Sweden has had sex education since 1918

While doing a literature review for a paper about syphilis, I learned that Sweden has had what we would now call comprehensive sex education since 1918 ("Venereal Diseases and Sex Education", Report by a Swedish Government Committee, British Medical Journal, vol 1, no. 3204, May 27, 1922, p.842), as part of their "venereal disease" prevention law.

A 1943 discussion of sex education shows that current discussions are almost identical to past dicussions. The Archbishop of Canterbury noted that "if men and women would abstain from fornication the problem would be reduced greatly and become a purely medical matter. The bulk of the evil is primarily a moral problem." and he suggested that by distributing condoms to the troops "the implication is that many are expected to practice fornication" and thus it increases. One person cited one example in which moral suasion worked to prevent sex among soldiers --- the Black Sea Army in World War I --- and that the forces would respond if chastity were portrayed "in the right way".

On the other side, a medical officer from St. Pancras argued that the Church's teaching was unhelpful and that creating a taboo against premarital sex causes those who break the taboo to become rebels and outcasts. An alderman calls for sex education for those age 13 and up since otherwise they will learn about sex from "street talk", while a doctor calls for sex ed starting at age 11. Meanwhile, a minister in the Church said that he has discussed venereal diseases openly for years, and in a separate report, a psychiatrist noted that "The clergy were more broad-minded than schoolmasters."

Three months without federal abstinence-only funding

The US had 3 months without abstinence-only funding on the books before the health reform law reinstated it: $50 million a year for 5 years for the states, the exact same level of state-level abstinence funding as in the previous administration, even though fewer states are applying for the funds. Even Alaska under Sarah Palin "missed the deadline" for abstinence grants in the last round. (No Sarah Palin jokes. Missing the deadline just seems to be the politically expedient method of not participating in abstinence funding.)

The difference between current funding and the previous administration seems to be $154 million: community organizations are no longer given abstinence grants ($141 million in 2009) and the Adolescent Family Life abstinence program is no longer listed in the budget ($13 million in 2009). Not funding AFL is surprising, and I wonder if I've missed something since that program has been funded consistently since the early 1980s, but I don't see in the 2011 HHS budget; this program generally flies under the radar and is usually not mentioned in media reports about abstinence education, even though organizations like Advocates for Youth track it.

The decrease in abstinence-only education funding from $204 million to $50 million represents additional good news: the $50 million is going to states who are scrutinized more heavily. For instance, some states have laws requiring that all sex education be medically accurate. On the other hand, increasing numbers of states require contraception to be taught in sex education, which may mean that even if the states wanted to apply for the abstinence funds, their state law mandates a curriculum that is incompatible with the abstinence education requirements. The a-h definition of abstinence education in the Title V is so restrictive that the only abstinence-only program that has ever been shown effective (Jemmott and Jemmott's research) could not be funded under Title V.

Another difference between the pre-2009 and current HHS budgets is that abstinence was featured prominently in the budget in 2009 and before. Many pages of the pre-2009 budgets mentioned abstinence, and there was a whole subsection describing all the sources of abstinence funding and their histories. The 2011 budget doesn't have any text about abstinence and only includes abstinence in the itemized totals, mostly for past years, and has "--" where future years of abstinence funding are supposed to be listed. (The new 50 million a year isn't yet listed in the 2011 budget.)

While the country had only the 3 month period between the zero-ing out of abstinence education at the end of December 2009 and the passage of the health reform bill at the end of March 2010, there's certainly a big shift.

The really interesting question is how many states will apply for abstinence funds, since more states now have comprehensive sex education laws that are incompatible with applying for the funds, and whether it would be possible for the a-h definition to be changed. Or if the $50 million will go only to the states with strong abstinence-only constituencies such as Louisiana and Texas.

Sex Education of the Weird

A recent News of the Weird had two pieces of news related to sex education, but the weirdest was in this Thursday's New York Times.

First, abstinence-only sex education was the explanation for a teen's harassment of women:

Sheriff's deputies in Austin, Texas, arrested Anthony Gigliotti, 17, after complaints that the teen was annoying women by following them around in public and snapping photographs of their clothed body parts. Gigliotti told one deputy that he needed the photos because the sex education at his Lake Travis High School was inadequate. [KXAN-TV (Austin), 2-2-10]

On the other hand, condom education isn't necessarily safe either:

Clumsy: Teacher Karen Hollander filed a lawsuit in November against the New York City Department of Education after taking a fall on "slippery foreign substances," including condoms, on the floor at the High School of Art & Design. Since schools distribute condoms on campus, she said, the department is responsible when students open them and discard them during the lunch period, littering the floor. [New York Daily News, 11-21-09]

The weirdest of all, however, was in the New York Times. In response to a new comprehensive sex education law that requires contraception education to be included in any sex education course, the district attorney of a county in Wisconsin "warned that teachers face 'possible criminal liability' for teaching youths how to use contraceptives."

As the GAO found, some fraction of abstinence-only education just isn't true. While well-intentioned, this prosecutor's warning is no exception.

Do teens consider oral sex to be sex?

A recent study finds that only 20% of a convenience sample of teens consider oral sex to be sex. This finding has been documented anecdotally, such as in the classic scene from the 1994 movie _Clerks_, where the main character is described to hear the discrepancy in his girlfriend's number of sexual partners and number of oral sex partners. (3 vs. 37.) He had only been told about the former.

Of course there's the caveat that this convenience sample has no implications about US teens' norms in general since the sample wasn't random.