When The National Campaign to Prevent Teen and Unplanned Pregnancy launched Bedsider three years ago, it wanted to create the “cool kid” of sexual health and contraceptive information. Bedsider live-tweets the Golden Globes, has a Frisky Friday newsletter full of sex tips, and tweets things like: “98 percent of women have used birth control. Not one of them? Maybe it’s time to upgrade your sex life.” While this irreverent and quirky take on sexual health has gotten Bedsider more than 50,000 Twitter followers, it’s also gotten the program blocked from promoting its tweets, because Bedsider’s account has violated Twitter’s ad policy.

As one might expect, Twitter prohibits the promotion of adult or sexual products or services. “Safer sex education, HIV/STD awareness campaigns, and non-prescription contraceptives” can be promoted, but only with the provision they “do not contain sexual content and do not link to sexual content.” For example, an approved condom tweet might read: “A condom can actually fit over your entire head! #Themoreyouknow,” whereas an offending tweet would be “If you think condoms aren’t for you, you just haven’t found the right one yet. See how good safer sex can feel.”

In fact, it is exactly those words that sounded the alarms last spring, when a sponsored tweet linked back to the Bedsider homepage, where the article about loving condoms (with the above tagline) was featured. It wasn’t the words of the promoted tweet itself that were an issue, it was the fact that that tweet linked back to a website with “sexual content.” A Twitter account strategist alerted Bedsider’s director, Lawrence Swiader, there would be an issue promoting any tweets while the condom love article was featured on Bedsider’s homepage. Even though the article was about safer sex, said the rep, “It still paints sex in a recreational/positive light versus being neutral and dry.”

Under Twitter’s ad policy, it’s okay to have messages about safer sex, they just can’t be sexual. So if an organization wants to encourage safer sex, they are limited to headlines like, “Use Condoms.” This is a problem for Bedsider, the entire existence of which is based on the premise that safer sex is better sex. “We need to be able to talk about sex in a real way: that it’s fun, funny, sexy, awkward … all the things that the entertainment industry gets so well,” Swiader says. “How can we possibly compete with all of the not-so-healthy messages about sex if we have to speak like doctors and show stale pictures of people who look like they’re shopping for car insurance?” While Kim Kardashian’s bare butt is “breaking the Internet” with click-throughs, sexual-health organizations must compete for attention with slogans fit for high-school health books.

Sexual health is something that has to be sold, like anything else. “We have to make healthy behaviors desirable by using creative, humorous, and positive appeals. We don't use negative, fear-based messaging to promote products, and we can't use it to promote behaviors,” says Susan Gilbert, co-director of The National Coalition for Sexual Health. “If we really want to improve sexual health in this country, we must give Americans access to accurate and engaging information that can help them protect their bodies, build good relationships, and access key health services."

Twitter’s non-sexy sex policy is one of many that have made online ventures difficult for the sexual-health community. A Facebook ad for a Bedsider article titled “Six Things You Should Know About Your Well-Woman visit” with the tagline “You’re so sexy when you’re well” was recently rejected because it violated “Facebook's advertising guidelines for language that is profane, vulgar, threatening or generates high negative feedback.” So said the email Facebook sent to Bedsider disapproving the ad. This policy, like many others, is so vaguely written that it’s difficult for organizations to abide by it. Was it the word sexy that was “profane?” Or is the idea of a well-woman visit threatening? (Fair enough, speculums can be intimidating.)

Even policies that are ostensibly black and white can have room for interpretation. One sexual-health organization ran into this problem while selling contraceptive education kits online using Google Checkout. They were told they were no longer able to sell the kit because “Google didn’t allow the sale of sex toys.” Confused, the organization asked what in the kit was considered a sex toy, and discovered the Google representative was referring to the wooden penis demonstration model used for showing how to put on a condom. The organization debated extensively with many different representatives—each time having to explain that wood would be uncomfortable to insert into a vagina, and that the user would risk splinters if the model were actually used as a sex toy. But the representatives stood by their interpretations, and the kits were removed from Google Checkout.

According to Deb Levine, many policies are enforced with overly strict interpretations, or are so broad that they’re enforced completely inconsistently. Levine has worked in the sexual-health and tech field since 1993, and is the founder of YTH (Youth+Tech+Health) an organization that focuses on promoting young people’s reproductive health using technology. “Ambiguous terms of service are left completely up for interpretation by individual customer-service reps,” she says.

