

teenage pregnancies is also very alarming. “The teen pregnancy rate in the U.S. is the

highest among the most developed countries in the world… and despite recent declines in

teenage pregnancy rates, 31 percent of American teens still experience pregnancy

(Planned Parenthood, 2006)”. Sex education for kids and teens has been an extremely

controversial topic, mostly due to the fact that there are many conflicting views between

parents and educators. Most people agree that American school systems need to have

some kind of sexual education program, and most do, the question is, what kind?

One part of a nurses’ role is to act as an educator. This means ensuring that their

clients have proper information when it comes to sexual education. Nurses are currently

seeing more and more young people presenting with sexual health issues that may

potentially take a negative toll on the rest of their lives. It is frustrating for nurses to see

these kids suffer because they had incorrect information, or no information on the

consequences of sexual activity. School nurses play a large role in the sex education (sex

ed) programs in schools. School personnel look to school nurses for providing accurate

information to use in their programs.

 Sex Education 4

There are currently two different types of sex ed programs being taught in the

United States. Comprehensive sex education programs emphasize the importance of

abstinence while also teaching kids about STDs and contraceptive devices. Abstinence

only programs teach kids that the proper thing to do is to abstain from having sex until

marriage. They do not teach about contraceptives or the consequences of having

unprotected sex. Abstinence only programs are the only kind of programs being funded

by the federal government, and the Bush administration spends approximately 200

million dollars on these programs every year (Robb, 2007). Planned Parenthood is

encouraging states to refuse to accept federal funding so that they can continue or start to

teach comprehensive programs, and states are doing so (Craig, 2007). Despite this fact,

the majority of states are only teaching abstinence-only programs. We will now look

further into the programs that are being taught in our schools, the content of these

programs, parental viewpoints and the rights of parents in participating in their children’s

sexual education.

Comprehensive Sex Education is one of the two major viewpoints that are

associated with sex education in schools. By definition, Comprehensive Sex Education is

an educational program that provides a balance of sex education by promoting abstinence

in accordance with information on contraceptive devices and other birth control methods.

The main goals of this educational teaching style is to reduce the number of teen

pregnancies and sexually transmitted infections (STIs) and/or diseases. According to

Advocates for Youth, “Comprehensive sex ed stresses abstinence and includes age-

appropriate, medically accurate information about contraception. Comprehensive sex ed

is also developmentally appropriate, introducing information on relationships, decision-

 Sex Education 5

making, assertiveness, and skill building to resist social/peer pressure, depending on

grade-level.” (“Comprehensive sex education,” n.d.). Furthermore, Advocates for Youth

addresses the issue of teen pregnancies and STDs in regards to Comprehensive Sex

Education by stating that “Comprehensive Sex Education teaches about abstinence as the

best method for avoiding STDs and unintended pregnancy, but also teaches about

condoms and contraception to reduce the risk of unintended pregnancy and of infection

with STDs, including human immunodeficiency virus (HIV). It also teaches interpersonal

and communication skills and helps young people explore their own values, goals, and

options.” (“Sex education programs,” n.d.) Another source describes Comprehensive Sex

Education in terms of “three key components: It provides complete, accurate, positive

and developmentally appropriate information on human sexuality, including the risk

reduction strategies of abstinence, contraception and STD protection; it promotes the

development of relevant personal and interpersonal skills; and it includes parents or

caretakers as partners with teachers” (Constantine, Jerman, & Huang, 2007). This

definition provides a broader view of the topical outline and focus of comprehensive sex

education as opposed to the definition commonly used by the media and politicians that

merely refers to it as being an educational style which addresses “contraception and

protection from those that strategically omit these topics” (Constantine et al., 2007).

Since 1991, US teen pregnancy rates have seen a decrease in number (Hulton,

2007). Although one study found that “there was a substantial retreat from a

comprehensive approach to sex education from 1995 to 2002” (Lindberg, Santelli, &

Singh, 2006), another source stated that “[d]ramatic improvements in contraceptive use

occurred between 1995 and 2002” (Santelli, Lindberg, Finer, & Singh, 2007). This same
 Sex Education 6

study concluded that the “declining adolescent pregnancy rates in the United States

between 1995 and 2002 were primarily attributable to improved contraceptive use. The

decline in pregnancy risk among 18- and 19-year-olds was entirely attributable to

increased contraceptive use. Decreased sexual activity was responsible for about one

quarter (23 percent) of the decline among 15- to 17-year-olds, and increased

contraceptive use was responsible for the remainder (77 percent)” (Santelli et al., 2007).

