Shame Hurts

Scared Straight

Last spring, a school program provider looking to hire peer educators to lead sex education workshops for her students asked if the youth facilitators I worked with were effective at “Scaring kids straight.” When I explained that the organization I work with avoids using shame and fear tactics in our workshops, the program provider responded, “No shame? Honey, these kids need shame. Maybe if they had a little more we wouldn’t need your workshop to begin with.”

In my first year of work at the Illinois Caucus for Adolescent Health (ICAH), I supported a group of peer educators in leading sexual health workshops in schools, programs and conferences. ICAH is unique in our approach to youth development and sexuality education. We operate from a reproductive justice and sex positive framework in support of any sexual decision that a young person makes, as long as it is safe, healthy and consensual. This includes supporting the decisions of young people to have sex safely or not have sex, to express their sexuality safely, to access and utilize contraception, and to parent if they choose. I also work as the Artistic Director of For Youth Inquiry (FYI), a participatory theater company that uses games and role-plays to host sexuality-related conversations with youth. At the core of FYI’s work is the idea that talking about sex should be pleasurable.

Explicit in both ICAH and FYI’s framework is the unspoken belief that youth are, most often, sexual beings. And that’s ok. I’m not suggesting that most youth are or should be having sex. I am, however, making the daring and outrageous claim that most youth have at least thought about sex or experienced desire in one way or another before turning sixteen. Even asexual youth likely think about sex regularly in considering how the public dialogue about it rarely affirms or acknowledges their identities. This needs to be acknowledged in the public health field beyond shame and fear scripts.

Beyond sexuality education and prevention initiatives, shame lives at the core of most cultural conversations about sexuality. When I ask the young people I work with where they experience shame tactics around their sexuality, they include families, peer groups, religious institutions, healthcare settings, schools, sports teams and various cultural groups, just to name a few on their extensive list. Above the rest, young people point to the media’s exhaustive use of shame as most significantly impacting their self-determination in negative ways. Off and online media provide unattainable definitions for how to be sexual that often leave youth feeling inadequate, abnormal and confused (as if slut shaming and fear mongering weren’t enough).

Shame is everywhere. In the world of sexuality discourse, it’s in every magazine, classroom, dinner table, and provider’s office; it’s in the air we breathe. And it makes us sick.    

Four Negative Health Impacts of Shame

Countless longitudinal studies prove that if youth perceive the risks of sexual behavior as equal to their efficacy to engage with prevention strategies, youth are more likely to adopt preventative behavior. When they perceive their efficacy as less than the risk of sexual behavior, they do not avoid sex. They have it unsafely. When their perceived risk of unintended pregnancy or contracting an STI is high, but their self-efficacy for prevention is low, they see through risk messages and dismiss them as propaganda.  When youth feel shame about their desire or unable to protect themselves from all of sex’s negative consequences, they become less well. Shame needs to be a public health concern for this reason.

Tools for Shame Resilience:
Stay skeptical of messages created to “freak you out.” Dig through fear tactics to find the truth. For example, most STD pictures used in sex-ed classrooms don’t actually reflect the common impacts of STIs on the body. (This is a dangerous since it prevents many students from understanding that the most common STI symptom is no symptom). When something freaks you out, question it. Ask, “Why is this scaring me, and what do I need to know to reduce my fear?”

1. Shame stops us from exploring desire in safe and pleasurable ways.

Using shame and silence in classrooms does not discourage sexual activity. Instead, it discourages safe sexual activity by preventing youth from asking the questions they need to ask and accessing the information they need to make informed decisions about their bodies. Texas provides a clear example of this point.

Tools for Shame Resilience:
Ask Questions! And remember that if you don’t know something, it’s likely that most of your peers don’t either (especially if you received the same sex ed). If you can’t find a reliable adult or friend to talk to, check out
sexetc.org or scarleteen.com.

More than a decade ago, Texas legislature made the decision to promote abstinence-only curricula over any other method of sexuality education in schools (Wilson, Wiley and Rosen, 2012). Texas uses the Why kNOw?, FACTS, and the Scott & White Worth the Wait curriculum, all famous for their use of shame and fear strategies that focus on the negative outcomes of sex. The FACTS curriculum is strung together by a common theme of shame and sickness, tellingeighth graders, “You know people talk about you behind your back because you’ve had sex with so many people. It’s so empty too. Finally you get sick of it all and attempt suicide” (Wilson, Wiley and Rosen, 2012). Slut-shaming messages like these do not serve young people in developing healthy sexual practices. In 2009, the teen birth rate among girls ages 15–19 in Texas was 60.7, compared to 39.1 in the US. Texas youth also ranks well above national averages on virtually every published statistic involving sexual risk-taking behaviors.

Tools for Shame Resilience:
Speak out against the language of shame when you hear words like “slut,” “ho,” and “thot.” But, avoid shaming the person who used the word. Remember that we were all taught negative messages about sexuality. We want to transform harmful ideas rather than shut down the people who hold them. Also, expect others to speak out against this language and hold them accountable when they don’t (especially teachers, principals, etc).

