The internet has changed how kids learn about sex, but sex ed in the classroom still sucks. In Sex Ed 2.0, Mashable explores the state of sex ed and imagines a future where digital innovations are used to teach consent, sex positivity, respect, and responsibility.

When Americans talk about sex ed, it's typically as a punch line. But the awkward laughter distracts us from a less humorous reality: Sex ed is an ideological battle for a small but vocal group of Americans who believe that abstinence until marriage is the only right approach.

The long-simmering conflict, decades in the making, escalated rapidly once Donald Trump took office and appointed abstinence-only-until-marriage partisans to administration positions where they could influence the federal government's priorities for sex ed.

That might seem so far removed from what happens in America's classrooms that it's inconsequential. Indeed, states, counties, districts, and schools determine what students are taught. But the federal government plays a critical role when those players don't have the will or resources to ensure that young people learn about sexual health. The government can also put large sums of money behind research that could yield insights about what type of sex education works best for different young people — particularly those who are most at risk of engaging in sexual activity or becoming pregnant.

That's exactly what Congress designed the Teen Pregnancy Prevention Program (TPPP) to do. The initiative is the result of bipartisan legislation passed in 2010. Funded at $101 million annually, it's the federal government's biggest investment in educating adolescents and teens about their sexual health. It was designed to support evidence-based interventions that were measurably successful and rigorously tested, and to provide funding for promising new interventions.

The goal was to reach young people with an effective curriculum that addresses subjects like contraception, healthy relationships, sexual development, and yes, abstinence. To understand what the state of sex ed looks like under Trump, it's essential to understand how his administration has tried to sabotage the Teen Pregnancy Prevention Program.

Trump's 2018 budget proposed eliminating the Teen Pregnancy Prevention Program altogether. And among his appointments to the Department of Health and Human Services was Valerie Huber, formerly the president of an organization once called the National Abstinence Education Association. Now named Ascend, the group urges youth to "...avoid all sexual activity, hopefully until they marry."

The Teen Pregnancy Prevention program serves 500,000 teens in 39 states with a modest investment of approximately $100 million annually. But under the Trump administration, funding for the program has been diverted elsewhere: https://t.co/b5hA1dkYx4 — Brookings Econ (@BrookingsEcon) October 24, 2018

TPPP had drawn the ire of social conservatives who were angry that it diverted resources away from abstinence-only-until-marriage education, which research shows often fails to prevent sexual activity and pregnancy, and critics say is harmful to young people who are LGBTQ and have experienced sexual trauma. A few months before her appointment to HHS, Huber wrote a March 2017 op-ed for the Hill arguing that the approach of teen pregnancy prevention programs like the kind being supported by the federal government "typically normalizes teen sex."

Then, in July 2017, HHS suddenly informed 81 grant recipients that their TPPP funding would be eliminated, only three years into the five-year grant. It didn't take long for health officials, researchers, and educators all over the country to feel the effects.

The Cuyahoga County District Board of Health, which includes the townships and municipalities surrounding Cleveland but not the city itself, had won a 5-year, $4.8 million grant from the Obama administration to provide evidence-based sex education to young people. The teen birth rate was as high as 50.8 per 1,000 females in some parts of the county.

"We need to reach these kids, because no one else is doing it."

Ohio requires schools to teach STI and HIV prevention, but doesn't require them to offer sex ed, or budget money for that purpose. The federal grant made it possible for local health officials and educators to teach the most vulnerable youth about sexual health, including how to prevent pregnancy. The Cuyahoga County District Board of Health chose from a list of evidence-based sex ed curricula and contracted with a nonprofit group to deliver lessons to area youth between the ages of 12 and 19.

"We need to reach these kids because no one else is doing it in a comprehensive type of way," says Brandy Eaton, supervisor and project director for the Cuyahoga County Board of Health. "They get things here and there from their friends, from the internet, from pornography, but no one is doing it comprehensively."



Eaton described the lessons as age-appropriate, medically accurate, culturally relevant, LGBTQ inclusive, and adapted for students who'd experienced trauma.

Sex ed that is age- and culturally-appropriate relies on curricula that reflects students' unique needs, says Samantha Dercher, federal policy director of the Sexuality Information and Education Council of the United States (SIECUS), a research and advocacy organization. Sex ed instruction should change depending on age, and factors like race, ethnicity, ability, socioeconomic status, sexual orientation, gender identity, and immigration status, which can impact the type of sex ed students receive and the kind of access they have to sexual health services.

