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Home > Research Articles > The Battle Over Abstinence


Monday, December 2, 2002

Dec. 9 issue — Karie Hughes tosses a pair of black fuzzy dice across the classroom floor. “Sex before marriage is like gambling,” Hughes tells students in her federally funded abstinence workshop, “Passion and Principles.” Each number on the dice represents a risk, Hughes explains—pregnancy, a sexually transmitted disease, a broken heart.

HUGHES, 42, IS HIP enough for her audience to relate to—she reveals a sliver of belly above her slim black pants—but authoritative enough to have an impact. By the time she darkens the room for the slide show at Highland High School outside Phoenix, Ariz., the kids are captivated. The screen fills with grotesque images—a uterus swollen by pelvic inflammatory disease, a penis oozing pus from gonorrhea. “Eeeeeew,” the students groan. Afterward, many seem persuaded. “That totally changed my view on pretty much everything,” says freshman Laura Hurst, 14. “Ohmigod.”

Phoenix isn’t the only place the abstinence message is taking hold. In classrooms around the country, programs that urge teens to postpone sex are on the rise. More than one third of U.S. high schools teach abstinence until marriage and 700 abstinence programs spread the sex-can-wait gospel in all 50 states. Next year George W. Bush hopes to boost abstinence spending to $135 million—up from $60 million in 1998—fulfilling a campaign promise to spend as much on abstinence as on teen family-planning programs. Abstinence is such a big priority that it falls into the portfolio of top Bush political guru Karl Rove. It’s also one social issue the new Republican Congress is eager to advance. “There’s certainly nothing in the election results that will push this in another direction,” says Oklahoma Rep. Ernest Istook Jr.

Though no parents really want their teenager to have sex, there’s plenty of disagreement over how to persuade kids to wait. Major medical groups and supporters of “comprehensive sex education” like the Sexuality Information and Education Council (SIECUS) agree abstinence should be promoted as a first choice. But they also want to teach kids how to reduce their risks if they do have sex. “We have to look at the health harm of not using contraceptives,” says SIECUS president Tamara Kreinin, who contends that many abstinence programs spread fear and misinformation. Besides, there’s little research proving they work. Polls show that parents overwhelmingly favor the comprehensive approach, but the pro-abstinence forces have shown more political fervor.

The abstinence drive comes at a time when teen chastity is on the rise—the percentage of high schoolers who said they’d ever had sexual intercourse dropped from 54 in 1991 to 46 in 2001, according to the Centers for Disease Control. Teen pregnancies are down, too. But that doesn’t mean teens aren’t having sex at all: more than half of seniors still lose their virginity before high-school graduation. Teen condom use is up and so are levels of many STDs. That leaves abstinence advocates and their opponents battling over the best approach.

For teachers like Karie Hughes, building the case for abstinence goes beyond “just say no.” Even if you manage to avoid pregnancy, Hughes tells students, it’s harder to protect yourself against stealthy, often symptomless STDs that can crop up years later. Sexual intercourse isn’t the only danger. There’s now growing evidence that teens are engaging in other risky behaviors, including oral and anal sex. Both sides are trying to tackle the issue. Comprehensive sex-ed advocates want to offer kids explicit lessons on how to protect themselves with condoms and dental dams. And abstinence classes play up the hazards of deep kissing and mutual masturbation. “This teaches you ways to prevent yourself from doing stuff,” says Lindsey Raver, 17, sitting in the back row of Hughes’s class in hip-huggers and a pink V neck. “It gets you thinking.”

Karie Hughes teaches abstinence at a high school outside Phoenix through her federally funded workshop, Passion and Principles

That’s just the kind of response George W. Bush was hoping for. To the White House, abstinence seems like an easy win: it resonates with conservative voters, but doesn’t upset pro-choice moderates. Rove, who’s responsible for shoring up support among the religious right, signaled the issue’s importance when he recently penned a personal letter to the president of the Abstinence Clearinghouse, an educational and networking organization. Rove detailed how “we are pushing the policy agenda on abstinence,” stressed Bush’s commitment to the cause and promised “we will certainly come up with some increase in funding.” Rove wasn’t just pandering to a key constituency, the letter was official White House policy vetted by the president’s domestic-policy council. Bush foreign-policy advisers also want to expand abstinence in HIV-prevention efforts abroad, a move critics say may be too simplistic an answer to the spreading AIDS epidemic in Africa and other parts of the developing world.

At home, Bush has not only increased funding; he’s poured all the new federal dollars into the most restrictive type of abstinence program—Special Projects of Regional and National Significance (SPRANS)—more than doubling its budget to $73 million. To get the cash, groups must follow eight strict criteria, including teaching that “sexual activity outside the context of marriage is likely to have harmful psychological and physical effects” and “a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity.” By law, SPRANS programs cannot promote or endorse condom use. Many of the groups that won these grants in 2002 are faith-based, including anti-abortion crisis-pregnancy centers, Catholic charities and a Christian college. (The groups aren’t supposed to preach: in July a federal judge in Louisiana ruled that the state’s abstinence program was illegally using federal money to promote religion.)

It often falls to Claude Allen to explain Bush’s philosophy. As deputy secretary of Health and Human Services, Allen is the administration’s point man on abstinence. Allen sees sex as just one more risky teen behavior to curb and argues that abstinence is the only way to reduce a teen’s risk to zero. “Condoms may be effective in preventing transmission of HIV/AIDS and, in some cases, transmission of gonorrhea in men, but beyond that they do not protect adequately against other sexually transmitted diseases,” he says. A 2001 report from the National Institutes of Health agrees with Allen about HIV and gonorrhea, but says there’s insufficient evidence to say whether condoms protect against other STDs. Lately, Allen has fought off criticism that politics prompted the CDC to delete a condom fact sheet from its official government Web site. He says the site is being revised to reflect the most recent research.

That’s little comfort to the comprehensive camp. When Human Rights Watch researcher Rebecca Schleifer studied abstinence programs in Texas, she found that they actually posed a threat to adolescent health. “They’re getting the message out that condoms don’t work,” Schleifer says. She concluded that the programs jolt kids with worst-case scenarios—like the gory slide show—but don’t prepare them to deal with their emerging sexuality. “It doesn’t really help you. It’s just trying to scare you,” says Hughes’s student Carol Lujan, 14.

Schleifer and others also worry that stressing abstinence until marriage ostracizes sexual-abuse victims who may not see themselves as virgins, gay kids who can’t legally marry and children from single-parent homes. It’s also unrealistic, says James Wagoner, president of Advocates for Youth, a comprehensive sex-ed group, at a time when the most recent study shows that more than 80 percent of Americans didn’t make it to their wedding night as virgins.

In many communities, parents are still wrestling with which side to take. When the Wake County, N.C., school board decided to review the abstinence curriculum, both sides began lobbying. Bart Frost, 15, and his mother, Pamela, showed up at one October meeting to press for comprehensive classes after Bart’s abstinence course left too many gaps. “There wasn’t anything to it,” he said. Last month, after a heated public hearing and a contentious 5-4 vote, the school board decided to keep an abstinence focus, but add information about contraceptives, STDs and tolerance for gays. Abstinence backers vow revenge at the next school-board election.

Although Bush has said he wants to fund only “scientifically proven” education programs, there’s so far little evidence to show abstinence works. “The jury is still out,” says Douglas Kirby, who chairs the task force on effective programs at the National Campaign to Prevent Teen Pregnancy. Many studies did not use sound research methodology or showed mixed outcomes, says Kirby. One study that followed students who took virginity pledges found the vows did delay sexual activity—but students who lapsed were less likely to use contraceptives. A federally sponsored evaluation of abstinence programs will provide some early data next year. Other early results suggest there won’t be a single answer. Stan Weed, a researcher who evaluates abstinence programs for many states, studied four Virginia courses and found that two lowered the rate of students losing their virginity by at least 65 percent. But two other programs didn’t seem to work at all.

At Flowing Wells High School in Tucson, Ariz., the sophomores clamor for the free “Sex Can Wait” pens in Pat Merrill’s abstinence class, but it’s still not clear whether the message will last any longer than the ballpoint ink. Merrill helps students identify “love languages” besides sex (like words of affirmation) and has them list “turn-ons” that focus on personality instead of proclivities. A poster on the wall depicts two teens in low-slung jeans with their zippers padlocked shut: put a lock on it, it advises. And that’s the big question: will they? That used to be a matter for parents to worry about. But as abstinence moves to the center of the political battleground, even the White House wants to know the answer. © 2002 Newsweek, Inc.