Challenging Dogma - Fall 2008

Thursday, December 18, 2008

Knowledge is Power: Government Funded Abstinence-Only Programs Omit Crucial Information on Sexual Health -Diana Theriault

“Vows of abstinence break more easily than latex condoms (1).” Yet America is still taught to abstain from sex. Education is important. How can anyone make an informed decision when much of the information is not provided? Abstinence-only education is ineffective at preventing many teens from engaging in sex before marriage and only hurts those who do have sex without the knowledge of how to do so safely.
When you think of the word sex, what comes to mind? For many there is a negative connotation that comes along with that word. In America, people don’t talk about sex openly. We keep that part of our lives a secret. It is almost like you have to hide it. Sex should be a topic that everyone is comfortable talking about. This is the first step in having a safe and healthy sexuality. Communication is key in this area. If the only thing we tell the children of America is, “don’t do it,” then what happens if and when they do? Are we just supposed to say, “I told you not to?” No. We should be promoting abstinence, but saying “in the event you do have sex, here is how to protect yourself.” Because when it is all said and done, teenagers are going to have sex whether or not you tell them to.
The data shows that people do have sex before marriage. “The average age of first intercourse is 16.9 for boys and 17.4 for girls (2).” Yet the “average age of first marriage continues to rise. for women the average age is 25.6 and for men it is 27.5 in 2007 (3).” This is a major drawback of these types of programs. We can see that the programs don’t work, that people are still having sex anyway, and many are just ignorant to the way contraception works and how it can protect them. Still, abstinence-only education is valuable right? The following studies show otherwise.
Abstinence-Only Education: More harmful than helpful?
If you think about it, almost everything that we engage in, such as driving a car, jumping on a trampoline, smoking cigarettes, taking prescriptions, swimming in pools and many more, have safety guidelines to abide by. Also in case of an emergency, there are steps to take to prevent any further harm. But why is it that when it comes to sex, we fail to teach those safety guidelines? It’s like throwing someone in the driver’s seat of a car and saying go! If you don’t know how to drive, you don’t know the rules of the road, how to be safe and what to do incase of an emergency, do you really want that person to be behind the wheel? I surely don’t. “In 2005, 37.2 percent of sexually active high school students and 44.6 percent of sexually active twelfth grade students did not use a condom during their last sexual intercourse (4).” Many of them ‘got behind that wheel’ without learning about safety. Unprotected sex can lead to unintended pregnancies and sexually transmitted infections which can lead to other complications. Even more distressing is that, “One-quarter of sexually active adolescents nationwide have an STD, and many STDs are lifelong viral infections with no cure (4).”
A survey from the Kaiser Family Foundation found that young adults want to learn. “They want to know more about how to use condoms, how to recognize the signs of STD and HIV infection, what STD and HIV testing involves, and where they can get tested. They also want more instruction on communicating effectively with partners about sensitive sexual concerns and relationship issues (5).”
Abstinence-only education programs have been funded by the government for many years, however, comprehensive sex education programs have suffered from new restrictions on what can be taught to receive funding. Essentially any program that teaches about contraception has been limited in the funding they can receive under the Bush administration. This allows for more programs that refuse to teach about contraception and safety. If teens want to learn about safety and healthy sexual relationships, shouldn’t we give them guidance?
A study done following over 2000 students from elementary school to middle school and through high school that had abstinence-only education failed to prove that this education is valuable. The study found that there was no difference between those who participated in abstinence-only education versus those who did not. This study confirmed what other studies have already shown. "The most effective programs are those that say abstinence is the best choice but birth control and protection are also worth knowing about (6)." Yet abstinence is still funded heavily by the government. I like the way one woman, Martha Kempner, put it when she said,”Abstinence-only was an experiment and it failed (6)." Failed experiments should not be continued and especially not funded with tax payers dollars.
These programs have not taught our kids properly. Some adolescents even believe they are being safe by using contraception, but they may be using it in correctly. I believe that this proves the point: “One in five young people believe that birth control pills offer protection from STDs and HIV/AIDS. The same amount of people believe that condoms are not effective in preventing the transmission of STDs and HIV/AIDS (5).” If people believe they are protecting themselves or that using condoms won’t protect them from contracting diseases this is a serious misconception. The lack of knowledge about sexual behavior and protection is astounding. I do believe that abstinence is an important thing to teach the young people of America. Children need to develop feelings of self-confidence, independence, and all in all, just grow and mature to make these complicated sexual decisions. But abstinence taught alone leaves people with the knowledge of the dangers of sex but no way to prevent the dangerous consequences.
