Dr. Joycelyn Elders: Public Health & Sex

Podcast Transcript Season 3 Episode 40


Interviewer: Liz Goldwyn
Illustration BY Black Women Animate

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The following is a transcript of the interview from the episode:

Liz Goldwyn Intro:

Hello, and welcome to the season three premiere of The Sex Ed podcast. I’m Liz Goldwyn, your host and the founder of The Sex Ed, your #1 source for sex, health, and consciousness education. On our website TheSexEd.com, you can read original essays written by our network of experts, watch live talks and videos, listen to past episodes of this podcast, and sign up for our weekly newsletter. You can follow us on Instagram @TheSexEd. 

We have been working hard to bring you this new season. We pride ourselves on having top notch sound quality, however— due to the COVID-19 pandemic, we have had to get creative about recording methods. Some of the interviews this season were conducted in person before the outbreak, and some have been recorded remotely. As we say in Hollywood, the show must go on!  

The Sex Ed is positively Orgasmique to be partnered with Gucci for your listening pleasure on this season of our podcast. That’s right, OH! YES! Gucci baby! We are so grateful to Gucci for sponsoring this epsiode and helping us answer everything you wanted to know about sex...but were afraid to ask!

Today, my guest is Dr. Joycelyn Elders, the first African-American woman to hold the position of Surgeon General of the United States. Dr. Elders was born in 1933, one of eight children in a sharecropping family. 

She received her undergraduate degree in biology, she enlisted in the Army and served as a Vice Admiral. 

Post enlistment, Dr. Elders received her doctorate and a masters in biochemistry from the University of Arkansas. 

She then taught as a professor until she was appointed Director of the Arkansas Department of Health by then-governor Bill Clinton. 

During her tenure, teenage pregnancy rates dropped, and accessibility to birth control, HIV tests and breast cancer screenings were expanded. 

In September 1993, Dr. Elders was confirmed as Surgeon General of the United States under President Bill Clinton. During her time in office, she  stirred up controversy with her strong stances in favor of comprehensive sex education, drug legalization and expanded abortion access. After only 14 months as Surgeon General, Dr. Elders was forced to resign after suggesting that teens should learn to masturbate as part of safe sex education during a speech she gave at the UN on World AIDS Day. 

I talked to this sex ed icon about being the Condom Queen of Washington, DC; entering the White House shortly after the Anita Hill trial; how spirituality figured into her medical practice; the benefits to passing out vibrators in nursing homes; and why she’s optimistic about the future of sex education.

Liz Goldwyn:

Thank you so much for speaking with me today.

Dr. Elders:

A pleasure.

Liz Goldwyn:

How are you today? How are you doing?

Dr. Elders:

I don't know. I've had better days, but I'm okay.

Liz Goldwyn:

Well, I hope you're staying healthy with all crazy news about the coronavirus.

Dr. Elders:

Oh, I know, that's right.

Liz Goldwyn:

My generation thinks that this time we're living in is apocalyptic, but you grew up in the Depression, so you might have a different perspective on that.

Dr. Elders:

Well, I think that's true, but then we had things like ... Well, we got rid of chicken pox, then we had smallpox ... We got rid of smallpox, excuse me. And then we're getting rid of chicken pox and we had mumps and measles and whooping cough. We have all of those diseases and now... then we had the polio epidemic. I've lived through many of those epidemics and saw and treated many of those diseases and I think that now we're seeing a lot of diseases that probably were there, but we didn't have the diagnostic tools then that we've got now. And we are able to treat and handle them better.

Liz Goldwyn:

And I mean, you also experienced one of the worst economic crises our country has seen growing up in Arkansas during the depression.

Dr. Elders:

Yes, oh yes.

