Natural family planning

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Natural_family_planning

Natural family planning
Background
Type	Behavioral
First use	Ancient: calendar, LAM mid-1930s: BBT 1950s: mucus
Failure rates (First six months: LAM Per year: symptoms- and calendar-based)
Perfect use	LAM: 0.5% Symptoms based: 1–3% Calendar based: 5–9%
Typical use	LAM: 2% Symptoms based: 2–25% Calendar based: 25%
Usage
Reversibility	Yes
User reminders	Dependent upon strict user adherence to method
Advantages and disadvantages
STI protection	No
Period advantages	Prediction
Benefits	Personal self-awareness, no side effects, can aid pregnancy achievement, in accord with Catholic teachings, no blocks that affect intercourse

 

Natural family planning (NFP) comprises the family planning methods approved by the Catholic Church and some Protestant denominations for both achieving and postponing or avoiding pregnancy. In accordance with the Church's teachings regarding sexual behavior, NFP excludes the use of other methods of birth control, which it refers to as "artificial contraception."

 Periodic abstinence is now deemed moral by the Church for avoiding or postponing pregnancy for just reasons. When used to avoid pregnancy, couples may engage in sexual intercourse during a woman's naturally occurring infertile times such as during portions of her ovulatory cycle. Various methods may be used to identify whether a woman is likely to be fertile; this information may be used in attempts to either avoid or achieve pregnancy.

Effectiveness can vary widely, depending on the method used, whether the user was trained properly, and how carefully they followed the protocol. Pregnancy can result in anywhere from 1 to 25% of the user population per year for users of the symptoms based or calendar based methods, depending on the method used and how carefully it was practiced. If perfectly practised, pregnancy rates can be as low as 1% per year; if imperfectly practised, as high as 25%. (See sidebar.) The largest natural family planning study was of 19,843 women in Calcutta, India who were 52% Hindu, 27% Muslim and 21% Christian. The unexpected pregnancy rate was 0.2 pregnancies/100 women users yearly.

Natural family planning has shown very weak and contradictory results in pre-selecting the gender of a child, with the exception of a Nigerian study at odds with all other findings. Because of these remarkable results, an independent study needs to be repeated in other populations.

History

Pre-20th century

In ancient history, some Christian writers were against abstinence to prevent childbirth and some allowed it. Possibly the earliest Christian writing about periodic abstinence was by Clement of Alexandria. He wrote, "Let the Educator (Christ) put us to shame with the word of Ezekiel: 'Put away your fornications' [Eze. 43:9]. Why, even unreasoning beasts know enough not to mate at certain times. To indulge in intercourse without intending children is to outrage nature, whom we should take as our instructor."

In the year 388, St. Augustine wrote against the Manichaeans: "Is it not you who used to counsel us to observe as much as possible the time when a woman, after her purification, is most likely to conceive, and to abstain from cohabitation at that time...?" The Manichaeans (the group the early church father St. Augustine wrote of and considered to be heretics) believed that it was immoral to create any children, thus (by their belief system), trapping souls in mortal bodies. Augustine condemned them for their use of periodic abstinence during fertile periods: "From this it follows that you consider marriage is not to procreate children, but to satiate lust." About the year 401, St. Augustine wrote "Of the Good of Marriage" in which he affirmed married couples have the option of having sex without either of them intending procreation: "For, whereas that natural use, when it pass beyond the compact of marriage, that is, beyond the necessity of begetting, is pardonable in the case of a wife, damnable in the case of an harlot; that which is against nature is execrable when done in the case of an harlot, but more execrable in the case of a wife."

Saint Thomas Aquinas wrote in his Summa Contra Gentiles: "Hence it is clear that every emission of the semen is contrary to the good of man, which takes place in a way whereby generation is impossible; and if this is done on purpose, it must be a sin. I mean a way in which generation is impossible in itself as is the case in every emission of the semen without the natural union of male and female: wherefore such sins are called 'sins against nature.' But if it is by accident that generation cannot follow from the emission of the semen, the act is not against nature on that account, nor is it sinful; the case of the woman being barren would be a case in point."

In the Catholic Church, the Council of Trent, issued the following anathema: "If any one saith that the Church errs in that she declares that, for many causes, a separation may take place between husband and wife, in regard of bed, or in regard of cohabitation, for a determinate or for an indeterminate period; let him be anathema."

Protestant Reformers such as Martin Luther and John Calvin, were opposed to unnatural birth control. Centuries later, John Wesley, the leader of the Methodist movement said that unnatural birth control could destroy one's soul.

If the Manichaeans had an accurate idea of the fertile portion of the menstrual cycle, such knowledge died with them. Documented attempts to prevent pregnancy by practicing periodic abstinence do not appear again until the mid-19th century, when various calendar-based methods were developed "by a few secular thinkers." The Roman Catholic Church's first recorded official approval of periodic abstinence from 1853, where a ruling of the Church's Sacred Penitentiary addressed the topic. Distributed to confessors, the ruling stated that couples who had, on their own, begun the practice of periodic abstinence—if they had "grave reasons"—were not sinning by doing so.

In 1880, the Sacred Penitentiary reaffirmed the 1853 ruling, and went slightly further. It suggested that, in cases where the couple was already practicing artificial birth control and could not be dissuaded to cease attempting birth regulation, the confessor might morally teach them of periodic abstinence.

Early 20th century

In 1905, Theodoor Hendrik van de Velde, a Dutch gynecologist, showed that women only ovulate once per menstrual cycle. In the 1920s, Kyusaku Ogino, a Japanese gynecologist, and Hermann Knaus, from Austria, working independently, each made the discovery that ovulation occurs about fourteen days before the next menstrual period. Ogino used his discovery to develop a formula for use in aiding infertile women to time intercourse to achieve pregnancy.

In 1930, John Smulders, a Roman Catholic physician from the Netherlands, used Knaus and Ogino's discoveries to create the rhythm method. Smulders published his work with the Dutch Roman Catholic medical association, and this was the official rhythm method promoted over the next several decades. While maintaining procreation as the primary function of intercourse, the December 1930 encyclical Casti connubii by Pope Pius XI gave recognition to a secondary—unitive—purpose of sexual intercourse. This encyclical stated that there was no moral stain associated with having marital intercourse at times when "new life cannot be brought forth." This referred primarily to conditions such as current pregnancy and menopause. In 1932, a Catholic physician published a book titled The Rhythm of Sterility and Fertility in Women describing the method, and the 1930s also saw the first U.S. Rhythm Clinic (founded by John Rock) to teach the method to Catholic couples. It was during this decade that Rev. Wilhelm Hillebrand, a Catholic priest in Germany, developed a system for avoiding pregnancy based on basal body temperature.

Later 20th century to present

A minority of Catholic theologians continued to doubt the morality of periodic abstinence. Some historians consider two speeches delivered by Pope Pius XII in 1951 to be the first unequivocal acceptance of periodic abstinence by the Catholic Church. The 1950s also saw another major advance in fertility awareness knowledge: Dr. John Billings discovered the relationship between cervical mucus and fertility while working for the Melbourne Catholic Family Welfare Bureau. Dr. Billings and several other physicians studied this sign for a number of years, and by the late 1960s had performed clinical trials and begun to set up teaching centers around the world.

The Vatican II Constitution on the Church in the Modern World declared: "While not making the other purposes of matrimony of less account, the true practice of conjugal love, and the whole meaning of the family life which results from it, have this aim: that the couple be ready with stout hearts to cooperate with the love of the Creator and the Savior. Who through them will enlarge and enrich His own family day by day" (50). Beyond that the council of bishops was told to leave to the Pontifical Commission on Birth Control the task of advising Pope Paul VI on the issue. While a majority of the Commission (64 of 68 who voted) recommended allowing other means of contraception, Paul VI would determine otherwise.

