order to resolve conflicts, a person needs room for experimentation, for testing. He must decide what "authorities" and information he will assign some validity to, at least for the time being. What does this mean to the adolescent, who is most immediately concerned with how to resolve morality and sexuality? The answer is not to avoid "controversy❞ and keep silent about sexuality. To deny adolescents information is to impede them in their struggle to find out what morality is. How can we hold young people responsible for their decisions, sexual and otherwise, if we allow, and even guarantee, their ignorance? In public schools, we certainly would be neither wise, nor democratic, to advocate one particular doctrine. That would be an infringement of religious freedom. However, public schools are certainly the place to teach "democratic humanism." In fact, they implicitly accept this responsibility every time they undertake to teach any pupil anything. In general, the schools do try to instill in a student the idea of personal responsibility in his or her involvements with others. There is no reason why we should not present information, along with diverging opinions, that adolescents most want to know about sexuality. Clarifying issues that represent acute areas of personal anxiety is extremely important if we are to allow adolescents to get on with the job of maturing into responsible adults and citizens. In the short run, we can tell them bluntly that sex should not be used as a weapon against themselves or other people. In the longer run, this is a realistic and democratic way to aid people in forming for themselves a responsible sexual moral code. That youths do need information, and do not "know it all," we will demonstrate elsewhere. However, it is appropriate at this time to mention that a survey of the literature by Kirkendall and Deryck Calderwood, supports us significantly. They make four generalizations: 1. Adolescents get the majority of their in- 2. When sex information is obtained from 3. The education received from the "appro- 4. What occurs between parent and/or teacher and youth in sex education is usually a matter of something being told. (Usually when sexual relationships become the center of concern what youth receive are injunctions and moralisms devoid of any analysis or evaluation of the intricacies facing the individual.)1 3 They conclude: "It is adults much more than adolescents who should be the recipients of sex education efforts in our culture. Youth groups need it, but adolescents by their inhibitions and their neuroticisms are not blocking the efforts of adults to obtain it. The converse cannot be said."14 While we agree tht adults should certainly receive sex education also, clearly it is youth who must have priority. For they are, for the most part, not yet set in their ways. We have discussed, in general, the pitfalls of doctrinaire attitudes of people who would flatly repress sex education. But, as Mary Breasted points out, there are also pitfalls involved in doctrinaire attitudes of people who teach sex education. Her studies drew her to conclude that sex education teachers "in general" espoused "... middle-class morality more in keeping with the society adults knew 15 or 20 years ago than with the society that the young are moving in today." She points out that: Premarital chastity was still, directly or sex. And she comments: It seemed to me that such teaching was simply unrealistic for the large majority of American youngsters, that it had been designed for another era. I thought that the courses were, in a sense, projections of the kind of teaching that the pro-sex-education adults wished they had been given during adolescence.15 She believes that "the morally charged material" prevalent in sex education classes "reflects a fundamental misunderstanding of the concerns of the young and a terrible disrespect for their values" and that "what adults fail to understand is that the young are not, most of them, insatiable libertines. They are not particularly interested in sexual conquest for its own sake. Even as Women's Liberation stridently blasts away at the double standard, that standard has already started to wane among the college population."16 In my experience, this last quote tends to describe youth who are within a higher educational milieu. They have better access to enlightened approaches and attitudes toward sexual behavior. And, importantly, they have access to a variety of "non-sexual" ways to assert their personhood and to establish their self-worth. Hence, wary of the pitfalls, we need to present information that is the consensus of secular authorities, such as the medical and psychological professions. Where significant divergences of opinion exist, they should be discussed in the classroom. Remembering that the public schools have the right to advise: "Do not maliciously harm another," it becomes the responsibility of the individual, his family, and his church to interpret the moral issues involved. For example, it is society's responsibility to discuss birth control information in the schools. Whether a pupil regards birth control moral or immoral is his family's and his church's