My phone rang more than usual yesterday, and my e-mails were filled with rallying cries. The reason? “Sex Ed in Washington,” a New York Times column by Ross Douthat.

Friends who know my history in sex education urged me to “write a letter to The New York Times,” “write an op-ed,” and “please just do something to answer him back.” In fact, one friend simply wrote, “GO GAL, GO!” (The last time I heard those words was over 12 years ago when I was at the 19-mile mark of the New York City Marathon.)

Not wanting to lose friendships, I’m taking up the challenge of refuting Douthat’s subtle attack on sex education. He pretty much damns most sex education programs currently practiced in the U.S., calls for the end to federal funding streams that support them, and suggests shifting responsibility for deciding their content to localities and states.

First, Douthat claims that while federally funded abstinence-only-until-marriage programs have not shown any positive results in reducing teen pregnancies, neither have what he calls “contraceptive-oriented programs.” Comprehensive sex ed programs teach both abstinence and contraception.

This is his “a pox on both your houses” argument. But I think it is clear that abstinence-only-until-marriage programs should bear the brunt of what is wrong with many current sexuality education programs in America.

The federal government has funded abstinence-only-until-marriage programs for almost 20 years and only awarded money to programs that adhered to a strict set of eight guidelines, one of which is to teach only the negative features about contraception.

Some 14 states—including California, New York, and New Jersey—refused to take any abstinence-only money for their public schools, because state education officials believed that these programs lack integrity and are not in young people’s best interests.

The U.S. still has the highest teen pregnancy rate of any Western industrialized nation. True, the rate has plummeted in the last decade—although rising again in the last two years—but researchers attribute the success more to comprehensive rather than abstinence-only programs and teens using contraceptives more consistently.

A half-billion dollars of taxpayer money has been spent on abstinence-only programs, and proponents have come up empty-handed when asked for research proving their programs’ effectiveness. Although comprehensive sex ed programs have never received federal funds and have had to rely on private research funding, prominent researcher Douglas Kirby, Ph.D., found that some programs that teach both abstinence and contraception are effective in reducing teen pregnancies, the number of sexual partners, and the onset of teen sex.

Douthat claims that what’s taught in the classroom takes second place to family values, culture, economics, parental examples, friends, after-school activities, and “the cross-cutting of wealth, health, and self-esteem.” He claims popular TV programs like MTV’s Teen Mom have a more profound effect on young people than what they learn in school.

This is a “throw up your hands and do nothing to improve school programs” argument. Of course young people’s sexual behavior is affected by out-of-school factors that school programs cannot totally overcome. Our kids grow up in the most sexualized society on the planet, and many adults are schizophrenic about sex. On the one hand, we use sex to sell every product in sight, and on the other hand, we refuse to give young people high-quality sex-ed programs that will help them make smart, responsible decisions. (This is not quite the case in New Jersey as in other states.)

Further, if students’ math scores are low, we don’t throw up our hands and toss the subject out of the curriculum. Instead, we convene experts to study the issue and implement their recommendations. We do our best to strengthen programs, because we understand that they’re vital to help young people succeed. Why can’t we do this for sex ed?

Douthat goes on to argue that Washington should no longer fund sex-ed programs, but if the federal government continues to do so, “the funds should be available to states and localities without any ideological strings attached.”

This is a “change the rules that we used to like” argument. Taxpayers have already spent over half a billion dollars to support failed abstinence-only-until marriage programs and not one single penny on what Douthat calls “contraceptive-oriented education” programs. Now is the time for us to look at the efficacy of a different type of program—one with proven success in reducing teen pregnancy.

President Obama’s budget and the House of Representatives’ version of the health care reform bill include funds for comprehensive sex education programs for the very first time in the nation’s history—and none for abstinence-only programs. Change is in the air, and abstinence-only folks are needy and greedy for more federal dollars.

Proponents of abstinence-only programs may be feeling bereft. I don’t blame them. Perhaps they will now experience the same feelings of exclusion that proponents of comprehensive programs have felt for years. But at the height of the abstinence-only movement, no columnist—or anyone else, if I remember correctly —suggested that Washington stop funding sex education programs, or that programs be competitive with “no ideological strings” attached.

As to Douthat’s suggestion that localities and states should make decisions about the content of sex-education programs, I don’t think this is the moment to turn all programs back to the states. Historically, local and statewide controversies have often kept young people from accessing life-saving health education.

Douthat claims that there are “competing visions of sexuality” in the U.S.: “permissive and traditional,” and that they will “probably be in conflict for generations to come.” In other words, it’s his “no common ground” argument.

Many in the media like to paint abstinence-only and comprehensive sex-ed supporters in black and white. They fan the flames of controversy by using words that Douthat uses, like “permissive” to describe those who support comprehensive sex ed programs, and “traditional” to describe those who favor abstinence-only. Guess who loses when words like “permissive” are used?

There is a sliver of common ground to stand on in this culture war. Any sex education program worth its salt should cover abstinence and provide correct information about contraception. Programs should be balanced. Abstinence, last I looked, is a very good form of protection from unplanned pregnancy and disease. It is not if you teach about it, but how you teach about it that counts. Scare tactics don’t work, but intelligent strategies do.

