Sex Education

Kenny Harrison, a 17-year-old teen advocate for Planned Parenthood, stood in front of a health education class at Huntington Beach High School and posed this scenario:

“You’re thinking of becoming sexually active. You have lots of questions and concerns. You want to talk to your parents about it. How do you bring up the subject?”

After a moment of awkward hesitation, two student volunteers playing a boy and his mother began improvising their responses.

Boy: “I was just wondering, how would you feel if I, uh, had sex?”

Mother: “I don’t want you to. I really don’t want you to. What are you going to do if you get her pregnant?”

Boy: “Well. . . .”

Mother: “Are you going to bail? What are you going to do?”

What indeed.

Teaching teenagers how to avoid having to face that question is the reason Harrison and his co-presenter, Planned Parenthood Teen Services Program coordinator Christina Weckerly, had gone to Huntington Beach High School.

Their 80-minute presentation ranged from talk of abstinence and other birth-control methods to a lively student discussion of a subject that few in the classroom had ever contemplated: How much they would have to earn to live on their own. Then came the kicker: How their budgets--and their lives--would be affected if they or their girlfriends became pregnant and they had a baby to raise.

“We just want them to consider all their options and to realize the decisions they make now--no matter what they are--will impact them in the future,” Weckerly explained after class.

Planned Parenthood of Orange and San Bernardino Counties has offered a variety of teen outreach and educational programs since it opened in 1965.

Now the nonprofit reproductive health-care agency is making its most comprehensive effort to reduce unintended teenage pregnancies and sexually transmitted infections among young people in Orange County, and teenagers such as Harrison are playing a major role.

Harrison, a senior at Capistrano Valley High School in Mission Viejo, is one of 10 teen advocates working for Planned Parenthood’s Teen Services Program.

The 2-year-old educational program, funded by the state Office of Family Planning, focuses on teaching teenagers skills to be responsible not only sexually but also in other areas.

The use of teen advocates, says Planned Parenthood officials, makes their family-life education program unique in Orange County.

The teen advocates, who are paid $5.50 an hour for about 10 hours of work a week, have undergone 52 hours of training on topics that include abstinence, contraceptive use, sexually transmitted infections, the risks of alcohol and drugs, date rape, body image, healthy relationships, decision-making skills and communication skills.

The teen advocates serve as liaisons at their high schools in arranging Planned Parenthood presentations in health education classes and at school health fairs.

Some assist Weckerly and her fellow Teen Services Program coordinator, Kristen Woolever, with classroom presentations. In April, the teen advocates conducted workshops at Teenwork ’97 in Anaheim, an annual conference on substance abuse and other adolescent issues.

Other teen advocates work in the weekly teen clinics that are offered at all five Planned Parenthood medical centers in Orange County. The after-school teen clinics provide an opportunity for anyone 19 and under to come in without an appointment.

Teen advocates who qualify to work in the medical centers have undergone on-site clinical training for at least six months. They meet with the teenage clients, providing them with information on birth-control methods and the options that are available if they are pregnant.

“The teens feel more comfortable talking to someone their own age,” said Maria Elena Cuevas-Avila, manager of the Planned Parenthood medical center in Anaheim, where 15 to 30 teenagers typically show up during the weekly teen clinic hours. About 50% come in for pregnancy testing, she said, and 50% for birth control.

Teen advocates also serve as sex-education resources at their schools, informally answering classmates’ questions about sex-related issues and Planned Parenthood’s services.

They also hand out Planned Parenthood information cards, including one that can be turned in at the medical clinics for a “safety sack”--a paper bag containing condoms and educational information such as a pamphlet titled “You’re Not Ready to Have Sex If. . . “

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Sunny Haberman, manager of Planned Parenthood’s health education department in Santa Ana, said the teen advocates give credibility to the educational programs.

“Teens tend to ask their peers more than their parents about sexuality issues, anatomy and physiology issues, dating and relationships. So if you can have educated peers, then those [other] kids--most of whom aren’t educated in these areas--will have an accurate resource.”

As Weckerly said: “Who better to educate teens than other teens? It helps to have someone they can relate to that’s going through the same issues they’re going through. There is no generation gap.”

Huntington Beach High School health education teacher Bill Garland welcomed the presence of Weckerly and Harrison in his classroom.

“The students look at me as Old Grandpa,” said Garland, 59. When it comes to talking about sex, he said, “they like to listen to somebody who’s young.”

