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Every Saturday the CSPH highlights news or recent research in the field of human sexuality. This week we’re looking at an analysis conducted by the University of Georgia to evaluate the efficacy of different sex education programs with regards to teen pregnancy.

Researchers Kathrin Stanger-Hall and David Hall discuss how the U.S. ranks first among developed nations in rates of both teenage pregnancy and sexually transmitted diseases and in an effort to reduce these rates, the U.S. government has funded abstinence-only sex education programs for more than a decade. The central message of these programs is to delay sexual activity until marriage, and under the federal funding regulations most of these programs cannot include information about contraception or safer-sex practices. In 2010, the Labor-Health and Human Services, Education and Other Agencies appropriations bill provided funding to states for a new evidence-based Teen Pregnancy Prevention Initiative – the first large-scale federal investment dedicated to preventing teen pregnancy through research and evidence-based efforts. Despite accumulating evidence that abstinence-only programs are ineffective however, funding for abstinence-only sex education still represents a much larger chunk of government financial support for states. With two types of federal funding programs available, individual states now have to decide which type of sex education to choose while pursuing the ultimate goal of reducing teen pregnancy rates. Stanger-Hall and Hall’s analysis aims to evaluate the most recent data on the effectiveness of different sex education programs with regard to preventing teen pregnancy for the U.S. as a whole.

They collected the most recent (2005) teenage pregnancy, abortion, and birth data from 48 U.S. states (all U.S. states except North Dakota and Wyoming) along with information on each state’s prescribed sex education approach to find quantitative evidence regarding whether or not abstinence-only education is effective in reducing U.S teen pregnancy rates. There published analysis, entitled “Abstinence-only education and teen pregnancy rates: why we need comprehensive sex education in the U.S.,” cites that of the 48 U.S. states in the study, 21 states stressed abstinence-only education, 7 states emphasized abstinence education, 11 states covered abstinence in the context of comprehensive sex education, and 9 states did not mention abstinence in their state laws or policies. In 2005, the states that did not mention abstinence in their state laws or policies had an average teen pregnancy rate of 58.78 teen pregnancies per 1000 girls aged 14–19, states that covered abstinence in the context of comprehensive sex education averaged 56.36, states that emphasized abstinence education averaged 61.86, and the states that stressed abstinence-only education averaged 73.24.

The level of abstinence education was positively correlated with both teen pregnancy and teen birth rates, indicating that abstinence education in the U.S. does not cause abstinence behavior. To the contrary, teens in states that prescribe more abstinence education are actually more likely to become pregnant. A multivariate analysis of teen pregnancy and birth rates identified the level of abstinence education as a significant influence on teen pregnancy and birth rates across states. According to Stanger-Hall and Hall, their analysis included data on four possibly confounding factors: socio-economics status, education level, ethnicity, and Medicaid-funded access to family planning services.

Please click here to read the entire article.

What does GTA training entail?

Training and Materials:
Megan Andelloux, a board-certified sexologist and sex educator, teaches both the ins and outs of a comprehensive physical exam (including breast examination and an optional rectal examination) and the communication skills necessary to give proper feedback when training providers, as well as a sample curriculum/syllabus for training providers in reducing patient anxiety, performing competent and sensitive exams, and more. This knowledge will help aspiring GTAs develop the skills and gain the knowledge necessary to provide effective instruction as well as understand pelvic exams they themselves might undergo with their OBGYNs. Here is a sample syllabus on pelvic exam training from Project Prepare that is the kind of training GTAs would give to providers.

The training will consist of a theoretical portion and a practical applications portion (where each person will see, perform, and receive a pelvic exam).

Handouts and materials will be provided.

Referrals:
Not only will participants be trained, but upon successful completion of the course, The CSPH will have them on-list whenever providers request names of GTAs for trainings at their medical schools and/or clinics.

Cost:
The cost of this training is $125 dollars, which covers materials, staff-time, and more.  Financial assistance is available to those with need (inquire for more information).

Directions:
The Women’s Medical Center of RI located at 1725 Broad St., Cranston, RI 02905.
It is accessible via bus line #1 (if you take bus #42 from Pawtucket or Thayer, it turns into the 1 after it hits Kennedy Plaza).
Parking is available.

