by Christina Clark Okarmus and Meagan Lyle
The Alabama Campaign for Adolescent Sexual Health is committed to advancing comprehensive sex education for all youth. In 1999, we began as a group of dedicated community leaders concerned by the rise of unplanned teen pregnancy in our state. Upon diving into the research and listening to educators, parents, community leaders, and adolescents themselves, we realized that giving young people more agency over their health and family planning decisions requires much more than risk avoidance and abstinence-only education. Over the past two decades we have expanded our work to include STI/HIV prevention, consent communication and healthy relationships, anatomy and physiology, puberty and development, gender identity and expression, sexuality, and interpersonal violence prevention. These are the topics outlined in the National Sex Education Standards. Our name may be a mouthful and is often met with confusion and hesitation, but once we explain our work, we receive a lot of support. So why is it necessary to talk to young people about sexual health? What is included in sexual health curricula? We thought it would be helpful to outline the current reality in which young people come of age in Alabama. We’ll start with some data.
Whether we like it or not, young people are engaging in sexual activity. According to the Youth Risk Behavior Surveillance Survey (YRBSS 2021), 47% of 12th grade students in Alabama have had sexual intercourse (YRBSS is administered by the Alabama State Department of Education to high school students every two years). The same survey also highlights that 52% of sexually active high schoolers (grades 9-12) reported that they did not use a condom the last time they had sexual intercourse. Alongside consistently low rates of teen condom usage, Alabama ranks 4th in the country for highest reported gonorrhea cases, 5th in the country for highest teen birth rates, and 6th in the country for highest reported chlamydia cases, according to 2021 CDC data. Additionally, six cities in Alabama fall in the top 100 worst metro areas for STI transmission in the country: Birmingham, Tuscaloosa, Huntsville, Montgomery, Decatur, and Mobile. While condoms cannot provide absolute protection, laboratory and epidemiologic studies executed by the CDC show that “consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV” and many other STIs. The CDC’s School Health Profiles 2020 reports the percent of secondary schools (grades 6-8) in which teachers taught about the efficacy of condoms (9%), the importance of using condoms consistently and correctly (8.3%), and how to obtain condoms (6.9%) all fell below 10%. Only 51.2% of Alabama high schools are providing instruction on how to correctly use a condom in a required course according to the same report. Without medically accurate school instruction on this topic, where might students look for information about safer sex and healthy relationships? We know they are turning to their peers, older siblings, and online to get the information they seek. A report released this year from Common Sense Media found that 73% of teens under 17 years old have watched pornography online, either intentionally or accidentally, with some children having seen it by age 10 or younger. These online exposures can give young people a false impression of sexuality, safety, and intimate partnerships, especially when there isn’t a trusted adult they can talk to and ask questions of.
While some students in Alabama don’t receive sexual health education at all, many experience limited access to information that is delivered with fear-mongering tactics rooted in shame. In 2020, the Human Rights Watch did a qualitative report on the state of sexual health in Alabama. The report includes 45 interviews with young people between the ages of 14-26 from across the state who describe their experiences with sex ed. One participant states that her middle school ran a “three-day abstinence education program that culminated with ‘promise rings’ and an abstinence pledge. In high school, she learned the basics of anatomy and pregnancy in lessons that glossed over prevention and treatment of STIs and HIV.” Another student from Montevallo stated that their “instructor had boys in the class spit into a cup of water that she then compared to girls who have sex before marriage.” Another student expressed frustration that they “did not recognize how unhealthy [their high school relationship] was because there was no one that was able to discuss […] what a healthy relationship and sexual life looks like.” The testimonies continue like this throughout the report, illustrating how our current approach to sex education is harming students. The report matches other stories we hear from students and parents across the state, all of whom feel shame and embarrassment about their bodies, while remaining uninformed about the facts.
