Abstaining from sexual activity is a surefire way to prevent pregnancy and avoid sexually transmitted diseases. But programs advocating abstinence often fail to prevent young people from having sex, researchers write in the September issue of the Journal of Adolescent Health.
Such programs, sometimes referred to as "abstinence only until marriage" programs, typically advocate monogamous, heterosexual marriage as the only appropriate context for sexual intercourse and as the only certain way to avoid unwanted pregnancies and sexually transmitted diseases.
That's "not just unrealistic, but it leaves our young people without the information and skills that they need," said Laura Lindberg, a coauthor of the report and a research scientist at the Guttmacher Institute, a reproductive health research group that supports abortion rights. "We fail our young people when we don't provide them with complete and medically accurate information."
The analysis confirms previous public health findings that abstinence-only education programs don't succeed in reducing rates of teen pregnancies or STDs. Moreover, public health data indicate that such programs "have little demonstrated efficacy in helping adolescents to delay intercourse," the authors write.
When American teens do begin having sex, they may fail to use condoms or other forms of contraception, unlike their peers in other countries who have routine access to contraceptive education and counseling, the report suggests.
Promoting abstinence until marriage as the only legitimate option for young people "violates medical ethics and harms young people," Lindberg says, because such programs generally withhold information about pregnancy and STD prevention and overstate the risk of contraceptive failure.
According to a 2004 report prepared for House Democrats, language used in abstinence-based curricula often reinforces "gender stereotypes about female passivity and male aggressiveness" — attitudes that often correlate with harmful outcomes including domestic violence, the report notes.
The new analysis argues there's another reason that abstinence until marriage is increasingly unrealistic: Americans are marrying later, on average, and some are not marrying at all, but they're not waiting longer to begin having sex. The average age for initiating sexual activity has remained around 17 or 18 since the early 1990s. The net effect, the report concludes, is a substantial increase in premarital sex.
Conservative groups have long advocated abstinence education in public schools, pointing to a smaller number of studies that support abstinence-based approaches. Reacting to the report, Concerned Women for America CEO Penny Nance noted that abstinence is the only 100 percent effective form of birth control.
"It seems we have swung so far left as to embrace promiscuity for our kids," Nance said in a statement to NPR. "And at the least, we are surrendering to the idea that teenagers will be sexually active. We, as a culture, can do better."
Nance added, "Schools and public health advocates owe it to parents and people of faith to support the young girl or boy who wants to delay sexual behavior. Marriage, and delaying sex until at least adulthood, are good goals."
The U.S. government has funded abstinence programs in schools and community organizations since the early 1980s. An increased focus on and funding for them began as part of welfare reform efforts undertaken during the Clinton administration. According to Guttmacher, the federal government has spent about $2 billion over the past 20 years on abstinence-based education.
President Trump has also been friendly to such programs, naming Valerie Huber, an advocate for abstinence-only education, to a post at the Department of Health and Human Services. The administration recently cut more than $200 million in federal funds for teen pregnancy prevention programs. Meanwhile, the administration's budget proposal includes millions of dollars to extend the "Abstinence Education and Personal Responsibility Education Program."
That approach pleases much of Trump's conservative base. In a statement to NPR, Arina Grossu, director of the Center for Human Dignity at the Family Research Council, said abstinence-based programs "provide the optimal message for teens." She compared the approach to "other public health models used to address underage drinking and drug use" that aim to discourage such behaviors.
Guttmacher's Lindberg takes the comparison in a different direction in arguing that teens should be given comprehensive sex education that includes training in contraception and STD prevention.
"We tell people not to drink and drive," she says. "We don't teach them not to drive. ... We would never withhold information about seat belts because they wouldn't know how to protect themselves."
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