Missouri leaves a lot of room for interpretation in its state statutes around sexual health education. There is no mandate that schools to provide sex education and is amenable to both Teen Pregnancy Prevention and Abstinence Only programs, as well as anywhere in between. Decisions about the depth of sex education that students receive is left up to the school board. In practice, this means that students across the state get wildly different education.

We wanted to see what this looks like in the St. Louis area. TPPP recently produced a report on current sex education policy in the St. Louis-area public school districts, which includes results from a survey with youth about their experiences with sex education. The report, St Louis-Area Sex Education: Policies Practices Experiences (which can be downloaded at the bottom of this page) will help TPPP in providing highly relevant professional development programming, and support efforts for advocacy around evidence-based and medically accurate sex education.

This survey was given to 55 students in the St. Louis region. These teens were disappointed with the sex education they received in school. They don’t feel that sex education gets enough time during the school day. This means that there isn’t time dedicated to the topics that teens report wanting more education on: LGBTQ+ topics, consent, and healthy relationships.

All St. Louis-area schools surveyed failed to meet NSES guidelines and only 1/3 of them met MSEP guidelines. Students at the schools with more comprehensive education policies reported learning about more than their peers without those policies. These results remind us that, although the teen pregnancy rate continues to decline, sex education is an essential part of teen’s education experience. It is essential that we continue to work with our stakeholders and partners to advocate for Missouri teens.

TPPP is currently conducting an evaluation of sex education policies and practices in St. Louis City and County public schools. As part of this process, we are organizing a Youth Review to gather teens’ perspectives on the sex education they have received in those schools. As of now, little publically-available data on teens’ first-hand experiences and opinions of sex education in St. Louis exists. We think that this represents a major gap in our understanding of the current state of sex education in our community. Teens’ perspectives are a vital piece of the picture and should inform the work we are doing to achieve a high standard of in-school sex education for our state. 

We have created this short, confidential, online survey that teens can complete in about five to ten minutes. Feel free to share this survey with the youth your serve who attend a public school in St. Louis City or County! 

Check-back in at our website to see the evaluation results that will be shared later this the spring.

If you have any questions, please don’t hesitate to contact Lucy Puckett, the practicum student who is managing this project, or TPPP’s Executive Director, Meg Boyko, directly. 

lpuckett@wustl.edu

executivedirector@teenpregnancy-mo.org 

Post Written By: Lucy Puckett, TPPP Practicum Student 

Findings from the 2017 National School Climate Survey (NSCS) by GLSEN–the Gay, Lesbian and Straight Education Network (pronounced “glisten”)–uncovered devastating realities for Missouri youth and points to the need for community partners to continue to rally behind strategic implementation of LGBTQ+ inclusion in our schools. The NSCS reveals that most LGBTQ+ Missouri teens experience targeted, anti-LGBTQ+ discrimination, often in the form of physical assault, in their schools. 

One of the findings, that 19% of Missouri students surveyed were prohibited from forming a GSA in 2017, is timely, as some local schools have come under scrutiny in the last year for prohibiting the formation of GSAs or have faced backlash from parents for allowing them. A GSA, or, Gender and Sexuality Alliance (formerly referred to as a Gay-Straight Alliance), is a voluntary, student-led organization which provides “a safe place for students to meet, support each other, and talk about issues related to sexual orientation and gender identity and expression” (GSA Network, n.d., para. 1).

“School-based supports such as supportive and inclusive school policies, school personnel who are supportive of LGBTQ students, GSAs, and LGBTQ-inclusive curricular resources can positively affect school climate for LGBTQ students” (GLSEN, 2019, p. 2). 

Further, only 14% of students reported having LGBTQ inclusive curriculum of any type taught in their schools, a number that has stayed the same since GLSEN’s 2013 NSCS. Additionally, only 3% of students surveyed reported receiving inclusive sex education. According to the CDC’s reports on Health Risks Among Sexual Minority Youth, LGBTQ youth are at higher risk than non-LGTBQ+ students of experiencing dating violence or forced sex, and are more vulnerable to some sexual risk behavior and unintended pregnancy (CDC, 2019).