Not only do these programs fail to educate, but they give out false and misleading information. A report put out by the House of Representatives actually proves that 80% of the curriculum guarantees to contain false, misleading, or distorted information about reproductive health. This false information includes the effectiveness of contraceptives, the risks of abortion, and even scientific errors such as the number of chromosomes that an individual has (7). These things are important. Everyone should know the true facts. How can you make an important judgement like this without having all of the correct information? The same report states that, “youth who pledge abstinence are significantly less likely to make informed choices about precautions when they do have sex (7).”
Community Influence on the Development of Sexuality
Abstinence-only programs teach an ideological view. We set the bar very high when we expect everyone to abstain from sex until marriage. Although this may prevent a few sexual encounters out-of-wedlock, it certainly does not apply to everyone. As kids, we are taught values and morals to live by. As we get older, we discover our own morals and values that we wish to live by. However, when society pushes virginity as the only option, it makes it seem like sex is a bad thing. Therefore, if you have sex, you are bad. This can have social and emotional implications.
Abstinence-only education is an example of the Health Belief Model applied in practice. The Health Belief Model is a theory that suggests that an individual will make a rational decision based on perceived benefits weighed against perceived barriers. It also implies that if a person feels susceptible and that the consequence is severe enough, a person would take action to avoid that behavior (8). Abstinence-only educators believe that if one is taught the severity of consequences and how easily susceptible they are to pregnancy and disease that everyone will abstain. They portray it in such a way that the barriers greatly outweigh the benefits. Even the governments definition of abstinence-only education includes “teaching the social, psychological, and health gains to be realized by abstaining from sexual activity its exclusive purpose (4).” They are trying to prove the benefits of abstinence. These benefits are real, however, we know that decisions are not only based on the individual level alone and so these benefits may not be as important as the beliefs of others for example.
“ ASRH (Adolescent Sexual and Reproductive Health) programming should be approached from an ecological perspective, with the belief that individual behaviors and decisions are not made or practiced in a vacuum, and that social norms and institutions often determine the choices available to most individuals (9).”
There is a large factor of social influence that abstinence only programs come along with. Social norms stereotype men and women as well as heterosexual and homosexuals into different categories. These stereotypes portray “girls as naturally chaste and boys as constantly struggling to control their rampant sexuality and raging hormones (10).” Sexist views put gender roles on men and women. In education like this these stereotypes are taught as facts. The are biological sciences that makes men and women act differently towards sex. This teaches women that if they do express desires and wish to talk about sex, they may be found as promiscuous where men are just generally curious because they have testosterone and it is natural for them to feel these desires (10). This conservative thinking heeds much guilt for women and leaves both sexes uneducated about safety and communication among adolescents. Although gender stereotypes have an enormous impact on teens, stigmas of sexual orientation have an even greater impact. Abstinence-only education programs do not even bring up the subject of homosexuality. This is deliberately left out because programs like these are actually “required by the federal funding guidelines to instruct students that heterosexual marriage is the ‘expected standard’ (10).” Since gay marriage is not recognized nationally in the United States as legal, it is easy to see why the government would leave this discussion out of the program. Because how can you stay abstinent until marriage if you can’t even get married? And we already know that sex out-of-wedlock can be a burden on society so those who do not follow the ‘expected standard’ must also be a burden, right? That is what these programs teach us. It almost allows for discrimination and increases homophobic beliefs which is not right. In society today, everyone should be treated equal regardless of gender, sexual orientation or any other differences we have between us.
As we can see, society and our surrounding communities can greatly influence our views and what we consider social norms. We must adopt a culture open to communication and discussing all sexualities. Teaching teens about contraceptive options, physical differences between men and women, and sexual orientation does not encourage adolescents to go explore what they just learned. We are just providing the facts and allowing them to make an informed decision on their sexuality and bringing about safe options while doing so.
