The Sex Education Curriculum in South Carolina s Public Schools: The Public s View

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1 The Sex Education Curriculum in South Carolina s Public Schools: The Public s View Forrest L. Alton, Robert W. Oldendick, and Katherine A. Draughon Introduction Sex. The word alone is enough to stir up strong feelings among the South Carolina public, and the topic often becomes contentious when it includes distribution of sexuality education and information to young people. The apex of this contentiousness often involves the provision of such education in public schools. For several decades, the issue of how sexuality education should be provided in the public schools has been debated in the state, and remains a potentially divisive issue today. Despite declines throughout the 1990s in rates of teen sexual activity, teen pregnancy, and teen births, South Carolina still has rates that greatly exceed national averages. According to the 2003 Youth Risk Behavior Survey, 56.0% of high school students in South Carolina report having had sexual intercourse compared to 46.7% nationally. 1 High rates of sexual activity contribute to high rates of teen births and sexually transmitted diseases (STD). In 1988, the rate of teen births for females ages in South Carolina was 65 per 1,000, compared to the national average of 53 per 1,000. By 2000, rates in South Carolina had declined to 59 per 1,000, but were still above the national rate of 48 per 1, In addition, in 2003 South Carolina ranked fourth nationally (among all age groups) in diagnosed cases of gonorrhea, tenth in cases of chlamydia, and ninth for new cases of AIDS. 3 Declines in teen pregnancy have been attributed both to an increase in the number of young people who choose to delay the initiation of sexual activity and to an increase in the consistent and effective use of contraception by those young people who are sexually active. 4 Sexuality education and information that encourages young people to delay sexual activity and to increase their use of contraception if they are sexually active is generally considered to contribute to a decline in the teen pregnancy rate. 5 Even so, South Carolina, like much of the rest of the country, has not been able to reach a consensus on what information and approaches should be presented to public school students in terms of sex education. Two divergent schools of thought have emerged on this issue. On one side of the debate are those who are opposed to comprehensive sexuality education in the schools, or at best, support education which emphasizes abstaining from sexual activity as the only acceptable option for adolescents. 6 Proponents of this approach, often referred to as abstinence-only until-marriage education, believe that sexual intercourse should not occur, at any age, outside of marriage, and are of the opinion that discussions of contraception should be brief and take place only in the context of their failure rates. 7 8 Accordingly, proponents of this view believe that a comprehensive approach to sexuality,

2 which includes contraceptive information, is not only morally wrong, but more damagingly, promotes sexual activity. There is also some sentiment among this group that comprehensive sexuality education is in direct opposition to what parents want their children to be taught and ultimately undermines their authority. 9 At the seemingly opposite end of the spectrum are supporters of a comprehensive approach to sexuality education. We say seemingly because, at least initially, the views of those in favor of a comprehensive approach parallel those who favor abstinence-onlyuntil-marriage education. The approaches are in agreement in the belief that schools should teach abstinence as the first option for young people and emphasize that abstinence is the only 100% effective method of preventing unwanted pregnancy and sexually transmitted diseases. Abstinence is not the source of disagreement between these groups; their divergence comes from the word only. Proponents of a comprehensive approach, referred to as abstinence-plus or abstinencebased sex education, believe that in addition to a strong focus on abstaining from sexual activity, programs should discuss medically accurate information about contraception. The Guidelines for Comprehensive Sexuality Education, 10 published in 1996 by the Sexuality Information and Education Council of the United States, concludes that comprehensive school-based sexuality education that is appropriate to a student s age, developmental level, and cultural background should be an important part of the education program at every age. In 2001, then Surgeon General, Dr. David Satcher, released a Call to Action which stressed the importance of approaching the issue of sex education from a comprehensive manner. Satcher stated that education about sexual health should stress the value and benefits of remaining abstinent but assure awareness of optimal protection from sexually transmitted diseases and unintended pregnancy, for those who are sexually active. 11 In 1988, South Carolina enacted a Comprehensive Health Education Act (CHEA) which, among other things, provides guidelines for the provision of sexuality education in the state s public schools. Since 1990, there have been more than twenty attempts to change these provisions, either through amendments to the existing Act or through new legislation. In most cases, these proposed changes have reflected a move towards a more abstinence-only approach to sexuality education. For example, in 1998, legislation was introduced to repeal language stating the purpose of the CHEA was to promote responsible sexual behavior. 12 In its place, the bill suggested the following: the goal of this act is to reduce the incidence of sexual activity among school aged youth. As recently as the legislative session a bill was pre-filed so as to among other things, revise the guidelines of the 1988 Act. 13 Sexuality education has been a part of our nation s public schools for some time, and current laws and policies virtually ensure that adolescents will receive some form of formal education specific to sexuality while they are in school. 14 Nearly all youth ages have had some form of sexuality education during their school years 15, and the evidence is that school-based health education programs can have a considerable impact on the health of children. 2

