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When only 13 states require sex education to be medically accurate, a lot is left to interpretation in teenage health literacy. Research published by the Public Library of Science shows that when sex education is comprehensive, students feel more informed, make safer choices and have healthier outcomes. This results in fewer unplanned pregnancies and more protection against sexually transmitted diseases and infections.

While many teenagers pick up sexual health information from sources other than schools like parents, peers, social media and pop culture, sometimes that information is not accurate or it is biased.

My guest today on Health You is Planned Parenthood's Director of Education for St. Louis and Southwest Missouri Michelle Linschoten. A Washington University in St. Louis graduate, Linschoten specializes in sexual health and has been an educator for more than a decade.

Linschoten created and currently directs the sexual health interviewing training for Washington University's School of Medicine OB/GYN clerkship. Her job as Director of Education includes developing, implementing and evaluating sexual health programs for individuals, classes, children, youth and adults no matter their abilities, identities or backgrounds.

Ruth: Michelle, welcome to Healthy You!

Michelle: Thank you for having me.

R: It's very good. I'm looking forward to this conversation. Now, your bio is pretty lengthy, so give our audience some more insight into your role at Planned Parenthood.

M: My role as director includes preparing staff, whether they are in the Education Department or the Patient Services Department, to treat our patients, our students and our clients within our values, with respect. I, of course, prepare and direct the Education staff. Our team runs internal and external programs, and I direct the planning, implementation and evaluation of those programs. We do external training for providers such as medical students, youth-serving professionals and we also do education for anyone aged 9-99.

R: Yeah, so you're covering the gamut in terms of age?

M: Yes, we are.

R: Why is sex education so important? I ask you that because many people shy away from the topic or think it's taboo.

M: I think that's really why it's so important because a lot of us have shame, stigma, maybe just general discomfort around sexual health, our own sexuality, how do we talk about it. And so, education is so important to empower us to know ourselves, know what we want and understand and respect each other.

R: So, how many participants to you have every year and just how detailed is your sex ed program?

M: We have around 10,000 individuals annually who participate in our programs. Again, a range of ages, a range of developmental stages and locations. Our programs can be as simple as a one-time session. We encourage a minimum of four sessions in a series, but we can come in one time if you need us to talk about STIs or consent and be your one-time guest speaker. Or, we have gone in every week for an entire school year to some schools. The level of detail depends on the partner's needs and the participants' needs. I'm very proud of our program because we're able to modify and adjust it and tailor it to the needs of the audience versus saying, "this is the one thing we offer, take it or leave it." We can make it very detailed, as much as needed.

R: What is the requirements for participating in a sex ed course and is there attached to that?

M: We are funded by very generous granters and donors, so for education services there is no cost to the partner. Our training services, we have a suggested training fee. Also, our mission is to provide services to everyone, no matter what. We care no matter what so we will work with people based on what budget they have, like at a university. The biggest barrier to participation, honestly, is negotiating schedule. Everyone is busy. We are busy. But once we get the time down, there's really little else to no [barriers]. We, of course, have cooperative agreements that we sign with everyone.

Our big thing is, sometimes, people want us to come in and spread misinformation. Sometimes it's from a good place, you know, they are worried about the teens in the classroom and they say, "Will you please come tell these young people that it will ruin their self-esteem if they have sex?" Well, I'm not going to say that because that's not true for everybody. What I will do is talk about self-esteem and what are their values, what do they want to and empower them to have sex only if they want to in a safe, healthy, consensual environment. So, that's really our only thing. We're here to provide medically-accurate information. We're not here to push any values. We're not here to push any myths. We're here to empower every individual, no matter their age, to be an agent for their own sexual health.

R: You know, I was surprised to learn that Planned Parenthood has a lot of partners for this program, including religious groups! So, talk to me about those partnerships.

M: Yeah, we have some really amazing partners, some folks who've been with us for years. The religious groups are also interesting and really inspiring to me. For a lot of people, actually, their religion, spirituality, faith calls them to say we need to have comprehensive, good sex education and we need to empower individuals to be healthy and take ownership of their lives. We work with not just schools but also a lot of community-based organizations, after school programs, assisted-living facilities, groups that serve all ages, all abilities. There's a lot of folks.

R: So, could you describe some of the topics the program covers?

M: I can, and these are well laid out on our website at www.ppslr.org and you can go to our Education page and we got info on who we teach, what we teach and there's actually a lot of stuff we can cover. So often, I get to bust the myth that sex ed is only about STIs, pregnancy, body parts and condoms. It's really about a lot more. So, when I go into a fourth grade class, I'm not talking to them about sex behaviors and what they can do with each other's bodies. That's not age or developmentally appropriate and it's not really what they're interested in. They want to know about puberty, what can they expect, what the heck is even happening to my body right now, how do I stay a good friend, how do I make good friends, what is self-esteem. And maybe they're not using those words but those are the subjects that we cover that they are interested in.

