Making choices: educators and experts explain how leaders can re-evaluate their districts' sex education programs.

Back in the 1980s and early 1990s, boys and girls in sixth grade in Osseo Area Schools, Minn., learned the term masturbation. All fourth-graders learned about anatomy in mixed-gender classes and the definition of sexual intercourse. And junior high students learned methods to avoid the risk of HIV infection.

It was a comprehensive family life curriculum, considered a prime model of a comprehensive human sexuality and family life education, according to B.J. Anderson, then the curriculum and instruction specialist for the district.

About 10 years ago, when district leaders were updating the health curriculum, including family life and sex education, a phone call from one parent changed everything.

She asked Anderson how parents were involved in the process. Prior to adopting new materials the curriculum, Anderson told her, district leaders sent surveys to a random stratified sample of parents, asking them how they felt about what the district was teaching students at every grade level up to that point.

The parent claimed she never received the survey and pressed further. "She felt that parents weren't able to make decisions," Anderson recalls. "They were getting information but they were not involved in an active process."

From there, the floodgates opened. She and several other parents immersed themselves in the process. And what has resulted, years later, is a curriculum that gave parents of students in eighth and 10th grades choices: Now, parents choose between an abstinence--until-marriage track or an abstinence-based plus comprehensive sex education program. Students in K-6th grade have the same curriculum, but parents can have their child removed from any class if they object to the lessons.

Anderson claims the choices might not be the best or only way other districts should go, but she says it works for Osseo Area Schools, where about 20 percent of the students are black, 13 percent are Asian and 5 percent are Hispanic.

"What I quickly learned in this particular case was that when we work with ... people who live with absolute belief systems, they cannot compromise," Anderson says.

It's a prevalent issue in schools. The debate is about abstinence only versus comprehensive sex education. Middle ground appears intangible.

"This has been going on much longer than the evolution debate and it's much more contentious," says James Bogden, project director of the Safe and Healthy School Project at National Association of State Boards of Education. "Sex education in the schools has been controversial for 30 years.... Everyone agrees we should teach abstinence. The question is, is it the only thing we teach? The division of opinion is so profound. There is no such thing as compromise. You teach abstinence only or abstinence plus. You can't fudge it. Often many districts don't teach it.

The Abstinence Clearinghouse, which promotes abstinence until marriage, agrees there are only two paths. If youths are taught to wait to have sex until marriage, they shouldn't be learning in school how to use condoms, says Leslee Unrue, Abstinence Clearinghouse president and founder. Students will get confused with the mixed messages, she adds.

The History of Sex Ed

Sexuality education has been controversial since it began in the early 1900s when it was more about hygiene, says Martha Kempner, director of public information at Sexuality Information and Education Council of the U.S. In the early 1960s, the question became, Is sex education appropriate to teach in schools?

In the late 1980s, the AIDS epidemic threw a new twist in the debate now encouraging 34 states to teach students about HIV, STD and/or sex education. In the early 1990s, conservative and mainly Christian organizations focused on sex education, claiming the only way to prevent pregnancy and STDs is to stay abstinent until marriage, Kempner says.

"It's a distortion of the debate," she says. "It does make it look like it's 'either/or.' We tell [students] the best way to prevent teen pregnancy and STDs and HIV [is abstinence] but we feel you can't limit the information young people have. Our main criticism of abstinence-only is that [it] denies young people critical information."

And she adds that values on premarital sex are not universally held. One study led by sociologist Peter Bearman in the late 1990s found that teenagers who took abstinence pledges held off sexual activity by about 18 months, but those same youths--who also had fewer sexual partners than others who did not take abstinence pledges--were just as likely to have had an STD because they used condoms less.

Sex is, indeed, everywhere so children should learn about relationships and intimacy from parents, Kempner agrees. But schools also "have a job to teach kids to think critically and those skills are needed to be healthy throughout life," Kempner adds.

As Bogden and others agree many districts don't go by the book. Take South Carolina for example, which has a very progressive law on the books. "It sounds like a comprehensive sex education program yet that is not what is being promoted by the state education agency," Bogden says.

While the final curriculum your district adopts may differ depending on what part of the country your district is located in and what residents feel comfortable having taught in schools, there are some rules to follow when adoption takes place.

No state in the U.S. mandates abstinence-only programs, but the latest figures from NASBE show that 13 states mandate broad sex education while 34 states require that abstinence be stressed and 20 of those specify abstinence until marriage.

"The state with the strongest abstinence mandate is North Carolina," Bogden says. "It mandates abstinence only but does allow a district to pursue a process to have a more comprehensive program."

Thirty-one states allow parents to remove students from classes, or have an opt-out policy; three states require active parental permission, or opt-in policies, for classes that discuss certain sexual issues; and three states have variations of the two, according to NASBE.

Staying Local

Like NASBE, the National School Boards Association takes no position on the issue, but instead, leaves each district to decide its curriculum in the context of state standards and community values. "It's a local control issue," says Brenda Greene, NSBA's director of school health programs.

