SABINE COUNTY 鈥� When condoms were distributed at a career fair five years ago, West Sabine High School鈥檚 seventh and eighth graders took handfuls and tucked them inside their jackets and pants pockets. It set field trip chaperone Carnelius Gilder into a panic.
Gilder had driven the students to a church in the area to attend the career fair. Students had attended it in previous years with no problems; Gilder was taken aback to see a vendor giving away contraception for the first time.
鈥淣o, no, no, no, no, no, no, no, no, no, no. We cannot bring these home,鈥� Gilder, now West Sabine school district鈥檚 superintendent, recalled thinking. 鈥淭hese are junior high kids. And we鈥檙e in a church.鈥�
In rural Sabine County, a part of Deep East Texas near Louisiana鈥檚 western border, Gilder knew many parents who would light up his phone if students came home with condoms from a school-sanctioned field trip. So before the students got back on the bus, Gilder told all of them to empty their pockets.
West Sabine High School students haven鈥檛 been back to the career fair since. The school district now organizes its own health fair, which parents attend, and school officials can decide whether contraception will offered to the students.
鈥淓ast Texans believe in and have a great deal of morality,鈥� said Gilder, who graduated from West Sabine High School in 2002. 鈥淎nd, well, you have to include the parents.鈥�
In Sabine County, pine trees outnumber the people. To commute between Pineland and Hemphill, the two towns that anchor the county, residents drive down a road that winds through a national forest. The towns are dotted with churches that loom large in daily community life. Bible scriptures are printed on plaques in local stores and even in Gilder鈥檚 office.
has shown access to contraception and comprehensive sex education prevents unplanned pregnancies. But for sexually active teens trying not to get pregnant in Sabine County, it鈥檚 hard to access either.
Sex education in Texas is taught amid tight parameters and bureaucratic strings. Texas schools have to offer health class at the middle school level, but parents must opt their children in to any lessons about sexual health. And when teachers do touch on sex education, state law requires them to stress abstinence as the preferred choice before marriage.
Even if teens in this region want contraception, it鈥檚 nearly impossible to get without parental consent. In small towns like Hemphill and Pineland, parents have eyes and ears everywhere, making teens reluctant to go to the local Brookshire Brothers or dollar store to purchase condoms. They could go to a family planning clinic, which provides contraception at little to no cost, but only clinics program do not require parental permission 鈥� and a federal judge in Texas that the program violates parents鈥� rights and state and federal law.
As , the nonprofit group that is the state鈥檚 Title X administrator, awaits guidance from the U.S. Department of Health and Human Services on how to proceed, it informed Texas providers this week to require parental consent out of precaution.
Today, family planning programs are few and far between, thanks to funding cuts by the Texas Legislature in 2011. No family planning clinic exists in Sabine County. To get to the nearest one, teens in the region must travel to an adjacent county.
Meanwhile, Texas has one of the in the country. And in 2020, Sabine County鈥檚 teen birth rate was the statewide average. Nearly 7% of Sabine County teenage girls between the ages of 15 and 19 gave birth that year, compared with about 2% statewide.
Evolving health education standards
In Texas, abstinence became the cornerstone of sex education in the mid-1990s when conservatives , insisting sex education was an inappropriate topic for teens. Then-Gov. George W. Bush signed a forcing school districts that offer sexual education to emphasize abstinence until marriage. The law allowed health educators to discuss contraception with students only if they spent more time emphasizing abstinence.
In 2009, the state removed health class as a high school graduation requirement, further minimizing the importance of health education. As a result, less than a third of Texas high school students took a health class between 2016 and 2020, according to an analysis of state course enrollment data by Healthy Futures of Texas, a nonprofit that works to reduce teen pregnancies.
In 2021, state lawmakers made it even harder for students to learn about safe sex. Now, parents must give written permission before their children can learn about 鈥渉uman sexuality,鈥� , child abuse or sex trafficking. Texas is one of only in the nation, along with Nevada, Utah, Mississippi and North Carolina, to have such a requirement for sex education and the only state requiring parental permission to teach about child abuse.
Students whose parents allow them to attend sex education classes are still taught that abstinence is the 鈥減referred choice of behavior.鈥� But, for the first time in more than 20 years, the Texas State Board of Education in November 2020 voted to overhaul the middle school health curriculum standards. These students should now learn about contraception and sexually transmitted diseases, conversations previously reserved for high school health classes.
, the Lufkin-based chair of the State Board of Education, called the new requirements a 鈥済ood middle ground鈥� between comprehensive sex education 鈥� which prioritizes accurate and exhaustive information about contraception, sexual health and sexually transmitted infections 鈥� and an abstinence-only class.
Schools were scheduled to adopt these new standards by August of this year. But in Sabine County, as well as many others in East Texas, schools are sticking with an abstinence-based curriculum for middle school students.
