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Here in Arizona, Tucson Unified School District has been taking steps toward adopting a comprehensive, inclusive, age-appropriate, and medically accurate sex education program, but it’s been repeatedly delayed by a vocal minority. In September, a vote was put on hold after the superintendent recommended changing the proposed curriculum to focus on abstinence as the preferred method for avoiding STDs and unintended pregnancies.

Additionally, many opponents of TUSD’s proposed curriculum believe its inclusiveness of LGBTQ kids is tantamount to “indoctrination,” that this type of education “sexualizes” children, and that discussions of gender identity will confuse students. LGBTQ kids have traditionally been ignored or demeaned in sex education programs, and their health matters too. Presenting medically accurate and age-appropriate information does not indoctrinate or sexualize children — it simply helps them make healthy decisions, no matter who they are. And these days, students need to be empowered with as much knowledge as possible to make decisions that protect their health.

Confronting the STD Epidemic

Last month, the Centers for Disease Control and Prevention (CDC) released its annual report on sexually transmitted diseases. It did not contain good news. For the fifth straight year, STD rates are climbing.

Picture below: STD Rates 2018

At the turn of this century, syphilis had nearly been eliminated in the United States. Unfortunately, syphilis is making a comeback, and since 2014 there has been an 185% increase in congenital syphilis — the transmission of syphilis from mother to fetus during pregnancy. In 2018, 1,306 babies were affected, resulting in 78 stillbirths and 16 infant deaths. Arizona has the unfortunate distinction of being a hot spot for congenital syphilis — it ranks No. 4 in the nation, behind Texas, Nevada, and Louisiana. Most cases of congenital syphilis occur in babies whose mothers received inadequate prenatal care.

Gonorrhea had been on the decline, but it’s also been making a comeback this decade. Gonorrhea is more likely to strike young people, and is more commonly diagnosed in men. The rise in gonorrhea is troubling, given that the infection is becoming increasingly resistant to antibiotics.

Last year set a record for the most cases of chlamydia ever reported: 1.7 million. Two-thirds of chlamydia cases strike young people — and the burden disproportionately affects girls and young women. An estimated 10.5% of girls and young women, ages 14-19, had chlamydia in 2018. That’s more than one out of 10! In total, half of STDs strike young people in their teens and early 20s.

The State of Sex Education

If young people are bearing the brunt of the STD burden, how do we reach out to them? If you’re like me, you’re an advocate for sex education. But what’s the state of sex education in this country?

Only 27 states, plus Washington, D.C., mandate both sex education and HIV education in public schools. And only 17 states require content to be medically accurate. Abstinence-only is the dominant model for sex education in the country. There are 29 states in which abstinence must be stressed — not just included, but stressed. Arizona is one of these states.

Abstinence is a great choice for many people and absolutely must be included in a comprehensive curriculum, but it’s only one tool among several. You might have heard that condoms are 98% effective with perfect use, but only 85% effective with typical use, because a lot of people have problems using them consistently and correctly. Well, abstinence is 100% effective with perfect use — but a lot of people have problems using this method consistently and correctly, and most kids who sign abstinence pledges break them. Most teens — 57% — have had sex by the time they graduate from high school. And many teens are forced into unwanted sexual contact — 7% of women say their first sexual encounter, at an average age of 15, was unwanted. Abstinence-only programs leave these kids out, and don’t give them the information they need to keep themselves healthy.

Furthermore, programs that explicitly ignore or marginalize LGBTQ youth send the message that their health is unimportant. With 4-5% of the population identifying as lesbian, gay, bisexual, or transgender, that translates into thousands and thousands of students being left out.

And, unfortunately, abstinence-only programs don’t work. Students who receive this education, or no sex ed at all, are more likely to acquire STDs than those who receive comprehensive sex ed.

Sex Education and Values

A lot of people believe abstinence-only is important for instilling values into students. And when you boil down what those values are, it comes down to an emphasis on sexual purity. Purity sounds like a good thing, but the flip side of purity is the idea that anyone who is not “pure” is contaminated or dirty. Stories abound of teachers using shaming analogies, such as comparing sex to using a piece of tape: If the tape “sticks” to too many people, it loses its ability to form bonds.

Upholding the concept of purity requires the implicit accusation that anyone who has had sexual contact outside of marriage is tainted in some way. Elizabeth Smart, who was kidnapped at the age of 14 and held captive for nine months, explained the consequences of promoting “purity” in the most heartbreaking terms:

When Smart spoke at a Johns Hopkins University panel last week, she explained one of the factors deterring her from escaping her attacker: She felt so worthless after being raped that she felt unfit to return to her society, which had communicated some hard and fast rules about premarital sexual contact.

“I remember in school one time, I had a teacher who was talking about abstinence. And she said, ‘Imagine you’re a stick of gum. When you engage in sex, that’s like getting chewed. And if you do that lots of times, you’re going to become an old piece of gum, and who is going to want you after that?’ I thought, ‘I’m that chewed-up piece of gum.’ Nobody re-chews a piece of gum. You throw it away. And that’s how easy it is to feel you no longer have worth. Your life no longer has value.”

Emphasizing sexual purity delivers the deeply cruel unspoken message that children whose lives go in a different direction are dirty or without value.

It might not promote ideas like sexual purity, but comprehensive sex education promotes other powerful values: informed decision-making, consent, and inclusion. Alongside abstinence, it includes information on birth control, condoms and other barrier methods, other STD prevention strategies, and STD screening and treatment — so that all students are empowered with the information they need to make healthy decisions. It is inclusive of everyone, not just an approved subset of people who choose abstinence and are heterosexual and cisgender. It teaches children to value themselves and others by honoring consent and nurturing healthy relationships. And comprehensive sex ed values a nonjudgmental approach that upholds every individual’s basic dignity, avoiding derogatory language that might cause psychological harm.

Using Your Voice Locally

Make your voice heard. Send letters or emails to your school board members and the superintendent. If you’re in Tucson, look for contact information for TUSD’s superintendent and board members on the TUSD website. Speak up at your next local school board meeting when there is a call to the audience — TUSD posts their meeting schedule on their website, in English and Spanish. If you live in the district or have kids who attend school there, mention it. Don’t let TUSD bury this issue just because of the controversy surrounding it — our children’s right to quality education and good health are too important to shrug away.

That so many adults consider abstinence to be ideal is understandable — but it’s unrealistic to expect widespread compliance. Sex education must empower all students, not just those choosing abstinence.

Click here to check out other installments of our monthly STD Awareness series!


Tags: LGBTQ, Arizona, CDC, sex education, chlamydia, gonorrhea, sexually transmitted infections, abstinence only, Tucson

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About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.


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