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Toward a Sexually Healthy America Roadblocks Imposed by the Federal Government’s -Only-Until- Education Program

Advocates for Sexuality Information and Education Council of the United States (SIECUS) Staff members of both Advocates for Youth and the Sexuality Information and Education Council of the United States worked diligently to create and produce this publication. In particular, thanks go to Sue Alford, Debra Hauser, Marcella E. Howell, and James Wagoner of Advocates for Youth and to Dana Czuczka, Mac Edwards, Debra Haffner, Martha Kempner, Tamara Kreinin, and William A. Smith of SIECUS.

Design by Alan Barnett, Inc. Printing by Success Printing, Inc.

Copyright © 2001 Advocates for Youth 1025 Vermont Avenue, N.W. Suite 200 Washington, DC 20005 and Sexuality Information and Education Council of the United States (SIECUS) 130 West 42nd Street Suite 350 New York, NY 10036-7802 FOREWORD

Most agree on what is not healthy for teenagers. Health professionals, educa- tors, policymakers, and share a deep concern about unintended adolescent , sexual , and sexually transmitted diseases, including HIV/AIDS. The question for policymakers is what approach will be most successful in helping young people avoid these negative outcomes and grow to become sexually healthy adults. In recent years, the federal government has allocated hundreds of millions of dollars for programs that have as their “exclusive purpose” teaching teens to remain abstinent until marriage. These programs pose a simplistic solution to a complex challenge and provide young people with one message: avoid all sexual activity. Whether adults agree with young people’s actions or not, they cannot ignore the fact that millions of teenagers in the United States are engaging in sexual behavior. That is why it is time to take a new view of sexuality education, one that helps adoles- cents postpone early sexual activity, protect themselves from disease and pregnancy when they do become sexually active, and ultimately become sexually healthy adults. Comprehensive and age-appropriate, school-based sexuality education should be taught in every grade. Such programs respect the diversity of values and beliefs represented in the community and complement and augment the sexuality educa- tion children receive from their , religious and community groups, and health care professionals. Support for comprehensive sexuality education is at an all time high. A recent poll conducted by SIECUS and Advocates for Youth shows that 93 percent of adults support teaching sexuality education in high school and 84 percent support sexuality education for middle school. The Kaiser Foundation recently released a survey that found virtually all parents, teachers, principals, and students support some form of sexuality education that includes information on and “safer .” A new view of sexuality education that ensures young people access to compre- hensive skills and information is the first step toward a sexually healthy America.

Tamara Kreinin James Wagoner President and CEO President SIECUS Advocates for Youth CONTENTS

A Brief History: Abstinence-Only-Until-Marriage Education Programs ...... 5

Sexuality Education: Definitions and Comparisons ...... 7

States Implement Section 510(b) Abstinence-Only-Until-Marriage Education Programs ...... 9

What Is Wrong with Abstinence-Only-Until-Marriage Education Requirements? ...... 12

Research Supports Comprehensive Sexuality Education ...... 16

Americans Support Comprehensive Sexuality Education ...... 19

Professional Organizations Support Comprehensive Sexuality Education ...... 22

Prominent National Organizations Support Comprehensive Sexuality Education ...... 25

What Advocates Can Do to Support Comprehensive Sexuality Education ...... 28

For More Information ...... 31

References ...... 34 A Brief History of Abstinence-Only-Until-Marriage Education

Abstinence-only-until-mariage education has been taught for over two decades and yet there is still no peer-reviewed research that proves it is effective.

Government funding of abstinence- Finally, an out-of-court settlement in only-until-marriage programs is not 1993 stipulated that AFLA-funded sexu- new. In fact, the federal government ality education programs must: (1) not has poured large sums of money into include religious references, (2) be such programs for the past 20 years. medically accurate, (3) respect the “prin- ciple of self-determination” regarding AFLA:the birthplace of abstinence-only contraceptive referral for teenagers, and programs. The U.S. Office of Population (4) not allow grantees to use church began administering the sanctuaries for their programs or to give Adolescent Family Life Act (AFLA) in presentations in parochial schools 1981. This program was designed to during school hours.3 Within these limi- prevent teen pregnancy by promoting tations, AFLA continues to fund absti- and self-discipline.1 During its nence-only programs today. first year, AFLA received $11 million in Abstinence-only-until-marriage federal funds. In fiscal year 2000, AFLA education as defined in AFLA has been received $19 million. taught for over two decades and yet AFLA’s early programs taught absti- there is still no peer-reviewed research nence as the only option for teens and that proves it is effective in changing often promoted specific religious values. adolescents’ behavior. To the contrary, a As a result, the American Civil Liberties meta-evaluation of AFLA program eval- Union filed suit in 1983 charging that uations found them “barely adequate” to AFLA violated the separation of church “completely inadequate.”4 and state as defined in the U.S. Constitution. In 1985, a U.S. district Congress institutes similar programs judge found AFLA unconstitutional. On through Doolittle amendment.The first appeal in 1988, the U.S. Supreme Court Congressional attempt to censor sexu- reversed that decision and remanded the ality education using an abstinence-only case to a lower court.2 provision came in 1994 during the

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 5 reauthorization of the Elementary federal dollars with three state-raised and Secondary Education Act. dollars and then disperse the funds for Representative John Doolittle (R-CA) educational activities.5 introduced an amendment to limit the Programs that use the funds are content of HIV-prevention and sexuality required to adhere to a strict eight-point education in school-based programs. definition, which, among other things, Fortunately, four federal statutes requires them to teach that “sexual required alterations to the Doolittle activity outside of marriage is likely to amendment. The Department of have harmful psychological and physical Education Organization Act (Section effects.”6 (The complete definition is on 103a), the Elementary and Secondary page 11.) The section 510(b) abstinence- Education Act (Section 14512), Goals only-until-marriage funds are up for 2000 (Section 319 (b), and the General reauthorization in 2001. Education Provisions Act (Section 438) all prohibited the federal government Other federal abstinence legislation. from prescribing state and local school Funding for unproven abstinence-only- curriculum standards. until-marriage education has increased Proponents of abstinence-only nearly 3,000 percent since the federal programs learned from this that entitlement program was created in even though they could not 1996.7 In November 1999, opponents of legally restrict state and comprehensive sexuality education, “This entitlement local education programs , and reproductive rights program,Section that they could restrict began a process that successfully secured 510(b) of Title V of and define the scope of an additional 50 million federal dollars the Social Security Act, state and local health for abstinence-only-until-marriage policy and funding. They programs over the next two years. funneled $50 million applied their new-found Although these funds are not part of per year for five years lesson in 1996. Section 510(b), they are only available into the states.” for programs that conform to the strict Federal entitlement program eight-point definition in 510(b).8 promotes abstinence-only-until- These new funds will be awarded marriage. That year, the federal directly to state and local organizations government attached a provision to by the Maternal and Child Health the popular welfare-reform law estab- Bureau through a competitive grant lishing a federal entitlement program process instead of through state block for abstinence-only-until-marriage grants as is the case for 510(b) funds. education. Many viewed this decision as an This entitlement program, Section attempt by conservative lawmakers to 510(b) of Title V of the Social Security control the funding and prevent money Act, funneled $50 million per year for from supporting media campaigns, five years into the states. Those states youth development, and after-school that choose to accept Section 510(b) programs that they saw as diluting the funds are required to match every four abstinence message.9

6 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program Sexuality Education: Definitions and Comparisons

Comprehensive programs provide opportunities for students to develop communication, decision making,and other personal skills.

