NARRATION: Deep in southern Georgia, in a region that has long grappled with the issue of teenage pregnancy, sits the small town of Cairo.

For the past few years, Daphne Melissa McClendon has been teaching sex education at the high school.

DAPHNE MELISSA MCCLENDON (TO HER CLASS): Were going to talk about contraception, okay? Ways to prevent pregnancy. Question, why do men need that information?

DAPHNE MELISSA MCCLENDON (HEALTH AND PHYSICAL EDUCATION TEACHER): At the beginning it was difficult for me. I did grapple with, you know I dont know that this is what I need to be doing, because I did feel like, hey, Im a Christian. I dont know that I believe in giving this kind of information out. And I also didnt want them to think that I was saying, hey, its OK to have sex.

NARRATION: The question of what public schools should teach teens about sex has roiled communities around the country for decades. But the roots of todays sex ed conflicts lie in the 1990s, when the stakes of the debate were brought into sharp relief after years of high teen pregnancy rates and the spread of AIDS.

ARCHIVAL (NBC NEWS, 1-2-90):TOM BROKAW: An emotional new battle over sex education in public schools in this country.

ARCHIVAL (NBC NEWS, 12-30-87):ANCHOR: How much should children be told about safe sex and is this a case of the more you know the more you do?

ARCHIVAL (NBC NEWS, 11-28-93):ANCHOR: Today the U.S. Surgeon General Jocelyn Elders called for comprehensive health and sex education from kindergarten through 12th grade.

ARCHIVAL (ABC NEWS, NIGHTLINE, 9-8-93):DR. JOYCELYN ELDERS I think I tick a lot of people off that refuse to deal openly and honestly about the predicament of our children today.

DR. JOYCELYN ELDERS (FORMER U.S. SURGEON GENERAL): I feel that if you dont understand and cant control your reproduction, you cant control your life.

NARRATION: While working in Arkansas, first as a doctor and then as the state health director, Joycelyn Elders came to embrace comprehensive sex education age appropriate, fact-based instruction on topics as varied as anatomy, relationships, and contraception.

ARCHIVAL (CBS, 12-9-94):DR. JOYCELYN ELDERS: I always tell young women, you know, Dont ever go out on a date with anybody you like without a condom in your purse.

NARRATION: But backlash to Elders and the approach to sex ed she advocated for mounted quickly.

ARCHIVAL (C-SPAN, 7-7-93):With evangelistic fury, she preaches that teenagers should have a love affair with a condom.

ARCHIVAL (CBS, 4-18-93):MS. JOYCE LEBRIGHT (PARENT): They call them condoms because its a con job and theyre dumb, and we feel like thats what were telling kids. Theyre being conned into believing that they can have safe sex. They cant.

NARRATION: A growing number of people felt instruction on birth control could prompt teens to have sex. Instead, they felt young people should only be taught abstinence no sex at all until marriage.

ARCHIVAL (ABC, 4-1-87):PRESIDENT RONALD REAGAN: I think that abstinence has been lacking in much of the education.

NARRATION: It was an idea first funded under the Reagan administration, and supported in the years that followed by the increasingly influential religious right.

ARCHIVAL (ABC, 3-18-94):RON CLAIBORNE: The new curriculum says it emphasizes Christian morality and chastity.

ARCHIVAL (ABC, 4-1-92):KAREN BURNES: Teenagers are told there is no safe sex outside of marriage. They are not taught contraception. Instead they are taught slogans like: Control your urgin, be a virgin. And Pet your dog, not your date.

DR. JOYCELYN ELDERS: They certainly were not the appropriate programs for the young people that I was accustomed to dealing with.

