GYT: Keeping it safe

By Rosanna Cacace, Health Educator II, Planned Parenthood Pasadena & San Gabriel Valley

For the past few years I have been lucky enough to spend my day talking to people about sex. For some, the word “sex” makes people cringe and run for cover. The idea of talking about vaginas and penises makes people uncomfortable, but for me, it is empowering because I know that I am able to provide my community with the resources they need to make healthy decisions about their body and their relationships. When I started as a reproductive and sexual health educator for Planned Parenthood of Pasadena and the San Gabriel Valley in Southern California, I didn’t have any experience teaching sexual health, but I was passionate about reproductive health and social justice and was looking forward to a new challenge. Initially, I didn’t realize that there was such a dire need for sexual health educators because I just assumed sex education was being taught in our public schools.

To my surprise, I found out that comprehensive sex education was not taught in many of our public schools. According to The California education code, public schools are only required to teach HIV/AIDS education at least once in middle school and once in high school—that is it!  If a public school goes beyond that, then the school would have to teach comprehensive sex ed., but with the recent budget cuts and the lack of oversight, most schools have either eliminated health classes all together or just taught the two hours of HIV education. But, without comprehensive sex education, how can we expect our youth to make safe and healthy decisions if they do not have the tools to do so?  It’s simple. They can’t. As of last year, the CDC stated that 83% of teens (15 to 19 years old) did not receive any sex education before they had sex.  And, although teen pregnancy rates are at its lowest, the United States continues to carry the highest teen pregnancy rates out of all the industrialized countries; furthermore, U.S’s teens are still at high risk for contracting STI’s. If they are lucky, they might have someone like me coming into their classrooms talking to them about sex and relationships, or they might have a trusted adult to turn to when they have questions, but what about all the other students who don’t have anyone to talk to about sex and relationships? How will they learn to foster positive relationships? It is impossible. And, as we wonder why we continue to see teen pregnancies and see the rates of infections remain high, we must also consider our collective responsibility to our youth.

Last spring, while facilitating a year-long peer education program at one of our local high schools, I had a difficult time connecting with the group at first. They were shy and didn’t quite understand the importance of sex education, in part because many of them were not sexually active and had mixed feelings about Planned Parenthood. But, after a few weeks of team building, they started to warm up to me. Slowly, they began to ask questions and shared their personal stories and feelings about relationships in general. Although they were still pretty quiet, we started to build a wonderful team of peer advocates.

After a few days discussing STIs, we spent the last day focusing on prevention strategies. We talked about the need to always give and receive consent in any long or short term  relationship, the need to talk to one’s partner about condoms and STI testing, and how often one must get an STI screening. We practiced refusal skills and negotiating safer sex using role play activities. They even learned how to put a condom on properly, and during the last STI session, they decided to create a “teen action plan” for their peers so that if they or someone they knew felt that they were ready to engage in sexual activity, they had the proper tools to keep themselves and their partners’ safe and healthy.

Overall, I thought the prevention session went really well. I was proud of them for taking the initiative to create an action plan for their peers. After class, the teacher asked me if I would be willing to stay and speak with one our female peer educators. The instructor said that she really wanted to talk with me but she was hesitant to do so. I was quite surprised when he asked me to speak with this particular student because she was very shy and often times seemed uncomfortable during class. She never participated in any of our class discussions and avoided most of the in-class activities and simply listened to our discussions. So, when he informed me that she wanted to speak with me, I wasn’t sure how to take it. As usual, I began to worry. As I waited for her to come and talk with me, I started thinking about all of the discussions I’ve had with the group and wondered if there was anything I said that might have upset her.  I immediately jumped to conclusions and thought that I offended her in some way, and for a brief moment forgot that she may in fact be in need of help.

Once she returned to the classroom and the instructor left, we sat down and I asked her how I could help. She just stared at her hands and began to cry. Immediately, I realized that the reason why she wanted to talk to me was not because I offended her or that she is upset with me, but that she was in trouble. I had no idea what the problem was, but I knew it must have been something serious and wanted to make sure she felt safe to talk. I reminded her that anything she disclosed was confidential and that if she was in trouble, I would do my best to help her and/or to seek outside help if needed. Then, she took a deep breath and asked, “What does it mean when the lips of your vagina swell up and burn?” I explained that it could mean any number of things and that only a doctor would be able to answer that question. She shared that over the summer, she became sexually active with her now ex-boyfriend, and that after they broke up, she started seeing someone else and then began to experience symptoms of burning, swelling and pain during sex. At first, she thought the symptoms would go away, but after six months, the symptoms were increasing. It wasn’t until she listened to our STI discussions that she realized she could get an infection from having sex. She admitted that she didn’t think she could get and STI from her ex-boyfriend because he was a “virgin,” and she did not know that STI’s could be transmitted by same sex partners, which scared her because she was currently dating someone of the same sex and they were not using protection.

Although she didn’t verbalize her fears, I knew she was petrified and worried that I would judge her. I waited until she finished crying and told her that she was brave to talk to me and that I was glad she had the courage to do so. I explained that the best thing she could do was make an appointment with a doctor. Since she did not have a health care provider, I suggested Planned Parenthood of Pasadena and San Gabriel Valley. Initially, she was afraid to make the appointment. She had never been to a Planned Parenthood health center, and although she knew about our services through our weekly meetings, she was unsure about it.  I reassured her that our health center was a safe place for her to seek help. She then asked if I could call and make the appointment for her and I did. I made her appointment for the following day and I told her that her school allows students to leave campus without parental consent or notification for confidential medical appointments but she would need to talk to her counselor first. So, we walked over to her guidance counselor and once she was in his office, I left.

The following week, I touched base with her with and the minute I saw her, I knew everything turned out just fine. She came up to me smiling and thanked me for my help. It turned out that her infection was curable, she even got her partner to make an appointment to get tested, and they started using condoms. She said that if it wasn’t for our weekly “sex talks,” she would have not only put herself at risk of permanently damaging her body but would have also put her partner at risk.  

Back in my office, I reflected and was grateful that the student had the courage and the strength to reach out to me and seek help. At the same time, I was saddened that up until recently, she did not have the education, the resources, or a trusted adult to help guide her through such a crucial moment in her life. It is not enough to go through a textbook and teach two hours of HIV and call it “sex education.” It is not enough to tell teens to “use a condom” and “get tested,” and it is not enough to tell them to wait until they are older. They need to have regular conversations about relationships so that can ask questions and receive medically accurate information on an on-going basis. They need to have a safe space where they can talk about sex and relationships without the fear of judgment and shame. But most importantly, teens need to learn the social skills required to advocate for themselves in any given situation.  When we talk about prevention, we need to frame it within the context of communication and consent so that students are not only sexually literate, but that they have the capacity to keep themselves and their partners safe and healthy.