My heartfelt thanks to everyone who helped. First, all the wonderful people at Eagle Publishing: Marji Ross, Karen Woodard, Harry Crocker, Kathleen Sweetapple, Sally Brock, John Lalor, Alex Novak, Jeanne Crotty, Christian Tappe, Mary Beth Baker, Emily Thiessen, Amanda Larsen, Amber Colleran, and Sekayi Brunson. Special recognition goes to my editor, Anneke Green, whose painstaking work and long hours are deeply appreciated.
Being a fellow at the Clare Booth Luce Policy Institute allowed me to take a break from practicing medicine, and to focus on research, writing, and speaking. I owe Michelle Easton and the other “Luce ladies”—in particular the multi-talented Jessica Cantelon and Kathleen McCann—gratitude for their generosity, creativity, enthusiasm, and warmth. Katie Collins was the ideal assistant—exceptionally bright, good natured, and principled. Katie, you’ve set the gold standard for any help I might have in the future.
“Questioning” is dedicated to the memory of Hector Roybal. Hector was a warrior and a leader of men. His life story continues to inspire me and countless others.
My work has benefitted from the research and writing of so many, including Joe MacIlhaney, LouAnn Brizendine, John Potterat, James Jones, John Colapinto, Anne Bernstein, Ruth Jacobs, Judith Reisman, Gerianne Alexander, Selma Freiberg, Jay Giedd, Laurence Steinberg, Ronald Dahl, Anna-Barbara Moscicki, Sylvia Ann Hewlett, Lisa M. Diamond, and Paul R. McHugh.
I also acknowledge the awesome work of the thousands of abstinence educators around the country working in small communities and on the national level to promote the healthiest choice for teens. Valerie Huber, Leslee Unruh, all the people at the Medical Institute for Sexual Health, and many others have devoted their lives to this cause.
I am beholden to Naomi Decter, who is brilliant, professional, and high-speed. Boy was I lucky to find you!
I’m also grateful to, in no particular order, Ashley Herzog, Leah Klein, Molly Resnick, Elizabeth Christy, Charles Paternina, Tim Flanigan, Sue Schmidt-Lackner, Victor Grossman, and Adina Rimmon. Thank you Tova Pollen for your friendship and hospitality, in good times and bad. The Bendik-Rimmon household is my favorite place to eat, drink, debate, and be merry. Angela Villatoro makes my life easier.
Tanya, you’ve been so forgiving about my piles of work all over the place. Now we can use the dining room table for eating. You—along with Shuki, Chasida, and Ruchama, of course—are what life is all about.
Sex Education Policy by State
Author’s note: Parents, this chart gives you a place to start in unveiling sex education practices in your area.
STATE SEX AND STI/HIV EDUCATION POLICY
Source: Guttmacher Institute, State Sex and STI/HIV Education Policy, State Policies In Brief, New York: Guttmacher, 2009, http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf>, accessed June 17, 2009
Notes
Introduction
1 I pointed out this refers only to the minority of lesbians who have never been sexually active with males.
2 H. Trottier and E. L. Franco, “The epidemiology of genital human papillomavirus infection.” Vaccine 24, Suppl 1 (March 2006): S4–15.
3 “Managing HPV: A New Era in Patient Care,” Association of Reproductive Health Professionals (January 2009) http://www.arhp.org/publications-and-resources/quick-reference-guide-for-clinicians/managing-hpv.
4 Press release, 2008 National STD Prevention Conference, March 11, 2008; available online at: http://www.cdc.gov/stdconference/2008/media/release-11march2008.htm.
5 Dr. John Douglas, in an interview on The Early Show, CBS News, March 12, 2008.
6 Statement of SIECUS President Joseph DiNorcia Jr. on New Data on Teen STD Rates, www.siecus.org/media/press/press0166.html.
7 Victoria Stagg Elliott, “Plans sought to curb teen girls’ high STD rate,” amednews.com, April 14, 2008; available online at: http://www.amaassn.org/amednews/2008/04/14/hlsa0414.htm.
8 “Teen Talk: Pregnancy,” Planned Parenthood; available online at: http://www.teenwire.com/interactive/movies/do-070213-pregnancy.php.
9 “Fast Facts: S&M,” gURL.com; available online at: http://www.gurl.com/findout/fastfacts/articles/0,,605386_708158,00.html.
10 Esther Drill, Heather McDonald, and Rebecca Odes, Deal With It! A whole new approach to your body, brain, and life as a gURL (New York: Pocket Books, 1999), 87–90.
