Surgeon General Releases Report on Sexual Health for Teens, Calls for Open Dialogue Between Adults, Youth
Surgeon General David Satcher yesterday released a "long-awaited" report promoting an open discussion about sexuality with teens and calling on parents, schools and communities to provide youths with "thorough and medically accurate sex education" to prevent unintended pregnancies and STDs, the New York Times reports (Schemo, New York Times, 6/29). The report, titled "The Surgeon General's Call to Action to Promote Sexual Health and Responsible Behavior," encourages open dialogue on sex "with respect for diversity" and "respect for what science shows is effective" and notes that "[g]iven the diversity of attitudes, beliefs, values and opinions, finding common ground might not be easy, but it is attainable." In the United States, 39% of ninth graders and 65% of twelfth graders have had sex, and one in four sexually active teens will contract at least one STD, AP/MSNBC.com reports. Forty percent of girls become pregnant at least once before the age of 20, and 60% of HIV-positive Americans became infected in their teens. Satcher said that the first step in reducing these statistics is to confront the issue of teen sexuality, noting that "[a]t every level we have problems discussing it." Parents are primarily responsible for encouraging the sexual health of their kids, but schools also "play an important role" as "great equalizers" when needed, Satcher said.
To be effective, sex education must be wide-ranging, begin early and be available throughout life, the report says. It recommends that the "benefits of abstinence" be discussed, but points to the importance of instructing teens in how to prevent pregnancy and disease. The report said that more research must be done before conclusions are reached on the efficacy of "abstinence-only" programs (AP/MSNBC.com, 6/28). Further, the report found "no scientific support" for concerns that sex education in the classroom leads to earlier sexual activity among teens. Instead, studies have shown that students who had been taught comprehensive sex education rather than abstinence-only sex education were more likely to use contraception when they did become sexually active (New York Times, 6/29). However, Satcher said that he would not take sides on the sex education debate, calling it a "political decision." He said, "We try to make very clear what's needed to improve sexual health and what's supported by the science." But unlike federal abstinence programs that urge abstinence until marriage, the report encourages abstinence until people are involved in a "committed, enduring and mutually monogamous relationship." The report also makes the following recommendations:
- Providing adequate training in sexual health for health care providers;
- Ensuring the availability of programs that aim to prevent sexual abuse;
- Encouraging stable and committed adult relationships to strengthen families;
- Increasing scientific research on sexual health throughout life;
- Developing and distributing education materials for sex ed classes that cover the "full continuum of human sexual development" for parents, teachers, clergy and others (AP/MSNBC.com, 6/28).
The report drew "swift criticism" from conservative groups that fear that it may pose a threat to the reauthorization of funding for abstinence-only programs later this year, the New York Times reports (New York Times, 6/29). Heather Cirmo of the Family Research Council said, "In an attempt to find common ground, Dr. Satcher is really on shaky ground," as his efforts to "please everyone may ultimately help no one." She added, "It would have been better if all of his recommendations were rooted in science and research as opposed to being the result of talking to a variety of individuals" (Bayot, Boston Globe, 6/29). Cirmo continued, "Although Dr. Satcher emphasizes abstinence, he encourages people to wait until they find the right person instead of a lifelong marriage partner. Marriage is the best protection against STDs and out-of-wedlock pregnancies" (Duin, Washington Times, 6/29). Traditional Values Coalition President Andrea Lafferty agreed, saying, "According to Satcher, marriage is almost an afterthought. What children in high-risk areas really need to hear is that it is marriage that works -- not a set of monogamous relationships" (Connolly, Washington Post, 6/29). Project Reality Director Kathleen Sullivan said that abstinence educators may welcome the report's acknowledgement that "sexual health cannot be separated from emotional and physical health," but added that "[w]e do teens a disservice by advocating condoms as the answer, since condoms do nothing to prevent or protect from the emotional, mental and social consequences of teen sexual activity" (Project Reality release, 6/28). Peter Brandt, director of issue response of the Christian ministry Focus on the Family, called the report "ideology disguised as science from the beginning to the end" (New York Times, 6/29). Brandt said it represented "bad science and bad medicine" and called for President Bush to replace Satcher "immediately," as he is being used as a "pawn by liberal groups to add credit to the ideology" (Peterson, USA Today, 6/29). The Bush administration has "distanced" itself from the report. White House spokesperson Ari Fleischer noted that the report was commissioned under President Clinton and that Bush's "overall approach on these matters focuses on abstinence, abstinence education." HHS Secretary Tommy Thompson viewed the report before its release, but made no changes to it. Satcher's report is "a completely independent work," Thompson spokesperson Anthony Jewell explained (New York Times, 6/29).
"Two years of scientific research has resulted in a highly scientific report by the nation's top doctor that will save lives," Human Rights Campaign Political Director Winnie Stachelberg said, adding, "We urge the administration to immediately adopt the more science-based guidelines and let them serve as a policy roadmap for improving public health in America." Addressing the issue of HIV/AIDS, Stachelberg noted, "These are welcome recommendations because if we do not begin to talk openly and honestly, a new generation will be at risk. ... This report will help teach these young Americans the dangers of diseases such as HIV and ways to prevent contracting them" (HRC release, 6/28). Deborah Hauser of Advocates for Youth called Satcher's document "a good report. I respect the surgeon general for getting it out." William Smith of the Sexuality Information Council of the United States agreed, saying he is "particularly pleased this report has brought human sexuality to the forefront of public discussion" (USA Today, 6/29). Speaking on FOX News' "The O'Reilly Factor," former Surgeon General Joycelyn Elders said she was "pleased that [Satcher] has ... pulled together all of the available data around the United States and tried to put it into a report to make us concentrate and think about [sex education] again so we can begin to address the problems. ... I think that he's outlined ... mechanisms for us to begin to address those problems." Elders said she supports "teaching comprehensive health education from K through 12" ("The O'Reilly Factor," 6/28).
More Information Available
Drew Altman, president of the Kaiser Family Foundation, said, "There is nothing in [the Satcher] report that isn't endorsed wholeheartedly in every survey we've done of parents" (New York Times, 6/29). KFF has published two reports pertaining to teen sexual activity. "Sex Education in America: A View from Inside the Nation's Classrooms" (September 2000) is based on a series of national surveys with more than 4,000 public secondary school students and their parents, sex education teachers and school principals about their experiences with and attitudes toward sex education. The surveys found that most parents look to school sex education programs to provide their children with practical skills that students and teachers report are not consistently covered, including how to use condoms and other forms of birth control, how to talk about birth control with partners, how to deal with peer pressure to have sex and the emotional consequences of becoming sexually active. To view this report and U.S. sex education policies, click here. A second KFF survey, titled "Teen Information Needs: A National Survey of U.S. Teens" (May 2001), found that 42% of teens between the ages of 12 and 17 say they want more information about sexual health from health class at school. Fewer than half of teens (47%) say they know "for sure" where to go to get information about HIV or other STDs. To view this survey, click here. Please note that links are available only to readers of the report's Web version.