Humanae Vitae, published in 1968 by Pope Paul VI, addressed a pastoral directive to scientists: "It is supremely desirable... that medical science should by the study of natural rhythms succeed in determining a sufficiently secure basis for the chaste limitation of offspring." This is interpreted as favoring the then-new, more reliable symptoms-based fertility awareness methods over the rhythm method. Just a few years later, in 1971, the first organization to teach a symptothermal method (one that used both mucus and temperature observations) was started. Now called Couple to Couple League International, this organization was founded by John and Sheila Kippley, lay Catholics, along with Dr. Konald Prem. During the following decade, other now-large Catholic organizations were formed: Family of the Americas(1977), and the Creighton Model as part of the Pope Paul VI Institute (1985), both mucus based systems of NFP. 

Today, use of the term natural family planning to describe calendar-based methods is considered 

incorrect by the United States Conference of Catholic Bishops: it considers such methods "inaccurate". Still, some organizations consider calendar-based methods to be forms of NFP. For example, in 1999 the Institute for Reproductive Health at Georgetown University developed the Standard Days Method (SDM), which is more effective than the rhythm method. SDM is promoted by Georgetown University as a form of natural family planning.

Prevalence

It is estimated that 2%–3% of the world's reproductive age population relies on periodic abstinence to avoid pregnancy. However, what portion of this population should be considered NFP users is unclear. Some Catholic sources consider couples that violate the religious restrictions associated with natural family planning to not be NFP users.

There is little data on the worldwide use of natural family planning. In Brazil, NFP is the third most popular family planning method. The "safe period" method of fertility awareness is the most common family planning method used in India, although condoms are used by some. Of all American women surveyed nationally in 2002, only 0.9% American women were using "periodic abstinence" (defined as "calendar rhythm" and "natural family planning") compared to 60.6% American women using other contraceptive methods. In Italy, where the vast majority of citizens claims to be Catholic, NFP methods are rarely taught.

In 2002, Sam and Bethany Torode, then a Protestant Christian couple, published a book advocating NFP use. (Five years after writing the book, the Torodes retracted their advocacy of pure NFP and also supported barrier methods as moral; the couple divorced in 2011 and both left from conservative Evangelicalism to join liberal churches.) Many NFP clinics and teaching organizations are associated with the Catholic Church, as well as The Church of Jesus Christ of Latter-day Saints (LDS Church) and some members of the Muslim faith.

Some fundamental Christians espouse Quiverfull theology, eschewing all forms of birth control, including natural family planning.

Contraception

Some proponents of NFP differentiate it from other forms of birth control by labeling them artificial birth control. Other NFP literature holds that natural family planning is distinct from contraception. Proponents justify this classification system by saying that NFP has unique characteristics not shared by any other method of birth regulation except for abstinence. Commonly cited traits are that NFP is "open to life," and that NFP alters neither the fertility of the woman nor the fecundity of a particular sex act. That NFP can be used to both avoid or achieve pregnancy may also be cited as a distinguishing characteristic.

Methods

There are three main types of NFP: the symptoms-based methods, the calendar-based methods, and the breastfeeding or lactational amenorrhea method. Symptoms-based methods rely on biological signs of fertility, while calendar-based methods estimate the likelihood of fertility based on the length of past menstrual cycles.

Clinical studies by the Guttmacher Institute found that periodic abstinence resulted in a 25.3 percent failure under typical conditions, though it did not differentiate between symptom-based and calendar-based methods.

Symptoms-based

Some methods of NFP track biological signs of fertility. When used outside of the Catholic concept of NFP, these methods are often referred to simply as fertility awareness-based methods rather than NFP. The three primary signs of a woman's fertility are her basal body temperature (BBT), her cervical mucus, and her cervical position. Computerized fertility monitors, such as Lady-Comp, may track basal body temperatures, hormonal levels in urine, changes in electrical resistance of a woman's saliva, or a mixture of these symptoms.

From these symptoms, a woman can learn to assess her fertility without use of a computerized device. Some systems use only cervical mucus to determine fertility. Two well-known mucus-only methods are the Billings ovulation method and the Creighton Model FertilityCare System. If two or more signs are tracked, the method is referred to as a symptothermal method. Two popular symptothermal systems are taught by the Couple to Couple League and the Fertility Awareness Method (FAM) with Toni Weschler. A study completed in Germany in 2007 found that tymptothermal method has a method effectiveness of 99.6%.

A study by the World Health Organization involving 869 fertile women from Australia, India, Ireland, the Philippines, and El Salvador found that 93% could accurately interpret their body's signals regardless of education and culture. In a 36-month study of 5,752 women, the method was 99.86% effective.

A symptohormonal method of NFP developed at Marquette University uses the ClearBlue Easy fertility monitor and cycle history to determine the fertile window. The monitor measures estrogen and LH to determine the peak day. This method is also applicable during postpartum, breastfeeding, and perimenopause, and requires less abstinence than other NFP methods. Some couples prefer this method because the monitor reading is objective and is not affected by sleep quality as BBT can be.

Calendar-based

Calendar-based methods determine fertility based on a record of the length of previous menstrual cycles. They include the Rhythm Method and the Standard Days Method. The Standard Days method was developed and proven by the researchers at the Institute for Reproductive Health of Georgetown University. CycleBeads, unaffiliated with religious teachings, is a visual tool based on the Standard Days method. According to the Institute of Reproductive Health, when used as birth control, CB has a 95% effectiveness rating. Computer programs are available to help track fertility on a calendar.

Lactational amenorrhea

The lactational amenorrhea method (LAM) is a method of avoiding pregnancy based on the natural postpartum infertility that occurs when a woman is amenorrheic and fully breastfeeding. The rules of the method help a woman identify and possibly lengthen her infertile period.

Debates

Roderick Hindery reported that a number of Western Catholics have voiced significant disagreement with the Church's stance on contraception. In 1968, the Canadian Conference of Catholic Bishops issued what many interpreted as a dissenting document, the Winnipeg Statement, in which the bishops recognized that a number of Canadian Catholics found it "either extremely difficult or even impossible to make their own all elements of this doctrine" (that of Humanae vitae). Additionally, in 1969, they reasserted the Catholic principle of primacy of conscience, a principle that they said should be properly interpreted. They insisted that "a Catholic Christian is not free to form his conscience without consideration of the teaching of the magisterium, in the particular instance exercised by the Holy Father in an encyclical letter." Catholics for a Free Choice claimed in 1998 that 96% of U.S. Catholic women had used contraceptives at some point in their lives and that 72% of U.S. Catholics believed that one could be a good Catholic without obeying the Church's teaching on birth control. According to a nationwide poll of 2,242 U.S. adults surveyed online in September 2005 by Harris Interactive (they stated that the magnitude of errors cannot be estimated due to sampling errors, non-response, etc.), 90% of U.S. Catholics supported the use of birth control/contraceptives. A survey conducted in 2015 by the Pew Research Center among 5,122 U.S. adults (including 1,016 self-identified Catholics) stated 76% of U.S. Catholics thought that the Church should allow Catholics to use birth control.

In 2003, the BBC's Panorama claimed that Church officials have taught that HIV can pass through the membrane of the latex rubber from which condoms were made. It was considered not true according to the World Health Organization, despite a 2000 report by the National Institutes of Health (NIH) stating that consistent use of latex condoms reduced the risk of HIV transmission by approximately 85% relative to risk when unprotected, not 100% safe.

In an interview on Dutch television in 2004, Belgian Cardinal Godfried Danneels argued that the use of condoms should be supported to prevent AIDS if sex with a person infected with HIV should take place, though it is to be avoided. According to Danneels, "the person must use a condom in order not to disobey the commandment condemning murder, in addition to breaking the commandment which forbids adultery. ... Protecting oneself against sickness or death is an act of prevention. Morally, it cannot be judged on the same level as when a condom is used to reduce the number of births." In 2009, Pope Benedict XVI asserted that handing out condoms is not the solution to combating AIDS and actually makes the problem worse. He proposed "spiritual and human awakening" and "friendship for those who suffer" as solutions.

