In a Catholic middle school, Jenni Perkins learned not to have sex before marriage. At Perkins' charter high school, a P.E. teacher said the same, after he separated the class into boys and girls and demonstrated how to use a condom by putting his entire hand into one.
Sex education in Louisiana is limited to programs that promote abstinence, though legislators have tried several times over the last few years to introduce bills to mandate "comprehensive" sex ed in schools — including learning about contraception and sexually transmitted diseases — in a state with the country's highest rates of new infections among people under 18 years old. Lawmakers largely have been challenged by conservative colleagues and religious groups that want to keep sex talk at home — and out of schools.
But health officials and advocates point to a gap between the state's prescription for sex ed (and lack thereof) and Louisiana's enormously high rates of sexually transmitted diseases (STDs) and unplanned pregnancies among teenagers and young people.
The Centers for Disease Control and Prevention (CDC) says a higher prevalence of STDs among young people likely is due to "multiple barriers to accessing quality STD prevention and management services, including inability to pay, lack of transportation, long waiting times, conflict between clinic hours and work and school schedules, embarrassment attached to seeking STD services, method of specimen collection and concerns about confidentiality."
While Louisiana lawmakers once again are fighting to get sex ed in schools, several groups that stress the importance of comprehensive sex education — including information on contraceptives, stress, peer negotiation, coping skills, consent and other lessons to help navigate complex, still-growing bodies and minds — hope to remove some of those barriers.
Perkins is on the Louisiana Youth for Truth (LYFT) council, a committee of young people under the umbrella of the Institute of Women and Ethnic Studies (IWES) advocating for comprehensive sex education in schools statewide.
"[LYFT] made me more confident to talk to my friends about sexual health," Perkins says. "Being in high school, I have lots of friends who are (sexually) active. Before, I couldn't really talk to them — I barely knew what to say. I didn't know anything except 'maybe you should wear a condom.' It was an eye-opener in that it gave me a new train of thought to tackle a situation."
Louisiana has the seventh-highest rate of teen pregnancies in the U.S., with a birth rate of 37.5 per 1,000 teens aged 15-19, according to the (CDC).
Rates for STD infections are much higher. The state has the highest rates of gonorrhea and syphilis infections and the second-highest rate of chlamydia in the U.S.
According to the CDC, half of all new STD diagnoses in the U.S. are among young people, and one in four sexually active girls has an STD. Compared with older adults, sexually active people ages 15-24 are at higher risk of getting an STD, through a "combination of behavioral, biological and cultural reasons." While that demographic is just a little more than a quarter of sexually active people, it accounts for more than 50 percent of the 20 million new STDs reported each year.
According to the CDC, chlamydia rates among young people aged 15-24 in Louisiana were 2,231 per 100,000 people in 2015. Gonorrhea rates reached 341 per 100,000, while syphilis cases have risen steadily since 2003. HIV prevalence has continued to rise among young people over the last decade, and young people of color constitute a disproportionate number of all cases of STDs.
The CDC administers an anonymous health risk survey to students covering drug and alcohol use, smoking, diet, physical activity and sexual behavior. In Louisiana, students aren't asked about the latter. Results from those surveys determine federal funding to the state's health and education departments to ensure programs reflect what kids are actually doing.
State Sen. Yvonne Colomb, D-Baton Rouge, filed a measure that would allow high school students to receive those survey questions about sex — data that's already being collected in 38 other states. Previous attempts in the state Legislature have failed. Colomb's Senate Bill 85 moved successfully out of the Senate's Health and Welfare Committee May 10, and it now heads to the full Senate for a vote.
Before administering the survey, the CDC contacts a school superintendent, who then decides whether schools in the district should participate. Parents or guardians can opt out. Questions related to sex — which aren't included in the current surveys sent to Louisiana students — ask whether students have had sex and how often. Results are anonymous and don't identify the students or schools.
