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Texas’ teen pregnancy rate is the result of bad policy choices

From the Rivard Report:

In Texas each year, about 35,000 young women get pregnant before they turn 20. Traditionally, the two variables most commonly associated with high teen birth rates are education and poverty, but a new study, co-authored by Dr. Julie DeCesare, shows that there’s more at play.

“We controlled for poverty as a variable, and we found these 10 centers where their teen birth rates were much higher than would be predicted,” she said.

DeCesare, whose research appears in the June issue of the journal Obstetrics & Gynecology, said several of those clusters were in Texas. The Dallas and San Antonio areas, for example, had teen pregnancy rates 50% and 40% above the national average.

Research shows teens everywhere are having sex. Gwen Daverth, CEO of the Texas Campaign To Prevent Teen Pregnancy, said the high numbers in Texas reflect policy, not promiscuity.

“What we see is there are not supports in place,” Daverth said. “We’re not connecting high-risk youth with contraception services. And we’re not supporting youth in making decisions to be abstinent. We’re just saying that is an approach we want to take as a state – whereas other states have put in more progressive policies.”

Daverth said California invested in comprehensive sex education and access to contraception. There, the teenage birth rate dropped by 74% from 1991 to 2015. The teen birth rate in Texas also fell, but only by 56%.

In South Carolina, young women on Medicaid who have babies are offered the opportunity to get a long-acting form of birth control right after they give birth. They’re also trying that approach in parts of North Carolina. And Colorado subsidizes the cost of long-acting birth control. There, both abortions and teen birth rates are dropping faster than the national average.

Texas makes it hard for teenagers to get reproductive health care, Daverth says.

In Texas, if a 17-year-old mom wants prescription birth control, in most cases she needs her parents’ permission. “Only [Texas] and Utah have a law that if you’re already a parent, you are the legal medical guardian of your baby, but you cannot make your own medical decisions without the now-grandma involved,” Daverth said.

That’s part of the reason, she notes, Texas has the highest rate of repeat teen pregnancies in the country.

Emphasis mine. That’s pretty much our state in a nutshell. The problem is that any effort to deal with this necessarily begins the acknowledgment of the realities of the situation – you know, like that teens have sex and that teens who have sex without access to contraception and good information about reproductive health are much more likely to become parents than teens who do have those things – and we’re no good at that. Shame and denial is so much easier, and we live with the results of that.

Let’s talk about sex education

We’re not good at it.

Rep. Mary Gonzalez

A Democratic state lawmaker is looking to bolster high school sex education requirements in hopes that Texas can lower its teen birth rates.

Rep. Mary González, D-Clint, filed House Bill 1547 to require sex education classes to include “medically accurate, age-appropriate” human sexuality education. The bill would allow students to be excused from the course with the written request of a parent or guardian.

“It’s deeply troubling that Texas has one of the highest teen birth rates in the nation,” González said Tuesday. “Our young people deserve to have correct, accurate information.”

Teen birth rates in Texas are among the highest in the country. According to a 2014 report from U.S. Department of Health and Human Services, the teen birth rate among Texas women ages 15 to 19 was nearly 40 in 1,000 girls. The national birth rate in 2015 for teenagers of the same age was 22 births per 1,000 girls, according to the agency.

González filed the bill on the heels of the Texas Freedom Network’s most recent report that found that more than 80 percent of the state’s public school districts are not teaching sex education or exclusively teach abstinence-only birth control.

The study found that the number of school districts that do not teach sex education has increased to more than 25 percent in 2016 from 2.3 percent in 2008.

The group also found that another 58 percent of school districts took an abstinence-only approach to sex education last year. Those districts did not include information about condoms or other forms of contraceptives.

“All of these findings make clear that policy makers need to create common-sense, very necessary solutions,” González said.

That would be nice, wouldn’t it? For lots of things. There are lots of reasons why this would be a good thing for the Lege to do, and at least as many reasons why they won’t. We’re going to need a different Lege for that. The Trib and the Observer have more.

We don’t need no (sex) education

Here’s the state of Texas leading the nation in yet another unflattering category.

In Texas and across the country, the rate of teenage births has declined significantly since its peak in 1991. Birth rates among teenagers in Texas dropped 43 percent between 1991 and 2012. In states like California and Connecticut, the drop was even larger, and nationwide, the rate declined 52 percent in that period.