Artificial family planning proponent Stephen D. Mumford claimed that the primary motivation behind the Church's continued opposition to contraceptive use is the impossibility to make changes without spoiling papal authority with regards to papal infallibility. Mumford gives as an example the citation made by dissident theologian August Bernhard Hasler of a minority report co-authored by Pope John Paul II prior to his papacy:

If it should be declared that contraception is not evil in itself, then we should have to concede frankly that the Holy Spirit had been on the side of the Protestant churches in 1930 (when the encyclical Casti connubii was promulgated), in 1951 (Pius XII's address to the midwives), and in 1958 (the address delivered before the Society of Hematologists in the year the pope died). It should likewise have to be admitted that for a half century the Spirit failed to protect Pius XI, Pius XII, and a large part of the Catholic hierarchy from a very serious error. This would mean that the leaders of the Church, acting with extreme imprudence, had condemned thousands of innocent human acts, forbidding, under pain of eternal damnation, a practice which would now be sanctioned. The fact can neither be denied nor ignored that these same acts would now be declared licit on the grounds of principles cited by the Protestants, which popes and bishops have either condemned or at least not approved.

It is said that none of the instances cited falls under the domain of papal infallibility; the Pope is not considered infallible except in the rare, solemn occasions when he is speaking ex cathedra. According to M. R. Gagnebet, though the encyclical Humanae vitae is considered by some to be a non-infallible document, "the doctrinal authority of the Pope and the Bishops is not limited to infallible teaching. The duty of obedience is not restricted to definitions of faith".

Theological opposition has come from some denominations of Protestant Christianity. The Reformed theologian John Piper's Desiring God ministry states of NFP, "There is no reason to conclude that natural family planning is appropriate but that 'artificial' (non-abortive) means are not." Eastern Orthodox couple Sam and Bethany Torode, former advocates of NFP-only, have redacted their position to include barrier methods and explain their current theology this way:

We also see honest congruity with the language of the body by saying "no" to conception with our bodies (via barrier methods or sensual massage) when our minds and hearts are also saying "no" to conception. We don’t believe this angers God, nor that it leads to the slippery slope of relativism or divorce. We strongly disagree with the idea that this is a mortal sin.... It’s a theological attack on women to always require that abstinence during the time of the wife’s peak sexual desire (ovulation) for the entire duration of her fertile life, except for the handful of times when she conceives.

Traditionalist Catholic priest Francis Ripley criticizes the concept:

The use of the term "Natural Family Planning" has come under sharp attack from traditional Catholic writers in recent years because it implies the right of the couple to "plan" their family; whereas the Catholic norm is to let God plan one's family and to accept the children when (and if) God gives them--as a blessing from Him on the marital union and on society.

Religion and birth control

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Religion_and_birth_control

Religious adherents vary widely in their views on birth control. This can be true even between different branches of one faith, as in the case of Judaism. Some religious believers find that their own opinions of the use of birth control differ from the beliefs espoused by the leaders of their faith, and many grapple with the ethical dilemma of what is conceived as "correct action" according to their faith, versus personal circumstance, reason, and choice.

Christianity

Among Christian denominations today there are a large variety of positions towards contraception. The Roman Catholic Church has disallowed artificial contraception for as far back as one can historically trace. Contraception was also officially disallowed by non-Catholic Christians until 1930 when the Anglican Communion changed its policy. Soon after, according to Flann Campbell, most Protestant groups came to accept the use of modern contraceptives as a matter of what they considered Biblically allowable freedom of conscience.

Roman Catholicism

The Catholic Church is opposed to artificial contraception and all sexual acts outside of the context of marital intercourse. This belief dates back to the first centuries of Christianity. Such acts are considered intrinsically disordered because of the belief that all licit sexual acts must be both unitive (express love), and procreative (open to procreation). The only form of birth control permitted is abstinence. Modern scientific methods of "periodic abstinence" such as natural family planning (NFP) were counted as a form of abstinence by Pope Paul VI in his 1968 encyclical Humanae Vitae. The following is the condemnation of contraception:

Therefore We base Our words on the first principles of a human and Christian doctrine of marriage when We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortion, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children. Equally to be condemned, as the magisterium of the Church has affirmed on many occasions, is direct sterilization, whether of the man or of the woman, whether permanent or temporary. Similarly excluded is any action which either before, at the moment of, or after sexual intercourse, is specifically intended to prevent procreation—whether as an end or as a means.

A number of other documents provide more insight into the Church's position on contraception. The commission appointed to study the question in the years leading up to Humanae Vitae issued two unofficial reports, a so-called "majority report" which described reasons the Catholic Church should change its teaching on contraception, signed by 61 of 64 scholars assigned to the pontifical commission, and a "minority report" which reiterated the reasons for upholding the traditional Catholic view on contraception. In 1997, the Vatican released a document entitled "Vademecum for Confessors" (2:4) which states "[t]he Church has always taught the intrinsic evil of contraception." Furthermore, many Church Fathers condemned the use of contraception.

The 1987 document Donum Vitae opposes in-vitro fertilization on grounds that it is harmful to embryos and separates procreation from union of the spouses. Later on, the 2008 instruction Dignitas Personae denounces embryonic manipulations and new methods of contraception.

Roderick Hindery reported that a number of Western Catholics have voiced significant disagreement with the Church's stance on contraception. Among them, dissident theologian Charles Curran criticized the stance of Humanae vitae on artificial birth control. In 1968, the Canadian Conference of Catholic Bishops issued what many interpreted as a dissenting document, the Winnipeg Statement, in which the bishops recognized that a number of Canadian Catholics found it "either extremely difficult or even impossible to make their own all elements of this doctrine" (that of Humanae vitae). Additionally, in 1969, they reasserted the Catholic principle of primacy of conscience, a principle that they said should be properly interpreted. They insisted that "a Catholic Christian is not free to form his conscience without consideration of the teaching of the magisterium, in the particular instance exercised by the Holy Father in an encyclical letter". According to the American Enterprise Institute, 78% of American Catholics say they believe the Church should allow Catholics to use birth control, though other polls reflect different numbers.

According to Stephen D. Mumford, the Vatican's opposition towards birth control continues to this day and has been a major influence on United States policies concerning the problem of population growth and unrestricted access to birth control.

However, in December 2018, in a responsum (a reply by a Curial department that is intended to settle a question or dispute, but that is not a papal document), the Congregation for the Doctrine of the Faith (CDF), under its Prefect, Cardinal Luis Ladaria Ferrer, S.J., stated that if the uterus can be found, with moral certainty, to not be able to ever carry a fertilized ovum to the point of viability, that a hysterectomy could be performed, because under that very narrow circumstance it is considered the removal of a failed organ and not per se a sterilization, since viability is not possible. If a hysterectomy is only done under this circumstance, it does not represent a shift in church teaching.

Protestantism

Author and FamilyLife Today radio host Dennis Rainey suggests four categories as useful in understanding current Protestant attitudes concerning birth control. These are the "children in abundance" group, such as Quiverfull adherents who view all birth control and natural family planning as wrong; the "children in managed abundance" group, which accept only natural family planning; the "children in moderation" group which accepts prudent use of a wide range of contraceptives; and, the "no children" group which sees itself as within their Biblical rights to define their lives around non-natal concerns.

Meanwhile, some Protestant movements, such as Focus on the Family, view contraception use outside of marriage as encouragement to promiscuity.

