Sex Ed the Texas Way

Teenagers have a favorite word, one they deploy frequently. An easy way to ensure its arrival in conversation is to bring up sex education.

"The abstinence stuff is awkward," says a teenage girl, rolling her eyes. Whenever the teacher breaks it out in class, "everybody's laughing."

It's an overcast afternoon, and the girl is standing in a cluster of friends outside Skyline, a large public high school in Pleasant Grove. There are six teenagers in the circle, four girls and two guys. The girls are wearing track shorts and high ponytails; the guys are looking at the girls. With the exception of one shy girl, all of them say they've been sexually active for some time.

"I lost my purity ring at the club," one of the guys cracks.

"Mine's getting detailed," the other dude tosses back. They high-five.

"Abstinence ain't gonna help," another girl chimes in. "People lost it already. Most people are having sex."

At Skyline, there's a class specifically for pregnant students. "We call it the pregnancy pact," one of the girls explains. "They're shopping for their prom dresses with their bellies out like this." She pantomimes an enormous pregnant belly and winces dramatically.

This group all swears that they're good about using condoms. They buy them at the neighborhood Walgreens. As is the case for all Texas public schools, condoms can't be handed out during sex ed at Skyline. Many schools choose not to make condoms available at all.

"I'm always strapped," one of the dudes crows. The girls roll their eyes and groan in unison, then feint like they're going to walk away before quickly coming back.

Some of the Skyline teens have had sex ed during their health classes. Others haven't; their teachers felt too uncomfortable and skipped right over the subject, which they're allowed to do under state law.

"Or they talk about it real fast," one girl says. One teacher, who's also a track coach, dealt with the subject in one sentence: "Get pregnant and I'll whoop your ass."

This is the way sex ed looks in Texas, the way it's looked for years: Under the law, abstinence has to be taught as the first and best choice. Everything else — talking about contraception, disease prevention, even teaching sex ed at all — is strictly optional.

That may be about to change, at least in Dallas. A small group of Dallas Independent School District parents is determined to implement a better sex-education curriculum, replacing a current curriculum that's respectable in some spots but outdated or just plain weird in others.

This is still Texas, though. Standing in the way of those parents and their desire to keep their kids well-informed, non-pregnant and STD-free for just a little longer? Elected officials, state law, DISD's very cautious lawyers, cost and a little deceptive advertising from the organization who will likely take over sex ed in Dallas schools.

In other words: Before it gets better, it's gonna get awkward.

Premarital sex is like jumping off a bridge.

Premarital sex with a condom is like jumping off a bridge wearing elbow pads to cushion the fall.

Premarital sex is like a beautiful gold statue in the middle of the town square that turns a "putrid shade of green" after the townspeople manhandle it, each thinking just one little touch wouldn't hurt.

Your virginity is like a wrapped present. Try not to let too many people tear at the paper.

Premarital sex is like a frog slowly boiling alive in a pot of water.

Premarital sex, you've probably gathered, is like a bunch of awfully weird stuff, at least according to the sex education most students in Texas public schools receive, which by law must stress abstinence as the only acceptable choice for unmarried teens. Sex-ed classes have to devote more time to abstinence than any other behavior, emphasizing that it's the only "100 percent effective" way to prevent pregnancy, STDs and "the emotional trauma" caused by premarital sex. When condoms and other forms of contraception are discussed, teachers have to talk about their effectiveness in real life rather than "theoretical laboratory rates."

"Texas State students, you ought to see them," says David Wiley, a health education professor at Texas State University and a critic of abstinence-only sex ed. He marvels at some of the misconceptions his students lug to his classes — the male student who asked about his risk for cervical cancer, the female ones who "have no idea how" their own birth control works.

In 2009, Wiley and another professor reviewed sex-ed curricula across the state for the Texas Freedom Network, a left-leaning research and advocacy group. They found an astonishing variety of skits and teacher demos involving things like unwrapped, melting candy and leaky balloons. The skits were frequently paired with religious references, sexist assumptions about men and women, homophobia and a lot of fear-mongering about death and disease.

"They're high achievers, but their sexual knowledge is almost nonexistent," he says of his students. "They do not know anything, literally. These are college kids who have graduated high school and are upper-quarter kids. Middle-class kids. I mean, it's embarrassing. It is embarrassing."

