JE: I think President Obama would like to do an awful lot more than he's done, but he's burdened down with three wars, a marked decline in our economic situation and the job losses. I think he's doing the best he can.

For example, [American political leaders had] been trying for 100 years to pass a health care bill of some sort. What President Obama signed was not complete, but I was very pleased that we at least got a bill that we can improve. And legislators are still out there trying to put riders on that so that the health exchanges in the states can't offer and pay for abortions. I'm so tired of them playing vaginal politics that I could just vomit.

TR: Do you think attitudes about sexuality and contraception have evolved since 1994?

JE: I think our attitude toward sexuality certainly is evolving, and that's because more people are better educated. We were operating under a theory at that time that ignorance is bliss. Now we know that by sitting around and saying our children aren't having sex, what we're doing is sacrificing them to unplanned pregnancies, HIV and [sexually transmitted infections].

A [Centers for Disease Control and Prevention] study in 2008 said that 25 percent of all 14- to 19-year-old girls have an STI, and among black girls it's up to 49 percent. So we need to teach them how to protect themselves. Other countries can do it. Why can't we?

TR: Talking to teens about contraception is one thing. The last straw with you in 1994 was your remark about possibly teaching masturbation. I suspect that wouldn't go over much better today.

JE: I think you're right, but we're at least talking about it much more. Back then, everybody was acting like this was a word they'd never heard. Everybody does it, but nobody admits to it. If everybody in Congress who'd ever masturbated in their life would turn green, then we would have a green Congress. That's true for the whole country, and other countries, too.

TR: But given that you were the surgeon general in the midst of a culture war in Washington, did you ever think about toning down your ideas to avoid potential backlash?

JE: No. That never occurred to me in any way, shape or form. I felt that I was a surgeon general for the people of this country, and especially adolescents. I was doing what I thought had to be done at that time to improve education and access to services for adolescent youngsters, and I think we did some of that.

There was a lot of progress made. Not as much in the area of comprehensive health education as I would have liked, but I think we made progress in other areas. Over the past 20 years, teen pregnancy has dropped by almost 40 percent.

TR: What do you make of your firing then?

JE: I feel, even to this day, that President Clinton didn't have any real problems with anything I said or did. I feel that he was trying to get some other issues through, such as improving our economic situation and the environment. If he was having to spend all of his time defending Joycelyn Elders, well, then, it was better to let me go. He knew that I was not going to change -- I'd worked for him for six years [as director of the Arkansas Department of Health]. And I didn't really have any bad feelings in regard to what he did.

TR: Given that you're an older, Southern African-American woman, people might expect your attitudes toward sexuality and sexual health to be more conservative. What life experiences shaped your frank and open approach to discussing these matters?

JE: I grew up in a small, rural farming community, and nobody ever talked to me about sex or sexuality. My parents didn't sit me down at the kitchen table, but they demonstrated to me all the time the importance of honesty, integrity and treating everybody right. That was demonstrated to me every day in everything they did.

I realized as I got older how much I didn't know. But my thoughts about women's health come from the values that I grew up with. Reproductive rights are just an extension of every other kind of justice and right there is.

Cynthia Gordy is The Root's Washington reporter.

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