Texas, struggling with teen pregnancy, overhauls sex education standards

DALLAS – JR Chester became pregnant the summer before his senior year of high school. A bright student with good grades, she gave birth, graduated, and was pregnant again when she arrived at college that fall.

She was a teenager – like her mother, grandmother and great-grandmother. Her school did not teach sexual health education, and pregnancy prevention was a foreign concept. Her sons are now teenagers.

“If you don’t know your options, you don’t have any,” said Chester, now program director for Healthy Futures of Texas, a sexual health advocacy and education nonprofit. “They were all pregnant. And I just felt like: When it happens, it happens.

While teen pregnancies have declined statewide and nationwide in recent decades, Texas continues to have one of the state’s highest teen birth rates — 22.4 births per 1,000 to girls and women ages 15-19 — the lowest in Massachusetts is 6.1. Along with Alabama, Texas has the highest teenage repeat pregnancy rate in the country. This fall, Texas school districts are marking a shift to what educators call an abstinence-plus curriculum — the first time the state has revised its sexual health education standards in more than 20 years.

Although districts can choose their own curriculum and teach more than the state requires, the state’s minimum health standards now go beyond a focus on abstinence to end pregnancy and include teaching middle school students about contraceptives and providing additional prevention information of sexually transmitted infections, such as the human papillomavirus (HPV), which is linked to several types of cancer.

Previously, a 2017 report showed that 58 percent of Texas school districts offered “abstinence-only” sexual health education, while only 17 percent offered curricula that expanded beyond that. A quarter of schools do not offer a sex edition.

Research shows that sex education programs that teach about contraception are effective in increasing contraceptive use and even delaying sexual activity among young people. Abstinence-focused education programs, on the other hand, have not been particularly effective in curbing sexual activity among teenagers.

Whether Texas teens will receive sex education at all, however, depends on whether their parents enroll them. Whereas parents previously had to “opt out” of sexually taught parts of their children’s health classes, now they have to “opt in” for their children to receive these lessons. That means parents must sign and return a permission slip — a change they fear children may miss out on not so much because of parental objections but because of lost forms and language barriers.

These changes to sex education come as the state restricts access to abortions after the Supreme Court’s ruling was overturned in June Roe v. Wade, which guarantees a constitutional right to abortion. Texas has one of the most restrictive abortion laws in the country. The question of how schools educate young people about their sexual health and development has taken on new urgency now that many countries’ governments have introduced abortion bans.

Health advocates say many women may have no choice but to get pregnant at term, and that has created a new class of haves and have-nots: those who have the knowledge, resources and freedom to prevent pregnancy, and those who don’t. .

Texas is large and diverse enough to need education policies that can be tailored to outlying border towns and sprawling metropolitan areas—both of which have high rates of unintended teenage pregnancy.

In 2019, the Texas Board of Education began rewriting health education standards that had been in place since the 1990s. It upholds the standards which state that “there are risks associated with sexual activity and that abstinence from sexual activity is the only 100% effective method of avoiding the risks.”

According to the Guttmacher Institute, a reproductive health research organization, 39 states, plus the District of Columbia, require sex education classes to provide information about abstinence, with 29 requiring it to be “stressed.” Only 20 states and DC require classes to provide contraception information.

Under Texas law, sex education must still present abstinence as the “preferred choice.” When schools teach about condoms and other forms of contraception, they must provide what Texas calls “actual human use rates” — or, as it’s described in the medical literature, “typical use” — that detail effectiveness. of these methods outside the laboratory setting.

The changes taking effect this year primarily address if and when a Texas student learns about certain sexual health topics. Under the state’s previous standards, Texas schools could teach about birth control methods beyond abstinence, but only in optional high school health classes. Information about contraceptives, as well as more about STIs, is now taught in compulsory secondary school health classes.

In May, the Dallas Independent School District, one of the nation’s largest, approved curriculum materials to meet the state’s new requirements. But school officials here wanted to do more given the scope of the problem. Advocates say Dallas County has the highest rate of teenage re-pregnancies in the nation.

The district’s curriculum exceeds the state minimum and includes gender identity and supplemental information about contraceptives, as well as a contract with Healthy Futures of Texas to teach an optional after-school program for high school students.

The previous curriculum was “very scientific” and “very dry,” said Dustin Marshall, a school district board member, and left out basic information about contraceptives, such as how to put on a condom.

“One of the main ways to reduce teenage pregnancy and alleviate generational poverty from teenage pregnancy is to teach contraception,” he said. “Don’t just assume that if you teach abstinence, every child will obey.” From my point of view, that’s a bit too much burying one’s head in the sand.”

Some critics say the state’s standards, while an improvement, are inadequate when it comes to consent and LGBTQ+ issues, including gender identity. The State Board does require schools to teach about healthy relationships and setting personal boundaries for sexual activity.

Under Texas law, parents have the final say not only on whether their child receives sexual health education, but also what is covered in those lessons.

For nearly 30 years, school districts have been required to create and appoint school health advisory boards charged with reviewing and recommending health curricula, including sexual health. Most members must be parents, not district employees, so the content of sex education classes can still vary widely by district.

Jen Bindo, senior director of policy and research at Healthy Futures of Texas, described a study she helped conduct asking parents and teens who they would prefer to teach teens about sex. Although parents and teens ranked them differently, she said their choices were the same: schools, doctors and parents. Health advocates point out that not all parents can or succeed in educating their children about sex — and that many teenagers live in precarious situations such as foster care.

Biundo said that when teenagers were asked where they learned about sex, the most common answers were “my friends and the Internet.”

Indeed, some parents, especially those who have been mothers of teenagers themselves, may not know about birth control or how to access it. “Where are parents supposed to get knowledge from?” Chester said. “Because they went through the same school system that didn’t teach sex education, and suddenly they had to know what to teach their kids.”

“We’re trying to end the generational curse of being uneducated,” she said.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Along with Policy Analysis and Polling, KHN is one of the three main operational programs of the KFF (Family Kaiser Foundation). KFF is a charitable, non-profit organization providing information on health issues to the nation.


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