Importantly, however, GLSEN notes in the full, nationwide study: “This report also demonstrates LGBTQ youth’s resilience, even in the face of hostile environments, and highlights the ways LGBTQ students are engaging in school, and taking steps to improve their schools and communities” (Kosciw et al., 2018, p. 4). 

Findings in Missouri

Below is a summary of key findings taken from GLSEN’s Missouri State Snapshot. We encourage you to look at the state snapshot and the full report, which include helpful graphics and summaries, and to share them within your agencies and communities. 

• The vast majority of LGBTQ students in Missouri regularly (sometimes, often, or frequently) heard anti-LGBTQ remarks. Many also regularly heard school staff make homophobic remarks (23%) and negative remarks about someone’s gender expression (44%). Fewer than 1 in 10 (7%) attended a school with a comprehensive anti-bullying/harassment policy that included specific protections based on sexual orientation and gender identity/expression.
• Most LGBTQ students in Missouri experienced anti-LGBTQ victimization at school. Only 18% of students who reported incidents said it resulted in effective staff intervention.
• More than 1 in 3 LGBTQ students (36%) and nearly 3 in 4 transgender students (72%) were unable to use the school restroom aligned with their gender.
• The vast majority (96%) could identify at least one school staff member supportive of LGBTQ students, but fewer (55%) could identify 6 or more supportive school staff. Approximately 2 in 5 (44%) had access to a GSA or similar student club which provides a safe and affirming space and promotes a more welcoming school climate for LGBTQ students. 
• Approximately 1 in 10 (14%) were taught positive representations of LGBTQ people, history, or events (“inclusive curriculum”). Only 3% reported receiving LGBTQ-inclusive sex education at school.

Action 

Recommendations & Resource Guide

Below are GLSEN’s recommendations along with links to our resource pages that include online, local, and regional resources. To download all resource pages, click here. 

“Given the high percentages of LGBTQ students in Missouri who experience harassment at school and the limited access to key resources and supports that can have a positive effect on their school experiences, it is critical that Missouri school leaders, education policymakers, and other individuals who are obligated to provide safe learning environments for all students take the following steps” (GLSEN, 2019, p.2):

1. Implement supportive and inclusive school policies, such as comprehensive anti-bullying/harassment and supportive transgender and gender nonconforming student policies
Click here to download a list of resources related to this recommendations. 

2. Support GSAs
Click here to download a list of resources related to this recommendations. 

3. Provide professional development for school staff, families and healthcare providers on LGBTQ student issues   
Click here to download a list of resources related to this recommendations.  

4. Increase student access to LGBTQ-inclusive curricular resources

Click here to download a list of resources related to this recommendations. 

Visit the Links Below for More Missouri-based Resources for LGBTQ+ youth and adults 

• PROMO’s community services directory https://promoonline.org/services# 
• TransParent supports and connects parents of trans youth, with chapters in Kansas City, Springfield, St. Louis, and St. Charles, Missouri https://transparentusa.org/chapters/missouri/. View their regional resource directory https://transparentusa.org/resources/find-local-resources/missouri/ 
• The Metro Trans Umbrella group also has helpful resource and service directories https://www.stlmetrotrans.com/other-services/
• ACLU’s Transgender Education and Advocacy Campaign https://www.aclu-mo.org/en/campaigns/transgender-education-and-advocacy-program 

References

CDC, & Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. (2019, January 1). Sexual Minority Youth | Disparities | Adolescent and School Health | CDC. Retrieved March 1, 2019, from https://www.cdc.gov/healthyyouth/disparities/smy.htm 

Kosciw, J. G., Greytak, E. A., Zongrone, A. D., Clark, C. M., & Truong, N. L. (2018). The 2017 National School Climate Survey: The experiences of lesbian, gay, bisexual, transgender, and queer youth in our nation’s schools. New York: GLSEN.

