I want to highlight one specific issue raised in the article — the lack of awareness among high school students about what women’s genitalia look like. While there has been little fanfare about the elective class so far, its instructor, Al Vernacchio, a well-liked and respected sex scholar who also teaches English at the school, notes that some lessons do draw more attention than others:

The lessons that tend to raise eyebrows outside the school, according to Vernacchio, are a medical research video he shows of a woman ejaculating — students are allowed to excuse themselves if they prefer not to watch — and a couple of dozen up-close photographs of vulvas and penises. The photos, Vernacchio said, are intended to show his charges the broad range of what’s out there. “It’s really a process of desensitizing them to what real genitals look like so they’ll be less freaked out by their own and, one day, their partner’s,” he said. What’s interesting, he added, is that both the boys and girls receive the photographs of the penises rather placidly but often insist that the vulvas don’t look “normal.” “They have no point of reference for what a normal, healthy vulva looks like, even their own,” Vernacchio said.

One female student remarked that when the class covered a biology unit, she was surprised she knew quite a bit about the opposite sex: “I probably would’ve been able to label just as many of the boys’ body parts as the girls’, which is sad. I mean, you should know about the names of your own body.”

Compounding the problem of a lack of education is that many students are relying on the most readily accessible photos of women’s naked bodies — media-distorted images and online pornography — and these images don’t exactly promote a realistic view.

I recall that my own sex education experiences involved uniform line drawings of healthy genitals and graphic photos of STI-affected genitals, but nothing visual, and especially not photographs, to indicate that there really is a wide range of what healthy genitalia look like. At Our Bodies Ourselves, we have a long history of encouraging people to grab a mirror and take a look at their own genitals, advice that shows up from the earliest to the most recent editions. Another good resource about women’s genitals is this article over at Scarleteen, which talks realistically about normal variation in size, shape, and color.

Meanwhile, there’s a petition at SignOn.org calling for better tracking of cosmetic genital surgery. The petition also wants surgeons who offer these services to “provide full information on genital diversity” when working with women who have concerns about the appearance of their genitals. “Without this information, women cannot make an informed choice,” the petition reads. It continues:

Most surgeons’ websites are loaded with photographs that misinform the public about female genital diversity. The “before” photos in the before-and-after online photo galleries depict a range of genitals as abnormal, but scientific studies show that many different shapes, sizes, and colors are normal. The photo galleries not only misinform, but they increase women’s and girls’ self-consciousness and add to anxiety. Photos may even be photoshopped or retouched.

This is a topic Heather Corinna also covers in the Scarleteen article, explaining that while some women do have physical discomfort or other medical reasons for wanting genital surgery, “for the most part, for nearly all women, your labia ARE normal, however much they vary. Beauty — as ever — remains in the eye of the beholder.”

That’s a lesson all students could benefit from.

As The New York Times Magazine reported this past weekend, a truly comprehensive sex-ed class does exist — one that gives as much weight to female orgasm as to navigating complex emotional and physical terrain. Sexuality and Society is a highly regarded senior elective at Friends’ Central School, a co-ed, Quaker, college preparatory day school in Philadelphia.

Now what if there were a book — a workbook of sorts — that could be used in a class like this, and made available to teens and young adults everywhere who don’t have a progressive forum for discussing sexuality?

Luckily for everyone, that book exists.

“What You Really Really Want” is the latest title on sex and sexuality by Jaclyn Friedman, co-editor of the 2008 hit anthology “Yes Means Yes: Visions of Female Sexual Power and A World Without Rape,” and a contributor to the 2011 edition of “Our Bodies, Ourselves.” In her new book, Friedman takes on the role of your smartest, most honest, least judgmental, down-to-earth friend, serving as a helpful guide through 11 chapters on defining, understanding and owning your sexuality.

The book’s subtitle — “The Smart Girl’s Shame-Free Guide to Sex and Safety” — explains the roadmap within. To make the most of this excursion, Friedman encourages readers to do two things: Write every day, with a pen or keyboard, and love your body — and not just in general; you should spend at least 30 minutes a week doing something that “makes you feel nothing but good.”