3 Given the range of views on the issue of sexuality education in public schools, where does the public stand on this issue? Do South Carolinians support an abstinence-onlyuntil-marriage approach to this topic or are they more likely to favor one based on abstinence plus? In order to determine how South Carolina s registered voters feel about this issue, in early 2004, the South Carolina Campaign to Prevent Teen Pregnancy 19 commissioned the Institute for Public Service and Policy Research to conduct a survey of the state s registered voters. The following sections describe the results of this survey. Methods Data for this study were collected by telephone interviews with registered voters in the State of South Carolina, with interviewing done by the staff of the University of South Carolina s Institute for Public Service and Policy Research (IPSPR). The topics included in this survey were identified by the staff of the South Carolina Campaign to Prevent Teen Pregnancy and were similar to those of an earlier survey on this topic conducted in IPSPR staff provided technical consultation on the design of the questionnaire and conducted a pretest of the instrument. The respondents interviewed for this study were selected from a random sample of households with telephones in the state. Within these households, a respondent was randomly chosen from among those registered to vote. To avoid biasing the sample in favor of households that could be reached on multiple phone numbers, each case was weighted inversely to its probability of being included in the sample. The data presented have also been weighted to correct any potential biases in the sample on the basis of age, race, gender, region, and number of registered voters in the household. Interviewing for this study was done between February 16 and April 7, Calls were made from 9:00 AM to 9:30 PM Monday through Friday, from 10:00 AM to 4:00 PM on Saturday, and 3:00 PM to 8:00 PM on Sunday. A total of 501 fully completed interviews and 46 partially completed interviews were conducted. For all questions that were answered by 500 or so respondents, the potential for sampling error is +/- 4.4%. Results for questions answered by significantly fewer than 500 respondents and results for subgroups of the population have a potential for larger variation than those for the entire sample. Results One of the first items in the survey concerned the general topic of sexuality education in which respondents were asked, Do you think that sexuality education which emphasizes abstinence as the first and best option for young people, but also teaches youth about the benefits and importance of using contraception to prevent pregnancy and/or sexually transmitted diseases should be taught in South Carolina public schools? Approximately three-fourths of respondents believed that such sexuality education should be taught, 11.4% thought it should not be, 8.9% said it depends, and 4.4% said they did not know. 20 3

4 Appropriateness of Various Topics as Part of School-Based Sex Education As part of this study, respondents were asked whether topics such as reproductive anatomy, sexual decision-making and parenting responsibilities should be part of schoolbased sex education programs and, if so, the earliest grade level at which it should be taught. The vast majority of South Carolina adults (over 90%) feel that schools should include information about sexually transmitted diseases, abstinence, and sexual abuse/rape as part of a school-based comprehensive, age-appropriate sex education program (Figure 1). In addition, more than 80% of the South Carolina public feels that teachers should include the topics of parenting responsibilities, physical changes associated with puberty and adolescence, reproductive anatomy, contraception, and pregnancy and childbirth in their sex education lesson plans. Despite the fact that most South Carolina registered voters agree that topics such as contraception, sexually transmitted diseases, abstinence, and sexual abuse should be included in school sex education curriculums, only slightly more than two-thirds feel that children should receive information about sexual decision making at school. Of the 12 sex education topics included in this study, there were two that less than half of those interviewed thought should be taught in public schools: abortion and homosexuality. Among those surveyed, 53.8% thought that information about abortion should not be taught and 57.6% felt that information about homosexuality should not be taught. Appropriateness of Sex Education Topics by Grade Level Respondents who believed that a particular sex education topic should be taught in the public schools were asked what was the earliest grade level at which this topic should be taught. As the data in Table 1 demonstrate, registered voters generally believe that these topics should be introduced in middle school (grades 6, 7, and 8). A majority feels that information about abstinence, sexually transmitted diseases, and changes associated with puberty and adolescence is most appropriate to teach at the middle school level. In addition, between 40% and 50% of respondents said that middle school is the most appropriate time to introduce information on sexual abuse and rape, parenting responsibilities, reproductive anatomy, contraception, pregnancy and childbirth, and responsible relationships. More than 25% think that information on sexual abuse and rape, changes associated with puberty and adolescence, and reproductive anatomy should first be taught in grade school, while 32.6% feel that the earliest information on parenting responsibilities should be taught in high school. Support for Sex Education Topics - Demographic Differences While the voting public generally believes that these various sex education topics should be taught in public schools, there are a number of significant differences across 4