business; but, to regard information, in and of itself, as moral or immoral is pernicious to democracy. SEXUAL AND PERSONAL Adolescent Pregnancy and Disorganization Whatever causes might exist for unwed adolescent pregnancies, the seriousness of the problem requires that it receive immediate and concerted attention. Even if psychological factors were discovered to have a causal relationship to premarital pregnancy, even if it were discovered that many girls become pregnant because they want to, we would not be excused from the task of making serious efforts to reduce the rate of pregnancy among adolescents. In 1965, 591,000 teenagers gave birth; 129,000 were to unwed mothers.17 It is estimated that, by 1970, the number of births to unwed teenage girls was up to 180,000.18 At least one source is calling adolescent pregnancy an epidemic: "At least two out of five out-of-wedlock babies in the U.S. were born to teenage mothers."19 The urgency of the problem, however, is not reflected in the numbers of teenage births alone. Adolescent pregnancy presents a generally bleak picture of serious physical, psychological, and social damage to mother and child. Once a girl becomes pregnant out of wedlock, her chances of enjoying a rewarding, satisfying life are drastically diminished. Pregnancy is the number one school drop-out cause among females in the United States.20 Once she has dropped out of school, h choices are not very promising. James Jekel21 h described Elizabeth Herzog's work on the typic patterns of behavior an adolescent girl will adopt whe she discovers she is pregnant. If she is of middle or upp socioeconomic class (as one-third of pregnant adole cents are), she will characteristically put the child up f adoption unless she gets married. She will usually resolv her problem in one of three ways: abortion, marriage, c going to another city or a maternity home to have baby which she will put up for adoption (the mo characteristic solution for whites). If she is of the lowe socioeconomic class, the pregnant girl's choices are mor limited. (Only 12 percent of the girls in maternity home are nonwhite.)22 Ninety percent of the time she wil keep the child. She will seldom seek an illegal abortion but when she does, the abortionist is unlikely to be qualified doctor. Such abortions rank high as a cause of maternal deaths. Prenatal care is obtained late, if at all and the lower-class pregnant adolescent is less likely than her middle- or upper-class counterpart to receive needed social services. In 1965, 120,000 of the children born to teenage wives were conceived out of wedlock.23 Marriage is a poor solution to the problem of adolescent pregnancy. From one-third to one-half of all teenage marriages are complicated by pregnancy, and one-half of these marriages end in divorce. The rate of separation in teenage marriages is two to four times that of olde couples. 24 If marriage is not a good solution to the problems of a pregnant teenager, the alternative of remaining single is no more attractive. In a 1965 study, Krantz reported that the typical unwed teenager who becomes pregnant could be expected to deliver nine out-of-wedlock preg nancies during her reproductive years.? rate. 25 Adolescent pregnancy poses a serious health risk both for the mother and her child. A pregnant teenager runs a four to five times higher risk of pregnancy complications than a woman in her twenties. The younger the adolescent patient, the higher the risk e.26 This high risk rate is a result of generally poor (too late and inadequate use of services) prenatal care and a low level of biological maturation. The major complications are toxemia, premature birth, and maternal and infant mortality. Premature children of teenagers are four times as likely to have neurological defects and mental retardation as the children of women in their twenties.2 27 Hofman and Shenker28 reported that, in 1965, 196 percent of all out-of-wedlock babies were bom pre mature, as opposed to 7.7 percent of babies bor in wedlock. The rate of maternal deaths for unwed mothe was 21.3 per 10,000 live births. For married women, the rate was five per 10,000 live births. The psychological effects of adolescent pregnancy are indicated by the frequency of suicide attempts among teenage mothers. Gabrielson, Klerman, Currie, Tyler, and Jekel,29 in a study of teenage mothers 17 years old or younger found that 22 percent who were single made suicide attempts, as opposed to seven percent of the teenage mothers who were married. Based on comparisons with other studies, they calculated that teenage mothers have a suicide attempt rate higher than that expected among young women in an urban population. The detrimental effects on the children of teenage mothers is not limited to the risk of death, neurological defects, and retardation at birth. The adolescent mother has often not developed the maturity needed to do a good job of raising her child in this sophisticated society. Oppel and Royston 30 have reported findings that mothers under 18 are less likely than older mothers to remain with their children. If they keep their children, they are less likely to raise them in an atmosphere considered "healthy." While the under-18 mothers were more likely to believe that children should be independent, their children were more likely to be psychologically dependent on others than were the children of older mothers. The children of teenage mothers (compared to the children of older mothers) were underweight, shorter, and behind in grade level; had lower I.Q.'s; and displayed infantile behavioral problems. A teenage girl who becomes pregnant is unlikely to receive the job and social skills needed for employment. As a result, she and her children often become dependent on public welfare for their livelihood. In short, pregnancy is a crisis of major proportions for most unwed teenagers. Sarrel provides an excellent summary of the drastic costs involved: Pregnant teenagers are high risks medically, Educational Provisions In spite of the seriousness of the problems of the unwed mother and their effect upon society, Wurtz and Fergen state that "... scarcely one school district in three makes any educational provison at all for its unmarried, pregnant school-age girls."32 Only 5,450 systems of the 17,000 in their study provided for the continuing education of school-age pregnant girls despite the fact that state funds were available for this purpose in many cases. In those systems that do provide for the education of pregnant school-girls, the pattern of continued education is by no means consistent. The pattern varies from not remaining in regular school-night school, adult education classes, home study courses-to attending special schools or attending regular school with special classes. Variation exists not only in pattern and curriculum, but in teachers' attitudes as well. In spring 1970, the NEA Research Division asked a nationwide sample of public school classroom teachers: "What provision, if any, should school systems make for the continuing education of pregnant girls (whether or not married) who are pupils in their schools?" The poll indicated that: More than eight out of ten teachers responded The survey continues: The type of provision teachers preferred varied with the size of the school system in which they were teaching. In systems with 25,000 or more pupils, the largest proportion favored special schools. In systems with less than 25,000 pupils, the largest proportion favored homebound instruction. The distribution of opinion of teachers in different size systems was generally similar in regard to the other The surveys cited emphasize the need to establish, on a national scale, the community approach to meeting the educational, medical, and social needs of the teenage pregnant girl. The awareness of this need is illustrated by the more than 175 comprehensive programs now serving close to 40,000 school-age pregnant girls,34 as compared with 35 programs in 1968.35 Although these programs may differ in curricula, Marion Howard, director of the Research Utilization Project of the Cyesis Programs Consortium, feels that comprehensive programs generally have the following goals in common: 1) to increase the chances of a normal preg- 2) to help the girls solve the personal problems 3) to help girls keep up their studies during She adds that "achieving these goals is not simple" and "most programs attempting to do so are still in flux-constantly evaluating their efforts and either altering methods or adding components. In an attempt to solve the problems involved in establishing and maintaining comprehensive programs, the National Alliance Concerned with School-Age Parents (NACSAP), an independent national organization founded to serve as the advocate for the school-age parent at the national level, was created in 1970. In addition to NACSAP's efforts in the area of communication, organization, and planning, the Maternal and Child Health Section is presently undertaking an in-depth study of programs for pregnant school-age girls as part of the Cyesis Programs Consortium.3 38 Currently there is also the recognition that efforts should not be geared to girls alone. As Timothy Wirth states: .. there are other severe problems inhibiting our goals of education for all youth. One serious lack is the fact that the young father is seen only "as a shadowy figure" if he is recognized at all. And yet his educational needs and his vocational needs, his emotional and social needs are as great as those of the It cannot be overlooked that the fact of being a putative father may also be the cause of school drop-out among teenage boys. Programs which involve the teenage pregnant girl (as well as the putative father in some cases) have much to contribute in the area of secondary pregnancy prevention. Sex education should be the major goal of comprehensive programs for the teenage pregnant girl as well as the putative father. Certainly, it is as crucial, if not more so, for this group. Vivian Washington, President of NACSAP, makes this urgent plea: We must help the girls before they become pregnant and the boys before they become putative fathers. We must help them to know something about what it means to carry the respective roles of parenthood. I think we must include education toward family life in our curriculum. And most important, it must