The Role of the Media and TV in Adolescent Sexuality Education and Pregnancy Prevention

Last Editorial Review: 3/24/2004

WebMD Live Events Transcript

How influential are the media and TV with the sexual attitudes of youth? Media expert Kate Langrall-Folb will explore this issue.

Event Date: 05/23/2000.

The opinions provided by Kate Langrall-Folb are hers and hers alone. If you have medical questions about your health, you should consult with your personal physician. This event is intended for informational purposes only.

Moderator: Welcome to WebMD Live's Family Wellness Auditorium. Today we are discussing "The Role of the Media and TV in Adolescent Sexuality Education and Pregnancy Prevention," with Kate Langrall-Folb.

Kate Langrall-Folb is director of The Media Project, a partnership of Advocates for Youth and the Kaiser Family Foundation. The Media Project ( provides research and informational briefings for the entertainment industry on important topics in the field of sexual health. Langrall-Folb also helped to create AdSmarts, one of the first media literacy curricula for middle school students. Langrall-Folb has a bachelor's degree from the University of Denver and a master's in education from the University of California at Los Angeles. In addition, Langrall-Folb has helped create several campaigns targeting at-risk youth for HIV testing.

Kate, welcome to WebMD Live. What is The Media Project? What is its purpose, what does it do, and how did it start?

Langrall-Folb: The Media Project is a collaborative effort of Advocates for Youth and the Kaiser Family Foundation. We provide entertainment industry professionals with the most up-to-date socially relevant and accurate information about sexual health issues. Because many teens receive information about values, attitudes, and behaviors from television, the Media Project offers writers, producers, and network executives an array of services to support accurate portrayals of family planning, sexuality, and reproductive health in their work.

Moderator: How does that happen? Do you work with the writers, producers and executives on story lines and characters?

Langrall-Folb: Yes. We approach the industry in several ways. First, we conduct ongoing outreach to the television industry to get private meetings with a television production company where we can educate, inform and gently encourage the writers to think about sexual health when portraying sexuality in their shows. We also offer a hotline, which is called The Media Project Help Line, where writers can call for quick facts or statistics or information. We also consult on scripts. For example, a writer can send me the pages from the script that deals with HIV testing, or with regard to teen pregnancy -- perhaps a young girl having a pregnancy test and then being counseled on her options. We can review the script and check it for accuracy, make sure this is something a doctor would really say or do, to make sure they're not giving out misinformation over the air. We also sponsor informational briefing sessions or panel discussions to the industry where we will focus on a particular topic of interest or something that's newsworthy, again, to inform the industry and to encourage them to think about ways they could incorporate that information into their shows. Lastly, we host the annual SHINE Awards (Sexual Health in Entertainment). They're in late October, and it's a gala entertainment industry celebrity-attended television event, where we honor television programs from the past season that have made an extra effort to convey important family planning or reproductive health messages. We're in the process of sending out our call for entries, so the programs will then be submitted and screened internally for accuracy and appropriateness, and then we will have a formal judging in August in which members of the reproductive health community, entertainment industry, and teens will judge the finalists based on category: Comedy, drama, daytime drama, et cetera. We give them very specific criteria by which to judge the shows for accuracy, for entertainment value, for does it give you cause for dialogue amongst the viewers or cause people to think and consider the issues. Then we hold the event in late October where we announce the winners. It's our way of giving back to the industry and celebrating the good things that TV is doing. There are plenty of people and organizations out there that like to finger point and blame the industry.

Moderator: What is "responsible" and "irresponsible" programming? Could you please provide specific examples?

Langrall-Folb: We feel that it's important to give a young person the whole picture when it comes to sexuality. With regard to teen pregnancy, that would mean not just portraying the romance of sex, but also risks and responsibilities that go along with sexual activity, so that young people get a clear picture of what it means to be sexually active. They can better make a decision for their own lives. If all we're doing is telling them that sex is fun and romantic and you get the attention of the boys or whatever, but we don't tell them the other consequences, they're not able to make a responsible decision because they don't have all the information. We're not trying to clean up TV by taking all sexual content off the air, because that's unrealistic. We are asking the industry to paint a more realistic picture for the young people, and that will normalize healthy behaviors and provide them with the information they need to make the best decision for their own lives.

Moderator: Your organization's literature states that "TV is one of the primary sources for information about sex." Why, since this is the most computer and media savvy generation of young people ever?

