3. Sexual Knowledge and Education

According to the National Coalition to Support Sexuality Education,
Sexuality education is a lifelong process of acquiring information and forming attitudes, beliefs, and values about identity, relationships, and intimacy. It encompasses sexual development, reproductive health, interpersonal relationships, affection, intimacy, body image, and gender roles [among other topics]. Sexuality education seeks to assist children [people] in understanding a positive view of sexuality, provide them with information and skills about taking care of their sexual health, and help them to acquire skills to make decisions now and in the future. (SIECUS 1992)
A. A Brief History of American Sexuality Education

Sexuality education in the United States has always been marked by tension between maintaining the status quo of the “acceptable” expression of individual sexuality, and change as precipitated by the economic, social, and political events of the time. The major loci for sexuality education have shifted from the family and the community (in earlier times being more influenced by religion, and in modern times, by consumerism and the media), to schools. Much of the education has been developed by and targeted towards middle-class whites. As will be described in more detail, the two major movements to formalize sexuality education in the United States were spearheaded for the advancement of either “social protection” or “social justice.” Throughout history, the goals, content, and methodologies of sexuality education in these two movements have often been in opposition to one another.

According to D'Emilio and Freedman (1988), young people in colonial America learned about sexuality through two primary mechanisms. In these agrarian communities, observation of sexual activity among animals was common. Observation of sexual activity among adults was also common, since families lived in small, often-unpartitioned dwellings, where it was not unusual for adults and children to sleep together. Second, more formal moral instruction about the role of sexuality in people's lives came from parents and clergy, with lawmakers endorsing the religious doctrines. The major message was that sexual activity ought to be limited to marriage and aimed at procreation. However, within the marital relationship, both the man and woman were entitled to experience pleasure during the procreative act.

Ministers throughout the colonies invoked biblical injunctions against extramarital and nonprocreative sexual acts, while colonial statutes in both New England and the Chesapeake area outlawed fornication, rape, sodomy, adultery, and sometimes incest, prescribing corporal or capital punishment, fines, and in some cases, banishment for sexual transgressors. Together, these moral authorities attempted to socialize youth to channel sexual desires toward marriage (D'Emilio and Freedmen 1988, 18)

A small minority of colonists also were exposed to a limited number of gynecological and medical-advice texts from London. These underscored the primary goal of sexuality as reproduction, with pleasure only to be associated with this goal.

After the War for American Independence, small autonomous rural communities gave way to more-commercialized areas, and church and state regulation of morality began to decline. Individual responsibility and choice became more emphasized. Thus, instruction on sexuality changed from community (external) control to individual (internal) control. For example, between the 1830s and 1870s, information about contraceptive devices and abortion techniques circulated widely through printed matter (pamphlets, circulars, and books) and lectures. However, peer education was the primary source of sexuality education, with more-“educated” people, especially women, passing along their knowledge to friends and family members.

Increasing secularization and the rise of the medical profession spawned a health-reform movement in the 1830s that emphasized a quest for physical, as well as spiritual, perfection. With advances in publishing and literacy, a prolific sexual-advice literature, written by doctors and health reformers of both genders, emerged. The central message was that, for bodily well-being (as well as economic success), men and women had to control and channel their sexual desires toward procreative, marital relations. “Properly channeled, experts claimed, sexual relations promised to contribute to individual health, marital intimacy, and even spiritual joy” (D'Emilio and Freedman 1988, 72). The popularity of these materials demonstrated Americans' need for and interest in sexuality education. Much of the self-help and medical-advice literature directed at men emphasized the dangers of masturbation. Women were taught that they had less sexual passion than men, and their role was to help men to control their sexual drives. In other words, a standard of female “purity” was the major theme of the sexuality education of the time.

Two studies of women's sexuality conducted in the early 1900s provide insight into the sources of sexual information for women during the nineteenth century. Katharine B. Davis (1929) studied one thousand women (three quarters born before 1890) and Dr. Clelia Mosher (1980) surveyed forty-five women (four fifths born between 1850 and 1880). Over 40 percent of the women in Davis' study and half in Mosher's reported that they received less-than-adequate instruction about sex before marriage. Those who indicated that they had received some sexual information identified Alice Stockham's advice manual, Tokology, about pregnancy, childbirth, and childrearing as their chief source.

In the later nineteenth century, a combined health and social-reform movement developed, that attempted to control the content of and access to sexuality education. Middle-class reformers organized voluntary associations, such as the Women's Christian Temperance Union (WCTU), to address issues, including prostitution and obscenity. The social-purity movement in the late nineteenth century added the demand for female equality and a single sexual standard to the earlier moral-reform movements. The WCTU spearheaded a sex-education campaign through the White Cross to help men resist sexual temptation. Social-purity leaders authored marital advice books that recognized women's sexual desires and stressed that women could enjoy intercourse only if they really wanted it. Women's rights and social-purity advocates issued the first formal call for sex education in America. They argued that women should teach children about sex: “Show your sons and daughters the sanctities and the terrors of this awful power of sex, its capacities to bless or curse its owner” (D'Emilio and Freedman 1988, 155). They demanded a public discourse of sexuality that emphasized love and reproductive responsibility rather than lust.

