Empowerment Through Education:

A study of sexuality education and how it relates to social inequality through a comparison of programs provided in public schools to those provided in community-based organizations.
A Plan of Concentration submitted to the faculty of Marlboro College in partial fulfillment of the requirements for the Bachelor of Arts.

By Margaret Ann Hutslar Wood May 2013

Plan Sponsors: Ken Schneck Renee Byrd Outside Examiner: Gary F. Kelly Marlboro College Marlboro, VT

This Plan of Concentration is dedicated to my mother, Jan Hutslar, who has always been there to support me through everything from panic attacks to overdrawn bank accounts, and who taught me the importance of fighting for what you believe in. Mom, youre my biggest inspiration and I constantly strive to be worthy of being your daughter. Thank you.

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Acknowledgments
Throughout the process of writing this Plan, Ive had an amazing support network of absolutely irreplaceable people. You guys are all so great that words cannot even describe how youve touched my life, but Im going try anyway. First, I would like to acknowledge my family. Mom, you are the reason that Im here. Not only did you literally give me life, but you also instilled in me the importance of having strong values and fighting for social justice. Furthermore, you have made me realize that life is an adventureone that I am honored to share with you. To my father and stepmother: You have been great. I never expected to get care packages after freshman year, but Ive been pleasantly surprised by a constant stream of candy, socks, and juice boxes for the past four years. Thank you. To my stepsisters: Nikki, Marissa, and Danielle, you guys are wonderful. Thank you for accepting me into your family and being the best big sisters a girl could ask for. Nikki, we have a geek-bond that will last foreverthank you for everything youve done for melending me books, teaching me how to be a Bostonian, letting me come over and watch movies on your huge TV, and so much more. And to my partner, Jonathan: What can I say? Youve been my best friend and companion for three years. Youre my better half. You keep me grounded. Without you, I would float away in a bubble of my own crazy, and you keep me tethered to reality. I love you more than I could ever express in words, and so, at the risk of being cutesy to the point of vomit, Ill stop with a simple thank you. To the rest of my family, you guys have been not only putting up with me, but supporting me for the past 21 years, and that is astounding. Thank you. I would also like to acknowledge the amazing friends that have supported me through my Plan writing process. To my friends who graduated before me: You guys have helped me by editing my papers, encouraging me with cute animal pictures, and reassuring me that writing Plan will not kill me. Megan, Lauren, Devin, Bryon, and Carolyn, thank you. You guys are super awesome. To my fellow seniors: The stress of this year has been made so much more bearable by being able to commiserate with you guys. Joy and Peter, you know you have a special place in my heart and I know you two will keep serving Marlboro realness and being sickening, darlings. Sam, youre awesome. Watching Community with you has provided an excellent distraction from Plan. You get it, girl. Mellman, you know I love you. Keep on Mellman-ing. Geordie. Dudebro. You rock. 3!

Lindsey, my darling, I dont even know what to say. You are a strong, powerful, badass woman. I know youre going to rock your senior year. Dont take anyones shit and just keep being the amazing woman you know you are. I love you. To all my other friends, dont think I forgot you. You guys are all beautiful snowflakes and knowing you has enriched my life forever. I also want to thank all the incredible people who have directly or indirectly helped me complete this Plan. While I was writing, I could hear the voices of my Plan Sponsors urging me on. After every paragraph, I imagined that Renee was saying So? What does this mean? This needs to be analyzed. And of course, Ken was sassing me the entire time. This might possibly mean that I am certifiably insane, but it also means that Ive had some pretty amazing Plan sponsorsyou guys are the perfect mix of snarky and serious, reassuring and stressful, and without you both constantly pushing me to be better, this Plan would never have been completed. As all three of us move on to the next phases of our lives, I wish you nothing but the absolute best. To Kelly Johnson-Eilola: You taught me that I could actually make a career out of taking about sex. Thank you for introducing me to the wonderful world of sex education and serving as an unofficial mentor for me for so long. To Sue Conley: Working with you was incredible. I was so lucky because I was able to get college credit for hanging out with you and talking about condoms. Thank you for being a huge inspiration to me. Katherine McLaughlin, Alex Potter, and everyone else that I have had the pleasure of working withhowever brieflyin the sex education field: Thank you. I have had unbelievably cool experiences working with all of you. To SJ and Jeremy: Thank you so much for letting me play with Vera when I needed a break from writing; being able to hang out with a baby helped me get perspective and maintain my sanity during this incredibly stressful year. To Reily Mumpton: Dude. You had absolutely no reason to devote your time and energy to helping this crazy senior who decided to make videos even though she had no experience, and yet, you did. Thank you for teaching me how to edit and do all sorts of nifty video stuff. To everyone who let me practice the activities from my curriculum with them: Thank you. Your feedback was so valuable, and I am so grateful that you all took the time out of your busy schedules to help me with something that you werent even getting paid for. You guys are wonderful. And of course, to my amazing actors: Lindsey Grace Daniel Mellman Jon Fryer 4!

Sam Auciello Adam Halwitz Daniel Kalla Angelique Krohn Raina Workman Rosie Kahan Felix Jarrar Peter Sullivan Noah Bedford Jen Dudley Lia Gips Thanks for putting up with my often scatterbrained and confusing filming sessions. Finally, to Gary Kelly: Thank you so much for being my outside examiner. I hope you enjoy reading this Plan as much as I did writing it!

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Table of Contents
Introduction Part One: Public School and Community-Based Health Education: A Comparison Study Public School and Community-Based Health Education: A Comparison Study Works Cited Part Two: Sex Education and Social Inequality: History and Analysis Sex Education and Social Inequality: History and Analysis Works Cited 7 9 46 48 103

Introduction to Empowerment Through Education: 106 A Sexuality Education Curriculum Developed Through the Lens of Social Justice Introduction to Empowerment Through Education: 127 A Sexuality Education Curriculum Developed Through the Lens of Social Justice Works Cited Introduction to Independent Project Part Three: Empowerment Through Education: A Sexuality Education Curriculum Developed Through the Lens of Social Justice (Accompanying Packet) Independent Project: Carnal Knowledge: Sex Education Videos (Accompanying DVD) 130

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Introduction I decided to do my undergraduate work in the field of sex education because it is an issue that has personally affected my life for many years. In my public high school, teenage pregnancy was just a part of lifeit wasnt spoken about often, but it happened regularly. It was not a strange experience to have classes with a pregnant girl or a girl who already had a child. It wasnt really until I started college that I realized that not everyone had the same relationships with teenage pregnancy that I did. However, in talking about it with friends, I began to realize that those who had attended public high schools often had similar experiences to mine, while those who attended private high schools often had vastly different experiences. This got me thinking about socioeconomic class and how it relates to the prevalence of teenage pregnancy, which I immediately connected with a lack of comprehensive sex education. There was a very clear link between low-income communities such as the one I grew up in and high rates of teen pregnancy, accompanied by little to no comprehensive sex educationin schools or community-based organizations. This piqued my interest and I began to wonder if other social factorsrace, gender, and sexual orientation, specificallywere also connected to sex education. By the time I began my fieldwork in a local high school, I was in the midst of exploring the intersections between the popular discourses around sex education and the continued marginalization of oppressed groups. My fieldwork only solidified these ideas, and it gave me specific incidents to point to and say, This, right here, is a problem. This was what I focused on in Part One of my Plan. I knew, however, that I couldnt base my work on one small high school in New England. Therefore, I began my search for a wider context in which these discourses were present. I have to admit that I wasnt prepared for what I foundI had realized that these discourses were deeply ingrained into society, but I hadnt realized how they had been reinforced throughout history or what events led them to be so common in modern culture. Exploring this context led me to Part Two of my Plan. I am not the type of person to identify a problem without attempting to solve it, so I knew that I wanted to propose a solution to combat the harmful discourses that I had written about. I decided to write a curriculum because I couldnt find one that I thought was perfect. There were some that came awfully close (The Our Whole Lives Curriculum, for example), but still did not address social inequality to the extent that I would like to see it addressed in a sex education program. Therefore, Empowerment Through Education was born. As a supplement to this curriculum, I also created three sex education videos, which serve as my
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Independent Project. I will discuss my process of making these in the Introduction to my Independent Project (page 130). I hope that as you read this Plan of Concentration, you will find, as I have, that it meets a need in our society that has yet to have been met. Enjoy! Margaret Wood

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Public School and Community-based Health Education: A Comparison Study

Introduction As I set out to design a curriculum for teaching sex education, I was curious about the information that was being taught today, both in classrooms and in communities. In order to get a better sense of current practices, over the past year, I have been conducting participant observation in the sexual health education field. In this paper, I will compare two different sex education methodologies that I have observed: one based in a public high school health classroom and one conducted by a community health education organization. My reasoning for studying these two methods was that I could both compare different types of sex education as well as get an idea of what to expect in my professional future. Furthermore, I was interested in finding out what characteristics make for an effective sex educator, and I wanted to observe some sex educators to see if they fulfilled these characteristics. Participant observation is a qualitative research methodology which aims to gain familiarity with a group of people through various techniques including informal interviews, direct observation, participation in the group, collective discussions, analyses of documents produced within the group, self-analysis, results from activities undertaken by the group, and self-histories.1 The predominant techniques that I used were direct observation of the delivery of information and informal interviews with the educators. I also analyzed handouts and other documents that were distributed as part of these deliveries. In my fieldwork, I observed classes in a public high school health education classroom !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
1

Kathleen M. DeWalt, Billie R. DeWalt, and Coral B. Wayland. (1998). Participant Observation. In H. Russell Bernard (Ed.), Handbook of Methods in Cultural Anthropology. Walnut Creek, CA: AltaMira Press.

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and peer education activities at a community-based health education organization for women that focused on preventing the spread of HIV and AIDS (I will be referring to this organization as the Community HIV Center during this paper). Both of the places I observed are located in the same small New England town. It should be noted that the bulk of my focus will be on the high school classroom with the community education efforts providing a contrast to looking at health education. The World Health Organization defines health education as any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes.2 To me, this means that comprehensive health education programs should provide individuals with the tools they will need to increase their knowledge and influence their attitudes in order to become healthy adults. Health education in the high school classroom included discussions of sexual health, tobacco, alcohol and other drug use, and nutrition. Although these different topics have quite a bit of overlap, my focus is on sexual health. Therefore, while I will touch on every topic that was covered, I will spend far more time focusing on the sexual health unit.

Demographics The high school in which I observed is located in a small town in New England. At the time of my research, the school enrolled 968 students, 886 of whom were white.3 The majority of students I observed in the high school were ninth graders, fourteen or fifteen years old. All of the teenagers in the classes except two were white. The classes were evenly split between male and female students. There was an average of 20 students per class. I have no way of knowing these !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
2 3

Organization, World Health. (2012). Health Education, from http://www.who.int/topics/health_education/en/. National Center for Education Statistics. (2012). National Center for Education Statistics, Retrieved May 2, 2012, from http://nces.ed.gov/.

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students' social class backgrounds, but the average annual income for households in that New England county is $27,247, according to the 2012 Census.4 Since the average annual income for households in the United States is $25,000, these students are probably not outside of the norm in terms of social class standing.5 The teacher, Bob Milton6, was a white male who appeared to be in his mid-fifties. He coached football and informed me at the time that he was married with grown children. Though I dont know his social class standing, the average annual income for a high school teacher in this county is $53,000.7 The women that attended the workshops at the Community HIV Center were in their mid-twenties to mid-thirties. As the Community HIV Center receives grant money to educate at-risk women, the women needed to fall into certain categories. According to the Community HIV Center's data, the most at-risk demographic for contracting HIV and AIDS is heterosexual women of color who are living below the poverty line.8 Other factors that increase risk are having a sexual partner in prison, being an intravenous-drug user, and engaging in unprotected sex with multiple partners or partners whose HIV status is not disclosed. I observed some women of color, but most of the women were white. All of the women I observed who chose to disclose this information were heterosexual and low-income. One of the women that I observed revealed that her boyfriend was in prison, and two other women related that they had been in prison themselves. Information was not provided on their drug use or sexual behavior. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
4

U.S. Census, "State and County Quick Facts." Last modified September 18, 2012. Accessed December 3, 2012. http://quickfacts.census.gov/qfd/states/50/50025.html. 5 Newman, Rick. U.S. News, "How to Gauge Your Middle-Class Status." Last modified 2012. Accessed December 3, 2012. http://money.usnews.com/money/business-economy/slideshows/how-to-gauge-your-middle-class-status/2. 6 Name has been changed. 7 National Education Association-Vermont, "Vermont-NEA Southern Region Salary." Last modified 2009. Accessed December 4, 2012. http://www.vermontneasouth.org/Salary.php. 8 Centers for Disease Control and Prevention, "HIV Among Women." Last modified August 10, 2011. Accessed November 12, 2012. http://www.cdc.gov/hiv/topics/women/index.htm.

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Reflexivity Before I could begin my research, I needed to examine my process of reflexivity. Research scholar Carla Willig describes two types of reflexivity in qualitative research: Personal reflexivity and epistemological reflexivity.9 Personal reflexivity involves reflecting upon the ways in which our own values, experiences, interests, beliefs, political commitments, wider aims in life and social identities have shaped the research.10 Epistemological reflexivity encourages us to reflect upon the assumptions (about the world, about knowledge) that we have made in the course of the research, and it helps us to think about the implications of such assumptions for the research and its findings.11 Throughout the course of my research, I have been very conscious of analyzing both my personal and epistemological reflexivity. The first step in the process of examining my personal reflexivity was to look at my background and take into account how it might affect my research. I grew up in a rural town in northern New York State in a county with a high unemployment rate, a low average income, and a high teenage pregnancy rate.12 Though many of my friends and classmates in high school became pregnant as teenagers, I have never been pregnant myself and I have never contracted a sexually transmitted infection (STI). My status as a young, educated, working-class white woman had impact on my research. For example, as a woman, I think that I am more prone to be on the lookout for misogyny in education, and therefore my evaluation of this research might be biased in that way. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
9

Willig, Carla. Introducing Qualitative Research in Psychology: Adventures in Theory and Method. Buckingham: Open University Press, 2001, 10. 10 Ibid, 10 11 Ibid, 10. 12 New York State Department of Health, "St. Lawrence County Teenage (Age 15-19) Pregnancy Rate Per 1,000 Females Age 15-19." Last modified 2009. Accessed May 2, 2012. http://www.health.ny.gov/statistics/chac/birth/tp151940.htm.

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In examining my epistemological reflexivity, I analyzed my assumptions about this research. I know that since I attended high school in a small, rural town not unlike the one in which I was conducting my research, I might assume that the experiences of the students in this high school were similar to my own. I also know that since I had been informed about the features that categorize at-risk women, I was concerned that I might assume that every woman that I observed fits those criteria. To prevent these assumptions from becoming troublesome, I was careful to be aware of their possibility and to analyze and challenge them as they occurred.

Objectivity Before beginning my research, it was also important to consider my objectivity. Objectivity is defined as expressing or dealing with facts or conditions as perceived without distortion by personal feelings, prejudices, or interpretations.13 In qualitative research, however, it is often almost impossible to completely separate personal feelings, prejudices, or interpretations from one's research, especially when one is personally invested in the issues that one is researching, as I am. Therefore, I have modified the definition of objectivity as it pertains to my research. A more fitting definition for my purposes is expressing or dealing with facts or conditions as perceived with minimal distortion by personal feelings, prejudices, or interpretations. When distortion does occur, it is necessary to record and analyze it. I have conducted my research using a constructivist philosophy, which states, All knowledge is a compilation of human-made constructions.14 While objectivism focuses on

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13

Merriam-Webster Dictionary Online. (2012). Definition of Objectivity, from http://www.merriamwebster.com/dictionary/objectivity 14 Raskin, Jonathan D. (2002). Constructivism in Psychology: Personal Construct Psychology, Radical Constructivism, and Social Constructivism. In Jonathan D. Raskin and Sara K. Bridges (Ed.), Studies in Meaning: Exploring Constructivist Psychology. New York: Pace University Press.

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finding an unbiased truth, constructivism is concerned with how we construct knowledge.15 Constructivism does not strive for the neutral discovery of an objective truth, and instead recognizes that objectivity is not possible for most, if not all, forms of research.16 Instead, it examines ways in which knowledge is constructed in different settings. Therefore, though I strove to remain objective in most aspects of my research, I was unable to be completely devoid of feelings and opinions, the most obvious being my opinion about the importance of health education. It was difficult for me to separate my conviction that comprehensive health education should be provided in all public high school classrooms from the research I was doing in that setting. However, I believe that it is important to have opinions about the research that one is doingotherwise, the research would not be engaging. As will be noted, I also struggled to remain objective not just about the content of the information being delivered, but also about the individuals delivering such information. I especially had trouble with keeping my personal opinion of Mr. Milton separate from my research. What follows will be descriptions of what I observed interspersed with my reflections on the information being presented. As long as one is aware of one's opinions and how they might affect one's work, I believe it is possible to conduct accurate and meaningful research, especially qualitative research, which is what I had to keep in mind especially as I observed the health education units in the high school.

Experiences in Public School Setting Tobacco Unit !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

15

Jonassen, David H. (1991). Objectivism vs. Constructivism: Do we Need a New Philisophical Paradigm? Educational Technology Research and Development, 39(3), 10. 16 Castello, Montserrat and Luis Botella. (2006). Constructivism and Educational Psychology. In Joe Kincheloe and Raymond Horn (Ed.), The Praeger Handbook of Education and Psychology. Westport, CT: Praeger.

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In the first unit that I observed in the public high school health education class, Mr. Milton addressed tobacco use. In that very first class for which I was present, I noticed that he made statements that seemed to promote unhealthy behavior. For example, he told the students that models, actors, and actresses smoke cigarettes because they are appetite suppressants and cause weight loss. While his statement regarding smoking and weight loss may be accurate, my immediate internal response was that telling teenagers (86% of whom report an eating disorder by the time they are twenty17) that doing something will make them lose weight would likely make them consider doing it. Also, by telling students that models, actors, and actresses, who are often seen as role models for teenagers, are smoking, it could be interpreted that Mr. Milton was promoting the activity, rather than discouraging it. I also noticed that Mr. Milton made broad claims without providing evidence to support his statements. For example, he told the students if you hang around a barbershop long enough, you'll get a haircut. If you hang around smokers long enough, you'll start smoking. and warned them that [Smoking is] gonna kill you. There's not even a doubt about it. These kinds of broad claims seemed to weaken his argument and I thought they would be less likely to prompt students to take his statements seriously because they are too general to possibly be accurate. The only handout he gave the students during the tobacco use unit was called Tobacco Horrors (See Appendix 1), which is a list of statements about tobacco. Searching for this handout on the Internet led me to discover that it is over a decade old. This could be problematic because information that might have been accurate when materials were published is likely to be inaccurate ten years later. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
17

National Association of Anorexia Nervosa and Associated Disorders. (2012). Eating Disorders Statistics Retrieved May 3, 2012, from http://www.anad.org/get-information/about-eating-disorders/eating-disordersstatistics.

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My first reaction in observing the tobacco unit was that Mr. Milton's style of teaching appeared to rely on scare tactics in order to get his point across (such as declaring that smoking will undoubtedly kill anyone who participates in it), which have been proven to be ineffective in helping people make decisions about whether or not to do something potentially dangerous. In 2006, biologist Martin Lindstrom conducted a brain-imaging experiment in which researchers used functional magnetic resonance imaging, a scanning technique that allowed them to observe which specific regions of the brain are active at any given time. They scanned the brains of both smokers and non-smokers while they were shown cigarette package warning labels with graphic descriptions of the dangers of smoking. The researchers found that in both groups the warnings prompted no blood flow to the amygdala, the part of the brain that registers alarm, or to the part of the cortex that would be involved in any effort to register disapproval.18 To the contrary, the warning labels backfired: In both groups, they stimulated the nucleus accumbens, sometimes called the "craving spot," which lights up on an F.M.R.I. whenever a person craves something.19 This experiment shows that scare tactics are not effective in educating young people about the dangers of tobacco. Therefore, it is logical to assume that scare tactics are not effective in educating young people about alcohol and other drugs and sexual behavior, and it is clear that new methods need to be implemented instead.

Alcohol and Other Drugs Unit The next unit that Mr. Milton taught was on alcohol and other drug use. He screened a movie called Brandon Tells His Story (1995), which is the story of a teenage boy who drove while drunk and got in a car accident. He ended up with severe brain injuries and had to re-learn !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
18 19

Lindstrom, Martin. (2008, November 12). Scare Tactics Don't Work, New York Times. Ibid.

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how to eat, talk, walk, and do everything else that he had become accustomed to doing. While Mr. Milton seemed confident that this movie was helpful to the students, it seemed to follow the same scare tactic methods he previously used. I further noticed the students were talking amongst themselves and didnt seem to be paying attention during the movie. After the movie, Mr. Milton made a statement that perpetuated harmful gender stereotyping: Every single one of you, especially the girls, will be pressured into getting into a car with someone who is drunk, or to drive drunk yourself. He never went on to discuss why he felt that the girls were especially vulnerable to peer pressure around drunk driving, and it certainly left me wondering, so I wouldnt be surprised if this also confused the students as well. This statement struck me as particularly odd because, according to a survey conducted by the National Highway Traffic Safety Administration, male teenagers were involved in almost twice as many drunk-driving accidents than their female counterparts.20 Regardless of his reasoning, statements such as this that single out women are incredibly troublesome because they send the message that young women need to be more concerned with issues like peer pressure and drunk driving than young men do. I would argue that the responsibility lies equally with all young people who are drinking and driving. During this unit, Mr. Milton made statements that werent related to alcohol use and instead promoted unhealthy sexual messages for young people. At the end of one class, he gave students an assignment that asked them to write alternative activities you can do that dont involve drinking. (See Appendix 2) He made a point of telling the students, Now, don't put 'sex' down on these sheets, either, 'cause girls, you know if you get pregnant, he ain't stickin' !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
20

National Highway Traffic Safety Administration. (2008). National Survey of Drinking and Driving Attitudes and Behaviors: 2008 Retrieved December 4, 2012, from http://www.nhtsa.gov/DrivingSafety/ImpairedDriving/NationalSurveyofDrinkingandDrivingAttitudesandBehaviors: 2008.

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around. This statement obviously struck me as incredibly problematic. First of all, it puts all responsibility for sexual consequences on femalesthe statement implies that it isn't the boy's fault that he won't be stickin' around; it is simply the nature of his gender. It also implies that all sexual activity will likely lead to pregnancy, which is both untrue and hetero-normative. Statements such as this place more of an unhealthy stigma on teenage sexuality than there already is and give the predominant message don't have sex rather than a healthier message of if you decide to have sex, practice safer sex. I am basing my definition of 'healthy' on Foucault's repressive hypothesis. This hypothesis speculates that we, as a culture, have always shunned discourse around sexuality and emphasizes the importance of sexual discourse to a society's healthy functioning.21

Nutrition Unit Mr. Milton also taught a unit on nutrition. During his lessons for this unit, he repeatedly made statements that promoted unhealthy eating habits that could lead to eating disorders or low self-esteem in his students. The most prominent example of this type of statement was when he described amounts of food in extreme ways, presumably in order to scare the students. For example, he told them that the amount of cheese we eat per day would fill a football field. However, he was talking about the amount of cheese that everyone in the United States eats per day, but then he would say Can you imagine eating that much cheese in one day? which insinuates that one person would ever eat that much cheese. He did this with a lot of foods, such as hamburgers, soda, and French fries. I understand that his intention was to show that those foods are unhealthy, but I find the statements troubling for two reasons. First, again, it is employing the same types of scare tactics !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
21

Foucault, Michel. (1978). The History of Sexuality, Volume 1: An Introduction. New York: Vintage Books.

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on which he has continuously relied, and secondly, it sends the message that there are certain foods that should never be eaten because they are objectively unhealthy. According to Dr. Pulkit Sharma, a Psychoanalytical Therapist at Vidyasagar Institute of Mental Health and NeuroSciences in New Delhi, eliminating certain types of foods completely from your diet is one type of behavior that can lead to eating disorders, especially in teenagers. Sharma's research found that when you try to keep away from something you like, a tension builds inside and this makes people go for an impulsive uncontrollable binge.22 I think that a much healthier message to send to these impressionable high school students might have been eat healthy foods, but don't be afraid to have 'unhealthy' foods in moderation.

Human Sexuality Unit The last unit I observed Mr. Milton teaching was human sexuality. This unit covered the topics of abstinence, contraception, sexually transmitted infections (STIs), sexual activities, and relationship skills. During my observation of this unit, I noted that Mr. Milton made broad, gender-stereotyping statements. For example, when discussing the cost of raising a child, he said, Girls, don't go crazy [with the cost of baby clothes]. Your baby doesnt need to be dressed in Calvin Klein. Later in the unit, he said, No offense to you guys, but girls are the most responsible. The issue that I had with these types of statements was that they were general claims that served to separate boys and girls instead of unite them as human beings. As gender scholar Cordelia Fine states in her book, Delusions of Gender: How our Minds, Society, and Neurosexism Create Difference, gender stereotyping of children and teenagers can create many !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
22

Healthmeup.com. (2012). Why You Shouldn't Deprive Yourself of Your Favourite Foods Retrieved May 4, 2012, from www.healthmeup.com/news-healthy-living/why-you-shouldnt-deprive-yourself-of-your-favouritefoods/11923.

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problems in future relationships, both romantic and otherwise.23 By promoting these stereotypical messages in his classes, Mr. Milton could be creating complications for his students down the road. Since claims such as the ones Mr. Milton made also cannot be proven (how does one prove that girls are more responsible than boys, when the word responsible is so subjective?), he is also providing the students with his own opinions rather than factual information, which is inappropriate in a health education classroom setting. When discussing STIs, Mr. Milton told the students that they could get pubic lice from filth and dirt, or from a toilet seat, but neglected to tell them that they could get it from sexual activity. By focusing on the non-sexual ways in which students can contract pubic lice and omitting the sexual ways (which are by far the most common means of transmission24) Mr. Milton is promoting the message that good, normal students would never contract an STI, and if they did, then it could only have been contracted through innocent means, not from sexual contact. This further stigmatizes anyone in his class who does contract an STI from sexual behavior. Rather than teaching the students how to avoid contracting STIs, Mr. Milton is only making it more likely that they will feel shameful if they do contract one. Mr. Milton also made factually inaccurate statements such as HPV is a highly contagious herpes and that students' only option for condoms if they have a latex allergy are lambskin condoms. Giving them inaccurate information about STIs could cause complications if they ever contracted an STI. Telling students that HPV (human papilloma virus) is a form of herpes is problematic because if they were to contract HPV, they might not know the potential seriousness of the infection and might not seek proper treatment. Omitting key information such !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
23 24

Fine, Cordelia. (2010). Delusions of Gender: How our Minds, Society, and Neurosexism Create Difference. New York: W.W. Norton. Leone, Peter A. (2007). Scabies and Pediculosis Pubis: An Update of Treatment Regimens and General Review. Clinical Infectious Diseases, 44, S156.

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as the distinguishing characteristics between different STIs does not promote healthy sexuality in teenagers. Neglecting to tell students about other non-latex options besides lambskin condoms, such as polyurethane or polyisoprene condoms, could be very harmful to them. Lambskin condoms are much more expensive and not nearly as effective in preventing STIs as synthetic non-latex condoms.25 Students who are told that lambskin condoms are their only options are at risk for contracting an STI from using one. They also might be at risk for pregnancy if they decide the cost of lambskin condoms is too high and they arent aware of polyurethane or polyisoprene condoms. Mr. Milton also told the students that they would have healthier relationships with themselves and others if they abstained from sexual activity. These broad claims take away students' sexual agency by teaching them that they are making healthy decisions only if they are abstaining from sexual activity. By refusing to legitimize teenagers' ability to say yes to any type of sexual activity, we, as educators, are stripping them of the power they have over their own bodies. I discuss this idea further in part two of my Plan, Sex Education and Social Inequality. The first handout from this unit, Teen Sexuality Vocab Health Quiz, (See Appendix 3), features a word bank and questions to fill in with words from the bank. I found many of the questions on this quiz to be troubling. Question 3, for example, is as follows: Penis penetration into the vagina during sexual activity is what? The correct answer is intended to be intercourse. While this is true, it is not the only type of intercourse that is possible, and this question reinforces a hetero-normative attitude that has been prevalent throughout my observations of this class. This question sends the message that heterosexual penile-vaginal !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
25

Planned Parenthood Advocates of Arizona. (2012). Allergic to Latex? You Can Still Have Safer Sex. Last modified 2012. Accessed November 5, 2012.

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intercourse is the only acceptable type of intercourse. Another problematic question on this handout is question 6, Communication intended to show off one's sexuality. Does not have to lead to sexual activity. The intended answer is flirting. I find that this statement perpetuates rape culture, the idea that rape and sexual violence are so prevalent in our society that it is normal to excuse, tolerate, or even condone such horrors.26 This question implies that, though flirting amongst teenagers does not have to lead to sexual behavior, it commonly does, placing the responsibility for any resulting sexual activity on anyone who engages in flirting. Another statement with which I took issue on this handout is question 8, which states, Avoiding sexual activity that puts myself in danger of disease or life altering situations. The correct answer is intended to be abstinence. This is an incredibly loaded statement, as it implies that if one is not abstinent (or refraining from sexual contact), one is immediately in danger of disease or a life-altering situation. While this is true in some cases, there are many ways besides abstinence to protect oneself from disease, pregnancy, and other negative consequences of sex. While I understand the importance of promoting abstinence as an ideal option for teenagers, this statement not only neglects to mention other safe options, it also puts an enormous stigma on being sexually active as a teenager. The statement, and the message implicit in it, promote slut-shaming, or the idea of shaming and/or attacking a woman or a girl for being sexual, having one or more sexual partners, acknowledging sexual feelings, and/or acting on sexual feelings.27 Furthermore, according to Tekanji,28 a feminist blogger, slut shaming !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
26

Rozee, Patricia. (2012). Resisting a Rape Culture. Retrieved December 4, 2012, from www.raperesistance.org/research/rape_culture.html Tekanji. (2010). FAQ: What is 'Slut-Shaming'? Retrieved from http://finallyfeminism101.wordpress.com/2010/04/04/what-is-slut-shaming Internet pseudonym

27 28

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is about the implication that if a woman has sex that traditional society disapproves of, she should feel guilty and inferior.29 Tekanji goes on to discuss the negative effects that slut shaming can have: It is damaging not only to the girls and women targeted, but to women in general and society as a whole. It should be noted that slut-shaming can occur even if the term 'slut' itself is not used.30 Seemingly harmless statements such as the one on this handout perpetuate slut shaming and misogyny. The next handout that the students received during the human sexuality unit was the Unit 1 Health Quiz (see Appendix 4). There were two questions on this quiz on which I found myself focusing, which asked students to name 5 Risky Areas of our bodies that fluids can enter, and 5 Risky Fluids that can cause disease or pregnancy. I believe that the intention of these two questions was to provide the students with an understanding of how STIs are transmitted and how pregnancy can occur. While I wholly agree with the importance of providing this information, the way that these questions were worded implies that certain body parts and fluids are inherently risky, which can lead the students to feel shame about their bodies. Something that I noticed in my observation was that Mr. Milton consistently positioned men as powerful and women as victims. This is shown by question three on the Unit 1 Health Test (see Appendix 5), a matching-words-to-definitions quiz, which states The most powerful hormone we know, runs through a man's body, helps him grow and make sperm and semen. The correct answer is intended to be testosterone. The word powerful is incredibly subjective, and the test does not define what it means by powerful. Implying that testosterone is more powerful than any other hormone perpetuates the idea that men are stronger and more powerful than women. This continues the pattern in Mr. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
29 30

Supra at 27. Ibid.

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Milton's language that simplifies men and women as aggressors and victims respectively. Since estrogen, the hormone most closely associated with women, isn't discussed in this handout or in class, the focus on testosterone as most powerful implies that women are inherently weaker or less important than men. Another question that was troubling for me on this handout was question 11, which states, What miracle happens in the reproduction system of the female? (Italics in original document) The correct answer to this question is intended to be fertilization. Why is fertilization considered a miracle? The association of a scientific process with this historically religious word is troublesome as well as misleading. Fertilization occurs via a logical process that can be explained by science. Why, then, are students being taught that it is a miracle, defined as an extremely outstanding or unusual event, thing, or accomplishment manifesting divine intervention in human affairs31? Bringing religious terminology into a class that is teaching factual and non-biased information strikes me as completely inappropriate. Question 13 on this test also stood out. It stated, Women have a menstrual cycle for one reason. What is it? The correct answer to this question is intended to be cleaning. This question confused me because the menstrual cycle is not simply for cleaning. Menstruation is the process of a woman's body shedding the lining of the uterus because an egg has not been fertilized during that cycle.32 I suppose that one could argue that menstruation is the process of cleaning the excess lining from the uterus, however, that is clearly not the only reason that women have a menstrual cycle. The next question that I had problems with on this handout was question 14, which reads, !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
31

Merriam-Webster Dictionary Online. (2012). Definition of Miracle Retrieved May 3, 2012, from http://www.merriam-webster.com/dictionary/miracle. 32 U.S. Department of Health and Human Services Office on Women's Health. (2009). Menstruation and the Menstrual Cycle Fact Sheet. Retrieved from http://www.womenshealth.gov/publications/our-publications/factsheet/menstruation.cfm.

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Name the two uses of the female vagina. The correct answers to this question are intended to be sperm collector and birth canal. This question is troubling for many reasons, the first of which is that it reinforces hetero-normative ideas, because a woman could easily go through life without using her vagina for either of those purposes. Does that mean that, according to this handout, her vagina is useless? This question assumes that hetero-normative sexual activity and child bearing are the only possible opportunities for women to use their vaginas. This question also promotes the idea that women are only useful in relation to men. The phrasing of the term sperm collector is also incredibly disturbing to me because it sends the message that the vagina solely holds sperm and doesnt have a purpose of its own separate from the penis and semen. The term is also entirely framed around male pleasure, with a distinct omission of any possible use for female genitalia that isn't simply to provide pleasure to men (through ejaculation, the source of the sperm collection). The next page of this handout featured one open-ended question with which I took issue: Considering all the sexual activities talked about in class, which is the absolutely most dangerous [?] (Italics in original document) Though Mr. Milton never provided me with the intended correct answer to this question, positioning any singular sex act as the absolute most dangerous sends an unhealthy message about sexuality. If a student in the class participated in the activity deemed most dangerous, a question such as this could lead them to feel ashamed and embarrassed, even if they were conducting themselves safely. This question also promotes the unhealthy idea that sexual activity is inherently dangerous, and though one act might be most dangerous, they are all dangerous to begin with. Since there are ways to ensure that the risks of sexual activity are minimal, this message is not only inaccurate, but also potentially harmful to students perspectives about sexual behavior.