Langrall-Folb: Television is still cited as one of the top three to four resources that kids turn to for information about sex. Obviously the computer world has begun to have a role, but if you look at our society as a whole, there are still many young people that do not have computers or are computer literate for that purpose. I expect it will change and computers will become even more influential, but right now young people cite school, parents, and television as their top resources for sex. The fourth is their friends, and there could still be some misinformation conveyed from those two resources.

Moderator: Whatever happened to "creative license" and creative freedom? Isn't it the parent's individual responsibility to educate their own children?

Langrall-Folb: Personally, absolutely. I believe that parents should be a very large presence in their young persons' lives. specifically with regard to sexuality. We know this is not the case for a lot of young people. It's not getting discussed in the home. It's not getting taught in school because of the debate in Washington and many schools are adopting the Abstinence Until Marriage message. From our perspective, what's going on in Washington right now is that a lot of money has been appropriated to go to state school boards of education for the purpose of promoting "Abstinence Until Marriage" health education program. There are several guidelines spelled out that if the state takes the money, they have to teach certain things. They have to say that waiting until you're married is the expected standard, and they can talk about HIV and AIDS or pregnancy as a medical condition, but they cannot teach how to prevent those things from happening. A lot of them do not teach birth control, or they may teach how it works, but they cannot tell you where to go to get them. They cannot tell you any more information about making it available to young people. I'm not the authority on this. The problem arises in that kids are not receiving the whole picture in school either, as far as risks, responsibilities, actions they can take in order to protect themselves. They're being given one message, which is wait until you're married. This does not work for everyone. It's a very one-sided approach and, consequently, kids are not being informed at school. It's not being talked about in the home because parents are not there, they're working, or they are embarrassed, and so kids are looking to TV for the answers. TV is in a unique position because it offers a window. Kids look at it as a window to the adult world, whether it's realistic or not, and they are picking up on cues and behaviors and all of that from TV. If we can work with TV, we try very hard not to infringe on a writer's creative vision for his/her show but rather to say, if you are planning a sexual encounter or even discussion of sex on your show, could you think about portraying the risks and responsibilities as well, or somehow incorporating the other side to this message? We very much respect their creative vision, and I am not a television writer and I'm very much in awe of the creativity in the city of Los Angeles and these people who come up with wonderful stories on a weekly basis. I would not pretend to be able to tell them how to do their job, but to keep them informed and to encourage them to let us see a condom, or let us hear two young people talking about their decision to become sexually active. Things like that that don't change the story but enhance it.

Moderator: Does your influence also cover music videos? Are there any current statistics about the effects of these videos on teenagers' behavior?

Langrall-Folb: We extend the SHINE awards to music videos, and some years I get music video submissions and some years I get none. My services are extended to anyone in the entertainment industry. However, we have found that 99.9% of our clientele are TV writers and producers. I can't say that a lot of our attention is directed there. I would love to be able to create a whole project that's aimed just at music video. Music video is a different beast completely. TV, they have to come up with a story once a week. Music video comes from the artist's song, and that song came from their soul and it wasn't on a deadline. It's a different process.

Moderator: It seems that more and more partial nudity and risqu? scenes have made their way into prime time programming. Has there been an easing of television guidelines for what can be shown on TV, and if so, where do you see television in five years? Ten years?

Langrall-Folb: Certainly anyone who's watched TV for the last ten or 15 years or longer has seen a change in portrayals, even just the language has -- they've allowed a lot more language that was never allowed in the past, as well as nudity. I don't know if it's written down anywhere with the networks, because that's not really my field, but certainly there's been a loosening of some of the restrictions, either for shock value or ratings, or I feel it's probably more because the networks feel they are in competition with cable, and so they have to push the envelope to get the viewers.

Moderator: What is your opinion about television shows which use twenty-somethings to portray teenagers in high school? Is this damaging to our youth who seem to increasingly portray themselves as older and more mature than they are?

Langrall-Folb: Studies show us that young people generally aspire to the next level, to the next generation. A 12-year-old or a 13-year-old would be most attracted to a show that portrays 17- and 18-year-olds. A 17-year-old would be more interested in a show that portrays college kids. They're always looking a notch beyond. Young people do that. They look at the next generation as a window for what's it going to be like when I get there. We found that with a TV show like "Felicity," which deals with a young woman in college, the majority of her viewers are high school students. We do see that young people sort of aspire to the next level and that's what they like to watch.