5 demographic groups. The largest and most consistent differences are across age groups, with the general pattern being that younger people are more likely to support having these topics included as part of the public school curriculum. Differences across age groups are Figure 1 Level of Support for Sex Education Topics % Who Agree Topic Should Be Taught In School Sexually Transmitted Diseases Abstinence Sexual Abuse/Rape Level of Support for Sex Education Topics Parenting Responsiblities Reproductive Anatomy Changes Associated w/ Puberty & Adolescence Contraception Pregnancy & Childbirth Sexual Decision Making Responsible Relationships Abortion Homosexuality Table 1 Earliest grade level at which sex education topics should be taught in South Carolina public schools (% giving each response) Grade Middle High Should Not School School School Be Taught N Sexually Transmitted Diseases Abstinence Sexual Abuse/Rape

6 Parenting Responsibilities Changes Associated w/ Puberty & Adolescence Reproductive Anatomy Contraception Pregnancy & Childbirth Responsible Relationships Sexual Decision Making Abortion Homosexuality significant for eight of these twelve items. On the question of whether sexual decision making should be taught in schools, for example, 79.7% of those ages 18 to 29 think that it should be; this declined to 74.7% among those ages 30 to 45, 64.8% of those ages 46 to 64, and 54.9% among those age 65 or older. Similarly, the percentages who think that contraception should be taught in the schools ranged from 94.2% among those in the age group to 77.8% among those 65 or older. Whether a respondent is the parent or legal guardian of a child age 17 or younger also made a difference in their views on these items. For four of these items sexual decision making, physical and social growth changes associated with puberty and adolescence, reproductive anatomy, and contraception parents were significantly more likely than those who were not parents to believe they should be taught in public schools. A higher percentage of those who were not parents (49.3%) than those who were (39.5%) feel that information about abortion should be taught in public schools. While other group differences such as those across education groups, by race, or by religion are evident, they are not as significant as those found across age groups or between respondents who are parents and those who are not. Time Allotted for Sex Education in Schools When asked if the time required for sex education instruction in high schools should be increased, decreased, or remain the same, 50.0% say it should be increased and 39.4% feel it should remain about the same as it is now; only 6.6% think that the current amount of time allotted to sex education in schools should be reduced, and 4.0% said they are not sure. 6

7 Across subgroups, significant differences were found across age categories, level of family income, and whether the respondent is a parent or not (Table 2). The younger the respondent, the more likely he or she was to feel that the time allotted for sex education in schools should be increased, with approximately two-thirds of the 18 to 29 age group responding that the time should be increased, compared to slightly more than a third of those age 65 or older. None of the 18 to 29 year old respondents thought that the time allotted for sex education should be decreased. South Carolinians with household incomes of less than $25,000 are more likely than those with higher incomes to believe that the amount of time currently required for sex education instruction should be increased. Similarly, respondents who were parents or legal guardians of a child age 17 or younger are significantly more likely (56.1%) to feel that the amount of time devoted to sex education in schools should be increased than were those who are not parents (45.8%). Support of State Funding of Teen Pregnancy Prevention Programs When South Carolina registered voters were asked if they would favor or oppose increasing state funding for teen pregnancy prevention programs in their community, a majority (70.0%) said they would favor such an increase, 23.2% would oppose it, and 6.8% said they were not sure. Moreover, as the data presented in Table 3 demonstrate, a majority of each subgroup examined was in favor of increasing state funding for teen pregnancy prevention programs and with the exception of those age 65 or older more than 60% of each group supported such an increase. The largest difference in support was across age groups. More than 80% of those ages 18 to 29 say they would support increased funding of teen pregnancy prevention programs. This percentage declines to 74.2% of those ages 30 to 44, 68.0% of those ages 45 to 64, and 56.0% of those age 65 or older. Table 2 Required time for sex education instruction increased, decreased or remained the same (% giving each response) Remain Do Not Increased Decreased the Same Know N Total Gender Male Female Race Non-White White