Abstinence-only sex ed is a peculiarly American invention, built by religious and social conservatives starting around the late 1960s. Sex ed had been taught the old-fashioned way — with science — for the previous three decades when the most intense backlash began, led by groups like the Christian Crusade, an evangelical ministry in Oklahoma. In 1968, Dr. Gordon Drake wrote a pamphlet for the Christian Crusade called, alluringly, "Is the School House the Proper Place to Teach Raw Sex?" (Spoiler alert: He thought not.) The document called sex education a "giant Communist conspiracy," and warned that it served only to undermine the morals of American youth, infecting them with venereal disease and atheism.

The push was on to change sex ed into "no sex until marriage" ed. By 1981, under President Reagan, the federal government was pouring money into abstinence-only education. The programs gained an even stronger hold in 1996, under President Clinton's push to reform welfare. Congress thought fewer babies born out of wedlock would mean fewer people on welfare, so it created a $50 million-a-year stream of abstinence-only funding. In 2000, Congress created a special federal abstinence program that would allow states to get grant money for abstinence initiatives through Title V of the Social Security Act, usually reserved for maternal and child health programs.

President George W. Bush was especially bullish on abstinence, making campaign-trail promises to "elevate abstinence education from an afterthought to an urgent goal." After his re-election in 2004, he asked Congress to allocate more than $230 million for the programs. (They gave him a paltry $131 million.) At the same time, in a wild burst of optimism, the Bush Administration began promoting abstinence not just for teens but for unmarried twentysomethings. By 2008, federal abstinence funding had ballooned to $204 million.

Texas was among the first states to line up for the cash. As far back as 2002, advocates were using Texas as a case study for what not to do when it came to teaching sex ed: no discussion about condoms, HIV or disease prevention.

"In Texas, these programs don't just censor information, they actively promote misinformation about condoms," Rebecca Schleifer, an HIV/AIDS researcher at Human Rights Watch, said at the time. "And they deprive adolescents of one of the most important tools that they need to protect themselves from HIV."

As the other states would quickly realize, taking those tools out of the toolbox didn't work. In 2006, teenage pregnancy rates in the U.S. rose for the first time in decades. In 2007, Congressional researchers found elementary and middle school kids from abstinence-only sex-ed classes were just as likely to have sex in the next year as those who hadn't.

Texas' students proved especially unmoved by the movement. The state now ranks third in teen pregnancies, first in repeat teen births, sixth for gonorrhea among young women and ranks 12th for diagnosed HIV cases among teenagers.

The pregnancy rates aren't surprising: Several studies of Centers for Disease Control data have shown that states with abstinence-only sex ed have higher rates of teen pregnancy than those with more comprehensive programs. There's also evidence that abstinence-only programs deter the use of contraception, perhaps under the logic that it won't make much difference anyway.

With the damning data pouring in, many states began rejecting abstinence-only funding: In 2011, only about seven states applied to receive abstinence-only funds alone; the rest applied for what's known as a PREP grant, which requires states to also teach contraceptive use. By 2012, 15 states were taking no abstinence money at all.

The pregnancies and STDs have prompted some soul-searching in Texas. In 2011, Texas Freedom Network found "a quiet revolution underway in Texas school districts." While abstinence-only instruction remained the most common model, just over 25 percent of school districts reported using "abstinence-plus" sex ed: following the state mandate to emphasize abstinence but adding in basic information about contraception. That was up from about 4 percent a few years earlier.

But despite a few brave school districts deciding to try something that works, Texas' abstinence-only culture is still going strong. While other states have backed away from the funding, Texas' state health department received $5.4 million from the feds in 2010 alone. And it's got support from the very top: In an interview with the Texas Tribune that year, Governor Rick Perry was asked why Texas continued with abstinence-only education programs when they didn't seem to be working.

"Abstinence works," Perry said stolidly, to laughter from the audience. "It works. Maybe it's the way it's being taught, or the way it's — it's being applied out there. But the fact of the matter is it is the best form to teach our children." Despite some prompting, he couldn't give any statistics or evidence to back it up.

"I'm just gonna tell you from my own personal life," the governor said finally, emitting a nervous little chuckle. "Abstinence works."

