Still That Kind of Girl: Teens, Sex, and Contraception
My sophomore year of high school, the French teacher taught my English literature class. At some point in the semester we had to give a five minute persuasive speech on any topic of our choosing. Mine was “Why There Should Be Condom Dispensers in the School Bathrooms.” I do not remember the response of my classmates, but I will never forget what my teacher said, even before I had reached my seat: “Caroleeen, I had no idea you were that kind of girl.”
In my mind, I flipped him off. In actuality, I just sat down.
This experience came to mind as I reacted to an article I came across that asked “Should Schools Offer Plan B to Students?” In a pilot program launched in select New York City schools in January 2011, students are able to obtain Plan B from the school nurse without their parents’ knowledge or consent. Students also have access to the contraceptive pill. The program began in five schools and has now expanded to thirteen. Since the program began, a total of 567 students have received Plan B. Nearly an equal number have taken advantage of the availability of the contraceptive pill.
I am confident that my fifteen-year-old self would have approved of this program. My thirty-six-year-old self agrees. What I knew then from anecdotal evidence has been confirmed by my study of history. Teenagers have sex. They always have. They always will. It might be illegal. There might be an epidemic of sexually-transmitted diseases. It might mean pregnancy, childbirth, parenting, going to hell. Doesn’t matter. They will still do it.
Moreover, teenagers who are sexually active or considering becoming sexually active know that trusted adults are often few and far between. It can be hard to find one who can answer questions comfortably. In my high school, the gym teacher taught health class. He also happened to be one of the prominent farmers in our community. In fact, his family’s farm stand is now one of the big local attractions. I failed his multiple choice test on contraceptives. I don’t think we had a school nurse; instead, we had moms who worked in the main office. Even more awkward. This was the 1990s. 
Imagine what it has been like for teenagers in previous eras. Girls hid pregnancies in order to avoid getting expelled from school, kicked out of their parents’ homes, or sent to a home for unwed mothers. Trying to find someone who would answer their questions before they had sex was just as difficult as trying to find someone they could turn to when they realized they must be pregnant. You can read Adam Turner’s earlier blog on the history of sexual health education for some great examples of the advice and mixed messages that young people received just a few decades ago. The situation isn’t much better today. Despite the prevalence of teen pregnancy, girls can still find it difficult to gain access to contraceptives. Teens have to see a doctor to get a prescription for birth control, which means that their parents’ insurance policies will be charged for the visit (assuming they have medical insurance). Who wants to admit to their parents that they are about to have sex? One of the reasons the American Congress of Obstetricians and Gynecologists recently endorsed making contraceptive pills available over-the-counter and the American Academy of Pediatrics now recommends making prescriptions for emergency contraceptives available to teen girls prior to their need for them is to reduce the teen pregnancy rate by making birth control more readily available to those teenaged girls who clearly are not comfortable asking their parents for help in this matter.
History and experience also confirms that desperate teenagers will go to desperate measures. In my school, it was sneaking out after dark to meet a boyfriend, shoplifting condoms from the local drugstore, and whispering about which girl had had how many abortions. 
This seems ridiculously mild compared to the extremes teenagers have gone to in other times and places. In 1972, one-third of the women who had abortions were nineteen-years-old or younger. This was pre-Roe, when getting an abortion often meant leaving the country and always meant risking your life. Preventing conception in the first place was not so easy when many states and local communities still adhered to – and prosecuted violation of – the Comstock Laws. The best most sexually active teens could do was “pull and pray.” If she got pregnant – and 90% of teenagers who are sexually active without contraceptives do get pregnant within the first year of intercourse – then they would deal with the consequences later. Abortion or early marriage was usually more appealing than single motherhood. Less common but more horrifying was infanticide. A 1998 study in the New England Journal of Medicine reported that while only 2% of all births nationwide are to mothers under age seventeen, 7% of all infant victims of homicides are the babies of mothers in that same demographic. According to the Encyclopedia of Domestic Violence, “Teenagers who commit neonaticide often lack relationships with open, caring, reliable adults.” Shame, fear, and panic mean they see murder as the only way out of a bad situation. This may be the extremist of the extremes, but when even one teenaged girl thinks this is the best solution to her Problem, it is one teenager and one baby too many. 
All this is to say that this program in the New York City schools seems like a smart idea. It is not encouraging students to have sex (because teenagers already are!), but it is encouraging them to take greater responsibility for their sexual health and giving them the means to make choices about their reproductive destinies. It is identifying one adult in the school as someone whom they can trust and turn to for help and medically accurate information. In an ideal world, everyone would wait until they were emotionally and physically mature enough and financially independent enough to handle the varied consequences that come with being sexually active. But that is not the world we live in. History has shown us that our efforts to create that world have failed time and time again. Perhaps we are fighting nature. Perhaps instead we should create something entirely new: a world in which it is not extraordinary that teenagers request and schools offer comprehensive sexual health education, access to contraceptives, and a support network to help young people navigate the complexities of becoming adults.
For Further Reading:
John D’Emilio and Estelle B. Freedman, Intimate Matters: A History of Sexuality in America. New York: Harper & Row, 1988.
Ann Fessler, The Girls Who Went Away: The Hidden History of Women Who Surrendered Children for Adoption in the Decades Before Roe v. Wade. New York: Penguin Press, 2006.
Susan K. Freeman, Sex Goes to School: Girls and Sex Education before the 1960s. Urbana and Chicago: University of Illinois Press, 2008.
Leslie J. Reagan, When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867-1973. Berkeley: University of California Press, 1997.
Carolyn Herbst Lewis is a co-founder of Nursing Clio. She is the author of Prescription for Heterosexuality: Sexual Citizenship in the Cold War Era (UNC Press, 2010). Her current project is a history of the Chicago Maternity Center.
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