In 2011, legislators in Mississippi passed a law (HB 999) requiring all schools to choose between a strict abstinence-only policy or one, called abstinence-plus, that includes all aspects of the abstinence-only approach but also teaches young people about contraception and disease-prevention. A new report published by Mississippi First, the Women’s Foundation of Mississippi, and the Sexuality Information and Education Council of the United States (SIECUS), found that of the 151 school districts and four special schools in Mississippi, 81 chose abstinence-only, 71 chose abstinence-plus, and three chose a combined approach.
While it is good news that some students in Mississippi, a state that ranks at the bottom of all sexual health indicators, may be taught something other than “just say no until marriage,” the report also notes an oddity in how the law has been interpreted and implemented, which means that some curricula have ended up (without alterations) on the “approved” list for schools with both abstinence-only and abstinence-plus policies. Having spent much of my career reviewing abstinence-only-until-marriage curricula and material, I can promise that just adding a lesson about contraception cannot turn a fear- and shame-based program into anything better.
The Choosing the Best series, which includes curricula for grades six through 12, can be used by schools that pick either policy. In fact, this series is overwhelmingly popular in Mississippi as it is being used by 74 percent of schools that chose an abstinence-only policy and 39 percent that chose the supposedly more expansive abstinence-plus approach. The point of schools adopting the abstinence-plus policy is to be allowed to discuss, in the words of the law, “other topics such as contraceptive options and the cause and effect of sexually transmitted diseases and HIV/AIDS.” Unfortunately, Choosing the Best does not do that. (Note: The examples below are from the SIECUS review of the 2006 editions of this series. Schools in Mississippi may be using a newer edition, though in my experience few things change between editions.)
The discussions of contraception and STDs within the Choosing the Best series are very limited and based more on fear than fact. For example, in the program designed for sixth graders, the teacher is told to hold up cauliflower and explain that this is like a genital wart, one of the many STDs young people are likely to get if they are sexually active. (Something green and oozy is used to represent chlamydia.) Though this representation might seem clever to program planners who have seen pictures of genital warts left untreated for many years, which do in fact resemble cauliflower, most cases of warts are tiny dots that are not visible to the naked eye. Young people should know this so they know what to look out for and do not just assume they are fine unless they see something as large and obviously problematic as what their teacher is holding up during this presentation.
The program for older kids includes this story in lieu of education about chlamydia:
The first time I had sex with anybody, I got Chlamydia. So one week I was a virgin, and two weeks later, I had an STD….I became violently ill. I had a 105 fever, severe abdominal cramps, and throwing up. The conclusion was yes, that I was infertile. My tubes had been damaged beyond repair.
While it is entirely possible to get chlamydia from one’s first sexual experience, it would be nice if the curriculum clarified that a condom could have prevented this outcome. More importantly, though, the infection would not progress to irreversible tube damage in just a couple of weeks (which despite the clever use of ellipses is how the story reads). Chlamydia, which often has no symptoms, is easily curable with antibiotics. If not treated it can lead to pelvic inflammatory disease (PID), which is what would cause someone to have fever, cramps, and vomiting. PID can also be cured with antibiotics. It is when PID is left untreated that scar tissue builds up. This would not happen rapidly, and given the symptoms this character experienced, there would have been plenty of opportunity for her to seek help and get treatment long before permanent damage was done. In actuality, the danger with chlamydia and the reason why it leads to infertility is that there are usually no symptoms, and without testing a person doesn’t even know she has had it until damage has been done. Implausible stories like this do little to educate students.
My favorite story from Choosing the Best has always been this one in which a new bride tells of how she’s suffered because of her husband’s infidelity:
I was rushed to the hospital with intense abdominal pain. Emergency surgery revealed such an extensive infection that my uterus, tubes and ovaries all had to be removed. My husband of six months had infected me with gonorrhea, which he had contracted from a ‘one-night stand’ prior to our engagement. Our dreams of biological children will never be realized.
Throughout the lessons plans, the authors make it clear that the only way to protect yourself from STDs is to stay abstinent until marriage. This point is underscored so often that it almost seems like wedding rings themselves have some kind of magic protective properties. And yet, the author’s own story proves this wrong. The speaker here could very well have taken the program’s advice and stayed abstinent until her wedding night but she got gonorrhea anyhow. Clearly, she and her new husband would have been better off had they been given real information about how STDs are transmitted, prevented, and treated.If they had, perhaps her husband would have known to us a condom during his one night stand and get tested for STDs before he had unprotected sex with his wife.
Information on condoms and contraception is quite sparse and laser-focused on failure rates in Choosing the Best. The program tells students, for example, that the failure rate for condoms is 15 percent in preventing pregnancy which is more or less accurate though fails to note that this rate includes couples who used a condom incorrectly or didn’t use a condom at all when they became pregnant. When used consistently and correctly condoms are 98 percent effective in preventing pregnancy. The curricula then says: “Could you live with a 15% annual failure rate on: A roller coaster ride? “An airline flight? Skydiving?” Again, because the 15 percent includes non-use, to be accurate, the skydiving analogy would have to include all of those people who jumped out of an airplane without their parachute.
Of course, even if the curriculum provided decent information about condoms or contraception, this would be instantly undermined by the messages of shame that suggest young people who have sex lack character and values. Take the exercise “Mint for Marriage” in which the teacher passes around an unwrapped peppermint patty and asks each student to hold it for a second. When it is returned to the front of the room she says: “Why is this patty no longer appealing?” The answer: “No one wants food that has been passed around and neither would you want your future husband or wife to have been passed around.” A similar exercise called “A Rose with No Petals” ends with the explanation “Each time a sexually active person gives that most personal part of himself or herself away, that person can lose a sense of personal value and worth. It all comes down to self-respect.”
Almost 60 percent of high school students in Mississippi have had sex. It’s hard to see how learning that they lack personal value, worth, and self-respect will be a good motivator for making sure they protect themselves from sexually transmitted diseases and pregnancy when they have sex in the future.
Jamie Bardwell, of the Women’s Foundation of Mississippi, one of the groups that authored the new report, told RH Reality Check, “It is incredibly confusing that the law allows a sex education curriculum to be labeled as both abstinence-plus and abstinence-only. True abstinence-only-until-marriage programs like Choosing the Best, should not be labeled ‘abstinence-plus’ simply because they mention the word contraception.”
Bardwell added: “Programs like these that shame LGBT young people and include wedding ceremonies, inaccurate information, and gender stereotypes. They should not be taught in any Mississippi classrooms and certainly not in schools that want an abstinence-plus programs. Young people need and want good, medically accurate information to make healthy decisions.”
Advocates in Mississippi are trying to get the law changed so that better curricula are required, at least in schools that chose an abstinence-plus approach. In the meantime, a clear majority of students in the Magnolia State will be told by Choosing the Best that sexually active teenagers are like a pitcher of spit—dirty, gross, and not wanted.
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