Velouette Zavadil is in her mid-40s, with a long, curly brown braid slung over one shoulder. In the fight to inject some logic into sex ed, she's a bit of a dual threat: She's a pediatrician as well as a Dallas ISD parent. She also is one of the 25 or so who belong to the district's School Health Advisory Council, a committee of about 50 parents, administrators and community members that makes recommendations to the school board on health instruction. And she knows how badly that logic is needed.

"We have really high teen pregnancy rates, really high STD rates and one of the highest new-HIV rates in the country," Zavadil says. "We're clearly not doing a good job of educating our general population about how to keep themselves healthy."

Zavadil has two children, a 5-year-old and a younger child. She doesn't object to them being taught abstinence, per se: "If you say abstinence is the only 100-percent effective way of preventing pregnancy or STDs, that's true." But she wants that to be paired with accurate information about contraception and disease-prevention.

"How do we teach good decision-making?" she says. "In order to do that you have to provide comprehensive, accurate facts. You have to give accurate facts about STDs and all the options that are available for preventing them."

Which is why Zavadil and some cohorts — all members of the SHAC's small human growth and sexuality subcommittee — set out to do something about the state of the district's sex ed.

When Zavadil first looked at DISD's curriculum, she didn't think it was awful. "I'd probably be OK with my daughter being taught it," she says. "I'd be OK with it. But it could be better." She noticed that the graphics, statistics and some of the language about the differences between boys and girls were rather dated.

"We inherited it," Karen Burnell says of the current program. She's a coordinated school health specialist with Dallas ISD, one of the four people who make up the physical education department. Along with the department's director, Burnell has been guiding the SHAC through the process of choosing a new sex-ed curriculum.

No one's quite sure when or why the current sex-ed curriculum was adopted. The district health department theorizes that portions of it were written and implemented with some federal grant money that no longer exists, but they can't be sure. Wherever it came from, the curriculum seems freshly updated in spots — students are taught each year about sexual harassment, with language similar to what's in DISD's student handbook. But other lessons seem to be from another era entirely.

Basic sex ed starts in the fourth grade, with lessons on anatomy, peer pressure, boundary-setting and the meaning of sexual harassment. Messages about perceived, bizarrely stereotypical differences between girls and boys are also instilled early. A handout about puberty tells students that "even the slightest things can make a girl angry or sensitive to a situation." She also may "feel fine one minute and cry the next." Each of the six bullet points on girls, in fact, have to do with how totally moody they are. Boys, meanwhile, are encouraged to make close friends and not "keep all your feelings inside."

The word "condom" first appears in the seventh grade, in an illustrative little story about a girl named Jana whose boyfriend Lamar has been pressuring her for sex. One Saturday night, Lamar shows up with some condoms and tells her "that if she doesn't have sexual intercourse the relationship might be over." The seventh graders are asked to figure out how Jana can "refuse and keep the relationship."

Although HIV and AIDS are mentioned starting in grade school, it's not until high school that the curriculum mentions that using a condom might help avoid infection. The students are never actually told directly to use a condom to prevent HIV — that information is only available in the teacher training materials. Teachers are supposed to emphasize that condoms only work if they're used correctly each and every time, but teachers aren't required to show the students how.

There appears to be only one full lesson on contraception, to be administered sometime in high school. It's generally accurate, albeit brief, but does contain a number of outdated, incorrect assertions: that IUDs are not available for women who haven't given birth, and that the morning-after pill is "not available for general use" and is typically only used by rape victims. Both assertions have been untrue for at least five years.

Those are the things that Zavadil and Co. want to fix. And how hard could it be? If there's general agreement from the parents that more information on condoms is needed, that should be easy enough. Shouldn't it?

Not really. Even as the SHAC tries to swim a little further out into reality, that Texas undertow keeps dragging them back. A pair of bills in the State Legislature are pushing for an even more restrictive set of rules on what school districts can teach in sex ed. The legislation, by Representative Jeff Leach and Senator Ken Paxton, would prohibit "abortion providers and their affiliates from teaching sex education and/or providing family planning instruction in Texas schools." Parents would also be required to opt their kids in to sex ed, by signing a permission slip at least 14 days before any instruction. (DISD already does this, for reasons that are unclear; administrators say it's causing children to miss out on sex-ed instruction.)The bills are part of state lawmakers' ongoing assault on Planned Parenthood. The nonprofit provides some sex-ed materials to "a handful" of school districts in the state, says spokeswoman Sarah Wheat, and the material has to be approved by each district's SHAC. They're required by law to stress abstinence, like everyone else. But the hearing on Paxton's bill allowed anti-abortion activists ample room to air out some of their favorite conspiracy theories, ones the lawmakers seem to support.