This section compares two contrasting funded, teach abstinence from all approaches to teaching young people sexual activity as the only morally about their sexuality: comprehensive correct option for unmarried young sexuality education and abstinence-only- people. They teach that “a mutually until-marriage education. The differences faithful monogamous relationship in point to the real public health threat the context of marriage is the expected imposed by current federal policy. standard of human sexual activity” and that “sexual activity outside of the Comprehensive sexuality education. context of marriage is likely to have These programs emphasize the bene- harmful psychological and physical fits of abstinence while also teaching effects.”10 These programs, also about contraception and disease- referred to as abstinence-only prevention methods. Ideally, they start programs, censor information on in kindergarten and continue through contraception for the prevention of twelfth grade. They provide develop- sexually transmitted diseases and unin- mentally appropriate information on a tended . broad variety of topics related to Abstinence-only-until-marriage sexuality such as sexual development, programs and curricula are, by their , interpersonal nature, very limited in scope. They relationships, affection, intimacy, typically limit discussion to sexually body image, and roles. transmitted diseases, unplanned preg- Comprehensive programs provide nancies, contraceptive failure rates, and opportunities for students to develop the need to refrain from sexual activity communication, decision-making, and outside of marriage. They often fail to other personal skills. mention basic sexual health informa- tion relating to and reproduc- Abstinence-only-until-marriage. These tion and contain no information about programs, many of which are federally- pregnancy and disease-prevention

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 7 methods other than abstinence. programs, often referred to as fear- Consequently, these abstinence-only- based, are designed to control young until-marriage programs deny young people’s sexual behavior by instilling people the information necessary to fear, shame, and guilt. They often make informed, responsible sexual contain biased information about decisions. Some, however, go beyond gender, family structure, sexual orien- withholding information by using fear tation, and abortion. as an educational tool. These

Comprehensive Sexuality Education Abstinence-Only-Until-Marriage Education

teaches that sexuality is a natural,normal,healthy part of life teaches that sexual activity outside of marriage will have harmful social,psychological,and physical consequences teaches that abstinence from is the most effective teaches that abstinence from sexual intercourse method of preventing and STDs,including HIV before marriage is the only acceptable behavior offers students the opportunity to explore and define their individual teaches one set of values as morally correct for all students values as well as the values of their families and communities includes a wide variety of sexuality related topics, often limits topics to abstinence before marriage and such as human development,relationships, to the negative consequences of premarital sexual activity interpersonal skills,sexual health,and society and culture includes accurate,factual information on either omits or contains biased information about topics abortion,,and such as abortion,masturbation,and sexual orientation provides positive messages about sexuality and sexual often relies on fear and shame to control behavior,including the benefits of abstinence young people’s sexual behavior teaches that the proper use of latex , discusses condoms only in terms of failure rates; along with water-based lubricants,can significantly often exaggerates failure rates reduce,but not eliminate,the risk of unintended pregnancy and of infection with STDs,including HIV teaches that consistent use of contraception can discusses contraception only in terms of failure rates; greatly reduce a couple’s risk for unintended pregnancy often exaggerates contraceptive failure rates includes accurate medical information about STDs, often includes inaccurate medical information including HIV;teaches that individuals can avoid STDs and exaggerated statistics regarding STDs, including HIV;suggests that STDs are an inevitable result of premarital sexual behavior teaches that religious values can play an important often promotes specific religious values role in an individual’s decisions about sexual behavior;offers students the opportunity to explore their own and their family’s religious values teaches that a woman faced with an unintended teaches that is the only morally pregnancy has options:carrying the pregnancy to correct and mature decision for a teenager term and raising the baby,carrying the pregnancy faced with an unintended pregnancy to term and placing the baby for adoption, or ending the pregnancy with an abortion

8 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program States Implement Section 510(b) Abstinence-Only-Until-Marriage Education Programs

Educators particularly expressed concern that abstinence- only-until-marriage programs are,in effect,censoring more comprehensive programs.

During the first year* of the Section while 18 made grants to faith-based 510(b) federal abstinence-only-until- institutions and 11 funded crisis marriage program, all 50 states, the pregnancy centers District of Columbia, Guam, the Virgin • twenty-seven states and the District Islands, and Puerto Rico applied for of Columbia included a media grants. Only two states—California campaign in their programs; this was and New Hampshire—eventually a new effort in 20 states and the declined them. District of Columbia States spent this federal money on • twenty-three states funded school nearly 700 abstinence-only-until- classroom programs marriage grants to education agencies, • 36 states and the District of community-based organizations Columbia focused on 10- to 14-year- (including some faith-based organiza- old youth, 25 states focused on 15- to tions), and statewide programs. 17-year-old youth, 16 states focused SIECUS published a report titled on 18- to 19-year-old youth, three Between the Lines that detailed states’ states focused on 20- to 24-year-old use of the federal funds during that adults, and 13 states and the District first year. Findings included: of Columbia included youth 10 years • twenty-two states introduced new old and younger as part of their abstinence-only-until-marriage intended audience.11 programs while 21 continued existing In the second year* of Section abstinence-only-until-marriage 510(b) federal funding for abstinence- programs only-until-marriage programs, 49 • twenty-five states made grants to states, Puerto Rico, and the Virgin education agencies; 22 states made Islands applied for and received funds. grants to school districts California initially applied for funds but • thirty-eight states made grants to again opted not to participate. In the community-based organizations third year*, California was the only

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 9 state that did not apply for federal A study recently published by the funds. Alan Guttmacher Institute in Family The status of all programs under the Planning Perspectives titled “Changing second and third years of funding is not Emphases in Sexuality Education in yet known. Anecdotes from educators U.S. Public Secondary Schools, during the first year of implementation 1988–1999” shows that 23 percent of do, however, provide some insight. secondary school sexuality education Educators particularly expressed concern teachers in 1999 taught abstinence as that abstinence-only-until-marriage the only way of preventing pregnancy programs are, in effect, censoring more and STDs as compared to two percent comprehensive programs. in 1988—an increase of 21 percent.13 What is clear is that since 1996 absti- This clearly indicates that sexuality nence-only-until-marriage programs education is increasingly focused on have expanded in states and communi- abstinence-only and is, therefore, less ties because policymakers appear to likely to provide students with vital perceive the federal funds as a “stamp of information on contraception as both approval” for this type of education.12 birth control and disease prevention.

* First year was 1998 federal fiscal year, second year was 1999 federal fiscal year, et cetera.

Get Informed; Ask Questions The terms used to describe sexuality education often do not provide insight into the scope, goals, and messages of particular programs. It is important that parents, educators, and other interested individuals go beyond these labels to develop a true understanding of local programs. The following questions, based on evaluations of effective programs, can help individuals truly assess sexuality education in their community: • Does the program provide basic, accurate information about the risks of sexual intercourse and methods of avoiding unprotected intercourse, including abstinence and contraception? • Does the program allow students to develop decision-making, communication, and negotiation skills? • Does the program incorporate behavioral goals, teaching methods, and materials that are appropriate to the age, sexual experience, and culture of the students? • Does the program last a sufficient length of time to actually educate young people or is it a one-shot, hour-long presentation? • Does the program include activities that address social pressures associated with sexual behavior? • Does the program use well-trained teachers?

10 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program Section 510(b) of Title V of the Social Security Act,P.L.104–193 For the purposes of this section, 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.

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 11 What Is Wrong with Abstinence-Only-Until-Marriage Education Requirements?

The federal definition of abstinence-only-until-marriage education clearly prohibits programs from discussing pregnancy and disease-prevention methods other than abstinence.