One of the book’s elements that readers will find particularly useful are the “dive-in” exercises that encourage thinking through how to apply what you’ve read to your own circumstances. At various times, Friedman pauses and encourages you to ask questions, assess your comfort zone, and identify the tools you need to overcome barriers to expressing your sexuality. These check-ins come across as authentic, which is difficult to pull-off on the printed page. That success is largely due to Friedman’s engaging writing style and genuine concern for women’s health and safety; she is the founder and executive director of Women, Action & the Media, which works for gender justice in media, and has been an outspoken advocate for challenging the ways society shames women.

The first chapter, aptly titled “You Can’t Get What You Want Till You Know What You Want,” opens with a discussion of influences on sexuality, from family and religion to our peers and partners. Friedman also provides a concise summary of confusing media messages that limit women to a “teeny window of ‘correct’ sexuality” combined with artificial ideals, followed by a dive-in exercise on media representations of women:

Dive In: Think back to some adolescent media crushes—that song or album you listened to over and over, the magazine subscription you thought would change your life, the book you picked up again and again, the movie you imagined yourself starring in, the video game you played and played and played, the TV show you just couldn’t miss. What drew you to these particular experiences? What, if anything, did they say to you about sexuality? What lessons did you learn from them that you’ve since rejected, and what did you learn that you still adhere to today? If you could go back and tell your adolescent self something about your media choices, what would it be? Get out your journal, and write about it for five minutes.

“What You Really Really Want” gradually shifts from looking at external influences that can prevent women from developing their own sexual identity to exploring different identities and assumptions about sexuality. Following sections on gender and sexual orientation, readers encounter this exercise:

Dive In: Make a list of all the words you can think of that you’ve used yourself or heard someone else use to describe someone’s sexual orientation. Don’t hold back—list the slang and slur words right alongside the more formal terms. Next, cross out every word that you think no one should ever use about anyone. Then cross out every word that you personally would never use to describe someone else. Then, of the remaining words, cross out every one that you wouldn’t want anyone else to use when describing you. Lastly, cross out any word that’s left that you would never use to describe yourself.

Write all of the words that are left in a new list. How do they make you feel? Do they describe your sexual orientation? Are there facets of your orientation that words don’t exist for? If you feel like it, invent a word that helps fill in those gaps.

It may seem like a lot of self-analysis, but that’s exactly what’s needed. As The New York Times Magazine article points out, teens have a difficult time articulating their own desires, in part due to the abundance of manufactured sexual imagery that creates false and harmful standards for what we (or our partners) should look like naked and how we should act.

Friedman wisely concentrates on the individual reader before expanding the discussion to include sexual partners. And even then, Friedman doesn’t offer advice on how to find a compatible sexual partner; rather, she helps the reader to define what compatability even means:

We all get dealt a different hand when it comes to what we’re capable of, and we all need partners who contribute different things. Is it important that your sexual partners are funny? Smart? Good dancers? Sweet with children? Great at communication? This is where you can get specific about bedroom skills, too: How talented does your partner need to be in the sack, and what qualifies as sexual talent to you?

Once you figure out what qualities you want in a partner, it’s time to add another layer of choosiness: How important is each quality to you? Because, let’s get real, nobody’s perfect, and you’re unlikely to find someone who simultaneously checks all of your boxes. Maybe you’d love to have a partner who is really athletic, but you wouldn’t rule out someone who was less active. On the other hand, it may be a total deal breaker if your partner doesn’t like to read. Get clear on what’s cake vs. what’s icing, and you’ll be steering yourself toward what you really really want before you know it.

Making a list for ourselves is one thing, but healthy sexual relationships require honesty with our partners about pleasure and safety.

“Talking freely about sex and safety with your partners not only makes sex more fun and relaxed—because you’re worrying less and getting more of what you really really want—but also makes it easier to tell the great partners from the ones you want to avoid before you get too hurt,” writes Friedman. “And that information means your intuition will get better and better, which means you’ll get even better at knowing your own desires and boundaries and finding people who can simultaneously respect and satisfy you. In short: It’s the best possible kind of positive-feedback loop.”

