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Condom Nation: The U.S. Government's Sex Education Campaign from World War I to the Internet [Hardcover]

Alexandra M. Lord

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Book Description

23 Nov 2009

This history of the U.S. Public Health Service's efforts to educate Americans about sex makes clear why federally funded sex education has been haphazard, ad hoc, and often ineffectual.

Since launching its first sex ed program during World War I, the Public Health Service has dominated federal sex education efforts. Alexandra M. Lord draws on medical research, news reports, the expansive records of the Public Health Service, and interviews with former surgeons general to examine these efforts, from early initiatives through the administration of George W. Bush.

Giving equal voice to many groups in America—middle class, working class, black, white, urban, rural, Christian and non-Christian, scientist and theologian—Lord explores how federal officials struggled to create sex education programs that balanced cultural and public health concerns. She details how the Public Health Service left an indelible mark on federally and privately funded sex education programs through partnerships and initiatives with community organizations, public schools, foundations, corporations, and religious groups. In the process, Lord explains how tensions among these organizations and local, state, and federal officials often exacerbated existing controversies about sexual behavior. She also discusses why the Public Health Service's promotional tactics sometimes inadvertently fueled public fears about the federal government’s goals in promoting, or not promoting, sex education.

This thoroughly documented and compelling history of the U.S. Public Health Service's involvement in sex education provides new insights into one of the most contested subjects in America.

Product details

  • Hardcover: 240 pages
  • Publisher: Johns Hopkins University Press (23 Nov 2009)
  • Language: English
  • ISBN-10: 0801893801
  • ISBN-13: 978-0801893803
  • Product Dimensions: 22.9 x 16 x 2.3 cm
  • Amazon Bestsellers Rank: 2,364,251 in Books (See Top 100 in Books)

More About the Author

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Product Description


Lord, a public health historian, argues that the U.S. government has spent the past 90 years trying to give Americans frank sex education, but the power of religious groups and Americans’ own squeamishness in admitting to having premarital sex has thwarted public health officials for nearly all of that time.

(Publishers Weekly)

Lively historical account... Lord is particularly enlightening about the ways in which race, religion and geography have produced an inconsistent approach to sex education.

(Susan Jacoby Washington Post Book World)

This fascinating history of the past hundred years of sex education in America explores public and private efforts to eradicate sexually transmitted disease and promote healthy sexual behavior: It also reveals our hang-up, Alexandra Lord observes: 'Americans' uneasiness with sexual behavior.'

(Youth Today)

Americans have a split on the issue: using a condom is a responsible action, but having the sex that makes using a condom a responsible action, well, that’s irresponsible and immoral. Lord, a former historian for the Public Health Service, has documented this ambivalent stance throughout her fascinating book, which surprises throughout in showing just how little sex education changed through the twentieth century, even though we profited from an increase in scientific knowledge and from improved contraceptive and prophylactic technologies.

(Erotica Readers and Writers Association)

An informative and enjoyable read.

(James Wagoner Conscience)

This is a highly readable study about a hot-button issue... Condom Nation contextualizes federal policies within the changing sexual mores of the twentieth century and shows how important it is to look at the story behind sex education campaigns.

(Tamara Myers H-Education, H-Net Reviews)

About the Author

Alexandra M. Lord received her Ph.D. from the University of Wisconsin, Madison. She previously served as a historian with the U.S. Public Health Service.

