Dry Humping Saves Lives

Greetings to the teen pregnancy prevention community!

Congratulations are in order – the federal government is finally funding comprehensive sex education! I have my fingers crossed for those of you that submitted grants.

I’m writing to you all as a follow up to the communications workshop you attended. As you (hopefully) recall, I’ve been training the teen pregnancy prevention community be more attentive to and intentional with the language we use to talk about what we do. I am delighted that these trainings have been embraced by you all and thrilled to see changes in our framing and messaging, possibly due in some small part to my efforts.

You might have noticed that in using “teen pregnancy prevention” to define our community I’m ignoring the communications advice I’ve been delivering. Whether you heard it in my training or a conference or a lunchroom conversation, as of 2010 we have generally agreed to describe our issue and ourselves in positive, asset-driven terms (Hat tip: Karen Pittman!). More and more we hear “adolescent sexual health” or “adolescent reproductive health” used to replace “teen pregnancy prevention.” More and more, alliances and advocacy/training organizations are re-branding themselves away from the narrow health problem (teen pregnancy or AIDs). More and more, these same organizations are changing how they report on the issue – producing “sexual health reports” rather than “teen pregnancy reports.”

I’m using this old, unproductive language to make a point. I believe that in addition to re-framing the issue, we must address a gaping ethical hole in our approach to supporting the sexual health of youth. To use a very tired metaphor – we’ve started to talk the talk, but don’t seem ready to walk the walk.

I am not referring to the longstanding ethical debates that our advocates participate in at a policy level: abortion, minor’s consent or access to contraception and birth control. With these issues, we are clearly operating from a shared belief that young people have rights (This is, in and of itself seemingly controversial. The US still has not ratified the United Nations Rights of the Child) and policies pertaining to these rights should be shaped by what works in their (adolescents’) developmental context, not by personal perspectives or religious beliefs. Our community embraces a moral obligation to protect and defend these rights.

Rather, I am talking about our unwillingness to see adolescent sexuality as a positive thing in and of itself. When you consider the content of our conferences, the nature of our research inquiry, the priorities we use to make decisions about sex ed programming, the evaluation instruments we use ­– even how we define success, there is something essential is missing. To make this point, I’ve given this post a provocative title: Dry Humping Saves Lives.

I owe this title (and my personal illumination) to the young people at the Cascade AIDs Project. I met them at Oregon’s Adolescent Sexuality Conference. In the conference hall, among the booksellers, health care companies, universities and local tourist goodies, were youth selling their wares – including this button. I bought 10.

 This button uses a very clever marketing technique. Instead of a fairly unappealing product offer

Abstain from sex = Stay alive

it provides an incentive

Dry humping = Stay alive

Despite my appreciation of the button’s effectiveness, I know it will never play in prime time to public audiences (and isn’t intended to). This button is taboo. We don’t talk about dry humping in polite conversation, do we?

I immediately put the button on my bag. During my return trip to Minnesota I am in line at airport security; my bag sits next to a young woman’s backpack that is covered with adorable animal stickers. The security woman remarks “How cute!” while taking a minute to look. Naturally, she then must examine my lone button. She reads it. Blanches. Looks at me. I smile. She does not.

For all our attention to the rights and developmental needs of young people, the idea that sex is pleasurable, good and desirable is noticeably lacking. Do I need to remind you that the World Health Organization includes “pleasure” as an important part of sexual health? If our job is to promote and support the sexual health of young people, why do we ignore their sexual expressions, contexts and pleasure? What message does that send?

In some respects, this may be an ethical failure not entirely of our own creation. Teen pregnancy prevention is a political debate, polarized between “abstinence until marriage (Ab-Ed)” and “comprehensive sex education (CSE).” (Fairness in reporting: I acknowledge my personal affiliation with the latter.) The underlying concerns for each approach are similar (values, science, rights) and each side criticizes the other as having too much or too little focus in these areas. Both sides claim to represent a moderated approach. CSE proponents insist that they lead with abstinence messages. Ab-Ed proponents offer their own scientific evidence of effectiveness. CSE advocates are charged with ignoring the interests and concerns of parents, Ab-Ed advocates are accused of denying young people their human rights.

