What's Actually Taught In Sex Ed Class

Guests

Nora Gelperin, director of training and education, Answer
Dr. Diane Foley, pediatrician and director of Education for a Lifetime

The New York City public schools recently sparked controversy with a new sex education curriculum that critics complain is too explicit. New York, and many other school districts, relies on curricula designed by outside experts. Guests talk about who decides what's included, and what's left out.

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NEAL CONAN, host: This is TALK OF THE NATION. I'm Neal Conan, in Washington. And before we begin, a word of warning: We're about to start a conversation on sex education that will include mention of body parts and practices.

There are few educational issues that are more controversial. In New York City, public schools are about to start a new curriculum that some complain is too explicit. In some places, classes focus on abstinence until marriage. Others discuss oral sex, and teach kids how to use condoms.

There is, in fact, a range of programs that are often adjusted by local school boards. So when you're in the classroom, how do they actually differ? Parents, teachers, what should be taught? Who should teach it? Give us a call, 800-989-8255. Email, talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Later in the program, cautious optimism as change begins in Myanmar. But first, sex education, and we begin with Nora Gelperin. She's director of training at Answer, an organization that promotes comprehensive sexuality education - based at Rutgers University. She trains educators nationwide to teach all types of sex education curricula, and joins us now from a studio in Piscataway, New Jersey. Nice to have you with us.

NORA GELPERIN: Thanks so much.

CONAN: And help us understand. What kinds of sex ed curricula can schools choose from?

GELPERIN: There's quite a range, from abstinence-only-until-marriage programs, which have rarely shown to be effective; to comprehensive sexuality education, which is age appropriate and medically accurate, and implemented across the grade spans of kindergarten through 12th grade. So quite a range.

CONAN: And as I understand, there are different companies, like textbook companies that have - well, offer different curricula.

GELPERIN: That's true. There's many different nonprofit organizations that promote various curriculum that are available. Some are evidence-based. Some are evidence-informed. Many of them are infused into the school day by the individual teacher - or the districts - that figures out what's best for their students.

CONAN: And you work with teachers to teach whatever curricula their local school board, or their state, mandates, right?

GELPERIN: Exactly. So the state board of education decides what's the policy at the state level, and then the individual districts decide, based - what's in compliance with their state policy, what's going to be in best interest of their young people. So it goes - a tiered effect, from the state down to the local districts.

CONAN: And obviously, this varies from - you know, it's quite different, say, in Louisiana or New York.

GELPERIN: Absolutely. The policies really range. Only about 35 states mandate comprehensive sexuality education, or HIV-STD prevention. Some of them don't require it at all. So it's left up to the discretion of the local district - or actually, sometimes teacher to teacher.

CONAN: And in some cases, you are prohibited from discussing abortion.

GELPERIN: Absolutely. So the state of Michigan is a good example. They're prohibited from discussing that term or that concept at all. Actually, sometimes there can be financial penalties if they do versus, like a state - here in New Jersey - that is actually required to teach about pregnancy options, including abortion, in high school.

CONAN: In high school and obviously, these lessons can vary as - whether they're taught in middle school or high school.

GELPERIN: Right, absolutely. So middle-schoolers need different information than high-schoolers do. Obviously, that's much more age appropriate, relevant to where they are in their lives and developmentally appropriate as well, versus high school students, which need something different - whether they're sexually active in high school, or looking toward the future.

CONAN: And language - I mean, is the language in different curricula different? I mean, in some cases, do they use clinical terms? In other cases, do they tend more towards - well, expressions that the kids in class might be more familiar with?

GELPERIN: Absolutely. So we at Answer really promote and recommend that schools adopt curriculum that are medically accurate and using the scientifically correct terms. Sometimes what also happens is, a teacher really struggles that her students or his students know a different set of terms than what is medically accurate. So they struggle with the street terms, or the slang. So we really encourage teachers to make sure that their students are aware of what the medically accurate terms are, and make sure to use those in their teaching.

CONAN: And obviously, sometimes students are uncomfortable with language and can giggle. Obviously, sometimes teachers can be uncomfortable with the language, too.

GELPERIN: Absolutely, that's so true.

CONAN: Who are the teachers?