Haberman said the teen advocates serve as role models.

“If teens are listening to teen advocates, they’re going to say, ‘Well, they can do it’--whether it’s abstinence or using birth control responsibly. They see a role model for healthy sexuality where it can be talked about openly. . . . The teen advocates can tell their friends, ‘Hey, there are choices out there. There are so many birth-control methods.’ And also, ‘You don’t even have to be having sex. You don’t have to be pressured. And if you are sexually active and you decide today you don’t want to be sexually active any more, we support you in that.’

“So it’s the whole gamut, and they’re listened to.”

“There are a lot of myths about sex out there,” said teen advocate Harrison. “The whole point of our program is just to promote the facts and responsibility--what they need to know.”

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Teen advocate Ernesta Brito heard about the Teen Services Program last year when Weckerly made a presentation in Brito’s health class at Los Amigos High School in Fountain Valley.

Brito, an 18-year-old senior who works one afternoon a week at the Planned Parenthood medical center in Anaheim, is one of 300 high school students who applied for the teen advocate jobs for the current school year.

All applicants, who must have at least a 2.5 grade-point average, good communication skills and be dependable, were screened over the phone. Fifty-two were interviewed, and 16 underwent training in August. Of the 10 current advocates, four are boys.

“I thought I’d like to help out in the program because I was always trying to give my friends advice because they were being sexually active and weren’t being careful about it,” Brito said. “I’ve had a lot of friends who ended up pregnant.”

In Orange County, the teen birth rate among girls 15 to 17 is 37.2 per 1,000, according to the California Department of Health. For girls under 15, it’s 1.5 per 1,000; for those 18 to 19, it’s 96.6 per 1,000.

The Centers for Disease Control says teenagers account for about 75% of all sexually transmitted infections. According to the Orange County Health Care Agency, there were about 4,396 teenage cases of syphilis, gonorrhea and other sexually transmitted diseases in 1994, the most recent year for which figures are available.

Teen advocate Alexis McLeod, a 17-year-old junior at Capistrano Valley High School, hopes to help combat those numbers.

“I want to influence as many people as I can to be safe and make the right decisions about their sexual life,” she said.

McLeod works once a week at the Mission Viejo Planned Parenthood medical center. Of the teenagers who go for pregnancy tests during her weekly 2 1/2-hour stint, she said, one or two usually test positive.

Without endorsing any option, health care workers provide information on the three choices available: continue the pregnancy and keep the baby; continue the pregnancy and put the baby up for adoption; terminate the pregnancy.

McLeod said the younger clients she sees “tend to go for termination, but people in their 20s go through with the pregnancy.”

McLeod said many of the sexually active students she talks to at school aren’t using any method of birth control.

“I just feel more people are experimenting [with sex] and especially since we don’t have a reproductive health [class], I think that’s dangerous,” she said.

McLeod’s concern over Capistrano Valley High School’s lack of a comprehensive health education class recently prompted her to write to Capistrano Unified School District Supt. James Fleming.

Fleming was so moved by McLeod’s letter, in which she described the teenagers who go to the Mission Viejo Planned Parenthood medical center, that he phoned her.

A teacher at McLeod’s school was heading an effort to develop an updated, comprehensive health curriculum for the district.

“We had been painfully aware for some time for the need to improve our health curriculum for high school students,” Fleming said in an interview.

He sent McLeod a copy of the proposed curriculum, asking for her input and inviting her to speak at the school board meeting at which they would be voting on implementing the health course.

“Alexis’ input was very helpful,” Fleming said. “She came in as a student who, first of all, was deeply concerned about the issue and had personal experience with children who could have used this kind of information.”

What McLeod had to say, Fleming said, “carried a great deal of weight with the school board. I was very impressed with her.”

Fleming said that “any time you get into human sexuality and teenagers, it has the potential of being controversial with members of the community and school board.” The new curriculum, he said, passed without “a single negative comment from any board member.”

“I think Alexis played an important role in laying the foundation for this being a generally acceptable and positive course,” Fleming said.

Next fall, all four high schools and the continuation school in the Capistrano Unified School District will initiate a required freshman health course that will include separate units on human sexuality, sexually transmitted diseases and AIDS.

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Not all high school health classes are as comprehensive.

As manager of Planned Parenthood’s education department, Haberman sees the organization’s role as one of helping teachers. “They’re mandated to teach it. It’s like, ‘Let us come in. We’re the experts. We can give a really comprehensive session on it.”

