Texas, fights teen pregnancy, restores 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 by the time she got to college that fall.

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

“If you don’t know your options, you have no options,” said Chester, now program director of Healthy Futures of Texas, a nonprofit sexual health advocacy and education organization. “Everyone was pregnant. And it just felt like: when it happens, it happens.”

Although teenage pregnancies have declined in the state and across the country in recent decades, Texas has the highest birth rate at 22.4 per 1,000 girls and women ages 15-19 — the lowest in Massachusetts. 6.1. Along with Alabama, Texas has the nation’s highest rate of repeat teenage pregnancies. This fall, school districts across Texas are rolling out what educators are calling an “abstinence-plus” curriculum — the first time the state has revised its standards for sexual health education 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 focusing on abstinence to end pregnancy and include teaching middle school students about contraception and providing additional information about preventing sexually transmitted infections. including, for example, human papillomavirus (HPV), which is associated with various cancers.

Previously, a 2017 report showed that 58% of school districts in Texas offered “only” sexual health education, while only 17% offered curriculum that expanded beyond that. A quarter of schools did not offer sex education.

Research shows that sex education programs that teach about contraception are effective in increasing contraceptive use and even delaying sexual activity among youth. On the other hand, abstinence-focused education programs have not been shown to be particularly effective in preventing sexual activity among adolescents.

Whether teens in Texas get any sex ed at all depends on whether their parents sign them up. While parents previously had to “opt out” of the sex ed portions of their children’s health classes, they now have to “opt in” for their children to receive those lessons. That means parents must sign and return a permission slip — with some changes children may lose not so much because of parental objections but because of lost forms and language barriers.

The changes to sex education come as states reduce access to abortion after the Supreme Court overturned a decision in June. Roe v. Wade, which guaranteed the 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 state governments have banned abortion.

Health advocates say many women have no choice but to get pregnant, and that this has created a new category of haves and have-nots: those who have the knowledge, resources and agency to protect themselves from getting pregnant, and those who don’t.

Texas is large enough and needs diverse education policies that can be adapted for remote 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 in place since the 1990s. It set standards that “there are risks associated with sexual activity and abstinence from sexual activity is the only 100% effective method of avoiding risk.”

According to the Guttmacher Institute, a reproductive health research organization, 29 of the 39 states and the District of Columbia that mandate that sex ed classes provide information on abstinence must be “stressful.” Only 20 states and DC require that classes provide information about contraception.

Under Texas law, sex ed must be abstained from as a “preferred choice.” When schools teach about condoms and other forms of contraception, they must include what Texas calls “reality rates of human use” — or, as described in the medical literature, “typical use” — that detail the effectiveness of those methods outside of laboratory settings.

The changes that went into effect this year primarily address when and if a student in Texas learns about certain sexual health topics. Under previous state standards, Texas schools could teach birth control methods beyond abstinence, but only in high school health classes, which are optional. Now, information about contraception, as well as more about STIs, is taught in middle school health classes, which is required.

In May, the Dallas Independent School District, one of the nation’s largest, approved reading 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 one of the highest teen pregnancy recurrence rates in the country.

District curriculum exceeds state minimums and includes additional information about gender identity and contraception, 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 “too scientific” and “too dry,” said Dustin Marshall, a member of the school district’s board of trustees, and omitted basic information about contraception, such as how to wear a condom.

“One of the primary ways to reduce teen pregnancy and eliminate generational poverty from teen pregnancy is to teach contraception,” she said. “Not just assuming that if you teach abstinence, every kid is going to comply. That’s a little too sandy from my perspective.”

Some critics have said that the state’s standards for compliance with gender identity and LGBTQ+ issues, while an improvement, are insufficient. The state board requires that schools teach about healthy relationships and setting personal boundaries for sexual activity.

Under Texas law, parents have a say in not only whether their children receive sexual health education, but also what those lessons include.

One picture shows a wall full of pamphlets.
Pamphlets about sexually transmitted infections and pregnancy prevention are part of the materials available at the Dallas office of Healthy Futures of Texas, a statewide nonprofit sexual health advocacy and education organization.(Emmarie Huetteman/KHN)

For nearly 30 years, school districts have been required to create and appoint school health advisory councils, which are tasked with reviewing and recommending health curricula, including sexual health. Most members must be parents and not district employees, so sex ed class content can still vary widely by district.

Jane Biundo, senior director of policy and research at Healthy Futures of Texas, described a study she conducted asking parents and teens what they would prefer to teach teens about sex. Although parents and teenagers ranked them differently, he said their choices were the same: school, doctor and parents. Health advocates point out that not all parents can or will educate their children about sex — and many teenagers live in unstable situations like foster care.

Biundo said that when they asked teenagers where they learned about sex, the top answer was “my friends and the Internet.”

In fact, some parents, especially those who were teenage mothers, did not know about birth control or how to access it. “Where are parents supposed to get knowledge?” Chester Dr. “Because they came through the same school system that didn’t teach sex ed, and all of a sudden they had to know what to teach their kids.”

“We are trying to end that generational curse of being illiterate,” he said.

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