Church-State Separation

THE CONSEQUENCES OF ABSTINENCE-ONLY SEX EDUCATION

Clark Moeller
The Consequences of Abstinence-Only Sex Education
November 1, 2005

(click here for pdf version, updated 11/16/05)

Synopsis: The overwhelming evidence from the research on abstinence-only sex education is that it is a failure. It is doing more harm than good. Students should be taught medically-accurate comprehensive sex education which includes recommendations that students abstain from sexual activity.

This paper summarizes research findings on abstinence-only sex education (AO) since its inception in Texas under Governor George W. Bush and since 1997, when AO became a federally funded program. The overwhelming evidence from the research of the last 5 to 8 years indicates that AO is a failure. It is doing more harm than good.
  As a result of these findings, the Bradford County Alliance for Democracy (BCAD) recommends that AO be stopped immediately in all our public schools, because AO is putting teenagers at a higher risk of getting pregnant and contracting sexually transmitted diseases (STD). Medically accurate, comprehensive sex education (CSE), which includes recommending abstinence, should be taught.
  AO rests on a simple proposition: if a girl or women does not have sexual intercourse, she won't get pregnant. The problems with this proposition are in the "if," as well as the fact that both women and men can become infected with an STD such as HIV/AIDS without actually engaging in intercourse. Oral or anal sex is all it takes to get an STD if one person has an STD and his or her sex partner has a small break in the skin where the sex takes place.
  In order to appreciate the actual context within which AO has been operating, the National Center for Health Statistics reported this September that a national survey about the sexual practices of Americans found that, "... 49 percent of [teenage] boys and 53 percent of [teenage] girls have had sexual intercourse"... and of those teens who have had intercourse, " ... 88 percent of boys and 83 percent of girls" engaged in oral sex. Of those teens who have not had intercourse, "... 55 percent of boys and 54 percent of girls" reported that they had "... given oral sex."1
  According to the Guttmacher Institute, 1 in 4 youth, 15 - 24 years, will get an STD.2 This age group accounted for about half of all new incidents of STDs in 2000.3 Ninety percent of these, according to H.W. Chesson et al, are HIV and human papillomavirus (HPV) infections which can be contracted by having oral sex as well as intercourse.4 "Human papillomavirus (HPV) is the most common sexually transmitted disease in the United States," according to Karl E. Miller, MD. "Some studies have shown a potential lifetime risk of HPV infection of 70 percent or greater. Men and women in the 20 to 24 year age group are at highest risk for HPV infection, especially if they are attending college. HPV infection is considered the most important causative factor in the development of cervical cancer, and it increases the risk of penile and anal cancers in men."5
  These are the threats to our youth despite the fact that AO has been increasingly taught in public schools since 1996. Inadequate sex education and the lack of easy access to contraception for teens has been cited in many studies as the reasons that teens in the U.S. have had a higher teen pregnancy rate compared to Canada, England, and France, all of which have rates that are half that of the U.S. The U.S. has had a teen pregnancy rate that has been 10 times higher than the Netherlands, which has the most liberal approach to sex education in the world.6 These are apples to apples comparisons because a number of international studies have found that the typical age at first sexual intercourse in the United States starts, on average, at 17.2 years. This is similar to youths in Great Britain (17.5 yrs), Netherlands (17.7 yrs), and France (18 yrs).7

