Taking a look: the effectiveness of sex education

CDC Graph's Data Sources (which does not account for number of abortions):

1. Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary data for 2007. National vital statistics reports; vol 57 no 12. Hyattsville, MD: National Center for Health Statistics. 2009.
2. Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Estimated pregnancy rates by outcome for the United States, 1990-2005. National vital statistics reports; vol 58 no 4. Hyattsville, MD: National Center for Health Statistics. 2009.
3. Hamilton BE, Martin JA, Ventura SJ. Births: Preliminary data for 2008. National vital statistics reports web release; vol 58 no 16. Hyattsville, Maryland: National Center for Health Statistics. Released April 2010.
4. Ventura SJ, Abma JC, Mosher WD, Henshaw SK. Estimated pregnancy rates by outcome for the United States, 1990-2004. National vital statistics reports; vol 56 no 15. Hyattsville, MD: National Center for Health Statistics. 2008.
5. Singh S, Darroch JE. Adolescent pregnancy and childbearing: levels and trends in developed countries. Family Planning Perspectives 2000;32(1):14–23.

     For my Human Development class, I'm writing an analytical paper on responsible scientific research writing v. spin, and how to discern between the two to get to the facts.  Although the topic of choice is on the effects of divorce on children (to be posted later), I've been doing the readings for the other suggested topics, as I believe in being well informed and knowing both sides of a debate.  Tried-and-true facts and observation are precious in the experiment called life.  As you likely can infer from other blogs or my general character, I am pro-chastity-until-marriage and you-are-free-to-be-chaste-even-after-you-mess-up.  I have an unfortunate number of friends who have had to pay the price in a number of regards concerning not keeping their virginity.  Thus it is a personal issue.  Disease, depression, abortions, unsupported pregnancies, male abandonment, loss of identity, and stress (to say the least) have been some of the issues.  Quite the cost to beat loneliness or engage in hedonism...
     Is sex important? Yes!
     Is sex good for your health?  I can say without a doubt, yes!
     Is there an optimal time to engage in sex?  Yes, and that is defined as within marriage -- monogamy really is the safest bet for so many sane reasons.
     I do believe adolescents/young adults should be informed about the purpose and function of their bodies for the purpose of comprehension, and should certainly learn to recognize physical cues and verbal meanings to keep them safe from sexual predators.  But I do not think it is necessary for children to know the how to's of intimacy.  Youth are passionate, full of vigor and a need to belong.  When it comes to moral issues, youth are typically stuck in one of two paradigms:

• they want to see how much they can get away with if boundaries are not defined, or
• they are caught in a true fixation with role; ie: "I am the good student," "I am the unbending rebel."

     In short, a kid is going to choose to engage in sex or not: the answer is character/opportunity based.  People do not suddenly make a life-changing decision in a moment.  Ideas are mulled over at great length, even lifetimes before a choice is made.  Example:  When I was a child, I took one look at the Disney princesses, Jessica Rabbit, and the gorgeous actresses of the Golden Age of cinema and thought to myself, "I want to be beautiful and alluring and sought after by everyone when I grow up!"  Those sexy, perfectly designed dresses, the awesome curve of a woman's back/shoulder/neckline  -- sigh! -- are still things I drool and pine for, and would flaunt in a heartbeat if I could.  Also as a child, I began an early understanding of my faith, and I had an unflagging desire to remain chaste and worthy that I could be married to an eternal beloved in the temple (the San Diego temple being the most romantic I could aspire to).  Lo and behold!  The second desire had more power in my course than the first.  AND I had the honor of being married to Brant in combination with my dream temple.  Not too shabby a result.  Was my libido flat-lining through adolescence until my honeymoon?  Hardly.  I tend to think I had it a touch harder than most kids maturing, as all my growth stopped in fourth grade.  And yes, I do still wear some of the same things I did then.  My face has altered with time, but that's it.  Which, let me tell you, made dealing with males of all ages very interesting.  Eleven year old me had to turn down the advances of 24+ year old men in my first fencing class at Delta College; who all found it very difficult to believe that someone so young had already become a woman in appearance, let alone was involved in the rigorous course.  However this was far from the first time I had had to deal with this scenario.  The first time a boy kissed me was age 5.  The moral of this story is that young people have to deal with sexuality a lot earlier than adults would prefer to think about.
     Is sex education needed?  Yes, it could be useful, but not in the way that it is currently handled.  From page 5 of "Roadblocks Imposed by the Federal Government’s Abstinence-Only-Until-Marriage Education Program":

