Science Vs - The Legendary Condom Queen

Episode Date: October 21, 2021

Dr. Joycelyn Elders is a total badass. She grew up in poverty in rural Arkansas, but in 1993 she rose to become the surgeon general of the United States — appointed by President Bill Clinton. Joycelyn wanted to put sex education front and center, to help teenage girls avoid getting pregnant. Decades ago, she was saying things that could be ripped out of the headlines today. But America wasn’t ready for this, and after just over a year, she was fired.  Today on the show: a conversation with Dr Joycelyn Elders. We'll take you inside the room when Clinton fired her, and we’ll find out what it takes to get America's politicians to talk about sex education. Here’s a link to our transcript: https://bit.ly/3prfvnR  This episode was produced by Wendy Zukerman with help from Michelle Dang, Ekedi Fausther-Keeys, Meryl Horn, Rose Rimler, and Nick DelRose. We’re edited by Blythe Terrell. Fact checking by Eva Dasher. Mix and sound design by Bumi Hidaka. Music written by Peter Leonard, Bobby Lord and Bumi Hidaka. And a big big thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. Today on the show, the condom queen. We're telling the story of the rise and fall of one of the most controversial public health figures of our time, Dr. Joycelyn Elders. She grew up poor in rural Arkansas, but in 1993, she rose to become the Surgeon General of the United States, appointed by President Bill Clinton. She was basically the nation's top doctor for public health. Dr. Joycelyn Elders, our newly confirmed Surgeon General. In her role, Joycelyn wanted to put sex education front and centre

so that so many teenage girls didn't get pregnant. We've got to prevent our teens from becoming parents before they become adults. She wanted to get condoms out to anyone who needed them, particularly teenagers. We've got to go out and market prevention like Mr MacDonald has marketed hamburgers. Decades ago, Joycelyn was saying things that could be ripped out of the headlines today.

And I do feel that we would markedly reduce our crime rate if drugs were legalized. You know, I don't know all of the ramifications of this, that every American should have a right to health care. It's far cheaper to pay for college than it is to pay for prisons. But it turned out that America wasn't ready for this. And these ideas made her a lot of enemies. Dr. Elder's statements have been profoundly disturbing and profoundly offensive. And after just over a year, Bill Clinton fired her.

So today on the show, a conversation with Dr. Joycelyn Elders, how she rose from rural Arkansas to the White House. We'll take you inside the room when Clinton fired her and find out what it takes to get America's politicians to talk about sex education. Dr. Joycelyn Elders, coming up just after the break. What does the AI revolution mean for jobs, for getting things done? Who are the people

creating this technology and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. It's season three of The Joy of Why, and I still have a lot of questions. Like, what is this thing we call time? Why does altruism exist? And where is Jan Eleven?

I'm here, astrophysicist and co-host, ready for anything. That's right, I'm bringing in the A-team. So brace yourselves. Get ready to learn. I'm Jana Levin. I'm Steve Strogatz. And this is Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. Welcome back. Today on the show, we're chatting with the remarkable Dr. Joycelyn Elders. Hello. How are you?

I'm good. How are you doing? I'm here. Yay. We're going to start at the beginning. You were the eldest of eight. I was the real mother hen. You know, we were very poor. We had to work in the fields from sunup to sundown. It was hard work, but I don't remember

us being hungry. It may not have been what we wanted to eat, but we always had enough to eat. Joycelyn grew up on a farm. Her dad was a sharecropper. And she remembers eating whatever was ready from the field, corn, squash. And her dad would also go out hunting, often for raccoons. Her family would eat the meat, which she says tastes somewhere between deer and turkey. And then they'd sell the hide. My dad would scan the raccoons, stretch them out and sell them for money. And you did this too. You helped him out. Of course I helped. I'm not sure I did a very good job,

but I helped to do what I did. Now you, you, you know, would go on to, to fight for sex education. As a kid, were you told a lot about sex? Did you get a good sex education? Well, I don't remember my parents ever really telling me much of anything about sex? Did you get a good sex education? Well, I don't remember my parents ever really telling me much of anything about sex. In fact, I probably learned more about menstruation and all from reading the Kotex box. Someone once told Joycelyn that you could get pregnant from eating watermelon seeds. Yes. And so we were petrified of eating a watermelon, swallowing the watermelon seeds. My grandfather grew a huge watermelon patch. We ate lots of watermelon, but we were very careful to get the seeds out. So tell me, fast forwarding to when you got a scholarship to go to college. Yes. You've told this story that your brothers and sisters

