Abstinence-Only vs. Comprehensive Sex

Back in 1996, Congress authorized $50 million annually for five years to fund state programs that teach abstinence from sexual activity outside of marriage as the expected standard for school-age children. That new grant program, created under Title V, Section 510 of the Social Security Act and known as the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), had a catch or two.

First, every state accepting a grant had to provide $3 in matching funds for every $4 in federal funds. No matching funds, no state grants. And there was one final, non-negotiable stipulation: all funds had to be used for the exclusive purpose of teaching the benefits of abstinence. Period. Sure, states could still decide which programs to fund and at what level, but local agencies or organizations accepting money could not advocate contraceptive use or teach contraceptive methods. They were not even allowed to facilitate discussion of abortion, homosexuality, bisexuality, HIV or other sexually transmitted diseases.

What happened if teens raised those topics themselves? The federally sanctioned response was that abstinence from sexual activity is the only way to avoid out-of-wedlock pregnancy and sexually transmitted diseases. Homosexuality and bisexuality are off-limits because the U.S. government officially declared "a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity." Thus, recipients of federal abstinence-only funds operated under a gag order mandating the censorship of crucial sexuality information for teenagers.

Naturally, a few states objected, as did many advocacy groups, from the American Civil Liberties Union to the Sexuality Information and Education Council of the United States and Planned Parenthood. Supporters of abstinence-only education say their message is clear and sex education programs that teach about sexuality, contraceptives and abstinence are sending mixed messages: encouraging teens to abstain, but telling them how to protect themselves if they choose to have sex, anyway. On the other side, proponents of comprehensive sexual education programs say abstinence is preferred, but broader information is vital because more than half of all American teenagers are sexually active by the time they finish high school -- over three million get a sexually transmitted disease every year and four of every ten girls under 20 becomes pregnant.

Despite the fact that every reputable sexuality education organization in the U.S., as well as prominent health organizations including the American Medical Association, have denounced abstinence-only programs, an obscure department of the United States government known as the Maternal and Child Health Bureau began doling out abstinence-only education program grants for the next five years starting in 1998.

About half a billion dollars got sucked up by abstinence-until-marriage proponents from 1998 through 2003, so where's the data to prove it works? In 2002, four years into the grant cycle, a federally funded evaluation of these programs failed to obtain any evidence of success. A 2003 follow-up report never even materialized. Will a promised final evaluation in the summer of 2005 make this expensive experiment in censorship seem any less sanctimonious or fallacious?

Research from as close as Canada and as far away as Sweden validates comprehensive sexual education for teenagers. It works. Shockingly, among industrialized nations, the United States has the highest rates of teen pregnancy and sexually transmitted diseases. Polls show an overwhelming majority of parents want kids to receive thorough, medically accurate sex education at school. They may not agree on what that should look like, but they know it allows them to avoid having that potentially mortifying conversation themselves. Through its Partnership for a Drug-Free America campaign, the U.S. government encourages parents to talk to their kids about drugs. What about sex? The Feds have got your back! Don't worry about the icky sex stuff. It's all being taken care of through the Partnership for a Dumb-as-Dirt Teenage America campaign, otherwise known as abstinence-only education.

Even if you happen to believe teenagers really shouldn't be having sex, consider that around age 13, they stop caring what you think, anyway. By fifteen, the girls are already menstruating, the boys are having erections, hair is sprouting and everybody's hormones are raging. Shouldn't we come up with something better than, "Okay, kids, a mutually faithful, monogamous relationship in the context of marriage is your only option and that's all you need to know?" Maybe the Feds should just eliminate dating altogether and start arranging marriages like the ancient Egyptians and Romans. It's still done in Iraq. Oops ... bad example.

The thing about teenagers is that when you give them no information, they start making things up all by themselves. That's why 16-year-old girls end up with gonorrhea of the throat -- somehow they determine that oral sex isn't real sex because no adult has ever told them otherwise. Comprehensive sexual education can dispel sexual myths, acknowledge the potential consequences or risks of sexual behavior and explain what's going on with teenage bodies. And because abstinence-only education places everything in the context of a monogamous, heterosexual marriage, America's gay and lesbian youth are dismissed, thus reinforcing feelings of isolation or shame.

That five-year abstinence-only grant cycle was up in 2003, so where exactly did the half billion dollars go? Across the country, from Louisiana to Montana, Christian ministries and religious institutions asked for and received plenty, reminding us once again how that whole separation of church and state thing set up by our Founding Fathers never really caught on. When schools won grants -- California, Pennsylvania, Alabama and others -- they used it to create "chastity" events and rallies where students were assembled, usually during school hours, and asked to pledge to God that they would remain abstinent from sex until they marry.

Now remember that you only got the money if you agreed to the exclusive promotion of abstinence only. That means comprehensive sexual health classes and programs got cancelled or replaced -- even if parents or students liked them. To get bucks, the school board of Franklin County, North Carolina, ordered that three chapters be literally sliced out of a ninth-grade health textbook because the material did not promote abstinence-only.

That grant cycle has run its course and legal challenges from various states assured it wouldn't be revived. Do abstinence-only programs work? Five years later, no compelling evidence suggests they do. Will the federal government go on funding them anyway? You bet. The U.S. Department of Health and Human Services is quietly approving community-based abstinence education project grants for public and private entities across the country. Got a lame, one-dimensional abstinence-only message for America's adolescents, ages 12 through 18? Get a grant!

That's what Phillippia Faust, a nurse at Georgia's Rockdale County Medical Center, did last year. Faust was awarded a federal grant of $177,809 a year for three years (that's $533,427, or half a million dollars) to create an abstinence-only program. She no longer has to carry a poster from classroom to classroom -- Sex Outside of Marriage is ... Not needed. Not normal. Not expected! -- as she did in the past. Now, Faust can afford a staff, supplies and a real curriculum. "We do discuss teen pregnancy and STDs," says Faust. "But abstinence is all about strengthening the family. Abstinence upholds the family as the basic unit of society and recognizes marriage as the framework for the family, which equates childbearing within the context of family. Abstinence identifies marriage as the only acceptable and legitimate place for the sexual experience and that avoidance from premarital sexual activity, including but not limited to sexual intercourse, is the expectant standard for the unmarried." It's entirely possible that Phillippia Faust is a really nice person, but she sure does sound like an insufferable, proselytizing control freak with an astonishingly narrow and oppressive view of human sexuality.

Faust's goal -- a 10% decrease in the number of teens who are engaging in premarital sexual activity, the number of first-time and/or repeat pregnancies and the number of reported sexually transmitted diseases -- is admirable. She hopes to accomplish this by staging mock weddings -- complete with props, scenery, bridal attire and graphic slideshow presentations of the ghastly things sexually transmitted diseases can do to your body. After two mock weddings last May, Faust told The Atlanta Journal-Constitution, "I just wanted kids to have a grand visual of what their day-to-day decisions can lead to for their families, with an image of two beds -- the bed of poor choices and the bed of 'we made good choices by waiting.'"

Those are your tax dollars at work ... and a half a million bucks can buy a lot of mock weddings.

David Salyer is an HIV-positive journalist and AIDS educator living in Atlanta, Georgia. He leads safer-sex presentations for men and has facilitated workshops for people infected or affected by HIV since 1994. Reach him by e-mail at cubscout@mindspring.com.