According to the Sexuality Information and Education Council of the United States, the federal government has spent millions of dollars over several decades promoting abstinence-only sex education even though they “rarely provide information on even the most basic topics in human sexuality such as puberty, reproductive anatomy, and sexual health, and they have never been proven effective.” In this post, a nursing professor who had a child when she was a teenager discusses why it is time for a change in school-based sex ed. Imelda Reyes is a clinical assistant professor of nursing, specializing in pediatrics and a Public Voices Fellow of The OpEd Project at Emory University.

I am a health-care provider. Sarah, one of my teen patients who was 16 years old, came to see me about a private problem and could barely walk. She was scared about what was happening, and her mother was worried.  I asked her mom to leave the room, talked to Sarah and then examined her. I found that she had herpes and the infection was pretty bad in the perianal area. She cried when I told her the diagnosis. I asked her if she was going to tell her mother. She said she was too embarrassed because her mother thought she was still a virgin.

We started talking about her sexual history, and she insisted that she was still a virgin. She said she had engaged in unprotected anal sex with her boyfriend but he told her that she would still be a virgin as long as they didn’t have vaginal sex. She said she had Googled the question: “Am I still a virgin if I had anal sex?” And the answer she read on the Internet was, ‘Yes.’

It is time to rethink how and where teens are accessing information about sex and sexually transmitted infections and pregnancy — and to push it to the front of our public health agenda. Moving away from abstinence-only curricula in schools and strengthening the public image is the only way to start to solve the problem.

According to the Youth Behavior Risk Survey System, 47 percent of high school students have engaged in sexual intercourse before graduating. Of those teenagers, 33 percent engaged in sex within the past three months and nearly 40 percent did not use a condom and 77 percent did not use birth control. The United States has the highest teen pregnancy rate among all industrialized countries. In terms of sexually transmitted diseases, according to the Centers for Disease Control, half of all new sexually transmitted infections occur in young people ages 15-24.

Depending on your state, some teens only get limited sexual education in their schools, according to 2011 report of the Sexuality Information and Education Council of the United States (SIECUS), 34 states applied for abstinence-until-marriage funding, meaning that programs “may not in any way advocate contraceptive use or discuss contraceptive methods except to emphasize their failure rates.” As a health-care provider and former teen mom, I am concerned about the way our society has sought to curb teen pregnancy. Abstinence is, of course, the only 100 percent proof-positive way to avoid everything — but it doesn’t work for everyone, and pretending it does doesn’t make it true.

Whose job is it to educate children on this topic?

Many people say it is the job of parents to talk to their kids about sex. Have you ever had “The Talk” with a teenager? The CDC reports that parental monitoring can be a protective factor in reducing risky behavior among adolescents. As the parent of a young man with lots of education about the subject, I can definitely sympathize with the grief associated with bringing up the topic. My husband and I worked together to figure out the best way to convey information, make sure condoms were readily available and tried to be open about the subject. I can only imagine the heartache if you don’t have that kind of background or you assume that they will get the information in school. Or worse yet, you fall into the pool of people that have incorrect information that you share with your children.

If not our parents, then why not look to the schools to educate kids on this subject? Here we run into all sorts of problems. According to the SIECUS report, some states offer abstinence-only curricula. According to the National Conference of State Legislature, only 19 states require that if provided, sex education must be medically, factually or technically accurate.

If not the schools, what about public educational campaigns?  There are some great organizations out there with vital information, but the teens have to actively seek it out, and in some cases may just default to their friend’s advice.

What about a child’s health-care provider? Can parents count on health-care providers to broach the subject and make teens safe? Not necessarily. Not everyone has access to a health-care provider. Some teens only see a health-care provider when they are sick. Some providers may not address the topic when they are seeing a teen for a routine health exam. After years of training, observation and picking up clinical pearls about how to approach the subject, I feel comfortable about bringing up the issue with my teen patients, but it has definitely taken some time and effort to get there.

It is time to rethink our attitude and approach toward population-based sex education and face reality.

When I asked my patient Sarah who had talked to her about sex education, she remembered her abstinence-only talk from school. She said her mother only told her to remain a virgin. Her last medical exam occurred when she was 12 years old, and she couldn’t remember if they had discussed changes with puberty and general sexual health.

Adults need to make it a priority to provide the younger generation with  information and access to health care. Specialists that focus on adolescent health care, such as nurse practitioners and other providers, could be engaged to help convey this important information within our schools. School-based, nurse-managed health care clinics could offer a full range of services. Once we open our eyes and hearts to the future of our nation, we too can talk about sex. Safe sex.

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