Challenging Dogma - Spring 2008

...Using social sciences to improve the practice of public health

Wednesday, April 23, 2008

The Failure of Abstinence-Only Sexual Education in Schools in Reducing the Rates of STD’s and Pregnancy in the Adolescent Population – Katelyn Spada

Abstinence-only sexual education has failed in reducing the rates of STD’s and pregnancy in teens because those implementing the program neglected to frame the issue to teens in a relatable manner. The main focus of this paper is to address the need for abstinence-only sexual education programs to incorporate the social and behavioral sciences, such as psychology and sociology, in order to reframe abstinence-only sexual education so that it appeals to teens. Current abstinence-only sexual education programs fail to incorporate concepts that play important roles in teenagers’ lives. These programs neglect to address the importance of the messages about sex that are displayed by the mass media and accepted by society. Also, many abstinence-only educators fail to realize that teens are in the process of establishing their own sense of autonomy and may not abstain in order to prove that they can make their own decisions about sex (1). Although many teens intend to abstain from sex until marriage, there are few who are able to maintain this commitment (2). Abstinence-only sexual education fails to inform teens about contraceptives and birth control that could protect them should they choose to have sex. By incorporating the social and behavioral sciences, these programs would be able to address these issues and be more effective in lowering the rates of pregnancy and STD’s in the adolescent population.
About Abstinence-Only Sexual Education
Abstinence-only sexual education exclusively promotes the importance of abstaining from sexual intercourse until marriage and typically includes no discussion of contraceptives, birth control, or abortion. The abstinence-only curriculum emphasizes that abstinence is the expected social standard for school-aged children and teaches children that pre-marital sex leads to STD’s, teen pregnancy, and social stigma (3).
The federal government largely funds abstinence-only sexual education in public schools through Title V of the 1996 Welfare Reform Act and through Community-Based Abstinence Education. Title V of the Welfare Reform Act allows the government to allocate grants to states whose public schools teach abstinence-only sexual education (3). The government outlines strict curriculum criteria that must be met in order for the state to receive federal funding. The programs funded by this act are able to discuss contraceptives, but are allowed only to give examples of their failures. These programs do not educate teens on the benefits of contraceptive use (4). A large amount of money has been allocated to fund abstinence-only education programs. From 1996-2006, the federal government has given over 1 billion dollars to state-run abstinence-only programs through Title V of the Welfare Reform Act. Abstinence-only sexual education programs also receive funding through Community-Based Abstinence Education (CBAE), which began in 2000. CBAE is the largest federal abstinence-only funding source, giving 115 million dollars in grants in 2006. These grants bypass state governments and are awarded directly to state and local organizations that teach abstinence-only sexual education. Many grantees are faith-based or small non-profit organizations that service local private and public schools and other organizations in their area (3).
The Importance of Recognizing Teen Autonomy
Current abstinence-only sexual education programs fail to engage teens and educate them about the dangers of promiscuity because the curriculum does not take into account the fact that teens are in the process of establishing their own sense of autonomy. Proponents of abstinence-only programs argue that teens must be taught abstinence in order to guide them away from promiscuity, but they fail to recognize that many teens are mature enough to know the difference between acceptable and unacceptable behavior. According to psychological theory, teens aim to be independent, self-governing individuals who make their own decisions and live by their own rules of morality (3). Programs aimed at educating teens about sexual behavior should incorporate this theory in order to help teens create their own set of morals without the values of others being forced upon them.
Studies have shown that sexuality is especially associated to freedom and control during adolescence. While parents and teachers should be involved in the surveillance and control of teen behaviors to ensure their safety, teens should be in charge of creating their own morals and making their own decisions. Battles over right and wrong behavior are often fought between adult and child, but the more important struggles are within the teens themselves (5). Sexual education programs should not emphasize the beliefs of those in charge of presenting the material, but should present information on all of the ways to practice safe sex.
The Impact of the Mass Media and Societal Norms
Society as a whole regards sex as normal and acceptable. This conflicts with the message that “sex is immoral and wrong” that is being presented by abstinence-only educators. Oftentimes, teens feel pressured to do what everyone else is doing in order to fit in with their peers (6). By not taking into account the role of social norms and the messages presented by the media, abstinence-only educators are setting their programs up for failure. Teens are exposed to the “sex sells” message sent out by the media on a daily basis. Media outlets, such as television, radio, and magazines, are constantly presenting teens with sexual images and lyrics that are contradictory to the message taught by abstinence-only programs (7).
Media sources are important life-lesson educators for teens and teens often use media sources to gain information about sexuality (7). Bandura’s Observational Learning Theory is based on the idea that learning results from observing the behavior of some other person or model (7). This theory can be applied to suggest that teens can learn the mechanics, motives, and consequences of sexuality from the media and store such knowledge for use in their own personal circumstances. Teens often use this information like a script that outlines what behaviors are expected of them in sexual situations (7). For example, many articles in teen magazines say that girls should not kiss their dates until they have had a second date with them to avoid giving off the wrong impression, and studies have shown that many girls take this advice (8). In this way, the media plays a crucial role in educating teens on the “right” way to act according to societal norms.
While parents and the community may have some influence on the decisions teens make, studies have shown that the mass media and peer influence have the most impact on teen decision-making processes (9). These studies have also shown that families have little to no influence on adolescents’ self-evaluation of sexuality when compared to the influence of the media and peers (9, 10). The information that teens gather about sexuality from the media and from their peers plays an important role in the development of their own sexual behavior (10).
Intent Does Not Always Lead to Behavior
Abstinence-only sexual education programs have failed in reducing the rate of pregnancy and the incidence of STD’s in the adolescent population because these programs have relied too heavily on the idea that if teens intend to abstain from sexual intercourse until marriage, they will uphold that commitment (2). In reality, intentions to abstain from sexual intercourse until marriage may not determine whether or not teens actually do abstain (2). Many external factors may interrupt the intention-behavior continuum.
A recent study presented at the 2003 annual meeting of the American Psychological Society found that over 60% of college students who had pledged virginity during their middle or high school years had broken their vow to remain abstinent until marriage (2). While many of these students may have intended to uphold their vows to abstain from sexual intercourse until marriage, their behavior did not follow their intentions.
There are many situations in which adolescents choose to have sexual intercourse even if they had previously intended to abstain. Teenage romance often evokes strong emotions. Studies have shown that when involved in a serious relationship, teenagers who may have intended to abstain from sexual intercourse before marriage choose to have sex for a number of reasons (11). Most commonly, teens who once intended to remain abstinent have had sex in order to make their relationship feel more adult and to feel more intimate with their partner (11).
Teens also choose to engage in sexual intercourse when under the influence of alcohol or drugs. An estimated 50% of American teenagers have experimented with alcohol and/or drugs at least once (12). Alcohol and drug use has been proven to cause individuals to engage in behaviors that they would not have engaged in otherwise (12). For this reason, intentions to abstain from sexual intercourse until marriage do not accurately predict one’s actual behavior.
Correcting Abstinence-Only Sexual Education Programs’ Failures
Today’s abstinence-only sexual education programs neglect many issues that affect how teens view sexuality. Those developing these programs must realize that social norms and peer pressure, in conjunction with a teen’s developing sense of autonomy, have a strong influence on sexual behaviors. It is also important for these programs to provide teens who choose not to abstain from sex with information on ways to protect themselves. In order to be more effective in reducing the rates of pregnancy and STD’s in America’s adolescent population, these ideas must be incorporated into abstinence-only education programs.
Social norms must be modified in order to make abstinence a more acceptable option in today’s society (13). Abstinence-only sexual education proponents must work with the media in order to incorporate more examples of behaviors that are in accordance with abstinence-only program values. By making abstinence a social norm, these programs will be more relatable, and therefore more successful, in increasing the number of teens who choose to abstain (13).
Abstinence-only sexual education programs need to be restructured in order to be effective in reducing the rates of pregnancy and STD’s in teens (14). While abstinence should remain the focus of these programs, information regarding contraceptives and birth control should also be included. Many proponents of abstinence-only education may be unwilling to accept the need for information about contraception and birth control in abstinence-only programs, but this information is important for those who choose to have sex to know in order to protect themselves from STD’s and to prevent unplanned pregnancies. Studies have shown that programs that focus on abstinence but include information regarding contraceptives have been the most successful in reducing pregnancy and STD’s in adolescents (14). Since abstinence-only sexual education is taught in many public schools and students do not have a choice to enroll in other sexual education programs, including information regarding safe sex is important for all students – especially those who do not agree with the abstinence-only sexual education programs’ goals.
Involving teens in the development and the presentation of the abstinence-only sexual education curriculum would also have a positive impact on abstinence-only programs. Peer influence plays a major role in decision-making processes during adolescence (6). By involving teens in the development and the delivery of the abstinence-only sexual education curriculum, these programs would be able to increase the social acceptance of abstinence among the adolescent population (13).
Current abstinence-only sexual education programs have failed to reduce the rate of pregnancy and incidence of STD’s in the adolescent population. This failure is a result of the fact that those implementing the programs have not framed the issue in a way that is relatable to teens. Abstinence-only sexual education program creators neglect to consider the fact that teens are in the process of establishing their own sense of autonomy and may rebel against the messages being taught to them by their instructors (1). They also fail to acknowledge that the messages about sex received by teens through the mass media and social norms conflict with the values being promoted by abstinence-only programs (7). Lastly, abstinence-only sexual education programs are based on the idea that intent directly governs behavior. This is not always true; there are many external factors that influence whether or not an individual’s behavior reflects their intentions (2).
Addressing the failure of current abstinence-only sexual education programs is an important public health matter because of the high rates of pregnancy and STD’s in the American adolescent population. In order for these programs to have an impact on teen sexuality, social norms must be altered to make abstinence more commonplace and information about contraceptives needs to be included in these programs.

