This past Monday celebrated World Contraception Day, a international campaign for sexual and reproductive health supported by a coalition of medical societies, scientific companies and non-governmental organizations.
As part of this campaign, these organizations conduct an annual multi-national survey of young people’s attitudes about sex and understanding about reproductive health.
The results of this survey, which queried more than 6000 people from 26 countries around the world, were shocking. A significant percentage of young Americans, for example, do not receive comprehensive sex education in school. Twenty-four states, New York included, do not mandate sex education in public schools.
Many states also require that sex education, if it is offered, provide an abstinence-only message that emphasizes the importance of sex only within marriage. Few states require that the information provided be medically accurate or culturally unbiased, and only two states prohibit the promotion of religious beliefs in sex education classes.
The federal government also provides $150 million a year in financing to support abstinence-only education programs in which frank information on how to prevent sexually-transmitted diseases and avoid pregnancy is not offered. To date, the federal government has spent almost $2 billion on abstinence-only programs. By contrast, there is no comparable federal funding to provide comprehensive sex education in public schools.
Although the amount of federal money spent on abstinence-only education is down slightly from the heyday of the Bush Administration, there is a renewed push in Congress to reinstate financing for abstinence-only programs despite our legislators new-found frugality and despite evidence that these programs do not change sexual behaviors among American teens.
Not only do these programs not work, but a federal investigation found that the majority of abstinence-only programs contained medically- and scientifically-inaccurate information. Some of the unproven or outright false claims include: that HIV can be spread via sweat and tears, that women who have an abortion are more prone suicide and have higher rates of infertility, and that condoms fail to prevent pregnancy and transmission of sexually-transmitted diseases 30% of the time.
It should not be surprising then that the number of American adolescents who report having unsafe sex has nearly doubled in the last few years. Teen pregnancy rates are also up for the first time in two decades, as are rates of abortion and certain sexually-transmitted infections like syphilis and chlamydia. The US now has the highest teen pregnancy rate of any industrialized nation.
Supporters of abstinence-only education are quick to point out that there is no clear causal relationship between the expansion of abstinence-only programs and the increase in teen pregnancy. They are partially correct. As Sarah Brown of the National Campaign to Prevent Teen and Unplanned Pregnancy notes there are likely a number of factors at play, including “less fear of AIDS to our anything-goes culture where it’s O.K. to get pregnant and have a baby in your teens.” The proliferation of television programs like MTV’s Teen Mom and 16 and Pregnant are having an impact.
However, it’s well established that students who receive abstinence-only education are less likely to use contraception and less likely to seek testing and treatment for sexually-transmitted diseases. Moreover, if we look at those states that lack a sex education mandate or those states that emphasize abstinence-only education, a disturbing trend appears.
All five of the states that have the highest rates of teen pregnancy in the US — Arkansas, Mississippi, New Mexico, Oklahoma and Texas — have policies that require an abstinence-only message when sex education classes are offered within public schools. Rates of sexually-transmitted infections among adolescents are significantly higher than the national average in all of these states except New Mexico. Coincidentally, New Mexico is the only of these five states that actually mandates sex education.
By contrast, of the five states with the lowest rates of teen pregnancy in the US — Connecticut, Massachusetts, New Hampshire, New Jersey and Vermont — only New Jersey requires that abstinence be stressed in sex education classes. These five states also have lower-than-average rates of sexually-transmitted diseases.
We can’t blame the recent increase in rates of unprotected sex, pregnancy and sexually-transmitted diseases among American youth solely on abstinence-only programs. However, too many teenagers in the US lack access to accurate and unbiased information about reproductive health. They do not receive comprehensive sex education in the schools, and may be too afraid or embarrassed to ask their parents or physicians about sex.
Current federal, state and local policies exacerbate this problem, either by failing to mandate sex education (as in the case of New York) or by insisting on an ineffective emphasis on abstinence only. What we need to do is get over our embarrassment, set aside our personal biases, and design effective public programs that provide our kids with accurate and honest information about sex.
[This blog entry was originally presented as an oral commentary on Northeast Public Radio on September 29, 2011. It is also available on the WAMC website .]