11 For example, David Parker, see www.massresistance.org.
12 Patricia Barthalow Koch, quoting M. Greene, Landscapes of Learning (New York: Teachers College Press, 1978) in “Integrating Cognitive, Affective, and Behavioral Approaches into Learning Experiences for Sexuality Education,” in James T. Sears, ed., Sexuality and the Curriculum: The Politics and Practices of Sexuality Education (New York: Teachers College Press, 1992), 255.
13 SIECUS, “Guidelines for Comprehensive Sexuality Education,” touts itself as providing “an opportunity for young people to question, explore and assess their own and their community’s attitudes about society, gender, and sexuality,” 19; available online at: http://www.siecus.org/_data/global/images/guidelines.pdf.
14 See David Elkind, The Hurried Child: Growing Up Too Fast Too Soon (Reading, MA: Addison-Wesley, 1988).
15 Patricia Barthalow Koch , “Integrating Cognitive, Affective, and Behavioral Approaches Into Learning Experiences for Sexuality Education,” chapter in James T. Sears, ed., Sexuality and the Curriculum: The Politics and Practices of Sexuality Education (New York: Teachers College Press, 1992), 258.
16 “Growth and Development, Ages Four to Five—What Parents Need to Know,” Advocates for Youth; available online at: http://www.advocatesforyouth.org/storage/advfy/documents/4_5.pdf.
17 SIECUS, “Guidelines for Comprehensive Sexuality Education,” 3rd edition, 25; available online at: http://www.siecus.org/_data/global/images/guidelines.pdf..
18 Planned Parenthood, “Human Sexuality—What Children Need to Know and When,” October 29, 2008; available online at: http://www.plannedparenthood.org/parents/human-sexuality-what-children-need-know-when-they-need-know-it-4421.htm.
19 Early Childhood Sexuality Education Task Force, Right From the Start: Guidelines for Sexuality Issues, Birth to Five Years (SIECUS, 1998), 53; available online at: http://img.thebody.com/siecus/pdfs/RightFromTheStart.pdf.
20 Planned Parenthood, “Human Sexuality—What Children Need to Know and When,” October 29, 2008; available online at: http://www.planned-parenthood.org/parents/human-sexuality-what-children-need-know-when-they-need-know-it-4421.htm.
21 “I want to buy a vibrator but ...” Go Ask Alice! September 8, 2000; available online at: http://www.goaskalice.columbia.edu/1757.html
22 “Menage a Trois?” Go Ask Alice! July 5, 2002; available online at: http://www.goaskalice.columbia.edu/2184.html.
23 “S/M Role-Playing,” Go Ask Alice! May 12, 1995; available online at: http://www.goaskalice.columbia.edu/0646.html.
24 One recent study of adult women found that the probabilities of contraceptive failure for withdrawal (18 percent) and condom (17 percent) are similar: Kathryn Kost, Susheela Singh, Barbara Vaughan, James Trussell, and Akinrinola Bankole, “Estimates of contraceptive failure from the 2002 National Survey of Family Growth,” Contraception 77, no.1 (January 2008): 10–21. Guttmacher Institute, “Get ‘In the Know’: Questions about Pregnancy, Contraception and Abortion,” reports the percentage of women who will become pregnant in their first year of use of male condoms is 2 percent for “perfect use” and 15 percent for “typical use.” They also report that of women who had an abortion following proper condom use, 42 percent, had said it slipped out of place. Available online at: http://www.guttmacher.org/in-the-know/prevention.html. Also see Rachel K. Jones, Jacqueline E. Darroch, and Stanley K. Henshaw, “Contraceptive Use Among U.S. Women Having Abortions in 2000-2001,” Perspectives on Sexual and Reproductive Health 34, no.6 (2002): 294–303; on inconsistent condom use in adults, see Bruce Jancin, “Despite Guidelines, U.S. Condom Use Still Low,” Clinical Psychiatry News (January 2004): 66; and in college student
s, see “American College Health Association—National College Health Assessment (ACHA-NCHA) Spring 2004 Reference Group Data Report,” Journal of American College Health 54, no.4 (2004): 207. On limited efficiency of condoms in preventing HPV transmission: “Using condoms (‘rubbers’) can lower the chance of HPV infection, but they cannot completely prevent infection,” in American Cancer Association, “Can Penile Cancer Be Prevented?” available online at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_Can_penile_cancer_be_prevented_35.asp?sitearea=; Lisa A. Manhart and Laura A. Koutsky, “Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia?” Sexually Transmitted Diseases 29, no.11 (2002): 725–35; Rachel L. Winer et al, “Genital Human Papillomavirus Infection: Incidence and Risk Factors in a Cohort of Female University Students,” American Journal of Epidemiology 157, no.3 (2003): 218–26.