What is a GTA and what do they do?
A Gynecological Teaching Associate (GTA) is a trained medical educator who uses their own body as a tool for teaching medical students how to perform pelvic exams so that the experience will not be traumatic for future patients or intimidating for the practitioners. For a couple of hours, a GTA uses their body to guide medical students through the entire process of performing a thorough pelvic exam: a visual exam (checking for any lumps or bumps), a speculum exam (confidently guiding in the duckbill), a bi-manual (hello, ovaries!), and a rectal exam (every pelvic exam is supposed to include a rectal screening, but this is shyly skipped in most visits to the gynecologist). The GTAs coach medical students on their clinical skills and give “hands on” instruction, as well as comments on technique, language, and overall approach.

This job is not recommended for someone who is just strapped for cash. A person must be healthy—both mentally and physically—to handle this work. It can be draining and sometimes extremely difficult to endure. However, there are compelling reasons why people get involved. Some view it as a form of public service. Others want to work within the medical field, or enjoy the teaching aspect. There are also those who regard GTA work as a form of activism, promoting sex-positive health care.

For more information or to register for the training, contact us at info@thecsph.org!

This new edition carries on that tradition.  The CFLE and co-editors Susan Milstein and Sue Montfort, have updated old lessons, developed new ones, and selected from (and then edited) dozens of submissions from outstanding sexuality educators nationwide (including the CSPH!).  The result is 50 lessons in TWO volumes! These new lessons explore culture, inclusivity, relationships, sexting, sexual pleasure, and much more in an effort to continue to expand the scope of “sexual safety”.

Both volumes are currently in review, and the CFLE is expecting to have it in print in March. Meanwhile, you can check out the preliminary table of contents. Also, be sure to take advantage of the special pre-ordering discount! $80 for the set (original pricing is $55 each, $95 for the set).

In Feminist Theory from Margin to Center, bell hooks critiques feminist thought and practice as it existed before 1984 and theorizes new ways to achieve a society without oppression. Hooks argues that the early feminist movement was dominated by middle class white women who separated racial and class struggles from feminism. This problematic view pushed women of color to the margins of the feminist movement, a phenomenon that was damaging to women of color, and society at large.

Hooks begins by criticizing the ways that the concerns of white middle class housewives were wrongly portrayed as the most urgent issues for all women. When feminist thinkers like Betty Friedan portrayed feminism as a middle class housewife’s problem, they excluded the important voices and perspectives of black women who experience oppression along multiple lines. Defining feminism as the struggle to end sexist oppression, hooks argues that sexist oppression is but one of many problematic forms of oppression, all of which must be fought and eliminated together. Not only does hooks push for solidarity of women and an end to the harmful, needless competition between women, but also for a joint effort with men to unlearn sexism.

Additionally, hooks criticizes the way that middle class biases in feminism have negatively depicted housework as something to be abandoned in favor of work outside of the home. In equating work with liberation, hooks maintains that white middle class feminists overlooked the lower class women of color who already worked outside of the home, but were by no means liberated. Instead, hooks argues for a rethinking of housework as important and dignifying in its own way, without the classist conceptions that only work outside the home is valid.

Hooks contends that a true feminist liberation must include all women, and therefore it is necessary to educate all women. While feminist ideas are primarily shared through writing, hooks points out that feminist theory is dominated by college-educated women, ignoring the needs of women lacking basic literacy and education.

According to hooks, sexist politics of the family validate violence against women in the home, leading into hooks’ concept of a new family politics and parenting model, one where masculinity is redefined to include an equal share of parenting. Also, hooks advocates for a sexual liberation in which sexual desire is uninfluenced by the norm of heterosexuality. Hooks finishes by calling for a gradual and deliberate feminist revolution.

Feminist Theory from Margin to Center thoughtfully brings the essential issues of class and race to the forefront of feminist struggle. Although hooks appears to rely heavily on a gender binary in which the non-gender conforming are invisible, hooks is successful in lending visibility to feminist issues that had been hidden. Not only does hooks deconstruct the formation of a margin in feminist thought, but hooks also provides concrete plans for reforming feminism as inclusive and conscious. Hooks’ insights in rethinking feminism powerfully map strategies for a feminist liberation that is inclusive of all women and positive for those oppressed along the axes of gender, race, and class.

