Friday, April 13, 2007

Abstinence Only Programs Don't Work

Well, yes, I've been saying that for a long time. Since 1997 when the programs were first proposed to be exact.

But a just released evaluation study, funded and directed by the U.S. Department of Health and Human Services, found that students who took abstinence-only-until-marriage education programs were no more likely to abstain than students in the control group. They also had the same average age of first intercourse and the same number of partners.

Ten years into the program, and a billion dollars expended, the federal evaluation study confirms what those of us who are sexuality educators knew all along -- that telling teenagers to "just say no" was not effective education.

The press releases from organizations that support abstinence-only education are trying to find the best spin on the story. One said that it doesn't matter that the programs aren't effective because they offer the right moral message.

But, they don't. As our "Open Letter to Religious Leaders on Sex Education" says we have a Scriptural and theological commitment to truth-telling. And programs that lie or deny young people life saving information about their sexuality are wrong.

And immoral.

And now we have clear evidence that they are ineffective.

I'm sure that there is a Biblical prohibition about gloating that I am violating right now. But young people's futures, indeed, their lives have been at stake because of this program. One can only hope that the Congress and the Bush administration will pay attention to their own report.

It's time we offer America's young people education that works -- education that helps them abstain from sexual behaviors until they are physically, emotionally, and spiritually ready and education that helps them protect themselves from pregnancy and disease if they become sexually involved. Those programs have been shown to be effective -- and to this minister, they are the moral response as well.


Pam said...

Rev. Haffner - though I can understand why you are tempted to gloat about this study, I'm not sure the study is really conclusive. The fact is (and I think you would on some level agree) that sex education classes in a school setting alone likely have little impact whether they teach or promote birth control or abstinence until marriage. What I would like to know about the students in these studies is the extent to which their sex education was followed up in the home with honest discussions with parents and modelling of the family's sexual and family values openly in the family life. I would be interested in seeing closer interviews with the kids who DID choose abstinence (there were some, I gather) and find out what made the difference.

Just as one hour of health education per week as a part of "gym" class doesn't make teens choose to eat a diet of nothing but fresh fruits, vegetables, whole grains and grass-fed organic meats (occasionally, if desired, along with wild-caught salmon twice a week and plenty of tofu and beans, nuts and seeds), one hour of sex education (no matter what it teaches) isn't going to help students understand how self-respect and a true understanding of marriage (as a total gift of self, and a lifelong commitment to lay down one's life for the good of the partner) and entice them to go against all the messages of our popular culture and choose abstinence (or even birth control).

As you seem to indicate in your book (which I in the process of reading), the process of sex education (especially the encouragement of chastity, properly understood as the positive virtue in contrast to what some see as the negative practice of abstinence) really does have to take place "from diapers to dating."

I personally don't believe that without parents, not to mention Hillary Clinton's "village", that students can gain real positive sex education from a class in a school.

How many other subjects that we learn only as a class in school, with no real-life application actually have an impact on the way teens lead their lives? How many government classes actually produce in and of themselves, without family or community support, informed and conscientious voters?

I don't think this study is the death-knell of abstinence-only sex education. I think it belies the claim that public instruction in sex education has much of an effect either way.

Pam said...

Thanks for posting my comment above. I had a bit more to say after reading the Washington Post reporting on it this morning. Interestingly, the online WP article does not include the language I quote below from the print version on page A2 of this morning's print edition:

"Slightly more than half [of the children in the study] had 50 hours or more of education that taught them to wait to have sex until after marriages. The rest either had no sex education or received instruction in contraception as well as abstinence.

By the end of the study, when the average child was just shy of 17, half of both groups had remained abstinent. The sexually active teenagers had sex the first time about age 15. Less than a quarter of them, in both groups, reported using a condom every time they had sex. More than a third of both groups had two or more partners."

At the end of the article it states:

"Brown said Mathematica's results underscore what other, smaller studies have shown: "The most effective programs are those that say abstinence is the best choice but birth control and protection are also worth knowing about."

An official at the Sexuality Information and Education Council of the United States agreed.

"Comprehensive education means teaching about abstinence and a myriad of other topics," said spokeswoman Martha Kempner. Among them, she said: "contraception, critical thinking, one's own values and the values of your family and your religious community.

"Abstinence-only was an experiment and it failed.""

If the kids in the contraception-inclusive classes are doing exactly the same things at the same rates as the kids in abstinence-only education, what is the basis for calling contraception education "effective" at all? Even by the contraception-ed proponents' own measure of success(not the number of kids who choose to wait but the number of kids who use condoms or other birth control), they are doing NO BETTER than the abstinence-only programs even at achieving their own goals.