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Front Cover | Copyright | Table of Contents | Excerpt | Index
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Most Helpful Customer Reviews on (beta) 4.8 out of 5 stars  5 reviews
6 of 7 people found the following review helpful
5.0 out of 5 stars The Thwarted History of the PHS and Sex Education 1 Feb 2010
By R. Hardy - Published on
America is not a "condom nation." American teenagers, for instance, have about the same rate of sexual activity as their European contemporaries. But they have a higher rate of sexually transmitted diseases, and of unplanned pregnancies, and of abortions. They aren't using condoms the way they ought. But _Condom Nation: The U.S. Government's Sex Education Campaign from World War I to the Internet_ (Johns Hopkins University Press) is the title Alexandra M. Lord has given her book (can it be that she was not only being ironic, but was punning on "condemnation"?). Condoms work, and so do IUDs or the pill or other measures if all you want to do is prevent pregnancies. That's a good thing, but the bad thing is that they keep people who enjoy sex from bearing what other people think they ought to have as consequences from enjoying sex. Americans have a split on the issue: using a condom is a responsible action, but having the sex that makes using a condom a responsible action, well, that's irresponsible and immoral. Lord, a former historian for the Public Health Service, has documented this ambivalent stance throughout her fascinating book, which surprises throughout in showing just how little sex education changed through the twentieth century, even though we profited from an increase in scientific knowledge and from improved contraceptive and prophylactic technologies.

When science began to understand the role germs played in illness, the Marine Health Service (formed by the federal government to help ill seamen) performed such non-nautical efforts as investigating dairies for typhoid. The organization became the Public Health Service in 1912. There wasn't anything controversial about the PHS fighting typhoid, tuberculosis, or malaria: they weren't connected to sex. After World War One, with growing confidence that there was effective treatment for syphilis and gonorrhea, the PHS constructed its health education against disease, not against pregnancy; babies were held to be the welcome effect of sex, which ought to happen in marriage anyway. By 1937, the PHS broke the taboo on mentioning condoms, referring to them in a short sentence in a pamphlet on syphilis and gonorrhea that explained that condoms protect both the man and the woman. The government was not interested in preventing pregnancies, and no contraceptive use of condoms was mentioned. In the years around World War Two, when soldiers were being briefed on the necessity of condoms, kids in school were not. Conservative teaching was just what was expected when C. Everett Koop was appointed by President Reagan in 1981 to be surgeon general. Progressives were worried that the born-again Koop was only there to appease evangelicals and to reverse the legality of abortions. Koop knew little about Washington, and assumed he would be able to advocate sex education any way he thought best. For the first five years of his tenure, however, he was forbidden to talk publically about the newly-understood AIDS epidemic. When unleashed, he spoke like a doctor but not the way the fundamentalists wanted him to. His 36-page report on AIDS was widely disseminated in 1986, and not only did it explain that the disease was a public menace (not just to "any one segment of society"), and that those who merely shook hands, kissed, used public restrooms, or masturbated were safe from it, it also depicted condoms and stressed their usefulness. Koop thought he was building a bridge between religion and science, but he alienated many Christian fundamentalists, who named him the "Condom King." Such fundamentalists were much more comfortable with abstinence-only programs which were pushed especially during the second Bush presidency. (The biggest news during the Clinton years, besides the education many people got about what oral sex was, was when his appointed surgeon general Joycelyn Elders publically announced that masturbation was part of human sexuality and might be a subject of classroom discussion, a harmless and correct stance that got her fired.) The medical and moral forces on the abstinence question continually talk past each other: yes, if you abstain you can never get pregnant or catch a disease from sex; but yes, people are not by nature abstinent and need other tools. Not only was abstinence stressed, there was condom-bashing that was unscientific and untrue. It isn't surprising that teens who took abstinence-before-marriage pledges broke them almost 90% of the time, but they were far less likely (perhaps because they had been told how wicked or unreliable condoms were) to use condoms. It isn't surprising that many states were refusing to accept federal dollars for abstinence nonsense.

Lord's book provides an entertaining and useful historic overview that shows, mostly, that we have not gotten far from where the PHS started. In 1918, parents and teachers were in favor of government-sponsored sex education; today, they still are. The question has always been what to teach, and it has always been colored by our worry about sex, and that young people indulge in it, and even that some of them might masturbate. If the best we can come up with after all this time is abstinence, it is hard to be optimistic that the PHS will be able to get useful scientific advice out to the public as long as conservative religious forces are holding it back.
3 of 3 people found the following review helpful
5.0 out of 5 stars Impeccable research on a controversial subject 12 Nov 2010
By EJ - Published on
Format:Hardcover|Verified Purchase
This book is a tour de force of public health history on a subject that is still considered to be controversial in the United States, but emphatically should not be. Alexandra Lord has managed to trace the history of sex education in America in a manner that is both impeccably researched and graced with a fluid and fast-paced writing style.