In the South we were black, we were very poor, and we lived on a farm and we didn't know anything else. We didn't have T.V. We didn't even know about anything else. And the only thing I can say is, we were very poor, but it's like we lived in the country and on a farm. But things I could say we didn't have what we wanted to eat, but we always had food to eat. We never went hungry. My mother always implanted in us that if you want to get out of a cotton patch, you've got to get something in your head. But to us, at that time, we didn't know any more. But then, to us getting an education was finishing high school. And it was only when I was a senior in high school, then I was just wanting to be able to, if I graduated from high school, and did well, maybe I could get a job working as a clerk at Dillard's Department Store. We hadn't seen any better, and you can't dream of being what you can't see.

Liz Goldwyn:

When did you first see something else?

Dr. Elders:

I was in college. And the way I ended up in college, it was the United Methodist Women came to our community and school, was telling about the availability of scholarships for students, the valedictorian and salutatorian, of the classes, and offered them a scholarship.

A United Methodist College.

Liz Goldwyn:

And from there, you really went on a trajectory joining the military, training to be a therapist, and then taking up a residency at University of Arkansas?

Dr. Elders:

Well, not only was it Smith College, Dr. Elia Thereby Jones came and spoke to our chapel program, and she talked about the difference between the high roads and the low. I thought she was the most beautiful, charming woman I'd ever seen. And that she was a sophomore in medical school. She was studying to be a doctor at that time. But all I could think of after I saw her and heard her speak, the rest of my life I always dreamed I wanted to be just like her. So that was where my inspiration came.

Liz Goldwyn:

When did you start to specialize in pediatrics and get into adolescent sexual behavior?

Dr. Elders:

Well, I started specializing in pediatrics when I was a senior medical student. My internship was at the University of Minnesota. It was a straight pediatric resident. And I wanted to be a pediatric surgeon. 

I got married so I didn't do pediatric surgery. I ended up doing pediatric endocrinology. And then I start seeing children with precocious puberty or ambiguous sexuality, or other disorders of sexual development. It was a part of my training to take care of them. But, that did not really get me that involved with necessarily adolescent sexual behavior. I saw some sexual abuse that really probably got me upset.

Liz Goldwyn:

And I know you saw a lot of teen pregnancy during this time, right?

Dr. Elders:

Yes.

I saw many of them had been abused, and they didn't know better. They didn't know how to protect themselves. Nobody had ever taught them anything, anything about sexuality. They didn't teach us in medical school, and we couldn't teach the young people. And the parents couldn't teach them because they didn't know anything. The teachers couldn't teach them anything about sex at school because we didn't talk about it. And I guess, I just during the years I just got more and more frustrated and upset.

Liz Goldwyn:

So if you weren't getting sexual intake history in medical school, how did you start to study and learn things that you would impart to adolescents?

Dr. Elders:

You had to read. Masters and Johnson, see, that came up but that was in the early '60s. And that was during my time. That was during my time, during my residency and training. I began to, because I was dealing with children with ambiguous genitalia, dealing with girls who went into puberty early, their body was developed but their brain hadn't developed. And so they ended up getting pregnant. And so, what I'm saying is, I was kind of forced to learn things, just out of necessity.

Liz Goldwyn:

This is still time ... I mean, in 1960 it was illegal for married people to even use condoms in the US under the Comstock Laws.

Dr. Elders:

That's right. That's right.

Liz Goldwyn:

What else did the Comstock Laws govern in terms of regulating, even passing along oral information relating to sexuality?

Dr. Elders:

Well, I mean, the Comstock Laws are really very bad. They wanted to outlaw the knowledge. You couldn't even have the knowledge present information. [inaudible 00:13:43] was really trying to teach women about their sexuality and what they could with ... That was absolutely against the law, and she was being jailed for that. It was just a horrible incidence of men trying to totally control women's bodies and their reproduction. And then even want them to know anything about what they could do to prevent that. You have to remember, we're sexual beings from the day we're born until the day we die. And for people to feel that we can write laws to govern our sexuality and our relationships and our behavior, just makes no sense. But we have to teach people and organize them so that they can make responsible decisions.