GLSEN. (2019). School Climate in Missouri (State Snapshot). New York: GLSEN. 

GSA Network. (n.d.). What is a GSA. Retrieved March 1, 2019, from https://gsanetwork.org/what-is-a-gsa/

Through the Eyes of a Survivor: Danesha

Danesha was fourteen years old when she was kidnapped and forced into sex trafficking. Throughout adolescence, Danesha was sexually abused by her mother’s boyfriend. In hope that her mother would empathize, she shared her traumatic experiences, but her mother did not understand. Due to these unbearable circumstances, Danesha became an underage prostitute. 

A year or so later, Danesha finally escapes the cycle of sex trafficking. After studying the streets, Danesha was able to communicate with the police. With the help of law enforcement, Danesha was relieved from the life of trafficking. Although Danesha escaped trafficking, she did not want to return home nor end up in foster care; so she found herself missing the feeling of being loved. Because she was seeking affection and nurturance, she returned to sex work. However, her experience was rather different this time around; she became pregnant and was arrested several times for prostitution. After spending time in jail, Danesha gave birth to a baby girl who changed her perspective on life, influencing her decision to flee prostitution and become the best mother for her daughter. You can hear Danesha’s story on the YouTube channel Not for Sale.

Changes to State Statute Proposed in Missouri

Sex trafficking is a global phenomenon, like Danesha, every survivor’s story is unique and may not result in the same ending. A victim’s experience with sex trafficking is deeply affected by experiences with the criminal justice system, including whether the victim is supported or penalized for their involvement in sex work. 

In Missouri, victims of sex trafficking can by criminalized and given jail time even for engagement in nonconsensual sexual activity. Victims are required to prove the existence of coercion in order to reduce the risk of being charged for prostitution and receive social services. (See Missouri Statute 567.020)

Consent is an important part of all sexual relationships. Sex trafficking, by its very nature, is not consensual. Although Danesha made a choice to return to prostitution, she was not legally capable of consenting to any sexual activity with adults due to her age. Sexual consent is defined as freely given, verbal, continuous, and an informed agreement to participate in a sexual activity. Lack of verbal or physical resistance or submission resulting from the use of force, threat of force, or placing another person in fear does not constitute consent. In Missouri the age of consent is 17 years old. A child/teen age 16 and younger is not legally able to consent to sexual activity with an adult. An adult who engages in consensual sexual intercourse with a child/teen age 17 or younger is a violation to statutory rape law.

Representative Coleman has introduced House Bill 397 that is currently moving through the Missouri legislature. Current statutes (567.020, 578.421 and 610.131) state that a person under the age of 18 with proof of coercion may be classified as a victim of sex trafficking. However, minor language changes have been made in HB 397; proof of coercion will no longer be required to be classified as a victim of human trafficking if the individual involved is under 18.

Considering it’s difficult to prove any form of coercion without evidence and possibly risks the health and safety of not only the victims but also their families, implementing this minor language change provides victims with an easier path to justice. Victims will be much less likely to be arrested and charged with prostitution but rather have a better chance of escaping the life and retaining the services needed. 

TPPP will continue to work with our members and partner organizations to monitor this and other legislation related to adolescent sexual health during the 2019 legislative session in Jefferson City. We hope you will contact us if you need information or support for your advocacy efforts.

In order to achieve health equity, it is crucial to center community voice and participation, along with data, for lasting and meaningful change. We’ve created a list of tools, tips, and resources to support you in applying the findings of our report, Teen Pregnancy, Infant Mortality, and STIs: A Profile of Critical Health Inequities, to your work and community. It includes key questions, local and regional resources, online toolkits, and action-guides for reducing racial health disparities and implement participatory practices.

Ours is not an exhaustive list and we welcome any resources you would like to share!

Click here to download our guide.

