Abstinence-only sex education is a form of sex education that emphasizes abstinence from sex to the exclusion of all other types of sexual and reproductive health education, particularly regarding birth control and safe sex. This type of sex education promotes sexual abstinence until marriage and either completely avoids any discussion about the use of contraceptives, or only reveals failure rates associated with such use.
Proponents of abstinence-only sex education argue that this approach is superior to comprehensive sex education (see Sex education) for several reasons. They say that sex education should emphasize teaching a morality that limits sex to that within the bounds of marriage and that sex outside marriage and at a young age has heavy physical and emotional costs. They claim that comprehensive sex education encourages teen premarital sexual activity, which should be discouraged in an era when HIV and other incurable sexually transmitted infections are widespread and when teen pregnancy is an ongoing concern.
Opponents and critics, which include prominent professional associations in the fields of medicine, public health, adolescent health, and psychology, argue that such programs fail to provide adequate information to protect the health of young people. Some critics also argue that such programs verge on religious interference in secular education. Opponents of abstinence-only education dispute the claim that comprehensive sex education encourages teens to have premarital sex. The idea that sexual intercourse should only occur within marriage also has serious implications for certain types of people for whom marriage is either not valued or desired, or is unavailable as an option, particularly homosexuals living in places where same-sex marriage is not legal or socially acceptable.
Abstinence-only sex education became more prominent in the U.S. over the last decade stimulated by over $1 billion in federal funding. However, few long-term, rigorous studies have been done on these programs, and their effectiveness remains a matter of question. While abstinence-only sex education is a controversial subject, the fact that complete abstinence itself (even within marriage) is the most effective preventative measure against both pregnancy and sexually transmitted diseases has never been in dispute. What is in dispute is whether abstinence-only sex education actually succeeds in increasing abstinence.
Over the last decade, abstinence-only sex education became more common in the U.S., largely as a result of federal government funding initiatives. Through direct funding and matching grant incentives, the U.S. government steered more than a billion dollars to abstinence-only education programs between 1996 and 2006.
In 1996, the federal government attached a provision to a welfare reform law establishing a program of special grants to states for abstinence-only-until-marriage programs. The program, Title V, § 510(b) of the Social Security Act, is commonly known as Title V. It created very specific requirements for grant recipients. Under this law, the term "abstinence education" means an educational or motivational program which:
A) Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
B) Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
C) Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
D) Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity;
E) Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
F) Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents, and society;
G) Teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances, and
H) Teaches the importance of attaining self-sufficiency before engaging in sexual activity.
Title V-funded programs were not permitted to advocate or discuss contraceptive methods except to emphasize their failure rates.
The program dedicated $50 million annually to be distributed among states choosing to participate. States accepting the funds were required to match every four federal dollars with three state-raised dollars. For the first five years of the initiative, every state but California participated in the program. However, many states used the money to fund their existing science-based sexual education programs and never created abstinence-only sexual education programs.
After its first five years, many states evaluated the effectiveness of their programs. A comprehensive review of 11 state evaluations conducted by Advocates for Youth showed some short-term benefits, but did not find any programs with lasting positive impact.
Research conducted by the Kaiser Family Foundation in 2002 indicated that, by that time, about a third of U.S. secondary schools were using an abstinence-only approach. However, after their five-year evaluations, more states began declining the funding.
In 2000, the federal government began another large program to fund abstinence education, Community-Based Abstinence Education (CBAE). CBAE became the largest federal abstinence-only funding source, with $115 million granted for fiscal year 2006. The CBAE awards bypass state governments, offering federal grants directly to state and local organizations that provide abstinence-only education programs. Many of these grantees are faith-based or small non-profit organizations, including crisis pregnancy centers, which use their grants to provide abstinence-only programs and services in local public and private schools and to community groups.
Two major studies by the U.S. Congress have increased the volume of criticism surrounding abstinence-only education.
In 2004, U.S. Congressman Henry A. Waxman of California released a report that provides several examples of inaccurate information being included in federally funded abstinence-only sex education programs. This report bolstered the claims of those arguing that abstinence-only programs deprive teenagers of critical information about sexuality. The claimed errors included:
Out of the 13 grant-receiving programs examined in the 2004 study, the only two not containing "major errors and distortions" were Sex Can Wait and Managing Pressures before Marriage, each of which was used by five grantees, making them two of the least widely used programs in the study. With the exception of the FACTS program, also used by 5 grantees, the programs found to contain serious errors were more widely used, ranging in usage level from 7 grantees (the Navigator and Why kNOw programs) to 32 grantees (the Choosing the Best Life program). Three of the top five most widely used programs, including the top two, used versions of the same textbook, Choosing the Best, from either 2003 (Choosing the Best Life) or 2001 (Choosing the Best Path - the second most widely used program with 28 grantees - and Choosing the Best Way, the fifth most widely used program with 11 grantees).
