Abstract: The principles of sexual health education are not based on the hard sciences. Sex education is animated by a specific vision of how society must change, and because of this, sex ed curricula omit critical biological truths and endorse high-risk behaviors. The priority for SIECUS, Planned Parenthood, and Advocates for Youth is not the health and well-being of young people. These federally funded organizations are fighting “repression” and “intolerance,” not herpes or syphilis. But when sexual freedom reigns, sexual health suffers. Our children are being taught that you can play with fire, and we are obligated to inform them of the risks they face and to teach them biological truths, even when they are politically incorrect.

When I graduated from medical school, I took an oath. I stood up with my classmates, I raised my right hand, and I swore to prevent disease whenever I could. Now, many years later, I’m troubled by the obstacles that stand in my way. I’m not referring to threats like frivolous lawsuits or the Emanuel brothers’ vision for health care.[1] The issues that concern me come from within the professions of health and education.

The principles of sexual health education are not based on the hard sciences. They don’t rest on what’s seen under the microscope. Sex education is animated by a dream, a specific vision of how society must change, and because of this, sex ed curricula omit critical biological truths and endorse high-risk behaviors.

Three groups pay the highest price: girls, women, and men who have sex with other men. Not long ago, I spent my workdays like most of my colleagues: seeing patients and writing prescriptions, pretty much minding my own business. Then I noticed something. Coming through my office was a steady stream of students, most of them female, who were paying a high price for their sexual choices. I spent hundreds and hundreds of hours with these students, and they are the reason I’m here today.

I’d like to tell you about one of them. Stacy was a swimmer, an athlete who had been recruited to UCLA because of her accomplishments in high school. Her life changed drastically as a result of a single sexual encounter. She used to worry about mid-terms or her next swimming competition; now she was concerned about her abnormal pap smear. Instead of doing research for her thesis, she was Googling words like “dysplasia” and was online learning what to expect during a biopsy. She couldn’t believe this was happening to her. “I was so careful, Dr. Grossman. He said he was clean, and we used a condom.”

Now, for Stacy, staying in top physical condition was one of her priorities. She got up at 5 a.m. to swim laps, and she worked out for two hours every afternoon. She kept within a few pounds of her ideal weight, and, of course, she avoided alcohol and nicotine. But there she was at 18, infected with an incurable genital virus.

She hadn’t known that as a young woman, she’s more vulnerable to infection than her male partner. She was not aware that most men are asymptomatic carriers and that when they request routine testing, they’re not screened for the human papilloma virus the way girls are. Also unknown to her was that the HPV-16 that she had on her genitals, if the virus was in the mouth of her sexual partner, could years from now cause him to develop cancer in his throat.

Why these gaps in her knowledge? Why didn’t she know these risks? Why are so many young people unaware of the risks of their sexual behaviors?

You’re all familiar with the epidemics of STIs, sexually transmitted infections, in this country, but there’s another one. It’s a man-made one. It’s an epidemic of ignorance, misinformation, and duplicity.

If you go to the medical library and browse through the journals, you will learn some amazing things, such as a girl’s cervix is more easily infected by sexually transmitted infections than a woman’s because it has yet to mature. Boys and men don’t have a corresponding area of vulnerability in their reproductive system. The neurobiology of teen girls is unique, and it makes a girl’s developing brain more vulnerable to stress, especially the stress of failed relationships.

You’d learn that the adolescent brain functions differently from an adult’s. The area responsible for reasoning, suppression of impulses, and weighing the pros and cons of one’s decisions is not fully developed. Furthermore, under conditions that are intense, novel, and stimulating, teens’ decisions are more likely to be shortsighted and driven by emotion. You would discover that oral sex is associated with cancer of the tonsils and throat. The human papilloma virus infects those areas just like it does the cervix.

You’d find loads of articles—in fact, entire books— about oxytocin, a hormone that tells the brain, “You’re with someone special now; time to turn caution off and trust on; time to create an emotional bond.” In both sexes, oxytocin is released during cuddling and kissing and sexual touching, but estrogen ramps up the effects of oxytocin, and testosterone dampens them.