The statistics and stories cited above, and additional data found in the CDC’s latest School Health Profiles, suggest that young people desperately need age-appropriate and medically-accurate information and resources for maintaining sexual and reproductive health. Our mission is to advance comprehensive sexual health education because we believe that young people have the right to know about their bodies: how they work, how to communicate their needs and boundaries, how to listen to their friends and romantic partners, how to foster positive and affirming relationships and avoid abusive ones, and how to avoid risk of disease and unintended pregnancies. This is why we advocate for Alabama to institute a comprehensive sexual health mandate. Currently only 19% of lead health teachers at secondary schools in Alabama received professional development training on how to create a comfortable and safe learning environment for students receiving sexual health education in 2020. A mandate would ensure that funding would go toward implementing a comprehensive sexual health curriculum and training teachers on how to deliver the curriculum.
Sexual health education is common sense. Comprehensive sexual health education equips young people with the knowledge to make healthy choices for themselves. It includes abstinence as the only 100% guaranteed option for avoiding STIs and unintended pregnancy, but it also includes information on contraceptives, communication, and how to reduce risk for young people who are engaging in sexual behaviors. Research shows that affirming, inclusive, and comprehensive sexual health curriculum delays initiation of sexual intercourse, results in youth having fewer sexual partners, increases use of protection among youth (specifically condoms), decreases cervical cancer rates, and improves overall academic performance. By affirming and inclusive, we mean providing information that centers marginalized identities who are often ignored by the general school curriculum, including but not limited to: LGBTQ+ students, disabled students, low-income students, and non-white students. This could look like reading picture books about diverse family structures in the early years, or specifically talking about the gender spectrum and the spectrum of sexual orientation in later grades. This may be unfamiliar territory for many educators and parents in the South, but it is so vital – even life- saving – that we all try our best to understand, accept, and uplift different life experiences. Even if parents and educators make mistakes along the way, continuing to listen to students’ questions and concerns shows our young people that we love them for who they are.
You may still believe that parents are the people who should decide how to deliver this information to their own children. We agree that parents can be great sex educators and they need support in delivering this information. Perhaps it would be helpful to think of our own coming-of-age story. Who taught you about “the birds and the bees”? Did you feel comfortable asking questions? Do you feel like all the information you needed was provided? Did you feel prepared to enter a healthy, strong, communicative, romantic relationship in which you and your partner’s needs were met? Do you feel like you could have used some more guidance through the bumpier parts of relationships to prevent harm or hurt feelings? Those are the questions that the Alabama Campaign is doing our best to provide answers to so that parents can be the educators they want to be for their children. A large part of our work is focused on educating adults and parents on how to deliver medically accurate and age-appropriate information to young people in their lives. For those who are uncomfortable talking about this topic with their children, for those who would rather have their children learn elsewhere, we advocate for comprehensive sex education to be mandatory in all schools throughout Alabama and we are not alone. In 2017 we worked with the University of South Alabama to conduct a research study of how Alabama public school parents felt about sexual health education curricula being taught in schools. Of the 434 parents who completed the survey, 83% of parents “indicated sex education should be taught in the public school system.” Despite the support, many schools don’t provide this instruction. Alabama parents often reach out to us because they need resources to share with their children and they feel ill-equipped to start these conversations. If children are learning about sexual health at home and at school, then they have more perspectives and more information to educate their future decisions. If children are only receiving sex education at school, we better make that experience as informative, comprehensive, affirming, and respectful as possible.
Until Alabama adopts a sex education mandate, the Alabama Campaign will continue to work tirelessly to fill the gaps. We prepare young people through our Youth Advisory Council. We prepare parents, educators, and youth serving professionals on various comprehensive sexual health topics through in-person presentations and training, tabling at events, and our monthly webinar in which we host authors, medical professionals, sexual health educators, researchers, therapists, and more as guest speakers. We inform legislators and other key decision makers in this state by presenting them with data and research on the life-saving importance of sexual health education in Alabama. And we do all of this for a better future for Alabama’s young people.