An example of the restricted character of sexuality education at the time was the enactment of the 1873 “Comstock Law” for the “Suppression of Trade in, and Circulation of Obscene Literature and Articles of Immoral Use.” This revision of the federal postal law forbade the mailing of information or advertisements about contraception and abortion, as well as any material about sexuality. The Comstock Law was in effect until being overturned by a federal appeals court in 1936 in a decision about contraception: United States v. Dow Package.

Yet, the turn of the century ushered in a more “progressive” era fueled by industrial capitalism. Progressive reform provoked by the middle class called upon government and social institutions, including schools, to intervene in social and economic issues, such as sex education. One of the major movements for sex education was the social-hygiene movement spearheaded by Dr. Prince Morrow to prevent the spread of syphilis and gonorrhea. In 1905, he formed the Society of Sanitary and Moral Prophylaxis in New York City, later renamed the American Social Hygiene Association. This society was joined by the WCTU, YMCA, state boards of health, and the National Education Association in an “unrelenting campaign of education to wipe out the ignorance and the prejudices that allowed venereal diseases to infect the nation” (D'Emilio and Freedman 1988, 205). They held public meetings and conferences, published and distributed written materials, and endorsed sex education in the public schools. While insisting on frank and open discussions of sexual-health matters, they promulgated the traditional emphasis of sexuality in marriage for reproductive purposes and the avoidance of erotic temptation (like masturbation). More-conservative Americans considered such openness to be offensive. Former-President Howard Taft described sex education as “full of danger if carried on in general public schools” (D'Emilio and Freedman 1988, 207). Others considered this type of education to be too restrictive. For example, Maurice Bigelow, Professor of Biology at Columbia University Teachers' College, objected to the terms “sex” and “reproduction” being used synonymously. Not until after 1920 would these activists see any progress towards the goal of having some basic sex (reproductive) instruction integrated into any school curriculum.

The early 1900s found American minds being expanded by the writings of Sigmund Freud and Havelock Ellis, among others. These psychologists helped popularize the notion of sexuality as a marker of self-identity and a force permeating one's life, which, if repressed, risks negative consequences. In addition, socialist and feminist ideologies and the industrial economy created an environment fertile for the demand of birth-control information and services. These events spearheaded the second major movement for sexuality education, which was based on social-justice issues, particularly for women and the poor.

In 1912, Margaret Sanger began a series of articles on female sexuality for a New York newspaper, which was confiscated by postal officials for violating the Comstock antiobscenity law. Later, to challenge the constitutionality of this law, she published her own magazine, The Woman Rebel, filled with information about birth control. She was charged with nine counts of violating the law, with a penalty of forty-five years in prison, after writing and distributing a pamphlet, Family Limitation. To avoid prosecution, she fled to Europe; but in her absence, efforts mounted to distribute birth-control information. By early 1915, activists had distributed over 100,000 copies of Family Limitation, and a movement for community sexuality education was solidified. Public sentiment in favor of the right to such information was so strong that charges were dropped against Sanger when she returned to America. Community education about and access to birth control, particularly for middle-class women, began to become accepted, if not expected, as a matter of public health, as well as an issue of female equality (social justice).

Premarital experience became a more-common form of sexuality education among the white middle-class, beginning in the 1920s and accelerating as youth became more autonomous from their families (through automobiles, attendance at college, participation in more leisure activities like movies, and war experiences). Dating, necking, and petting among young peers became a norm. “Where adults might see flagrantly loose behavior, young people themselves had constructed a set of norms that regulated their activity while allowing the accumulation of experience and sexual learning” (D'Emilio and Freedman 1988, 261).

Courses on marriage and the family and (sexual) hygiene were being introduced into the college curriculum. Marriage manuals began to emphasize sexual expression and pleasure, rather than sexual control and reproduction, with more-explicit instructions as to how to achieve satisfying sexual relationships (such as “foreplay” and “simultaneous orgasm”). By the end of the 1930s, many marriage manuals were focusing on sexual “techniques.” In addition, scientific reports, such as Sexual Behavior in the Human Male by Alfred Kinsey and his associates (1948) and the corresponding Sexual Behavior in the Human Female (1953), were major popular works primarily read by the middle class. These books provided sexuality education about the types and frequencies of various sexual expressions among white Americans to more than a quarter of a million people. They also are considered landmarks in sexuality education:

What they [Americans] have learned and will learn may have a tremendous effect on the future social history of mankind. For they [Kinsey and colleagues] are presenting facts. They are revealing not what should be, but what is. For the first time, data on human sex behavior is entirely separated from questions of philosophy, moral values, and social customs. (D'Emilio and Freedman 1988, 286)
As scientific information on sexuality became readily available to the American public, more-explicit presentation of sexual material in printed and audiovisual media became possible through the courts' decisions narrowing the definition of obscenity. The proliferation of such sexually explicit materials was encouraged by the expansion of the consumer-oriented economy. For example, advertising was developing into a major industry, beginning in the 1920s. Sex was used to sell everything from cars to toothpaste. Gender-role education, in particular, was an indirect outcome of the advertising media. A “paperback revolution” began in 1939 placing affordable materials, such as “romance novels,” in drugstores and newsstands all over the country.