Unlike Douthat, I do not believe the sex-ed battles will continue forever. I am frankly tired of them and ready to extend an olive branch to abstinence-only supporters in the spirit of conciliation that President Obama urges us to foster. Perhaps together we can develop new programs that use sound research and will put the health and well being of our children and adolescents first. For starters, we should ask kids themselves what they want to learn about and when, since they often report that their sex ed programs are “too little, too late.”

No, Douthat’s column has not changed my mind about the importance of sex ed and what’s needed in the future. Thanks to my friends for urging me to write a rebuttal.

Happy Birthday, Susie!

Things were a little different in 1930. The US had 48 states, and a population of nearly 123,000,000. Milk cost 14 cents per quart, and bread, nine cents a loaf. But, to be honest, times were pretty hard then.

President Herbert Hoover was facing a national debt of $16 billion and skyrocketing unemployment as the Great Depression intensified. For those who were fortunate enough even to have a job, the average annual salary was $1,368.

In one very special way, however, 1930 was a pretty wonderful year. For on January 17^th, 1930, a sex ed heroine was born: Susan Neuberger Wilson. We at Answer would like to celebrate our dear friend by commandeering her blog today and sharing a bit about her amazing history and accomplishments with you.

Susie was raised in New York City, attended the Brearley School and then Vassar. She worked after college as an education reporter for Life magazine in New York where she met foreign correspondent, Donald Wilson, whom she later married.

Susie and Don moved to Washington, where he became President John F. Kennedy’s deputy press secretary and later the deputy director of the US Information Service. Susie’s close relationship with Robert and Ethel Kennedy had a significant impact on her, especially a trip she took with them in 1962 to some of the poorest parts of Asia. Susie returned fired up about taking action, and began tutoring lower-income children in Washington. She earned a master’s degree in early childhood education, and was instrumental in helping to start the first school for White House children.

Over 40 years ago, she and Don moved to Princeton, and Susie, a mother of three, remained active in childhood education. But 1978 became another significant milestone for her, when she was appointed to the New Jersey State Board of Education. Susie famously asked the commissioner of health at the time at what age he thought children needed to know how their bodies work. When he could not provide her with an answer, a sex ed force to be reckoned with was born.

Susie’s fight for age-appropriate, medically-accurate sexuality education in public schools opened her to vitriolic criticism from opponents to comprehensive sexuality education. Unfazed and determined, Susie continued the fight—and New Jersey is now a model state in the provision of comprehensive sexuality education in the United States. Susie devoted 23 years to the Network for Family Life Education, now Answer, as the executive coordinator, and remains extremely involved as our most trusted advisor. Susie’s passion extends far beyond sexuality education to women’s health and rights, and she continues to lobby legislators actively at the local, state and federal levels for their support. A brilliant, compelling writer, Susie’s blogs, Sex Ed Honestly and Sex Matters, never cease to make us think or challenge us to be better people.

Beyond her vastly impressive resume, Susie is also someone to be appreciated quite simply for who she is. Spending time with her is like enjoying a seven-course meal—each moment is to be appreciated slowly, has many layers to it and leaves one feeling sated for the time being but wanting more. Chances are Susie will begin her 80^th birthday as she does every other morning—by running six miles. My hope is that she will take some time out during this special day to reflect on the wide-reaching impact she has had on sexuality education and women’s rights for more people than I think she can even begin to imagine—just as I know that, rather than rest on her laurels, she has already begun her “to do” list for all the work she intends to accomplish in the decade to come!

Happy birthday, dearest Susie, with deepest gratitude from us all!

If you would like to leave Susie a birthday greeting, simply click here to register as a member of the Answer Web site and leave your comments.

Our state Senate could have made political and civil rights history in New Jersey this past Thursday—but it didn’t. It could have brought luster to our reputation as a progressive state that cares for all of its citizens—but it didn’t. It could have shown that a clear demarcation between church and state exists here—but it didn’t. It didn’t do any of these things, because Senate members defeated the same-sex marriage bill.

Instead of guaranteeing all its citizens the right to happiness, as stated in Article 1 of the State Constitution (”All persons…have certain natural and unalienable rights, among which [is] … obtaining … happiness”), a majority of senators gave in to the powerful impulse of fear of the unknown, fear of retribution at the polls by constituents, and acceptance of religious dogma to defeat the same-sex marriage bill.

For reasons beyond my understanding, 20 senators voted against the bill based on the general argument that “gay marriage would weaken the social fabric.” Only 14 voted for the bill, following Senate President Richard Codey’s prophetic words: “One day people will look back and say, ‘What were they thinking?’ and ‘What were they so afraid of?’ “

The day before the vote occurred-and with the rights and lives of so many New Jersey citizens hanging in the balance—I thought of the Democrat from Bergen County Senator Loretta Weinberg’s words: “[Senators] can’t be hesitant anymore … they have to come to the realization that we were elected to take sometimes difficult stands, but we were not elected to only worry about the next election.”

Weinberg’s words immediately reminded me of John F. Kennedy’s Pulitzer-Prize-winning book Profiles in Courage, which I hadn’t reread in years. I picked up a copy and leafed through it.

Kennedy presents his theme in the first chapter’s opening sentence: “This is a book about that most admirable of human virtues-courage.” Our late president is not speaking of physical courage. Rather, he speaks of “acts by men of integrity, who find it necessary, from time to time, to act contrary to public opinion” and “on national issues, on matters of conscience defying the angry power of the very constituents that control [their] future.” Kennedy applies this test to eight U.S. senators from different periods of American history and concludes that each passed it.