"Abortion providers like Planned Parenthood and their affiliates can't possibly communicate this message effectively because of their inherent conflict of interest," a Round Rock mom named Renate Sims told legislators. Sims is frequently quoted in opposition to sex-ed legislation and in support of anti-abortion causes. When Sims learned that Round Rock's SHAC planned to recommend a lesson on contraception, she reportedly complained that the members had been improperly appointed. The SHAC was quickly dissolved and re-formed, with Sims as one of the first members. Round Rock is no longer planning to teach contraception.

"If teenagers consistently viewed sex as something to be saved for marriage, Planned Parenthood would lose abortion business," Sims testified.

It's not just lone parents proffering this "recruiting" theory — that Planned Parenthood is all but prowling the halls of area schools with an abortion sign-up sheet. Representative Leach has said his bill would keep the state from "funding abortion providers' recruiting efforts." In an interview, his chief of staff, Mary McLure, insists that Planned Parenthood is promoting abortion in school districts everywhere. "We've actually heard from districts across the state — I'm not going to list any specifically — that it's going on across the state," she says. "We do think it's going to increase and just get worse."

Nor is it just distant, dusty towns clinging to abstinence-only. It's an approach embedded so deeply in Texas' schooling culture that it's even used at Maya Angelou High School, DISD's school for pregnant teens.

"We say we're focusing on second-time abstinence," says Maya Angelou principal Cheryl Humphrey. "There's always an opportunity for you to start over."

Zach Thompson isn't the sort of guy you'd expect to find in the eye of a Fox News shit-storm: He's a mild-mannered, low-toned bureaucrat who usually operates safely under the radar.

But for the past few months, Thompson, the director of Dallas County Health and Human Services has been trying, as politely and diplomatically as possible, to let Dallas know that abstinence-only education needs to stop. Earlier this year, Thompson said publicly that Dallas County schools could slow their skyrocketing HIV and STD rates with two simple steps: teach clear, evidence-based sex ed, and distribute condoms. He even suggested handing out condoms in churches — "wherever the young people are."

That was immediately controversial, earning a scandalized write-up on ultra-right Breitbart.com that was later reprinted on Fox News' website. "There is little evidence to suggest that comprehensive sex education and taxpayer-provided contraception lowers either pregnancy rates or STD rates in other localities," Breitbart sniffed. There's actually lots of such evidence, starting with the entire state of California, whose teen pregnancy rates were the highest in the nation in 1992 but fell 52 percent between that year and 2005. Public health experts attribute the drop to the state refusing abstinence-only funding and building a comprehensive program instead, one that begins teaching about disease prevention in middle school.

"We've been abstinence-based only and not hearing the other part that needs to be discussed," Zach Thompson says. "And that's put us as at a disadvantage in the area of STDs, teen pregnancy and HIV rates going up."

For Thompson, this isn't an abstract problem. Dallas County has the worst rate of HIV in the state, with men who have sex with men accounting for 70 percent of the diagnoses. The infection rate hit a five-year high last year, with the biggest increases among people aged 13-24. And while the Texas Education Code explicitly prohibits handing out condoms "in connection with instruction relating to human sexuality," that doesn't mean schools can't give them out. Given the dismal rate of STD infections, Thompson believes they should.

"I'm advocating that parents and school districts look at the opportunity of passing out condoms at an appropriate location, if not at a class," he says. "The Texas Education Agency should re-look at condom distribution, allowing condom distribution in the schools. There should definitely be parent input and a designated location, so it would be confidential in nature. You're trying to break down a barrier."

It might also be necessary to mention homosexuality. DISD's current curriculum doesn't; in fact, it warns teachers not to discuss "topics about sexual behavior and orientation." If they choose to discuss homosexuality, it recommends bringing in a panel to discuss the "gay/sexual lifestyle." Other than that little nugget — plus a mention of anal sex as a "high risk" activity — gay and lesbian students are virtually invisible in DISD's current program.