In December 1953, Hugh Hefner published the First issue of Playboy, whose trademark was a female “Playmate of the Month” displayed in a glossy nude centerfold. The early Playboy philosophy suggested males should “enjoy the pleasures the female has to offer without becoming emotionally involved” (D'Emilio and Freedman 1988, 302). By the end of the 1950s, Playboy had a circulation of 1 million, with the readership peaking at 6 million by the early 1970s. Many a man identified Playboy as his first, and perhaps most influential, source of sex education.

By the 1970s, sex manuals had taken the place of marital advice manuals. Popular books like the 1972 Joy of Sex by Dr. Alex Comfort encouraged sexual experimentation by illustrating sexual techniques. Sexual references became even more prolific in the mainstream media. For example, the ratio of sexual references per page tripled between 1950 and 1980 in magazines, including Reader's Digest, Time, and Newsweek. In addition, Masters and Johnson's groundbreaking book, Human Sexual Response, emphasizing that women's sexual desires and responses were equal to those of men, was published in 1966. The media were influencing Americans - female and male, married and single - to consider sexual pleasure as a legitimate, necessary component of their lives.

Yet, even with the explicit and abundant presentation of sexuality in the popular media, parents were still not likely to provide sexuality education to their children, nor were the schools.

In 1964, a lawyer, a sociologist, a clergyman, a family life educator, a public health educator, and a physician came together to form the Sex Information and Education Council of the United States (SIECUS). SIECUS is a nonprofit voluntary health organization with the aim to help people understand, appreciate, and use their sexuality in a responsible and informed manner. Dr. Mary Calderone was a co-founder and the first executive director. SIECUS soon became known all over the country as a source of information on human sexuality and sex education.

This private initiative for sexuality education was followed by a governmental one in 1966 when the Office of Education of the federal Department of Health, Education, and Welfare announced its newly developed policy supporting

family life and sex education as an integral part of the curriculum from preschool to college and adult levels; it will support training for teachers... it will aid programs designed to help parents... it will support research and development in all aspects of family life and sex education. (Haffner 1989, 1)
In 1967, a membership organization, first called the American Association of Sex Educators and Counselors, was formed to bring together professionals from all disciplines who were teaching and counseling about human sexuality. The organization later expanded to include therapists, and is known today as the American Association of Sex Educators, Counselors, and Therapists (AASECT). Opposition to sexuality education from conservative political and religious groups grew quickly. In 1968, the Christian Crusade published, “Is the Schoolhouse the Proper Place to Teach Raw Sex?” and the John Birch Society was calling sex education a “Communist plot.” In response, over 150 public leaders joined the National Committee for Responsible Family Life and Sex Education.

In 1970, Maryland became the first state to mandate family-life and human-development education at all levels in their public schools. However, the new “purity” movement by conservatives was under way, coordinating over 300 organizations throughout the country to oppose sex education in the public schools. Several states passed antisexuality-education mandates, with Louisiana barring sex education altogether in 1968. By the late 1970s, only half-a-dozen states had mandated sex education into their schools, and implementation in the local classrooms was limited.

In 1972, AASECT began developing training standards and competency criteria for certification of sexuality educators, counselors, and therapists. A list of the professionals who have become certified in these three areas is provided in a published register so that other professionals and consumers can locate people who are trained. (Currently this list identifies over 1,000 certified professionals.) AASECT also has developed a code of ethics for professionals working in these fields.

In 1979, the federal government through the Department of Health, Education, and Welfare conducted a national analysis of sex-education programs in the United States. The researchers calculated that less than 10 percent of all students were receiving instruction about sexuality in their high schools. The report's overall conclusion stated:

Comprehensive programs must include far more than discussions of reproduction. They should cover other topics such as contraception, numerous sexual activities, the emotional and social aspects of sexual activity, values clarification, and decision making and communication skills. In addition to being concerned with the imparting of knowledge, they should also focus on the clarifying of values, the raising of self-esteem, and the developing of personal and social skills. These tasks clearly require that sex education topics be covered in many courses in many grades. (Kirby, Atter, and Scales 1979, 1)
When AIDS burst upon the scene in the 1980s, education with the goal of “social protection” from this deadly disease was targeted for inclusion in public-school curricula. In a relatively short time, most states came to require, or at least recommend, that AIDS education be included in school curricula. The number of states mandating or recommending AIDS education surpassed those mandating or recommending sexuality education. Money and other resources were being infused into AIDS-education initiatives. For example, in 1987-88, 80 percent of the $6.3 million spent nationwide on sexuality education went specifically to AIDS-education efforts. Today, policies and curricula addressing AIDS tend to be much more specific and detailed than those dealing with other aspects of sexuality education, including pregnancy prevention. This may lead to students receiving a narrow and negative view of human sexuality (e.g., “sex kills!”).

