A bonus or bane? Health care package revives abstinence-only sex ed

Health advocates weren’t happy to learn that the sweeping federal health care package extends funding for abstinence-only education in schools, a concession by the Obama administration, which had opposed an abstinence-only approach to sex ed.

The push to revive abstinence funding in the bill had been led by Utah Sen. Orrin Hatch. (Neither Hatch nor any other Republicans voted for the health care bill.)

In a statement on abstinence education, Hatch said, “My first choice would be to not have the federal government involved in any way in these types of education programs and leave these discussions in the proper environment of the home with family members. However, if the federal government is going to spend money on educating people about sexual decisions, the absence of an abstinence only education program has negative health consequences for our nation’s most vulnerable citizens: teenage pregnancy is a leading contributor to poverty, which in turn leads to poor health outcomes for mothers and children; sexually active teens are more likely to experience mental health issues such as depression or attempted suicide; and sexually active teens are more likely to suffer health consequences such as increased rates of infection with sexually transmitted diseases.”

Most studies show poor results for abstinence programs. An eight-year study commissioned by Congress to determine the effectiveness of the programs concluded that abstinence programs were ineffective in reducing the rate of teen sexual activity.However, a recent University of Pennsylvania study found that that an abstinence-only intervention for pre-teens delayed the onset of sexual activity more than a health-promotion control intervention.

According to the university:

A total of 662 African American students in grades 6 and 7 participated in this randomized controlled trial, which was held on Saturdays in classrooms at four public schools participating in the study. The students were randomly assigned to an 8-hour abstinence-only intervention, an 8-hour safer sex-only intervention, an 8- or 12-hour combined abstinence and safer-sex intervention, or an 8-hour health-promotion control group. Participants in the comprehensive intervention had reduced reports of multiple sexual partners compared with the control group (8.8 percent vs. 14.1 percent).

It is not clear whether Obama was influenced by that study or if the abstinence funding was simply a political sacrifice.

According to Education Week:

Although overshadowed by other issues in the health-care debate, a controversial abstinence-only approach to sex education that recently saw its federal support severed is getting a new lease on life—a five-year lease worth $250 million, to be precise—under the final legislative package signed by President Barack Obama.

At the same time, the health-care law also provides $375 million over five years to promote more-comprehensive approaches to sex education that touch on both abstinence and the use of contraceptives to prevent pregnancy and sexually transmitted diseases. The emphasis in the program is on funding efforts that are “evidence-based,” “medically accurate,” and “age-appropriate,” the law says.

That funding stream, called the Personal Responsibility Education program, appears to dovetail with a new teenage-pregnancy-prevention initiative championed by the Obama administration and financed at nearly $115 million in fiscal 2011.

“Advocates for science-based, evidence-based sex education were stunned to learn that some Democrats had kept in the health-care-reform measure a reauthorization of the Title V abstinence-only-until-marriage program,” said James C. Wagoner, the president of Advocates for Youth, a Washington-based nonprofit focused on adolescent sexual health. “Everybody assumed it would be removed.”

The program was added to the health-care legislation through an amendment pushed by Republican Sen. Orrin Hatch of Utah during consideration in the Senate Finance Committee. In the end, no Republicans in Congress supported the health-care legislation.

The abstinence program, which provides grants to states, was first established in 1996 under welfare-reform legislation signed by President Bill Clinton. It is contained in Title V of the Social Security Act.

Valerie J. Huber, the executive director of the Washington-based National Abstinence Education Association, which represents organizations that provide such education, praised its inclusion in the final health-care package.

“Obviously, this is a health issue, so it makes perfect sense for it to be in a health bill,” she said. “We were delighted for the bipartisan support for Title V abstinence education funding.”

She added: “It shows that this continues to be an approach that has merit, and the growing body of research in support of it only strengthens the need for this to continue.” At the same time, Ms. Huber expressed disappointment that the law allocates significantly more money for the Personal Responsibility Education program.

“There is not equitable funding,” she said. “If you look at a public-health model, there is always priority given to the risk-avoidance method.”

The decision to reinstate the federal abstinence-only program comes after the release in February of a high-profile study showing promising results for a particular abstinence-based approach. The study from researchers at the University of Pennsylvania concluded that an abstinence program taught to African-American middle schoolers was more effective than other kinds of interventions in delaying sexual activity. It was described by one co-author as the first randomized, controlled study ever to demonstrate the effectiveness of an abstinence-only intervention.

