Sex-Ed: Can we teach more than consequences?

In my past job at Planned Parenthood, we often had groups of high school students come to the clinic to take a tour and speak with the staff about sexual health and the services we provided. I was often the point person for these groups, perhaps because I was the youngest employee at the clinic and perhaps because of my enthusiasm and desire to show adolescents who we were and what we did. Through my experience, I was often struck by the complexity of their questions. They wanted to know how to talk about sex in relationships, how to keep their partners happy, why people engaged in certain behaviors over others, and so forth. This nuanced way of integrating feelings, behaviors, and emotions into the way they thought about sex encompassed more than just body parts, pregnancy, and infections. 

Unfortunately, much of the education that teenagers receive about sex is provided in disjointed discussions about physiology and dangerous consequences, leaving out the parts about life. While I have fantasized about alternate ways of teaching sexuality education, I had not imagined a method so refreshing as Al Vernacchio’s way of teaching his Sexuality and Society course at Friends’ Central (a private K-12) in Philadelphia.  In Laurie Abraham’s article Teaching Good Sex, she describes her experience as a reporter sitting in on this class for two weeks, observing and interviewing both teacher and students about their experience. It was overwhelmingly positive for everyone involved, and provides hope that the sexuality education of the future can be much more useful to young people as they enter adulthood.

In reading this article, my thoughts are mostly infused with pride, appreciation, and awe at the courage and innovation it takes to teach like this in our current world. But despite this, I have a hard time picturing how this type of curriculum could be implemented in the real world of public schools and conservative communities, especially those that believe teenagers should not be having sex, and any education that teaches about pleasure is enabling illicit behavior. There is plenty of evidence that fact-based information about sex that acknowledges the good parts merely makes sex safer and does not promote it, but for most people, evidence does not trump ideology.

If we could get Mr. Vernacchio’s style of sexual health education to be implemented in private and alternative schools that have the political environment to tolerate such a way of teaching, the lives of those students would be greatly enhanced. But this will create a widening knowledge gap that may be correlated with class, location, and race. Those who are not privileged enough to be able to attend private school will miss out. Those who live in rural or more conservative areas will miss out. I find this problematic, but am not yet able to come to a conclusion for how to fix it. I know it is merely the job of the reporter to report and the teacher to teach, but I wish that both Ms. Abraham and Mr. Vernacchio were more in-tune with the social justice aspects of this issue. If I believe anything, I believe that knowledge is power. When the political climate prevents the spread of knowledge, this represents the most fundamental kind of problem.

I will continue to wrestle with this issue in my career. And, certain words uttered by Mr. Vernacchio in a recent Skype session with my Safer Sex in the City class give me hope: When asked about political climates, he stated that while things do change slowly, change can be great. If students at Friends’ Central grow up to be influential, and likely they will, they won’t think twice about supporting the kind of sexuality education they received as adolescents. It may take a while, but this could be all that is needed to create a receptive political environment and ensure accurate and life-based sexuality education for all.

Read Laurie Abraham's article here.

Rocky and me: On becoming a Boston bike girl

Rocky

I am a Boston bike girl. Me and my bike, whose name is Rocky, are a team who together take on the gritty urban streets of this city and make it our own. She is my transport, my friend, my ally, and I ride her everywhere. But it wasn't always this way. Here is the story of how I faced my fear of urban cycling in one of the nation's most unfriendly places for bikes, one pedal at a time.

I'm from Seattle where the rain and hills are plentiful, but people still manage to bike all over the place anyway. I had a structurally unsound mountain bike in my possession after college. I never rode it, it just sat there in its vivid purple glory and still managed to look sad. I was living on Capitol Hill after graduation, and my roommate Tim got this beautiful yellow Schwinn on Craigslist. It weighed about 100 pounds, but it was sleek and hip. I  was secretly jealous of his new moving machine and wanted my own badly. Brian, a dear friend and bike enthusiast, found Rocky at a swap meet and managed to get her for an excellent price of $250. Thus began a beautiful friendship between myself and a little red Lotus that continues to this day.

Fast forward a few years and I am accepted to grad school at BU. I disassembled Rocky and put her in a huge box, shipped her across the country and paid a bike shop in Boston to put her back together. But then I took her home and put her in the closet. Why? From the week or so I had been in Boston waiting for my bike to arrive, I had realized that this city was big and scary with no bike lanes and spirals of one-way streets. The drivers were insane and everyone was constantly double-parked. I was already stressed out from starting grad school in a new city, so Rocky just hibernated while I focused on other things.