What does GTA training entail?

Training and Materials:
Megan Andelloux, a board-certified sexologist and sex educator, teaches both the ins and outs of a comprehensive physical exam (including breast examination and an optional rectal examination) and the communication skills necessary to give proper feedback when training providers, as well as a sample curriculum/syllabus for training providers in reducing patient anxiety, performing competent and sensitive exams, and more. This knowledge will help aspiring GTAs develop the skills and gain the knowledge necessary to provide effective instruction as well as understand pelvic exams they themselves might undergo with their OBGYNs. Here is a sample syllabus on pelvic exam training from Project Prepare that is the kind of training GTAs would give to providers.

The training will consist of a theoretical portion and a practical applications portion (where each person will see, perform, and receive a pelvic exam).

Handouts and materials will be provided.

Referrals:
Not only will participants be trained, but upon successful completion of the course, The CSPH will have them on-list whenever providers request names of GTAs for trainings at their medical schools and/or clinics.

Cost:
The cost of this training is $125 dollars, which covers materials, staff-time, and more.  Financial assistance is available to those with need (inquire for more information).

Directions:
The Women’s Medical Center of RI located at 1725 Broad St., Cranston, RI 02905.
It is accessible via bus line #1 (if you take bus #42 from Pawtucket or Thayer, it turns into the 1 after it hits Kennedy Plaza).
Parking is available.

What is a GTA and what do they do?
A Gynecological Teaching Associate (GTA) is a trained medical educator who uses their own body as a tool for teaching medical students how to perform pelvic exams so that the experience will not be traumatic for future patients or intimidating for the practitioners. For a couple of hours, a GTA uses their body to guide medical students through the entire process of performing a thorough pelvic exam: a visual exam (checking for any lumps or bumps), a speculum exam (confidently guiding in the duckbill), a bi-manual (hello, ovaries!), and a rectal exam (every pelvic exam is supposed to include a rectal screening, but this is shyly skipped in most visits to the gynecologist). The GTAs coach medical students on their clinical skills and give “hands on” instruction, as well as comments on technique, language, and overall approach.

This job is not recommended for someone who is just strapped for cash. A person must be healthy—both mentally and physically—to handle this work. It can be draining and sometimes extremely difficult to endure. However, there are compelling reasons why people get involved. Some view it as a form of public service. Others want to work within the medical field, or enjoy the teaching aspect. There are also those who regard GTA work as a form of activism, promoting sex-positive health care.

For more information or to register for the training, contact us at info@thecsph.org!

Which is why I’m glad I know Megan Andelloux.

So what’s the first pearl of sexy wisdom Andelloux has for students in Rhode Island?

“Make it fun,” she says.

And if you’re not sure how to do that, Andelloux can help.

A former Planned Parenthood educator turned sex-positive specialist, Andelloux now runs the CENTER FOR SEXUAL PLEASURE AND HEALTH in Pawtucket, where she doles out advice and offers classes on blow jobs, female orgasms, and BDSM. I took a class with her once where people practiced cunnilingus on plum segments. It was splendid.

But fun sex is about more than just licking fruit. It’s also about knowing where to go for information, birth control, and safe sex toys.

For sex toy shopping right in Brown University’s backyard, check out Wicken-den Street’s MISTER SISTER, a store that’s as cheeky as its name. This little shop is queer-friendly — note the rainbow flag hanging in the back — and services a gay male crowd, although people of all genders and sexual orientations can find something inside, from the vast array of corsets and cock rings to the shelves lined with brightly colored vibrators. If handcuffs aren’t your thing, you’ll also find glow-in-the-dark massage lotion and massage oil laced with gold dust. If handcuffs are your thing, you won’t have to look far to find them. They’re in the front window. And don’t forget to pick up some condoms on your way out. Safe sex is fun sex, with or without the cuffs.