Throughout this time, SIECUS remained committed to comprehensive sexuality education, as emphasized in its mission statement: “SIECUS affirms that sexuality is a natural and healthy part of living and advocates the right of individuals to make responsible sexual choices. SIECUS develops, collects, and disseminates information and promotes comprehensive education about sexuality” (Haffner 1989, 4). In 1989, SIECUS convened a national colloquium on the future of sexuality education, “Sex Education 2000,” to which sixty-five national organizations sent representatives. The mission was to assure that all children and youth receive comprehensive sexuality education by the year 2000. Thirteen specific goals for the year 2000 were set forth as follows:

1. Sexuality education will be viewed as a community-wide responsibility.

2. All parents will receive assistance in providing sexuality education for their child(ren).

3. All schools will provide sexuality education for children and youth.

4. All religious institutions serving youth will provide sexuality education.

5. All national youth-serving agencies will implement sexuality education programs and policies.

6. The media will assume a more proactive role in sexuality education.

7. Federal policies and programs will support sexuality education.

8. Each state will have policies for school-based sexuality education and assure that mandates are implemented on a local level.

9. Guidelines, materials, strategies, and support for sexuality education will be available at the community level.

10. All teachers and group leaders providing sexuality education to youth will receive appropriate training.

11. Methodologies will be developed to evaluate sexuality education programs.

12. Broad support for sexuality education will be activated.

13. In order to realize the overall goal of comprehensive sexuality education for all children and youth, SIECUS calls upon national organizations to join together as a national coalition to support sexuality education (SIECUS 1990).

To aid in the attainment of the third goal of providing comprehensive sexuality education in the schools, a national Task Force with SIECUS's leadership published Guidelines for Comprehensive Sexuality Education, Kindergarten Through 12th Grade in 1991. These guidelines, based on six key concepts, provide a framework to create new sexuality-education programs or improve existing ones. The guidelines are based on values related to human sexuality that reflect the beliefs of most communities in a pluralistic society. They represent a starting point for curriculum development at the local level. Currently, another Task Force is working on ways to help providers of preschool education incorporate the beginnings of comprehensive sexuality education into their programs. In 1994, SIECUS also launched an international initiative in order to disseminate information on comprehensive sexuality education to the international community and to aid in the development of specific international efforts in this area.

Yet, in light of progress that has been made, challenges to sexuality programs from conservative organizations have become more frequent, more organized, and more successful than ever before (Sedway 1992). These nationally organized groups, including Eagle Forum, Focus on the Family, American Family Association, and Citizens for Excellence in Education, target local school programs that do not conform to their specific ideology. They attempt to control what others can read or learn, not just in sexuality education (which now is the major target), but in all areas of public education, including science (with the teaching of creationism), history, and literature (with censorship of many classics in children's literature). Although these groups represent a minority of parents in a school district, through well-organized national support, they often effectively use a variety of intimidating tactics to prevent the establishment of sexuality-education programs altogether or establish abstinence-only ones. Their tactics include personal attacks on persons supporting comprehensive sexuality education, threatening and sometimes pursuing costly litigation against school districts, and flooding school boards with misinformation, among other strategies. The greater impact of this anti-sexuality-education campaign on education, in general, and American society, overall, has been poignantly described:

In another sense, the continuing series of attacks aimed at public education must be viewed in the context of the larger battle - what has come to be known as a “Cultural Civil War” - over free expression. Motion pictures, television programs, fine art, music lyrics, and even political speech have all come under assault in recent years from many of the same religious right leaders behind attacks on school programs. In the vast majority of cases, in the schools and out, challengers generally seek the same remedy, i.e., to restrict what others can see, hear, or read. At stake in attacks on schoolbooks and programs is students' exposure to a broad spectrum of ideas in the classroom - in essence, their freedom to learn. And when the freedom to learn is threatened in sexuality education, students are denied information that can save their lives. (Sedway 1992, 13-14)
B. Current Status of Sexuality Education

Youth-Serving Agencies

National youth-serving agencies (YSAs) in the United States provide sexuality education to over two million youths each year. Over the past two decades, YSAs began developing such programs, primarily in response to the problems of adolescent pregnancy and HIV/AIDS.