Below are summarized three important characteristics of federally funded AO programs.
Effectiveness: The first important characteristic of abstinence-only sex education (AO) programs is that these do little to reduce teen pregnancies. While the rate of teen pregnancies for 15 to 19 year olds has declined from 61.8 per 1,000 in 1991, to 41.3 in 2003,8# AO has contributed very little to this decline and has increased the risk of STD.
  "A study presented at the American Psychological Society found that over 60% of college students who had pledged to remain chaste when they were in their middle and high school years had broken their vows to remain abstinent until marriage."9 Furthermore, teens who have taken an oath of celibacy until marriage have, on average, become sexually active only six months after those who did not take the oath, but the pledgers were less likely to use condoms when they did have their first sex. This increased their risk of getting pregnant and contracting a sexually transmitted disease. 10 "... about 50 percent of 9th-through 12th-grade students have lost their virginity, many without knowing how to protect themselves against pregnancy and disease."11 "Millions of these have participated in the more than 100 abstinence programs... ," according to a Congressional report.12
  An independent study commissioned by the Minnesota Department of Health found that the "... state's $5 million abstinence-only sex education program was not working. ... of 413 junior high school students surveyed, the rate of sexual activity increased from 5.8 percent to 12.4 percent in 1998-2002 – a pattern similar to that of kids statewide. The rate of students reporting they would likely have sex before high school graduation increased from 9.5 percent to 17 percent."13 The Minnesota report is just one of a growing body of research that shows AO does not work. Recent research now documents that AO increases the risk of teens' getting pregnant and/or becoming infected with sexually transmitted diseases (STDs).14
  Eleven of 13 AO programs evaluated in a congressional study found a pattern of disinformation being fed to school students. Following are some examples: "abortion can lead to sterility... as many as 10 percent of them [those who had had abortions] become sterile, .... half the gay male teenagers in the United States have tested positive for the AIDS virus and touching a person's genitals ‘can result in pregnancy,'.... A 43-day old fetus is a ‘thinking person,".... HIV, the virus that causes AIDS can be spread via sweat and tears, .... Condoms fail to prevent HIV transmission as often as 31 percent of the time in heterosexual intercourse." Lying to teenagers about sex is no way to protect them, it just makes them cynical; tell teenagers the truth. For example, condoms are 93% effective, oral contraceptives and IUDs are 97% effective.15 Accurate information about AO pledges, such as promoted by the Silver Ring Thing program, will let students know that 60% of their age peers in the past have broken that pledge before they are 21.
  In Pennsylvania, the effectiveness of 6 rural AO programs were evaluated by Advocates For Youth, Washington, DC, during the period between 1998 and 2002. In summary, the AO program evaluations found: -

"Four programs had no positive effect and two had mixed results. For example,
- Erie County's program had some limited success at changing specific attitudes, but showed mixed effects on behaviors. There was a slight impact on males' behavior (27 percent of male participants with two years of programming were sexually active versus 38 percent of comparison males), but the impact on young women's behavior was negative (42 percent of female participants with two years of programming were sexually active, versus only 27 percent of comparison females).
- Clinton County noted dramatic negative shifts in participants' attitudes and behaviors by the ninth grade. Positive attitudes towards abstinence declined significantly and there was ... "a concomitant increase in the proportion of young people who experienced sexual intercourse for the first time. Unfortunately, only about half of these sexually active youth used any form of contraception."
- Bradford County's program was evaluated twice; the first evaluation showed some modest, positive effects on sexual onset (males only) [i.e., age at which males started to have sex] and on intentions; the second demonstrated a positive impact only on refusal skills; no behavioral effects were found.

The authors of the evaluation study stated the following:
- "Youth expressed frustration… when staff attempted to tell them what was right and wrong. Youth wanted to be respected for their ability to weigh information… in arriving at their own decisions regarding sex.
- Youth expressed frustration with the lack of information regarding contraception. They… expected reliable information. Instead, they heard mostly about the potential failures of condoms.
- Some programs instilled fear… Many younger youth expressed the concern that sexual involvement could lead to death.
- Sexual violence is real. Many females reported that sexual abstinence was unrealistic in their world. Without prompting, they described episodes of forced sex.
- Taken as a whole, this initiative was largely ineffective in reducing sexual onset and promoting attitudes and skills consistent with sexual abstinence.
- The evidence from this evaluation indicates that even if the most effective programs are replicated and the proportion of sexually abstinent youth increases, a substantial proportion of youth will continue to become sexually active before graduating from high school in every Pennsylvania community.
- For those youth who do not remain abstinent the reduction of teenage pregnancy, STDs, and HIV/AIDS requires an alternative strategy."16 (Emphasis added)

   The research findings of those abstinence-only sex education (AO) studies which indicate some positive effect of an AO program, report statistically marginal benefits and/or benefits that might be characterized as trivial in nature or of no apparent consequence. For example, the evaluation in Bradford County recorded improved refusal skills but no positive change in behavior. What the report did not note, was that AO had displaced comprehensive sex education (CSE) in Bradford County's public schools.

