We’ve talked about it before, and we’ll probably talk about it again: stigma is a huge barrier to building healthy young people and communities. Every day, we see kind, supportive, caring youth-serving adults (YSA) unknowingly contribute to the shame and stigma that surrounds sexual health topics. So, where do shame and stigma pop up, and what can we do to combat them? We’ve outlined some specific topics below, along with talking points to avoid and some to use. 

As a general rule, try to frame things in a way that assumes someone in the room has a personal experience with whatever you’re discussing. This is a great way to make sure what you’re saying doesn’t feel alienating. For example, instead of saying “It’s hard for people with HIV to chest-feed their babies without passing the virus along,” (which assumes the students don’t need to know how someone can be HIV+ and have an HIV- baby) you could say, “With the help of a doctor and the right medication, people who are HIV positive can carry, deliver, and chest-feed HIV-negative babies.” 

The core message is the same – it’s important for someone who is pregnant and HIV positive to get proper medical care so they and their baby can be healthy, but in the second example, we are providing more context and information so that if youth or someone they know is HIV+ and pregnant, they can advocate for access to care. Now let’s dive into some specific topics to see how stigma shows up.

Abstinence

Even in comprehensive sex education, it’s common for YSA to overemphasize abstinence. You might be asking yourself, “How can you overemphasize the safest option for young people?!” 

It’s a fair question! Abstinence is the only 100% effective method against pregnancy, and it offers pretty excellent protection against STIs, too. It’s important to talk about abstinence, of course, but it’s also important to acknowledge that it isn’t the right choice for every youth we encounter, nor is it a reality for every youth we encounter. Sexual violence is a much more common experience, even for young people, than we like to think, and sex education should not contribute to the shame or stigma survivors often deal with.

Avoid saying things like:

  • Abstinence means not having sex until marriage.
  • Abstinence is the right choice/best choice
  • People your age should be abstinent
  • Having sex as a teen can have a negative impact on your relationships later in life

Instead, say things like:

  • Abstinence means a person is choosing not to engage in behaviors that could cause pregnancy or pass STIs. Behaviors that can pass STIs include oral, anal, and vaginal sex. Vaginal sex can also cause pregnancy. 
  • Abstinence is a choice someone can make at any time, even if they have had sex before. It doesn’t matter how old they are or what their relationship status is. 
  • Abstinence can be a long or short-term decision. Some people wait to have sex until they accomplish a set goal, like finishing school. Other people may decide not to have sex because they don’t have protection. In both situations, people are choosing abstinence for different reasons and different lengths of time, and that’s okay! 
  • Everyone deserves the right to decide whether or not they want to have sex, with whom, and when. Sometimes, one person might take that choice away from another – this is called rape or sexual assault and it is never okay. If this has happened to you or someone you know, you deserve care and support. Talking to me or another adult you trust can help ensure you get the support you need. 

Pregnancy Options

As YSA, it isn’t our role to decide for students the “best” or “right” pregnancy option for them. Instead, our role is to provide information without stigma. Every person and every pregnancy is different, and young people deserve to know about any and all options available to them. Anytime someone is pregnant, they can choose to continue the pregnancy and become a parent, to continue the pregnancy and make an adoption plan, or to end or terminate the pregnancy through abortion. We’ve highlighted information about adoption and abortion in this section – young parents & families have their own section toward the end of the blog, so keep reading!

When it comes to adoption, here’s a quick terminology guide:

Instead of…Consider using…
Real parent/natural parentBirth or biological parent
Own child/real childBirth or biological child
Give away/adopt out/give up/put upMake an adoption plan/choose adoption
To keep the childTo parent the child
Blood relativeBirth relative

When it comes to abortion, consider saying things like:

  • Abortion is a safe and legal way to end or terminate a pregnancy.
  • People have different feelings or values about whether or not abortion is okay. Talking with your family or trusted adults can help you decide how you feel. 
  • Each state has different laws related to abortion.
  • The vast majority of abortions happen in the first trimester (up to 13 weeks). 
  • When abortion does happen later in pregnancy, it’s typically due to one of three reasons:
    • 1. A fetal anomaly, which means the fetus or baby stopped developing or has a condition that makes them unable to survive outside of the uterus
    • 2. Maternal life endangerment, which means that the person carrying the pregnancy could die if they continue the pregnancy
    • 3. Lack of access – According to the Guttmacher Institute, 89% of counties in the United States do not have an abortion provider. Cost, being unable to miss work or get time off work, being unable to find care for one’s children, and more, can all impact a person’s ability to access abortion care when they need it.

Sexually Transmitted Infections

STIs are among the most stigmatized topics in comprehensive sex education today. We almost always teach from a prevention lens, which assumes that our students don’t have an STI right now, so we should focus on how to keep them from getting one. The truth is that most people will get at least one STI at some point in their life! Of course, prevention is an important part of the conversation, but if all we talk about is preventing STIs, we are unintentionally stigmatizing folks who have STIs. We’re making it seem like they are less worthy or desirable. 

STIs are incredibly common, and one of the biggest barriers to stopping their spread is the shame that comes with testing positive. This shame doesn’t result in safer sex, it actually results in sex that is less safe, because people avoid testing altogether. If we can work to eliminate that stigma, more folks will get regular testing and treatment, and STI rates will decrease!

Avoid saying things like:

  • STIs can damage your physical, social and emotional well-being.
  • STIs can kill you.
  • STIs are dirty.

Instead, say things like:

  • With proper medical treatment, people who get an STI can live safe, happy, healthy lives, including having healthy sexual relationships, without passing the STI on to their partner!
  • Some STIs can be cured completely. Some STIs stay with a person throughout their life, but the symptoms of the STI can be treated. Either way testing and medical care are really important!
  • Anyone can get an STI if they engage in behaviors that pass STIs, just like anyone can get the flu. Having an STI doesn’t make someone dirty, it means they have an illness and they need treatment.

Young Parents + Families

What we know as sex education started out as primarily moral instruction, it wasn’t fact-based or medical in nature. The primary focus was to discourage sex before marriage and especially procreation outside of marriage. So it’s no wonder that we see the remnants of that intention even today.

When talking about young parents and families, avoid saying things like: 

  • Teen parents
  • Unwed mothers
  • Babies having babies/kids having kids, etc.
  • Most teen moms don’t finish school/don’t go to college/etc. 

Instead, try saying things like:

  • Young families, young parents
  • It can be tough to balance school or work and raising a family, but with the right support, it is possible. 
  • Pregnant and parenting students are federally protected from discrimination in their education by Title IX. (You can read more about these protections here). 

When in doubt, ask yourself, “If this applied to me and someone said that, how would I feel?”

Resources for continued learning:

Abortions Later in Pregnancy, Kaiser Family Foundation

Guttmacher Data Center, Guttmacher Institute

RSEI Webinar, May 2019, “Is Teen Pregnancy Prevention Problematic?”

RSEI Webinar, December 2020, “Destigmatizing Birth for Young Folx”