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The last page of the handout features another worrisome question; Give me your best refusal skill for not wanting to engage in sexual activity. This implies that all high school students would prefer not to have sexual activity if someone offers it, thus reinforcing the message of slut shaming that was prevalent in this class. The negative messages implicit in these classroom materials are unhealthy, promote sexual repression, and discourage healthy sexual discourse. If we expect teenage girls to only say no to sexual behavior, we imply that they can never say yes. By doing this, we are taking away the option for them to have a healthy sexual relationship. This question also implies that all men will try to pressure women into having sex with them, which takes away girls' ability to differentiate between a potentially healthy sexual relationship and a potentially coercive one. While I agree that it is important to teach students about the characteristics of an abusive partner, it is equally important to allow them to identify a potentially healthy partner. By insinuating that some refusal skills can be better than others, we also promote the idea that if a teenager does not give effective enough refusal to someone who wants to engage in sexual activity, it is their fault if they are sexually assaulted. It also implies that more is needed to dissuade someone from initiating sexual behavior than simply saying no, which also puts the blame for sexual assault on the victim, because they didnt use a good enough refusal skill. This question also portrays boys in a negative light, sending the message that they cannot control their sexual urges when someone refuses their advances. The next handout that Mr. Milton gave the students was an article entitled Oral Report, which discussed the rise of oral sex among high school students. This article was accompanied by a quiz (See Appendix 6). One question on this quiz read, Why do girls today feel as though Oral Sex is O.K. or a safe alternative to safe sex? This question seems to place responsibility on

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girls. Throughout the article, the term oral sex was synonymous with fellatio, and therefore it seems logical that it would be so in the quiz as well. If girls are participating in fellatio, it is safe to say that boys are too. This question promotes troubling messages that place girls and women as the only responsible parties for the consequences of sexual activity. The distinct lack of mention of cunnilingus as another form of oral sex assumes that all sexual activity is about male pleasure, responding to cultural trends that position women as subservient to men. Instead of using the opportunity of teaching youth about sexuality to challenge these assumptions, Mr. Miller's curriculum perpetuates them. The last handout that the students received from Mr. Milton during the sexual health unit was entitled Health Quiz Human Sexuality Male and Female Reproductive STD's And (sic) (See Appendix 7). It should be noted that the last word of the title was cut off. That said, several questions jumped out at me. Question six, which asked What is one organ that separates men and women no matter what operation you get? is openly transphobic33. The question relays the message that even if you identify as one gender, if you don't have the right genitalia, you can't really be that gender. Perhaps there were no openly transgender students in Mr. Milton's class, or perhaps he was unaware that there may have been, but this is an unhealthy message to be sending to anyone, regardless of gender identity. The second question that I found worrisome on this quiz was question seven, which asked, Why do the poor females have to go through the menstrual cycle? The use of the word poor implies that there is something pathetic about females and menstrual cycles. Promoting the idea that women should be pitied for having a natural process occur in their bodies is !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
33

Transphobia refers to a range of negative attitudes and feelings towards transsexualism and transsexual or transgender people, based on the expression of their internal gender identity (as defined in Serano, Julia. (2007). Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity Emeryville, CA: Seal Press.)

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unhealthy and should not be taught in a classroom. One could argue that women's potential to reproduce is powerful, not an affliction or something to look down upon. I understand that the intention of this question was to evaluate students' knowledge of the menstrual cycle, however, the question devalues the female body and is framed in an overtly masculinist way. Questions like this only serve to promote unhealthy ideas about women and the reproductive process. This concluded my observations in the high school. As you will read later in this paper, I followed up with Mr. Milton after my observations to discuss his approach in teaching this material.

Experiences in Community-Based Setting The Community HIV Center is a non-profit organization dedicated to preventing the spread of HIV and AIDS. I worked specifically with the Women's Program. The woman that I worked with, Sally Connor,34 was an HIV Prevention Specialist and health educator. I was able to observe her conducting two Safe Talks, which are women-only sexual health education presentations. I also observed her participating in peer outreach, where she talked to women on the street about sexual health and HIV prevention. Although I will compare Ms. Connor's delivery of information to Mr. Milton's, there are some significant differences between the two. The Safe Talks were attended by a significantly smaller group of people than the high school classes, and they were intended for women only. The women attending the Safe Talks were also older than the high school students, and the Safe Talks were voluntary, as opposed to the mandatory high school classes. Because of these factors, I anticipated that the two programs would be different from one another. Also, because of the infrequency of the Safe Talks compared to the high school classes, I was not able to gather as !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
34

Name has been changed.

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much information from the Community HIV Program as I was from the high school. During the Safe Talks that I observed, Ms. Connor spoke about the ways in which HIV is transmitted. She showed the women a list of fluids that can carry the virus, as well as a list of orifices that the virus can be transmitted through. She presented this information in a neutral way, in comparison to Mr. Milton. Unlike Mr. Milton, she did not insinuate that the fluids or body parts were inherently risky, and therefore did not encourage the women to have shameful attitudes towards their bodies. Ms. Connor also showed the women how to properly use a male condom. She had a model penis on which she put the condom, and she showed them how to safely take it off without spilling its contents. She also demonstrated the use of a female condom and provided information about both types of condoms. After the presentation, she distributed free condoms and allotted time for the women to ask questions about sexual health. During the peer outreach that I observed, Ms. Connor and I sat on a bench downtown and she told me her criteria for choosing the women with whom she spoke. She explained that she would only approach a woman if the woman was alone or with other women. Her rationale for this is because if the woman is in an abusive relationship with a man, and Ms. Connor approaches the two of them, then the man could become angry with the woman for taking condoms from Ms. Connor or even talking to her. He could then potentially take out his anger on the woman. Ms. Connor relayed that she did not want to take that risk. While this outlook is understandable, it could also be potentially limiting because it makes assumptions about relationships that already frame women as victims and men as aggressors. Instead of looking at men and women as equals, this approach sees the inherent power that men have over women in our culture. While I am certainly not disputing this power dynamic, I feel that it is possible that Ms. Connor could be perpetuating it by assuming that it exists to a problematic degree in all

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cases. Ms. Connor also chose specific places in town to conduct peer outreach, due to the prevalence of at-risk women in those areas. When she chose a woman with whom to speak, she approached her and asked if she had a moment to talk about HIV and AIDS prevention. If a woman agreed to this, Ms. Connor would give her a Safe Talk pamphlet and offer her some condoms. She would then ask the woman about her condom use habits and encourage her to use condoms regularly if she did not already do so. I thought that this approach sent a positive message to women, encouraging them to practice safer sex and not condemning them if they engaged in sexual activities.

Analysis At the end of my first semester of fieldwork, I informally interviewed both Mr. Milton and Ms. Connor. I asked them both the same questions. The first question that I asked was In your opinion, what are the best qualities for a health educator to have? In response to this question, Ms. Connor answered Warmth, social skills, [the] ability to engage others, [the ability to be] non-judgmental. She also spoke to the idea of knowledge of the subject one will be educating about: I would put knowledge of the subject you are educating about at the bottom only because an educator is only as good as how she/he presents the information. I believe most people can learn about the subject they are presenting to others, it takes the other skills that I mentioned at the beginning to pull it off well. That, I believe, is the real skill. I found this to be a salient point: knowledge is important for education, but only if one knows how to talk to people in a way that will help them learn and not cause problems for them

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in the future. Mr. Miltons answer to this question was A wide understanding of a lot of things that kids are involved with, meaning (presumably) tobacco, alcohol and other drugs, and sexual behavior. That statement is a bit vague, but I agree that it is useful to have an understanding of these things if you will be teaching them. The second question that I asked was What is your goal in the work that you do? What do you hope that people walk away with after a class or presentation? Ms. Connor's stated goal in her work was to ensure that the women learn how to protect themselves from HIV and also understand the information that [she] give[s] them in a way that they can apply to their lives. She further stated that she tries to convey the information in language that [her] audience can understand in an atmosphere of trust, non-judgment and safety. I believe that, from what little I have observed, Ms. Connor generally reached her goal and created a safe space for the women she worked with to speak freely. She did this by eliminating judgment when educating and by prioritizing her students knowledge, safety, and comfort over her own personal opinions. Mr. Milton stated that his goal in teaching is to help the students understand that they have to be the most important person in their lives, and that they have to be their own best friends. He is expressing the idea that he wants his students to respect themselves, which I would agree is a valuable lesson. My third question was Where do you get your educational materials? Are they given to you by the State? How often do you update them? Ms. Connor told me that she receives her materials from the Centers for Disease Control and the State Department of Health. She also stated that she does use other sources of

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information from resources online to keep [her] knowledge up to date with all of the changes that happen within the HIV/AIDS world and that she is very careful to answer questions that are posed to [her] in groups as factual[ly] as [she] can. This last statement resonated with me because I feel that it is important to make sure that when you are teaching something, it is as upto-date as possible so that your students are learning the most accurate information. Mr. Milton conveyed that his materials (handouts, tests, etc.) have to meet certain criteria from the State. He told me that he creates most of them himself, although he gets some of them directly from the State. He informed me that he reviews the materials every semester, but that this stuff doesnt change much. I feel that this is problematic because, contrary to what Mr. Milton might believe, health education information is updated often, and Mr. Milton's students would likely benefit from having up-to-date information in their classes. My final question to the educators was What kinds of feedback do you get from the people you talk to? Do they seem to enjoy and learn from your work? Ms. Connor's answer to this question was that she uses pre- and post-tests (one directly before the presentation and one directly after) in order to measure outcomes of her Safe Talks. The tests measure knowledge of HIV transmission, increased efficacy of condom use, and participant preferences. I think that anonymous pre- and post-tests can be successful in measuring the effectiveness of health education programs. Mr. Milton stated that he has been told that the students love [his classes] and that he gets along with them well. I am convinced from observing his classes that his intentions are good and that he does truly care for his students, but, as I have been explicitly describing, his execution has been problematic. This then triggered the question Are good intentions enough to be a successful health educator? I would argue that they are not, that there are some

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characteristics, whether learned or inherent, that contribute to the success of a health educator.

Qualities of an Effective Health Educator In order to effectively evaluate the educators, I researched greater context for what makes for a successful health educator. According to Jane,35 the author of the article 5 Essential Qualities of a Successful Health Educator from healtheducator.org, there are some essential qualities that most successful health educators should have in common.36 The first trait that is mentioned is a love of learning. As the article states, the health field is constantly changing, and as new information is discovered and new research occurs, the field of health education changes rapidly.37 A health educator who does not enjoy learning will find it difficult to keep up to date with new information and practices. The second characteristic highlighted is a passion for health. I would argue that a passion for what you do is essential for succeeding at any profession, and health education is certainly not the exception to that rule. The next trait detailed is the ability to be an understanding person. It is important to understand other peoples perspectives when you are working with them as a health educator. The fourth quality listed is the ability to communicate effectively. As the article states, Many health educators find themselves making group presentations frequentlyin addition to group presentations many health educators work with clients in one on one situations. This requires them to listen to problems that their clients are having, and find effective solutions that

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
35 36

Internet pseudonym Jane. (2012). 5 Essential Qualities of a Health Educator Retrieved February 3, 2013, from http://www.healtheducator.org/5-essential-qualities-of-a-successful-health-educator/ 37 Ibid

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will be well received.38 The final characteristic is a commitment to the job. The article states health education is not a nine to five career. Emergencies sometimes happen and some health educators work unusual hours.39 The article emphasizes the importance of being committed to health education and making a difference for the people you are working with. In the conclusion to this paper, I will compare the characteristics of the health educators that I observed with those provided in this article, in an attempt to measure the educators effectiveness.

Conclusion In general, I think that it was very useful to observe both of these methods of health education because I was able to compare them in order to determine the best ways to educate people about health issues. I found that, for the most part, I preferred Ms. Connor's more comprehensive and non-judgmental style, although Mr. Milton's clear devotion to students who are not choosing to be there is also admirable. When analyzing the behaviors of both educators with the 5 Essential Qualities article in mind, I concluded that Ms. Connor demonstrated all five of these qualities. She keeps up to date with the changing information in her field, and she clearly loves learning. From observing her behavior, it is clear to me that she is passionate about health education and displays understanding of her participants backgrounds. From witnessing her Safe Talks, it is also apparent that her communication skills are excellent and that she is completely committed to her job and the health education field. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
38 39

Ibid Ibid

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When studying Mr. Miltons behavior, I concluded that he demonstrated fewer of the five essential qualities. Though he may have loved learning, this was not clear to me because he did not update his materials often or check his facts to make sure they were accurate. He was certainly passionate about his job, however, as he seemed to genuinely enjoy teaching and talking to his students. Though it seemed as though he tried to understand his students backgrounds, I dont think his intentions were reflected in his lessons, based on the problematic statements that he made throughout the classes. In a similar vein, his communication skills were also clearly lacking because he seemed unable to get his points across without relying on scare tactics and broad generalizations. Lastly, I believe he was committed to his job, as witnessing his classes seemed to show his devotion to his students. However, are two out of five essential characteristics enough to be a successful health educator? I would argue that they are not. From my observations, I have learned a lot about the health education field and what it takes to be a health educator. I have been able to see what works in health education and what does not, and I feel that this has prepared me for a future career as a sexual health educator and for developing a sexual health curriculum.

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Appendices Note: These documents are intended to reflect the originals, and all typographical styles have been transferred from the original documents.

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Appendix 1: Tobacco Horrors Cigarettes contain 4,000 chemicals, including 200 that are known poisons. Nicotine is twice as addictive as heroin. Cigarettes are so poisonous that if you ate an entire pack at once, it would probably kill you. Cigarettes fill the blood with carbon monoxide, the same poisonous smoke that comes out of a car's exhaust pipe. Cigarettes contain 43 ingredients that are known to cause cancer. Each year in the United States, smoking causes over 5 million years of lost life. Cigarettes contain arsenic, or rat poison. Nicotine is so poisonous that it is used in many bug and weed killers. Secondhand smoke fills the air with many of the same poisons found in a toxic waste dump. Each year in the United States, smoking kills more people than AIDS, alcohol, drug abuse, car crashes, murder, suicides, and fire...combined. The average pack-a-day smoker breathes in seven pounds of tar during his or her lifetime. Teenagers who smoke produce phlegm more than twice as often as non-smoking teenagers. In a crowded restaurant, secondhand smoke can produce six times more pollution than a busy highway.

HRM Video-The Tobacco Horror Picture Show 37!

Appendix 2: Alcohol Alternatives: Sometimes people drink alcohol because they want to fit in, or because they think drinking will make them feel better about themselves. For each of the examples listed below, come up with four alternative activities you can do that dont involve drinking. List four things you can do at a party. 1. 2. 3. 4. List four things you can do on a date. 1. 2. 3. 4. List four things you can do when you are bored. 1. 2. 3. 4. List four things you can do with friends on the weekend. 1. 2. 3. 4.

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Appendix 3: Teen Sexuality Vocab Health Quiz WORD BANK: FLIRTING HETEROSEXUALITY HOMOSEXUALITY HORMONES INTERCOURSE SEXUALITY SEXUAL ORIENTATION ABSTINENCE

1) Male person attracted to another male person is an example of what? 2) Chemicals that are produced by the body to help organs and our brain to mature are known as: 3) Penis penetration into the vagina during sexual activity is what? 4) Feeling very special about another person is a sign of your: 5) Who you are attracted to, tall, short, dark skin, light skin, male, female, is a sign of your: 6) Communication intended to show off one's sexuality. Does not have to lead to sexual activity. 7) Female person attracted to a male person is an example of what type of behavior? 8) Avoiding sexual activity that puts myself in danger of disease or life altering situations.

Explain the difference between SEX and SEXUALITY.

Name the THREE sexual activities that put us at risk for exchanging fluids.

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Appendix 4: Unit 1 Health Quiz 1) Explain the word CONTRACEPTION. 2) Name the 5 Risky Areas of our bodies that fluids can enter. 3) Name the 5 Risky Fluids that can cause disease or pregnancy. 4) LABEL THE LETTERS: HIV AIDS 5) Name the 3 METHODS of contraception. 6) Give one example of each METHOD. 7) What is a common trait about 2 of the 3 Methods of contraception? 8) Which two are they?

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Appendix 5: Unit 1 Health Test: Human Sexuality WORD BANK: PENIS SCROTUM TESTICLES TEMPERATURE CONTROL TESTOSTERONE 96 98.6 DEGREES SPERM COLLECTOR REPRODUCTION VASECTOMY TUBULAR LIGATION FERTILIZATION CIRCUMCISION CONDOM CERVICAL CAP BIRTH CANAL PITUITARY CLEANING VAS DEFERENS FALLIOPIAN TUBES

1) Human reproductive systems are for: 2) Two major organs of the male reproductive system are: 3) The most powerful hormone we know, runs through a man's body, helps him grow and make sperm and semen: 4) Surgical sterilization in women is called: 5) The testicles are located and housed in the: 6) What is the major job of the above answer to #5? 7) The human body has a core body temperature. What is it? 8) Male sperm works best at what degrees? 9) Name 2 barrier contraception examples: 10) Surgical sterilization in men is called: 11) What miracle happens in the reproduction system of the female? 12) Which gland tells our brain it is time for male and female puberty? 13) Women have a menstrual cycle for one reason. What is it? 14) Name the two uses of the female vagina: 15) What is the name of the organs operated on for female sterilization? 16) What is being cut in surgery to sterilize men? 17. Name the 5 RISKY AREAS that go with the fluids. METHODS AND EXAMPLES: List 3 methods of contraception and give one example of THAT method. CIRCLE THE CORRECT ANSWER: V=virus B=bacteria O=other Chlamydia Herpes Pubic Lice Genital Warts Syphilis Gonorrhea VBO VBO VBO VBO VBO VBO 41!

AIDS Hepatitis C

VBO VBO

*Which bacterial disease (above) left untreated could kill you? *Considering all the sexual activities talked about in class, which is the absolutely most dangerous? *Give me your best definition of abstinent behavior. NAME 5 RISKY FLUIDS *In your best understanding, what is the difference with having a baby and being a PARENT? *How might your life CHANGE if you had a baby to take care of right now? (Social life, school, work, jobs, future) *How might a relationship change if you and your partner decide to become sexually intimate? *Give me your best refusal skill for not wanting to engage in sexual activity.

BONUS:
Give your best definition of what the word CONTRACEPTION means in today's society.

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Appendix 6: ORAL REPORT quiz NAME: CLASS# 1) Why do girls today feel as though Oral Sex is O.K. or a safe alternative to safe sex?

2) Many young men consider oral sex as a form of what?

3) Most young people do not consider oral sex real sex because why?

4) What (2) types of STD's seem to be most active for women who participate in oral activity? a) b) 5) What do movies and popular music reiterate to teens today about women and young girls?

6) What label do women try to avoid?

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Appendix 7: HEALTH QUIZ HUMAN SEXUALITY MALE AND FEMALE REPRODUCTIVE STD'S AND NAME: WORD BANK: (NOT ALL WORDS USED) 97.6 SCROTUM PENIS FERTILIZATION UTERUS OVARY 1) 2) 3) 4) 5) 6) VAGINA CIRCUMCISION TESTICLES 98.6 TESTOSTERONE PITUITARY GLAND HORMONE FALLIOPIAN TUBES 96 CLEANING MUSCLE CLASS#

Where are the male testicles housed The Human Core temperature is around The cutting of the foreskin on a male's penis is called what? Sperm works best in what temperature environment? What miracle happens in the upper fallopian tube of the female? What is one organ that separates men and women no matter what operation you get?

SHORT ANSWER: 7) Why do the poor females have to go through the menstrual cycle? 8) What is the main job of the male scrotum? 9) When the female produces an egg where does it go? What is the name of this period of time called for women? A) B) 10) Which STD is the most common today? 11) Name the two main organs of the male reproductive system A) B) 12) Name the two uses of the female vagina. A) B) 13) Which bacterial STD that left untreated could kill you? 14) What sexual activities put us at risk of exchanging fluids? A) B) C) CIRCLE THE CORRECT LETTER: 1) 2) 3) 4) 5) 6) CHLAMYDIA PUBIC LICE HIV GONORREHEA (sic) V HERPES HEPATITIS-C V V V B V V B B B O B B 44! O O O O O

7) SYPHILIS V B O 8) GENITALWARTS (sic) V B O 15) Name the 3METHODS (sic) of contraception. A) B) C) 16) Give an example of each Method. A) B) C)

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Works Cited Public School and Community-Based Health Education: A Comparison Study
Castello, Montserrat and Luis Botella. (2006). Constructivism and Educational Psychology. In Joe Kincheloe and Raymond Horn (Ed.), The Praeger Handbook of Education and Psychology. Westport, CT: Praeger. Centers for Disease Control and Prevention. (2011). HIV Among Women. Retrieved from http://www.cdc.gov/hiv/topics/women/index.htm. Fine, Cordelia. (2010). Delusions of Gender: How our Minds, Society, and Neurosexism Create Difference. New York: W.W. Norton. Foucault, Michel. (1978). The History of Sexuality, Volume 1: An Introduction. New York: Vintage Books. Healthmeup.com. (2012). Why You Shouldn't Deprive Yourself of Your Favourite Foods Retrieved May 4, 2012, from www.healthmeup.com/news-healthy-living/why-you-shouldntdeprive-yourself-of-your-favourite-foods/11923. Jane. (2012). 5 Essential Qualities of a Health Educator Retrieved February 3, 2013, from http://www.healtheducator.org/5-essential-qualities-of-a-successful-health-educator/ Jonassen, David H. (1991). Objectivism vs. Constructivism: Do we Need a New Philisophical Paradigm? Educational Technology Research and Development, 39(3), 10. Kathleen M. DeWalt, Billie R. DeWalt, and Coral B. Wayland. (1998). Participant Observation. In H. Russell Bernard (Ed.), Handbook of Methods in Cultural Anthropology. Walnut Creek, CA: AltaMira Press. Leone, Peter A. (2007). Scabies and Pediculosis Pubis: An Update of Treatment Regimens and General Review. Clinical Infectious Diseases, 44, S156. Lindstrom, Martin. (2008, November 12). Scare Tactics Don't Work, New York Times. Merriam-Webster Dictionary Online. (2012). Definition of Objectivity, from http://www.merriam-webster.com/dictionary/objectivity Merriam-Webster Dictionary Online. (2012). Definition of Miracle Retrieved May 3, 2012, from http://www.merriam-webster.com/dictionary/miracle. National Center for Education Statistics. (2012). National Center for Education Statistics Retrieved May 2, 2012, from http://nces.ed.gov/. National Education Association. (2009). Vermont-NEA Southern Region Salary: National Education Association-Vermont. 46!

National Association of Anorexia Nervosa and Associated Disorders. (2012). Eating Disorders Statistics Retrieved May 3, 2012, from http://www.anad.org/get-information/about-eatingdisorders/eating-disorders-statistics. National Highway Traffic Safety Association. (2008). National Survey of Drinking and Driving Attitudes and Behaviors: 2008 Retrieved December 4, 2012, from http://www.nhtsa.gov/DrivingSafety/ImpairedDriving/NationalSurveyofDrinkingandDrivingAttit udesandBehaviors:2008. New York State Department of Health. (2009). St. Lawrence County Teenage (Age 15-19) Pregnancy Rate Per 1,000 Females Age 15-19. Retrieved from http://www.health.ny.gov/statistics/chac/birth/tp151940.htm. Newman, Rick. (2012). How to Gauge Your Middle-Class Status, U.S. News. Retrieved from http://money.usnews.com/money/business-economy/slideshows/how-to-gauge-your-middleclass-status/2. Planned Parenthood Advocates of Arizona. (2012). Allergic to Latex? You Can Still Have Safer Sex. Raskin, Jonathan D. (2002). Constructivism in Psychology: Personal Construct Psychology, Radical Constructivism, and Social Constructivism. In Jonathan D. Raskin and Sara K. Bridges (Ed.), Studies in Meaning: Exploring Constructivist Psychology. New York: Pace University Press. Rozee, Patricia. (2012). Resisting a Rape Culture Retrieved December 4, 2012, from www.raperesistance.org/research/rape_culture.html Serano, Julia. (2007). Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity Emeryville, CA: Seal Press. Tekanji. (2010). FAQ: What is 'Slut-Shaming'? Retrieved from http://finallyfeminism101.wordpress.com/2010/04/04/what-is-slut-shaming U.S. Census. (2012). State and County Quick Facts. U.S. Department of Health and Human Services Office on Women's Health. (2009). Menstruation and the Menstrual Cycle Fact Sheet. Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/menstruation.cfm. Willig, Carla. (2001). Introducing Qualitative Research in Psychology: Adventures in Theory and Method. Buckingham: Open University Press. World Health Organization. (2012). Health Education, from http://www.who.int/topics/health_education/en/ 47!

Sex Education and Social Inequality: History and Analysis

Introduction In the cultural discourses of sex education in the United States, women, people of color, people living in poverty, lesbian, gay, bisexual, and transgender (LGBT) people have been consistently portrayed as either promiscuous and lacking in morals or as victims. These discourses have promoted pervasive negative attitudes toward these groups. I believe that we, as a society, can combat these harmful messages by providing comprehensive sex education to all young people, education that is intentionally designed to work against the popular discourses. In order to understand these discourses we will need to understand their history. In this paper, I will provide a brief history of sex education in the United States and its relevance to socio-economic inequality. I will then analyze the problematic cultural dialogue around sex education and propose a solution to combat said dialogue. For the purposes of this paper, sex education refers to any program, whether based in a school or a community organization, which attempts to educate the public (often, but not always, youth) about topics relating to human sexuality. The two most common types of sex education are abstinence only education and comprehensive education. Abstinence only education teaches abstinence as the only morally correct form of sexual expression for teenagers and generally does not include information about condoms or other methods of contraception. Comprehensive sex education generally teaches abstinence as the preferred method for avoiding sexually transmitted infections (STIs) and unwanted pregnancy, but it also teaches about contraception and condoms

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as options if students are not abstinent. Comprehensive sex education also often teaches interpersonal and communication skills to help students enter into healthy relationships.40

Discourse and Social Inequality Discourse is a vital part of the way our society works, as stated by critical theorist Peter McLaren: [D]iscourse and discursive practices influence how we live our lives as conscious thinking subjects. They shape our subjectivities (our ways of understanding in relation to the world) because it is only in language and through discourse that social reality can be given meaning. Not all discourses are given the same weight, as some will account for and justify the appropriateness of the status quo and others will provide a context for resisting social and institutional practices.41 Schools and other educational institutions wield incredible power in defining popular discourse due to their role in teaching what the culture has deemed as important and normal for youth in society. Educational structures, textbook publishers, and educators all determine what students learn and whose knowledge is valued.42 McLarens idea of the school as a source of power and control is rooted in Foucault's concept of the Panopticon: an all-seeingyet invisiblecontrolling force that is particularly effective in reinforcing popular discourse because everyone unknowingly contributes to it.43 The popular cultural discourse that surrounds female sexuality emphasizes the potential for all women to become victims and at the same time holds them responsible for their victimization. Sex education classes commonly promote this discourse through the use of sexual assault prevention techniques that focus on what people can do to prevent themselves from being !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
40

Advocates for Youth. (2001). Sex Education Programs: Definitions & Point-by-Point Comparison Retrieved March 27, 2013, from http://www.advocatesforyouth.org/publications/655?task=view 41 McLaren, Peter. (1998). Life in Schools: An Introduction to Critical Pedagogy in the Foundations of Education. New York: Longman. 42 Ibid, 12 43 Foucault, Michel. (1977). Discipline and Punish. New York: Random House, Inc.

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assaulted as opposed to what they can do to prevent themselves from assaulting others. While women are not the only people at risk for sexual assault, it is important to note that the vast majority of reported sexual assaults are perpetrated against women.44 Therefore, by teaching, dont get abused instead of dont abuse, we, as a society, are putting the blame for sexual assault on women. These victim-blaming messages are common in sex education classrooms across the United States. Educational films such as Straight Talk: The Truth About Alcohol and Sex which portray female victims of sexual assault being ostracized far more than male perpetrators of said assault, demonstrate the all too real events that occur when women reveal their victim status.45 Instead of placing responsibility on the perpetrators of sexual assault, we are instead asking what the victims wore, whether they had been drinking, or what they might have said to allow themselves to be violated. The result of this shift in responsibility is that women are now being taught to expect to become victims and to anticipate having to control the sexual urges of the men they interact with. I will further elaborate on these problematic discourses of female victimization throughout the course of this paper. The discourse of race in sex education is centered largely on the idea that people of color are hypersexual and morally corrupt. This idea, which came out of the culture of slavery and has been reinforced in American society since then, affects the ways in which people of color are taught about sex. Stereotypical images and attitudes about the sexuality of people of color permeate sex education classrooms, from the token black person in educational films (usually depicted in a stereotypical way that defines them by the characteristics that are presumed about their race) to the lack of mention of cultural differences in ideas and values around sexuality. I !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
44

Rape, Abuse, and Incest National Network (RAINN). (2009). Who are the Victims? Retrieved April 16, 2013, from http://www.rainn.org/get-information/statistics/sexual-assault-victims 45 Bentley, Jared (Writer). (2009). Straight Talk: The Truth About Alcohol and Sex [film]. In Erahm Christopher and John C. Pohl (Producer).

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will discuss the origins and effects of these harmful discourses surrounding race and sexuality later in this paper. People from low socioeconomic class backgrounds are often portrayed in educational settings as lazy, greedy, and promiscuous. Images such as that of the welfare queen (a [usually black] woman who has many children for no reason other than to collect more welfare money) permeate our society and were once included in sex education materials. Indeed, some of the earliest forms of sex education focused on preventing middle class white men from reproducing with lower class women, immigrants, and women of color. I will further discuss these sex education programs and the classist discourses that they continue to promote later in this paper. Historically, the cultural discourse around homosexuality and gender nonconformity has been one of sin, illness, and deviant behavior; these ideas still permeate our society today.46 Schools are among the most common places where hetero-normative ideals are promoted, through sex education and other curricula as well as through extra-curricular activities. For example, schools almost exclusively study heterosexual romantic literature, and they present the nuclear heterosexual two-parent family as the ideal. Sex education in public schools usually focuses only on the reproductive aspects of sexuality and on abstaining from (heterosexual) sexual contact. Other forms of relationships are omitted from most curricula. Extra-curricular activities that promote hetero-normative values include Valentine's Day gift exchanges, kissing booths at school fairs, and proms and other formal dances.47 In order to counteract and deconstruct these incredibly strong social forces, one must understand how they work and seek to create educational spaces that offer a more inclusive and diverse sexuality curriculum.

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46

Meyer, Elizabeth J. (2012). From Here to Queer: Mapping Sexualities in Education. In Erica R. Meiners and Therese Quinn (Ed.), Sexualities in Education: A Reader. New York: Peter Lang. 47 Supra at 3, 12.

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Intersectionality It is important to note that while I am discussing four distinct groups of historically marginalized people, the divisions between these groups are often blurred. It is impossible, for example, to talk about race without recognizing that the experiences of women of color are far different than the experiences of men of color. As feminist and race scholar Kimberle Crenshaw states in Mapping the Margins: Intersectionality, Identity Politics, and Violence Against Women of Color, The narratives of gender are based on the experience of white, middle-class women, and the narratives of race are based on the experience of Black men.48 Therefore, when discussing a demographic in this paper, I will often further qualify my statements (referring specifically to white women as opposed to all women, for example). In this way, I hope I will be able to convey the importance of recognizing that oppression has many forms and affects various people in vastly different ways.

A Brief History of Sex Education in the United States and Analysis Through the Lens of Social Justice49

Sex Education at the Turn of the Twentieth Century Modern sexuality education as it exists today50 began at the turn of the twentieth century when The Public Health Service began their first sex education campaign, which was intended to protect the health and well being of the family. It instructed young men and boys to practice self!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
48

Crenshaw, Kimberle. (1991). Mapping the Margins: Intersectionality, Identity Politics, and Violence Against Women of Color. Stanford Law Review, 43(6), 1241-1299. 49 For the purposes of this paper, I am defining social justice as a state of mind that identifies social inequalities and aims to remedy them. During my analysis, I attempted to approach each event with this mindset. 50 Some may argue that modern sex education got its start in the 1830s and 40s, or possibly earlier, but for the purposes of this paper, relevant sex education began in the early twentieth century.

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control in their sexual endeavors in order to protect their future wives and children.51 The increase in immigration to the United States in the late nineteenth century led many white, native-born Americans to fear that their culture was under attack. The Public Health Service launched its campaign in large part to encourage young men to abstain from sexual contact with immigrant women, who were seen as promiscuous and dangerous.52 In 1914, the American Social Hygiene Association (ASHA) was formed with the intention to combat the spread of venereal diseases (what are now referred to as sexually transmitted infections, or STIs).53 During this time, the phrase social hygiene was a popular euphemism for sexual health.54 ASHA provided sex education in schools and researched the causes of sexually transmitted diseases. ASHAs campaign was mostly successful, and before long, the federal government joined them in the fight against venereal disease.55 The early twentieth century was also when Margaret Sanger began her campaign to provide contraception to the public, specifically to young women who were risking their lives by having dangerous and illegal abortions. Sanger began her career as a nurse for Henry Street Settlement in New York City, where she assisted working-class women who experienced the negative consequences of frequent childbirth and self-induced abortions.56 In later speeches, Sanger often recalled the experience that led her to devote her life to providing contraception to women who needed it: while Sanger was working as a nurse, she visited Mrs. Sachs, a young woman who was extremely ill because of a self-induced abortion. After the doctor with whom Sanger worked had assisted Sachs, the young woman begged him to tell her how she could !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
51

Lord, Alexandra M. (2010). Condom Nation: The U.S. Government's Sex Education Campaign from World War I to the Internet. Baltimore, MD: The Johns Hopkins University Press, 15. 52 Ibid, 15 53 Ibid, 18 54 Ibid, 18 55 Ibid, 19 56 Endres, Kathleen L. (1995). Women's Periodicals in the United States: Social and Political Issues. Westport, CT: Greenwood.

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prevent this from happening again, to which he simply told her to remain abstinent. A few months later, Sanger was once again called to this same womans home, only to find Sachs dead after another illegal abortion.57 Referencing this incident in a speech, Sanger stated I threw my nursing bag in the corner and announced ... that I would never take another case until I had made it possible for working women in America to have the knowledge to control birth."58 Sanger went on to popularize the term birth control instead of more common euphemisms such as family limitation and stated that every woman should be the absolute mistress of her own body.59 One of Sangers early goals was to provoke a legal challenge to the Comstock Act, which made it illegal to send any obscene, lewd, and/or lascivious materials through the mail, including contraceptive devices and information, and abortion information for educational purposes. Many states had their own versions of this act, which were referred to collectively as Comstock Laws.60 In 1915, Sanger visited a Dutch birth control clinic, where she learned about diaphragms and realized that they were far more effective than the suppositories and douches that she had been promoting in the United States. She began importing diaphragms from Europe to the United States, in violation of the Comstock Act.61 By October of 1916, Sanger opened a family planning and birth control clinic in Brooklyn. Just nine days after the clinic opened, she was arrested for breaking the New York State Comstock Law.62 In January of 1917, Sanger went to trial for this

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57 58

Kelly, Gary F. (2012). America's Sexual Transformation. Santa Barbara, CA: Praeger. Viney, Wayne and D.A. King (2003). A History of Psychology: Ideas and Context. Boston: Allyn and Bacon. 59 Engelman, Peter C. (2004). Margaret Sanger. In George R. Goethals et al. (Ed.), Encyclopedia of Leadership (Vol. 4, pp. 1382): SAGE. 60 Kevles, Daniel J. (2001). The Secret History of Birth Control, The New York Times. 61 Chesler, Ellen. (1992). Woman of Valor: Margaret Sanger and the Birth Control Movement in America. New York: Simon and Schuster. 62 Supra at 8, 101.