ARCHIVAL (NO SECOND CHANCE, ABSTINENCE EDUCATION VIDEO, 1991):TEACHER: Its kind of like you can think of it in terms of Russian roulette. What is it, one in six that youre going to die? When you use a condom its like youre playing Russian roulette.STUDENT: What if I want to have sex before I get married?TEACHER: Well, I guess you just have to be prepared to die

DR. JOYCELYN ELDERS: Every mother I know, every father I know, we all talk and support abstinence. But, also, we need to make sure that we educate our young people on how to protect themselves. People will say, Well, condoms will break. But always remember that the vows of abstinence break far more easily than does latex condoms.

ARCHIVAL (NBC, 12-9-94):TOM BROKAW: This week she went too far even for the president. She said that children should be taught in school about masturbation.

ARCHIVAL (NBC, 12-9-94):DR. JOYCELYN ELDERS: I think that that is something that its a part of human sexuality. And it is a part of something that perhaps should be taught.

ARCHIVAL (CBS, 12-9-94):CONNIE CHUNG: President Clinton today fired his outspoken U.S. Surgeon General, Joycelyn Elders. Mr. Clinton demanded and got her resignation.

DR. JOYCELYN ELDERS: If I had it all to do over again, Id do it exactly the same way. I did it right the first time.

NARRATION: The ousting of Elders provided easy fodder for late night television.

ARCHIVAL (NBC, SATURDAY NIGHT LIVE,12-10-94):DR. JOYCELYN ELDERS IMPERSONATOR: If masturbation is not taught in the home, then it must be taught in the schools!

NARRATION: But it also signaled a shift in the national mood, as a Republican majority took control of Congress in 1994, and abstinence-only gained political ground.

RON HASKINS (FORMER REPUBLICAN SUBCOMMITTEE STAFF DIRECTOR, U.S. HOUSE OF REPRESENTATIVES): The best thing of all is for teens to avoid sex. And I was hoping it would be possible to promote that by programs in the high schools. I thought we ought to try it. I thought it was a worthy investment.

NARRATION: When President Clinton signed the Welfare Reform Act, it included a provision on abstinence, which Ron Haskins helped draft. It provided federal funds for states to teach programs under a strict definition of abstinence-only.

RON HASKINS: Its a symbol of this is something that the federal government supports and we should support among the states. And it could grow. And that was what the people who supported this legislation had in mind. To start a movement, so to speak.

DR. JOYCELYN ELDERS: I told Bill Clinton of all the things that hed done, that was the one thing hed done that I would never forgive him for. I was very upset about that. Im still upset about it.

MARY ANNE MOSACK (PRESIDENT AND CEO, ASCEND): What you saw was a lot of local communities that, uh, really wanted this education for the very first time were able to implement it.

NARRATION: Mary Anne Mosack ran an Ohio-based abstinence-only organization that received an injection of federal funds, as the political climate grew even friendlier.

ARCHIVAL (C-SPAN, 1-20-04):PRESIDENT GEORGE BUSH: Abstinence for young people is the only certain way to avoid sexually transmitted diseases.

MARY ANNE MOSACK: That was a very, uh, good time for us in terms of expanding our message and our programming.

NARRATION: But over the years, researchers had been evaluating abstinence-only. One multi-year study, released in 2007, compared students who had gone through federally-funded abstinence-only programs, with their classmates who had not.

RON HASKINS: When I first saw the report, I was amazed. They would show the score for the experimental group and the score for the control group. And those bar graphs were just exactly the same height.

ARCHIVAL (ABC, 04-13-07):CHARLES GIBSON: The study found that students who took part in the programs became sexually active at the same age as those who didnt, and had about the same number of sexual partners.

RON HASKINS: I would describe myself as discouraged about abstinence-only. Most of the evidence shows that the more comprehensive programs are more effective.

LESLIE KANTOR: (PROFESSOR OF PUBLIC HEALTH, RUTGERS UNIVERSITY): There is a lot of evidence about what kinds of programs work. The scientific consensus is really there.

