Bay Area Reporter - July 6, 2001
Liz Highleyman

"The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior," which has been in preparation for two years, calls on parents, school officials, and community leaders to overcome their "nervousness" and deal honestly with sexual issues. "Sex is not an easy topic to discuss and it has never been," said Satcher. "Given the diversity of attitudes, beliefs, values, and opinions, finding common ground might not be easy, but it is attainable."

The 27-page report notes that an estimated 12 million people in the U.S. contract sexually transmitted diseases each year - including 40,000 new HIV infections - and over 100,000 children experience sexual abuse. In addition, over half of all pregnancies are unwanted, leading to nearly 1.4 million abortions.

But beyond reciting a litany of problems related to sex, the report also acknowledges that sexuality is a "integral part of human life," and that "human sexuality has come to serve many functions in addition to reproduction," including "foster[ing] intimacy and bonding as well as shared pleasure in our relationships." Sexual health is "not limited to the absence of disease or dysfunction," but rather "includes freedom from sexual abuse and discrimination and the ability of individuals to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose."

The report goes on to say that there is no scientific evidence that sexual orientation can be changed, acknowledges that harassment can lead to "psychological distress" for gays, lesbians, and transgendered people, and calls on Americans to respect "the diversity of sexual values within any community." Said Satcher, "We're certainly not trying to get anyone in any religious group to change their views. We're just saying these are people, these are human beings."

According to the report, sex education must be "thorough and medically accurate," beginning early and continuing throughout life. Although parents are a child's "primary educators and should guide a child's sexuality education in a way that is consistent with their values and beliefs," schools also have a part to play because many parents are uncomfortable discussing sexual matters with their children. "Parents sometimes need help," said Satcher. "Schools have always been the great equalizers."

The report also recommends wider availability of programs to prevent sexual abuse of children, adequate sexual health education and training for professionals, the development and dissemination of materials for sex education classes that cover "the full continuum of human sexual development," and increased research on sexual health from childhood through old age.

While the report notes that abstinence is the only sure way to prevent STDs and pregnancy, it also says that there is no valid evidence that "abstinence-only" sexual education programs are effective. The report encourages abstinence until one is in a "committed, enduring, and mutually monogamous relationship," but does not specify marriage. The report recommends the use of condoms and other methods of contraception to reduce the risk of STDs, HIV infection, and unwanted pregnancy. There is "no scientific support" for the idea that school-based sex education leads to earlier sexual activity. Saying "I have to deal with reality," Satcher called for further research on what types of sexual education programs actually work.

Report criticized

The report drew immediate criticism among religious and political conservatives - who promote abstinence, monogamy, marriage, and compulsory heterosexuality - despite its stated goal of "encouraging stable and committed adult relationships to strengthen families."

Andrea Lafferty, president of the Traditional Values Coalition, said the report's authors were "talking out of both sides of their mouths" by recommending condoms even while acknowledging that they are not a foolproof means of preventing pregnancy or STDs. A coalition of 11 conservative organizations issued a statement reading, "As chief medical officer of the United States, Dr. Satcher has an obligation to tell the truth about the risks of sex outside of marriage. Instead, he has painted an unrealistic picture that seems more geared toward achieving political correctness than educating Americans about the health risks of these behaviors." Peter Brandt of Focus on the Family had the strongest words, calling the report "ideology disguised as science," and asking President Bush to replace the surgeon general immediately.

But William Smith of the Sexuality Information and Education Council of the United States took the opposite view, saying he was "pleased this report has brought human sexuality to the forefront of public discussion."

Debra Hauser of Advocates for Youth stated that Satcher "should be praised for rising above the politics and the ideology."

Saying that she believed the report "will save lives," Winnie Stachelberg of the Human Rights Campaign called on the administration to "immediately adopt the more science-based guidelines and let them serve as a policy road map for improving public health in America."

The report was commissioned by the Clinton administration - the former president appointed Satcher as surgeon general in 1998. Satcher maintained that he was not taking sides in the political debate. "We try to make very clear what's needed to improve sexual health, and what's supported by the science," he said. Secretary of Health and Human Services Tommy Thompson, a Bush appointee, reviewed the report prior to its release but did not make changes.

White House spokesman Ari Fleischer said that despite the report, Bush would continue to focus on abstinence. Bush could ask for Satcher's resignation, but cannot require him to step down before the end of his term in 2002.

The full report is available online at www.surgeongeneral.gov/library/sexualhealth/call.htm.
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