Speaking of the differences between male and female, there’s a distinct boy brain and girl brain eight weeks after conception. The boy brain is due to instructions carried on the Y chromosome. The Y chromosome was once considered to be a wasteland with minimal information. That was before we had the tools and the know-how to scrutinize DNA and to map out each twist and turn. Now we know the Y chromosome is teeming with information that is unique to males.

You’d learn also that the healthy vagina, due to its architecture and biology, is an unfriendly environment for HIV, while the rectum has cells that facilitate the entry of HIV directly into the lymphatic system. This and many, many more things have been known for years, but when you turn to sex ed curricula and, most disturbing, the Web sites that are suggested to young people and their parents, nothing: none of this information.

So there is a man-made epidemic of ignorance: ignorance of biological truths that should be central in any sex ed curriculum or parent education program. Awareness of these truths can save lives.

I put the responsibility for the epidemic of ignorance directly on those organizations that are at the helm of teaching sex education because, contrary to their claims and promises, their programs are not comprehensive; they are not science-based or medically accurate or up-to-date.

I’ll go even further: They are not about preventing disease. Sex ed is a social movement. Its goal is to change society. The primary goal of groups like SIECUS,[2] Planned Parenthood, and Advocates for Youth is to promote sexual freedom and to rid society of its Judeo–Christian taboos and restrictions. In this worldview, almost anything goes. Each individual makes his or her sexual choices; each person decides how much risk he or she is willing to take, and no judgments are allowed.

The science that is used is selective. If it challenges this model of human sexuality, if what’s seen under the microscope threatens this dream for society, it doesn’t exist.

These eminent groups deceive the public and endanger the health and well-being of our children. The list of their crimes is long. Duplicity is one: promising one thing and doing another. There are also sins of commission and omission. This afternoon, I can only give you examples of omission because the sins of commission—the detailed instructions, the language, the images—my sense of decency prevents me from sharing with you.

SIECUS

My first example comes from SIECUS. It takes different positions, depending on the audience. SIECUS guidelines say, “Parents ought to be a child’s primary sex educator. Comprehensive school-based sex education complements and augments the education children receive from their parents.” In a 2007 NPR interview, SIECUS’s director of public policy was asked, “You would agree that it would be best if kids didn’t have sex in high school. Am I right?” He didn’t hesitate: “Listen, absolutely. It’s better for young people to wait to have sex. There is no question about that.”

And here’s a statement that I printed off the SIECUS Web site two weeks ago. It says, “Support real sex education,” and it’s about the Responsible Education About Life Act, the REAL Act. It was introduced in the House. It’s intended to promote sex education that delays the onset of sexual intercourse, delays sexual activity; three times in this SIECUS document, they speak about delaying sexual activity.

So the lesson for parents and policymakers is that we want kids to wait just like parents. Kids get the same instruction at school as they do at home. Sex during adolescence is not a good idea. Relax, parents; we’re all on the same page.

But SIECUS’s message is different when they’re speaking to teens. Now the message is about sexual rights and the freedom to make one’s own decision at any age, regardless of what adults think. For example, when you log on to the SIECUS Web site, the first resource recommended to teens is called “Talk About Sex.” This pamphlet is distributed in schools to grades 9 and up.

I have read “Talk About Sex,” and in it there is no encouragement whatsoever to delay sexual behavior. It begins by informing kids that sexuality is a part of who you are and that everyone has their own way of expressing their sexuality. Then there are eight pages about sexual rights. Some quotes:

• “Every human being has basic rights. Still, adults may say and do say things that make young people feel they don’t have rights. It’s important for you to know your rights so that you can stand up for yourself when necessary.”
  
• “At every point in your life, you can choose if and how to express your sexuality.”
  
• “It is up to you to determine how much risk you are willing to take.”
  
• “Many teens choose to be sexually active, and many choose not to. You have the right to decide what behaviors, if any, you are comfortable participating in….”

On a Web site that’s recommended to teens by SIECUS, the former head of SIECUS’s board of directors tells teens, “The only way to know if you are gay or bisexual is to experience it and reflect carefully on the feelings that come up as a result of the experience.”

You see what I mean. This is about individual freedom. It’s not about working with parents to safeguard their child’s health and well-being. Parents are told by these organizations, SIECUS in particular, “You want us to put up a big red light that says, ‘Delay sexual behavior,’ and that’s exactly what we do.” But kids are told at every age, “You are sexual, and you have the right to express it in whatever way you wish.”

