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Sex Education, Abstinence-Only Programs, and Guidelines (last updated January 12, 2002)

A political debate continues over what teenagers should learn about sex and whether teaching abstinence as the only way of avoiding pregnancy or sexually-transmitted diseases is effective. The federal government has supported and funded abstinence-only programs for decades, and many states now require such programs. On the other hand, many, including Surgeon General David Satcher, have called for more comprehensive education programs, though the content of such programs is controversial.

The federal government has funded abstinence programs since 1981, when the U.S. Office of Population Affairs began administering the Adolescent Family Life Act (AFLA). This legislation, enacted in 1978, initially called for ways of reaching adolescents before they become sexually active and to "promote self discipline and other prudent approaches to the problem of adolescent premarital sexual relations." In 1985, a federal judge found the program unconstitutional for promoting religious values; the case was appealed, reversed and remanded by the Supreme Court in 1988, and finally settled in 1993. Under the settlement, AFLA continues to fund sex education programs but must avoid religious references and be medically accurate.

In recent years, the federal government has increasingly supported state and local programs that promote abstinence. In 1996, as part of the welfare reform passed that year, the federal government created an entitlement program that provides $50 million in matching funds a year for five years to states. Programs that receiving such funding must follow specific guidelines, including teaching that "sexual activity outside of marriage is likely to have harmful psychological and physical effects."

The Bush administration has increased funding for abstinence-only programs and officials have said that their goal is to increase funding to $135 million a year, which would match current spending for family planning. White House spokesman Ari Fleischer said in a June 2001 press briefing that Bush believes that sex education is a matter for local control and that Bush "continues to believe that abstinence and abstinence education is the most effective way to prevent AIDS, to prevent unwanted pregnancy."

Sharing that view, many states now emphasize abstinence in mandated programs about the unintended consequences of teenage sexual activity, specifically sexually transmitted diseases. According to a January 2002 report by the Alan Guttmacher Institute, 39 states have established some requirements for sex education, with 34 requiring that abstinence be taught in schools and only 19 requiring that contraception be taught. Only five states specifically address abortion, and four of them (Connecticut, Louisiana, Michigan and South Carolina) only to prohibit any discussion with sex education; only Vermont requires that abortion be discussed.

Even as state governments and the federal government increasingly emphasize abstinence programs, many critics have said that such programs have limited effectiveness and do not reflect the general public's attitudes towards sex education. Some, such as the Sexuality and Education Information Council of the United States (SIECUS), have developed guidelines as to what should be taught. The 1996 edition of SIECUS's guidelines recognize that abstinence is the only guaranteed way to avoid unintended consequences but recommends educating on contraception and other forms of sexual behavior, such as masturbation.

While most of the guidelines deals with uncontroversial subjects such as how families operate and the importance of communication, more controversial aspects cover masturbation, abortion, and homosexuality. For example, the SIECUS guidelines recommends that children in early elementary school, ages 5 through 8, learn:

  • "Adults often kiss, hug, touch and engage in other sexual behavior with one another to show caring and to share sexual pleasure." (This is part of a topic on sexual behavior; the SIECUS guidelines do not recommend teaching about abstinence until ages 9 through 12, when it recommends teaching that "children are not ready for sexual intercourse."

  • "Touching and rubbing one's genitals to feel good is called masturbation." (This is part of a topic on sexual behavior; the SIECUS guidelines recommend teaching children ages 9 through 12 that "masturbation does not cause physical or mental harm" and that "some families and religions oppose masturbation")

  • "Many people experience sexually erotic thoughts called fantasies." (This is part of a topic on sexual behavior)

  • "Sometimes women become pregnant when they do not want to be or are unable to care for a child." (This is part of a topic on sexual health; the SIECUS guidelines recommend that children learn more about abortion in preadolescence, ages 9 through 12)

  • "Most men and women are heterosexual, which means they will be attracted to and fall in love with someone of the same gender. Some men and women are homosexual, which means they will be attracted to and fall in love with someone of the same gender." (This is part of a topic on human development; the SIECUS guidelines recommend that children ages 9 through 12 learn that "why a person has a particular sexual orientation is not now known" and that "homosexual love relationships can be as fulfilling as heterosexual relationships" and that children ages 12 through 15 learn that "people do not choose their sexual orientation" and that "some religious groups oppose homosexuality)

Most recently, on June 28, 2001, Surgeon General David Satcher unveiled a long-awaited report calling for more comprehensive and scientifically accurate sexual education and casting doubt on the federal government's support of programs teaching abstinence to delay sexual activity among teenagers. The report, The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, had been originally scheduled to be released in the fall of 2000 but was delayed for what some feel political reasons. Satcher released the report by himself, whereas he had released other reports with the secretary of health and human services, Tommy G. Thompson.

