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Sex… Education?

I first realized that there was something wrong with sex education when I drove my

cousin to a convenience store to buy a pregnancy test. Crying and dry heaving with her mascara

smudging around her eyes, she told me she was late and that she and her boyfriend hadn’t been

using protection. She did not have her license yet and was too embarrassed to go herself, so I

paid for it while she hung back. Ten minutes later, I was standing in line at a Taco Bell while she

was in the bathroom. I had already sat down and started eating when she came out of the

restroom and walked to the table I was sitting at. She sat down, let out a heavy sigh of relief, and

said, “We’re good”. Since the emotionally jarring part of the night was over, I felt free to lecture

her. I asked her, using some choice words, what she thought she was doing; why had she not

practiced safe sex? She gave me a worn-out shrug and explained that she did not think it was

likely that she would actually get pregnant; she thought it would “probably be fine”. I learned

about the holes in this thought process when I was fourteen, but she had not grown up in

California, like I had.

The next time I realized there was something wrong was when a friend of mine tipped me

off that my brother’s ex-girlfriend had syphilis. The next time I saw him, I let him know what I

heard. He looked at me and scoffed and said that even though she was a cheater, she would have

told him if that was something he needed to be concerned about. I told him who I heard it from

because this friend happened to be a credible source. His eyes got wide and stared at me for

about thirty seconds. By then, it was pretty obvious to me that he hadn’t thought to protect

himself from STIs. I told him to go get himself checked. His relief was as palpable as my

cousin’s had been a few weeks later when he told me that he was fine.

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The third time I realized there was something wrong with sex education, I was laying in

bed, watching Youtube videos on my phone, my eyes drooping as I fought off sleep in favor of

the media being presented to me. I was looking through the recommended section when an

interesting title caught my eye—“Kids Meet a Teen Mom”. I clicked on the video and was

greeted with a funny opening scene and some upbeat music. The mom revealed her name

name—Maddie—and then her age. Fifteen. She had conceived and given birth when she was

fourteen years old. According to her, most of her friends had also been having sex at the time,

but she was the one who ended up with a baby. When asked if she used protection, she said she

did not because they do not really teach about protection in Texas, instead focusing only on

abstinence. I was enraged on her behalf. How could the system fail her like this? How could they

just teach abstinence, knowing that it would not work 100% of the time and that the teens who

did not abstain would not know how to protect themselves? If this is the standard for Texas, and

for many other states as I have discovered through my research, exactly how many teens have

suffered due to this shoddy sex ed? Watching this video inspired me to investigate the question:

How does sexual education that primarily focuses on abstinence contribute to STI, teen

pregnancy, and teen sex rates in the United States?

It is no secret that sex education is a very necessary tool to slow down unhealthy

behaviors and the consequences young people face from these behaviors. After all, something

must be done about the fact that, compared to other industrialized countries, the United States

has had some of the highest teen pregnancy and STI rates in recent years (Kendall 10). However,

abstinence-only sex education often seems like an urban legend to many people in states like

California. Here, the California Healthy Youth Act of 2016 requires middle and high schools to

teach medically accurate, comprehensive sex education (Torlakson), which the California

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Education Code defines as “education regarding human development and sexuality, including

education on pregnancy, contraception, and sexually transmitted infections” (“Code Section

51931”). However, there is no federal legislation similar to this; states make their own laws

regarding sex education. While there is no federal legislation requiring or preventing sex

education, nor any specifying what the curriculum needs to include, the federal government has

been funding abstinence-only until marriage programs since the Reagan administration when the

Adolescent Family Life Act was passed and has continued to do so since, especially during the

Bush administration (“A History”). President Reagan allotted approximately $32 million dollars

to abstinence-only sex education and, despite Clinton’s attempts to cut funding to AFLA (Saul),

this number only increased during his administration to about $216 million dollars (“Dedicated

Federal”). According to the Sexuality Information and Education Council of the United States,

“Between 1996 and federal Fiscal Year (FY) 2018, Congress has funneled over $2.1 billion in

taxpayer dollars into abstinence-only-until-marriage programs, and that funding continues today”

(“A History”). Around $1.1 billion of that $2.1 billion was during the Bush administration

