Testimony for An Act Relative to Healthy Youth

JOINT COMMITTEE ON EDUCATION

***Testimony of Miriam R. Arbeit, M.A. in support of***

***H. 450/S. 209 An Act Relative to Healthy Youth***

May 14, 2013

Chairwoman Chang-Diaz, Chairwoman Peisch, and members of the Joint Committee on Education, I, Miriam R. Arbeit, am pleased to offer this testimony in support of H. 450/S. 209, An Act Relative to Healthy Youth.

I am a third-year doctoral student working on my Ph.D. in Child Development at Tufts University. As a youth development researcher, I enthusiastically commend the beneficial impact this bill would have on the youth and families of the Commonwealth.

An Act Relative to Healthy Youth is a critical legislative initiative that will help more young people have access to comprehensive, medically accurate, and age-appropriate sexual health education. It will also ensure that no young people are shamed or taught lies about their bodies and their choices while in public school.

In my research institute at Tufts, we study Positive Youth Development in diverse adolescents across the country, which means we see young people as resources to be developed, not as problems to be managed¹. This approach makes a vital difference when it comes to supporting adolescent health. For all of us – youth and adults – sex is an area of our lives that can be both positive and challenging – and, yes, even risky².  The best way to promote sexual health and address sexual risk is to talk about it. Sex education is a perfect opportunity for youth to develop skills like communication, healthy relationships, decision-making, planning, and critical thinking³. Such life skills can contribute to their positive development throughout adolescence and into adulthood⁴.

The power of this bill is that it sets meaningful standards for our schools. We don’t have to tell districts that they must include algebra in their math curricula, or that they cannot say triangles have five sides. But, unfortunately, we very much need to send these messages to districts regarding sex education: they cannot spread lies and they cannot omit vital information.

I used to be a health teacher in a Massachusetts school district. The health curriculum explicitly included sex ed and it was my job to teach HIV prevention to all of my students. But I was warned NOT to teach about homosexuality, condoms, or birth control, and not to discuss oral or anal sex.

How is anyone supposed to teach HIV prevention without discussing the life-saving potential of a correctly-used latex condom? How is anyone supposed to teach pregnancy prevention without discussing safe hormonal birth control methods and other medically available options? How is anyone supposed to promote sexual health without acknowledging the sexual world students already observe in the media every day^5,6?

I made a worksheet on the concept of consent. The goal was to establish the standard that when two people kiss each other or engage in other activities, it must be something they both want and agree to do.

I was reprimanded for making this worksheet and prohibited from discussing it with my students.

In 2011, 84% of high school students in the Commonwealth said they learned about HIV/AIDS in school and 49% said they learned how to use a condom⁷. That means that over one-third of our high school students learned about HIV without learning how to use condoms. What were they learning? There was nothing in place to protect those young people from the lies and shame that are too frequently invoked in the name of prevention. Such an approach leaves young people vulnerable to sexual coercion and more likely to have sex without protection^8,9.

It does not have to be this way. If schools provide sex education, we must require them to do it well.

We all agree that young people need quality education. And quality education includes medically-accurate, age-appropriate, comprehensive sexual health information. An Act Relative to Healthy Youth is one important step towards promoting the positive development of young people and helping them thrive in all areas of their lives.

Please Give a Favorable Report to An Act Relative to Healthy Youth

(H. 450/S. 209)

References

1. Lerner RM, Lerner JV, von Eye A, Bowers EP, Lewin-Bizan S. Individual and contextual bases of thriving in adolescence: a view of the issues. Journal of adolescence. 2011;34(6):1107–14. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22056088. Accessed June 13, 2012.

2. Tolman DL, McClelland SI. Normative Sexuality Development in Adolescence: A Decade in Review, 2000-2009. Journal of Research on Adolescence. 2011;21(1):242–255. Available at: http://doi.wiley.com/10.1111/j.1532-7795.2010.00726.x. Accessed March 8, 2013.

3. Kirby D. Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. The National Campaign to Prevent Teen and Unplanned Pregnancy; 2007:72–81. Available at: http://www.thenationalcampaign.org/EA2007/EA2007_full.pdf.

