WASHINGTON -- Surgeon General David Satcher called on parents, schools and community leaders Thursday to get past their nervousness about sex so they can do a better job preventing unwanted pregnancies and sexually transmitted diseases.
In a far-reaching report, Satcher called for a "mature and thoughtful discussion about sexuality," asking the nation to confront these issues with respect for diversity and respect for what science shows is effective.
"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 in an interview. "At every level we have problems discussing it," he said.
The "call to action," two years in the making, 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; and nearly 1.4 million abortions each year, with nearly half of all pregnancies unwanted. An estimated 800,000 to 900,000 Americans are now living with HIV.
It also touches on some of the most contentious sexual issues, calling on Americans to respect "the diversity of sexual values within any community."
It 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 have a responsibility to be more supportive and proactive than judgmental," Satcher said. "We're certainly not trying to get anyone in any religious group to change their views. 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 funding for them.
Satcher said 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."
Another difference with conservatives: His report 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 unable to give their children all the information they need.
"Parents sometimes need help. There are so many parents who are unprepared or uncomfortable discussing it," Satcher said. "Schools have always been the great equalizers."
"The Surgeon General's Call to Action to Promote Sexual Health and Responsible Behavior" also recommends:
-Providing adequate training in sexual health for health care professionals who deal with these issues.
-Ensuring that programs that aim to prevent sexual abuse are available.
-Encouraging stable and committed adult relationships, particularly marriage, to help strengthen families.
-Increasing scientific research on sexual health, including the entire life span, from childhood to old age.
-Developing and disseminating educational materials for sex-ed classes that cover the "full continuum of human sexual development" for use by parents, clergy, teachers and others.
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