SIECUS, Advocates for Youth, and other tently shown that 50 percent of high organizations who support comprehen- school students have engaged in sexual sive sexuality education also support intercourse.15 teaching young people about absti- Whether adults agree with young nence. They do not, however, support people’s actions or not, they cannot teaching young people only about absti- ignore the fact that millions of nence or using fear and negative teenagers in the United States are messages to motivate behavior. engaging in a range of sexual One of the four primary goals of behavior.16 That is why all young sexuality education—as set forth by people need the information, skills, the National Guidelines Task Force, a and access to services necessary to group of leading health, education, and make and carry out informed, respon- sexuality professionals—is to “help sible decisions about their sexuality. young people exercise responsibility Federally-funded abstinence-only- regarding sexual relationships, until-marriage education programs including abstinence [and] how to deny young people this very informa- resist pressures to become prematurely tion. In fact, they must adhere to a involved in sexual intercourse.” strict eight-point definition, many SIECUS’ Guidelines for Comprehensive aspects of which are in direct opposi- Sexuality Education; K–12, which was tion to the goals and tenets of compre- created by the Task Force, includes 36 hensive sexuality education. While the sexual health topics. Abstinence is one law does not require programs to focus of these topics.14 equally on each aspect of the definition, SIECUS and Advocates for Youth it does state that a federally-funded believe that abstinence is a healthy project “may not be inconsistent with choice for adolescents and that prema- any aspect of the abstinence defini- ture involvement in sexual behavior tion.”17 While some aspects of the law’s poses risks. However, data has consis- definition are not objectionable, others

12 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program run counter to common sense, virgins during their teen years engage in research, and genuine public health some forms of sexual behavior. Nearly realities and responsibilities. The one third of teens who identified them- following section highlights some of selves as virgins in that study had the more problematic points of the engaged in heterosexual masturbation of eight-point definition. (For a complete or by a partner, 10 percent had partici- listing of all eight points, see page 11.) pated in , and one percent had engaged in anal intercourse.22 Federal Requirement B “…teaches Teens are engaging in a variety of that abstinence from sexual activity outside sexual behaviors every day that marriage is the expected standard for all place them at risk for unin- school age children.” tended pregnancy and STDs, including HIV. There is no Although adults may want this as a research to support the “Teens are engaging standard, it is far from accurate in notion that they will stop describing the world of today’s in a variety of sexual sexual behavior simply teenagers. The reality is that sexual behaviors every day because adults ask them. behavior is almost universal among that place them at risk Yet, the federal defini- American adolescents. A majority of for unintended tion of abstinence-only- them date, over 85 percent have had a until-marriage education pregnancy and STDs, or a and have kissed clearly prohibits programs including HIV.” someone romantically, and nearly 80 from discussing pregnancy percent have engaged in deep kissing.18 and disease-prevention The majority of young people move methods other than abstinence. from kissing to more intimate sexual Such education denies teens the behaviors during their teen years. information they need to make Seventy-two percent of teens report informed responsible sexual decisions. “touching above the waist,” 54 percent report “touching below the waist,” 26 Federal Requirement C “…teaches percent report engaging in oral sex, and that abstinence from sexual activity is the 4 percent report engaging in .19 only certain way to avoid out-of-wedlock According to data from the most pregnancy,sexually transmitted diseases, recent Youth Risk Behavior Surveillance and other associated health problems.” System of the Centers for Disease Control and Prevention (CDC), On the surface, it is hard to argue with 50 percent of high school students this statement. The Guidelines state that have had sexual intercourse, a rate “abstinence from sexual intercourse is virtually unchanged since the study the most effective method of preventing began in 1990.20 A similar survey of pregnancies and STDs/HIV.”23 However, college students found that 80 percent this point clearly prevents funded of students 18 to 24 years of age had programs from discussing the effective- engaged in sexual intercourse.21 ness of condoms and contraception in In addition, a recent study found that preventing unintended pregnancy and even those young people who remain disease transmission. In fact, many

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 13 abstinence-only-until-marriage unintended pregnancy. programs discuss methods of contracep- In 1979, fewer than 50 percent of tion only in terms of their failure rate. adolescents used contraception at first After learning that abstinence is the intercourse. In 1988, more than 65 “only certain way” to avoid pregnancy percent used them. In 1990, more than and disease and that condoms and 70 percent used them.26 Unfortunately, contraceptive methods are not reli- abstinence-only-until-marriage educa- able, young people who do tion is likely to reverse these significant “Programs that become sexually active are less strides that youth in the United States teach students that likely to practice prevention have made toward safer sexual behavior condoms or techniques. in the past two decades. contraception do not Some strict absti- nence-only-until- Federal Requirement D“… teaches work will not necessarily marriage programs that a mutually faithful monogamous rela- prevent students from actually discourage the tionship in the context of marriage is the having sexual use of contraception, expected standard of human sexual activity.” especially condoms. intercourse but will Again, while members of Congress or These programs give teens likely prevent them society might wish this as a standard, it exaggerated and outdated from using is clearly not true in American culture. information about effective- protection.” The concept of chastity until marriage ness and tell them that correct is unrealistic in an age when young condom use is difficult. In reality, people are reaching puberty earlier than research has shown that using a ever before, when half of high school condom for protection from HIV is students have engaged in sexual inter- 10,000 times safer than not using a course27, when 80 percent of college condom. But people need to learn how students 18 to 24 years of age have to use condoms correctly if they are engaged in sexual intercourse28, and going to protect themselves.24 The CDC when the median age of first marriage states that “studies of hundreds of is 25.9 for men and 24 for women.29 couples show that consistent condom A brief look at Americans’ behavior use is possible when people have the indicates that this “expected standard” skills and motivations to do so.” The is highly unlikely in American society. CDC pointed out, however, that “people The vast majority of Americans begin who are skeptical about condoms aren’t having sexual relationships in their as likely to use them—but that doesn’t teens, fewer than seven percent of men mean they won’t have sex.”25 and 20 percent of women 18 to 50 Programs that teach students that years old were virgins when they were condoms or contraception do not work married, and only 10 percent of will not necessarily prevent students men and 22 percent of adult women from having sexual intercourse but will report their first sexual intercourse was likely prevent them from using protec- with their .30 It is likely this tion. These students will, therefore, “standard” was never true in America. put themselves at risk for STDs and A third of all Pilgrim brides were preg-

14 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program nant when they were married.31 Federal Requirement E“…teaches Federally-funded abstinence-only- that sexual activity outside of marriage is until-marriage programs are required to likely to have harmful psychological and teach young people that all unmarried physical effects.” individuals (both adults and youth) must remain celibate. While this is a value There is no sound public health data to held by many people in America, it is support this statement. It is true that clearly not universally accepted as truth. unprotected sexual activity can lead to Today, there are almost 80 million unplanned pregnancies, STDs, and American adults who are classified as HIV. It is also true that intimate rela- single because they have either delayed tionships can be harmful for some marriage, have decided to remain single, people. However, the reality is that the have divorced, are widowed, or have majority of people have had sexual entered into or relationships prior to marriage with no partnerships.32 It is unreasonable to negative repercussions. expect these adults to adhere to this “standard” and it is inaccurate and Federal Requirement F“…teaches misleading to tell students that adults that bearing children out-of-wedlock is are adhering to it. likely to have harmful consequences This part of the definition also seems for the child,the child’s parents, to assume that all people have an equal and society.” chance or desire to enter into a “mutu- In order to comply with “Abstinence-only- ally faithful monogamous relationship this part of the definition, until-marriage in the context of marriage.” Many abstinence-only-until- people choose not to marry. Others— marriage programs must programs must present like gays and —are legally present one family struc- one family structure barred from marrying. Students ture as morally correct and as morally correct and enrolled in abstinence-only-until- beneficial to society. In beneficial to society.” marriage programs are now essentially reality, any American class- learning that the sexual relationships of room is likely to have children these people—whether same-sex or of never-married or divorced opposite-sex—are in conflict with parents as well as children of gay, society’s standards. lesbian, and bisexual parents who can Finally, this part of the definition never legally marry. Telling these students may prove particularly harmful to that their families are the cause of societal young people who are or have been problems will likely alienate them and sexually abused. It requires telling could cause negative feelings about them- these students that the behaviors in selves and their families. which they have involuntarily partici- In sum, much of this eight-point pated go against society’s “expected definition written by Congressional standard.” Such statements are likely to staff under the influence of special produce additional feelings of guilt and interest groups has no basis in public shame in these abused individuals. health research.

