Advocates seek support for 'real' sex education
By Adam Sonfield
Senior Public Policy Associate
Guttmacher Institute
Washington, DC
During his 2008 campaign and in the budget framework that President Obama sent to Congress late in February, he signaled his support for a U-turn in federal policy to prevent pregnancy and sexually transmitted infections (STIs) among American youth. He criticized the ideological, abstinence-only-until-marriage approach that was strongly promoted by the Bush administration and congressional social conservatives and spoke of the need for a medically accurate and more comprehensive model of sex education.
The federal government has directed well over $1 billion since 1996 to abstinence-only education programs, funding that escalated rapidly at President Bush's behest.1 The vast majority of that money is tied to a highly restrictive, eight-point definition established that year by Congress. Programs receiving this funding must exclude any positive discussion of contraception or safer-sex practices and must teach questionable "facts," including that nonmarital sex is "likely to have harmful psychological and physical effects."
Numerous studies over the past decade have called into question the effectiveness and appropriateness of this approach, with two especially noteworthy studies released in 2007. First, a congressionally mandated evaluation of the federal abstinence-only effort by Mathematica Policy Research found, after nine years and almost $8 million, that none of the four programs considered to be promising had had a demonstrable impact on the sexual behavior of participants.2 Later that year, the National Campaign to Prevent Teen and Unplanned Pregnancy released a comprehensive review of sex education evaluation research concluding that "there does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence, or reduces the number of sexual partners."3
Abstinence-only programs also have been roundly criticized for ignoring basic principles of science and medical ethics. Two recent reviews by the Government Accountability Office, for example, found that many of the curricula used by grant recipients included false claims about condoms, other contraceptive methods, abortion, and STIs.4-6 Numerous medical professional associations, moreover, have challenged these programs as inherently problematic, because the federal requirements under which they operate are themselves scientifically inaccurate and require programs to withhold information that is necessary to protect young people's health.
Federal and state policy-makers have started to respond to these studies and criticisms. In April 2008, the House Committee on Oversight and Government Reform held the first-ever congressional hearing on the effectiveness of abstinence-only education, with public health experts from groups including the American Public Health Association, the Academy of Pediatrics, and the Institute of Medicine all testifying about the dearth of positive evidence. When Congress belatedly completed appropriations for the current fiscal year in March, it accomplished another first by cutting support for abstinence-only education by $14 million. The total federal abstinence-only allotment now stands at $162 million for the year. In addition, 23 states and the District of Columbia are no longer accepting the abstinence-only funds allotted to them; nearly 14 million adolescents, 46% of those nationwide, live in these states.1
With a new president who has been a vocal supporter of a more comprehensive and scientifically driven approach to sex education and with a stronger progressive contingent in Congress, advocates expect more changes in the coming months and years. The general goal is to stop funding the ineffective abstinence-only approach and to begin supporting more comprehensive sex education programs that are medically accurate, age appropriate, and proven to be effective. There are numerous such models: According to the 2007 report from the National Campaign, "two-thirds of the 48 comprehensive programs that supported both abstinence and the use of condoms and contraceptives for sexually active teens had positive behavioral effects," including less or later sexual activity, fewer sexual partners, or increased condom or contraceptive use.3
Most of the decisions around sex education and education more generally are made at the state and local levels, including state legislatures, state boards of education, municipal health departments, and individual school boards. Thus, advocates are working on multiple fronts to overturn abstinence-only requirements and instate a more comprehensive approach. Yet, leadership from the federal government is critical.
The principal model for federal action is the Responsible Education About Life (REAL) Act, introduced in 2009 by Rep. Barbara Lee (D-CA) and Sen. Frank Lautenberg (D-NJ). REAL would authorize $50 million in grants to states annually for sex education that follows a very different eight-point set of requirements from the one that governs abstinence-only programs. (For more on the REAL Act, see article, below.)
References
- Boonstra HD. Advocates call for a new approach after the era of 'abstinence-only' sex education. Guttmacher Policy Review 2009; 12:6-11.
- Trenholm C, Devaney B, Fortson K, et al. Impacts of abstinence education on teen sexual activity, risk of pregnancy, and risk of sexually transmitted diseases. J Pol Anal Manage 2008; 27:255-276.
- Kirby D. Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases. Washington, DC: The National Campaign to Prevent Teen and Unplanned Pregnancy; 2007.
- United States Government Accountability Office. Abstinence Education. Efforts to Assess the Accuracy and Effectiveness of Federally Funded Programs. Washington, DC; October 2006. Accessed at www.gao.gov/new.items/d0787.pdf.
- United States Government Accountability Office. Abstinence Education. Assessing the Accuracy and Effectiveness of Federally Funded Programs. Washington, DC; April 23, 2008. Accessed at www.gao.gov/new.items/d08664t.pdf.
- Kepplinger GL. United States Government Accountability Office. Letter to Michael O. Leavitt, Secretary of Health and Human Services. Subject: Abstinence Education: Applicability of Section 317P of the Public Health Service Act. Oct. 18, 2006. Accessed at www.gao.gov/decisions/other/308128.pdf.
What are the REAL Act program requirements? To be funded under the Responsible Education About Life (REAL) Act, a sex education program must be one that:
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