    According to the Union of Concerned Scientists (UCS), "[d]uring President Bush's tenure as governor of Texas from 1995 to 2000, .... with abstinence-only programs in place, the state ranked last in the nation in the decline of teen birth rates among 15- to 17-year-old females.
  .... The American Medical Association, the American Academy of Pediatrics, the American Public Health Association, and the American College of Obstetricians and Gynecologists all support comprehensive sex education programs that encourage abstinence while also providing adolescents with information on how to protect themselves against sexually transmitted diseases. In fact, a recent systematic analysis of pregnancy prevention strategies for adolescents found that, far from reducing unwanted pregnancies, abstinence programs actually "may increase pregnancies in partners of male participants."
"The fact that the Bush administration ignores the scientific evidence [about abstinence only], troubling though that is, is not the primary concern [of the UCS] ...... Rather, it is the fact that the Bush administration distorted science-based performance measures to test whether abstinence-only programs were proving effective, such as charting the birth rate of female program participants. In place of such established measures, the Bush administration has required the Centers for Disease Control (CDC) to track only participants' program attendance and attitudes, measures designed to obscure the lack of efficacy of abstinence-only programs.
  At the behest of higher-ups in the Bush administration, according to a source inside the CDC, the agency was forced to discontinue a project called "Programs that Work," which identified sex education programs found to be effective in scientific studies. All five of the programs identified in 2002 involved comprehensive sex education for teenagers and none were abstinence-only programs. In ending the project, the CDC removed all information about these programs from its website."17 (Emphasis added)

It is not just at the federal level that there is resistance to objective evaluations of abstinence-only sex education (AO); many of those at the state and local levels who promote AO resist independent scrutiny of AO programs. "Questions [such as those asked in surveys about sexual behavior] plant ideas," warns Peter Brandt, an official with Focus on the Family, a conservative Christian group. "Individuals involved with condom programs shouldn't have a role in evaluating abstinence programs," he argues. "And who cares what those people think, anyway?"18

AO displaces comprehensive sex education: The second characteristic of AO programs is that it pushes responsible comprehensive sex education (CSE) out of schools because the federal AO funds will only pay for AO programs, and many people who are opposed to CSE have been harassing public school teachers and administrators throughout the country in an effort to prevent educating students about contraceptives and the risks of sexually transmitted diseases.19 Most of the decline in teen pregnancies that has occurred since about 1990, is the result of CSE and the decline in the birth rates which has resulted in a smaller population of teens.
   Urging teenagers to remain abstinent is not wrong. It is the best choice for many teenagers. However, teaching only abstinence has proven to be a failed policy and practice, as pointed out above: "49 percent of [teenage] boys and 53 percent of [teenage] girls have had sexual intercourse"... and of those teens who have had intercourse, " 88 percent of boys and 83 percent of girls" engaged in oral sex. Turning a blind eye to these facts is irresponsible.
   Furthermore, abstinence-only sex education (AO) does not address the problems faced by some children who are innocent victims of dysfunctional home environments where they are not protected from a sexual predator. The Population Reference Bureau found that "... about two-thirds of births to teenage girls nationwide are fathered by adult men age 20 or older."20 Additionally, the Alan Guttmacher Institute's 1994 report, "Sex and America's Teenagers," found that six of ten girls who had sex before age 15 were coerced by males an average of six years their senior.21 The Urban Institute cites a study showing that "...three quarters of females who had sexual intercourse before age 14 reported having had sex involuntarily."22 Rape is a major contributor to unwanted pregnancies. Comprehensive sex education (CSE) does a better job than AO in providing teens relevant information to deal with the aftermath of rape, help them be protected against sexually transmitted diseases and being impregnated, than does AO because AO does not deal with the realities of these events.
   The state of Maine has taken these facts seriously. In 2002, An Act to Expand Family Life Education Services (LD 1603) passed "... the [Maine] legislature with widespread bi-partisan support ... ." LD 1603 inserted ‘... a definition for "family life education" into state education statutes and expanded Family Life Education Services. The law's definition of "family life education" recognizes that sexuality education should be medically accurate, inclusive of information on both abstinence and contraception, age-appropriate, and taught in kindergarten through twelfth grade.'23 As a result, Maine has seen its teen pregnancy rate drop from "... one of the nation's highest rates ... to the fifth lowest," and Maine has rejected AO federal funds. AO programs are "not only ineffective, they're harmful,"' said Dora Mills, Maine's director of public health.24 (Emphasis added)