Furthermore, this study stated that “[a]bstinence promotion is a worthwhile goal,

particularly among younger teenagers; however, the scientific evidence shows that, in

itself, it is insufficient to help adolescents prevent unintended pregnancies” (Santelli et

al., 2007). Another source pointed out that “[b]ased on over 15 years of research, the

evidence shows that comprehensive sexuality education programs for youth that

encourage abstinence, promote appropriate condom use, and teach sexual communication

skills reduce HIV-risk behavior and also delay the onset of sexual intercourse.” (“Based

on the research”, 2005). It stands to reason, based on recent studies, that a continued

reduction in the number of teen pregnancies would be promoted by teaching a balance of

abstinence and contraception education.

The position of parents on the issue of sexuality education in America is a

multifaceted topic. There is a wide spread agreement of the teaching of abstinence. The

disagreement stems from whether it should be the only thing taught. Many parents would

prefer their children remain abstinent until marriage; however, statistics show that they

are realistic in understanding that this is not always likely. This is where the approval of

comprehensive sexual education stems from; parents want their children to be as safe and

well informed as possible if they do choose to have sexual intercourse. The Kaiser
 Sex Education 7

Family Foundation conducted a survey of parents and the public regarding their opinions

on sex education among other things. When asked how they, the parents surveyed,

thought the funding for sex ed programs that come from the government should be used,

67 percent replied that, “The money should be used to fund more comprehensive sex

education programs that include information on how to obtain and use condoms and other

contraceptives.” (Kaiser Family Foundation, 2004) Among the topics that the survey

asked parents about, 96 percent thought that the basic information of how babies come

about, pregnancy and birth are appropriate for sex education programs. Ninety eight

percent of parents agreed that AIDS, HIV and STD information is appropriate to include

in such classes; 94 percent also wanted students to be taught how and where to be tested

for such diseases. Ninety four percent wanted information on birth control and methods

of preventing pregnancy to be included in school sex education classes and 87 percent

wanted information included on where to get such resources; although only 71 percent

wanted students made aware that they do not need parental permission to obtain such

resources. Though parents also showed great support of topics other than just abstinence,

they also highly supported teaching that emphasizes abstinence. Ninety five percent of

those surveyed wanted teachings to include the idea of waiting until you are older to have

sexual intercourse. Eighty two percent of respondents also stated that sexual education in

school makes it easier for them to discuss sexual issues with their children.

The legal rights of parents in such matters are complex. Laws on the issues of

sexuality education vary from state to state. In some states, abstinence is the only thing

that may be taught within public schools and much of the funding from the government

goes only towards programs that teach abstinence. Sometimes parental permission is
 Sex Education 8

required for a child’s participation in sex education and sometimes it is not. This is an

issue that is still developing legally and does not yet have a clear set of guidelines on

what is and what is not allowed, as well as what the rights of parents are.

In 1996, the Welfare Reform Act was set up by congress. This act allocated 550

million dollars a year, for five years, to promote and teach abstinence as the only morally

correct option for young adults to live by. In 1998, The Abstinence-Only Sexual

Education programs were put into effect in schools all throughout the United States. The

program is defined by Section 510(b) of Title V of the Social Security Act, P.L. 104-193.

This act lists eight rules that outline exactly what the program teaches. “For the purposes

of this section, the term "abstinence education" means an educational or motivational

program which:

1. has as its exclusive purpose teaching the social, psychological, and health gains to

be realized by abstaining from sexual activity;

2. teaches abstinence from sexual activity outside of marriage is the expected

standard for all school-age children;

3. teaches that abstinence from sexual activity is the only certain way to avoid out-

of-wedlock pregnancy, sexually transmitted diseases, and other associated health

problems;

4. teaches that a mutually faithful monogamous relationship in the context of

marriage is the expected standard of sexual activity;

5. teaches that sexual activity outside the context of marriage is likely to have

harmful psychological and physical side effects;

 Sex Education 9

6. teaches that bearing children out-of-wedlock is likely to have harmful

consequences for the child, the child's parents, and society;