TPPP has introduced a comprehensive new report, Health Disparities and Inequities Among Youth in Missouri using key data sources to illustrate the current sexual health crisis and the urgent need for action. This report supports our critical mission of promoting adolescent sexual health and preventing teen pregnancy.  We have collated a wide range of local, national and international public health data to highlight disparate outcomes in teen pregnancy, infant mortality, STIs, and HIV rates. We compare Missouri with other U.S. states and identify the most vulnerable populations within our state.

Looking at data from Flourish STL and the Missouri Foundation for Health, the report points to what Flourish describes as a “crisis in our region,” where Black babies are four times more likely to die from SIDS than White babies, regardless of the mother’s level of education, a disparity linked to racism-induced maternal stress ¹. It also highlights the need for increased access to healthcare and medically accurate sexual health education (MASHE). Currently, 18 Missouri counties do not have access to a single publicly funded clinic that provides contraceptive health services, which makes these counties “contraceptive deserts.” Young adults aged 13-24 account for 30% of the 500 new HIV infections that occur each year in Missouri–an infection that is preventable through correct use of barrier methods and, once again, access to affordable youth-friendly healthcare. 

Finally, our new report outlines a series of promising actions put forth by Health and Social Services to reduce health disparities nationally.

This report is only an initial step in understanding how disparities impact young people. We expect that there is much to learn from conversations with young people and community members with lived experience, as well as local data.

Through the participatory efforts of our tireless and dynamic community partners, we have already seen dramatic reductions in the rate of unplanned teen pregnancies. By providing a robust picture of the remaining challenges impacting adolescent sexual health and a platform of solutions, we are hopeful our report supports stakeholders in identifying areas for collaborative action to improve health equity for all in the state of Missouri.

Download Health Inequity Report

Sexual harassment and sexual violence are significant problems in the United States. 1 in 3 women and 1 in 6 men will experience sexual violence involving physical contact during their lifetime.¹ Sexual violence and harassment can lead to lasting and harmful effects on the victims, victims’ family and friends, and the community. However, teaching what sexual consent is can prevent sexual violence from occurring and increase awareness and understanding of this public health issue.

In the United States there are just 24 states and Washington, D.C. that require sexual education to be taught in public schools, and Missouri is unfortunately not one of those states. Currently, sexual education in Missouri is optional; the school districts who do provide sexual education can decide which curriculum to use (if any). In July, Gov. Mike Parsons signed a bill which amends Missouri State Statute 170.015, the statute that regulates sexuality education in public schools. Starting in August of 2018, sexual consent, sexual harassment, and sexual violence were all added as topics that should be covered if a school provides sexual health education. The following definitions were included in the newly signed amendment:

• Sexual consent- is a freely given agreement to the conduct at issue by a competent person. An expression of lack of consent through words or conduct means there is no consent. Lack of verbal or physical resistance or submission resulting from the use of force, threat of force, or placing another person in fear does not constitute consent. A current or previous dating or social or sexual relationship by itself or the manner of dress of the person involved with the accused in the conduct at issue shall not constitute consent.
• Sexual harassment- is any uninvited and unwelcome verbal or physical behavior of a sexual nature, especially by a person in authority toward a subordinate as mean causing or attempting to cause another to engage involuntarily in any sexual act by force, threat of force, duress, or without that person’s consent.
• Sexual violence- is causing or attempting to cause another to engage involuntarily in any sexual act by force, threat of force, duress, or without that person’s consent.

It is important to teach about sexual consent and healthy relationships and these changes to the state statute encourage schools to include these sexual health topics in their curriculum.  According to a study of 1,300 middle school children, 43% of the students surveyed reported being victims of sexual harassment.² In addition, 1 in 3 female rape victims experienced rape between the ages of 11-17.³ With many children and teenagers experiencing sexual harassment or violence, it is essential to start sexual health education and prevention programs as early as possible to stop harm before it starts. The CDC has published guidance and technical support, entitled STOP SV, for this reason. This online resource details necessary strategies to prevent sexual violence.⁴ Requiring schools to include consent, sexual harassment, and sexual violence in their curriculum can lead to fewer sex-related crimes by increasing awareness and understanding of the issue at an early age. The new amendment to Missouri State Statute 170.015 will lead to positive health changes in Missouri by highlighting the importance of sexual consent and healthy relationships to adolescents as part of their health education.