1. Huebner, Angela. Adolescent Growth and Development. Virginia Cooperative Extension: Virginia Polytechnic Institute and State University; 2000. Publication 350-850.
2. Dailard, C. Understanding 'Abstinence': Implications for Individuals, Programs and Policies. The Guttmacher Report on Public Policy: Guttmacher Institute 2003.
3. Howell, M. "The History of Federal Abstinence-Only Funding." July 2007. Advocates for Youth.
4. United States House of Representatives Committee on Government Reform –Minority Staff Special Investigations Division. The Content of Federally Funded Abstinence-Only Education Programs. Washington D.C.: U.S. House of Representatives, 2004.
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11. Ott, M. Media May Prompt Teen Sex. Perspectives on Sexual and Reproductive Health 2006; 38:84-89.
12. Califano Jr., J., Foster, S., Foster, W., Vaughan, R. Alcohol Consumption and Expenditures for Underage Drinking and Adult Excessive Drinking. JAMA 2003; 289:989-995.
13. Bersamin, M., et al. Promising to Wait: Virginity Pledges and Adolescent Sexual Behavior. Journal of Adolescent Health 2005; 36:428-436.
14. DeJoy, S., Perrin, K. Abstinence-Only Education: How We Got Here and Where We're Going. Journal of Public Health Policy 2003; 24:445-459

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