This book is not a polemic; it is nuanced, thoughtful, and balanced. Kennedy understands the tug of war that most politicians engage in to balance the views of opposing constituents. He mentions the specific pressures that most politicians face: the desire to be liked, the desire to be re-elected, the conflicting demands of constituents, the requirements of party obligations, and the inherent tensions between serving both state and national interests.

Kennedy writes eloquently about the need for politicians to compromise on issues, but not on principles, and to put national interests ahead of state ones at critical moments. He admits that beyond those he writes about “only the very courageous will be able to take the hard and unpopular decisions necessary for survival in the struggle.” He suggests that politicians are reluctant to show political courage, because they have too little faith in the people and need to have greater faith in them-because trust in their power is the essence of democracy.

Kennedy knew that political courage comes with a price. Most of the eight courageous U.S. senators he profiled endured “risks to their careers, the unpopularity of their courses, the defamation of their characters, and sometimes, but sadly only sometimes, the vindication of their reputations and their principles.”

Certainly the political courage it takes to vote in favor of same-sex marriage never entered Kennedy’s mind as he wrote his classic work. Yet I believe that had he been alive today, Kennedy would have sent this message to the state senators as they prepared to vote: “The nation is watching what you do. Act in behalf of its highest ideals and values and not necessarily in behalf of the citizens in your own legislative district, or even the entire state of New Jersey.”

He might also have used these words from the Declaration of Independence to reinforce his point: “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness.”

When talking to senators about why they planned to support or opposes same-sex marriage, I heard only the most parochial and personal reasons. I never heard any reference to the Constitution of New Jersey or the Declaration of Independence. No one mentioned “the right to happiness” of all citizens regardless of their sexual orientation.

Happiness for many gay and lesbian couples means the ability to marry. If most citizens believe in the concept of marital happiness, then how can those who can marry deprive others of the same right to seek happiness through this institution?

I wish more of our senators had reread (or at least skimmed) Profiles in Courage before they voted last Thursday. Perhaps it would have helped them understand the meaning of political courage in our society and how their vote affected not only people in their own district, but in the nation and even across the world. Perhaps it would have inspired them to seek a larger vision for our society-one based on the right of all people to find happiness.

If they had had the time to reread Profiles in Courage, perhaps last Thursday’s outcome might have been different.

In the final passages of the book, Kennedy includes a message that applies not only to politicians, but to all of us:

“To be courageous … requires no exceptional qualifications, no magic formula, no special combination of time, place, and circumstances. It is an opportunity that sooner or later is presented to us all.”

Dear Parents:

I don’t believe that you can find any more excuses to not talk about sex with your preteen and teenage children. Tiger Woods—by committing serial infidelity and having his appalling sexual behavior splashed all over the media—has handed you the perfect opportunity to talk about sex with your children, draw lessons, and offer your opinions and values about the scandal.

This opportunity is almost too good to be true. Who would have thought that Tiger—the seemingly perfect American Idol and man of impeccable morals—would help parents break the ice about sex, a topic they often avoid. Well, Tiger’s transgressions have given you a great chance to finally have “the Big Talk,” and also talk with your children about what constitutes really bad behavior by a husband and father.

I know that many fathers—and mothers to a lesser degree—may have knees of jelly and suffer from mouth-stuck-to-the-palate syndrome when they know that the subject is sex. But this conversation does not have to be about the S word. It should primarily be about the V word: Values. This may make it an easier conversation than you think, but talking about values with your children also requires courage.

I learned the importance of the V word in conversations about sexuality from Richard Cross, a wonderful medical doctor, professor, and sex educator who lived in Princeton until his death some years ago. Dick, who specialized in community medicine, had a distinguished career as a professor at the UMDNJ-Robert Wood Johnson Medical School in New Brunswick. He believed that all conversations about sex should include discussions about personal and societal values and not only focus on the clinical aspects of sex.

One of Dick’s claims to fame was the development of the first-ever sex education course for medical students and other health professionals offered as part of a medical school curriculum. Still called Sex Week at UMDNJ in New Brunswick, it remains an annual 40-hour course to “prepare students—regardless of their planned specialty—to deal with patients’ sexual concerns and…how to take a patient’s sexual history.” During Sex Week, students met in small groups and spent a lot of time discussing their values about the topic.

Dick would probably smile to know that I am pairing him with Tiger Woods since, to the best of my knowledge, I never saw him with a golf club in his hand. But I think he would endorse the idea that the golfer’s sudden free-fall from grace offers a great moment to discuss such values as honesty, respect, faithfulness, loyalty, trust, and love.

I believe Dick would want to tell you, as parents, to be completely honest and tell your children the truth about Tiger Woods’ behavior: Tiger Woods—a married man and the father of two young children—had a series of sexual affairs with a surprisingly large number of single women almost from the beginning of his marriage. Of course, Dick would say that parents should be prepared to answer their children’s specific questions, including “what is sexual intercourse?” and “what is an affair?”

Dick would also recommend that you say how you feel about Tiger’s infidelity and dishonesty. This requires getting your own values straight about sexual behavior within and outside of marriage. Here’s a father-and-son scenario that helps make my points:

Son (who is around 10 to 12 years old): Dad, what’s a cheetah?