CSE employs a public health approach; an approach that prioritizes prevention strategies like the use of condoms and contraception. CSE is intended to address a health objective (to prevent teen pregnancy and STI transmission). Ab-Ed programming is also intended to prevent teen pregnancy, but because socially conservative legislators crafted the guidelines, the health approach is modified by a moralistic one. Ab-Ed programs are required to promote “the expected standard of human sexual activity” as “a mutually faithful monogamous relationship in the context of marriage.” I’m fairly confident that dry humping does not meet that standard.

We spend a lot of time and energy distinguishing between our “camps” by focusing on these differences. Yet we both share the same objective: the prevention of a health or moral risk. Both camps loudly proclaim this goal – our collective shouting amplifies the message that what young people need is protection from disease and health/moral risk. By framing the issue as problem prevention we neglect the context in which young people look at and think about their own sexuality and sexual experiences. We demonstrate a condom or demand a purity pledge. They want to know how to tell when they are in love.

Certainly, both sides attempt to engage in broader notions of sexual health on some level. Almost all sex ed covers the biological changes adolescents experience. CSE programming frequently includes content geared toward relationships, but when time is a commodity (and this is a major concern), our default position is to place contraception and birth control content as the priority. We justify our decision by claiming that communities at high risk (youth of color, youth in poverty, LGBTQ youth) must have this life-saving information. This creates another set of injustices because youth from privileged backgrounds (at lower risk) receive more content on development and relationship issues than do their less well off counterparts. It may never have been our intention, but we’ve made condoms our top priority and ultimate policy objective.

Ab-ed programming is equally problematic, despite its inherent focus on relationships (narrowly defined as they are). Funding requirements have traditionally not permitted the promotion of condoms or contraception, although data that references failure rates is included. The absence of prevention strategies (beyond abstinence) from Ab-Ed programs is another reason the CSE community places such importance on condoms and condom demonstrations; research has shown that it (coupled with abstinence messages) are critical to effectiveness.

Ab-ed programming is also criticized for presenting an exclusionary and judgmental perspective that sex is only appropriate in the context of marriage. That presents a small problem for LGBTQ youth, since marriage is not an option (except for those lucky few in Connecticut, Iowa, Massachusetts, New Hampshire, Vermont, and Washington, D.C). Further, many youth have single parents, thus the “no sex outside of marriage” message is at least conflicting if not entirely fictional. And it’s not just parents who are judged, since many youth who receive Ab-Ed programming have already had sex themselves.

In contrast, sexuality educators from the CSE community work hard not to judge or stigmatize young people (or their parents) for their sexual choices or identity. This virtue, in addition to our unrelenting focus on condoms, has helped feed the accusation that CSE proponents are endorsing adolescent sex and teaching young people how to have sex. We all know that nothing could be further from the truth (despite my suggestion that it should be).

The CSE community goes to great lengths to combat this public perception. Ironically, we have attempted to deflect it by demonstrating the common ground between CSE and Ab-Ed. Our talking points are well established.

1. CSE programming emphasizes abstinence as the only 100% certain way to void pregnancy or STIs. 
2. We don’t think young people should have sex, but since research shows that many do, they need to know how to protect themselves. 

In the process, we’ve created our own echo chamber where both CSE and Ab-Ed advocates declare that sex among young people is wrong and dangerous.

At the heart of our protestations is an uncomfortable truth: we believe sex education is the lesser of two evils. Really, we’d rather not have to show a young person how to use a condom, but it is far preferable to seeing that young person contract HIV.

I understand our compulsion to deflect these accusations. Despite our political win at the federal level, CSE advocates will continue to struggle – one school at a time – to ensure that young people receive sex education. While we might have embraced the lesser evil, many adults have not. Our advocates blame the vocal minority for defeating CSE programs in schools, but at a very basic level the idea of young people having sex (despite its prevalence) is problematic for many adults and most parents. Thus the majority, who likely endorse the “lesser evil,” remain silent.