Like many states, Washington, New Mexico and Massachusetts, for example, have guidelines and curriculum frameworks of what a comprehensive sex education program, stressing abstinence, should look like, but do not require any district to adopt them.

New Mexico allows districts to teach sexuality in various courses, including science and social studies classes, if they want. If parents in a district want to handle sex education with their own children, they can work with districts on alternative lessons, according to Kris Meurer, director of school and family support bureau at the New Mexico Public Education Department.

Washington parents in a particular district concerned about the depth and content of a comprehensive sex program see what the school will teach and can opt out of it, according to Kim Schmanke, spokeswoman for the Washington State Board of Education. "We came up with accurate information about sexual health which was not about teaching them to have sex, but about reproductive health and knowing about their bodies and what they should do to maintain a healthy reproductive system," she says.

But Greene notes that there "isn't total agreement on what accurate and medically accurate mean [as] people interpret research in different ways."

Let's Talk About Sex

Officials must ensure the curriculum is factual, even if that's difficult to discern. Some untruths were exposed in a Heritage of Rhode Island program brought to the Pawtucket City School District two years ago, according to Joseph McNamara, health and wellness coordinator and director of Alternative Learning programs.

When the instructor from Heritage taught high school students, McNamara found that some materials were "inappropriate." It had students sign a pledge relating to staying abstinent until marriage. One piece of information explained something like appropriate ways for women and young girls to dress. It stopped immediately.

Now, the district is undergoing an overall reform movement, re-examining its curricula and looking to align health closely with the state framework for physical and health education. It's about making the district more accountable on every level. "If it meets the Rhode Island health standards and it's medically accurate, it would be suitable for use in public schools," Krieger says.

In Pawtucket, a curriculum committee of parents, teachers, department heads and administrators are meeting several times a year, and will have updated curriculum next spring.

Litigation Lessons

Lawsuits are a reality if officials don't include the public in building curriculum. Last year in Montgomery County, Md., Citizens for a Responsible Curriculum and the Parents and Friends of Ex-Gays and Gays challenged school officials when lessons about sexual orientation were to be added to the health education curriculum.

Just before the lessons were field tested in six Montgomery County Public Schools, the groups sued in federal court, where they were represented by the Liberty Council, a non-profit education and policy organization. The groups won a temporary restraining order, primarily by challenging the district's teacher resource materials.

The district withdrew the two lessons and settled the lawsuit.

Now the district is in the midst of developing new lessons to introduce sexual orientation in health classes in eighth and 10th grades and demonstrate the correct use of a condom, including a new video, in grade 10, says Brian Edwards, director of public information. The district is consulting with local medical professionals including physicians specializing in adolescent sexuality and health.

A newly appointed Citizens Advisory Committee on Family Life and Human Development is also consulting with district educators. The committee includes representatives of the plaintiffs in the settlement and the community including students, parents, and several physicians and health care professionals.

And then there is Berkeley, Calif., which might have programs that wouldn't work everywhere. Berkeley Unified School District has a state-of-the-art health center at Berkeley High School, where peer mentoring programs range from helping students deal with suicide to having students train other students on how to use condoms. At the "Condom Club," they also mentor them on making wise choices, impressing on students that having sex is a "serious" decision, according to Mark Coplan, a district spokesman.

Students who want condoms at the club go during lunch.

The health center has been praised as aiding the areas lowest teen pregnancy rate in the state, Coplan says. "Sophomores at Berkeley High are learning [in health class as well] the elements of safe sex and learning the elements of wise choices and decisions and learning that they have a choice and peer pressure is not something they have to fall for," he says.

Two months ago, however, a father challenged the health center's use of an advertisement on Berkeley High's daily announcements over the school's PA system that claimed, "Thinking about having sex? Come see us at lunch."

Coplan says administrators didn't want to look as if they were promoting sex and changed it to, "Interested in the Condom Club? Come see us."

A Few Good Ideas

Maybe students in Sioux Falls, S.D., aren't learning how to put on condoms, but they are learning about pregnancy prevention and contraceptives, according to Sandy Leonard, middle school curriculum coordinator at Sioux Falls School District.

The district was finalizing in June the sexual health materials for sixth through eighth graders' sexual health curriculum.

But it came after taking some lessons from parents.

The Curriculum Council, comprised of parents, K-12 teachers and administrators, decide the essential skills that become the roadmap for curriculum. Then they go to the Board of Education, which allows the Materials Selection Committee to consider materials that come from major publishers like Holt and McGraw Hill, as well as healthteacher.com.

Last fall, some parents questioned some materials and wanted abstinence stressed and defined, which is defined now as the practice of choosing not to be sexually active, Leonard says. Parents who have problems with the curriculum can file complaints with the assistant superintendent. In this case, the assistant superintendent suspended the curriculum, which meant the schools reverted to the former curriculum. So this past year has been about reviewing and revising the curriculum, Leonard says.