25 Joseph J. Sabia and Daniel I. Rees, “The effect of adolescent virginity status on psychological well-being,” Journal of Health Economics 27, no.5 (2008): 1368–81.
26 Debra Haffner, “Telling Teens Not to French Kiss,” RH Reality Check, September 13, 2006; available online at: http://www.rhrealitycheck.org//blog/2006/09/12/telling-teens-not-to-french-kiss (Haffner, in her book for parents, Beyond the Big Talk: Every Parent’s Guide to Raising Sexually Healthy Teens—from middle school to high school and beyond ( New Market Press 2001) recommends these sites to teens: goaskalice.com, positive.org, gURL.com, sexetc.org, teenwire.org (now Teen Talk)).
27 This is not to say girls should not be vaccinated.
28 (Statistics based on 9 million new infections a year in persons between the ages of 15 and 24.) Guttmacher Institute, “Facts on Sexually Transmitted Diseases in the United States,” August 2006; available online at: www.guttmacher.org/pubs/fb_sti.html.
29 “State of the Nation 2005: Challenges Facing STD Prevention in Youth,” American Social Health Association; available online at: www.ashastd.org/pdfs/ASHA_05.final.pdf.
30 Laura T. Coffey, “Survey: Unprotected sex common among teens,” msnbc.com Today, November 14, 2008; available online at: http://today. msnbc.msn.com/id/27706917/from/ET/.pdf.
31 “State of the Nation 2005: Challenges Facing STD Prevention in Youth,” American Social Health Association; available online at: www.ashastd.org/pdfs/ASHA_05.final.pdf.
Chapter 1
1 Clearly these sites fill a need, but I had a mixed reaction to the discovery of online “advice” for adolescents. As a child and adolescent psychiatrist, I’ve spent years helping kids like these. While there are benefits to quick and confidential access to an informed adult, there are also hazards.
2 This question appeared at www.gURL.com
3 Question and answer posted on Scarleteen: Sex ed for the real world; http://www.scarleteen.com/article/advice/is_it_normal_for_girls_to_experiment_with_sex_together_when_theyre_not_lesbian.
4 “Working the Kinks Out,” www.scarleteen.com/article/sexuality/working_the_kinks_out.
5 According to the homepage of www.scarleteen.com.
6 Heather also provides teens with objectionable material: “Want to learn how to flirt? Or talk dirty? Or go Tantric? The Society for Human Sexuality includes exercises to teach you how, as well as a concise guide to safer sex, a comprehensive and fully up-to-date annotated bibliography of books relevant to sexuality and/or sex-positive culture, and a guide to finding local sex-positive community resources. www.sexuality.org (the site warns that it is intended for adults).
7 www.sexuality.org (the site warns that it is intended for adults).
8 See “DASH Funded Nongovernmental Organization (NGO) Activities,” http://www.cdc.gov/DASH/program_mgt/docs_pdfs/ngo_activity_matrix.doc.
9 SIECUS Leadership and Staff, http://www.siecus.org/index.cfm?fuseaction=Page.viewPage&pageId=490&parentID=472.
10 “Frequently Asked Questions,” available at: http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=529
11 “This Is Planned Parenthood,” http://www.ppaction.org/ppvotes/08_issues.html.
12 Report available at: http://www.plannedparenthood.org/ppcw/files/ColumbiaWillamette/AR_07-08_web.pdf.
13 “Human Sexuality—What Children Need to Know and When,” Planned Parenthood, October 29, 2008; available online at: http://www.planned-parenthood.org/parents/human-sexuality-what-children-need-know-when-they-need-know-it-4421.htm .
14 “Advocates for Youth: Historical Overview,” http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=15&Itemid=44.
15 “Sexual Development through the Life Cycle,” The Media Project (adapted from Advocates for Youth, Life Planning Education, 1995), http://www.themediaproject.com/facts/development/lifecycle.htm.Every parent knows that babies and young children explore their bodies, and are capable of some response to genital stimulation. At the same time, they are cognitively, emotionally, and physically immature and therefore incapable of understanding, on any level whatsoever, what we adults call sexuality. Erections are a physiological response to various conditions, and children may touch their genitals for a number of reasons, not only to experience pleasurable sensations. In fact frequent touching of genitals in childhood is often a sign of anxiety.–MG
16 Planned Parenthood and Columbia University have placed their sites, Teen Talk and Go Ask Alice, on sites like Facebook, MySpace, and Twitter, where even the youngest teens spend large chunks of their time.