Besides offering examples of what, how and when to communicate, Friedman also provides an exercise that returns to the personal history and influences that can block us from advocating for our own needs:

Dive In: Pay attention this week to the times when you’re not speaking up. Do you want seconds at dinner but are afraid to say so? Do you actually want to wear that outfit, or are you doing it because you think someone else will like it on you? Did your friend or partner hurt your feelings, but you aren’t letting them know? Make a note each time it happens. Then, when you’ve got some time, pick one example and write about what it felt like. And then write about what it might have felt like if you had gone the other way and spoken on your own behalf.

Students at Friends’ Central School are fortunate to have a terrific teacher and a supportive educational environment that encourages exploration of these issues. Maybe, just maybe, other schools will start to follow suit. For the rest of us — and for those forward-minded sexuality classes — “What You Really Really Want” can make a lifetime of difference.

Excerpts of “What You Really Really Want: The Smart Girl’s Shame-Free Guide to Sex and Safety” are printed by arrangement with Seal Press, a member of the Perseus Books Group. Photo credit: Mandy Lussier. This post is a stop in Jaclyn’s blog tour. Check out yesterday’s stop at WIMN’s Voices. If you’re in the Chicago area, join me on Nov. 30 as Jaclyn reads from her book at Women & Children First (7:30 p.m.).

My Little Black Book for Sexual Health — LittleBlackBookHealth.org – is available online to help you navigate the maze. This resource offers information on various topics, including how to obtain low cost insurance and rules that might govern whether birth control is covered by your insurance.

Described as “a guide for getting the health insurance you need to prevent pregnancy until you’re ready,” My Little Black Book is aimed at young people between the ages of 18 and 26; this group is most likely to be uninsured and faces a high rate of unintended pregnancy.

The interactive website is easy to use (or download the PDF version). You can flip through the virtual pages, blow the text up for easy reading, follow the tabs, or click through the table of contents. I found all sorts of helpful information — who is eligible for a school’s student health plan, how to get prescription drug coverage, and what kinds of sexual and reproductive services are covered. It is very user friendly and easy to understand.

My Little Black Book for Sexual Health was developed as part of the Reproductive Empowerment and Decision Making for Young Adults (REaDY) Initiative, a unique statewide public-private partnership led by NARAL Pro-Choice Massachusetts and Ibis Reproductive Health, to prevent unplanned pregnancy and promote sexual health for young adults in the wake of Massachusetts health care reform. A Spanish language version will be available soon.

Nekose Wills is the OBOS program assistant.

A recent NPR story on the biological basis for the sometimes confrontational, erratic and seemingly irrational behavior of adolescents reminded me of my own experiences in raising adolescents (and gratitude that this particular stage of life is now behind me).

As Garrison Keillor recently reminded us, to be a parent is to live a life of constant silent prayer — prayer that everything will turn out all right. We know that adolescents don’t always exercise the best judgment, and now, at least, we have a better sense of why this is the case.

The Teen Brain – A Work In Progress

The physical evidence gathered from Magnetic Resonance Imaging (MRI), according to Harvard researchers Frances Jensen and David Urion, shows that the adolescent brain is only about 80 percent as developed as an adult brain.

In adolescence, the brain’s frontal lobe, responsible for such important functions as reasoning, planning and judgment, is not as well-connected to the rest of the brain by myelin, or “white matter,” as it is in an older individual. Because of the immaturity of their brains, adolescents are less capable than adults of rational thought processes.

White matter grows substantially over the course of adolescence, providing insulation that increasingly enables nerve signals to flow freely from one part of the brain to another. When the frontal lobe is fully connected to the rest of the brain, around age 25, the brain is more capable of “connecting the dots,” processing complex notions — such as that actions have consequences.

