The sexual health of teens in Texas have become a central issue in Republican presidential debates, even if they remained largely unmentioned. In pummeling Governor Rick Perry for having signed an executive order that mandated all young women in Texas receive the HPV vaccine before entering sixth grade, his opponents argued that he was stepping on parental authority, destroying the innocence of 11-year-olds, and giving a “license for promiscuity” to the young women of the Lone Star state.
What they seem not to discuss is how these young women (and their male peers) are now faring when it comes to their sexual health.
A new issue of the Journal of Applied Research on Children is dedicated to teen pregnancy and features a series of articles out of the University of Texas, Houston which focus on the issues young people in that state are facing. One of the articles, “Adolescent Sexual Behavior: Examining Data from Texas and the United States,” provides a great comparison between young people in Perry’s home state and their peers nationwide.
We already know from myriad statistics that Texas teens are having a rough go of it:
- Texas has the third highest birth rate in the United States with 63.1 births per 1,000 females ages 15 to 19 compared to the national rate of 41.5 per 1,000.
- The state’s teen pregnancy rate is fifth in the United States, with a rate of 88 pregnancies per 1,000 young women ages 15 to 19 compared to the national rate of 70 pregnancies per 1,000.
- In 2008, there were 35,038 cases of Chlamydia, 9,592 cases of gonorrhea, and 142 cases of syphilis reported among young people ages 15 to 19 in Texas.
- The state ranks 12th in the number of HIV cases diagnosed among young people ages 13 to 19.
The new research takes a closer look at the sexual behavior of Texas youth as well as other issues (such as poverty, restrictive laws, and education) that may account for these disparities. The researchers looked at three sets of data. First, they examined the Youth Risk Behavior Survey (YRBS), a nationally-representative survey conducted every two years by the Centers for Disease Control and Prevention (CDC) that looks at a range of risk behaviors such as drinking and drug use, violence, seatbelt use, and sexual behavior. The data examined are from the 2009 YRBS. They also looked at data from the 2009 Middle School YRBS which was conducted in 14 states but is not considered nationally representative. Since Texas did not participate in the study, the researchers used weighted data from five southern states with similar teen birth rates to estimate behavior of young teens in the Lone Star state. Finally, they looked at All About Youth, a study conducted in a large urban district in Texas which included questions about sexual behaviors other than vaginal intercourse.
The findings are not surprising given what we already know about the sexual health of young people in the state:
- Texas students are more likely to report having ever had sex (52 percent of 9thto 12th graders in Texas compared 46 percent of 9th to 12th graders nationwide).
- When looked at by grade, 10th graders in Texas are more likely to report having ever had sex than their peers nationwide (52 percent compared to 41 percent) as are high school seniors (69 percent compared to 62 percent).
- Texas students are more likely to report having had sex with four or more partners than young people nationwide (17 percent compared to 14 percent).
- Texas students are also more likely to report being currently sexually active which is defined as having had sex in three months prior to the survey (38% compared to 34 percent).
- Sexually active students in Texas are more likely to report not using a condom (42 percent compared to 39 percent) as well as not using birth control pills or Depo Provera (84 percent compared to 77 percent) the last time they had sex.
Moreover, the data show ethnic and racial disparities among youth in Texas:
- Black (63 percent) and Hispanic (54 percent) high school students in Texas are significantly more likely than non-Hispanic white students (45 percent) to have ever had sex.
- Sexually active black (94 percent) and Hispanic (89 percent) students are also more likely to report not using birth control pills or Depo-Provera the last time they had sex compared to non-Hispanic white students (75 percent).
- Black students (12 percent) are also more likely than Hispanic (6 percent) and non-Hispanic white (4 percent) students to report having had sex for the first time before age 13 and having had four or more lifetime partners (29 percent compared to 15 percent and 14 percent, respectively).
The authors go on to draw some conclusions as to why young people in Texas are engaging in riskier sexual behaviors and all of these conclusions point to the conservative policies of the state. Perhaps most notably, young people in Texas are less likely to have learned about HIV and AIDS in school than other young people in the United States. The 2009 YRBS found that 83 percent of high school students in Texas reported having been taught about HIV and AIDS in school compared to 87 percent of high school students nationwide.
But the bigger issue might be what they were taught about that and other topics related to sexuality.
