The Surgeon General’s got a tough job when it comes to tough love. Speak too bluntly and you’ll be shown the door -- just ask Joycelyn Elders. Not even Slick Willy wanted to hear what David Satcher had to say about sex and HIV -- the Clinton camp blocked the release of Satcher’s landmark “Call to Action to Promote Sexual Health and Responsible Behavior,” too. Post-election Beltway buzz had the report dead in the water, but in late June it surfaced. At the center are some strong words on the importance of sexuality -- it’s “a core component of personality,” Satcher writes. He also links homophobia to teen suicides and is carefully vague when referring to “partners in committed relationships.” But the report was barely leaked when President Bush’s press secretary, Ari Fleischer, downplayed the missive’s pro-sex ed stance and slammed Satcher. Below, POZ presents excerpts from the “Call to Action” and sound bites from a June 29 White House press briefing.

David Satcher, U.S. Surgeon General
www.surgeongeneral.gov

We, as a nation, must address the significant public health challenges regarding the sexual health of our citizens.

It is important to recognize the responsibilities that individuals and communities have in protecting sexual health. Issues around sexuality can be difficult to discuss -- because they are personal and because there is great diversity in how they are perceived and approached. Yet, they greatly impact public health and, thus, it is time to begin that discussion. Sexuality is a fundamental part of human life. While the problems usually associated with sexual behavior are real and need to be addressed, human sexuality also has significant meaning and value in each individual’s life.

I would like to add a few words for the many thousands of persons living with HIV in this country. We realize that you are not the enemy; that the enemy in this epidemic is the virus, not those who are infected with it. You need our support and encouragement. At the same time, it is also important that you realize you have an opportunity to partner with us in stemming the spread of this illness; to be responsible in your own behavior and to help others become aware of the need for responsible behavior in their sexual lives.

A majority of Americans favor some form of sexuality education in the public schools and also believe that some sort of birth control information should be available to adolescents. There are only a few published evaluations of abstinence-only programs. Programs that typically emphasize abstinence, but also cover condoms and other methods of contraception, have a larger body of evaluation evidence that indicates either no effect on initiation of sexual activity or, in some cases, a delay. This evidence gives strong support to the conclusion that providing information about contraception does not increase adolescent sexual activity. Providing sexuality education in the schools is a useful mechanism to ensure that this nation’s youth have a basic understanding of sexuality.

More research is needed, but based on the scientific evidence, we face a serious public health challenge regarding the sexual health of our nation. Doing nothing is unacceptable.

Ari Fleischer, White House Press Secretary
www.whitehouse.gov

REPORTER: Ari, on the surgeon general’s report, has the president read it, and if not, is he going to? What is his reaction?

FLEISCHER: The president has not read the full report. The president understands the report was issued by a surgeon general who was appointed by the previous administration and --

What does that have to do with him reading a report or not? I mean, he believes in education, doesn’t he?

Yes, he believes in education.

Why wouldn’t he read the report?

He’s aware of it. He has many things to read. He’s aware of what the report says.

Does the White House have a view on whether its views are things the White House would endorse?

The president believes that all individuals need to act responsibly, they need to understand the consequences of the choices they make. The president believes, and the report does have some indication on this, that the best way to prevent pregnancy, the only sure-fire way, is through abstinence. And that’s the best way to avert disease, as well.

Is the president concerned about the spread of AIDS?

The president is very concerned about the spread of AIDS. And, as you know, the president believes the nation and the world need to launch an effort that focuses on both education and treatment. It’s important to allow local control, to allow people in various schools to make these decisions. But the president continues to believe that abstinence and abstinence education is the most effective way to prevent AIDS, to prevent unwanted pregnancy.

What is his view on sex education taught in schools?

It’s a matter of local control.

There’s no curiosity about the effectiveness of sex education?

You do afford me the opportunity to remind you of the history of this report. The previous administration must have seen something that made them delay it until after the election.

But what is it that makes the president not want to read something like that? I mean, does he never read anything controversial?

I think it’s no secret -- presidents of the United States do not have the time to read each and every report that comes out of the federal government.