Brain development from age 5 to 20 / Source: Paul Thompson, professor of neurology, UCLA School of Medicine

Death and Disability Rates Double During Adolescence

If parents did not already intuit this, the difficulties that adolescents have in controlling their emotions and behaviors lead to a doubling in rates of death and disability during adolescence as compared to rates among younger children.

According to Ronald Dahl, Staunton Professor of Psychiatry and Pediatrics at the University of Pittsburgh Medical Center, increased risk-taking, sensation-seeking and reckless behavior lead adolescents to higher rates of traffic and other accidents, substance abuse, suicide, eating disorders, depression, violence and risky sexual behaviors.

Although Dahl does not promote a mechanistic view of biology as destiny, he does note that the life trajectories established in youth can have a major impact on later life, and it is best to alter these trajectories in a positive direction while one can.

Youth Reproductive Health: A Politically Charged Issue

Adolescents who become unintentionally pregnant or become infected with HIV are certainly in for a life-altering experience, and usually not one that will be advantageous.

For at least 15 years, reproductive health advocates have called for “youth friendly services” to enable youth who are, or intend to become sexually active, to obtain the information and services they need to remain healthy.

The concept of reproductive health services for adolescents has been, and remains politically controversial. In 2004, ideologues charged that the Global Health Conference [pdf], an international gathering of health professionals held annually in Washington D.C., would be a platform that year to advocate for youth reproductive health services, instigating a last-minute withdrawal of federal funding for the conference from the U.S. Department of Health and Human Services, the Centers for Disease Control (CDC) and the U.S. Agency for International Development (USAID).

While the conference proceeded with funding from other donors, the action had a chilling effect on some federal grantees, who swept their websites clean of any potentially damaging information. U.S. programs for youth in developing countries supported under the President’s Emergency Plan for AIDS Relief, PEPFAR, were firmly grounded in the “ABCs” — Abstain, Be faithful, use Condoms, even as domestic research showed that abstinence-only programs had no long-term health benefits.

Meanwhile, in some African countries, one in five young women is HIV positive and as many as one in two has been pregnant. In South Africa, 22 percent of young women attending antenatal care are both pregnant and HIV positive. These astounding statistics have largely been unmoved by the infusion of PEPFAR and other funding for proscriptive youth reproductive health information and services. And politically shaped policies in the United States help maintain pregnancy, birth and abortion rates among adolescents that are the highest in the developed world.

An Evidence-Based Practice

How should societies respond to the knowledge that adolescents may not be capable of obeying our pleas to “just say no,” “abstain until marriage,” or “always use a condom”?

Adolescents are capable of understanding, if not fully controlling, their own immature thought processes. They need realistic, truly “youth-friendly” tools and resources to help them make better decisions and remain healthy and safe.

If, based on brain research, adults come to view adolescence less as a period of self-centered disobedience and more as a period of innate vulnerability, we will do a better job of providing youth with comprehensive, compassionate services and education. We will do whatever we can to help them navigate this vulnerable period without becoming pregnant or HIV-positive, or undergoing an unsafely performed abortion, and if such outcomes occur, we will aim to minimize the harmful life-altering consequences.

Our obligation is to protect as best we can, those who by virtue of their not-fully-realized intellectual capacity, are less able than we previously assumed to look out for themselves.

Karin Ringheim, Ph.D., M.P.H., is a senior policy adviser at the Population Reference Bureau

Entrant: Emilia Gianfortoni
Nominee: Promotoras de la Salud Sexual Community Educators

The Latino community experiences vast sexual health disparities nationwide. Latinos disproportionately experience high rates of teen pregnancy and STIs compared to other ethnic groups. In Massachusetts, Latinas have a teen birth rate that is six times higher than non-Latinas.

The communities of Holyoke and Springfield experience the highest teen birth rates in the state, at 95.4 and 84.3 per 1,000, respectively, compared to 22 per 1,000 for the state as a whole.

As studies clearly show, teen pregnancy and birth rates are much related to high school drop out rates. Holyoke and Springfield are no exceptions with the two highest drop out rates for Latino teens in the state (34.9 and 33.3 per 1,000, respectively, compared to 22.8 in MA overall).