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 15 Research Supports Comprehensive Sexuality Education

Numerous studies and evaluations published in peer-reviewed literature suggest that comprehensive sexuality education is an effective strategy to help young people delay their involvement in sexual intercourse.

Abstinence-only-until-marriage educa- Proponents of abstinence-only- tion relies on the notion that young until-marriage programs often conduct people will “just say no” if they are told their own in-house evaluations and cite to do so. Proponents of this type of them as proof that their programs are education conclude that this is the only effective. However, outside experts way to encourage young people to delay have found them inadequate, method- sexual activity until marriage, and ologically unsound, or inconclusive consequently, to avoid becoming based on methodological limitations.34 involved in a pregnancy, infected with The CDC’s Research to Classroom an STD, or even emotionally hurt by a Project identifies curricula that have failed . shown evidence of reducing sexual risk There is no proof that these claims behaviors.35 A recent paper written by are true. There are no published the White House Office of National studies in the professional literature AIDS Policy points out that “none of the that show that abstinence-only curricula on the current list of programs programs will result in young people uses an ‘abstinence-only’ approach.” The delaying the initiation of sexual inter- paper goes on to say that “…it is a matter course. of grave concern that there is such a To date, there are six published large incentive to adopt unproven absti- studies of abstinence-only programs. nence-only approaches.”36 None have found consistent and signifi- cant program effects on delaying the Comprehensive sexuality education is onset of intercourse. In fact, at least one effective. On the other hand, numerous has provided strong evidence that the studies and evaluations published in program did not delay the onset of peer-reviewed literature suggest that intercourse.33 comprehensive sexuality education is

16 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program an effective strategy to help young of intercourse, increasing the people delay their involvement in frequency of intercourse, or increasing sexual intercourse. the number of sexual partners.”39 A review commissioned by the The conclusion reached by these Joint United Nations Programme on studies is echoed in a review by the HIV/AIDS (UNAIDS) looked at 22 World Health Organization of evalua- HIV-prevention and comprehensive tions of 35 sexuality education sexuality education programs and programs. The review concluded that found that they delayed the onset of the programs that are most effective in sexual activity, reduced the number of reducing sexual risk-taking behaviors sexual partners among sexually active among young people are programs that youth, and reduced the rates of unin- provide information on abstinence, tended pregnancy and STDs.37 contraception, and STD prevention.40 A report titled No Easy Answers, According to Dr. Kirby, effective written by Dr. Douglas Kirby, one of the programs: leading researchers in the field of sexu- • focus narrowly on reducing one ality education, also considered evalua- or more sexual behaviors that tions of HIV-prevention and sexuality lead to unintended preg- “Programs that education programs—both abstinence- nancy or STDs/HIV only-until-marriage and comprehen- infection cover both abstinence sive. It concluded that HIV-prevention • are based on theoretical and contraception and sexuality education programs that approaches that have delay the onset of sexual cover both abstinence and contracep- been successful in intercourse,reduce the tion can delay the onset of sexual inter- influencing other frequency of sexual course, reduce the frequency of sexual health-related risky intercourse,and reduce intercourse, and reduce the number of behaviors the number of sexual partners. It also found that • give a clear message by many of these programs significantly continually reinforcing a sexual partners.” increased the use of condoms and other clear stance on particular forms of contraception.38 behaviors Critics of comprehensive sexuality • provide basic, accurate information education often suggest that giving about the risks of unprotected inter- youth information about sexuality and course and methods of avoiding contraception will encourage them to unprotected intercourse engage in sexual activity earlier and • include activities that address social more often. However, research has pressures associated with sexual consistently found that “sexuality and behavior HIV education programs that include • provide modeling and the practice of the discussion of condoms and contra- communication, negotiation, and ception do not increase sexual inter- refusal skills course, either by hastening the onset

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 17 • incorporate behavioral goals, teaching There is no credible evidence that a methods, and material that are “just say no” attitude toward teen appropriate to the age, sexual experi- sexual activity will work. On the other ence, and culture of the students hand, study after study clearly support • last a sufficient length of time to an approach to sexuality education that complete important activities includes teaching young people about adequately abstinence, contraception, and disease- • select teachers or peers who believe in prevention methods. the program they are implementing and then provide training for those individuals41

Evaluations Support Comprehensive Sexuality Education Reviews of published evaluations of sexuality education, HIV-prevention, and adolescent pregnancy prevention programs have consistently found that such programs: • do not encourage teens to start having sexual intercourse • do not increase the frequency with which teens have intercourse • do not increase the number of a person’s sexual partners Instead many of these programs: • delay the onset of intercourse • reduce the frequency of intercourse • reduce the number of sexual partners • increase condom or contraceptive use

18 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program Americans Support Comprehensive Sexuality Education

Data from recent national surveys indi- The survey also found that cate that there is overwhelming Americans overwhelmingly rejected support for comprehensive sexuality current myths about sexuality educa- education from parents, teachers, prin- tion. Specifically, it found that only 12 cipals, and students. percent believed that “giving young people information about sex and sexu- SIECUS/Advocates for Youth survey. In 1999, ality only encouraged them to have SIECUS and Advocates for Youth sexual relations” and that 67 percent retained Hickman-Brown Research, rejected the idea that giving young a nationally known public opinion people information about contracep- research organization, to poll a national tion in schools sent a mixed message sample of 1,050 adults nationwide on that encouraged them to have inter- their attitudes about sexuality educa- course.43 tion in the United States. In addition, the study found that a Two major findings stood out. large majority of Americans also The vast majority of Americans (93 understood that sexuality education percent) supported comprehensive was about more than preventing sexuality education and believed young unwanted pregnancies and STDs. It people “should be given information to found that 86 percent believed that protect themselves from unplanned “young people need information about pregnancies and STDs,” and Americans sexuality so they will have healthy and believed abstinence should be a topic happy intimate relationships as adults,” in sexuality education even though that 79 percent believed that “whether they rejected abstinence-only-until- or not young people are sexually active, marriage education that denied young they should be given information about people information about contracep- sex and sexuality so they will have an tion and condoms.42 adequate understanding of it,” and that