helped you to pick cotton to raise money for the bus. That's right. And your brother told you something. Yeah, we had worked very hard all day. And I remember him looking up at me with his great big eyes and he says, do we have enough yet? I'll never forget those eyes, never forget that day, never forget that time because what that said to me

is my sisters and brothers were really trying to help me. Joycelyn graduated as the valedictorian of her high school and in 1949, she got that scholarship to go to college. Back then, Joycelyn had no idea what she wanted to become. She definitely didn't have ideas of going to the White House. She just knew that she didn't want to be on that farm forever. My mom had always told us, if you want to get out of the cotton patch,

you've got to get something in your head. And I thought at the time, you know, when we were out there growing up, that if I worked and I was able to get work at Dillard's department store, you know, as a clerk, well, that would be like going to heaven. So you went to college and in college you changed your name. You were born Minnie. I was born Minnie Lee. That was my grandmother's name, but she was called, for the most part, Big Minnie, and I was Little Minnie. While I was still in high school, I saw this wonderful sticks

of peppermint candy, you know, and it was made by a company called Joycelyn Company. And I thought that was such a beautiful name and I've wanted to be Joycelyn ever since. And so why didn't you like Little Minnie? Little Minnie's so cute. Oh, wow. Like, you know, it's fine when you're little but after you grow up,

you don't like being little Minnie anymore. Little Minnie being the, you know, Surgeon General. Yes. It's a little bit of a hard sell. While at college, Joycelyn was working her ass off with classes in biology and chemistry. She had a scholarship but still needed money for books, clothes and pencils.

And so she was working as a maid. And what kept her going was a talk that she'd heard by Dr. Edith Irby-Jones. She was the first Black student to attend the medical school at the University of Arkansas. And this talk, it changed everything for Joycelyn. First of all, I'd never seen a woman doctor. Secondly, you know, just even seeing a doctor was almost a miracle. I'd never even seen any doctor until after I was in college. And I remember her talking about the difference between the high rose and the low.

In her speech, Dr Edithith Irby Jones quoted a poem about making choices about which direction your life is going to take and then not getting distracted. And some 70 years on, Joycelyn still remembers this poem. Just in between on the misty paths, the rest walk to and fro. And, you know, it was just this beautiful beautiful point what did it why was it so important oh it well it was so important to me because she was saying to me to me anyway that we all walk some path now we have to choose the path that we're going to choose. Choose the way we're going to go.

And our lives should be about making lives better, not just roaming around out there somewhere hoping we do come out all right. You came out with like 100% certainty that you wanted to be a doctor. I wanted to be just like her. That's right. And I wanted to be just like her. That's right. And I wanted to be just like Dr. Edith Irby Jones. And I spent the rest of my life trying to be just like Dr. Edith Irby Jones. After college, Joycelyn joined the army, which ultimately helped to pay for some of her college fees so that she could become a doctor. And in 1956, she entered the University of Arkansas's medical school.

She was one of three Black students and the only Black woman. At the start of her degree, the cafeteria was still segregated, so the Black students couldn't eat with the white medical students. Instead, they had to eat with the maids and the cooks. Before Joycelyn graduated, the school did integrate the cafeteria. But she remembers this one day when she took her tray to sit next to some white students. One of my medical students, members of my class, got up, picked up his table and said that he refused to eat with the, he didn't say, you know, black person, you know, we didn't say black much at't say, you know, black person.

You know, we didn't say black much at that time. And he just got up and left. He just kind of made no bones and refused to eat with the black person. It's so awful because then you're in the graduating class with him and he's there in the classes. How do you deal with that? Well, but, you know, when you're in medical school, the aim of the game is to get out, is to get through. You don't have time to run around worrying about slurs. I didn't come to medical school to eat with white people.

Joycelyn graduated and specialised in paediatrics. And in these years, decades before she'd become a household name as the Surgeon General, she worked in the trenches at a hospital in Arkansas. And she saw some awful things there. Most of the stories, many of them, you like to forget. But there are a few that you can't. She told us about one child,

and this story is hard to hear, so you might want to skip ahead 15 seconds. One was about a nine-month-old who had been sexually abused. This was a baby, though, who had been raped? Sexually abused. Raped. That's right. Nine months as a baby. You're not even nine years.

It's nine months. Did she survive? Yes. How do you go home that night? What do you do? You go home thinking you've done the best you could. You take the best care of that child you could. And you move on to the next.