Second only to schools in the number of youth they serve, youth-serving agencies are excellent providers of sexuality education programs, both because they work with large numbers of youth, including many under-served youth, and because they provide an environment that is informal and conducive to creative and experiential learning. Some YSAs reach youth who have dropped out of school. Others reach youth who have not received sexuality education programs in their schools. The people who work at YSAs often build close relationships with the youth in their programs which allows for better communication and more effective educational efforts. (Dietz 1989/1990, 16)
For example, the American Red Cross reaches over 1 million youth each year in the U.S. with their “AIDS Prevention Program,” “Black Youth Project,” and “AIDS Prevention Program for Hispanic Youth and Families.” The Boys Clubs of America has developed a substance abuse/pregnancy prevention program, called “Smart Moves.” The Girls Clubs of America has a primary commitment to providing health promotion, sexuality education, and pregnancy-prevention services to its members and reaches over 200,000 youth each year. The Girl Scouts of the U.S.A. developed a curriculum, “Decision for Your Life: Preventing Teenage Pregnancy,” that focuses on the consequences of teen parenthood and the development of communication, decision-making, assertiveness, and values-clarification skills. The March of Dimes Birth Defects Foundation developed the “Project Alpha” sexuality-education program that explores teenage pregnancy from the male perspective and helps young men learn how to take more responsibility. The National Network of Runaway and Youth Services has developed an HIV/AIDS education program for high-risk youth, called “Safe Choices.” The program provides training for staff at runaway shelters, residential treatment facilities, detention facilities, group homes, street outreach programs, hot lines, foster-family programs, and other agencies that serve high-risk youth.

In addition to the national efforts of YSAs, many local affiliates have designed their own programs to meet the needs of their local communities in culturally sensitive ways. For example, the National 4-H Council estimates that most state extension offices have developed their own programs to reduce teenage pregnancy in their areas.


More than 85 percent of the American public approve of sexuality education being provided in the schools, compared with 76 percent in 1975 and 69 percent in 1965 (Kenney, Guardado, and Brown 1989). Today, roughly 60 percent of teenagers receive at least some sex education in their schools, although only a third receive a somewhat “comprehensive” program.

Each state can mandate or require that sexuality education and/or AIDS education be provided in the local school districts. Short of mandating such educational programs, states may simply recommend that the school districts within their boundaries offer education on sexuality, in general, and/or more-specific AIDS education. In 1992, seventeen states had mandated sexuality education and thirty more recommended it; see Table 3 (Haffner 1992). In addition, thirty-four states had mandated AIDS education, while fourteen more recommended it. Only four states (Massachusetts, Mississippi, South Dakota, and Wyoming) had no position on sexuality education within their schools; whereas Ohio, Wyoming, and Tennessee had no position on AIDS education. In 1995, the NARAL and NARAL Foundation (1995) issued a detailed state-by-state review of sexuality education in America with selected details of legislative action in 1994 and 1995.

Although the majority of states either mandate or recommend sexuality and AIDS education, this does not guarantee that local school districts are implementing the suggested curricula. Inconsistencies in and lack of implementation of these curricula result from: absence of provisions for mandate enforcement, lax regulations regarding compliance, diversity in program objectives, restrictions on course content, lack of provisions for teacher training, and insufficient evaluation.

In 1988, SIECUS conducted a project to examine and evaluate the recommended state sexuality and AIDS-education curricula (Di Mauro 1989-90). Of the twenty-three state curricula that they evaluated for sexuality education, only 22 percent were deemed to be accurate. Although most curricula stated that human sexuality is natural and positive, there was a lack of any content in the curricula to support this concept. Most focused on the negative consequences of sexual interaction, and little attention was paid to the psychosocial dimensions of sexuality, such as gender identification and roles, sexual functioning and satisfaction, or values and ethics. Only one half of the curricula provided thorough information about birth control.

In an evaluation of the thirty-four state-recommended AIDS-education curricula, 32 percent were found to be accurate in basic concepts and presentation. The majority (85 percent) emphasized abstinence and “just say no” skills, whereas only 9 percent covered safer sex as a preventive practice. Thorough information about condoms was provided in less than 10 percent of the curricula. There was no mention of homosexuality in over one third of the curricula. In 38 percent, homosexuals were identified as the “cause of AIDS.” The Utah curriculum was especially negative and restrictive:

Utah's teachers are not free to discuss the “intricacies of intercourse, sexual stimulation, erotic behavior”; the acceptance of or advocacy of homosexuality as a desirable or acceptable sexual adjustment or life-style; the advocacy or encouragement of contraceptive methods or devices by unmarried minors; and the acceptance or advocacy of “free sex,” promiscuity, or the so-called “new morality.” This section of their curriculum is replete with warnings of legal violations for instructors crossing prohibition lines; their guidelines indicate that with parental consent it is possible to discuss condom use at any grade level, but without it, such discussions are Class B misdemeanors. (Di Mauro 1989-90, 6; see also the discussion of Mormon sexuality in Section 2A.)
Table 3: State Requirements for Sexuality, STD, and HIV/AIDS Education in Primary and Secondary Schools

Sexuality Education - Required from Kindergarten Through Senior High School

Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Illinois, Iowa, Kansas, Maryland, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Rhode Island, Tennessee, Vermont, Virginia, and West Virginia