Moderator: Why is nudity and sexuality on TV such a big deal in America, but not Europe?

Langrall-Folb: I think it's a combination of many things. The results are astounding. First of all, Europe has always been somewhat more open with regard to nudity and sexuality, and that may come from having experienced two devastating wars. It reduces you to a different place. That's my own personal speculation. We do see that in a country like the Netherlands, which is reputed to be a very open society with regard to nudity and sexuality, prostitution is legal, as is marijuana and hash, and it's under controlled circumstances, but we look at the Netherlands and we look at the teen pregnancy rate, which is about nine times lower than the U.S. I think it's many different variables that play into that, one being that the government sponsors long-term broad-reaching media campaigns that encourage, not abstinence until marriage because they know that's unrealistic, but rather safe sex or no sex. There is a generation of teenagers now that have grown up with this mantra, "Safe Sex or No Sex." Literally these kids feel that it's their duty as a citizen of the Netherlands to protect themselves as well as their partner. When you look at teen birth rate in the Netherlands compared to the U.S., out of 1,000 women ages 15 - 19, the U.S. has about 52 births out of 1000. In the Netherlands, same number, they have four births. We're just so off the scale, and we wonder if this country were more open about sexuality, not only in media but also in the schools, because in the Netherlands, anything goes. They can talk about anything. The teachers are not restricted at all. There really is no sexuality education curriculum, because you can talk about it anytime you want. You can talk about it in sociology class, health, biology -- in religion class, they talk about it a lot. I visited Christian schools in Amsterdam that were very open and forthcoming about any topic of sexuality. I asked the head master if his sexuality education curriculum differed from what would be considered a public school, and he chuckled, and said we all have sex the same way so why would it be different. There are condom machines in the school bathrooms, on the street corners, in subway stations, in restaurants, just freely available. Young people have access to family-planning services and healthcare services freely available to them. It's a societal attitude about sexuality and could be perceived to be more open, but appears to us to be more healthy. Young people are not taught that sex is the forbidden fruit. It's not used as a teasing topic on TV, but rather a normal part of being a human being. The other interesting thing about Europe is that with all the information they have, with all the accessibility they have, consequently, that the young people in Holland wait two to three years longer to become sexually active than they do in this country. The average age of first sexual encounter in the U.S. is between 15 and 16, and in the Netherlands, it's between 17 and 18. Clearly the young people of Europe take the information they're being given about sexuality and take it very seriously when they make a decision about their own lives. In this country (personal opinion), I feel young people are frustrated at being told you're not old enough to know this and you're not old enough to do this. They want to prove to us that they are old enough, and they go out and prove this, but now they don't have the information so they wind up pregnant, or they wind up with an STD, or worse.


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Moderator: There has been a drop in teen pregnancies in the past few years. Has TV played a role in this, either negatively or positively?

Langrall-Folb: I would love to be able to say I have data on that and I would love to say yes, it's played a positive role. My personal opinion is it has, because if you think about it, in the last ten years, we've started to see condoms being mentioned on TV, or safer sex slowly becoming more normalized in a young person's life. A large percentage of the reason why the teen pregnancy rate has dropped is because young people are using contraceptives more. Just from viewing and from watching TV, you can see that it has become more normalized on TV, as well as in society and elsewhere. We still have a very long way to go.

Moderator: In what ways do the media reinforce or tear down sexual stereotypes? Are there certain ethnic or gender-related stereotypes that you frequently observe?

Langrall-Folb: TV, you have to understand, is drama. It's theater; it's pretend. Theater has to do with stereotypes a lot because to get the point across, you need the character to be way over the top. There's always going to be some degree of stereotyping on TV. I think that TV has made some great attempts at crossing over and portraying different characters and different roles. We see it in commercials now. We see it in the programming, the Mr. Mom's and sort of crossing those old stereotypes. I feel that sometimes TV is the last industry to catch up with some of the trends, for whatever their reasons are, be it fear of advertisers or backlash from the public. There have been incredible examples and pioneers in TV over the years. Norman Lear really broke down some barriers on TV by addressing subject matter that had never been addressed before in entertainment TV, like oral contraception, racism, many issues he dealt with. I find it interesting that some of the subject matter that he was able to portray in the 1970's is almost taboo today. I don't know of a situation comedy today that would tackle the subject of abortion.

