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Not Your Usual Sex Ed: The Unexpected Results of Teaching Teens Fertility Awareness

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MARGARET BRADY [8]

[9]Do you remember your first “very special” health class? Mine was taught by a middle-aged lady whose first priority was eliminating dirty fingernails. She stalked around our fifth-grade public school classroom, examining each girl’s hands, prepared to name and shame any offenders.

Besides the hygiene review, we also received a blurry diagram of the female reproductive system. The teacher unconvincingly strove to impress upon us that we each had inside ourselves a duplicate of this diagram, and that soon these organs would power on, like a self-aware computer. As far as I was concerned it may as well have been a map of the battle of Gettysburg, labeled entirely in French.

She explained that an egg would one day travel down one of our tubes like a marble, and if that egg wasn’t fertilized by sperm, “it” would happen. “It,” the teacher made clear, was an unstoppable part of life. The train was bearing down upon us and there was no way to unstrap ourselves from the track. Carnage—ahem, menstruation—was inevitable.

We also watched a sappy video produced under the mistaken assumption that all tween girls long with their whole hearts to get their periods, grow breasts, and most of all, be noticed by boys. I was in no hurry to grow up, and I experienced the same feeling of loneliness I got from reading Judy Blume novels. The girls in the video, like the characters in the Judy books, seemed anxious and very unhappy, so I was glad their problem was not my problem. Still, was there something wrong with me? Should I be worried that I wasn’t worried about eggs and tubes and bras?

Unless you were very lucky, you can probably tell a similar story about your first sex-ed experience. It was probably strange, awkward, and not what you needed. Can you imagine another way? What if the way kids learned the “facts of life” was positive, useful, and even feminist?

Fertility awareness has been grabbing headlines recently as women discover one of medicine’s best kept secrets—that they can plan their families [10] without being chained to a pill bottle [11]. But fertility awareness is not, at its core, about avoiding pregnancy. It proposes the radical notion that women are people with bodies that deserve to be studied, understood, and appreciated. I spoke with three women helping lead the fertility awareness charge to find out what that looks like with teenagers.

Sex ed that teen girls actually want to learn

Cassie Moriarty [12] is a women’s health dynamo based in New York City—she’s a certified breastfeeding counselor, a trained DONA [13] postpartum doula, and knows multiple methods of natural family planning. She’s also a certified teacher for FEMM [14], a comprehensive women’s program that helps women understand how their cycle intersects with their health.

“I got involved with TeenFEMM when I was training with FEMM,” Moriarty says. “I saw it as such an opportunity. I view sex ed as something that happens periodically throughout one’s life rather than a conversation that happens once; sex ed should happen even throughout your twenties. The idea of teaching teens about fertility awareness sets a great foundation for young girls with their bodies.”

Moriarty works with clients of all ages, usually in small groups or in one-on-one sessions, sometimes even with OB/GYNs alongside teens who are dealing with hormonal disorders. Regardless of the setting, the material hits home.

“Honestly teens are some of my best students!” says Moriarty. “For one, they are in the swing of learning. They are used to having homework and pop quizzes. Almost everyone I have taught has been bright, mature, curious, and excited . . . they are usually more intrigued than embarrassed. I joke that the couples I work with who are getting married sometimes act more squeamish than a 13-year-old girl.”

I asked Moriarty what young women can learn from fertility awareness that they may never discover otherwise.

“The biggest most obvious piece is cervical fluid. That is something virtually every teen girl experiences, and just about all of them aren’t taught about it in their public school sex ed. A lot of young girls, like myself at that age, experience shame about a totally normal bodily function,” she told me. She also says that students benefit from hearing “a different angle” than simply “Don’t get pregnant!”

I remember as a 13-year-old feeling like pregnancy wasn’t even close on my radar . . . but I did want to know more about that strange bleeding I was experiencing. And headaches and cramps.

“Sex ed is usually built upon the message of ‘here’s how pregnancy happens, here’s how to avoid it’ rather than ‘here are these amazing (and sometimes annoying, strange, and intrusive) things your body is doing.’ I hardly even talk about pregnancy in the first few classes. I talk more about mental health, hormonal health, and cycle health.”