Texas does not require any classes on sexuality or STD prevention but according to the state’s education code, if such classes are provided, they must, among other things:
- present abstinence from sexual activity as the preferred choice of behavior in relationship to all sexual activity for unmarried persons of school age;
- devote more attention to abstinence from sexual activity than to any other behavior, and
- direct adolescents to a standard of behavior in which abstinence from sexual activity before marriage is the most effective way to prevent pregnancy, STDs, and infection with HIV or AIDS.
Not surprisingly, Texas has a long history of promoting abstinence-only-until-marriage programming. Before he helped pump millions of dollars into the nationwide abstinence-only industry, President George W. Bush promoted it through his Lone Star Leaders. A 1998 Washington Post article described then-Governor Bush as “leading the pack,” when he initiated the program which included “an aggressive abstinence program, backed up with more than $9 million for local efforts and a statewide media campaign to encourage young people to save sex for marriage.” In the years since, the state saw a dramatic increase in the money for media campaigns, classroom lectures, and other programs designed to promote the same message. Between Fiscal Years 2001 and 2010, Texas received over $119 million in federal funding for abstinence-only-until-marriage programs.
The authors of the study also note that many school districts in Texas are using textbooks that omit medically accurate information on condoms and contraception. As one of the largest states, the Texas State School Board has a great deal of power (specifically, purchasing power) over textbook publishers. Over the years, the board has wielded this power to ensure that conservative views on everything from condoms to when the world began were represented in state-approved textbooks. A 2009 report by the Texas Freedom Network notes “Seeking to avoid previous political battles over providing information on contraception and disease prevention in health textbooks, publishers simply self-censored the health education textbooks they submitted for the 2004 Texas adoption process.” As a result, only one of the four textbooks approved for the state’s schools mentions condoms as a way to prevent pregnancy and even in that book, the word condom appears “exactly once.”
But it is not just the lack of good sexuality education that is putting Texas young people at a disadvantage; restrictive state policies regarding access to contraception and other reproductive health services are also to blame. The authors note that with few exceptions, Texas requires parental consent for prescription contraception for anyone under 18. Moreover, “health care providers are required to notify law enforcement officials of all patients under age 17 whom they suspect are sexually active.” (Let’s not forgot the data mentioned earlier that found, among other things, that 52 percent of high school sophomores in Texas – who should be about 15 or 16 – reported having had sex.) This certainly creates an environment in which young people are at best reluctant to seek reproductive health care.
That may be fine with Governor Perry and the legislators in his state who recently cut funding for family planning clinics. Though Texas politicians like to refer to them as “abortion clinics,” none of the state’s 71 clinics provide abortion. Instead, they provide reproductive health care and family planning services, which ultimately prevent the unplanned pregnancies that lead to abortion. One study suggested that in 2006, contraceptive services provided by Title X funding averted 9,708 unintended pregnancies in girls ages 19 or younger in Texas.
But Perry and his friend’s don’t seem to see, or at least care about, the irony here. Nor do they seem to care that their policies and budget cuts are actually costing the state money. One study estimated that the restrictive notification law (in which health care providers must report all those sophomores who are having sex) cost the state an extra $43.6 million in additional pregnancies, births, abortions, and sexually transmitted disease-related care for teenage girls using publicly funded health care systems. The most recent rounds of cuts will have a similarly devastating effect on young women in Texas. According to an NPR report, “The state estimates nearly 300,000 women will lose access to family planning services, resulting in roughly 20,000 additional unplanned births…In San Antonio alone, unplanned children born to teens would fill 175 kindergarten classrooms each year.”
That’s unforgivable, especially in a state where 24 percent of children live in poverty (compared to 20 percent of children nationally). In fact, Texas is tied for first among states for the percentage of children living below 200 percent poverty. As the authors of this study point out, “poverty, high unemployment, and residential instability have been associated with early sexual initiation and increased adolescent sexual risk behaviors.” They believe that these “neighborhood effects” explain, at least in part, the differences in sexual behavior across racial/ethnic groups as black and Hispanic youth are disproportionally more likely to live in poverty.
So, essentially what we’re saying here is that not only are today’s Texas youth more likely to engage in risky sexual behavior than peers in other states, but Governor Perry and the lawmakers in his state are putting policies in place that will ensure the next generation of Lone Star teens fare no better.
I, for one, see irony in the fact that his since-rescinded HPV-vaccine mandate – for which he has gotten all sorts of flak – may be the only good thing Rick Perry has ever done when it comes to young people and sexual health.