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The Answer Blog

From N.J. to D.C.: How – and Why – I Lobbied to Stop the Stupak Amendment

December 11, 2009

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.

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A Thanksgiving Grace for Sexuality Education

November 29, 2009

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.

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The First Lady Michelle Obama, and the Lessons “Double Dutch” Can Teach Our Youth

November 10, 2009

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?

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Kudos to Carrera and His “Top Tier” Teen Pregnancy Prevention Program

October 18, 2009

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.

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It’s All about Prevention: A Call for a National Health Education Test

October 5, 2009

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.

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A Fish Story: A Metaphor of Sorts

August 20, 2009

“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

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New Biography Details Life & Times of Prominent Sex Researchers

August 10, 2009

History informs, and so I recommend the new biography, Masters of Sex: The Life and Times of William Masters and Virginia Johnson, The Couple Who Taught America How to Love, by Thomas Maier for a good summer read. This is a book about sex—lots and lots of it—but the sex is not prurient or pornographic. Rather, it’s used primarily as a scientific tool to study the phenomenon of human sexuality in order to help us better understand and enjoy the sexual aspects of our lives.

Masters of Sex tells the story of the lives of two pioneer sex researchers, Masters and Johnson, who took the physiological aspect of human sexuality out of the dark ages of the Victorian era and into the sexual revolution of the late 1960s and modern times. Masters and Johnson authored a series of best-selling books—including Human Sexual Response, Human Sexual Inadequacy, The Pleasure Bond, and Crisis: Heterosexual Behavior in the Age of AIDS—that catapulted them to fame. They may have done more for sex than any two people since Adam and Eve.

Together, they studied the human sexual response cycle—particularly the female sexual response—by observing more than 10,000 orgasms at their clinic in St. Louis, MO. They created the sexual science of sexology and developed a two-week sex therapy regime based on “sensate touch,” for couples who experienced an array of sexual marital problems, for which they claimed an “80-percent cure rate.” They also came under attack for developing another two-week program to help gay people “convert” to heterosexuality, which has since been discredited, and for sounding a too-loud alarm bell about the HIV/AIDS crisis, including publishing incorrect information about transmission of the virus.

Masters and Johnson said little about sex education other than that they believed it should be grounded in sound scientific research. So I asked Pepper Schwartz, Ph.D., a respect sex therapist and professor of sexuality at the University of Washington, for her views about Masters of Sex, the value of Masters and Johnson’s legacy, and how parents can talk to their own children about sex.

Susie Wilson: The author of Masters of Sex, Thomas Maier, says that Masters and Johnson “revolutionized the way sex is studied, taught, and enjoyed in America.” Do you agree? And what specifically do you consider their greatest achievements?

Dr. Pepper Schwartz: The statement is more or less true, although as time goes on, some newer members of the sex education community may not realize their indebtedness to Masters and Johnson. They were the impetus to studying the body and its sexual abilities or disabilities, and they spurred research on context, emotions, etc., even if they themselves were overly biological and mechanistic.

They definitely created a climate where the right to sexual pleasure became a more common feeling among the general public—and they should be celebrated for this accomplishment over and above their specific contributions.

We now teach modifications of their human sexual response cycle, but they were the ones to give us the architecture to build on. They created the field of sexual therapy as a distinct specialization rather than as a part of some larger behavioral science or psychiatric practice. They gave us new information and new tools. Their contributions way overshadow their mistakes or shortcomings.

SW: Is the book for a general audience or a more a specialized one, such as sex therapists and educators?

PS: I think it is for a general audience, but especially for people who enjoy the history of science—finding out how knowledge is attained, who the people were who did pioneer work, and what that tells us about how the work was conceptually framed and measured. This book can help you figure out what to admire and what to doubt in terms of the highly influential work of Masters and Johnson.

Sex researchers will be particularly engaged, particularly people like me who knew Bill and Gini, but never knew about their private life and how it affected what they studied, how they interpreted it, and how the team influenced the methodologies and findings. The key points for sex education teachers would be to look at the evolution of the interviews, the construction, limits, and uses of [the therapy] sensate focus, and the methodologies of the original data collection.