A Violation of Basic Human Rights
Abstinence-only education fails to allow access to basic health information. To educate our children we must provide the full spectrum of options and information. When you hear questions like: “You can’t get pregnant the first time right? Isn’t everyone having sex? Can you get pregnant if you use birth control (11)?,” you know there is much more that teens have to learn before having sex. A person who is in the contemplating stages of having sex should first know their beliefs and feelings about sex. If they feel that they are ready then the next question to ask would be “in what kind of sexual relationship would sexual involvement be comfortable or OK for me (12)?” And when someone is ready to have sexual intercourse they need to be prepared for all of the consequences with that decision including emotional feelings. If kids are not taught the full spectrum of sexual responsibility they can not make informed decisions. Leaving information out or distorting truthful information is harmful to all. Health information should be freely provided and true. By giving out wrong information, these programs are violating our human right to education and information about sexual health.
“Individuals who lack information about sexual and reproductive health care thus also lack the ability to protect themselves from STIs, including HIV/AIDS, and unplanned pregnancy (10).” It is everyone’s right to seek out truthful information. This is why it is not only important for educators to teach the facts, but for parents to divulge all pertinent information as well. Most teens are influenced by many factors when making decisions about health. Parents, peers, and school education are at the top of the list for influencing children on sex. If your peers are taught the same as you, then they are most likely going to base their decisions on the same information you received which does not promote anything but continued misinformation. However, if parents step in, they may be able to influence the child and teach them the right things. Many adults however do not know everything about sex. Even the parent has the right to information and education. That is why it is up to the educators who are supposed to have up to date information on sex and sexual consequences to teach the future of America. Children only learn what they are taught, that is why it is our job to teach, and their right to learn health education.
“Major human rights documents discourage states from limiting access to contraceptives, and other means of maintaining sexual and reproductive health, from censoring, withholding, or intentionally misrepresenting health-related information, including sexual education, as well as from preventing people’s participation in health-related matters, or allowing third parties to do so (10).”
Abstinence-only education violates these rights which has a negative effect mostly on those who do not receive the knowledge. It puts those who do have sex at greater risk for health consequences that they do not even know about, or for that matter, how to prevent negative health effects and unintended pregnancies. Abstinence only education violates the rights of all humans, but has an even greater potential risk in LGBT (lesbian, gay, bi-sexual, and transgendered) individuals and their families by failing to provide “useful and appropriate sexual health information (10).” Men who have sex with men have the highest risk for developing HIV/AIDS (13). These statistics need to be known. Even for those who do not consider themselves gay when they are younger, may realize later in life that they are homosexual or bisexual and should have the facts on both homosexual and heterosexual encounters.
Final Thoughts on Abstinence-Only Education Programs
“The communities should provide access to education about sexual health and responsible sexual behavior that is thorough, wide-ranging, begins early, and continues throughout the lifespan” (14). Such education should give them knowledge about pregnancy, STD's, contraceptives and responsible choices. Abstinence-only education cannot provide this comprehensive education. It should be taught as part of an education program but not as the only program.
A New Perspective
“Comprehensive sex education teaches about abstinence as the best method for avoiding STIs and unintended pregnancy, but also teaches about condoms and contraception to reduce the risk of unintended pregnancy and of infection with STIs, including HIV. It also teaches interpersonal and communication skills and helps young people explore their own values, goals, and options (15).” This type of sex education is important for teenagers to get the full spectrum of knowledge on this topic. Comprehensive sex education have been proven to work (16). Mandates prohibiting educating the youth about the benefits of condoms and contraception make these programs ineligible for federal funding (17). Teens need to learn about all aspects of sexual health to protect them from the dangers of infection and pregnancy. This is something that abstinence-only education cannot provide.
Does Comprehensive Sex Education Provide Benefits?
A concern of many with comprehensive sex education is that it will encourage teenagers to want to have sex at a younger age than they would have had they had abstinence-only education. Research however shows that this is not the case. “Evaluations of comprehensive sex education and HIV/ STI prevention programs show that they do not increase rates of sexual initiation, do not lower the age at which youth initiate sex, and do not increase the frequency of sex or the number of sex partners among sexually active youth (15).” Knowing that these programs do not have an influence on increasing sexual activity of teenagers, we can say that they are not harmful. How though do these programs provide a benefit?