But despite the improvements in the Lone Star State, it is faring worse than most. Texas has the nation’s fifth-highest birth rate among teenagers, behind Arkansas, Mississippi, Oklahoma and New Mexico. And Texas, where schools are not required to teach sex education, has the highest rate of repeat births among teenagers ages 15 to 19. Teenage birth cost Texas taxpayers $1.1 billion in health care, foster care and lost tax revenue in 2010, according to the National Campaign to Prevent Teen and Unplanned Pregnancy. Teenage mothers often drop out of school, specialists said, and their children are also likely to become teenage parents.

Gov. Rick Perry’s office said a drop in the birth rate among teenagers in the last decade corresponded with the state’s abstinence education program.

“Teen pregnancy is a multifaceted issue with many contributing factors,” a spokesman for Perry, Travis Considine, said. Among those factors, advocates said, are race, ethnicity and economic status.

Dr. Janet Realini, president of Healthy Futures of Texas, a nonprofit that works to prevent teenage and unplanned pregnancy, said that Texas’ often ineffective sex education helped explain the state’s comparatively high teenage birth rate. Other factors, she said, include the limited access to health care and insurance for the poor as well as the high rates of school dropouts and poverty.

“It’s this mentality that we’re Texas, we do it our way, we ignore science and kind of go with our gut,” said David Wiley, a professor of health education at Texas State University in San Marcos. “That Wild West mentality about public policy is not helpful.”

One state with similar demographics to Texas is faring much better: California, which cut its teenage birth rate by 64 percent from 1991 to 2012. Melissa Peskin, an assistant professor at the University of Texas School of Public Health in Houston, said Texas could lower its teenage birth rate by following California’s example in areas like sex education and access to contraception.

Others are not convinced. Jonathan Saenz, president of Texas Values, which promotes family values and abstinence-focused sex education, said California’s abortion rate is higher than Texas’.

“In Texas, since when did we think it was a good idea to adopt any policy from California?” Saenz said.

“I don’t think the proper measure is how do we compare to other states,” he added. “It’s undeniable that not only in our state but across the country, teen birth rates are at historic lows.”

The real problem, he said, is the glamorization of sexual activity.

Boy, you couldn’t come up with a better illustration of what Professor Wiley is talking about if you tried. Jonathan Saenz is the perfect distillation of the idiotic theocracy that our state is beholden to. If you need to be reminded what 2014 is all about, think about him.

Anyway. As you might imagine, the recent budget cuts that slashed family planning funds and forced the closure of dozens of clinics didn’t help. It was so bad even some Republicans are now dimly aware that there’s a connection between unprotected sex and pregnancy. As usual, we’re in the position of hoping we can maybe get back to where we were a few years ago, which is better than where we are now but still way behind where we should be given the state’s robust population growth. Which means we’ll fall even farther behind California, and Colorado, too. Happy now, Jonathan?

On a side note, according to the Trib this story is one entry in a 10-part series on the flip side of state leaders’ aggressive pursuit of the “Texas Miracle”. Other entries will be found here, and see also their Hurting For Work series for more. Kudos on the reporting here, because Lord knows there’s a ton of stories like these out there needing to be told.

Another reason why Texas has a high teen pregnancy rate

We’re lousy at sex education.

In the mid-1990s, California embraced sex education that teaches students the importance of waiting until they’re older to have sex, but also the value of using protection if they don’t wait.

Compare this with classrooms in Texas, where messages around contraception — if they’re delivered at all — have sometimes been shrouded in negativity and misinformation.

Which method has proved most effective?

The numbers are telling: Texas had the fourth-highest teen birth rate in the nation while California was 29th in 2010.

California reduced its numbers despite sharing Texas’ demographics and sky-high teen birth rates in the early ’90s. And while more teens have abortions in California than in Texas, California reduced those at the same time it brought down teen births.

California teachers freely promote condom use and other birth control methods. They demonstrate condom use in class. Classroom talk is frank and open. Many schools have free condom handout programs.

In Texas, where a state code demands a heavy emphasis on abstinence, teaching tends to be more constricted. Condoms can’t be distributed as part of instruction.

Across the U.S. there are essentially two types of sex ed curricula — comprehensive programs that promote abstinence and contraception, and programs that promote only abstinence, many of which historically cast contraceptive use in a negative light, if it was included at all. Texas has been called the “poster child” for the latter.

But the buzzword in sex education now is “evidence-based” — programs that are proven to positively change teen behavior — most of which are comprehensive, at least for now.