Some proponents of abstinence-only education had been using the Penn study to argue for reinstating the Title V federal funding. But critics say the program it examined would not even have been eligible for that aid, in part because it did not stress remaining chaste until marriage. The federal abstinence-only program includes eight main points that local programs must adhere to to get funding, such as teaching “abstinence from sexual activity outside marriage as the expected standard for all school-age children” and teaching that “sexual activity outside the context of marriage is likely to have harmful psychological and physical effects.”

“It really is a very rigid, abstinence-until-marriage program,” said Heather D. Boonstra, a senior public-policy associate at the Guttmacher Institute, a New York City-based nonprofit that promotes sexual and reproductive health through research and policy analysis.

Even though the abstinence program will have $50 million to distribute annually over the next five years, some of that money may never be spent. Before the program expired in 2009, 22 states had declined to participate, said Ms. Boonstra. When a state declined the money, she noted, that share simply returned to the U.S. treasury.

Several issues help explain why states declined, she said. Some state officials have openly said they oppose the strict requirements for an abstinence-only approach, according to Ms. Boonstra. There’s also a financial matter. Unlike the Personal Responsibility Education program, the abstinence one requires matching state dollars, equivalent to 75 percent of its grant.

“That’s one question looking ahead: What will states decide to do, having these fiscal budget crises,” she said, “whether they decide, given the lack of evidence, if this is a waste of their taxpayer dollars.”

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Larry

April 5th, 2010
1:43 pm

No big deal; just say NO.

JacketFan

April 5th, 2010
2:15 pm

Why, oh why, do people actually think this kind of sexual education works? I mean, really! Are we actually going to continue to throw money at this beast?

k teacher

April 5th, 2010
2:45 pm

NO kind of sex-ed should be in the schools. Language Arts, mathematics, writing skills, social and scientific studies … those are where that 250 million need to go. We can’t even by books or “consumables” for our students and are having to make up class work or copy non-copyrighted sheets to hold class and wasting so much time gathering “data” as it is. Get us back to the basics people … stop with all the bully prevention, pregnancy prevention, obesity prevention, religious belief prevention, ALL of this stuff that should be the domain of the parent or guardian.

Teaching in FL is worse

April 5th, 2010
3:31 pm

I suspect this was a gimme to the conservatives, even though none of them voted for it.

redweather

April 5th, 2010
4:30 pm

I think there’s value in “teaching” sex-ed in schools. My kids have more reliable information about sex and its related issues than I ever had at their age, and that’s okay by me. As for whether sex-ed works, that depends on how you define “works.” If “works” must be synonymous with no unwanted teen pregnancies, sex-ed falls short. But if “works” is synonmous with better awareness of all the ramifications associated with unwanted pregnancies, then I think it does work.

LCD

April 5th, 2010
5:55 pm

so many people think sex is “dirty”, when in reality it is part of our everyday life. Abstinence education is one of the choices we need to let students know about; but, they should also be aware of safe pracitces that will reduce risk if followed. First and foremost parents should inform their children and answer their kids questions. Remember when we were teens and what if someone would have sat us down and explained to us what a loving monogamus relationship should/could be. Then without judgement answered our questions.

I have seen many marriages end because the couple could not talk to each other about their private matters, but they could talk to their soulmates they found on the net about anything. If they would have just talked to each other maybe it could have worked.

All in all, its the adults job to inquire of questions family members may have, no matter if its sex, drugs, or other matters.

Teaching in FL is worse

April 5th, 2010
7:34 pm

…but it’s not on the CRCT….

ScienceTeacher671

April 5th, 2010
8:50 pm

Maybe we should teach “parenting”, too…in the long term, that might improve schools and society.

Actually, from listening to the kids talk, most of the students know what causes pregnancy, and they know how to prevent it. Also from listening to these conversations, the majority of the teenagers who become pregnant do so intentionally, not accidentally.

If the purpose is to stop teenaged pregnancies, not only the schools, but the families, the communities, and the churches need to get involved. Of those four, the schools are the least influential.