Father: A cheetah is a wild animal, like a leopard or tiger. Why do you ask?

Son: Well, some guys at school were talking about a newspaper headline that said, “Tiger is a Cheetah.” I think the Tiger they meant is Tiger Woods.

Father: Yes, the use of the word “cheetah” is a play on words; what they mean is that Tiger is a “cheater.” It is spelled differently.

Son: So, Tiger Woods is a “cheater” the way someone who plays football or any sport can cheat during a game? How did he cheat at golf?

Father: Tiger Woods didn’t cheat at golf. He cheated on his wife, Elin, by having affairs with other women while he and Elin were married.

Son: What does “having affairs” mean?

Father: In Tiger Woods’ situation, having affairs means that he was having sex with women other than his wife. We call this “extra-marital” sex, or sex outside of marriage. When Tiger got married, he most likely took a vow to remain faithful to his wife, which meant that he promised not to have sexual intercourse with any other woman. He was unfaithful to her.

Son: When you married Mom, did you take the same kind of vow?

Father: Yes, I did. Your mom took the same vow saying that she was going to remain sexually faithful to me during our marriage, and I vowed to remain sexually faithful to her. Most of your friends’ parents took the same vows when they got married. Sadly, some adults do not remain faithful to their partners, despite the words that they say to each other. Tiger is definitely one of these people.

Son: How do you feel about Tiger Woods now, since he had affairs with other women?

Father: I still admire his prowess at golf. He is and probably may always be the best golfer in history. But I do not approve of his behavior at all and am disappointed by his lack of honesty and fidelity to his wife and his lack of respect for his little children and his marriage vows. Since I believe that a person’s character and values are as important as his or her accomplishments in life, I shall never have the same respect for Tiger Woods I once had. He is no longer a hero to me.

Son: I think I’ve got it straight. Thanks, Dad.

Father: We’ll talk more over the coming years about values, like honesty, respect, caring, love, and responsibility. But it makes me feel good to know that you can ask me tough questions about subjects like sex. Anytime you have another question, I will do my best to answer it.

Ideally, Dads and Moms should bring up Tiger Woods before their kids do. His story cannot be avoided: it’s on the cover of every magazine, and he’s the endless subject for commentators on cable news networks, late-night talk shows, and the Internet. Your kids must be itching to talk about Tiger, and have their questions answered and confusion wiped away.

I don’t think that Tiger’s behavior, reprehensible as it is, should be the only aspect of the scandal in family discussions. The women who had sex with Tiger were not, by and large, innocent bystanders. They were part of the problem, and they caused pain and suffering by their willingness to have affairs with Woods.

They strike me as women who hunger for celebrity and money. Some were naive to think that Tiger might leave his wife and small children for them, and some fancied he was in love with them, even though he was recently married. I found their stories and denials on the talk shows disheartening, even pathetic. They had so little self-esteem. Why, I wondered, couldn’t one of them have said no to Tiger and sent him packing? If you have teen daughters, you need to talk about why these women were so needy and willing to do whatever Tiger asked.

The Tiger Woods story is the surprising holiday gift of the year. It can help us all think more deeply about our values and sexual behavior. Perhaps if Tiger had had the chance to talk and think deeply about sex and values earlier in his life, things might have gone differently for him.

Best wishes, parents, and let me know how your discussions go. Happy new year, too.

Sincerely,

Susie

Some women like to go shopping when they want a break from their busy lives; others like to lunch. Not me. I like to lobby. In particular, I like to lobby my Congressional representatives in Washington, D.C., on causes I care about.

I love the give and take of reasonable argument and discussion; I like learning facts; I like testing my ideas; I like to plant the seed of change in another person’s mind or heart; I like to understand the reasons why they oppose my views; I like to try to make a difference in the formation of public policy.

Last week was a banner one for me. I went to Washington, D.C., with eight friends to participate in National Lobby Day to “Stop the Abortion Coverage Ban,” organized by Planned Parenthood Federation of America and other women’s reproductive health and rights groups after the passage of the House of Representatives’ bill containing the Stupak amendment.

The amendment would prohibit millions of women from purchasing health insurance coverage that includes abortion in the new exchanges, even with their own money.

The day’s purpose: for women across the nation to lobby their Senators to “Pass Health Care and Stop Stupak!” and to ensure that language similar to the Stupak amendment would not be included in the Senate bill.

The organizers didn’t want anti-choice groups to use abortion coverage as a way to hijack health care reform. They wanted to counter with their own overwhelmingly female lobbying force. (After all, women do hold up half the sky.)

As we sat on the early morning train from Trenton to Washington, my friends and I agreed that we supported the passage of health care reform legislation to cover the millions of Americans who have no insurance and to reduce the ever-growing health care cost burden on our economy.

But we also agreed that we did not want this bill hijacked by anti-choice forces and new restrictions placed on a woman’s right to choose.

The energy in the auditorium of the Dirksen Senate Office Building could have lit the White House Christmas tree without a switch. The room was brightened by Planned Parenthood staffers’ pink T-shirts proclaiming “Health Care for Every Community.” We picked up a packet of papers, pasted “Pass Health Care! Stop Stupak!” stickers on our chests, and attended one of several Lobby Day trainings. We learned the essentials of lobbying in a nutshell: “Be Concise, Compelling, Relevant, and Credible.”

