By Cheryl Alkon
Passionate and outspoken, Dr. Joycelyn Elders pulls no punches when it comes to sex education and health.
As highlighted in her autobiography, Joycelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States, Elders has followed a particular path: growing up in rural Arkansas, attending medical school and practicing medicine. She has held appointments as the director of the Arkansas health department and as America's Surgeon General under President Bill Clinton. Currently, she works as a pediatric endocrinologist at the University of Arkansas Medical School, writes, and speaks to audiences across the country.
In an exclusive HealthGate interview, Dr. Elders spoke about her compulsion to educate people about better sexual and reproductive health issues, her dismissal as Surgeon General, and her plans for the future.
HealthGate: Throughout your autobiography, a consistent theme emerges: education for all – especially youth – about sex and reproductive health. Why do you feel so strongly about this?
Joycelyn Elders: First of all, I think that all of the children in the community are our children. We pay for each and every one of them, and it's to our advantage to keep them healthy, educated, motivated, and have hope.
That's what I've been about. In the community where I grew up, I had 13 aunts and uncles on one side and 17 on the other side and the entire community, I think, felt responsible for me, at least they acted as if they did. They felt, and anybody felt, that they could tell me to stop, or not do something, and also get out their belt if they felt they needed to.
HealthGate: But that's not the way to teach sexual health issues. What's the best way to do that?
Joycelyn Elders: The best way to get the message through to all the children – and make sure that we don't miss any – is that it really has to be done in a uniform, coordinated, age-appropriate fashion through the schools. That's the only institution we have for all the children. We can reach everybody, and we can know that everybody is getting the message.
Health Gate: Your book chronicles your efforts to try to put more school-based health clinics – medical facilities within the schools that both students and teachers can use – into some rural areas not serviced by other clinics. Yet that work generated much disagreement within the communities. For instance, some critics believed the clinic's presence would signify that the school condoned irresponsible behavior among the young.
Joycelyn Elders: Most of that opposition and most of that controversy was really the religious right trying to use that to make a point about abortion. And it really probably had very little to do with school clinics. I think everybody would want children to really be able to have a nurse at school, or someone to consult with them at school, or provide primary preventative health care. I think that we all want that. If a child comes to school stressed out, (a clinic provides) somebody to talk to. Teachers don't have time to do that.
Health Gate: Beyond the experiences with the religious right, how would you describe the country's tolerance for these issues?
Joycelyn Elders: I think the country's tolerance is improving very drastically. I think that Washington is, on a scale of one to ten, Washington is a three, and the rest of the country is probably a seven or an eight.
Health Gate: Why? What accounts for the drastic improvement?
Joycelyn Elders: Well, I feel that things are improving drastically because we as parents are looking out and seeing the effects of all of these social and behavioral problems on our children. Listen, we will do whatever we have to do to save our children. What good is it for our children to be the best in physics, or the best in calculus, and then they go out and kill themselves by drunk driving, using drugs, or getting involved in sexual activities, getting a sexually transmitted disease or becoming pregnant?
Health Gate: What can people do to prevent those scenarios?
Joycelyn Elders: I think that parents need to go out and make sure that if there isn't a comprehensive health education curriculum in their children's schools, from K-12, they need to ask "Why?" And demand that the school boards get one there.
Health Gate: What about educating others? Those who are already in college, or beyond?
Joycelyn Elders: I think the colleges have a responsibility to train and educate teachers to be able to come out and teach the children.
You know, then you could say "Well, what about the parents now?" Well, I think our churches and other institutions can begin to train parents. But if we start now, in 12 years, we would have an educated set of people coming through. But if we don't start now, we'll be at the same spot 12 years from now as where we are today.
I think that parents are listening, they're seeing that young people are listening. They're beginning to feel it's all right to talk about sex. If we don't talk about it, that says we accept it. Silence is acceptance. If you see something going on and you don't say anything about it... isn't that saying you accept it?
Health Gate: Which leads to the comment you made that led to your dismissal as the Surgeon General.
Speaking at a World AIDS Day conference in 1994, Elders was asked about her opinions on masturbation as an alternative to sexual release other than intercourse. After some discussion, she said that "In regard to masturbation, I think that is part of human sexuality, and perhaps it should be taught."
These words caused President Clinton to dismiss her from the post. She returned to Arkansas, her home state, and continued her work as a pediatric endocrinologist at the University of Arkansas Medical Center.
Health Gate: You felt very strongly about your comment on masturbation.
Joycelyn Elders: Yes.
Health Gate: Looking back, would you have handled it differently?
Joycelyn Elders: No, no, no! I feel that it is very important, most important, that the Surgeon General take all of the available scientific facts and use them to educate and improve the health of America. If a Surgeon General can't do that, you shouldn't be Surgeon General.
A politician can take any set of facts and use any piece of it that he feels to be true. And then they can go out on that, and not mention the rest. But it's not acceptable for a Surgeon General to do that.