Your body is feminist

Leah Jacobson had been working with young people and moms for more than a decade by the time she founded the Guiding Star Project [15] in 2011. She saw a deep, unmet need for an initiative to bring together whole-woman feminism and women’s health. Guiding Star Centers around the country offer a variety of location-specific health-related services like childbirth education, breastfeeding support, postpartum care, and family planning to help women achieve or avoid pregnancy. It also includes fertility awareness outreach to young girls.

“The core of these programs and our philosophy on fertility, is that there’s nothing wrong with our fertility. It’s a really beautiful part of who we are,” Jacobson says. “It’s our belief that by giving [young people] the tools and the education to understand their bodies, they’re going to make better decisions that are in line with avoiding risky behaviors. They’re going to care for their dignity and the dignity of their partner.”

In our culture, which regards a woman’s fertility as an obstacle or a potential threat to her success and happiness, Jacobson has seen first hand how women have lost touch with their bodies.

“It’s sad; we have had women come in for the first time to learn how to chart their cycle, and you explain to them more than once that they have to come off the Pill to chart,” Jacobson told me. “They don’t understand, because they somehow think that they have a natural cycle, when what they actually have is withdrawal bleeding [when they take the ‘inactive’ drugs in their pill pack]. That’s an incredibly shocking and alarming situation for women to be in. They feel empowered, they feel like they’re ‘doing something’ because they’re taking the Pill. But for them to not even know that they’re not ovulating and that they don’t have a cycle . . . that’s disturbing, because it means they don’t at all understand the function of these drugs that they are [taking].”

For so many of us, that confusion starts at the very beginning, with that first period. Almost as a rite of passage, many moms take their daughters to the doctor, who may perform a pap smear but who almost certainly will want to discuss medication to “treat” and control her new, risky state of natural fertility.

The result is that thousands of children are prescribed synthetic hormones. It’s clear many kids are never told how the Pill works, nor are they routinely screened and warned about the Pill’s links to depression [16] and breast cancer [17]. Some girls stay on the drug for decades [18], until they decide to have children—only to confront the reality that they know virtually nothing about what to expect from their bodies once the medication leaves their system.

This is even more so the case if girls complain of symptoms like cripplingly painful periods or irregularity. Few OB/GYNs make the effort to find out what is wrong when hearing of period symptoms.Take for example endometriosis, a painful condition that affects one in every ten women [19] and can destroy a woman’s quality of life and fertility. Even though it is one of the most common diseases affecting women’s health, it takes a woman an average of seven years [20] of suffering, begging, and doctor-shopping before she can get a diagnosis. Because hormonal contraception covers up the symptoms of diseases like endo, doctors often employ birth control as an easy fix for any potential reproductive problem—as if passing the buck to the next doctor to figure out whatever it may actually be. One study [21] from the Guttmacher Institute found that more than 80 percent of teens on the Pill had been prescribed contraceptive meds for non-contraceptive reasons.

“What is our health-care system doing? This is a complete act of paternalism,” Jacobson says. “It’s dignifying to tell girls the truth about themselves. It should be the core of feminism. Feminism that fails to acknowledge the female body does not have women’s best interests at heart. All it is, is a facade for a male normative culture. Fertility is a liability to how success is currently defined in [that culture].”

Authentic feminism, according to Jacobson, will “redefine the worldview—not just accept the male normative world and say we have a right to fit ourselves into it. It’s confusing to tell our daughters, your breastfeeding is good, you should breastfeed, but your fertility is dangerous, you should suppress that. We have to have a consistent narrative. It’s all good.”

Each Guiding Star center has different programs, ranging from the Guiding Star Cycle Show [22]—a five-hour, interactive, hands-on experience for young girls—to offerings that can be accessed online, particularly useful in the era of coronavirus. Jacobson specifically points out that the programs are science-based and secular. “Our presentations don’t have a religious aspect. . . . We want every girl regardless of any religious affiliation to understand this applies to her,” she says. They’re already used in public schools in Germany, China, and the United Kingdom.

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