(“Dedicated Federal”). Today, only eighteen states and the District of Columbia require schools

to teach about contraception if sex education is provided (“Sex and HIV Education”). This leaves

the rest of the states free to provide abstinence-only sex ed programs, and those programs receive

funding from the government to this day, meaning abstinence-only education hasn’t gone away;

not by a long shot. But what effects do these programs have? Many people, especially religious

Americans, insist that abstinence-only programs exist to prevent teenagers from having sex,

which, in theory, reduces teen pregnancy and STI rates, while many other people insist that

teenagers will have sex no matter what and depriving them of comprehensive education leaves

them with no knowledge of how to protect themselves. However long the debate lasts, years and

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years of compiled research has shown that abstinence-only sex education can, if anything at all,

only prevent teenagers from having sex for a short amount of time and is significantly worse than

comprehensive sex ed at reducing teen pregnancy and STI rates.

Abstinence-only sexual education is ineffective at reducing STI and teenage pregnancy

rates and produces higher rates than comprehensive sexual education. For example, a study

conducted between 2002 and 2005, beginning just four years after the Bush administration began

to grant $50 million in annual support for states who taught abstinence-only sex ed (“A

History”), compared the teen pregnancy rates in five developed countries. In the United States,

for every 1000 girls aged fifteen through nineteen, 72.2 were pregnant, whereas in the

Netherlands, 11.8 were pregnant (Hall and Stanger-Hall). Clearly, there is a significant

difference between the two statistics, but why? To answer that question, a comprehensive review

on the differences in sex education between the British, who had a very similar approach to

sexual education as the United States, and the Dutch was published. The review highlighted

many aspects of Dutch sex ed that were unique and could be contributing to their low pregnancy

rates, but the starkest difference by far was the Dutch approach to contraception; “The Dutch

science texts provide full coverage of methods of contraception, discuss where they can be

obtained and why some are suitable for certain groups of people” (Knijn and Lewis). The

introduction of contraception to the curriculum greatly improved their teen pregnancy rates

because learning about contraception makes one more likely to use them during sex, which

would decrease the likelihood of becoming pregnant or contracting an STI significantly. This is a

clear example of how sex education programs that include information about contraceptives can

improve pregnancy rates. If it has worked in the Netherlands, it then follows that it should

increase contraceptive use in the United States, which would then lead to lower pregnancy and

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STI rates. In fact, there is plenty of evidence to support the effectiveness of comprehensive

sexual education programs in the States. Take, for example, a comparative review between

abstinence-only and comprehensive sex education in different states, which has found that

“States that… covered abstinence along with contraception and condom use... tended to have the

lowest teen pregnancy rates, while states with abstinence-only sex education laws… were

significantly less successful in preventing teen pregnancies” (Alagiri et al.) If the programs that

have been proven to lower teen pregnancy rates could be applied to every state, perhaps that

could substantially improve the nation’s pregnancy and STI problem. Jennifer Lucke, who has

taught sexual education at South High School in Minnesota, has found this to be true from her

own personal experience. Her sex education curriculum has changed over the years to gradually

focus less on abstinence. According to her, the current programs they have in place, which teach

abstinence but do not stress it, have helped to significantly reduce STI and teen pregnancy rates.

Of course, teen pregnancy and STI rates are not all that must be discussed when debating the

effectiveness of sex ed programs.

Some may argue that there have been several studies that show that abstinence-only

programs can be effective at reducing teen sex rates. While there have been studies that indicate

this, they have not been deemed conclusive and there are other studies that suggest that this

difference may be short term only. Proponents of abstinence-only sex education believe that it is

effective for a reason; there are several studies that, at first glance, seem like convincing

evidence in these programs’ favor. However, when evidence like this was compiled by two

credible reviews, “Neither review found scientific evidence that abstinence-only programs

demonstrate efficacy in delaying `initiation of sexual intercourse’” (Lyon et al.). One such

review commented that the studies could only speak for effects within three years of the

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programs (Kirby). The lack of long-term effects is a recurring issue. This can be seen when

examining an in-depth study into the effectiveness of abstinence-only education, funded by the

U.S. Department for Health and Human Services and the Administration for Children and

Families. Mathematica Policy Research conducted this study by measuring the results of students

who received abstinence-only education and the results of a control group, who received no sex

education in schools or in a program at all. According to the study, when surveyed right after the

program versus in a later follow-up, support for abstinence declined sharply, and “Among youth

in the program group, the decline in support for abstinence was even greater than among control

group youth, leading program impacts on this measure to disappear over time” (Clark et al.).