SW: Masters and Johnson’s first and groundbreaking book, Human Sexual Response, was published in 1966. Do you think most Americans understand and value Masters and Johnson’s contributions to the sexual revolution and present-day sexual behavior? Do most people understand the various stages of orgasm that Masters and Johnson discovered?

PS: Much of their contribution to the sexual revolution is confined to people over 40, so this book can enlighten a whole new population. The various stages of orgasm is probably the most common discovery of their research included in college sexuality courses, so it is more integrated into public knowledge—but only for people who have taken such a course sometime in their lives.

SW: In your praise for the book that appears on the back cover, you say that Masters and Johnson made “a real contribution to the history of science.” Some of their critics said that their work was nothing more than “voyeuristic.” Will you elaborate on what you mean by their contributions to science?

PS: The “voyeuristic” charge is humorous. In order to understand how human sexual response actually occurred, they had to look at how it began, how it proceeded, and how it ended.  This charge is akin to accusing anatomy researchers of body mutilation, because they dissected bodies in order to study internal organs.

The first time you watch someone make love, it is arousing. But if you do that day in and out, hooking them up to blood pressure machines, studying body heat responses, etc., I can assure you the thrill will be gone. This was work that needed to be done.

SW: During the years that Masters and Johnson worked together, they had sex with each other in a clinical, mechanical way. Masters was married at the time and had two young children; Johnson was a divorcee with two small kids. Masters eventually divorced his wife, Libby, and married Johnson, and they stayed together for 22 years until they divorced. Do you think that they compromised the sexual research they did or crossed an ethical line by having sex with each while doing this work?

PS: I found the story of their sexual relationship rather sad. I was sorry to find out how loveless it was. It wasn’t even clear that it was passionate, although perhaps it was upon occasion. Certainly Masters’ own restricted range of emotions affected the first book— later books took individual emotions more into account. But the sexual response cycle is quite stilted and unattached to human emotion, fears, background issues, etc.  Sexual skill is left out of the equation, oddly enough, in the first book. The Pleasure Bond—one of their last books—does a better job, but no better I think than many of the successors.

I don’t think any ethics were violated vis à vis the research by their relationship, although the fact that Johnson was subservient to him in many ways inhibited some true collegial contributions. However, given her lack of professional training, I think this would have been the case even if they weren’t having a relationship. Whatever ethical violations happened were purely the business of Master’s wife and family, who certainly were betrayed.

SW: Masters and Johnson’s work lauded “female sexual prowess.” Maier says that their research about women’s sexual response was “a remarkable achievement unlike anything medical science had ever seen in this realm.” Do you get the impression that most women today are away of their power and prowess?

PS: Actually I think a lot of women were somewhat oppressed by the idea of multiple orgasms when the book first came out. Overall, I think the idea that women were the superior sexual athlete was good for women’s egos and a reestablishment of their sexual pride. But I think the focus on multiple orgasms had its positive and negative aspects.

SW: Although Masters and Johnson’s research is based on viewing about 10,000 orgasms in their laboratory, the word “orgasm” itself is sometimes not used in school sex education programs. How would you try to persuade a balky school board, a cautious administrator, or a worried health teacher to include a discussion of orgasm in middle and high school classes?

PS: Knowledge demands the full cycle and propensities of a given phenomenon, and if it isn’t included, it is misleading and bad science education. Furthermore, many young women do not know if they have had an orgasm or not, which means, of course, that they have not had one. Teachers help create this profoundly confusing situation by not offering full information on the human sexual response cycle.

SW: How would you help parents of preteens and teens talk to their kids about orgasms, and is it important for them to do so? Any tips for shy, tongue-tied parents?