In the spring, I met Eric. He was a bike messenger and nonchalantly risked his life daily by flying around in all weather, delivering packages faster than any other method of transport the city had to offer. He would not accept my fears and instead piled on intense pressure for me to ride. "Bonnie," he said, "just get on your bike." So I did. I had run out of excuses.

It was terrifying at first. Torn up streets with no bike lanes, drivers yelling, having to go around double-parked cars by cutting into lanes of speeding traffic. But with time and true grit, it got much easier. I started to appreciate the good things about Boston for bikers. The city is actually pretty small. The city is flat. The city has beautiful bike paths, that once you find them are quite a treat. In time, Mayor Menino launched the Boston Bikes Initiative, which included an expansion of the city's bike lane plan to add most major thoroughfares. Even Mass ave in the South End has a bike lane now, which is excellent considering that strip was one of the scariest places I've ever biked. (Some day I'll tell you the story of how a car headed me off there, almost causing me to bike into a sub-terranean construction zone).

Of course, I know many people who would never hesitate like I did. Who would get right on their bikes without fear or worry. But I have a few accidents under my belt, so I know what being thrown on the street feels like, with the adrenaline and blood mixing together to form feelings worth avoiding. I needed time, and now three years later, I feel like a champ. I still wear a helmet, I still stop at red lights even when nobody is coming, and I still leave Rocky at home when the snow comes down. But she and I have conquered Boston, and that's a feeling I'll always be proud of.

Could it be a two-way street? Vasalgel and its potential as male contraception

Birth control. It works wonders for preventing pregnancy, making sexual activity more spontaneous, and allowing heterosexual couples and individuals to plan for when they want children. There are so many reversible methods available to choose from, but only one of those methods is male controlled, namely, the trusty male condom. All others require at least partial female participation, and most of them don't need male participation at all. Many of my man-loving female friends see this as a good thing. With something as important and life-changing as pregnancy, some women like knowing if they took their pill, or knowing whether their ring is in place or their patch is on right. Many of them have told me that they aren't sure whether they would trust a male partner to use birth control. Needless to say, this issue has not come up, as condoms remain the only truly male option...for now.

Enter Vasalgel. Vasalgel is a product, or "system" as business people like to say, that is actually quite revolutionary and intriguing. It is currently undergoing advanced clinical trials in India, and will hopefully make its way to be tested in the US without too much trouble in the coming years. It's a LARC (long-acting reversible contraception) which are the best kind for minimizing user error (the main cause for pregnancy while on birth control) and keeping babies away until you want them, and it is entirely for men without any need for female participation.

So, what is it? Vasalgel works as sort of a temporary vasectomy, but without any snipping. The gel is injected into the vas deferens (the tubes that transport the sperm from the testicles to the urethra) and kills sperm on contact so that ejaculate is just seminal fluid. It has very few side effects, and does not disrupt hormones or sex drive in any way. If the person is planning a pregnancy, another injection is performed that dissolves the gel and the sperm resume their normal trajectory into the urethra. Fascinating. And the whole thing can last for years (like 15 years!).

I find this method heartening, and I really hope it can make a US debut. I feel this for several reasons, one being that this method is long-lasting without requiring the user to do anything to maintain its effectiveness. I don't mean to say that men aren't capable of taking a pill or putting on a cream, but they just don't have to think about pregnancy in the same way women do, so I can see men having more trouble with birth control that requires a lot of pre-planning and assembly to get right. Don't get me wrong, I do trust men. But I would feel much more comfortable relinquishing control of my fertility to a partner who is using a LARC that he can't mess up.

The other thing I like about this method is that it would not disrupt hormones in any way. Many of the other birth control methods that have been in development for men have been hormonal, and the big drawback of messing with male hormones has been decreased sex drive. If a side effect of male birth control is lowered libido, I truly doubt that such a method would have staying power. Of course, lowered libido does happen to be a side effect of female hormonal birth control, but we are better able to tolerate that as a society. Any product that messes with a man's virility is much more difficult to engage with.

Of course, men might not want to have their testicles injected four times over the course of their lifetimes. The product might not prove to be as effective as we thought. Or, the US could have some political troubles engaging in its own tests or releasing the product onto the market. Whatever the case, there are significant hurdles to clear before this method could be a reality for American heterosexual men. Despite this, I truly feel that this is the most hopeful debut of male birth control yet, and think this idea of developing and offering LARCs for men is a step in the right direction. This step could increase male participation in contraception, diffuse the current political fight on women's bodies, and allow men to have more control in the decisions of when and whether to have children. Sounds awesome. What are your thoughts?

Read more about Vasalgel here