Sex is a powerful drive, and for most of human history it was firmly linked to marriage and childbearing. Only relatively recently has the act of sex commonly been divorced from marriage and procreation. Modern contraceptive inventions have given many an exaggerated sense of safety and prompted more people than ever before to move sexual expression outside the marriage boundary.

The Anglican Church in 1930 at the Lambeth conference said contraception is acceptable in certain cases.

Eastern Orthodoxy and Oriental Orthodoxy

The Greek Orthodox Archdiocese of America "permits the use of certain contraceptive practices within marriage for the purpose of spacing children, enhancing the expression of marital love, and protecting health."

The Russian Orthodox Church allows for the use of birth control as long as it does not fall under the class of abortifacients.

Hinduism

Some Hindu scriptures include advice on what a couple should do to promote conception—thus providing contraceptive advice to those who want it. The Mahabharata mentions that killing an embryo is a sin. It also mentions in the story of King Yayati that a man solicited by a woman who is fertile and doesn't grant her wishes is regarded as a killer of the embryo. From this one could infer that contraception is also equivalent to killing an embryo and would be regarded as sin. However, most Hindus accept that there is a duty to have a family during the householder stage of life, and so are unlikely to use contraception to avoid having children altogether. The Dharma (doctrine of the religious and moral codes of Hindus) emphasizes the need to act for the sake of the good of the world. Some Hindus, therefore, believe that producing more children than the environment can support goes against this Hindu code. Although fertility is important, conceiving more children than can be supported is treated as violating the Ahimsa (nonviolent rule of conduct).

Because India has such a large and dense population, much of the discussion of birth control has focused on the environmental issue of overpopulation rather than more personal ethics, and birth control is not a major ethical issue.

Islam

The Qur'an does not make any explicit statements about the morality of contraception, but contains statements encouraging procreation. The Islamic prophet Muhammad also is reported to have said "marry and procreate".

Coitus interruptus, a primitive form of birth control, was a known practice at the time of Muhammad, and his companions engaged in it. Muhammad knew about this, but never advised or preached against it.

Muslim scholars have extended the example of coitus interruptus, by analogy, to declaring permissible other forms of contraception, subject to three conditions.

1. As offspring are the right of both the husband and the wife, the birth control method should be used with both parties' consent.
2. The method should not cause permanent sterility.
3. The method should not otherwise harm the body.

Ahmadiyya Muslims believe birth control is prohibited if resorted to for fear of financial strain.

Judaism

The Jewish view on birth control currently varies between the Orthodox, Conservative, and Reform branches of Judaism. Among Orthodox Judaism, use of birth control has been considered only acceptable for use in certain circumstances, for example, when the couple already has two children or if they are both in school. However, it is more complex than that. The biblical law of being "fruitful" and "multiplying" is viewed as one that applies only to men, and women have no commandment to have children. This is the reason why women are the ones to choose a form of contraception that they wish to use (i.e. spermicide, oral contraception, intrauterine device, etc.), while males don't. Generally speaking, when Orthodox Jewish couples contemplate the use of contraceptives, they generally consult a rabbi who evaluates the need for the intervention and which method is preferable from a halachic point of view. Including the previously mentioned reasons (already having children, student status, etc.) there are many other reasons for a rabbi to grant a couple permission to use contraception. In many modern Orthodox communities, it is recommended for young newlywed couples to wait a year before having a child so as to strengthen their marital foundation and their relationship before bringing children into the home. This is because children generally require a strong parental unit, and bring challenges and difficult decisions which can be a heavier burden on the marriage itself if the parents are not functioning together well. Since marriage is a sacred relationship of the highest importance in Judaism, couples are always counseled to behave and live in a manner that constantly works to uphold a happy and loving home; this may include planning to slightly delay having children when the couple has had a speedy dating and marriage timeline (as is common in Orthodoxy when many couples abstain from premarital sex).

Conservative Judaism, while generally encouraging its members to follow the traditional Jewish views on birth control has been more willing to allow greater exceptions regarding its use to fit better within modern society. Reform Judaism has generally been the most liberal with regard to birth control allowing individual followers to use their own judgment in what, if any, birth control methods they might wish to employ. Jews who follow halakha based on the Talmudic tradition of law will not have sex during the 11–14 days after a women begins menstruating. This precludes them from utilizing some forms of "natural birth control" such as the "Calendar-based contraceptive methods" which are relatively unobjectionable to other religious groups.

The introduction of oral contraception, or "the pill," in the 1960s and the intrauterine device did not cause a big uprising in the Jewish community as it did in other religious communities due to the understanding of their great benefit and no strict association with their availability and greater promiscuity, as has been the fear in other religions.

Buddhism

Buddhist attitudes to contraception are based on the idea that it is wrong to kill for any reason. The most common Buddhist view on birth control is that contraception is acceptable if it prevents conception, but that contraceptives that work by stopping the development of a fertilized egg are wrong and should not be used.

Buddhists believe that life begins (or more technically: a consciousness arises) when the egg is fertilised. That is why some birth control methods, such as the copper IUD, which act by killing the fertilised egg and preventing implantation are unacceptable since they harm the consciousness which has already become embodied.

Bahá'í

Bahá'ís do not "condemn the practice of birth control or...confirm it," although they see procreation as an essential part of marriage and oppose contraception which violates the spirit of that provision.

Sex education curriculum

From Wikipedia, the free encyclopedia

https://en.wikipedia.org/wiki/Sex_education_curriculum

A Sex education curriculum is a sex education program encompassing the methods, materials, and assessments exercised to inform individuals of the issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, birth control, and other aspects of human sexual behavior. Common sex education curricula include an abstinence-only approach, as well as a comprehensive approach, implemented in academia via the Internet, peer education, visual media, games, health care organizations, and school instruction.

Purpose

The purpose of sexuality education curriculum in Europe is to facilitate adolescents to gain knowledge, attitudes, skills and values to make appropriate and healthy choices in their sexual behavior, thus preventing them from sexually transmitted infections, including HIV and HPV, teenage or unwanted pregnancies, and from domestic and sexual violence, contributing to a greater society. While European educators and policy makers recognize the benefits of sexuality education as being essential in the realm of sexual health, the content and approach of the curriculum have undergone significant changes over time and differ among each European country. Influenced by politics, as well as social and religious movements, European educators and policy makers recognize the struggle to find common criteria of sexuality education curriculum.

Common Sex Education Curricula

Researchers identify the most common delivery of sexuality education curriculum as being through a biology, relationship, and ideological focus. In this form of curriculum, practiced through a moral and informative approach by a teacher’s instruction, attention is directed towards the reproductive and physical aspects of sexuality education rather than the emotional and social aspects. While this approach is identified as the most common form of sexuality education in Europe, Europe is not limited to this practice. With a total of twenty seven countries within the European Union, a wide variety of practices are implemented in an attempt to address and/or ignore sexuality education. European policy makers and educators recognize the need for an implementation of an ideal curriculum for European countries to adopt, while distinguishing the political, social, and religious movements that hinder this action.

The Safe Project

The Safe Project was introduced by a coalition of European health organizations including the IPPF European Network, WHO Regional Office for Europe, and Lund University, in 2004 in response to European policy makers and educators speaking out about the political, social, and religious struggles encountered when implementing sexuality education curriculum in Europe. The SAFE project conducted extensive research, implemented advocacy, engaged the youth, and created a greater recognition among public health organizations of the sexual rights of European youth as well as the creation of a model curriculum, providing an outline of the ideal sexuality education curriculum to be practiced within the European Union. This model of sexuality education curriculum was charted in a ninety eight page product entitled The Reference Guide to Sexuality Education in Europe, selling thousands of copies to public health organizations and journals, as well as various books within academia.