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offense and was convicted and sentenced to 30 days in a workhouse.63 Although she was offered a more lenient sentence if she promised to abide by the Comstock Laws in the future, Sanger declined, publically stating, I cannot respect the law as it exists today.64 In 1918, with World War I bringing about an influx of venereal disease, Congress passed the Chamberlain-Kahn Act, which created a Venereal Disease Division within the Public Health Service and allocated $2 million to fight venereal disease.65 Around this time, the Commission on Training Camp Activities (CTCA) was formed, which provided sex education (with an emphasis on abstinence) to soldiers via informational films and pamphlets.66 These pamphlets paved the way for government-sponsored sex education, which became more prevalent later in the twentieth century. In the early 1900s, the popular discourse of minorities being sexually promiscuous began to develop. The influx of immigrants led to a more visible working class in most major cities in the United States, and many middle and upper class native born white Americans began to fear what they referred to as race suicide, the concept that if they bore children with poor immigrants, the elite class (often seen as a separate race altogether from even white immigrants) would die out. Therefore, any efforts to provide sex education to the middle or upper classes were focused onor at least accompanied byan emphasis on avoiding sexual contact with working class people and immigrants. This has, at least in part, led to the cultural discourse of women of color as promiscuous and uncontrollable. It is also important to note that the idea of people of color being promiscuous originates from the culture of slavery in the United States. Because slavery created a discourse of white superiority over blacks, the dissolution of slavery !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
63 64

Cox, Vicki. (2004). Margaret Sanger: Rebel for Women's Rights: Chelsea House Publishing, 64. Ibid, 65 65 Supra at 4, 26 66 Ibid, 28-29

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created what many white men thought of as the loss of their unchallenged supremacy.67 To maintain this power structure, white men would often lynch black men who allegedly raped white women, even if they were actually engaging in consensual sex. As scholar James Messerschmidt states, lynching enforced racial dominance as well as gender hierarchies between men and women and gender hierarchies among men.68 The master/slave relationship under slavery had allowed cultural ideas of idealized white gender roles to emerge. As Messerschmidt explains:
The master-slave relation constructed a masculine power hierarchy in which the white master was the representative of hegemonic masculinity. At the same time, cultural ideology and discourse claimed that the most advanced races had evolved the most pronounced gender differences. A white civilized planter woman (the mistress) thus represented the highest level of womanhood delicate, spiritual, exempt from heavy labor, ensconced in and dedicated to home. In contrast, a white civilized planter man (the master) was the most manly creature ever evolvedfirm of character and self-controlled, who provided for his family and steadfastly protected his woman and children from the rigors of the workaday world.69

In the creation of whites as the ideal forms of masculinity and femininity, blacks were often thought of as genderless and black men and women were considered far more similar to one another than white men and women were. Because both black men and black women were required to work for their white master, they could not conform to dominant white gender roles and were thus defined as savage and uncivilized. White Southerners also further differentiated themselves from black slaves by attributing [to blacks] a sexual nature that was more sensual, aggressive, and beastlike than that of whites.70 During Reconstruction (1865-1877), many white men dealt with the loss of their control over their slaves by culturally asserting control over !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
67

Messerschmidt, James W. (2007). "We Must Protect Our Southern Women": On Whiteness, Masculinities, and Lynching. In Mary Bosworth and Jeanne Flavin (Ed.), Race, Gender, and Punishment: From Colonialism to the War on Terror (pp. 77). Piscataway, NJ: Rutgers University Press, 77. 68 Ibid, 77 69 Ibid, 78 70 Ibid, 78

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them. Perpetuating the discourses of people of color as promiscuous and immoral was a way in which whites could continue to assert their dominance and prevent civilized white women from engaging in sex with black men.71 In this way, the harmful discourses that surround the sexuality of people of color have persisted even today. Sex education at the turn of the twentieth century was, for the most part, provided only to men because the popular discourse at the time saw middle-class white women as innocent and vulnerable. Because society in general believed that women needed to be protected from mens sexual appetites, men were encouraged to use self-control and women were encouraged to simply avoid men for fear of becoming victims of their uncontrollable urges. These attitudes have influenced the popular discourse today, which portrays women as victims and men as aggressors.

Sex Education in the 1920s In the 1920s, more Americans came to believe that sexual fulfillment was a crucial part of a healthy marriage. Educators then faced the dilemma of recognizing that sex was a positive force in marriage while at the same time feeling the need to condemn its expression among unmarried people. Sex educators reconciled these competing ideas by reemphasizing the health dangers of sex outside of marriage, but also by encouraging a healthy sex life within marriage.72 While access to contraception was still limited, it was becoming slightly more common thanks in large part to Margaret Sanger. In 1921, Sanger founded the American Birth Control League (ABCL), whose founding principle was: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
71 72

Ibid, 78. Moran, Jeffrey P. (2008). Sex Education Encyclopedia of Children and Childhood in History and Society.

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We hold that children should be (1) Conceived in love; (2) Born of the mothers conscious desire; (3) And only begotten under conditions which render possible the heritage of health. Therefore we hold that every woman must possess the power and freedom to prevent conception except when these conditions can be satisfied.73

In 1923, Sanger learned that physicians were exempt from the Comstock Act and could distribute contraception to women with a prescription. In order to take advantage of this loophole, she founded the Clinical Research Bureau (CRB), which was the first legal birth control clinic in the United States staffed entirely by female doctors.74 In 1928, Sanger resigned as president of the ABCL and took full control of the CRB, renaming it the Birth Control Clinical Research Bureau (BCCRB).75 In 1926, Surgeon General Hugh S. Cumming released a statement supporting sex education in schools. He noted, If young people of both sexes can be impressed with the dignity and true significance of sex, sordid experiences will tend to lessen and thus decrease the possible exposure to venereal disease.76 His emphasis was on abstinence as an effective method of achieving this goal. Cummings statement was groundbreaking because he was the first to advocate for sex education for both sexes. Soon after his comment, the Public Health Service launched a program that was aimed toward women as well as men. However, this program was nowhere near as focused as the one designed for males. While the educational materials provided for men and boys relied specifically on the message of abstinence, the materials provided for women and girls were more varied, and werent particularly successful at altering their

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73

Birth control: What it is, How it works, What it will do. (1921). Paper presented at the First American Birth Control Conference, New York. 74 Supra at 10, 25 75 McCann, Carole Ruth. (1994). Birth Control Politics in the United States, 1916-1945. Ithaca, NY: Cornell University Press, 177-178. 76 Supra at 4, 1

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behavior.77 As this was the first major instance of sex education being provided for women, it is likely that the Public Health Service was unsure of how to educate women effectively. A lack of success in early efforts did not deter the Public Health Service in its attempt to reach women. Much of the sex education in the 1920s was aimed toward preventing the spread of venereal disease, and the Public Health Service partnered with the General Federation of Womens Clubs in order to promote abstinence until marriage.78 However, the images that the Public Health Service made use of in their educational publications were of stereotypical female sexuality, as passive figures (mothers, wives, and daughters), or as prostitutes, who, while having sexual agency, were seen as dirty and morally corrupt.79 Sex education for women tended to focus not on the control of their own sexual behavior, but on the control of male sexual behavior.80 One of the Public Health Services most popular pamphlets, On Guard, stated that women should control male sexuality by demand[ing] clean living from the men of their choice, and by avoiding actions which arouse this natural but dangerous impulse.81 The pamphlet also warned against flirtatious behavior: [A woman who] thoughtlessly stimulate[s] the sex emotions of [her] male friend by careless words, familiar acts and too thin or otherwise suggestive and conspicuous clothing is arousing the feelings of the man and making herself responsible for his temptation and mistakes. 82 By shifting the responsibility for male sexuality to women, the Public Health Service perpetuated a discourse that remains prevalent today. The idea of women as the responsible parties for mens feelings and actions can be seen today in concepts such as the friendzone, which demonizes women who befriend men and dont have !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
77

Lord, Alexandra M. (2005). 'Naturally Clean and Wholesome': Women, Sex Education, and The United States Public Health Service, 1918-1928. Lister Hill National Center for Biomedical Communications Retrieved from http://www.lhncbc.nlm.nih.gov/lhc/docs/published/2005/pub2005001.pdf, 2 78 Ibid, 3 79 Ibid, 3 80 Ibid, 17 81 Ibid, 18 82 Ibid, 18

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sex with them. I will discuss the harmful discourses around gender in greater detail later in this paper. Furthermore, in the 1920s, the Public Health Service stated that it only took one woman to spark an outbreak of a venereal disease and insisted that 90 percent of [VD] infections are due to women and 10 percent to men, an outlook originating from the belief that only prostitutes could spread venereal disease.83 This led to the separation of women in popular discourse into two distinct types: the naturally clean and wholesome84 women, and the girlwho arouse[s] mens sex instincts.85 It was clear that middle-class white women fit into the first category, while poor women of color fit into the second. The separation served several purposes: firstly, it provided women with role models to emulate in terms of sexual behavior. Secondly, the Public Health Service was able to provide a simple solution to venereal disease without having to mention the highly debated idea of contraception. Finally, by endorsing a more conservative and traditional view of women, the Public Health Service opened itself up to wider support from the general public, as its insistence on any type of government funded sex education was a radical stance at the time.86 As white women in the 1920s gained more social independence, they became increasingly concerned with men of color, who they feared (based on the belief that people of color were more promiscuous than white people) might prey upon their daughters and rob them of their purity.87 As such, sex education began to focus on encouraging white women to marry within their race and to be wary of men of color.88 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
83 84

Ibid, 18 Stone, Lee Alexander. (1920). An Open Talk with Mothers and Fathers Presenting Some Present Day Problems in Social Hygiene. Kansas City, 6. 85 To Girls in Industry about the Enemy at Home. (1918). Washington D.C. 86 Supra at 24, 19 87 Supra at 3, 3 88 Ibid, 34

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Throughout the 1920s, discourses around womens sexuality shifted greatly. During the early twentieth century, women were seen as sexually passive or as victims of mens uncontrollable urges. However, in the early 1920s, reformers began to suggest that women had greater sexual agency. These conflicting views translated into a split in the cultural discourse along socioeconomic class and racial lines: it was presumed that if a middle or upper class white woman partook in sexual activity before marriage it was because she had been seduced by an uncontrollable man. However, if a working class woman of color was involved in such activities, she was actively choosing a life of sexual promiscuity and immorality.89 Sex education, therefore, became aimed at controlling womens sexuality, especially that of working class women, a trend that would continue for decades to come.

Sex Education in the 1930s and 1940s The discourse of sex education in the 1930s and 1940s was mostly focused on preventing the spread of venereal disease. In 1936, President Franklin Delano Roosevelt appointed Thomas Parran to the position of Surgeon General.90 Parran had a history of working to prevent the spread of sexually transmitted disease, and he brought this knowledge with him in order to spearhead a campaign during the late 1930s and 1940s in which he brought the venereal disease epidemic to the attention of the public.91 During Parrans term as Surgeon General, the Communicable Disease Center was formed, which forced the Public Health Service to become accountable for dedicating its sex education programs to fighting the spread of venereal disease.92 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
89 90

Supra at 23, 4 Supra at 9, 51 91 Ibid, 51 92 Ibid, 51

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During this time, however, there were warring discourses around sex education in the United States. On one side, Surgeon General Parran and his advocates crusaded for awareness of how to prevent the spread of venereal disease by educating the public about sexuality. On the other side were supporters of the Comstock Act and members of conservative and religious groups, who thought that it was morally wrong to discuss venereal disease or any aspect of sexuality and who actively tried to suppress any discourse around such topics.93 In 1930, a victory of sorts was won for proponents of sex education. The United States Court of Appeals for the Second Circuit decided that while condoms were still illegal when distributed as contraceptives, they were legal when distributed as a method of preventing venereal disease.94 This meant that the Public Health Service could now recommend condom use in their educational materials, but that unwanted pregnancy prevention was not widely mentioned in sex education during this time.95 Prompted by pressures from advocates of sex education, many state officials re-printed pamphlets that had originally been published earlier in the century by the federal government.96 Despite the positive intentions behind the republication of these materials, they proved ineffective in many communities, especially African American communities. Unequal access to education among people of color, especially in the South, led to widespread illiteracy among that population. Not only were people of color less likely than their white counterparts to be able to read these materials, they were also less likely to have access to the health care recommended.97 This lack of education led, in large part, to the highest rates of venereal disease at the time occurring in African American communities in the South. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
93 94

Ibid, 56 Ibid, 69 95 Ibid, 69 96 Ibid, 58 97 Ibid, 58

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In Mississippi, state officials were quick to point fingers at their African American citizens, stating, Negro syphilitics dont think that being cured [of syphilis] is worth it.98 They also echoed the sentiments of many white Americans when they stated that people of color were more inclined to contract venereal disease based on their alleged hypersexuality.99 Because of these attitudes, many white Americans began to have the belief, articulated by scholar Alexandra M. Lord, that sexually transmitted diseases were nationally known as special problems of the black rural South.100 As such, the harmful discourses of perceived hypersexuality among poor populations of color were promoted and reinforced by middle-class white Americans. Before the late 1930s, sex education had mostly focused on abstinence as the only way to prevent sexually transmitted disease. This changed in 1937, however, when the Public Health Service published two pamphlets, titled Gonorrhea: Its Cause, Its Spread, and Its Cure and Syphilis: Its Cause, Its Spread, and Its Cure. These pamphlets were groundbreaking for two reasons: First, they were the first sex education materials produced by the United States federal government that spoke clearly about sexuality without misleading euphemisms, and they were also the first materials of their kind that actively promoted the use of contraception: The use of the rubber (condom) during sexual intercourse protects both the man and the woman.101 While sex educators still encouraged abstinence, it was finally publically recognized that one could prevent sexually transmitted diseases while being sexually active. It is also worth noting that this was one of the first public sex education materials to recognize women as actively sexual beings. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
98 99

Ibid, 74 Ibid, 74 100 Ibid, 75 101 Ibid, 69

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In 1940, the U.S. Public Health Service again came out in strong support of sex education in schools, labeling it as an urgent need.102 The impetus for this statement was that the rate of venereal disease that was being contracted by soldiers in World War II had not significantly declined despite government efforts after World War I.103 As a response, the United States Army, the United States Navy, the Public Health Service, and the American Social Hygiene Association collaborated to create the Eight Point Agreement, which called for an expansion of the American military services existing campaign to control the spread of venereal disease.104 This plan encouraged those infected with venereal disease to seek treatment while also repressing the spread of prostitution and increasing sex education in the form of posters and pamphlets warning soldiers to avoid sexual encounters with prostitutes and good time girls.105 This continued focus on prostitutes as the primary carriers of venereal disease served to reinforce the woman-blaming discourse that originated in the early twentieth century and remains prevalent today, especially as it relates to women of color and women living in poverty. This discourse will be discussed in greater detail later in this paper. Not everyone in the United States thought that the military was doing enough to fight venereal disease, even after the Eight Point Agreement. In 1941, Surgeon General Parran published Plain Words Against Venereal Disease, in which he accused military leaders of complacency in the face of venereal disease.106 Many soldiers and sailors described the message that they received during the 1940s about sex as KPIP, or Keep Pecker in Pocket, because of the focus on abstinence and avoidance of discussion of contraception.107 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
102 103

Supra at 3 Ibid 104 Supra at 9, 72 105 Ibid, 76 106 Ibid, 73 107 Ibid, 85

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During the 1930s and early 1940s, the public school system was so decentralized that it was difficult to create any sort of standardized sex education programming.108 However, the Public Health Service decided that the schools must assume a major share of the responsibility for sex education.109 Therefore, they hired Benjamin Gruenberg, a consultant who had worked for them previously, to rewrite a new edition of his book, High Schools and Sex Education. In this book, Gruenberg argued that the recent influx of immigration into the United States had changed American culture for the worse. He stated that immigrants unfamiliarity with traditional American values led them to engage in dangerous sexual practices. He blamed immigrants for the rise in venereal disease, illegitimate pregnancy, and sex delinquencies, as well as rising divorce rates and rates of prostitution.110 Gruenbergs proposal for sex education in high schools was to teach immigrants to be more Americanized by instigating the socially desirable adult attitudes and practices necessary to insure homemaking [as well as] the establishing and building of families.111 Gruenberg also insisted that sex education should be taught not as a separate course, but integrated into every subject. He was an advocate for training teachers to be not only knowledgeable about sexuality, but also sympathetic to his ideas about immigration. He also insisted that teachers should educate students about sex humorously but at the same time avoiding dirty jokes.112 The public reaction to Gruenbergs proposed plan was mostly negative. Though many people did agree with his views on immigration and sexuality, few teachers had the sufficient knowledge to teach sex education in the ways that he proposed,

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108 109

Ibid, 64 Ibid, 64 110 Ibid, 64 111 Ibid, 64 112 Ibid, 64

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and parental opposition to any discussion of sexuality in a classroom setting presented serious obstacles to this approach.113 By the mid-1940s, however, more and more parents were advocating for sex education in schools. This change in opinion came about largely because of growing concern about young peoples behavior. Many American parents began to feel that their adolescent children were engaging in more promiscuous sexual activities than ever, and therefore decided that sex education could potentially benefit them.114 It also became much easier to implement sex education in public schools because of a significant increase in school enrollment during the 1940s. By the mid-1940s, three quarters of all teenagers in the United States were enrolled in school.115 This was the first time that American policymakers began to realize that schools were ideal sites to provide intervention to potentially stop risky sexual behaviors before they even began. Therefore, the Public Health Service made a second attempt at finding someone to design a new sex education curriculum. They hired Dr. Lester Kirkendall in 1944 to work with the Department of Education and to write a curriculum for teaching sex education in schools.116 Kirkendall had very strong beliefs about condoms, and he thought that knowledge of condoms would encourage teenagers to engage in sexual activity. He was also reluctant to teach explicit information about venereal disease or other sexual health topics because, as he stated, Youngsters may take a flippant attitude toward this type of education. Because of Kirkendalls concerns, the Public Health Service advocated for sex education courses aimed at the improvement of human relations and the strengthening of family life.117

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113 114

Ibid, 65 Ibid, 81 115 Ibid, 82 116 Ibid, 83 117 Ibid, 83

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This first school-based sex education, or family life education, as it was referred to at the time, focused on the positive impacts of a properly ordered family life.118 Lessons on child rearing, money management, wedding planning, dating, and a wide variety of other daily tasks were intended to bring a new generation of American youth into conformity with white, middleclass norms. Topics that were discussed in a 1944 class in San Diego, California included difficulties commonly involved when marriage is made between differing races, religions, and nationalities; family harmony, budgeting; respect for the opposite sex, [and the] role of both sexes in family life.119 This focus on the difficulties of interracial marriage served to reinforce the racist idea that interracial marriage was inherently problematic and should be prevented.

Sex Education in the 1950s and 1960s By the 1950s, the increase of sex education among adults led to a decrease in rates of venereal disease among the general population of the United States. However, these rates were steadily rising among teenagers.120 Prompted by a report in 1948 that indicated that adolescents primary source of information about sex was from friends of their own age and older boys and girls, the Public Health Service launched a new sex education campaign focused on preventing the spread of venereal disease among teenagers. This campaign included little to no mention of teenage pregnancy or any other sexual health issues that might face its intended audience, however.121 Many Americans at this time had become apathetic about preventing venereal disease since the introduction of penicillin in 1944, and thought that sex education was irrelevant. This attitude, coupled with the fact that most of the Public Health Services new !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
118 119

Supra at 18 Luker, Kristin. (2006). When Sex Goes to School: Warring Views on Sex--and Sex Education--Since the Sixties. New York: W.W. Norton and Company, Inc, 61. 120 Ibid, 94 121 Ibid, 109

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materials in this campaign were simply reprints of older materials originally produced before and during World War II, led to a widespread lack of interest in this campaign.122 A series of polls in the 1950s found that most Americans believed that they did not need sex education because they were morally superior to other communities that, in their eyes, did need this information.123 The communities that most Americans considered less morally sound were often poor areas with high populations of people of color, because of the aforementioned belief that people of color were more promiscuous than white people.124 In 1956, the Public Health Service released a report revealing that teenagers accounted for almost half of all new cases of syphilis and gonorrhea in the United States.125 By February of 1956, in the response to this report, most Americans were advocating for a big federal aid program to maintain a nation-wide control program.126 After the Public Health Service conducted more research, it was discovered that teenage girls were more prone to risky sexual behavior than adult women. Furthermore, the younger a man was when he became sexually active, the more likely he was to engage in risky sexual behavior in the future.127 Risky sexual behavior in this context referred to premarital sex, especially without the use of contraception. One of the most remarkable discoveries that came out of this research, however, was that the problems associated with unprotected sex (such as venereal disease and teenage pregnancy) were not confined to any sex, race, social group, or section of the country.128 This new information flew in the face of the assumptions that many middle-class white Americans had been making for decades about sexual behavior and its relation to race and class. Regardless of this clear proof !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
122 123

Ibid, 110-111 Ibid, 112 124 Ibid, 98 125 Ibid, 112 126 Ibid, 112-113 127 Ibid, 113 128 Ibid, 113-114

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that their stereotypes were unfounded, however, many of these problematic discourses were too ingrained to be removed so quickly without forces intentionally fighting against them. During the 1950s, the American Medical Association and the National Education Association worked together to publish a series of pamphlets that became the basis of the majority of school-based sex education programs. However, the range and depth of information taught in the classroom varied widely from school to school, and there was no national policy on what to teach and how to teach it. At the time, distribution of contraceptive information was still illegal in many states, and as a result it was omitted from sex education curricula.129 Despite this lack of explicit mention of sexual topics in the classroom, the majority of Americans were partaking in premarital sexual contact, according to Alfred Kinseys studies conducted in 1947 and 1953.130 Kinseys study also found that people were having sex at earlier and earlier ages, and these findings led to many organizations advocating for earlier marriage to prevent premarital sex. Womens Home Companion published an article that stated, When two people are ready for sexual intercourse they are ready for marriageand they should marry.131 In response to these pressures, the average age of marriage dropped steadily throughout the 1950s.132 Sex education during this time focused mostly on sexuality within the context of marriage, and on having children soon after marriage. This focus on early childbearing, coupled with the influx of men returning from the military in World War II, led to the baby boom, a period of time from 1946 to 1964 in which 76 million babies were born in the United States.133 In the early 1960s, public health experts echoed the common belief that unwanted out-ofwedlock pregnancies caused and exacerbated poverty, and therefore advocated for sex education !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
129 130

Supra at 3 Supra at 9, 95 131 Ibid, 95 132 Ibid, 96 133 Ibid, 96

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to be provided to poor communities in order to prevent these pregnancies. Public Health Service officials published a report stating that the children of unwanted pregnancies were more likely to endure physical abuse and neglect than their wanted counterparts.134 While well intentioned, this report only served to further separate low-income individuals from the rest of the population and promote inaccurate stereotypes of poor people as immoral and promiscuous. During the 1950s and 1960s, the eugenics movement had changed tactics in response to Hitlers horrific use of eugenics during World War II. Eugenicists in the United States began to focus less on race suicide and preventing unwanted populations from reproducing and more on ensuring the quality of life for all Americans through population control.135 Though many white Americans did not use birth control themselves, the majority expressed a desire for people of color to use birth control to keep what they viewed as a deviant groups population in check.136 The 1950s was also when fears about the sexual threat allegedly posed by people of color in the United States exploded. As the Civil Rights movement began and racial issues were brought to the forefront of American consciousness, more white Americans worried about people of color taking advantage of them sexually.137 This fear both stemmed from and exacerbated harmful discourses surrounding the sexuality of people of color. The first oral contraceptive was developed in 1956 by Gregory Goodwin Pincus, a biologist at the Worcester Foundation for Experimental Biology. The contraceptive was tested in Puerto Rico because its use was illegal in the state of Massachusetts at the time. Pincus also saw Puerto Rico as the perfect place to test his drug, as it was an overpopulated prototype

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134 135

Ibid, 122 Ibid, 98 136 Ibid, 98 137 Ibid, 102-103

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underdeveloped country on Americas own doorstep.138 Because women living in Puerto Rico were overwhelmingly uneducated, Pincus was also able to test to see if the oral contraceptive would require extensive training or education to use. By 1959, results indicated that the birth control pill (colloquially referred to as the Pill) was safe, effective, and easy to use, and in 1960, the FDA approved it for consumer use.139 The introduction of the Pill ushered in a new era in female sexuality. As more women began to use the Pill, they experienced an unprecedented sense of freedom. For the first time in history, they were in control of their own reproductive systems. Sexual experimentation became more common, because women could potentially explore their sexuality without the risk of unwanted pregnancy. The Pill also allowed women to postpone and limit childbearing, therefore leading to more successful and longer lasting careers.140 These benefits were really only felt by middle-class white women, however, because the Pill was expensive and its prescription was limited. During the 1950s, homosexuality was first being discussed publically. Homosexuality was thought of as a form of mental illness, and homosexual behavior was illegal in many states. While most gay people were closeted at the time, they were able to meet each other in sexsegregated military units and factories, and the very beginnings of the gay rights movement formed. Many Americans who were learning about homosexuality for the first time in the 1950s saw it as a threat to their families and the nation as a whole.141 This fear led to a widespread belief that gay people were promiscuous and unable to control their sexual urges. This belief is unfortunately still prevalent today, as demonstrated by the portrayal of gay characters on television shows such as Will and Grace and movies such as Scott Pilgrim vs. The World as !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
138 139

Ibid, 99 Ibid, 99 140 Streitmatter, Rodger. Sex Sells: The Media's Journey from Repression to Obsession. Cambridge, MA: Westview Press, 2004. xiii. Print. 141 Ibid, 103

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sexually uninhibited and morally questionable. Despite evidence that gay people have, on average, the same amount of sexual partners as straight people, these attitudes are still deeply ingrained into the cultural discourse in the United States.142 I will discuss the harmful dialogue around homosexuality in the United States in greater detail later in this paper. Beginning in 1955, the Public Health Service began to work in some of the United States poorest neighborhoods of color. Although this close work with people living in poverty and minorities led some Public Health Service employees to think critically about race and class, it did not directly translate into greater sensitivity in terms of their programming, which continued to promote racist and classist attitudes and actions.143 Because of the Public Health Services continued involvement with the Tuskegee Syphilis Experiment, which had allowed black men to live with, and die from, treatable syphilis in the name of scientific discovery, it was clear that their racist practices were far from over.144 It was clear that the governments priorities at this time were to provide sex education to middle-class white citizens and not to be concerned about the rest of America.

Sex Education in the 1970s In 1970, Congress passed Title X as part of the Family Planning Services and Population Research Act, which enabled the federal government to assist in making comprehensive family planning services readily available to all persons desiring such services.145 Title X set out to ensure that all Americans, regardless of their income, could obtain access to sexual health

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142 143

Strudwick, Patrick. (2010). So You Think Gay Men are Promiscuous? The Guardian. Ibid, 108 144 Heller, J. (1972). Syphilis Victims in U.S. Study Went Untreated for 40 Years; Syphilis Victims Got No Therapy, New York Times. 145 Supra at 9, 124

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services and contraception.146 In 1978, this act was amended to emphasize the prevention of unwanted teenage pregnancies.147 1970 also marked the groundbreaking case Roe v. Wade which legalized abortion at a federal level, ruling that the right to privacy stated under the due process clause of the 14th Amendment extended to the right to an abortion until fetal viability (when the fetus is potentially able to live outside the mothers womb).148 After Roe v. Wade, the Public Health Service was wary to promote abortion services because they had a history of advocating for the sterilization of women of color. They were concerned that any promotion of abortion services on their part would be viewed as a racist act.149 While I can understand the desire to not be perceived as racist, this was not a responsible decision on the part of the Public Health Service. Though it might have been difficult, I believe that the Public Health Service could have come up with a way to promote abortion services while making an intentional effort to combat racism. By doing nothing for seven years, they were only allowing racist discourses to flourish in the United States. During the late 1960s and 1970s, there was a divide among African American activists in regards to the use of family planning services (such as contraception and abortion) to limit the spread of poverty. Some African American activists, such as Martin Luther King, Jr, advocated for the use of these family planning services, but many did not. The Black Panthers and the Black Muslims harshly criticized the governments family planning efforts, citing them as evidence of federally sponsored black genocide and connecting them to the governments previous efforts to sterilize people of color.150 In general, this divide was along class lines, as !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
146 147

Ibid, 124 Ibid, 124 148 Wood, Mary and Lisa Hawkins. (1980). State Regulation of Late Abortion and the Physician's Duty of Care to the Viable Fetus. Missouri Law Review, 45, 394. 149 Supra at 9, 126 150 Ibid, 128

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most middle-class African Americans supported the governments family planning campaigns and lower-class African Americans did not.151 This was likely due to lower socioeconomic classes feeling attacked by the insistence on family planning services only for their demographic. This insistence further separated Americans along class lines. Women of color were also more likely to support the use of family planning services to combat poverty, while men of color overwhelmingly did not.152 This separation by gender was likely because providing family planning services to women gave them a taste of the kind of sexual agency that men had possessed for centuries. During the 1970s, the Public Health Service re-released a pamphlet titled Strictly For Teenagers: Some Facts About Venereal Disease, which called upon teenagers to talk frankly about venereal disease.153 This pamphlet was originally published a decade earlier. The most obvious difference between the two versions of the pamphlet were the images depicting what were intended to be typical teenagers. The older version depicts a clean-cut, modestly dressed, white heterosexual couple sipping soda at a restaurant. The boys arm rests lightly on the back of the girls chair, but there is no other physical contact between them. The overall tone of the image is innocent. In the newer version of the pamphlet, however, the teenagers are portrayed riding a motorcycle and wearing tight clothes. The couple depicted is still heterosexual, but this time, the girl has her arms wrapped around the boys waist and her pelvis pressed into his back.154 This was the Public Health Services way of showing the change in teenage behavior that had taken place in the past decade. Reports had indicated that more and more teenagers were having sex before marriage, and this evidence coupled with rising fears about teenage behavior !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
151 152

Ibid, 128 Ibid, 128 153 Ibid, 129-130 154 Ibid, 130-131

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led to changing attitudes about youth and sex in the United States.155 More Americans who had previously opposed sex education in schools were now advocating for it. Spurred by these changing attitudes, the Public Health Service published a groundbreaking pamphlet in 1977 titled Teenage Pregnancy: Everyones Problem, which stated, We can make sure that theres a place where sexually active teenage boys and girls can receive reliable information.156 This pamphlet discussed oral contraception, intra-uterine devices (IUDs), diaphragms, condoms, spermicidal foam, and natural methods such as the rhythm method. These unreliable natural methods were included at the urging of the conservative forces in public health at the time.157 The pamphlet was also the first government-published document that openly discussed abortion and the need for teenagers to have access to safe and inexpensive abortions.158 While this pamphlet was informative and fairly unbiased, it was not widely circulated because people had to specifically request it from the Public Health Service if they wanted it.159 This did not provide much information to populations who didnt already have access to comprehensive sex education, such as poor communities of color. As the 1980s approached, the divide between the middle-class white population and low-income communities of color deepened.

Sex Education in the 1980s and 1990s The climate of sex education underwent a gradual change in the 1980s as a result of nationwide concern over the Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome (HIV/AIDS) epidemic. As Surgeon General C. Everett Koop stated, [AIDS] entered !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
155 156

Ibid, 130-131 Ibid, 132 157 Ibid, 132-133 158 Ibid, 133 159 Ibid, 133

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the consciousness of the Public Health Service rather quietly, rather gradually, and with almost no fanfare at all.160 In early June of 1981, Public Health Service employees learned that five gay men had developed an extremely rare disease called Pneumocystis Carinni Pneumonia (PCP). Throughout the summer, more reports of PCP began to come in and people began to worry. Anthony Fauci, a researcher in immunology at the National Institutes of Health, recalled that by the early fall, he was starting to get a little worried thinking that this might be the emergence of a new disease.161 However, the Public Health Service did not make any sort of public statement about HIV/AIDS until 1986, when Surgeon General Koop published The Surgeon Generals Report on Acquired Immunity Deficiency Syndrome. This report included a description of HIV/AIDS and its symptoms, as well as an overview of the present situation with regards to the spread of the disease. There was an explanation of how HIV is transmitted and how to prevent transmission, and a discussion of the future of the disease and its possible impact on American society.162 The report also refuted the stereotype that only gay men could contract HIV by stating that [AIDS is] no longer the concern of any one segment of society, and that [AID is] the concern of us all.163 This report attempted to clear up the most prominent myths about HIV/AIDS by stating, You cannot get AIDS from casual social contact such as shaking hands, hugging, social kissing, crying, coughing, or sneezing [AIDS cannot be transmitted via] toilets, doorknobs, telephones, office machinery, or household furniture You cannot get AIDS from body massages, masturbation, or any non-sexual contact.164 Koop also stated the need for more comprehensive sex education: Information and education [are our] only weapons

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160 161

Ibid, 138 Ibid, 138 162 Ibid, 149-150 163 Ibid, 150 164 Ibid, 150

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against AIDS.165 Even though this report countered the misconception that gay men were the sole contractors of HIV/AIDS, it had been five years since the beginning of the epidemic, and during that time, negative associations had been made between homosexuality and the disease. Koop, who had been appointed Surgeon General as a representative of the Religious Right (a political faction that advocates for the inclusion of religious issues in government practices) by Ronald Reagan, believed that homosexuality was a sin, but he did not allow his personal beliefs to effect his opinions about providing comprehensive sex education to everyone, regardless of sexual orientation. He refused to lecture gay people about changing their ways, as many conservatives urged him to do, but he also refused to lecture homophobes about practicing tolerance, as many liberals desired. Koop did believe that homosexuals should be educated differently than others about sexual health issues. He made a notable statement about AIDS and its transmission when he said, People get AIDS by doing things that most people do not do and do not approve of. So when you [make] a decision about AIDS you must consider [how your words will affect] the way the decision-maker thinks and acts.166 Separating gay people from straight people by condemning their actions was problematic because it only served to further isolate and ostracize a group who was already facing extraordinary discrimination at this time. Though Koop made troublesome statements such as this one, he was also very open about the fact that his first priority was protecting people from contracting HIV, not passing judgment on their behavior.167 The type of sex education that Koop advocated for started at a very early age, ideally as early as kindergarten. He was a proponent of having sex education include discussions of abstinence and monogamy as well as information about condoms and STIs. During an address to !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
165 166

Ibid, 150 Ibid, 151-152 167 Ibid, 152

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students at Cardozo High School in Washington, D.C., Koop spoke candidly about condoms: If youre a man, you should wear a condom from start to finish. If youre a woman, you should make sure that your partner wears a condom from start to finish. The proper use of a condom is a persons best defense against the passing of the AIDS virus during sexual intercourse.168 Koops openness about sexuality and contraception caused a fair amount of backlash from people who had previously supported him. William Bennett, the Secretary of Education at the time, stated that including discussion of contraception in sex education classes might be clinically correct, [but] it [was] morally bankrupt.169 Many members of the Religious Right nicknamed Koop the condom king and condemned him for not insisting on abstinence only sex education.170 Koop also created numerous friends because of his statements, however. Jeff Levi, the executive director of the National Gay and Lesbian Task Force, stated that Koops report dramatically altered the level of public discussion on AIDS [by shifting it] from moral judgment to public health.171 As the HIV/AIDS epidemic began to spread across the United States, the federal government was not making a large effort to combat it. In 1988, the Secretary of the Department of Health and Human Services, Otis Bowen partnered with the Public Health Service, to publish a brochure about HIV/AIDS that, according to the Boston Globe, was inane and included only a minimal reference to condoms and an aside about gay men not being the only ones who can get AIDS.172 This pamphlet advocated abstinence only sex education, instructing citizens to just say no to sex.173 Furthermore, the pamphlet was only distributed to a limited number of !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
168 169

Ibid, 153-154 Ibid, 152 170 Ibid, 154 171 Ibid, 153 172 Ibid, 155 173 Ibid, 155

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people. Responding to widespread criticism of this pamphlet and other efforts to educate the public about HIV/AIDS, the Public Health Service wrote and distributed a seven-page mailer to American citizens in 1988. Congress gave the Public Health Service two million dollars to publish this mailer, which was written in English, several Spanish dialects, and Braille, thus allowing for a wider audience.174 The mailer provided citizens with information about what they could do to stop the spread of HIV and attempted to eradicate prevalent myths about HIV/AIDS, such as the idea that gay men were the only people who could contract the disease. The mailer stated, In spite of what you may have heard, the number of heterosexuals [with AIDS] is growing.175 The mailer also provided some clarification about how the virus was transmitted: You wont get the AIDS virus through everyday contact you wont get AIDS from a mosquito bite you wont get AIDS from saliva, sweat, tears, urine, or a bowel movement [and] you wont get AIDS from a kiss.176 This mailer was incredibly groundbreaking because it was sent to all Americans, regardless of race, gender, class status, or sexual orientation. It did not single out any specific group of people as being the most susceptible to the virus, and it was intentionally written to combat many of the homophobic and otherwise harmful discourses that were prevalent at the time.177 When polled, 82 percent of Americans revealed having read all or part of the mailer.178 A science reporter from Minneapolis noted that the mailer was just good, lifesaving reading [that did] an excellent job of simplifying the complex [issues while] presenting information in an easy-to-read form.179 The Boston Globe, who had previously been critical of the Public Health Services HIV/AIDS education efforts, was impressed by the mailer, !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
174 175

