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Health Textbook Hearings, Round Two: Fundamentalists strike back

September 8, 2004

Wednesday, September 8, was this year's second and last public hearing on the health textbooks by the Texas State Board of Education (SBOE). One can visit the Texas Education Agency's website for a transcript. The Texas State Board is scheduled to vote on the textbooks on Friday, November 5.

The stakes in this hearing, in the one that was held on July14, and in the final vote scheduled for November 5 (just three days after the US presidential election) are seen by many as a struggle between science and ideology--in this case, between medically accurate information that can help ensure the health of US youth and evasions that quietly defer to the puritanical fantasies of the religious right. Texas is the second largest textbook market, and the Texas State Board, which votes on the textbooks that can be taught in the state's public schools, essentially serve as gatekeepers. In the attempt to cater to the Bible Belt, publishers sometimes are willing to hedge on, if not disregard, empirically proven findings.\r\n \r\nThis year, with the delicate subject of sexuality on the SBOE agenda, publishers of three textbooks have decided to drop any references to contraception, whether it be for birth control or for preventing the spread of sexually transmitted diseases (STDs), which include, but which are far from limited to, the human immunodeficiency virus (HIV) that enables Acquired Immune Deficiency Syndrome (AIDS). Such evasions risk providing students with information that is both misleading and dangerous. The textbook proposed by Holt, Rinehart & Winston, for example, suggests that students "get plenty of rest" to avoid STDs. "When you're tired," it cautions, "it's hard to think." Worse, since the first public hearing on July 14, textbooks have now been revised to deny the effectiveness of even protected sex in preventing the spread of these diseases.\r\n \r\nIn a July 28th press release, Dan Quinn, Communications Director of the Texas Freedom Network, reported, "Documents released by the Texas Education Agency (TEA) reveal that publishers have agreed to make reckless new changes to their proposed high school health textbooks. One publisher even equates unprotected and protected sex, calling both 'high-risk behaviors' for acquiring sexually transmitted diseases (STDs).\r\n \r\n"The changes came at the insistence of state review panelists who evaluated the textbooks in June. The panelists included teachers, parents and other Texas citizens who are not experts in science, medicine or health education.\r\n \r\n" 'Replacing no information about sex education in the textbooks with bad information will have dangerous consequences for Texas teenagers,' said Samantha Smoot, president of the Texas Freedom Network. 'To raise responsible, healthy adults, families need the most accurate and reliable information possible, not dangerously misleading facts.'\r\n \r\n"Glencoe/McGraw-Hill agreed to change in its Glencoe Health book a list of behaviors that place people at high risk for STDs. The passage (on page 649) had included, 'Engaging in unprotected sex.' The new passage now reads, 'Engaging in either unprotected or protected sex.'"

'Glencoe's change contradicts established medical research,' said Janet P. Realini, M.D., M.P.H., chair of the Texas Medical Association's Committee on Maternal and Perinatal Health. Dr. Realini is also coordinator for Project WORTH, the city of San Antonio's teen-pregnancy prevention program. 'The change would also endanger teens by discouraging efforts to protect themselves from HIV/AIDS and other STDs.' "Dr. Realini also said Glencoe failed to correct a part of the same passage stating that barrier protection 'is not effective at all' against humanpapillomavirus (HPV). Some HPV strains can cause cervical cancer. 'Condom use reduces the risk of HPV diseases such as genital warts and cervical cancer,' she said. Dr. Realini pointed out the textbook's error at a July 14 hearing before the State Board of Education (SBOE). [See pages 56 through 64 of the July hearing's transcript.] "The federal Centers for Disease Control and Prevention also notes the importance of latex condoms in preventing STDs, especially HIV: 'Latex condoms, when used consistently and correctly, are highlyeffective in\r\npreventing the transmission of HIV, the virus that causes AIDS.' [That section of the Centers' website was last updated on January 23, 2003. Since then, the federal agency has also been subject to political interference.] "Holt, Rinehart and Winston also made changes to its textbook, Lifetime Health. Holt added more information about the effectiveness of abstinence in preventing unwanted pregnancy and STDs. Yet Holt added nothing about the effectiveness and ineffectiveness of barrier protection and other contraceptive methods. The Holt and two Glencoe textbooks, Glencoe Health and Health and Wellness, still lack this basic information. The information is required by Texas Essential Knowledge and Skills (TEKS) curriculum standard 7i. "Thomson/Delmar Learning added nine substantial references to abstinence in its textbook, Essentials of Health and Wellness. Delmar Learning also added information about the effectiveness of condoms and oral contraception." Up until the November vote by the SBOE, Quinn noted, "publishers may make additional changes to the books."\r\n \r\nQuinn also reported, "TFN, Planned Parenthood and other organizations have joined together in the Protect Our Kids campaign for responsible health textbooks." In contrast with the July hearing, the hearing on September 8 had a noticeable attendance of right-wing Christian supporters of the textbooks, many of whom were wearing "Abstinence Only" stickers. Most prominent among them were members of the Irving-based Texans for Life Coalition, a fundamentalist group known mostly for its opposition to abortion. (Fellow atheist Amanda Walker, who used to work at an abortion clinic, remembers that group among the religious protesters who shouted that Jesus hated her and her co-workers.) Also opposed to information on contraceptives, the group is basically the antithesis of the strictly secular and medically accurate Planned Parenthood. At the September hearing, the most bizarre, if also quite revealing, moment came with the appearance of a citizen by the name of Jack Ripley, who offered his testimony in the form of a prayer (pages 209 through 211 of the transcript). He said, "Dear Infinite, All-Powerful God of All Creation, I come before Your throne today in the awesome name of our Lord and Savior Jesus Christ. Heavenly Father, I pray. I come before You and ask Your forgiveness and seek Your direction and guidance. I know Your word says 'woe to those who call evil good,' but that is exactly what we have done as a nation. We have lost our spiritual equilibrium and inverted our values." He then went on to say, "We have endorsed perversion and called it an alternate lifestyle. We have exploited the poor and called it lottery. We have neglected the needy and called it self-preservation. We have awarded laziness and called it welfare. We have killed our unborn and called it choice. We have shot abortionists and called it justifiable. We have neglected to discipline our children and called it building esteem. We have abused power and called it political savvy. We have coveted our neighbor's possessions and called it ambition. We have polluted the air with profanity and pornography and called it freedom of expression. We have ridiculed the time-honored values of our forefathers and called it Enlightenment."

