Although the U.S. teen pregnancy rate is at an historic low, i.e. 75.4 pregnancies per 1,000 women aged 15–19 years, the rate is higher than in a number of countries including Australia, Canada, England, France, Germany, Israel, Italy, Japan, Netherlands, Norway, Romania, Spain, and Sweden.(1) Experts refer to limitations on teens' access to comprehensive sexuality education and contraception in the U.S., along with the widespread American attitude that a healthy adolescence should be abstinent until marriage. A 2006 study among adolescents aged 15 to 17 years showed that 77% of the decline in pregnancy risk was attributable to improved contraceptive use. This underlines the conclusion that the pragmatic European approach to teenage sexual activity, expressed in the form of widespread provision of confidential and accessible contraceptive services to adolescents, would be as effective for the American youth to decrease teenage childbearing.(2)

The main objective of abstinence education programs is to teach abstinence from sexual activity outside of marriage. A recent study commissioned by the U.S. Department of Health and Human Services focused mainly on the behavioral outcomes of students enrolled in abstinence programs around the country. The report concludes that the impact results from selected abstinence education programs show no impact on rates of sexual abstinence. About half of all study youth had remained abstinent at the time of the final follow-up survey, and program and control group youth had similar rates of sexual abstinence. Moreover, the average age at first sexual intercourse – 14.9 years - and the number of sexual partners were almost identical for program and control youth. Not a single methodologically rigorous study shows a positive impact on adolescents’ sexual behavior in any abstinence program which is funded under the federal government’s $176 million abstinence-only-until-marriage program. (3)

A January 2005 evaluation of five abstinence-only programs being taught in over a dozen Texas schools shows that abstinence-only messages are not altering the usual sex trends among young people. In fact, students in virtually all high school grades were more sexually active after taking the course.(4)

 

Comprehensive sexuality education is not only effective in providing adolescents with information to make responsible choices concerning their sexual health but also build up knowledge, attitude and skills. Abstinence is presented as a primary method of pregnancy and sexually transmitted infections (STI’s) prevention, but it is combined with basic and accurate information regarding contraception. In addition, the Comprehensive sexuality education programs provide young people with religiously neutral views of sexuality and promote healthy relationships that give emphasis to communication and do not rely on gender stereotypes. These messages are not confusing for adolescents nor do comprehensive sex education programs promote promiscuity. The American Academy of Pediatrics, American College of Obstetricians & Gynecologists, American Medical Association, American Public Health Association, Institute of Medicine, and Society for Adolescent Medicine, among others, support comprehensive sex education.(5)

5. Comprehensive sex education prevents teenagers from engaging in sexual relationship early and reduces unintended pregnancies and abortions.

Research strongly supports a comprehensive approach to sexuality education. Several studies conclude that comprehensive sex education programs can help young people delay intercourse, reduce the frequency of intercourse, reduce the number of sexual partners they have, and enhance their use of condoms and other contraceptive methods when they do become sexual active. Students in such classes do not engage in sexual activity more often or earlier, but when they become sexually active they do use contraception and practice safer sex more consistently reducing the number of unintended pregnancies and the spread of STI’s.(6)

6. A majority of parents in the U.S. supports comprehensive sex education.

National surveys underscore parental support for school-based sexuality education. Ninety-nine percent of Americans believe it is appropriate for young people to have information about STIs, and 94 percent of American want their children to be taught about birth control. 82% of Americans want their children to be taught more about sex than an abstinence-only sex education would provide. Almost half (46%) of Americans believe that education about abstinence from sexual intercourse is best for teens, but since some students would not abstain, sex ed classes should also provide information about condoms and other contraception. Yet 36 % believe that abstinence is not the most important thing, and that sex ed should focus on teaching teens how to make responsible decisions about sex. Only 15% of Americans believe schools should teach only about abstinence from sexual intercourse and should not provide information on how to obtain and use condoms and contraception. The survey also found that parents want sexuality education classes to cover topics that are perceived as controversial by many administrators and teachers. (7) By the way, not only the parents are in favor of comprehensive sex education, so is a majority of teachers and students.(8)

7. Research shows that comprehensive sex ed is more effective than abstinence-only sex ed, but the federal government is funding the latter.