Church-State Separation Violations: The third characteristic of a great many AO programs is that these are infused with religious proselytizing. On May 16, 2005, the Massachusetts American Civil Liberties Union (ACLU) and a cooperating law firm Jenner & Block LLP filed a lawsuit challenging the federal government's use of taxpayers' dollars to fund religious activities in the "Silver Ring Thing,"25 thus violating the First Amendment of our Constitution. The religious component of the Silver Ring Thing is clearly shown in the documentary film "Educating Shelby Knox," which was aired locally on PBS June 21, 2005. In the film, Pastor Ed Ainsworth, "an abstinence educator throughout Texas schools," claims "I'm having huge success. ... Abstinence will protect your heart, your mind, your emotions, and your body."26 Most claims such as Ainsworth's that sound too good to be true, usually are not true. The intense, heart-felt assertions by those who promote AO generally flow from some religious belief, not from a systematic evaluation of AO which should be the foundation of public policy.27 Federally funded Silver Ring Thing AO programs have been conducted in Pennsylvania and in 13 other states at a cost to the tax payers of $12 million.
Despite claims by AO supporters, parents throughout the U.S. find these claims are inconsistent with their own experiences. As a result, parents want their children taught CSE in schools. The survey of parents by the Kaiser Family Foundation documents that 98% wanted their children taught about HIV/AIDS, 90% want the basics of pregnancy and birth taught, 94% wanted their children to learn about how to talk to partners about birth control, 88% how to use condoms, 85% how to use and to get birth control, 79% wanted information about abortion taught, and 76% wanted information about sexual orientation included in the sex education curriculum.28
If some parents do not want their children to learn the basic facts of sexuality in public school, they can teach their children themselves, or send their children to private schools which do not teach medically-accurate information about sex, or have their children opt out of CSE programs in public schools. But our taxes should not be used to promote religion as the Silver Ring Thing program does, and a public school is supposed to educate, and certainly not misguide students about something as important as sex.

Summary: Abstinence-only sex education (AO) is not meeting its stated goals of reducing teen pregnancies. It is not keeping youngsters safe from sexually transmitted diseases (STD). Abstinence-only sex education (AO) displaces comprehensive sex education (CSE) programs which successfully reduce unwanted pregnancies and help protect teens from STD. Many AO programs are merely a vehicle for religious proselytizing which violates the First Amendment of our Constitution. And, these failures have cost the U.S. tax payers over $1 billion dollars since 1996.

Recommendations: The Bradford County Alliance for Democracy recommends that school administrators and officials in Bradford County, PA, no longer allow AO in their schools.