4. Lerner RM. Liberty: Thriving and civic engagement among American youth. Thousand Oaks, CA: SAGE Publications; 2004.

5. Kim JL, Sorsoli CL, Collins K, et al. From sex to sexuality: exposing the heterosexual script on primetime network television. Journal of sex research. 2007;44(2):145–57. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17599272.

6. Ward LM. Understanding the role of entertainment media in the sexual socialization of American youth: A review of empirical research. Developmental Review. 2003;23(3):347–388. Available at: http://linkinghub.elsevier.com/retrieve/pii/S0273229703000133. Accessed February 28, 2013.

7. Massachusetts Department of Elementary and Secondary Education. Health and Risk Behaviors of Massachusetts Youth. 2012;(May). Available at: http://www.doe.mass.edu/cnp/hprograms/yrbs/2011Report.pdf.

8. Fine MM, McClelland SI. Still Missing after All These Years. Harvard Educational Review. 2006;76(3):297–338.

9. Santelli J, Ott MA, Lyon M, et al. Abstinence and abstinence-only education: a review of U.S. policies and programs. The Journal of Adolescent Health. 2006;38(1):72–81. Available at: http://www.ncbi.nlm.nih.gov/pubmed/16387256. Accessed July 24, 2012. 

In Support of Effective Government

I am not protesting against the government. I am protesting in support of the government. I am in support of a government that works, one that does its job, one that takes care of the American people and demonstrates positive teamwork across the globe. I support President Obama, and I want to see this country’s administration doing its thing a little more. Let’s make change.

I support Occupy Wall Street because we are the 99 percent, and we want a better government.

In the fall of 2000, I was in 10th grade, and I learned that the government is not doing its job well, not supporting the American people in the ways in which they need support. I was a stellar student at a stellar suburban public school, told that if I worked hard I could achieve wonders. And I believed it, because I had the resources to help me and the people to encourage me. I read Savage Inequalities by Jonathan Kozol to do a book report, and my world changed. I read about other public schools, underfunded public schools, with run-down buildings, overcrowded and violent hallways, and classrooms in which tired and scared teachers struggled to teach hungry and traumatized students.

I was sold. I can fix this problem, I said to myself. I have found what I will do with my life. I love schools, and I love teaching, and I can help make all American public schools as great as mine.

Well, Jonathan Kozol and countless others had already spent decades trying to do the same, and they had not yet succeeded. The more I researched the issue and taught and tutored in urban public schools, the more I discovered classism, racism, financial crisis, financial restructuring, and what I consider a totally irresponsible government.

How did our government get away with spending money on corporations and war-waging when our schools needed that money for repairs, resources, curriculum, and teacher training? When our students were hungry? When our families needed health care, jobs, housing?

As someone passionate about education, I have done a lot of work in non-profit organizations. And yes, many of them are working to address inequities in education, and in other areas. But what I truly believe is that this work of ensuring high-quality education and providing high-quality health care and jobs and housing and food is the primary responsibility of an effective democratic government.

I quickly learned that I would not fix the system alone. It is too broken, in too many parts, and in such complex ways.

So I support Occupy Wall Street. Because I support the government. I support a government that is working for the 99 percent. We can do this work. I want to see the government take on this challenge. I want to see President Obama make this happen. I want to help make this happen.

Boston Teens Speak up for Sex Ed

This afternoon, Boston City Council's Committee on Women and Healthy Communities held a public hearing on a proposal to bring sexual health education and condom availability to Boston Public High Schools. Committee Chair Ayanna Pressley presided with eloquence and insight over the hearing this afternoon.

While I am happy to express the depth and breadth of my support for sexuality education and condom availability in the Boston public schools in future posts, for this post I will focus on what I experienced as the most powerful part of this afternoon's proceedings: the testimony from the teenagers themselves.

The Boston teens who spoke today totally stole the show, and rightly so. The teen activists from the Hyde Square Task Force have been leading this work all year. “Sexuality is a part of our lives,” said one teen, insisting that young people want to make responsible decisions but need the tools that will help them on the path. The teens advocated not just for condom availability but also for access to broadly comprehensive sex education. The teens named issues such as health, relationships, identity, power, and control.

