Sex education is also about what happens above the waist.
That's what former longtime Union Public Schools Superintendent Cathy Burden said at Tuesday's launch of the Tulsa Campaign to Prevent Teen Pregnancy.
"All of us have been scared of this topic for a long, long time," Burden said. "We have used that fear to get us to that appalling number of fourth in the nation."
Oklahoma is No. 4 in teen pregnancy, maintaining its long-standing top-five status.
Driving up that ranking are the 18- to 19-year-old mothers, coming in at No. 2 in the nation. Only Mississippi tops that.
Of all the social problems bringing down the economy, teen pregnancy is the most direct.
In Tulsa County last year, costs associated with teen childbearing was nearly $38 million, with 1,529 births, according to the campaign.
Statewide, the economic impact is about $190 million annually, the campaign states.
Parents failing, too: Two years in the making, the campaign rolls out armed in research, packed with data, with influential community partners in place and financial support from foundations.
It's a systemic approach to reach decision-makers through increased education and services backed by proven programs.
Tulsa attorney Kim Schutz is stepping outside her area of expertise to become the campaign's executive director.
"There are more 18- and 19-year-old girls giving birth in this state than entering OU and OSU as college freshmen," she said.
From a scientific view, a person's frontal cortex - which handles the part of the brain's function to understand consequences - is underdeveloped until the early 20s.
"As adults, we need to be that part of our teenagers' brains," said Dr. Rupa DeSilva, a Tulsa pediatric and adolescent gynecologist.
Mountains of data show that parents are the No. 1 influence in a child's life.
Yet only about one-third of teenagers say their parents are talking to them about sex and pregnancy, according to a study by the National Campaign to Prevent Teen Pregnancy.
"There is a disconnect," DeSilva said. "Maybe we aren't talking as much as we should."
Talking is key to change: The local campaign commissioned a poll of 700 Tulsa adults and found that nine out of 10 favor a comprehensive sex education program in Tulsa middle schools.
Forget the old lessons in biology about birds, bees and sex organs getting at teen pregnancy is about getting at the self-esteem, goals and confidence of preteen kids.
Two years ago, Union Public Schools started the Carrera program, which has extra staff teaching classes ranging from money management to career planning.
"Parents were so relieved and so grateful that schools were becoming a partner with them," Burden said.
Four Tulsa Public Schools middle schools offer a sex-education program, and the plan is to expand it into all middle and high schools.
"Teen pregnancy is preventable," Burden said, "if we have the political will, guts and courage to implement programs with research-tested methods proven to be effective."
Sad new world: In the past two years, I've interviewed many teenage parents. It's a sobering experience.
The teenagers made a bad decision and now struggle with school, work, finances and child care.
At one suburban district, a 14-year-old boy had fathered three children with three girls.
Among a group of teenage mothers I met, all were children of teenage moms, all were on welfare programs, and none had a relationship with their babies' fathers. Most did not realize they were on welfare, assuming that programs such as Women, Infants and Children and child-care subsidies were available to everyone.
That's not their fault. They were not taught or shown another way of life.
That's what the local campaign is setting out to accomplish.
Abstinence is part of this conversation; parental involvement paramount and education is essential.
Businessman Larry Mocha spoke about how the state's treatment of youths is reflected in a sluggish economy and unprepared workforce.
"We've got to do better by our young people," he said. "I think we can do it. But we can't do it by ourselves."