Abstinence-Only Initiative Advancing
Abstinence-Only Initiative Advancing
By: Sheryl Gay. Stolberg
Date: February 28, 2002
Source: Stolberg, Sheryl Gay. "Abstinence-Only Initiative Advancing." New York Times. (February 28, 2002).
Sexuality education in public schools in the United States began in the mid–1950s with the publication of a series of pamphlets from the American Social Health Association, the country's leading sexually transmitted disease public health organization. This curriculum, titled "Family Life Education," was followed in 1955 by the publication of a similar series by the American Medical Association. Strong opposition to such programs came from religious conservative groups such as the Christian Crusade, the John Birch Society, and Phyllis Schlafly's Eagle Forum, which characterized sexuality education programs as a threat to students' morality. By the 1960s, however, such programs were in place in many public schools, though heated debate over the participation of individual students and the content of sexuality education programs persisted.
The primary argument made by opponents was that exposure to sexuality education led to greater rates of sexual activity among teenagers. By the late 1960s and early 1970s, however, researchers had come to the opposite conclusion: Students enrolled in comprehensive sexuality education courses were sexually active at lower rates, and when they did make choices to participate in sexual activities, they did so with greater responsibility to protect themselves from sexually transmitted diseases and pregnancy.
Early sexuality education programs involved teaching the biology of reproduction, the identification of the organs and body parts used for reproduction, menstruation, and sperm and semen production; little attention was given to questions of emotional issues surrounding sexual activity. By the 1970s, however, curriculum shifted to emotional development, self-esteem, and sexually transmitted disease prevention. Late 1970s and early 1980s curricula assumed that teenagers were having sex—educators discussed abstinence as a choice, but also taught approaches to sexual activity that stressed emotional health and contraception.
In 1986 then-Surgeon General C. Everett Koop issued new sexuality education guidelines that would reach students as young as eight years of age. Koop believed that third graders should be the starting point for a comprehensive HIV/AIDS prevention program that would cover emotional development, risk factors for the disease, as well as traditional sexuality education topics, all with the goal of preventing HIV/AIDS. Religious conservatives argued that abstinence was the only 100%-effective method for preventing sexually transmitted diseases (including AIDS) and teen pregnancy.
By the early 1990s teen pregnancy had reached an all-time high in the United States, and social and health agencies struggled to manage the growing issue. In 1996 President William J. Clinton signed Public Law 104–193, which allocated more than $350 million over seven years to states for abstinence-only sexuality education in public schools. In 1990, approximately 2% of all sexuality education programs were based on abstinence-only curricula; by 2005 that figure reached 25%.
Like most groups devoted to curbing the spread of AIDS, the AIDS Resource Center of Wisconsin has spent years promoting condoms. So it was with some surprise that the center received a grant from the Bush administration to persuade teenagers to say no to sex, at least until they are married.
"There won't be any conversation or education about condoms" in the program, said Mike Gifford, the group's deputy executive director. "Our message is going to home in, quite substantially, on the fact that the only 100 percent pure way to protect yourself from HIV is to abstain."
That message—that sex outside marriage can be dangerous to your health—is precisely what the White House wants young Americans to hear.
When he ran for office, President Bush promised to spend as much on programs that teach abstinence until marriage as on medical services that provide contraceptives to teenagers. This month, he made good on that promise, proposing a budget for 2003 that would raise federal spending on "abstinence only" education by $33 million, to $135 million.
"Abstinence is the surest way, and the only completely effective way, to prevent unwanted pregnancies and sexually transmitted disease," Mr. Bush said on Tuesday in outlining his welfare reform plan. "When our children face a choice between self-restraint and self-destruction, government should not be neutral."
The line drew hearty applause from the audience of community activists at a church here. But the initiative is controversial—not because anyone opposes teenage chastity, but because the government requires that abstinence programs avoid mentioning contraceptives, except to state their drawbacks.
The scientific literature, including a recent report by former Surgeon General David Satcher, carries quite a different message. With scant research on abstinence-only programs, studies conclude there is insufficient evidence that they delay teenage sex. The only proven method for reducing pregnancy and sexually transmitted disease, the studies say, is to combine the abstinence message with one that teaches young people how to protect themselves against pregnancy and disease.
"There is no scientific evidence that 'abstinence only until marriage' programs work," Representative James C. Greenwood, Republican of Pennsylvania, said in a recent letter to Mr. Bush. The letter, also signed by Representatives Lynn Woolsey and Barbara Lee, Democrats of California, called increasing spending for abstinence education "dangerous and unnecessary."
The administration replies that this is circular reasoning. "Unless we put money there to find out whether it works," said Claude Allen, who as deputy secretary of health and human services is in charge of the government's abstinence initiative, "we will never know."
The issue is likely to come up on Capitol Hill this year. When Congress passed legislation to overhaul welfare in 1996, it adopted a companion bill that set aside $50 million a year for abstinence education. With both measures up for reauthorization, opponents are promoting a bill, introduced by Representatives Greenwood, Woolsey and Lee, that would devote $100 million for programs that teach both abstinence and contraception.
"We believe in abstinence education," said Tamara Kreinin, president of the Sexuality Information and Education Council of the United States, a nonprofit group that supports the bill. "Most Americans do. It's the 'abstinence only until marriage' message that concerns us."
