Beth Lewis, a health teacher at Moultrie Middle School, shook with emotion as she described a state of emergency in South Carolina sex education. “We’ve got throat cancer now, and we’ve got it in middle school, because these kids are engaging in oral sex,” Lewis said. “If [a curriculum] teaches them to use a dental dam, then I’m going to teach it so they don’t get throat cancer because they contracted the HPV virus.”

A recent forum at the College of Charleston was one of several hosted around the state by the New Morning Foundation and Tell Them SC, groups working to overhaul South Carolina laws regarding sex ed. As parents, medical experts, and school officials stepped up to the microphone, one topic kept coming back up: Abstinence. Under current state law, each school district is required to adopt its own sex education curriculum, and some have adopted abstinence-only programs, which stress refraining from sexual intercourse until marriage and do not teach students how to have protected sex.

Whatever the specific flaws in the state’s sex ed programs, the big picture is that they aren’t working. South Carolina has higher-than-average rates of most sexually transmitted infections, and an average of 21 South Carolina teenagers became pregnant every day in 2011, according to S.C. Department of Health and Environmental Control statistics (see graphs above).

South Carolina’s 1988 Comprehensive Health Education Act (CHEA) provides the basis for the current piecemeal sex education system. Among other things, CHEA requires each district to provide 750 minutes of sex education to each student during grades 9-12, create a 13-member Health Education Advisory Committee, and provide staff development for health teachers.

A new bill in the state House of Representatives (H.3435) would require that all 750 minutes be taught during grades 9 and 10, and it would also delete the requirement that male and female students be taught separately. Rep. B.R. Skelton, the Pickens Republican who wrote the bill, summed up the rest of the bill in a recent phone interview.

“First of all, not all of the school districts are complying with the requirements to provide the number of hours of health education,” Skelton says. A January report by the New Morning Foundation found that 75 percent of school districts were not in compliance with some portion of CHEA’s sex ed requirements (The study found that Charleston County School District was failing to teach middle school students about STD prevention). Skelton’s bill would require districts to provide annual compliance reports to the Department of Education and give staff development classes to health teachers every two years.

“Secondly, I think they’re getting some medically inaccurate results,” Skelton continues. Under the new bill, health education curricula “must be verified and supported by research in compliance with scientific methods, published in peer-reviewed medical or health journals, [and] be medically accurate and objective according to leading medical or health organizations.”

“Thirdly, I think that some of the people that are teaching it are not qualified to do so,” Skelton says. The bill would require all health teachers to have a certificate in health education by August 2016.

Superintendent of Education Mick Zais has already taken a stance against the bill, saying that it would weaken abstinence-based education, de-emphasize adoption as a route for teen mothers, and create an unfunded mandate for health teacher certification.

Another staunch opponent will be Heritage Community Services, a Charleston-based nonprofit organization that has received millions of dollars from federal Title V grants for abstinence-only education. The group is responsible for Heritage Keepers, an abstinence-only sex ed program that has been taught to more than 200,000 South Carolina students in the past 18 years. The program has drawn renewed criticism from safe-sex advocates since April 2012, when it became the first abstinence-only program to win approval from the Department of Health and Environmental Control.

The program does not teach students how to use condoms, dental dams, or other means of contraception and protection. A leader at Heritage declined to give an interview, but she pointed to a 33-page takedown of H.3435 on the group’s website, which claims the bill is part of an effort by the Planned Parenthood Network to teach students practices including “oral sex on a guy with a condom, sexual fantasy, body rubbing/grinding (with clothes on), and how to eroticize condom use with a partner.” The paper also questions the bill’s requirement that all sex ed programs have support from medical journals, stating, “Publication bias by editors of ‘medical and health journals’ has prohibited acceptance of positive abstinence-until-marriage education outcomes.”

Notably, a few parts of the 1988 law would not change under H.3435:

• The law would still read, “Abstinence and the risks associated with sexual activity outside of marriage must be strongly emphasized.”

• Specific references to condoms and dental dams appear nowhere in the bill. Rep. Skelton says he didn’t want to “specify every single thing that is done and said.”

• The bill would leave in a portion of the law stating that sex ed classes may not discuss “alternate sexual lifestyles from heterosexual relationships … except in the context of instruction concerning sexually transmitted diseases.”

• Schools would still not be allowed to distribute contraceptives or information about abortion services.

So far, the bill has four sponsors — notably, a male and female from both the Democratic and Republican parties. But battle lines are being drawn, and sex ed reform could become the next high-profile debate when the House returns to session April 11.