Findings put out by the National Campaign to Prevent Teen and Unplanned Pregnancy, stated that almost all of the comprehensive sex education programs they evaluated had a positive effect on the behavior of teenagers. “In particular, they improved factors such as knowledge about risks and consequences of pregnancy and STD; values and attitudes about having sex and using condoms or contraception; perception of peer norms about sex and contraception; confidence in the ability to say ‘no’ to unwanted sex...communication with parents or other adults about these topics.(18).” Comprehensive sex education is teaching teenagers responsibility, giving them confidence and teaching self-esteem. Not only this but this education is teaching them about risks and prevention. The APA stated, “Based on over 15 years of research, the evidence shows that comprehensive sexuality education programs for youth that encourage abstinence, promote appropriate condom use, and teach sexual communication skills reduce HIV-risk behavior and also delay the onset of sexual intercourse(19).” With all of the evidence shown, it is clear that comprehensive sex education has many benefits and proves to be the superior method to teach teenagers about sexuality.
Influence on Development of Sexuality
Comprehensive education also plays off of the Health Belief Model, although it includes other tools to educate as well. “Rather than trying to deter or frighten young people away from having sex, effective sex education includes work on attitudes and beliefs, coupled with skills development, that enables young people to choose whether or not to have a sexual relationship taking into account the potential risks of any sexual activity (20).” Teenagers need the opportunity to form their own opinions on this subject matter. Have they been taught the consequences of their actions? Have they been taught how to handle such consequences? Do they know where to get support? If one does become pregnant, do they know all the options? Are they emotionally prepared for such consequences? Also, can they communicate with parents and other adults from whom they are educated? There are so many more questions that need to be asked and answered pertaining to sex and the development of sexuality. These questions cannot be answered in an abstinence-only classroom. “Programs designed to prevent pregnancy need to give young women information about pregnancy and opportunities to discuss the topic so that they form opinions. Furthermore, programs should emphasize positive attitudes toward contraception, because effective contraceptive use is shaped by such attitudes and is strongly associated with reduction of pregnancy risk (21).”
Pregnancy is not the only topic discussed in comprehensive sex education. Sexual development, such as physiological, anatomical and emotional changes in puberty are also discussed. For this education to be comprehensive in all aspects it must also include discussions on healthy relationships. “In terms of information about relationships they need to know about what kinds of relationships there are, about love and commitment, marriage and partnership and the law relating to sexual behavior and relationships as well as the range of religious and cultural views on sex and sexuality and sexual diversity (20).” Like I said before, teenagers are going to have sex whether you tell them to or not. Given the tools, teenagers will make the right choice for themselves, and learn about their own sexuality armed with knowledge on how to be safe. The right attitudes and beliefs on sexuality and the known dangers of what sex can be without protection being taught to teenagers is great. Abstinence-only education may be able to provide these things. However, comprehensive sex education goes beyond the concepts in the Health Belief model and brings in the tools needed to develop a healthy sexuality and be safe when engaging in these activities.
Right to Information and a Right to Equality
America has always prided itself on freedom. We are the land of the free. Though many people do not feel this way. Shouldn’t all Americans have the right to decide if and when they want to engage in sexual activity? Abstinence-only education teaches teenagers that this is not a right. One must not engage in such activities until marriage. Well if one doesn’t have that right, than can’t they choose with whom they would like to engage in this activity with? According to abstinence-only education, that too is not a right. By definition marriage is between a man and a woman (22). Which leaves lesbian, gay. bisexual and transgendered teens to believe they do not have the same rights. So if one cannot decide with whom, or when to have sexual encounters, than at least the information on how to be protected and have safe sex is given, right? Wrong again. Contraceptives and other methods of protection are not taught in abstinence-only education programs because teenagers shouldn’t be having sex anyway (23). So when a teenager gets older and maybe does wait until marriage to have sex, do they know how to protect themselves? If never given the information to learn how to fully prepare for sex and the consequences that come with it, physically and emotionally, than no matter how old you get you still are not prepared. Comprehensive sex education prepares you for all of what is to come. You are given the knowledge and information needed to make the right decisions, so when it comes down to it, you can decide if, when and with whom you want to engage in sexual activity with knowing how to stay protected when that decision comes. “State parties must ensure that children have the ability to acquire the knowledge and skills to protect themselves and others as they begin to express their sexuality (23).” These are the rights and freedoms Americans are entitled to.
