Sexual and Gender Diverse Adolescents and the Failures of Traditional Education in Public Education: Post #2

* Second part of the term paper titled "Sexual and Gender Diverse Adolescents and the Failures of Traditional Education in Public Education." This post covers the Literature Review portion of the paper.

Literature Review

There has been much discussion and disagreement about how the subject of sexual education should be taught in schools and what information should be provided in those classes. This discussion has included parents and schools as well as local, state, and federal governments and influence has flowed both ways. These conversations tend to revolve around concerns about government involvement in family life and sexual education, parental control of the information taught, moral values that might be included in sexual education, and what constitutes age appropriate sexual behavior. (Shtarkshall et al., 2007) The history of sexual education, which recently has enjoyed a increase in research and publications, illuminates a wide variety of curricula and the ways and means of teaching them. (Blout, 2016) It appears that the only consistency in the teaching of sexual education is the controversy and the zeal of the advocates and reformers that are drawn to it.

Over the last few decades, there has been much research has focused on whether different methods of sexual education have been ‘successful’ in terms of stated goals and the desires of the community. However, even here there is disagreement as to what the goals of sexual education programs are: whether to promote safe sexual behaviors in the events of the initiation of sexual experience, prevent negative consequences of sexual behavior such as sexually transmitted disease and pregnancy, or to restrict any sexual behaviors by individuals before marriage for moral or social reasons. It is also difficult to determine whether curricula or outcomes of sexual education are successful because its difficult to collate data across diverse studies. New research provides data that can be used for changing current programs and making them more efficient and successful for students. As it is generally accepted that public schools are the one institution in our society that is regularly attended by most young people, it is schools that have the widest opportunity and responsibility for teaching and addressing sexual risk taking behaviors. (Kirby et al., 1994; Silva, 2002) While limited sexual education has been available to young people for decades, “the AIDS epidemic would change the way many people viewed sexual education; the question was no longer whether schools would teach sexual education; it was what they would teach, and how, and to what end.” (Zimmerman, 2015)

For the purposes of clarity throughout this review, I would like to clearly define a few terms that will be used going forward:

Abstinence-only sexual education is typically defined as curricula that tell learners that they should wait to participate in sexual intimacy until they are married. (Kirby et al., 1994) These programs may also contain extra lessons on self esteem, communication, decision making, life planning, and cooperative learning. (Denny et al., 2002) To receive federal funding, these programs must also comply with Section 510 A-H of Title V which includes: an exclusive purpose to teach the social, psychological and health gains that are achieved through sexual abstinence, that abstinence is the expected standards for all students and the only certain way to avoid STD’s and pregnancy (Kohler et al., 2008), that a mutually faithful monogamous relationship in the context of marriage is the expected social standard and that sexual activity outside of marriage is likely to have harmful consequences for the student, potential children, and society. It must teach students how to reject sexual advances, how alcohol and drug use increase vulnerability to sexual advances, and the importance of attaining self sufficiency before engaging in sexual activity. (Rubenstein, 2017) Federal law also states that programs that use federal funds can not teach about contraceptives except to emphasis failure rates. (Jeffries et al., 2010)

Comprehensive sexual education (CSE) is defined as programming that seeks to postpone early sexual involvement, but also discusses both abstinence and contraception (the different methods available, instructions for use, etc.) as well as HIV/AIDS prevention. Some comprehensive programming also teaches other pertinent topics: human development and puberty, reproductive anatomy and health, pregnancy and prenatal care, consent, development of positive relationships, decision making, communication and interpersonal skills, and intimacy. (Kirby et al., 1994) Also, this type of sexual education may, if allowed by law, discuss sexual assault, sexual orientation, other sexual behaviors, and gender identity. (Jeffries et al., 2010)