Cecile Richards, the friendly, low-keyed president of the Planned Parenthood Federation of America, thanked us all for coming. She told us that we represented every region of the nation and that busloads had come from as far away as Maine, Wisconsin, and “the deep South.”

The morning speakers were diverse: African-American women, Latina women, old women, young women, and even a smattering of men. I most appreciated the fiery Billie Avery, a longtime grassroots organizer for black women’s health, who urged us to tell our legislators that “women demand to have control over our own bodies. … If they turn their back upon their female constituents, you tell them, ‘You are in danger of losing your base.’ ”

Luckily, we caught Senator Frank Lautenberg as he left his office for a meeting on the health care legislation; he stopped and greeted us warmly. He knew why we were clustered outside his door: our stickers spoke volumes. Always a friend of reproductive choice over his many years of public service, he didn’t have to tell us his position on the bill. But he said that we would meet with his aide on health care and she would pass along all our ideas.

In the spirit of not practicing giving thanks more than once a year, I offer you this post written for Thanksgiving day, because it might have a bit more shelf life.

The Thanksgiving I remember most vividly and with the most fondness occurred in November 1980, almost 30 years ago this week. Five families, including mine, who lived along a stretch of road in Lawrence Township, New Jersey, decided to share the holiday meal together. Each family brought certain foods to the feast. I think we numbered around 25, and “we gathered together,” as the old hymn goes, in our family’s house, because everyone could sit at round tables in our living room when it was cleared of furniture.

I remember standing in my kitchen while my neighbors walked in the door with their steaming contributions (no microwaves back then), thinking of the first Pilgrims who brought their heaping platters of wild turkeys, ducks, geese, venison, sweet potatoes, corn, onions, other fruits and vegetables, and possibly a suckling pig, into a common house on that first celebration of the holiday. I felt a true bond with those first celebrants.

I cannot remember who came up with the idea, but we decided on the spot, as we sipped our cider and wine, to write “A Community Thanksgiving Grace.” We asked each adult, teen, and child to write something special for which they were particularly thankful. All the children were old enough to write, so everyone from the oldest grandmothers to the youngest boys and girls contributed words to the common grace. One adult and one teen sorted the slips of paper and compiled them into a prose poem. When we had gathered around the tables decorated with fall leaves and what flowers remained in our gardens, one of us rose and read the Grace.

Much as I would love to list all the contributions, I will only list a few to give a flavor of the thanks that were expressed that day: my 13-year-old daughter was thankful “for horses and pomegranates,” a young adult said she was thankful “for those who play soccer and football with those who can’t,” and the one most moving to me came from a young woman still in high school who said she was thankful “for this blue-green earth that had room for elephants, flies, whales, and humankind.” We chorused the last line together: “We are thankful.”

In keeping with the spirit and precedence of “A Community Thanksgiving Grace,” I am offering a list below of what and for whom I am thankful in the field of sexuality education this Thanksgiving 2009. The list is certainly not nearly as poetic as the original, and it contains only my ideas rather than those of a group. It is as follows:

For the children, teens, and adults who seek information about sex and sexuality;

For the parents who answer their young children’s questions without flinching. Questions such as “how are babies made?”—which are often posed without warning in strange locations, like the back seat of the car;

For parents who go beyond “the big talk,” and talk early and often with their teens about sex and their personal values about respect and caring;

For the excellent books by Robie Harris, especially “It’s Perfectly Normal: Changing Bodies,” “Growing Up,” “Sex and Sexual Health,” which celebrates its 15th year in print this year and makes it much easier for parents to talk to their 10 to 14-year-olds about sex;

For other adults-teachers, school nurses, social workers, nonprofit personnel, counselors, therapists, librarians, doctors, nurses, pharmacists, ministers, priests, friends, and others—who provide the answers to people’s questions and concerns in a variety of venues;

For members of state school boards who pass policies requiring K-12 family life education and sex education programs;

For state legislators and members of Congress who support funding comprehensive sexuality education and not funding abstinence-only programs;

For the school districts that provide K-12 sex education programs that are comprehensive and do not shy away from controversial topics;

For the professors who teach or administer sexuality education programs that prepare the educators of the future;

For the exceptional websites for teens, including Sexetc.org, Scarleteen, Teen Voices, and Teen Talk, who give young people reliable, honest, and accurate information and answers to their questions about sex;

For teens and adults who use contraception faithfully to avoid unplanned pregnancy and sexually transmitted diseases, including HIV;

For teens who understand and practice “Double Dutch,” the use of both the Pill and a condom whenever they have sex;

For the gay, lesbian, bisexual, and/or transgender teens who seek information that helps them feel more comfortable with their sexual orientation and gender identity and who have the courage to come out to their families and to classmates;

For the many teens who are abstinent during high school and for those who choose not to have sex until they marry or are in a long-term partnership;

For the national, state, and local organizations that promote sex education and work to prevent teen pregnancy and sexually transmitted diseases;

For members of religious denominations and congregations that support sex education;

For those who work to prevent the spread of HIV/AIDS in the U.S. and worldwide through programs that offer clean needle exchanges, condom distribution, and low-cost generic drugs, and support research to find a vaccine;

For those who are involved with organizations devoted to lessening the trauma of rape, incest, and sexual violence;

For those who see comprehensive sex education as the sensible common ground between those who oppose abortion and those who support the right to choose;

For all the leaders in the fight for sex education in America on whose shoulders I stand and for my colleagues in the field-past, present, and future;

For the opportunity to write about sexuality education on this website and for those who read this column; and

For the great gift of human sexuality, its never-ending story, and for the opportunity to help others, including myself, understand, appreciate, respect, and enjoy it,

I am truly thankful.