Culminating Thoughts
Given all of the information about abstinence-only education programs and comprehensive sex education programs, one is clearly able to see the benefits that comprehensive education provides over abstinence-only education. I believe that abstinence is necessary to teach and to instill core values and morals in teenagers. I also believe though that teenagers are rebellious in nature and because they are told not to do something they are more apt to do so. So when educating teens about sex, one should also be taught about contraceptives and how to respect one another’s choices. Whether those choices are to have sex or not, or whom they may choose as a partner, or even how to handle the event of an unintended pregnancy. Developing their own attitudes and beliefs about sexuality is essential. With comprehensive education, one can make an educated decision and learn about sexuality. Comprehensive sex education should be available to all teenagers, it is a right of Americans. Therefore, comprehensive sex education should be funded by the government instead of abstinence-only education. It is important that the children of America have the freedom to make their own choices when it comes to sexuality and they should be guided on how to make the right choices.
1. Elders, Joycelyn M. “Vows of Abstinence Break More Easily Than Latex Condoms.” Rethinking Schools Online. 2002. Milwaukee, WI. 20 November 2008 <>.
2. Guttmacher Instutute. In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men. 2002.
3. U.S.Census Bureau. Estimated Median Age at First Marriage, by Sex: 1890 to the Present. 2007.
4. Trenholm C. et al. Impact of Four Title V Section 510 Abstinence Education Programs. Final Report. Princeton: Mathematica Policy Research; 2007.
5. The Henry J. Kaiser Family Foundation. (2003). National Survey of Adolescents and Young Adults: Sexual Health Knowledge and Experiences.
6. Stepp, Laura Sessions. “Study Casts Doubt on Abstinence-Only Programs.” Washington Post. April 14, 2007.
7. UNITED STATES HOUSE OF REPRESENTATIVES COMMITTEE ON GOVERNMENT REFORM — MINORITY STAFF SPECIAL INVESTIGATIONS DIVISION. “The Content of Federally Funded Abstinence-Only Education Programs: Prepared for Rep. Henry A. Waxman.” December 2004.
8. Rosenstock, I. M. (1974). Historical Origins of the Health Belief Model. Health Education Monographs. Vol. 2, No. 4. 328 – 335.
9. Community Pathways to Improved Adolescent Sexual and Reproductive Health: A Conceptual Framework and Suggested Out come Indicators. December 2007. Washington, DC and New York, NY: Inter-Agency Working Group (IAWG) on the Role of Community Involvement in ASRH.
10. Kay J.K., Jackson A. Sex, Lies and Stereotypes. How Abstinence-Only Programs Harm Women and Girls. Legal Momentum; 2008
11. “Facts & Stats.” The National Campaign To Prevent Teen Pregnancy. 2002. Washington, D.C. 20 November 2008. <>
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13. Centers for Disease Control and Prevention. “A Glance at HIV/AIDS among Men Who Have Sex with Men.” January 2006.
14. “The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior: At a Glance: Vision for the Future.” U.S. Department of Health & Human Services. July 2004. Washington, D.C. <>
15. Advocates for Youth. “Sex Education Programs: Definitions & Point-by Point Comparison.” Accessed on December 6, 2008.
16. Kirby D. Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001.
17. American Foundation for AIDS Research. Assessing the Efficacy of Abstinence-Only Programs for HIV Prevention among Young People. [Issue Brief, no. 2] Washington, DC: Author, 2005.
18. Kirby D, Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases, Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy, 2007, p. 4, Accessed Dec. 6, 2008.
19. American Psychological Association (APA). (Feb. 2005). “Comprehensive Sex Education is More Effective at Stopping the Spread of HIV Infection.” Accessed December 8, 2008.
20. Avert: AVERTing HIV and AIDS.“Sex Education that Works.” Accessed on December 8, 2008.
21. Perspectives on Sexual and Reproductive Health, Vol. 36, No. 6, Findings from Add Health (Nov. - Dec., 2004), pp. 248-257 Accessed Dec. 10, 2008
22. "Marriage." Merriam-Webster Online Dictionary. 2008.Merriam-Webster Online. Accessed December 10, 2008 <>
23. Santelli, John S., MD, MPH, Schleifer, Rebecca, JD, MPH, and Lande, Lila J., MPH. “Abstinence and U.S. Abstinence-Only Education Policies: Ethical and Human Rights Concerns.” Accessed on December 10, 2008.

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