8 Age and older Education Less than HS HS Diploma Some College College Degree Income Less than $25, $25,000 - $49, $50,000 - $74, $75,000 and over Region Upstate Midlands Lowcountry Parent/Legal Guardian Yes No Religious Affiliation Baptist Other Protestant Catholic Other Table 3 Favor or oppose increasing state funding for teen pregnancy prevention programs (% giving each response) Do Not Favor Oppose Know N Total Gender Male Female Race Non-White White

9 Age and older Education Less than HS HS Diploma Some College College Degree Income Less than $25, $25,000 - $49, $50,000 - $74, $75,000 and over Region Upstate Midlands Lowcountry Parent/Legal Guardian Yes No Religious Affiliation Baptist Other Protestant Catholic Other Parents and Sex Education South Carolina s registered voters generally support the teaching of most sex education topics in schools, believe that additional time should be devoted to the teaching of these topics, and would approve additional state funding for teen pregnancy prevention programs in their community. Yet this does not mean that they believe that sex education should be the primary responsibility of the schools or of community programs. When asked, Where do you think children and teenagers should get their information about sex and sexuality?, 88.4% say parents or legal guardians and only 7.9% cite teachers or schools; 1.2% feel that religious leaders should be the source of this information, less than 1% mention friends or peers, and 1.6% name some other source of information. While voters overwhelmingly believe that parents should be the source of information about sex and sexuality, not all parents have talked with their children about sexual topics. When respondents who were parents or legal guardians of children age 17 or 9

10 younger were asked if they had discussed sexuality and relationships with their children, 67.6% said they had done so, 24.5% had not, and 7.9% said not yet. Similarly, when these parents or guardians are asked if they had educated their children about pregnancy and sexually transmitted diseases, including HIV/AIDS, 55.2% report that they have, 28.4% have not, and 15.7% indicate that they have not yet done so. Most Important Things Parents Can Do To Prevent Unwanted Teen Pregnancies A final question of interest in this survey was to identify what South Carolinians feel is the most important thing parents can do to help their teenage children avoid an unwanted pregnancy. The results to this question are as follows: % N Communicate/talk with them (general) Educate/teach them (general) Teach abstinence Explain consequences Provide/explain birth control Teach Christian principles Be aware/involved Other suggestions As these results demonstrate, the thing that the largest percentage (39.3%) of respondents think that parents can do to help their children avoid an unwanted pregnancy is to communicate with them. The next most frequently mentioned action (23.8%) is educating their children about sex, pregnancy, contraception and other sex related topics. Other more specific suggestions include such things as teaching abstinence (9.3%); explaining the consequences of an unwanted pregnancy (8.6%); providing or explaining birth control methods (4.7%); teaching Christian principles (4.5%); and being involved in their children s lives (3.9%). Communication and education are seen as the key elements in helping teenagers to avoid unwanted pregnancies. Some examples of responses to this question help to illustrate this point: Talk to them about sex and the burdens of being a parent. It s not as easy as it may look on television. Talk to them and explain the consequences. Get the closeness so they won t be scared to come to their parents about anything. Leave it open and don t make sex a dirty word. Be more alert about your kids; be aware of what s going on in their dating and relationships. Be open and straightforward with setting standards. What we expect has to come from the home and family. Talk to them about sex; communicate with them. 10