2. Shame stops us from seeking healthcare services, including testing for STIs

The stigma and shame associated with sexually transmitted infections have long been identified as barriers to the STI care-taking process and as contributors to negative psychosocial experiences in response to an STI diagnosis. A 1998 San Francisco study on sex-related stigma conducted with African-American youth ages 13–-19 found that youth were 73% less likely to have been tested for an STD if they reported high levels of stigma around having an STD, and were 81% less likely to have been tested if they reported high levels of shame around having an STD (Cunningham et al, 2002). This perceived negative reaction from healthcare professionals prohibited youth from seeking the services they needed, with only 56% of sexually active participants having sought STD related care in the past year (Cunningham et al, 2002).

Tools for Shame Resilience:
Know your STI status. Make a regular habit of getting tested every three months and after any risky interaction. STIs become far less scary this way. To find a clinic near you, check out
std-clinics.findthebest.com.

The same study found that avoiding the social interaction required for STD testing is a way in which some adolescents prevent feeling shamed and stigmatized. Chicago ranks first for cases of gonorrhea and syphilis in the country, and second for chlamydia. Approximately 19 million new cases of STIs are reported each year, almost half of which are among youth ages 15–24. 39.8% of youth reported not using a condom during their last sexual contact, and 35% of youth report that they engage in unprotected oral sex because they believe “you can’t get an STD” (Center for Disease Control and Prevention, 2013). As is the case in Chicago, youth often receive sexual health information including details about STIs and HIV. But when youth view sex as dirty or nasty, they are likely to view barrier methods similarly and therefore avoid using them. Reducing shame and stigma around adolescent sexual decision-making while increasing positive perception of self should be a primary concern of all sexuality educators—as primary a concern as HIV and STI prevention.

Tools for Shame Resilience:
Know your healthcare rights and advocate for yourself with your doctor, so shame doesn’t prevent you from getting what you need. Youth under the age of eighteen have the right to confidentiality around most reproductive and STI healthcare services. Check out
sexetc.org/action-center/sex-in-the-states/ to learn more about your healthcare rights. And remember that you know your body and your needs best.

3. Shame stops us from disclosing sexual history to partners or healthcare providers.

The same San Francisco study mentioned above found that 38% of participants anticipated that a negative reaction would result from disclosing sexual behaviors to a doctor or nurse (Cunningham et al, 2002). These youth were correct in anticipating that reaction, because a 2003 study on predictors of shame and stigma found that public health clinics expressed disapproval particularly of young women who sought STI-related care, especially if clients did not seem embarrassed or ashamed (Foster and Byers, 2008). As is the case with prejudice against people who are overweight, people with STIs may be shamed because of the inaccurate assumption that they have irresponsible or immoral characteristics.

When young people internalize stigmatized messages of irresponsibility or immorality, they are less able to disclose past sexual experience with partners or to disclose STI history or risk. Open communication with partners is an essential factor in creating healthy relationships. Similarly, open communication with healthcare providers is critical in getting the services that young people need. Shame closes the door to conversations that young people need to have in order to be safe, affirmed and healthy.

Tools for Shame Resilience:
TALK, TALK, TALK. Open communication is the enemy of shame. Silence is shame’s best friend. The more people and places you access for conversations about sexuality, they more power you give yourself to live and healthy and shame-free life.

4. Shame perpetuates and enforces rape culture.

Sexual contact for youth is not always a choice, and is sometimes a result of coercion, force, or survival. When young people, and young women especially, connect their moral worth and identity to their virginity, they experience severely damaging psychological effects when that virginity is taken from them by force. Redletterchristians.org featured a fantastic and critical piece on Elizabeth Smart, who was kidnapped, raped and held captive for nearly a year. Smart provides clear example of the silencing effects of shame-based sexuality education. After her rescue, she detailed how feeling shamed throughout her sex education prevented her from trying to escape her captors:

I thought, ‘Oh my gosh, I’m that chewed up piece of gum, nobody re-chews a piece of gum. You throw it away.’ And that’s how easy it is to feel like you no longer have worth, you no longer have value. Why would it even be worth screaming out? Why would it even make a difference if you are rescued? Your life still has no value. I was raised in a religious household where I was taught that sex only happened between a married man and a woman. After that rape, I felt so dirty . . . Can you imagine going back into a society where you are no longer of value? Where you are no longer as good as anybody else?”

Tools for Shame Resilience:
Remember that your value reaches far beyond your sexuality. Remind the people in your life of this by affirming their unique gifts, and surround yourself with people who do the same.

Equating virginity with purity silences survivors and creates roadblocks to their healing process. Lessons like Elizabeth Smart’s become particularly damaging to the one in three individuals who experience sexual violence in their lifetimes, who certainly don’t need help in feeling shame about their experience.  

If not shame, then…?

Much of what’s out there in discourse about sexuality is boring at best and shame-ridden at worst. Sex should be neither or these things, so we need to drastically rethink the way we teach and talk about it. In addition to the recommendations that the National Sexuality standards laid out for educators in 2011 (including guidelines for medical accuracy, age-appropriateness and content), sexuality education should be creative, engaging, pleasure-centered, and honest. This is how I teach about sexuality with youth at ICAH, and how I write plays about sexual health and sexual violence at FYI. We need to equip youth with self-efficacy skills to make positive sexual decisions. As a field, we need to amplify youth voice and make safe space for inquiry in sexuality education. If we listen deeply, youth will tell us shame doesn’t work. We need to support them in developing shame resilience to sex-negative messages so they can bounce back from its damaging interpersonal and internalized effects. Most critically, we need to understand the health risks of using shame in the classroom and in our culture at large as much as we want young people to understand the health risks of unprotected sexual activity.