One of the most important and easily quantifiable reasons that successful sexual education is needed can be seen in the recent statistics released for 2015 from the Centers of Disease Control. In that year, a total of 229,715 babies were born to women between the ages 15–19 years, for a birth rate of 22.3 per 1,000 women in this age group. In the same year, young adults (aged 13-24) accounted for an estimated 22% of all new HIV diagnoses in the United States. Half of the nearly 20 million new STDs reported each year were diagnosed in individuals between 15 to 24 years of age. (CDC, Sexual 2017) While 2015 shows birth rates for American teenagers at a record low with evidence suggesting the declines are due to abstinence and consistent contraception use, the teen pregnancy rate in the United States is still substantially higher than in other western industrialized nations, and racial/ethnic and geographic disparities in teen birth rates persist. (CDC, Teen 2017; Stanger-Hall and Hall, 2011)

Because we as a society have determined that pregnancy and sexually transmitted diseases are unfavorable outcomes for adolescents, research identifying distinguishing characteristics in effective sexual education programs- whether comprehensive or abstinence-only- is key. According to Kirby et al., effective programs used social learning theories such as social cognitive theory, social inoculation theory, and cognitive behavioral theory, etc. as a foundation for program development and included a narrow focus on reducing sexual risk-taking behaviors that may lead to STD’s or unintended pregnancy. (1994) According to Jeffries et al., more than 140 national scientific organizations acknowledge that CSE can effectively meet adolescents’ sexual needs. Their conclusions are based upon numerous findings that CSE effectively promotes abstinence and may delay sexual debut, reduce sexual frequency, reduce the number of lifetime sexual partners, reduce the risk of STD transmission, and increase the likelihood of consistent contraceptive use. (2010) Silva, who analyzed the success rates of several studies, found that some studies believe that more parental involvement in teaching sexual behavior may have contributed to higher abstinence rates; however, she acknowledges that parents who were willing and able to participate in these programs may differ in important demographic or lifestyle characteristics from those who did not participate, possibly skewing the data collected. (2002) Through research based on a national analysis of all state data available, Stanger-Hall and Hall show that abstinence-only education doesn't reduce, and likely increases teen pregnancy rates, while comprehensive sexual education that included abstinence as a desired behavior was correlated with the lowest teen pregnancy rates across states. (2011) However, all of these studies have some limitations which make for a shaky foundation when creating new programs and protocols for more effective sexual education. As suggested by Silva, research in sex education could be greatly improved if more efforts were directed to test interventions utilizing random controlled trials, measuring intervening variables variables and a more careful and detailed reporting of the results. (2002)

One clear oversight in both abstinence-only and many comprehensive sexual education programs is the recognition and teaching of sexual diversity. Very little research has been completed with a view to understanding how to recognize and teach individuals who claim a sexuality other than heterosexuality and students who report any form of sexuality other than heterosexuality are removed from studies to keep the results consistent for the majority population studied. For example, Kohler et al. specify in their research that “Individuals reporting sexual orientation other than heterosexual were also excluded as programs do not address same-sex behaviors.” (2008) Denny and Young state that in their questionnaires that sexual intercourse is defined as “ the male’s penis is in the female’s vagina” while Weed and his group of researchers measured data based on “virgin students who went on to have vaginal sexual intercourse.” (2006; 2008) Valenti writes that educators in abstinence-only sexual education are mandated to define the term ‘marriage’ as only “a legal union between one man and one women as a husband and wife” and the word ‘spouse’ as only “a person of the opposite sex who is a husband or wife” (Valenti, 2009) Luker notes in her book that she restricted herself to heterosexuality discussions “as the public discussion itself did.” (2006) Blount states that same sex desire and gender nonconformity have been so strenuously and consistently rooted out of sexual education curricula that the need for rigorous scholarship and additions to sex education protocols is significant. (2016)

