Lynn Kusmin

3/15/2017
Period 05

Introduction and Rationale

I don't remember exactly how long the sex education portion of my summer health class lasted.
Three days, maybe? Four? Not long enough, certainly. What I do know was that on only one of those days
were lesbian, gay, bisexual, and transgender (LGBT) people mentioned, for perhaps an hour out of three,
and the extent of the information with which we were presented was the fact that LGBT people existed,
and that we shouldn't be bigoted towards them. Thanks, I remember thinking, I 'd figured that out myself,
oddly enough. Figuring things out myself was the way that I, as a queer person, had had to get most of my
sexual health information. Four years of health class with a unit on family life and human sexuality
each year had taught me nothing relevant about my own desires and the sexual experiences I was bound,
someday, to have.
This experience, and conversations with friends who had had similar experiences, raised some
questions in my mind, both about the specific sexual health information I did not have what is a dental
dam and what is my chance, as a queer woman, of contracting an STI via oral or manual intercourse
and about the experiences of other queer students with in-school sex education, and the experience, if
such a thing can be said to exist, of queer students with in-school sex education in general. And what
about heterosexual students? What did they learn in their sex education classes, and what questions did
they have about sexual health?
According to one study by trend forecasting agency J. Walter Thompson Innovation Group, only
forty-eight percent of youth aged thirteen to twenty identify as exclusively heterosexual, fewer than
ever before; over a third place themselves between a one and a five on the Kinsey scale, indicating at least
some degree of attraction to both their own and other genders (Brathwaite, 2016). The sexual education of
queer youth can no longer be considered a niche concern irrelevant to the sexual decision-making and
sexual health of young adults as a whole, and yet, if my own sexual education experience was in any way
representative of broader queer experiences, LGB students are still being excluded by even relatively
progressive curricula. Furthermore, even the exclusively heterosexual American teenage minority is
internationally at a disadvantage the rate of teen pregnancy in the United States is higher than in any
other developed nation, and rates of use of various forms of contraception are lower. Abstinence-only
(AOE) and abstinence-only-until-marriage (AOUM) sex education, proven less effective than their
comprehensive counterparts, are far more common here than in other industrialized countries. The costs
physical, mental, emotional, and even financial of poor teen sexual decision-making and the outcomes
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of teenage sexual risk behavior are monumental, but, in order to minimize them, we must first know what
is the exact cause of the abysmal sexual decision-making by American teens. This is only one small part
of that, but a vital one; in-school sex education is a central source of information for teens about sexual
health and sexual decision-making, and an examination of just how effective this particular source is at
preparing queer and heterosexual students to be sexually responsible adults would doubtless either reveal
the fundamental cause of the teenage sexual health crisis in America, or rule out one of the likeliest
suspects thereof, giving researchers a much better idea of where to focus their efforts (Guttmacher
Institute, 2016).
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Queer Youth and Sex Education