This is exactly why the Associated Students of the University of Missouri (ASUM), a student run advocacy group that lobbies in Jefferson City on behalf of the roughly 72,000 students in the University of Missouri System (Missouri S&T, UMSL, UMKC, and Mizzou), proposed this amendment to the state statute. Each year, the ASUM Board of Directors sets the legislative agenda for the year and then lobbies for legislation in Jefferson City.

Being on a college campus, it is difficult to ignore the problem of sexual assault or harassment because it is so prevalent. As student leaders began looking further into the issue, they noticed some alarming statistics that pointed to this being, not only a college campus issue, but a national issue as well.  One of the most alarming college statistics dealt with the “Red Zone” (the time between the start of school and Thanksgiving break when about 1 in 5 women will experience assault or attempted assault). While colleges are making an effort to educate their students, it often comes too little and too late. The changes to Missouri State Statute 170.015 aim to provide consent education during high school. This not only helps educate students before they get to college, but it also helps educate those who do not attend college. ASUM is hopeful this legislation will better educate students about consent and reduce the number of incidents of sexual harassment and sexual violence across the state.

Agencies and advocates from across the state joined ASUM in supporting the revisions to the state statute. As the change goes into effect in August, Teen Pregnancy & Prevention Partnership continues to partner with educators and school districts to ensure that high quality lesson plans and additional resources are available for teachers and students. Below is a list with links to these resources:

Loveisrespect.org

Amaze.org

KidsHealth.org

CoachesCorner.org

Advocates for Youth offers a free comprehensive curriculum, Rights, Respect and Responsibility, that can be downloaded at their website AdvocatesForYouth.org. Here are some examples of the lesson plans that you can get from Advocates for Youth related to consent, sexual harassment and sexual violence:

Lesson 3: My Space, Your Space- Kindergarten

Lesson 3: Understanding Boundaries- Grade 6

Lesson 7: Warning Signs: Understanding Sexual Abuse and Assault- Grade 8

Lesson 3: It Wasn’t My Fault- Grade 9

Lesson 2: My Boundaries- Grade 11

In addition, TPPP has created fact sheets which can be downloaded and shared to ensure schools, teachers and parents understand the changes to the state statute and the impact of those changes. You can download them here or contact TPPP for electronic copies.

Fact Sheet on Changes to the Missouri Statute 170.015

Fact Sheet with Definitions

Overview of Topics Added to State Statute

References:(1) Centers for Disease Control and Prevention [CDC] (2018). Sexual Violence Prevention. Retreieved from, https://www.cdc.gov/features/sexualviolence/index.html(2) Espelage, D.L. (2016). Sexual harassment common among middle school children, study finds. Retrieved from, https://phys.org/news/2016-12-sexual-common-middle-school-children.html#jCp(3) Smith SG, Chen J, Basile KC, Gilbert LK, Merrick MT, Patel N, Walling M, Jain A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 State Report. Atlanta, GA: National Center for Injury Prevention and Control, Centersfor Disease Control and Prevention.(4) Centers for Disease Control and Prevention [CDC] (2018). Sexual Violence. Retrieved from, https://www.cdc.gov/violenceprevention/pdf/SV-Prevention-Technical-Package.pdf

Every May brings reflection as it has traditionally been Teen Pregnancy Prevention Month. Thanks to dedicated volunteers and data from state and national sources, we are proud to present a new report on teen pregnancy/birth and adolescent sexual health in Missouri.