As the tide turns toward such rigorously tested programs, once firm lines are blurring. Some so-called abstinence-only programs teach more than “just say no” — decision-making skills and the like — and some now address contraception in a more neutral way. Meanwhile, some so-called comprehensive programs spend more time teaching abstinence than contraception.

In Texas, parents, teachers and administrators are rethinking sex education.

It’s a fairly long story, and it’s worth your time to read. As we know, there are more factors involved in the teen pregnancy and birth rates than just the quality of sex education, but we’re not in good shape with any of them. You might also be surprised to learn that “abstinence only” sex education can be evidence-based, too. I have philosophical issues with the concept of “abstinence only”, but if such a curriculum can be shown to be effective in reducing teen pregnancy and STD transmission, I can live with it.

One more thing:

Teaching birth control, especially in middle school, “is a sad message, almost like giving up,” said one mother who asked not to be named so as not to identify her children. Her two teen sons took vows to remain virgins until marriage.

“Teaching that condoms provide safe sex isn’t true,” she said. “But the real problem is it makes you think you’re entitled to do whatever you want. You’re not entitled to have sex just because you want to.”

Kyleen Wright, president of the Texans for Life Coalition, agreed.

“We don’t tell kids, ‘Try not to be too fat or too drunk when you drive or just smoke a little bit,’” she said. “In Texas, we have a clear and singular message. We don’t change that message just because not everyone is getting it.”

But Cheyenne Armendariz, 12, who attends New Frontiers, said kids can discern the difference between information and permission. “I mean, like, duh, we have our own brains,” she said.

You tell ’em, Cheyenne. As the story notes, the facts are on your side. For more information, see these Texas Freedom Network reports.

Even in Midland

Fact-based sex education replaces mythical thinking in Midland. And they said it couldn’t be done.

In the spring, public school students in Midland will cross what until very recently was the political third rail of sex education. For the first time, they will be taught about contraception — and how to practice safe sex.

The West Texas town is known for oil and Republican presidents, not progressive social policy. But after watching the teen pregnancy rates creep up year after year — 172 pregnant girls were enrolled in the town’s public schools last year — many in the community realized something needed to change.

“These are girls as young as 13 that are pregnant, some of them are on their second pregnancies,” said Tracey Dees, the supervisor of health services in the district of just under 22,000 students, adding that many of them reported having sexually transmitted infections as well.

Eighteen months ago, with input from parents, staff and other community leaders, the school board decided to implement a new curriculum for seventh and eighth-graders — one that emphasizes that waiting to have sex is best, but also teaches students about condoms and birth control. Midland is just one of a number of schools, from West Texas to the suburbs of Houston, that are moving toward “abstinence-plus” education at the urging of their health advisory committees made up of community members.

“We’re getting calls from all over the state,” said Susan Tortolero, the director of the University of Texas’ Prevention Research Center in Houston who developed the curriculum being used in Midland. “It’s like we’re beyond this argument of abstinence, abstinence plus. Districts want something that works.”

What a novel idea. There’s a part of me that’s never quite understood why this is controversial. I mean, why wouldn’t you want your kids to have the best information? How can you expect them to make good decisions otherwise? I’m glad that even in places like Midland, people are starting to get that. It’s just a shame that so many kids had to be poorly served in the meantime.

Sonogram bill passes out of committee

As expected.

One of Gov. Rick Perry’s designated “emergency” pieces of legislation cleared an early hurdle on Wednesday when the Senate State Affairs Committee voted in favor of a bill that would require a physician to perform a sonogram on a pregnant woman at least 24 hours before performing an abortion.

The bill passed on a 7-2 vote, with Sen. Rodney Ellis, D-Houston, and Leticia Van de Putte, D-San Antonio, dissenting. It is likely to be heard by the full Senate as early as next week.

And barring anything unusual, it will be passed. I had wondered if there were enough Democratic votes to prevent it from coming to the floor, but with Sens. Lucio and Zaffirini in favor of it, the answer is no. I don’t see anything stopping it.

In its original form, doctors would be required to perform a sonogram, explain the procedure as it is performed and require a woman see the image and hear the heartbeat of the fetus. That version contained language that allowed a woman to “avert her eyes” if she chose.

A committee substitute introduced Wednesday would not compel the doctor to perform the sonogram or detect a heartbeat if a woman’s pregnancy was the result of sexual assault or incest or if the fetus has an “irreversible medical condition or abnormality.”