American sex education was originally designed in the early twentieth century to promote
proper sexual behavior, historically defined as sex only within the confines of monogamous
heterosexual marriage; therefore, it is no surprise that sex education programs do not frequently provide
queer youth with information relevant to their sexual desires and experiences (Elia & Eliason, 2010).
According to a 2001 study, Preventing Sexual Risk Behaviors Among Gay, Lesbian, and Bisexual
Adolescents: The Benefits of Gay-Sensitive HIV Instruction in Schools, only twenty percent of sex
education programs boast medium or high levels of gay-sensitivity, while fifty-six percent are either
minimally gay-sensitive or not gay-sensitive at all (Blake et al). What exactly gay-sensitivity entails for
the students, however, is unclear, as, while Blake's study found that ninety-eight percent of the teachers
who provided HIV instruction had taught their students about sexual orientation during the previous year,
[forty-eight percent] with 'some' or 'strong' emphasis, the Gay, Lesbian, and Straight Education
Network's (GLSEN) 2013 School Climate Survey reported that only five percent of LGBT students
received sex education which made mention of LGB sexualities. In addition, even the most progressive
and comprehensive guidelines for teaching students about queerness seem to do so through a
heteronormative lens: the Sexuality Information Education Council of the United States' (SIECUS) 2004
publication Guidelines for Comprehensive Sexuality Education: Kindergarten through 12th grade
recommends only that students be taught about the existence of LGB identities, the fact of their inherent
equality to heterosexual identity, and reality of anti-LGBT discrimination, rather than about the safer sex
practices LGB students themselves need to remain sexually healthy (Elia & Eliason, 2010).
Qualitative reports have similarly found that sex education overwhelmingly does not offer queer
students the information they need to make healthy and well-informed sexual decisions. In interviews
with young men who have sex with men (YMSM), one student described his abstinence-plus sex
education curricula as having covered puberty, heterosexual monogamous sex, actually let me clarify:
heterosexual, monogamous, penile vaginal sex they barely covered oral sex, barely covered [sexually
transmitted infection (STI) and sexually transmitted disease (STD)] infection; another said he could
have [learned more] in an adult bookstore than he did in his school-based sex education program (Pingel
et al, 2013; Elia & Eliason, 2010). Many young queer men have never even heard of anal sex until their
first sexual encounter with another man, often significantly older, and have no idea what precautions to
take in order to prevent pain and the contraction of STIs during intercourse (Pingel, et al, 2013; Kubicek
et al, 2010).
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The ignorance of queer youth with relation to their sexual behaviors described above logically has
ramifications for their sexual decision-making and, as follows, for their sexual health. LGB students were
anywhere between one and a half and three times more likely than heterosexual students overall to have
ever or recently had sexual intercourse, and to have used alcohol or drugs before last sexual intercourse;
they had also been, on average, younger at first sexual intercourse and less likely to use a condom at last
sexual intercourse, and to have had more lifetime sexual partners, than their heterosexual peers. Even in
schools with high levels of gay-sensitivity, which it must be remembered account for only seven percent
of schools, LGB students were still likelier than heterosexual students overall to have ever or recently had
sexual intercourse, and in schools with moderate levels of gay-sensitivity or below, LGB students were
worse off on all measures of sexual risk behavior than heterosexual ones (Blake et al). Consequentially,
LGB students were at more risk than straight students for negative outcomes of engagement in sexual
behavior. This is best shown through rates of HIV infection: men who have sex with men (MSM) account
for nearly two-thirds of new HIV infections in the United States each year, and among them, young men
between the ages of thirteen and twenty-four account for approximately two-thirds of those infections
(CDC, 2016; Pingel et al, 2013). Rates of having ever been or gotten someone pregnant were also higher
among LGB students than their heterosexual peers, with bisexual students at the highest risk for
experiencing this specific negative consequence of sexual intercourse (Blake et al, 2010; Tornello,
Riskind & Patterson, 2014).

Straight Youth and Sex Education

Unlike with queer students, for whom American sex education is, as established, overwhelmingly
unhelpful and irrelevant, the quality of sex education received by straight students in the United States
varies widely. This comparative efficacy, however, in no way suggests that heterosexual students are
effectively prepared by sex education for healthy and well-informed sexual decision-making, as sex
education is almost invariably taught from a traditional, conventional, conservative, and sex negative
perspective, and because, in comparison to other industrialized countries, the sexual health of American
youth is abysmal (Elia & Eliason, 2010; Advocates for Youth, 2011).
On the surface, the data regarding the presentation to straight students of relevant sexual health
information looks quite positive, particularly in comparison to the dismal data regarding queer students.
As of 2014, seventy-two percent of high schools in the United States reported teaching about pregnancy
prevention, and sixty-one percent about contraceptive efficacy; nearly sixty percent of students reported
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receiving instruction about birth control. Such information is frequently rendered ineffective, however, in
that it comes too late; only half of sexually experienced teens received instruction about contraception
before their sexual debut, while just under forty percent received practical instruction about where to get
birth control before initiating sex (Guttmacher Institute, 2016).
The effectiveness of specific sex education programs for heterosexual students, like the amount of
relevant information they receive, varies widely, and to some degree in conjunction with the
aforementioned. AOE and AOUM programs, which comprise approximately a third of all sex education
programs in the United States, tend to be the least effective, with either no impact or negative impact on
the sexual behaviors of youth and the negative consequences of those behaviors, and also to present the
least relevant information about sexual behaviors, sometimes going so far as to present students with
counterfactual information (Dailard, 2001; Levin, 2010; Kirby et al, 2007; Cianciotto & Cahill, 2003).
Even among more progressive and generally more effective comprehensive sex education (CSE)
programs, however, effectiveness varies widely. These programs, according to Douglas Kirby's
Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually
Transmitted Diseases, were about equally likely to delay initiation of sex, to reduce number of sexual
partners, and to increase condom use as to have no effect on these measures, and likelier than not to
reduce sexual risk behavior as measured by a composite of sexual activity and condom use, a criterion
correlated strongly with reduced rates of pregnancy and contraction of HIV and other STIs. It must be
noted, though, that not all of these measures are applicable to all teens enrolled in CSE programs; no
program, for example, can delay initiation of sex in a student who is already sexually active prior to their
enrollment in said program. Effectiveness was often conditional, although not always in so logical a way;
one program, for example, increased contraceptive use among sexually experienced females and lower
risk youths, but not among males or higher risk youths, while another increased use of contraception
among those who initiated intercourse after the program, but not among those who were sexually
experienced at pretest (Kirby et al, 1994).
The literature clearly shows that existing sex education can be effective for heterosexual youth;
the question that remains, of course, is how representative effective sex education programs are of
American sex education as a whole. According to one review published in Public Health Reports,
effective curricula for sex education share a variety of traits vital to their effectiveness, including a narrow
focus, a basis in completion of activities rather than a simple presentation of information, and a
commitment to the promotion of specific values (Kirby et al, 1994). Programs which do not fulfill these
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criteria are less likely to reduce sexual risk behavior and the negative consequences thereof among
heterosexual students; however, of hundreds of programs analyzed by the Center for Disease Control
(CDC), only five, in which the vast majority of American students are not enrolled, meet all of these
criteria (Levin, 2010).