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 19 63 percent, including 44 percent of they should wait to engage in sexual those who identified themselves as behavior but that they should practice conservative, believed that sexual “safer sex” and use birth control if they exploration among young people was a do not. In contrast, 33 percent of natural part of growing up and that the teachers and 34 percent of principals best approach was to provide informa- described their school’s main message tion and services to help young people as abstinence-only-until-marriage.46 act responsibly.44 When asked what they wanted their children to learn, parents named these The Kaiser Family Foundation survey. Titled topics and skills: resisting pressure to in America: A View from have sexual intercourse (94 percent); Inside the Nation’s Classrooms, the knowing how to discuss birth control Kaiser Family Foundation released a with a partner (88 percent); knowing how survey in September 2000 that looked to use condoms (85 percent); knowing at current school-based sexuality how to use other forms of birth control education in the United States from (84 percent); having information about the viewpoint of 1,501 pairs of abortion (79 percent); and learning about students and their parents, 1,001 sexual orientation (76 percent).47 sexuality education teachers, and 313 Nearly three-quarters of parents principals.45 (74 percent) also said that they wanted The study found that 61 percent of schools to present issues in a teachers and 58 percent of principals “balanced” way that represented reported their school takes a compre- different views in society. A third of hensive approach to sexuality education parents (33 percent) said they wanted described as teaching young people that their children to learn abstinence as

People Want Sexuality Education to Cover Many Topics The SIECUS/Advocates for Youth study found that adults wanted middle school and high school students to learn about a broad range of topics in sexuality education programs. 7–8 Grades 9–10 Grades 11–12 Grades Puberty 82% 94% 96% Abstinence 79% 91% 95% HIV/AIDS 76% 92% 95% STDs 74% 91% 96% / 63% 86% 92% Contraception/Birth Control 59% 84% 91% Condoms 58% 82% 90% Sexual Orientation 56% 76% 85% Abortion 40% 68% 79%

20 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program the only option until marriage. of being sexually active (46 percent); However, many of the same parents knowing how to talk to or with a also wanted their children to learn partner about birth control and STDs preventative skills such as how to use (46 percent); and knowing how to use condoms and other birth control or where to obtain birth control methods.48 (40 percent).49 When asked what they wanted to Both surveys dramatically confirm learn in sexuality education classes, that Americans want sexuality educa- students named the following: knowing tion for young people that includes what to do in case of or sexual information on both abstinence and assault (55 percent); knowing how to contraception to prevent STDs and deal with the emotional consequences unintended pregnancy.

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 21 Professional Organizations Support Comprehensive Sexuality Education

Reputable professional health organiza- birth control, and other issues tions and government-supported health aimed at prevention of pregnancy and educational institutions endorse and sexual transmission of diseases; comprehensive sexuality education. d. utilize classroom teachers and other professionals who have shown an The American Medical Association’s Council aptitude for working with young on Scientific Affairs “urges schools to people and who have received implement comprehensive, develop- special training that includes mentally appropriate sexuality educa- addressing the needs of gay, lesbian, tion programs that: and bisexual youth; a. are based on rigorous, peer reviewed e. include ample involvement of science; parents, health professionals, and b. show promise for delaying the onset other concerned members of the of sexual activity and a reduction in community in the development of sexual behavior that puts adolecents the program; and at risk for contracting human f. are part of an overall health educa- immunodeficiency virus (HIV) and tion program.”51 other sexually transmitted diseases and for becoming pregnant; The American Academy of Pediatrics c. include an integrated strategy for recommends that “…Condom avail- making condoms available to ability programs should be developed students and for providing both through a collaborative community factual information and skill- process and accompanied by compre- building related to reproductive hensive, sequential sexuality educa- biology, , sexual tion, which is ideally part of a K–12 responsibility, contraceptives health education program….”52 including condoms, alternatives in

22 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program The American College of Obstetrics and The National Governors’Association and Its Gynecology’s Committee on Adolescent Center for Best Practices states that Health Care—Committee Opinion 1995 “programs that combine factual infor- states that “although abstinence should mation about sex and be stressed as the certain way to prevent with assertiveness training and activi- STDs and pregnancy, sexually active ties that help teens improve decision teens, male and , must nonethe- making and communication skills less be taught to use condoms properly, appear to be more effective than tradi- effectively, and consistently.”53 tional sex education programs. The most effective programs of this type The Society for Adolescent Medicine include the following components: recommends “that all states should stressing the importance of delaying mandate the teaching of health and sex sexual activity, providing contraceptive education from kindergarten through information, addressing social and twelfth grade as part of the overall media influences, and building curriculum in schools. Content of communication and negotiation education should include discussion of skills.”59 sexuality, reproduction, , deci- sion making, delaying first intercourse, White House,Office of National abstinence, methods of contraception, AIDS Policy states that abortion, parenting, and sexually “schools and other “Legislative barriers transmitted disease with emphasis on prevention service that discourage HIV and AIDS, teaching risk assess- providers should adhere effective programs ment and risk reduction with the use to the best practices as aimed at youth must of explicit language and illustrations identified by prevention applicable to the student population.”54 science, and those be eliminated.” receiving new funding The National Institutes of Health says that should be held strictly “legislative barriers that discourage accountable for such adher- effective programs aimed at youth ence. A relatively large amount of must be eliminated. Although sexual federal funding is currently dedicated abstinence is a desirable objective, to untested, abstinence-only programs. programs must include instruction in Priority for future funding increases safer sex behavior, including condom should be given to programs with use. The effectiveness of these demonstrated effectiveness in programs is supported by strong scien- decreasing behavioral risk of infection tific evidence. However, they are with HIV and other STDs, and of unin- discouraged by welfare reform provi- tended pregnancy.”60 sions, which support only programs using abstinence as the goal.”55

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 23 The Institute of Medicine appear to be effective in delaying the onset of sexual intercourse and encour- Committee on HIV Prevention Strategies in aging contraceptive use once sexual the United States says: “Therefore the activity has begun, especially among Committee recommends that: younger adolescents.”57 Congress, as well as other federal, state, and local policymakers, eliminate the Committee on Unintended Pregnancy requirements that public funds be used says that “several studies have shown for abstinence-only education, and that that sexual activity in young adoles- states and local school districts cents can be postponed and that use of implement and continue to support contraception can be increased once age-appropriate comprehensive sex sexual activity has begun by compre- education and condom availability….”56 hensive education that includes several messages simultaneously: the value of Committee on Prevention and Control of abstinence, in young ages especially; Sexually Transmitted Diseases states that the importance of good communica- “sexuality education programs that tion between the and with provide information on both absti- parents regarding a range of interper- nence and contraceptive use neither sonal topics including sexual behavior encourage the onset of sexual inter- and contraception; skills for resisting course nor increase the frequency of peer pressure to be sexually active; and intercourse among adolescents. In fact, the proper use of contraception once programs that provide both messages sexual activity has begun.”58

More Support for Comprehensive Sexuality Education A recent Institute of Medicine study titled No Time to Lose: Getting More from HIV Prevention investigated abstinence-only programs’ ability to provide youth with the knowledge they need to protect themselves from HIV and other STDs. Researchers noted that comprehensive sexuality education had been proven effective in reducing high-risk behavior while abstinence-only programs had not. They recommended that all federal, state, and local policymakers “eliminate requirements that public funds be used for abstinence-only education” and that local school districts “implement and continue to support age-appropriate comprehensive sex education and condom availability programs in schools.”61

24 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program Prominent National Organizations Support Comprehensive Sexuality Education