An out-of-court settlement in 1993 stipulated that AFLA-funded sexuality education programs must: (1) not include religious references, (2) be medically accurate, (3) respect the “principle of self-determination” regarding contraceptive referral for teenagers, and (4) not allow grantees to use church sanctuaries for their programs or to give presentations in parochial schools during school hours.

Fine.  Separation of Church and State. But:

Abstinence-only-until-marriage education as defined in AFLA has been taught for over two decades and yet there is still no peer-reviewed research that proves it is effective in changing
adolescents’ behavior. To the contrary, a meta-evaluation of AFLA program evaluations
found them “barely adequate” to “completely inadequate.”

.....Let's see.  If I keep my hands to myself, I don't contract any STDs.  I also don't get impregnated by day-dreaming. I don't know, but I think that puts me in the clear.  So how does it not work?
     The choice to ignore the consequences for short-term pleasure. IE: I'm impatient and have little control.
     If you make sex a "right" instead of treating it as the basic instinct it is like eating and sleeping, which has a time/place/amount for good health, it automatically asks the nitty-gritty of what is acceptable and when.  Funny that unlike eating and sleeping, "moderation in all things" does not prevail in today's conversation; it's have more now sooner and here's how to get started.  How do I know?  My childhood dealt with the conversion from abstinence programs to the how-to-have-sex-and-not-let-your-parents-know programs, from 5th to 9th grade, CA.  Which was before the program extended itself all the way down to Kindergarten.  Are you aware of the most desired subjects of porn and human trafficking?  The answer is children.  The younger the better.  In softer porn, adults play at being teenage minors.  In the real hard porn, actual children are being denied their right to a normal lifestyle, their health questionable at best.  Human trafficking?  I don't need to write the ugliness that prevails concerning the poor children around the world and the degrading circumstances they are pressed into, usually leading to their deaths since they are so "replaceable."  I declare myself as a Modern Abolitionist, and as such, I have to ask why we are teaching so many specifics beyond birds and bees to our youth?  To quote my mother, I would ask you to consider the question, do some research and, "Follow the money." The answers you will find -- as there are more than one -- are hard, unpleasant, and not uplifting.  Which is why it is not a major talking point in our country when it should be.  So, if you ever feel yourself getting riled and protective of children everywhere, become an Abolitionist and start making a difference.
     With that said, are there more kids being foolish in their relationships than in previous years?  Yes.  However, I cannot say at this point without more research if the ratio to the population has been steady or if it has spiked.  Most media outlets aren't going to point out that consideration either.  If either is true, then backing reasons likely "won't fit the narrative," as they say.  Like I wrote before, youth choose how they will handle different situations, long before they happen.  Compromising situations do happen even to the most stalwart, and we're not even getting into the sad truth of the prevalence of sexual abuse/assault/rape.  We're just talking the average experience for now.  Boy meets girl.  Crushes blossom into promises of love.  Someone asks to prove love.  Now what?
     Sex education, when presented like an anti-drug campaign, is valuable for those who are already at risk or already engaging too soon in a behavior with consequences youth are not ready for.  But sex education as I and most others after me have experienced it, know the program to be about product placement for feminine sanitary supply, pills, condoms, and specific phone numbers to get around those concerned parents who keep bugging you.  Because parents clearly never figured out they weren't supposed to give birth to you (married or not), so you have to be smarter!  Your existence endangers, and adds another carbon footprint on the poor planet.
     And we wonder why lack of empathy and depression percentages in the country are so high?
     The majority of the talk I was lectured about, and have heard younger friends deal with, was sex, positions, elimination of gender, and shirking of responsibilities with deceptively no consequences.  Interestingly enough, many were appropriately uninterested in pursuing sexual relations until they had the mandatory classes.  Then they were revved to partake.  With a rare nod to abstinence or rearing your own child, adoption is barely mentioned as a possibility.  With infertility beginning to spike, not just in America, but around the industrialized world, it is becoming a privilege to be able to conceive at all.  With so many honestly trying to get pregnant, even willing to monetarily sponsor anyone who could grant them a bestowed title of parenthood, one would hope that this would be given greater notice as an option for the young and sexually foolhardy, but no.
     From the American Pregnancy Association comes this summary:

Reproductive Health:

Every year in the United States, there are 60,000,000 women in the childbearing years of 15-44 :

• 70% of these women are sexually active

• 64% use a form of contraception

• 3,000,000 use NO contraception, accounting for 47% of unplanned pregnancies

• 6,000,000 women deal with infertility

• 2,000,000 married couples are infertile

  Currently there are 68,000,000 individuals with an STD:

  • There are 15,300,000 new STD cases each year

  • 3,000,000 teenagers acquire an STD each year

     So why not the abstinence based programs?  Because they apparently censor out contraceptive information and instill fear and shame.  Well, if you're not planning to do anything until you're a logically reasoning adult who can choose what has the most personally desirable effect, then what's the point in delving into smooth vs. ribbed as a child?  For the record, I have never experienced a censorship of truth concerning intimacy.  The information given to me has always come straight from well documented studies, honored doctors and psychologists, parents, and personal physicians.  In my experience, they all point to the same conclusion.  Abstinence is empowering.  The scientific facts behind the reasoning gives the freedom to have mastery of one's body and interactions with others, to say no because you don't want to, and not feel compelled because you believe that sex is an expected behavior.
     Sex is great.  But it is greatest when it is unfettered by the concerns that come from "casual encounters."  I have never regretted my decision to give myself only to my husband.  In fact, I claim true bliss with the result.

     The choice belongs to the youth in question, what to do with the information available.

     The truth is the truth no matter how you try to look away or sugar-coat realities.  It will be obvious and speak for itself.

     Don't take my word for it.  Do your own critical thinking and examine both sides of the argument.  Be careful to observe whether what you discover is citing good research, is trying to sway people with emotion rather than evidence, is drawing conclusions about cause and effect from correlational data, etc.  Look for the source material and read it to know the proper conclusions were derived.  Look for the numbers.  Look for simplicity, not lulled stupidity.  Take a look.

    Below is an article written over a decade ago now, whose data is upheld.  I've highlighted parts that had special significance to my own study.  May you enjoy the reading and consider the findings.

 

School-Based Health Clinics and Sex Education

Written by Kerby Anderson, 1998

School-based Health Clinics

     As comprehensive sex education curricula have been promoted in the schools, clinics have been established to provide teens greater access to birth control information and devices. Proponents cite studies that supposedly demonstrate the effectiveness of these clinics on teen sexual behavior. Yet a more careful evaluation of the statistics involved suggests that school-based health clinics do not lower the teen pregnancy rate.
     The first major study to receive nationwide attention was DuSable High School. School administrators were rightly alarmed that before the establishment of a school-based health clinic, three hundred of their one thousand female students became pregnant. After the clinic was opened, the media widely reported that the number of pregnant students dropped to 35. As more facts came to light, the claims seemed to be embellished. School officials admitted that they kept no records of the number of pregnancies before the operation of the clinic and that three hundred was merely an estimate. Moreover, school officials could not produce statistics for the number of abortions the girls received as a result of the clinic.
     The most often-cited study involved the experience of the clinic at Mechanics Arts High School in St. Paul, Minnesota. Researchers found that a drop in the number of teen births during the late 1970s coincided with an increase in female participation at the school-based clinics. But at least three important issues undermine the validity of this study.
     First, some of the statistics are anecdotal rather than statistical. School officials admitted that the schools could not document the decrease in pregnancies. The Support Center for School-Based Clinics acknowledged that "most of the evidence for the success of that program is based upon the clinic's own records and the staff's knowledge of births among students. Thus, the data undoubtedly do not include all births."
     Second, an analysis of the data done by Michael Schwartz of the Free Congress Foundation found that the total female enrollment of the two schools included in the study dropped from 1268 in 1977 to 948 in 1979. Therefore the reduction in reported births could have been merely attributable to an overall decline in the female population at the school.
     Finally, the study actually shows a drop in the teen birth rate rather than the teen pregnancy rate. The reduction in the fertility rate listed in the study was likely due to more teenagers obtaining an abortion.
      Today, more and more advocates of school-based health clinics are citing a three-year study headed by Laurie Zabin at Johns Hopkins University, which evaluated the effect of sex education on teenagers. The study of two school-based clinics in Baltimore, Maryland showed there was a 30 percent reduction in teen pregnancies.
     But even this study leaves many unanswered questions. The size of the sample was small and over 30 percent of the female sample dropped out between the first and last measurement periods. Since the study did not control for student mobility, critics point out that some of girls who dropped out of the study may have dropped out of school because they were pregnant. And others were not accounted for with follow-up questionnaires. Other researchers point out that the word abortion is never mentioned in the brief report, leading them to conclude that only live births were counted.
     The conclusion is simple. Even the best studies used to promote school-based health clinics prove they do not reduce the teen pregnancy rate. School-based clinics do not work.

