On January 1, 2016, The California Comprehensive Sexual Health and HIV/AIDS Prevention Act went into effect. The Act is intended to equip students with information to protect their reproductive health, and foster healthy attitudes about puberty, sex, gender, and relationships. The law mandates that HIV/AIDS prevention be taught at least once in middle and once during high school, and that comprehensive sexual health education conform to certain standards, which excludes abstinence-only teachings. The law sparked controversy in some counties, but San Francisco schools have generally conformed to the new requirements without difficulty.
Though the legislation only affects public schools, many private institutions, such as Live Oak School, located on Mariposa Street, have long histories of providing sex education curriculums and fostering open dialogue about sex. Nate Lundy, Dean of Student Life at Live Oak, emphasized the importance of adjusting curriculum in response to changing cultural realities. “We provide an adolescent health curriculum taught by a trained Planned Parenthood professional,” Lundy said. “She caters the conversation to anything the kids want to discuss, and recently remarked that the current sixth grade class is the most advanced ever in terms of being able to have a mature discussion. It’s absolutely necessary, and we wouldn’t ever think of backing off of it. The curriculum is currently offered for fourth through eighth grades in an age appropriate manner. For the fourth through sixth grades especially, we cover things like anatomy, peer pressure, social media pressures, gender roles, and healthy relationships.”
Lundy admitted that the school’s sex education program, which has been offered for the past nine years, differs greatly from lessons parents of current students received when they were young. He cited proactive communication as essential to dispel parental fears about what’s being discussed in classrooms. Before lessons are given, teachers and school staff have conversations with parents about what exactly will be taught, providing an opportunity to ask questions or voice concerns. Parents are encouraged to initiate their own dialogues with their kids.
“We cover all issues of sex, gender and sexual orientation,” Lundy clarified. “We made adjustments to our curriculum this year. In addressing fluidity and also to help girls and boys learn from each other, we no longer separate them during the sex ed classes. It helps take the mystery and discomfort of talking about it away. We just started having discussions about gender identity. We’ve added gender neutral bathrooms and have started relevant discussions at an age appropriate level.”
The San Francisco Unified School District has been ahead of the new legislation, providing a high school curriculum that meets the Act’s requirements even before it was enacted. Other school districts, such as Oakland and Marin, asked SFUSD for assistance, and incorporated some of the lessons developed in the City into their materials.
According to Christopher Pepper, a former health education teacher at Balboa High School and the District’s Young Men’s Health Project Coordinator, the California law prompted SFUSD to make sex education more consistent at the middle school level. “About five percent of our middle school students have reported that they are sexually active. We want pregnancy and STI prevention for these students,” Pepper stated. “It’s been hard to fit the sex education lessons into the greater health curriculum for the middle school level because it’s taught throughout various subjects at different times. It hasn’t been consistent so far, but we’re working on improving it.”
Be Real, Be Ready is the sex education curriculum taught at SFUSD high schools. The class is required for graduation, and was developed three years ago by San Francisco Department of Public Health staff, school district teachers, and the Adolescent Health Working Group. Community-based organizations – such as Mission Neighborhood Health Center, Huckleberry Youth Programs, and Planned Parenthood – assisted with curriculum development. In addition to teaching about HIV, sexually transmitted diseases, and pregnancy prevention, the class covers issues around sexual consent, and is being expanded to address sex trafficking.
In February, the San Francisco Board of Education approved a policy to require middle schools to make condoms available to their students beginning this fall, in addition to the current condom distribution program at the high school level. “There were some parents who expressed concern about the condom availability program,” said Kevin Gogin, SFUSD Director of Safety and Wellness. “The students have to dialogue with someone; even in high school there’s always an adult present. Students have to talk with a nurse or educator before accessing condoms. Knowing this alleviated some concern for many parents. We always encourage students to talk to their families and try to facilitate some of those conversations. We hope that parents can reinforce talking openly about these topics at home.”
Live Oak School doesn’t distribute condoms. “We teach the safe use of condoms and how to put them on. We leave it to parents to get sexual health care and condoms for their kids,” Lundy remarked.
Burton Academic School, O’Connell, Mission, and Balboa high schools have wellness centers that’re staffed with nurses and health educators who provide support around complex issues, such as depression, bullying, substance use, and sexual health. Students can access free condoms at these centers. Willie Brown Jr Middle School, which recently opened in Bayview, is the City’s first middle school to have a wellness center.
Because the wellness centers don’t provide more sophisticated levels of care, such as sexually transmitted illness testing and treatment, schools have historically referred students to the New Generation Health Center, a free-standing young adult clinic run by the University of California, San Francisco. The clinic, founded 20 years ago, will close its doors this summer. DPH is forming a working group to develop plans to ensure the continuation of services for youth through other City clinics.
“There are a lot of youth clinics in the City, what’s unique about New Gen is that it’s free standing. They’re not going to run into their aunt or other adults at the clinic,” said Rebecca Jackson, MD, Chief of Service for OB-GYN at Zuckerberg San Francisco General Hospital. “This is a really treasured resource for youth.”
Outreach work that New Generation Health Center provided high schools will be taken over by DPH. Youth who access care at the center will be referred to other clinics that have capacity.
Jackson, technically an UCSF employee, has received numerous letters from schools and community members thanking her for New Gen’s outreach efforts. Though she feels the center’s closing will be a loss to City youth, she’s hopeful about the new legislation. “It’s fantastic,” she said. “I feel like our country in general is behind in its ability to talk about sex, but this is especially true with kids. In Europe, sex is considered a normal part of life and is openly talked about. They also openly talk and teach about parenting. which is very related to this.”