In Latin American countries and culture, health care is often provided in a more personal and informal way than in the United States. Promotoras offer customized health information from volunteers with first-hand knowledge of the communities they serve and the experiences they have that effect their health care knowledge and access.

Through a partnership with the Puerto Rican Cultural Center and Planned Parenthood League of Massachusetts, the Promotoras, or community health workers, in Springfield, Mass., have been providing sexual health education to their community in group and individual settings to raise awareness and increase access to sexual health information and services.

In just four short months, and with strong leadership and dedicated guidance from Iris Coralí, the Latino community health education coordinator from Planned Parenthood, the promotoras have connected with over 1,300 individuals in their community through charlas, health and community fairs, and family and friends. Each person they connect with receives accurate information about sexual health from someone they can identify with, along with answers to questions they may have and referrals to health services in their community. The promotoras include:

* Maribel Cabrera is 32 years old and was born and raised in Rio Piedras, Puerto Rico. She recently moved to the United States, to Springfield, and is studying English at the Massachusetts Career Development Institute. For Maribel, being a promotora means being a leader in her community and a confident advisor. As promotoras, she believes she can access and attain knowledge, information and resources to advise the Latino community. Maribel has two sons who are her main reason to keep moving forward.

* Paola Figueroa is 25 years old and was born and raised in Rio Piedras, Puerto Rico. She came to the United States to achieve some of her greatest drams, which included seeing snow and having a better life – both of which she has achieved. Paola is studying English at the Massachusetts Career Development Institute to be able to have a better job in the future. She loves being a promotora de salud sexual because she believes it is a very important topic for our children and their future and to be able to give advice to the community. As a promotora she has the skills to give correct information and be knowledgeable about the health services.  For Paola, being a promotora signifies the confidence in her community. She has a very intelligent 5-year-old daughter, Lenalisse, and a wonderful supportive husband.

* Jessica Rivera was born and raised in Arecibo, Puerto Rico and is 29 years old. She decided to come to the United States to find a better job and to give her sons a better future. Jessica has two sons who, along with her family, are her biggest love; they are 8 and 9 years old. She has a bachelors degree in Elementary English from Puerto Rico and is currently studying English at the Massachusetts Career Development Institute. Jessica likes to help other people, and to talk a lot. Being a promotora means she is an example for the community to give correctly information about sexual health and sexuality to help the community. Through her knowledge as a promotora she can help other people in need be able to have a healthy future.

* Sandy Soto was born in 1969 and raised in Puerto Plata, Dominican Republic. She completed her law degree from the Universidad Technologica de Santo Domingo and moved to the United States in 2006 after visiting a few times before. Sandy has always liked to work with people to help them and she believes that by being a promotora she can do that. Being a promotora means she can advise her community about how to protect their physical and mental health and how they can help their families. Sandy has three sons and one grandson.

So far, they have received very positive feedback, and it is clear many community members are appreciative of the information they are receiving.

A woman staying at a homeless shelter in West Springfield, where she lives with her two children, took a bus to the Center’s recent Three Kings Day Celebration. The woman was 35 years old and moved to Massachusetts from Puerto Rico six months ago after divorcing her husband and escaping domestic violence. As part of the process for signing up for toys at the Center, the woman attended a charla and filled out a subsequent evaluation. On the evaluation form, the woman mentioned having little knowledge of birth control options and STI prevention. She also listed that she had never had an annual gynecological exam.

After listening to the charla, the woman was very happy to have received such helpful information and commented that she felt many in the community could benefit from it. She also wrote that she would like to become a Promotora herself, and provided her contact information.

The Sexuality Information and Education Council of the United States (SEICUS) would like you to get REAL about sex education.

SEICUS has declared October “Sex Ed Month of Action,” and the organization is encouraging young people to raise awareness for the need for comprehensive sex ed — and specifically the Responsible Education About Life (REAL) Act [pdf].