- Our students need CSE that includes medically-accurate information about all contraceptives, how unsafe sexual behaviors can result in sexually transmitted diseases and pregnancy, as well as learning about the advantages of abstinence.
- Responsible CSE is so important for the health of our school students that this educational responsibility should not be subcontracted, farmed-out, or delegated to outside persons who are not professionals in the field of CSE and who are not committed to teaching medically accurate CSE. Our public schools should be a safe place for students, a place for education, not dis-information.
- We should not let theology or ideology drive programs such as CSE out of public schools when the overwhelming body of data shows CSE is more effective than AO, and the results of AO runs counter to the goals of all parents who don't want their teenage daughters to become pregnant or their sons to cause such a pregnancy.
- It is immoral and unethical to conduct AO training in schools just because federal funding has made AO training available to the schools at no-direct cost to the schools.
- Finally, government-funded AO training has been a $1 billion waste of taxpayers' money.

If religious groups or parents want to promote and teach AO on their own, they have the right to do that. But they should not be doing that using tax money and doing it with the stamp of approval of our public schools.

Endnotes:

1. Lewin, Tamar, "Nationwide Survey Includes Data on Teenage Sex Habits," The New York Times, 16 September 2005, p. A11.

2. Alan Guttmacher Institute, Sex and America's Teenagers. New York: Alan Guttmacher Institute, 1994.

3. Weinstock H, Berman S, Cates W, Jr. (2004). "'Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000." Perspectives on Sexual and Reproductive Health, 36, 6 10.

4. Chesson HW, Blandford JM, Gift TL, Tao G, Irwin KL. (2004). "The estimated direct medical cost of sexually transmitted diseases among American youth, 2000." Perspectives on Sexual and Reproductive Health, 36, 11 19.

5. Miller, Karl E., M.D, "Tips from Other Journals," American Family Physicians, January, 15, 2002.

6. "Abstinence-Only "Sex" Education," Planned Parenthood, New York, NY, 2004, p. 4. see: http://www.plannedparenthood.org/pp2/portal/medicalinfo/teensexualhealth/fact abstinence education.xml. Also: "Researchers at the World Congress of Gynecology and Obstetrics report that sex education in school, contraceptive use, and legal abortions helped reduce the teen pregnancy rates in Sweden and Scandinavia. For every 1,000 Swedish teens aged 15 to 19 in 1965, 50 became pregnant; but that rate had fallen to 10 pregnancies per 1,000 women by 1995. Dr. Roger Short, professor of reproductive biology at Australia's University of Melbourne, said the United States could reduce its high teen pregnancy rate with youth to youth sex education campaigns. The Netherlands has the lowest teen pregnancy rate and one of the lowest abortion rates worldwide, due to its openness about sex, formal sex education, and easy access to services, according to Dr. R.H.W. Van Lunsen of the University of Amsterdam." [Source: Sex Ed, Contraception Lowers Teen Pregnancy Rate Reuters Health Information Services (www.reutershealth.com)09/07/00. Search: http://www.thebody.com/cdc/news_updates_archive/2004/jul27_04/nh_abstinence.html ]

7. "Adolescent Protective Behavior: Abstinence and Contraceptive Use," Advocates For Youth, Washington, DC, http://www.advocatesforyouth.org/publications/factsheet/fsprotective.htm

8. According to Stephanie Ventura of the National Center for Health Statistics as cited by Schmid, Randolphe E., "Birth to Unmarried U.S. Women Set Record," Associated Press, 28 October 2005.

9. Dailard, Cynthia, "Understanding 'Abstinence': Implications for Individuals, Programs and Policies," The Guttmacher Report on Public Policy, Volume 6, Number 5, December 2003. See www.guttmacher.org/pubs/tgr/06/5/gr06054.html

10. Bruckner, Ph.D., Hannah,and Peter Bearman, Ph.D., "After the Promise: the STD consequences of adolescent virginity pledges," Journal Adolescent Health, Number 36, 2005, pp.271-278. Also: Appuzzo, Matt, Associated Press, "Abstinence vows worsen risk of STDs, a study suggests," Philadelphia Inquirer, 18 March 2005.