Let me start with an admission: I share a birth date with First Lady Michelle Obama and am therefore a special fan. Like me, she is a Capricorn (the Goat), but oh, so much more. Before I read that her birth date is January 17th — albeit some 34 years after mine — the only two people with whom I shared a birthday were Benjamin Franklin and Bobby Kennedy, Jr. Now I don’t want to sneeze at either of these two gentlemen; I am proud to be in their company. But I feel a strong, indescribable bond with the First Lady because of the January 17th connection.

I have avidly followed Michelle Obama’s travels and accomplishments since she has arrived at The White House. I have watched as she dug into the historic soil of the South Lawn and planted a garden to encourage more children to eat their veggies (with the exception of beets, which the president doesn’t like). I laughed out loud when I read that on St. Patrick’s Day last March, she ordered the water in the White House fountains turned a brilliant shade of green.

It is fun and games wherever this lively, outgoing, stunningly chic woman puts her touch. She seems to be perpetually surprised and thrilled that she and her family are living in the People’s House and doesn’t want to miss a minute to enjoy the experience. Michelle — as we have never met, I hope she won’t interpret my use of her first name as a sign of disrespect-makes me, at an advanced age, feel young and ready for new adventures. She makes me smile.

My admiration for Michelle’s Peter Pan spirit was only reinforced last Saturday when I read that she participated in the jump-rope exercise “Double Dutch” at a recently held “healthy kids fair” on the South Lawn. For the uninitiated or those who haven’t thought about jumping rope in some time, Double Dutch is a routine usually performed by 10-year-olds, not women in their mid-40s. It involves skipping between two ropes swinging at the same time in opposite directions, and it is very difficult not to trip and get your feet entangled in one or the other of the ropes. (The First Lady did not miss a step.)

Apparently, Michelle has a keen eye for what’s the latest rage among preteen and teen girls, probably because of her own two daughters. Double Dutch has an interesting history among games young people play. It was first played by Dutch settlers on the shores of the Hudson River some 400 years ago. The British dubbed it “Double Dutch,” when they arrived in the New World.

During World War II, it became very popular with urban children living in Manhattan, who made up and sang rhymes as they turned the ropes. The first tournament was held in 1974 and drew nearly 600 children. Today, the Apollo Theater in Harlem hosts competitions that draw Double Dutch teams from around the world.

Recently, Double Dutch has gained further recognition as “the newest of 35 varsity sports” played in New York City, according to this New York Times piece. (New Jersey, are we there?) There is also a team called the Dynamic Diplomats of Double Dutch that performs internationally with members ranging from teens to adults in their 30s.

The fact that Double Dutch has become an international sport gives me the perfect segue, since I heard a different definition for the term about ten years ago from a group of sexuality educators. They had returned from a trip organized by the Washington, D.C.-based Advocates for Youth, a national organization devoted to the sexual and reproductive health of adolescents. They had visited the Netherlands and other European countries to study sex education programs and societal attitudes about sexuality that shape public policy for young people.

These educators told me that “Double Dutch” is a common slogan that most teens growing up in the Netherlands learn at home and in school. It reflects the deeply held societal belief that a good sexual relationship is based on mutual respect and mutual responsibility. Young people are taught that before you have sex, you must have a solid relationship based on honesty, equality, and trust (no “hooking up” or one-night stands). They also learn to use two forms of protection against unplanned pregnancy and disease each time they have sex: the female always uses the Pill and the male always uses a condom (the “Double Dutch” method).

Most young people and adults know the meaning of “Double Dutch” and practice it, giving the Netherlands the lowest rates of teen and adult pregnancies, births, abortions and sexually transmitted diseases of any nation in the western Industrialized world.

I do not expect Michelle Obama to take on the issue of adolescent pregnancy in the U.S. It would be too controversial and too difficult in her husband’s young presidency to get mired in the culture wars. Instead, I wish her the best of luck in her effort to encourage young people to eat well and to exercise. I hope she will continue to amaze us by participating in more games of Double Dutch without missing a beat, or a step.

But leaders in urban communities nationally and here in New Jersey, where teen pregnancy rates are stubbornly high, can teach young people that the term “Double Dutch” has a second meaning — and that integrating this meaning into their behavior can make a real difference in their lives. They can even hold Double Dutch events and work in important lessons about sexual health to teens.

Who says that teaching an important concept about sexual responsibility can’t be fun?

I recently went to New York City to celebrate an old friend and the successful adolescent pregnancy program that he created and has faithfully administered for 25 years. I joined about 150 people at the Harvard Club in to applaud Dr. Michael Carrera and celebrate his outstanding  Children’s Aid Society Carrera Adolescent Pregnancy Prevention Program, which he developed at The Children’s Aid Society in New York City. The Program’s goal is to help young people growing up in poverty improve their life’s chances and avoid the rough seas of teen pregnancy.

The Carrera Program has nine sites in Manhattan and replications in Georgia, Washington, D.C., Maryland, Michigan, and Ohio. Recently, it was  designated a “Top Tier Youth Program” by The Coalition for Evidence-Based Policy’s Top Tier Evidence Initiative initiated by Congress.