Inconsistency persists across the board when it comes to sex and social media. While Bedsider cannot have its tweets link back to its website if the homepage features any content deemed too sexual, Playboy has been able to promote its Twitter account even though its feed has shown bare breasts and highly suggestive text that is decidedly not health-oriented. Many non-branded Twitter feeds are highly sexual, too—belfies (sexual selfies showing bare butt), for example, are a thing. “Twitter, Facebook … all of these platforms with such strict policies … it’s like they don’t know their sites are absolutely flooded with sexual content,” Levine says. “We just want to get in there and offer some healthy sexual messages alongside everything else people are inundated with on a daily basis.”

This double standard is simply a microcosm for how sex and sexuality are dealt with in our larger culture, according to Gilbert. “We live in a hypersexual world.” she says. “Sexual images and content are literally everywhere, from suggestive advertisements and erotic romance novels to provocative TV series to sex-tip columns in magazines and on the Internet. Yet we have limited access to positive, credible sexual-health information and open dialogue that can help keep us healthy.”

Social media’s strict policies wouldn’t be such an issue if teens (and adults) didn’t use technology as one of their primary sources of sexual-health information. But in fact, 89 percent of teens say they learn about a variety of sexual-health issues online. There is no other source—not doctors, friends, school, parents, TV, magazines, anything—where teens are more likely to get their information.

And so even the Centers for Disease Control and Prevention have turned to social-media vehicles to help raise awareness about sexually transmitted diseases. “It is important for us to continue harnessing the power of digital technology to engage with populations that are especially vulnerable to sexual risk,” says Rachel Kachur, a health-communications specialist in the CDC’s Division of STD Prevention. “Whether it is the Internet, mobile phones, or gaming, technology is increasingly influencing the lives of youth and has changed the way they interact and access information.”

Access to approachable and scientifically accurate information about sexual health is especially important in light of the statistics. While teen births have decreased by half since the 1990s, the U.S. still has one and a half times the teen birth rate of the U.K. (which has the highest birth rate in Europe) and nearly 10 times the teen birth rate of Switzerland (which has the lowest). When an American teen gives birth, she’s significantly less likely to graduate from high school or attend college, and significantly more likely to end up in poverty.

Chlamydia rates in the U.S. are more than three times that of Europe, gonorrhea rates are more eight times that of the Europe, and prevalence of HIV/AIDS is three times higher than Europe’s. The U.S. spends $16 billion a year in healthcare costs related to STDs, and $12 billion in costs related to teen pregnancy—combined, that’s double the direct healthcare costs of child obesity. So it’s unfortunate that many positive messages about sexual health are prohibited by these social media policies.

It’s fair to say that over the past few years many sexual-health organizations have reached out—mostly unsuccessfully—to a number of tech platforms about their overly strict policies. A year and a half ago YouTube took down four educational videos about women and girls’ health produced by Spark and YTH. The organizations made numerous attempts to contact YouTube to rectify the error, including filing two appeals through an online process. When they were unsuccessful, they contacted a lawyer, and even then, were only able to get their videos restored because their lawyer happened to go to law school with someone high up in YouTube’s policy department, according to Levine."While some organizations have had success getting content through after initial rejection, the process of winning that minor victory is tireless,” Swiader says. “Many smaller organizations just don't have the bandwidth to fight for each individual piece of content."

Even people who have made more visible protests have been ignored. This past summer, Twitter banned ads by Lucky Bloke, a condom retailer with a mission to educate people about how proper condom fit leads to greater pleasure and more consistent use. Melissa White, the CEO, started a petition and a #Tweet4Condoms campaign in response to the ban that was supported by thousands of individuals and organizations, according to White’s publicist. And yet she says Twitter only responded to her once, and that was to refer her back to their policy. “It was very clear they were just waiting for it to blow over and for us to go away,” she says.

One might wonder how it is that the technology field—otherwise associated with innovation and forward progress—could have such conservative policies towards sexual health. But on the other hand, it’s easy to see why a tech platform wouldn’t want to risk looser policies that might offend some of its users and affect its bottom line.

“Our ask,” Levine says, “is to get some of the higher-ups at Twitter, Facebook, YouTube, Pinterest, Yahoo, and all the other platforms we use, to sit down with some people in the sexual-health field, and we can work to amend these policies.” YTH is holding its annual conference in San Francisco at the end of April. Levine says they would be delighted to feature a conversation between tech giants and sexual health educators about potential policy revisions. If that doesn’t work, “We’ll come to you,” Swiader says. “We’re happy to bring some sexual health experts to Silicon Valley and hash this out together. We provide content your users want and need to be informed and healthy—and it’s bad business, and poor citizenship, to restrict them from it."