If you don’t mind a short train ride north, you can visit GOOD VIBRATIONS in Brookline, Massachusetts, where you’ll find top-of-the-line vibrators, dildos, and other sex toys (some for top-of-the-line prices, with others in a more reasonable range) and a friendly staff that is happy to talk to you about things like nipple-stimulating cream — without blushing. Good Vibrations is woman-friendly and seems designed to diminish the shame associated with sex toy shopping. You won’t find customers lurking red-faced behind porn magazines or pretending they mistakenly stumbled into a sex shop on their way to Starbucks. Instead, you might find people of all ages talking about sex as they buzz the display models on their noses and fingertips.

These shops also have a delightful selection of books for education and…pleasure.

For a huge selection of porn DVDs and magazines, there is AMAZING SUPERSTORES, an adult-store chain with locations in Warwick, Providence, East Providence, Johnston, North Kingstown, and Newport. (The store in Newport is called Wild Orchid but it’s part of the same chain.) Amazing’s Thurbers Avenue location is the only sex shop I’ve ever entered that has an in-house smoke shop, where you can find an array of bongs and pipes (for tobacco use only, of course). Locations in Johnston, Providence, and North Kingstown have viewing rooms for adult videos, if that’s your thing. If that’s not your thing, you can browse the range of sex paraphernalia, from penis-shaped cookie cutters to vibrators, butt toys, and lingerie.

She (we’ll call her Janice, age 41) was unhappy with her husband (we’ll call him Pat, 42). After several years of his inability to sustain an erection, she started blaming herself and lost confidence in her sexual appeal. She began to doubt the value of their marriage and decided to see a sex therapist for counsel.

After her first few sessions with Rhode Island-based certified sexologist and sexuality educator Megan Andelloux, BS, Janice gained the courage to ask Pat to see a doctor to rule out a medical condition. That turned out to be the case: He had weight issues that were affecting blood flow (which can cause erectile dysfunction). At Andelloux’s suggestion, the couple began to explore intimacy not based solely on erections, while Pat worked to lose weight and improve his overall health. For Janice and Pat, it was a new beginning. For Andelloux, it was another day at the office.

Which raises the question: Just what goes on behind the doors of a certified sexologist?

Sex Therapy, Talk Therapy

While any title that contains the word sex may sound provocative, what happens in the offices of certified sex educators, counselors, and therapists is all about talk, much like any other form of therapy and counseling. “We are not allowed to touch our clients, nor would we consider doing so,” Andelloux says. “No sex ever takes place in a sex therapist’s office.”

Her office is a venue for clients struggling with any range of sexual issues to feel completely safe and candid in discussing and working on these problems. “It could be about two people having different levels of desire,” she says. “We see everything from couples dealing with aging and changes in sexual functioning, to women dealing with rape trauma in their sex lives, to men being concerned and ashamed about the content of their fantasies. It’s a large range.”

‘Purposeful Touch’

As a sex educator, Andelloux’s work focuses on far-ranging conversations about sex and sexuality, including a typical technique in traditional therapists’ offices: homework. For couples having trouble with intimacy (a common problem), Andelloux may prescribe what’s called purposeful touch. “I might advise 10 minutes a day of touching one’s partner that doesn’t lead to sex,” she says.

For Janice and Pat, the homework goes on. “They’re still together,” Andelloux says. “He’s lost weight and gained confidence, and they’re working on their sex lives as well as their marriage.” It was a good day at the office.

What Is a Sex Therapist?

What leads a couple to a sex therapist?

Most begin dealing with relationship issues in traditional therapy settings, with marriage counselors or therapists, Andelloux says.

But sometimes this professional may not be educated in a range of issues regarding sexuality, so a referral is in order. Here’s how sex therapists learn their craft:

Added knowledge. While trained therapists such as those with a master’s degree in social work, or MSWs, receive a number of hours of sexuality training in their overall education, accredited sex therapists build on already-existing backgrounds in social work, medicine, psychology, or specific graduate work in sexuality.

Extra hours. The American Association of Sexuality Educators, Counselors, and Therapists, the field’s central body of oversight and accreditation, requires 90 hours of graduate-level coursework, plus supervised clinical hours.

- Tracey Minkin

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