In any circumstance, the doctor and the woman cannot be prosecuted for the woman’s decision not to see the sonogram or hear the heartbeat.

“This is an issue about empowering women,” said [bill sponsor Sen. Dan] Patrick, an outspoken abortion opponent. “What this bill does is remove the barrier that is placed in front of women now from getting information they’re entitled to.”

No, it’s about shaming them, which Patrick hopes will lead to fewer abortions. If he could have passed a bill requiring women seeking abortions to write 100 times on a blackboard “I am a bad person and I should be ashamed of myself”, he’d do it. This was the next best thing. Patrick and his ilk think these women are ignorant victims who are being duped by unscrupulous doctors. This is why anti-abortion legislation never holds the women responsible for getting an abortion they’re trying to make illegal even though they say it’s murder. In the case of this bill, the only penalty provided is that the doctor could be subject to losing his or her license if they fail to show the sonogram. Shouldn’t “empowerment” imply some kind of responsibility? It would if that’s what this were really about, but it’s not.

I’ve no doubt that Sen. Patrick is sincere in his desire to reduce the number of abortions in Texas. It may surprise him to know that I share that goal. It’s just that I would go about it by trying to reduce the number of unintended and unwanted pregnancies. That means a greater investment in making contraception more accessible and affordable, better and more comprehensive sex education, ensuring prenatal care is more available and affordable, and ensuring the social safety net is strong, since people do take financial factors into account when they consider their options. (It’s expensive to be pregnant, birth a child, and rear it, in case you hadn’t heard.) That would require spending some money, which outside of making other people spend theirs on unnecessary sonograms, the Senator is not inclined to do. It’s true that my method would not eliminate the need for abortions. But then, neither will Sen. Patrick’s. Even if he someday succeeds in his goal of outlawing them completely, women will still get them, one way or another, just as they did before Roe v. Wade. At least my way would have the ancillary benefit of improving women’s health overall. Other than maybe sonogram machine manufacturers, I don’t know who will benefit from SB16. Katherine Hanschen has more.

No federal sex ed money for Texas

Stay ignorant, kids. It’s what the state of Texas wants you to do.

At the end of the summer, Texas quietly opted to forgo yet another pot of federal money — specifically, $4.4 million that would have gone toward educating youth on abstinence and contraception to prevent teen pregnancy.

The Department of State Health Services began drafting the application for the Personal Responsibility Education Program funds, but the decision was made not apply before the Aug. 30 deadline. Carrie Williams, a spokeswoman for DSHS said, “The [Health and Human Services] Executive Commissioner [Tom Suehs] made the final decision, and the governor’s office was part of that discussion.”

“This is yet another example of politics dominating policy in the governor’s office,” said state Rep. Mike Villarreal, D-San Antonio. “Unfortunately, the governor’s re-election campaign theme of running against Washington has, yet again, hampered our ability to access much needed funds to overcome very real challenges that our state is facing.”

[…]

Dr. Janet Realini, the president and CEO of Healthy Futures of Texas, a nonprofit geared toward “reducing teen and unplanned pregnancy,” said that mission would be easier with the “evidence-based” education programs the PREP money would have funded. “I feel this is a great loss for the state,” she said. “This is a huge amount of money, and there’s such a need for these programs in Texas.”

DSHS did apply for $5.4 million in federal funding for abstinence-only education. “Applying for this funding is in line with state goals and strategies,” Williams said, noting that the state’s “first choice is that teens choose not to have sex.” In an e-mail, she said the abstinence-only funds would have been lost to other states, whereas the state’s decision not to apply for the PREP funding opens the door for individual communities to apply for the money directly “if it meets the needs/values in their communities.”

Texas is of course one of the nation’s capitals of teen pregnancy. If our idiotic focus on abstinence-only education produced better results, it would be different, but we’ve spent millions and millions of dollars on it and have nothing but a lot of babies being born to children to show for it. What a waste.

Let’s not talk about sex

Sometimes all you can do is marvel.

A Hitchcock school board member’s discussion about sex with a class of middle-school girls led the district to issue an apology and on Monday to offer counseling for girls in the class, a district spokesman said.

The apology and counseling offer came after parents complained during a school board meeting last week about a Jan. 15 discussion school board member Shirley Price had with an assembly of sixth-, seventh- and eighth-grade girls at Crosby Middle School.