Ibid, 158 Ibid, 158 176 Ibid, 158 177 Ibid, 159 178 Ibid, 159 179 Ibid, 159

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stating, Hooray for the United States Congress for insisting that the government get a plainspeaking pamphlet on AIDS out to the public.180 The mailer was not well received by everyone, however. Judie Brown, president of the American Life League, stated that [The brochure] caters to such lifestyles as homosexuality and bisexuality by avoiding even a modest encouragement toward a type of sexual relationship designed by nature for man and woman to become one in marriage.181 Many advocates for abstinence only sex education were upset by the mailers honest discussion of condoms, even though they were only recommended as a resource for those who did not choose to practice abstinence, and abstinence was promoted as the best way to prevent the spread of HIV/AIDS.182 The backlash against this mailer stemmed from stereotypes about homosexuality that are still prevalent today. These stereotypes were not new, but this was the first time that a government publication intentionally counteracted this discourse. During his time as President, Ronald Reagan appointed many members of the Religious Right to prestigious positions in the Public Health Service and the government as a whole. Because of this, government-funded sex education efforts were greatly limited during the 1980s.183 Despite this opposition from Reagan, however, by 1988, over 90 percent of all U.S. schools offered some sex education programming.184 This was caused in part by a report that found that American girls and their European counterparts became sexually active at the same time, on average. However, American teenage girls were almost twice as likely to become pregnant than European girls.185 This was mostly because Europe had a variety of family planning programs set up with easy access to inexpensive or free contraception. The tone of !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
180 181

Ibid, 159 Ibid, 159 182 Ibid, 159 183 Ibid, 144-145 184 Supra at 3 185 Supra at 9, 146

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European sex education was also focused on preventing teen pregnancy as opposed to the American focus on chastity and abstinence.186 In the 1980s and 1990s, this focus on chastity remained constant as abstinence only sex education continued to be promoted by the government. With the appointment of Antonia Novello to the position of Surgeon General by George H. W. Bush, support for comprehensive sex education from the federal government was limited. Novello, who was described by her peers at the National Institutes of Health as a good soldier who doesnt squawk, was reluctant to come out in opposition to the strong proponents of abstinence only sex education in the United States.187 When Novello was asked to publish a report on AIDS in 1992, it was vastly different from Koops report. Novello called for sex education to be provided mostly by parents: The most effective sex education programs support and reinforce the AIDS prevention message given at home.188 Unfortunately for many children, however, sex education was not given at home. It was impossible to ensure that every child was able to receive any sort of consistent sex education at home, especially for children with unstable home lives. These children were overwhelmingly of low socioeconomic class background, and education discrepancies along class lines only led to an exacerbation of many of the problems that were often associated with the lower classes in the cultural discourse. Furthermore, studies dating as far back as the 1920s had shown that the majority of American parents failed to provide their children with any reliable sex education in the home.189 Novello did not call for any sort of widespread distribution of educational materials, as Koop had done, and there was very limited mention of condoms and other contraception in her report.190

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186 187

Ibid, 146 Ibid, 164 188 Ibid, 167 189 Ibid, 168 190 Ibid, 168

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With the knowledge of the decline of comprehensive sex education during the 1980s and 1990s, it should come as no surprise that the Adolescent Family Life Act (AFLA), which provided government funding to any sex education program that focused only on abstinence, received a great deal of support during this time. Passed in 1981 and co-sponsored by Orrin Hatch and Jeremiah Denton, conservative congressmen from Utah and Alabama, respectively, AFLA provided funding to programs that taught chastity education. It channeled funding to mostly religious organizations and subsequently away from programs that promoted comprehensive sex education, such as the Planned Parenthood Federation of America. For example, AFLA funds went to support St. Margarets Hospital, a Catholic facility in Dorchester, Massachusetts, in order to create an abstinence only program that distributed materials such as The Churchs Teachings on Abortion and The Churchs Teachings on Artificial Contraception. It wasnt until 1993 that the Department of Health and Human Services agreed to provide stricter monitoring of the programs that received state funding and to make sure that the government was not funding religious organizations.191 The institution of AFLA had various adverse effects on the state of sex education in the United States in the 1980s and 1990s. For example, the proportion of teachers who taught abstinence only sex education rose from 1 in 50 in 1988 to 1 in 4 in 1999.192 In 1990, the Public Health Service planned a large-scale survey on American sexual behavior. This survey, which would have been the most detailed survey of its kind since Kinseys work in the 1940s and 1950s, would have determined which Americans were most at risk of contracting sexually transmitted infections or become pregnant unintentionally.193 The Public Health Service planned to use the information gathered by this survey to create a sex !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
191 192

Ibid, 166 Ibid, 167 193 Ibid, 165

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education campaign that intentionally written for who were most at-risk for the negative consequences associated with unprotected sex. However, many powerful members of the Religious Right were strongly against the survey, saying that it was an intrusion into Americans private lives and that it would lead to a more sexually permissive society. William Dannemeyer, a conservative representative from California, complained that a sexual behavior survey would sway public opinion to liberalize laws regarding homosexuality, pedophilia, anal and oral sex, sex education, and teenage pregnancy.194 In response to this outrage, Congress cancelled the survey.195 In the mid-1990s, the state of comprehensive sex education in the United States began to improve. The Sexuality Information and Education Council of the United States (SIECUS), which had been founded in the 1960s and had advocated for abstinence education during its early years, officially came out strongly in favor of comprehensive sex education. Debra Haffner, the director of SIECUS at the time, declared that the distribution of condoms in schools was not an immoral act and that the immorality involved in sex education was in fact the common attitude of those who say just say no or die.196 In 1993, Bill Clinton appointed Joycelyn Elders to the position of Surgeon General. An African American woman from Arkansas, Elders had previously overseen a much-debated program to distribute condoms in schools across her home state.197 Elders was a controversial figure, however. Besides advocating for comprehensive sex education, she was also publically dismissive of the Religious Right, saying things such as [The Religious Right] love[s] little babies, as long as theyre in someone elses uterus.198 She also notably dismissed the Religious Right as religious non-Christians. It was revealed that during !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
194 195

Ibid, 165 Ibid, 165 196 Ibid, 171 197 Ibid, 171 198 Ibid, 172

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the condom distribution program in Arkansas, Elders had unknowingly distributed defective condoms without publicizing this information, which caused many Americans to dislike her.199 Elders also made a comparison of unmarried teen mothers to slaves.200 With this comment, she was likely trying to connect the African American community to the issues that she was passionate about, but by bringing up the issue of slavery, which was a very personal issue to many African Americans, she alienated members of a demographic that she was not only a part of, but was trying to reach out to specifically. Elders did not let this misguided comment stop her, however. She was intent on promoting comprehensive sex education and discouraging abstinence only education or what was often referred to as morality education. When discussing the teaching of morality in education, Elders said, Our children are out in the ocean drowning while were sitting on the beach worried and talking about whose values and whose morals we are going to teach.201 Elders was aware of the strong connections between teenage pregnancy and poverty. She realized that the high rate of teen pregnancy associated with lower socioeconomic classes and people of color was connected to a lack of comprehensive education provided specifically to these populations, as opposed to a promiscuity inherent to these groups.202 Elders not only advocated for sex education for people of color and people living in poverty, but for the LGBT community as well. No one in the federal government had ever publically come out in support of education for LGBT-identified people before, but Elders believed that everyone deserved comprehensive sex education regardless of sexual orientation, race, gender, or socioeconomic status. As John Cowen, the co-founder of the youth advocacy group Lead or Leave, stated, The political system is squeamish about the truth, [but Elders is !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
199 200

Ibid, 172 Ibid, 172 201 Ibid, 173-174 202 Ibid, 174

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advocating for the truth] as far as young people are concerned.203 Robin Kane, the Media Director of the National Gay and Lesbian Task Force, supported Elders sex education efforts as well, stating, [She is] the only person in [a] high position who speaks about how gay and lesbian people live in the country and [how] they are a part of communities.204 In setting out to provide comprehensive sexuality education to all United States citizens, Elders found that Americans, as a society, had a fear of sex, which she summed up as the belief that fornication must be punished and teenage pregnancy and the bad things that happen are the punishment.205 Elders thought that this belief was ridiculous, because, as she stated in 1994, [While] everyone in the world is opposed to sex outside of marriage everyone does it.206 As Koop had been labeled the condom king, Elders was often referred to as the condom queen. Her controversial work made her plenty of enemies. Janet Parshall, the special assistant to the president of Concerned Women for America, a conservative womens organization, used Elders own rhetoric of slavery against her, stating, [Elders] would like to enslave every child in America to her idea of sexuality education.207 Elders also had many strong supporters in the government, such as Donna Shalala, the Secretary of the Department of Health and Human Services during the Clinton administration. Shalala defended Elders, stating, Those who would portray Dr. Elders as being radical or out of touch with the desires of the American people are distorting her record [Elders] supports comprehensive health training but that does not mean inappropriate sex education for young children, as her critics

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203 204

Ibid, 175 Ibid, 175 205 Ibid, 174 206 Ibid, 174 207 Ibid, 172-173

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suggest.208 The Director of the United Church of Christs Office for Church in Society summed up many liberals opinions on Elders by stating, We are frankly disturbed to see [Elders] candidacy used to attack sex education, birth control, people with AIDS, and a womans right to choose abortion 209 Recalling his first meeting with Elders, former President Clinton recalled, I know how Abraham Lincoln felt when he met Harriet Beecher Stowe [and he said]: This is the little lady that started the great war.210 Clinton was able to tell upon meeting Elders that she was going to create controversy as Surgeon General, but he was aware that it was a necessary and positive controversy. His use of a reference to the Civil War is interesting because it uses much of the same rhetoric that Elders herself used in the fight for comprehensive sex education. While some might deem it unnecessary to bring the topic of race into a discussion of sex education, it is apparent that in this situation, it would be a racist act to omit it. So many of the issues that sex education aims to solve are exacerbated by racism in this country, of which Elders was acutely aware. Fifteen months after her appointment to Surgeon General, Elders responded to a question from an audience member at a public appearance. The audience member asked if she thought there would ever be a shift in the taboo against public discussion of masturbation. Elders responded by saying, Masturbation is a part of sex education and should perhaps be taught.211 The outragemostly from the Religious Rightfrom this comment was immense, and many prominent conservative and religious figures demanded that Elders be fired, and Clinton, feeling that he had no choice but to do so, fired her.212 Though Elders time as Surgeon General was short-lived, she left a lasting impact on the nation as the first government official to support !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
208 209

Ibid, 173 Ibid, 173 210 Ibid, 175 211 Ibid, 162 212 Ibid, 176

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comprehensive sex education for all people, regardless of race, gender, socioeconomic status, or sexual orientation. Though one person cannot completely change the harmful discourses around sex education and minorities in the United States, she certainly led the country in that direction. In 1996, three years after Elders was fired, proponents of abstinence only sex education won another victory in the form of the Welfare Reform Act, which included an allocation of 50 million dollars per year to fund abstinence only education programs.213 This Act was very specific in its guidelines about what each program must do in order to receive funding. Every program was required to: Have as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity Teach that abstinence from sexual activity outside marriage is the expected standard for all school aged children Teach that abstinence from sexual activity is the only certain way to avoid illegitimate births and sexually transmitted diseases Teach that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity Teach that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects Teach that bearing children illegitimately is likely to have harmful consequences for the child, the childs parents, and society Teach young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances Teach the importance of attaining self-sufficiency before engaging in sexual activity214

These provisions were extremely problematic for a variety of reasons. First, asking schools to teach abstinence as the expected standard promotes the message that if a student is not abstinent, they are behaving improperly and should remedy their actions. Secondly, since the Welfare Reform Act funds these programs, they are being implemented in the poorest states, which are also overwhelmingly the states with the highest populations of color. Through the !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
213

Haskins, Ron and Carol Statuto Bevan. (1997). Abstinence Education Under Welfare Reform. Paper presented at the Abstinence Education Grants and Welfare Reform, University of Maryland Welfare Reform Academy 214 Ibid

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harmful messages being promoted in these programs, the discourses of hypersexuality of people of color and people living in poverty are being reinforced. Finally, these programs specifically focus on heterosexual marriage as the only acceptable place for sexual expression, which promotes a message that any other form of relationship is unacceptable. This only serves to reinforce the discourse of LGBT-identified people as deviant and abnormal. Modern Sex Education (2000 to Present) Unfortunately, the state of comprehensive sex education in the United States has not improved significantly since the 1980s and 1990s. Abstinence only sex education is still the norm in many states, and chastity is widely promoted as the only acceptable option for teenage girls. In 2001, Surgeon General David Satcher released a report that revealed that 12 million Americans were contracting STIs each year, and that over 700,000 new AIDS cases had been reported since 1981. The report also indicated that almost half of all pregnancies in the United States were unintended and that over 1 million abortions were performed n the United States since 1996.215 Each of these problems, the report stated, Carries with it the potential for lifelong consequences for individuals, families, communities, and the nation as a whole.216 Satcher called for a mature and thoughtful discussion about sexuality, and said that [Finding] common ground might not be easy, but that it would be necessary if Americans were going to be able to lay a foundation for a healthier society in the future.217 This report also showed no scientific evidence indicating that comprehensive sex education led to early sexual activity, that sexual orientation could be changed or that abstinence only sex education prevented or even !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
215 216

Supra at 9, 179 Ibid, 179 217 Ibid, 179

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delayed teens from having sex.218 There was scientific evidence in this report that a high incidence of STIs, unintended pregnancy, rape, and sexual abuse had swept the nation.219 Satcher called upon schools to combat these problems by becoming the great equalizer[s] and providing comprehensive sex education across the board.220 Satchers call was not heeded, however, and by 2005, the United States had the highest teenage pregnancy rate of any nation in the industrialized world, a fact that remains accurate today, though Americans on average were no more or less sexually active than other developed nations.221 Furthermore, a comprehensive report on sex education programming conducted in 2004 revealed that over 80 percent of the curricula used by the majority of recipients of Welfare Reform Act grants contained false, misleading or distorted information about reproductive health.222 This report also found that there was a significant blurring of religion and science in most of these programs and that many of them endorsed outdated gender stereotypes. For example, a program called Choosing the Best featured a story in which a knight attempted to rescue a village from a dragon. When the knight does not know how to kill the dragon, he receives advice from a princess. When he uses this advice to successfully slay the dragon, he feels ashamed that he had to rely on the princess advice, so he decides that instead of marrying her, he will marry a village maiden after making sure she knew nothing [about how to kill dragons].223 I believe that this story is a metaphor for women who have knowledge about sex. The story promotes the message that if a woman has sexual knowledge or experience and shares it with a man, he will leave her for someone who is more innocent or pure. It is possible, !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
218 219

Ibid, 180 Ibid, 180 220 Ibid, 180 221 Ibid, 182 222 Ibid, 182 223 Ibid, 182

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however, that this story is not a metaphor and is simply a warning against taking advice from women, but either way, it promotes problematic messages in the form of outdated and sexist gender stereotyping. During the George W. Bush administration, more and more federal funding was being funneled toward abstinence only sex education and away from programs that provided comprehensive sex education. Democratic Representative Henry Waxman stated during this time that he felt that funding would be better spent on comprehensive sex education: I have no objection [to] talking [about] abstinence as a surefire way to prevent unwanted pregnancy and sexually transmitted diseases [but] I dont think we ought to lie to our children about science [Something] is seriously wrong when federal tax dollars are being used to mislead kids about basic health facts.224 Richard Carmona, the Surgeon General during most of the Bush administration, was the first Surgeon General to be silent on the topic of sex education since before Koop. He later revealed that he had been forbidden by the Bush administration to speak publically about the issue.225 The cultural discourse around female sexuality in the United States today remains one of shame and victimization. Abstinence educator Darren Washington, addressing young women at a conference in 2004, stated, Your body is a wrapped lollipop. When you have sex with a man, he unwraps your lollipop and sucks on it. It may feel great at the time, but, unfortunately, when hes done with you, all you have left for your next partner is a poorly wrapped, saliva-fouled sucker.226 This quote exemplifies the discourse of virginity-as-morality that permeates American culture. The idea that sex makes women dirty is one that has been around for !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
224 225

Ibid, 183 Ibid, 183 226 Valenti, Jessica. (2010). The Purity Myth: How America's Obsession with Virginity is Hurting Young Women. Berkeley, CA: Seal Press, 41.

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centuries, from the idea of hysteria (a condition that many women were diagnosed with in the Victorian era that connected emotional problems with female genitalia) to modern virginity pledges. Feminist author Laura Kipnis argues that the fear of womens genitalia is at the heart of this discourse:
Recall the unhappy fact that throughout history theres been the universal conviction that women are somehow dirtier than men. The male body is regarded, or is symbolically, as cleaner than the female body Possibly its that outjutting parts of the body, like a penis, are regarded as somehow cleaner than holes and cavities The vagina is frequently associated with rot and decay 227

This discourse of female sexuality as dirty is echoed in the virginity movement today, which idealizes virginity and shames women who partake in sexual activity. This movement also alienates women of color by omitting them from the discourse of virginity. As bell hooks wrote in a 1998 essay, Marked by shame, projected as inherent and therefore precluding any possibility of innocence, the black female body was beyond redemption [I]t was impossible to ruin that which was received as inherently unworthy, tainted, and soiled.228 In The Purity Myth, Jessica Valenti elaborates on hooks point, stating, Women of color, low-income women, immigrant womenthese are the women who are not seen as worthy of being placed on a pedestal. Its only our perfect virgins who are valuable, worthy of discourse and worship.229 This separation of women into good (e.g. pure, virginal, white, middle-class women) vs. bad (e.g. dirty, sexual, poor, women of color) is reminiscent of the same sort of separation that occurred in the 1920s. Indeed, a statement about the current discourse from feminist and race scholar Patricia Hill Collins could just as easily be referring to the events almost a century ago: Dividing women into two categoriesthe asexual, moral women to be protected by marriage !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
227 228

Kipnis, Laura. (2006). The Female Thing: Dirt, Sex, Envy, Vulnerability. New York: Pantheon Books. hooks, bell. (1998). Naked Without Shame: A Counter-Hegemonic Body Politic. In Ella Shohat (Ed.), Talking Visions: Multicultural Feminism in a Transnational Age. Cambridge, MA: MIT Press. 229 Supra at 179, 45

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and their sexual, immoral counterpartsserved as a gender template for constructing ideas about masculinity and femininity.230 It is disheartening that these negative discourses that were present in the 1920s are still harmful today, but unfortunately, due to the nature of discourse, they will continue to prevail unless significant intentional efforts are made to combat them. A report published in 2007 revealed that teenagers who were enrolled in abstinence only sex education programs were not only just as likely to engage in sexual behavior at the same time or earlier than their counterparts in comprehensive programs, but they were also less likely to use protection and thus more likely to experience the negative consequences often associated with sexual promiscuity.231 It has also been revealed that even in programs that reportedly teach comprehensive sex education, harmful discourses, such as ones of women as victims and minorities as hypersexual, are still incredibly prevalent. In Part One of this Plan, Public School Health Education and Community-based Health Education: A Comparison Study, I describe how these discourses are presented.232 I conducted a comparison study of a public school sex education classroom in rural New England and a women-only adult sex education organization focused on preventing the spread of HIV. In order to have a broader perspective on sex education in the United States, I have read and analyzed a case study conducted by Carissa M. Froyum describing a sex education program for low-income girls of color in the Southern United States. What follows is my analysis of the ways in which this program serves to reinforce the harmful discourses that I have mentioned throughout this paper.

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230

Collins, Patricia Hill. (2000). Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment. New York: Routledge, 134. 231 Supra at 9, 183 232 Wood, Margaret. (2013). Public School Health Education and Community-based Health Education: A Comparison Study. Marlboro College.

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Case Study: Teaching Abstinence-Only Sex Education to Low-Income Female Youth of Color Sociologist Carissa M. Froyum conducted an ethnography of Kidworks, a large non-profit youth agency that provided abstinence only sex education to low-income girls of color in a southern city in the United States.233 Kidworks was formed in order to provide recreational and life-skills services to disadvantaged children to help them become productive adults.234 The state in which this program is located mandates abstinence-only sexuality education, which prohibits directing students toward resources for birth control or abortions.235 Froyum observed programming at Kidworks and conducted 24 semi-structured in-depth interviews with staff and volunteers who worked directly with the youth. She focused the interviews on work experiences, relationships with kids and other staff, evaluations of the kids, and experiences of racism in the program.236 Finally, Froyum analyzed cultural artifacts from her time at the program, such as curriculum books, posters, and website excerpts.237 The goal of Kidworks' sexuality education program is abstinence among girls, as stated in their manual:
Young people should postpone sexual involvement. The best way for youth to avoid the risks of pregnancy and sexually transmitted diseases is by postponement of premature sexual involvement. Participants are provided a clear, consistent message that sexual involvement at their age is not appropriate. Contraceptive information is not taught.238

One of the primary discourses within the Kidworks curriculum was that sexuality made girls vulnerable. By emphasizing the dangers that sex poses to girls, such as STIs, pregnancy, and

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233

Froyum, Carissa M. (2010). Making 'Good Girls': Sexual Agency in the Sexuality Education of Low-Income Black Girls. Culture, Health & Sexuality, 12(1), 59. 234 Ibid, 61. 235 Ibid, 62. 236 Ibid, 62. 237 Ibid, 62. 238 Ibid, 63.

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sexual violence, the program transformed girls' expression of sexuality into a burden.239 Girl Might, a curriculum used by Kidworks and aimed at adolescent girls, taught its students the risks and symptoms of STIs and how they are spread and characterized the potential for pregnancy as the primary dimension of girls' sexuality. Froyum found that the message of many of their activities was: Girls can have sex, but their susceptibility to pregnancy makes it perilous to do so.240 Girl Might included a unit on female victimization, which focused on avoiding sexual harassment, violence, and date rape. Girls were asked to identify the warning signs of different forms of abuse and role-play scenarios in which boyswho were brought in specifically for this exercisecoerced and harassed them. The program suggested that they write about how [they] might be vulnerable to violence, as well as ideas [they] have about how females in general are often victimized.241 The prominent message from this unit was that vulnerability was a part of womanhood brought about by sexuality. The program also stressed that the dangerous consequences of sexual activity would fall solely on the young womenremoving all responsibility from the men that they might choose to have sex with. With the clear message that girls should not be interested in sex, Girl Might reminded them that it was their responsibility to avoid, deflect, and repress any unnatural sexual feelings they might have.242 One activity asked the girls to brainstorm ways to avoid becoming pregnant...It is important for the list to include the following: knowing the benefits of postponing sex; ways to say 'no' to boys who want to have sex; and things to do with boys other than sex.243 This activity again places all responsibility for sexual behavior on women, and removes it from men, as it is assumed that they will always want sex. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
239 240

Ibid, 63. Ibid, 63. 241 Ibid, 63. 242 Ibid, 63. 243 Ibid, 63.

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The Girl Might manual encourages girls to not be pressured into having sex, avoid isolated situations with a boyfriend, and ask an adult how to avoid HIV.244 This curriculum came with Refusal Scripts that taught girls ways to say 'no' to boys who want to have sex.245 Another curriculum that was used in the Kidworks program suggested that girls only ever wanted to engage in sexual activity to become popular with boys or to avoid rejection and being socially outcast.246 The curriculum stated, Girls need to remember that how they say 'no' will influence how their 'no' message is received, and recommended that girls use an assertive yet non-aggressive 'no' in order to stop boys' advances in the most effective way.247 These statements portray boys as aggressors and girls as defenders and put all of the responsibility for sexual violence on girls by refusing to acknowledge the sexual agency of the boys who might be violating them. The lack of mention of consensual sexual activity or the possibility of sexual assault perpetrated by females is problematic because it normalizes sexual assault by males toward females, and it defines girls' primary sexual role as that of a constant deflector of men's desires, as opposed to an individual with her own sexual desires and agency. This message of sexual desire as uncontrollable in boys but nonexistent or easily suppressed in girls is strongly tied to traditional ideas of morality. Kidworks programming presents the repression of sexual desires and the refusal of boys' inevitable advances as a matter of personal value, responsibility, and self-control. The Girl Might curriculum instructs group leaders to remind the girls that they are responsible for their sexual health and that they must make good choices to stay healthy. It is important for the group to know that not making a decision as to how they will be sexually responsible is making a decision to not have control !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
244 245

Ibid, 63. Ibid, 63. 246 Ibid, 63-64. 247 Ibid, 64.

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over their lives.248 In the lessons that focused on personal values and dating relationships, the girls were encouraged to make lists of positive and negative aspects in potential partners. Abstaining from sexual activity was promoted as a trait inherent in a healthy partner.249 Girl Might introduced a decision-making model to help girls figure out whether or not they should engage in sexual activity. This model asked the following questions: 1. Can I take full responsibility for my actions? 2. Am I willing to risk obtaining a sexually transmitted disease? 3. Am I willing to risk getting pregnant? 4. Can I be an effective single parent or could I handle putting my child up for adoption? 5. Can I handle the guilt and emotions that I may feel if I decide to have sex? 6. How will my decision to have sex impact others, like my family and friends?250 These questions, while not necessarily troublesome in and of themselves, make the assumptions that every girl in the program has a moral commitment to abstinence and that they would inevitably feel guilty if they did engage in sexual activity. It also assumes that girls feel obligated to please others, and therefore abstain from sexual activity because they dont want to upset their family and friends, who are assumed to be very concerned about their sexual behavior.251 This model advises the girls to do the moral thing and avoid all sexual activity. The amount of assumptions that Kidworks makes is worrisome because it excludes girls who do not fit into their expectations of female sexuality. The discourses of female vulnerability and victimization that are prevalent in Kidworks' curricula are problematic because they present female sexuality as naturally wrong, and the only !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
248 249

Ibid, 64. Ibid, 64. 250 Ibid, 64. 251 Ibid, 64.

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model of sexual behavior that they provide is one of repression. While Kidworks (likely unintentionally) reinforces traditional gender stereotypes, its curricula was designed to be colorblind and race neutral as a way of combating racism. Of course, having a lack of discussion of racism and classism does not mean that it does not exist in the environment that these girls live in. In fact, I would argue that a lack of discussion of race in a setting in which racist discourses are occurring is a racist act in and of itself. As Michael K. Brown et al stated in their book, Whitewashing Race: The Myth of a Color-Blind Society:
Color-blindness...made sense in the 1950s and 1960s when segregation was legal and was based on a rigid system of racial classification. Color-blindness undermined and transformed that system. But fifty years later when statesanctioned racial segregation is illegal and people of color have still to achieve truly equal opportunity with white Americans, the color-blind idea actually impedes efforts necessary to eliminate racial inequality. Formal color-blindness fails to recognize or address the deeply rooted institutional practices and longterm disaccumulation that sustains racial inequality.252

Because of the absolute lack of mention of race or class in the Kidworks curricula, racist and classist stereotypes are being unwittingly perpetuated. As Froyum interviewed the educators at Kidworks, she found that, for the most part, their opinions were in sync with those stated in the curricula, but they occasionally changed the ways they taught to fit the population of at-risk girls that they taught.253 They saw race and class as important cultural influences that affected girls and their sexual experiences, yet they allowed racial stereotypes to infiltrate the ways that they discussed these issues in their programming. They believed that the majority of the girls came from dysfunctional backgrounds, based simply on the facts that they were black and from low-income families. The white chair of the board told Kidworks donors The majority of [the kids] come from single parent households ... !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
252

Michael K. Brown, Martin Carnoy, Elliott Currie, Troy Duster, David B. Oppenheimer, Margorie M. Schultz, David Wellman. (2003). Whitewashing Race: The Myth of a Color-Blind Society. Berkeley, CA: University of California Press. 253 Supra at 6, 65.

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Those kids have to go through ... verbal abuse maybe or other kinds of changes, being in foster homes or God knows what.254 Kidworks' white administrators perpetuated racism themselves, as many employees complained that they refused to promote black women, made only the black employees clean the facilities, and used racist language (referring to black girls' hair as nappy, for example) that made them feel uncomfortable and humiliated.255 The women of color at Kidworks were concerned that the girls might appear too black or too poor and encouraged them to look presentable and put [themselves] together in a respectful manner, or, in other words, to appear more white.256 Danielle257, a black educator, described how she felt about the girls' appearances:
I want these girls to develop and learn how to present themselves ... You don't need to walk out your house lookin' at your child like, What in the world is wrong with her? ... I dont want my girls here at Kidworks to walk in anybody's classroom lookin' like they done hit Hurricane Katrina [looking unkempt as if they had just been in the hurricane].258

Louise259, another educator, warned the girls that their peers would ostracize them if they had a bad reputation, so she told them to avoid oral sex and other nasty behaviors.260 Often, educators would use examples from their own lives to warn girls of the dangers of engaging in sexual activity. While potentially effective in deterring girls from having sex, they also often reinforced the idea that being a woman meant being a victim. For example, during a Kidworks program, an educator who was good friends with a single mother told the girls [the single mother] made choices she shouldnt have, and she's now suffering the consequences ... Her baby's father wasnt there. At the time, her parents werent even there, so all she had was me ... !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
254 255

Ibid, 65. Ibid, 65. 256 Ibid, 65. 257 Names have been changed. 258 Supra at 186, 65. 259 Names have been changed. 260 Supra at 186, 65.

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You might not have that support. Your baby's father might not want to be there. He might say that it's not his ... 261 Through her attempts to prevent teenage pregnancy, this educator conveyed the message that sexual behavior would lead to a life filled with abandonment and loneliness. Adults who were involved in the Kidworks program continued to portray sexual activity as scary, overwhelming, and dangerous. Danielle encouraged girls to abstain from sex by saying [When you have sex,] you have the risk of having a child. You have the risk of catching STIs. You have the risk of upsetting your parent and really breaking that trust that they have with you, especially when you dont tell them.262 Amber263, another educator, explained the tactics that were often employed at Kidworks: Put more fear in there to the fact that it's not safe [to have sex].264 When a group of sorority sisters volunteered to lead a session of the Girl Might program, they went off-script when talking about STI transmission, saying that AIDS is small enough to get through the condom and by insisting that STIs are transmitted through dry humping, both of which are inaccurate statements.265 Another Girl Might session taught girls ways to refuse sexual advances, equating holding hands to rape and placing the responsibility for sexual assault solely on the girls:
Group facilitator: 'What if you had a boyfriend and went to the movies? I dont think you all should be doing that, but you go and he wants to hold your hand. You dont really want to. Then he wants to kiss you. What do you do?' Girl: 'Slap him'! The room erupts with giggling. Another facilitator: 'That's not funny. That's violence.' Girl 2: 'I'd tell him I'm not ready to do that.' Facilitator: 'That's good. That's a great answer. Tell him that you're not ready for that yet.' Another facilitator: 'Don't smile and be like no. This is serious. If you say no when youre smiling, he's not going to take you seriously. He's going to think youre not serious. It could turn into something more.' Girl: 'Like rape.'

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261 262

Ibid, 66. Ibid, 66. 263 Names have been changed. 264 Supra at 186, 67. 265 Ibid, 67.

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Facilitator: 'Yeah. Like rape.'266

By using scare tactics and exaggerating facts to make them seem more frightening, Kidworks educators reinforced the message of abstinence as a form of self-preservation. By insisting that simply saying no wouldnt be enough to dissuade men from sexually assaulting the girls, the educators reinforced cultural norms of women being responsible for any negative consequences of sex. All of these messages further strengthened the idea of female sexuality being synonymous with victimization. The educators equated suppression of sexual desire with morality by making it clear to the girls that their virtue, or ability to abstain from sex, was deeply connected to their moral worth. Louise told the girls that if they had sex, then [the boy's] taking the very essence of who you are. He's taking your virtue with him when he goes and he hasnt earned that. He doesnt deserve that.267 Danielle reinforced this idea by explaining to Froyum, Their body is the only thing that's theirs. I always tell them, 'That is your pride and joy. That's all you have is your pride and your reputation. And you need to cover it and protect it at any cost and at all cost because once it's gone, it's gone ... '268 While intended to be helpful, these statements sent the message that girls' bodies aren't truly their ownthey are only theirs if they are abstaining from sexual contact, but once they engage in sex, they are giving away their bodies as well as their virtue and their morality. The educators did not seem to see the harm that they were doing to the girls by stressing these messages of passive female sexuality and victimization. They argued that they were providing the girls with a sense of control over their own bodies, not taking away their sexual

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266 267

Ibid, 67. Ibid, 68. 268 Ibid, 68.

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agency.269 Sociologist Elaine Bell Kaplan's research found that low-income youth of color often particularly value control because they feel overwhelmed by their surroundings. To them, being out of control is uncomfortable and representative of low-status. This produces shame and despair, causing them to fear being manipulated.270 Being in control, Kaplan found, instills a sense of worthiness and morality in low-income youth of color.271 Therefore, educators at Kidworks were attempting to provide girls with a sense of control over their bodies. While their intentions were admirable, their methods were problematic, because in their attempts to protect the girls from damaging their reputations and losing control over their bodies, they are actually taking the girls' control away from them. By only allowing them to be in control if they behave in a certain way (abstaining from sexual activity), they were putting limits on the girls' sexual agency. Abstinence-only sex education programs, especially for low-income youth and youth of color, tend to define female sexuality in terms of victimization and morality in environments where women and girls are likely to already feel victimized or demoralized. Through the teaching of abstinence-only sex education programs, we are only serving to further victimize them.

Conclusion The discourses of victimization and hypersexuality of oppressed groups have been prominent in our society for so long that in order to combat them, we must make an intentional effort. These harmful discourses will not disappear on their own. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
269 270

Ibid, 68. Kaplan, Elaine Bell. (1997). Not Our Kind of Girl: Unraveling the Myths of Black Teenage Motherhood. Berkeley, CA: University of California Press. 271 Ibid, 36.

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My proposal for combatting these problematic discourses is to create sex education programming that is specifically written to benefit young women, people of color, people living in poverty, and LGBT-identified people. Through intentional resistance to the harmful cultural dialogue that surrounds these groups, we can begin to change this dialogue. In Part Three of this Plan, Empowerment Through Education: A Curriculum for Teaching Sex Education to At-Risk Youth, I have written a curriculum that speaks to the needs of oppressed groups. If widely implemented, this curriculum can be a first step toward changing the harmful discourses that I have discussed in this paper.

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Works Cited Sex Education and Social Inequality: History and Analysis
Advocates for Youth. (2001). Sex Education Programs: Definitions & Point-by-Point Comparison Retrieved March 27, 2013, from http://www.advocatesforyouth.org/publications/655?task=view Bentley, Jared (Writer). (2009). Straight Talk: The Truth About Alcohol and Sex [film]. In Erahm Christopher and John C. Pohl (Producer). Birth control: What it is, How it works, What it will do. (1921). Paper presented at the First American Birth Control Conference, New York Brown, Michael K, Martin Carnoy, Elliott Currie, Troy Duster, David B. Oppenheimer, Margorie M. Schultz, David Wellman. (2003). Whitewashing Race: The Myth of a Color-Blind Society. Berkeley, CA: University of California Press. Campos, David. (2002). Sex, Youth, and Sex Education: A Reference Handbook. Santa Barbara, CA: ABC-CLIO, Inc. Chesler, Ellen. (1992). Woman of Valor: Margaret Sanger and the Birth Control Movement in America. New York: Simon and Schuster. Collins, Patricia Hill. (2000). Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment. New York: Routledge. Cox, Vicki. (2004). Margaret Sanger: Rebel for Women's Rights: Chelsea House Publishing. Crenshaw, Kimberle. (1991). Mapping the Margins: Intersectionality, Identity Politics, and Violence Against Women of Color. Stanford Law Review, 43(6), 1241-1299. Ebsco Host Connection. (2013). History of Sex Education Retrieved February 14, 2013 Endres, Kathleen L. (1995). Women's Periodicals in the United States: Social and Political Issues. Westport, CT: Greenwood. Engelman, Peter C. (2004). Margaret Sanger. In George R. Goethals et al. (Ed.), Encyclopedia of Leadership (Vol. 4, pp. 1382): SAGE. Foucault, Michel. (1977). Discipline and Punish. New York: Random House, Inc. Froyum, Carissa M. (2010). Making 'Good Girls': Sexual Agency in the Sexuality Education of Low-Income Black Girls. Culture, Health & Sexuality, 12(1), 59. Gordon, Linda. (2002). The Moral Property of Women: A History of Birth Control Politics in America (3rd ed.). Chicago, IL: University of Illinois Press. 103!