Health Gate: How do you feel the dismissal was handled?
Joycelyn Elders: I think the President has a right to do whatever he feels he needs to do in regarding to choose the people that he wants to work with his administration. So if he chose not to have me as a part of his administration, that's the right of the president.
HealthGate: What would be an ideal state of affairs for you, concerning the country, sexual education and health?
Joycelyn Elders: The ideal state of affairs for me would be to go home and plant in my garden! (She laughs.)
Health Gate: Well, I know you've worked very hard to try to get school-based clinics in the schools...
Joycelyn Elders: And they're coming. We've gone from having 30 to over a thousand. Schools are doing it now and they don't even talk about it. When some things cease to be and people accept it for something, that's good. Now, they just work to get the money (to fund the clinics).
Health Gate: In light of all that, it sounds like you'll be out of a job.
Joycelyn Elders: Well, not in my lifetime. Listen, the last thing I need now is a job. There comes a time in your life where you just need to sit down, and reflect, and think about it and write and talk.
I think that I could probably do a far greater service if I spend all of my time either writing or going around talking or whatever. I think that a lot of people can doctor as well as I can.... But, I think that not a lot of people can motivate and get people involved or even want to do what I do.
For the country, if I spent all of my time working with educators, politicians, religious organizations, churches and all – to really get them involved and on the bandwagon for doing things for adolescents – I think we'd have a far better country.
Health Gate: What does the future look like for you?
Joycelyn Elders: I'm going to go home and raise my garden. (She laughs.) No, no, I'm going to write. I'm writing on a book now, with a theologian and myself. We're writing a book on masturbation.
Health Gate: It sounds like you are expanding on the very topic that caused you to be dismissed.
Joycelyn Elders: I think we're just discussing it in light of it being a normal part of human sexuality. Scientifically, there's no question I was correct. Politically, well, I don't feel I was incorrect. I think the president may have felt I was incorrect, but that's the prerogative of the president. I don't feel I went to Washington to be the president's rubber stamp. If that's all that I was going for, I should have stayed at home.
Health Gate: Any last words?
Joycelyn Elders: I think the important thing is that we need to educate our children. Ignorance is not bliss, and we need to educate them about their health, about their sexual health, their physical health, their mental health. The greatest cause of death related to our adolescents is related to social and behavioral problems and if we don't educate them, who will? And our silence, our failure to do it, means we accept it.
Passionate and outspoken, Dr. Joycelyn Elders pulls no punches when it comes to sex education and health.
As highlighted in her autobiography, Joycelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States, Elders has followed a particular path: growing up in rural Arkansas, attending medical school and practicing medicine. She has held appointments as the director of the Arkansas health department and as America's Surgeon General under President Bill Clinton. Currently, she works as a pediatric endocrinologist at the University of Arkansas Medical School, writes, and speaks to audiences across the country.
In an exclusive HealthGate interview, Dr. Elders spoke about her compulsion to educate people about better sexual and reproductive health issues, her dismissal as Surgeon General, and her plans for the future.
HealthGate: Throughout your autobiography, a consistent theme emerges: education for all – especially youth – about sex and reproductive health. Why do you feel so strongly about this?
Joycelyn Elders: First of all, I think that all of the children in the community are our children. We pay for each and every one of them, and it's to our advantage to keep them healthy, educated, motivated, and have hope.
That's what I've been about. In the community where I grew up, I had 13 aunts and uncles on one side and 17 on the other side and the entire community, I think, felt responsible for me, at least they acted as if they did. They felt, and anybody felt, that they could tell me to stop, or not do something, and also get out their belt if they felt they needed to.
HealthGate: But that's not the way to teach sexual health issues. What's the best way to do that?
Joycelyn Elders: The best way to get the message through to all the children – and make sure that we don't miss any – is that it really has to be done in a uniform, coordinated, age-appropriate fashion through the schools. That's the only institution we have for all the children. We can reach everybody, and we can know that everybody is getting the message.
Health Gate: Your book chronicles your efforts to try to put more school-based health clinics – medical facilities within the schools that both students and teachers can use – into some rural areas not serviced by other clinics. Yet that work generated much disagreement within the communities. For instance, some critics believed the clinic's presence would signify that the school condoned irresponsible behavior among the young.
Joycelyn Elders: Most of that opposition and most of that controversy was really the religious right trying to use that to make a point about abortion. And it really probably had very little to do with school clinics. I think everybody would want children to really be able to have a nurse at school, or someone to consult with them at school, or provide primary preventative health care. I think that we all want that. If a child comes to school stressed out, (a clinic provides) somebody to talk to. Teachers don't have time to do that.
Health Gate: Beyond the experiences with the religious right, how would you describe the country's tolerance for these issues?
