I recently attended a talk by pediatric endocrinologist, and former Surgeon General, Jocelyn Elders. She's not a particularly gifted speaker, but delivered an enlightening presentation, with a lot of statistics and advocacy recommendations, and a little biographical context.

I had been curious if she had regrets about her outspokenness, which ultimately led to her resignation. She brought this up early on, when she reflected on how much she loved her job as Surgeon General, and how she feels she conducted herself exactly right. She said she'd do it again the same way, promoting the same measures, saying the same things.

Well, I'm glad she's sleeping easy. But the rest of her talk was about the numerous problems and setbacks facing teenagers -- poverty, limited access to healthcare, and ultimately, trouble getting access to abortions. These are difficult challenges, to be sure. And I don't think Elders' message is misdirected. But I can't help wonder that, if she had been a little more savvy in her tenure, if she had better marshalled political will and produced the appropriate studies, teens might be in better shape now.

Certainly, after the terms of C. Everett Koop and Jocelyn Elders, the public role of the Surgeon General as an advocate for health matters has decreased dramatically. I can't remember the last time I heard anything about current SG Richard Carmona's speeches or initiatives.

We certainly haven't heard anything about the preponderance of data suggesting teen sexual habits don't change, from country to country, with or without sex education, with or without abortion access. Elders reveals that, given the global constant of teen sex, the only variable seems to be unwanted teen pregnancies that keep poor people mired in poverty.

In light of this, it's unfortunate that American teens, and their healthcare providers, have to contend with abstinence-only sex education. Elders had one rhetorical zinger in her speech, when she criticized proponents of the stark 'abstinence-only' sex education curricula. In this age of teen pregnancy and increasing teen STD rates, she quipped, "They say condoms break, but we all know the vows of abstinence break more frequently than any condom."

Elders also said something really interesting, something that doesn't get said enough in the debate about sex education: The age of menarche (first menstruation) in U.S. girls is dropping. The age of marriage is rising. The two used to roughly coincide, in the late teens. But now menarche occurs, on avergage, at age twelve (she said eleven in her speech, I can't find that datum). Conversely, marriage is being postponed. If sex educators are trying to keep sex within marriage, without using condoms, without allowing abortions, they're facing a widening time gap.

She doesn't tie it together as tightly in her speech, but I think this is the crux of the matter. The push in recent years to promote sex for procreation, in married couples only, something at odds with a century's worth of changes in human society and human biology.

UPDATE: Dr. Quinn was there, too! It's a small blog world.