This oversight in the acknowledgment and instruction of sexual diversity has come at a high cost to LGBTQI students and young adults. Among young people (aged 13-24) diagnosed with HIV in 2015, 81% were gay and bisexual males. (CDC, Sexual 2017) Data provided from the 2015 National Youth Risk Behavior Survey of surveyed LGBT students states that these students are at an increased risk of being threatened, bullied, or injured on school property or online. LGBT students are also at an increased risk of sexual and physical dating violence, and rape. (no author, LGBT…2017) These students are more likely to have problems with depression and are four times more likely to commit suicide than heterosexual youth. (Frieden et al., 2015) Eight states- Alabama, Arizona, Louisiana, Mississippi, Oklahoma, South Carolina, Texas, and Utah- limit what teachers can say about homosexuality and some of these states require inaccurate information to be shared with students. (Segal, 2017) For instance, Alabama education law requires that sex education programs emphasize that homosexuality is not a lifestyle acceptable to the general public, that homosexual conduct is a criminal offense under the laws of the state, and prevents educators from mentioning “that some methods of sex are safe methods for homosexual sex.” (Rubenstein, 2017) Hess notes that if some abstinence-only providers mention homosexuality, it is mentioned as a lifestyle with shocking negative consequences that can only be solved by marrying someone of the opposite gender. (2010) Therefore, students who do not identify as heterosexual may not find any mention of sexual diversity in their taught curriculum and, if it is mentioned, only negative or possibly inaccurate information is provided. It is important to note that until recently, same sex marriage was not an available option for homosexual individuals, effectively telling these students that they must remain celibate throughout their life span. While the legal union of marriage is now open to either heterosexual or homosexual relationships, many sexual education programs still teach that if you are homosexual, you must remain abstinent unless you marry a partner of the opposite sex. (Hess, 2010) Lastly, teachers who identify as LGBTQI fall in the minority and it can still be a challenge for a teacher that is known to identify as other than heterosexual to keep a teaching job. This discrimination suggests to students that their sexuality can affect future employment unless closeted. (Jennings, 2005; Jackson, 2007)

Another significant problem with specific abstinence-only curricula is how these lessons are taught: metaphors used, abstinence decisions as absolutes, etc. Most abstinence-only curricula do not discuss consent or sexual assault, but do use metaphors that imply that sexual activity degrades the female body. (Valenti, 2009) These metaphors include licked cupcakes or chocolate, sharing cups of spit, chewed up gum, old and worn out shoes, a piece of tape, a rose with no petals, etc. (Rubenstein, 2017) When these metaphors are used or demonstrated to students, many students who have been victims of sexual assault see themselves as broken, dirty, or worthless. These metaphors increase feelings of shame, anger, and embarrassment in victims-- most of whom are women. (Valenti, 2009) Another drawback to using these metaphors is that the use of them can diminish the self worth of individuals who choose to have sex and make them more vulnerable to other health conditions such as depression, eating disorders, etc.

Therefore, it is vitally important that research is conducted and programs tailored to use successful strategies for teaching sexual education to students. An abbreviated listing of sexual education laws per state was compiled by the Guttmacher Foundation in early 2017 which found only 13 states require that the information taught in sexual education protocols must be medically accurate, only eight states require the teaching should be ‘culturally appropriate and unbiased’, and only two states require that sexual education teachings cannot promote religion. (no author, Sex 2017) According to Blount, no program will be successful until the curricula recognize young people as sexual beings, a viewpoint that defies many community assumptions about the sexual innocence of youth. He also states that researchers need to recognize or acknowledge the sexuality of adults who work with adolescents instead of the current standard of assumed asexuality or sexual purity of school workers as a class. (2016) It should also be a given that teachers’ beliefs about the content of sexual education curricula may influence what they teach their students despite what is specifically in the curriculum itself. (Jeffries et al., 2010) Zimmerman suggests that no program will be successful if, at its core, the goals are to control sexuality by fear. (2015) As there is so little consensus on what to teach, how to teach it, when to teach it and what aspects of programs are the most successful, it is vital to encourage further research and scholarship into the matter.