Moderator: To what extent are advertisers responsible for what we see on TV programming today?

Langrall-Folb: The networks will tell you that they very much are in control of what we see on TV today, specifically in regard to sexuality and sexual health messages. I am constantly being told, we would show condoms or we would discuss protection or contraception or pregnancy prevention, except the advertisers will get very upset and will remove sponsorship of the show. If we show a condom, we lose sponsors, which I don't doubt is true. The advertises are living in fear of public outcry or boycotts of their product. Our research shows us that the general public is not nearly at offended as seeing condoms on TV as the advertisers think they are. That's part of our work, to conduct more outreach to advertisers and to educate them on the issues and the importance of portraying some of this in an effort to reduce teen pregnancy and the abortion rate. We're trying to do that now by conducting more research about public opinion or mentioning contraception on TV. It strikes me as quite odd that an advertiser will sponsor a show that exploits sex but will be terrified to sponsor a show that mentions contraception.

Moderator: Why is sexuality taboo to a certain extent, but violence is okay? In your opinion, which is more damaging to youth and why?

Langrall-Folb: I come from the generation of "make love, not war" and a friend of mine told me once he had an epiphany. He was watching TV with his teenaged son whom he had raised with awareness of when a sex scene came on TV, to cover his eyes, when the passion scenes came on, yet they did nothing about the violence that they allowed their son to see. My friend has this revelation in the midst of watching a movie with his son, and here came the love scene and the son covered his eyes, yet there had been numerous violent scenes which he had watched with wide-open eyes. My friend realized, sex is something people do and you need to know and see this. He told his son to uncover his eyes and watch, that this is what people do. He realized he had approached the issue backwards. My opinion is I feel the same way. I am much less concerned about my children seeing a love scene than I am about them seeing exploitive violence. I would rather them learn to love people than to kill them. We do have a lot of research out there on violence in the media and its effect on children. It's hard to do those same sorts of studies with sex in the media. You can't sit a focus group down in front of a sex scene and watch to see if they go have sex afterwards. There are few studies about sexual activity. We do see that violence does have an effect.

Moderator: Do you feel that we are now seeing that in our society, the effects of violence?

Langrall-Folb: I don't blame the media. I don't blame TV or film entirely, because it's nobody's sole responsibility, just as it's not the media's responsibility to educate our kids about sex. I believe it should come from the parents, schools, et cetera. In Europe, everyone is on the same page with regard to sexual education and they're also on the same page on violence. They don't have guns. I think that the media play a role, just as parents play a role, just as our government plays a role in this issue of violence and that's an entirely different show. I take the approach of trying to applaud the TV industry for what strides they are making. You go nowhere by blaming someone, other than making them more defensive.

Moderator: If you enjoy tongue-in-cheek shows like "Married With Children" or "The Simpsons," is that a bad influence on children?

Langrall-Folb: I think that (personal opinion) the treatment of children in families on TV for dramatic purposes is entertaining, and it makes for a more interesting story. We have to remember that TV is drama. It's our version of theater. To drive a story, you need a certain amount of drama or spark or spunk or conflict. The way children are portrayed in TV in families, there's always the one sort of smart-alecky kid who has all the wise cracks. To some degree, I don't feel that's healthy. I used to teach junior high and high school, and the golden rule for teachers, especially with adolescents, is you do not use sarcasm. It's damaging to young people. Sarcasm is very damaging because it's very confusing. What is the message here? Are they being straight with me? It's a double message. I find some of those portrayals to be negative in portraying what family life is like and how children are treated or should be treated. It's the source of humor and I don't think we should take it so seriously that our society is going to crumble based on the fact that this show has a loud-mouth, smart-aleck kid in it. I think there are much more important issues to deal with than something like that.

Moderator: Does The Media Project do any research or work with people in the movie industry, or is your focus primarily on TV? If so, what do you do, and if not, why not?

Langrall-Folb: Our focus is primarily TV; however, we do conduct outreach to films that we know are coming up that might have to do with a teenage theme or that are aimed at young people. The film business is very different as well. By the time I hear about a movie, it's been written and produced. It's difficult to catch them in the writing stage. Many studios are aware of us and many have contacted us, and we do work with cable productions and occasionally we get a call from someone working on a production film.

