This is part of the Women’s Voices Project, a series of pieces based on as-told-to conversations with two dozen Texas women about gender, work, and what needs to change for women in their home state.

Jan Realini is a physician dedicated to reducing teen and unplanned pregnancy. In 2006, she founded Healthy Futures of Texas, which educates teens and adults about pregnancy. She also founded Project WORTH, the City of San Antonio’s teen pregnancy prevention program, and wrote “Big Decisions,” an “abstinence-plus” sexuality curriculum for teenagers used in 30 Texas school districts. She also founded the Texas Women’s Healthcare Coalition, which advocates for access to preventive care, including contraception.

#MeToo is very much on the minds of those of us who are trying to help young people understand what healthy relationships are—what it means to respect someone and to expect respect for yourself.

With minors in Texas, “consent” is not exactly the right term to consider, because legally adolescents can’t consent to sexual activity until they’re at least seventeen years old. So for those of us who are working with younger teens, we have to be able to formulate ways of helping them have healthy understandings of how to effectively draw their boundaries, defend their boundaries, and respect other people’s boundaries.

In the Big Decisions curriculum, we recommend that abstinence is really the safest and healthiest choice. But we also know that young people need to develop their own agency and be able to communicate well in a relationship. So we talk about respecting what someone else wants in a healthy relationship and about the refusal skills that they are going to need someday. We teach that everyone has the right to say no to sex, and that it’s never OK to pressure anyone for sex.

There’s a much bigger issue looming behind the need for “affirmative consent,” and that’s gender roles. In many of our cultures, young men are expected to be aggressive and have sex, and women are the ones who have to say no. In that dynamic, you have one person who asserts and one who defends. This is not just something you can teach in a class—students are being influenced by their families, by the media, by what they see in the real world. It is complicated by unequal power. For example, how do you say no to your boss without offending that person? To say no to someone who has that kind of power over you is difficult.

We have to help young women understand that bad situations happen and give them tools for how to handle them. Practicing something is a really important part of the learning of behavior. Think about a fire drill. You don’t just tell little kids how they’ll line up if there’s a fire—you practice it right in school. You do that so that they remember an experience, rather than remembering words or concepts. The same is true with training airline staff for emergencies—they have to demonstrate that they can do all the needed things. That’s the principle that we use in sexual health education as well: women need to know what to look for and how to respond. It should really be taught like a life skill: this is how you do a resume, this is how you manage credit cards, this is how you understand sexual harassment and what to do if you’re in that position.

The need for practice goes for bystanders too. It’s not just about teaching that you’re responsible for defending your body. It’s about helping everyone in the class understand that it’s really not OK to pressure someone or harass someone—and teaching the bystanders how to respond and speak up too.

To see resources about female mentorship, getting involved in local issues, and what to do if you experience sexual harassment, read here.

More from this collection

The Women’s Voices Project

In a series of as-told-to conversations, two dozen Texas women talk about gender, work, and what needs to change for women in their home state. Read their perspectives here.