V for Vendetta

April 5th, 2010
10:29 pm

Sheesh. Teens have sex. Deal with it. Teach them how to prevent STDs and pregnancy using contraceptives. Since they’re out there doing it anyway, teach them useful information. Abstinence-only sex ed is like trying to shame them into not doing it–when they’re doing it anyway.

I agree with ScienceTeacher 671: most kids KNOW how to prevent pregnancy and STDs, but we’ve made them so damn afraid of TALKING ABOUT sex that they do not talk to their parents about it, are to embarrassed to purchase birth control, and do not use their brains when the time comes. Er, no pun intended . . . .

It's called Self Control

April 5th, 2010
11:46 pm

Wow, abstinence actually prevents STD’s and teen pregnancies. That is a shocker. It is amazing that grown adults have not figured this one out yet. If sex education is going to be taught in the public school system then abstinence should definitely be a part of the conversation. I am no Obama supporter but I actually agree with this logic. “Teens have sex” is one of the most Captain Obvious comments I have heard in a while. Why not teach these kids to save themselves until marriage. That is hard for a lot of people to support because they were to weak to do that themselves when they were teens. Maybe it is because abstinence was never taught.

Entitlements...it never ends

April 6th, 2010
12:08 am

All we hear about is how they are spending our tax dollars? That is all they do…spend, spend and spend…meanwhile we are deeper and deeper in debt and will never get out. Sadly, our entitled culture also believes that sexual activity is a right and that the consequences of this activity bare no responsibility…why does no one address the problem of what we have created? a culture full of entitled people…they expect everything given to them, don’t want to work, their god is their belly, their music, their clothes, cars and their women that are abused and left for nault once they are tired of them…our culture is 100% messed up…all we can talk about is our entitlements, entitlements, entitlements!!! We are entitled! Yes…we demand our entitlements…thank you Obama for standing up for our entitlements! What do we do in ten years when our entire county is the slave of China? They don’t have any entitlements.

Jeff

April 6th, 2010
12:13 am

Hey JacketFan (2:15 p.m.)… this kind of education DOES WORK!!! If you DON’T have sex, if you ABSTAIN, if you DON’T mess around, there is a ZERO PERCENT chance you will get pregnant, get an STD, or have to deal with any emotional scars or baggage from a sexual relationship (that 13, 14, 15, 16-year-olds are NOT prepared for)…. kids who don’t have sex don’t have babies and don’t get AIDS and don’t have to deal with the myriad of issues regarding sexual relationships.

It worked for my grandparents, my parents, me, my friends, the kids in my youth group, my neighbors, etc. I don’t know what’s wrong with saying “Don’t do this, it’s harmful to you.” We tell kids not to drive drunk, not to try drugs, not to be involved in violence, not to put themselves in unsafe situations… why can’t we tell them to delay sex because the consequences are just too great to risk at such a young age?

Condoms break, birth control pills and devices fail, but abstinence works 100 percent of the time. Let’s not think that 80s teen movies or 2009 videos by Kid Rock are the norm… let’s acknowledge that for a lot of families, responsibility and abstinence ARE the norm.

Alabamastan

April 6th, 2010
12:13 am

Teaching abstinence as “part of the conversation” is not the same thing as abstinence only. You teach a kid all the positive benefits of waiting until you are in a long term mature monogamous relationship. That’s great. Then when the kids find themselves in the heat of the moment with the one they think it The One, as far as they are concerned it IS a Mature long-term relationship. The situation meets the criteria as they see it and they have sex. They have not been taught about how to prevent STD’s or pregnancy so they are totally unprepared. Abstinence only sets them up for failure. IT DOESN’T WORK.

Jeff

April 6th, 2010
12:19 am

Oh, and V for Vendetta (10:29 p.m.)… let’s quit assuming that “Well, kids are gonna do it anyway, what can we do?” NO!!! I will NOT accept that premise. I BELIEVE in our kids and that we can EXPECT BETTER. Set the bar higher in terms of the behavior we expect and, shocker of shockers, they MIGHT actually try to live up to it!!!

Let’s quit acting that we as humans are slave to our hormones, our desires, our urges…. let’s start acting that we’re more advanced life forms than squirrels or lemurs or yard dogs. Let’s tell people to get a grip (no pun intended) on their bodies and their lives and their desires and learn to CONTROL it instead of our sexual urges controlling YOU.