Sexuality Education - Required for Grades Five or Six Through Senior High School

South Carolina, Texas, and Utah

Sexuality Education - Not Required

Alaska, Arizona, California, Colorado, Connecticut, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Maine, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Washington, Wisconsin, and Wyoming

STD/HIV/AIDS Education - Required from Kindergarten Through Senior High School

Alabama, Arizona, Arkansas, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island,1 Tennessee,2 Vermont, Virginia, Washington, and Wisconsin

STD/HIV/AIDS Education - Required Grades Five or Six Through Senior High School

California, Illinois, Maryland, Oklahoma, South Carolina, Texas, Utah,3 and West Virginia

STD/HIV/AIDS Education - Not Required

Alaska, Colorado, Hawaii, Kentucky, Louisiana,4 Maine, Massachusetts, Mississippi, Montana, Nebraska, North Dakota, South Dakota, and Wyoming

1 Instruction in sexuality and HIV/AIDS is required at least once a year in all grades.

2 Instruction in sexuality and HIV/AIDS is required only in counties with more than 19.5 pregnancies per 1,000 females aged 15 to 17. Only one county did not meet this standard.

3 HIV/AIDS education is required from third to twelfth grades.

4 Louisiana law prohibits sex education before the seventh grade, and in New Orleans, before the third grade.

Source: Sexuality Education in America: A State-by-State Review. NARAL/The NARAL Foundation, 1995.

Currently, a broad focus on sexuality education is being supplanted by a narrow focus on AIDS education. Sexuality and AIDS education are being treated independently with separate curricula and teacher training. The report concluded that: “What is needed [for each state] is a comprehensive sexuality education or family-life education curriculum with an extensive AIDS education component that contextualizes preventive information within a positive, life-affirming approach to human sexuality” (Di Mauro 1989-90, 6).

Yet, recommended curriculum content cannot automatically be equated with what is actually being taught in the classroom. To determine what is being taught, a study of public school teachers in five specialty areas (health education, biology, home economics, physical education, and school nursing) in grades seven through twelve was conducted (Forrest and Silverman 1989). It was estimated that nationwide 50,000 public school teachers were providing some type of sexuality education in grades seven through twelve in 1987-88; representing 45 percent of the teachers employed in those areas. Roughly 38.7 hours of sex education were being offered in grades seven through twelve; with 5.0 hours devoted to birth control and 5.9 hours covering STDs.

The teachers cited the encouragement of abstinence as one of their primary goals. The messages that they most want to give included: responsibility regarding sexual relationships and parenthood, the importance of abstinence and ways of resisting pressures to become sexually active, and information on AIDS and other STDs. The teachers agreed that sexuality education belongs in the schools and that students should be taught to examine and develop their own values about sexual behaviors. They reported that there is often a gap between what should be taught, and when and what actually is allowed to be taught. The largest gap concerned sources of birth-control methods; 97 percent of the teachers believed they should be allowed to provide information to students about where they could access birth control, but this was allowed in less than half of their schools. In fact, one quarter of the teachers were permitted to discuss birth control with students only when they are asked a student-initiated question. In addition, over 90 percent of the teachers believed that their students should be taught about homosexuality and abortion, topics that are often restricted by school districts. In addition, the teachers believed that the wide range of sexuality topics should be addressed with students no later than seventh or eighth grade; however, this is not usually done until tenth through twelfth grades, if at all.

The teachers described many barriers to implementing quality sexuality education in their classrooms. The major problem that they identified was opposition or lack of support from parents, the community, or school administrators. They also felt that they lacked appropriate materials because of the difficulties in getting current relevant materials approved for use. They also encountered student-related barriers, such as discomfort, lack of basic knowledge of anatomy and physiology, and misinformation, poor attitudes, and a lack of values and morals reflecting favorable attitudes toward teen pregnancy. Teachers also lacked enough time and training to teach the material effectively. Almost none of them were certified as sexuality or family-life educators by the American Association of Sex Educators, Counselors, and Therapists or the National Council on Family Relations. The level of the teachers' own knowledge on sexual topics was questionable, and some experienced personal conflicts in dealing with certain issues.

The authors concluded that:

Perhaps the most important step toward improved sex education would be increased, clear support of the teachers. One form this support should take is the development of curricula that provide teachers with constructive, planned ways to raise and deal with the topics on their students' minds, since the data indicate that students will often raise topics even if they are not in the curriculum. Greater support should also help increase the availability of high-quality instructional materials and on-going education and information for teachers. Adequate teaching materials and support for teaching in earlier grades the topics students want to know about might help solve the problem of student inattention and negative reactions, to say nothing of helping with the problems of teenage pregnancy and the spread of AIDS and other STDs. (Forrest and Silverman 1989, 72)
Yet, in recent years, well-organized conservative organizations throughout the United States have been promoting the adoption of their own abstinence-only curricula in the public schools. Since 1985, the Illinois Committee on the Status of Women has received $1.7 million in state and federal funds to promote such a curriculum, called Sex Respect. They have been successful in having Sex Respect adopted in over 1,600 school systems, even though this curriculum is designed to proselytize a particular conservative sexual-value system. The Sex Respect curriculum has been criticized because it:
(1) substitutes biased opinion for fact; (2) conveys insufficient and inaccurate information; (3) relies on scare tactics; (4) ignores realities of life for many students; (5) reinforces gender stereotypes; (6) lacks respect for cultural and economic differences; (7) presents one side of controversial issues; (8) fails to meaningfully involve parents; [and] (9) is marketed using inadequate evaluations. (Trudell and Whatley 1991, 125)
Careful scientific evaluation of over forty sexuality- and AIDS-education curricula commissioned separately by the Centers for Disease Control and the World Health Organization resulted in the following conclusions:
1. Comprehensive sexuality and HIV/AIDS-education programs do not hasten the onset of intercourse nor increase the number of partners or frequency of intercourse.

2. Skill-based programs can delay the onset of sexual intercourse and increase the use of contraception, condoms, and other safer-sex practices among sexually experienced youth.

3. Programs that promote both the postponement of sexual intercourse and safer-sex practices are more effective than abstinence-only programs, like Sex Respect (Haffner 1994).

C. Informal Sources of Sexual Knowledge

Researchers over the past fifty years have consistently found that adolescents identify peers, particularly of their same gender, as their primary source of sexuality education, followed by various types of media, including print and visual media. Parents and schools are usually identified as significantly less-influential sources.

Peers as a Sexual Information Source

Males seem to be more dependent on peers for their sexuality education than are females. One problematic aspect of receiving sexuality education informally from peers is that the information they provide is often inaccurate. However, when peers are formally trained to provide sexuality education, such as on the high school or college level, they are very effective in providing information and encouraging the development of positive attitudes towards responsible and healthy sexual expression. Thus, the peer model is being used more widely in school and community sexuality-education programs.

The Media

The various media are pervasive and influential sources of sexuality education in American culture. Media have been identified by adolescents and college students as being more influential than their families in the development of their sexual attitudes and behaviors. As to television, the radio, and movies, adolescents spend more time being entertained by the media than any other activity, perhaps with the exception of sleeping (Haffner and Kelly 1987).

Television, in particular, has been identified as the most influential source of sexual messages in American society, even though sexual behavior is not explicitly depicted. Yet, in an analysis of the sexual content of prime-time television programming, about 20,000 scenes of suggested sexual intercourse and other behaviors, and sexual comments and innuendos were documented in one year (Haffner and Kelly 1987). These portrayals of sexual interaction are six times more likely to happen in an extramarital, rather than a marital, relationship. In soap operas, 94 percent of the sexual encounters happen between people who are not married to one another. Minority groups are extremely underrepresented on TV, with gay and lesbian characters nearly nonexistent.

In the United States, by the time a child graduates from high school, she or he will have spent more time watching TV than being in a formal classroom setting. There is conflicting evidence as to the impact media portrayals have on youth's developing sexuality (Haffner and Kelly 1987). Gender-role stereotyping is a pervasive aspect of television programming, with children who watch more TV demonstrating more stereotypic gender-role behaviors than those who watch less. Some studies have linked young people's television-viewing habits, including the watching of music videos, to the likelihood that they would engage in sexual intercourse, while others have not supported this relationship. Yet, there is no denying that TV serves as a sexuality educator. Adolescents report that TV is equally or more encouraging about engaging in sexual intercourse than are their friends, and those that have high TV-viewing habits are likely to be dissatisfied about remaining virgins. In addition, those who believe that TV accurately portrays sexual experiences are more likely to be dissatisfied with their own.

Soap operas are one of the most popular television genres. Depictions of sexual behaviors are common. Yet, television censors still establish rules, such as not showing unbuttoning clothes or the characters at the moment of “penetration.” Unfortunately, very few references to or depictions of safer sex are part of television programs. As the National Academy of Sciences concluded, the media provide “young people with lots of clues about how to be sexy, but... little information about how to be sexually responsible” (Haffner and Kelly 1987, 9).

Sexuality has become a focal point of some newer types of television programming. Sexual topics, such as teenage pregnancy, incest, or AIDS, are often the subject matter of made-for-TV movies and “after-school specials.” In addition, the “sexually unconventional,” such as transvestites, sex addicts, or bigamists, are often the guests of television talk shows, such as Donahue, Oprah, and Geraldo. Some critics believe that this diversity has encouraged viewers to become more tolerant and open, whereas others believe it has done the opposite, reinforcing negative and hostile attitudes. Among adolescents and young adults, music videos have become one of the most popular forms of television entertainment. Yet, context studies of these music videos indicate that women tend to be treated as “sex objects.” Madonna is one exception, depicting a powerful image of female sexuality.