Students who received abstinence-only sex education generally held more favorable views

towards abstinence when asked right after the study, but three to five years later, they were no

more predisposed towards waiting until marriage than the control group. The study also suggests

that peer pressure might have had a bigger role in the students’ reported attitudes towards sex

than the actual program did (Clark et al.). This could mean that the abstinence-only sex

education didn’t even have a short term effect; students may have said they supported abstinence

without any plans to actually abstain because that is what they felt they were supposed to say.

Overall, existing evidence of positive effects of abstinence-only education is shaky at best and

cannot prove that it reduces teenage sex rates.

Even if abstinence-only programs could reduce teen sex rates, which is their goal, no

program could completely eradicate teenage sex and using a program that does not teach about

safe sex leaves the teenagers who do not remain abstinent vulnerable to teen pregnancy or STIs.

Regardless of how heavily abstinence until marriage is pushed, it is inevitable that some, if not

many, will still have sex before marriage. Sex before marriage has been a common occurrence

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for a very long time. In fact, according to LB Finer, “Among cohorts of women turning 15

between 1964 and 1993, at least 91% had had premarital sex by age 30. Among those turning 15

between 1954 and 1963, 82% had had premarital sex by age 30, and 88% had done so by age 44”

(Finer). Even during the Reagan administration when the government was heavily championing

abstinence, a lot of women had premarital sex. Abstinence-only programs seek to reduce teen

sex, since eliminating it is impossible. Even if abstinence-only programs could cut teen sex rates

in half, which they cannot, there would still be a lot of people having premarital sex. It is

important for those people, often teenagers, to have sex responsibly in order to minimize their

risks. Abstinence-only programs, however, fail at equipping student with the knowledge to make

informed choices. The Mathematica Policy Research study found that “Youth in the program

group were significantly less likely to report that condoms usually prevent STDs than those in

the control group” (Clark et al.). In fact, many students in the program group reported that

condoms were never effective in preventing STIs, which is medically inaccurate—condoms are

actually proven to reduce the risk of contracting an STI (“Condoms”). While the program did not

teach them that condoms were ineffective, it avoided mentioning condoms at all and taught them

that abstinence was the only certain way to avoid pregnancy and STIs which, while not untrue,

when paired with the lack of introduction to other forms of contraception, can make other

methods of contraception seem futile. This is harmful to those who will not abstain because

when they do have sex they will not be predisposed to using a condom. Why use one if it does

not work? That this mindset exists is supported by a comparative study between comprehensive

and abstinence-only sex education, which demonstrated that the students who were only taught

abstinence “had reduced favorable attitudes toward condom use, and were more likely to have

unprotected sex than the comparison group. Findings suggest that adolescents who receive

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abstinence-only education are at greater risk of engaging in unprotected sex” (Girard, et al.).

Providing the teenagers that will have sex with information about contraceptives is done by using

comprehensive curriculum. Kerry Ginsberg, a teacher at Las Lomas who is responsible for

teaching a unit on sex education, describes her curriculum as one that focuses less on abstinence

and more on “students feeling empowered to make informed choices so that if they do choose to

have sex, that they have the actual practical knowledge about how to protect themselves from

STIs and from pregnancy, and that also they have the awareness of the risks.” When asked if she

felt she had been successful in teaching these things, her response was an enthusiastic yes.

Many people have a lot of different assumptions about how opposing kinds of sexual

education programs work. However, my findings have shown patterns that defy several of these

assumptions. Abstinence-only sex education programs have only short-term impacts on teen sex

rates, if any at all, and have no impact on STI or teen pregnancy rates when compared to the

effects of receiving no sexual education at all. Compared to a comprehensive approach, however,

abstinence-only programs fall behind in terms of improvement to STI and teen pregnancy rates.

Abstinence-only sex education teaches students that waiting until marriage is the only acceptable

and healthy way to live, which is impractical in a real-life setting. It is unreasonable to expect

every single teen taught abstinence-only to abstain until marriage, and the teenagers who do not

still deserve to be given the tools to make informed decision. This is why the federal government

should fund and why state governments should mandate comprehensive sexual education

programs. For maximum effect, these comprehensive programs should include medically

accurate information about contraceptives, as well as how to access them like the Netherlands

teach. These programs do not need to exclude abstinence; it is, after all, the most effective

contraceptive and a healthy way for teenagers to live. Many sex education programs that are

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relatively successful in preventing STIs and teen pregnancy mention or even stress abstinence.