Every few years, the Texas State Board of Education sets standards about what is to be included in teachers鈥� lesson plans, whether it鈥檚 social studies, math or health. These standards are known as the Texas Essential Knowledge and Skills, or TEKS. But no state agency tracks whether districts employ these standards. Students eventually take annual standardized tests on core subjects like math and science, but there is no such test for health.
鈥淭here鈥檚 no guarantee that every single TEK is taught to every single student,鈥� Ellis said. 鈥淚n the state of Texas, I鈥檓 sure some TEKS get skipped over, hopefully inadvertently, but probably in this case a little less inadvertently.鈥�
When new health requirements for schools come from the state capital, districts turn to their to advise their local school boards about how to implement them. The councils, made up of parents and administrators appointed by the local school boards, are there to ensure that 鈥渓ocal community values are reflected鈥� in their school districts鈥� health education instruction. School boards tend to listen to their suggestions.
Inside a classroom at Hemphill High School this fall, members of the local advisory council struggled to navigate the new state requirements about sex education.
鈥淗ave we been able to decipher the bill yet?鈥� Cecily Bridges, a Hemphill school nurse and the council鈥檚 chairperson, asked during the meeting. She turned to Stephen English, Hemphill Independent School District鈥檚 superintendent, for an assist.
鈥淣ot really,鈥� English replied.
鈥淚t鈥檚 hard to interpret what we鈥檙e required to do,鈥� Hemphill Middle School principal Jeremy McDaniel interjected.
At the end of the meeting, Bridges instructed committee members to read through the new laws and the updated curriculum before the next meeting. And she said she鈥檇 reach out to the district鈥檚 education service center for guidance.
Across the rest of religious and conservative Deep East Texas, some districts are choosing not to offer sex education to middle school students.
鈥淚 don鈥檛 care for the school to be teaching the kid sex ed. That鈥檚 my job,鈥� one parent said during the health advisory council meeting for Chester ISD in nearby Tyler County in April. 鈥淚鈥檒l do that.鈥�
If a district is not complying with state standards, the only recourse would be for a parent to file a complaint with the school board. But that puts the responsibility of tracking district curriculums on parents who, in Deep East Texas, would often prefer to avoid sex education altogether.
In Hemphill, a town of less than 1,000 people, churches outnumber medical clinics. Wednesday night church services are part of the weekly rhythm. And religion has long been entangled in debates about sex education.
Some parents in this region clam up when the words 鈥渟ex education鈥� come up, said health educator Ashley Cook. She鈥檚 trying to get into the Hemphill schools to teach students about child abuse, teen dating violence and sex trafficking as part of her Lufkin-based nonprofit, Harold鈥檚 House.
But even Cook has to reassure school officials and parents that she will stick to euphemisms like 鈥減rivate parts,鈥� even for middle and high school students.
鈥淚 don鈥檛 say the biological terms,鈥� Cook said. 鈥淭he schools are a little concerned about that, so I鈥檓 careful about how I use my language.鈥�
Inconsistent sex education
Because sex education is voluntary, it鈥檚 not clear what Texas students know about sex and contraception. According to a , 58% of Texas school districts teach abstinence-only sex education while 17% teach an abstinence-plus curriculum that includes information about contraception. The remaining 25% teach no sex education at all.
Tenaha ISD in Shelby County 鈥� about 50 miles north of Hemphill 鈥� invited nonprofit Excellent Teen Choice to deliver abstinence-based lessons to students.
On a Friday morning in November, Excellent Teen Choice educator Eric Love, 47, launched into a class about sexually transmitted diseases as he stood before 10th graders at Tenaha High School.
鈥淒id anybody know you could have sex and catch a disease? Isn鈥檛 that cool?鈥� Love said sarcastically, his eyes wide and hands gesticulating wildly.
For 45 minutes, the high-energy instructor enthusiastically told students about the signs and symptoms of infections like gonorrhea, HPV and chlamydia. Students followed along in workbooks.
To demonstrate how widely the diseases can spread, students ran around the room collecting as many signatures as they could on index cards. Love then explained that each signature represented someone they had sex with.
Two students, unbeknownst to them, had tiny X鈥檚 printed on the corners of their notecards. That X, Love said, meant the student had a sexually transmitted disease.
鈥淚t鈥檚 living in their body and they鈥檝e been transmitting the STD to other people, and they just don鈥檛 know it,鈥� Love said.
He then had the two 鈥渋nfected鈥� students stand at the front of the room and read the names on their cards. Now those students were infected, too, Love explained.
鈥淚 need you guys to understand the way this happened,鈥� Love said. 鈥淎lthough this is a game, it鈥檚 not a game in real life.鈥�
Love understood this personally. His half-sister became pregnant when she was in high school, an experience that inspired Love to educate young people about the consequences of premarital sex.
