Condom Nation: The U.S. Government’s Sex Education Campaign from World War I to the Internet

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Alexandra M. Lord
The Johns Hopkins University Press
224 pages. $40.

This fascinating history of the past hundred years of sex education in America explores public and private efforts to eradicate sexually transmitted diseases and promote healthy sexual behavior. It also reveals our hang-up, Alexandra Lord observes: “Americans’ uneasiness with sexual behavior.”

Having been a historian with the U.S. Public Health Service (PHS), Lord shares her insider’s view of how the PHS promotes sex education as a public health issue.

In the early 20th century, syphilis and gonorrhea threatened everyone, regardless of class or race, so sex education appealed to all, Lord explains. But when these diseases became identified with groups such as minorities or homosexuals, eradication campaigns were attacked as welfare programs. As the pendulum continues to swing between seeing sex education as medical science or morality, the public has become polarized.

Today, through a “complex mosaic of private-public partnerships,” the government provides sex education funding to a variety of organizations – conservative, progressive, secular and religious. Private groups struggle to control the agenda amid complaints of “federal bureaucratic meddling.” Lord shows that what our children need to learn for their sexual health has been sidelined by political maneuvering.

To understand how we got here and where to go next, Lord shows us where we’ve been, describing each sex education campaign launched since World War I – enhancing the details with illustrations and slogans from period films, posters and pamphlets that bring each era to life. Much of our national identity is revealed in colorful details such as these:

• As World War I ended, the 1918 People’s War began, with a public outcry about the “moral corruption” of young women. The Public Health Service launched the first government-sponsored sex education, a “wholesome” program covering reproduction, child care and marriage – without mentioning birth control.

• During World War II, the American military distributed 50 million condoms a month to soldiers.

• Skyrocketing teen pregnancy rates in 1957 were obscured by how records were kept: Pregnancies weren’t counted when girls lived with their parents or hid until they gave up their babies for adoption, obtained illegal abortions or married because of pregnancy. By 1959, almost half of all brides were under 19.

• Between 1959 and 1979, the Sexual Revolution meant Americans finally acknowledged reality, with the availability of the birth control pill, the legalization of abortion and interracial marriage, the recognition that women are not responsible for rape, the rejection of the belief that homosexuality is a mental illness, and the acceptance of unmarried couples living together openly.

• Early 1970s parents clung to the belief that their children would refrain from sexual experimentation, as urged by the Public Health Service’s sex education pamphlet – its message unchanged since the 1920s.

• In 1977, the PHS released its first pamphlet about teen pregnancy with frank discussion of birth-control methods and the right to obtain an abortion.

• By the mid-1980s, the Religious Right emerged, with parents protesting sex education in schools and taking their views to the ballot box, just in time for the AIDS epidemic.

What strikes the reader is the endless cycle of rediscovering, each decade or so, that rates of sexually transmitted disease and teen pregnancy are rising – and something must be done about it. Because that “something” has rarely acknowledged the reality of teen sexual behavior, the cycle continues.

In the last 25 years, the collision of politics, religion and sex education has become hopelessly divisive. From the Reagan presidency to that of George W. Bush, Lord chronicles each step.

She highlights Surgeon General C. Everett Koop’s landmark 1985 public report on AIDS as a rare, unifying force. An evangelical Christian who did not allow his personal beliefs about homosexuality to halt his vital message about preventing disease, Koop influenced behavior in a public health crisis with “nonjudgmental” and “extraordinarily explicit language,” Lord writes. A simple brochure based on this report was mailed directly to 114 million Americans in 1988. More than 80 percent of the population believed that schools should teach comprehensive sex education, which more than 93 percent of schools provided.

The abstinence-only vs. comprehensive sex education wars began in earnest as the Reagan administration’s Adolescent Family Life Act changed federally funded sex education. By 1999, schools had stopped providing birth-control information. After $1 billion went to abstinence education between 1996 and 2005, the U.S. had the highest teen pregnancy rate among the world’s industrialized nations.

Now more than half of all teens have sex by age 19 – and 88 percent of teens who have taken abstinence pledges have violated them, Lord writes. Instead of ensuring that teens won’t engage in sex, conservative sex education programs merely assure the public that we won’t be forced “to acknowledge unpleasant truths about our behavior,” Lord writes. But as of 2007, 14 states had abandoned millions of dollars in federal funding to return to comprehensive sex education.

If our government’s efforts to provide sex education become irrelevant, Lord asks in closing, “What will the consequences be for the vast majority of Americans who have depended on the federal government to provide them with the sex education they need and want?”

Will we ever get sex education right in America? (800) 537-5487, http://www.press.jhu.edu.