You know, what I'm saying is you can't get lost worrying about that one. You have to make sure you move on and do the best you can for the next child. And you keep doing that. Her days were filled with trying to help children with all sorts of problems. She remembers infant wards filled with scores of babies who had diarrhea and dehydration, their eyes all sunken.

There was dysentery from the poor drinking water in Arkansas, salmonella, cholera. Joycelyn treated all of these kids. She worked her way up at the University of Arkansas. In 1963, she became the chief resident in charge of the all-white, all-male group of residents at the time. She did important research into stuff like juvenile diabetes and became a full professor. And then in 1987, Bill Clinton, who was the governor of Arkansas, asked her to become the head of the Arkansas Department of Health. And one issue that you took on was teenage pregnancy. Why was that important to you?

Well, I guess I never really thought about it. I worried too much about it before I became the director of health. And after I became director of health and was traveling all over the state and seeing young girls becoming parents before they became adults. Do you remember the youngest pregnant girl you saw? Eight. Eight. That was the youngest one I saw.

There were some that I heard about that were younger than that, but there was one that was eight on the ward. Oh, my goodness. And you visited a, I think it was Bill Clinton's hometown of Hope. You visited a school and heard from boys about their understanding of sex. Do you remember what some of them were saying? Oh, well, most of it was probably the untrue that, you know, they talked about what they called blue balls.

Yep, our old friend blue balls. These boys had no idea about sex. They thought if you got an erection but didn't ejaculate, then horrible things would happen to you. They asked Joycelyn if you could get a girl pregnant if you had sex standing up. They thought condoms were dangerous and could get stuck inside a girl and kill her.

And worse still, a lot of these boys were already having sex. Joycelyn was floored. These kids needed a good sex education and fast. As Joycelyn put it, quote, we've taught kids what to do in the front seat of cars. Now we have to teach them what to do in the back seat. That's right. And, you know, And we've got to teach them healthy sexuality. Our parents don't know better. The preachers don't know better. The teachers don't know better. That's the reason why the

children don't know better. The reason why we had far more teenage pregnancy in poor, less well-educated girls because nobody taught them anything. As the head of the health department in Arkansas, she announced a plan, comprehensive sex education. And once, when a reporter asked, are you going to distribute condoms? She said, quote, we aren't going to put them on the

lunch trays, but yes. Joycelyn was excited to get these kids learning about safe sex, but the moment she brought it up, the hate mail came in thick and fast. Some accused her of wanting to teach their little children how to perform sex, and even though at this time she'd never mentioned abortions, others were so riled up about sex ed that they called her a baby killer. So when you were suggesting sex education, did you expect the controversy that ended up being thrown your way? Oh, of course not. I never even really thought about it.

I never thought everybody was as dumb as we were down in the country, you know, since we didn't, hadn't learned anything. But, you know, I think that people who were criticizing the most were often people who knew the least. It was crazy reading your book, you know, which was written 25 years ago. I was so struck by how it could have been written today. Yeah. The wrath that was thrown at you was thrown in letters, but these days it could just as easily have been on Twitter or Facebook. To me, you know, you have to know what you're about.

You have to be clear about your own goals and I was very clear about what I wanted to do is I wanted to reduce the number of bright young people who had unplanned children I said I'm not about abortions I've never been about abortions yeah and and people say well if they go out and get pregnant, they need to have the baby. Well, you know, those are often people, you know, they don't want to pay for healthcare. They don't want to pay for welfare. They don't want to pay for a good education. And I always say, and I've said that they have a love affair with the fetus. So how did that go when you told these people that they had a love affair with the fetus. So how did that go when you told these people

that they had a love affair with the fetus? That's used to me being an atheist and not being religious. But, you know, you have to know what you're about. And I was fighting for the health and education of bright young people and to have hope for the future. You do. of bright young people and to have hope for the future. You have an amazing ability to be laser focused on the high road and not get caught in the mist. Well, that was what my mentor told me.

Always thought of the bright young women that I was seeing down in the Delta who had nowhere, and I was thinking, what can we do to help them climb the ladder of success? And so that's all I thought about. Now, so in 1989, the Arkansas legislature mandated a K-12 curriculum that included sex education. Yes, yes.

