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In Utah high schools, health teachers tread a fine line when they are asked to share medically accurate information with teens about preventing sexually transmitted diseases but not advocate the use of contraception.
When does talking about different forms and methods of contraception cross the line?
For the State Office of Education, the line may be too fuzzy to draw.
In response to complaints, the office has scrapped a slide show intended to help teachers present factual information about contraception in 11th-grade health courses without running afoul of state law, which forbids the "advocacy or encouragement" of the use of contraceptive devices and methods.
"At this point, we're not going to use it," said Brenda Hales, the state's associate superintendent for instruction. "It's almost impossible to get the various stakeholders to agree."
The 21-slide PowerPoint, which explains types of contraception along with efficacy rates and side effects, drew criticism from some lawmakers, activists and state board members, Hales said, before it ever went to the state board for approval. Gayle Ruzicka, director of the Utah Eagle Forum, cited the slide show during a legislative hearing in January as an example of why education leaders should be reined in by the Legislature.
"I'm certainly glad to hear that" the slide show has been dropped, Ruzicka said in an interview. "The message you send when you say abstinence is best but here's all the different kinds of contraception the message you send is, in case you're not abstinent, here's what you need to be doing. I think that advocates."
Ruzicka also disapproved of photos in the slide show of specific brands of contraception, such as Trojan condoms and Delfen spermicide, saying those advertised contraception.
And state Sen. Bill Wright, a Holden Republican who crafted Utah's sex-education law, said a photo of a young man giving a young woman a piggy-back ride is "inappropriate." The photo of the couple, who are fully clothed, appears on a slide about abstinence that states choosing not to have sex is the only 100-percent effective method of birth control and STD prevention.
"They have some pretty enticing pictures on there that would advocate or encourage young men and women being involved sexually. There's no question about that," Wright said.
Ruzicka and others recently asked the Utah Attorney General's Office whether the slide show violated state law but did not receive a formal opinion.
Karrie Galloway, chief executive officer of Planned Parenthood of Utah, called the decision to ditch the slide show "unfortunate."
"Advocacy is in the eye of the beholder," she said. "I don't believe that providing students medically accurate information which they may need at some point in their lives is advocating. … Regardless of whether I as a parent or I as the director of Planned Parenthood believe that young people should be engaging in sexual activity, they make that decision without my input darn it all, but they do. I believe they should be able to have protection when available."
Nationally, 46 percent of students in grades 9-12 report they have had sexual intercourse at least once, according to a 2009 survey by the Centers for Disease Control and Prevention. Of those who said they were sexually active, 61 percent used a condom the last time they had sex. No Utah numbers are available because students are not asked about sexual activity.
In Utah in 2009, 3,361 girls ages 15 to 19 delivered babies, according to the state Department of Health. And 2,900 women ages 15 to 24 tested positive for chlamydia nearly half of all cases of the state's top communicable disease.
The Office of Education began developing the contraception slide show last year after a failed legislative attempt to clarify in state code that while teachers are barred from advocating contraception, they still are allowed to share information about it. Sponsored by Sen. Stephen Urquhart, R-St. George, the bill also would have specified that contraception-instructional materials, to be selected by the State Office of Education, would be available to parents for their review.
"It seems more responsible to have one well-produced PowerPoint than 41 different approaches to contraceptives," Urquhart said. "Contraceptives are part of the curriculum and a PowerPoint is a perfect way to know exactly what is being taught and make sure it is being taught correctly within the mandates of Utah law."
Utah's 41 school districts and 78 charter schools are allowed to approve their own human-sexuality course materials and also may adopt policies that are more restrictive than Utah's "abstinence-plus," which promotes abstinence but allows information about human reproduction. Jordan, Canyons, Nebo and Provo districts have "abstinence-only" policies.
State law requires parents give written permission for their students to participate in any lessons about human sexuality.
"The neat thing about the PowerPoint was parents could preview it," said Liz Zentner, Utah PTA health commissioner. Referring to Ruzicka's Utah Eagle Forum and other groups, Zentner said, "it's such a small minority of parents that are just ultra-conservative that don't want children to know any of this because they feel like it's advocating. But I say it's educating."
The state PTA board has not officially voted on whether to support the presentation, said Margaret Wahlstrom, PTA spokeswoman.
Despite the state decision to back away from the contraception slide show, it could be used in the Granite School District. Ron Burnside, the district's health-curriculum specialist, said he plans to ask Granite's sex-education advisory committee for permission next month. He helped develop the presentation and does not believe it encourages teens to have sex.
"It's very informational. A lot of teachers do feel a little bit intimidated by talking about [contraception]," Burnside said. "This slide show does it for them."
Sample slide from abandoned contraception slide show
The State Office of Education has scrapped a presentation for use by health teachers after hearing complaints it violated a state law that forbids "advocacy" of contraception in schools. This is a "key points" slide from the end of the presentation:
Abstinence is the only 100 percent effective method of contraception.
Abstinence is the only 100 percent effective method of preventing STDs [sexually transmitted diseases], including HIV.
Condoms provide limited protection from many STDs, including HIV.
Many methods of contraception are effective if used properly but may have side effects to consider.
Abstinence has no side effects.
Maturation program also scrutinized
In addition to criticism of a contraception slide show, the Utah State Office of Education has received complaints about a state-approved maturation program, "Growing Up Comes First." Planned Parenthood of Utah developed the program a decade ago to explain puberty to Utah's fifth- and sixth-graders.
But critics dislike a parent guide that Planned Parenthood also developed at http://www.growingupcomesfirst.org, which links to more explicit information about sex on the non-profit's main website. Brenda Hales, a state associate superintendent, said the information on the main website does go beyond state law, which prohibits instruction in "the intricacies of intercourse" and "erotic behavior."
Planned Parenthood has removed a statement that "Growing Up Comes First" is endorsed by the State Office of Education from the program's website. On Wednesday, Planned Parenthood also agreed to remove the parent guide, Hales said.