Sex Education

     For more than thirty years proponents of comprehensive sex education have argued that giving sexual information to young children and adolescents will reduce the number of unplanned pregnancies and sexually transmitted diseases. In that effort nearly $3 billion have been spent on federal Title X family planning services; yet teenage pregnancies and abortions rise.
     Perhaps one of the most devastating popular critiques of comprehensive sex education came from Barbara Dafoe Whitehead. The journalist who said that Dan Quayle was right also was willing to say that sex education was wrong. Her article, "The Failure of Sex Education" in the October 1994 issue of Atlantic Monthly, demonstrated that sex education neither reduced pregnancy nor slowed the spread of STDs.
      Comprehensive sex education is mandated in at least seventeen states, so Whitehead chose one of those states and focused her analysis on the sex education experiment in New Jersey. Like other curricula, the New Jersey sex education program rests on certain questionable assumptions.
     The first tenet is that children are sexual from birth. Sex educators reject the classic notion of a latency period until approximately age twelve. They argue that you are "being sexual when you throw your arms around your grandpa and give him a hug."

     Second, children are sexually miseducated. Parents, to put it simply, have not done their job, so we need "professionals" to do it right. Parents try to protect their children, fail to affirm their sexuality, and even discuss sexuality in a context of moralizing. The media, they say, is also guilty of providing sexual misinformation.

     Third, if mis-education is the problem, then sex education in the schools is the solution. Parents are failing miserably at the task, so "it is time to turn the job over to the schools. Schools occupy a safe middle ground between Mom and MTV."

     Learning about Family Life is the curriculum used in New Jersey. While it discusses such things as sexual desire, AIDS, divorce, condoms, and masturbation, it nearly ignores such issues as abstinence, marriage, self-control, and virginity. One technique promoted to prevent pregnancy and STDs is noncoital sex, or what some sex educators call "outercourse." Yet there is good evidence to suggest that teaching teenagers to explore their sexuality through noncoital techniques will lead to coitus. Ultimately, outercourse will lead to intercourse.
     Whitehead concludes that comprehensive sex education has been a failure. For example, the percent of teenage births to unwed mothers was 67 percent in 1980 and rose to 84 percent in 1991. In the place of this failed curriculum, Whitehead describes a better program. She found that "sex education works best when it combines clear messages about behavior with strong moral and logistical support for the behavior sought." One example she cites is the "Postponing Sexual Involvement" program at Grady Memorial Hospital in Atlanta, Georgia, which offers more than a "Just say no" message. It reinforces the message by having adolescents practice the desired behavior and enlists the aid of older teenagers to teach younger teenagers how to resist sexual advances. Whitehead also found that "religiously observant teens" are less likely to experiment sexually, thus providing an opportunity for church- related programs to help stem the tide of teenage pregnancy.
      Contrast this, however, with what has been derisively called "the condom gospel." Sex educators today promote the dissemination of sex education information and the distribution of condoms to deal with the problems of teen pregnancy and STDs.