7. teaches young people how to reject sexual advances and how alcohol and drug

use increase vulnerability to sexual advances, and

8. teaches the importance of attaining self-sufficiency before engaging in sexual

activity” (Advocates for Youth, 2007)

The program usually forces teachers to censor information about condoms and

birth control, as well as any information about other methods of contraceptives and/or

protection against STDs. This means that if a student asks a question regarding any of

these subjects, the teacher is not permitted to answer. The only acceptable form of

information regarding the use of condoms, is listing the failure rates. Abstinence-Only

Education also teaches that there can be harmful physical, social, and psychological

consequences for individuals who engage in pre-marital sexual activity. It does not

discuss certain controversial issues like masturbation, sexual orientation or abortion. It

also suggests that STDs are inevitable if an individual engages in pre-marital sexual

activity.

Although this is a very controversial issue, there are some who say that positive

effects have come out of this program. In 2005, a study was done on seventh, eighth, and

ninth graders in a south metro Atlanta school, to compare the effects of the past sexual

health textbook versus the new abstinence-only “Choosing the Best” textbook program.

Over a one-year period, the study showed that there was a 47 percent decrease in the

initiation of teen sex. Another study was performed from 1995 to 1996 by Northwestern

University Medical School. “Graduates” evaluated 2,541 Illinois public school students
 Sex Education 10

from the age of 13-16. After one year of the “Choosing the Best” program, 54 percent of

the students were no longer sexually active. The number is believed to have dropped due

to the changes in curriculum. (Choosing the Best, 2007).

The abstinence-only programs were formed due to the idea that if children are

taught ways to prevent pregnancy or protect against STDs, that this is promoting, and

encouraging pre-marital sex. It has never been doubted that abstinence is truly the only

way to protect oneself 100 percent of the time against STDs or unwanted pregnancy. The

choice we now have to make is how do we decide, as a nation, which way is “the right

way” for our children to learn to learn about sex.

In 1990, Sexuality Information and Education Council of the United States

(SIECUS) started a task force aimed chiefly at creating a curriculum framework or

guideline used to create new sexual education programs and evaluate existing ones. The

task force was comprised of 20 individuals in the fields of medicine, education, youth

services and sexuality. These guidelines are outlined in a 112 page document. These

guidelines do not only cover the sex part of sexual education, but many other areas such

as puberty, self esteem, body image, and development issues. These issues are just the tip

of the iceberg of what is covered within the program guidelines.

The guidelines set up by SIECUS for sexual education are based first upon four

different age levels. Next, the recommended curriculum is based on six key concepts

consisting of five to seven topics within each concept. Within each topic is a listed

curriculum guide for what should be covered according to the age appropriateness within

each of the age levels designed.

 Sex Education 11

Before the curriculum itself, the task force says “The educators must be educated”

(Sexuality and Education Council of the United States, 2004). What does this mean?

Educating the educators means that those teaching the curriculum must know the subject

matter well and be able to communicate it effectively. Teachers must be confident that

the message they are relaying makes a difference. Very few educators called to teach

sexual education will have had professional preparation thus making pre- and in-service

training invaluable. It is a must that sexual education teachers feel comfortable teaching

the content outlined within their school’s program. Determining sexual education content

can be a challenging process. The following is a small portion of the guidelines created

by the National Guidelines task force.

First and foremost, the task force defined the age groups for which they would

focus each of the key concepts and topics. The following tables explain the age groups

and curriculum used.

Table 1
Age levels as defined by SIECUS, 2004

Level 1 Middle childhood

Ages 5 through 8 (early elementary school)

Level 2 Preadolescence
Ages 9 through 12 (upper elementary school)

Level 3 Early Adolescence

Ages 12 through 15 (middle/junior high school)

Level 4 Adolescence
Ages 15 through 18 (high school)

Table 2
Recommended Curriculum as defined by SIECUS, 2004

Key Concept 1: Human Development

Topic 1: Reproductive and sexual Anatomy and Physiology
 Sex Education 12

Developmental Message examples:

Level 1: Each body part has a correct name and specific function
a boy/man has nipples. A penis, scrotum, and testicles
Level 2: During puberty, internal and external sexual and reproductive organs
in preparation for adulthood.
Level 3: Some sexual and reproductive organs provide pleasure
Level 4: Hormones influence growth and development as well as sexual and
reproductive functions.
Topic 2: Puberty
Developmental Message examples:
Level 1: Puberty is a time of physical and emotional change that happens as
children become teenagers.
Level 2: Everybody’s body changes at it’s own pace.
Topic 3: Reproduction
Topic 4: Body Image
Topic 5: Sexual Orientation
Topic 6: Gender Identity

