As a result, five social conservatives on the 15-member Texas board, frequently joined by five more moderate Republicans, have enormous clout -- and often control the content used to teach millions of children.
Publishers have no choice but to heed many of the group's wishes, said Don McLeroy, a dentist, Sunday school teacher and Texas Board of Education member.
"They've got to sell books," he said. "It's business."
Conservatives' efforts over the years to edit textbooks are legendary here. In a nod to those who believe God created the Earth 6,000 years ago, a sentence saying the ice age took place "millions of years ago" was changed to "in the distant past." Descriptions of environmentalism have been attacked as antithetical to free-enterprise ideals; a passage describing the cruelty of slavery was derided as "overkill."
The pace of such efforts to alter curriculum is expected to increase because Christian conservatives are "emboldened" by the Republican gains on election day, Leo said.
The board's stance on the health texts, some observers said, speaks to a critical factor in the GOP's recent success: a recognition by evangelical conservatives that all politics is local.
The political ascendance of Christian conservatives in the 1980s and 1990s was fueled by their coordinated effort to win seats on school boards, city councils and other local bodies. A leader of the Christian Coalition said at the time that he would be willing to train an evangelical to run for dogcatcher.
Conservative forces began targeting the Texas Board of Education in the 1990s. Some, including Leo, ran for election unopposed.
Success at the local level has been used as a springboard to national power, said Robert Simonds, president of California-based Citizens for Excellence in Education; the group, which helped train the first wave of Christian conservative candidates, recently has lobbied for the withdrawal of Christians from the "secularist" public school system.
"It's like an athlete," Simonds said. "If you want to be a top-level baseball or football player, first you have to learn to run. So we ran.
"The secular world has jumped on it, but only after seeing so much success in Christian education and the like."
But Evan Wolfson, director of Freedom to Marry -- a New York group that seeks marriage rights for gays and lesbians -- said that the conservatives' drive to control local and state political boards might not look smart in the long run if their agendas were seen as mean-spirited.
"It does not help our kids to use them as pawns for divisive social agendas," he said. "It might be astute in the short term, but not in any meaningful sense for our kids or our country."