We can and should expect kids to respect the fact that sexual relationships are too complex and too serious for 14,15,16 year old kids to handle. Hey, when you get to college and you’re 21 and on your own, do whatever you want… but if you are just a slave to your desires and screw up with your little girlfriend ONE TIME, you’ve stuck your parents with a responsibility of being grandparents, not to mention changing your life, your girlfriend’s life and your new kid’s life forever.

Oh, I forgot… to liberals, abortion solves all that. Nevermind.

Sheesh. Grow up people, and ACT and DEMAND responsibility and maturity from our teenagers!!!

Jeff

April 6th, 2010
12:24 am

Hey Alabamastan, EVERY KID IN AMERICA KNOWS HOW TO PREVENT STDS!!!!! They know condoms and stuff are supposed to prevent that. But my point is that your theory assumes that kids can’t get a hold of their sexual urges and control them and think clearly beyond the raging hormones and throbbing body parts. You assume “They are going to do it anyway.” MY theory is that if we hammer away that “No matter WHAT, no matter how hot your GF or BF is, no matter if you’re ‘in love’, no matter what…. DON’T. Hold off. Wait. Show patience and self control.”

I think if we put that message out there as an EXPECTATION, not just an OPTION, kids MIGHT live up to it. Why can half of the 15-year-olds out there do it and your kid can’t? Let’s teach self control people… the LACK of self-control we’ve shown in our society since the 1960s has led to out-of-control teen pregnancy, skyrocketing STDs, more AIDS cases, broken hearts, broken homes, broken lives, suicide, drop-outs, poverty and dispair…. choosing ABSTINENCE leads to a clear conscience, a better life, and more satisfying relationships as an adult.

Think about it — which of those scenarios would you want for your kid?

Ole Guy

April 6th, 2010
1:37 am

How in hell did civilization ever get this far without the billions/trillions invested in basic human functioning. Now one ever taught my gen how to eliminate, fornicate, or copulate. Somehow, through teachers, parents, clergy, and, yes, even the locker room, we have learned, throughout the history of mankind, what goes where, how and why.

Now, in the grand style of 21st Century education, we’re going to throw yet more scarce public monies, not to mention valuable time from that 12-year pipeline, into “secrets” which we have somehow managed to acquire throughout the ages.

Sometimes, the best educator is Father Darwin. If we’re stupid enough to fall into the venus flytrap, maybe, just maybe, we deserve all the woe which rains upon us.

Larry

April 6th, 2010
7:31 am

Jeff, you probably know the difference between herpes simplex virus I and II and the unrelated transmission mechanisms, but kids who went through abstinence-only education – at least the ones in Gwinnett – do not. The revolting book Gwinnett used intentionally made no distinction between HSV-1 and HSV-2, and specifically asserted that something like 75% of the population has a sexually transmitted disease.

Also, it didn’t promote abstinence until a responsible age as you do, or abstinence until marriage as many do, it promoted abstinence period. The entire book was a series of horror stories, one of which about a girl who had sex for the first time on her wedding night and was infected with an STD. The message was very clear: sex is evil, always evil under any circumstances and should be avoided your entire life.

You really need to look at the garbage used to teach abstinence-only courses to see how bad it is.

It is abstinence-ONLY, not standard sex education, which is exclusionary.

ScienceTeacher671

April 6th, 2010
8:34 am

Jeff, it takes more than the schools.

When you have a high school senior commenting that her family is surprised, and maybe a little disappointed, because she hasn’t gotten pregnant yet, and everyone else in the family had a baby out of wedlock before graduating – that might be a success for the school, or perhaps for the student, but there is a family and cultural expectation that the student will have a baby which needs to be addressed.

When you have a high school freshman telling her friends that she & her boyfriend have decided that having a baby would be cool, so they do, it’s not a matter of that student not having enough information.

When parents tell you that they took their high school aged daughters to the health department and got them birth control shots because they believed their daughters were or would be sexually active and didn’t want them getting pregnant, I’m not sure that is something the school can control. Same with the 14, 15, and 16 year old girls who spend their weekends at “clubs” where alcohol is served. that is a parental and law enforcement problem, and those who could address it are not doing so.