Where can kids go for help in advocating for their sexual rights? One site suggested by SIECUS is the American Civil Liberties Union.

Now, does this instruction complement and augment what teens hear at home? To the contrary, SIECUS undermines parents. It comes between parent and child. It seeks to inculcate beliefs that 90 percent of parents, at least, don’t share: that postponing sex is one option among many, and all are equally acceptable.

This is like a nutritionist saying, “There are many types of diets; a diet low in saturated fats, carbohydrates, and sugars will help avoid obesity and cardiac disease. Some people choose to follow this diet; others don’t. Every person has the right to decide what to eat.” And because SIECUS wants young people to be aware of all the choices available to them, it refers them to Web sites that describe behaviors that parents don’t even want their kids to know about, let alone try.

Like I said earlier, in the interest of decency and the civil society to which this fine center is dedicated, I will not describe these to you.

Planned Parenthood

Next, Planned Parenthood promises to educate parents about how to protect the health of loved ones, and it claims to have a comprehensive and commonsense approach. They have a feature on their Web site in which questions are submitted and answered by a board-certified OB–GYN who is also President of Medical Affairs at Planned Parenthood Federation of America.

One question came from a worried mom. At what age, she asked, should she take her daughter to the gynecologist? They’ve talked about menstruation and sex, but is it appropriate, she wonders, to start her on birth control when she starts her period? This mom gave birth at 16, and she’s scared to death, she writes, of her daughter going through the same thing. The girl in question is 12.

After providing the standard guidelines for timing of initial gynecologic exams, the Planned Parenthood expert explains that a young woman may want to consider taking hormonal birth control prior to becoming sexually active because there are benefits such as lighter periods and reduced acne. She’ll have those benefits and also be protected against pregnancy when that becomes a possibility.

She then told this mom that young women are often more comfortable with their own health care providers, their own gynecologists. She advised her to ask her daughter, “now that she is older,” if she wants her own nurse or doctor to take care of her, and the mom should respect whatever decision she makes. Young people, in addition, the doctor says, should be encouraged to have their visits with the health care provider in private, by themselves. They should be given every assurance that their confidences will be respected.

I’m going to deconstruct this. Here’s a 12-year-old whose mother is already thinking about birth control for her; that’s how worried she is about a teen pregnancy. Yes, the doctor says, birth control is something your daughter may want to consider when she begins to menstruate, but get your daughter her own health care provider, and during the appointment, Mom, you stay in the waiting room. Young women get to make their own decisions about their sexuality, and their privacy must be respected.

That’s the answer of a Planned Parenthood expert OB–GYN. There are so many disturbing aspects to this. One of them, of course, is the choice of words. The doctor keeps referring to “young women.” This girl is not even a teenager. What’s the rush?

Next is the assumption that this girl is going to be sexually active, as if it’s a done deal. Does Planned Parenthood believe it’s healthier for her to abstain, at least until after high school? If yes, why don’t they explain the benefits of waiting and arm her with strategies that can make a difference? Remember: This group promises to educate parents about how to protect the health of loved ones with a comprehensive and commonsense approach.

Naturally, given her experience, the mom’s concerns are understandable. She’s terrified that her daughter could end up a teen mom, and she wonders if birth control is the answer. What’s astonishing is that this doctor says, yes, it is. Why does she do that? Why does she automatically reach for a prescription pad?

At age 12, what this girl needs isn’t pills; it’s parenting. Planned Parenthood missed an opportunity to educate this mom about what is now known about parenting styles. There’s so much that this mom can do to keep her on track.

Recent studies overwhelmingly confirm that the impact of parents is profound. They demonstrate that good parenting has a significant, enduring, and protective influence on adolescent development. The mom who turned to Planned Parenthood needs to know which family factors and parenting style can deter risky behaviors, can moderate the influence of peers and optimize her daughter’s potential.