The report simply stated that it was "too early to draw definite conclusions" about the effectiveness of abstinence-only programs. At the same time, it recommended that education "stress the value and benefits of remaining abstinent until involved in a committed, enduring, and mutually monogamous relationship" but also "assure awareness of optimal protection from sexually transmitted diseases and unintended pregnancy, for those who are sexually active, while also stressing that there are no infallible methods of protection, except abstinence."

Despite such muted language, White House spokesman Ari Fleischer backed away from the report during a June 2001 press conference, pointing out that it was issued by a Surgeon General from a prior administration but not going so far as to say that Satcher lacked Bush's confidence or should resign.

Sources: Surgeon General David Satcher's report, The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, is available here. Ari Fleischer's press briefing in which he is asked about the report is available here. General information on the federal government's funding of abstinence-only programs is available here. The U.S. Office of Population Affairs has information on the Adolescent Family Life programs here; the Supreme Court case reversing and remanding the district court's decision that the AFLA was unconstitutional is Bowen v. Kendrick, 487 U.S. 589 (1988) (available via Findlaw.com. The Alan Guttmacher Institute is available on-line here; its report on state sexuality education policies is available here. Also useful was its August 2001 report on state-level policies on sexuality, STD education (The Guttmacher Report, 2001, 4(4):4-7). The Sexuality and Education Information Council of the United States (SIECUS) is on-line


Teenage Sexuality: Activity (last updated January 11, 2002)

About half of all never-married teenagers aged 15-19 years old had had sexual intercourse at least once in 1995. According to surveys, the percentage of male teenagers who are sexually experienced has fluctuated around 70 percent, whereas the percentage of female teenagers who are sexually experienced has risen from about 30 percent in 1971 to about 50 percent in the 1990s.

About 35 percent of male teenagers and about 32 percent of female teenagers in 1995 had had sexual intercourse by the time they reach age 16. About 83 percent of males and about 70 percent of females had had sexual intercourse by the time they reach age 19.

White male and female teenagers seem to have sexual intercourse for the first time more often between age 16 and 19. About 28 percent of white male teenagers in 1995 had had sexual intercourse by 16, and 86 percent by age 19. About 28 percent of white female teenagers in 1995 had had sexual intercourse by age 16, and 69.4 percent by age 19.

On the other hand, black male and female teenagers seem to have sexual intercourse for the first time more often before reaching age 16. About 64 percent of black male teenagers in 1995 had had sexual intercourse by 16, and 94 percent by age 19. About 48 percent of black female teenagers in 1995 had had sexual intercourse by age 16, and 74 percent by age 19.

Sources: National Survey of Family Growth, Sexual Activity and Contraceptive Practices Among Teenagers in the United States, 1988 and 1995 (data taken from Table 2, document available on-line via here).


Teenage Sexuality: Consequences (teen births, abortions, STDs) (last updated January 11, 2002)

In general, the consequences of teenagers having sex have declined in recent years. Births to teenage mothers has gone down from 6.3 such births for every 100 live births in 1970 to 4.4 in 1999, abortion ratios for teenaged females have fallen by about half since the 1980s, and the rates of sexually transmitted diseases such as syphilis and gonorrhea have fallen as well.

The reasons for these changes are debatable. Some point to the increased use of contraceptives, some to the promotion of abstinence in sex-education programs, and some to changing social conditions such as increased opportunities for those who would otherwise become parents earlier.

Sources: All data taken from Health, United States, 2001, by the National Center for Health Statistics (available on-line here). Teenage childbearing data taken from Trend Table 8, abortion data from Trend Table 16, sexually transmitted disease data from Trend Table 52.


Homosexuality: Incidence (last updated January 13, 2002)

There is no formal measure of the prevalence of homosexuality, especially because the definition is open to some interpretation. Homosexuality can be viewed as a matter of behavior, attraction, or identity, and can vary depending on whether one is exclusively or predominantly "homosexual" in such ways.

In general, the literature, as reviewed by the Kinsey Institute, ranges widely. Studies show incidence rates from 1 to 15 percent, with slightly higher incidence rates for homosexual men than for homosexual women.

Kinsey's studies from 1948 and 1953 showed that 37 percent of males and 13 percent of females had at least some overt homosexual experience to orgasm, and that 8-10 percent of males and 2-6 percent of females had been more or less exclusively homosexual after the onset of adolescence. This data is weighted towards younger adults, particularly college-educated, and the sample set included institutionalized men, so subsequent reviews have eliminated bias to show lower incidence rates.

Sources: Kinsey Institute, Prevalence of Homosexuality: Brief summary of U.S. Studies (Compiled in June 1999, available on-line here.

 

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