Between 1996 and federal Fiscal Year 2006 more than $1.5 billion in federal and state matching funds have been committed to abstinence-only programs. For the Fiscal Year 2007, the federal government has allocated $176 million for abstinence-only-until-marriage programs. The President has planned to augment this funding level to $204 million for Fiscal Year 2008.(9) Moreover, since the states are obliged to match federal funds for abstinence-only programs, state budgets that before supported comprehensive sexuality education diverted their money to abstinence-only education programs.(10) Interestingly though, sexual behaviors of teenagers did significantly improve from 1991 to 1997, but recent studies show that little change evolved from 1999 to 2003 – this is after the implementation of federally funded Title V abstinence-only-until-marriage initiatives in 1998.(11)

8. More than 80 percent of the federally funded abstinence-only curricula contain “false, misleading, or distorted information about reproductive health.”

In December 2004, the U.S. House of Representatives released a report evaluating the content of federally funded abstinence-only programs. These curricula contain misinformation about condoms, abortion, and basic scientific facts. They also blur religion and science and present gender stereotypes as fact.To give only some of numerous examples at this point: - Several curricula understate the condom effectiveness by claiming “Couples who use condoms to avoid a pregnancy have a failure rate of 15%.” In fact, the failure rate is 2% to 3% mostly due to incorrect or inconsistent use over the course of a year.- One curriculum states that five to ten percent of women will never again be pregnant after having a legal abortion. In fact, “obstetrics textbooks teach that fertility is not altered by an elective abortion”.- By describing the fetus’ developmental state inaccurately, several curricula offer as scientific fact that a developing fetus is a person or a baby: “About the sixth to tenth day after contraception (…) baby snuggles into the soft nest in the lining of the mother’s uterus.” In fact, the so-called baby is technically a ball of 107 to 256 cells at the beginning of uterine implantation.- Several curricula treat stereotypes about girls and boys as scientific fact, e.g. women necessitate “financial support” and men need “admiration”.The report summarizes that “serious and pervasive problems with the accuracy of abstinence-only curricula may help explain why these programs have not been shown to protect adolescents from sexually transmitted diseases and why youth who pledge abstinence are significantly less likely to make informed choices about precautions when they do have sex.”(12)

9. Wisconsin decided to spend its money on responsible and effective sex education, not on extremist ideology.

Research to date continues to support comprehensive sexuality education as more effective in reducing sexual risk behaviors, teen pregnancy rates, and STI/HIV infection rates than abstinence-only education Given the evidence, the Institute of Medicine, American Academy of Pediatrics,American Medical Association, the American Public Health Association, the National Education Association, the National Medical Association, the National School Boards Association, the Society for Adolescent Medicine, and other organizations support comprehensive sexuality education and recommend elimination of mandates for abstinence-only and abstinence until marriage programs. The Wisconsin Department of Public Instruction supports comprehensive sexuality education that stresses abstinence from sexual activity but also provides age-appropriate instruction on condoms and contraceptive use. (13)Wisconsin is one of the 14 states including California, Colorado, Connecticut, Maine, Massachusetts, Minnesota, Montana, New Jersey, New Mexico, New York, Ohio, Rhode Island, and Virginia, that have rejected federal abstinence-only money. (14)While this is true, it does not necessarily mean that all students in Wisconsin are having access to comprehensive sexuality education. The curriculum on sex education is not mandated by the state and an overview about what different Wisconsin schools are teaching cannot be obtained.

