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Pills and Dirty Books for Everybody!

I’m never sure how news-wise y’all Gentle Readers are. Have you been following the whole business of the Portland (ME) school board, the clinic at the King Middle School, and contraceptives? Short version, the school board is allowing the clinic to prescribe The Pill to middle-school students without specific parental permission. Since middle school is presumably 6th to 9th grades, that means that in theory eleven-year-old girls might get on The Pill without their parents knowing. I wouldn’t blame you, Gentle Reader, for being sick of the whole story, but bear with me.

I was listening to NPR recently, it would have been, yes, it was Talk of the Nation on Monday, and I was getting all infuriated by the discussion of priceless virginity (actually spouted: can your pills mend a broken heart?) and how easy it is to spot those students who lack love and are therefore more likely to be having all that nasty sex. Your Humble Blogger is aware that people really do talk like that, but I am fortunately shielded from most of it. In fact, almost all of that sort of rhetoric I do see is reprinted on various pro-choice blogs for the sole purpose of mocking it, and I tend to discount (as I should, and as should you) the craziness displayed, because the bloggers are cherry-picking the most mockable stuff, so that their blogs won’t be quite so dull as mine. Anyway it’s always a shock to discover in real life that people really are as crazy as my fellow Left Blogovians think they are.

Part of what disturbed me, though, was that I really am ambivalent about making contraceptive pills available to pre-teens. That may just be my squeamishness about pre-teen sexuality, but then, I am squeamish about pre-teen sexuality, and furthermore, I think people should be at least a little squeamish about pre-teen sexuality. Even the ninth-graders, and I think we can assume that there will be at least a few students who will be fifteen by the end of their ninth-grade year, seem very young to be having sex. So if I were told that the middle-school which my Perfect Non-Reader will attend will have a health clinic that may provide prescriptions for contraceptives without my (or my Best Reader’s) specific approval, I would be … I don’t really know, actually. I would be ambivalent, I expect.

What I was eventually able to articulate, through conversation with my Best Reader, was that I can easily imagine a situation where an eleven-year-old girl ought to have a prescription for contraceptives, and that her parents should not be informed, and that in those rare, unfortunate, but conceivable circumstances, I would prefer that the clinicians be allowed to recognize that and act on it.

Digression: This reminds me of my rant about Banned Books Week, which was last week or the week after. I want some books to be banned from the local primary school library, which is the same thing as saying that there are books I don’t want to be in the library. I just want the librarian to make that decision. The librarian knows more than I do about the books and about the students, and more than the other parents do about the books and the students, and we have to either trust the librarian or get a new one we can trust. It’s not about whether any books get banned, or even which books get banned, it’s about who bans them. End Digression.

The problem, as was pointed out by Becks over at Unfogged, is that my ideal world with smart, capable, perceptive, well-paid clinicians spending loads of time getting to know the students closely does not necessarily closely resemble the real world. It might. I’m not sure. It doesn’t always, I know that. I wasn’t personally asked to take a pregnancy test at my college health center, but every single female student in knew who went in for any reason whatsoever was. It’s easy to imagine a smart policy (make contraception available, don’t stock acquisition inappropriate books, discover pregnancies early) degenerating into a dumb policy (put them all on The Pill, ban Harry Potter, make the student with the sprained ankle pee on the stick).

I wouldn’t want contraceptive prescriptions to become routine at the middle school level, particularly the early middle school level. But I wouldn’t want to ban them altogether. If it your town, Gentle Reader, what would you do?

Tolerabimus quod tolerare debemus,
-Vardibidian.

Comments

Well, I'm actually in favor (in theory) of absolute freedom.

I'm also in favor of swords that glow and hum in the presence of evil. It would make it so much easier to impeach Cheney. "See? Look! It's glowing and humming! What else do you NEED, people?!?!" Unicorns would be nice, too.

Sometimes, however, reality interferes with those things of which I am in favor.