Dr. Elders:

And we were totally dishonest about all of that. We have to be honest, we have to educate and empower our young people so they can be responsible. You can't hold people responsible, and you have to give them the resources. If they don't have the resources, and I remember young people down in the delta, was trying to use saran wrap for condoms.

Liz Goldwyn:

That sounds messy and also ineffective, saran wrap as condoms.

Dr. Elders:

Well, of course it was, but they were trying their best to ... They didn't want their girlfriends to get pregnant.

Liz Goldwyn:

What do you think is the relationship between self esteem and sexual wellness?

Dr. Elders:

Why, I think that there is a great relationship between self esteem and sexual wellness. You can't be sexually healthy unless you understand and know and appreciate your sexuality. And then if you do that, you can really feel good about protecting, always protecting your own body. And so you have to think, well, what do you need to do to protect your body? First, you've got to have the knowledge to be able to protect your body. But then you've got to have the resources to do that… You've got to feel well enough about yourself, and strong enough about your own self, that you can demand a certain amount of respect for your body. I'm not saying don't have sex, but make sure you use appropriate protection to protect yourself, should you just choose to be sexually active.

Liz Goldwyn:

We're not in the habit of teaching kids to understand their own sexuality before they start exploring that with someone else. So it gives that agency or power to another person, instead of the individual.

Dr. Elders:

Well, we've got to teach our young people, first of all, we've got to teach them that their body is their own. We've got to teach them about their sexuality, and that it's healthy sexuality. We've got to teach them that it's normal, that it's a hormone imperative that they have all of these feelings. We've got to make sure that we protect ourselves and the other person. And we've got to make sure that we understand that sex is about pleasure, 99.999% of sex is about pleasure. It's not about procreation. Not every sperm was meant to be a baby.

Liz Goldwyn:

Tell that to the religious right.

Dr. Elders:

Well, the religious right knows better. They may not admit it, but they know that billions of sperm and that all of those sperm are not meant to be a baby. And the only way we know that we can really be responsible and protect ourselves from creating a baby, or from getting pregnant, or from getting a disease, is that we have to make sure that the sperm does not come in contact with the egg. Well, we can do that with condoms.

Well, then, let's say that they don't choose to use a condom, they're hormone controlled. We have probably 15 or 20 different ways now these days of preventing pregnancy, are contraceptives, but we've got to also prevent disease. We've got HIV disease, syphilis is on the rise, gonorrhea. And there some other sexually transmitted diseases. So we have to protect ourselves and our partners from these sexually transmitted diseases. And so all of that has to be considered. In addition, we have to also realize that we have to be sexually responsible people.

Liz Goldwyn:

When Bill Clinton was governor of Arkansas, he appointed you to the head of the Arkansas Department of Health. And, you campaigned for clinics and expanded sex education. Is that the first time that you started coming up against conservative and religious groups for your outspoken views at the time about sex ed?

Dr. Elders:

Well, probably, but before I never really ... I was a pediatric endocrinologist, so I was really taking care of the problem after it became a problem. Or I was just trying to make sure that I was teaching ... I was really working hard teaching young people, especially those who had gone into puberty early, I would talk to them about the sex [inaudible 00:21:40] when I learned the parents didn't really know anything, and that they wanted you to educate their children. And many times people say, "But parents don't want you to talk to their children about sex." Parents do want you to talk to their children about sex. They may go to church and spout out that they don't want you to talk to their children about sex, but they want their children to know about it. Knowledge never hurt anybody. The more you know, the more responsible they can be. How can you be responsible if you're ignorant?

Liz Goldwyn:

Was there comprehensive sex ed in public schools at that time, in the late '80s, when you were the head of the Department of Health?

Dr. Elders:

No, we worked hard to try and get them, and we worked hard. And we finally got a bill passed that they had to have a comprehensive sex ed, but it was not complete. Nobody at that time ... I won't say nobody, not many schools were really teaching comprehensive sexuality health education.