Proponents say leaving those questions out of the survey means the state doesn't get potentially millions of dollars in federal funding to support sexual health programs. States that include the sex questionnaire are funded significantly higher. Louisiana receives $4.7 million through federal funding for health and education and community organizations — compared to Oklahoma, which includes the sex survey and receives $7 million, or South Carolina, which receives $6 million.
At the Senate's Health and Welfare Committee May 10, Raegan Carter, senior manager and region two manger for the Louisiana Campaign for Tobacco-Free Living and Louisiana Public Health Institute, said the bill is "not a sex education mandate." The bill only applies to high school students, and parents and guardians can opt their children out of participating.
"Because we don't have the data on sex risk behaviors, public health practitioners are unable to correlate" the rates of infections and appropriate outreach, she said. "The numbers are extremely high and disturbing."
"Data makes a difference," said state Sen. Regina Ashford Barrow, D-Baton Rouge. "As someone who advocates for abstinence ... I have seen the numbers tick up. ... As someone from the faith-based community, I believe we have to do more. We're not doing enough."
State Sen. Gerald Long, R-Winnfield, said the state's sky-high numbers of adolescent STDs and pregnancies reflect a "social and moral and spiritual problem."
"You really believe a student is going to openly, candidly tell you the correct facts?" said Long, adding that the survey appears to be "Big Brother and big government."
Kathleen Benfield, legislative director with the Louisiana Family Forum, the powerful conservative Christian group fiercely opposing comprehensive sex ed measures, said that "opting out is not enough. It should be opt-in."
"I don't know about you, but I don't think these are appropriate questions to ask students at any grade level," she said. "These are innocence-destroying questions."
IWES' Believe in Youth-Louisiana (BY-LA) program aims to reduce the rates of teen pregnancy, HIV and other STDs among young black and Latino people ages 11-19 in southeast Louisiana. The program is funded through the U.S. Department of Health and Human Services' Office of Adolescent Health and uses a curriculum from Making Proud Choices!, published by ETR. BY-LA is on track to reach 16,000 students in the greater New Orleans area, Baton Rouge and River Parishes by 2019.
"I'd say we're pretty busy," says BY-LA facilitator Aurora Tom-Quinn. "There's not a lot of down time. The team grew from three to more than 10. That's grown because of the need. It went from reaching 500 to 4,000 in a year."
But without the results of the CDC's survey on risk behaviors, IWES' programs don't have a complete picture of the health of their students.
"We implement it here already, we get federal funding to do so — we just omit the sexual health questions," says IWES' Steffani Bangel, advocacy and engagement program coordinator with sex ed and reproductive health program Creating a Future Together (CrAFT). "The bill's intention is to allow for those questions to be asked."
"That assessment is a huge opportunity to lend resources and link the general community with our office, which is a holistic office," Tom-Quinn says.
Louisiana Youth for Excellence (LYFE), a program under the wing of the governor's office, advocates for "abstinence-centric" sex ed programming to "impact and lower the high statistics of teen births as well as STDs in Louisiana across the state," says Sarah Parker, LYFE's program manager and outreach coordinator.
"What we do then is we educate, we partner strategically with different community-based organizations, schools, faith-based organizations and other governmental agencies to provide resources, to both youth and their parents, in order to assist in making a positive impact in their lives and teaching them to make healthy, life-long choices."
The passage of Colomb's bill — which also has the support of Gov. John Bel Edwards — would allow LYFE to "more thoroughly and accurately do our jobs," Parker says. "The end goal is not to pry or enter into a conversation or area where we're not wanted. There's always an opportunity to opt out of something they're not comfortable with. ... We never cross that line. But we do need to have the ability to have that information provided to us by the youth themselves to paint a better picture of where we stand."
State Sen. Wesley Bishop, D-New Orleans, has tried for several years to convince the Louisiana Legislature to approve his measures expanding sex ed programming in Louisiana — or even in just New Orleans, where the New Orleans City Council and school board pleaded for change. In 2015, Bishop introduced a bill to mandate "comprehensive" sex ed for middle and high school students in Orleans Parish public schools by the 2017 school year. Parents and guardians would have the choice to opt their children out from those lessons. That bill failed.
