1. Valuing Fertility A sexuality education program which transcends the current dichotomy in sexuality education

2. Valuing Fertility presented by Teen STAR ® Sexuality Teaching in the context of Adult Responsibility, a program of the Natural Family Planning Center of Washington, D.C. Hanna Klaus, M.D., F.A.C.O.G. Executive Director http://www.teenstarprogram.org :

3. Valuing Fertility Major players Abstinence-only education Comprehensive sexuality education

4. Valuing Fertility Both approaches address sexuality. Abstinence-only A-H [Title V] guidelines demand that teens be taught the acceptable parameters for genital expression – only within marriage. Message is re-inforced by detailing consequences of premarital sex, i.e. STI’s and pregnancy

5. Valuing Fertility Comprehensive sexuality education places abstinence and contraception on a line relationship but focuses on the sexual act while trying to assure that it does not lead to pregnancy or infection

6. Valuing Fertility Neither addresses the teen at their level of psychosexual development, which is at the level of the Personal Fable (Erikson)

7. Valuing Fertility At this stage, consequences mean little or nothing because the teen is totally absorbed in the present moment, and also feels invulnerable.

8. Valuing Fertility Both boys and girls are trying to understand the changes in their bodies which accompany puberty and spend considerable time and energy thinking, talking and fantasizing about this.

9. Valuing Fertility Teens receive conflicting messages about the value of sexuality from the surrounding culture(s). If the youngster is fortunate enough to grow up in an intact and loving family, they will usually receive affirmation of their changing power together with boundaries which will help them come to terms with their potential for becoming a parent without needing to actualize it.

10. Valuing Fertility At puberty the need to establish one’s own personality means beginning to separate from parents, which is seldom without conflict. Many teens are sure their parents know nothing about sex, while every other adult is more knowledgeable.. Teen STAR tries to build a bridge

11. Valuing Fertility But many in our culture live in “virtual reality” where one can be in contact with the whole world electronically, yet physically isolated, and the boundaries between actual and virtual reality blur. Yet sexual intercourse is always an act of the body, cannot be expressed virtually as it requires a partner, a spouse

12. We have found that when girls experience the cyclic signs of their fertility and have the opportunity to discuss its implications they move away from peer pressure - the dominant force in middle adolescence - and begin to make their own decisions, a sign of greater maturity. Valuing Fertility

13. Similarly, when boys learn to understand their bodily reactions and how to master them, they also view and value themselves differently and behave differently. Valuing Fertility

14. To teach teens to understand and value their sexuality and fertility requires a personal relationship

15. Valuing Fertility Teachers need to be “in tune” with all aspects –physical, emotional, social, intellectual, spiritual. Not only do they need to understand all the topics and accept the underlying ethical basis, but know how to communicate them effectively. This requires personal interaction.

16. Valuing Fertility Behavioral outcomes, Chile Study Controls sig N males 251 195 N females147147 % transitions virgin – nonvirgin Males8.817.6 p =<0.004 Females3.412.4 p= <0.001 Discontinuation of intercourse * Rate increase20% 9% p=<0.03 Resumption of intercourse 011% p=<0.04 * No intercourse within the last three months of the program Vigil P et al. J Ped & Adol. Gyn 2005:212

17. Valuing Fertility The Teen STAR program has been evaluated twice in Poland in rigorous, controlled scientific studies (1996-1998, and 2002-2005). The evaluations have shown: - delay of sexual debut among boys; - decrease in genital contacts among girls - 3 years post- program effect; - decrease in sexual contacts in the past year among both sexes - 3 years post-program effect - decrease in use of psychoactive substances among boys; - change in attitude towards love and sexuality towards a more mature one; - increase in knowledge about male and female reproductive physiology and sexual reaction. - No pregnancies nor STI’s in the program group, while 2 pregnancies, and 2 STI infections occurred in the control group. Grzelak et al. presented MISH Wash. D.C. June 2005 & Profilaktyka ryzykownych zachowan seksualnych mlodziezy. Warsaw.2006

18. Valuing Fertility Placing a high value on possessing fertility as well as sexuality and therefore waiting until one can make full rather than partial use of this power enhances premarital abstinence and inevitably reduces premarital pregnancy and STI transmission.