The Case Against Condoms

     At the 1987 World Congress of Sexologists, Theresa Crenshaw asked the audience, "If you had the available partner of your dreams and knew that person carried HIV, how many of you would have sex, depending on a condom for your protection?" None of the 800 members of the audience raised their hand. If condoms do not eliminate the fear of HIV infection for sexologists and sex educators, why encourage the children of America to play STD Russian roulette?
     Are condoms a safe and effective way to reduce pregnancy and STDs? Sex educators seem to think so. Every day sex education classes throughout this country promote condoms as a means of safe sex or at least safer sex. But the research on condoms provides no such guarantee.
     For example, Texas researcher Susan Weller, writing in the 1993 issue of Social Science Medicine, evaluated all research published prior to July 1990 on condom effectiveness. She reported that condoms are only 87 percent effective in preventing pregnancy and 69 percent effective in reducing the risk of HIV infection. This 69 percent effectiveness rate is also the same as a 31 percent failure rate in preventing AIDS transmission. And according to a study in the 1992 Family Planning Perspectives, 15 percent of married couples who use condoms for birth control end up with an unplanned pregnancy within the first year.
     So why has condom distribution become the centerpiece of the U.S. AIDS policy and the most frequently promoted aspect of comprehensive sex education? For many years the answer to that question was an a priori commitment to condoms and a safe sex message over an abstinence message. But in recent years, sex educators and public health officials have been pointing to one study that seemed to vindicate the condom policy.
     The study was presented at the Ninth International Conference on AIDS held in Berlin on June 9, 1993. The study involved 304 couples with one partner who was HIV positive. Of the 123 couples who used condoms with each act of sexual intercourse, not a single negative HIV partner became positive. So proponents of condom distribution thought they had scientific vindication for their views.
     Unfortunately, that is not the whole story. Condoms do appear to be effective in stopping the spread of AIDS when used "correctly and consistently." Most individuals, however, do not use them "correctly and consistently." What happens to them? Well, it turns out that part of the study received much less attention. Of 122 couples who could not be taught to use condoms properly, 12 became HIV positive in both partners. Undoubtedly over time, even more partners would contract AIDS.
     How well does this study apply to the general population? Not very well. This study group was quite dissimilar from the general population. For example, they knew the HIV status of their spouse and therefore had a vested interest in protecting themselves. They were responsible partners in a committed monogamous relationship. In essence, their actions and attitudes differed dramatically from teenagers and single adults who do not know the HIV status of their partners, are often reckless, and have multiple sexual partners.
And even if condoms are used correctly, do not break, and do not leak, they are still far from 100 percent effective. The Medical Institute for Sexual Health reported that "medical studies confirm that condoms do not offer much, if any, protection in the transmission of chlamydia and human papilloma virus, two serious STDs with prevalence as high as 40 percent among sexually active teenagers."

Abstinence Is the Answer

     Less than a decade ago an abstinence-only program was rare in the public schools. Today, directive abstinence programs can be found in many school districts while battles are fought in other school districts for their inclusion or removal. While proponents of abstinence programs run for school board or influence existing school board members, groups like Planned Parenthood bring lawsuits against districts that use abstinence-based curricula, arguing that they are inaccurate or incomplete.
     The emergence of abstinence-only programs as an alternative to comprehensive sex education programs was due to both popularity and politics. Parents concerned about the ineffectiveness of the safe- sex message eagerly embraced the message of abstinence. And political funding helped spread the message and legitimize its educational value. The Adolescent Family Life Act, enacted in 1981 by the Reagan Administration, created Title XX and set aside $2 million a year for the development and implementation of abstinence-based programs. Although the Clinton Administration later cut funding for abstinence programs, the earlier funding in the 1980s helped groups like Sex Respect and Teen-Aid launch abstinence programs in the schools.
Parents and children have embraced the abstinence message in significant numbers. One national poll by the University of Chicago found that 68 percent of adults surveyed said premarital sex among teenagers is "always wrong." A 1994 poll for USA Weekend asked more than 1200 teens and adults what they thought of "several high profile athletes [who] are saying in public that they have abstained from sex before marriage and are telling teens to do the same." Seventy-two percent of the teens and 78 percent of the adults said they agree with the pro-abstinence message.
     Their enthusiasm for abstinence-only education is well founded. Even though the abstinence message has been criticized by some as naive or inadequate, there are good reasons to promote abstinence in schools and society.
     First, teenagers want to learn about abstinence. Contrary to the often repeated teenage claim, not "everyone's doing it." A 1992 study by the Centers for Disease Control found that 43 percent of teenagers from ages fourteen to seventeen had engaged in sexual intercourse at least once. Put another way, the latest surveys suggest that a majority of teenagers are not doing it.
     A majority of teenagers are abstaining from sex; also more want help in staying sexually pure in a sex-saturated society. Emory University surveyed one thousand sexually experienced teen girls by asking them what they would like to learn to reduce teen pregnancy. Nearly 85 percent said, "How to say no without hurting the other person's feelings."
     Second, abstinence prevents pregnancy. After the San Marcos (California) Junior High adopted the Teen-Aid abstinence-only program, the school's pregnancy rate dropped from 147 to 20 in a two-year period.