The Model Sex Education Curricula

The ideal sexuality education curriculum within the European Union, as proposed by the SAFE Project, is one that would be provided for varying ages of students, from the primary to the secondary level. A multi-dimensional staff including public health professionals, school instructors with knowledge in the sciences, and non-governmental organizations, would be responsible for providing instruction in an interactive approach. Educators recognize the benefits of health organizations and agencies not only as offering a more emotional and social approach to sexuality education, but also expertise in recognizing issues among youth such as indications of sexual abuse, sexually transmitted diseases, and pregnancy. Similarly, non-government organizations(NGOs) provide students as well as the public with private counseling, sexuality seminars, public health campaigns, as well as peer-led informational groups, in which they are able to step outside of a strictly lecture and informational curriculum in sexuality education and accommodate the personal needs of European youth.^{[2][page needed]} While the ideal curriculum would be altered to accommodate the needs of its audience, its goal is to inform students on the topic of sexuality, raising awareness and therefore allowing students to make healthier decisions in regards to sexuality and relationship activity as well as European youth distinguishing their sexual rights. Younger audiences within the primary setting would be instructed by their classroom teacher in areas of puberty, sexual development, and bullying while secondary audiences would be instructed by a multi-dimensional staff in the topical areas of racism, homophobia, sexual violence, abstinence, safe sex, sexually transmitted diseases, pregnancy and contraceptives, as well as the biological, emotional, and social effects of sexuality.

Complications

Several complications are associated with the implementation of an ideal sexuality education curriculum including the area and diversity of each European country, variances in political and religious views, and a lack of sustainability. The area in which a country is located can affect religious and political beliefs, as well as resources and access to health education, similarly the idea of diversity and the exposure to information and resources as well. Politics and religion are two controversial topics that both have strong oppositions to sexuality education. With strong oppositions and public protests, political and religious affiliated organizations voice their negative opinions of a sexuality education curriculum that informs youth of sexual resources and options concerning contraception and abortion. With sexuality education not being mandatory in all twenty seven countries of the European Union and the controversial opposition of political and religious organizations, policy makers are unable to make an ideal sexuality education curriculum concrete. A lack of sustainability within sexuality education curriculum is also an issue addressed by European policy makers and educators. Upon a country acknowledging the benefits, as well as a need for sexuality education, they implement the ideal sexuality education curriculum in which they see positive results in the decline of sexually transmitted diseases as well as teenage and unplanned pregnancies. Upon government officials recognizing the positive results of the curriculum, the program is eliminated due to the significant improvements and the mindset that the problem is fixed and therefore the curriculum is no longer needed. With governmental cuts in sexuality education programs as well as the funding provided for those programs, policy makers and educators face great difficulty in the implementation of a continent-wide curriculum.

Corrupted Children

A child's mindset is shaped in numerous ways whether it is from their:

• parents
• environment
• experiences

As they grow, sex education will become a topic in their life that they will be curious about. Depending on how they are raised, they will have many questions or no questions at all. This article explains sexual innocence and how children flourish as adults.

Article Sexuality Education in the United States:Shared Cultural Ideas across a Political Divide states that:

"Sexuality education debates and policy may sometimes posit young people as categorically less able, less intelligent, and less responsible than their adult counterparts. In the United States, young people’s relationships are at times denigrated as no more than puppy love, their sexual desires simply signs of raging hormones, and their sexual behaviors transgressions to control. Within this adult-leaning framework, young people are at their best when sexually innocent. At their most vulnerable, they are on the verge of succumbing to sexual danger; and, at their most corrupting, they are the source of significant risks to others."

From a more liberal standpoint, the sexuality of a teenager is complex. Truly age of consent cannot be put on the liberal or the conservative side of a liberal to conservative spectrum. However, liberals will debate that teenage sexuality should be expressed more often than the conservative side.

Website Official Website

 

For different parenting styles that could affect the way your child perceives sex: Check out- Official Website

Benefits

Several benefits are associated with the implementation of this model of sexuality education curriculum, including youth empowerment, an increased awareness of sexuality, a decline in the acquiring or conveying of sexually transmitted diseases, as well as a decrease in unintended pregnancies.

Supporters

The IPPF European Network strives for support and access to sexual and reproductive health services, while serving as a voice for the sexual rights of European individuals globally. The WHO Regional Office for Europe advocates for public health, implements programs for disease prevention and control, addresses health threats, responds to health emergencies, and sustains and supports the implementation of public health policies. Lund University is one of Europe’s most renowned universities, as well as one of the top one-hundred universities globally.

European Union Countries

Austria

Sexuality education in Austria is addressed in the manner of a Biology, German, Religious Studies, and Social Studies/Factual Education curriculum through a method of formal classroom instruction. Sexuality education curriculum is introduced in a primary school setting, middle school setting, as well as a secondary setting. Topics discussed are differences between sexes, pregnancy, puberty and physical changes, genitals, masturbation, contraceptives, safe sex, abstinence, abortion, and sexually transmitted diseases.

Belgium

Sexuality education in Belgium is a mandatory practice that offers schools a great amount of autonomy on the curriculum that they offer. Majority of the curriculum offered to students is mandated by school instructors calling upon outside resources such as health organizations or facilities for guidance. Topics discussed within the curriculum are gender, physical development, sexual orientation, intimacy, morality, and risk prevention.

Bulgaria

Sexuality education is not mandatory in Bulgaria; therefore no minimum standards of a curriculum are intact. Students and parents are able to request an optional discipline of sexuality education in which the schooling system relies heavily on non-governmental organizations in relaying the information in the following topical areas of reproductive systems, HIV and AIDS, contraception, and violence.

Cyprus

The curriculum of sexuality education within Cyprus is referred to as Sexuality Education and Interpersonal Relationship Education. The curriculum is taught through the instruction of biology, home economics, and religion educators in which a great emphasis is placed on the importance of family relationships and development, rather than sexuality.

Czech Republic

The sexuality education curriculum in the Czech Republic is introduced to students by teachers and school staff with the reliance on non-governmental and health organizations as early as the age of seven. The curriculum is considered comprehensive, covering areas in sexual abuse, contraceptives, reproduction, sexual crimes, homophobia, pregnancies, and sexually transmitted diseases.

Denmark

Sexuality Education has been mandatory since 1970 in Denmark in which school staff and educations have great autonomy within the curriculum. The curriculum is delivered through a biological and Danish focus, in which topics discussed include contraceptives, pregnancy, and puberty.

Estonia

Sexuality education within Estonia is offered through the lens of human studies in formal classroom settings, in which an instructor focuses on a personal relationships curriculum.

Greece

Sexuality education is a mandatory practice in Greece in which a multi-dimensional team of teachers, nurses, and health organizations focus on the curriculum of biological and relational aspect of sexuality education, as well as human anatomy.

Hungary

Sexuality education is referred to as Education for Family Life in Hungary in which a staff of teachers and health care professionals focus on a curriculum that addresses the human body, drinking, smoking, drugs, and AIDS.

Ireland

Sexuality education in Ireland is a mandatory practice as of 2003, however parents are able to remove their children from the curriculum, focusing on a variety of topics in the areas of relational, social, and personal health.

Italy

Italy, with great influence from the Catholic Church, has created a sexuality education curriculum taught through formal classroom instruction, focusing on the biological aspects of sex and behavior.

Latvia

Sexuality education in Latvia is taught through a social science perspective in which instructors focus on a curriculum outlining the development of family, roles of family, gender, child development, relationships, and pregnancy.

Lithuania

Sexuality education in Lithuania is taught through the perspective of Biology, Ethics, and Physical Culture in which instructors base a curriculum off of their responsibility to inform students how to make healthy life style choices.

Luxembourg

Sexuality education in Luxembourg is provided by teachers in the topical areas of biology, citizenship, and religion with a curriculum focusing on love, sexual activities, family, contraception, pregnancy, sexually transmitted diseases, and drugs.

Netherlands

Sex Education Curriculum redirects here. For other uses see The Netherlands in Sex Ed.

