General Articles

Debate Over Health Education Textbooks in Texas

Four health textbooks in Texas are causing a controversy that is getting national attention. In June, a panel appointed by the Texas Education Agency recommended these four textbooks for the Texas schools. Of the four textbooks, only one mentions condoms in the actual textbook. The other three discuss condoms only in the teacher editions and supplemental sections.

Many people have criticized the lack of information on contraception in the textbooks and argue that it violates Texas education code. The state curriculum standard, Texas Essential Knowledge and Skills, requires that students need to "analyze the effectiveness and ineffectiveness of barrier protection and other contraceptive methods."1 Those who oppose the textbooks argue that only including information about contraception in supplemental sections does not adequately provide this information. One of the textbooks, Lifetime Health textbook published by Holt, Rinehart and Winston, for instance, doesn’t mention condoms in a list of ten ways to prevent STDs, but does suggest "get plenty of rest."2 Another textbook was written in part by, Joseph McIlhaney of the Medical Institute for Sexual Health, one of the nation’s most prominent abstinence-only-until-marriage supporters.3

A group calling themselves the "Protect Our Kids Campaign" has formed to advocate for the textbooks to include more information on contraception. Some of the groups involved include the Texas Association of Obstetricians and Gynecologists, Texas Freedom Network, Planned Parenthood, Women’s Health and Family Planning Association of Texas, and League of Women Voters.

Samantha Smoot, the president of Texas Freedom Network said, "Texas has the nation’s highest birth rate among teens ages 15-17. In addition, nearly half of all new cases of sexually transmitted diseases occur among young people ages 15-24. Clearly, failing to include scientifically and medically accurate sexuality information in health textbooks would have dangerous repercussions."4

The 15-member Texas Board of Education held a public hearing in Austin on July 14, 2004 to discuss the textbooks. Over 100 people signed up to testify about the textbook decision. The majority of teachers, parents, religious leaders, and other activists who spoke voiced their opposition to the sex education sections of the textbooks.

A doctor who works with a local teen pregnancy prevention program pointed out that the reality is that more than 50 percent of Texas high school students are sexually active: "Sometimes abstinence intended is not abstinence achieved," she said.5 A student who testified against the books said, "As a high school student, I am aware that abstinence is the best choice, but by not stating other options, as well, students are not prepared to responsibly decide what’s best for their own health."6

In contrast, however, some speakers praised the textbooks’ abstinence-only approach. A high school student who is interning with the Texas Justice Foundation, a conservative law center, voiced his support for the textbooks and said, "As a whole, they send out the message that teens need to live a healthy life."7 He also said, however, that some changes should be made. For instance, "Macmillan McGraw Hill’s Texas Health and Wellness does not accurately describe an embryo as a human life," he said.8

A woman representing the Texans For Life Coalition, a state-wide anti-choice group, said she supported the textbooks, "By putting it in the hands of the teacher and in the teacher’s edition, then parents and schools can work with kids in a family-friendly way."9

The textbook publishers argue that the books fulfill the state requirements because additional information on condoms and other contraception is available in the teachers’ editions and student supplements. A spokesman for Holt Publishing said that "The reason for including the more explicit sexual content in a separate volume is that it gives local school districts more flexibility in when and how they want to treat this material."10

According to a recent press release from Texas Freedom Network, a non-profit group opposed to the textbooks, the publishing companies have made further additions to the textbooks recently at the insistence of state review panelists. For instance, Glencoe/McGraw-Hill recently agreed to change a section in its Glencoe Health textbook which lists behaviors that place people at high risk for STDs. The list had included "engaging in unprotected sex" but the publisher recently changed it to "engaging in either unprotected or protected sex."11

This controversy over textbooks has gained national attention, in part because of the effect it may have on the rest of the country. Texas is the second largest purchaser of textbooks in the United States and the books they adopt are often marketed in other states.

Another public hearing on the textbooks is scheduled for early September. The State Board of Education is expected to make its final decision in November. The books, if adopted, will be first used in the 2005-06 school year.

For more information on sexuality education in Texas, please see SIECUS’ state profile for Texas.

For more information on the textbook controversy, see the "Protect Our Kids" website.


  1. Texas Essential Knowledge and Skills for Health Education, Subchapter C. High School.
  2. R. Proctor May, "Don’t Ask, Don’t Tell, Don’t Know at the SBOE," Austin Chronicle (TX), July 23, 2004.
  3. "Public Hearing On Health Textbook Selection," KXAN36 News (Austin, TX), July 13, 2004, Available online.
  4. Email Correspondence between Dan Quinn, TFN, and Myra Batchelder, SIECUS, July 30, 2004.
  5. K. Adler, "Textbooks fire debate at hearing in Austin," San Antonio Express-News (TX), July 15, 2004.
  6. Ibid.
  7. Ibid.
  8. Transcript, "Before the State Board of Education, Texas Education Agency, Public Hearing," July 14, 2004. Available online.
  9. B. Hawkins, "Sex-education textbook hearing draws varied opinions" WFAA-TV (TX), July 14, 2004
  10. R. Proctor May, "Don’t Ask, Don’t Tell, Don’t Know at the SBOE," Austin Chronicle (TX), July 23, 2004.
  11. Texas Freedom Network, Press Release, "From Bad to Worse: Publishers Make Reckless Changes to Proposed New Health Textbooks," Released July 28, 2004.