GELPERIN: Typically in a school district, you might have a range. Typically, it's a health and physical education teacher who's implementing comprehensive sexuality education. Sometimes, it might be a biology teacher or a science teacher. Rarely, we might see implementation done by a guidance counselor or social worker; sometimes even a school nurse, if we're talking about elementary schools.

CONAN: And they can run into conflicts, too. Somebody who might believe, for example, in a comprehensive program might be required by their school or their state to teach something else, and vice versa.

GELPERIN: Definitely. So sometimes health professionals might have their own religious or moral beliefs, which might be in contradiction with the curriculum that they're required to implement. We definitely have those professionals in our workshops, and we work with them about ways that they might be able to accommodate their own beliefs.

But typically, school districts really are in alignment with what Answer believes, which is that young people deserve medically accurate and complete information so they can make healthy choices in their lives.

CONAN: We want to get some callers in on the conversation. We want to hear from parents and teachers today. What should be taught in your child's sex education classes, and who should teach it; 800-989-8255, email us, talk@npr.org. We'll start with Peter, and Peter's on the line from Berkeley.

PETER: Hi, thanks for this topic. My contribution I wanted to make was bringing up the advisability of having a checklist for healthy relationships so that young people, as well as older people, can match up their expectations of what they expect out of this relationship before they get into it, and how important that is psychologically - because I think, you know, teenagers are, like the rest of us, often very romantic around sex.

And just having some feet-on-the-ground criteria to go through to discuss before they jump into bed with somebody and get emotionally bonded, as often can happen, it would be a very, very great contribution, in addition to physical sex education.

CONAN: Nora Gelperin, is that taught in - in what kinds of classes is that taught?

GELPERIN: It's a terrific question, and I think what's so wonderful is to think beyond the physicality of sexuality education. We know sexuality is complex, and what young people really crave is to talk about the emotions that come along with relationships and sexual behaviors, not just the plumbing.

So at sexetcetera.org, our teen website, we really hear from the 5,000 young people every day who are looking for just that kind of information your caller suggested - some criteria by which to base their actual lived experiences on what's healthy or not as healthy.

CONAN: But are there any programs that would skip that?

GELPERIN: There might be. If some have an exclusive focus just on abstinence only until marriage, or just on HIV or STD prevention, they might not have the time, the luxury of time, to talk about things in a positive way, like healthy relationships or positive body image - or even things like media literacy, navigating technology, preventing sexting. All of these topics are of critical importance but often get shortchanged when we focus exclusively on health outcomes.

CONAN: Peter, thanks very much for the call.

PETER: Here, here.

CONAN: You raised the question of time. How much time is devoted in schools, typically? - and let's just say high schools, for example. This would vary. I mean, there may be a health class of which sex ed may be a part, but so would be other things, including phys ed and obesity, for example.

GELPERIN: That's true, Neal. And too often, what we hear from young people is sexuality education is too little and too late. There are just a few, precious hours to cover all of health education, of which sexuality education is one, small piece. And what we hear time and again, from both our health teachers and our young people, on sexetcetera.org is that it's just too little, too late, and they crave more.

CONAN: Here's an email from Antoine(ph) in Oakland, California: I do not want, under any circumstances, to have teachers or experts on any level teaching sexual behavior to my children. Teaching behavior is a license to practice. Teaching about diseases that go along with casual sex or health-related talk, I am fine with, but I do not want it to go any further than that.

California, I note, does not require sexual education.

GELPERIN: That's right, and I think that the writer has really identified a very common concern we hear from parents. They worry that talking about information is harmful when really, decades of research has shown us that actually, talking about information is helpful, not harmful. It's not giving directions; it's giving realistic, reality-based information about how to protect yourself, both now

and into the future.

CONAN: Well, that's an argument for, and there's a time and place for that. But as a practical matter, does he have an alternative? Are there - is he - can he opt in or out for his child?

GELPERIN: Absolutely. So every parent, no matter the topic area, is always given the right to opt their child out of any topic area that they deem in conflict with their strongly held moral or religious beliefs. So he as a parent, if he felt strongly that the local curriculum was in conflict with his beliefs, could approach the health teacher in the district and choose to remove his child from that portion of instruction.

CONAN: Let's go next to Tina, and Tina's on the line from San Antonio.

