Population, Reproductive, and Sexual Health: Data Are Essential Where Disciplines Meet and Ideologies Conflict

The flourishing of the individual human person, the health of human society, and the ecological well being of planet earth are inextricably connected with the issues of human population, sexuality, and reproduction. Many academic disciplines have strong interests in these issues, approaching them from different perspectives and with different emphases. However, these areas of study are also infused with controversy and strong ideological positions arising from cultural, religious, political, and social traditions that sometimes clash with each other. To address these issues, two things are needed: (1) data that address questions from different underlying assumptions; (2) open and respectful discussion among scientists, clinicians, and policy makers who have different backgrounds, narrative frameworks, and conceptual perspectives (1). The new Section on Population, Reproductive and Sexual Health, Frontiers in Public Health will contribute constructively to these critical needs. There is no substitute for data, carefully collected, analyzed, and considered, to contribute to and inform scientific and policy discussion in healthy, transformative ways. It is universal to human nature that preconceived assumptions drive perceptions and explanatory models: ultimately one can only see what one is willing to consider might be true. Scientists are not exempt from cognitive bias (2, 3). However, the essence of the scientific method is that data are allowed to challenge assumptions. Scientists and professionals have the great opportunity to allow their models of the world to be influenced, updated, and improved by data, carefully collected and objectively analyzed. Research results can and should fundamentally inform theory and challenge assumptions, regardless of their popularity or social currency within the researchers' own peer groups. Consider as an example, research that has challenged both advocates and opponents of emergency (post-coital) contraception (4). Advocates for emergency contraception have proposed confidently that widespread dissemination and promotion of emergency contraception would decrease rates of unin-tended pregnancy and induced abortion (5, 6). However, the large preponderance of evidence from extensive interventional research is that emergency contraception has not decreased unintended pregnancy nor induced abortion, and is unlikely to do so (7–10). Additionally, levonorgestrel emergency contraception is certainly much less effective to prevent pregnancy than originally proposed (11–13). On the other hand, skeptics and opponents of emergency contraception have assumed or proposed that levonorgestrel emergency contraception acts after fertilization to prevent successful implantation of the embryo (14–16). However, the preponderance of recent evidence for postcoitally administered levonorgestrel does not support this as a significant mode of action …