Take Ginsberg’s curriculum, which teaches that abstinence is “the only 100% effective method

of avoiding pregnancy and the only 100% effective method of avoiding STIs” without pushing it

on students the way abstinence-only programs do. Another example is Lucke’s curriculum,

which devotes a whole day to discussing abstinence in great detail, as well as mentioning it

throughout the class. In addition to programs that merely mention abstinence, there are several

programs that put a great emphasis on abstinence while still including contraceptives in their

curriculum. According to The Sex Education Debates, “between [abstinence-only and

comprehensive] approaches lies a vast (and expanding) range of programs that are often

classified as ‘abstinence-plus,’ ‘abstinence-based,’ or ‘abstinence-centered’ programs” (Kendall

25). This shows that there are ways to successfully encourage abstinence in youth without

depriving teenagers of information that could prevent pregnancy or STIs. The United States must

take steps towards finding the best way to reduce teen sex rates while protecting those who do

partake from pregnancy or STIs. One thing is certain; the state of sexual education in this

country needs to change, and it needs to change now.

Works Cited

“A History of Federal Funding for Abstinence-Only-Until Marriage Programs.” Siecus.org,

Sexuality Information and Education Council of the United States, Aug. 2018,

siecus.org/wp-content/uploads/2018/08/A-History-of-AOUM-Funding-Final-Draft.pdf.

Accessed 03 Mar. 2019.

Alagiri, Priya, et al. Abstinence Only vs. Comprehensive Sex Education: What Are the

Arguments? What Is the Evidence? AIDS Policy Research Center & Center for AIDS

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Prevention Studies, Mar. 2002, www.issuelab.org/resources/3100/3100.pdf. Accessed 04

Mar. 2019.

Clark, Melissa et al. “Impacts of Four Title V, Section 510 Abstinence Education Programs.”

Mathematica Policy Research, Apr. 2007,

file:///C:/Users/phoeb/Downloads/impactabstinence.pdf. Accessed 03 Mar. 2019.

“Code Section 51931.” California Legislative Information, California Legislative Information,

2018,

leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?sectionNum=51931.&lawCode

=EDC. Accessed 03 Mar. 2019.

“Condoms and Sexually Transmitted Diseases.” U S Food and Drug Administration Home

Page, U.S. Department of Health and Human Services, 8 Jan. 2018,

www.fda.gov/forpatients/illness/hivaids/ucm126372.htm. Accessed 04 Mar. 2019.

“Dedicated Federal Abstinence-Only-Until-Marriage Programs Funding by Fiscal Year (FY),

1982–2018.” Siecus.org, Sexuality Information and Education Council of the United States,

Apr. 2018, https://siecus.org/wp-content/uploads/2018/07/AOUM-Funding-Table-FY18-

April-2018.pdf. Accessed 09 Apr. 2019.

Donovan, Megan K. “The Looming Threat to Sex Education: A Resurgence of Federal Funding

for Abstinence-Only Programs?” Guttmacher Institute, 30 March 2017,

https://www.guttmacher.org/gpr/2017/03/looming-threat-sex-education-resurgence-federal-

funding-abstinence-only-programs. Accessed 17 January 2019.

Finer, LB. “Trends in Premarital Sex in the United States, 1954-2003.” PubMed.gov, National

Center for Biotechnology Information, Feb. 2007,

www.ncbi.nlm.nih.gov/pubmed/17236611. Accessed 02 Mar. 2019.

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Ginsberg, Kerry. Sex education teacher at Las Lomas High School. Personal Interview. 27 Feb.

2019.

Girard, JM, et al. “Comparison of Comprehensive and Abstinence-Only Sexuality Education in

Young African American Adolescents.” PubMed.gov, National Center for Biotechnology

Information, Dec. 2017, www.ncbi.nlm.nih.gov/pubmed/28963952. Accessed 04 Mar. 2019.

Hall, David and Kathrin Stanger-Hall. “Abstinence-Only Education and Teen Pregnancy Rates:

Why We Need Comprehensive Sex Education in the U.S.” PMC, National Center for

Biotechnology Information, 14 Oct. 2011,

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3194801/#pone.0024658-Darroch1.

