Sex Education: How Should It Be Offered?

James S. Marks, MD; Willard Cates, MD, MPH
JAMA. 1986;255(1):85-86. doi:10.1001/jama.1986.03370010091031.
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Sexual messages pervade our lives—at home, in schools, in media, in shopping centers, on airplanes, and even in physicians' offices. Rightly so, since being sexual is part of being human. Using public health values, sex can be a conduit for either good (enjoyment, planned pregnancy) or unfortunate (unplanned pregnancy, sexually transmitted diseases [STD]) outcomes. To avoid the adverse consequences, individuals need both factual information and decision-making skills to make informed choices to reduce their risks of these unfortunate outcomes.

Teenagers are especially vulnerable, not only to sexual messages but also to sexual misfortunes.1,2 Adolescent pregnancy and childbearing, as well as STDs in adolescents, continue to be major public health problems in the United States. In 1981, an estimated 1.3 million adolescents became pregnant, and of these over 500,000 had live births.3,4 Over 80% of these pregnancies were unintended. Between 1971 and 1982, the proportion of metropolitan-area, never-married 15- to


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