Prescription for Sex Ignored



can’t be easy being the Surgeon General. Well, at least not when you choose to

talk about sex. After months of what appears to contentious infighting within

and with the Bush Administration Dr. David Satcher has finally released – or

been allowed to release – his long-awaited report on sexual attitudes and

education. The report was to be distributed in April but never materialized.

Satcher’s office dodged questions and spokespersons for the Bush administration

were equally mum. But, as James Wagoner, president of Advocates for Youth, a

group that promotes extensive sex education in schools, noted: "It doesn’t take

a lot of political math to figure out what happened here." After a flurry of

news reports – all of them indicating that Satcher’s study was being suppressed

by the White House – the report has finally been made public, and it is easy to

see why conservatives were eager to have it languish.


in 1998 the Surgeon General’s report had a radical reputation from its

inception. As planned by Satcher, the report would, by giving an accurate

overview of the tolls of sexually transmitted diseases on young people as well

as the extant of unwanted pregnancy, make a strong argument for comprehensive

sex education in all grades in public schools as well as promote greater access

to condoms and contraceptives. Last April, after returning from an AIDS

conference in Durban South Africa, Satcher gave a speech in which he expressed

his hope that in five years "all schools would have comprehensive sex education,

and all people would be empowered, regardless of orientation, to be sexually

responsible." Supporters of the forthcoming report were hopeful that it would be

a potent intervention in usually right-leaning, ongoing battles over sexuality

and public policy.

Finally released on June 28th, the report, indeed, is a much needed rejoinder to

the increasingly rightward slant of government attitudes and policies about

sexuality. Defining sexual health as including "the ability to understand and

weigh the risks, responsibilities, outcomes and impacts of sexual actions and to

practice abstinence when appropriate" the report is a strong counter to the

federally funded abstinence-only programs that now make up most high school

curriculum. But the report went even further in stating that sexual health "also

includes freedom from sexual abuse and discrimination and the ability of

individuals to integrate their sexuality into their lives, derive pleasure from

it and reproduce if they choose." It also emphasizes the need to respect

diversity in sexual orientation and states that there is no proof that sexual

orientation can be changed. In fact, it contends, there is proof that physical

and emotional abuse of gay teenagers can result in depression and suicide. In

what may be its boldest move, it defines abstinence as celibacy "outside of a

mutually monogamous relationship," not necessarily marriage.


health and education professional have praised Satcher’s report, conservatives

have, universally, condemned it. Peter Brandt of Focus on the Family, a

Protestant church-based lobby group, called it ideology disguised as science

from the beginning to end" and claimed it called into question Satcher’s

"ability to remain chief medical officer of the United States." The Bush White

House has not disowned the report it has made clear that it had nothing to do

with commissioning or releasing it (Satcher works under the Department of Health

and Human Services) and has stated that the President’s "overall approach on

these matters focuses on abstinence and abstinence education." If the Surgeon

General’s report is an embarrassment, they are choosing to ignore, not attack,



release of the Surgeon General report is something to celebrate. But the larger

question remains: will it have any effect on this administration’s policies? It

is hard to see that it will. The federal government, with matching state funds,

has budgeted nearly $500 million for abstinence programs over the next five

years. Even though Satcher’s report stated that there was absolutely no evidence

that these programs prevent the spread of AIDS, unwanted pregnancies, or even

delayed sexual activity of unmarried teenagers they are, at the moment, a

securely fixed item of Republican social policy. As for the other issues raised

by the report? For more than two decades Republicans have consistently battled

liberal sex education programs, AIDS and safe-sex education, access to

contraceptives or safe-sex materials for teens in schools, and recently have

even attacked educational programs that address the verbal and physical abuse of

gay teens in high schools. This is a culture war that is here to stay.


this history it is astonishing that Dr. Satcher’s report was even released. But

none of this should be a surprise. Satcher himself had a difficult time

attaining the post of Surgeon General when he was nominated in fall of 1997.

Senate opposition led by John Ashcroft attacked Satcher for his "soft" stand on

abortion, his limited support of needle exchange, and his endorsement of a study

on AIDS in the third world. His nomination itself was in the shadow of another

recent battle – Dr. Henry Foster, Clinton’s original choice for the post had,

months earlier, failed to win confirmation when it became known that he had

performed abortions during his medical career. Before that, the post of Surgeon

General had been unoccupied for almost three years after Dr. Joycelyn Elders was

forced to resign because of her support of sex education and her implicit

endorsement of masturbation as "safe sex." Some political commentators at the

time of Satcher’s nomination suggested that his moderately easy confirmation

(the vote to end the debate was 75-23) was helped by the fact that many Senators

were leery about denying the Surgeon General post yet again to an



sad and chilling reality is that Satcher’s report will probably have very little

effect. Although he remains Surgeon General until 2002, Satcher’s power is

extremely limited. Under Clinton he also held the post of Assistant Secretary of

Health and Human Services, with a staff of 200, but was replaced by a Bush

appointment, and as Surgeon General he has only a staff of four. But staffing is

not the problem. Although national surveys show that three out of four parents

support sex education in school, including access to contraceptives and condoms,

conservative pressure is far too great for that to be implemented in any

comprehensive way. While educational curricula that support sexual orientation

diversity or address homophobic abuse are being designed on a school by school

basis, there is no sustained support for this on a state or federal level. As is

so often the case about sex in America both public discourse and public policy

are lagging far far behind people’s needs and desires.





Leave a comment