PS: This is tough for most parents. They can talk anatomy, but not pleasure. I would counsel them to get a good book and go to Guttmacher, Planned Parenthood, SIECUS, Sex, Etc., Go Ask Alice, among other websites, and take a look at available books, pamphlets, etc. [Editors' note: Click here for Answer's resources as well.]

Give the book to your child—at least by age 12 or 13, but preferably a lot earlier—and have them read it. Tell them you will be happy to answer any questions, clarify the book, or, for that matter, read it with them. Get a book that talks about orgasm frankly. This doesn’t require a parent to be a gifted sex educator, just a discussant with their child about important topics.

SW: What is the connection between sex research and sex education, and why is one important to the other?  Do you think that better school sex education programs would reduce some of the problems that are observed by sex therapists?

PS: There are a lot of myths and surmise about sexual functioning. Without sex research, sex educators would unknowingly be passing on a lot of them. Of course, sometimes the research gets it wrong, and then new research comes along and corrects the situation. That’s why sex research has to be ongoing—and, of course, sex changes as the culture changes and personal circumstances of life change. For example, late marriage versus early marriage, recessional times versus flush economies, new technologies of birth control or pleasure, etc.

Certainly better sex education would help reduce sexual problems. A few examples: helping students feel good about carrying and using condoms, helping students recognize sexual abuse or misinformation and dismissing it early in life rather than having it control their sexual response and feelings.

SW: Maier quotes William Masters as saying, “The truth about sex is often unpalatable to many, including those in academia and the healing arts.” You work in academia. Do you observe changes in the last decade that show that this is no longer true?

PS: It is better than it was, but people are still squeamish about sexuality and academics are not different. I do think, however, there is more respect for sexuality research in academe than there was in Masters and Johnson’s time…and part of that has been due to the AIDS crisis, where sexuality information was desperately needed and ultimately funded.

SW: Who is building on Masters and Johnson’s important legacy?

PS: There are a lot of good people doing sex research all around the world. In fact, the globalization and collaboration of an international group of colleagues is a major advance in the sexual research field. Sandy Lieblum and Ray Rosen, who did great clinical work at Robert Wood Johnson Hospital and Rutgers, would be on my A-list. Sandy has done some fascinating work on spontaneous sexual desire in women. There are many other clinically based researchers out there whose names I could add.

Certainly one of the great additions—too long in coming, I might add—has been the work of minority researchers, so that now specific clinical advice for gays, lesbians, Chicanos, various Hispanic groups, Asians and African Americans, and other ethnic and racial groups will get treatment specific to their own cultural backgrounds and needs. This has been sorely needed for way too long a time!

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Bringing the Dreaded “P-word” into Sexuality Education

July 21, 2009

“In case you didn’t see this,” read the subject line of an e-mail from my friend forwarding the story “The joy for sex—for teens!” from Salon’s “Broadsheet.”

The story was indeed eye-popping by any standard. It covered how the National Health Service in the United Kingdom had recently published a pamphlet for young people telling them, among other things, that orgasms feel good. Its title: “Pleasure.” The “finger-wagging moralists” were outraged, reported Broadsheet.

To give you some perspective on the brouhaha in the U.K. over the pamphlet, consider what would happen if the Centers for Disease Control and Prevention, Department of Health and Human Services, or any of state health departments across the U.S. published such a pamphlet.

What’s that expression?: “All hell would break loose.”

In America, the P-word draws lightening whenever you join the topics teens and sex. Many people here—as I’m surprised to learn in the U.K., too—think that any mention of the word “pleasure” in a talk about sex with young people sends the wrong message, whether the talk is taking place between parents and their kids or between students and their teachers using a classroom curriculum. That message? That talking about pleasure encourages young people to have sex.

Americans tell pollsters that of course they talk to their children about sex and support sex education programs in public schools. But there’s always a caveat to that support: These discussions must emphasize the negative and dangerous aspects of sex. The thinking goes something like this: If we shroud sexual behavior in fear and shame, then we shall discourage young people from engaging in it at too early an age.