Joycelyn Elders: I think the country's tolerance is improving very drastically. I think that Washington is, on a scale of one to ten, Washington is a three, and the rest of the country is probably a seven or an eight.
Health Gate: Why? What accounts for the drastic improvement?
Joycelyn Elders: Well, I feel that things are improving drastically because we as parents are looking out and seeing the effects of all of these social and behavioral problems on our children. Listen, we will do whatever we have to do to save our children. What good is it for our children to be the best in physics, or the best in calculus, and then they go out and kill themselves by drunk driving, using drugs, or getting involved in sexual activities, getting a sexually transmitted disease or becoming pregnant?
Health Gate: What can people do to prevent those scenarios?
Joycelyn Elders: I think that parents need to go out and make sure that if there isn't a comprehensive health education curriculum in their children's schools, from K-12, they need to ask "Why?" And demand that the school boards get one there.
Health Gate: What about educating others? Those who are already in college, or beyond?
Joycelyn Elders: I think the colleges have a responsibility to train and educate teachers to be able to come out and teach the children.
You know, then you could say "Well, what about the parents now?" Well, I think our churches and other institutions can begin to train parents. But if we start now, in 12 years, we would have an educated set of people coming through. But if we don't start now, we'll be at the same spot 12 years from now as where we are today.
I think that parents are listening, they're seeing that young people are listening. They're beginning to feel it's all right to talk about sex. If we don't talk about it, that says we accept it. Silence is acceptance. If you see something going on and you don't say anything about it... isn't that saying you accept it?
Health Gate: Which leads to the comment you made that led to your dismissal as the Surgeon General.
Speaking at a World AIDS Day conference in 1994, Elders was asked about her opinions on masturbation as an alternative to sexual release other than intercourse. After some discussion, she said that "In regard to masturbation, I think that is part of human sexuality, and perhaps it should be taught."
These words caused President Clinton to dismiss her from the post. She returned to Arkansas, her home state, and continued her work as a pediatric endocrinologist at the University of Arkansas Medical Center.
Health Gate: You felt very strongly about your comment on masturbation.
Joycelyn Elders: Yes.
Health Gate: Looking back, would you have handled it differently?
Joycelyn Elders: No, no, no! I feel that it is very important, most important, that the Surgeon General take all of the available scientific facts and use them to educate and improve the health of America. If a Surgeon General can't do that, you shouldn't be Surgeon General.
A politician can take any set of facts and use any piece of it that he feels to be true. And then they can go out on that, and not mention the rest. But it's not acceptable for a Surgeon General to do that.
Health Gate: How do you feel the dismissal was handled?
Joycelyn Elders: I think the President has a right to do whatever he feels he needs to do in regarding to choose the people that he wants to work with his administration. So if he chose not to have me as a part of his administration, that's the right of the president.
HealthGate: What would be an ideal state of affairs for you, concerning the country, sexual education and health?
Joycelyn Elders: The ideal state of affairs for me would be to go home and plant in my garden! (She laughs.)
Health Gate: Well, I know you've worked very hard to try to get school-based clinics in the schools...
Joycelyn Elders: And they're coming. We've gone from having 30 to over a thousand. Schools are doing it now and they don't even talk about it. When some things cease to be and people accept it for something, that's good. Now, they just work to get the money (to fund the clinics).
Health Gate: In light of all that, it sounds like you'll be out of a job.
Joycelyn Elders: Well, not in my lifetime. Listen, the last thing I need now is a job. There comes a time in your life where you just need to sit down, and reflect, and think about it and write and talk.
I think that I could probably do a far greater service if I spend all of my time either writing or going around talking or whatever. I think that a lot of people can doctor as well as I can.... But, I think that not a lot of people can motivate and get people involved or even want to do what I do.
For the country, if I spent all of my time working with educators, politicians, religious organizations, churches and all – to really get them involved and on the bandwagon for doing things for adolescents – I think we'd have a far better country.
Health Gate: What does the future look like for you?
Joycelyn Elders: I'm going to go home and raise my garden. (She laughs.) No, no, I'm going to write. I'm writing on a book now, with a theologian and myself. We're writing a book on masturbation.
Health Gate: It sounds like you are expanding on the very topic that caused you to be dismissed.
Joycelyn Elders: I think we're just discussing it in light of it being a normal part of human sexuality. Scientifically, there's no question I was correct. Politically, well, I don't feel I was incorrect. I think the president may have felt I was incorrect, but that's the prerogative of the president. I don't feel I went to Washington to be the president's rubber stamp. If that's all that I was going for, I should have stayed at home.
Health Gate: Any last words?
Joycelyn Elders: I think the important thing is that we need to educate our children. Ignorance is not bliss, and we need to educate them about their health, about their sexual health, their physical health, their mental health. The greatest cause of death related to our adolescents is related to social and behavioral problems and if we don't educate them, who will? And our silence, our failure to do it, means we accept it.