TINA: Hi. I was a teenage mother, and I also now have a teenager. So what I have taught my daughter, starting from very young - about 7 - just the basics, and I always built on it. And building on it over the years helps us to become comfortable with all of the terms.

But I tell her now, as a teenager, that the best thing is for me to give her all the information that's out there so she can make the best decisions for herself. And I think that that should be what the school should do also - without the emotional portion of what sex

education is, put into the curriculum, but with space for that when students need someplace to talk about it - because not everybody parents the way I do.

CONAN: Yeah, no, I understand that. Do you know what she does learn in high school?

TINA: Yes, actually, I do. She has a really open-minded health teacher who was a teen parent, and they watch videos. They do learn all of the anatomical, but they also deal with some emotion also, as well.

CONAN: OK, thanks very much for the call. We wish you the best of luck.

TINA: Thank you.

CONAN: OK, the - as we get down to the relationship with the parents, obviously, parents can help school districts. Sometimes, they serve on the boards that advise school districts on what kind of sex education package to pick up, or to teach. But they also, I would assume, all of these classes say, talk to your mom and dad.

GELPERIN: Absolutely, Neal. Parents and schools must work together. Parents play a critical role. They're the most important sexuality educator to provide the values, the family culture, all of those pieces that schools cannot provide. But what parents tell us is they want help, they want support.

Schools and health professionals are trained to deliver sexuality education. They have the knowledge and the expertise. So they must work together.

CONAN: Here's an email from Meadow in Sacramento. No matter what program is taught, abstinence instruction needs to be given to students as an option. Teaching women and men that they do not have to engage in sex empowers them to control what happens to their bodies. When we don't present abstinence as an option to our young women, we are keeping that power from them.

Abstinence as an option - is that commonly taught in all of these different programs?

GELPERIN: Absolutely. It's one of the central tenets of all responsible sexuality education. I think there's a misunderstanding that comprehensive sex ed skips abstinence, but it's absolutely at the forefront, and I couldn't agree with your caller any more.

CONAN: Well, stay with us if you would. We're talking about what schools teach about sex. Parents, teachers, what should be taught? Who should teach it; 800-989-8255 is the phone number. You can also drop us an email. The address: talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION, from NPR News.

(SOUNDBITE OF MUSIC)

CONAN: This is TALK OF THE NATION, from NPR News. I'm Neal Conan. We're talking today about sex ed. Policies on what to teach, and what not to, vary from state to state. Fewer than half mandate any sex ed at all. More require education on HIV and STDs. Some prohibit any discussion of abortion, while others cover detailed methods of contraception.

You can find a link to a chart that shows how each state handles these issues. Go to npr.org, and click on TALK OF THE NATION. Parents, teachers, what should be taught? Do you want discussions about homosexuality or sexting? And who should teach it; 800-989-8255. Email us, talk@npr.org. You can also join the conversation at our website. That's at npr.org. Click on TALK OF THE NATION.

Our guest is Nora Gelperin, director of training and education at Answer, a national organization that promotes comprehensive sexuality education. And joining us now is Dr. Diane Foley, a pediatrician who specializes in adolescent gynecology. She's director of Education for a Lifetime, which is a nonprofit organization that focuses on abstinence in Colorado Springs Public Schools, and joins us now by phone from her home there in Colorado Springs. Nice to have you with us today.

DIANE FOLEY: Thank you so much, Neal.

CONAN: And clarify for us, if you will: As I understand it, there are different kinds of programs that describe themselves with the word abstinence.

FOLEY: Yes, there are, and I think that that's one important fact that has come out already in the program - is that I think it's very important for parents to find out exactly what's being taught in their own schools because as has already been mentioned, most local school districts are the ones who make the choice about which curricula are used and how it's taught, actually, in their own school districts.

And so you can't make an assumption by hearing that this is a comprehensive program, or this is an abstinence program, and know exactly what's being taught in your own school.

CONAN: For example, I gather there's something called abstinence-plus.

FOLEY: Well, I agree, and I think sometimes the terminology is a little bit confusing. And so I think it's important, again, that parents are able to look at that curriculum and see exactly what is being taught.

CONAN: Well, your program - an abstinence-only program, is that accurate?