As students returned to their desks, Love flashed images on a screen at the front of the room. One showed pus-filled bumps on a male penis that made some students鈥� jaws drop. Another pictured an infected cervix, the narrow passageway between a woman鈥檚 vagina and her uterus. A student cocked his head and remarked that the fallopian tubes resembled frozen Tyson chicken wings.
Before students went on to their next classes, Love returned to his main point: abstinence. 鈥淚t is our hope, our aim that you all will listen to this message: The best decision for your health, for your life, for your children鈥檚 lives is to save sex until marriage.鈥�
Ninth grader Jasmine Santos said she was ignorant about STDs before the lesson.
鈥淣ow that I understand what can happen, I鈥檒l probably say no [to sex] until marriage,鈥� she said.
abstinence-only sex education or no sex education at all correlates with high teen birth rates. Medical experts, meanwhile, have championed comprehensive sex education.
When Brittany Henson, 33, attended Hemphill High School, she and her mother never talked about safe sex. The school district wasn鈥檛 teaching sex education, either. The gaps in her sex education were a byproduct of how little the town and the community had discussed the subject, Henson said.
鈥淭hat is the culture of Hemphill. It is 鈥楲et鈥檚 not talk about it. It鈥檚 not a problem,鈥欌�� said Henson, whose family has lived and worked in this town for generations. 鈥淧eople feel like it鈥檚 so wrong to talk about it. And like if you talk about it, 鈥極h, let me grab my shirt and button it all the way up to my neck because you shouldn鈥檛 be talking about these things.鈥欌��
Without formal sex education, Henson turned to other students. Their information was often incorrect.
鈥淪o, result? Hey, you got a baby,鈥� she said.
Henson was in her junior year of high school when she got pregnant. She was on birth control but wasn鈥檛 taking her pills consistently and didn鈥檛 know that would raise her risk of pregnancy. She was, by no means, an anomaly. Five other girls in her high school class also got pregnant before graduation, she said.
Contraception access
Over the years, Valerie Polk has gotten very comfortable with subterfuge. Polk works at the only clinic in the region that has historically been able to prescribe birth control without parental consent, and she鈥檚 had to find creative ways to help young people protect themselves.
She鈥檚 met students off the highway, at the post office, on the bleachers during a high school football game and in the checkout line at the local Brookshire Brothers.
Once, in 2017, Polk wrapped contraceptive pills inside a Walmart bag and slipped the bag to a teen cashier at the local grocery store. The cashier laughed at Polk鈥檚 stagecraft before accepting the bag and putting it out of sight.
Valerie Polk, a public health worker at the Jasper Newton County Public Health District, describes the challenges of getting contraception to patients in a rural area.
鈥淲e do what we have to do to get our patients taken care of,鈥� Polk said.
Polk has worked at the Jasper Newton County Public Health District for more than 25 years, providing health services to residents in Jasper and Newton counties as well as other nearby areas, including Sabine County.
The Jasper Newton County Public Health District is a federal Title X health care provider, one of 156 such clinics in the state. That has allowed Polk to give anyone birth control, free of charge. The Title X program has been one of the only ways minors in Texas can access birth control without parental consent. But last month, a Trump-appointed federal judge in Texas that Title X violates parents鈥� rights and state and federal law.
Legal proceedings are ongoing, but the state's Title X administrator has instructed Title X clinics to stop giving out birth control to minor patients without proof of consent for now. The ruling has left Polk and her team in a bind. Starting this week, they now began requiring parental consent.
"This isn't somewhere we've been before 鈥� where we really can't help someone," Polk said. "This is a new era for us. I just hope the ruling is overturned sooner rather than later."
Already, over the past decade, the number of Title X clinics in the region has fallen, further impeding sexually active teenagers who want to avoid becoming pregnant. In 2011, there were four federally funded clinics in Deep East Texas. That number has been sliced in half, with just two clinics within a 100-mile radius of Sabine County. The Jasper Newton County Public Health District runs both those clinics 鈥� with one in Jasper and the other in Newton.
In Lufkin, a health care hub about 50 miles away from Sabine County, the Angelina County and Cities Health District suspended its contract with Title X in 2021, citing onerous requirements and paperwork. While the health district still provides contraception, teens must be 15 or older and have parental consent to receive it.
In 2011, in an effort to stop state dollars from flowing to Planned Parenthood鈥檚 health care clinics, Texas legislators 鈥� from $111 million to $37.9 million for the 2012-13 budget. Within three years, across the state shuttered, including those that were never affiliated with Planned Parenthood.
Some of the clinics that closed were also Title X providers. , which has administered the state鈥檚 Title X funds since 2013, has tried to rebuild the network of family planning services. But restarting services brings up a host of challenges.
