In some classrooms, sex education means a dark message about the frightening potential consequences of sex outside marriage. Yet in others, a class of the same title involves graphic, practical information about contraceptives, presented with the casual expectation that these are things every teen needs to know.
There are few topics in US public education that ignite more emotion - or bridge more divergent viewpoints - than sex ed. In an age when Americans talk about sex more freely than ever, they still struggle with the question of what to tell their children.
When it comes to deciding what should be taught about the subject in school, it is hard to find an inch of common ground in what has become a highly polarized battleground.
"[Sex education] has become an ideological war, full of very fuzzy thinking," says Douglas Besharov, the Jacobs Scholar at the American Enterprise Institute in Washington. "I blame this whole thing on the adults - on the left and the right - who have confused this mightily."
On the one side of the divide are proponents of "abstinence-only" programs. These programs teach that sex outside of marriage, at any age, is wrong. Because advocates of this approach are concerned about presenting a mixed message, most insist that these classes may not include any information about contraceptives.
On the other side are those who favor what is called "comprehensive" sex education. This approach may include teaching students that abstinence outside marriage is either one option or perhaps even the best course, but this message is followed up with practical information about sex. Generally this focuses on how contraceptives work, where to get them, and why they are important.
The two sides find themselves almost entirely at odds.
Abstinence-only supporters protest that comprehensive sex ed confuses teens by encouraging promiscuity. But those who favor comprehensive sex ed worry that failing to give kids basic information about sex - and particularly about contraceptives - only increases the danger of sexually transmitted diseases and teenage pregnancies.
However, somewhere in between these two sets of concerns, some argue, lies a broad middle ground in which students are being deprived of something more essential: enough context in which to understand the information they're being given.
It's hard sometimes to be patient with either side of this debate, Mr. Besharov says. The abstinence-only supporters are so adamant about preventing sex outside marriage that they may squelch useful information. But at the same time, he says, those who favor comprehensive sex ed often fail to distinguish between the needs of a 12-year-old and those of a 17-year-old.
They fail to appreciate that, "beyond some kind of moral issue, having sex too early can be horribly damaging to young people," he says.
When sex ed was first introduced into US public schools in the 1940s, it was not done with concern for the morals or emotions of teenagers but rather to control sexually transmitted diseases and cut back on teen pregnancies. But in recent years conservative politicians have embraced abstinence programs as the most effective approach to questions of teen sex.
Abstinence programs received some government support as early as the 1980s, but in 1996 the Welfare Reform Act - signed into law by President Clinton - upped the ante by providing $50 million annually for their propagation. But it's been under the Bush administration that they have grown far more rapidly.
The federal government now funds such programs at $120 million annually, with a proposal on the table to increase that to $135 million in fiscal year 2004. States that accept such funding must agree that sex ed classes will make it their "exclusive purpose" to teach "the social, psychological, and health gains to be realized by abstaining from sexual activity."
Today, 95 percent of US public secondary schools teach some kind of sex ed. Comprehensive sex ed is still the favored approach. But with increasing funds becoming available for them, abstinence-only programs are expected to grow rapidly over the next few years - a development that worries those who want a broader approach.
"Delay [sexual] activity, decrease the number of partners, and increase use of contraceptives," says Tamara Kreinin, president and CEO of the Sexuality Information and Education Council of the US. Those, she says, should be the main goals of public sex education.
Ms. Kreinin estimates, however, that in the 1990s, after almost 50 years of sex ed, only about 5 to 10 percent of the sex ed classes in public schools were what she would call "high quality" programs.
In general, she says, there isn't enough interaction in the classroom, and few chances for students to ask the questions they really care about. Teachers have little or no training and often very low comfort levels when it comes to conducting such sessions.
"Kids want to hear about love and values and relationships," she says. "This is not something simply mechanical, it's multidimensional."
Of course this is sensitive territory, something many argue would be best handled at home. But that doesn't appear to be happening in many homes today.
"Any public health expert would tell you that the best place to learn about [sex] is at home," says Tina Hoff, vice president of the Kaiser Family Foundation in Menlo Park, Ca. "If this were happening we wouldn't even be having this debate."
Surveys the Kaiser Family Foundation has done of young people show a very strong desire for more information about sex, says Ms. Hoff, and children aged 10 or 11 definitely want that information to come from their parents.
However, if parents don't take advantage of that window of opportunity they may lose it, she adds. Within a few years - about the age of 13 and 14 - teens begin to say they prefer talking to their friends. Yet it's a task many parents seem to continue to shirk.
"Survey poll after survey poll shows parents believe that kids should have comprehensive sex ed in school and if you ask them if they should talk to their kids they say yes," Kreinin reports.
But when children are queried, they say they are still waiting to hear from their parents.
Some observers are baffled that parents today, who accept prime-time TV shows rife with sexual innuendo, are still so intensely uncomfortable talking about sex with their children.
"We are a sex-saturated and sex- repressed society simultaneously," says Michael Carerra, founder of the Children's Aid Society Carerra Adolescent Pregnancy Prevention Program.
Dr. Carerra believes strongly in the need for what he calls a "holistic" approach to sex education for young people.
He worked for two decades attempting to educate low-income teens about sex in hopes of reasoning them out of irresponsible behavior and teenage pregnancies. But he never felt his message fully got through.
"I finally saw that what I needed to do to get my sexuality message to stick was to deal with all the rest of their lives," he says.
He saw the kids around him using sex in an effort to find power, influence, or love. What they needed, he realized, was not just to learn about the consequences of sex outside marriage, but also to understand all the other avenues to success and self-esteem available to them.
"They needed help with school, jobs, sports, arts, someone to talk to, and someone to talk to about sex," he says.
The program Carerra founded now operates nationwide, focusing on mentoring, counseling, job opportunities, companionship, and sex ed for low-income teens.
A recent three-year survey of 12 of its sites showed that students participating had one-third fewer pregnancies and births than teens in a control group.
Yet such success is far from the norm in the US.
According to figures compiled by the Centers for Disease Control and Prevention and the National Campaign to Prevent Teen Pregnancy, in Washington, between 10 and 40 percent of US teen girls will get pregnant before the age of 20 - double the rate in Britain and 10 times that of the Netherlands.
Some insist there is a link between such statistics and a weak sex ed system.
"Other industrialized nations do a much better job" of giving their young people information about sex, Kreinin says. "They are more comfortable and it is reflected in their kids' behavior."
Yet there is some encouraging news. The number of high school students who say they've never had sexual intercourse rose by almost 10 percent between 1991 and 2001, according to the Centers for Disease Control in Atlanta.
Some speculate that teens today may be reacting against what they perceive to be an overly permissive society. Supporters of abstinence-only programs hope that this could be a sign that their message just might be getting through.
But whatever the cause, say some who work with teens, it doesn't lessen the imperative need to learn to communicate better with young people on this topic.
In society today, "our technology is unbelievable," says Carerra. "But when it comes to talking about sex, we're still antediluvian."
Sometimes the best way to talk to kids about sex is not to talk about sex at all, some argue. At least not all the time.
"I love this program because they said, 'Let's not focus on the fact that so many teens have babies and you could be one of them,' " says Nickey-Ann Leon, a junior in college, majoring in communications. "Instead they said, 'Let's focus on the fact that you're intelligent and can do many things with your life.' "
Ms. Leon became involved with the Children's Aid Society Carerra Adolescent Pregnancy Prevention Program in New York when she was 13. She joined, she says, because she wanted to make friends. She hoped a carefully supervised teen group might be one of the few activities her strict parents would approve.
The program changed her life, she says, giving her a chance "to focus on something else, not just on sex."
Michael Carerra, formerly a professor of health sciences at Hunter College in New York, had educated low-income teens about sex for 20 years and was often praised for his excellent classes.
But he was neither content nor convinced that he was making any progress in reducing teen pregnancy.
"I was in a battle against a tide so powerful I could not make any headway," he says. It occurred to him, however, that the best way to help teens keep sex in its proper context was to ensure that their lives have a broader outlook. To do so, he created a program that focuses on mentoring, finding jobs, counseling, listening - and learning about sex.
As part of the program, sex education combines basic information and practical knowledge about contraceptives with the chance to talk seriously about love and relationships - and why sexual activities are important and require careful thought.
Sugey Palomares and Melissa Marcial entered the program together in Brooklyn at the age of 13. In a neighborhood where teen pregnancies are the norm, they've bucked the tide and are now both in college.
Their high school provided comprehensive sex ed and yet also offered a nursery because so many students already had babies.
Sex ed at school wasn't effective, the young women say, because it was an uncomfortable setting, where asking a question would have been embarrassing.
At the program, however, they not only had classes but also a counselor they could talk to in private whenever necessary.
"They helped us to understand that you don't have to prove your love to someone by sleeping with him," Ms. Marcial says.
"They were so open with us and let us ask questions about anything," Ms. Palomares adds.
There was also a chance to actually talk to the opposite sex about things like relationships, says Richard Johnson, now a junior in college, who participated at a program site in the Bronx.
"I learned to talk to women, to respect them," Mr. Johnson says. "I just didn't know that before."
Being able to talk about male-female relationships was great, agrees Leon: "It covered emotions and feelings and it wasn't just procedural. It was real."
95% of US public secondary schools teach some kind of sex ed.
89% of the nation's 20 million public secondary school students will take at least one sex ed course between seventh and 12th grade.
58% of principals call their curriculum "comprehensive," including the message that "young people should wait to have sex but if they do not they should use birth control and practice safer sex."
34% say their school's main message is "abstinence only" before marriage.
10% of 15- to 19-year-old girls and women became pregnant in 2000.
Teen pregnancies cost taxpayers about $7 billion annually.
Sources: Kaiser Family Foundation, Alan Guttmacher Institute, Centers for Disease Control and Prevention, and the Brookings Institution