Haskins, Ron and Carol Statuto Bevan. (1997). Abstinence Education Under Welfare Reform. Paper presented at the Abstinence Education Grants and Welfare Reform, University of Maryland Welfare Reform Academy. Heller, J. (1972). Syphilis Victims in U.S. Study Went Untreated for 40 Years; Syphilis Victims Got No Therapy, New York Times. hooks, bell. (1998). Naked Without Shame: A Counter-Hegemonic Body Politic. In Ella Shohat (Ed.), Talking Visions: Multicultural Feminism in a Transnational Age. Cambridge, MA: MIT Press. Kaplan, Elaine Bell. (1997). Not Our Kind of Girl: Unraveling the Myths of Black Teenage Motherhood. Berkeley, CA: University of California Press. Kelly, Gary F. (2012). America's Sexual Transformation. Santa Barbara, CA: Praeger. Kevles, Daniel J. (2001). The Secret History of Birth Control, The New York Times. King, Wayne Viney and D.A. (2003). A History of Psychology: Ideas and Context. Boston: Allyn and Bacon. Kipnis, Laura. (2006). The Female Thing: Dirt, Sex, Envy, Vulnerability. New York: Pantheon Books. Lord, Alexandra M. (2005). 'Naturally Clean and Wholesome': Women, Sex Education, and The United States Public Health Service, 1918-1928. Lister Hill National Center for Biomedical Communications Retrieved from http://www.lhncbc.nlm.nih.gov/lhc/docs/published/2005/pub2005001.pdf. Lord, Alexandra M. (2010). Condom Nation: The U.S. Government's Sex Education Campaign from World War I to the Internet. Baltimore, MD: The Johns Hopkins University Press. Luker, Kristin. (2006). When Sex Goes to School: Warring Views on Sex--and Sex Education-Since the Sixties. New York: W.W. Norton and Company, Inc. McCann, Carole Ruth. (1994). Birth Control Politics in the United States, 1916-1945. Ithaca, NY: Cornell University Press. McLaren, Peter. (1998). Life in Schools: An Introduction to Critical Pedagogy in the Foundations of Education. New York: Longman. Messerschmidt, James W. (2007). "We Must Protect Our Southern Women": On Whiteness, Masculinities, and Lynching. In Mary Bosworth and Jeanne Flavin (Ed.), Race, Gender, and Punishment: From Colonialism to the War on Terror (pp. 77). Piscataway, NJ: Rutgers University Press. 104!

Meyer, Elizabeth J. (2012). From Here to Queer: Mapping Sexualities in Education. In Erica R. Meiners and Therese Quinn (Ed.), Sexualities in Education: A Reader. New York: Peter Lang. Moran, Jeffrey P. (2008). Sex Education Encyclopedia of Children and Childhood in History and Society. Rape, Abuse, and Incest National Network (RAINN). (2009). Who are the Victims? Retrieved April 16, 2013, from http://www.rainn.org/get-information/statistics/sexual-assault-victims Stone, Lee Alexander. (1920). An Open Talk with Mothers and Fathers Presenting Some Present Day Problems in Social Hygiene. Kansas City. Strudwick, Patrick. (2010). So You Think Gay Men are Promiscuous? The Guardian. To Girls in Industry about the Enemy at Home. (1918). Washington D.C. Valenti, Jessica. (2010). The Purity Myth: How America's Obsession with Virginity is Hurting Young Women. Berkeley, CA: Seal Press. Wood, Margaret. (2013). Public School Health Education and Community-based Health Education: A Comparison Study. Marlboro College. Wood, Mary and Lisa Hawkins. (1980). State Regulation of Late Abortion and the Physician's Duty of Care to the Viable Fetus. Missouri Law Review, 45, 394.

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Empowerment Through Education: A Curriculum Introduction

Rationale for the Curriculum Given the negative impact that most sexuality education can have on at-risk youth in the United States today, my proposed solution is to write a curriculum that is designed specifically with these teenagers in mind. What follows is the narrative and rationale for the accompanying curriculum written intentionally to empower at-risk youth. When I say at-risk youth, I am referring to young people who have, for any number of reasons, faced disadvantages in their lives. For my purposes, this population includes youth of color, youth living in poverty, lesbian, gay, bisexual, or transgender (LGBT) youth, and young women. I have written this curriculum for youth ages 13 to 17 because my goal is to provide different programming for each age group in the community-based health education organization that this curriculum is intended to be taught in. Although the organization would work with youth ages 13 to 25, there are very obvious differences in the type of sexuality education that 13 year olds would benefit from and the type that 25 year olds would benefit from. Because the average age of first intercourse in the United States is 16.9 for males and 17.4 for females, I have aimed my curriculum toward youth ages 13 to 17, when teenagers are beginning to engage in sexual activity, or at least consider it.272

The Need for the Curriculum !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 272 !The!Kinsey!Institute.!(2012).!Sexuality!Information!Links!D!FAQ!Retrieved!January!6,! 2013,!from!http://www.kinseyinstitute.org/resources/FAQ.html#Age!! ! ! ! 106!

I am focusing on at-risk youth because, statistically speaking, these youth experience a higher risk of teenage pregnancy, sexually transmitted infections, sexual violence, and bullying or harassment. I have written this curriculum because I feel that it can be a solution to four problems that at-risk teenagers face in the United States today: teenage pregnancy, high rates of STIs, bullying and harassment, and intimate partner violence. I will address each of these issues in the following paragraphs. The United States has one of the highest teen pregnancy rates in the industrialized world, with more than 750,000 girls ages 15-19 becoming pregnant each year.273 More than 80 percent of these pregnancies are unintended.274 Furthermore, teenagers of color have much higher teen birth rates than white youth, a trend that has persisted for decades.275 Teen pregnancy is associated with adverse health, educational, and economic outcomes for both mothers and children. Teens who become pregnant are less likely to complete high school or college. For those who do manage to stay in school, pregnancy raises major obstacles to academic achievement and substantially exacerbates the challenge of completing high school and continuing on to college. Girls born to teen mothers are also 66 percent more likely to become teen mothers themselves than girls born to older mothers.276 The second problem facing at-risk youth today is the rising rates of sexually transmitted infections (STIs) among youth in the United States. Young people (ages 15-25) make up only one quarter of the sexually active population in this country, yet they contract approximately half !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 273 !Kost,!Kathryn,!Stanley!Henshaw,!and!Liz!Carlin.!(2011).!U.S.!Teenage!Pregnancies,!Births! and!Abortions:!National!and!State!Trends!and!Trends!by!Race!and!Ethnicity.!Guttmacher* Institute.! 274 !Finer,!Lawrence!B.!and!Mia!R.!Zolna.!(2006).!Unintended!Pregnancy!in!the!United!States:! Incidence!and!Disparities.!Contraception.!! 275 !Ibid,!615!! 276 !Ibid,!615.! ! 107!

of the 19 million STIs transmitted per year.277 Youth ages 13-29 also account for about one-third of the estimated 50,000 new HIV infections each year.278 Furthermore, while youth of color make up only 15 percent of U.S. teenagers, they account for 65 percent of teenage AIDS cases and 70 percent of HIV-infected teenagers in the United States.279 The third problem that needs to be addressed with this curriculum is the high incidence of bullying and harassment towards lesbian, gay, bisexual, or transgender (LGBT) students. According to the 2011 National School Climate Survey, 81.9 percent of LGBT students reported being verbally harassed or bullied, while 38.3 percent reported being physically harassed. Furthermore, 6 out of 10 LGBT students reported feeling unsafe, and almost one-third reported skipping at least one day of school because of concerns about their personal safety.280 Finally, I would like to address the problem of intimate partner violence among teenagers. Although violence in teen relationships is often underreported, it is estimated that 10 percent of teens experience violence at the hands of a romantic partner annually.281 Violent relationships in adolescence can have serious consequences for victims: many will continue to be abused in their adult relationships and are at higher risk for substance abuse, eating disorders,

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 277 !Weinstock,!Hillard,!Stuart!Berman,!and!Willard!Cates.!(2004).!Sexually!Transmitted! Diseases!Among!American!Youth:!Incidence!and!Prevalence!Estimates.!Perspectives*on* Sexual*and*Reproductive*Health,*36(1),!6D10.! 278 !Centers!for!Disease!Control!and!Prevention.!(2009).!HIV!Surveillance!Report,!from! http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/pdf/cover.pdf!! !http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/pdf/cover.pdf! (accessed!January!27,!2013).! 279 !Brown,!Steve!and!Bill!Taverner.!(2001).!Streetwise*to*Sex>Wise:*Sexuality*Education*for* High>Risk*Youth.!Morristown,!NJ:!Planned!Parenthood!of!Northern!New!Jersey,!Inc.! 280 !Marra,!Andy.!(2012).!The!2011!National!School!Climate!Survey:!The!Experiences!of! Lesbian,!Gay,!Bisexual!and!Transgender!Youth!in!our!Nation's!Schools.!New!York:!GLSEN.! 281 !Centers!for!Disease!Control!and!Prevention.!(2009).!Youth!Risk!Behavioral! SurveillanceUnited!States.! ! 108!

risky sexual behavior, and suicide.282 Youth who perpetrate relationship violence are also at high risk to continue abusing their intimate partners as adults.283 Recent studies have shown that comprehensive sex education programs can help youth delay the onset of sexual activity, reduce the number of sexual partners they have, and increase condom and other contraceptive use. It was also found that teens that received comprehensive sexuality education were 50 percent less likely to become pregnant than teens that had received abstinence-only sexuality education.284 Therefore, I believe that with the implementation of comprehensive sexuality education written specifically with at-risk youth in mind, the problems of teenage pregnancy, STI transmission, harassment, and intimate partner violence among these youth can begin to be solved. Another benefit of this curriculum is that studies have shown that comprehensive sex education can improve students academic performance. An extensive review of health education programs found that health education had a positive effect on overall academic outcomes in young people. The Centers for Disease Control and Prevention found that there is a connection between healthy behaviors in students and good grades: Students who do not engage in healthrisk behaviors receive higher grades than their classmates who do engage in health-risk behaviors.285 Since comprehensive sexuality education programs have been proven to decrease the likelihood of students engaging in health-risk behaviors, this curriculum provides an opportunity for students to improve their academic performance.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 282 !Boston*Public!Health!Commission.!Intimate!Partner!Violence!&!Teen!Dating!Violence! Fact!Sheet,!from!//www.bphc.org/Pages/Home.aspx! 283 !V.A.!Forshee!et!al.!(1996).!Health!Education!Research.*11(3),!275D286.!! 284 !Future!of!Sex!Education!Initiative.!(2011).!National!Sexuality!Education!Standards:!Core! Content!and!Skills,!KD12!(pp.!7).! 285 !Ibid,!7! ! 109!

Despite some vocal opponents to comprehensive sex education, the majority of parents of teenagers favor it as opposed to abstinence-only sex education. In 2004, National Public Radio, the Kaiser Family Foundation, and the Kennedy School of Government released a poll that found that 93 percent of parents of junior high school students and 91 percent of parents of high school students believe that it is very important to have sexuality education as part of the school curriculum.286 Furthermore, 95 percent of parents of junior high school students and 93 percent of parents of high school students agree that, birth control and other methods of preventing pregnancy are appropriate topics for sexuality education programs to discuss.287 However, because many public high schools do not provide comprehensive sexuality education for their students, I have decided to design this curriculum for use in a community based health education organization. I have decided to focus on at-risk youth of the prevailing negative discourses around their sexuality that are discussed in depth in Part Two of this Plan.288 In the following paragraphs, I will speak about some subgroups of the teenage population I am looking to target.

Sexual Orientation/Gender Identity and the Curriculum Sex education in public schools is often lacking because its focus is entirely heteronormative (promoting heterosexuality as the normal or preferred sexual orientation). LGBTidentified and questioning students are not likely to receive the information that they need from these types of classes, such as examples of healthy non-heterosexual relationships, accurate information about sexually transmitted infections (STIs) in the LGBT community, and validation !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 286 !Ibid,!8! 287 !Ibid,!8! 288 !Wood,!Margaret.!(2013).!Public*School*and*Community>Based*Health*Education:*A* Comparison*Study.!Marlboro!College.!!!! ! 110!

of non-conforming gender roles. Moreover, these students are far more likely to be bullied, ridiculed, and harassed because of their perceived or actual gender identity or sexual orientation.289 As feminist theorist Judith Butler noted in Gender Trouble, gender is constructed through a set of ongoing social interactions.290 When the daily behaviors that signify our gender (such as clothing, hairstyles, mannerisms, and body language) adhere to traditional expectations of masculine males who partner with feminine females, our social interactions are rarely questioned. However, when even just one aspect of these interactions is changed (such as two men holding hands or a person who does not dress in the traditional manner of their biological sex), the individuals' social interactions are questioned, and they are subjected to exclusion, ridicule, violence, and other unwanted attention.291 Targeting gay students or students who dress and act in gender non-normative ways supports patriarchal heterosexual hegemony, especially if the perpetrators of the harassment and bullying are not properly educated and disciplined by the school administration, as is often the case.292 It would be helpful to look at Antonio Gramsci's definition of hegemony, derived from a prison context but with application to the educational system. Gramsci defines hegemony as ways in which groups in power maintain structures that benefit them by gaining the consent of subordinate groups through subtle, yet powerful, messages that repeatedly permeate daily life.293 !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 289 !Meiners,!Erica!R.!and!Therese!Quinn,!ed.!(2012).!Sexualities*in*Education:*A*Reader.!New! York:!Peter!Lang.! 290 !Butler,!Judith.!(1990).!Gender*Trouble.!New!York:!Routledge!Classics.! 291 !Supra!at!2,!11.! 292 !Ibid,!10.! 293 !Gramsci,!Antonio.!(1971).!Further*Selections*from*the*Prison*Notebooks.!Minneapolis:! University!of!Minnesota!Press.! ! 111!

Common messages in health classes that reinforce hegemonic norms about gender such as Girls need to remain virgins until marriage and Boys cant help but be sexually aggressive can be harmful to all students, especially those who do not conform to traditional gender and sexual roles.294 As noted in a nationwide study conducted in the United States by the Human Rights Watch, Regardless of their sexual orientation or gender identity, youth who violate [gender and sexual norms] are punished by their peers and too often by adults.295 Although teachers and staff are generally not directly inflicting the harassment and harm on nonconforming youth, their lack of effective inclusion in the curriculum sends an unwelcoming message of intolerance.296

Race and Socioeconomic Class and the Curriculum Comprehensive sexuality education information has been denied to students of color and students living in poverty because of the inherent racism and classism present in most traditional school-based sex education classes, from a lack of depictions of people of color in educational materials to a lack of mention of cultural and class differences in attitudes around sexuality. I am combining these two groups in my discussion of the harmful messages prevalent in sex education curricula because of the significant amount of overlap of racist and classist dialogues implicit in these curricula.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 294 !Supra!at!2,!10.! 295 !Bochenek,!Michael!and!A.!Widney!Brown.!(2001).!Hatred!in!the!Hallways:!Violence!and! Discrimination!Against!Lesbian,!Gay,!Bisexual,!and!Transgender!Students!in!U.S.!Schools.! Human*Rights*Watch.! 296 !Supra!at!2,!12D13.! ! 112!

As part of a welfare reform program in the 1990s, abstinence-only sex education curricula targeted poor women of color in an effort to curtail their reproduction.297 Advocates of abstinence-only sex education also use racist and classist rhetoric to promote such programs.298 These programs depict poor young black women as sexually aggressive and immoral, functioning as a contrast to the images of middle-class white women as pure, passive, and moral, as discussed in Part Two of this Plan.299 Sociologist and social theorist Joe R. Feagin observes that middle class white people have long portrayed black people, especially poor black people, as hypersexual, as a way to set them apart as different from, and inferior to, whites.300 Stereotypes of the welfare queen (typically a black woman who has multiple children in order to receive as much government assistance as possible, usually portrayed as ill-mannered and unrefined) and the jezebel (often associated with women of color who sleep around or are sexually promiscuous) have become so prolific that sociologist Patricia Hill Collins notes that poor black girls now embody the bad girl as a cultural subject.301 Abstinence-only curricula, then, often targets poor black girls whose sexual appetites are supposedly out of control, hoping to shame them into behaving more ladylike.302

Gender and the Curriculum

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 297 !Kendall,!N.!(2008).!Sexuality!Education!in!an!AbstinenceDOnly!Era:!A!Comparative!Case! Study!of!two!U.S.!States.!Sexuality*Research*and*Social*Policy,*5,!26.!! 298 !Fields,!J.!(2005).!'Children!Having!Children':!Race,!Innocence,!and!Sexuality!Education.! Social*Problems,*52,!560.!! 299 !Supra!at!17! 300!Feagin,!J.R.!(2001).!Racist*America:*Roots,*Current*Realities,*and*Future*Reparations.!New! York:!Routledge.! 301 !Collins,!P.H.!(2004).!Black*Sexual*Politics:*African*Americans,*Gender,*and*the*New* Racism.!New!York:!Routledge.! 302!Supra!at!11,!61.! ! 113!

From educational videos that blame women for sexual assault to affirmation of gender role stereotypes in the classroom, traditional sex education often promotes sexist attitudes. Federally funded abstinence-only programs in the United States emphasize the harmful consequences of sex, including emotional distress, teenage pregnancy, and STIs without mentioning contraception or ways to prevent these consequences besides abstaining from sexual contact altogether.303 These programs portray heterosexuality in patriarchal ways that reinforce male domination and female sexual subordination. They also promote sexuality discourses that restrict girls' sexual agency (their ability to know and assert their own desires). Michelle Fine wrote a piece for the Harvard Educational Review in which she found that sexuality education programs often equated female sexuality with victimization and female sexual expression with immorality.304 Fine identified three common sex education discourses that she found to restrict female sexual agency. First, educators often would present sexuality as inherently negative and assumed that sexual activity would not occur if it were not spoken about. Second, womanhood was framed as victimization, as educators failed to distinguish between consensual and coercive sexual activity. They ignored the possibility that girls could choose to be sexual, thus removing their ability to be so. Third, educators presented the idea of sexual control as moral, suggesting that girls must control their impulses and desires out of a moral imperative.305 When girls in the classes Fine observed would raise the issue of pleasure, teachers would quickly warn against the dangers of sexuality. Often, sex educators promote fear in their students by focusing on pregnancy, disease, and other adverse consequences to sexual activity !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 303 !Froyum,!Carissa!M.!(2010).!Making!'Good!Girls':!Sexual!Agency!in!the!Sexuality! Education!of!LowDIncome!Black!Girls.!Culture,*Health*&*Sexuality,*12(1),!59.! 304 !Fine,!Michelle.!(1988).!Sexuality,!Schooling!and!Adolescent!Females:!The!Missing! Discourse!of!Desire.!Harvard*Educational*Review,*58,!32.! 305 !Ibid,!35.! ! 114!

rather than the kind of agency necessary to make empowered sexual decisions.306 These messages reinforce the cultural notion that girls are good only when they suppress their sexual desires or shape themselves into heterosexual males' ideals. In contemporary youth culture, attention and affection from boys serves to raise girls' social status. The most popular girls are those who establish a reputation as a good girl (that is, sexually pure), yet manage to remain attractive and pleasing to boys.307 Good girls are seen as only being sexual as a symbol of commitment to their boyfriends, not because they desire sexual pleasure. Bad girls, on the other hand, are thought of as promiscuous; exhibiting their sexuality to get attention.308

Pedagogy and Standards of the Curriculum My curriculum is based on the idea that an inclusive and diverse pedagogy would empower educators to explore traditionally silenced discourses and create a space for students to examine and challenge the hierarchy of binary identities that schools create and support, such as male-female, white-black, rich-poor, and gay-straight. My curriculum questions traditional ideas instead of equating knowledge with what educational theorist Deborah Britzman refers to as certainty, authority, and stability,the idea that the school is the arbiter of all that is true and that values promoted therein are non-negotiable.309 Kevin Kumashiro, a groundbreaking theorist of anti-oppressive education, suggests four approaches to challenge multiple forms of oppression in schools: education for the Other, education about the Other, education that is critical of privileging and Othering, and education that changes students and !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 306 !Allen,!L.!(2007).!Doing!'it'!Differently:!Relinquishing!the!Disease!and!Pregnancy! Prevention!Focus!in!Sexuality!Education.!British*Journal*of*Sociology*of*Education,*28,!577.! 307 !Supra!at!11,!61.! 308 !Ibid,!61.! 309 !Britzman,!Deborah.!(1995).!Is!There!a!Queer!Pedagogy?!Or,!Stop!Reading!Straight.! Educational*Theory,*45(2),!151D165.! ! 115!

society.310 He pushes educators to find new methods to destabilize traditional ways of learning and offers tools with which we can build a useful understanding of the world. Kumashiro's approach about education that changes students and society, as well as his idea of education aimed specifically at oppressed groups, are driving forces in the creation of my curriculum. My curriculum incorporates the National Sexuality Education Standards developed by the Future of Sex Education Initiative311 as well as four other health education organizations in 2011.312 These standards are intended to provide clear, consistent and straightforward guidance on the essential minimum, core content for sexuality education that is developmentally and ageappropriate for students in grades K-12.313 In these standards, it is specified that effective sexuality education: Focuses on specific behavioral outcomes. Addresses individual values and group norms that support health-enhancing behaviors. Focuses on increasing personal perceptions of risk and harmfulness of engaging in specific health risk behaviors, as well as reinforcing protective factors. Addresses social pressures and influences. Builds personal and social competence. Provides functional knowledge that is basic, accurate and directly contributes to healthpromoting decisions and behaviors. Uses strategies designed to personalize information and engage students. Provides age-and developmentally appropriate information, learning strategies, teaching methods and materials. Incorporates learning strategies, teaching methods and materials that are culturally inclusive. Provides adequate time for instruction and learning. Provides opportunities to reinforce skills and positive health behaviors. Provides opportunities to make connections with other influential persons.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 310!Kumashiro,!Kevin.!(2002).!Troubling*Education:*Queer*Activism*and*Antioppressive* Pedagogy.!New!York:!Routledge!Farmer.! 311 !The!Future!of!Sex!Education!Initiative!is!a!partnership!between!Advocates!for!Youth,! Answer,!and!the!Sexuality!Information!and!Education!Council!of!the!United!States!(SIECUS)! 312 !The!other!organizations!are!the!American!Association!of!Health!Education,!The! American!School!Health!Association,!The!National!Education!AssociationHealth! Information!Network,!and!The!Society!of!State!Leaders!of!Health!and!Physical!Education.! 313 !Supra!at!7,!6! ! 116!

Includes teacher information and plans for professional development and training to enhance effectiveness of instruction and student learning.314

When writing my curriculum, I tried to keep these characteristics in mind, and I believe that I have met all of the criteria laid out in the National Sexuality Education Standards. I also referred to the Standards often when making decisions with regard to the content of my curriculum.

Empowerment When I use the term empowerment, I am referring to an ambiguous concept that has been defined by many scholars. The definition that is most fitting in the context of this curriculum is Gibsons (1991), which defines empowerment as a social process of recognizing, promoting and enhancing peoples abilities to meet their own needs, solve their own problems and mobilize the necessary resources in order to feel in control of their lives.315 The main goal of my curriculum is to provide students with these necessary resources so that they can maintain control of their own lives.

Components of the Curriculum Section 1: Human Anatomy and Development 1 I chose to begin my curriculum with a two-unit section on human anatomy and development because it is impossible to understand the more nuanced aspects of sexuality without having an understanding its most basic elements. This section includes an overview of sexual anatomy, reproduction, puberty, menstruation, and body image. If an educator feels that

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! 314 !Ibid,!9! 315 !Gibson,!C.!(1991).!A!Concept!Analysis!of!Empowerment.!Journal*of*Advanced*Nursing,*16,! 354D361.! ! 117!

these first two units are unnecessary for their program, it is acceptable to modify them or remove them altogether. The most notable difference between my curriculum and other sex education curricula available today is that it is intentionally designed to only use gendered language (male, female, etc.) in specific ways. This is especially relevant in this particular unit because it is almost impossible to talk about reproduction and sexual anatomy without using gendered language, yet that is what I attempted to do. Because of my intentional efforts to keep gendered language out of this curriculum, and to clarify what I mean when I do use such language, I have taken the necessary steps to limit discrimination based on gender identification. The other notable difference between this curriculum and other comprehensive sex education curricula is the opportunity that I provide for discussion about cultural differences with regard to sexuality. This is relevant in many of the sections of my curriculum, including the sections on human anatomy and development. When discussing issues that may vary greatly from culture to culture (such as slang terms, for example), I have noted the importance of recognizing these differences instead of ignoring them and allowing the discourses of the most privileged groups to dominate the conversations.

Section 2: Human Anatomy and Development 2 This section, which is the second part of the Human Anatomy and Development unit, includes discussions of menstruation and body image. While these topics are relatively straightforward, it is important to keep in mind throughout the unit the tone that is used to convey this information. It is essential that educators teach about these topics in a non-judgmental and inclusive manner in order to prevent their own opinions from influencing what they are teaching.

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Because of the popular discourse of shame and silence surrounding menstruation, it is important to teach the topic to every student, regardless of biological sex or gender identity. It is important that all students know what is going on not only in their own bodies, but also in the bodies of those they care about. In continuing the practice of using non-gendered language, it is important to discuss menstruation in a way that clearly differentiates biological sex and gender identity. Therefore, educators are discouraged from using words such as female and woman when describing the process of menstruation. Instead, this curriculum aims to make it clear that some male-identified people menstruate and that it is not shameful. It is also relevant to note that in a discussion of menstruation, educators may wish to address the fact that first menstruation is occurring at earlier ages among people living in poverty, due in large part to higher rates of obesity among lower socio-economic classes. While this is mentioned in the curriculum, it is up to the educator to decide if this should be mentioned, based on their individual class makeup. When discussing body image, it is important to discuss differing ideas of beauty held by students respective cultures in order to provide students with a broader perspective than they might have if the class focused only on the societally dominant culture. Educators are encouraged to do this in a way that does not dismiss any cultures beliefs but also supports individual students self-worth. Therefore, judgmental comments and put-downs are not acceptable, but discussion of what is traditionally considered attractive in different cultures (whether or not the educator or students agree with these ideas) is acceptable and encouraged.

Section 3: Sex and Gender

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In this unit, the curriculum covers the differences between biological sex and gender identity. We will also discuss the differences between sexual orientation and gender identity/expression. This unit is an opportunity to counter popular discourses that alienate and discourage individuals who express their gender or sexuality in ways that are outside of societal norms. This unit will likely be very personal in that it allows students to explore their own beliefs and what they have been taught about sex and gender. Therefore, educators are encouraged to respect all students beliefs while at the same time discouraging negative or harmful stereotypes. This unit includes the Genderbread Person activity, which is an incredible resource for personal exploration of sex and gender. Taking the time to teach this activity is a way of counteracting the discourse of silence around many issues of gender and sexuality. This unit intentionally includes fewer activities than others because of the importance of allowing enough time to fully explore the Genderbread Person in depth without feeling constrained.

Section 4: Sexual Behavior and Fantasy In many sex education classrooms, the act of sex is discussed only in the most clinical of terms and then pushed aside. It is also uncommon that any type of sex acts other than penis-invagina intercourse will be discussed. This unit, therefore, is devoted to providing information that most students will not be receiving elsewhere. It discusses sexual behavior, sexual desire, and masturbation, attempts to define the term sex, and includes a discussion on asexuality, another often overlooked topic in sex education. Because of the popular discourse of shame around female sexual pleasure, educators are encouraged to promote healthy sexual expression among all of their students. By emphasizing

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that everyone can experience sexual desireand that it is normaleducators can help to combat the discourse of shame that surrounds sexually active young women. While this does not need to be stated explicitly, it is important to note the differences in cultural messages that are likely to be received by students from a variety of racial and ethnic backgrounds. Cultural stereotypes (for example, the idea that people of color are more sexual than their white counterparts) are likely to have an impact on the way different students might experience this unit, and therefore educators are encouraged to keep combatting these stereotypes in mind while teaching these lessons. This unit is an excellent time to make note of two prominent discourses around sexuality and young people. The first is the discourse of shame around young white women who engage in sexual activity. The second is the discourse of young women of color as hypersexual and lacking in morality. It is important for educators to speak to these discourses in order to show students that they are problematic and not acceptable in their classes.

Section 5: Safer Sex 1 The goal of this unit is to help students understand the risks of unprotected sex and learn about contraceptive options, including over-the-counter contraception, prescription contraception, and emergency contraception. There will also be demonstrations of male and female condoms and opportunities for students to practice using them. This unit is intentionally placed before the unit that discusses pregnancy and STIs because while many sex education programs tend to focus on the negative consequences of sex before mentioning ways to prevent them, I believe that this order of discussion is both counter-intuitive and promotes shame among sexually active young people. While I agree that it is important to teach the negative

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consequences of unprotected sex, it makes the most sense to do so after teaching about the ideal way for sex acts to happen among teenagers (using contraception). The contraception list used in this unit was intentionally adapted from Planned Parenthood to fit this curriculum in order to remove gendered words such as male and female as much as possible. This is intended to counteract the discourse of shame around gender exploration and identification beyond ones assigned sex. When teaching about condom use, educators are encouraged to discuss cultural ideas surrounding condoms. Based on the individual makeup of each class, educators can decide if such a conversation would be helpful. It is also important to point out that when this unit refers to male and female condoms, it is speaking about biological sex rather than gender identity. It is therefore encouraged to point out that it is completely acceptable to identify as female and use male condoms or vice versa.

Section 6: Safer Sex 2 This unit focuses on providing a comprehensive understanding of the stages of pregnancy, as well as the characteristics of various STIs. When discussing pregnancy, it is important to educate every student about pregnancy regardless of whether or not they are currently having sex that puts them at risk of it. Teen pregnancy is an issue that, whether directly or indirectly, affects every teenager. By including all students in discussions of pregnancy, we are intentionally combatting the popular discourse that places all responsibility for pregnancy on women. It is also relevant to discuss the differences in cultural myths around pregnancy that are likely to be popular among students from a variety of racial and ethnic backgrounds. The educator should use their best judgment when deciding

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whether or not to address this issue explicitly, but it is important to be aware of it when teaching this lesson. In continuing to be conscious of gendered language, educators are encouraged to specifically remind students that the use of gendered terms in the discussion of pregnancy are again referring to biological sex as opposed to gender identity. It is important to emphasize the possibility of a male-identified person getting pregnant or a female-identified person getting someone pregnant. When discussing pregnancy options, and specifically when discussing abortion, it is important to be aware that many public policies prohibit many people, especially those of lower socioeconomic class, from accessing abortion services. Therefore, it is likely to be helpful to provide students with relevant resources and state laws relating to abortion in order to give them realistic access to these services.

Section 7: Personal Skills The goal of this unit is to give students the opportunity to explore their personal values around sexuality and to hone the skills that they already have in order to become more empowered and mature people. This unit includes discussions of personal values and opinions as well as decision-making skills. Sections Seven, Eight, and Nine are incredibly valuable because they provide what is often missing in sex education: a context for the information that students learn about sex. When students are simply taught about sex acts without then being given a healthy frame of reference in which to think about these acts, important information is being omitted. I believe that young people need to know how to have healthy relationships as much as they need to know how to practice healthy sexual behavior.

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I have included an activity that allows students to create a list of their personal values because this gives them a chance to look at their own values and acknowledge their own sexual agency. Therefore, it is important that educators are not pushing their own values onto their students and that you are allowing them to form their own opinions, a technique that is not often employed in sex education classes.

Section 8: Relationship Skills The purpose of this unit is to discuss relationships and the skills that are necessary in order to have healthy relationships. This unit covers communication skills, ways to distinguish between healthy and unhealthy relationships, and consent. This unit can be incredibly beneficial to all teenagers because it provides them with the practical skills that they will be able to use in their lives in order to cultivate healthy relationships and communicate effectively.

Section 9: Sexual Violence The purpose of this unit is to familiarize students with sexual violence, harassment, and abuse and what they entail. A large portion of this unit will also be focused on preventing sexual violence by teaching students to treat others respectfully and to take responsibility for their own actions. Because so much of sexual violence prevention strategies focus on the potential victim, this unit focuses on the potential abuser because it isnt possible to control whether or not you get abused, but it is possible to decide whether or not you abuse, and I hope that this unit will influence young peoples choices and help them to decide not to abuse.

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When discussing sexual violence, it is important to mention cultural ideas surrounding sexual violence (and contributing to its prevalence) while still emphasizing the fact that sexual violence is never acceptable. It is also important to note that sexual assault occurs within every type of relationship and can be perpetrated by anyone of any sex, gender, or sexual orientation. While it is true that men perpetrate most sexual assaults, this does not invalidate the experiences of people who have been sexually assaulted by women. The lesson on sexual harassment provides an excellent opportunity to discuss the ways in which women are harassed in different ways than men are. While it is important to not dismiss mens experiences of harassment, it is also important for educators to remind students that sexual harassment of women is more societally accepted and therefore is almost invisible because it is so prevalent. Recognizing this harassment when it occurs is crucial to stopping it.

Section 10: Putting it All Together The purpose of this unit is to provide students with a wider context in which the information they just learned about sexuality fits. This gives students the ability to put what theyve learned into practice and to see how sexuality is intertwined into almost all aspects of life. The goal of the Sex in the Media activity is to provide students with a wider cultural context of the issues that they have learned about in this class. The media is an incredibly pervasive part of our society and it would be irresponsible to omit a discussion of its relation to sexuality from this curriculum.

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This unit also includes a lesson on gender roles. The goal of this activity is to help students understand the concept of gender role stereotyping and the ways in which gender roles affect their lives.

Setting of the Curriculum I hope to teach my curriculum in Boston, because it is the urban area with which I am most familiar. The classes would take place from 3:30 to 5:00 pm and would be free and open to anyone within the age range to join. Snacks would be provided. It should be noted that the process for choosing a specific audience for my curriculum was difficult because I did not want to create a curriculum that was so targeted that it would exclude other populations. Therefore, although a wider audience, for the reasons listed above, could potentially use my curriculum, I am tailoring it towards a specific group.

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Works Cited Empowerment Through Education: Introduction Allen, L. (2007). Doing 'it' Differently: Relinquishing the Disease and Pregnancy Prevention Focus in Sexuality Education. British Journal of Sociology of Education, 28, 577. Boston Public Health Commission. Intimate Partner Violence & Teen Dating Violence Fact Sheet, from //www.bphc.org/Pages/Home.aspx Bochenek, Michael and A. Widney Brown. (2001). Hatred in the Hallways: Violence and Discrimination Against Lesbian, Gay, Bisexual, and Transgender Students in U.S. Schools. Human Rights Watch. Britzman, Deborah. (1995). Is There a Queer Pedagogy? Or, Stop Reading Straight. Educational Theory, 45(2), 151-165. Brown, Steve and Bill Taverner. (2001). Streetwise to Sex-Wise: Sexuality Education for High-Risk Youth. Morristown, NJ: Planned Parenthood of Northern New Jersey, Inc. Butler, Judith. (1990). Gender Trouble. New York: Routledge Classics. Centers for Disease Control and Prevention. (2009). HIV Surveillance Report, from http://www.cdc.gov/hiv/surveillance/resources/reports/2009report/pdf/cover.pdf Centers for Disease Control and Prevention. (2009). Youth Risk Behavioral Surveillance--United States. Collins, P.H. (2004). Black Sexual Politics: African Americans, Gender, and the New Racism. New York: Routledge. Feagin, J.R. (2001). Racist America: Roots, Current Realities, and Future Reparations. New York: Routledge. Fields, J. (2005). 'Children Having Children': Race, Innocence, and Sexuality Education. Social Problems, 52, 560.