11 Talk to them and explain to them that you should wait until marriage to have sex and that your partner should be the one you want to spend the rest of your life with. Encourage the child to wait until after they are married before having a baby. Discussion A very large percentage of the South Carolina voting public believes that sex education that emphasizes abstinence, but includes the importance and benefits of using contraception to prevent pregnancy and/or sexually transmitted diseases should be taught in the public schools. The specific topics that most feel should be included in the curriculum are sexually transmitted diseases, abstinence, and sexual abuse or rape. Less than a majority believe that information about abortion or homosexuality should be provided by the schools. Moreover, there is a general belief that middle school is the most appropriate time to introduce these topics to students, and that the amount of time required for sexual education in the public high schools should be increased. Less than 10% think the current time requirement should be decreased. While the public supports increased efforts at sex education in the schools, it also acknowledges the roles of parents and other community-based programs. Registered voters overwhelmingly believe that the primary source for such information should be parents. Additionally, a large majority of registered voters support increasing state funding for teen pregnancy prevention programs in their community. Many parents are trying to provide sex education/information to their children. Two-thirds of the parents in this survey say they have discussed sexuality or relationships with their children and more than half have had discussions about sexually transmitted diseases. Many of those who have not provided their children with information on sexuality indicated that they have not yet done so because they feel their children are too young. Communicating with children and educating them about sex, pregnancy, and contraception are viewed as the two most important things that parents can do to help teenagers avoid unwanted pregnancies. Conclusion While the issue of sexuality and the provision of sex education are often very complex, it is evident that South Carolina voters are fairly clear in their views of the appropriate approach to this topic in the state s public schools. A majority of the state s registered voters support comprehensive sex education (including information on abstinence and contraception) and support instruction on a variety of specific topics. In addition, respondents would like to see sex education begin in middle school and for more instruction than the currently required 750 minutes to be given. As programming in South Carolina s schools continues to evolve, and decisions are made relative to the content of school-based sexuality education, the views of the large majority of the voting public both parents of school-age children and those who are not should be given considerable consideration. 11

12 References The Alan Guttmacher Institute. (2004). U.S. teenage pregnancy statistics. Overall trends, trends by race and ethnicity and state-by-state information. New York, NY: Author. Brener, N.D., et al. (2003). Variation in school health policies and programs by demographic characteristics of U.S. schools. Journal of School Health, 73(4): Centers for Disease Control and Prevention. (2004, May 21). Surveillance summaries. MMWR 2004: 53 (No. SS-2). Dailard, C. (2001). Sex education: Politicians, parents, teachers and teens. The Guttmacher report on public policy. New York, NY: The Alan Guttmacher Institute. Darroch, J.E., Landry, D.J., and Singh, S. (2000). Changing emphases in sexuality education in U.S. public secondary schools, Family Planning Perspectives, 32(5): Donovan, P. (1998). School-based sexuality education: The issues and challenges. Family planning perspectives, 30(4). Retrieved April 6, 2005 from html. Kirby, D. (2000, October). What does the research say about sexuality education? Educational Leadership, Kirby, D. (2001). Emerging answers: Research findings on programs to reduce teen pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy. Landry, D.J., et al. (2003). Factors associated with the content of sex education in U.S. public secondary schools. Perspectives on Sexual and Reproductive Health, 35(6): National Guidelines Task Force. (1996). Guidelines for comprehensive sexuality education. New York, NY: SIECUS. Ramey, M.A., and Young, M. (2001). Support among Arkansas legislators for comprehensive school health programming. American Journal of Health Education, 32(2): Reininger, B., and Lindley, L. (1997). South Carolina speaks. Columbia, SC: South Carolina Council on Adolescent Pregnancy Prevention. 12