In 2007, a study ordered by Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex in their teenage years as those who did not. The study followed more than 2,000 students from age 11 or 12 in 1999 to age 16 in 2006. It included those who had participated in one of four abstinence education programs as well as a control group who had not. By age 16, about half of each group - participants in the abstinence-only program as well as the control group - were still abstinent. Abstinence program participants who became sexually active during the study period reported having similar numbers of sexual partners as their peers of the same age, and first had sex at about the same age as other students. The study also found that students who took part in the programs were just as likely to use contraception when they did have sex as those who did not participate. Abstinence-only education advocates claim the study was too narrow, began when abstinence-only curricula were in their infancy, and ignored other studies that have shown positive effects.
Abstinence-only education has been criticized in official statements by the American Psychological Association,Comprehensive Sex Education is More Effective at Stopping the Spread of HIV Infection the American Medical Association, the National Association of School Psychologists,NASP Position Statement on Sexuality Education the Society for Adolescent Medicine, the American College Health Association, the American Academy of Pediatrics, and the American Public Health Association,APHA: Policy Statement Database which all maintain that sex education needs to be comprehensive to be effective.
The AMA "urges schools to implement comprehensive... sexuality education programs that... include an integrated strategy for making condoms available to students and for providing both factual information and skill-building related to reproductive biology, sexual abstinence, sexual responsibility, contraceptives including condoms, alternatives in birth control, and other issues aimed at prevention of pregnancy and sexual transmission of diseases... [and] opposes the sole use of abstinence-only education..."
The American Academy of Pediatrics states that "Abstinence-only programs have not demonstrated successful outcomes with regard to delayed initiation of sexual activity or use of safer sex practices... Programs that encourage abstinence as the best option for adolescents, but offer a discussion of HIV prevention and contraception as the best approach for adolescents who are sexually active, have been shown to delay the initiation of sexual activity and increase the proportion of sexually active adolescents who reported using birth control."
On August 4, 2007, the British Medical Journal published an editorial concluding that there is "no evidence" that abstinence-only sex education programs "reduce risky sexual behaviours, incidence of sexually transmitted infections, or pregnancy" in "high income countries".
A comprehensive review of 115 program evaluations published in November 2007 by the National Campaign to Prevent Teen and Unplanned Pregnancy found that two-thirds of sex education programs focusing on both abstinence and contraception had a positive effect on teen sexual behavior. The same study found no strong evidence that abstinence-only programs delayed the initiation of sex, hastened the return to abstinence, or reduced the number of sexual partners. According to the study author:
"Even though there does not exist strong evidence that any particular abstinence program is effective at delaying sex or reducing sexual behavior, one should not conclude that all abstinence programs are ineffective. After all, programs are diverse, fewer than 10 rigorous studies of these programs have been carried out, and studies of two programs have provided modestly encouraging results. In sum, studies of abstinence programs have not produced sufficient evidence to justify their widespread dissemination."
Joycelyn Elders, former Surgeon General of the United States, is a notable critic of abstinence-only sex education. She was among the interviewees Penn & Teller included in their Bullshit! episode on the subject.
Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania, argues that abstinence-only sex education leads to the opposite of the intended results by spreading ignorance regarding sexually transmitted diseases and the proper use of contraceptives to prevent both infections and pregnancy.
Congress extended funding of Title V several times, through fiscal year 2006. In October 2007, Congress again extended funding, only until December 31, 2007; there is ongoing debate on whether to continue funding it beyond that date.
The proposed Responsible Education About Life Act ( and ) would provide federal funding for comprehensive sex education programs which include information on both abstinence and contraception and condoms.
In 2004, U.S. President George W. Bush announced his Five-Year Global HIV/AIDS Strategy. Also known as The President's Emergency Plan for AIDS Relief (PEPFAR), the plan committed the U.S. to provide $15 billion over five years towards AIDS relief in 15 countries in Africa and the Caribbean, and in Vietnam. About 20 percent of the funding, or $3 billion over five years, was allocated for prevention. The program required that, starting in fiscal year 2006, one-third of prevention funding be earmarked specifically for abstinence-only-until-marriage programs. Global AIDS prevention advocates have criticized the funding restriction, and in 2006 a report by the U.S. Government Accountability Office (GAO) also criticized the earmark, outlined the challenges that the funding restriction posed to countries hardest hit by the AIDS epidemic, and urged Congress to reconsider how this funding should be spent. A Congressionally authorized three-year evaluation of PEPFAR by the non-partisan Institute of Medicine in 2007 also criticized the earmark. In preparation for PEPFAR's reauthorization, bills have been introduced in both houses of Congress that would drop the earmark.
Williams, Mary E. (Ed.). (2006). Sex: opposing viewpoints. Detroit: Greenhaven.
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