Although CSE now has a dedicated federal funding stream, we still must contend with American attitudes about sex and sexuality –– including our own. Cognitive linguists have documented how Americans associate sexuality with an object that can easily be lost, stolen, tarnished or soiled, rather than as a core component of personhood. And we, CSE and Ab-Ed proponents alike, reinforce the belief that sex, particularly adolescent sex, is somehow wrong and inappropriate by continuing to make abstinence our lead message. As we’ve discussed in my workshop, the word “abstinence” frames sexuality in terms of restraint and denial; implicitly labeling sex as a sin or evil to be avoided, rather than as a natural, normal part of human development. I’m sure you all recall my recommendation that we “abstain from the word abstinence” in our literature, web sites, surveys, press releases, conference workshops and, most importantly, CSE curriculum.

You may also recall my insistence that we all have a responsibility to talk about sex: at the dinner table, grocery store check-out lane, and holiday party. I’m not asking us to share sexual practices or anything incredibly personal (unless that feels right to you). I am asking us to talk about the role sex plays in our lives, how it impacts our identity, how we view our gender, where it fits in relationships, how it is represented in the media, what we think of policies that pertain to it, how it changes over time, and so on.

In talking about it, we normalize it. By doing this, we counterbalance the sensationalized messages that permeate the media. We send the message that it is not a taboo subject, that it is a normal, integral part of our lives. A change in this social norm will minimize the pain and anxiety parents feel over “the talk,” boost acceptance of CSE (and other policies related to sex) and improve perceptions of young people over all. If these recommendations seemed radical, hold onto your hat. I’m about to up the ante.

I think we need to start talking about dry humping.

I would propose that to fully embrace “adolescent sexual health” as our goal we must re-vision our organizations, programs, policies and communications to that end. We’ve got to go beyond talking about sex by framing sex and sexuality as a positive. We’ve got to include pleasure in the mix. And we’ve got to infuse this orientation into everything we do. (Gulp.)

I’m not saying that the world is ready to discuss how dry humping saves lives. I am suggesting that we (members of the CSE community) must start to discuss and prioritize dry humping. Seeing and acting on the idea that sex is a positive, productive influence in our lives must become our ethical standard. To act virtuously will mean that:

• Our organizations will ensure that staff development of includes a deeper understanding of sex and sexuality. At a minimum we should all experience the Circles of Sexuality activity or participate in an OWL adult training seminar. Our conference will include break out sessions or speakers focused on sexuality and/or sexual pleasure.
• Staff will be hired, promoted, valued and evaluated based on their ability to understand and promote a positive view of sex and sexuality.
•  CSE programming will be restructured to prioritize the contextual content that describes what it means to be sexually healthy. We will go beyond negotiation and refusal skills to talk about relationships, identity, love, pleasure, power, gender, intimacy, development and pleasure. We will develop activities that engage young people with these topics in age-appropriate ways. Our sex educators will feel comfortable talking about hand holding and dry humping.
• When we cannot get our entire curriculum into a school, we will compromise neither the condom demonstration nor the sexual health content. Instead we will be creative about where the content is delivered and create new partnerships with churches, youth programs and the media.
• We will create a new way to evaluate what we do. Our researchers will embrace our new goal and shape measures that suit it. Our survey instruments will include more questions about assets and attitudes than health behaviors.

Of course, these are just my ideas, and I’m merely an ex-advertising executive who remains your biggest fan. You are the experts -- it will take your ideas and your actions to truly support the sexual health of young people. I hope to have at least provoked or inspired you to think about what dry humping saves lives means to us all.

Please tell me what you think! Your comments will make this blog post better. It’s confidential and you don’t even need to register. If you don’t have an immediate reaction to my accusation, rationale or recommendations, I’m curious to know:

• Have you started to talk about sex in social settings? How is it going? What’s working for you?
• Have you had any “sex positive” training or education? What resources can you recommend to others? 
• Have you had any luck introducing broader sexual health content into your programming? Where do you see innovation in this area?