Despite a steady decline in the teenage birthrate over the past decade, pregnancy and sexually transmitted disease remain a huge problem for American teenagers. By the time they graduate from high school, two-thirds of the nation's young people have had sexual intercourse, according to the federal Centers for Disease Control and Prevention; one in four sexually active teenagers contract sexually transmitted diseases each year.
How to turn that trend around has been the subject of intense study and debate. Scientists at the disease control agency have identified eight programs that have been proved to reduce teenage pregnancy and sexually transmitted disease, including one that stresses abstinence, said Dr. Lloyd Kolbe, who directs the agency's division of school and adolescent health. Interestingly, he said, analysis of that particular program showed that in addition to delaying sex, it increased condom use.
But the vast majority of the more than 700 different abstinence education programs in use in the nation have never been thoroughly studied. The report by Dr. Satcher concluded that without more research, "it is too early to draw definite conclusions about this approach."
A rigorous study, financed by the federal government and led by Rebecca Maynard, a professor of education and social policy at the University of Pennsylvania, is under way, but will not be complete until 2005. Preliminary data will be available next year, Dr. Maynard said.
Yet as the experience of AIDS Resource Center of Wisconsin suggests, abstinence education is catching on, if only because there is more federal money available for it.
Mr. Gifford, the center's deputy executive director, said the idea of teaching abstinence until marriage struck him after his government grant writer identified it as "a new funding opportunity." With 40,000 Americans becoming infected with the AIDS virus every year, he said, "we didn't believe we could just keep doing the status quo."
Nationally, a recent survey by the Alan Guttmacher Institute, the nonprofit organization that focuses on sexual and reproductive health, found that 23 percent of secondary-school teachers said they did not discuss any method other than abstinence as a way to avoid pregnancy, up from just 2 percent in 1988. Federal health officials, meanwhile, say competition for abstinence-only education grants is intense. Of 360 recent applications, 173 were approved and 53 received financing.
At the AIDS Resource Center, the decision to apply for the grant generated intense debate among the staff. Federal law explicitly requires abstinence programs to teach that "sexual activity outside the context of marriage is likely to have harmful psychological and physical effects," and that "a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity."
These were ticklish requirements for an organization that has a large gay constituency. But ultimately, Mr. Gifford said, center officials concluded that there was a market for abstinence education in their state, particularly in rural areas.
They applied for, and received, a $91,000 grant to plan a program aimed at 12-to 18-year-olds. Their plan is to use "peer educators," teenagers who are trained to talk to other teenagers, and to run four-to six-week sessions to provide support to help young people abstain. The issue of what to say about condoms proved tricky. Years ago, proponents of abstinence education cast the issue in moral terms. Today, abstinence education is more often cast in terms of the risk of disease.
"The more sexual partners a person has, the more risk of disease they have," said Dr. Joe S. McIlhaney, founder of the Medical Institute for Sexual Health, a group based in Austin, Tex., that is a leader in abstinence education. "Our goal is to give objective information that we draw from credible scientific sources."
Those sources include the National Institutes of Health, which last year reported that while condoms reduced the spread of AIDS, there was insufficient evidence that they prevented other sexually transmitted diseases, like herpes and chlamydia.
The Wisconsin center has decided to steer clear of condoms and the institutes' study. "That would leave them with a more negative vision of condoms," said Scott Stokes, the agency's prevention expert. "We can't speak positively about them either. We are just going to leave the issue alone."
A December 2004 report on abstinence-only education programs, requested by Representative Henry Waxman, a Democrat from California, examined the content of abstinence-only programs and found a wide range of factual errors as well as gender bias and discrimination against homosexuality. The report found materials in the curricula stating that HIV/AIDS can be spread through sweat and tears, that 43-day-old fetuses can think, that condoms have a failure rate of 14%, and that 10% of women who have abortions later commit suicide. Waxman's report examined thirteen of the most popular abstinence-only curricula, used in twenty-five states, and compared the information taught to current textbooks in obstetrics, gynecology, biology, and other sciences related to reproductive health and sexuality.
Researchers at Columbia University found that of those students educated under abstinence-only programs, although students delay sexual activity, 88% do engage in premarital sex. Many abstinence-only programs offer "virginity pledges" for students. Researchers examined differences in behavior between "pledgers" and "nonpledgers." Abstinence-only educated teens also seek treatment for sexually transmitted diseases at lower rates than traditionally educated teens, and are one-third less likely to use contraception when they engage in sexual intercourse. In addition, oral and anal sex rates for abstinence-only educated teens are higher as such teens seek to preserve traditional virginity. Two percent of teens who did not take a virginity pledge engaged in oral or anal, but not vaginal intercourse, while thirteen percent of pledgers engaged in anal or oral sex, rarely while using any form of protection against sexually transmitted disease.
One in four teenagers acquires a sexually transmitted disease, and public health officials and critics of abstinence-only education point to the growing rates of STD transmission among teens as an epidemic that abstinence-only education cannot prevent; while 7% of nonpledgers acquired a sexually transmitted disease, 4.6% of those who took the virginity pledge also acquired STDs. Between 1996 and 2005, nearly $1 billion was devoted to abstinence-only education.
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