Data from the Cuyahoga County District Board of Health show the average teen birth rate dropping from 24.8 per 1,000 to 21.4 between 2015 and 2016. Data from 2016 to 2017 isn't available yet. While Eaton says several factors likely played a role in the initial decrease, including more teens opting for long-acting reversible contraception like an IUD, she believes reaching them with sex ed that included information about pregnancy prevention, STI and HIV risk, contraception, limit setting, and abstinence skills made a difference.

Any significant decrease in the birth rate translates to more teen girls staying in school, which means they're more likely to become gainfully employed, and less likely to live in poverty, says Eaton. But once HHS decided to abruptly terminate TPPP grants, the county had to start winding down its efforts and several of its trainers got jobs elsewhere. There would be no replacement program.

We agree, the TPP Program is helping us learn what works best to reduce teen pregnancy #EvidenceOverIdealogy Via https://t.co/mFdWWQZ7n3 pic.twitter.com/p5EaEZOsiG — Power to Decide (@powertodecide) August 28, 2018

In August 2017, HHS published a fact sheet arguing that TPPP was ineffective and wasted taxpayer dollars. It also noted that the program, which includes support for original research projects, could in fact be ended midway because the same thing had been done to abstinence grantees back in 2010, when Congress passed the legislation that created the Teen Pregnancy Prevention Program.

"[T]he TPP Program was literally created by hastily ending the [Community-Based Abstinence Education] Program," read the fact sheet. If abstinence-only crusaders were looking for revenge, they found a way to declare victory — at least temporarily.

Several grantees, along with advocacy organizations like Public Citizen and Planned Parenthood Federation of America, sued the administration, arguing that the termination of TPPP funding was unlawful. A federal judge sided with grantees in four of those lawsuits in May, forcing the administration to continue funding their work through 2020.

What does "overwhelming support" for sex ed look like? #iHeartSexEd



Find out ⬇️⬇️ https://t.co/T6JkCKLDeM — SIECUS (@SIECUS) October 21, 2018

The news both relieved and angered Eaton. The county spent months wrapping up its efforts when it could've been building relationships in the community and reaching more young people.

In April 2018, HHS announced a new funding opportunity for TPPP that would require grantees to focus on "sexual risk reduction" or "sexual risk avoidance," the latter of which is a rebranding of abstinence-only-until marriage. The administration describes sexual risk avoidance as teaching "participants how to voluntarily refrain from non-marital sexual activity." Critics say programs based on that goal often promote harmful gender stereotypes, omit key information about sexual health, and offer medically inaccurate information.

In reporting this story, Mashable asked HHS via email about critics who say the agency has abandoned an evidence-based approach in order to promote abstinence-only-until-marriage, particularly under the directive of Trump appointees. A spokesperson who didn't identify themselves said HHS "disagrees with the premise" of such questions and provided no further comment.

Lawsuits filed against the government following the April announcement argued that the administration's new requirements violated the Congressional intent behind TPPP, and federal judges agreed. HHS declined to comment to Mashable on whether it would appeal the rulings.

"There was a real effort during the Obama administration to invest in programs that had been rigorously tested and see if we could replicate them again," says Rachel Fey, director of public policy at Power to Decide, formerly known as The National Campaign to Prevent Teen and Unplanned Pregnancy. "That's gone out the window and been replaced with strong abstinence-only-until-marriage policy."

In addition to the administration's effort to radically change TPPP, a bill passed by Congress earlier this year included $75 million for state grants for "education on sexual risk avoidance" that focuses on "refraining from nonmarital sexual activity." Another bill set aside $35 million in grants for sexual risk avoidance programs that use "medically accurate information" and an "evidence-based approach" in pursuit of teaching young people to delay any sexual activity before marriage.

"Given past actions of this administration, we take nothing for granted."

Dercher believes that guaranteeing students access to evidence-based sex ed is up to state and local leaders, given the administration's "clear anti-sex ed agenda." Though 21 states still don't require sex ed or HIV/STI curricula to be age-appropriate, medically accurate, culturally appropriate, or evidence-based or evidence-informed, progress at the state level is actually a bright spot amid the administration's attacks on sex ed. Of the 139 sex ed bills introduced in state legislatures in 2018 or carried over from a prior session, more than three-quarters aimed to advance the quality of sex ed in schools, according to SIECUS research.

Common provisions included adding child sexual abuse, assault, and dating violence prevention instruction to existing sex education requirements and establishing medically accurate, age-appropriate, and evidence requirements for sex education content, says Dercher.

The #MeToo movement has sparked much of the conversation about gaps in sex ed, says Dercher: "It's taking what's been a horrible and triggering year in the news and trying to do some good."

Such gains are cherished victories for sex ed advocates, who are trying to prepare for what comes next in the battle over what, and how much, young people learn about their own sexual health.

"Given past actions of this administration," says Fey, "we take nothing for granted."