Email to the San Diego Unified Sexual Health Program (SHEP) Office

Wednesday, August 28, 2019

Subject: Lesson One (Gender) Inaccuracies

Dear ______,

Thank you very much for explaining the responsibilities of the [Sexual Health Education Advisory]  committee. I realize that’s not the best avenue for me, so I won’t apply.

My main concern is that information presented in Lesson One on gender is not accurate. I’m drafting a longer letter with references to support my position (unless this email is good enough and a separate letter is unnecessary). Let me know if my letter should be addressed to you or the school board. Here are a few examples (high school):

  • Lesson one fails to mention that biological factors (in addition to environmental factors) also influence gender and gender differences between males and females. Teaching students about “gender scripts” while omitting biological factors gives students the false impression that society is entirely responsible for gender/ gender differences. (See Notes: 1, 2, 3)
  • The lesson’s definition of “transgender” is not accurate and is in fact the definition of gender dysphoria. According to the APA Handbook of Sexuality and Psychology Vol 1, gender dysphoria is “discomfort with the sex or gender role assigned at birth.” (743-744). The APA Handbook further states that “in no more than about one in four children does gender dysphoria persist from childhood to adolescence or adulthood.” (744). The majority of boys with gender dysphoria (who may have expressed the wish to be of the other sex in childhood) later on identified as gay (63-100%), not transgender; for girls 32-50% later identified as lesbian, not transgender.
  • The APA Handbook also states: “Premature labeling of gender identity should be avoided. Early social transition (i.e. change of gender role, such as registering a birth-assigned boy in school as a girl) should be approached with caution to avoid foreclosing this stage of (trans)gender identity development.” Furthermore it states: “Early social transition maybe necessary for some; however, the stress associated with possible reversal of this decision has been shown to be substantial.”(744).
  • The statement “Gender identity is not a choice” is not accurate because it omits any mention of gender dysphoria, or the fact that gender dysphoria does not persist into adulthood in the majority of youth who experience it. I think this is important information to include in the lesson for students who may be struggling with gender identity–they should know that it possible their dysphoria may not persist, and they may in fact be gay or lesbian, not transgender. (There’s also a study that’s recently been published by Lisa Littman about social media’s role in  “rapid onset gender dysphoria,” especially in cases where a group of friends all suddenly identify as transgender at the same time. One of the conclusions of the study is that some adolescents “may be employing a drive to transition as a maladaptive coping mechanism.” )
  • A question on page 6 of lesson one asks students: “How did you think about the white people as compared to the people of color?” This question is irrelevant to the topic of gender and sexuality. It’s inappropriate to ask students to judge the subjects in the photos based on their skin color or race when the lesson is about gender and sexuality. Section 51933 (4) states: “instruction and materials shall not reflect or promote bias against any person on the basis of any category protected by Section 220” which includes “race or ethnicity.”
  • There should be a lesson devoted to teaching the value of marriage. Section 51933 (6)(f) states that  “instruction and materials shall teach the value of and prepare pupils to have and maintain committed relationships such as marriage” but I don’t see this anywhere in the curriculum. I don’t even see the word “marriage” anywhere. Of all the required topics listed in the CA Healthy Youth Act, instructions teaching the value of marriage is the only one that’s missing. It doesn’t make sense to leave this out when it’s required by the CA Healthy Youth Act.

It’s important that all information presented in the curriculum be accurate (and without bias). Inaccuracies in any part of the curriculum undermines the credibility of the entire curriculum.

I’ve attached to this email a PDF of chapter 24, “Transgender Identity and Development” from the APA Handbook of Sexuality and Psychology Vol 1.

If there is an opportunity to review an updated version of the curriculum in the future (whenever that happens, a couple years from now when the next 5-year grant period begins), I’d like to have a chance to review it and offer feedback.


Lisa Hagerman


(1) According to a report published by the National Academy of Sciences titled Exploring the Biological Contributions to Human Health: Does Sex Matter?, “basic genetic and physiological differences, in combination with environmental factors, result in behavioral and cognitive differences between males and females” (p. 79).

Wizemann, Theres M. and Mary-Lou Pardue, eds. Exploring the Biological Contributions to Human Health: Does Sex Matter? Institute of Medicine, Committee on Understanding the Biology of Sex and Gender Differences, Board on Health Sciences Policy, Washington D.C.: National Academy Press, 2001.

(2) In the book The Blank Slate: The Modern Denial of Human Nature, the psychologist Steven Pinker devotes an entire chapter debunking the myth that gender differences between men and women are due entirely to social influences, and provides numerous examples from peer-reviewed scientific studies. He states: “neuroscience, genetics, psychology, and ethnography are documenting sex differences that almost certainly originate in human biology.”

(3) In chapter 2, “Sexuality and Gender: the Interplay,” the APA Handbook of Sexuality and Psychology Vol 1 states that biological and cultural influences are “both at work, likely in tandem, in producing sexuality and gender.” (p. 43)

(Reply from the San Diego Unified Sexual Health Program (SHEP) Office)

Hi Lisa,

Thank you so much for your thoughtful and detailed comments.

I’m so glad you referenced the American Psychological Association (APA) in your statements below, since the APA is also funded by CDC to provide technical assistance and capacity building (please see bottom of this page) for school districts across the country for the CDC grant that we receive to implement sexual health education, access to sexual health services, and support for our LGBTQ students. In fact, APA has been funded by CDC for several grant cycles, along with Advocates with Youth (AFY) who created the Rights, Respect, Responsibility (3Rs) curriculum that our district implements, and APA provided guidance to AFY on supporting the safety and inclusion of LGBTQ youth while the 3Rs curriculum was in development.

I will definitely reach out to both APA and AFY with your comments, since both of these organizations are indeed experts in the field of supporting the health and safety of youth, including LGBTQ youth, as well as adapting academic research and findings to youth- and age-appropriate instructional materials to be implemented within a classroom setting.

With the ten 50-minute Sex Ed lessons that we are allotted to implement within 6th grade, 8th grade, and high school, I’m sure that you can appreciate the challenge of fitting in all of the CHYA-required topics in a meaningful and relevant way into these ten lessons. We would absolutely love to have more time to devote to additional topics, including sex and human trafficking, negotiation and refusal skills, and sexual consent. As it is, these topics, along with discussions of marriage, are interwoven throughout the lessons in relevant sections. Fortunately, we do include important discussions of committed relationships, including marriage, in numerous lessons throughout the entire curricula.

Please see:

  • Grade 6:
    • Lesson 6 (Liking and Loving – Now and When I’m Older): Step 4, pages 2-3
  • Grade 8:
    • Lesson 2 (Sexual Orientation, Behavior and Identity: How I Feel, What I Do and Who I Am): Myth or Fact Answer Key, page 9
    • Lesson 6 (Birth Control Basics): Step 2, page 2; Step 3, page 3
    • Lesson 10 (Let’s Talk about Sex): Step 1, page 1; Step 5, page 5
  • High School:
    • Lesson 2 (Sexual Decision Making): infused throughout worksheets for students to think through and find ways to communicate their values on sex, relationships, and marriage to their partners
    • Lesson 9 (Is It Abuse If…?): Step 1, page 2

Thank you for the offer to send a formal letter, although I think email is certainly sufficient to document your suggestions and I will retain it for our review and for our records. And we will certainly keep you posted if any large-scale curriculum reviews are scheduled in the future!

Thank you again and have a wonderful day,

_____________, M.Ed. (she/her/hers)