Compounded Ineffectiveness
In-school sex education is not the only source of information about sex and sexual health that is
available to American youth; other sources include parents, peers, and the internet, the last of which is
utilized by anywhere between one and four fifths of students aged 13-18, depending on sexual orientation,
and considered the top source of sexual health information among nearly ninety percent youth aged 13-
24 (Kubicek et al, 2010; Mitchell et al, 2014; National Coalition for Sexual Health, 2013). Online
resources are therefore due substantial consideration in examining sex education in America, especially as
the link between ineffective sex education and use of the internet as a resource for sexual health
information is a strong one; as Mitchell, et al. write in Accessing Sexual Health Information Online:
Use, Motivations, and Consequences for Youth with Different Sexual Orientations, queer students, and,
at least to an extent, all students deprived of sexual health information in their sex education classes,
may be particularly likely to turn to the Internet because they lack access through traditional means.
The question that remains, of course, is, if American youth are supplementing their ineffective in-school
sex education with the nearly limitless sources of the internet, why their rates of sexual risk behavior
remain so high; the answer lies in the compounded ineffectiveness that comes about as a result of students
deprived of sexual health information in school using unreliable online sources in order to fill in the gaps
in their sexual knowledge.
Much of the sexual health information, such as it is, that students access online, comes in the
form of pornography. Pornographers do not make pornography for the purpose of realism or the
promotion of healthy sexual practices, and, in general, consumers of pornography do not consider those
qualities in their search for porn; according to one study of men who have sex with men (MSM), cost
and looks were the most important characteristics of [sexually explicit media (SEM)] to participants,
while condom use and sexual behaviors themselves were least important (Galos et al, 2013). The content
that young people receive from pornography is often biased in favor of kinky and even unhealthy or
unsafe sex; several of the YMSM interviewed by Kubicek et al. in In the Dark: Young Men's Stories of
Sexual Initiation in the Absence of Relevant Health Information reported learning only about kink and
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fetish activities, which some termed as the 'nasty stuff people do' (e.g., fisting, water sports, bestiality)
[and] 'dirty stuff, because they do dirty things, not healthy'. Despite this, another study found that the
majority of boys and nearly forty percent of girls believed that pornography was realistic, with obvious
negative implications for what students do with the information they acquire from pornographic content
(Martellozzo et al, 2016). Even the sexual health information which comes from more appropriately
educational sources than pornography, however, is not guaranteed to be reliable; although many students
reported valuing the perceived reliability of sources in their online search for sexual health information,
one study of such sources referenced in a Sex Res Social Policy study on YMSM found that there was no
correlation between the accuracy of information and the quality of the site defined by criteria such as
credibility of authors and date of last update (Pingel et al, 2013).
Admittedly, what students do with the sexual health information they seek online varies; almost
half do nothing at all, a quarter have a conversation with a family member or friend, and only about the
last quarter thereof take action based on the often-faulty information received; this is partially explained,
however, by the fact that about one-third of youth look for sexual health information because they are
curious, not because they have a particular or actionable concern (Mitchell et al, 2014). The
consequences of a inaccuracy-riddled base of knowledge about sexual health have not been studied and
are thus not known; however, it is likely that even among the three-quarters of students who do not take
immediate action with their newfound knowledge, the faults therein will have eventual repercussions for
the sexual health of said students and their future partners.
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