I guess all that is to say that I would prefer that eleven-year-olds who need contraception would be able to get contraception, and that librarians would not censor the availability of books. But similarly, I would prefer that someone who is offended by the notion of a sexually active eleven-year-old not be ordered to actually hand it to her, or what-have-you.

Ideally, it would be nice if everyone were wise enough not to do foolish things and tolerant enough not to mind when someone did something foolish.

Can I have my glowing, hummy sword now?

peace
Matt


When I first heard of this story, it was told from the point of view that I should be outraged. That's how the news on the radio presented it, and that's how my coworkers presented it. When I read the story, I noted two details missing from the office chatter:

1) Once a child has permission from his/her parents to use the free clinic, the child is entitled to the same confidentiality any patient is supposed to be entitled to.
2) As of the time the story came out, no contraception had been prescribed to any of the students. The clinic nurse was asking the school board about the possibility of doing this, since some of the students were already sexually active.

We might not want to think of sexually active 6th graders, but they exist. A friend of mine in Maryland teaches elementary school. After school, he has tutoring sessions with some students who need to catch up on core subjects in order to be up to speed for middle school. He told me of a student he was tutoring who, while not particularly bright, was still underperforming in her studies. It seemed she just couldn't keep her mind on topic. She needed help with math, particularly word problems. He worked with her at breaking the word problems down to the point where they could be expressed in simple math terms.

At one point, he postulated, "Say you have a $20 bill..."
She interrupted, "Oh, I made four of those last night!"

At that point, he knew why her mind wasn't focused on school. She knew something was wrong, but she was being rewarded for it as well. I wish I could tell you that he knew exactly what to do to get her out of a dangerously icky situation, but short of turning her life inside-out, there wasn't a whole lot he could do.


It's a difficult topic. The key point for me, though, continues to be that teens are having sex. I imagine they always have, and I suspect they always will.

The average age of first sexual intercourse in the U.S. in 2005 was about 17 (see also an Advocates for Youth stats page), but that's an average (not sure if it's a mean or a median); among U.S. girls and women aged 15-24 in 2002-2003, 14% had sex before age 15 (PDF) (see table on p. 76). (I imagine that number varies quite a lot by region, class, race, and plenty of other factors. And I'm not sure what definition of "sex" they used, but in this context I'm assuming intercourse.)

Unfortunately, about 20% of those "reported their first intercourse as not voluntary." Still, that means that (if I'm calculating right) about 11% of U.S. girls these days have had self-defined-voluntary intercourse before age 15. (Yes, yes, that "voluntary" brings up lots of further issues about capability of consent and so on. I'm not defining terms, just using the ones the CDC used.)

Anyway, setting aside the voluntariness issue, it sounds like roughly 1 in 7 15-year-old girls in the U.S. have had sex. But I suppose a key issue in this particular case is the question of how many 11- and 12-year-olds have, and I'm not seeing data about that.

This comment was going to have a point, but I ran out of time and data before I could form a coherent one, so I'm stopping here.


Well, and as you point out, teenagers are having sex. But there's a huge difference between thirteen and nineteen (legally, in addition to everything else), and a huge difference between tweens and teens. If a tween is having pregnancy-risk sex, particularly non-consensual sex, I think it's very likely that this is a tween that needs something more than a prescription.

Now, is that a reason for not giving that tween a prescription? Is not having that option at all likely to improve that tween's life? Is having that option likely to make the clinicians give her only a prescription? I've heard some ... not horror stories, not like Chris'sses, but stories that make it plausible to me that the option would become the preferred option, and in effect the only option, just to keep the kid out of the office, and I'd be against that. On the other hand, presumably a school board could check on that, somehow.

On the whole, I think I'd make the option available, based on the near-certainty that its absence would hurt a few girls, rather than not make it available, based on the plausibility of its being overused and hurting a lot of girls. I'd be cautious about it, though, and although I certainly have no truck with the outrage of the priceless-virginity gang, I sympathize with the parents who find the whole thing troubling, and would rather not have to think about it.

Parents not thinking about it, of course, is the greater part of the problem...

Thanks,
-V.


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