We had a reader comment on our own blog about this last month in the discussion about teen fertility charting. She wrote:

"This sort of leads me to a larger point, which is that I don’t think teenagers are nearly as impressionable as adults think they are. By the time I was 12 or 13, I already knew I wasn’t going to have sex until I was married or use contraception. I took sex ed at my Godless public school, and believe it or not, I did not suddenly decide to run off and have sex after hearing the teacher say the word “condom.”

In fact, most of sex ed was pretty innocuous; just stuff about how babies are made and whatnot. The only thing about the sex ed I had that might be objectionable to Catholic or Christian parents was that we learned about different types of birth control. But I just did what I did for almost all my classes back then: memorized it for the test and forgot it. If parents raise their kids right, they should have little reason to worry. (And if you’re still worried, you can always opt out)."

Sure, this study may prove that four (of the many more programs out there, many of which DO actually teach 'critical thinking, one's own values and the values of your family and religious community')abstinence-only programs were exactly as effective as so-called comprehensive sex ed programs. Which were exactly as effective as no sex ed at all.

I think that trying to put this education on the shoulders of already-overburdened schools is asking too much of the school institutions.

Cassandra said...

Pam nicely expressed my inital reaction (and then some!)to the post. Like her, I'd really want to know whether this message was being reinforced at home, because parents have a much bigger impact on their children's moral foundation than any public school class will ever have. While abstinence lessons taught at public schools may be a complement to what I am teaching my child at home, I understand that I am my child's primary educator in regards to the sexual education.

Debra W. Haffner said...

I've just found the link to the entire study so you can read it yourself.

You can read the entire Abstinence Education evaluation report at

Readers know that I believe that parents are the most important sexuality educators of their children. I've written two books on this! I tend to agree, Cassandra and Pam, that it is the values we give our children in our home that is most influential, and there is ample data that shows that where parents give their teens explicit messages about delaying intercourse, their children delay longer (but not until marriage...)

The problem is that the US Government has spent a BILLION dollars on this ab-only-until-marriage program, believing without any evidence, that it would help young people abstain until marriage. Now they have the evidence -- it does not.

Yes, some of the young people in the control group reported that they had had sex education but many did not, and the researchers did not look to evaluate or understand the content of THOSE programs. There are many many studies, going back to the 1980's, that demonstrate that programs that include abstinence and contraception and condoms do help young people delay and do help them use protection if they have intercourse. Google Scholar search "Doug Kirby" and you will get to his very fine reviews.

One last thing, before I go out to enjoy this nice day (since it's supposed to be winter here again tomorrow)...the four programs Mathmatic picked were picked because they were viewed as the ones most likely to show the impact of the ab-only program. It's too late to now say "oops they only did four."

The fact is that in a country where 95% of Americans have sexual intercourse BEFORE country no school based program is going to achieve a goal of abstinence until marriage. What we should all be able to agree on is that teenagers need our support -- parents support, school support, religious institution support, media support -- to not have mature sexual relationships until they are ready and to have the skills to protect their lives and future.

glendenb said...

Reading through the comments here, I had some thoughts.

I'm still in the process of reading the Mathematica report so I haven't studied it in depth - basically I've skimmed it once and I'm now I'm doing a deep read.

If I'm reading it correctly the abstinence group wasn't compared to comprehensive education group it was compared to a control group which received the normal "hour in health class" education. The study discusses at length the methodology of assigning the control versus program groups; control group students included students whose parents did not consent to their participation in sexuality education (page 20) so I think we can assume those students were received nothing beyond the basic health class with the gym teacher routine.

Having said that, the outcomes for abstinence only suggest that it is a complete waste of time and resources - even the most optimal outcomes were insignificant compared to the control group.

To Pam's question - what is the difference if the outcomes are the same, the answer is the outcomes aren't the same since this report doesn't compare the two types of programs. Where it has been studied, comprehensive sexuality education has had successful outcomes in terms of contraceptive use, reducing unplanned pregnancy and the transmission of STI's. But the Mathematica report did not assess the effectiveness of comprehensive sexuality education.

By almost every measure, the program group underperformed or matched the performance of the control group in terms of knowledge and behavioral choices. The few measures where the program group excelled were within the margin of error.

Mathematica's study only reinforces what researchers and advocates have long known - abstinence only does not achieve the results its supporters claim it will achieve. Abstinence only, in my estimation, is geared toward parental and adult fears of adolescent sexuality, not addressing the needs of adoloscents for accurate, comprehensive sexuality education.

Bill Baar said...

The MD who taught my kid's OWL class was pretty firm on abstinence. He gave a lot of examples from his practice. He was pretty disgruntled with the public schools for suggesting otherwise.

Having watched a number of people perish brutally, I agree.