So, we will talk about body image, self-esteem, healthy relationships, communication. We talk a lot about consent, which there is a Missouri state law saying schools need to teach about consent in their sex ed courses. We talk about identities, self advocacy, responsibilities. We, of course, talk about what people think sex ed is. It's important: pregnancy, birth control, STIs, barrier methods like condoms, testing, anatomy. One of my favorite things to teach about is media literacy, especially now it's so important to talk about sexting... pornography obviously finds children. As young as age 8, people are non-consentually having pornography just show up on their electronic devices. So, we teach about media literacy and where they can go to get their answers. Fairly, they're not going to remember every word I say in that hour. So, we give them skills on how to go find the answer to the questions they next have.

R: This new media, it has just been... really, it's scary. I'm not a parent, but I would be freaking out knowing all the stuff that could come into my child's smartphone from nowhere. It is kind of dangerous and children, especially, that age between elementary and junior high school when all those changes start taking place. Is that your most challenging age group to deal with?

M: No, that's my favorite age group to deal with! I would say it's complex, and they can be squirrely, but it's in the best way. I think it's because they have so much going on they know they need it. I love everyone so much, and there are age groups, like late teens and young adults where they're like, "I know everything. I don't need to know what you're telling me." But, 4th through 8th grade is like, "Please, please tell us what is even happening! We're confused." I'm also not a parent, but I have a great deal of empathy for them. I helped raise my brothers and sisters and we didn't have to deal with all this. So, I try to empower caregivers to talk to your kids, make it not a one-time conversation. We have resources on our website and some of our partner websites to support caregivers and parents because it should be more than one conversation. When we do middle school and early high school, we want to make sure it's at least four classes. They may be a little shy, take a minute to warm up and then the questions just keep coming and coming. We could do hours and hours of just Q&A.

R: Tell me about another program I read about, the TASH program. What's that and who's enrolled in that?

M: That is Teen Advocates for Sexual Health. It is actually in it's 20th year at our affiliate. It's a fantastic program. It is youth from 9th-12th grade in the region who come together. Last year, we had over 50 students involved and we are building it to be virtual at least this first semester because of COVID. But, we will continue on. They are a really interesting, passionate group of young people. Anyone is welcome as long as they are a teen and in high school, they are welcome to join. It's a place to get the comprehensive sex education you might not be getting in school. It's a place to build self awareness, self-esteem and advocacy skills, both for advocating your own needs and advocating with your school. And then also we go to Jefferson City every year and do a Lobby Day where the students get to practice speaking to their representatives about sexual health issues that are important to them. They meet twice a month throughout the entire school year, so that's 20, 22 times in a year they meet. We also do some Saturday retreats.

R: Sounds like they also get communications experience if they're basically lobbying, that's pretty advanced!

M: Yeah, absolutely. They do a training with our political team and our community engagement team to build some lobby day skills and they're fearless! I thought it could be nerve-wracking and they go on in, they're really assertive and it's fantastic. They also get community service hours for it... some schools require it for graduation. Their engagement with TASH counts as community service hours and we'll give a letter to the school stating how many hours they completed.

R: Oh, that's certainly an incentive!

M: It is. We also give snacks, whenever we're live.

R: That's a major incentive! One last question: do you have any data on the benefits of a strong and accurate sexual health education program?

M: I do. There's information and resources on our website, especially our library page website, The Sunnen Library, connects to this. But, we know a few things that are really key. Adolescents want sexual health [education]. We know through sexual health studies of the past couple decades, we know that comprehensive sex ed that actually talks about sex behaviors and how to protect yourself leads to not only increased prevention engagement also it actually decreases when people initiative partnered sex. So, if people learn about their bodies and learn about communication and learn about empowerment they're less likely to start having sex with other people until later on. We also know that if we provide sex education that is empowering and inclusive of all it can help reduce stigma and discrimination and bullying of lesbian, gay, bisexual, transgender, asexual, queer and questioning youth. We also know that good sex ed helps prevent intimate partner violence. Empowerment and teaching people what abuse is and isn't can help them have healthier relationships and prevent them from being abused or being abusers.

R: And that can make for healthier marriages down the road?

M: Absolutely, and we're about healthier lives.

R: Absolutely. We've been talking with Michelle Linschoten. She's the Director of Education at Planned Parenthood. I want to thank you for joining us and for all this valuable information.

M: Thank you so much for having me.


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