Norway

School teachers and nurses are responsible for the implementation of sexuality education. A biological curriculum is common in which educators focus on the areas of sex, contraception, pregnancy, puberty, families, and relationships.

Spain

Sexuality education in Spain is not a mandatory practice however upon a school deciding to instruct its students on the topic, educators rely heavily on outside health organizations and professionals to provide private workshops.

Other Countries

Australia

The Victorian Government (Australia) developed a policy for the promotion of Health and Human Relations Education in schools in 1980 that was introduced into the State's primary and secondary schools during 1981. The initiative was developed and implemented by the Honorable Norman Lacy MP, Minister for Educational Services from 1979-1982.

A Consultative Council for Health and Human Relations Education was established in December 1980 under the chairmanship of Dame Margaret Blackwood; its members possessed considerable expertise in the area. 

The Council had three major functions:

1. 1. to advise and to be consulted on all aspects of Health and Human Relations'Education in schools;
2. 2. to develop, for consideration of the Government, appropriate curriculum for schools;
3. 3. to advise and recommend the standards for in-service courses for teachers and relevant members of the school community.

Support services for the Consultative Council were provided by a new Health and Human Relations Unit within the Special Services Division of the Education Department of Victoria and was responsible for the implementation of the Government's policy and guidelines in this area. The Unit advised principals, school councils, teachers, parents, tertiary institutions and others in all aspects of Health and Human Relations Education. 

In 1981 the Consultative Council recommended the adoption of a set of guidelines for the provision of Health and Human Relations Education in schools as well as a Curriculum Statement to assist schools in the development of their programs. These were presented to the Victorian Cabinet in December 1981 and adopted as Government policy.

Canada

A catalog of Canadian sex education films, ranging from 1953 to 2012, was recently compiled by researchers at the University of Waterloo, Ontario, Canada.

Comprehensive sex education

From Wikipedia, the free encyclopedia

 

Comprehensive sex education (CSE) is a sex education instruction method based on-curriculum that aims to give students the knowledge, attitudes, skills and values to make appropriate and healthy choices in their sexual lives. The intention is that this understanding will prevent students from contracting sexually transmitted infections in the future, including HIV and HPV. CSE is also designed with the intention of reducing unplanned and unwanted pregnancies, as well as lowering rates of domestic and sexual violence, thus contributing to a healthier society, both physically and mentally.

Comprehensive sex education ultimately promotes sexual abstinence as the safest sexual choice for young people. However, CSE curriculums and teachers are still committed to teaching students about topics connected to future sexual activity, such as age of consent, safe sex, contraception such as: birth control, abortion, and use of condoms. This also includes discussions which promote safe behaviors, such as communicating with partners and seeking testing for sexually transmitted infections. Additionally, comprehensive sex education curricula may include discussions surrounding pregnancy outcomes such as parenting, adoption, and abortion. The most widely agreed benefit of using comprehensive sex education over abstinence-only sex education is that CSE acknowledges the student population will be sexually active in their future. By acknowledging this, CSE can encourage students to plan ahead to make the healthiest possible sexual decisions. This ideology of arming students to most successfully survive their future sexual experiences underlies the majority of topics within CSE, including condoms, contraception, and refusal skills.

History

As of the year 2019, sex education in the United States is mandated on a state level. It is up to the different states, districts, and school boards to determine the implementation of federal policy and funds for sex education. 24 out of the 50 U.S. states and the District of Columbia mandate sex education and 34 states mandate HIV education. Where sex education is mandated, there is no federal policy requiring the instruction of comprehensive sex education.

In prior years under the Bush administration, there was strong support in congress by conservative republicans for the sanction of abstinence-only-until-marriage sex education. Under President Obama's administration, abstinence-only-until-marriage sex education was opposed and suggested to be eliminated. Now under President Trump's administration, federal agenda has reverted back to supporting an abstinence approach. The Centers for Disease Control and Prevention’s 2014 School Health Policies and Practices Study found that on average high school courses require 6.2 hours of taught class time on human sexuality, but only 4 hours or less on HIV, other sexually transmitted infections and pregnancy prevention.

Benefits

Studies have found that comprehensive sex education is more effective than receiving no instruction and/or those who receive abstinence-only instruction. Acknowledging that people may engage in premarital sex rather than ignoring it (which abstinence-only is often criticized for) allows educators to give the students the necessary information to safely navigate their future sexual lives.

CSE advocates argue that promoting abstinence without accompanied information regarding safe sex practices is a disregard of reality, and is ultimately putting the student at risk. For example, programs funded under AEGP are reviewed for compliance with the 8 standards (listed below in "Abstinence Education Grant Program (AGEP) Requirements), but are not screened for medical accuracy. Therefore, critics believe that students under these educational programs are put at a disadvantage because it prevents them from making informed choices about their sexual health. Additionally, under these AEGP programs, health educators have referred to those that engage in sex, especially females, as "dirty" and "used." They have also used phrases such as "stay like a new toothbrush, wrapped up and unused" and "chewed-up gum" to teach abstinence. Under a CSE model, language would be more sensitive. 

There is clear evidence that CSE has a positive impact on sexual and reproductive health (SRH), notably in contributing to reducing STIs, HIV and unintended pregnancy. Sexuality education does not hasten sexual activity but has a positive impact on safer sexual behaviours and can delay sexual debut. A 2014 review of school-based sexuality education programmes has demonstrated increased HIV knowledge, increased self-efficacy related to condom use and refusing sex, increased contraception and condom use, a reduced number of sexual partners and later initiation of first sexual intercourse. A Cochrane review of 41 randomized controlled trials in Europe, the United States, Nigeria and Mexico also confirmed that CSE prevents unintended adolescent pregnancies. CSE is very beneficial in regards to teen pregnancy because studies show that, teen pregnancy and childbearing have a significant negative impact on high school success and completion, as well as future job prospects. A study in Kenya, involving more than 6,000 students who had received sexuality education led to delayed sexual initiation, and increased condom use among those who were sexually active once these students reached secondary school compared to more than 6,000 students who did not receive sexuality education. CSE also reduces the frequency of sex and the number of partners which in turn also reduces the rates of sexually transmitted infections.

UNAIDS and the African Union have recognized CSE’s impact on increasing condom use, voluntary HIV testing and reducing pregnancy among adolescent girls and have included comprehensive, age-appropriate sexuality education as one of the key recommendations to fast track the HIV response and end the AIDS epidemic among young women and girls in Africa.

As the field of sexuality education develops, there is increasing focus on addressing gender, power relations and human rights in order to improve the impact on SRH outcomes. Integrating content on gender and rights makes sexuality education even more effective. A review of 22 curriculum- based sexuality education programmes found that 80 per cent of programmes that addressed gender or power relations were associated with a significant decrease in pregnancy, childbearing or STIs. These programmes were five times as effective as those programmes that did not address gender or power. CSE empowers young people to reflect critically on their environment and behaviours, and promotes gender equality and equitable social norms, which are important contributing factors for improving health outcomes, including HIV infection rates. The impact of CSE also increases when delivered together with efforts to expand access to a full range of high- quality, youth-friendly services and commodities, particularly in relation to contraceptive choice.

A global review of evidence in the education sector also found that teaching sexuality education builds confidence, a necessary skill for delaying the age that young people first engage in sexual intercourse, and for using contraception, including condoms. CSE has a demonstrated impact on improving knowledge, self-esteem, changing attitudes, gender and social norms, and building self-efficacy.

Criticism

Comprehensiveness

While CSE implementation is on the rise in the United States, it remains difficult for state officials to regulate what is and is not taught in the classroom. This is due in large part to the undefinability of CSE; CSE has the potential to comprise such a wide range of sexual information, and over-all focus varies widely between curriculums. Educators have also accused CSE as fundamentally operating as a form of "abstinence-plus," due to the reality that CSE often involves minimal body related information and excessive promotions of abstinence. "So-called Comprehensive Sex Ed" says Sharon Lamb, a professor at the University of Massachusetts Boston, "has been made less comprehensive as curricula are revised to meet current federal, state, and local requirements."

