It's not as colorful a statement as Elders, a pediatrician, made six years ago after Gov. Bill Clinton named her director of the Arkansas Department of Public Health. Asked then if she intended to distribute condoms in public schools, she said:
"Well, I'm not going to put them on their lunch trays, but, yes."
While not as snappy, her statement in an interview last week in her office at the Department of Health and Human Services is equally plain in its implications:
The new surgeon general does favor making contraceptives available at school to sexually active teens, if the community and individual parents agree, and she does favor the right to abortion, calling it "a very hard, difficult choice that (a woman) has to make with her significant other, her doctor and her God."
Elders, 60, makes no apologies for these opinions, even as conservative critics, who vigorously fought her confirmation, accuse her of fostering a climate of immorality.
"I as much as anyone else support abstinence," Elders says, "but if I know from the facts that young people are not being abstinent, I can't bury my head in the sand and pretend we don't have the problem."
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Certainly the nation's first black surgeon general isn't known for burying her head in the sand. If anything, she's prone to kicking up dust.
An Elders sampler from well before the Senate's 65-34 confirmation vote in September includes blunt statements that her detractors have characterized as intemperate, intolerant, insulting and divisive.
"Pro-lifers are very religious but non-Christian," she has said.
Of anti-abortion activists: "They love little babies as long as they're in somebody else's uterus, rather than caring about children after they're born"; and they have "a love affair with the fetus."
Also, she once said: "Look who's fighting the pro-choice movement - a celibate, male-dominated church." She later offered the Catholic Church an apology that some found less than heartfelt.
At Elders' confirmation hearing in July, Sen. Nancy Kassebaum (R., Kan.) asked the nominee if she had ever said, "We teach teenagers what to do in the front seats of cars, and now should teach them what to do in the back seats." Elders said yes, she had said it, and explained that she was advocating teaching young people to be responsible about sex.
Kassebaum cautioned Elders that to avoid polarizing people, she might need as surgeon general to modulate her words - to adopt what Kassebaum called "a little bedside manner."
Elders, who will be at Philadelphia's City Hall tonight to receive an award, became so well known in Arkansas for her sharp words, Dateline NBC reported, that a newspaper coined the verb to elders, meaning "to tongue-lash or outrage, and to invite criticism."
Sitting at the end of a conference table in her spacious but as-yet- undecorated office last week, Elders didn't retreat from her statements or her style.
"I haven't made any statements that I regret," she said. "If I've said something that's untrue, I'd like to correct that. But if (the statements) are not untrue, I haven't made any I'm sad about making."
She intends to use the surgeon general's bully pulpit to push her agenda - including not only preventing teen pregnancy but also providing prenatal care and childhood inoculations and attacking violence as a health problem among young people - as far and as fast as possible.
Advancing such causes is exactly what her boss Bill Clinton expected of her, she believes, when he asked her in December to be his surgeon general.
Elders remembers warning him then that, having had six years to watch her sometimes-controversial service as Arkansas health director, "now you know exactly what you're getting."
"Yes, I do, Joycelyn," she recalls his saying. "I want you to do for the nation what you've done for Arkansas."
One thing she did in Arkansas was set up a program of school-based health clinics that dispensed contraceptives and offered abortion referrals if the local school board requested it and if individual parents gave permission.
Still, Elders' critics point out, the teen pregnancy rate in Arkansas did not decline during her tenure as health director. Elders herself says that the rate, already high, went up 11 percent, compared with a 16 percent increase nationally.
"I'm not all that proud about that," she says. "We didn't get all of our programs implemented. It takes time. You don't just go out there and flip the switch."
Due to limited funding, clinics were set up in only 24 schools, she says, with 28 other schools on a waiting list.
Yet she isn't discouraged about starting such initiatives elsewhere. And she feels confident that what she calls "comprehensive health education" in schools, which includes sex education, is an idea that enjoys a consensus around the country.
She intends to do all she can to see such programs implemented.
"I know there's going to be some furor," she says, "but I don't think it'll be a very serious furor."
In her new role, Elders sees herself as "the voice and the vision for the poor and powerless, and if I'm not going to do anything for the people who can't do for themselves, I need to go home."
She comes by such sensitivities naturally.
The eldest of eight children, she grew up Joycelyn Jones, in the small town of Schaal, Ark., living in a three-room cabin without an indoor toilet, doing backbreaking work in cotton fields first sharecropped, then owned, by her father.
"The whole family pitched in" to do the farm work, she remembers.
