San Francisco Chronicle - Saturday, June 30, 2001
Ray Delgado, Chronicle Staff Writer

The White House expressed disappointment with Surgeon General David Satcher's report released yesterday, which called on communities to encourage abstinence as well as birth control.

Satcher, who was appointed by former President Bill Clinton, also said Americans should develop greater understanding toward gays and lesbians.

"The president thinks abstinence education is important," Bush spokesman Ari Fleischer said this morning, declining to comment further on Satcher's more liberal recommendations.

Fleischer refused to say whether Bush stood behind Satcher. "In this case," Fleischer said, "the surgeon general was not appointed by this administration."

The report was the latest in a long history of surgeon general reports that have rankled the White House. Past surgeons general have issued reports on venereal disease, smoking and AIDS, often to the consternation of the president.

Satcher's report, billed a "call to action," says students need to learn about the failure rates of condoms and other contraceptives, and encouraged abstinence as the only fail-safe method of protection.

"Sex education ought to include abstinence from a positive perspective," Satcher said in an interview. "You don't let anybody take your sexuality lightly, and you preserve it for special relationships."

But the report discourages education programs that promote only abstinence, saying that there were no scientific grounds for fears that talking about sex in the classroom led teenagers to have sex earlier.

The surgeon general called on individuals and communities to respect diversity in sexual orientation, saying that there was little evidence that sexual orientation, once discovered in adolescence, could be altered later on.

The report opens with sobering statistics, including that nearly half of the pregnancies in the United States are unintended and that roughly 600,000 Americans living with HIV either don't realize they're carrying the virus, which causes AIDS, or haven't sought treatment.

The plan calls for a national dialogue that relies on science while respecting diversity. It further seeks to target socioeconomically vulnerable communities.

Satcher expected the study to incite controversy, describing the dialogue it has already begun as long overdue.

"We have a long way to go in our comfort in talking about sex. I think we have created a conspiracy of silence," he said.

Satcher was appointed by Clinton and began his four-year term in 1998 after surviving a confirmation battle in the Senate led by then-Sen. John Ashcroft, R-Mo., now Bush's attorney general. His term expires in February and Satcher has said he does not expect to be reappointed.

Bush advisers said conservative groups, the core of his political base, are demanding Satcher's resignation. One senior official, speaking on the condition of anonymity, said Bush strongly objected to portions of Satcher's report and had little confidence in him.

As expected, the report drew both favorable and negative responses from different groups.

Meyla Ruwin, San Francisco Unified School District's health programs administrator, praised Satcher's approach, much of which has been implemented in San Francisco schools for the past seven years.

Currently, varying degrees of sex education are provided to students after sixth grade, including condom distribution for high school students, provided that their parents don't object, Ruwin said.

"We've really seen quite a drop in terms of sexual activity (due to the programs)," Ruwin said. "I attribute it to prevention, as well as early intervention. If a young person has questions, they're able to get them answered here and make informed decisions."

But some groups say Satcher's attempts to please everyone may ultimately help no one.

"In an attempt to find common ground, Dr. Satcher is really on shaky ground," said Heather Cirmo of the Family Research Council, a conservative public policy organization based in Washington, D.C.

Cirmo argued that the report should have stated, for instance, that homosexuality is risky behavior.

"It would have been better if all of his recommendations were rooted in science and research as opposed to being the result of talking to a variety of individuals," Cirmo said.

But spokesman David M. Smith of the Human Rights Campaign, the country's largest gay rights organization, said the scientific research that forms the study actually supports gay and lesbian issues.

"This report articulates the need to end antigay attitudes," he said. Brad Dacus, president of the conservative Pacific Justice Institute in Sacramento, said that while he was pleased with the report's stress on abstinence, the surgeon general had disregarded the rights of parents to take a stance on what kind of sex education is appropriate for their children, particularly by advocating the distribution of condoms at schools.

"That's a complete undermining of the rights of parents," Dacus said. "If schools would like to mail information to the parents about the problem and their prospective solutions to provide condoms and allow parents to provide a consent form, that's a different solution. He doesn't trust parents enough to play the active role that many parents wish to play."

Chronicle news services contributed to this report. / E-mail Ray Delgado at rdelgado@sfchronicle.com.

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