I’ll never forget seeing this bright 17-year-old in school health clinic. I’ll call her Jessica.

Jessica came to me in a panic. I’d never taken care of her before, but another provider at the clinic had recently helped her access oral contraception. Jessica had been in a monogamous sexual relationship for the past six months and had been using condoms consistently, but she and her partner wanted to abandon the condom: they found it burdensome. Jessica had understood all of the risks of condomless sex. She also understood the instructions she was given: she was to start her pills right away, and she was to use condoms or abstain from sex for at least one week while the pills took effect. Jessica had done all of those things.

It was the morning after she had sex without a condom for the first time in her life, when Jessica came to see me, in tears. She was horrified. She was sure her anatomy was abnormal because “the stuff didn’t go up there. It just came right out.” It took me a minute or two to understand Jessica’s concern. In short, Jessica did not understand that her vagina was sort of like a pocket, that it had an ending. She thought that the “stuff” was to be sucked up into her body in a way that would make it disappear. Instead, she spent the night, sleepless, panicking that she was put together wrong and that she would certainly never be able to have children.

I know some may read this story and think that young people shouldn’t be having sex, or that they certainly shouldn’t be having sex without a condom. After all, birth control pills don’t protect from STIs, but I ask the reader to move beyond these points. This story is a powerful indictment of sexual education in the U.S. Indeed, Jessica had transferred to New York from a state in which she did not have access to comprehensive sex education. She consequently did not have foundational, fundamental knowledge about her own body.

Shielding adolescents from important information about sexual health and sexual relationships does not prevent sex. It does ensure that sex happens without foundational knowledge, and in a way that promotes fear and shame.

I am so happy to have been able to help Jessica that day. She was lucky to have moved to a school with a health clinic that provided contraception.