This story is part of Made In Philly, a series about young residents shaping local communities.
When Shanaye Jeffers was in fourth grade, she often skipped touch football and double-dutch jump rope at recess to read a book on puberty. In fifth grade, she jumped at the chance to do a school project on childbirth.
By the time Jeffers got her period in sixth grade, she was already well-versed in reproductive health. She knew that women are most fertile when they're ovulating. That wearing tight, synthetic clothing can increase the risk of a yeast infection. That it's important to wash private parts but not with heavily scented products.
And she also knew her dedication to understanding reproductive health was unusual.
Most girls don't know about the inner workings of their bodies, sexual-health experts say — especially black teenage girls, who often face stigma against asking questions at home and are poorly served by sex-education school curriculums tailored for a white majority.
"Sex ed is not serving young black women really at all," said Jeffers, now a 28-year-old obstetrics and gynecology resident at Thomas Jefferson University Hospital.
She's trying to change that. As Philadelphia site director for Daughters of the Diaspora, a nonprofit founded in 2012 to teach black teenage girls about reproductive health and self-esteem, Jeffers is working to give other girls the same knowledge and passion to take charge of their health that she had as a child.
The information is often hard to come by, Jeffers said. If girls ask family members about sex or development, they'll likely be accused of "trying to be grown." Many parents fear discussing sex is the first step toward having it. For immigrant families from Africa, there can be additional stigma around the topic of HIV, which is widespread among young women there and causes more than half a million deaths on the continent each year.
In U.S. schools, black students are more likely to receive abstinence-only education than white students, according to a Washington University study. And even when they receive a comprehensive curriculum, it is rarely tailored to their lives and culture, experts say.
Though birth rates for black teens have dropped significantly in recent decades, they are still more than twice as likely as white girls to become pregnant. They have a higher risk of facing sexual violence and contracting a sexually transmitted disease, especially in Philadelphia, where rates of transmission are three to five times higher than the national average.
"I really want to break the cycle," Jeffers said.
Daughters of the Diaspora (DoD) recruits medical students to lead groups of three to five teenage girls, typically from West or Southwest Philadelphia, in lessons on female anatomy, contraception, and goal-setting over a three-month period. The teens are recruited through local schools and community connections.
Though the curriculum is heavy on medical information — describing how different hormones interact with the brain, ovaries and uterus — it's meant to be relatable. A SEPTA map is used as an analogy for the endocrine system. Quotes from Maya Angelou and Zora Neale Hurston are scattered throughout.
The medical students, as young black women themselves, act as role models, often sharing their own experiences in the hopes of boosting girls' self-esteem and helping them envision new futures.
"We try to get these young ladies to see themselves in a way they probably haven't before," Jeffers said. "As agents of their own health."
Joy Cooper can still remember sitting in a health class at Philadelphia High School for Girls, listening to her middle-aged, male volleyball coach recite textbook passages on contraception to an all-female class.
Students were too uncomfortable to answer questions, let alone ask any, said Cooper, a co-founder of DoD and now a 34-year-old ob-gyn in Oakland, Calif. "I realized who's delivering the information makes a difference," she said.
More than a decade later, 18-year-old Fatme Chaloub had a similar experience. A 2017 graduate of Girls' High, she said her sex-ed class was also taught by a middle-aged white man. The class had good information, but "if an older person is talking to me, I feel uncomfortable," Chaloub said. The DoD curriculum, taught by women just a few years older than she, "was more relatable."
But this isn't a Girls' High problem. Or even a Philadelphia problem. Across the nation, research shows, black girls are poorly served by sex ed, if they're getting any at all.
In Pennsylvania, schools are required only to provide education on HIV and AIDS, with a focus on abstinence. The Philadelphia School District provides teachers with additional information on contraception and dating violence, but it does not require any specific curriculum. What students learn can vary greatly depending on the teacher.
At Horace Furness High School in South Philadelphia, health and physical education teacher Colleen Hanna supplements the district-provided textbook with song lyrics that discuss sexual stereotypes of women. She is working to include more information on gender identity and sexual violence, too, but it's a slow process. While the district provides guidance, "a lot of the research comes down to me," Hanna said.
Though it isn't the case in Philadelphia, research shows that, nationally, black students are more likely to receive abstinence-only education because they are often in poorer school districts that rely on federal funding. "Schools with few resources can hardly afford to turn away these offers of outside help," a report in the Berkeley Journal of African-American Law & Policy states.
But abstinence-only curriculums can reinforce harmful stereotypes of black people, said Tracie Gilbert, an independent sex educator with a doctorate in human sexuality education from Widener University. "The narrative is that, without restriction, black girls will be the most amoral sexual beings of society," she said. Rather than teaching them to make informed decisions about their sex lives, many curriculums suggest they must be abstinent to avoid harming themselves or others.
Even more expansive curriculums, though — often created by white educators and based on research of white subjects — can be tone-deaf for students of color, said Laura McGuire, a certified sexuality educator and founder of the National Center for Equity & Agency. They often tell students to use birth control, but "there might not be easy access to any of those things," she said. Similarly, telling someone to delay pregnancy because it will help her get to college ignores students who don't plan to take that path.
Daughters of the Diaspora tries to supplement the shortcomings of school-based sex ed by creating a cycle of education within the black community. The idea is to make learning fun and show that it's not confined to a classroom, Cooper said. The goal is that girls who participate in the curriculum will pass on that knowledge to their friends.
"How we educate people [in schools] is about the majority," she said. "So when you're in the minority, it's left up to people in your community to try to make things better."
About 40 girls in Philadelphia have gone through the curriculum in the last two years, Cooper said, and there are smaller chapters in New York, Oakland, and Apam, Ghana. Some of the students have started spreading the message.
Chaloub, from Southwest Philly, gave her cousin and her best friend recaps after every DoD class. She'd recount for them the different ways someone can contract an STD, the difference between bacterial and viral infections, and how to treat them.
"There's a recognition that the way it's always worked hasn't worked well," said Mariotta Gary-Smith, co-founder of WOCSHN. "These communities are going to continue to find ways to make sure their voices are heard."
But it's unclear whether educational efforts will impact the larger health disparities faced by black women in America. Research shows that even highly educated and high-income black people experience higher rates of hypertension, preterm birth, and other negative health outcomes compared with their white peers.