This designation is very meaningful. The Carrera Program is only one of two national programs to receive it. As a result, it stands to receive a sizable infusion of federal funds set aside to help communities lower their stubbornly high rates of adolescent pregnancy. The Carrera Program has a seven-year plan to quadruple the number of young people it serves every year. Presently 3,000 youth are enrolled in the Program. Replications in local, community-based organizations that will accept the entire program’s concept and hands-on supervision from Dr. Carrera are presently planned in New Jersey and Connecticut with others across the nation to follow.

Dr. Carrera always refers to his work as “a long-term, above-the-waist approach that is guided by the principle that youth are ‘at promise’ not at risk.’”

The program works with boys and girls beginning at the age of 11, six days a week, 50 weeks a year, and follows them through high school and beyond. It helps them avoid too-early pregnancy by offering them after-school, weekend, and summer activities based on seven fundamental components: general education; employment and the opportunity to open a bank account; lifetime sports, including golf, tennis, swimming, squash, and bowling; comprehensive, no-cost medical and dental services; mental health services; self expression, including dance, drama, music, and writing; and family life and sex education! (He believes that when young people can see little hope for themselves in the future, sex education cannot do the job alone.)

Until its recent designation as “Top Tier” that will make it eligible for federal funding, Dr. Carrera has raised only private money from foundations and individuals to support his program. Thousands of young people and their families have participated in the program during its 25 years of existence. It costs less than $10 a day per student and reduces pregnancies by 50 percent in the communities served.

About 70 percent of program participants enter college and have found employment in education, law, medicine, media, science, engineering, and social work. As the program expands to serve more students, Dr. Carrera believes the costs will further decrease.

Guests at the 25th anniversary celebration received a booklet that detailed the high rates (and high costs) of unplanned teen pregnancy: “One hundred teens get pregnant every hour of every day in America. Fifty adolescents give birth and twenty-five adolescents have a pregnancy termination every hour of every day. The taxpayer cost of teen pregnancies, including public assistance, housing, food stamps, health care and other factors, is nearly seven billion dollars annually.”

Recently, for one brief evening, Dr. Carrera set aside his passion and let he and his accomplishments be celebrated. The crowd applauded and cheered for several hours. The speakers of the evening were numerous and included Jane Fonda, actress, author, and founder of the Georgia Campaign for Adolescent Pregnancy Prevention, which has adopted his approach. When it was Dr. Carrera’s turn to speak, he characteristically thanked everybody else for his Program’s accomplishments.

I first encountered Michael Carrera, the original energizer bunny, when he was teaching sex education to his daughter’s class at a private co-educational school, the Lenox School, in New York City.  His energy was unbelievable as was his comfort in talking about sex and answering any question that any student tossed at him.

Years went by but I kept following his accomplishments. He became chair of the Board of SIECUS, the Sexuality Information and Education Council of the United States, the major national organization committed to promoting sexual health in the nation, and wrote a coffee-table-sized book called Sex: The Facts, the Acts and the Feelings. He was a popular speaker at sex education conferences, and I always gravitated to his sessions hoping to pick up ideas for improving my teaching. After noticing me in the audience for perhaps the third, or possibly fourth time, he turned to me and said somewhat sharply, “You’ve heard everything I have to say. Now go and do something to help young people.”

Over the past 25 years, Dr. Carrera has certainly done just that.

I believe that strengthening school health and sex education programs should play a role in health care reform. A big national effort to prevent health problems like obesity, sexually transmitted diseases, unplanned pregnancy, smoking, and drug use among young people could do much to lower the ever-climbing costs of health care in America. To do this, we have to increase the emphasis on health education in our public schools. Presently it is a stepchild in the national curriculum.

The Senate Finance Committee should consider adding an amendment to the health care bill now under debate that would include an appropriation for the development of a national health education test for teens. Let’s call it, the National Health Education and Literacy Test. The ultimate goal would be for all students to pass the test sometime during high school in order to graduate.

Why does health education remain on the margins of the school curriculum, particularly when it has such potential for lifelong learning? I’ve always thought that the main reason why the subject resides in a sort of limbo is because students’ knowledge about health – as indicated in a standardized test – is not a requirement for acceptance to a university or college.

No state requires its students to pass a health education test in order to graduate high school. No student has ever been rejected from a college or university because he or she lacks knowledge about health issues.

If only Harvard would require all entering freshman to demonstrate basic health knowledge by passing a health literacy test, things might change — dramatically.

Suddenly, the school’s health education curriculum would come under close scrutiny; teachers would receive increased training; and kids would realize that health class really counts.

Health education would be moved from the back to near the front of the high school curriculum line. It would gain in stature. I am not guaranteeing that better health education and a health literacy test would result in 100-percent behavioral change, but sound knowledge is the first step in the process.

I decided to find out more about the possibility of developing a nationally standardized test in health education. A health educator referred me to Nancy Hudson, a senior associate at the Council of Chief State School Officers, in Washington, D.C.  She works for the Health Education Assessment Project (HEAP), whose mission is “to develop effective standards-based health education resources … to improve health literacy through improved instruction.”

When I asked Hudson about the availability of a national health literacy test, she e-mailed that “there is no national test, but we do have the technology to produce one through the Health Education Assessment Project.”