     An abstinence-only program for girls in Washington, D.C. has seen only one of four hundred girls become pregnant. Elayne Bennett, director of "Best Friends," says that between twenty and seventy pregnancies are common for this age-group in the District of Columbia.

     Nathan Hale Middle School near Chicago adopted the abstinence-only program "Project Taking Charge" to combat its pregnancy rate among eighth-graders. Although adults were skeptical, the school graduated three pregnancy-free classes in a row.

     Abstinence works. That is the message that needs to be spread to parents, teachers, and school boards. Teenagers will respond to this message, and we need to teach this message in the classroom.
Third, abstinence prevents sexually transmitted diseases (STDs). After more than three decades, the sexual revolution has taken lots of prisoners. Before 1960, doctors were concerned about only two STDs: syphilis and gonorrhea. Today there are more than twenty significant STDs, ranging from the relatively harmless to the fatal. Twelve million Americans are newly infected each year, and 63 percent of these new infections are in people under twenty-five years of age. Eighty percent of those infected with an STD have absolutely no symptoms.
     Doctors warn that if a person has sexual intercourse with another individual, he or she is not only having sexual intercourse with that individual but with every person with whom that individual might have had intercourse for the last ten years and all the people with whom they had intercourse. If that is true, then consider the case of one sixteen-year-old girl who was responsible for 218 cases of gonorrhea and more than 300 cases of syphilis. According to the reporter, this illustrates the rampant transmission of STDs through multiple sex partners. "The girl has sex with sixteen men. Those men had sex with other people who had sex with other people. The number of contacts finally added up to 1,660." As one person interviewed in the story asked, "What if the girl had had AIDS instead of gonorrhea or syphilis? You probably would have had 1,000 dead people by now."
     Abstinence prevents the spread of STDs while safe sex programs do not. Condoms are not always effective even when they are used correctly and consistently, and most sexually active people do not even use them correctly and consistently. Sex education programs have begun to promote "outercourse" instead of intercourse, but many STDs can be spread even through this method, and, as stated, outercourse almost always leads to intercourse. Abstinence is the only way to prevent the spread of a sexually transmitted disease.
     Fourth, abstinence prevents emotional scars. Abstinence speakers relate dozens and dozens of stories of young people who wish they had postponed sex until marriage. Sex is the most intimate form of bonding known to the human race, and it is a special gift to be given to one's spouse. Unfortunately, too many throw it away and are later filled with feelings of regret.
     Surveys of young adults show that those who engaged in sexual activity regret their earlier promiscuity and wish they had been virgins on their wedding night. Even secular agencies that promote a safe-sex approach acknowledge that sex brings regrets. A Roper poll conducted in association with SIECUS (Sexuality Information and Education Council of the United States) of high schoolers found that 62 percent of the sexually experienced girls said they "should have waited."
     Society is ready for the abstinence message, and it needs to be promoted widely. Anyone walking on the Washington Mall in July 1993 could not miss the acres of "True Love Waits" pledge cards signed by over 200,000 teenagers. The campaign, begun by the Southern Baptist Convention, provided a brief but vivid display of the desire by teenagers to stand for purity and promote abstinence. For every teenager who signed a card pledging abstinence, there are no doubt dozens of others who plan to do the same.
      Teenagers want and need to hear the message of abstinence. They want to promote the message of abstinence. Their health, and even their lives, are at stake.