FOLEY: No, our program is actually - we actually refer to this as a sexual risk-avoidance program. And the reason it's that way is because we know that teenagers are going to be involved in high-risk behavior, and we know that the healthiest choice for them is to avoid that high-risk behavior. And we know that a lot of these behaviors are related to each other. And so we teach them that the healthiest choice for them, again, is to avoid that behavior.

CONAN: To avoid that behavior. In the event they do not, do you teach birth control?

FOLEY: Yes, we do, and we - that's another one of the misconceptions that is out there about programs that are called abstinence only, that they aren't supposedly allowed to teach about contraception. But that's not true. And in fact, we agree that teenagers deserve to have medically accurate and complete information given to them about this area. And so these programs - and again, that's important.

So our particular program does teach about contraception as a part of the whole message that is given; that there is a risk avoidance, and there's also a way to reduce your risk if you are involved sexually.

CONAN: And then there are other sexual behaviors that are also controversial. Does your program address homosexuality, transgender, that sort of thing?

FOLEY: We address that simply from the standpoint that the risks are the same in those programs. It depends on the particular school district as to how, specifically, you can address each of those issues. And so for the most part, they are not dealt with other than to explain that the risk behaviors for the type of sex that you're having increase with the number of partners that you have.

CONAN: And Nora Gelperin, I wanted to bring you in. There are, as I understand it, a number of programs around the country that are what they describe as LGBTQ biased. What does that mean?

GELPERIN: Sure, so some - actually, state laws require that there is a negative bias perpetuated through sexuality education. So for example, it must be stated that it's not an acceptable lifestyle, in some states. That's, literally, lifted from the laws. It - there sometimes is misinformation perpetuated that people who are gay or bisexual may have higher rates of HIV, which we know is actually, also incorrect.

So it's really damaging to young people, and to young people who have family members who are LGBTQ, to have some of these biases exist in our state laws.

CONAN: And Diane Foley, this is - there's scarcely anything that is more controversial.

FOLEY: Right, that's right, and I think that again, parents need to know what's being taught in their local areas, and it's very important that what is being taught is being taught by people who are credible and actually have medical information that is accurate for them.

CONAN: OK, let's see if we can get another caller in on the conversation. Let's go to Mike(ph), and Mike's with us from Miami.

MIKE: Thank you. I just wanted to remind the folks who were concerned about their middle-schoolers that your children grow up fast, and when they are turning in college applications, you may wish that they had even more sex education.

CONAN: And do you know what your kids received, what they were taught?

MIKE: Well, fortunately, my wife is a nurse. We have two daughters. And the education was comprehensive. And - but still, I wasn't part of it, being the dad, and so I still have a little bit of fear if the kids move out, you know, was there something else? It's human nature, I think.

CONAN: All right, Mike, thanks very much for the call. Here's an email we have from Sara(ph): When I was going through sex ed, no one ever mentioned rape or sexual assault. I think it would be crucial for this conversation to be introduced to both boys and girls candidly and early. Dr. Foley, is it discussed there in Colorado Springs?

FOLEY: Yes, it is. Actually, a big part of our program talks about recognizing healthy and unhealthy relationships and actually, gives the students the warning signs for - particularly, dating violence and date rape, but also gives them listing of things that they are to do should they be involved in a rape themselves, and numbers to call with the other organizations that we work with here in our city.

CONAN: And Nora Gelperin, I understand, for example, the one - the curriculum in New York City that's about to get under way in the second semester of this year includes tactics for avoidance, if that's what you want.

GELPERIN: Absolutely, and I think strategies for young people to prevent and delay sexual behavior is critical, understanding community resources and most particularly, giving them the skills that they need to be healthy. And that's all part of the New York City curriculum. It's a terrific one.

CONAN: Here's an email from Laurie(ph) in Palo Alto: Is high school too late to be discussing sex? I'm wondering if age-appropriate content for middle-schoolers needs to be more comprehensive. What's the reality of sexual activity within that really young age group? Dr. Foley?

FOLEY: Well, I do think that age-appropriate discussion needs to be there and in fact, when we have middle school - as well as high school - programs, and when we're in the high school, a lot of times what we hear from students is: Where were you last year?