11. Sharon Lerner, "An Orgy of Abstinence," Village Voice, 1 August 2002.

12. The Content of Federally Funded Abstinence-Only Education Programs, Prepared for Rep. Henry A. Waxman (Washington, DC: United States House of Representatives Committee on Government Reform - Minority Staff Special Investigations Division, December 2004), 22 pages. (See www.democrats.reform.house.Gov)

13. Marcotty, Josephine, "Minnesota's Abstinence-only Sex Education Doesn't Work Any Better, Report Says," Star Tribune, reported in HIV/AIDS Newsroom, January 5, 3003.

14. "A state task force report released Monday criticized New Hampshire's media focused abstinence campaign as ineffective and detailed a new approach to promoting abstinence among sexually active youths. New Hampshire has received $545,637 in federal abstinence funds since 1997, when such funds were first authorized by federal legislation, but has little to show for it, the report said. The task force -- put together by Health and Human Services Commissioner John Stephen -- recommended spending about $60,000 on advertising and $37,000 on grants for groups that teach the skills youths need to avoid sex. ... Teen pregnancy rates are dropping in New Hampshire, but the state has seen STDs increase, particularly among youths." ... [Source: Associated Press, ANew Hampshire: State to Target Money Toward Abstinence Education, U.S. News, 27 July, 2004. Search: http://www.thebody.com/cdc/news_updates_archive/aug3_01/abstinence.html]

15. The Content of Federally Funded Abstinence-Only Education Programs, Prepared for Rep. Henry A. Waxman (Washington, DC: United States House of Representatives Committee on Government Reform - Minority Staff Special Investigations Division, December 2004), 22 pages. (See www.democrats.reform.house.Gov)

16. Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact: August 1998- September 2002. State, Pennsylvania, Advocates For Youth, Washington, DC, 2002. http://www.advocatesforyouth.org/publications/stateevaluations/pennsylvania.htm

17. www.ucsusa.org/global_environment/rsi/page.cfm?pageID=1355

18. Sharon Lerner, "An Orgy of Abstinence," Village Voice, 1 August 2002.

19. Weisberg, Sheli, "The Devolution of Sexuality Education in Michigan," Siecus Report, Fall 2004. See: www.findarticles.com/p/articles/mi_qu3781/is_200410/ai_n9.

20. Carol J. De Vita, "The United States at Mid Decade," Population Bulletin, vol. 50, no. 4 (Washington, D.C.: Population Reference Bureau, Inc., March 1996)

21. The Alan Guttmacher Institute, "Sex and America's Teenagers," 1994. Also see: www.age of consent.com/comments/numbereleven.htm

22. The Washington Times Editorial Board, "The Fathers of Teen Mothers," The Washington Times, 9 April 1996.

23. "Maine Becomes the 3rd State to Reject Federal Abstinence Only Until Marriage Funding," News Release from SIECUS, September 20, 2005.

24. Cocco, Marie, "Sometimes, just say no," Washington Post Group as cited in The Daily Review, 15 October 2005, p. 4.

25. ACLU of Massachusetts v. Leavitt was filed in the U.S. District Court for the District of Massachusetts.

26. Rhoshalle Littlejohn, Janice, for the AP, "'P.O.V.' spotlights sex, lies, and schools in 'The Education of Shelby Knox,'" The Daily Review, 17 June 2005, p. 9A.

27. A recently reported study published by the conservative Heritage Foundation purports that AO is successful. However, "Independent experts .... criticized the Heritage team=s analysis as flawed and lacking the statistical evidence to back up its conclusions." [Source: Altman, Lawrence, "Studies Rebut Earlier Reports On Pledges Of Virginity," The New York Times, 15 June 2005, p. A21.]

28. "Issues and Answers: Fact Sheet on Sexuality Education," Siecus Report, August/September 2001, Volume 29, Number 6., page 11.

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