鈥淚t鈥檚 a lot easier to close. It鈥檚 a lot harder to reopen a clinic,鈥� said Stephanie LeBleu, the group鈥檚 acting deputy Title X project director. 鈥淲e still see the legacy of that choice to cut family planning funding throughout the state.鈥�
The Title X program has faced its own politically motivated attacks in recent years. Under the Trump administration, clinics that provided abortions or made abortion referrals were disqualified from the program.
Adding to the barriers to contraception access, the teens Polk wants to serve don鈥檛 even seem to know that Title X exists. Some teens who want birth control don鈥檛 know where to go for it. Few have formally been taught about sex. Those who have were instructed to abstain.
鈥淭he Bible Belt says, 鈥楴o, we鈥檙e not going to talk to our kids about birth control,鈥欌�� Polk said. 鈥溾�榃e鈥檙e not going to talk about premarital sex.鈥欌��
English, the Hemphill school superintendent, said contraception was not covered in the district鈥檚 sex education curriculum and he doubted students could access it if they wanted to.
Polk and her team have tried to get into the public schools to educate students about their options for contraception. But that鈥檚 been nearly impossible, she said.
Polk details some of the obstacles to teaching high school students about contraception.
鈥淚t may not be the superintendent, it could be the school board. It could be some parents that are going, 鈥極h, no, you're going to tell my child about sex,鈥欌�� Polk said.
What students do learn, Polk said, is often inaccurate information that comes from social media platforms like Snapchat or TikTok.
So Polk and her team do what they can to make themselves known in their community to address the misinformation. Outside of work, they wear health district T-shirts to raise its visibility. And when teenagers come in for appointments, Polk asks them to tell all their friends about their services.
Some doctors are also filling the gap left in education and access. George Fidone, a Lufkin pediatrician, said he speaks openly about sex with his adolescent patients and prescribes contraception on a weekly basis 鈥� but only with parental permission.
鈥淚鈥檝e had too many kids come in with their parents, and the parents think they鈥檙e coming in for a sore throat,鈥� Fidone said. 鈥淎nd the kid will give me a look. And I鈥檒l know that look is 鈥業鈥檓 pregnant, and I need help with this.鈥欌��
Another thing that keeps teens from accessing birth control is that Texas is one of just two states that do not cover contraception through the Children鈥檚 Health Insurance Program, the insurance plan for low-income families. Also, state-funded family planning clinics require parental consent before minors can get contraception. Even a teenager who has had a baby cannot obtain birth control without parental consent.
Teen pregnancy
When Henson was a junior in high school, she bought an at-home pregnancy test from the local dollar store and took the test in her parents鈥� bathroom.
But after the two pink faint lines emerged, signaling she was pregnant, she didn鈥檛 call her mother. She didn鈥檛 call her older siblings who had already left home.
Instead, she initially kept quiet about her pregnancy. She took herself to and from doctors鈥� appointments. She continued to make straight A鈥檚 and work her job as a cashier at Brookshire Brothers. She said she even competed in the state track meet while five months pregnant.
鈥淚 just didn鈥檛 want to deal with the disappointment. ... I wasn鈥檛 ready for that,鈥� said Henson, who was an all-star athlete and a straight-A student. 鈥淚 felt like I had the weight of not only my family, but the weight of my community.鈥�
Hemphill and West Sabine school districts work with pregnant students to provide accommodations to get them to graduation, including homebound services late in the pregnancy. But teen moms are less likely to finish high school. Just over half of 20- to 29-year-old women who were teen moms have high school diplomas, according to a 2018 report from .
But after Henson gave birth to her daughter, she kept a firm grip on her dreams. She drove straight from the Jasper Memorial Hospital delivery room to the school athletics office to rejoin the school basketball team. She would go on to graduate high school on time and attend Sam Houston State University on a track scholarship.
Henson now lives in Hemphill. She鈥檚 worked as a nurse at the Sabine County Hospital. Her daughter, Bremyiah, now 16, attends the same high school she did.
Bremyiah is dating now, but Henson says she feels OK about it. She fiddles with a silver ring on her finger, emblazoned with the word 鈥淢om鈥� in cursive. She hopes she鈥檚 given her daughter the information to make the right decisions.
The mother and daughter talk about safe sex and contraception. Bremyiah doesn鈥檛 want to get on birth control, but Henson hopes her daughter can come to her if she changes her mind.
Last year, Henson drove Bremyiah to the gynecologist for the first time, an appointment where her daughter could get basic reproductive information from a doctor.
鈥淲hat am I going here for?鈥� Bremyiah asked as they were getting ready. 鈥淚鈥檓 not having a baby.鈥�
鈥淭hat鈥檚 the point. It鈥檚 to keep you from having a baby,鈥� Henson said. 鈥淲e gotta learn, we gotta learn.鈥�
