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Surgeon general issues `call to action' on sexual health

WASHINGTON (AP) _ In a new report on sexuality, Surgeon General David Satcher urges Americans to respect a ``diversity of sexual values'' and calls on parents, schools and community leaders to engage in honest discussion about sensitive sexual issues.

The report released Thursday says communities must provide lifelong sex education, encouraging sexual abstinence as well as birth control. Americans should rely on scientific evidence to determine what works, Satcher said, and develop greater understanding toward gays and lesbians.

The report, two years in the making, says the nation must get past its nervousness about the subject in order to reduce unwanted pregnancy, sexually transmitted diseases and sexual abuse, while promoting healthy sexual relationships.

``Given the diversity of attitudes, beliefs, values and opinions, finding common ground might not be easy, but it is attainable,'' the report concludes. The first step is confronting the issue, Satcher added. ``Sex is not an easy topic to discuss and it has never been.''

The ``call to action'' begins by detailing the problem: 12 million Americans infected by sexually transmitted diseases each year, with some 40,000 new HIV infections; more than 100,000 children victimized by sexual abuse annually.

The report says there are nearly 1.4 million abortions each year, and that nearly half of all pregnancies are unwanted. An estimated 800,000 to 900,000 Americans live with HIV.

In the tradition of surgeons general, Satcher does not flinch from reporting even controversial data.

He says there is no valid scientific evidence that one's sexual orientation can be changed and details the consequences of harassment on the mental health of gays and lesbians.

``We're certainly not trying to get anyone in any religious group to change their views,'' he said. ``We're just saying these are people, these are human beings.''

Sexuality education must be wide-ranging, begin early and be available throughout one's life, the report says. It recommends that sex-education programs discuss the benefits of abstinence from sex, but also explain how to prevent unwanted pregnancies and sexually transmitted diseases. It recommends improving access to reproductive health care services for ``all persons in all communities.''

Abstinence is the only certain way to prevent pregnancy and the spread of disease, the report says, and even properly used condoms do not prevent the spread of all sexually transmitted diseases. But the report finds no evidence that ``abstinence-only'' programs are effective, saying more research is needed.

These programs, which bar any talk of contraception, enjoy the support of many conservatives, including President Bush, who has pledged to raise federal support for them.

Satcher insisted he was not taking sides in the debate. ``Those are political decisions,'' he said. ``We try to make very clear what's needed to improve sexual health and what's supported by the science.''

The report also encourages abstinence from sex until one is involved in a ``committed, enduring and mutually monogamous relationship.'' Federal abstinence programs call for abstinence until marriage.

``I have to deal with reality,'' Satcher said when asked about the difference.

Sex education begins with parents, the report says, but schools play an important role because some parents are uncomfortable or unable to give their children all the information they need.

``Parents sometimes need help,'' Satcher said. ``Schools have always been the great equalizers.''

The report got a chilly reception among conservatives. Andrea Lafferty of the Traditional Values Coalition said Satcher ignored evidence that homosexuality can be changed. He sent a mixed message about condoms, she said, by admitting they do not provide absolute protection against disease and pregnancy but still encouraging people to use them.

``They're talking out of both sides of their mouths,'' she said.

She added that schools should not be concentrating on sex education when they have failed to teach the basics like math and reading. ``Yet we should teach kids how to put on a condom which won't even protect them from pregnancy or disease?'' she said.

Debra Hauser of Advocates for Youth, which encourages comprehensive sex education programs that included birth control information, said Satcher did his job properly.

``He should be praised for rising above the politics and the ideology,'' she said, ``and for asking for a national dialogue based on respect and evidence.''
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