In 1990, six organizations joined American Association of School together to establish the National Administrators Coalition to Support Sexuality American Association of Sex Education (NCSSE). It has grown Educators, Counselors, and significantly during the past decade to Therapists include 123 national organizations American Civil Liberties Union, representing social workers, religious Reproductive Freedom Project officials, educators, advocates, physi- American College of Nurses and cians, health care professionals, child Midwives development specialists, researchers, American College of Obstetricians libraries, and academicians.62 Coalition & Gynecologists members include: American Counseling Association Advocates for Youth American Jewish Congress AIDS Action Council American Library Association The Alan Guttmacher Institute American Medical Association American Academy of Child and Adolescent Psychiatry American Medical Students Association American Academy of Pediatrics American Medical Women’s American Association for Health Association Education American Nurses Association American Association for Marriage and Family Therapy American Orthopsychiatric Association American Association of Family American Psychiatric Association & Consumer Sciences American Psychological Association American Association of Mental American Public Health Association Retardation

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 25 American School Health Association Gay and Lesbian Medical Association American Social Health Association Girls Incorporated Association of Reproductive Health Hetrick-Martin Institute Professionals Human Rights Campaign Association of Sexuality Education and The Institute for Advanced Study of Training Alumni Association Association of State & Territorial Jewish Women International Directors of Public Health Education The Kinsey Institute for Research in Association of State & Territorial Sex, Gender, and Reproduction Health Officials The Latina Roundtable on Health ASTRAEA National Lesbian Action & Reproductive Rights Foundation Midwest School Social Work Council AVSC International ’ Voices Balm in Gilead National Abortion Federation Blacks Educating Blacks about Sexual Health Issues National Abortion & Reproductive Rights Action League Boston Women’s Health Book Collective National Alliance of State and Territorial AIDS Directors Catholics for a Free Choice National Asian Women’s Health Center for Law and Social Policy Organization Center for Policy Alternatives National Association for Equal Center for Reproductive Health Policy Opportunity in Higher Education Research National Association of Counties Center for Reproductive Law National Association of County and and Policy City Health Officials Center for Sexuality and Religion National Association of People Center for Women Policy Studies with AIDS Child Welfare League of America National Association of School Children’s Defense Fund Psychologists Choice USA National Black Women’s Health Project Coalition on Sexuality and Disability, National Center for Health Education Inc. National Coalition of Advocates ETR Associates for Students Education Development Center, Inc. National Coalition of Abortion Providers. Equal Partners in Faith National Coalition of STD Directors Federation of Behavioral Psychological and Cognitive Sciences National Committee for Public Education and Religious Liberty Feminist Majority Foundation

26 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program National Council of La Raza Network for Family Life Education National Council of Negro Women Office of Family Ministries & Human National Council of State Consultants Sexuality, National Council for School Social Work Services of Churches National Council on Family Relations Parents, Families and Friends of Lesbians and Gays National Education Association Health Information Network People for the American Way National Family Planning and Planned Parenthood Federation Reproductive Health Association of America National Federation of Abortion Population Communications Providers International National Gay and Lesbian Task Force Presbyterians Affirming Reproductive Options National Information Center for Children & Youth with Disabilities Religious Coalition for Reproductive Choice National Latina Health Organization Sexuality Information and Education National Latina/o Lesbian, Gay, Council of the United States Bisexual & Organization (LLEGO) Society for Adolescent Medicine National League for Nursing Society for Developmental and Behavioral Pediatrics National Lesbian and Gay Health Association Society for Public Health Education National Medical Association Society for the Scientific Study of Sexuality National Mental Health Association Unitarian Universalist Association National Minority AIDS Council United Church Board for Homeland National Native American AIDS Ministries Prevention Center United States Conference of Mayors National Network for Youth United States Student Association National Organization on Adolescent Pregnancy, Parenting and Prevention University of Pennsylvania, Graduate School of Education National Resource Center for Youth Services YAI/National Institute for People with Disabilities National School Boards Association The Young Women’s Project National Urban League YWCA of the U.S.A. National Women’s Health Network Zero Population Growth, Inc. National Women’s Law Center

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 27 What Advocates Can Do to Support Comprehensive Sexuality Education

Advocates for comprehensive sexuality • Conduct a local poll or organize a education can make a difference by focus group discussion to deter- speaking up. Where there is silence, mine local opinion about comprehen- elected officials tend to hear agreement sive sexuality education. or acquiescence. The following actions will help support comprehensive sexu- Get Support ality education and counter abstinence- • Contact local family planning and only-until-marriage education. advocacy organizations to deter- mine what groups or coalitions are Get Informed already working on this issue and • Find out what sexuality education how you might participate. looks like in your schools. Ask your • Create a community group that children, teachers, principals, superin- supports comprehensive sexuality tendents, and school board members education in schools. Have parents, about the sexuality education community members, and students programs that are taught in your sign a statement of support or a schools. petition. • Contact the maternal and child • Encourage your local - health program within your state’s Teacher Association/Organization health department to determine local (PTA/O) to participate in this issue. organizations that have received Ask them to endorse your efforts. federal and state funding for absti- Consider making a presentation on nence-only-until-marriage programs. the lack of evidence stating that absti- (Check the “blue pages” or govern- nence-only-until-marriage education ment pages of your phone book for programs are effective at their next contact information.) meeting and bringing young people to provide testimonials.

28 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program • Include senior citizens in your often have the most powerful influ- efforts by contacting senior centers ence over sexuality education in their and clubs. Individuals may be willing community. Ask how you and your to speak about the lack of compre- friends can join the committee. hensive sexuality education available during their school years and to advo- Get Your Message Out cate for today’s children and youth. • Use the tried-and-true strategy • Involve faith-based organizations. of writing your elected representa- Many denominations have affirmed tives. Draft a letter about the impor- the need for sexuality education, both tance of sexuality education to use as a within their own faith community template. Change it slightly as you and in the public schools. Ask reli- write to various individuals such as gious leaders who support compre- your governor, state health commis- hensive sexuality education to discuss sioner, state education commissioner, the issue with their congregation. state representatives and senators, federal representatives and senators, Get Involved city council members, mayor, munic- • Locate the group or task force in ipal officials, school board members, charge of overseeing or moni- and school superintendents. (You can toring the abstinence-only-until- usually find contact information for marriage program in your state or these individuals in the “blue pages” or territory by calling the maternal and government section of your phone child health program in your state’s directory.) health department. Ask how you can • Get the local media participate as a citizen member of involved in this issue. this oversight body. [You may find Find out which reporter there is no such task force. If so, write writes about school- “Use the tried- your governor and ask him or her to related issues. Call him and-true strategy create such an entity to monitor or her and ask to speak possible conflicts of interest (such as about your concerns. of writing your elected the separation of church and state) by Inform the reporter representatives.” abstinence-only-until-marriage about the results of education providers.] your local poll or petition • Locate the health curricula review to support sexuality educa- committee in your school district, tion. Invite the reporter to a county, city, or state. These commit- sexuality education class, a tees, usually made up of parents, roundtable discussion about the teachers, professionals, and students, topic with youth, educators, and are responsible for evaluating sexu- parents, a student rally, or commu- ality education curricula before they nity group meeting. are adopted by schools. As such, they

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 29 • Write an article for your local remember that the old adage “all poli- paper’s opinion/editorial section. tics is local” is particularly relevant on Determine which local organizations topics related to education. It is true have newsletters or other periodicals that federal and state programs and that might also publish this article. entitlements affect local school • Use the Internet to get your districts. Still, districts have a great message across. Create a Web site or deal of autonomy over what they can bulletin board dedicated to compre- teach. Grassroots efforts, like those hensive sexuality education in your discussed here, can help turn the tide area or contribute opinions to against abstinence-only-until-marriage existing Web sites or bulletin boards. education and the dangers it presents to the health and well being of As you work to promote compre- America’s children and communities. hensive sexuality education programs,