Her reply to my next question about the cost of creating such a test didn’t surprise me:

“Unfortunately, we do not have the funding or the staff to make this a reality,” she said and added, “We have over 1,900 assessment items to work with in constructing a test. We have the ability to develop and field-test new items; we would need to do that. We would need to construct the test instrument and test the instrument for validity and reliability.

“We would have to work to get national commitment, which would be a challenge in this environment (of skepticism about testing from some advocacy groups).”

Since I happen to live down the road from the Educational Testing Service – the national nonprofit institution known famously worldwide as the developer of the SAT (Scholastic Aptitude Test) and other educational products – I decided to gather more information about the cost of developing a national test.

I carried my search to Tom Ewing, ETS’s Director of External Relations. He lead me through the steps of developing and piloting a health education test specifically for New Jersey high school students rather than conjecturing about developing a national test. His bottom line is that it would take $250,000 and 18 months to develop a standardized health education/literacy test for New Jersey public school students and that it could be done with the necessary funding.

Knowing that 1,900 test items exist for a national health education test and that the cost for one state to create and pilot such an instrument would be around $250,000, let me suggest an amendment for consideration by senators who are marking up several health care reform bills.

It would set aside an appropriation of a million dollars to create a national health education test and pilot test it in four states in different parts of the country. The results of the pilot could be a wake-up call about what our young people know and do not know about health issues and the work that lies ahead to help them gain knowledge to prevent medical problems as they age.

My next step is to e-mail this column to New Jersey Senators Robert Menendez and Frank Lautenberg. If you think developing a National Health Education and Literacy Test is a good idea and should be incorporated into health care reform, let them know. You can reach them through their websites, www.lautenberg.senate.gov and www.menendez.senate.gov.

In the meantime, Harvard, it’s up to you.

“Grandma Susie, you have a tadpole in the fish pond.”

My six-year-old grandson Reed’s announcement begins this story.

“A tadpole, Reed,” I countered, “I thought that I only had goldfish in the pond. How do you suppose I landed up with a tadpole too?”

He shrugged and I answered my own question: “Well, I guess some frog jumped into the pond and laid her eggs.” Then I turned to my daughter and said, “We’ve had those goldfish for about three years and they must be of the same gender, because we’ve had no babies.”

Fast-forward a few hours. Steve, the man from the pond company who comes periodically to clean the pool, arrived. He told me that the pool was full of algae and perhaps it would be a good idea to have some tadpoles to help to clean it up. I assured him that if my grandson was right, we had at least one tadpole already, to help the cause.

“I’ll have to take off my shoes and get into the pond to clean the filter,” Steve told me, and he stripped off his shoes and socks and climbed in. I went back to my house chores and when I checked in some minutes later, Steve dropped the bomb. “You have about 50 baby goldfish in this pond, Mrs. Wilson, and not a tadpole among them.”

I felt like a woman who has just been told that she is pregnant with sextuplets: “Babies,” I choked, “but I always thought those fish must be of the same gender.  They’ve lived together for almost three years and have never reproduced.”

Steve did not give me the benefit of his thoughts. He gathered the flotsam and jetsam of his trade along with at least a pound of algae he had pulled out of the pond, and said he’d be back sometime with the tadpoles, leaving me frozen in place.

Steve may not have had any opinions as to the reasons why the goldfish had begun to reproduce, but my husband had plenty when he was told the news.

“The sex educator doesn’t understand why the fish in her pond are having babies?” he exclaimed. “That’s a hoot! What have you been telling teens and adults for the past 25 years you’ve been in business?”  I decided not to respond to his gallows-type humor.

I realized that I must look pretty foolish. Usually when I hear about unintended and unplanned pregnancies, certain rote responses come immediately to my mind: the schools are providing abstinence-only-until-marriage education for the students; the students are hearing only about the negatives associated with condom use and have never had a chance to realize their effectiveness; sex education programs are provided only in senior year of high school long after a great many of the students have become sexually active; and teen pregnancy is a complex issue requiring multiple solutions, particularly for young people growing up in urban and rural poverty.

But with fish? None of the above responses seem relevant. They had had no sex education—good, bad, or indifferent. All my years working as a sex educator had suddenly bumped up against the randomness of unplanned and unintended pregnancy. When I called my friend Polly to tell her about what was taking place in the pond in the garden, which she helps me tend, she laughed and laughed.

“Susie, they’ve become sexually mature,” she said. “They are no longer babies or preteens, which they probably were when you first bought them three years ago. They’ve reached sexual maturity. Get it?”

Yes, I did get it, though still in shock. “I guess we’re godmothers together,” I answered back.

“No, goldmothers,” she said still laughing, moving on to water the plants and leaving me with the 50 little goldfish growing up in my pond.

Surely in this story, there is a teachable moment for Reed and his mom to launch a conversation about gender and sex, but definitely not about the differences between the ways fish and humans reproduce. For educators who read this blog, there may be an embedded lesson starter about the suddenness, randomness, surprise, pleasure but inevitability of human reproduction, unless one uses protection or abstains from having sexual intercourse.

As for me, I stopped looking into the pond and began humming Cole Porter’s great song:

Birds do it,

Bees do it,

Even educated fleas do it,

Let’s do it, let’s fall in love.

Only when I sang the words, I substituted “fish” for “bees.”

Photo by Martha Rathgens