If the conversation is about sexual pleasure, many people think we’re sending the opposite and inherently wrong message. The powerful abstinence-only-until-marriage movement, on which the U.S. spent more than half a billion dollars, is predicated on instilling fear and shame into young people by telling them only about the drawbacks to having sex as a teenager or outside of marriage.

Fortunately, the Obama administration has removed this funding from its 2010 budget, but that doesn’t mean leaders are going to suddenly endorse instruction about pleasure.

The U.K. pamphlet encourages “parents and educators to add a dose of honesty about carnal delights to traditional sex talks.” A spokesman for the conservative British organization Family and Youth Concern called the pamphlet and approach “nothing less than child abuse.”

My hunch is that if such a pamphlet were to ever see the light of day in the U.S.—and I think it would be a long time coming, if ever—a slew of groups and politicians would use the same words, doing their best to ensure that the pamphlet would never appear in any public school or library.

This whole controversy reminds me of a comment I once heard from a 15-year-old teen awaiting the birth of her first child due to unplanned pregnancy. “I sure hope,” she said, “that giving birth won’t hurt as much as having sex.”

Obviously, the first and perhaps only time this teen had had sex before getting pregnant was far from pleasurable. I thought to myself at the time that probably no one in her life had ever told her that sex was supposed to be a mutually pleasurable experience. I doubt that anyone had ever mentioned the word “orgasm” to her, or told her about attraction, stimulation, lubrication, foreplay, intimacy, and enjoyment.

Had she been able to read a pamphlet such as “Pleasure,” she might have realized that she could delay losing her virginity until she was more knowledgeable about sex and the pleasure it’s supposed to provide. She might have also learned that sexual behavior is a two-way street, and that she deserved to feel satisfaction when engaging in it. She might have learned that she and her partner could have used protection, it would not have detracted from that pleasure, too.

My hunch is that if we talked to many young women who starting having sex at 13 or 14 years of age, we would find them abysmally ignorant about sexual pleasure, orgasms, and all the good stuff about human sexual response. Of course, they see sexual behavior on TV, the Internet, and in movies all the time—yet I wonder how many young heterosexual women ever get a chance to talk to anyone about the fact that sex is supposed to feel good for them as well as the guy.

For far too long, we have focused on the negative and dangerous aspects of sex. The outcomes of this approach are none too good. The U. S. has the highest teen pregnancy rate in the Western industrialized world and, according to the latest statistics, one in four teens has a sexually transmitted disease.

Enough of the dire warnings about sex: Let’s take a new approach in a new century. Let’s use the P-word with young people. I’ll take any bet from any reader that if we adopt a positive approach and communicate honestly about sex’s delights, then we can raise a generation of young people who are more careful and more caring about their sexuality.

If young people understand that there is something precious about the gift of human sexuality, they might treat it with more respect than they presently do. The Centers for Disease Control and Prevention and state health departments in more progressive states like New Jersey, for starters, should publish pamphlets similar to “Pleasure.”

It would take a lot of courage to step up and speak honestly to young people about the pleasurable aspects of sex—but what a gift they would give them.

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Author Robie Harris Talks Candidly to Children About Sex

July 8, 2009

If Robie H. Harris looks like a grandma, it’s because she is one. But unlike almost every other grandma in the United States, Harris is an award-winning author of picture books about sex, sexual health, and safety for young children, school age children, preteens, and adolescents.

The books—It’s Not the Stork!: A Book about Girls, Boys, Babies, Bodies, Families and Friends, for ages 4 and up; It’s So Amazing: A Book about Eggs, Sperm, Birth, Babies and Families, for ages 7 and up; and It’s Perfectly Normal: Changing Bodies, Growing Up, Sex & Sexual Health, for ages 10 and up—have sold millions of copies and been translated into numerous languages. It’s Perfectly Normal, at last count, has been translated into 27 languages. They feature the charming illustrations of Michael Emberley.

I happen to think that Harris’s delightful and informative books belong in every elementary and middle school library, public library, and home in America. I once somewhat jokingly suggested that all new parents should be given Harris’s books for free when they leave the hospital with their first baby and told to put them on a shelf and retrieve them when their kids reach certain ages.