Beginning with the formation of the Marine Health Service, which sought to keep sailors healthy, government agencies have attempted to craft sex education programs that strike a balance between informing the public and avoiding scandal. As Lord deftly outlines in her book, the vast majority of Americans have always wanted to have accurate information on how to prevent sexually transmitted diseases and unwanted pregnancies, as well as expanded knowledge on the range of human sexuality. However, as described in the book, public health practitioners have had to walk a fine line between giving the facts and placating those who might be offended by detailed information on these subjects. Lord also compares and contrasts the public health strategies of the U.S. with other industrialized countries, and the bottom line is that sex education programs in the U.S. are downright ineffective and embarrassing in comparison. The author brings up an outstanding explanation for this in the diversity of the United States vs. these other countries; because the U.S. is so large and diverse even a minority (perhaps ill-informed) faction may carry the numbers needed to make an impact (perhaps negative) on public health.

After reading this book I became even more baffled as to why the U.S. is still so ridiculously prudish about sex and sexuality in 2010. Based on the solid and well-documented research in this book, we as a country seem to actually be going backward on sex education. I'm actually surprised this book did not get more press when it was published--it should have. It's a very well-researched and well-written book on a controversial subject. It is an absolute must-read.
1 of 1 people found the following review helpful
5.0 out of 5 stars Fascinating 9 Dec 2010
By 4real 4ever - Published on
Format:Hardcover|Verified Purchase
Brilliant original research into how our nation has wrestled with sex education. And a riveting read to boot!

The British Medical Association agrees -- they just honored Condom Nation with two of their 2010 book awards & the judge remarked: 'Who would have thought that a social history of sex education in the US would be such an absorbing page-turner? ... I found this account to be enlightening, entertaining, sobering and enraging."

I couldn't have said it better. I only wish there were a website where I could see all the pamphlets, posters, films etc. mentioned in the book.

Here's to hoping powers-that-be within the US book-award circles don't let the controversial subject matter blind them from considering similar honors for Condom Nation here at home.
5.0 out of 5 stars condemnation 9 July 2013
By Kindle Customer - Published on
Format:Kindle Edition|Verified Purchase
This is a wonderfull, well-reasearched piece of writing that explores a controversial topic in an academic way. I enjoyed the opportunity to re-examine how I think about public health initiatives in general and sexual education more specifically.
4.0 out of 5 stars Sex ed in the US 20 Mar 2012
By Mike B - Published on
The title is somewhat misleading, as this is more of a history of government sponsored sex education programs in the U.S. since the turn of the century.

There were times where I felt this book vague or not explicit enough, particularly on the history before 1970. The author mentions programs sponsored by the Public Health Service, but often with little on the details of these programs. It is too general to state that the Public Health Service sponsored such and such or that the programs had not changed in twenty years - but we end up knowing very little of the contents. Also different states would alter the contents (censor) of various programs, but again, little is said as to which parts were being altered or expunged. Religious leaders reacted negatively to a film in 1956 called "Baby Doll", but we are not told why they were infuriated.

It is only with the appointment of Everett Koop as surgeon general that the book becomes more rounded. Even though Koop was a Biblical fundamentalist, he was able to separate science from religion. His reports on the growing AIDS epidemic - sent to all Americans via the postal service - were explicit and to the point.

U.S. society does come off as prudish and fanciful with the advent of the "abstinence" programs beginning in the Reagan era - as if teenagers were to suddenly become saints. Surgeon general, Jocelyn Elders, was forced to resign because she spoke positively about masturbation during a speech in 1994. Contrast this with the leader of Thailand who was openly distributing condoms during the 1990's. One can imagine the controversy if an American President, or for that matter the current Canadian Prime Minister Stephen Harper, were to do the same!
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