Liz Goldwyn:

Do you think we'll ever get to that point where we have it in the US, or is there just too much political red tape?

Dr. Elders:

Yes, we will. We're slow, we're slow learners. We've come a very long way, and I think that we're learning more and more. And we're also learning, a lot of the people that hollered the loudest was probably out doing the most behind their backs and abusing children. So, I'm saying that if we educate our children, make sure they know, but then that's the way we're going to get rid of all the silence. Our silence has been deafening, and then I think the Me Too Movement is making a lot of people aware that a lot of things were going on, how our children were really being abused. And we allowed that to go on.

Liz Goldwyn:

Speaking of Me Too, before then-President Clinton appointing you to be US Surgeon General, just right before that was the Clarence Thomas/Anita Hill trial, right?

Dr. Elders:

Yes.

Liz Goldwyn:

So you must have had a front row view of all of that.

Dr. Elders:

I did. Oh, no, I really did, and I felt that she was telling the truth. I still feel that she was telling the truth and have the utmost respect for her. And I felt that I've not had very much respect for our supreme court justice, Mr. Thomas. I feel that he really tried to denigrate or put down a young woman who was really being honest and telling the truth. And I don't feel that that's the only one. Well, we're finding out that that's certainly not the only ... She was not the only one that ... Maybe not Mr. Thomas that said anything to, I don't mean that. But I think that a lot of young women took an awful lot of abuse for a long, long number of years. And a lot of women took a lot of abuse. All sexual abuse does not have to be physical abuse, but you can have emotional abuse.

Liz Goldwyn:

How did that work when you're transitioning into your office as US Surgeon General in 1993? I mean, I know you say that you think things have changed a lot but, when I look at the US government now, it's hard to see that. And I can't imagine you being already so outspoken and advocating for sex education-

Dr. Elders:

Yeah, I think our government certainly has to make rules and laws, but our government is going to do what the people want. And until we can educate the people, make them aware of what they've got to have, and that they've got to stand up and fight for their children, fight for their communities, fight for their societies, and start demanding more things. And the more our young people know, the better decisions they are going to make, and the better decisions our government will make, and the better off we'll all be.

Liz Goldwyn:

So, did you just go in fighting, basically? Did you go in fighting when you took office in 1993?

Dr. Elders:

Well, I was the health director before I went in as surgeon general, and I was fighting about teenaged pregnancy before I went to Washington as the surgeon general. And of course, I came in, in the midst of the AIDS epidemic. So we were having to talk about sex, whether we wanted to or not.

Liz Goldwyn:

And you had a condom tree in your office, right?

Dr. Elders:

Absolutely.

Liz Goldwyn:

How did that go down?

Dr. Elders:

And I always told everybody I'd put the crown on my head and sleep in it, if everybody who needed to use one would use it.

Liz Goldwyn:

A condom crown?

Dr. Elders:

Condom crown, that's right.

Liz Goldwyn:

And what was the opposition like when you were in office from conservative groups? Did it get you down?

Dr. Elders:

I knew that I was fighting for the most valuable resource we've got, that's our bright young people. And I knew that once I got enough of them educated and moving and making decisions, I wouldn't have to worry about the people that were screaming, because I know most of the people that were out there screaming were doing so out of ignorance.

Liz Goldwyn:

Were you advocating at this time for legal abortion and looking at the legal use of cannabis for medical purposes? Or did that come later?

Dr. Elders:

I felt that the decisions about abortions should be between a woman, her doctor, and her God. And I feel that it's nobody else's business. And I was never about abortion, I was about preventing unplanned pregnancies. If we prevent unplanned pregnancies, there would never be a need for an abortion. Because I've never known a woman to need an abortion who was not already pregnant. So we really were about preventing unplanned pregnancies. You can't be about preventing sex. We aren't going to prevent sex, but we can make sure that we have healthy, responsible sexual relationships.