I suggest that a comprehensive and commonsense answer would sound like this: “I endorse you for being proactive and seeking advice on protecting your daughter. Rest assured that at 12, 14, and 16, your influence on her is greater than you imagine. What’s critical for your daughter is the parenting she receives. She’ll do best if you model good behavior and you’re warm, supportive, and hands-on. You need to establish firm rules and high expectations. Does your daughter’s father live at home? Teens from two-parent families are more likely to delay sexual activity. The research findings are robust. The longer a girl lives without her father in the home, the more likely she’ll engage in early sexual activity and experience a teen pregnancy.”

One study found that girls whose fathers lived outside the home from an early age were seven to eight times more likely to have a teen pregnancy. But even without her dad in the home, your attitude toward teen sex, Mom, and the rules you make about dating will influence your daughter to delay sexual behavior. Here’s the bottom line: Your daughter needs you and her father. Instead of visits to the gynecologist, schedule time together, just the two or three of you. Strengthen your connection with her. She wants a close and confidential relationship with you, not with her health care provider.

Speak about what you’ve learned from your own experiences, and communicate your values. They are at least as important as talking about contraceptives, if not more. Make sure that your daughter is certain about your values and expectations. These will impact her behavior. She may object, but studies show that high parental expectations are associated with postponing sex. If your disapproval of teen sex is absolutely clear, it can have a powerful effect on her behavior. A study based on data from almost 8,000 mother–teen pairs found that the more liberal teens think their mothers’ sexual opinions are, the more likely they are to have had sex, and the more sexual partners they are likely to have.

If you have religious beliefs about sex, Mom, you must convey those to your daughter, and even more protective is her devoutness. Sincere religious beliefs and practice in adolescence are inversely associated not only with teen sex, but with binge drinking, marijuana use, and cigarette smoking.

What about guilt? Guilt is a powerful variable; that is, if teens believe that teen sex is wrong, it does limit their behavior significantly. Sex educators are very big on removing sex from morality, and in doing so they remove the guilt factor, but parents should not be able to do so as long as the child understands it’s the timing of sex, not sex itself, that is the issue.

Monitor your daughter, know where she is, and know her friends and her activities. More unsupervised time with groups of peers and a member of the opposite sex is associated with sexual behavior. Do we really need studies to confirm that? Reduce your daughter’s opportunities for sexual encounters. You may want to consider enrolling her in a program that encourages abstinence. Some have a proven track record. For example, junior high and middle school–aged girls in the Best Friends Program here in Washington, D.C., are six and a half times less likely to have sex compared to their peers in other public schools.

The advice that Planned Parenthood provided this worried mother is not based on health. If this was about girls’ health, this is a perfect opportunity to discuss all those subjects I mentioned to you earlier—the teen cervix, the vulnerability, and so on— but Planned Parenthood’s advice comes from this notion of cradle-to-grave sexuality. It represents the height of irresponsibility. It’s contradicted by common sense as well as years of research.

Advocates for Youth

My third example is that of Advocates for Youth and their approach to gender. This past August, in the House of Representatives, there was an amendment that was passed to be added to the health reform bill. That amendment would grant $50 million to organizations that promote the type of sex education that I’ve described. In response to that, the president of Advocates for Youth stated that this move would bring science back into sex education.

I found that astonishing, because when you go to the Web sites of Advocates for Youth—and there are many; this is a very large organization that has a lot of resources—science is one thing that is missing. Advocates for Youth is telling kids that gender, the internal feeling of whether one is male or female, is completely separate from biology, from one’s anatomy and one’s chromosomes. It’s an internal feeling, they say. This goes back to the gender theory of John Money, a notorious psychologist from Johns Hopkins who introduced these radical ideas in the ’50s and ’60s. The idea again is that one’s identification of being male or female is a result of one’s internal feelings.

Advocates for Youth not only promotes this, but it tells kids that gender, being male or female, exists on a spectrum. Male and female are at the extreme ends of that spectrum, but it is a wide spectrum with many possibilities in between male and female. I want to make sure that you understand this, because there are a small number of people who have a disorder called gender identity disorder, and that is a real disorder in mental health, and they deserve our compassion and our understanding and our treatment.

But gender identity disorder is about Robert becoming Roberta, or the other way around. What Advocates for Youth is saying is that Robert does not become Roberta and Roberta does not become Robert, but that they become neither Robert nor Roberta; that there are many possibilities in between, and that the notion that we are all either male or female is a repressive ideology.