13 Santelli, J.S., et al. (2004). Can changes in sexual behaviors among high school students explain the decline in teen pregnancy rates in the 1990s? Journal of Adolescent Health, 35: Satcher, D. (2001). The Surgeon General s call to action to promote sexual health and responsible sexual behavior. American Journal of Health Education, 32(6): S.C. Department of Health and Environmental Control South Carolina. (2004, June 30). STD/HIV/AIDS data: STD/HIV division surveillance report. Columbia, SC: Author. Vincent, M.L., et al. (1999). Pregnancy prevention, sexuality education, and coping with opposing views. Journal of Health Education, 30(3): Wiley, D. (2002). The ethics of abstinence-only and abstinence-plus sexuality education. Journal of School Health, 72(4): About the Authors Forrest L. Alton, MSPH, CHES Mr. Forrest L. Alton is currently the Associate Director at the S.C. Campaign to Prevent Teen Pregnancy. Prior to becoming the Associate Director, he was the Director of Youth Initiatives and was responsible for the replication of Teen Outreach Program statewide, including training, technical assistance, oversight of mini-grants and evaluation. Specialist. Mr. Alton can be reached at falton@teenpregnancysc.org. Robert W. Oldendick, Ph.D. Dr. Robert W. Oldendick is the Executive Director of the University of South Carolina s Institute for Public Service and Policy Research and a Professor of Government and International Studies. Dr. Oldendick has over 25 years experience in the field of survey research and public opinion. He is also the author of numerous publications on survey research methodology, including procedures for sample selection in telephone surveys, methods of respondent selection within households, and the effects of question wording and format on responses to survey questions. He can be reached at oldendick-bob@sc.edut. Katherine A. Draughon, MPH, Ph.D. Dr. Katherine A. Draughon is the president of Draughon Research of Evansville, Indiana. From she was Assistant Director and Research Professor with the Survey 13

14 Research Laboratory at the University of South Carolina s Institute for Public Service and Policy Research. She also served three years as Senior Project Coordinator in the University of Illinois - Chicago Survey Research Laboratory. She can be reached at draughon.research@insightbb.com. Endnotes 1 Centers for Disease Control and Prevention. (2004, May 21). Surveillance summaries. MMWR 2004: 53 (No. SS-2). 2 The Alan Guttmacher Institute. (2004). U.S. teenage pregnancy statistics. Overall trends, trends by race and ethnicity and state-by-state information. New York, NY: Author. 3 S.C. Department of Health and Environmental Control South Carolina. (2004, June 30). STD/HIV/AIDS data: STD/HIV division surveillance report. Columbia, SC: Author. 4 Santelli, J.S., et al. (2004). Can changes in sexual behaviors among high school students explain the decline in teen pregnancy rates in the 1990s? Journal of Adolescent Health, 35: Kirby, D. (2001). Emerging answers: Research findings on programs to reduce teen pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy. 6 Wiley, D. (2002). The ethics of abstinence-only and abstinence-plus sexuality education. Journal of School Health, 72(4): Kirby, D. (2000, October). What does the research say about sexuality education? Educational Leadership, Dailard, C. (2001). Sex education: Politicians, parents, teachers and teens. The Guttmacher report on public policy. New York, NY: The Alan Guttmacher Institute. 9 Donovan, P. (1998). School-based sexuality education: The issues and challenges. Family planning perspectives, 30(4). Retrieved April 6, 2005 from Hhttp:// htmlH. 10 National Guidelines Task Force. (1996). Guidelines for comprehensive sexuality education. New York, NY: SIECUS, p Satcher, D. (2001). The Surgeon General s call to action to promote sexual health and responsible sexual behavior. American Journal of Health Education, 32(6): See bill S. 819 (South Carolina General Assembly, Session ) at Hhttp:// 13 See South Carolina Code of Laws, Title 59, Chapter 32, as amended. Comprehensive Health Education Program. Available at Hhttp:// 14 Darroch, J.E., Landry, D.J., and Singh, S. (2000). Changing emphases in sexuality education in U.S. public secondary schools, Family Planning Perspectives, 32(5): Landry, D.J., et al. (2003). Factors associated with the content of sex education in U.S. public secondary schools. Perspectives on Sexual and Reproductive Health, 35(6): Vincent, M.L., et al. (1999). Pregnancy prevention, sexuality education, and coping with opposing views. Journal of Health Education, 30(3): Ramey, M.A., and Young, M. (2001). Support among Arkansas legislators for comprehensive school health programming. American Journal of Health Education, 32(2): Brener, N.D., et al. (2003). Variation in school health policies and programs by demographic characteristics of U.S. schools. Journal of School Health, 73(4): See Hhttp:// 20 When this question was repeated toward the end of the questionnaire, 80.9% believed that sexuality education should be taught in public schools, 11.2% thought it should not be, 5.4% said it depends, and 2.5% said they did not know. These results are almost identical to those from a similar survey conducted in 1997 in which 81% of South Carolina registered voters said that sexuality education should be taught in public schools (Reininger and Lindley, 1997). 14