Biden's nominee for assistant secretary of health at HHS, Dr. Rachel Levine, is historic. If confirmed by the Senate, Dr. Levine will become the highest-ranking openly transgender government official in U.S. history. As one of the key officials tackling the COVID-19 pandemic, she will have her hands full as she works to roll back harmful Trump-era health policies.
Among the Herculean tasks she faces is rebuilding sex education. Currently only 30 states require any sex education at all. Of those states that do, policies vary widely regarding what critical information should be included. Incredibly, only 17 states require that the program content be medically accurate. Only 20 require providing information on contraception.
Our children deserve better. In November, the citizens of Washington State voted to make sexuality education mandatory throughout the state, granting a parental “opt-out” allowance — far preferable to the “opt-in” rules that require parental permission before such subjects can be taught.
We need the content of sexuality education programs to follow science and evidence, not ideological agendas. That would be a big departure from the Trump administration, which radically reshaped the Teen Pregnancy Prevention (TPP) program, a national grant program that provides funding to organizations working to prevent teen pregnancy. Trump officials imposed an abstinence-only-until-marriage (AOUM) agenda which isn’t effective at preventing teen pregnancy and ignores the needs of LGTBQ+ youth.
The Biden administration can and should restore support for comprehensive sexuality education (CSE), an approach that goes beyond abstinence and safe sex to include discussion of sexual orientation, gender identification, and other health and sexuality topics. While CSE also teaches that abstinence is the best method for avoiding sexually transmitted infections (STIs) and unintended pregnancy, it does not assume that everyone will be abstinent until married. It helps young people navigate inconsistent cultural messages about sexuality and gender and encourages them to develop positive views of themselves and their relationships and health. It seeks to instill confidence, dignity, and respect for oneself.
CSE conversations between teachers and students address important questions that have real-world consequences for reproductive health outcomes, including teen pregnancy. How can students recognize and understand the development of feelings between themselves and others? What is safe and mutually acceptable physical contact between people, and at what ages? What is affirmative consent?
The U.S. is already lagging behind other industrialized countries in terms of sexual health outcomes. Our youth would benefit significantly from CSE. The framework is evidence-based and has been shown to reduce STIs among teens, increase contraceptive use among those who are sexually active, and decrease sexual health disparities among LGBTQ+ youth. Teens who receive CSE are 50 percent less likely to become pregnant compared to those who only received AOUM education.
It’s hard to argue with results like that. AOUM advocates claim that CSE encourages sex, but classroom discussions on contraception and sexual health, sexuality, relationships, and affirmative consent have not been shown to increase sexual activity among young people. On the contrary, the evidence is that CSE delays sexual debut among teens and can even decrease rates of sexual assault, as well as teen pregnancy. That ought to satisfy politicians on both sides of the aisle.
There is much Dr. Levine and the new Congress need to do to move past the unscientific, ineffective AOUM programs promoted by the Trump administration. Supporting CSE and ensuring that federal funding be redirected to evidence-based, inclusive education initiatives under the TPP program should be high on the list.
Bridget Kelly is research director of the Population Institute, a nonprofit based in Washington, D.C. that supports reproductive health and rights.