Moderator: Now that AIDS education TV specials and safe-sex plot lines are on the rise, how has that influenced teen sexual behavior?

Langrall-Folb: I don't have hard data, but my personal feeling is yes. We did conduct a very unscientific on-line survey of viewers of the show "Felicity" in which there was an episode where Felicity decides she's ready to become sexually active, and goes to the health clinic and learns about birth control. Actually on camera, they demonstrate how to put on a condom on a prop. So we linked up with three teen-created "Felicity" web sites, and we asked the kids that came to the site about their viewing habits, about some other things that had been on the "Felicity" show that season, and we asked them their opinion of that episode. Did they think if was informative? How did they feel about seeing a condom demonstration? We had about 100 girls between ages of 12 and 21 that we tabulated, and 36 out of that 103 girls said they had never seen a demonstration of the correct way to use a condom before. Eighty-nine out of that 103 said that teens get helpful information about sex and birth control from TV. Sixty said they felt the demonstration of the correct way to use condom was informative. Twenty-seven said they learned something new about birth control or safer sex from the condom demonstration episode of "Felicity." It tells us that kids are watching and are picking up information. We also after a previous episode of "Felicity" which dealt with date rape (two-part episode). We consulted with the writers extensively and succeeded in getting them to mention emergency contraception. We also encouraged them to put up an 800 number for a rape crisis hotline. The hotline received over 1000 calls. This tells us that young people are watching, learning and, if given the opportunity to take some action, they will do that.

Moderator: Where can I find more information about these issues?

Langrall-Folb: I'll give one suggestion to parents. I always tell parents that first of all, watch what your kids are watching. Sit down with them and watch it. If you really want to read or get dinner ready, it might be worth your while to sit down and get to know the programs they're watching. Even the bad stuff you can use to spark dialogue with your child. You can say at the commercial, what do you think about the decision that the character made? Even if the character made a decision that the parent disagreed with, the parents can give their perspective, and give their child a chance to consider the differences. It's also helpful because you can relate to that favorite character. What would Felicity have done? Use the stuff that you don't approve of to start a discussion. You can get information about TV or what organizations like ours are doing. We have a web site which is primarily geared for writers and producers to use as a tool, but you're welcome to come and use our web site,, and Kaiser Family Foundation has a web site and the Department of Entertainment Media and Public Health and that is  Those are two great resources about the work we're doing. There are numerous web sites that describe what's coming up on TV, and give parents some tips on the subject matter on those programs.  lists all the shows and a description and the characters, and keeps you up-to-date about what's on television. TV Guide also has a web site as well and it describes the programs, 

Moderator: In your opinion, as the new season is winding down, what shows portrayed sexuality in a responsible way?

Langrall-Folb: I think all shows have the potential. I think every show has done something responsible and has the potential to do so. I can tell you shows we've worked with and we've had success. For the next season, starting in the fall, we hope and presume there will be more health messages. We are not trying to specifically remove sexual content from television, but rather enhance it by encouraging the writers to portray the whole picture, including risks and responsibilities. Removing sex from TV is unrealistic for many reasons. We work closely with "Felicity," we work with "Dawson's Creek," we work with "Moesha," we work with David Kelly Productions which does "The Practice" and "Ally McBeal," and next year we'll have a show called the "Boston Public." We work with "Judging Amy." We provide information for "ER," "Any Day Now" which is on Lifetime. Any of those shows usually approach it in a pretty responsible way or at least a well-rounded way. I like to encourage people to understand that TV is here, and it's not going to go away. It is a part of our lives and our children's lives, and it's not solely to blame for society's ills. If we can look at it as a tool for positive change, we can look at what we see on TV with a little more positive attitude. Even the things you don't agree with can be used to impart your own values to your child, and to cause your child to think about where he or she is with these issues. We want them to make intelligent decisions in their own lives. We want to make sure they have all the tools to make those decisions. If you watched more often, you probably would see that there's some good stuff out there.


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Moderator: Kate, thank you for joining us today. WebMD members, please join us every Tuesday at 1 pm EDT here in the Family Wellness Auditorium for our live weekly event. 

Langrall-Folb: You're welcome. Thank you.

The opinions provided by Kate Langrall-Folb are hers and hers alone. If you have medical questions about your health, you should consult with your personal physician. This event is intended for informational purposes only.

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