In an interview, you said that in Central High School, which was the largest school in Arkansas, after condoms were offered, kids got sex education, teenage pregnancies dropped from 40 a year to three. Right, that's right. Under your watch. How did you feel when those numbers came in after all this controversy? Oh, I guess I was really more thrilled and happy

for the young girls who didn't get pregnant. Now, it's not totally clear that it was just the sex ed year that made the difference. Teen pregnancy was actually going down all across the country at the time. But we do know that getting a good sex education, it sure doesn't hurt. Studies find that it doesn't make it any more likely

that kids will have sex or get pregnant. That's not true when you teach abstinence though. In fact, one study found that a group of kids getting taught abstinence only were actually more likely to be having sex compared to a group that was taught proper sex ed. And Joycelyn was working on all kinds of other stuff too. While she was the director of health at Arkansas, childhood immunization rates skyrocketed across the state. She helped expand prenatal care and cancer screenings. She even worked with churches to get care to patients with HIV.

But through it all, she was also fighting to stop young girls having babies. After the break, Joycelyn takes sex education to the White House. And like a lot of teenage pregnancies, it doesn't go according to plan. That's coming up. Welcome back. Today on the show, we're having a chat to Dr. Joycelyn Elders. When we left, Joycelyn's sex education program is going great in Arkansas. Despite the hate mail, she is riding high.

And now she's about to go even higher. In 1993, the governor of Arkansas, Bill Clinton, becomes the president of the United States. And after seeing all this amazing stuff that Joycelyn had done in his home state, he offers her the role of Surgeon General. As Joycelyn remembers it, he said, Joycelyn, I think you'll be terrific. All I want is for you to do for the country what you've done for Arkansas. Did you want that job? No.

It was my mother who told me that I should take it. She says, you know, I saw him on TV last night and he just looked pitiful. Pitiful? Can you imagine my mother, who has an eighth grade education, who was looking at the president and thinking he looked pitiful. But she felt that I should say, you need to just go on up there and help him. But even before she stepped foot in her new D.C. office, the pundits were bad-mouthing her. One editorial said, quote, Dr. Elders could do great damage because her philosophy would trickle down to infect America's children, end quote. A letter to the Kansas City Star said that Joycelyn was pushing, quote, feminist rhetoric

and a liberal agenda. Joycelyn Elders is no lady either, end quote. But no matter. In September of 1993, she was confirmed as Surgeon General of the United States. What was the funnest moment of being a Surgeon General? Were there any fun moments? You know, when you talk about fun moments, I enjoyed most of the time when I was a surgeon.

Even when I was being beat on and called all kinds of names and everything. And one of the names was the condom queen. When did you, how did that happen? Well, you know, the health department, we passed out condoms. In fact, they had a condom tree. What do you mean a condom tree? It was a tree. It was decorated like a Christmas tree, but it was decorated with condoms.

We had big bowls, like a fishbowl, full of condoms sitting out in my office. Did Clinton ever come and take one? Well, no. I don't remember. But, you know, we didn't sit around and watch who took them. But it was easily accessible and anybody who wanted one could get one. Did you mind being called the condom queen? I'm actually a little jealous of it. It's quite a good nickname. No, I didn't mind being called the condom queen? I'm actually a little jealous of it.

It's quite a good nickname. No, I didn't mind being called the condom queen as long as everybody who needed to use one would use it. People would always say, oh, but Dr Elders, condoms will break. I reminded them that the bowels of abstinence break far more easily than does a fake condom. For more than a year, Joycelyn fought to get better sex education across the country and to improve access to health care more generally. And she was starting to make some real strides, even convincing some conservatives

that schools needed to be talking about slapping on the old love glove. I would tell them how much we paid each year in welfare, health care, for unplanned pregnancies, and for babies born to babies. They really would learn and really would change. And we did change some things. You know, ignorance is cured with a good education. And I worked hard to educate all of them. But stupidity lasts forever. And so we had a few politicians that were stupid.

So, Joycelyn was doing what she'd come to Washington to do, bringing up these taboo topics that America needed to be talking about. And then, everything went kablooey.

It all started on December 1st, 1994. Joycelyn was giving a speech at the World AIDS Day Conference at the UN. After her speech, she was asked about what we should do to prevent HIV from spreading. And specifically, someone wanted to know whether promoting masturbation might help to give people sexual release so they wouldn't have sex. And Joycelyn said, yeah, she advocated for complete sexual education,

which would include masturbation. Here's the audio from that conference. In regard to masturbation, I think that that is something that, it's a part of human sexuality, and it is a part of something that perhaps should be taught. It was just such a tiny comment. People got all upset. Nobody could believe that, you know, masturbation happened.