At least two parents complained that Price discussed sex, said Randy Dowdy, director of school sports services. “They said it was graphic,” Dowdy recalled. News reports said the discussion included descriptions of how to perform oral and anal sex. Price, speaking through her pastor, declined to comment, but Pastor S.D. Siverand of the Galilee Missionary Baptist Church denied that she told students how to perform sex acts.

More here. I get that some people would not appreciate Price doing what she is alleged to have said – if you read the whole story, it sounds like what she was mostly doing was answering questions and telling girls not to feel pressured to have sex, which last I checked was a pretty good message for them to hear – but counseling? Seriously? Whatever Price may or may not have said, it seems to me that the freakout about it is much more likely to be actually damaging to the kids.

The sad state of sex education in Texas

We do a really lousy job of it.

In sex education classes, 94 percent of Texas school districts teach that abstaining from sex is the only healthy option for unmarried couples, and, in many cases, students are given misleading and inaccurate information about the risks associated with sex, according to a 72-page report released Tuesday.

Two percent of districts — in a state that has the third highest teen birth rate in the nation — ignore the subject completely, according to the study.

The two-year study, “Just Say Don’t Know: Sexuality Education in Texas Public Schools,” was conducted by two Texas State University researchers and funded by the Texas Freedom Network Education Fund, the research arm of the Texas Freedom Network, which describes itself as “a mainstream voice to counter the religious right.”

You can find the report and all related materials, including some fascinating videos that demonstrate just how sex ed is done these days, here.

Researchers David Wiley and Kelly Wilson, who both teach health education, examined tens of thousands of lesson plans, student handouts, speaker presentations and other related documents obtained from 990 school districts, 96 percent of Texas’ districts, through the Texas Public Information Act.

“Most of the mistruths share a common purpose, and a likely effect, and that is discouraging young people who might already be sexually active from using condoms, a message I find shocking as a professional health educator,” Wiley said.

[…]

In the report, researchers documented at least one factual error in the materials received from 41 percent of the school districts. The study’s authors found instances in which districts used what they called sexist, religious and shame- or fear-based techniques during instruction. The findings include:

On wearing condoms during sex, the Brady district has told teens, “Well if you insist on killing yourself by jumping off a bridge, at least wear these elbow pads.”

The Edinburg school district policy states, “Students should be informed that homosexual acts are illegal in Texas and highly correlated with the transmission of AIDS.”

I guess if you think the only acceptable sex is married heterosexual sex, and that nobody needs to know how not to have kids, then all this makes sense. For the rest of us, I think we could maybe do a little better than this. Kudos to the TFN for taking this on.

And in a bit of fortuitous and not-coincidental timing, I got a piece of email shortly after this came out from State Sen. Leticia Van de Putte and State Rep. Mike Villarreal, who have legislation filed to address some of these concerns. From the email:

SB 1076 and HB 1567 require abstinence curriculum that includes instruction on contraception to provide scientifically accurate information about contraceptives and methods of reducing the risk of sexually transmitted diseases. SB 1076 and HB 1567 prohibit these school districts from discouraging contraception use by students who are sexually active. This legislation does not mandate that schools provide sex education, but if they choose to offer a sex education course, it prohibits them from providing inaccurate information.

“While it is true that abstinence is the healthiest choice for teens, we cannot close our eyes and pretend we do not have students that are sexually active. We must equip students with the knowledge necessary to protect themselves against sexually transmitted diseases and unplanned pregnancies,” said Van de Putte.

“We have a responsibility to ensure that our children receive accurate information in the classroom, particularly when students’ health is at stake,” Villarreal said. “We’re dealing with a myriad of problems in Texas as a result of our sky high teen pregnancy rates. We cannot allow our schools to provide erroneous information – the stakes are far too high.”

The Observer reports on more such bills.

Sen. Kirk Watson and Rep. Mark Strama filed legislation, Senate Bill 1100 and House Bill 1694, which they are calling the Prevention Works Act, which requires that school districts notify parents about the content of their children’s sex education classes. Rep. Joaquin Castro’s House Bill 741 and its companion, Sen. Rodney Ellis’ Senate Bill 515, require health education to be comprehensive, age-appropriate and based on medically accurate information. “I know that sounds like a ridiculously minimal standard,” says Ryan Valentine, deputy director of the Texas Freedom Network Education Fund, “but it’s not an inconsequential first step.”

No it isn’t is it? Both of the Senate bills above have at least one Republican coauthor, though neither of the House bills do. Perhaps if we can tear our attention away from ultrasounds for a few minutes, we might get something that would actually help people passed. Click on for more from the TFN.

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