"Quite frankly, there were a few good suggestions" from parents, Leonard says.

Under the new program, students will learn that abstinence is the only 100 percent effective way to prevent STDs and pregnancy.

And now students in gender-like groups, not together, learn about male and female reproductive systems. If parents are uncomfortable with the curriculum, there is an opt-out policy so students don't attend class during that part of the health unit, Leonard says.

Giving Choice

But what seems to work best for Osseo Area Schools is the two-track human sexuality curriculum, where about a third to a half of all junior high students take abstinence-until-marriage programs and about a quarter of senior high students take it, according to Kathy Omberg, curriculum specialist.

"I think it works well," Omberg says. "Any time you give parents a choice they are happier than if there is only one direction you can go."

Since the early 1970s, the district taught a comprehensive family life education course, acknowledged by the Minnesota Department of Education as a stellar model. As part of the district's seven-year curriculum evaluation, the program was reviewed. Parent surveys asked them about the program that included anatomy taught in fourth grade, with boys and girls together, she says.

Before the curriculum team adopted new materials, such as videos and written material, Anderson got a call from the parent, pushing for more say in the program. It quickly moved to the administrative level and the school board halted the adoption of new materials until further review.

Multiple board meetings ensued and parents saw the lessons, Anderson says. "The parents wanted the materials to take home," she says. "At that point, they felt they wanted to not only be more involved but they wanted to make the decisions. It was kind of a very unusual time."

The school board developed a parent committee, with several teachers, that determined definitions and grade levels at which students would be taught certain topics.

Although Anderson supports more comprehensive education, she says schools need more parental involvement for balance. But she says there is a point at which language and definitions have to be fair and accurate. Right now, sixth graders learn sexual intercourse is when a husband and wife have sexual intercourse.

"At some point, you can't control for everyone the way you want to paint the world for your son or daughter," Anderson says.

When Omberg took over as curriculum specialist in 1998, the parent committee reported to the school board and recommended objectives in human sexuality by grade level. The two-track system starts in eighth grade.

Health will be coming up for reevaluation next year, Omberg says. "We'll look at research and trends in health education and perhaps even do some surveying of community members, kids and teachers of the current health curriculum and see what they think about it."

Talk and Get Input

Leonard's biggest tip to administrators re-evaluating their health curriculum is to understand the community. "We need communities and parents for kids to truly make choices that keep them healthy," says Leonard of Sioux Falls. "A nine-day unit is not supposed to be a magic silver bullet." Again, communication is key between parents and administrators.

"School officials want to be responsive to their communities--not dictated to by their communities," Greene of NSBA says.

Many districts have separate committees reviewing sex education. "You want to make sure you are looking at things in a comprehensive way, not just looking at what goes on in the classroom," Greene says. Are the school clubs and organizations in line with the district sex education program? What is going on in the health services center?

"Make sure you are communicating with those with expertise and opinions," she adds. Stakeholders involved can include health education teachers, staff from the health department, experts from the community such as Planned Parenthood, or a social service agency in the field. Experts from a local university, health care provider and even a family pediatrician could be helpful.

Enrue of Abstinence Clearinghouse agrees that parents need to be "on board" to feel comfortable. "Let the parent have an opt-out policy" that would also be seamless for the student, she advises.

Just the STATS

19 states mention contraceptives or condoms in health curriculum

13 states specify that instruction must be medically accurate

7 states address homosexuality

0 states mention oral or anal sex 

Source: National Association of School Boards of Education

Tips for Districts Re-Evaluating Programs:

* Create discussion groups, conduct surveys and poll parents and community members about what they want to address. Disclose what students are learning, what is being taught via Web sites or closed cable networks.

* Be open to other sides. "People had taken a side or position and came in fighting for that position." Osseo Area Schools' B.J. Anderson says. "Opening doors of choice is helpful."

* Use a school advisory council or board that includes parents and experts to share the best information

* Review standards for health education and the latest research.

* Look at the forthcoming Health Education Curriculum Assessment Tool from the federal Centers for Disease Control and Prevention. If the state has standards, align the curriculum to those and review any laws that require districts to teach one standard over another.

Feds Fund Abstinence Only

Three federal programs give funds to schools to promote abstinence-until-married programs. They are:

* Adolescent Family Life Act: A $13 million teenage pregnancy prevention program.

* 1996 Welfare Reform Act: Under Title 5, $50 million a year goes to states to fund such programs.

* Community-Based Abstinence Education: $115 million is sent to community-based organizations every year.

Groups can approach districts and say, "Hey, we will give you a program for free," says Martha Kempner, spokeswoman at Sexuality Information and Education Council of the U.S. " 'We have the curriculum and the teachers. You don't have to do anything.' ... It's really tempting for districts to take this."

Angela Pascopella is senior features editor.