I’m really excited to announce that “We’re Teaching About Condoms All Wrong: How Sex Educators Reinforce Negative Attitudes and Misinformation About Condoms and How to Change That,” an article I co-wrote with my friend and colleague Dr. Logan Levkoff, has just been published in the American Journal of Sexuality. In it we argue that condom lessons haven’t changed all that much since we were in college and that even those lessons that are considered the gold standard may be doing condoms (and the young people we want to be using condoms) a disservice.
The article isn’t a listicle, it’s in a peer-reviewed journal after all, but for Wednesday purposes, here are the top mistakes we found when we looked at a number of popular condom lesson plans. (You can read the whole article complete with academic citations and everything here.)
Make condom usage overcomplicated. The article actually grew out of our critique of the “Condom Line Up,” an activity we each facilitated as peer sex educators in college that is still included in many of the lesson plans we looked at. The teacher hands each student a piece of paper that includes one step in the process of putting on condoms and then asks participants to put the steps (or themselves) in chronological order. This activity probably originated as a way to teach students how to use a condom in places where demonstrations weren’t allowed. We get that—there are still many school districts and the entire state of Mississippi that do not allow condom demos in the classroom. The problem is the activity sometimes includes 15 or 20 steps. (We get that too, the more steps, the more students who can participate.) But anyone who has used a condom knows it’s not rocket science and there are not 20 steps. Open it, put it on the penis, roll down, and go. The message students need to take away from condom lessons is that they are really easy to use and this common activity undermines that message.
Focus on the wrong mistakes. I know that when I was doing condom demos in and after college, I would always joke that you should store them in a cool, dry place (I suggested a band-aid tin because it was long enough ago that band-aids still came in tins), check the expiration date, and open them carefully never using your teeth or a scissor. These things are technically true but they do not represent where condom use goes awry for most people. Condoms are not fragile and last way past their expiration date. The real biggest error in use is non-use—leaving the condom in their purse, night table drawer, or band-aid tin just this once. Or, wearing the condom for part of sexual intercourse (as in putting it on after intercourse starts or taking it off before ejaculation).
Use outdated descriptions and images of condoms. Most photos of condoms show one with a nipple tip and many sex educators still talk about pinching that nipple tip as part of condom use instructions. But most condoms don’t look like that anymore. In fact, when unrolled some of the most popular condoms are shaped more like a baseball bat, narrower on the bottom and wider toward the top. Condoms are also thinner than ever and include high quality lube on the inside and outside. And, some are textured for added pleasure. Condom innovation is important and sex education should keep up with what is available on the market today.
Assume that people hate condoms. The barriers brainstorm. Another well-intentioned exercise that may backfire. In this case, teachers start out by asking why people don’t like to use condoms. Expected answers are things like “sex doesn’t feel as good,” “condoms take the spontaneity out of sex,” or “they’re difficult to use.” While the end goal is to help young people overcome each of these barriers, we question the framing of this activity. Most of the young people in these classes will have had little to no experience with sex let alone condoms. Why tell them up front that most people hate condoms? We’re not suggesting that teachers ignore the latex elephant in the room, but it is possible to start from a positive place. One lesson plan we reviewed had students do a condom obstacle course in which they were tickled with a feather while wearing a condom on their hand to prove that condoms don’t block sensation. This might not be allowed in many classrooms, but discussions could take a similar, positive approach.
Confuse the stats. Logan and I have spent a lifetime correcting people’s perception of condom failure. It was one thing when I had to tell the abstinence-only crowd that no, using a condom was not akin to jumping out of an airplane without a parachute or playing Russian Roulette, but we’ve had to correct doctors and sex educators on this as well. Contraceptive efficacy rates are complicated and often misunderstood. When we say that condoms are 98% effective in preventing pregnancy when used consistently and correctly, that does not mean that 2% of condoms fail. Effectiveness is calculated by tracking 100 heterosexual couples who say that they used condoms as birth control for one year. In that year, two couples will likely experience an unintended pregnancy. But think about this: the average couple has intercourse about 83 times a year. So, 98% effective really means 2 pregnancies out of 8,300 acts of intercourse which is a remarkably low pregnancy rate (.002%) when calculated on a per-condom basis.
Ignore relationships. Condom use doesn’t happen in a vacuum, it happens in a relationship whether that’s a long-term monogamous relationship, a hook up, or a friends-with-benefits situation. Research has found, however, that most couples stop using condoms after about three weeks. We believe that this short window of use is a reflection of the negative attitudes about condoms and the misunderstandings about efficacy. (The belief that real couples who need pregnancy protection switch to “a better” contraceptive as soon as possible.) We also think that there’s a misplaced belief among young people that not “having to use” condoms somehow means that your relationship is strong and healthy and that you trust each other. It doesn’t – it just means that you might be at risk for STIs and unintended pregnancy. Most sex education programs talk about relationships, but it’s separate from the talk of condoms which is usually stuck into the STI section and wrapped up in talks about chlamydia and HIV. We need to spend more time talking about condoms in the context of relationships and working through what they mean (or don’t mean) in addition to how they work.
The goal of our article was in no way to blame or shame individual sex educators. We are both sex educators and understand that there are many factors that go into what gets taught in a classroom (think state laws, no money, school board politics, curriculum choices outside of the educator’s control, and parents with opinions and publicists). And, as I said earlier, these activities have been held up as the gold standard for decades so today’s sex educators were trained to use them.
Our goal was really to start a conversation among sex educators and others. Condoms have a PR problem despite the fact that they are cheap, easy to get, and remain the only method of birth control that also protects against STIs. And we think sex educators might be able to help future generations appreciate this method more.