The motto that “Sex Sells” has been generously applied to television advertising. Television uses sexual innuendos and images to sell almost every product from toothpaste to automobiles. The most sexually explicit commercials are generally those for jeans, beer, and perfumes. Paradoxically, commercials and public service announcements for birth control methods are banned from television. Those for “feminine hygiene” products and the prevention of sexually transmissible diseases, including AIDS, are quite restricted.

Subscriber cable television offers more sexually oriented programming, such as the Playboy Channel, than does network TV. However, the Exxxtacy Channel was forced out of business because of numerous government obscenity prosecutions. Virtual-reality technology is being developed to allow cable subscribers to use goggles, gloves, and body sensors to enjoy their own virtual sexual reality.

Film making is a huge business and American films are marketed worldwide. Movies have been reported as one of the leading sources of sexual information for adolescent Anglo-American, Latino, and Native American males (Davis and Harris 1982). Films are given greater license to depict sexual behavior explicitly than on television; however, they are still censored. In fact, films, such as Basic Instinct, have more explicit sex in their uncut versions that are marketed abroad than the “cut” versions that are marketed domestically. Female nudity has become acceptable, whereas male frontal nudity is still censored. Sexual behaviors other than heterosexual intercourse tend to be missing from most films.

Video cassettes and videocassette recorders (VCRs) have revolutionized the viewing habits of Americans. Two hundred million X-rated video cassettes were rented in the U.S. in 1989. One study of college students determined that males viewed about six hours and females two hours of sexually explicit material on their VCRs a month (Strong and DeVault 1994).

Another very popular form of media, directed at females, is the romance novel, comprising 40 percent of all paperback book sales in the U.S. Romance novels are believed to both reflect and create the sexual fantasies and desires of their female American audience. The basic formula of this form of media is: “Female meets devastating man, sparks fly, lovers meld, lovers are torn apart, get back together, resolve their problems, and commit themselves, usually, to marriage” (Strong and DeVault 1994, 22).

Sexual language is disguised by euphemisms. For example, the male penis is referred to as a “love muscle” and the female vagina as a “temple of love.” Yet, romance novels are filled with sensuality, sexuality, and passion, with some people considering them soft-core pornography.

Young males in the U.S. tend to learn about sexuality through more-explicit magazines, such as Playboy and Penthouse. Playboy is one of the most popular magazines worldwide, selling about 10 million issues monthly. Half of college men, but much fewer women, report that pornography has been a source of information for them regarding sexual behaviors (Duncan and Nicholson 1991).

Finally, with increased public access to computer technology, sexuality education is now being offered through the computer-based superhighway. This represents the “wave of the future” and is thoroughly discussed in a section at the end of this chapter.

Parents as a Source of Sexual Information

It is widely believed that parents should be the primary sexuality educators of their children. They certainly provide a great deal of indirect sexuality education to their children through the ways that they display affection, react to nudity and bodies, and interact with people of different genders and orientations - as well as the attitudes they express (or the lack of expression) towards a myriad of sexual topics.

However, most parents in the United States provide little direct sexuality education to their children, even though the majority of children express the desire to be able to talk to their parents about sexuality. Studies of American adolescents consistently find that up to three quarters state that they have not discussed sexuality with their parents (Hass 1979; Sorenson 1973). Parents have expressed the following as barriers to discussing sexuality with their children: anxiety over giving misinformation or inappropriate information for the developmental level of their children; lack of skills in communicating about sexuality, since very few parents ever had role models on how to handle such discussions; and fear that discussing sexuality with their children will actually encourage them to become involved in sexual relationships.

When sexuality education occurs in the home, the mother is generally the parent who handles such discussions with both daughters and sons. Studies do indicate that, when parents talk to their children about sexuality, the children are more likely to wait to become involved in sexual behaviors until they are older, than those children who have not talked with their parents (Shah and Zelnick 1981). Further, when parent-educated teens do engage in sexual intercourse, they are more likely to use an effective means of birth control consistently and to have fewer sexual partners. In addition, high family sexual communication seems to be related to similarity in sexual attitudes between parents and their children.

Recognizing the importance of having parents involved in their children's sexuality education, efforts are being made to prepare parents to become better sexuality educators. Sexuality-education programs for parents are offered separate from, and in conjunction with, children's programs in some schools, and through some community and religious organizations. The goals of these programs include developing parents' communication skills so that they can become more “askable,” increasing their knowledge about various aspects of sexuality, and exploring their attitudes and values surrounding these issues. For example, the National Congress of Parents and Teachers' Associations (PTA) has created programs and publications on aspects of sexuality and HIV/AIDS prevention for use by local affiliates.

It is clear that we must continue to strive to reach all Americans with positive and comprehensive sexuality education through all of our available informal and formal channels. It is also imperative that sound qualitative and quantitative research methodologies be used to ascertain the impact of differing sexuality education strategies and sources on the diverse groups of people - e.g., gender, age, orientation, race and ethnicity - in the United States.