10. Young people express their need for more information about sex and sexual health.

Among adolescents, the top three sources of information are sex education in school, friends, and parents. Media sources like television, the movies, magazines and the Internet follow closely. But young people report that it is difficult to access reliable and factual information. A survey found that more than 75% of adolescents and young adults express a need for more information about sexual and reproductive health issues. Topics how to recognize STDs and HIV/AIDS infection, what STD and HIV testing involves, and where they can go to get tested are especially important to them. About 50% of the students in grades 7-12 claim more information about what to do in the event of rape or sexual assault, and how to talk with a partner about birth control and STDs. Two in five young people also want more factual information on birth control, how to use and where to get birth control, how to communicate more effectively with partners about sensitive sexual concerns and issues and how to handle pressure to have sex. 25% of the students declare they need more information on how to use condoms. Those surveyed report that these topics are not covered in their most recent sexuality education course, or that they are not covered in sufficient depth.(15)

Notes

1. Guttmacher Institute, U.S. Teenage Pregnancy Statistics National and State Trends and Trends by Race and Ethnicity, 5 (Updated September 2006) at http://www.guttmacher.org/pubs/2006/09/12/USTPstats.pdf (last visited December 4, 2007).

2. John S. Santelli et al., Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of abstinence and Improved Contraceptive Use, American Journal of Public Health, 97(1), 150–6 (2007); Susheela Singh and Jacqueline E. Darroch, Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries, Family Planning Perspectives, 32 (1) (January/February 1999) at http://www.guttmacher.org/pubs/journals/3201400.html (last visited December 4, 2007); Planned Parenthood, Abstinence-Only Programs, at http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/teen-pregnancy-sex-education/abstinence-6236.htm (last visited December 4, 2007); Debra Hauser, Five Years of Abstinence-Only-Until-Marriage Education: Assessing the Impact, (2004) at http://www.advocatesforyouth.org/publications/stateevaluations.pdf (last visited December 13, 2007).

3. Christopher Trenholm et al., Impacts of Four Title V, Section 510 Abstinence Education Program: Final Report (April 2007) at http://aspe.hhs.gov/hsp/abstinence07/report.pdf (last visited December 6, 2007); Guttmacher Institute, Review of Key Findings of “Emerging Answers 2007” Report on Sex Education Programs, Guttmacher Advisory, November 2007 at http://www.guttmacher.org/media/evidencecheck/2007/11/07/Advisory_Emerging_Answers_2007.pdf (last visited December 13, 2007).

4. Laura Beil, Abstinence Programs: Lessons in Futility? Classes Aren’t Changing Texas Teens’ Sexual Habits, Researchers Say, Dallas Morning News, Jan. 30, 2005, at 1A.

5. Healthy Teen Network, Fast Fact: Comprehensive Sexuality Education at http://www.healthyteennetwork.org/vertical/Sites/%7BB4D0CC76-CF78-4784-BA7C-5D0436F6040C%7D/uploads/%7B4C5F842E-E67A-4AC2-921B-287950431BD7%7D.PDF (last visited December 10, 2007); Guttmacher Institute, Review of Key Findings of “Emerging Answers 2007”: Report on Sex Education Programs, Guttmacher Advisory, November 2007 at http://www.guttmacher.org/media/evidencecheck/2007/11/07/Advisory_Emerging_Answers_2007.pdf (last visited December 13, 2007).

6. Douglas Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy (May 2001); Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases (November 2007), 15-16; Guttmacher Institute, Review of Key Findings of “Emerging Answers 2007” Report on Sex Education Programs, Guttmacher Advisory, November 2007 at http://www.guttmacher.org/media/evidencecheck/2007/11/07/Advisory_Emerging_Answers_2007.pdf (last visited December 13, 2007).

7. National Public Radio et.al., Sex Education in America: General Public/Parents Survey (January 2004) at http://www.npr.org/programs/morning/features/2004/jan/kaiserpoll/publicfinal.pdf (last visited December 17, 2007)

8. Cynthia Dailard, Sex Education: Politicians, Parents, Teachers and Teens, The Guttmacher Report on Public Policy, February 2001, Volume 4, Number 1 at http://www.guttmacher.org/pubs/tgr/04/1/gr040109.html (last visited December 13, 2007).