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Fine, Michelle. (1988). Sexuality, Schooling and Adolescent Females: The Missing Discourse of Desire. Harvard Educational Review, 58, 32. Finer, Lawrence B. and Mia R. Zolna. (2006). Unintended Pregnancy in the United States: Incidence and Disparities. Contraception. Froyum, Carissa M. (2010). Making 'Good Girls': Sexual Agency in the Sexuality Education of Low-Income Black Girls. Culture, Health & Sexuality, 12(1), 59. Future of Sex Education Initiative. (2011). National Sexuality Education Standards: Core Content and Skills, K-12 (pp. 7). Gibson, C. (1991). A Concept Analysis of Empowerment. Journal of Advanced Nursing, 16, 354-361. Gramsci, Antonio. (1971). Further Selections from the Prison Notebooks. Minneapolis: University of Minnesota Press. Kendall, N. (2008). Sexuality Education in an Abstinence-Only Era: A Comparative Case Study of two U.S. States. Sexuality Research and Social Policy, 5, 26. The Kinsey Institute. (2012). Sexuality Information Links - FAQ Retrieved January 6, 2013, from http://www.kinseyinstitute.org/resources/FAQ.html#Age Kost, Kathryn, Stanley Henshaw, and Liz Carlin. (2011). U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity. Guttmacher Institute. Kumashiro, Kevin. (2002). Troubling Education: Queer Activism and Antioppressive Pedagogy. New York: Routledge Farmer. Marra, Andy. (2012). The 2011 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual and Transgender Youth in our Nation's Schools. New York: GLSEN. Meiners, Erica R. and Therese Quinn, ed. (2012). Sexualities in Education: A Reader. New York: Peter Lang.

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Weinstock, Hillard, Stuart Berman, and Willard Cates. (2004). Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates. Perspectives on Sexual and Reproductive Health, 36(1), 6-10. Wood, Margaret. (2013). Public School and Community-Based Health Education: A Comparison Study. Marlboro College. V.A. Forshee et al. (1996). Health Education Research. 11(3), 275-286.

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EMPOWERMENT THROUGH EDUCATION

A Sexuality Education Curriculum Developed Through the Lens of Social Justice

M AG G I E WO O D

COPYRIGHT

2013 Maggie Wood

Please do not reproduce without crediting the author. i

DEDICATION

This curriculum is dedicated to the students who will (hopefully!) benefit from it in the future. If this makes a difference in even one of your lives, then it has been successful.

Special thanks to my family, friends, and academic advisors. This would never have been possible without you.

ii

RESOURCES
My Resources

Throughout the writing of this curriculum, I was inspired by many curricula and textbooks. The following resources provided the foundation for Empowerment Through Education, and I am eternally grateful to everyone that put effort into creating them.

Brown, S. and Taverner, B. (2001). Streetwise to Sex-Wise: Sexuality Education for HighRisk Youth, 2nd Edition. K.J. Riley (Ed.). Morristown, NJ: Planned Parenthood of Greater Northern New Jersey, Inc. Goldfarb, E.S. and Casparian, E.M. (2000). Our Whole Lives: Sexuality Education for Grades 10-12. J.A. Frediani (Ed.). Boston, MA: Unitarian Universalist Association of Congregations. Kelly, G. (2010). Sexuality Today, 10th Edition. New York, NY: McGraw-Hill. SIECUS Task Force. (1998). Filling the Gaps: Hard to Teach Topics in Sexuality Education. Sexuality Information and Education Council of the United States.

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FORWARD
Empowerment Through Education was designed to be a sexuality education resource for at-risk youth. For the purposes of this curriculum, the phrase at-risk youth, refers to young people who have, for any number of reasons, faced disadvantages in their lives. This population could include youth of color, youth living in poverty, lesbian, gay, bisexual, or transgender (LGBT) youth, and young women. For a more thorough explanation of the motivation behind writing this curriculum, please see the accompanying paper, Introduction to the Curriculum. Throughout this curriculum, there will be activities, handouts, or discussions that were designed to most effectively serve the needs of a specific subgroup of at-risk youth. To assist educators in determining which parts of this curriculum are best suited for their students, I have included the following symbols signifying a particular benefit for each subgroup that I hope to reach. It is important to note that the symbols themselves have been randomly chosen and do not represent the authors opinion of the subgroups to which they have been assigned. When you see this symbol, it signifies that the programming it refers to was designed to have a particular benefit for LGBT youth.

When you see this symbol, it signifies that the programming it refers to was designed to have a particular benefit for youth living in poverty.

When you see this symbol, it signifies that the programming it refers to was designed to have a particular benefit for youth of color.

When you see this symbol, it signifies that the programming it refers to was designed to have a particular benefit for young women.

When you see this symbol, it signifies that there is an important note that is relevant to all student populations.
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Introductory Activities
Each class should begin with an activity that serves two functions: to educate and to help students overcome any awkwardness that they might be feeling. When teaching about sexual topics, it is almost certain that students will feel awkward, and they might express these feelings by giggling, making jokes, and making potentially inappropriate comments. Introductory activities are designed to familiarize students with talking about sexual topics and to allow them to express any discomfort that they might feel. It is important to emphasize that feelings of discomfort about these topics are completely normal and expected, but that they should not distract from the learning experience. Educators should welcome questions, and specify that there are no questions that will be ignored, as long as they are respectful.

Question Box
The end of every class session in this curriculum should be marked by the educator answering questions from the Question Box. In the very first class, explain to the students that there will be a box somewhere in the room at all times, and that they will receive blank index cards at the beginning of each class. At any time during the class, if a student has a question that they feel embarrassed to ask aloud, they may write the question on an index card. At the end of the class, instruct the students to write I dont have a question on any blank index cards that they might have left, and then to deposit all of their cards into the Question Box. This is important because it does not serve to separate the students with questions from the ones that dont, thus potentially perpetuating embarrassment and shame about having questions. After all cards have been deposited in the box, the educator should pull them out one by one and answer them. Ideally, the educator should set aside enough time to answer every question, but if time runs out, they can begin the next class by answering the left over questions before the introductory activity.

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Assessment and Evaluation

At the end of each class, students should be given an anonymous Evaluation Form (below) to fill out and 5 minutes to do so. This form will be the same every class and asks simple open-ended questions in order to provide educators with constructive feedback and allow them to constantly improve their program. The form also allows the students to reflect on their experiences in each class and to state a commitment to something, whether its showing up on time, participating in every discussion, or anything else.

Evaluation Form
Date: Fill in these sentences as they pertain to todays lesson and/or the class as a whole.
1. I enjoyed:

2. I learned:

3. I wish:

4. I am committed to:

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HUMAN ANATOMY AND REPRODUCTION : PART 1

Although it may seem unnecessary to teach high school aged students about the names and functions of reproductive body parts, it is information that is often overlooked, especially with at-risk youth. Therefore, we are starting with the basics. However, if students clearly demonstrate knowledge of these topics, it is completely acceptable to skip this unit.

Introductory Activity: Slang Terms

Suggested time: 15 minutes
This activity serves to familiarize the students with both slang and medical terms for their body parts. This activity can also help students relax and become more comfortable in the learning space. Materials:
4 Large Pieces of Paper Markers

Instructions:
1. Before class, you should label the 4 pieces of paper as follows: Penis, Testicles, Vulva/Vagina, and Breasts. Hang these pieces of paper on the walls of the room. 2. Divide the students into 4 groups, and give each group a marker. 3. Explain to the students that each group will have 2 minutes at each piece of paper to write down as many slang words as they can think of for each body part. 4. When the students have finished making slang lists, discuss these words, and decide as a group which words will be appropriate to use in class.

Highlighting Race: This would be an excellent time to discuss slang terms that are prevalent in students respective cultures in order to provide students with a broader perspective than they might have if the class focused only on one culture.

Anatomy Handout and Activity

Suggested time: 30 minutes
This activity serves to familiarize the students with the names and locations of male and female sexual anatomy. Materials:
Male Anatomy and Female Anatomy Handouts Pens

Instructions:
1.Give each student the male and female anatomy handouts and tell them to label the body parts to the best of their ability. 2. When the students have labeled the body parts, go over them as a class, using the key provided.

Highlighting Sexual Orientation/Gender Identity: This unit would be an excellent time to briefly discuss the difference between biological sex and gender identity. This topic is further discussed in chapter 3, but it is important to mention it in this unit in order to prevent students from feeling excluded.

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Female Anatomy Handout

11

copyright 2000, Our Whole Lives Program.

Female Anatomy Key

1. Clitoris 2. Labia Majora (Outer Lips) 3. Labia Minora (Inner Lips) 4. Bartholins Glands 5. Hymen 6. Vagina 7. Cervix 8. Uterus 9. Fallopian Tubes (Oviducts) 10.Ovary 11. Perineum 12.Grafenberg Spot (G-Spot) 13.Ovum (Egg) 14.Vaginal Opening 15.Urethral Opening 16.Mons 17. Vulva 18.Urethra 19.Bladder 20.Anus 21.Rectum

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Male Anatomy Handout

13

copyright 2000, Our Whole Lives Program.

Male Anatomy Key

1. Penis 2. Foreskin 3. Glans 4. Testicle (Testis) 5. Seminiferous Tubules 6. Scrotum 7. Vas Deferens 8. Seminal Vesicle 9. Sperm 10.Cowpers (Bulbourethral) Gland 11. Prostate Gland 12.Urethra 13.Bladder 14.Anus 15.Rectum 16.Epididymus 17. Urethral Opening

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Reproduction Activity
Suggested time: 30 minutes
The purpose of this activity is to familiarize students with the human reproductive process. We will focus on pregnancy more in depth later in the program. For now, the goal is to familiarize the students with the process.

Materials:
Laminated Cards with the Steps of Reproduction (Page 9) printed on them and either velcro or magnets attached to backs. Felt or magnetic board

Instructions:
1. Place the Steps cards in piles on the floor, and invite the students to work together as a group and arrange them in the correct order. 2. Once the students are satisfied with the order of the cards, discuss reproduction and re-arrange the cards if necessary. 3. Lead students in a discussion of reproduction and answer any questions that they might have.

Highlighting Sexual Orientation/Gender Identity:: The Steps of Reproduction have been intentionally written without the use of gendered words such as male and female. This is intended to combat the cultural discourse that discourages gender exploration and identification beyond ones assigned sex. It is the educators choice whether to mention this omission explicitly or to let its message be implicit.

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Steps of Reproduction

Pregnancy
Fertilizes ovum develops into a fetus, which grows in the uterus for nine months.

Intercourse
Erect penis enters vagina.

Implantation
Fertilizes ovum adheres to the wall of the uterus.

Ejaculation
Semen is expelled from the penis and enters into the vaginal canal.

Childbirth
After about 9 months, the fetus is fully developed and exits through the vagina into the world.

Sperm Travels
Sperm travels through the vagina and cervix into the uterus or Fallopian tubes.

Fertilization
Sperm meets the ovum in the Fallopian tubes or uterus and fertilizes it.

Key: The correct order of the steps is: Intercourse, Ejaculation, Sperm Travels, Fertilization, Implantation, Pregnancy, Childbirth.

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HUMAN ANATOMY AND REPRODUCTION : PART 2

In this unit, we will be discussing menstruation and body image. While these topics are relatively straightforward, it is important to keep in mind throughout the unit the tone that is used to convey this information. It is essential to teach about these topics in a non-judgmental and inclusive manner.

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Introductory Activity: Menstrual Products

Suggested time: 15 minutes
This activity aims to familiarize students with the different menstrual products on the market today. By making a game out of it, it shows students that discussions of sexual topics do not have to always be serious. They can still have fun while learning important information.

Materials:
Tampons Menstrual pads
Menstrual cup

Menstrual sponge Chocolate or other small prizes

Instructions:
1. Divide students into four equal groups of mixed gender/sex. 2. Give each group one type of menstrual product. 3. Ask each group to discuss amongst themselves what they think the products are for. Then, ask them to each prepare 3 statements (they can write these down or just remember them) to present to the class about their product. 2 of these statements should be inaccurate descriptions of what their product does, and 1 should be what they have decided is the accurate description of their products purpose. 4. Have each group present their statements. After each statement, ask the other groups to vote for the correct product description. Provide the group(s) who guess the correct description with a prize. Provide the groups who can get the other groups to guess the correct description with a prize. 5. After all groups have presented their descriptions, provide them with the Menstrual Products Key (pg. 18) and give them time to read it and ask any questions that they might have.

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Menstrual Products Key

1. Tampons: Tampons, usually made of cotton or a cotton/rayon blend, are inserted into the vagina and held in place by the vaginal muscles. They absorb menstrual blood before it leaves the body. Tampons are inserted either by using a finger or with an applicator, and are removed by pulling on a string that is attached to the end of the tampon. It is important to change tampons every four to eight hours (depending on the heaviness of the flow) in order to avoid experiencing Toxic Shock Syndrome (TSS), a potentially fatal condition. If you experience a fever, chills, nausea or vomiting, dizziness, or other irregular symptoms when using tampons, discontinue use and see a doctor immediately. Menstrual pads: Menstrual pads are made from absorbent wood cellulose fibers, usually with an additional top layer of perforated plastic. Pads have an adhesive plastic back that sticks to the crotch of your underwear. Pads should be changed every four to six house (depending on flow), though there is no risk of TSS from using them. Menstrual cup: Menstrual cups are made of silicone or gum rubber and are worn internally, held in place by the vagina muscles, and collect the menstrual flow. They need to be emptied every 6 to 12 hours, but there is no risk of TSS from using them. They usually cost between $30 and $40, but can last up to 10 years. Menstrual Sponge: Menstrual sponges, made of natural sea sponges, work in the same way that tampons do, but they can be reused for up to 8 months. The same precautions taken with tampons should be taken with menstrual sponges.

2.

3.

4.

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Menstruation Discussion
Suggested time: 20 minutes
During this activity, provide students with the Menstruation Handout (pg. 18), and discuss the process of menstruation with them. It is important to present the facts as objectively as possible during this unit in order to prevent students from feeling judged or separated based on whether or not they menstruate. It is also important to include every student, regardless of biological sex and gender identification, in this discussion in the interest of providing everyone with relevant information.

Highlighting Gender: It is important to use intentionally judgment-free language in order to combat the discourse of shame that many young women face in regards to menstruation.

Highlighting Sexual Orientation/Gender Identity: In order to combat the discourse of alienation of gender non-conforming youth, it is important that discussion of menstruation include emphasis on gender identity being separate from biological sex. This differentiation will be discussed further in Section 3.

Highlighting Socioeconomic class: It might be relevant to point out that earlier ages of first menstruation have a tendency to occur among people living in poverty, due in large part to higher rates of obesity among lower socio-economic classes. It is up to the educator to decide if this should be mentioned, based on their individual class makeup.

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Menstruation Handout
Page 1
The purpose of this handout is to familiarize students of all sexual orientations, biological sexes, and gender identities with the process of menstruation. While this is an unusual way of teaching about menstruation (in most traditional sex education programs, classes are divided by biological sex, at least for this lesson), it is important that all students know what is going on not only in their own bodies, but also in the bodies of those they care about. Menstruation Facts:
-Menstruation is the process of the uterus shedding its lining through the vagina when pregnancy does not occur. This results in vaginal bleeding. -Menstruation usually occurs in biological females somewhere between 8 and 16 years of age, with an average age of 12. -The menstrual cycle tends to last around 28 days. -Menstrual periods can be preceded or accompanied by any of the following: -Moodiness -Trouble sleeping -Food cravings -Abdominal cramps -Abdominal bloating -Tenderness of the breasts For the first few years of your period, it is normal to have irregular periods, miss periods occasionally, and experience spotting (bleeding between periods). However, if you experience these symptoms after having regular periods for years, or you think you may be pregnant, it is advisable to see a doctor.

Menstruation information for this handout provided by The Cleveland Clinic (www.my.clevelandclinic.org) and Epigee Womens Health (www.epigee.org)

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Menstruation Handout
Page 2
The phases of the menstrual cycle are as follows:
1. The follicular phase: This phase occurs when the estrogen levels rise, causing the lining of the uterus (the endometrium) to grow and thicken. Meanwhile, the folliclestimulating hormone causes follicles in the ovaries to grow. One of these follicles will then form a mature egg (ovum). 2. Ovulation: This phase occurs when an increase in luteinizing hormone causes the ovary to release its egg. 3. The luteal phase: During this phase, the egg begins to travel through the fallopian tubes to the uterus. Progesterone levels rise to help prepare the uterine lining for pregnancy. If the egg does not become fertilized by sperm, estrogen and progesterone levels drop and the menses phase occurs. 4. The menses phase: During the menses phase, the lining of the uterus is shed out through the vagina if pregnancy has not occurred. This stage can last anywhere from 2 to 7 days.

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Body Image Activity

Suggested time: 40 minutes
The goal of this activity is to allow students to explore their feelings about their bodies. It is not realistic to expect educators to completely change their students negative ideas about their bodies, but a discussion of cultural standards of beauty and the importance of having a non-judgmental attitude is certainly a step in the right direction. Materials:
Variety of Magazines Scissors

Instructions:
1. Provide students with a variety of magazines ranging from glamor magazines to gossip magazines to nature magazines. 2. Instruct the students to spend time looking in the magazines for pictures of people that they find attractive, whether they find them sexually attractive, or they aspire to look like them, or they just like the way they look. Ask the students to cut out these pictures. 3. After the students have each cut out various pictures, lead a discussion about why they might find these people attractive. Try to steer the conversation so that it includes discussion of cultural standards of beauty (Barbie Doll ideals, etc.) and emphasis on the importance of not judging people based on their appearance.

Highlighting Sexual Orientation/Gender Identity:: The students should be encouraged to find images of people with any gender expression so as not to promote hetero-normative discourses.

Highlighting Race: This would be an excellent time to discuss differing ideas of beauty held by students respective cultures in order to provide students with a broader perspective than they might have if the class focused only on one culture.

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SEX AND GENDER

In this unit, we will discuss the differences between biological sex and gender identity. We will also discuss the differences between sexual orientation and gender identity/ expression. This unit is an opportunity to counter popular discourses that alienate and discourage individuals who express their gender or sexuality in ways that are outside of societal norms.

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Introductory Activity: Sex and Gender Shout Out Exercise

Suggested time: 15 minutes
This activity allows students to explore their own ideas about what sex and gender mean to them. It can help them understand their own preconceptions about these issues before they move on to the rest of the activities in this chapter. Finally, this activity provides students with a definition of sex and gender that Materials:
Index cards Bulletin Board/Magnet Board Thumbtacks or magnets Markers

Instructions:
1. Give each student a stack of index cards, some thumbtacks or magnets (the same amount as index cards), and a marker. 2. Tell the students to write on their index cards as many words or phrases that come to their mind when they hear the words that you are about to say. Specify that each word or phrase should have its own card. 3. Ask the students to write whatever comes to mind when they hear the word sex. 4. Wait for the students to finish writing, then ask them to do the same thing when they hear the word gender. 5. When the students have finished writing, ask them to come up to the bulletin board or magnet board and put some or all of their cards on it. Emphasize that they do not have to do this if they feel uncomfortable sharing their cards. 6. Lead the class in a discussion of the students cards and what sorts of things came to mind when they hear the words sex and gender. 7. Finally, provide the class with the definitions of sex and gender. (Provided on pg. 25)

Important Note: Be careful during this activity to respect all students ideas while at the same time discouraging harmful stereotypes. Each educator should use their best judgment about how to best do this, but it is crucial to portray the message that every students opinion is valid but that offensive comments will not be tolerated.

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Definitions of Sex and Gender

Sex refers to the biological and physiological characteristics that define men and women.
What does this mean? When we refer to your sex, we are talking about the sex that was assigned to you at birth (male, female, or intersex). We are not talking about your gender identity, presentation, or expression.

Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for men and women.
What does this mean? When we refer to your gender, we are talking about the way that you identify and express yourself. Ones gender might be the same as their sex or different from it. It is also possible to identify as one gender and present (or act/dress like) another, or to identify as agender (not having a gender) genderqueer (somewhere in the spectrum from male to female but not simply one or the other), or third gender (a separate gender that is not male or female)

Highlighting Sexual Orientation/Gender Identity: It is important that educators have a thorough understanding of the intricacies of gender identity, expression, and presentation. It is recommended that prior to teaching this course, educators utilize the resources provided on pg. xcvi of this curriculum.

Definitions of sex and gender provided by the World Health Organization (www.who.int)

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Genderbread Person Activity

Suggested time: 45 minutes

Genderbread Person version 2.0 from itspronouncedmetrosexual.com.

Instructions:
1. Give each student a copy of the Genderbread Person Version 2.0 Handout. 2. Explain each section of the Genderbread Person to the students. 3. Give the students time to fill in their own Genderbread Cookie with their personal information. Make sure to let them know that all of their answers are for their own benefit and will not be shared with the class or with the educators. 4. Discuss what the students learned from this activity using the Genderbread Person Discussion Questions on the next page.

Important Note: The Genderbread person is important because most students are not receiving the opportunity to learn this information, and taking the time to teach it is a way of counteracting the discourse of silence around many issues of gender and sexuality.
27

Genderbread Person Discussion Questions

The purpose of the Genderbread Person activity is to inspire students to think about gender and sex. Every student will react differently to this activity and come into it with differing levels of knowledge of these issues. As an educator, it is important to make sure that every students questions are answered and try to ensure that everyone learns something from this activity. The following questions are good starting points for a discussion of the Genderbread Person, but the educator should use their best judgment to add or subtract questions based what they feel is appropriate for their class. Discussion Questions
1. Did you learn anything about yourself when doing this activity? Share it with the class if you feel comfortable. 2. Can you give an example of gender expression? 3. Can you imagine what it might be like to have your gender identity contrast with your biological sex? How might you feel if that was the case for you? (Note: Be sure to stress that you are not asking students to out themselves in any way. If they feel comfortable speaking about their personal experiences, that is fine, but this question is meant only to provoke thoughts about gender, not to make students uncomfortable.) 4. Can you explain the sentence Gender is not a binary.? 5. Explain the difference between gender identity and gender expression (or presentation) 6. Name one thing about gender and sexuality that you learned during this activity.

28

SEXUAL BEHAVIOR AND FANTASY

In many sex education classrooms, sexually activity is discussed only in the most clinical of terms and then pushed aside. It is also uncommon that any type of sex acts other than penis-in-vagina intercourse will be discussed. This unit, therefore, is devoted to providing information that most students will not be receiving elsewhere. We will discuss sexual behavior, sexual desire, and masturbation. We will also work together to develop a communal definition of sex and have a discussion on asexuality, another often overlooked topic in sex education.
29

Introductory Activity: Slang Terms

Suggested time: 15 minutes
This activity serves to familiarize the students with both slang and technical terms for sex acts. This activity can also help students relax and become more comfortable talking about these issues. Materials:
4 Large Pieces of Paper Markers

Instructions:
1. Before class, you should label the 4 pieces of paper as follows: Masturbation, Sexual Intercourse, Cunnilingus, and Fellatio. Hang these pieces of paper on the walls of the room. 2. Divide the students into 4 groups, and give each group a marker. 3. Explain to the students that each group will have 2 minutes at each piece of paper to write down as many slang words as they can think of for each sex act. If students need clarification, define each term before the students begin their lists. 4. When the students have finished making slang lists, discuss these words, and decide as a group which words will be appropriate to use in class.

Highlighting Race: This would be an excellent time to discuss slang terms that are prevalent in students respective cultures in order to provide students with a broader perspective than they might have if the class focused only on one culture.

30

Sexual Desire Discussion

It is important to discuss sexual desire in this curriculum because it is often omitted in most sex education programs. When approaching this topic, please use the discussion points listed below, and feel free to add your own if you think they would add to the conversation. Discussion Points:
1. What is sexual desire? Allow students to offer their own opinions, but be prepared to give them the official definition: Sexual desire is a desire for sexual intimacy. (According to the Merriam-Webster Dictionary) This can mean any sort of desire for sexual contact, whether it is with another person or with oneself. 2. Who can experience sexual desire? Make sure that students are aware that anyone--regardless of gender, age, race, or any other characteristic--can experience sexual desire. 3. Sexual desire is not something to be ashamed of. As a society, we often expect people--especially young people--to be ashamed of their sexual desires. This is not a healthy expectation, and by encouraging students to own their desires, you are working against this discourse. 4. Is it OK if you dont experience sexual desire? Encourage students that while it is perfectly normal to experience sexual desire, it is also normal if you dont. Tell students that if they are not experiencing sexual feelings, they might eventually experience them, or they might not, and either way, that is completely fine. We will discuss asexuality further on page 35.

Highlighting Gender: As an educator, your goal should be to encourage healthy sexual expression among all of your students. By emphasizing that women can experience sexual desire--and that it is normal--you can help to combat the discourse of shame that surrounds sexually active young women.

31

Masturbation Activity: Messages, Myths, and Facts

Suggested time: 30 minutes
The purpose of this activity is to clear up any misconceptions that students might have about masturbation, as well as to explore the messages that students receive about masturbation. Since there is a discourse of shame around masturbation in our society, it is important that the educator emphasizes that it is a healthy and normal part of human sexual expression. Materials:
2 Index Cards, each labeled Myth 2 Index Cards, each labeled Fact

Instructions:
1. Divide students into pairs. 2. Have each pair answer the following questions amongst themselves: a. What did your parents or other adult family members tell you about masturbation when you were a child? b. What did your peers or siblings tell you about masturbation when you were a child? c. What do people tell you about masturbation now? 3. When students have finished answering these questions, lead them in a short discussion about the messages they have received about masturbation since childhood. Ask them if they think these messages were generally positive or negative, and how they think the messages have influenced their current feelings about masturbation. 4. Next, divide the students into two groups and provide them each with one Myth index card and one Fact index card. 5. Explain that you are about to play a game about masturbation myths and facts. 6. Read Masturbation Myths and Facts (pg. 34) aloud. When you read a statement, each team will have to decide if it is a myth or a fact. When the team has decided, they will hold up their corresponding index card. One point is awarded for each correct answer. If a team gets the answer wrong, the other team is given a chance to answer. You may further elaborate on any statement that you deem necessary. Highlighting Race: While this does not need to be stated explicitly, it is important to note the differences in cultural messages that are likely to be received by students from a variety of racial and ethnic backgrounds. Cultural stereotypes (for example, the idea that people of color are more sexual than their white counterparts) are likely to have an impact on this lesson.
Activity adapted from Our Whole Lives Sexuality Education Curriculum for grades 10-12. (2000)

32

Masturbation Myths and Facts

Page 1
1. Most women masturbate by inserting something (a finger, cucumber, or dildo, for example) into their vaginas. MYTH. Most women masturbate by using their fingers to directly or indirectly stimulate their clitoris and labia. 2. Sexual fantasies are always about things we secretly want to do. MYTH. Sexual fantasies are frequently about things we do not want to do in real life but are curious about or feel aroused by thinking about. 3. If members of a couple masturbate, something is lacking in their sexual relationship. MYTH. Masturbating privately and/or as part of a couples shared sexual expression is common among married or partnered couples and does not at all indicate sexual problems. Sometimes one partner may want sex when the other does not. Also, orgasms experienced during masturbation are often different from those experienced with a partner, and sometimes a person will be in the mood for one particular type of orgasm. 4. It is fine to masturbate while menstruating. FACT. There are no adverse effects caused by masturbating when menstruating. However, If you are using a tampon, you should remove it before insertive masturbation. Otherwise the tampon and its string could get pushed up too deep in the vagina for you to get it out yourself. 5. Boys who masturbate together in groups are showing early signs of being gay. MYTH. Some boys masturbate together in groups during adolescence. This form of sex play has more to do with curiosity and competition than with sexual orientation. Both gay, straight, and bisexual boys participate in this kind of group masturbation. 6. If you masturbate a lot when you are young, you will suffer adverse health consequences, such as a loss of eyesight or an influx of hair on your palms. MYTH. Masturbation will not cause blindness, hairy palms, or any other medical problem.

Masturbation Myths and Facts adapted from Our Whole Lives Sexuality Education Curriculum for grades 10-12. (2000) and Planned Parenthood (www.plannedparenthood.org)

33

Masturbation Myths and Facts

Page 2
7. If a person masturbates a lot during adolescence, they will not enjoy sexual experiences with a partner as much when they are older. MYTH. Masturbating is a good way for young people to express their sexual feelings safely. It can also help people discover what kinds of stimulation they like so that they can share that information with sexual partners and thus have more pleasurable sexual experiences in the future. 8. Masturbation is a perfectly normal part of sexual expression. FACT. The vast majority of people masturbate, and it has no adverse health effects. Masturbation is not shameful, and it does not indicate a moral failing. 9. If you masturbate, it means that you want to be having sex. MYTH. Masturbation is a good way to explore your sexuality on your own before you decide to seek out a sexual partner. 10. Masturbation is a risk-free activity. FACT. There is no risk of pregnancy or contracting a sexually transmitted infection (STI) from masturbation. As long as you regularly clean any sex toys that you use and use common sense with regard to any items that you insert into your vagina or anus, masturbation is completely risk-free.

Highlighting Sexual Orientation/Gender Identity: The Masturbation Myths and Facts are written in gendered language (referring to women and men). It could be helpful to state that these statements are referring to biological sex rather than gender identification.

Masturbation Myths and Facts adapted from Our Whole Lives Sexuality Education Curriculum for grades 10-12. (2000) and Planned Parenthood (www.plannedparenthood.org)

34

Defining Sex and Virginity Activity

Suggested time: 20 minutes
The purpose of this activity is to allow students to develop a definition of sex and virginity that works for them. The educator should emphasize that there are no incorrect definitions, and that this activity is focused more on exploring students personal beliefs around sex and virginity. The ultimate goal of this activity is for students to realize that sex and virginity are socially constructed concepts. Materials:
1 piece of paper for each student Pens or pencils

Instructions:
1. Distribute paper and pens/pencils to students. 2. Ask each student to write the following on their paper: a. Their own personal definition of sex (Note: Specify that for todays class, sex is referring to an act as opposed to biological sex, which we discussed in chapter 3.) b. Their own personal definition of virginity. (If you prefer, you may pose this question as What would someone have to do to not be considered a virgin in your opinion?) 3. Lead students in a discussion of their (likely varied) definitions of sex and virginity. You may refer to the discussion points/questions listed below or come up with your own.

Discussion Points/Questions:
1. If many students defined sex as insertion of the penis into the vagina or something similar describing penis/vagina intercourse, ask them how two people with penises or two people with vaginas might engage in sex. This should inspire further discussion of how sex is defined. 2. In your opinion, how much sexual activity can someone participate in before they are no longer a virgin? 3. If a heterosexual couple engage in sexual intercourse and the woman doesnt have an orgasm, is it still sex? What if the man doesnt have an orgasm? 4. This activity will likely lead the students to a realization that sex is a concept that should best be individually defined by each person. It might also be relevant to point out that there is no medical definition of sex or virginity and that they are both social constructs. Highlighting Gender and Race: This is a good time to make note of two prominent discourses around sexuality and young people. The first is the discourse of shame around young white women who engage in sexual activity. The second is the discourse of young women of color as hypersexual and lacking in morality. It is important to speak to these discourses in order to show students that they are problematic and not acceptable in your class.
35

Suggested time: 20 minutes

Asexuality Activity

The purpose of this activity is to allow students to explore any preconceived opinions that they might have about asexual-identified people. It should also help normalize the concept of asexuality in order to avoid ostracizing any asexual, demisexual, or questioning students. Materials:
1 piece of paper for each student Markers, crayons, glitter, and other art supplies

Instructions:
1. Distribute paper and art supplies to students. 2. Ask each student to draw a picture of whatever comes to mind when they think of an asexual person. Once they have finished their drawings, ask if anyone would like to share what they drew and explain why they drew it. Note: If no one wants to share their pictures, that is completely fine. Make it clear that the purpose of these pictures is to explore students personal ideas of asexuality. 3. Lead students in a conversation about asexuality. Use the definitions below to give students a thorough understanding of what asexuality is.

Asexuality is the experience of someone who does not experience sexual attraction. This is different from celibacy or abstinence, which are the experiences of having sexual attraction but not acting on it. Asexuals may be interested in romantic relationships and identify as heteroromantic (interested in romantic partnerships with the opposite sex), homoromantic (interested in romantic partnerships with the same sex), or biromantic (interested in romantic partnerships with either sex). Asexuals also might identify as aromantic, or not interested in romantic partnerships. Asexuality differs from demisexuality in that demisexuals do feel sexual attraction, but only with people with whom they have already formed romantic attachments.
Highlighting Race: This is an excellent opportunity to talk about various representations of asexuality in different cultures. If you think it would be appropriate, encourage students to talk about what it means to be asexual in their respective cultures.
Asexuality information from the Asexuality Visibility and Education Network (AVEN): www.asexuality.org

36

SAFER SEX 1
The goal of this unit is to help students understand the risks of unprotected sex and learn about contraceptive options, including over-the-counter contraception, prescription contraception, and emergency contraception. There will also be demonstrations of male and female condoms and opportunities for students to practice using them.

37

Introductory Activity: What is Safer Sex?

Suggested time: 15 minutes
This activity serves to familiarize students with the term safer sex and what it entails. Materials:
5 Large Pieces of Paper Markers

Instructions:
1. Divide students into 4 groups and give each group a marker. 2. Explain to the students that each group will have 5 minutes to come up with a definition for the term safer sex. When the student come with with this definition, they should write it on their paper. 3. When the students have finished coming up with their definitions, have one student from each group read their definition to the class. 4. Decide as a class what definition you would like to use from now on. Ideally, this definition will include elements from each groups definition. You may also choose to use the definition provided below. Write this definition on the 5th piece of paper and hang it on the wall in your classroom. 5. With the students, discuss the benefits of practicing safer sex. You may use the ones listed below as well as any others you might think of.

What is safer sex?

Safer sex (sometimes referred to as safe sex) is defined by the Merriam-Webster Dictionary as: Sexual activity and especially sexual intercourse in which various measures (as the use of latex condoms or the practice of monogamy) are taken to avoid disease (as AIDS) transmitted by sexual contact. Benefits of safer sex include: A reduced risk of getting a sexually transmitted infection (STI) A reduced risk of pregnancy Fewer worries about disease or pregnancy can lead to more pleasurable and exciting sex.

Safer sex information provided by Planned Parenthood: http://www.plannedparenthood.org

38

Contraception Discussion
Suggested time: 30 minutes
This activity will provide students with the information that they need about the various forms of contraception available. This will give students the power that they need to make informed choices. Instructions:
1. Hand out the Contraceptive Options handout (on pages 40-42) and give them a chance to read it. 2. When the students have finished reading the handout, ask them the discussion questions provided below (as well as any you might want to add) and lead them in a conversation about contraception.

Discussion Questions:
1. Which types of contraception also prevent against STIs? 2. What type of contraception do you think would be best for you? Why? 3. Why do you think the withdrawal method and fertility-awareness based methods are generally not recommended for teenagers? 4. If you are in a gay or lesbian relationship, do you still need to use protection? Why? What kind of protection might you use?