Ripley was received warmly by the religious conservatives at the hearing, even eliciting at least one "Amen" from the crowd.

Meeting with an even more sympathetic reception from the fundamentalists was Angel Bell, a high-school junior from Waco, who described herself as a Christian raised by clergy (pages 195 through 197 of the transcript). She said, "[W]hen people say that you should include condoms in these textbooks, I know my father, being a pastor that he is, would not want me to know about condoms and pretty much so that I don't want to sit up in a classroom with a banana trying to put a condom on it. That is not something that I think we should have in school. A banana is to eat and not to demonstrate something like that on." Explaining how she earlier described her stance to someone else, she recollected that she had "said, 'If they're going to do that, they might as well tell them to go ahead and read this Playboy and have fun in classroom,' because that's how lewd and nasty they were. Promoting masturbation and all types of things like that, stuff that I particularly do not believe in, and if a teacher handed me a book like this, I would hand it right back to her and tell her you need some help if you're going to teach this type of thing."

Fortunately, other people relied on science and reason instead of religiously based morality, but they tended to receive fewer questions from the Texas State Board. Also, fewer people in the audience were willing to cheer them on.

Among the people testifying in the name of medical accuracy was Dr. Gordon Crofoot, medical director of the Montrose Clinic in Houston, who in July had attended the International AIDS Conference in Bangkok (pages 82 through 85 of the transcript). At the September hearing, Dr. Crofoot said, "The South, including Texas, has the highest rates of poverty, the worst education statistics, the worst health care statistics, the slowest decline in teen pregnancies, an increase in all STDs and AIDS. The South has increasing abstinence-only educational programs, and decreasing condom use. This is our reality.

"These textbooks do not meet the criteria and are factually and scientifically incorrect in what they say, but their major fault is in what they don't say and the resulting consequences.

"Young people are both our greatest hope for our future, but also our most threatened.

"I have learned through my patients and thousands of scientific studies that fear-based abstinence-only programs are kind of like the Texas father with a shotgun. They don't really work. Abstinence until marriage in theory is 100 percent effective, but in reality fails 88 percent of the time. Condoms in the laboratory are 100 percent effective in preventing viral and sperm transmission, but in life with appropriate education failed only 3 percent of the time. The greatest risk in the world for HIV is being female. The major risks in women are poverty, youth, and being married. "I agree with most of the countries in our world, most of our scientists, public health experts, most religions, 93 percent of our parents. I agree with the United Nations, the American Medical Association, the Texas Department of Public Health. I agree with the past 30 years of the FDA [Food and Drug Administration], CDC [Centers for Disease Control and Prevention], and NIH [National Institutes of Health]. We all say a comprehensive sex-education program including abstinence is essential for the health of our youth.

"The estimated direct yearly cost to Texans for new teen STDs, HIV, and pregnancy is $1.6 billion. 100 percent abstinence programs [that is, those focused exclusively on abstinence] at best do not affect the incidents of STDs or pregnancies and at worst increased both. If we do nothing, the direct cost over the next 10 years could $10.6 billion. Comprehensive sex-education programs might reduce this cost by 50 percent.\r\n \r\n"Can Texas afford this cost? Can Texas afford to support our unwed teen mothers on welfare? Can Texas afford to see our youth get sick? The answer is easy. For you [the members of the SBOE], the answer is obvious. Just say no to these textbooks and [to] 100 percent abstinence programs."\r\n \r\nAt the conclusion of his testimony, Dr. Crofoot received no questions from the Texas State Board.\r\n \r\nYet at a press conference the day before the hearing, on Tuesday, September 7, the Protect Our Kids campaign announced a new poll that showed 90 percent of Texans in favor of sex education that includes medically accurate information on abstinence, birth control and the prevention of sexually transmitted diseases. "Publishers and a few State Board members mistakenly think sex education is controversial or somehow political," said Austin parent Susan Moffat. "But parents know better. Parents know that making sure our kids have the most accurate and reliable information is the best protection we have for raising safe, healthy, responsible adults."\r\n \r\nWith both hearings concluded, the Texas State Board was scheduled to vote on Friday, November 5. In the meantime, the Protect Our Kids campaign asked Texans to write their State Board of Education member and insist that the textbooks fully conform to state curriculum standards on contraception and the prevention of STDs, including HIV. More information can be found at the Texas Education Agency's website and at A follow-up account regarding the Texas State Board's vote on November 5 can be found at this website.

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