Key Concept 2: Relationships

Topic 1: Families
Topic 2: Friendship
Topic 3: Love
Developmental Message examples:
Level 1: People can experience different types of love
Level 2: Feeling good about oneself enhances loving relationships
Level 3: Love is not the same as sexual involvement, but it can happen at
the same time.
Level 4: Loving another person can be one of life’s greatest joys
Topic 4: Romantic Relationships and Dating
Topic 5: Marriage and Lifetime Commitments
Topic 6: Raising Children

Key Concept 3: Personal Skills

Topic 1: Values
Topic 2: Decision-making
Topic 3: Communication
Topic 4: Assertiveness
Developmental Message examples:
Level 1: Telling people about one’s feelings and needs is acceptable
Level 2: Assertiveness is a skill that can be learned and improved
Level 3: Being assertive in sexual situations may be especially difficult.
Level 4: Sexual partners may need to assertively communicate their
needs and limits.
Topic 5: Negotiation
Topic 6: Looking for help
 Sex Education 13

Key Concept 4: Sexual Behavior

Topic 1: Sexuality throughout life
Topic 2: Masturbation
Developmental Message examples:
Level 1: Touching and rubbing one’s own genitals to feel good is called
masturbation.
Level 2: Some boys and girls never masturbate
Level 3: Many negative myths exist about masturbation
Level 4: People who are single, married, or in committed relationship may
masturbate.
Topic 3: Shared sexual behavior
Topic 4: Sexual Abstinence
Topic 5: Human Sexual Response
Topic 6: Sexual Fantasy
Topic 7: Sexual Dysfunction

Key Concept 5: Sexual Health

Topic 1: Reproductive Health
Topic 2: Contraception
Developmental Message examples:
Level 1: Each family can decide how many children to have, if any
Level 2: When a man and a woman want to have vaginal intercourse
without having a child, they can use contraception to prevent
pregnancy.
Level 3: Young people can buy non-prescription contraception in a
pharmacy, grocery store, market, or convenience store.
Level 4: People can find creative and sensual ways to integrate
contraception into their sexual relationships.
Topic 3: Pregnancy and prenatal care
Topic 4: Abortion
Topic 5: Sexually Transmitted Diseases
Topic 6: HIV and AIDS
Developmental Message examples:
Level 1: Once a person gets HIV, he/she will have it for the rest of his/her
life
Level 2: HIV is not spread by casual, social, or family contact, by insects,
or by donating blood.
Level 3: Some sexual behaviors that not involve exposure to another
person’s semen, vaginal fluid, or blood (such as masturbation or
hugging) pose no risk for HIV infection.
Level 4: People can always reduce their risk of HIV infection by abstaining
from certain behaviors, using condoms and other latex barriers,
and using only clean or sterilized needles.
Topic 7: Sexual Abuse, Assault, Violence and Harassment.

Key Concept 6: Society and Culture

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Topic 1: Sexuality and Society

There is no Level 1 Curriculum for this topic
Topic 2: Gender Roles
Topic 3: Sexuality and the Law
There is no level 1 or 2 Curriculums for this topic
Topic 4: Sexuality and Religion
Topic 5: Diversity
Topic 6: Sexuality and the Media
Developmental Message examples:
Level 1: Some movies, TV programs and websites are not appropriate for
children.
Level 2: Parents have the right to decide what appropriate viewing
material for their own children is.
Level 3: Some television shows and movies provide positive models of
relationships and sexuality.
There is no level 4 curriculum for this topic
Topic 7: Sexuality and the Arts
There is no level 1 or level 2 curriculums for this topic.

The previous is a very small portion of the guidelines presented by the

guidelines task force. Each topic goes into much more detail within each age appropriate

level.

Sexual education is as important for the parents at home as it is for the students

who receive it. As much as possible, parents need to be involved with their student’s sex

education at school. Parents can be involved by participating in parent night. Most often

schools offer a parent night where the curriculum that will be taught to their children can

be previewed. This preview may include videos, handouts, and activities that will be used

during the sexual education process. Often times, parents come away learning something

they didn’t know previously and feeling more comfortable knowing their children will be

taught age appropriate material.