Inclusion of LGBT community

The LGBT population experiences health disparities associated with stigma, discrimination, negative connotations as well as stereotypes. This population is subject to systemic barriers to adequate healthcare services ultimately impacting their wellbeing and welfare negatively. The care that they are provided with often is from clinicians who are not trained well in addressing the concerns of this population. This lack of training from the provider hinders the experience and ultimately influences the quality of care and adequate delivery of healthcare. Due to discrimination and lack of cultural sensitivity that perpetuate prejudice, this population experiences limited health-seeking behaviors. Thus, making preventative services unattainable, furthermore, increasing and prolonging illnesses and ailments. Research shows higher risk of contracting HIV and other STDs; the number is increased when assessing the intersecting population of gay men of color. Lesbian and bisexual females are less likely to obtain routine care like: breast and cervical cancer screenings. Gay men are at an increased risk of prostate, testicular, anal, and colon cancers, while lesbian and bisexual women have an increased risk of ovarian, breast, and endometrial cancers. As a result stigma, discrimination, victimization, and sexual abuse LGBT youth is more likely to be involved in high-risk sexual behaviors at an earlier age.

While comprehensive sex education exists in schooling, many programs do not address the needs of the LGBT community. This population faces different health disparities ultimately driven by discrimination, shortfalls of peers, the lack of parental support, community services, and school based sex education. The implementation of LGBT comprehensive sex education utilized as an intervention seeks to combat these health disparities, by informing the population of the importance of developing sexual health. Sexual health involves not only preventing disease, but also a respectful approach to sexual relationships, sexuality, and accepting an individual's gender iedntity and sexual orientation.

The term "comprehensive" is also often misleading because some comprehensive programs do not show the holistic picture of human sexuality. LGBT advocates have long been critical of the ways in which comprehensive sex education generally promotes marriage as the end goal for students. LGBT advocates want to express other forms of relationships other than marriage. Students should have sex education that encompasses the different forms and should be allowed to exercise those forms in which they are most comfortable with. Even when curriculums claim to be inclusive of LGBT experiences, they often promote heteronormative lifestyles as "normal."  Inclusion of LGBT identities and health topics is necessary for LGBT students to feel safe and seen in their sex ed classrooms. When sex education fails to include LGBT identities and experiences, LGBT youth can be vulnerable to risky sexual behaviors and encourage negative sexual health outcomes. Due to the lack of LGBT sex education provided in schools, LGBT youth will look to peers and the internet which can lead to misinformation. When these students do not have access to or an interest in marriage they are practically erased from the CSE narrative.

In a Canada, a federal report showed that LGBT community has less access to health services and faces more comprehensive health challenges compared to the general population. As a result of lack of support for the LGBT population, the Comprehensive Health Education Workers (CHEW) Project emerged in October 2014. Their goal is to educate the LGBT community about topics such sexual and gender identity, sexually transmitted infections (STIs), healthy social relationships, and depression. They do this though workshops, arts‐based projects, and one‐on‐one meetings. The CHEW project is set exclusively to the LGBT community in order to establish a safe environment in which LGBT youth can gain resources for sex education.

A cross sectional study done in New York City analyzed the sexual behaviors of high school girls. Studies found that, "high school girls who identified as LGBT were more likely to report substance use such as: alcohol, marijuana, cocaine, heroin, meth, ecstasy and prescription drugs. They also had higher rates of contemplating and/or attempting suicide." Another study found that "the LGBT youth accesses health information online five times more than the heterosexual population, and these rates are even higher for LGBT youth that identify as a person of color which stems from the fact that they lack health resources. Rights, Respect, Responsibility includes an inclusive LGBT curriculum for grades K-12. By having a curriculum, such as the Right, Respect, Responsibility suggests, students will be have accurate information to all identities as well as establish a safe classroom for LGBT students.

As of May 2018, only 12 states require discussion of sexual orientation and of these, only 9 states require that discussion of sexual orientation be inclusive (California, Colorado, Delaware, Iowa, New Jersey, New Mexico, Oregon, Rhode Island, and Washington). Additionally, several states have passed legislation that bans teachers from discussing gay and transgender issues, such as sexual health and HIV/AIDS awareness, in a positive light. Furthermore, three states require that teachers only portray LGBT people in a negative light (Alabama, South Carolina, and Texas).

School context

"Before the late 1800s, delivering sex education in the United States and Canada was primarily seen as a parent’s responsibility. Today, programs under the Sexuality Information and Education Council of the United States (SIECUS) begin comprehensive sex education in pre-kindergarten, drawing criticism related to the age at which it is appropriate to address sexual matters with children.

Federal funding for sexual education

Although there is no federal mandate that requires states to teach sexual education, there is federal funding available to assist with sexual education programs.

Abstinence Education Grant Program (AGEP)

Historically, funding for abstinence education has always been favored over CSE. In 1996, during Bill Clinton's presidency, legislation was passed to promote abstinence in education programs. Under Title V Section 510 of the Social Security Act, the Abstinence Education Grant Program (AGEP), was passed. AEGP has always been renewed before its expiration date, and each time funds gradually increase from fifty million dollars per year to seventy-five and as high as $6.75 million per state grant in 2015. The way the funds are disbursed are based on the proportion of low-income children in each state. So far, thirty-six states have been given AEGP funds.

Abstinence Education Grant Program (AGEP) Requirements

Part of Section 510(b) of Title V of the Social Security Act, contains the "A-H guidelines," which are the eight criteria that programs must abide by order to be eligible to receive federal funding. They are as follows:

A. Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;

B. Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;

C. Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;

D. Teaches that a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity;

E. Teaches that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects;

F. Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents, and society;

G. Teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances; and

H. Teaches the importance of attaining self-sufficiency before engaging in sexual activity;

In addition to abiding by these 8 conditions, AGEP compliant programs cannot discuss contraception, STIs, or methods for protecting against STIs, except when describing failure rates.

Teen Pregnancy Prevention Program (TPP)

More recently legislation has pushed for funding that goes beyond abstinence only education. In 2010, President Obama introduced the Teen Pregnancy Prevention Program (TPP), which provides a total of $114.5 million annually to sex education programs that are "medically accurate and age-appropriate." TPP falls under a subsection of United States Department of Health and Human Services ("HHS") which is overseen by the Office of Adolescent Health. Funding for TPP is dispersed if "they emulate specific evidence-based programs promulgated under TPP."

California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act

In January 2016, the California Healthy Youth Act, amended the California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act to include minority groups and expand health education. Before it authorized schools to provide comprehensive sex education and required that all materials are made accessible to students with a variety of needs. It also focused solely on marital relationships. It now mandates that schools provide comprehensive sex education and states that "materials cannot be biased and must be appropriate for students of all races, genders, sexual orientations, and ethnic and cultural backgrounds, as well as those with disabilities and English language learners." Additionally, education must now include "instruction about forming healthy and respectful committed relationships," regardless if marital status. Furthermore, it is now required to have discussions about all FDA-approved contraceptive methods in preventing pregnancy, including the morning after pill.

In conclusion now requires that all sex education programs promulgated in the state should

• normalize sexuality as part of human development;
• ensure people receive integrated, comprehensive, accurate, and unbiased sexual health and HIV prevention and instruction; and
• provide pupils with the knowledge and skills to have healthy, positive, and safe relationships.

As a human right

Some critics state that young people’s access to CSE is grounded in internationally recognized human rights, which require governments to guarantee the overall protection of health, well-being and dignity, as per the Universal Declaration on Human Rights, and specifically to guarantee the provision of unbiased, scientifically accurate sexuality education.

