Medical Accuracy
My experience with the myth
“Medical accuracy” is a term coined by the reproductive action arm of the ACLU during the Kendrick vs. Bowan Supreme Court decision. The litigants charged violation of separation of church and state then threw in several other “lesser” charges in the lawsuit. Even though abstinence education won the case and was pronounced within the appropriate guidelines for federal funding, a lower court ruling, and finally, Kendrick vs. Bowan Settlement was made through the Office of Population Affairs. At that time, the office allowed a clause that would let the reproductive rights organization challenge each federally funded curriculum for “medical accuracy.” The settlement provision was to be dropped after 10 years from the department’s requirements but the department created a self imposed censorship for medical accuracy to avoid conflict.
Washington State picked up on this terminology and inserted it into its HIV legislation in the late 1980’s. On the surface the purpose of the legislation was to control content and suggested that school committees were unable to present scientific information without the control of the HIV/AIDS Office, but underneath the office was politically motivated to ensure that condoms were promoted as “highly effective.”
The Office of Superintendent of Public Instruction (OSPI) and the HIV/AIDS Office had only two requests for reviewing curriculum for medical accuracy that year. Surprise--surprise, they were both abstinence until marriage curricula. Over the next several years, any abstinence oriented program was reviewed and deemed medically inaccurate, including Medical Institute and Focus on The Family materials (both reputable organizations who do their homework). While the program advocating the use of Saran Wrap as an emergency condom, received approval and state promotion. (The author now promotes explicit comprehensive Sex Education with federal and state funds.) The program wasn’t revised for over a decade. During those years, packets of information were sent out across the country from the OSPI charging medical inaccuracy as well as racism and sexism. Medical accuracy reviews encompass more than factoids and footnotes.
Attorneys deposed the authors of the OSPI critique and found that sexism was a “positive view of marriage.” The deposition revealed that OSPI found the skill of goal setting to be “an historically male activity” OSPI also found the use of a soccer ball, a graduation hat and a car as sexist symbols leaving women out of the curriculum.
The state approved model materials that were not updated for 15 years. Schools continue to use outdated and often do not even teach the mandated HIV education because of the cumbersome and frightening process. School districts are only allowed to use approved materials. The schools or publishers have no means for challenging the opinion of the officials or have a process for submitting new materials from non approved publishers. There was and still is no due process for submitting new or revised materials from publishers therefore unchallenged rulings from 20 years ago are still being posted as “medically inaccurate” on their web site. Publishers have no way of resubmitting updated materials for approval. Is this furthering the cause of current information?
The offices’ problems with “inaccurate” materials were that they promoted abstinence until marriage and that they did not demonstrate or have students practice using condoms. After a meeting with OSPI plus two private attorneys and two physicians, the OSPI office could only challenge one footnote from more than a hundred. That footnote was from the CDC. They asserted that they didn’t like its conclusion, and methodology. So it is not enough to cite footnotes that are peer-reviewed, they must be footnotes that are accepted by the state office that has power to control information. More recently, a legislator supporting medical accuracy legislation said she wouldn’t accept CDC data, “it was inaccurate and political.”
This phenomenon of “medical accuracy” was not isolated. It spread from Washington to Florida where abstinence education was being widely received. Planned Parenthood and the Jewish Women’s League sued the Jacksonville School District. After 5 years of depositions, the case was dropped because no inaccuracies were ever found. However, all the sales to Florida and many other places were killed, leaving a shadow over all abstinence for several years.
The Waxman Report followed the lead of these 1990’s censors because both took quotes out of context to create the case desired. Waxman’s goal is to eliminate funding for all youth serving programs that promoted abstinence until marriage. Political agendas cannot drive skill-based programs that happen to include information about disease risk. Critics forget that abstinence programs are not medical programs, and generally are taught to students under age 16. The students do not have medical minds and need information presented at their level of understanding.
It may seem radical to talk about the Constitution but speech is not free when it is controlled by a department of the state. The unsolvable hurdle for implementing medical accuracy, legislation and policy is that it requires “an Oracle of truth.” Ultimately some agency determines “accuracy”/TRUTH. Controlling thought and speech as well as commerce is not the American way.
Many opponents of abstinence education define “medical accuracy” as the use of peer-review citations. Abstinence education materials have copiously cited medical journals since its inception in 1981. However, the use of the term “peer-reviewed” was not used in any other health curricula or science program until the political use of the term appeared.
Peer-review is a tactic of anti-abstinence and medical accuracy advocates that should be uncovered. Peer-review opinions change over time. (Remember contradicting studies on salt, coffee, wine, Viox and Ephedrine or John Santelli in the Journal of Adolescent Health.) Therefore, they were not the ultimate truth, but part of a process. Recently peer-review journals have had misinformation submitted and life-threatening consequences occurred.
A key fact to remember is when it comes to abstinence education, medical journals are not peers. They are not abstinence educators. In fact, most journals have policy statements denouncing abstinence education as a viable option. In the last few years, a Harvard professor wanted to submit research showing the role of abstinence and fidelity in reversing the spread of HIV in Uganda, he was denied review.
So who will be the office that has final authority over accuracy?
Considering who coined the phrase, why it was coined, and how it’s been used, one must seriously pause before embracing the politically charged concept that opposes the freedom of thought by medical doctors writing abstinence materials. In the medical field, (not the political field) second opinions from other medical experts are welcomed, often recommended and even paid for by insurance companies. It is time for abstinence educators to stand up for their rights and demand that a second opinion be allowed within the reproductive health discussion, without state censorship.
This op-ed piece is written by LeAnna Benn an abstinence educator of 25 years. She lived the process, she was deposed by the ACLU and Planned Parenthood, she was defamed, nearly bankrupted and she continues to proclaim abstinence until marriage.