As a group, we feel that comprehensive sex education is better than abstinence-

only programs. Although both programs have advantages, we feel that in the long run

children and teens will have more positive outcomes with comprehensive information.
 Sex Education 15

Teens are going to do what they want to do despite what we teach them. Hopefully,

having more knowledge will lead them to make smarter choices whether they chose to

remain abstinent until marriage or become sexually active before.

 Sex Education 16

References

Advocates for Youth. (n.d.) Comprehensive sex education. Retrieved

November 1, 2007, from http://www.advocatesforyouth.org/sexeducation.htm

Advocates for Youth. (2007). The History of Abstinence-Only Funding. Retrieved

November 9, 2007. (http://www.advocatesforyouth.org/rrr/definitions.htm)

Advocates for Youth. (n.d.). Sex education programs: Definitions & point-by-point

comparison, Retrieved November 1, 2007, from

http://www.advocatesforyouth.org/rrr/definitions.htm

American Psychological Association (2005). Based on the research, comprehensive

sex education is more effective at stopping the spread of HIV infection, says

APA committee Research shows that abstinence-only programs have a limited

effectiveness and unintended consequences. Washington, D.C. Retrieved

November 1, 2007, from http://www.apa.org/releases/sexeducation.html

Choosing the best. (2007). Research results. Retrieved November 9, 2007.

(http://www.choosingthebest.org/research_results/index.html

Constantine, N.A., Jerman, P., & Huang, A.X. (2007) California parents’ preferences

and beliefs regarding school-based sex education policy. Perspectives on Sexual

and Reproductive Health, 39 (3). Retrieved October 27, 2007, from

http://proquest.umi.com.ezproxy.plu.edu/

Craig, Tim - Washington Post Staff Writer (2007, November 21). Va. GOP Assails

Kaine on Sex-Ed; Abstinence-Only Funding at Issue. The Washington

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Post,p. B.1. Retrieved November 21, 2007, from National

Newspapers(5) database. (Document ID: 1386075251).

Drolet, Judy C., & Clark, Kay. (Eds.). (1994). The Sexuality Education

Challenge, Promoting Healthy Sexuality in Young People. Santa Cruz: ETR

Associates.

Hulton, L.J. (2007). An evaluation of a school-based teenage pregnancy prevention

program using a logic model framework. The Journal of School Nursing, 23(2).

Retrieved October 27, 2007, from http://proquest.umi.com.ezproxy.plu.edu/

Lindberg, L.D., Santelli, J.S., & Singh, S. (2006). Changes in formal sex education:

1995-2002. Perspectives on Sexual and Reproductive Health, 38 (4). Retrieved

October 27, 2007, from http://proquest.umi.com.ezproxy.plu.edu/

National Public Radio/Kaiser Family Foundation/Harvard University Kennedy

School of Government 2004 Poll “Sex Education in America”. Retrieved

November 12, 2007. www.plannedparenthood.org

Pregnancy and Childbearing Among U.S. Teens. (2006, January 1). Updated on

2007, September 18. Retrieved November 21, 2007,

http://www.plannedparenthood.org/news-articles-press/politics-policy-

issues/teen-pregnancy-6239.htm

Robb, Amanda (2007, October 18). Abstinence 1, S-Chip 0 :[Op-Ed]. New York

Times(Late Edition (east Coast)), p. A.31. Retrieved November 21, 2007, from

National Newspapers (5) database. (Document ID: 1367420201).

Santelli, J.S., Lindberg, L.D., Finer, L. B., & Singh, S. (2007). Explaining recent

declines in adolescent pregnancy in the United States: The contribution of

 Sex Education 18

abstinence and improved contraceptive use. American Journal of Public Health,

29 (1). Retrieved October 27, 2007. http://proquest.umi.com.ezproxy.plu.edu/

Sexuality Information and Education Council of the United Dtates. (2004).

Guidelines for Comprehensive Sexuality Education. Retrieved October 26,

2007. http://www.siecus.org/pubs/guidelines/guidelines.pdf

Schafer, Ethan D (2006, May). Training Your Staff to Manage the Challenges of

Adolescence. The Camping Magazine, 79(3), 32-37. Retrieved November 21,

2007, from Research Library database. (Document ID: 1035897761).