Introduced by Sen. Frank Lautenberg (D-N.J.) and Rep. Barbara Lee (D-Calif.), the legislation (S.611, HR.1551) calls for a dedicated federal funding stream ($50 million) that would cover state grants for developing comprehensive sexuality education programs. A petition in support of the REAL Act is online at AmplifyYourVoice.org.

Reviewing these quick facts about the need for comprehensive sex education, I was reminded of my own “real” sex education.

Picture this: It’s Sunday morning, and I’m competing in a condom-stretching contest in the basement of a pre-school. Other kids are trying to blow up the largest condom-balloon, shoot a condom the farthest (rubber-band style), or beat my record of 24-inches for the condom-stretch (all the way from the floor to my hip). Four adults are recording scores and announcing winners. In the center of the room, next to a few condom-clad bananas, sits a box of donuts, a subtle bribe to get us out of bed so early on a weekend.

I was in eighth grade, and I was a reluctant student in Our Whole Lives.

Our Whole Lives (OWL), a sexuality education curriculum developed jointly by the Unitarian Universalist Association and the United Church of Christ, was first published in 1999, and subsequently updated in 2005. The class provides a comprehensive, interactive, unabashed look at sexuality, offering six sets of curricula for age groups spanning kindergarten to adulthood.

The “big curriculum” for seventh-to-ninth graders is predominantly offered outside of schools (I took OWL as part of Sunday school at my local UU church), and tends to take a more personal angle than classroom based sex-ed classes, offering time for discussion, games and unlimited questions.

The first sessions of the curriculum focus on building rapport between the instructors and the students, as well as creating a high level of comfort between the students themselves. One of my OWL classmates recently said: “Because of the intimate environment of OWL, it felt really awkward at times, but in the end was really effective in achieving its purpose… There was room for open discussion, and questions arose that never would have when surrounded by 22 random kids from school.”

This “intimate environment,” as well as the fact that, by virtue of being taught outside of the school system, OWL does not need to conform to any state or federally-imposed limitations, means that OWL can address sexuality education more broadly. Topics include everything from anatomy and physiology (I clearly remember being ejaculated on by a working model of a penis built by a class-mate), to gender roles in dating (we had a long argument about who should pay for dinner and a movie).

There was a whole session devoted to “love making,” and another devoted to masturbation. Trading colored m&ms taught us about the terrifying ease of spreading sexually transmitted diseases. We played with condoms, diaphragms, female condoms and spermicidal gels. We discussed our feelings about abortion at length. We spent three weeks discussing sexual orientation and gender identity. At an all-class sleepover, as part of our unit on responsible sexual behavior, we watched “American Pie.”

When I took OWL at age 14, issues like herpes, emergency contraception and “responsible sexual decisions” often seemed remote to the point of irrelevance, and I can’t deny that my high school health class served as somewhat of a necessary refresher. However, what I really absorbed from OWL at the time, and what I have carried with me ever since, is an outlook on sexuality that was strikingly absent from my sex-ed unit in health class: OWL taught me that sexuality is not something to be ashamed of, to be hidden or feared. It is something to be questioned and explored, respected and protected. It is nuanced and complex, and sometimes infuriatingly confusing.

Most of all, it is an essential part of the human experience that last from birth until death – Our Whole Lives.

So, am I bitter that I had to be up by 9 a.m. every Sunday for a year? Yes. I’m I glad my parent made me do it? Absolutely.

Meg Young recently graduated from high school in Middlebury, Vt., and will enroll at Tufts University in the fall of 2010 after taking a gap year.

Compiled by Anna Clark, who blogs at Isak, these texts cover not only the basics, but the complex policies and politics surrounding birth control, gender, race, abortion, adoption and more. From the introduction:

If we can agree that few teens learn about sexuality in an accurate, age-appropriate, and comprehensive way, then where does that leave adults who came through the same school systems they did? Many of us are still full of questions that we aren’t quite sure how to articulate. Few can claim that they’ve figured sex — and its social influence — out.

