The Surgeon General’s Call to Action

To Promote Sexual Health and Responsible Sexual Behavior

By the Office of the Surgeon General

US Department of Health and Human Services, 2001, 32 pages

Review by Barry Cramer

This report is the culmination of a nearly two-year process initiated by Surgeon General David Satcher. It incorporates findings and recommendations from an extraordinarily large number of scientific studies, numerous contributors, and over 100 participants at two national conferences. The process was guided by a steering committee from government and other institutions. Religious voices were present in the process, including representatives from Abyssinian Baptist Church, University of Judaism, Weston Jesuit School of Theology, and Widener University and its Center for Sexuality and Religion, as well as participants from conservative Christian organizations not listed in the report. Satcher himself is a devout Baptist.

The purpose of the report, as the title indicates, is to summons the American people to engage in forthright discussion about sexuality so as to promote healthy sexuality and to begin addressing problems stemming from sexuality. The sexually-related problems covered by the report are sexually-transmitted diseases (STD’s), infertility and cancer resulting from STD’s, HIV/AIDS, sexual abuse and coercion, prejudice against sexual minorities, unintended pregnancy, and abortion. The focus is not limited to the reproductive years since sexual health "begins early in life and continues throughout the lifespan."

The discussion on "religion" is thin. One paragraph in the section "Risk and Protective Factors for Sexual Health" is devoted to religion. Every other factor (biology, parents and relatives, schools, health care professionals, etc.) is discussed with a minimum of two paragraphs and up to four. The discussion focuses solely on attendance at church activities. As might be expected, "frequent attendance at religious services is associated with less permissive attitudes about premarital sexual activity and a greater likelihood of abstinence." Startling, however, is the reported finding that, "for adolescents who are sexually active, frequency of attendance is also associated with decreased use of contraceptive methods among girls and increased use by boys."

The role of clergypersons is virtually ignored. "Schools often have access to training and communications that is frequently not available to families or clergy," says the report as it also points out the role of many health care professionals as "first point of contact." But nothing more is said about pastors as a first point of contact or the nature of the training and communications that is lacking. In discussing "intervention models" the report notes that while religion-based programs might reasonably be expected to "have an impact on sexual behavior, the absence of scientific evaluations precludes arriving at a definitive conclusion on the effectiveness of these programs. More research is needed." We could wish for more on both points. And given the current climate of discussion on "faith-based initiatives," I would have preferred references to "faith communities" and "faith-based services," or to "religious institutions," rather than simply to "religion."

The report cannot be faulted, however, for its willingness to address the most controversial areas around the subject of sexuality.

On abortion, the report notes that "there is broad accord that abortion should be a rare procedure," and that "the underpinning of the public health approach to this issue is to apply a variety of interventions at key points to prevent unintended pregnancy from occurring, and thus, [to] ensure that all pregnancies are welcomed."

On sexual minorities, the report is straightforward in its inclusion of gays, lesbians, and transgendered persons. It calls upon communities to provide "freedom from stigmatization and violence on the basis of . . . sexual orientation." Furthermore, it states that "sexual orientation is usually determined by adolescence, if not earlier. . . and there is no valid scientific evidence that sexual orientation can be changed." Research on transgendered persons is limited.

On persons with developmental, physical or mental disabilities, "sexuality and sexual needs have often been ignored, or at worst, exploited and abused." Additional materials, programs, and research are needed, says the report.

The Surgeon General's call is for a "mature and thoughtful discussion" about sexuality, not just for policy makers or health care professionals, but "for parents, teachers, clergy, social service professionals--all of us." Those who take up this challenge in their respective communities may benefit from the document "Exploring Dialogue and Debate" prepared by Educators for Social Responsibility and incorporated into materials published by the Study Circles Resource Center.

The core of the Surgeon General’s report is 16 pages. The size doubles with the inclusion of a personal cover letter from Surgeon General David Satcher, a table of contents, 6-1/2 pages of references, an appendix on methodology, and acknowledgments. The report is available online from http://surgeongeneral.gov/sgoffice.htm. Those who are interested in learning more are encourage to download the report for themselves.

Barry Cramer is Editor of Spirit Restoration Ministries.