Until recently, state law also didn't even allow school districts to talk about homosexuality, at least not in any sort of positive light. The Health and Safety Code still states that in addition to emphasizing abstinence, education programs must tell students that "homosexual conduct is not an acceptable lifestyle and is a criminal offense."

That's no longer true, and hasn't been for a decade, when the Supreme Court ruled that the law violated adults' rights to privacy and liberty. Yet numerous attempts by Democratic legislators to get the unenforceable law off the books have been unsuccessful. (They're trying again this year.)

The inconsistency seems primed to create confusion among districts about whether they're allowed to mention homosexuality or gay sex. Despite the fact that DISD is looking into new curriculum, there doesn't seem to be any plan to try to address the concerns of LGBT teens.

"We've had some discussions with DISD," says Cece Cox, the chief executive officer of Resource Center Dallas, a nonprofit serving LGBT people. "There is not, from what we can tell, any strategic approach to dealing with LGBT and questioning youth."

It's one of several areas where DISD officials try to make it clear they're following what they think the law requires because they have to, not because they want to.

"You have school districts over here, trying to deal with reality, and meanwhile, the Legislature is trying to pretend like they're still in the '50s," one frustrated DISD administrator says. "Ask Rick Perry what he thinks about discussing LGBT issues."

In a stuffy, fluorescent-lit room at DISD's Ross Avenue headquarters, something is happening, and it looks strangely like progress. Velouette Zavadil is sitting around a table with a few other SHAC members, including officials from the district's health department and Dallas County. Everyone looks relieved.

"I feel like we've found a really good program," Zavadil says. "How soon can we implement this?"

After months of work, Zavadil and the other SHAC members think they've found a curriculum to satisfy everybody. After presentations from several different sex-ed programs, they appear ready to recommend that the board buy Worth the Wait, a program from Scott & White Memorial Hospital in Temple, Texas. If approved by the board, the program will likely be implemented in the 2014-2015 school year.

Zavadil wants it sooner, but she accepts that there are logistical hurdles to clear: board approval, allocating the budget to pay for the program and, perhaps most basic of all, figuring out what it will cost. (No one seems to know that either.) She also wants the opt-in requirement removed, and for parents to have to actively bar their children from getting sex-ed instruction instead. During the meeting, she's told that opt-in is required under state law, which it isn't.

Zavadil was impressed with Worth the Wait, and with a presentation by its creator, Patricia Sulak, an OB-GYN and former PTA mom. Sulak, who's also a member of the Christian Medical & Dental Associations, has said that she "wanted to have nothing to do with sex ed" but created a program after being asked to help pick a new curriculum at her son's school and finding the options lacking. (Sulak was also at one time an advisory board member for the Medical Institute of Sexual Health, an official-sounding entity that in fact was founded by an evangelical Christian doctor in order to push abstinence.)

"Our program is about teenagers making healthy decisions," says Blair Murphy, a Worth the Wait program manager. "Historically, that's been sex ed, but now it's health risk factor avoidance — abstaining not just from sex, but from drug use, alcohol, et cetera."

Worth the Wait is in the process of changing its name to Wellness and Sexual Health, which is part of a broader shift away from just talking about abstinence. They say their program now focuses on "risk factor avoidance" in everything from drugs to sex to driving fast.

It's a transition that appears more practical than philosophical. As federal funding has waned, abstinence-only sex-ed organizations lost a lot of money in the past few years. Take Austin LifeGuard, a program written and administered by the anti-abortion crisis pregnancy center Austin LifeCare. After several profitable years, with annual revenues close to a million dollars, records show that between 2010 and 2011, Austin LifeCare suddenly lost half of its total revenue. The money that vanished had all previously come from grants and contributions. At the same time, the LifeGuard program was dropped by a number of school districts, including Austin ISD, in favor of a more comprehensive curriculum.

Which is probably why LifeGuard now insists that it's "abstinence-plus." In an email interview — the only format in which they would answer questions — LifeGuard director Corey Tabor said the program is based on "sexual risk avoidance," and includes "an age appropriate section on contraception in each of our presentations that communicates what contraceptives are and their effectiveness rates based on typical human usage."