What they’re telling kids is that newborns are designated male or female, they’re wrapped in the blue or pink blanket, and then they’re socialized to fit cultural expectations. Messages from their environment teach them masculine or feminine behaviors, interests, and ways of relating. But when a boy insists he’s a girl or vice versa, that should not be a concern, says Advocates for Youth. It is, they claim, “as normal as being alive.”

The premise that there are only two genders, male or female, is inaccurate, they say. It restricts our freedom of gender expression. The idea that an individual must be one or the other, male or female, is an arbitrary, repressive paradigm. It’s another noxious “ism,” like sexism.

This organization that claims to bring science back into sex education teaches that gender can change. A 10-year-old might be certain she’s a girl, but at 20 she might realize she’s a man. People can realize their gender at any point in their lives, young people are told. Is this the “science” that they’re referring to? Or perhaps instructing children that they could be male, female, both, or neither is an example of the critical sexual health information they need to make responsible decisions about their lives.

This lesson on gender is not only unscientific; it’s a departure from reality. Here’s what real science in this century says about being male or female. Cell biology indicates that the Y chromosome is teeming with units of DNA that are unique to males. There are distinct male and female blueprints from the moment of conception. Embryology provides evidence of the earliest activity of those genes: Eight weeks after conception, when the embryo is the size of a kidney bean, the Y chromosome directs the testes to produce testosterone. The testosterone travels to the brain, enters the neurons, and propels the development of a distinct boy brain with smaller centers for communication, observation, and emotional processing and larger centers for sex and aggression.

Neurobiology maps out the complex and widespread differences in male and female brains. MRIs create color images that highlight distinct boy and girl patterns of thinking and feeling. Infant development reveals that at one day of age—presumably before children have been socialized to meet society’s expectations—girls show a stronger interest in the face, while boys look longer at a mobile. At one year, girls are drawn to a video of a face moving, and boys prefer the video of cars moving.

I love this one: The typical toy preferences of children are also found in juvenile monkeys. Females like dolls, and males prefer vehicles and balls. Sexual stereotypes in the animal kingdom? Male and female are culturally assigned? Gender is a feeling separate from hormones and chromosomes? I don’t think so. Advocates for Youth lesson plans are based on last century’s social movements and the wish to blur the distinctions between male and female. Anyone following this century’s hard science knows that those moth-eaten theories have been discredited.

But in sex ed class, these discoveries don’t exist. Students are being force-fed an ideology from 50 years ago: Gender is man-made, sex ed educators insist in 2009. Cultures teach what it means to be a man or a woman. Are they stuck in a time warp or just completely blinded by ideology? Either way, it spells disaster for young people.

Conclusion

I was told in a recent interview that I must be exaggerating: that it must be hyperbole when I say sex education is madness, that it teaches untruths and that it exposes our kids to smut. If that’s true, I was told, wouldn’t there be congressional hearings? I am not exaggerating: This is madness. The priority for SIECUS, Planned Parenthood, and Advocates for Youth is not the health and well-being of young people. These federally funded organizations are fighting “repression” and “intolerance,” not herpes or syphilis. To them, it appears the blisters and the warts, the worry and the depression, can be tolerated, but the “isms” must go.

From the thousands of hours I’ve spent with students, I can affirm that when sexual freedom reigns, sexual health suffers. Our kids are being taught that you can play with fire, and the waiting rooms of doctors and therapists are filled with people who’ve been burned, inside and out. Is every young person going to postpone sex? Of course not, but we are obligated to inform them of the risks they face and to teach them biological truths, even when they are politically incorrect.

The only power that I have to fight this calamity is the power of the pen. While the nation struggles over issues related to health and stands on the verge of supporting organizations like SIECUS with millions of tax dollars, it’s my hope that my message will reach the ears and the heart of someone with authority who will have the courage to stand up and put an end to this fiasco.

—Miriam Grossman, M.D., is a board-certified child, adolescent, and adult psychiatrist who writes and speaks to parents, students, educators, and health professionals internationally on the dangers of political correctness and incorrect science in her profession. She is the author of You’re Teaching My Child What?: A Physician Exposes the Lies of Sex Education and How They Harm Your Child and Unprotected: A Campus Psychiatrist Reveals How Political Correctness in Her Profession Endangers Every Student.