Even as teen births have declined in recent years, there continue to be areas of Missouri where rates remain high. Rates of sexually transmitted infections (STIs) have not seen the same downward trend and other health and community outcomes vary widely between Missouri counties. In the report Teen Pregnancy and Adolescent Sexual Health in Missouri: Factors, Trends, and Impact (which can be downloaded at the bottom of this page), data is combined in multiple ways to highlight counties and regions of our state where the health of young people is being impacted. This report is intended to provide an overview of existing resources and trends that draws stakeholders together to explore local data, gather additional input from young people, and create programs that will promote adolescent sexual health. 

We hope this report is only the beginning of more discussion and local partnership to support young people in creating the future they want for themselves and their community. It is also being released at a critical time as the Department of Health and Human Services recently announced the federal funding opportunity for the Teenage Pregnancy Prevention Program. For more information related to the report or for ideas on how the Teen Pregnancy & Prevention Partnership can support your community in promoting adolescent sexual health, please contact TPPP.

On Friday January 19^th TPPP members gathered for the first 2018 Professional Development event, Technology Trends & Tools. This event was held at the Thomas Dunn Learning Center (3113 Gasconade Street St Louis, MO 63118) which will be the location for all bi-monthly professional development events in 2018.

Technology Trends & Tools was facilitated by Meg Boyko, and featured a webinar fromAnswer, a Rutgers agency which provides information about teen health and sexuality in a variety of media forms. Answer’s award-winning website and magazine Sex, Etc. is created by teens for teens. Their website features a state by state breakdown of laws regarding adolescent sexuality, FAQ where teens answer submitted questions, trivia games to test your knowledge on birth control methods, and more.

Attendees discussed how digital media affects young adults and teens in relation to theNational Sexuality Education Standards. Some of the pros of digital media included; easily accessed sexuality information through internet access, LGBTQIAA students being able to reach out and find community through technology, and facts about birth control methods being readily available. Cons discussed were; the rise in cyber bullying, body negativity based on impossible beauty standards featured on venues such as Instagram, and the possibility of young people not being capable of distinguishing medically-accurate websites from non-evidence-based (or even misleading) websites.

Technology trends were shared throughout the event, including data on what mobile apps teens are using most often. The most popular app in 2017 among young people ages 12 to 24, with a 79% use rate, was Snapchat. This was followed closely by Facebook at 76% and Instagram at 73%. Attendees broke into small groups and explored other apps including WhatsApp, Omegle, and Musical.ly. The groups considered the possible benefits and drawbacks of each of these apps for teens.

Apps can also be used for sexual health and personal safety. Attendees looked at theBedsider Birth Control App, Eve, and Circle of Six and considered their features and utility. Several attendees noted that the Bedsider Birth Control App and Eve featured gendered language that may not be inclusive to all users. An alternative, which does not appear gendered in its design or language, is Clue.

TPPP members and partners are also encouraged to explore sexual health resource websites and evaluate them for quality of information. Three suggestions for further exploration are Amaze, Common Sense Media, and Planned Parenthood. Attendees contributed other ideas for resource websites, including Scarleteen which features a Sex and Disability section, and Adventures in Sex City which is a game for young adults to build knowledge in a fun interactive way.

March 3^rd TPPP will present Not Another Trivia Night, a chance to test your knowledge about sexual health while having fun! Then, March 9^th at the Thomas Dunn Learning Center please join us for our next Professional Development event. If you have a new email, or are interested in joining the TPPP email list for updates and reminders, please reach out to Meg Boyko at ExecutiveDirector@teenpregnancy-mo.org

On October 13, members of Teen Pregnancy & Prevention Partnership and sexual health educators from across the St. Louis region met for a networking and information-sharing event. More than 15 organizations were represented along with individuals working in the community. The group provided valuable feedback to TPPP about the barriers they face providing sexual health education in the St. Louis region, as well as, information about what professional development topics they need to be supported in their work. You can download a summary of the feedback below.

At the end of the event, TPPP previewed a new youth-friendly service directory. 

For more information about the event or how to partner with TPPP, please contact us at info@teenpregnancy-mo.org