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Surgeon General Urges Frank Sex Talk

Government report a ‘call to action’

Originally published by MSNBC News, June 28, 2001

June 28 — Pointing to “alarmingly high levels” of sexually transmitted diseases, unintended pregnancies, abortions and sexual violence in the United States, Surgeon General David Satcher called on parents, schools and community leaders Thursday to get past their nervousness about sex so they can do a better job of educating the nation’s youths.

Sex education begins with parents, the report says, but schools play an important role because some parents are unable to give their children all the information they need.

In a far-reaching report that touches on issues ranging from teen sex to gays’ mental health, Satcher called for “beginning a mature, thoughtful and respectful discussion” nationwide about sexuality.

Given the diversity of attitudes, beliefs, values and opinions, “Finding common ground might not be easy,” the report acknowledged, “but it is possible.”

The only course that is not acceptable, Satcher added, is inaction.

“We’ve known we’ve had a problem for a long time—it’s time we admit we have a problem and do something about it,” former Surgeon General Joycelyn Elders told MSNBC.

“Our efforts not only will have an impact on the current health status of our citizens, but will lay a foundation for a healthier society in the future,” the report concludes.

The “call to action” is only a first step, Satcher said—one of confronting the issue. Two years in the making, the report begins by detailing the problem: 12 million Americans infected by sexually transmitted diseases each year, with some 40,000 new HIV infections; more than 100,000 children victimized by sexual abuse annually; and nearly 1.4 million abortions in a year, with nearly half of all pregnancies unwanted. An estimated 800,000 to 900,000 Americans are now living with HIV. More than one in five women have been victims of rape.

It also touches on some of the most contentious sexual issues, calling on Americans to respect “the diversity of sexual values within any community.”

It says there is no valid scientific evidence that one’s sexual orientation can be changed and details the consequences of harassment on the mental health of gays and lesbians.

“We have a responsibility to be more supportive and proactive than judgmental,” Satcher said. “We’re certainly not trying to get anyone in any religious group to change their views. We’re just saying these are people, these are human beings.”

Teens and sex

• Thirty-nine percent of ninth-graders and 65 percent of twelfth-graders have engaged in intercourse.

• Just over 8 percent of high-school students in 1999 said they’d had sex by age 13.

• One in four sexually active teen-agers will contract at least one STD.

• Four in 10 girls become pregnant at least once before they reach the age of 20—nearly 1 million a year.

• Just 25 percent of sexually experienced 15-to-17-years olds had ever been tested for HIV in 1998; 29 percent for other STDs.

• Fifty-eight percent of sexually active high-schoolers reported using a condom the last time they had sex.

• Three out of five Americans living with HIV were infected as teens.

• Gonorrhea rose 13 percent among teens between 1997 and 1999, with teen-age girls having the highest rates of any females.

• An estimated 3 million people contract chlamydia each year in United States; 40 percent of cases occur in 15-to-19-year-olds.

Sources: CDC; Kaiser Family Foundation; National Campaign to Prevent Teen Pregnancy

Sexuality education must be wide-ranging, begin early and be available throughout one’s life, the report says. It recommends that sex-education programs discuss the benefits of abstinence from sex—but also explain how to prevent unwanted pregnancies and sexually transmitted diseases. It recommends improving access to reproductive health care services for “all persons in all communities.”

Abstinence is the only certain way to prevent pregnancy and the spread of disease, the report says, and even properly used condoms do not prevent the spread of all sexually transmitted diseases. But the report finds no evidence that “abstinence-only” programs are effective, saying more research is needed.

These programs, which bar any talk of contraception, enjoy the support of many conservatives, including President Bush, who has pledged to raise federal funding for them.

Tips for sexually active teens

• Sexually active teen-agers should be tested annually for HIV, chlamydia and gonorrhea (more often if they’re changing sexual partners frequently or having sex without condoms.)

• Girls engaging in sexual activity should get annual Pap smears to ensure that they’re not experiencing cervical cell changes from HPV, which, if left untreated, could eventually lead to cervical cancer.

• Adolescents should use a condom for all sexual encounters, but recognize that even then, sex is not risk-free. For example, HPV and herpes can be spread despite condom use if the carrier is shedding virus from parts of the genital region not covered by the condom.

Sources: Dr. Penelope Hitchcock and Kathleen Ethier

The Institute for Youth Development, a group that promotes “risk avoidance,” immediately issued a statement stating that the report “would represent a much stronger contribution to the public health had it clearly made the medical case for one uninfected lifetime partner as the best and only way for an individual to avoid the risk for contracting a STD.”

Satcher said he was not taking sides in the debate. “Those are political decisions,” he said. “We try to make very clear what’s needed to improve sexual health and what’s supported by the science.”

Another difference with conservatives: His report encourages abstinence from sex until one is involved in a “committed, enduring and mutually monogamous relationship.” Federal abstinence programs call for abstinence until marriage.

“I have to deal with reality,” Satcher said when asked about the difference.

Sex education begins with parents, the report says, but schools play an important role because some parents are unable to give their children all the information they need.

“Parents sometimes need help. There are so many parents who are unprepared or uncomfortable discussing it,” Satcher said. “Schools have always been the great equalizers.”

Elders agreed. “Schools are the only institution we have where all children go. We have to use the only institution we’ve got to educate our children about their sexuality.”

OTHER RECOMMENDATIONS

“The Surgeon General’s Call to Action to Promote Sexual Health and Responsible Behavior” cited three fundamental strategies—increasing awareness, implementing interventions and expanding research—for promoting sexual health. Among its specific recommendations:

• Providing adequate training in sexual health for health care professionals who deal with these issues.

• Improving access to sexual health and reproductive health care services.

• Ensuring that programs that aim to prevent sexual abuse are available.

• Encouraging stable and committed adult relationships, particularly marriage, to help strengthen families.

• Increasing scientific research on sexual health, including the entire life span, from childhood to old age.

• Developing and disseminating educational materials for sex-ed classes that cover the “full continuum of human sexual development” for use by parents, clergy, teachers and others.