Two teenagers from the Asian Task Force Against Domestic Violence also spoke. One said that sex education has the potential to help each student learn how to become a better person and a better partner. The other said that her last relationship had been unhealthy, but she did not know it until she had the opportunity to learn about healthy relationships through her involvement in this task force. Her story illustrates the importance of making this education available to all teens.

A representative from the Boston Student Advisory Council said that without sexuality education, students feel confused, and they feel they are not receiving the support they need from their school. She wants teenagers to learn about both the emotional and physical risks of sexual activity.

Two teens spoke for Massachusetts Asian and Pacific Islanders for Health (MAP for Health). The first teen scrolled through his Blackberry, reading aloud that students need an environment in which they can ask questions without judgment. When he finished, he reached across to pass the Blackberry to his fellow speaker. Lovely laughter flowed through the room. I felt it was a very sweet and humbling moment… The next teen was a bit flustered, but soon he started speaking and spoke eloquently. He emphasized that teachers need appropriate training in order to feel comfortable addressing issues of sexuality in the classroom. Therefore, he argued, Boston should invest in getting more teachers trained and certified to teach sexuality education. Both teens also made a plea for sexuality education that is fully inclusive of lesbian, gay, bisexual, transgender, and queer youth.

Many adults who work in various capacities to address the health and wellbeing of Boston youth also spoke with poise and insight, as did the Chair herself. But tonight, I am prioritizing the voices of the teens themselves, the people whose lives and whose friends’ lives can be changed for the better through the passage of this bill. Let’s listen to the voices of the teenagers, who organize their peers, educate themselves and others, and have the courage to speak at City Hall and ask that their right to education be fulfilled. These youth really want to be educated and equipped and responsible and healthy—we, the adults in power, now need to give them what they want.

Study Shows Intelligent Conversation with Caring Adults Helps Teenagers Make Healthy Decisions

Several people have asked me what I think of the study that found one abstinence-only program to be effective in delaying sex for middle school students. See coverage from the Washington Post, the Salt Lake Tribune, and the New York Times. Here’s my response:

• This study looked at the effectiveness of just one program. It's not a comprehensive study of what abstinence-only has come to mean in this country, meaning that we must not generalize the findings to abstinence-only education overall.

• The program studied did not follow the definition of abstinence-only under the guidelines for federal funding.:

o They taught students to be abstinent until ready to have sex -- not abstinence until marriage. They did not condemn sex outside of marriage.

o They discussed with students the pros and cons of deciding to have sex. This conversation can be useful and powerful -- and could not have occurred openly and honestly in federally-funded abstinence-only programs.

o The program was not sex negative and moralistic. Furthermore, they used only medically accurate information about condoms and contraception. Often, abstinence-only programs inaccurately present failure rates in order to discourage condom usage and scare students into feeling there is no such thing as safer sex.

All of these aspects of the program make it particularly hard to believe it in any way representative of what abstinence-only implies in practice.

• What did the control programs teach? The coverage reveals very little about the programs used for comparison. So-called comprehensive sex education can be fantastic — and can also be taught poorly and ineffectively, especially if taught for a study designed to disprove it. From news coverage, it seemed as if the control programs focused on teaching health information, with perhaps very little opportunities for discussion and emotional processing. If so, they do not represent the myriad of comprehensive sex education programs focused on supporting the development of social and emotional skills that can help teenagers stay healthy and safe.

• Let's take a step back and look at our goals in teaching sex education. The coverage cited growing rates of unwanted pregnancy and STIs among teenagers. Decreasing these rates is a public health priority. However, the results of this study showed that the program did not have any effect on frequency and consistency of condom use. To quote directly from the abstract of the study itself: “Abstinence-only intervention did not affect condom use.” What the coverage calls evidence of success is evidence that the program delayed the onset of sexual activity for a certain percentage of participants. But when these teenagers to start to have sex, they need to know how to use and learn about condoms and contraception. If they don't, they're at risk for the very same unwanted pregnancies and STIs that we need to prevent.