I recently interviewed Harris about the new, updated, 15th anniversary edition of It’s Perfectly Normal, which her publisher, Candlewick Press, will release in early September. The edition includes a new chapter on young people’s fascination with and use of the Internet.

Susan N. Wilson: What is the main purpose of your books about sex and sexuality for children and preteens?

Robie Harris: My overall purpose is to give information to help kids stay healthy from their early years through puberty and adolescence. Kids today are swamped by sexual words and images. The media sometimes gives accurate information, but sometimes it gives inaccurate and even dishonest information and that can lead to unhealthy behaviors and risks.

Our kids must have the most up-to-date and accurate information, so they can make healthy decisions, not risky ones. That’s why I consult with many experts in the field of sexuality when I’m updating my books. I have great respect for parents and teachers and hope that the books Michael and I have created can help them to talk with and educate children about sexual matters.

SW: You’ve updated It’s Perfectly Normal for the 21st century as the banner headline on the new edition proclaims. Since you wrote it 15 years ago, the Internet has come of age and kids find it very exciting.  How have you addressed this new technology and what it offers children in the way of information, good and scary, about sex and sexuality?

RH: Children accept the Internet’s presence 100%, but parents need to help their kids navigate and use it in a safe way and let their kids know the risks it can pose. I tell older kids that while the Internet is a great place to look up topics about sexual health and keep in touch with friends through e-mail, instant messaging, or social networking sites, there are still things they need know to ensure that their own personal health and relationships stay safe and healthy.

I tell kids of all ages that what makes good sense is to ask a grown-up you trust to help you to find sites where you can get responsible information. I also tell them that talking with a trusted adult is a great way to get the information they want. We all know that our children live in a world of sexualized images, and they need to be guided through it by trusted adults.

SW: What do you call the chapter on the Internet in the new edition?

RH: With older kids, ages 10 to 14, I acknowledge the Internet with a new chapter called “Helpful, Fun, Creepy, Dangerous.” The purpose of the chapter is to help kids get information while at the same time stay safe. Some of the information they can get on the Internet will be helpful, some will be fun, but some could be creepy, confusing, and make them feel very uncomfortable. I suggest ways for them to find responsible sites that have helpful and age-appropriate information, so they can make good decisions. I also suggest what to do if they end up on a site that makes them feel upset or creepy.

SW: How would you define the word “pornography” and do you use the word in your revised book?

RH: I think the best definition of pornography is, “You know it when you see it.” I think kids know it when they see it, too. They can’t quite explain it, but they know it, and it can make some feel creepy and upset and others feel excited. I define “puberty” and many other terms in the book, but while I talk about pornography, I do not define it, as I could not come up with a definition I felt would make sense for kids.

But having a conversation with kids, when needed, is something that can happen over time and over many days. There is nothing wrong with using the word if a parent needs to talk with their child about it. Parents and kids can even try to define the word together to help them understand the perfectly normal reactions they may have if they do see it.

SW: Do all children have the same reaction to what you call “creepy” sites?

No, I think that while some find these sites by pure accident, some intend to go to them and find them sexually exciting.

SW: What advice would you give to children or students who come across upsetting information online and are frightened by what they’ve seen or “grossed out” by creepy images?

RH: If they have seen upsetting information online or meet someone online they don’t know, like a stranger who tries to meet them in person, my immediate advice is to quit the site and immediately talk to a trusted, responsible older person about what they have just seen. I also hope that the responsible, older person will assure them that they haven’t done anything wrong in finding the site, and that they are just curious. And being curious about sexual matters is not bad; rather, it’s normal and healthy.

SW: There is a lot of talk about the prevalence of cyberbullying. Do you address this issue?

RH: Yes, I definitely let children know that saying something mean, bullying someone, or spreading gossip—even sexy gossip—when they are communicating with others online can make a person feel crummy and hurt that person’s feelings. This is something all our kids need to know not to do.