In a recommendation letter to the Senate Committee on Labor and Human Resources, her brother Chester R. Jones, a district superintendent for the United Methodist Church in Pine Bluff, wrote:
"When she was only 4 years old, she walked five miles a day to catch the school bus. She had to learn how to cook at age 5 to help take care of seven sisters and brothers while her parents worked the fields.
"She performed many chores, which included pulling corn, stripping cane, sawing wood with a crosscut saw, baled hay, helped our father stretch coon hides for money to buy food, picked and chopped cotton, milked cows, fed and slopped the hogs, made fires in the fireplace and cookstove . . . pulled peanuts, dug potatoes, picked cucumbers and dewberries, and helped her father clean out the barnyard to fertilize the cotton and corn fields."
Elders talks about her childhood in matter-of-fact tones. Any suggestion that it was horrible, she says, is "not true at all."
"There were 13 aunts and uncles on one side, loads of family. There were just always lots of people.
"I really didn't know I was poor until other people started telling me I was poor. I remember I wore boots because I didn't have shoes, but I didn't feel" - long pause - "alone."
A bright child, she graduated from high school at 15 and from Philander Smith College in Little Rock, a black school she attended on a United Methodist scholarship, at 18.
"I think one of the big things that drove me was that I didn't want to go back to the cotton patch," Elders says. Classes "were better than being on the farm chopping and picking cotton all day."
At Philander Smith, an alumna, a medical student named Edith Irby Jones, came to speak to Elders' college sorority, and changed Elders' life.
"She was just really very impressive," Elders says. "I can just always remember her silhouette. I remember wishing I could be just like her."
Now Elders and Jones, a physician in Houston, sometimes see each other at professional meetings. "I was overjoyed that I had some influence," Jones told the Dallas Morning News.
After graduation, Elders did a stint in the Army, receiving training as a physical therapist. Then in 1956 she enrolled in the University of Arkansas Medical School on the GI Bill, one of only a handful of black students there in the very early days of desegregated education in the South.
Dining halls were segregated, she remembers, so she and the few other black students ate with the cleaning staff.
Elders says she was not a participant in the civil rights marches, sit-ins and protests that were beginning to sweep the South. "I was so busy trying to get out of medical school and pass, I was not involved in things going on in the community." She graduated from medical school in 1960 not owing a dime, she says proudly.
After an internship at the University of Minnesota and a pediatric residency at the University of Arkansas Medical School, Elders earned a master's degree in biochemistry and later became board-certified in pediatric endocrinology. She joined the faculty at her medical school alma mater in 1976 as a professor of pediatrics.
Oh, a second significant encounter happened when Elders was a senior in medical school. She was sent over to a local high school to do medical exams on the basketball team, whereupon, of course, she met the coach, a tall, stately man named Oliver Elders. They fell in love, married and now have two grown sons.
Until she and her husband - now retired from basketball and working at the U.S. Department of Education - moved to the five-bedroom, five-bath house in Bethesda, Md., that the government provides for the surgeon general, Joycelyn Elders says she could often be found in the stands at Little Rock's Hall High School basketball games. She was "the woman that's always up there screaming and hollering."
One morning last month, Joycelyn Elders came to Philadelphia to deliver one of the thousands of speeches she'll be called on to make as surgeon general, a job that consists largely of being a public advocate for health policies.
Her audience was young people attending a regional meeting of the American Medical Student Association at the Wyndham Franklin Plaza Hotel. They awaited her eagerly.
"She's someone who is a physician who is also pro-choice, pro-family, pro- child," said Hillary Kunins, a medical student at Columbia University and a founder of Medical Students for Choice.
"This is incredibly important for us as a role-model for the kind of physicians we can become - to take unabashed positions on issues."
Forty-five years after the Philander Smith College freshman was awed and inspired by the medical student who came to speak to her sorority, the roles were reversed. Now she would do the inspiring.
On the podium, Elders didn't disappoint. Her cadences were strong and rhythmic, like those of a skilled Southern preacher. Responding to a question about how she stays motivated in the face of seemingly intractable social problems, her words were firm and definite:
"I feel that the world has really been very good to me. I started out poorer than most . . . (but) because a lot of things happened right, I was able to end up in college, medical school.
"I don't ever think of burning out. I just think about keeping on pushing,
because I think of all those young people out there who can't get where I can.
"When I'm doing these things, I don't get tired. For all of those who think I'm going to get tired and quit, they just need to forget about it."
IF YOU GO
* Tonight the Family Planning Council of Southeastern Pennsylvania will present Joycelyn Elders with its second annual Harry A. Blackmun Reproductive Freedom Award at a fund-raising reception in Conversation Hall on the second floor of City Hall. The reception is from 5:30 to 7:30 p.m. Admission is $50. For information, call 215-985-2619.