NARRATION: Leslie Kantor, a sexual health researcher and longtime advocate of sex education, points to findings that have repeatedly shown that comprehensive sex ed has significant effects on delaying teen sex, reducing sexually transmitted infections and teen pregnancies, and increasing the use of contraception.

LESLIE KANTOR: It turns out that when you give young people information, as well as the skills that theyre going to need to navigate in relationships, those are the young people who are actually able to wait longer to have sex.

NARRATION: Governors began rejecting some of the federal abstinence money

ARCHIVAL (KFVS12, 2-19-16):NEWS REPORT: Congress spent more than 1.5 billion dollars on abstinence-only sex education, an approach many now call a failure.

NARRATION:And with the Obama administration, came a large scale effort to fund the programs with the most scientific evidence behind them.

LESLIE KANTOR: It really was the first time in this area, at least, when the government was actually starting to bring science to bear.

NARRATION: But sex ed is ultimately a state and local issue, and there are striking differences in whats taught in schools around the country and whether certain topics are covered at all.

LESLIE KANTOR: What you actually end up seeing is that we are teaching less about birth control as a country than we did before all of this abstinence-only money came into play. If we have increasing evidence of a body of programs that works, then why wouldnt we get behind those evidence-based programs?

NARRATION: The Trump administration has prioritized abstinence-only, now being referred to as sexual risk avoidance. And while some of these programs now include some information on contraception, their underlying message remains essentially the same teens should avoid sex, hopefully until marriage.

MARY ANNE MOSACK: Were guiding you toward risk elimination, risk avoidance, to eliminate risk. So, when Im talking about contraception, Im giving you all the information. But Im also putting in the context that the only 100% safe way, um, to avoid pregnancy, or STD is sexual risk avoidance. Its interesting because sometimes students dont ever hear that message that they dont have, have to have sex.

RON HASKINS: The idea that abstinence-only is a fabulous idea, is a, its an ideology. Its not supported by good data. Im concerned that if we have public debates that are based on ideology, that were not going to make public decisions based on evidence and experience. Thats what we should try to do.

NARRATION: Cairo, Georgia is trying to do just that. A group of women had begun meeting regularly to discuss the issues they faced locally.

LAURA REGISTER: We had religious people, non-religious people, um, very liberal, very conservative, all come together to say, what can we do as women to make a difference in Grady County.

NARRATION: One night the subject of teen pregnancy came up.

LAURA REGISTER: One of us arrived late, and she goes, Its been a day. In a community I was in just northwest of here, there are three 10-year-olds pregnant. What can we do? As we got to talking, everybody knew a story. Everybody knew somebody affected.

NARRATION: Nationally since the 1990s, teen pregnancy rates have declined dramatically. Teens are having less sex today than in the past and more are using contraception when they do.

But some communities, like Grady County, are still challenged by the problems of teen pregnancy and sexually transmitted infections. And the Cairo women viewed comprehensive sex ed as part of the solution.

LAURA REGISTER: When you put the data on the table about whats happening to our kids, political barriers go away.

NARRATION: Teresa Gee Hardy, a school board member long involved with the church, helped get pastors and faith based organizations on board with the idea.

TERESA GEE HARDY: Theres a scripture that talks about My people perish because of lack of knowledge. Teens suffer because of lack of knowledge. Teen pregnancy rate is high because of lack of knowledge.

NARRATION: Grady County is now in the fifth year of its comprehensive sex ed program. And according to the district superintendent, feedback from teachers and students has been positive.

DAPHNE MELISSA MCCLENDON (TO HER CLASS): Lets look at what we talked about yesterday. Relationships, healthy and unhealthy relationships.

DAPHNE MELISSA MCCLENDON: I think my role is to give them the information to make sure that they understand that Im not judging them, but I want them to be informed and I want them to be empowered.

LAURA REGISTER: I think our community can be a model in the sense that, yes, this is scary. Yes, were very conservative. Yes, were very Christian. But, yes, were looking out for whats best for our kids.