Liz Goldwyn:

And what about cannabis use, because I know that you were pretty open about that?

Dr. Elders:

Yes. I felt that our abortion, our drug laws, were more very often have been more related to, very often racial laws, to me. In the United States, we were the world's fattest jailer. It put more young Black men in jail and destroyed lives for smoking or using pot. And I always felt that cigarettes were probably worse or more dangerous. So I really do support the legalization and control of marijuana, cannabis.

Liz Goldwyn:

Then you see that as directly linked to prison reform?

Dr. Elders:

Yes, I do.

Liz Goldwyn:

I'm curious, you said a moment ago that the relationship between or whether or not you want to have an abortion is between and your God.

Dr. Elders:

Right.

Liz Goldwyn:

And I actually believe that we learn a lot about sexuality from religion, and I'm not sure what your faith is, but do you feel that it's possible to have a strong sense of faith and also a strong sense of sexuality? Because I think in this culture we really segregate those ideas.

Dr. Elders:

I feel that you can have a very strong sense of faith, and I feel very strongly about my faith, but I feel that my faith is my faith. It's me and my God. People often talk about prayer, and open prayer. I always feel that the best prayers are the prayers that are just between me and God.

Liz Goldwyn:

Does your God believe that sex should be pleasurable? And does your God believe in masturbation?

Dr. Elders:

My God certainly believes in ... As I said, we're talking about my God. My God and your God may be a different God, but my God feel, as I said, I feel the 99% of sex is for pleasure. It's about pleasure. I feel that God meant for sex to be wonderful, enjoyable, and pleasurable. And I feel that God taught us how to masturbate. If He had never wanted, my God, would feel that if He never wanted us to touch ourselves or get any pleasure from masturbation, we would have never learned how. The babies masturbate.

Liz Goldwyn:

Babies do-

Dr. Elders:

All you have to do is, if you've ever had a son, you know.

Liz Goldwyn:

They do. How do you suggest that parents talk to their kids about masturbation when they're first learning about their bodies?

Dr. Elders:

I feel that parents should tell their children that there is nothing wrong with touching yourself. You aren't going to go crazy, you aren't going to go blind, you won't get a disease, and you know you're having sex with somebody you love. You're not going to get anybody pregnant. But the other thing, you should do it in the privacy of your own room. It's not to be done in public. It should always be done in private.

Liz Goldwyn:

So masturbation is probably the safest sex that you can have?

Dr. Elders:

Absolutely.

Liz Goldwyn:

And I know you were promoting that, especially at the height of the AIDS crisis, as part of your safe sex campaign, and the blowback from that forced the Clinton Administration to suggest you resign.

Dr. Elders:

Right.

Liz Goldwyn:

How did that go down?

Dr. Elders:

I felt that I was right then, and I still feel that I'm right now.

Liz Goldwyn:

What's it like to take such an unpopular position at the time and be in a high ranking level of government, and have just people go after you for these views? For something that you believe is right?

Dr. Elders:

But if you feel strongly about it, and if you feel you're right, the last thing you can ... You can't give up the rightful thinking that you feel, regardless to what's popular. But at the end, you find out later you're wrong, you don't mind saying you were wrong. But I think that, until then, you have to stand up and fight for what you feel is in the best interest of all of the people.

Liz Goldwyn:

That's interesting because it seems like the Clinton Administration was taking a very high moral ground when they forced you to resign, and then yet, a little while after that, he was mired in his own scandal.

Dr. Elders:

President Clinton was taking the moral round that he had probably been taught all of his life. As a Baptist religious person, I think that this is probably what he had always been taught. But we all do things at some point, we might end up doing things that's different from what we may have been taught at some point. I think we look at the Catholic priests who've abused young children. And to me, almost the worst form of abuse, is abuse of children. But I feel that not educating children, and teaching them about their bodies and teaching them about their sexuality, is also another form of child abuse.