And I think I see this even more so in my private practice, where I deal with adolescents that come in with questions about sexual activity. And the information that is out there, they certainly are exposed to it much younger than high school - in our media and other things. And so that discussion is - that's a good place to have that, in a younger age group as well.

CONAN: You raise an interesting question about media. It's been a long time since boys, you know, tittered over Playboy magazine. There are far more explicit options available on the Internet. Nora Gelperin, do sex education classes at any range of these - in this wide range, do they deal with what's available on the Internet - what's healthy, what's not?

GELPERIN: I think that's a central component of any quality program. Unfortunately, the reality is that many programs don't have the luxury of time to cover these really critical issues, which is why we need to elevate the importance of sexuality education so they're given more time.

But you're right - a lot of the images that a lot of young people see on the Internet, in the media, are very confusing. And if they don't have these conversations at home, or at school, to get reality-based sexuality education, our young people suffer.

CONAN: Dr. Foley, I wanted to ask you about that. Obviously, this is a world in which sexting is a reality, and this is not something that most parents have any experience with whatsoever.

FOLEY: Right. And again, some of it depends on how your curriculum is accepted in the school, and how much time you are given. But we have the opportunity to be able to introduce the concept of sexting - and the kids already know about it - but really, to help them understand the significant ramifications that can occur, particularly depending on what state you're in, that it's considered - it could be students that send pictures of themselves can actually be charged with significant crimes as a result of that.

And they really tend to look at it as a very harmless activity, and they don't really understand that. So that's a big part of the education that needs to happen.

CONAN: Let's go next to Sharon(ph), Sharon on the line with us from Redwood City in California.

SHARON: Yes, hi. I have two teenage girls in high school, and I honestly believe this has to be taught in the schools because we don't know what's being taught at home. And my girls came through a junior high and a high school that have pregnant schools in them.

Sometimes, in junior high, the girls don't know how they got that way. They're just following what feels good. So they need to have the information. It needs to be taught by people who are well-educated and open. I want them to know that everything is OK if it's not abusive and that a loving, monogamous, respectful relationship is a good thing.

CONAN: And thank you very much for the call, Sharon - and two girls in high school, good luck.

SHARON: Thank you so much. I need it.

(SOUNDBITE OF LAUGHTER)

CONAN: I wonder, Dr. Foley, what percentage of parents decide to opt out?

FOLEY: A very small percentage in our community. I think that - I mean, it would depend - it depends school by school, but certainly, less than 5 percent of the parents opt out of this type of education when we're there.

CONAN: And Nora Gelperin, do you get feedback from the teachers that you talk to, about what kind of percentages they encounter?

GELPERIN: I would agree with Diane. That's about the rates that we're hearing out of a class of about 25 to 30 kids. Our teachers tell us it's maybe one or two students. Unfortunately, what happens is the parents that have concerns, even though nine out of 10 parents in the United States support and want their kids to have comprehensive sexuality education, it's the small, vocal minority that can sometimes instill the fear of controversy in our administrators and our elected officials and therefore, programs can be changed as a result.

CONAN: Here's an email from Gene: I want to share a very smart way I encountered last month, when I visited Lincoln Elementary in Washington State. A student in a higher grade was given a computer-program toy baby to care for, for 24 hours. That means the baby would cry in the middle of the night, so the student had to get up, figuring if the baby needed to be fed or changed diaper. This taught the students that sex takes great responsibility, and not just an impulse action or just fun. Is that a technique that's taught in some programs, Nora Gelperin?

GELPERIN: It is. It's called a Baby Think It Over doll, and there was certainly a lot of enthusiasm about this program. I think that writer really has hit the nail on the head. It's important that young people have a taste of reality and understand the reality of the importance of responsibility coming along with any decision connected to sexuality. That particular program hasn't been shown to be very effective, so we want to make sure that any program that goes into - impact young people is based in evidence and is shown to be effective.

CONAN: Do you use that in Colorado Springs, Dr. Foley?

FOLEY: It is not used as part of our program. I know that some of the health classes do use it, but it's not considered part of what we do. One my concerns is that we recognize that the consequences of teens starting to have sex are much more than just getting pregnant or getting a sexually transmitted infection. And I think it's important that the emotional consequences are discussed with them, if there are mental consequences that can occur, and helping them to make a healthy choice. They need to understand that it goes beyond just getting a sexually transmitted disease or getting pregnant.