If you want to graduate to the next level of sexual health, pleasure, and social awareness, now’s your chance. Get yourself schooled with a crash course in sex ed for adults. From orgasms to organs, from contraceptives to court decisions, look to the reading list below for the can’t-miss books and articles about sex.

There are a number of titles here that I’ve been meaning to read, including such recent releases as “The Girl Who Went Away: Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade,” by Ann Fessler, and “The Means of Reproduction: Sex, Power, and the Future of the World,” by Michelle Goldberg. Any books on the list that you’d highly recommend, or other titles you would add?

The health care reform debate hasn’t been encouraging for reproductive health advocates, but on Wednesday the Senate Finance Committee pushed back against a Republican amendment designed to “doubly triply restrict abortion coverage in the bill,” as Rachel Maddow described it last night.

Republican Olympia Snowe of Maine joined almost all of the Democrats to defeat the amendment 13-10. Sen. Kent Conrad of North Dakota, a Democrat, voted for the restrictions along with the rest of the Republicans. Robert Pear of The New York Times explains the framework of the amendment:

The bill, written by the chairman of the Finance Committee, Senator Max Baucus, Democrat of Montana, says that no tax credits could be used to pay for abortions except as allowed in the latest appropriations for the Department of Health and Human Services — in case of rape or incest or if the life of a pregnant woman was in danger.

Under the bill, some health plans would cover abortion, and some would not. Private insurers that chose to cover abortion would be required to segregate money, taken from private premiums, to cover the procedure.

The amendment, offered Wednesday by Senator Orrin G. Hatch, Republican of Utah, would have gone much further. It said that no money provided under the legislation could be used to pay “any part of the costs of any health plan that includes coverage of abortion,” with a few limited exceptions. Under the proposal, insurers could have offered “a separate supplemental policy” to cover abortions. Such policies would have been financed “solely by supplemental premiums paid by individuals choosing to purchase the policy.”

Once again, Sen. Debbie Stabenow (D-Mich.), who demonstrated last week during a debate about pregnancy coverage that she is a no-nonsense force to be reckoned with, fired back against treating women as second-class citizens. She argued that the amendment goes far beyond existing law, which already prohibits spending federal dollars to pay for abortions for women on Medicaid, and it would restrict access to abortion for all women. Here’s my transcript of the video above:

In fact, with all respect to my friend, as a woman, I find it offensive that in [this amendment], any woman, any family purchasing through the exchange — if they did not receive any tax credit — would be prohibited from having the full range of health care options that they may need covered. This doesn’t just refer to the tax credits. As I read this: “prohibit private insurers operating through the exchange from offering coverage” — this is an unprecedented restriction on people who paid for their own health care insurance.

Then, when we look at the fact that this offers, that people could have a supplemental single-service rider, the assumption that somehow a woman or family would say, “You know, some day we may have an unintended pregnancy, so we’re going to get a separate rider. Or maybe my pregnancy is going to have a crisis — many, many crises — and so we’re going to try to find some other rider.”

In my judgment, I don’t even know how that would work. In the few states that have tried to do that, there’s no evidence that even those kinds of riders are available.

It’s remarkable that discussions about abortion conveniently leave out that it is a legal, medical procedure. Or that one in three women will have had an abortion by age 45. Or that three-fourths of women who obtain an abortion say they cannot afford to have a child. Or — as we saw in the weeks after the murder of Dr. George Tiller, when women stepped forward to reveal their stories — the decision is sometimes heartbreakingly, medically necessary.

We’re not the only ones frustrated by the way abortion has turned into a wedge issue for health care reform.

“In a rational system of medical care, there would be virtually no restrictions on financing abortions,” reads an editorial published in today’s New York Times. ”But abortion is not a rational issue, and opponents have succeeded in broadly denying the use of federal dollars to pay for them, except in the case of pregnancies that result from rape or incest or that endanger a woman’s life.”