And I think if everybody who ever masturbated would turn green, we'd have a green society. Even today, Joycelyn doesn't get why it's such a big deal to talk about wanking. It won't make you go crazy. It won't make you go crazy. It won't make you go blind. And you know you're having sex with somebody you love. Yeah.

So you didn't think anything of it. So when was the first time you realised this might have been a bigger controversy? A reporter flew from Washington, D.C. with me to New York. We had lunch together and then he told me, he said that he thought that I was going to be a problem for Bill Clinton because any question that anybody asked of me, I would answer truthfully and fully.

So I was a poor politician. But a very good public health expert. And so when Bill Clinton calls you, do you remember what he said in that call? Well, the first call was not from Bill Clinton. It was from from Bill Clinton. It was from Leon Panetta. Leon Panetta was the White House chief of staff at the time, and he asked Joycelyn to resign.

And I told him that, no, I wasn't going to resign. I wasn't going to resign until Bill Clinton called me. He reminded me that Bill Clinton, you know, the president didn't have time to talk to me. And I told him, well, I wasn't going to resign until he did. There was no way I was going to resign or walk up and leave on the basis of the hired help, what the hired help was saying. He asked me to come to be the Surgeon General. He would have to ask me to leave.

And so, well, about an hour or two later, he did call me. And he said he wanted my resignation on the secretary's desk by 2 o'clock. And so I said, Mr. President, do you know what I said? And he said, yes, they told me. I said, but do you know what I said, Mr. President, do you know what I said? And he said, yes, they told me. I said, but do you know what I said? You know, he assured me that, yes, he did. Is that because you suspected he didn't know?

Because if he knew, there's no way he would fire you based on such a small, authentic comment. It never occurred to me that Bill Clinton would fire me. He knew what I was about. He'd heard me say things like that before. But, you know, things were different then, and I realized that. And so I just said, thank you, Mr. President. What was going through your mind when you hung up the phone?

What was going through my mind is I still couldn't believe that he asked me to resign. I couldn't believe that that had happened. I felt that his arm had been twisted by, you know, others. You've said that when you got to Washington, you felt like prime steak, but you left feeling like a low-grade hamburger. That's true.

Did you think that if a white man had said what you said, he would have been fired? I don't know. See, I'm not sure that a white man would have ever said that. It needed to be said, but I'm not sure that a white man would have said that. You see, some of the things that I was saying really took a black woman to say. I was thinking, I was speaking my mother's truth. It wasn't about being a politician.

It was about getting the job done. Whatever I had to do, I didn't even think about. I didn't know enough at the time to think about the politicians and their problems. After she was pushed out, Joycelyn went back to Arkansas to her job as a professor.

And she continued doing her research and fighting for better sex ed, which actually she's still doing today at the age of 88. But despite Joycelyn's hard work, these days in the US, sex education is still hit and miss. Most states require that abstinence be stressed in sex education policies. And while teen pregnancy rates have gotten a lot better since Joycelyn was the Surgeon General, the US still has the highest rate of teen pregnancy among similar countries.

And these days, people tell Joycelyn, she's been right all along. And, you know, he even said, well, Dr Elders, if we'd listened to you, we wouldn't be in this mess now. You know, my mom always tell us, always tell the truth. The day you see the truth and cease to speak

is the day you begin to die. I tell people all the time, you can tell I'm going to live a long time. Thank you. Thank you so, so much for your time. Oh, it's been a pleasure. I've enjoyed it very much. Thank you. That's Science Versus. If you want to hear more from Joycelyn, then I reckon you should go listen to the podcast 70 Over 70. It's interviews with people who are over 70,

and it's really, really wonderful, and they've recently done an episode with Joycelyn Elders too. Our episode was produced by me, Wendy Zuckerman, with help from Michelle Dang, Akedi Foster-Keys, Meryl Horn, Rose Rimler, and Nick Delrose. We're edited by Blythe Terrell. Fact-checking by Eva Dasher. Mix and sound design by Bumi Hidaka.

Music written by Peter Leonard, Bobby Lord and Bumi Hidaka. A huge thanks to the Zuckerman family and Joseph Lavelle-Wilson. I'm Wendy Zuckerman. I'll fact you next time. A letter to the Kansas City Star said that she was pushing, quote, feminist rhetoric. Nope. Rhetoric. Feminist rhetoric. Rhetoric.

Rhetoric. Oh, my God. Rhetoric. Feminist rhetoric and a liberal agenda. That's it, right?