Accessed 03 Mar. 2019.

Kendall, Nancy. The Sex Education Debates. Univ. of Chicago Press, 2013.

Kirby, Douglas. “Emerging Answers: Research Findings on Programs to Reduce Teen

Pregnancy (Summary).” Taylor and Francis Online, American Journal of Health Education,

22 Feb. 2013, www.tandfonline.com/doi/abs/10.1080/19325037.2001.10603497. Accessed

02 Mar. 2019.

Knijn, Trudie and Jane Lewis. “Sex Education Materials in The Netherlands and in England and

Wales: a comparison of content, use and teaching practice.” ResearchGate, Carfax

Publishing Taylor & Francis Group, Aug. 2010,

https://www.researchgate.net/publication/261667721_Sex_Education_Materials_in_The_Ne

therlands_and_in_England_and_Wales_A_comparison_of_content_use_and_teaching_pract

ice. Accessed 03 Mar. 2019.

Lucke, Jennifer. Sex Education teacher at South High School. Personal Interview. 13 Mar.

2019.

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Lyon et al. “Abstinence-only education policies and programs: A position paper of the Society

for Adolescent Medicine.“ Journal of Adolescent Health, Elsevier, Jan. 2006,

https://www.jahonline.org/article/S1054-139X(05)00276-4/fulltext. Accessed 02 Mar. 2019.

Saul, Rebekah. “Whatever Happened to the Adolescent Family Life Act?” Guttmacher Institute,

01 April, 1998, https://www.guttmacher.org/gpr/1998/04/whatever-happened-adolescent-

family-life-act. Accessed 10 April 2019.

“Sex and HIV Education.” Guttmacher Institute, 04 Mar. 2019, www.guttmacher.org/state-

policy/explore/sex-and-hiv-education. Accessed 04 Mar. 2019.

Torlakson, Tom. “California Healthy Youth Act-Comprehensive Sexual Health Education.”

California Department of Education, 05 Apr. 2018,

www.cde.ca.gov/nr/el/le/yr18ltr0405.asp. Accessed 03 Mar. 2019.

Works Consulted

“Abstinence-Only-Until-Marriage Programs Are Ineffective and Harmful to Young People,

Expert Review Confirms.” Guttmacher Institute, 22 Aug. 2017, www.guttmacher.org/news-

release/2017/abstinence-only-until-marriage-programs-are-ineffective-and-harmful-young-

people. Accessed 04 Mar. 2019.

Chin, H B, et al. “The Effectiveness of Group-Based Comprehensive Risk-Reduction and

Abstinence Education Interventions to Prevent or Reduce the Risk of Adolescent Pregnancy,

Human Immunodeficiency Virus, and Sexually Transmitted Infections: Two Systematic

Reviews for the Guide to Community Preventive Services.” PubMed.gov, National Center

for Biotechnology Information, Mar. 2012, www.ncbi.nlm.nih.gov/pubmed/22341164.

Accessed 04 Mar. 2019.

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Paulson, Amanda. “Abstinence-only study could alter sex-education landscape: The study found

that abstinence-only sex education programs showed relative success in dissuading 12 year

olds from having sex for two years afterward. It is the most comprehensive study to date to

bolster an abstinence-only approach to reducing teen pregnancy.” The Christian Science

Publishing Society, 2 Feb. 2010,

http:/search.proquest.com/docview/405571467?accountid=193803. Accessed 5 February

2010.

Smith,Virginia. “As Abstinence-only education programs expand, the marriage of conservative

ideals and teenage realities faces an uncertain future.” Dayton Beach News, Halifax Media

Group, 28 Mar. 2004, https://search.proquest.com/docview/382883790?accountid=193803.

Accessed 05 Feb. 2019.

“State Policies on Sexual Education in Schools.” National Conference of State Legislatures, 21

Dec. 2016, www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx.

Accessed 03 Mar. 2019.

Wihbey, John. “Changes in Americans' Attitudes about Sex: Reviewing 40 Years of Data.”

Journalist's Resource, Harvard Kennedy's Shorenstein Center on Media, Politics and Public

Policy, 27 May 2015, journalistsresource.org/studies/society/public-health/changes-

americans-attitudes-sex-reviewing-40-years-data/. Accessed 03 Mar. 2019.

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