“There should be no restrictions on abortion coverage in the exchanges,” the editorial concludes. “Health care reformers should not retreat on this issue, but we recognize that principle is often sacrificed in Congressional bargaining. Democrats who support the compromise must find a way to prevent it from being used later to go after other tax subsidies and thus further deny Americans’ rights to make their own health-care decisions.”

Hatch put forth a second amendment to strengthen existing “conscience clause” laws protecting healthcare workers from performing abortions or other services to which they have moral or ethical objections. It also failed on the same on the same 10-13 margin; Snowe voted with the Democrats, and Conrad with the Republicans.

Funding for Abstinence Only Education

On Tuesday night, the committee approved a comprehensive sex education funding stream, the Personal Responsibility Education for Adulthood Training. That amendment, proposed by Baucus, provides $75 million for states, according to the Sexuality Information and Education Council of the United States (SIECUS), “$50 million of which would be geared to evidence-based, medically accurate, age-appropriate programs to educate adolescents about both abstinence and contraception in order to prevent unintended teen pregnancy and sexually transmitted infections, including HIV/AIDS. The remaining funds would be for innovative programs as well as research and evaluation.”

Snowe joined all Democrats in passing the amendment; the vote was 14–9.

Yet on the same night, the committee voted for an amendment introduced by Hatch to restore federal funding for abstinence-only education — “better known,” said Maddow, “as the best teen pregnancy and STD delivery system politicians have ever devised.”

Democrats Conrad and Blanche Lincoln of Arkansas joined all 10 Republicans on the Finance Committee to vote in favor of adding $50 million-a-year funding for the Title V abstinence-only program to the health care bill, despite the fact that President Obama’s 2010 budget eliminated funding for abstinence-only education programs — because they simply don’t work.

Even Texas got the message. The state that ranks first in spending on sexual abstinence has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once. As the Austin American-Statesman reported on Sunday, some school districts are giving up the abstinence-only model and adopting a more comprehensive sex education curriculum, also called “abstinence-plus.”

Both amendments still have to pass the full House and Senate, so it’s anyone guess where the dollars will fall, but SEICUS is optimistic that legislators will wake up and reject the abstinence-only funding.

“This amendment takes a giant step backward by restoring funding for the failed and discredited abstinence-only-until-marriage program for the states,” said William Smith, vice president for public policy at SEICUS. “However, because this program so clearly doesn’t work and half the states don’t even participate, we are confident it will be stripped from the final bill and ask Congressional leaders and the White House to ensure this happens.”

I watched some of episode one; Maci, the mom shown here with her boyfriend, Ryan, and their son, Bentley, is amazing. She basically gives up everything to take on this new responsibility, with little help from Ryan. I was a bit surprised, though, to read her update describing her life now in far more upbeat terms. I’m thrilled for her, of course, but I do wonder if some teenage viewers will be conflicted.

Baltimore Sun critic David Zurawik highly recommends the series and praises the realism: “Parents who don’t go out of their way to see or record this six-week series of profiles of pregnant teenagers are making a big mistake. If you have no other involvement in your kids’ media lives, make them see this.”

Plus: When it comes to sex-ed, who’s the voice of reason?

Her conclusion:

As a pediatrician with two sons and a daughter, I acknowledge the need to emphasize manners and respect as boys maneuver into adolescence and adulthood, and to help them understand the implications and obligations of their increasing size and strength. And I acknowledge that for their own protection, boys need to understand that there are people — male and female — who will see them as potential predators, and judge them automatically at fault in any ambiguous situation.

But I am enough of an old-fashioned feminist to want to teach daughters the same fundamental lessons I teach sons: err on the side of respect and good manners; understand that confusion, doubt and ambiguity abound, especially when you are young; never take advantage of someone else’s uncertainty; and, just as important, remember that adolescence should be a time of fun, affection, growth and discovery.

It’s too bad that one side of teaching our children about sex and relationships means reminding them that there are bad people in the world; stay away from them, stay safe, speak up if someone hurts you or pushes you. But everyone needs that information, and that promise of adult support. We have to get that message across without defining some of our children as obvious perpetrators and others as obvious victims, because that insults everyone.