Liz Goldwyn:

You were mentioning the STDs that are not prevented by birth control. And we know that right now, one of the biggest rise of syphilis, for example, is in senior citizens' communities. And you also were talking about how we're sexual being from birth to death.

Dr. Elders:

Right.

Liz Goldwyn:

I feel like, actually, an older generation is neglected in this conversation around sexuality.

Dr. Elders:

We're really doing some working, and doing some education and working on sexuality in the elderly, the highest incidence of new age cases has been in the over 55 age group.

Liz Goldwyn:

What do you think that stems from?

Dr. Elders:

Well, they were never taught about condoms, they were never taught about sexuality and protecting themselves. They just didn't know about that, and this was before the AIDS epidemic and all that. And so we hadn't taught them, and we've got to teach them about that. That you just don't have sex with anybody that you don't know. I think, as I said, the older women in nursing homes, they have sexual desires. We've taught them you don't touch yourself, you don't masturbate. And we've not taught them to use condoms.

And many of the nursing homes now are, when the public health doctor or nurse goes out to the nursing homes, they take condoms with them, and they're saying some of the best attendant sessions that they have is when the condom lady comes.

Liz Goldwyn:

Maybe they should be passing out vibrators also.

Dr. Elders:

I think they should. I don't have any problem with that. I think that would be a wonderful idea.

Liz Goldwyn:

When did you first come across vibrators?

Dr. Elders:

Well, I probably learned about vibrators, it was probably in the '70 or '80s. I haven't known about vibrators for a long time. You remember I told you I grew up in the country.

Liz Goldwyn:

I mean, you had quite an interesting career trajectory between the Army and being the chief resident and-

Dr. Elders:

Yeah, but I didn't know about vibrators when I was in the Army. I didn't know about vibrators when I was in medical school. I really learned the most about vibrators probably in the last 20 years.

Liz Goldwyn:

Is that because National Masturbation Month in May was named after you?

Dr. Elders:

Well, I don't know. I didn't know that, but that's wonderful.

Liz Goldwyn:

You didn't know that?

Dr. Elders:

No.

Liz Goldwyn:

Oh, so there's a sex toy store in San Francisco called Good Vibrations, and when the Clinton Administration forced you to resign, they decided to call May, National Masturbation Month in your honor.

Dr. Elders:

Oh, well, I'm proud of it. I think that's wonderful. We should make sure that all women who want, make sure that they have vibrators. And I think many of our women don't know about vibrators, and we've not stressed that enough.

Liz Goldwyn:

What are you still learning about sex?

Dr. Elders:

Well, I'm learning that, much of our population are still very ignorant in regard to sexuality, and they don't really understand it.

What surprised me, I think, is how little we educate our young people, our [inaudible 00:45:31], our educators, our ministers, how little sexuality education we really provide to our professionals. And if we don't educate our professionals, how can we expect the rest of our society to know anything? And that we're really not educating them. The reason why we have the highest teenage pregnancy, the highest AIDS, or HIV, and the reason why syphilis and many sexual diseases are higher in African-American populations are, is because of knowledge. We've not educated our people on how to have healthy sexuality.

We've talked about all this silence and that all of these myths going on, and I think we need to be able to get rid of all of that, and really talk openly and honestly about sex. And such that our children can be able to talk to us. The reason why our children don't know any more is that we don't allow them to talk to us about it.

Liz Goldwyn:

So they have to go online and look.

Dr. Elders:

Yes. And sometimes the information they get is not the information that they need to have.

Liz Goldwyn:

Thank you so much, Dr. Elders. I really appreciate you speaking with me.

Dr. Elders:

You're very welcome. It's a pleasure. Thank you.

Liz Goldwyn Outro:
That was my conversation with Dr. Joycelyn Elders. You can purchase her memoir, Joycelyn Elders, MD: From Sharecropper’s Daughter to Surgeon General of the United States, wherever books are sold.

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