17 James H. Jones, Alfred C. Kinsey: A Public/Private Life (New York: W. W. Norton & Co., 1997), 512 and 519.
18 “Kinsey Report, 50 Years Later,” NPR Politics and Society, November 9, 2004; available online at: http://www.npr.org/templates/story/story. php?storyId=4161159
19 James H. Jones, Alfred C. Kinsey, 610.
20 Ibid., 610, reference: “Author’s interview with Anon.A, Dec 15, 1987, 83; author’s interview with Anon B, Feb 17, 1988, 95.”
21 James H. Jones, Alfred C. Kinsey, 739.
22 Ibid., 603.
23 Ibid., 609.
24 Why is there no consideration of his mental illness in recent books on the sex ed conflict, like Moran’s and Irvine’s?
25 Anything outside of sexual intercourse within marriage.
26 “5,940 Women,” TIME Magazine, August 24, 1953; available online at: http://www.time.com/time/magazine/article/0,9171,818752,00.html.
27 Margaret Mead, “An Anthropologist Looks at the Report,” in Problems of Sexual Behavior (New York: American Social Hygiene Association, 1948), from James H. Jones, Alfred C. Kinsey, 579.
28 Lawrence S. Kubie, M.D., “Psychiatric Implications of the Kinsey Report,” Psychosomatic Medicine 10, no.2 (1948): 97; available online at: http://www.psychosomaticmedicine.org/cgi/content/abstract/10/2/95.
29 “Manners & Morals”, TIME, March 1, 1948. 16.
30 Pomeroy admitted under oath to seeking funds from the sex industry to produce his own child pornography (Campbell District Court, Commonwealth of Kentucky vs. Happy Day, Inc., et al 1980, 803).
31 SIECUS Report, May–July 1982, 6: the Kinsey Institute omitted one major field: sex ed. “[I]t seemed appropriate, not only to the Institute but to its major funding source, the NIMH, to leave this area for SIECUS to fulfill.”
32 Hefner continued to fund it and other programs that would develop curricula for changing the sexual attitudes of young men and women.
33 Christie Hefner, introduction to Earl E. Shelp, ed., Sex, Medicine, Ethics, Vol. 2, Ethical Viewpoints in Transition, (Boston: D. Reidel Publishing Co., 1987).
34 Janice M. Irvine, Talk About Sex: The Battles over Sex Education in the United States (CA: University of California Press, 2002), 31.
35 Jeffrey P. Moran, Teaching Sex: The Shaping of Adolescence in the 2oth Century (Boston: Harvard University Press, 2000), 161.
36 Richard Stiller, The Love Bugs: A National History of the Venereal Diseases (New York: Thomas Nelson, 1974).
37 Larry Brilliant, “The Age of Pandemics,” Wall Street Journal, May 2–3, 2009, W1; ava
ilable online at: http://online.wsj.com/article/SB124121965740478983.html.
38 Genital herpes and warts existed, but their incidence was low. Chlamydia was not reportable until 1984. HIV was not yet on the scene.
39 Roger W. Libby, introduction to a volume in which Kirkendall was interviewed: Alternative Lifestyles 2, no.1 (February 1979): 5.
40 Lester Kirkendall, A New Bill of Sexual Rights and Responsibilities (New York: Prometheus Books, 1976).
41 Janice M. Irvine, Talk About Sex, 26.
42 “Happy Birthday, Dr. Kinsey,” Planned Parenthood, http://www.planned-parenthood.org/issues-action/other/articles/happy-birthday-dr-kinsey-21171.htm.
43 “Who We Are,” Planned Parenthood, http://www.plannedparenthood.org/about-us/who-we-are-4648.htm.
44 In high school, the same rationale can be used to justify including explicit porn on the required reading list. See for example: Pete Winn, “High School Offers Homosexual Porn, Parents Complain,” CNSNews.com, March 10, 2008.
45 Evonne Hedgepeth and Joan Helmich, Teaching About Sexuality and HIV: Principles and Methods for Effective Education (New York: New York University Press, 1996), 31.
46 Barbara Defoe Whitehead, “The Failure of Sex Education,” The Atlantic Monthly, 274.n4 (Oct 1994)
47 SIECUS, Families Are Talking 2, no.2 (2003).
48 Ibid.
49 “How to Talk with Your Children About Sex,” http://www.plannedparenthood.org/parents/how-talk-your-child-about-sex-4422.htm.
50 Ibid.
51 “Human Sexuality—What Children Need to Know and When,” http://www.plannedparenthood.org/health-topics/parents/human-sexuality-what-children-need-know-when-they-need-know-it-4421.htm.
52 Barbara Huberman, RN, Med, “Growth and Development, Ages Six to Eight—What You Need to Know,” Advocates for Youth, 2002; at The Media Project, http://www.themediaproject.com/facts/development/6_8.htm.
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