Highlighting Sexual Orientation/Gender Identity: The contraception list was intentionally adapted from Planned Parenthood to fit this curriculum in order to remove gendered words such as male and female as much as possible. This is intended to counteract the discourse of shame around gender exploration and identification beyond ones assigned sex.

Highlighting Gender: It is relevant to note the existence of dental dams as precautions against STIs when performing oral sex on a female-bodied person. They are not mentioned in the list of contraception options because they dont prevent pregnancy, but it would be useful to mention their importance in this lesson.

39

Contraceptive Options
There are four main categories of contraception available: Barrier, Chemical, Surgical, and Other. This handout will go over each category and its options and then describe Emergency Contraception.

Page 1

Barrier Methods:
Barrier methods of contraception provide a physical block between semen and the vagina, anus, or mouth. It is ideal to use a barrier method with a chemical or other method for the most effective pregnancy prevention.Barrier methods include:
The male condom is worn on the penis during intercourse, made of latex or plastic, and are 98% effective at preventing pregnancy and STIs when used correctly. Male condoms usually cost around $1 each. The female condom is a pouch made of synthetic nitrile that is inserted into the vagina or anus during intercourse. Female condoms are 95% effective at preventing pregnancy and STIs when used correctly, and usually cost around $2-$4 each. The diaphragm is a shallow silicone cup inserted into the vagina before intercourse to prevent pregnancy. Diaphragms are 94% effective at preventing pregnancy, cost around $15$17 and last up to two years. They are not effective against STIs. The cervical cap is a silicone cup inserted into the vagina before intercourse to prevent pregnancy. Diaphragms are 86% effective at preventing pregnancy, cost around $60-$75 and last up to two years. They are not effective against STIs. The sponge is a foam sponge that released spermicide and is inserted into the vagina before intercourse to prevent pregnancy. Sponges are 91% effective at preventing pregnancy and cost around $9-$15 for a package of three. They are not effective against STIs.
Information and images from Planned Parenthood: http://www.plannedparenthood.org

Both of these options can usually be obtained for free at a family planning clinic!

These three options are more effective for women who have never given birth.

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Contraceptive Options
Page 2
Chemical Methods:
Chemical methods of contraception use hormones to prevent pregnancy. These methods are not effective in preventing STIs.
The birth control pill is taken each day to prevent pregnancy. Pills release two hormones: estrogen and progestin, though some only include progestin.Birth control pills are more than 99% effective at preventing pregnancy if taken every day as directed. You need a prescription to get birth control pills, and they usually cost $15-$50 per month. The birth control ring (NuvaRing) is inserted into the vagina once a month for three weeks at a time to prevent pregnancy. The ring is more than 99% effective at preventing pregnancy if used as directed. You need a prescription to get the ring and it costs $15-$80 per month. The birth control implant (Implanon or Nexplanon) is a matchstick-sized rod that is inserted by a doctor into the arm to prevent pregnancy. The implant is more than 99% effective and costs between $400 and $800, but lasts up to 3 years. The birth control patch (Ortho Evra) is a small patch that sticks to the skin to prevent pregnancy. The patch is more than 99% effective if used as directed. You need a prescription to get the patch, which costs between $15 and $80 per month. The birth control shot (Depo-Provera) is a shot in the arm that prevents pregnancy. The shot is more than 99% effective if used as directed. You need to get the shot once every three months, and it usually costs between $35 and $100 per injection. Spermicide is a substance that prevents pregnancy by stopping sperm from moving. It is inserted into the vagina before intercourse and is 85% effective when used as directed. You can make increase its effectiveness by using it with a male or female condom. Spermicide costs about $8 per package.
Information and images from Planned Parenthood: http://www.plannedparenthood.org

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Contraceptive Options
Page 3
Surgical Methods:
Surgical methods of contraception use surgical procedures to permanently or temporarily sterilize people to prevent pregnancy. These methods do not prevent STIs.
Female Sterilization (Tubal Sterilization) is a surgical procedure in which a medical provider closes or blocks the fallopian tubes. Sterilization is almost 100% effective at preventing pregnancy and can be reversed in some cases, but is meant to be permanent. It generally costs between $1,500 and $6,000. Vasectomy is a surgical procedure in which a medical provider closes or blocks the tubes that carry sperm. Vasectomy is almost 100% effective at preventing pregnancy and can be reversed in some cases, but is meant to be permanent. It generally costs between $350 to $1,000.

Other Methods:
Other methods do not fit into any of the first three categories. None of these methods prevent against STIs.
Fertility-Awareness Based Methods (FAMs) are ways to track ovulation in order to prevent pregnancy. While these methods are free, they are only 76% effective and are often complicated and require close monitoring of temperature, menstrual cycles, and other bodily functions. IUDs (ParaGard or Mirena) are small, T-shaped device inserted into the uterus by a health care provider to prevent pregnancy. The IUD affects the way sperm move so they cant join with an egg. IUDs are more than 99% effective, cost between $500 and $1,000, and can last up to 12 years. LAM (Lactational Amenorrhea Method) is the act of using breastfeeding to prevent pregnancy. While it is free and almost 99% effective, it also requires that the baby doesnt eat anything besides breast milk, and it is only an option for 6 months after giving birth. The withdrawal method, or pull out method involves the withdrawal of the penis before ejaculation. Withdrawal is 96% effective at preventing pregnancy when used consistently, which doesnt happen often. This method requires partners to be on the same page during intercourse.
Information and images from Planned Parenthood: http://www.plannedparenthood.org

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Contraceptive Options
Page 4
Emergency Contraception:
If you have unprotected sex, you can still take emergency contraception to prevent pregnancy. There are two kinds of emergency contraception: Emergency contraception pills (Next Choice One Dose, Plan B One Step, and ella), also known as the morning-after pill ParaGard IUD insertion Both types of emergency contraception can be used up to five days (120 hours) after having unprotected intercourse. You can get emergency contraception (except ella) pills from a pharmacy without a prescription. You will need a prescription for ella. Emergency contraception pills cost anywhere between $10 and $70. Levonogestrel pills, such as Plan B One-Step and Next Choice One Dose, are up to 89 percent effective when taken within 72 hours (three days) after unprotected sex. They continue to reduce the risk of pregnancy up to 120 hours (five days) after unprotected sex, but they are less effective as time passes. ella is 85 percent effective if taken within 120 hours (five days) after unprotected sex. It stays just as effective as time passes after sex.

A ParaGard IUD can be used as emergency contraception if inserted by a health care provider within 120 hours (five days) after unprotected intercourse. It is 99.9 percent effective, even on day five, and can be left in as ongoing birth control for as long as you want, up to 12 years. This makes itthe most effective type of emergency contraception out there. While IUDs can be more expensive upfront (ranging from $500 to $900), they are more economical because they can be left in as extremely effective birth control for years.
Information and images from Planned Parenthood: http://www.plannedparenthood.org

43

Male Condom Video and Discussion

Suggested time: 30 minutes
The purpose of this video is to familiarize students with the correct way to put on and take off a male condom. Instructions:
1. Show students the Male Condom Video (provided in accompanying DVD) and lead them in a discussion using the discussion questions provided below and any others that you feel might be important.

Discussion Questions:
1. What kinds of lubricant are safe to use with latex condoms? (Answer: Water or Silicone based) 2. What are non-latex condoms made out of? (Answer: Polyurethane or polyisoprene) 3. Why is it important to leave room at the tip of the condom when putting it on? (Answer: To allow room for the ejaculate so that the condom wont break) 4. If you use two condoms at once, does that mean you will be twice as protected? (Answer: No, the condoms will rub against each other and break down the latex. One condom, used correctly, is 98% effective at preventing pregnancy and STIs.) 5. Why is it best to bring your own condoms when you have sex? (Answer: In order to insure that the condoms havent expired, been tampered with, or been stored in an unsafe place) 6. What should you do if your partner refuses to wear a condom or allow you to wear a condom? (Answer: Know whats best for yourself and dont have sex with someone who wont use a condom--they dont have your best interests at heart!)

Highlighting Race: This would be an excellent opportunity to discuss cultural ideas surrounding condom use. Educators are encouraged to discuss this to whatever degree they feel necessary based on the individual makeup of each class.

Highlighting Sexual Orientation/Gender Identity: It is important to point out that when we refer to male and female condoms, we are speaking about biological sex rather than gender identity. It is completely acceptable to identify as female and use male condoms or vice versa.
44

Male Condom Relay Race

Suggested time: 20 minutes
This activity will give students an opportunity to practice using male condoms and working in groups. It is important to provide students with hands-on experience as well as pertinent information. Materials:
2 demonstration penises or other phallic objects (bananas, cucumbers, etc) Male condoms for each student and 2 small buckets of extras

2 adult educators Chocolate or other small prizes

Instructions:
1. Divide the class into two equal groups. 2. Give each group a demonstration penis or other phallic object and give each individual a male condom. 3. Assign each group to an adult educator. 4. Have each adult educator stand on one side of the room at opposite corners, each holding a phallic object. Place each bucket of extra male condoms next to an adult educator. 5. Have each group line up on the other side of the room across from their adult educator. 6. Explain to the students that they will be participating in a relay race. When you say Go! the student at the head of each line will approach their adult educator and then proceed to put their condom on the phallic object in the way that was just demonstrated on the video. If they make a mistake, they must get a new condom from the bucket and start over. When they have successfully put the condom on, they must then safely remove it (as demonstrated in the video) and discard it. After they are finished, the next person from their group must do the same thing until everyone in the group has completed the task. Whichever team finishes first wins, though every team should get prizes.

45

Female Condom Video and Discussion

Suggested time: 30 minutes
The purpose of this video is to familiarize students with the correct way to put on and take off a female condom. Instructions:
1. Show students the Female Condom Video (provided in accompanying DVD) and lead them in a discussion using the discussion questions provided below and any others that you feel might be important.

Discussion Questions:
1. Are female condoms made of latex? (Answer: No, they are made from synthetic nitrile) 2. What are some benefits of using female condoms rather than male condoms? (Answers can include: They are non-latex, you can put them in before intercourse [so, no need to wait for an erection], and they can give female-bodied people the power over their own contraception) 3. Can you use a male condom and a female condom at the same time? (Answer: No, the friction will break down the latex of the male condom. One type of condom at a time is recommended.) 4. What kinds of lubricant are safe to use with female condoms? (Answer: Water, oil, or silicone-based lubricant)

46

Female Condom Practice

Suggested time: 20 minutes
This activity will give students an opportunity to practice using female condoms and working as pairs. It is important to provide students with hands-on experience as well as pertinent information. Materials:
Female condoms for each student

Instructions:
1. Separate students into pairs and give each pair two female condoms. 2. Have one student from each pair make a fist and the other student practice inserting the female condom using their fist as a substitute vagina. 3. Once each person has completed this, ask them to switch and allow the other student to practice. 4. When this activity is completed, students should have a thorough understanding of how to use female condoms.

47

SAFER SEX 2
During this unit, students will learn the basics of pregnancy and the options available to pregnant teenagers. They will also learn about sexually transmitted infections and spend time specifically discussing HIV/AIDs. The goal of this unit is to familiarize students with the potential consequences of unprotected sex.

48

Introductory Activity: Safer Sex Discussion Role-Plays

Suggested time: 15 minutes
This activity allows students to practice the act of negotiating and insisting upon condom use with their partners. The goal of this activity is to emphasize the importance of safer sex and taking care of ones sexual health. Instructions:
1. Divide students into pairs and give each pair one Safer Sex Discussion Scenario (pg. 49-50) 2. Ask students to act out their Safer Sex Discussion Scenario within their group. 3. After everyone is finished, ask if one or two pairs would like to act out their scenarios in front of the class. 4. Facilitate a conversation about safer sex discussion skills and allow students to ask any questions that they might have. It is important to mention here that while in an ideal world, everyone would be practicing safer sex, these discussions are all too real parts of life, and therefore things that are useful to learn about.

Highlighting Race and Gender: This is an excellent time to discuss the differences in cultural attitudes around safer sex. In some students cultures, discourses of shame around female sexual agency might make it more difficult for women to insist on safer sex.

Highlighting Sexual Orientation/Gender Identity: This is also a good time to discuss attitudes around condom in the LGBT community. For example, gay men often have different attitudes about condom use than straight men, who often have different attitudes about condom use than straight women.

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Safer Sex Discussion Scenarios

Page 1
Scenario 1
Alfred and Elli have been dating for a year and havent had intercourse yet. They are each others first partners and theyve decided that they are ready to have intercourse. Elli wants Alfred to wear a condom. Alfred has heard that condoms make sex uncomfortable and thinks that because its their first time, Elli wont get pregnant anyway. Have a conversation about condom use, with one person acting as Elli and one person acting as Alfred.

Scenario 2
Rogerio and Lazarus have been having sex regularly for 3 months. They have used condoms consistently during this time. Rogerio wants to continue using condoms because he is scared of contracting an STI, but Lazarus want to try something new and start having sex without condoms. Have a conversation about condom use, with one person acting as Rogerio and one person acting as Lazarus.

Scenario 3
Lori and Isadora have been seeing each other casually for a few weeks, and they have decided to start having sex. Lori enjoys using sex toys with her partners, but thinks that because she doesnt have sex with men, its not necessary to use condoms on her toys or dental dams with her partners. Isadora wants to be as safe as possible and has gotten dental dams and condoms from a local health clinic to use with Lori. Have a conversation about condom/dental dam use, with one person acting as Lori and one person acting as Isadora.

Scenario 4
Olivier and Jules have been having vaginal intercourse for a few months and using condoms consistently. They have decided that they would like to try anal sex, and Olivier insists that since he cant get Jules pregnant this way, there is no need to use a condom. Jules isnt so sure about that and wants to be safe and use a condom. Have a conversation about condom use, with one person acting as Olivier and one person acting as Jules.

50

Safer Sex Discussion Scenarios

Page 2
Scenario 5
Andre and Minerva both enjoy sexual relationships with multiple people as well as each other. They have been using condoms since they began having sex with each other and recently got tested for STIs. Both tests came back negative for any STIs, and since Minerva is taking a birth control pill, Andre wants to stop using condoms. Minerva is excited about this idea, but is a little concerned because she doesnt know the STI status of her or Andres other partners. Have a conversation about condom use, with one person acting as Andre and one person acting as Minerva.

Scenario 6
Darrel and Thomas have been in a monogamous relationship for 2 years and have never had sex with anyone but each other. They have been using condoms, but now Darrel wants to stop, since they have no plans to stop being monogamous. Thomas is worried about this, however, because he knows that Darrel sometimes uses intravenous drugs and shares needles with his friends. Have a conversation about condom use, with one person acting as Darrel and one person acting as Thomas.

Scenario 7
James and Layla have been dating for 6 months and having intercourse with condoms for 4 months. James thinks condoms are lame and would much rather not use them. He figures that if he just pulls out before he ejaculates, there wont be a chance of getting Layla pregnant, and even though hes sleeping with other women, he doesnt think they have any STIs. Layla is worried because she suspects that James might be sleeping with other women behind her back, and she would rather continue using condoms. She loves James, though, and wants to make him happy. Have a conversation about condom use, with one person acting as James and one person acting as Layla.

Scenario 8
Samuel and Valerie have been dating for 3 months. Theyve been fooling around, but have not had intercourse or oral sex yet. Samuel seems interested in Valerie, but whenever she brings up the idea of sex, he changes the subject. Finally, after a long conversation, Samuel reveals that he is HIV-positive and, while interested in having sex with Valerie, is scared of infecting her. He also mentions that he is taking a drug cocktail to keep the virus in check. Valerie is also nervous, but still wants to have sex with Samuel. Have a conversation about condom use, with one person acting as Samuel and one person acting as Valerie.
51

Pregnancy Activity
Suggested time: 20 minutes
This activity familiarizes students with the reality of the risks of teen pregnancy associated with unprotected sex and the benefits of practicing safer sex. Materials:
Plain Hersheys kisses and caramel-filled Hersheys kisses (Note: You can substitute other candies for these, as long as there are two different kinds of candy) Bag

Instructions:

1. Fill the bag with the same number of candies as the number of students in your class. Caramel-filled Hersheys kisses represent the chances of pregnancy if you are having consistent unprotected sex for a year. Plain Hersheys kisses represent the chances of not getting pregnant if you are having consistent unprotected sex for a year. 85 out of every 100 people who have regular unprotected sex will get pregnant per year. Therefore, you will need to reduce this ratio when filling your bag. For example, if your class has 20 students, you will need to put 17 caramel-filled Hersheys kisses and 3 plain Hersheys kisses in the bag. 2. Have each student reach into the bag and pull out one candy. Explain that the act of reaching into the bag symbolizes a year of consistent unprotected sex. Once every student has pulled out a candy, explain to them that, if they had actually been having unprotected sex, they would be pregnant if they were holding a caramel-filled Hersheys kiss. 3. Next, re-fill the bag with the correct ratio for a year of safer sex. 2 out of every 100 people who consistently use male condoms during intercourse will become pregnant every year. This is where it gets complicated, though. If you have a class of 20 students, only .4 students will become pregnant. Therefore, cut a caramel-filled Hersheys kiss into fourths and put in the bag. This will further emphasize the difference between unprotected sex and safer sex in terms of risk of pregnancy. Highlighting Sexual Orientation/Gender Identity: This activity is based around penis-in-vagina intercourse, so it is important to state that outright in order to avoid excluding people partake in different types of sex. This activity is included in this curriculum because it is important that everyone be educated about pregnancy regardless of whether or not they are currently having sex that puts them at risk of it. Teen pregnancy is an issue that, whether directly or indirectly, affects every teenager.
Activity adapted from Our While Lives Sexuality Education Curriculum for grades 7-9 (2000). Pregnancy statistics from Kids Health: www.kidshealth.org and Planned Parenthood: www.plannedparenthood.org

52

Pregnancy Myths Debunked

Suggested time: 15 minutes
This activity familiarizes students with common myths surrounding pregnancy and provides factual information debunking these myths. Instructions:
1. Give the students the Pregnancy Myths handout (pg. 51) and allow them to read it. 2. When students have read the handout, lead them in a conversation about the myths and ask them if they had heard any other myths that were missing from the page. If so, discuss these myths.

Highlighting Sexual Orientation/Gender Identity: Some of these myths include gendered terms such as woman, girl, man, or guy, so it is important to remind the students that this is again referring to biological sex as opposed to gender identity. It is important to emphasize the possibility of a male-identified person getting pregnant or a female-identified person getting someone pregnant.

Highlighting Race: This is an excellent time to discuss the differences in cultural myths that are likely to be popular among students from a variety of racial and ethnic backgrounds. The educator should use their best judgment when deciding whether or not to address this issue explicitly, but it is important to be aware of it when teaching this lesson.

53

Pregnancy Myths
MYTH: You cant get pregnant the first time you have sex. FACT: If you are ovulating, it doesn't matter if it's the first time or the hundredth time you've had sex, you can still get pregnant. MYTH: You cant get pregnant during your period. FACT: There is a chance that you can get pregnant if you have sex during your period. Once in the vagina, sperm can stay alive for several daysthat means that, even if the last time you had sex was three days ago during your period, you could now be ovulating and therefore you could get pregnant. MYTH: You cant get pregnant if youve never had a period. FACT: You may ovulate 14 days before your first period so it is possible to get pregnant even if you haven't had a period yet. MYTH: You cant get pregnant/get someone pregnant if: you have sex standing up, the girl is on top, you have sex in a hot tub, you jump up and down immediately after sex, the girl douches after sex, the girl makes herself sneeze after sex, etc. FACT: You can get pregnant ANY time you have unprotected sex (unless youre already pregnant), regardless of position, location, or actions after sex. MYTH: You cant get pregnant if the guy pulls out before ejaculation. FACT: There is a chance that you can get pregnant even if the guy pulls out before ejaculation because sperm cells can be present in the pre-ejaculatory fluid (pre-cum). MYTH: You cant get pregnant if the girl doesnt have an orgasm. FACT: As long as the person with the penis has an orgasm or excretes pre-ejaculatory fluid, you can get pregnant. MYTH: You cant get pregnant if you drink (or douche with) Mountain Dew before sex. FACT: The rumor that ingredients in Mountain Dew (and other popular sodas) can prevent pregnancy has been around for years, but the simple truth is that drinking soda wont do anything to prevent pregnancy, and douching with it will only increase your risk of a yeast infection because of the sugar content.

Myths and Facts adapted from Stay Teen: www.stayteen.org 54

Pregnancy Options Discussion

This activity familiarizes students with the options that are available if they were to get pregnant. When presenting these options, it is important that educators do not dismiss any of them or use judgmental language when discussing them. Instructions:
1. Present the Pregnancy Options listed below. 2. Lead students in a discussion of pregnancy options and allow for questions as they come up.

Suggested time: 20 minutes

Parenting
Carrying a pregnancy to term, giving birth, and keeping the baby is one option when one becomes pregnant. Being a parent can be exciting and deeply rewarding, but parents usually give up a lot for their children. If you choose this option, you will lose sleep and have less time for yourself. If you have a partner, you might find that parenting puts a strain on your relationship. If you are single, you might find it difficult to relate to other people your age and find a partner who is responsible or invested enough to co-parent.

Adoption
Adoption--a permanent, legal agreement in which you agree to place your child in the care of another person or family--is another option when one becomes pregnant. Someone might choose adoption because they are not ready to be a parent, cannot afford to raise a baby, dont want to be a single parent, or for various other reasons. Adoption can be very rewarding because you know that your child is being taken care of in a way that you might not be able to, but it can also be a very difficult experience to go through.

Abortion
Terminating the pregnancy, or having an abortion, is another option when one becomes pregnant. People decide to have abortions for many of the same reasons that they choose adoption and also if they dont feel that they can go through pregnancy. Abortion is an option that many people choose: 1 in 3 women in the United States will have an abortion by the time they are 45 years old. If you decide to have an abortion, make sure you know your state laws about the procedure and remember that the health risks increase the longer into your pregnancy you get an abortion. Highlighting Socioeconomic Class: It is important to note that many public policies prohibit many people, especially those of lower socioeconomic class, from accessing abortion services. Therefore, it is likely to be helpful to provide students with relevant resources and state laws relating to abortion.
Pregnancy Option Information adapted from Planned Parenthood: www.plannedparenthood.org 55

Sexually Transmitted Infections Handout and Discussion

Suggested time: 40 minutes
The goal of this activity is to provide students with information about sexually transmitted infections so that they will know what to do if they or someone they know contracts one. This activity discusses symptoms, transmission, and treatment of every STI that exists today. Instructions:
1. Give the students the Sexually Transmitted Infections Handout (pg. 53-61) and give them time to read it. 2. Lead students in a discussion of STIs using the discussion questions provided below as well as any that you want to add. 3. Make sure to answer any questions that students might have.

Discussion Questions:
1. What is a distinguishing characteristic of bacterial STIs? (Answer: They are all curable) 2. What should you do if you suspect that you have an STI? (Answer: See a medical professional as soon as possible) 3. What is the difference between HIV and AIDS? (Answer: HIV is the infection that is transmitted and AIDS is the most advanced form of HIV) 4. What is a good way to protect against STIs? (Answer: Make sure that you are using condoms every time you have sex and that you get tested regularly.) 5. What would you do if a close friend or family member revealed to you that they had an STI? 6. Why is it important to disclose your STI status to any potential sex partners you might have? (Answer: Full disclosure will allow your partner to give informed consent with regard to sexual contact with you, and to be especially careful about using condoms.)

Important Note: During this lesson, it is strongly recommended to provide students with a list of local clinics that offer free and anonymous STI testing. These incredibly helpful resources may not be easily available to your students otherwise.

STI facts from Planned Parenthood: www.plannedparenthood.org and the Centers for Disease Control and Prevention: www.cdc.gov 56

Sexually Transmitted Infections

Page 1
There are three main categories of STIs: Bacterial, Viral, and Other. This handout will discuss each STI by category, describing the infection, common slang for it, its symptoms, who is at risk for it, how it is transmitted, and how it is treated.

Bacterial STIs

Bacterial STIs are caused by bacteria and are all curable if diagnosed early.
NAME OF STI DESCRIPTION AND SLANG SYMPTOMS TREATMENT TRANSMISSION AND COMPLICATIONS

Bacterial Vaginosis

BV will sometimes clear up without treatment, but can Female-bodied also be treated with Bacterial Vaginosis, people are at risk antibiotics. If not or BV, is a condition Symptoms include for BV, which can treated, where the normal abnormal vaginal develop on its own, complications can balance of bacteria discharge, odor, though it is most include increased in the vagina is pain, itching, or commonly susceptibility to HIV disrupted and burning. Most people transmitted and other STIs as replaced by an report no symptoms, well as through sexual overgrowth of however. complications in contact or certain bacteria. pregnancy if douching. contracted by someone who is pregnant. Usually, chlamydia has no symptoms, though they may experience abdominal pain, Chlamydia is an abnormal genital infectioncaused by discharge, bleeding a kind of bacteria between periods, a that is passed during low fever, painful sexual contact. intercourse, pain or burning while urinating, or swelling of the genitals or anus. 57 Anyone who is sexually active can contract Chlamydia is treated chlamydia, which is with antibiotics. If transmitted by not treated, vagina, anal, and complications can occasionally oral include Pelvic sex. It can also be Inflammatory spread by touching Disease, infertility in your eye with your women, and hand after touching epididymitis in men. someones genitals or to a fetus during birth.

Chlamydia

Sexually Transmitted Infections

Page 2 Bacterial STIs (Continued)
NAME OF STI DESCRIPTION AND SLANG SYMPTOMS TREATMENT TRANSMISSION AND COMPLICATIONS

Chancroid

Symptoms of Anyone who is Chancroid is easily Chancroid is a type chancroid include sexually active can treated with of bacteria that is open sores on the contract chancroid, antibiotics. There are transmitted genitals or anus which is spread no serious through sexual and swollen through skin-tocomplications contact. glands in the skin contact with associated with groin. infected areas. chancroid. Symptoms include Anyone can small, waxy, contract round growths in Molluscum the genital area or Contagiosum, on the thighs. which is spread There is often a through vaginal tiny indentation in and anal the middle of the intercourse, oral growth. These sex, nonsexual, bumps might itch intimate contact, or feel tender to or sharing clothing the touch. or towels. A health care provider can remove the small growths with chemicals, with an electrical current, or by freezing them. Or you can use a prescription medicine that can be applied at home.

Molluscum Contagiosum

Molluscum Contagiosum is a virus that affects the skin.

Gonorrhea

Many people report no symptoms with gonorrhea, but some may Gonorrhea, also experience known as the abdominal pain, drip or the clap, abnormal vaginal is an bleeding, fever, infectioncaused pain during by a bacteria intercourse or thatis spread urination, through sexual yellowish or contact. greenish genital discharge, nausea, vomiting, or frequent urination. 58

Anyone who is sexually active can contract gonorrhea, which is spread through anal, vaginal, or oral sex or to a fetus during childbirth.

Gonorrhea can be treated with antibiotics. If left untreated, it can lead to pregnancy complications, infertility, Pelvic Inflammatory Disease, and arthritis.

Sexually Transmitted Infections

Page 3 Bacterial STIs (Continued)
NAME OF STI DESCRIPTION AND SLANG SYMPTOMS TREATMENT TRANSMISSION AND COMPLICATIONS

Syphilis

Syphilis is a sexually transmitted disease caused by bacteria that are passed sexually.

Syphilis can be Syphilis often has treated with no symptoms, antibiotics. If left Anyone who is though people untreated, however, sexually active is at may experience it can cause serious risk for syphilis, painless sores damage to the which is spread by called chancres nervous system, contact with followed by rashes heart, brain, or other syphilis sores on the hands and organs, and during vaginal, feet, flu-like potentially lead to anal, and oral sex, symptoms and death. This can occur or (rarely) kissing. hair and weight anywhere from 1 to loss. 20 years after infection.

Viral STIs
Viral STIs are caused by viruses and are treatable but not curable.
NAME OF STI DESCRIPTION AND SLANG SYMPTOMS TREATMENT TRANSMISSION AND COMPLICATIONS

Herpes

Herpes can be Herpes is caused without by two different Anyone is at risk symptoms, or it Herpes is not but closely related for herpes, which is can manifest as curable, but it can be viruses, herpes spread by blistery sores on simplex virus type treated with various the mouth, touching, kissing, 1 (HSV-1) and medications, and genitals, or anus. and sexual contact, herpes simplex outbreaks will People with including vaginal, virus type 2 generally become herpes may also anal, and oral sex. (HSV-2) They fewer and weaker experience flu-like and is most remain in the body within a few years symptoms contagious when for life and can after infection. anywhere from 2 sores are open. produce symptoms to 2o days after that come and go. infection. 59

Sexually Transmitted Infections

Page 4 Viral STIs (Continued)
NAME OF STI DESCRIPTION AND SLANG TREATMENT AND COMPLICATIONS

SYMPTOMS

TRANSMISSION

HIV/AIDS

HIV symptoms usually take more than 10 years to develop and can include swollen glands in the throat, armpit, or Human groin, fever, Immunodeficiency headaches, Virus (HIV) is the fatigue, and virus that causes muscle aches. Acquired Immune Symptoms can Deficiency come and go for Syndrome (AIDS). years. Symptoms HIV breaks down of AIDS can the immune include thrush, system and causes yeast infections, people to become chronic PID, sick with extreme weight infections that loss, fatigue, normally wouldn't bruising easily, affect them. AIDS coughing, is the most shortness of advanced stage of breath, flu-like HIV, which often symptoms, weakens the unexpected immune system so bleeding, much that it is numbness or pain fatal. in the extremities, loss of muscle control, decreased mental abilities, and other adverse affects, which can lead to death. 60

HIV is transmitted through blood, semen, vaginal fluids, and breast milk. The most common ways in which HIV is spread are by having unprotected vaginal or anal intercourse with an infected person, sharing needles with an infected person, or otherwise getting HIV-infected blood, semen, or vaginal secretions into open wounds or sores. It is also possible to transmit HIV from a mother to a child during birth or from breastfeeding.

There is no cure for HIV/AIDS, but there are treatments for people living with the virus. HIV/AIDS is treated with combinations of medicines called drug cocktails which are designed to strengthen the immune system to keep HIV from developing into AIDS or to relieve AIDS symptoms. These drugs are often very expensive, may have serious and very uncomfortable side effects, and may not be available to everyone. If you know that you have been exposed to HIV/AIDS, you can also take PostExposure Prophylaxis (PEP) within 36 hours, which, while having very unpleasant side effects, can greatly reduce your risk of infection.

Sexually Transmitted Infections

Page 5 Viral STIs (Continued)
DESCRIPTION AND SLANG TREATMENT AND COMPLICATIONS

NAME OF STI

SYMPTOMS

TRANSMISSION

Cytomegalovirus, or CMV, is a virus that is Cytomegalovirus transmitted through many bodily fluids.

CMV usually has no symptoms, though it may cause flu-like symptoms and jaundice.

Anyone is at risk for CMV, which is There is no cure for spread through any CMV, but symptoms contact in which can be managed with saliva, semen, blood, medication. CMV vaginal secretions, can cause urine, or breast milk complications such is exchanged, such as blindness and as close personal mental disorders in contact, vagina, people with anal, and oral sex, weakened immune sharing needles, and systems. through childbirth and breastfeeding. There is no treatment for HPV itself, though there are treatments available for its complications, such as genital warts (which can be removed by freezing, surgery, lasers, topical medication, or can simply go away on their own) and the cancers caused by high-risk HPV (which can be treated in various ways, including removing or freezing the abnormal cells to allow new healthy cells to grow instead.

HPV/Genital Warts

Anyone is at risk for HPV, which is Low-risk HPV, which can cause transmitted through skin-to-skin contact, genital warts, manifests as usually during There are around flesh-colored vaginal, anal, or oral 40 types of bumps on the skin sexual contact. Two Human vaccines (Gardasil on or near the Papillomavirus and Cervarix) are genitals, anus, or (HPV), which can available that can (rarely) the mouth have no effect or protect against the or throat. Highcan cause genital HPV types that risk HPV, which warts or cancer cause 7 out of 10 can cause cancer, of the cervix, usually does not cases of cervical vagina, anus, have any cancer. Gardasil also penis, or throat. symptoms and protects against the requires a pap types of HPV that smear in order to cause 9 out of 10 be diagnosed. cases of genital warts. 61

Sexually Transmitted Infections

Page 6 Viral STIs (Continued)

NAME OF STI

DESCRIPTION AND SLANG

SYMPTOMS

TREATMENT TRANSMISSION AND COMPLICATIONS

Hepatitis A/B/C

Hepatitis A, Hepatitis B, and Hepatitis C are viral infections of the liver.

Hepatitis A is There are no special spread through treatments for any oral contact with type of Hepatitis. the fecal matter of Most people with an infected person, these viruses will feel including through sick for a few months oral-anal contact. before they begin to Hepatitis B is feel better. A few spread through people will need to contact with blood, be hospitalized. semen, or other During this time, body fluids of an doctors usually The three kinds of infected person, recommend rest, Hepatitis do not including through adequate nutrition, always show sexual activity. and fluids, and symptoms, but Hepatitis C is avoidance of alcohol. they can cause fluspread through Occasionally, like symptoms, contact with the Hepatitis B or jaundice, dark blood of an Hepatitis C will urine, joint pain, infected person, develop into a or clay-colored usually through chronic condition, bowel movements. sharing needles, which, while not though it can fatal, will persist on occasionally be and off for the spread through infected persons sexual activity lifetime and can where blood is sometimes be exchanged. There controlled with is a vaccine for medication. This Hepatitis A and complication does Hepatitis B, but not occur with not yet for Hepatitis A. Hepatitis C. 62

Sexually Transmitted Infections

Page 7 Other STIs
Other STIs are STIs that do not fit into any other category. They are all curable if diagnosed early.
NAME OF STI DESCRIPTION AND SLANG SYMPTOMS TRANSMISSION TREATMENT AND COMPLICATIONS

Intestinal Parasites

Intestinal parasites can be treated by medication Intestinal parasites prescribed by a are spread when There are often health care fecal matter gets no symptoms of into the mouth, such practitioner, though Intestinal parasites intestinal as through pregnant women are microscopic, parasites, but contaminated food cannot take some of one-cell animals infected people or water or oral-anal them and they may called protozoa may experience sexual contact. They not be as effective for that infect the diarrhea, people with can also be spread intestines. abdominal pain, weakened immune through nonsexual bloating, nausea, systems. For such intimate contact and vomiting. people, intestinal such as diaper changing. parasites can be very serious and even lifethreatening. Symptoms of pubic lice usually do not appear for Pubic lice are spread Over-the-counter around five days during sexual and prescription after contact or medications are exposure,and occasionally through available to treat may include other kinds of close pubic lice, and all intense itching in physical contact. bedding, towels, and the genitals or Very rarely, they can clothing that may anus, mild fever, be spread from have been exposed feeling runcontact with should be thoroughly down, infected bedding, washed. There are no irritability, and clothing, serious the presence of upholstered complications lice or nits in furniture, and toilet associated with pubic hair. seats. pubic lice. Occasionally, symptoms never appear. 63

Pubic Lice

Pubic lice, often referred to as crabs, are tiny insects that attach themselves to the skin and hair in the pubic area.

Sexually Transmitted Infections

Page 8 Other STIs (Continued)
DESCRIPTION AND SLANG TREATMENT AND COMPLICATIONS Medical professionals can prescribe medications to treat scabies, and bedding, towels, and clothing that could be infected should be thoroughly cleaned. There are no serious complications associated with scabies.

NAME OF STI

SYMPTOMS

TRANSMISSION

Scabies

Symptoms of scabies might not occur, but if they do, they may Scabies is a skin include intense condition caused itching, especially by a mite that at night, and burrows under small bumps or the skin. rashes that appear in small curling lines on the infected areas.

Scabies is spread through sexual contact, other close personal contact, and contact with infected bedding and clothing.

Trichomoniasis

Trichomoniasis, often called trich, is an infection caused by a protozoan called a trichomona.