not begin in high school but instead in kindergarten and continue throughout formal education.40 The Influence of Poverty Charles V. Willie and Janet Weinandy41 point out that those in low-income problem families lack a commitment to any viable social system and, therefore, lead relatively unregulated lives. This uncontrolled behavior seems to cause an instability among low-income families. And, writes Rainwater,42 whereas middle and working class families regard their pre-adolescents as "innocents" in such adult-like behaviors as sexual activity, smoking, and gambling, the low-income problem family, of necessity, regard their pre-adolescents differently. One mother in Rainwater's study of families in a public housing slum revealed: These kids grow up fast in this project. The five William R. Reevy43 has reported how social factors greatly affect the incidence of coitus in adolescents, as has Kinsey: So nearly universal is premarital intercourse we have been unable to find a solitary male The influence of poverty on the sexual behavior of Appalachian women is meticulously observed in Robert E. Kuttner's study.45 His subjects viewed "prostitution" as a necessary fact of life, reflecting that a "decent woman" can "always get a boyfriend or two" to help pay the bills. "Some even arrange to have 'several' birthdays each year to insure a steady flow of extra income." Living with one man was considered sinful by most Appalachian women, but having a few dozen each year was considered "good." Only pregnancy, it seems, forced a woman to live with one man. This was a point of ridicule by other prostitutes: Prostitutes called illegitimate children "trick Kuttner's study of the sexual behavior of American Indian women revealed that these subjects made no moral judgments as to sexual behavior. They needed no rationalization to move "from promiscuity to prostitution and back again...." Kuttner concludes: "By the standards of the whole society... Appalachian and Indian women were sexually ignorant and reproductively irresponsible... indifferent to educational, cultural, political, and economic opportunities."47 Rainwater48 suggests that birth control is not effective in low-income families because of poor sexual knowledge and communication. Women lack knowledge of their own physiology and fertilization process. Husbands and wives do not communicate. Males' attitudes toward their own masculinity prevent them from accepting contraceptives. Boris M. Levinson, commenting on Kuttner's article, suggests that the unsatisfactory childhood of homeless men left them "emotionally immature and unable to develop nurturant relationships with others. Whenever [he] loved in the past, he was either hurt or rejected. He thus developed fear of either offering or accepting affection. Love and sex have become equivalent with pain and fear. The homeless man unconsciously projects his hostility on women and sees them as his enemy. is exploitive without any care for the woman or possible progeny."49 ... The basic problem is social oppression. For example, society has traditionally denied black males the accepted means of achieving self-respect through occupational achievement and financial success. Black youths are forced to find alternative methods of asserting their masculinity, and perhaps the most common way this is done is through sexual activity. Sex provides a release from the emotional pressures of frustration and despair for both male and female adolescents in the ghetto. The instability of ghetto life places a value on the short-term sexual experience, with boys often feeling it is unmasculine to sustain a lasting affectionate relationship with a woman. As a result, adolescent males in the ghetto often take an exploitive approach to sexuality. The girls tend to defend themselves against feelings of being exploited by minimizing the importance of virginity and emphasizing the intrinsic and social rewards that they themselves can gain from sexual intercourse. Premarital pregnancy has different implications for the ghetto adolescent than it does for her middle-class counterpart. With her hopes for the future severely restricted by poverty, she is not so likely to view unwed pregnancy as having a serious effect on her chances for a happy life. The various forces affecting the ghetto adolescent makes the problem of dealing with unwed births very complex. Thomas Edwards Brown believes that factual information can benefit these adolescents in terms of helping them understand themselves and providing them with the contraceptive information they need to avoid pregnancy. However, he adds: ... it remains very doubtful to this writer that At this point, we can apprehend the connection made by some blacks between birth control (especially Federally sponsored family planning) and "genocide." By pushing birth control for poor blacks (but not for poor whites) on the one hand, and by cutting anti-poverty monies and otherwise reducing the effectiveness of Federal poverty agencies on the other hand, it is not surprising that Willie must "state categorically that many people in the black community are deeply suspicious of any family planning program initiated by whites."51 |