Education: Sex and Schools

AIDS and the Surgeon General add a new urgency to an old debate

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The feistiest combatants are fighting against not school curriculums but school clinics. These health facilities are attached to or near public schools around the country, and they are spreading rapidly. Most are funded with a mix of public and private money. All offer across-the-board medical care. Some 28% dispense contraceptives, 52% prescribe them, and the rest make referrals to family-planning agencies. So far there are 72, mostly in poor neighborhoods of big cities. A hundred more are in the works.

The Roman Catholic Church, which on the whole has reacted mildly to the growing clamor for more sex education, has been anything but docile about the clinics' birth-control services. Two weeks ago Archbishop Roger Mahony of Los Angeles issued a heated pastoral letter calling for "all those who value the family and have hope for the future of our children" to join him in vigorous protest against a proposal to establish three school-based clinics. In Boston, Bernard Cardinal Law denounced four proposed health clinics that would provide contraceptives in junior and senior high schools. In an 86-page attack, the archdiocese challenged the constitutionality of school clinics and argued that contraceptives increase the amount of teen sex by eroding "cautions and reluctance." Replied Nancy Drooker of Massachusetts' Planned Parenthood: "Most teenagers are sexually active for over a year before they get contraception, so you can hardly say birth control was the cause."

A few black leaders in Boston and New York City have denounced the clinics as racist. In Chicago, 13 black clergymen are suing to block distribution of contraceptives at the DuSable High School clinic. Says the Rev. Hiram Crawford: "If these clinics are so good for black kids, why don't they put them in white areas? It's a form of genocide. Why do they so readily recommend abortion?"

The conservative belief is that such clinics lead students to be more promiscuous, but clearly established facts are difficult to come by. In St. Paul, records show that birth rates fell 40% in schools with clinics, though Health Supervisor Wanda Miller was hesitant to claim full credit for the clinics. Of the adolescent mothers who used the services, 80% stayed in school, and repeat pregnancies were almost nonexistent. Follow-ups are important, says Miller, because teens are "rotten contraceptors."

Other clinics report lower birth rates among those counseled or treated. And a survey of two inner-city schools, released this year by a team headed by Laurie Schwab Zabin of Johns Hopkins' School of Public Health, reported that sexually inactive high school students who used the clinic postponed their first sexual encounter about seven months, to age 16.2 instead of the 15.7 that otherwise was typical. Zabin's study is one of the most frequently cited by activists who support sex education and school clinics. In the first two- plus years of the study, the pregnancy rate fell 30% among teenagers who had access to birth-control supplies at a clinic near their school, while the pregnancy rate rose 57% among a control group.

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