Often, trichomoniasis Medical has no symptoms, Trichomoniasis is professionals can though infected spread through people may prescribe vaginal intercourse, experience medications to treat sharing sex toys, and abnormal genital trichomoniasis. mutual discharge, itching, There are no serious masturbation if bleeding, pain, complications fluids are painful urination, associated with exchanged. and the urge to trichomoniasis. urinate frequently.

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PERSONAL SKILLS AND VALUES

The goal of this unit is to give students the opportunity to explore their personal values around sexuality and to hone the skills that they already have in order to become more empowered and mature people. This unit includes discussions of personal values and opinions as well as decision-making skills.

65

Introductory Activity: Four Corners

Suggested time: 20 minutes
This activity allows students to explore their personal opinions on many issues surrounding sexuality that they may not have previously considered.

Materials:
Masking or duct tape 4 signs labeled as follows: Agree Strongly Agree Disagree and Strongly Disagree A classroom with four corners and room to move between them freely.

Instructions:
1. Hang one sign in each corner of the classroom. 2. Ask students to stand up and, as you read each Sexuality Opinion Statement (pg. 67), choose a corner to stand in that fits their opinion about the statement. For example, if the statement was I like apples, a student who loved apples would stand in the Strongly Agree corner, a student who hated apples would stand in the Strongly Disagree corner. Someone who enjoys apples but doesnt love them would stand in the Agree corner, and someone who doesnt like apples but doesnt hate them would stand in the Disagree corner. 3. Read each statement and then have them move to the places in the room that they deem appropriate. You may add or remove statements if you feel that it is helpful. It might not be possible to go through every statement in the time provided, depending on the amount of discourse after each statement. 4. After students have all moved to their chosen corners, ask one person standing in each corner to explain why they made the choice that they did. This may develop into a conversation, or it may not. Dont force it to become a conversation, but dont stop it if it does.

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Sexuality Opinion Statements

1. I could marry someone without having sex with them first. 2. I would worry about my friends future if they came out to me as gay. 3. If I got pregnant/got someone pregnant tomorrow, I know what I would do. 4. I feel comfortable asking someone I like out on a date. 5. I know where to get condoms and other forms of contraception. 6. If my sexual partner was unconscious or asleep, I would have sex with them if they told me before that it was okay. 7. If my boyfriend/girlfriend wanted to have an open relationship, I would be fine with that. 8.I can have open conversations with my parents about sexuality. 9. I would intervene if I saw my drunk friend hooking up with someone, even if they told me beforehand that they wanted to.

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Personal Value Statement Activity

Suggested time: 25 minutes
This activity allows students to create personal value statements relating to sexuality and relationships to refer to when they need to. Materials:
Colorful card stock Art supplies

Instructions:
1. Distribute card stock and art supplies to students. 2. Ask students to make lists of their values (as they pertain to sexuality and relationships) on their card stock using the art supplies. It might be helpful to show them an example, which you can make ahead of time. These Values might include broad statements such as I will always respect myself when making decisions about sex and relationships. or more specific statements such as I will always insist on safer sex. 3. After this activity is finished, ask students to keep their value statement lists in a safe place where they wont get lost or damaged. Emphasize that they can refer back to these statements whenever they are making decisions about sex or relationships, or at any other time. 4. You may lead students in a discussion about their value statements if they are interested, but it is also completely acceptable to simply allow them to think about their value statements without talking about them with the class.

Important Note: This activity can be incredibly helpful to all students because it gives them a chance to look at their own values and acknowledge their own sexual agency. Therefore, it is important to make sure that you, as the educator, are not pushing your own values onto your students and that you are allowing them to form their own opinions, a technique that is not often employed in sex education classes.

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Decision Making Activity

Suggested time: 45 minutes
This activity allows students to practice their decision making skills by exploring scenarios in which they have to make difficult decisions. Instructions:
1. Divide students into pairs and give each pair one Decision Scenario (pg. 70) 2. Ask students to discuss their Decision Scenario within their group and decide what they would each do if they were in that situation. They do not need to make the same decision as their partner, as long as they discuss their decision making process. 3. After everyone is finished, ask if one or two pairs would like to act out their scenarios in front of the class. 4. Facilitate a conversation about decision making, using the following discussion questions.

Discussion Questions
1. Why did you end up making the decision that you did? 2. What was your decision making process like? Did you weigh the pros and cons of your decision? Or did you just go with what you felt was right? How do you think your process would work for other decisions? 3. What was difficult about making this decision? What was easy? 4. Can you think of a decision that you had to make in your own life that was difficult? What kind of decision making process did you use when you made that decision? 5. Do you think you could use the decision making process that you used in this activity to help you make decisions in your future?

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Decision Scenarios
Page 1
Scenario 1
Mary has been dating her boyfriend Vlad for 6 months. Theyve been having intercourse, but they only use condoms when they remember to. Mary isnt taking birth control because shes afraid her parents will find out shes having sex. Shes been feeling nauseous lately and her period is three weeks late. This morning, she took a pregnancy test and it was positive. If you were Mary, what would you do?

Scenario 2
Daniel and his boyfriend Maximilian are very happy together and have been dating for 8 months. Their close friends and Maximilians family know about their relationship, but Daniel hasnt told his family yet. Daniels parents are very conservative and he is afraid they wont understand his relationship with Maximilian. He knows someone who came out to his parents and got kicked out of their house. Its getting harder and harder to keep his relationship a secret, however. If you were Daniel, what would you do?

Scenario 3
Esther has been dating Thor for almost a year and they are very happy. Recently, however, Esther has been getting very close to her friend Ana and she is beginning to have romantic and sexual feelings towards her. Esther has never felt like this about a girl before and while it is exciting, its also a little scary. She still really likes Thor, but she cant deny that she is interested in Ana as well. If you were Esther, what would you do?

Scenario 4
Paulina is a senior in high school and has never been interested in dating or sex. She just met Finley, however, and she thinks hes really cool. She thinks she definitely wants to pursue a romance with him, but she still isnt interested in sex. Finley hasnt pressured her into sex, and they havent really talked about it at all, but she knows that hes had sex before. Paulina really likes Finley but is afraid that he wont like her if he knows that she isnt interested in sex. If you were Paulina, what would you do?

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Decision Scenarios
Page 2
Scenario 5
Adrian and Marcia have been on a few dates, but they havent had sex even though Adrian wants to. Adrians friend Brian told him that Marcia will be at a party this weekend and that it would be easy to get her drunk there. Brian said that once Marcia is drunk, Adrian can get her to have sex with him. Adrian feels a little weird about this, but Brian insists that its not wrong. If you were Adrian, what would you do?

Scenario 6
Lydia has been noticing a cute girl in her math class for a few weeks now. Yesterday, her best friend told her that the girl is named Bethany and that shes a new student. Lydia really wants to talk to her, but shes afraid because shes never initiated a relationship before. She cant seem to get Bethany out of her mind, however. If you were Lydia, what would you do?

Scenario 7
Allie has always felt like there was something about her that didnt feel quite right. Recently, shes begun to realize that she is uncomfortable with being female. She has been thinking about what it would be like to be a man and she thinks she would be much happier that way. She told her friend this, however, and was told that she was a freak. Allie doesnt think she is a freak, but shes afraid to tell anyone else. She knows that if she continues living as a woman forever, however, that she will be miserable. If you were Allie, what would you do?

Scenario 8
Lincoln enjoys having casual sex with various partners, and because he enjoys the feeling of sex without a condom, he makes sure to get tested regularly. His most recent test came back positive for herpes, and he was a bit freaked out at first, but its been a few weeks and his sores are beginning to go away. Lincoln has been having sex with Kristin for 3 months and he knows that if he tells her about the herpes, she will want to stop having sex. Lincoln really enjoys sex with Kristin and doesnt really want to tell her about his herpes, but he thinks that maybe he should. If you were Lincoln, what would you do?
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RELATIONSHIP SKILLS
The purpose of this unit is to discuss relationships and the skills that are necessary in order to have healthy relationships. We will cover communication skills, ways to distinguish between healthy and unhealthy relationships, and consent.

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Introductory Activity: Conflict Resolution

Suggested time: 15 minutes
This activity allows students to think of ways in which common conflicts that occur in relationships can be solved. This will give them the opportunity to practice conflict resolution skills that can be applied to their everyday lives. Instructions:
1. Divide students into four equal groups and give each group a Conflict Scenario (pg. 72) 2. Ask students to read their Conflict Scenarios in their groups and then discuss how they would solve the problems described in their scenarios. They should discuss multiple potential solutions and then ultimately decide on one that they think would be the most effective. 3. After everyone is finished, ask if any groups would like to share the solution that they came up with and talk about why they decided on that particular solution. 4. Facilitate a conversation about conflict resolution, using the following discussion questions, as well as any that you would like to add.

Discussion Questions
1. What, if anything, was difficult about solving the conflict in your scenario? 2. Was it easy or hard for your group to decide on a most effective solution? 3. Do you think that these types of scenarios happen in real life? 4. Do you think that you could use any of the skills you learned in this activity in situations that might come up in your life? 5. How did you come up with the solution that you did? Did you refer to a situation in your life where you might have had to use conflict resolution skills? 6. Can you think of a way in which your situation could have been handled that would have been harmful instead of helpful? Why would it be harmful?

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Conflict Scenarios
Scenario 1: Kevin and Demetrius have been together for almost a year. They are mostly happy together, but Demetrius has heard from some of his friends that Kevin might be cheating on him. He doesnt think Kevin would do that, but he does go out late sometimes and is vague about where hes been and who hes been with. Demetrius doesnt want to be obnoxious or clingy but hes becoming more and more worried about this as time goes on. If you were Demetrius, what would you do in this situation?

Scenario 2: Courtney and Katja have recently started dating and seem right for each other in so many ways. They both enjoy the same books, TV shows, and music, and they have a lot of fun hanging out together. However, Courtney has been noticing that whenever they hang out with a group of her friends, Katja is very rude and dismissive to them. Courtneys friends have begun to avoid hanging out with the two of them because Katja has been insulting and belittling them. Courtney doesnt understand why Katja does these things because shes so nice when theyre alone. If you were Courtney, what would you do in this situation?

Scenario 3: Rupert and Ermelinda have been dating for 2 years. Lately, Rupert has been getting more and more jealous of Ermelindas male friends. He doesnt like it when she hangs out with them because hes afraid that she will cheat on him. He doesnt know why she needs male friends, anyway. Isnt he enough for her? Rupert doesnt want to make Ermelinda unhappy or control her life, but whenever she spends time with her male friends, he feels like he needs to call her constantly to make sure shes not doing anything he doesnt approve of. Ermelinda has started to get irritated with Rupert because of this. If you were Rupert, what would you do in this situation?

Scenario 4: Julian and Horace have been dating for 3 months and things have been great except for one issue. Julian has noticed lately that Horace enjoys making fun of people at school. He mocks people that are less popular than he is and when Julian asked him about it, he said that it was all a joke and that everyone thought it was funny. Julian noticed some of the people that Horace made fun of crying in the bathroom later that day, however. He doesnt think that Horace realizes that what hes doing is so hurtful, but its bothering him more and more as time goes on. If you were Julian, what would you do in this situation?
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Communication Activity
Suggested time: 30 minutes
This activity allows students to learn about the four main types of communication and then practice communicating in different ways through the use of role-play scenarios. Instructions:
1. Divide students into pairs and give each pair one Communication Scenario (pg. 76) 2. Go over the Four Communication Styles (pg. 75) 3. Ask students to act out their Communication Scenario within their group and practice using active, passive, passive-aggressive, and assertive communication skills. 4. After everyone is finished, ask if one or two pairs would like to act out their scenarios in front of the class. 5. Facilitate a conversation about communication skills, using the following discussion questions, as well as any that you would like to add.

Discussion Questions
1. What style of communication do you think was the most helpful to use in your scenario? 2. What style(s) of communication do you think was the most harmful to use in your scenario? 3. Did you find it difficult to be on the receiving end of any of the communication styles? Which ones? 4. Do you think that you could use any of these communication styles in the future? Which one(s) 5. Why do you think some of these communication are styles less effective than others?

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Four Communication Styles

These are the most common styles of communication that you will see used in your everyday life.
Passive Communication: Passive communication is a communication style in which people avoid expressing their opinions or feelings, protecting their rights, and identifying and meeting their needs. Passive communication often indicates a lack of self esteem and a feeling that your opinion isnt as important as others opinions. Passive communicators often speak softly and have trouble asserting themselves and making eye contact. Example: Im not sure if I really want to do that...um...I dont know. If you want to, I guess its OK. I dont know. Aggressive Communication: Aggressive communication is a communication style in which individuals express their feelings and opinions and advocate for their needs in a way that violates the rights of others. Aggressive communication often indicates a verbally or physically abusive person. Aggressive communicators often try to dominate, humiliate, or interrupt others, speak loudly, and use threatening posture and gestures to intimidate the people they are speaking to. Example: There is NO WAY Im doing that! Hell no! Are you stupid or something? Passive-Aggressive Communication: Passive-aggressive communication is a communication style in which individuals appear passive on the surface but are really acting out anger in a subtle, indirect, or behind-the-scenes way. Passive-aggressive communication is often an indicator of feelings of powerlessness. Passive-aggressive communicators often use facial expressions that dont match how they feel (i.e., smiling when angry), use sarcasm, deny that they are upset, and attempt to sabotage the people that they appear friendly with. Example: No, no, thats fine. We can do whatever you want. I mean, I dont really want to, but I want to make you happy. Besides, Im clearly not as important as you are. Assertive Communication: Assertive communication is a communication style in which individuals clearly state their opinions and feelings, and firmly advocate for their rights and needs without violating the rights of others. Assertive communication is often indicative of high self-esteem. Assertive communicators will state their needs, wants, and feelings clearly and respectfully, stand up for their rights, speak in a calm and clear tone of voice, and have a relaxed posture. Example: Im sorry, but I am not interested in doing that. I would be happy to do something else, however.
Communication style information from Serenity Online Therapy: www.serenityonlinetherapy.com 76

Communication Role-Play Scenarios

Page 1
Scenario 1
Lilith and Nicholas are going on their 6th date tomorrow night. Lilith is hoping that they will have sex, but she isnt sure if Nicholas wants to. They are about to have a conversation about their plans for the evening. Have one person act as Lilith and use each style of communication with their partner, who should act as Nicholas. Decide which type of communication is best in this scenario.

Scenario 2
Amy and Emilie have been dating for a few months. Amy realized that Emilie is more invested in the relationship than she is, and she is worried that they might be getting too serious too quickly. They are about to have a conversation about their relationship. Have one person act as Amy and use each style of communication with their partner, who should act as Emilie. Decide which type of communication is best in this scenario.

Scenario 3
Xander went to a party last night and got pretty drunk. He thinks he might have hooked up with his friend Aaron, but hes not entirely sure. He really likes Aaron, but hes afraid that Aaron might feel uncomfortable around him now. They are about to have a conversation about last night. Have one person act as Xander and use each style of communication with their partner, who should act as Aaron. Decide which type of communication is best in this scenario.

Scenario 4
Johan has been close friends with Ruby for years and has recently begun to develop romantic and sexual feelings toward her. Hes not sure how she feels about him, but he thinks she might be interested because she flirts with him sometimes. They are about to go out to lunch together and Johan wants to talk about the possibility of a romantic relationship. Have one person act as Johan and use each style of communication with their partner, who should act as Ruby. Decide which type of communication is best in this scenario.

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Communication Role-Play Scenarios

Page 2
Scenario 5
Camilla has had sex with Dorothy a few times, and while they didnt use dental dams, she figured that Dorothy would have told her if she had an STI. However, Camilla has been noticing some painful sores on her genitals and shes beginning to wonder if Dorothy might have given her an STI. They are about to have a conversation in which Camilla is going to confront Dorothy. Have one person act as Camilla and use each style of communication with their partner, who should act as Dorothy. Decide which type of communication is best in this scenario.

Scenario 6
Michael thought his boyfriend Angelo was happy in their relationship, but yesterday, Angelo broke up with him. Michael is distraught and doesnt understand what he did wrong in the relationship. Michael knows that Angelo has class on Tuesday mornings, and he plans to wait outside his class to ask him about the cause of the breakup. Have one person act as Michael and use each style of communication with their partner, who should act as Angelo. Decide which type of communication is best in this scenario.

Scenario 7
Yorick and Zoe have been dating for almost 2 years. They have consistently used condoms during sex, but Yorick hates the way they feel. He thinks that he shouldnt have to use condoms since hes monogamous with Zoe and she is taking birth control pills.They are about to have a conversation about this issue. Have one person act as Yorick and use each style of communication with their partner, who should act as Zoe. Decide which type of communication is best in this scenario.

Scenario 8
Anyas younger sister Haley has been getting involved with some people that Anya doesnt think are very good influences. They take her out partying every weekend and shes been coming home drunk a lot. Now shes dating this new guy, Ricky, who is 5 years older than her and already has a kid with another girl. Anya is worried about her sister and is about to have a conversation with her. Have one person act as Anya and use each style of communication with their partner, who should act as Haley. Decide which type of communication is best in this scenario.

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Healthy vs. Unhealthy Relationships Activity

Suggested time: 20 minutes
This activity allows students to think critically about the characteristics that are indicative of healthy relationships versus the characteristics that are indicative of unhealthy relationships. Instructions:
1. Read Healthy or Unhealthy? statements (pg. 79-80) and ask students to raise their hand if they think the statement indicates a healthy relationship. Next, ask them to raise their hand if they think they statement indicates an unhealthy relationship. 2. After each statement, ask students why they thought what they did about the statement. 3. After you have read all statements, lead students in a discussion of what a healthy relationship looks like, using the image below as a reference.

It is important to emphasize that these characteristics should all be present in a healthy relationship!

Healthy relationship graphic from Haven Montana: www.havenmt.org

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Healthy or Unhealthy? Statements

Page 1

Sex is the most important thing in the relationship.

You can be yourself; you dont have to pretend to be someone else.

You feel energized being with the person.

You have fun being with the person.

You feel worn out and tired being with the person.

One person usually decides what to do and where to go.

You are constantly fighting and making up.

You dont spend time with your other friends anymore.

Youre embarrassed or uncomfortable being with the other person in a group.

You accept your partner the way they are.

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Healthy or Unhealthy? Statements

Page 2

You feel closer and closer to the other person as time goes on.

Your time with your partner interferes with your studies or work.

You spend time by yourself without the person.

You like being seen with the person.

Your partner respects your thoughts and feelings about being sexual.

Youre not afraid to talk to your partner about whats bothering you.

You stay in the relationship because its better than being alone.

Youre afraid to bring up the subject of birth control or condoms.

Healthy or Unhealthy? Statements adapted from Streetwise to Sex-Wise: Sexuality Education for High-Risk Youth (2001)

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Activity: What is Consent?

Suggested time: 20 minutes
This activity allows students to decide what consent looks like and what it does not look like. While consent is difficult to define, this activity can help students get at least a basic understanding of the concept. Materials:
2 large pieces of paper and tape or other ways to stick them to the walls Markers

Instructions:
1. Hang pieces of paper on the wall and label them Consent is and Consent isnt 2. Give students the dictionary definition of consent (provided below) and ask them if they can think of examples of what consent looks like. Write these examples on the paper labeled Consent is. Examples may include statements such as An enthusiastic yes, Non coerced agreement, A sober yes, etc. 3. Next, ask students if they can think of examples of what consent does not look like. Write these examples on the paper labeled Consent isnt. Examples may include statements such as A drunken agreement, The lack of the word no, Saying yes after being threatened, etc. 4. Lead students in a conversation about consent, answering any questions they might have and referring to the questions about the definition of consent below.

Consent is defined by the Merriam-Webster dictionary as compliance in or approval of what is done or proposed by another. Do you agree or disagree with this definition? What might you change about it to make it more accurate or suitable for this context?

Highlighting Race: This would be an excellent time to discuss attitudes around consent that are prevalent in students respective cultures and discern if definitions of consent differ between cultures.

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SEXUAL VIOLENCE
The purpose of this unit is to familiarize students with sexual violence, harassment, and abuse and what they entail. A large portion of this unit will also be focused on preventing sexual violence by teaching students to treat others respectfully and to take responsibility for their own actions. Because so much of sexual violence prevention strategies focus on the potential victim, this unit focuses on the potential abuser because it isnt possible to control whether or not you get abused, but it is possible to decide whether or not you abuse, and we hope that this unit will influence young peoples choices and help them to decide not to abuse.
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Introductory Activity: Defining Terms

Suggested time: 15 minutes
This activity familiarizes students with different terms that are often used when talking about sexual violence. Instructions:
1. Give each student a copy of the Sexual Violence Terms Handout (pg. 84) 2. After students have read this handout, facilitate a discussion using the discussion questions provided below, as well as any that you would like to add.

Discussion Questions
1. What style of communication do you think was the most helpful to use in your scenario? 2. What style(s) of communication do you think was the most harmful to use in your scenario? 3. Did you find it difficult to be on the receiving end of any of the communication styles? Which ones? 4. Do you think that you could use any of these communication styles in the future? Which one(s) 5. Why do you think some of these communication are styles less effective than others?

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Sexual Violence Terms Handout

This handout defines many terms that are used when discussing sexual violence.
Sexual Assault
Sexual assault is a continuum and can include a variety of sexual acts that are forced, coerced, or unwanted. Sexual assault can include (but is not limited t0): Rape, sexual threats and intimidation, incest, sexual assault by intimate partners, child sexual abuse, human sexual trafficking, sexual harassment and other forms of nonconsensual activity.

Page 1

Rape
Rape is a legal term that is defined by individual states. In the state of Massachusetts, rape is defined by three elements: penetration of any orifice by any object, force or threat of force, and against the will of the victim (when consent is not given.) Consent cannot be legally given if a person is impaired, intoxicated, drugged, underage, mentally challenged, unconscious, or asleep.

Sexual Abuse
Sexual abuse is a term that is used to refer to situations that include multiple sexual assaults or threats of sexual assault over time, such as cases of ongoing child sexual assault or intimate partner violence that includes sexual assault. Sexual abuse often includes physical forms of sexual assaults, but may consist of verbal abuse or threats without physical contact.

Sexual Harassment
Sexual harassment is unwelcome or unwanted sexual advances. Sexual harassment includes physical and sexual acts as well as sexual or gender influenced comments and an environment that is created by the acceptance of such comments. Sexual harassment can occur in workplaces, schools, congregations, community centers, and other places.

Definitions from Jane Doe, Inc (www.janedoe.org) and Clark University (www.clarku.edu)

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Sexual Violence Terms Handout

Page 2
Drug/Alcohol Facilitated Sexual Assault/Rape
Drug/alcohol facilitated sexual assault/rape is a term used when perpetrators use alcohol and/or other drugs to make a victim incapacitated prior to a sexual assault. Alcohol and other drugs can result in impaired judgment and memory. Whether the victim was coerced into using drugs or alcohol or chose to use them, they cannot give consent while intoxicated and therefore sex with them is rape.

Acquaintance Rape/Date Rape

Acquaintance rape, which is commonly referred to as date rape, is a term that refers to a situation in which that rape is not only perpetrated by strangers but by people with whom the victim might be involved with. This person could be a friend, partner, former partner, family member, acquaintance, or anyone else that the victim knows. Acquaintance rape is particularly devastating because of the trust that has been violated and the difficulty in speaking out against someone who may be trusted and respected in your community. Acquaintance rape makes up 75% of all reported sexual assault in the United States.

Date Rape Drugs

Date rape drugs refer to the various substances used by abusers to make a victim incapacitated prior to sexual assault. These drugs include Rohypnol (commonly known as roofies), GHB, and Ketamine. The most common date rape drug, however, is alcohol.

Child Sexual Abuse

Child sexual abuse is a term used to describe an ongoing series of sexual assault or threats against a child. Any sex act between an adult and a child under the age of consent is considered a sexual assault. Some sex acts between children may also be considered sexual assault if there is a significant age or developmental difference between the children.

Definitions from Jane Doe, Inc (www.janedoe.org) and Clark University (www.clarku.edu)

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Sexual Violence Terms Handout

Page 3
Statutory Rape
Statutory rape is a legal term that describes any type of non-forcible sex act with a child under 16. According to federal law, sex act is defined as any type of sexual penetration (i.e. vaginal, anal, or oral) including any penetration of the vagina or anus by hands, fingers, or objects. State laws vary. In the state of Massachusetts, a child under the age of 16 is unable to consent to sexual activity. If someone of any age has sexual contact with anyone under age 14, the perpetrator could be charged with statutory rape.

Rape Culture
Rape culture is a term that describes the environment that is created in society with the existence of cultural influences that promote and condone sexual violence. Rape culture encourages male sexual aggression, portrays violence as sexual, and normalizes sexual assault. Rape culture determines the messages that we receive via media and popular culture, as well as from traditionally held beliefs about gender roles, which have an impact on how we respond to reports and experiences of sexual violence.

Stranger Rape
Stranger rape refers to a situation in which a person is raped by an unknown attacker. Contrary to media coverage and common myths, stranger rapes only account for 25% of all reported sexual assaults, as most victims know their attackers.

Coercion
Coercion is the use of emotional manipulation to persuade someone to something they may not want to do, such as being sexual or performing certain sexual acts.Examples of some coercive statements include: If you love me you would have sex with me. and If you don't have sex with me I will find someone who will. Being coerced into having sex or performing sexual acts is not consenting to these acts and is considered sexual assault.

Definitions from Jane Doe, Inc (www.janedoe.org) and Clark University (www.clarku.edu)

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Sexual Violence Terms Handout

Page 4
Survivor
Survivor is a term often used in place of victim to describe someone who has survived sexual abuse or assault. The term survivor is often used because it honors and empowers the strength of the individual it refers to.

Domestic Violence/Intimate Partner Violence

Domestic violence/intimate partner violence is verbal, physical, psychological or sexual violence within the fluid concept of family. Such violence can occur between domestic partners, parents and children, siblings, or extended family members.

Battering
Battering refers to a series of verbal, physical, or psychological tactics that a person uses to gain control over another person, often a partner or ex-partner. Battering can occur in intimate relationships or within a family. The term battering is often used as a synonym for domestic violence or intimate partner violence and is often preferred because it forces people to

Stalking
Stalking occurs when someone willfully and repeatedly follows and harasses another person and who makes a threat with the intent to place a person in fear* for their personal wellbeing. A person can stalk someone by following, calling, instant messaging, writing, or emailing another person.

*According to the state of Massachusetts. Definitions of stalking vary from state to state.

Definitions from Jane Doe, Inc (www.janedoe.org) and Clark University (www.clarku.edu)

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Sexual Violence Video and Discussion

Suggested time: 30 minutes
The purpose of this video is to familiarize students with the ways in which sexual violence can occur and to teach them to distinguish between appropriate and inappropriate forms of social interaction. Instructions:
1. Show students the Sexual Violence Video (provided in accompanying DVD) and lead them in a discussion using the discussion questions provided below and any others that you feel might be important.

Discussion Questions:
1. What is one way that you could approach someone who you were sexually interested in without making them uncomfortable? 2. Why is threatening to hurt yourself not an acceptable way to get someone to have sex with you? 3. If someone says no to an offer of sex and then later says yes because youve insulted, coerced, or threatened them, has consent been given? 4. If you are in a sexual relationship with someone and they have previously given consent, is it possible for them to later withdraw their consent? 5. If someone is drunk or otherwise incapacitated, can they consent? 6. Did you learn anything new from this video? If so, what did you learn?

Highlighting Race: This would be an excellent opportunity to discuss cultural ideas surrounding sexual violence while still emphasizing the fact that sexual violence is never acceptable.

Highlighting Sexual Orientation/Gender: It is important to emphasize that sexual assault occurs within every type of relationship and can be perpetrated by anyone of any sex, gender, or sexual orientation. While it is true that most sexual assaults are perpetrated by men, this does not invalidate the experiences of people who have been sexually assaulted by women.

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Sexual Harassment Activity

Suggested time: 15 minutes
This activity serves to familiarize students with the types of behavior that constitute sexual harassment in order to avoid harassing someone in the future. Materials:
3 pieces of paper tape Enough copies of the Is this Harassment? Statements (pg. 90) for each group of ~4 students (Pre-cut into strips with one statement per strip)

Instructions:
1. Divide students into equal groups of ~4. 2. Distribute a set of Is this Harassment? Statements to each group. 3. Ask students to discuss the statements as a group and separate them into three categories: Harassment, Not Harassment, and Unsure. 4. Lead students in a conversation about harassment and why they put each statement into the category that they did, making sure to answer any questions that they might have.

Highlighting Gender: This would be an excellent opportunity to discuss the ways in which women are harassed in different ways than men are. While it is important to not dismiss mens experiences of harassment, it is also important to remind students that sexual harassment of women is more societally accepted and therefore is almost invisible because it is so prevalent. Recognizing this harassment when it occurs is crucial to stopping it.

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Is this Harassment? Statements

Telling your friend that they look nice today. Wolf-whistling at an attractive person walking down the street. Waving at someone you know from across a room. Texting a graphic description of your favorite sex act to a casual friend. Making sexual gestures at someone from your car at a stoplight. Engaging in dirty talk with your partner who told you they were into it. Sending a picture of your genitals to your entire contact list. Making sexual comments to someone on an online forum. Hugging your best friend. Groping someone at a party and then walking away. Making friendly conversation with someone you just met. Staring at someones breasts the entire time you are speaking to them. Telling a sexually explicit joke in front of someone who does not enjoy those kinds of jokes. Touching your partners genitals while they are asleep. Calling someone by pet names without asking them if that is OK.

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10

PUTTING IT ALL TOGETHER

The purpose of this unit is to provide students with a wider context in which the information they just learned about sexuality fits. This gives students the ability to put what theyve learned into practice and to see how sexuality is intertwined into almost all aspects of life.

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Introductory Activity: Gender Roles

Suggested time: 20 minutes
The goal of this activity is to help students understand the concept of gender role stereotyping and the ways in which gender roles affect their lives. Materials:
Paper and pens/pencils for each student

Instructions:
1. Give each student paper and a pen/pencil and ask them to write for 10 minutes about what would happen if they woke up tomorrow in the body of the opposite gender from the one they identify as. How would their day be different? How would people treat them differently? 2. After 10 minutes, ask students to share some of what they wrote with the class. Lead students in a conversation about the ways that different people are treated differently based on their perceived gender identity. Use the discussion questions provided below as well as any you want to add.

Discussion Questions
1. What are some of the first things that you noticed would be different in your life in this situation? 2. How do people treat you differently from people of a different gender? 3. What are some things that you are concerned about that people of a different gender arent? Why do you think this is? 4. What is one positive thing that you think would come from switching genders for a day? One negative thing?

Highlighting Sexual Orientation/Gender Identity: While this activity attempts to be inclusive of all gender identities, it might not be as effective for trans or genderqueer students. The educator should use their best judgment when deciding whether or not to include this activity in their class.
Activity adapted from Our Whole Lives Sexuality Education Curriculum for Grades 10-12 (2000)

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Sex and Gender in the Media Activity

Suggested time: 45 minutes to 1 hour (Can be spread out over two class sessions if necessary)
The goal of this activity is to provide students with a wider cultural context of the issues that they have learned about in this class. The media is an incredibly pervasive part of our society and it would be irresponsible to omit a discussion of its relation to sexuality from this curriculum. Materials:
Computer with Internet access

Instructions:
1. Prior to this class, ask half of the students to each bring in an example of a positive message about sexuality and gender that they have witnessed in music, a TV show, a movie, an advertisement etc. Ask the other half to each bring in an example of a negative message about sexuality that they have witnessed in music, a TV show, a movie, etc. They can bring in a link to a clip online or they can describe their example. 2. After each example is shown or described, ask students why they thought the message in it was negative or positive. Facilitate a conversation about the effects that the media has on peoples opinions about sexuality. Ask students to discuss the effects that their specific examples might have on people.

Note to educators: If students are confused about what kinds of media sources to look at, you may refer them to the list of examples (pg. 93). These examples provide potential for both negative and positive messages. Students will still need to decide for themselves which type of message is being promoted in each example, but this might provide them with a starting point.

Highlighting Socioeconomic class: Some students might not have access to a computer to find a link to a clip. Educators should make it clear that students can describe something they witnessed instead of bringing something in if they need to.

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Sex in the Media Examples

TV Shows:
1. Glee 2. 16 and Pregnant 3. Teen Mom 4. Girls 5. RuPauls Drag Race 6. Buffy the Vampire Slayer

Music:
1. Katy Perry - I Kissed a Girl 2. Salt N Pepa - Lets Talk About Sex 3. Lady Gaga - Born this Way 4. Madonna - What it Feels Like for a Girl 5. Avril Lavigne - Sk8er Boi 6. Boyz II Men - Ill Make Love to You

Movies:
1. Scott Pilgrim vs. The World 2. The Little Mermaid 3. Grease 4. Saved! 5. The Education of Shelby Knox 6. The Boy Who Can Fly

Advertisements:
1. Dove Campaign 2. Axe 3. Trojan Condoms 4. Budweiser 5. Womens Tennis Association 6. Herbal Essences

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Applying What Youve Learned to Everyday Life

Suggested time: 15 minutes
The goal of this activity is to facilitate a discussion of ways in which students can bring the things theyve learned into their day to day lives. Instructions:
1. Sit in a circle and ask students to go around the circle and mention one thing that they learned in this class that the think can be relevant to use in their future. 2. Facilitate a conversation about the ways in which students can integrate what theyve learned in this class into their lives using the discussion questions below as well as any you might like to add.

Discussion Questions
1. Has this class changed the way that you think about certain topics? If so, how? 2. Has this class provided you with the ability to notice things that you might not have noticed before? If so, what types of things? Does anyone have a specific example? 3. Do you think that you can pass on any of the information you learned in this class to your friends and family members? If so, how do you think they would react? 4. Do you think that anything you learned in this class will influence the way that you act in relationships (romantic or otherwise)? 5. Do you think that this class gave you the ability to look at issues from the perspective of others? If so, what ways do you think that this might effect you later in your life?

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11

RESOURCES
These resources should provide both students and educators with the necessary information to continue the conversation about sex and gender outside of class.

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Resources
Resources for Educators and Students
Throughout the creation of this curriculum, I have found many excellent resources for both educators and students. The following resources were valuable to me and I would like to share them with others who might find them useful as well.

Human Anatomy and Reproduction:

The Cleveland Clinic: www.my.clevelandclinic.org Epigee Womens Health: www.epigee.org

Sex and Gender:

Gender Spectrum: www.genderspectrum.org Genderbread Person: www.itspronouncedmetrosexual.com World Health Organization: www.who.int

Sexual Behavior and Fantasy:

Asexuality Visibility and Education Network (AVEN): www.asexuality.org

Safer Sex:
Planned Parenthood: www.plannedparenthood.org Kids Health: www.kidshealth.org Stay Teen: www.stayteen.org Centers for Disease Control and Prevention: www.cdc.gov

Relationship Skills:
Serenity Online Therapy: www.serenityonlinetherapy.com Haven Montana: www.havenmt.org

Sexual Violence:
Jane Doe, Inc: www.janedoe.org Clark University: www.clarku.edu

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Introduction to Independent Project When I decided to make a series of educational videos for my Independent Project, my utter lack of experience with filming or editing didnt seem to be a problem. While it was certainly daunting at times (and I found myself wondering why I thought I could do this thing Id never done before), I kept going because I had a vision of what I wanted: Sex education videos that promoted healthy discourses and that young people would want to watch. I think that I achieved this goal with Carnal Knowledge. With these three videos, I strove to be educational yet entertaining; serious yet funny. Each video has a serious message, but this message is delivered in such a way that I think teenagers will find fun and will want to watch. I want to promote the idea that sexuality doesnt have to be serious all the timeits OK to laugh because some of this stuff is silly! I believe that my videos are easy to understand, entertaining, educational, and unique. I hope you enjoy my filmmaking debut and forgive my lack of technical skill!

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