This year, Bishop believes he'll have better luck getting sex ed onto college campuses. His Senate Bill 106 mandates public universities to "develop and implement an action plan to address the prevention of unplanned pregnancies among unmarried students."
"I spent the last 20-something-odd years working on college campuses," says Bishop, a former educator. "We've tried to get this kind of education and information to students before they finish high school, but now what this bill attempts to do, when they come into their freshman year, during orientation ... when they have the same conversations about time management, money management, drugs — let's talk about unplanned pregnancies to try and improve their possibility of being able to graduate from college. ... Typically when pregnancy enters into the equation, it becomes much more difficult."
Bishop's bill faced significantly less pushback than his previous bills and received relatively swift approval from the Senate Committee on Education last month. "This had a much better chance of passing, in talking to my colleagues," he says. "We're talking about college students. It takes away the fears some of my colleagues had before, that something would be introduced to their children. I took that in mind."
Lawmakers added amendments, however, prohibiting lesson plans from discussing abortion and barring anyone from directing students to Planned Parenthood.
"The bill has nothing to do with Planned Parenthood, pro-life or pro-choice or any of that," Bishop says. "I just want the students to get the information. I didn't want it to get caught up in some of the other arguments I've seen my bills and other bills get caught up in."
It's unlikely the state will introduce comprehensive sex ed programs on a statewide level soon, leaving advocacy groups to offer their programs to schools and faith-based groups to help fill the gaps.
"The bottom-line, 100-percent sure way to prevent the spread of STDs and HIV and teen pregnancy is by abstinence," says Parker with LYFE. "We understand that (abstinence) is the ultimate goal, but we are going to do everything in our power to make sure youth are informed and embrace a more holistic approach to ensuring they're prepared to face the challenges they face as teens."
But those programs aren't merely about sexual health — at IWES, programs address trauma at home, mental health and other stressors that impact a young person's daily life as well as how they view their body. In addition to BY-LA's eight "modules" on sexual health, there are emotional wellness lessons about stress, coping skills, emotional resilience and "building blocks to a positive self."
"It's not just talking about the absence of disease or pregnancy but how you approach yourself, how you view yourself, how the world engages you and how you choose to represent your sexuality," Tom-Quinn says.
"It's not just about getting factual information about how to protect yourself and what gonorrhea looks like," Bangel says. "It's about helping young people understand their bodies, understand how to talk to each other about relationships, whether they're intimate or not."
That "trauma-informed" approach helps teachers and schools better understand their students and "get the community to think about reframing the way they think about young people and their issues," Bangel says.
"Young people of color are often penalized or pushed out of school for conduct reasons," she says. "Acting-out behavior doesn't mean these kids are bad. It means a lot of them are traumatized, suffering from PTSD or dealing with a lot of stuff with their families and communities. Anyone living in the city of New Orleans knows there's a lot of violence at the community level, at the individual level, at the interpersonal level — all of those things influence the way a young person enters any space, let alone a space they have to sit in, often silently, for eight hours a day."
Legislation isn't the only obstacle to comprehensive sexual health programs in classrooms. Some schools are overburdened with other course work and "the same obstacles in terms of what you'd see [when] adding anything new to a curriculum," Bangel says.
"We hear the same couple of things: 'We feel passionately about this but there's no space in the curriculum,'" she says. "We don't generally hear what you expect, that parents are going to yell at us, we're all gonna burn."
Getting parents' approval is less of a hurdle than ensuring ongoing parental and school support beyond an awkward conversation about the facts of life.
"If there's no conversation, then there's no chance to grow and be educated, which is our job," Perkins says. "The thought of sex ed and the possibility of learning more is something that should be there for life. At the end of the day, what we're talking about is health."