JacketFan

April 6th, 2010
9:57 am

@Jeff – and to add Larry’s comment, I’m not saying not to teach abstinence, I’m saying that Abstinence-Only sex ed does not work. That’s what we’re talking about here. I also agree with Larry’s point about how many Abstinence-Only courses present sex as something dirty or evil. It’s disturbing.

Melisa Holmes, MD

April 6th, 2010
12:21 pm

Using the Penn study to revive enthusiasm for abstinence-only sex ed is laughable. The Penn study actually showed that the abs-only program resulted in a 15% reduction in kids who had had sex by age 14 from 48% to 33%. So 33% of 14 yr olds in the study WERE having sex by end of the study. That alone tells us there are plenty of kids who need to learn about contraception and using condoms to prevent sexually transmitted infections. We need to keep it real, for our kids, and quit pretending we can really change everyone’s behavior. Teen pregnancy is a complex issue that requires complex and diverse solutions. Abstinence is clearly the best message for teens, but abstinence-ONLY “education” has failed too many of them already.

V for Vendetta

April 6th, 2010
2:11 pm

Jeff,

Not to jump on a bandwagon here, but many of us were referring to the ineffectual nature of “abstinence-ONLY” education. Kids who receive abstinence-only education are far less likely to understand the workings of sexually transmitted diseases or even pregnancy. Example: A girl I knew in college, educated in Gwinnett and deeply religious, finally broke down and did the deed with her fiance before they were married. She called a mutual friend of ours crying that she was going to get pregnant because some of his, um, leavings got in her belly button. This was an HONOR GRADUATE of a major Gwinnett County high school.

Pathetic.

Listen, I know you think with enough fear and anger you can scare kids into doing anything, and that Darwinism and Biology are not real or some kind of pseudoscience, but that’s simply not the case. People WANT to have sex. People LIKE to have sex. And, when practiced responsibly, sex is pretty awesome. (My definition of responsible would be while in a monogamous relationships, just FYI.) I really feel for all of the guilt-ridden conservatives out there who probably feel dirty when they look down in the shower. Get over yourselves.

I would much rather my children learned the facts about sex–and the consequences of making such a major life decision. Sure, I will tell them that not having sex is 100% safe. Then again, that makes perfect sense. But, when the time comes, I would rather they come to me and discuss their decisions instead of getting it on in secret for fear of my retribution. Fear is a powerful tool when used correctly . . . but so are compassion and understanding.

Josh

April 7th, 2010
12:30 pm

Ah I remember my old sex-ed class where we put condoms on bananas…good times, good times

Janine

April 7th, 2010
12:33 pm

I think we should also make the definition of ’sex’ clear. Is oral sex really sex? Many kids don’t think it is, and think that actual intercourse is the only activity that makes them sexually active. http://www.glamour.com/sex-love-life/blogs/smitten/2010/04/what-exactly-counts-as-sex-the.html

mystery poster

April 8th, 2010
11:47 am

@V
As usual, you said what I was thinking much more eloquently than I could.

By the way, let’s ask Bristol Palin how that abstinence only program worked for her.

Current parent, former teacher

April 9th, 2010
8:47 am

Sex education is a complex subject, just like sex itself. Students deserve to know how their bodies work, the proper anatomical names, and how to protect themselves from unplanned pregnancies and—of growing concern in Georgia–STDs. They deserve accurate, age-appropriate, COMPLETE sex education. Parents should talk to their kids often about sex and their values, but schools should teach complete sex education–including contraceptives. The narrow study showing the effectiveness of abstinence-only education was in young students, certainly not high school.

It is NOT acceptable to give our kids incomplete information about how their bodies work and how to take care of them–which is what abstinence-only programs provide. Comprehensive sex education is the only education that is acceptable because it teaches the importance of delaying sexual activity, but also how to protect yourself if you become sexually active— and 50% of our teens will fall into that category before they graduate from high school.

It was irresponsible of Congress to leave the Abstinence-only funding in the health care reform bill. The Centers for Disease Control and Prevention concluded last June that there is not enough evidence to support abstinence-only programs. http://www.thecommunityguide.org/hiv/abstinence_ed.html

However, comprehensive sex education, they concluded, is effective in preventing pregnancies and STDs. http://www.thecommunityguide.org/hiv/riskreduction.html

Shame on Congress.