Over the past two years, Teen Services Program coordinators Weckerly and Woolever have made presentations in schools in all but five of the county’s 15 high school districts.

This year their goal is to visit nearly 300 high school classrooms and youth-serving agencies.

But even many schools that welcome Planned Parenthood’s classroom presentations do so only with restrictions.

Some schools won’t allow them to show birth-control methods, primarily the condom; Others will allow condoms in the classroom as long as they’re kept in the package. Still others ask that abstinence be the only focus and that they not talk about other methods of birth control.

Haberman said Planned Parenthood will provide “abstinence only” presentations upon request, “but it’s been shown not to work because kids need information.

“The more information they have and the more facts they have to make an educated decision, the more likely it is they will make a responsible decision. Withholding information doesn’t help.”

Bill Garland has his own ground rules for outside speakers in his health class at Huntington Beach High School. He asks that they identify abstinence as the only sure way to prevent pregnancy and that they not use the word “abortion.”

Planned Parenthood’s lesson plans are consistent with both requests.

“None of our curriculum mentions abortion,” Haberman said. “It’s brought up only if a student asks about it. It’s addressed quickly, and we move on. People have a misconception that Planned Parenthood goes in and talks about abortion, whereas, in fact, we don’t because we don’t consider that to be a contraceptive method. We talk about abstinence and the other contraceptive methods.

“Just because we’re pro-choice--we believe people have a right to make up their own mind--they think we’re pushing abortion, and that that’s all we do.

“We do not promote abortion in education; we do not promote abortion in the clinics.”

In fact, she said, abortions make up only a small percentage of the services offered by Planned Parenthood of Orange and San Bernardino Counties.

The largest number of patients--nearly 65%--come in for contraceptive services. Pregnancy testing and HIV testing account for 12% each. Other services, such as prenatal care, are in the single-digit percentages.

Abortion is less than one-half of 1% of services provided, according to the agency. None of the five Planned Parenthood medical centers in Orange County provides abortions.

For those seeking to terminate pregnancies, referrals are made to Planned Parenthood’s medical center in Upland or to outside medical centers.

A recent count by the agency shows that, of the approximately 9,100 pregnancy tests it conducted in 1996, roughly one-third were positive.

Of that number, at the end of “options counseling” about 1,400 said they wanted to continue the pregnancy, with about 20 of those indicating their intention to put the baby up for adoption. About 1,160 planned to terminate the pregnancy; about 600 had not decided.

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Haberman acknowledges that some parents believe sex education should be taught exclusively in the home, but she said many kids don’t want to talk about sex with their parents.

“I raised two boys on my own--from ages of 6 to 7--and they knew about condoms from the time they were in fifth grade, and I’d bring home [educational] videos and say, ‘Do you think other kids would like this for HIV prevention?’ and they knew everything and it was open, but they were too embarrassed to talk to me. Me--moi! --who has been in the field for 15 years.”

Which is why having educated teen advocates is important, she said.

In fact, Haberman said, Planned Parenthood is expanding its use of teens in its education programs in Orange County.

In addition to the teen advocates, she said, four peer educators have been hired for an HIV-prevention project. The program is funded to reach young people in non-mainstream schools such as alternative schools, group homes and shelters.

And, she said, the agency has funding to hire more teens for a third educational project.

“We’re committed to utilizing teens,” she said. “Kids will not listen to adults like they will to their peers.”

* For information on the teen advocate program, call Planned Parenthood at (714) 973 2525.

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Adolescent Birth Rates in Orange County

Births during 1994 to Orange County women younger than 20 where rate is statistically significant:

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Total Rate per ZIP code School districts served births thousand 92805 Placentia 273 77.1 92802 Anaheim, Garden Grove 136 61.0 92801 Anaheim, Fullerton 177 59.5 92707 Newport-Mesa, Santa Ana 248 56.3 92706 Orange, Santa Ana 131 71.1 92704 Garden Grove, Santa Ana 370 60.0 92703 Tustin, Santa Ana 334 68.6 92701 Orange, Santa Ana 292 70.1 92632 Fullerton 78 53.4 92627 Newport-Mesa, Santa Ana 135 55.3

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Orange County overall rate: 33.6 California overall rate: 37.8 Source: California Department of Health Services 1994, Maternal and Child Health Epidemiology Section / Planned Parenthood of Orange and San Bernardino Counties