SW: In this age of Facebook and other social networking sites, do you give preteens and teens any advice to follow in the new chapter?

In order to protect kids from danger, I include a list of rules for the Internet for them to keep in mind whenever they go online. Parents and teachers can reinforce that these rules are ways to ensure kids’ privacy and safety. Here are a few of the rules:

  • Never use your real name;
  • Do not post any personal details, such as your telephone number,
    street address, or the name of your school;
  • Do not say you’re a kid; and
  • Never give your password.

SW: If a child’s parents are unable to discuss unpleasant and confusing sexual images, what should the child do?

I recommend that the child seek out another trusted adult, such as the school nurse or psychologist or the child health care professional, to discuss what s/he has seen. Similarly, if parents are not able to discuss these Internet events—and some aren’t—asking another trusted adult in the family, a neighbor, or their health professional for help can often help their child.

SW: I hear you’re working on a new picture book for very young children. Could you tell me more about it?

It’s a picture book for very young children ages two-and-a-half and up about naming all the outside parts of their bodies. It is normal, healthy, and developmentally appropriate for young children to want to know “the science names” for all of these parts, so they will learn early on that having these parts—whether you’re a girl and have a vagina or you’re a boy and have a penis—is as normal and healthy as having elbows, chins, and other body parts. When young children can name these parts, they feel proud of the body they have—a feeling that will help them all through their childhood and as they go through puberty and adolescence.

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Sex Education for Older Adults: Not an Oxymoron

July 2, 2009

The gray blue and pale green cover certainly doesn’t attract attention, but the words on it are eye-openers: “Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only.” They’re not written in scarlet, but some may think they should be.

Sex ed for adults?  Don’t we think that it’s best left to high school seniors or parents who have to deliver “the big talk” around puberty? The brave among us may have taken a course in college, but often only because we thought we’d get an A to bolster our GPA. What’s going on here?

What’s going on is that the authors of the manual—Peggy Brick, Jan Lunquist, Allyson Sandak and Bill Taverner, all nationally respected sex educators—wanted to provide guidance about sexuality to people in mid and later life, between the ages of 50 to 100.  The Center for Family Life Education at Planned Parenthood of Greater Northern New Jersey published the 258-page manual. It’s aimed primarily at educators and counselors, but can easily used by lay folks.

Here’s a sample of the contents:

•    What’s So Funny? Laughing at Ourselves—What Jokes Tell Us about Sex Over 50;
•    Sages Through the Ages:  Advice from the Past, Questions for the Present;
•    Skin Hunger: Everyone Needs Touch;
•    A “Touchy” Subject:  Masturbation in Mid and Later Life; and
•    Safer Cyber Sex: Exploring Online Relationships

These lessons are neither pornographic nor clinical. Rather, they are thoughtful, creative, and respectful of adult sexuality. As Peggy Brick writes in the Introduction, “Sexuality education aims to help people evaluate all the messages they receive from the media, advertisers and pharmaceutical companies and then discover for themselves what really can enhance their sexual lives.”

What are the settings for curriculum? Other than using all 30 lessons over several months in a graduate course in human sexuality in a social work program, a medical school or a seminary setting, I think it would be best to teach a selection of them—possibly 12 to 15 at a time—in a variety of settings, including a retirement community for adults age 55 and older; YWCAs and YMCAs; senior resource centers; adult evening schools and community colleges; adult classes in religious institutions; prison settings and any other venues where older citizens gather.

Whatever your age, I promise you’ll learn more than a thing or two, which you can use immediately in your own relationships, store in your head until you reach the magic number (50) or get guests’ attention at the next dinner party you attend, when you say, “Do You Know about Older, Wiser, Sexually Smarter: 30 Sex Ed Lessons for Adults Only?”

Indeed, the cool blue and spring green of the covers of this powerful curriculum about adult sexuality are deceptive. Open the manual and settle down for an illuminating and mind-tingling read.

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