Condom Nation: The U. S. Government’s Sex Education Campaign From World War I to the Internet
By Alexandra M. Lord
Johns Hopkins University Press 2010
224 pages
Illustrations, Annotated Endnotes & Index

The 1950's pulp-fiction style cover is what caught my eye. It shows a voluptuous, provocatively dressed woman–she has an ample bosom shown to great advantage by a low cut top, a Barbie doll waist and slim hips–lounging on a tabletop between two servicemen. She has that come hither look that has both of the men all but smacking their lips. (Think Michelle Pfeiffer in The Fabulous Baker Boys.) The subtitle of the book is in white letters placed in a red box, which instantly reminded me of the Surgeon General’s warning on cigarette packages.

Condom Nation is a serious look at the long, disjointed, and sometimes downright wacky–see the chapter on abstinence-only efforts!–attempts on behalf of the federal government in general and the Public Health Service in particular to impart sex education to Americans. Lord’s clever book illustrates how the various levels of government have been branded as being too explicit for some and too opaque for others, and she does an excellent job of showing how the government’s messages have teetered precariously between science and morality.

The precursor to the Public Health Service was an agency founded by Congress in 1798. The Marine Hospital Service (MHS) was charged with the task of safeguarding the health of American seamen; hence its quasi-military status, uniform and the title given its director, U. S. Surgeon General. The MHS coordinated the American Hospital Service, a network of hospitals in the port cities of the U. S. which were funded by a monthly twenty cent deduction from the pay of American seaman. The hospitals were useful in slowing various epidemics if for no other reason than that it quarantined the sick, an important advance during the days when medicine was at its most rudimentary. As the federal government expanded its role during the Progressive era in the late nineteenth century, the role of the agency expanded. In 1902 Congress renamed the MHS the Public Health Service; in 1953 its functions were transferred to the newly created cabinet agency the Department of Health, Education and Welfare (HEW). It was during this period that the PHS took over responsibility for the Food and Drug Administration (FDA)–another Progressive-era agency–and the Indian Health Services (IHS).

While it enjoyed some early and important successes, its most notorious and shameful role was that of the Tuskegee Syphilis Experiment of Untreated Syphilis in the Negro Male. While one premise of the study may have been minutely scientific–researchers assumed that untreated syphilis reacted in blacks very differently than in whites–its rationale was patently racist. Scientists assumed that blacks were inherently syphilitic, notoriously promiscuous, indifferent to treatment and a threat to the health of whites. The study which focused on poor, black and mainly illiterate sharecroppers in Macon county Alabama, began in 1932 and initially treated a few hundred patients. But because of the Great Depression, it lost its funding for the experiment and stopped treatment, watching as hundreds of men sickened, infected their partners and children or died, even after penicillin became the standard treatment in the nineteen forties. The indefensible study lasted until 1972.

The Tuskegee Syphilis Experiment is only the most egregious example behind part of the government’s reasoning for taking the lead in sex education: Educate the inferiors of American society–blacks, poor whites and immigrants–so that whites were not at risk. Women were also special targets of the government’s efforts. They were portrayed as immoral, seductive Loreleis–cue George and Ira Gershwin here–waiting to make fools of and infect unsuspecting soldiers and sailors, who after all, were only responding to nature’s call. Servicemen, who had high rates of sexually transmitted diseases (STDs) were constantly and explicitly warned to stay away from “loose women” through posters, pamphlets and films. Why the simple act of picking up a supposed lady’s hankie off the floor was fraught with the worst kind of danger! The heavy handed message that venereal diseases negatively impacted combat readiness and victory and subsequently endangered wives and sweethearts at home might have been amusing if it were not so blatantly prejudicial against women. It apparently did not occur to the PHS that men who engaged in casual sex with multiple partners and without a condom were part of the problem.

Condom Nation is at its best when dissecting the culture wars of the late twentieth century. Lord rounds up the usual suspects on the left and right: the liberal secular media; President Bill Clinton’s frank talking Surgeon General Jocelyn Elders, often referred to as the Condom Queen; conservative Republican U. S. Senator Orrin Hatch of Utah; the Catholic and Evangelical churches and Republican Vice Presidential candidate Sarah Palin, the governor of Alaska–a proud supporter of abstinence only education who was clearly caught off guard by the pregnancy of her teenaged, unmarried daughter. But she also spotlights individuals who flew under the sex education radar, including a little known conservative bureaucrat in the administration of George H. W. Bush, William R. Archer III, who served in the Department of Health and Human Services (HHS–the former HEW) as assistant secretary for population control. Archer was a passionate proponent of sexual abstinence education for teens and the unmarried, and had a crucial hand in securing federal funding for abstinence programs.

Lord also reminds us that one of the biggest challenges to the government’s efforts was the discovery of HIV and AIDS in 1981. Surgeon Generals from Ronald Reagan’s Dr. C. Everett Koop to Dr. Regina Benjamin in the current administration of Barack Obama have grappled with how best to wield the might of the federal government to slow the spread of both diseases.

In Condom Nation, Lord, a former historian for the Public Health Service, has given us a carefully researched and lively history of the federal government’s role in ensuring the health of America. It is also a pointed rejoinder to a nation awash in incredibly irresponsible sexuality, yet terribly fearful of sex education.


Dr. Marilyn K. Howard earned a BA in criminal Justice from Ohio Dominican College; an MA in political science from The Ohio State University (Thesis: The Entrance of Black Voters Into the Mississippi Electorate) and her PhD in American history from The Ohio State University (Dissertation: Black Lynching in the Promised Land: Mob Violence in Ohio 1876 - 1916). She was an associate professor in the Department of Humanities at Columbus State Community College, where she now holds the same position in the Department of Humanities. Dr. Howard has twice received the Distinguished Teaching Award from Columbus State, and was twice recognized as an outstanding staff member by the National Institute for Staff and Organizational Development. She was also named a top educator by Ohio magazine. Dr. Howard has served as an editor of the Southern Historian, a freelance book critic for the Columbus Dispatch and Ohioana Library. She has published essays in a number of anthologies, including the Encyclopedia of Racial Violence in America and the Encyclopedia of Jim Crow. She continues to conduct research on the lynching of black men by white mobs in Ohio.