Condom Nation: The U.S. Government's Sex Education Campaign from World War I to the Internet (review)

Condom Nation tracks almost one hundred years of Public Health Service (PHS) efforts to teach Americans about sex. Alexandra Lord, a former historian with the PHS, takes up the story in the early years of the twentieth century, when the PHS—along with private organizations such as the YMCA and the American Social Hygiene Association—launched its fight against sexually transmitted diseases. Most of the book focuses on these myriad interventions against sexually transmitted infections, while later sections also examine teen pregnancy and sex education in the schools. The book concludes with discussion of controversies over recent surgeons general and reflections on the ongoing state of conflict over sex education in American society.

Lord is at her best when focused specifically on the PHS, and we encounter occasional historical gems in her archival research. For example, she recounts that when the PHS initiated community sex education efforts in 1918, it encouraged lecturers to modify programs to suit their own needs. A director of the YMCA observed that they could "take the Government material and… Christianize the message" (p. 42). This casual intermingling of Christian morality and government-sponsored sex education is fascinating in light of intense controversies that erupted in the 1980s and later over federal funding of programs with religious content. Unfortunately there are too few of these insights from primary research in Condom Nation, with Lord even burying some of them in footnotes.

Instead of a sharp focus on the government's role in sex education (in the form of the PHS), Lord meanders through social history that distracts more than contextualizes. This is partly because her material here largely derives from familiar secondary sources and partly because Lord regularly overreaches in her presentation, for example, through suggestions of what parents or teenagers might well have thought or felt in a particular era rather than sticking to the evidence of what they actually did think. Her failure to focus more consistently on the PHS is also unfortunate since Lord's main topics—government campaigns related to sexually transmitted infections, teen pregnancy, abstinence-only programs—have been so thoroughly researched by prior scholars such as Allan Brandt, Constance Nathanson, and Jeffrey Moran, all of whom Lord draws from extensively.

The book suffers from other weaknesses. There are numerous contradictions (on one page parents were "pleased with" a program while on the next page there was "shock" about it (pp. 38–39), repetitions (there is discussion of the Tuskegee experiment in several chapters, written as though it had not been mentioned before), and errors (disclosure: in five references to my work, my last name was incorrectly cited three times). At the very least, these problems should have been corrected by a copy editor.

Still, Condom Nation deepens our knowledge about PHS approaches to sexuality education and ongoing controversies about the federal government's role in teaching about sex. And Lord's emphasis on how federal officials addressed issues of racial and cultural diversity is vital. Although these sections often draw on secondary sources, their attention to PHS interventions among African Americans, Jews, and rural Americans is admirable in a literature that is often limited to studies of the white middle class.