30 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program FOR MORE INFORMATION

These organizations can provide more American School Health Association (ASHA) information to advocates of compre- Advocating high-quality school health hensive sexuality education. When instruction, health services, and a visiting these organization’s Web sites, healthful school environment. advocates should follow the links to 7263 State Road 43, P.O. Box 708 other organization’s Web sites for more Kent, OH 44240 information. Phone: 330/678-1601 Fax: 330/678-4526 Advocates for Youth E-mail: [email protected] Dedicated to promoting policies which help Web site: www.ashaweb.org young people make informed and respon- sible decisions about their sexual health. Center for Law and Social Policy (CLASP) 1025 Vermont Avenue, N.W., Suite 200 Seeking to improve the economic security Washington, DC 20005 of low-income families with children and Phone: 202/347-5700 securing access for low-income persons to E-mail: [email protected] the nation’s civil justice system. Web site: www.advocatesforyouth.org 1616 P Street, N.W., Suite 150 Washington, DC 20036 The Alan Guttmacher Institute (AGI) Phone: 202/328-5140 Providing research data and policy Fax: 202/328-5195 analysis on reproductive health issues, E-mail: [email protected] both domestic and international. Web site: www.clasp.org 120 Wall Street 21st Floor Centers for Disease Control New York, NY 10005 and Prevention (CDC) Phone: 212/248-1111 Promoting health and quality of life by Fax: 212/248-1951 preventing and controlling disease, injury, E-mail: [email protected] and disability. Web site: www.agi-usa.org 1600 Clifton Road Atlanta, GA 30333 Phone: 800/311-3435 Fax: 770/488-3110 Web site: www.cdc.gov

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 31 ETR Associates Maternal and Child Health Bureau (MCHB) Dedicated to enhancing the well-being of Dedicated to promoting and improving the individuals, families, and communities by health of the nation’s mothers and children. providing leadership, educational 5600 Fishers Lane resources, training, and research in health Room 18-05 promotion with an emphasis on sexuality Rockville, MD 20857 and health education. Phone: 888/434-4MCH P.O. Box 1830 Fax: 703/821-2098 Santa Cruz, CA 95061-1830 Web site: www.nmchc.org Phone: 800/321-4407 Fax: 800/435-8433 National Abortion and Reproductive Action E-mail: [email protected] League (NARAL) Foundation Web site: www.etr.org Working to protect access to safe, legal abortion and to expand the full range of Institute of Medicine reproductive rights. Advancing and disseminating scientific 1156 15th Street, N.W. knowledge to prove human health. Suite 700 2101 Constitution Avenue, N.W. Washington, DC 20005 Washington, DC 20418 Phone: 202/973-3000 Phone: 202/334-3300 Fax: 202/973-3070 Fax: 202/334-3851 E-mail: [email protected] E-mail: [email protected] Web site: www.naral.org Web site: www.iom.edu National Campaign Kaiser Family Foundation to Prevent Teen Pregnancy An independent philanthropic organiza- Working to improve the life prospects of tion focusing on the major health issues this generation and the next by influ- facing the nation. encing cultural values and building a more 2400 Sand Hill Road effective grassroots movement. Menlo Park, CA 94025 1776 Massachusetts Avenue, N.W. Phone: 650/854-9400 Suite 200 Fax: 650/854-4800 Washington, DC 20036 E-mail: [email protected] Phone: 202/478-8500 Web site: www.kff.org Fax: 202/478-8588 E-mail: teenpregnancy@ teenpregnancy.org Web site: www.teenpregnancy.org

32 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program National Family Planning Reproductive Planned Parenthood Federation Health Association (NFPRHA) of America (PPFA) Dedicated to assuring access to voluntary, Dedicated to the principles that every indi- comprehensive, and culturally sensitive vidual has a fundamental right to decide family planning and reproductive health when or whether to have a child and that care services and to support reproductive every child should be wanted and loved. freedom for all. 810 Seventh Avenue 1627 K Street, N.W. New York, NY 10019 12th Floor Phone: 212/541-7800; 800/230-PLAN Washington, DC 20006 Fax: 212/245-1845 Phone: 202/293-3114 E-mail: [email protected] Fax: 202/293-1990 Web site: www.plannedparenthood.org E-mail: [email protected] Web site: www.nfprha.org Sexuality Information and Education Council of the United States (SIECUS) National Organization on Adolescent Promoting comprehensive education about Pregnancy,Parenting,and Prevention sexuality and advocating the right of indi- (NOAPPP) viduals to make responsible sexual choices. Dedicated to providing general leadership, 130 West 42nd Street education, training, information, advocacy, Suite 350 resources and support to individuals and New York, NY 10036-7802 organizations in the field of adolescent Phone: 212/819-9770 pregnancy, parenting, and prevention. Fax: 212/819-9776 2401 Pennsylvania Avenue, N.W. E-mail: [email protected] Suite 350 Web site: www.siecus.org Washington, DC 20037 Phone: 202/293-8370 U.S.Department of Health Fax: 202/293-8805 and Human Services E-mail: [email protected] Dedicated to promoting the health of all Web site: www.noappp.org Americans, this federal agency consists of 12 operating divisions responsible for public health, biomedical research, Medicare and Medicaid, welfare, social services, and more. 200 Independence Avenue, S.W. Washington, DC 20201 Phone: 202/619-0257; 877/696-6775 (toll free) Fax: 202/205-3558 E-mail: [email protected] Web site: www.hhs.gov

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 33 REFERENCES

1. R. Saul, “Whatever Happened to the 13. J. E. Darroch, et al., “Changing Emphases on Adolescent Family Life Act?,” Guttmacher Report Sexuality Education in U.S. Public Secondary on Public Policy, vol. 1, no. 2, April 1998. Schools, 1988-1999,” Family Planning 2. Ibid. Perspectives, vol. 32, no. 5, pp. 204–11, 265. 3. D. Daley, “Exclusive Purpose: Abstinence-Only 14. National Guidelines Task Force, Guidelines for Proponents Create Entitlement in Welfare Comprehensive Sexuality Education: Reform,” SIECUS Report, April/May 1997. Kindergarten–12th Grade (New York: SIECUS, 1991, 1996). 4. C. Bartels, et al., Adolescent Abstinence Promotion Programs: An Evaluation of Evaluations. 15. “Youth Risk Behavior Surveillance System— (Paper presented at the Annual Meeting of the United States, 1999,” Morbidity and Mortality American Public Health Association, Nov. 18, Weekly Report, June 9, 2000, vol. 49, no. SS-5. 1996, New York, NY.) 16. Ibid. 5. Daley, “Exclusive Purpose” SIECUS Report, 17. Section 510, Title V of the Social Security Act April/May 1997. (Public Law 104–193). 6. Section 510, Title V of the Social Security Act 18. R. Coles and F. Stokes, Sex and the American (Public Law 104–193). Teenager (New York: Harper and Row, 1985); 7. C. Dailard, “Fueled by Campaign Promises, Drive Roper Starch Worldwide, Teens Talk About Sex: Intensifies to Boost Abstinence-Only Education in the 90s (New York: Funds,” The Guttmacher Report on Public Policy,” Sexuality Information and Education Council of vol. 3, no. 2, April 2000. the United States, 1994). 8. W. Smith, “Public Policy Update: More Federal 19. Ibid. Funds Targeted for Abstinence-Only-Until-Marriage 20. “Youth Risk Behavior Surveillance System— Programs,” SIECUS Report, June/July 2000. United States, 1999,” Morbidity and Mortality 9. Ibid. Weekly Report, June 9, 2000, vol. 49, no. SS-5. 10. Section 510, Title V of the Social Security Act 21. “Youth Risk Behavior Surveillance System— (Public Law 104–193). National College Health Risk Behavior Survey, 1995,” Morbidity and Mortality Weekly Report, 11. D. Daley and V. C. Wong, Between the Lines: Nov. 14, 1997, vol. 46, no. SS-6. States’ Implementation of the Federal Government’s Section 510(b) Abstinence Education Program in 22. M. A. Schuster, R. M. Bell, D. E. Kanouse, Fiscal Year 1998. (New York: SIECUS, 1999). “The Sexual Practices of Adolescent Virgins: Genital Sexual Activities of High School Students 12. M. Kempner, “Sexuality Education Is Who Have Never Had Vaginal Intercourse,” Debated As Restrictive Programs Gain American Journal of Public Health, 1996, vol. 86, Popularity,” SIECUS Report, vol. 28, no. 6, pp. 1570–76. August/September 2000, p. 3. 23. National Guidelines Task Force, Guidelines for Comprehensive Sexuality Education:

34 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program Kindergarten–12th Grade (New York: SIECUS, (Berkeley, CA: University of California, School of 1991, 1996). Social Welfare, Family Welfare Research Group, 24. R. F. Carey, et al., “Effectiveness of Latex 1995); D. Kirby, No Easy Answers. Condoms As a Barrier to Human 35. Office of National AIDS Policy, The White Immunodeficiency Virus-sized Particles under House, Youth and HIV/AIDS 2000: A New the Conditions of Simulated Use,” Sexually American Agenda (Washington, DC: Government Transmitted Diseases, vol. 19, no. 4, p. 230. Printing Office, 2000), p. 14. (Individuals can 25. Centers for Disease Control and Prevention download the report as a PDF file at (CDC), “Questions and Answers about Male http://www.white Latex Condoms to Prevent Sexual Transmission house.gov/ONAP/youth_report1.pdf) of HIV,” CDC Update (Centers for Disease Control 36. Office of National AIDS Policy, The White and Prevention: Atlanta, GA: April 1997). House, Youth and HIV/AIDS 2000, p. 14. 26. D. Haffner, editor, Facing Facts: Sexual Health 37. Joint United Nations Programme on for America’s Adolescents (New York: Sexuality HIV/AIDS, “Sexual Health Education Does Lead Information and Education Council of the to Safer Sexual Behaviour,” press release, United States, 1994). Oct. 22, 1997. 27. “Youth Risk Behavior Surveillance System— 38. D. Kirby, No Easy Answers: Research Findings United States, 1999,” Morbidity and Mortality on Programs to Reduce Teen Pregnancy Weekly Report, June 9, 2000, vol. 49, no. SS-5. (Washington, DC: National Campaign to Prevent 28. The Alan Guttmacher Institute, Sex and Teen Pregnancy, 1997), p. 27. America’s Teenagers (New York: The Alan 39. D. Kirby, No Easy Answers, p. 31. Guttmacher Institute, 1994). 40. A. Grunseit and S. Kippax, Effects of Sex 29. U.S. Bureau of the Census, Statistical Education on Young People’s Sexual Behavior Abstract of the US 1998 (118th edition), (Geneva: World Health Organization, 1993). Washington, DC, 1998. p. 112 41. D. Kirby, “What Does the Research Say about 30. E. Laumann, et al., The Social Organization of Sexuality Education?,” Educational Leadership, Sexuality—Sexual Practices in the United States Oct. 2000, p. 74. (Chicago: The University of Chicago Press, 1994). 42. D. W. Haffner and J. Wagoner, “Vast Majority 31. J. D’Emilio and E. Freedman, Intimate of Americans Support Sexuality Education,” Matters: A History of Sexuality in America SIECUS Report, August/September 1999, p. 22. (New York: Harper and Row, 1988). 43. D. W. Haffner et al., “Vast Majority of 32. U.S. Census Bureau. Marital Status and Americans Support Sexuality Education,” Living Arrangements of Adults 18 Years Old pp. 22–3. and Over, March 1998. 44. Ibid., pp. 23. 33. D. Kirby, No Easy Answers (Washington, DC: 45. The Kaiser Family Foundation, Sex Education National Campaign to Prevent Teen Pregnancy, in America: A View from Inside the Nation’s 1997). Classrooms (Menlo Park, CA: The Kaiser Family 34. C. Bartels, et al., Federally Funded Abstinence- Foundation, 2000), p. 10. Only Sex Education Programs: A Meta-Evaluation. 46. The Kaiser Family Foundation, Sex Education Paper presented at the Fifth Biennial Meeting of in America, p. 17. the Society for Research on Adolescence, San 47. Ibid., p. 31. Diego, CA, Feb.11, 1994; B. Wilcox, et al., Adolescent Abstinence Promotion Programs: An 48. Ibid., p. 30. Evaluation of Evaluations. Paper presented at the 49. Ibid. Annual Meeting of the American Public Health 50. D. W. Haffner et al., “Vast Majority of Association, New York, NY, Nov. 18, 1996; D. Americans Support Sexuality Education,” Kirby, M. Korpi, et al., Evaluation of Education pp. 22–3. Now and Babies Later (ENABL): Final Report

Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program 35 51. Council on Scientific Affairs, American Diseases; T. R. Eng, W. T. Butler, eds., The Hidden Medical Association, Report 7 of the Council on Epidemic: Confronting Sexually Transmitted Diseases Scientific Affairs: Sexuality Education, Abstinence, (Washington, DC: National Academy Press, 1997). and Distribution of Condoms in Schools (Chicago: 58. Committee on Unintended Pregnancy, American Medical Association, 1999). Institute of Medicine; S. S. Brown, L. Eisenberg, 52. American Academy of Pediatrics, “Policy eds, The Best Intentions: Unintended Pregnancy and Statement: Condom Availability for Youth,” the Well-Being of Children and Families Pediatrics , vol. 95, 1995, pp. 281–85. (Washington, DC: National Academy Press, 1995). 53. American College of Obstetrics and 59. The National Governors’ Association, Center Gynecology, Committee on for Best Practices, Preventing Teen Pregnancies: Care—Committee Opinion, 1995. Key Issues and Promising State Efforts 54. Society for Adolescent Medicine, Position (Washington: The Association, 1996). Statements and Resolutions: Access to Health Care 60. Office of National AIDS Policy, The White for Adolescents, March 1992. (Individuals can House, Youth and HIV/AIDS 2000: A New download this information from www. American Agenda (Washington, DC: Government adolescenthealth.org.) Printing Office, 2000). 55. National Institutes of Health, Consensus 61. No Time to Lose: Getting More From HIV Development Conference Statement (Rockville, Prevention,” M. S. Ruiz, A. R. Gable, E. H. Kaplan, MD: The Institutes, 1997). M.A. Stoto, H. Fineberg, and J. Trusell, editors 56. No Time to Lose: Getting More from HIV (Washington, DC: Institute of Medicine, 2000), Prevention,” M. S. Ruiz, A. R. Gable, E. H. Kaplan, p. 6.62. (Individuals can download the member- M.A. Stoto, H. Fineberg, and J. Trusell, editors ship list of the National Coalition to Support (Washington, DC: Institute of Medicine, Sexuality Education from the SIECUS web site: 2000), p. 6. www.siecus.org) 57. Institute of Medicine, Committee on Prevention and Control of Sexually Transmitted

36 Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program