These rights are protected by internationally ratified treaties, and lack of access to sexual and reproductive health (SRH) education remains a barrier to complying with the obligations to ensure the rights to life, health, non-discrimination and information, a view that has been supported by the Statements of the Committee on the Rights of the Child, the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) Committee, and the Committee on Economic, Social and Cultural Rights.

The commitment of individual states to realizing these rights has been reaffirmed by the international community, in particular the Commission on Population and Development (CPD), which – in its resolutions 2009/12 and 2012/13 – called on governments to provide young people with comprehensive education on human sexuality, SRH and gender equality.

Other analysis show that comprehensive sex education is not an international right nor a human right because it not clearly stated in either a treaty nor custom. By international law, states are required to provide access to information and education about reproductive health, but this does not require a sex education curriculum. It may take different forms such as mandating that local school districts create a system for providing information to students, or mandating that health clinics and practitioners dispense information to patients.

In curricula

Teaching methods

As CSE gains momentum and interest at international, regional and national levels, governments are increasingly putting in place measures to scale-up their delivery of some form of life skills-based sexuality education, as well as seeking guidance on best practice, particularly regarding placement within the school curriculum. Sexuality education may be delivered as a stand-alone subject or integrated across relevant subjects within the school curricula. These options have direct implications for implementation, including teacher training, the ease of evaluating and revising curricula, the likelihood of curricula being delivered, and the methods through which it is delivered.

Within countries, choices about implementing integrated or stand-alone sexuality education are typically linked to national policies and overall organization of the curricula. The evidence base on the effectiveness of stand-alone vs. integrated sexuality education programming is still limited. However, there are discernible differences for policy-makers to consider when deciding the position of CSE within the curriculum.

As a stand-alone subject, sexuality education is set apart from the rest of the curriculum, whether on its own or within a broader stand-alone health and life skills curriculum. This makes it more vulnerable to potentially being sacrificed due to time and budget constraints, since school curricula are typically overcrowded.

However, a stand-alone curriculum also presents opportunities for specialized teacher training pathways, and the use of non-formal teaching methodologies that aim to build learners’ critical thinking skills. The pedagogical approaches promoted through sexuality education – such as learner-centred methodologies, development of skills and values, group learning and peer engagement – are increasingly being recognized as transformative approaches that impact on learning and education more widely. As a standalone subject, it is also significantly easier to monitor, which is crucial in terms of evaluating the effectiveness of programming, and revising curricula where it is not delivering the desired learning outcomes.

When sexuality education is integrated or infused, it is mainstreamed across a number of subject areas, such as biology, social studies, home economics or religious studies. While this model may reduce pressure on an overcrowded curriculum, it is difficult to monitor or evaluate, and may limit teaching methodologies to traditional approaches.

Terminology

Apart from the different teaching methods, termiology also differs. Abortion, homosexuality, abstinence have connotations and definitions that vary state. For example, the word "abstinence" may refer to disengaging from all forms of sexual activities until marriage or may refer to only disengaging from sexual intercourse. Furthermore, the degree of sexual activity that "abstinence" connotates is often unclear, because sexual behavior that is not sexual intercourse may or may not be included in its definition. As a result, students are left confused about what activities are risky and teachers do not know what they can and cannot teach.

The term "comprehensive," is also falls on spectrum, therefore can be considered an umbrella term. CSE means something radical for some institutions while it can mean something moderate and even conservative for others.

According to the Sexuality Information and Education Council of the United States (SIECUS), the guidelines for comprehensive sexuality education are as follows:

• appropriate to the age, developmental level, and cultural background of students;
• respects the diversity of values and beliefs represented in the community;
• complements and augments the sexuality education children receive from their families, religious and community groups, and healthcare professionals;
• teaches not only about abstinence, but also contraception, including emergency contraception and reproductive choice;
• teaches about lesbian, gay, bisexual, transgender (LGBT) issues and questions issues;
• teaches anatomy, development, puberty, and relationships;
• teaches all of the other issues one would expect to be covered in a traditional sexuality education class; and
• should be science-based and medically accurate

Sexual education exemption

Just as teaching methods and curricula vary by state, excusal from sex education also varies by state. States may have with an opt out or opt in produce. In some states, students can opt out of receiving sexual education without specifying a particular reason. In other states, students can only opt out for religious or moral reasons. In an opt-in provision, parents must actively agree to allow their children to receive sex education prior to the start of the sexual education.

Sexual content in the media

Since 1997, the amount of sexual content on TV has nearly doubled in the United States. Additionally, a study done in 2008 showed that nearly 40% of popular music lyrics contained sexual references which were often sexually degrading. These lyrics were also often accompanied with mentions of other risk behaviors, such as substance use and violence.

Teens (ages 13–15) in the United States, use entertainment media as their top source for education in regards to sexuality and sexual health. Additionally, a study found that 15-19 year olds in the U.S use media far more than parents or schools to obtain information about birth control. Some studies have found that, "very few teen television shows mention any of the responsibilities or risks (e.g., using contraception, pregnancy, STIs) associated with sex and almost none of the shows with sexual content include precaution, prevention, or negative outcomes as the primary theme."  Television shows 16 and Pregnant and its spin-off, Teen Mom, which first aired on MTV in 2009 received major disapproval from some parents as they thought the shows glamorized teen pregnancy and motherhood. However, 16 and Pregnant actually led to a 4.3 percent reduction in teen pregnancy, mostly as a result of increased contraceptive use. In contrast, other data shows that exposure to high levels of sexual content on the television causes adolescents to have twice the risk of becoming pregnant in the following 3 years, compared to those who were exposed to low levels.

The film Mean Girls, directed by Mark Waters shed light on the state sex education in some parts of the United States. In the film the health instructor states, "At your age, you're going to have a lot of urges. You're going to want to take off your clothes and touch each other. But if you do touch each other, you will get chlamydia and die." This line is meant to be satirical, but it illustrates common flaws within sex education in the U.S. It depicts simplistic descriptions of sexual activity and implementation of fear without any legitimate basis.

Comprehensive sex education is the main topic in the documentary The Education of Shelby Knox released in 2005 about Lubbock, Texas, which has one of the highest teen pregnancy and STD rates in the nation. The "solution" to which is a strict abstinence-only sex education curriculum in the public schools and a conservative preacher who urges kids to pledge abstinence until marriage.

In 2013, How to Lose Your Virginity was released, a documentary that questioned the effectiveness of the abstinence-only sex education movement and observed how sexuality continues to define a young woman's morality and self-worth. The meaning and necessity of virginity as a social construct is also examined through narration and interviews with notable sexuality experts, such as former Surgeon General Dr. Joycelyn Elders, "Scarleteen" creator and editor Heather Corinna, historian Hanne Blank, author Jessica Valenti, and comprehensive sex education advocate Shelby Knox.

Not only have films portrayed sex education, but so has social media. Platforms such as YouTube, Facebook, Vine, and others are used as a tool to uplift the narratives of marginalized communities such as persons of color and LGBT persons in hopes to "strengthen sexual health equity for all."

As a result of the mass amount of sex content in media, media literacy education (MLE) has emerged. It was created to address the influence of unhealthy media messages on risky health decisions, such as intention to use substances, body image issues, and eating disorders. A study analyzed the effectiveness of a teacher-led MLE program, called Media Aware Sexual Health (MASH), which provides students with accurate health information and teaches them how to apply that information to critical analysis of media messages. This comprehensive sex education resulted in increased intentions to talk to a parent, partner and medical professional prior to sexual activity, and intentions for condom use.

Due to knowledge gaps in most sex education curricula for teens, free online resources like Sex, Etc., Scarleteen.com, and teensource.org have been created to promote comprehensive, inclusive, and shame-free sex education for teenagers.