Sex Ed: Abstinence-Only Education Gets a Failing Grade (and STDs!)

Earlier this year,  I discussed a point that Freakonomic's author and economist Steven Levitt made: it's difficult to persuade people to change their minds by showing them contradictory data, because everyone thinks that their opinions are already based on truth and science and statistics. No one believes their opinions are rooted in myth and extremism and bias and misinformation, even and sometimes, especially   if their opinions run directly contrary to all facts. So, it's difficult to set out a bunch of "science" and "data" and expect it to change people's minds. But, there are some issues where the data is so one-sided, yet public opinion is so lopsided, that I feel moved to try, if only to arm those of you who already agree with me with some good stats and links and quotes.

So today's topic is this totally bullshit idea that the absence of sex education in schools, or it's prudish cousin, "abstinence only" sex education, is at all effective to curb or quell sexual activity, disease, or pregnancy in teenagers. Let's go.

First: unlike the anti-vaccine movement, which has no logical genesis in science at all, "abstinence only" sex education benefits from its easy, commonsense-sounding logic: if you don't teach kids how to have sex they won't have sex, right? And, conversely, if you teach a room full of hormonal tweens and teens how to sheath a cucumber in a condom, aren't you condoning the idea that they might have sex, and therefore, implicitly encouraging and allowing them to have sex? It's an argument that makes sense in the abstract: if you teach your kid how to tap a keg even while warning him not to drink underage aren't you acknowledging that you expect him to go to that party, tap that keg, and drink that beer?

And man, I get it. That kinda sounds right, right? Combine that with the unsavory image of ill-equipped public school teachers — health teachers, gym teachers! God, remember your gym teacher!?! imparting on your child this intimate, adult knowledge and all its sticky, weird intricacies? Parents don't know what teachers are saying or what they're showing and it's scary and it's unsettling. And it's not impossible to understand why some people vehemently make the argument that sex should be taught by your parents in your home, not by strangers in public.

The problem, of course, is that the parents who make these arguments do a terrible job at teaching their kids about sex, if they teach their kids at all. As one example, a 2009 study in the journal Pediatrics surveyed 141 families of teenagers about sexual discussions at four different times over a year. By the end:
Forty-two percent of girls reported that they had not discussed the effectiveness of birth control and 40% admitted they had not talked with their parents about how to refuse sex before engaging in genital touching. Nearly 70% of boys said they had not discussed how to use a condom or other birth-control methods with their parents before having intercourse. Yet only half of the boys' parents, by contrast, said they had not discussed condom use or birth control with their sons. 
Did you get that last part? Because it's the scariest. Fifty percent of parents admitted they had not discussed condoms or birth control with their sons, which is pretty pathetic on its own. But 70% of boys said their parents hadn't talked about condoms with them. That means there's a disconnect to the tune of 20% of parents who think they've talked with their kids about safe sex, but their kids don't think they had that talk. Maybe the kids didn't hear it, didn't remember it, or didn't process it. Maybe it just didn't happen.

 This comports with a 2014 study by the Centers for Disease Control that found that "almost a quarter of females aged 15–17 years have not spoken with their parents about how to say no to sex or about methods of birth control." This means a significant chunk of of older teens aren't hearing about birth control or abstinence from their parents. And worse, when teenagers are learning about safe sex, it's often too late: a whopping 83.3% of sexually-experienced girls did not receive any formal sex education until after they had already had sex for the first time. As the report concluded, "[t]his represents a missed opportunity to introduce medically accurate information on abstinence and effective contraceptive use" prior to first sex. Uh, yeah.  

So, we can't rely just on parents to provide consistent never mind accurate information about sex to their kids (even, sometimes, when they think they have), and we can't rely on them to do it soon enough.  But we've got to tell teenagers something. So, the next question becomes: what do we tell our kids about sex?

Maybe we can't all agree that it's in teenagers' best interests to be abstinent, but let's all agree that we have the combined public health goal of avoiding teen pregnancy (which has well-documented, disastrous socioeconomic effects on both mother and baby), avoiding sexually transmitted diseases, and encouraging healthy, positive, consensual sex. So, what do we say to our kids to achieve these goals?



Resoundingly, we must teach them something more than just "don't do it." Rarely do studies come down so firmly, so indisputably, so overwhelmingly on one side of a debate as they have on the idea that abstinence only education is ineffectual at prevent teen sex, teen pregnancy, or STDs.

First, "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."1 This was true even when the abstinence programs that were evaluated had been "handpicked" to be "promising" examples of success! A meta-study evaluated the results of 13 independent abstinence only trials comprising approximately 16,000 U.S. students and concluded;
Abstinence-only-until-marriage programs were ineffective in changing any of the behaviors that were examined including the rate of vaginal sex, number of sexual partners, and condom use. The rates of pregnancy and sexually transmitted diseases (STDs) among participants in abstinence-only-until-marriage programs were unaffected.2
Indeed, "no study in a professional peer-reviewed journal has found abstinence-only programs to be broadly effective."3 This includes a massive, comprehensive study commissioned by Congress to evaluate the effectiveness of their more than $50 million in funding for Title V abstinence-only education programs.4

Yeah, but just because it's ineffective doesn't mean that abstinence-only education is bad, right? WRONG, Y'ALL. Studies show that students who have taken a "virginity pledge" (which is strongly correlated to having participated in some type of abstinence-only instruction) did in fact delay their first instance sexual intercourse by approximately 18 months (though largely not until marriage, the purported purpose of such a pledge).5 However, when the "virginity pledge" teens commenced (premarital) sexual intercourse, they were one-third less likely to use contraceptives than their peers. And, the pledges had the same STD rates as their peers, but were less likely to use protector or seek treatment, so they were an at-risk group for increased STD transmission. "In other words, [virginity] pledges can cause harm by undermining contraceptive use when the young people who take them become sexually active."

These examples just scratch at the surface of a well-researched, well-published, well-articulated data set that absolutely proves abstinence only education not only doesn't work, but it actually backfires. Instead of thinking about it like teaching your kid to tap a keg, think about it like teaching your kid to drive. You wouldn't refuse to teach your child to drive a car to prevent them from being in car accidents, would you? Because it's much more likely (and studies show that it's reliably, quantifiably more likely) that your child will find themselves behind the wheel, and will be dangerously unprepared. If your kid knows how to drive, it doesn't mean they will volunteer to drive all the time. It means that if they choose to drive, they'll know how to do it safely.

So, what DO we teach our kids? Fortunately, as overwhelmingly as the research disavows abstinence-only education, it emphatically supports what's called "Comprehensive Sex Education," which teaches teenagers about correct contraceptive use, as well as important, nuanced life skills like communication and consent. And, to address the hovering concern about this type of education: Comprehensive Sex Education resoundingly does not cause teenagers to have sex, to have sex sooner, or have sex with more partners. In fact:
"The National Survey of Family Growth [conducted a study] to determine the impact of sexuality education on youth sexual risk-taking for young people ages 15-19 and found that teens who received comprehensive sex education were 50 percent less likely to experience pregnancy than those who received abstinence-only education."6
Fifty. Per. Cent. Fifty percent, y'all! So, counter-intuitive as it may be: teaching kids abstinence only does not make kids more likely to be abstinent, but teaching kids about sex does! Why? Because teenagers are smarter than we think they are. Teens don't live in a vacuum where the only information they get about sex comes from school; they're going to learn from friends and peers and movies and omg, the insane avalanche of internet porn that they have ready access to. Schools telling them not to have sex is a message that profoundly does not work. But when we respect our teenagers enough to give them clinically accurate information about sex and contraceptives, and when we provide them with a venue to ask difficult questions and get medically-sound not religiously-charged answers, it is proven that it encourages teenagers to make smarter sexual choices.

There is so much more to be said on this subject: the massive amount of funding that pours into these misguided abstinence programs, the backwards correlation between high rates of teen pregnancy and highly religious states, the role that poverty and class play in all of this. But this post has already been an information dump, so I'm going to leave it here for now. I've cited some of my sources below, but if you're so inclined, the internet is a wealth of information. And porn. Lots of information and porn for you.

Journal Sources:
  1. Guttmacher Institute: Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases.
  2. British Medical Journal: "Sexual abstinence only programmes to prevent HIV infection in high income countries: systematic review."
  3. Human Rights Campaign: "Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act."
  4. Mathematica Policy Research: "Impacts of Four Title V, Section 510 Abstinence Education Program." 
  5. American Journal of Sociology: "Promising the Future: Virginity Pledges and the Transition to First Intercourse."
  6. Journal of Adolescent Health: Abstinence-only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy.” 
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