I don't want to discount the specific program studied per se; I do want to temper the myth that we now have scientific evidence in favor of abstinence-only education. We do not. What we might have, however, if we pursue this research further using responsible methods, is a demonstration of the power of training caring adults to facilitate intelligent conversations

A New Campaign in Boston

When multiple friends forward me the same news story, I figure I should write about it. Today's news is the latest sex ed campaign of the Boston Public Health Commission, which features a video on STIs and condoms to be played on YouTube and cable television. In addition, the campaign has its own Facebook page through which teenagers can comment and post questions.

Fantastic! I definitely want to meet the people behind this campaign. I've heard lots of talk about a growing desire to reach teenagers through technology. This campaign combines peer education, one of my favorite methods, with new ways of using the media. In particular, I'm interested to see how teenagers respond to the Facebook page, and whether they really do frequently ask cyber questions. I'm also glad that the large technological component of the campaign does not preclude in-person work -- teams will also perform street theater in Boston.

While I'm very pleased with the campaign, I'm not as pleased with the rhetoric used to explain the need for the campaign. The Boston Globe article cited teenagers’ age – “barely old enough to drive” – and their “casual attitudes about sex” as the reasons for increased STI rates. Can't we seek to support teenagers without such condescension? We must be able to explain our reasons for wanting to teach sex ed without putting down the very same people we need to empower.

One choice that did not seem to demand justification, however, was the selection of a featured video that focused on promoting condoms and STI screening and did not mention abstinence. Here's a question that I've been pondering for a while: Do sex educators in the field of public health have more political leeway than those of us in schools? No school committee writes the rules for the Boston Public Health Commission. And this funding was for preventing communicable disease, not for character education. If we can frame public school sex education in terms of these public health priorities, how would that affect the discourse around what we should and should not teach?

While sex education through cable and the Internet is exciting and chic, it cannot replace face-to-face conversation. The benefits of structure, space and relationship building will remain unique and powerful elements of school-based sex ed, in addition to and (hopefully) in conjunction with Facebook and YouTube.

Sex Ed before Text Ed

The New York Times fashion section ran a very telling feature this weekend on “The Birds and the Bees Text Line,” a North Carolina public health program. As cool as all this texting might seem, teenagers would gain a lot more from living in a society full of adults they could discuss these issues with face to face.

According to the article, North Carolina public schools must teach abstinence only sex ed (although the legislature is debating an endorsement of comprehensive sex ed). Meanwhile, as teen pregnancy and STIs remain a problem, the public health officials freak out and are forced outside the schools for answers because all the programs within the schools are doomed to failure by law. I've got to say it again: The state restricts sex education in the public schools, which is arguably the best possible means of educating teenagers, and consequently the state encounters a health crisis and pours money into a much less-than-ideal means of reaching the same teenagers whom the state also spends money on actively not reaching in sex ed class. Why can't they just spend money on providing effective education the first time around -- in class?

One of the teen texters said that before texting the hotline she had asked her question to her health teacher, but was made to “feel ashamed.” What if her health teacher had been empowered to provide comprehensive information, and had been trained to discuss touchy subjects without judgment? What if her health teacher had approached sex education with the same pro-health, pro-teen attitude with which the adult texters treat their anonymous questioners?

What if the government put money into ensuring that every public high school has a staff member who encourages teenagers to ask all their questions in person? Such a staff member could use the process of sex education as a means of developing teenagers and emotional and social understanding of sexuality. Such a staff member could start conversations that allow teenagers to act on the “longing to unburden themselves.” Such a staff member could build long-lasting relationships with teenagers who need more loving adults in their lives.

The staff members of the text-education line offer important support to the teenagers of North Carolina. However, the support they offer should be available face-to-face in the public schools. Teenagers deserve adults in their schools who help them ask anything they want to without feeling shame. Teenagers deserve adults who provide them with positive feedback, accurate information and helpful referrals in person.

I do think it would be really cool to continue exploring how technology can help us promote sexual health, but we can't do this without teenagers and adults engaging conversation, in person and explicit, at times challenging and at times awkward, but always caring, truthful and attentive to the teenagers’ spoken and unspoken needs. They may ask a lot over text, but they will never ask enough in those short lines. We need to be there in person to help them understand what they cannot yet put into words.