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Sexual healing | 1, 2

Hardly the case for a moratorium on the discussion of sexuality and contraception. Rather, says Satcher, it is "a call to begin a mature and thoughtful discussion about sexuality."

As expected, in Satcher's evenhanded consideration of all points of view, he has placed a few spoonfuls of rhetorical sugar in the report to help public and private proponents of abstinence-only sex education get this strong medicine down. But in many, even most, cases these buzzwords and phrases are modified, minimized or nullified by strong language and the repeated suggestion that little or no evidence exists to support them.

For instance, he says that "few would disagree" that "sexual abstinence until engaged in a committed and mutually monogamous relationship is an important component in any sexuality education program." But Satcher repeatedly makes the case for thorough, school-based sex education, including the dissemination of accurate information about birth control.

Satcher also discusses the strengthening of families, "whatever their structure," by encouraging stable, enduring relationships, "particularly marriage." At the same time, he indicates that "human sexuality has come to serve many functions in addition to reproduction," and states that one might benefit from staying abstinent not until marriage, but until involved in a committed relationship.




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It is possible, while reading certain passages of the report, to be haunted by aural hallucinations of sex-positive whiners screeching and moaning as they spy words like "marriage" and "mutually monogamous relationship" and "abstinence" in the report.

I would ask these well-meaning perfectionists to repeat Satcher's mantra: "I have to deal with reality." And then read the report.

It is a pity that the whole thing can't be reprinted here. But you can get it easily enough at the surgeon general's Web site. In the meantime, it behooves me to mention certain amazing statements, if only because their simple eloquence is very uplifting:

"We need to appreciate the diversity of our culture, engage in mature, thoughtful and respectful discussion, be informed by the science that is available to us, and invest in continued research."

"Sexual health is not limited to the absence of disease or dysfunction, nor is its importance confined to just the reproductive years ... It includes freedom from sexual abuse and discrimination and the ability of individuals to integrate their sexuality into their lives, derive pleasure from it, and to reproduce if they so choose."

"We cannot afford the consequences of continued or selective silence."

"Sexual orientation is usually determined by adolescence, if not earlier, and there is no valid scientific evidence that sexual orientation can be changed."

"Close, warm parent-child relationships are associated with both postponement of sexual intercourse and more consistent contraceptive use by sexually active adolescents ... However, parental control can be associated with negative effects if it is excessive or coercive."

Simply being affiliated with a religion does not appear to have great effect on sexual behavior."

These are not fighting words; they are the succinct utterances of the 16th surgeon general of the United States, backed by the research and review of dozens and dozens of researchers, academics and health professionals who cite more than 100 scientific sources for their statements.

Infuriating as it may be to blinkered partisans who believe that sexual health is a political issue, the report is devoid of advocacy but full of urgency and concern. It is that rare governmental text that acknowledges, in real time and with no nonsense, the fears and wishes of its citizenry. It manages to respect parents without picking political favorites, address adolescents without condescending blather and view all sexual humans without judgment.

If David Satcher is removed from his post, it will be our duty to take up the battle, demanding, with this report as our primary weapon, that his vision be followed. As he points out in the cover letter of this report: "Doing nothing is unacceptable."

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Jennifer Foote Sweeney is the editor of Life.

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