CONAN: Dr. Diane Foley is a pediatrician and director of Education for a Lifetime, a nonprofit organization that teaches sexual risk-avoidance education in public schools in Colorado Springs. Also with us is Nora Gelperin, director of training and education at Answer, a national organization that promotes comprehensive sexuality education. She's with us from Piscataway, New Jersey, and the campus at Rutgers University. You're listening to TALK OF THE NATION, from NPR News.

And here's an email from Marjorie in Ann Arbor: Many years ago, in the 1960s, I had sex ed. Later, when I was pregnant, I realized I knew nothing about getting un-pregnant, i.e. delivery and labor. It was a very scary void. I hope sex ed goes beyond the medical terms, the mechanics, even the ethics, but goes all the way through the birth process and the work involved in raising a baby. Nora Gelperin, is that part of different kinds of programs?

GELPERIN: Certainly. In New Jersey, it is. There's a lot of emphasis placed on a healthy pregnancy, prenatal care, the importance of parenting. I think that's another area where we don't do a very good job of helping young people realize what goes into being a healthy, productive parent. So certainly, in the states that have more progressive policies, that would be part of it.

CONAN: And is it part of it in Colorado Springs?

FOLEY: Yes, it is. And one of the things that we also focus on is, we really look at teen fathers because a lot of times, the only - that we tend to focus on the teenage girls that are pregnant without really looking at the ways it affects young men as well - as becoming teen fathers. And so it's a big part of what we teach.

CONAN: And let's get Christina on the line. She's with us from St. Cloud, in Florida.

CHRISTINA: Yes. Hi. I'm more concerned - I've been an health educator for quite a few years, and what I was teaching in middle and high school was, actually, abstinence. And I also have teenagers in my home. And I think one of the points that had been missed throughout the entire sex education programs, or abstinence programs, is to do it comprehensive, because they have to make right choices in general. That's the only way that we're going to raise children and kids that are actually able to take care of themselves and their own kids.

It's not just about sex. You have to include drugs. You have to include alcohol, cigarettes, every risky behavior that they can encounter. And when you kind of separate the sex from the entire purpose, it's just defeated. You know, you have to teach everything. It has to be a one - it's one ball. You cannot separate the choices that they made in regards to alcohol or drugs, or the ones that they do with regards to sex, you know? So I think it's very important that they just do, like, a whole theme for them to make the right choices in every sense.

CONAN: And when you were teaching it, Christina, were you able to include those other risky behaviors?

CHRISTINA: I did in every lesson. And the important thing about that, we did here Florida - unfortunately, we don't have the funds anymore - we started in fifth grade. So of course, in fifth grade, we did not talk about sex. But we talk about responsibility, discipline, making the right choices on friendships, on school work. So that's doing the, you know, the basics. It's a nice foundation. So at the time that they start going out, going to middle school, includes bullying and all that. It just give them all the tools that they're going to need in order to make the right choices in everything.

CONAN: Nora Gelperin, that means even less time devoted to - yes, those things are important, too. I'm not denying that for a second, but it takes up time.

GELPERIN: It does. But I think Christina has an excellent point - that really, the skills to keep a young person healthy around sexual risk avoidance and postponement are the same skills that come into play to help a young person stay healthy around not using drugs, substance abuse, obesity prevention. All those same kind of health skills are interconnected. And so it's so terrific to hear about a program that Christina's mentioning that really, weaves them together, because we don't operate sexually in a vacuum. There's so much context to our lives.

CONAN: Nora Gelperin, thanks very much for your time today. We appreciate it.

GELPERIN: My pleasure.

CONAN: Again, Nora Gelperin is director of training for Answer, a national sexuality education organization based at Rutgers, and joined us today from a studio there. Dr. Foley, appreciate your time as well.

FOLEY: Thank you so much.

CONAN: Diane Foley, a pediatrician and director of Education for a Lifetime, a nonprofit that focuses on abstinence education in Colorado Springs, joined us by phone from her home there. Coming up: signs of change in Myanmar, and plenty of skepticism, too. We'll talk to a reporter recently back from that country, which is, of course, also known as Burma. Stay with us. I'm Neal Conan, TALK OF THE NATION, NPR News.

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