9. SIECUS — Sexuality Information and Education Council of the United States, A Brief History of Federal Abstinence-Only-Until-Marriage Funding (2007) at http://www.siecus.org/policy/states/2006/explanation.html (last visited December 18, 2007); Spending for Abstinence-Only-Until-Marriage Programs (1982-2008),(2007) at http://www.siecus.org/policy/states/2006/federalGraph.html (last visited December 18, 2007).

10. Planned Parenthood, Abstinence-Only Programs, at http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/teen-pregnancy-sex-education/abstinence-6236.htm (last visited December 18, 2007).

11. Ammie N. Feijoo, Trends in Sexual Risk Behaviors among High School Students—United States, 1991 to 1997 and 1999 to 2003 (2004) at http://www.advocatesforyouth.org/publications/factsheet/fstrends.pdf (last visited December 13, 2007).

12. United States House of Representatives, Committee on Government Reform, The Content of Federally Funded Abstinence-Only Education Programs (December 2004) at http://www.democrats.reform.house.gov/Documents/20041201102153-50247.pdf (last visited December 18, 2007).

13. Narra Smith Cox - for the Wisconsin Department of Public Instruction: Student Services/Prevention and Wellness Team, Human Growth and Development: A resource packet to assist school districts in program development, implementation and assessment, (2005) at http://dpi.wi.gov/sspw/pdf/hgd4.pdf (last visited January 8, 2008) 116; Douglas Kirby, Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases (November 2007), 15-16.

14. The Associaton of State and Territorial Health Officials, Information on State Abstinence from Abstinence-Only Education (Section 510) Funding (2007) at http://www.astho.org/pubs/TAAb-Ed.pdf (last visited January 15, 2008); Marcela Howell, Marilyn Keefe, Advocates for Youth, The History of Federal Abstinence-Only Funding (July 2007) at http://www.advocatesforyouth.org/publications/factsheet/fshistoryabonly.htm (last visited January 15, 2008); Ann Friedmann, Let's Talk About Sex: A pushback against federally-funded abstinence-only sex ed finally gathers steam, The American Prospect (March 2007) at http://www.prospect.org/cs/articles?articleId=12609 (last visited January 15, 2008); Press Release, SIECUS, Advocates for Comprehensive Sex Education Praise Governor's Decision to Reject Federal Funding for Abstinence-Only-Until-Marriage Programs: Federal requirements contradict NJ's comprehensive curriculum (Oct. 25, 2006); Leila Atassi, Ohio Could Become 8^th State to Reject Abstinence-Only Money; Congress Studies Paying for Instruction on Birth Control, STDs, Cleveland Plain Dealer, Mar. 27, 2007; Press Release, The Commonwealth of Massachusetts Executive Office, Governor Patrick Signs $26.8 billion FY ’08 State Budget; Spending Plan Reflects Shared Priorities, Investment in the Future (July 12, 2007); Press Release, New York State Department of Health, Statement by State Health Commissioner Richard F. Gaines (Sept. 20, 2007); Josephine Marcotty, State Says No Thanks to No-Sex Funding, Minn. Star Trib., Oct. 19, 2007; Press Release, SIECUS, SIECUS Applauds Colorado’s Refusal of Title V Funding (Oct. 31, 2007); The Commonwealth of Virginia, Governor’s FY 2008 Budget Reduction Plan Detailed Report, Department of Planning and Budget (Oct. 1, 2007).

15. Kaiser Family Foundation, National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes and Experiences (2003) at http://www.kff.org/youthhivstds/upload/National-Survey-of-Adolescents-and-Young-Adults-Sexual-Health-Knowledge-Attitudes-and-Experiences-Summary-of-Findings.pdf (last visited January 7, 2008); Cynthia Dailard, Sex Education: Politicians, Parents, Teachers and Teens, The Guttmacher Report on Public Policy, February 2001, Volume 4, Number 1 at http://www.guttmacher.org/pubs/tgr/04/1/gr040109.html (last visited January 7, 2008).