LifeGuard remains far from "comprehensive," but it's now able to qualify for the same grant money as medically accurate programs, simply by mentioning that they don't believe condoms work. David Wiley, the Texas State professor, has seen a number of abstinence-only programs make the same change. They need to, in order to survive.

"When the Obama administration came in, they started promoting evidence-based programs and giving them money," he says. "So a lot of these abstinence-only programs funded under the Bush administration got nervous." When they did start covering condoms and other birth control, he says, all of them focused on "how much they fail."

"If Romney had been elected, abstinence-plus would still be abstinence-only," Wiley says.

Worth the Wait, the program being eyed by DISD, has undergone a similar makeover. These days, its website assures students that it wants to help them make "informed, educated decisions and smart life choices."

"We're not saying sex is bad!" it reads. "It is great at the right time and stage in your adult life."

It's an astonishing, and very recent, turnaround for the program. Although it's busily remaking itself as a totally rad, sex-positive enterprise, as late as 2010 Worth the Wait was a strictly abstinence-only program, with its own share of weird metaphors and bizarre skits. "They got onboard because they saw the money being cut off," Wiley says.

A 2002 report from Human Rights Watch faulted Worth the Wait for an especially misleading piece of their curriculum, which "compares pieces of latex condoms with plastic of different thicknesses." It was, the NGO argued, "designed to teach that condoms are not effective because they are thinner than many kinds of plastic, and easily broken by fingernails."

It was Worth the Wait that used that charming story about a beautiful golden statue. It turns a "putrid green," teachers are instructed to tell the students, after each townsperson thought that one little touch couldn't hurt.

"What each person thought was a harmless touch turned into the total destruction of a beautiful statue," the lesson reads. It goes on to liken statue-touching with sex: "Sex is special. When someone is able to save this gift for his/her wedding night, it is a gift that is irreplaceable. However, if a person has had numerous partners and numerous sexual encounters, sexual activity loses its special quality."

Worth the Wait was also the program that used frogs boiling alive as a metaphor for sex: "Getting involved in a physical relationship with someone can be like the pot of boiling water. First, you start kissing and then hands start roaming and then, oops! Sex just kind of happens!"

It also used intensely shaming language to subtly refer to those students who did have sex. The 2005 curriculum argued that "self-control, modesty, good judgment, courage, wisdom, and respect for self and others" were characteristics of an abstinent person. Students were encouraged to sign virginity pledges, which have been shown to do nothing to reduce teen pregnancy rates.

The 2008 curriculum, which the Observer reviewed in full, is full of sweeping, moralistic statements based in neither medicine nor science. Couples who live together before marriage "don't value one another." Teens who listen to "sexually degrading music," especially rap, are more likely to have sex, binge drink and smoke pot. Repeated casual sex outside of a relationship will lead to "the bonding process" becoming "distorted and damaged." Those same bonding problems, it claims, lead to marital difficulties and divorce in adults, as well as "the increase in depression and suicide in teens who are sexually active."

In other words, Worth the Wait — the 2008 version, at least — is hardly a model of modern science education. "The worst part is that it's one of the better abstinence-only programs out there," Wiley says.

Today, Blair Murphy says, the contraception section "is in accordance with the TEA." A review of Worth the Wait's contraception PowerPoint, from 2011, shows plenty of medically accurate information about birth control. But it also only refers to "safe sex" in sarcastic scare quotes, and promises students that "condoms cannot protect your feelings."

The goal of Worth the Wait is to get students to be "aware and empowered to say no," Murphy says. "And of course that complies with the goal to have them abstinent." As for addressing LGBT students, she says, "We don't really differentiate. Every person who's going to have sex is at risk. We're not saying this person or that person. Everybody's at risk."

Ultimately, it's hard to tell how much of Worth the Wait's new image is a sincere turn toward a more evidence-based approach, and how much of it is just savvy marketing. Murphy declined to provide a copy of its most current curriculum, and in fact the DISD committee that chose it hasn't even seen it. It was presented not with actual teaching materials but handouts that broadly summarized the curriculum.

One thing they made sure to mention: At the program's end, each student is still asked to sign what looks like an abstinence pledge. Now, though, it's referred to as a "Key to Succeed Pledge Card."

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