Comprehensive Sex Ed is Much More Effective than Abstinence Education in Preventing Teen Pregnancies
There are some core issues which differentiate Democrats from Republicans such as abortion and gay marriage that can't be influenced much by scientific studies and research. However, there is also quite a number of public policy issues about which we can draw upon scientific inquiry to find answers. And sometimes those answers are quite definitive. This is part one in an ongoing series in which we will examine myths that Republicans believe and how they impact public policy.
Myth 1. Abstinence-only-until marriage sexual education [AOUM] is the best way to prevent unwanted teen pregnancies.
Not true, and the evidence is overwhelming.
Despite a virtual mountain of research to the contrary, President Trump and conservatives in Congress continue to push abstinence-only sex-ed programs in order to further an ideological agenda and appease their evangelical base.
In 2018, the Trump administration first tried to cut all funding for Teenage Pregnancy Prevention [TPP] programs and when that move was blocked by Federal Courts, issued new rules for TPP programs, favoring those that promote abstinence-only, even those with less rigorous evidence of effectiveness.
New York Times: "While the funding announcement, issued Friday by the Department of Health and Human Services, does not exclude programs that provide information about contraception and protected sex, it explicitly encouraged programs that emphasize abstinence or “sexual risk avoidance.”
And, in April, at the UN Commission on the Status of Women conference, the Trump administration insisted that agencies of the United Nations adopt their abstinence-only policy.
The facts: Recent studies are quite clear on this point; comprehensive sex education programs have a higher success rate than AOUM programs. In fact, when you employ comprehensive sex education with free birth control the results are astounding. Such programs, like the "Colorado Miracle" described below, dramatically reduce teenage pregnancy and abortions while also saving tax dollars.
First, the most current research on abstinence-only programs demonstrates that they have little value and can harm those we wish to help.
Journal of Adolescent Health: "Policies or programs offering abstinence as a single option for unmarried adolescents are scientifically and ethically flawed. AOUM programs have little demonstrated efficacy in helping adolescents to delay intercourse, while prompting health-endangering gender stereotypes and marginalizing sexual minority youth. While abstinence from sexual intercourse is theoretically fully protective against pregnancy and STIs, in actual practice, AOUM programs often fail to prevent these outcomes. AOUM programs have generated considerable political support from social conservatives, despite their lack of scientific evidence of efficacy and the fact that they withhold critical health information."
Society for Adolescent Medicine: "Providing “abstinence only” or “abstinence until marriage” messages as a sole option for teenagers is flawed from scientific and medical ethics viewpoints. Efforts to promote abstinence should be based on sound science. Although federal support of abstinence-only programs has grown rapidly since 1996, the evaluations of such programs find little evidence of efficacy in delaying initiation of sexual intercourse. Conversely, efforts to promote abstinence, when offered as part of comprehensive reproductive health promotion programs that provide information about contraceptive options and protection from STIs have successfully delayed initiation of sexual intercourse. Moreover, abstinence-only programs are ethically problematic, being inherently coercive and often providing misinformation and withholding information needed to make informed choices. In many communities, abstinence-only education (AOE) has been replacing comprehensive sexuality education. In some communities, AOE has become the basis for suppression of free speech in schools. Abstinence-only education programs provide incomplete and/or misleading information about contraceptives, or none at all, and are often insensitive to sexually active teenagers. Federally funded abstinence-until-marriage programs discriminate against gay, lesbian, bisexual, transgender and questioning youth, as federal law limits the definition of marriage to heterosexual couples."
In her recent article, Dr. Heather Sher sums it up quite well, quoting from a study published by the National Institute of Health:
Dr. Heather Sher: "Research studies show that teaching about contraception is not associated with increased risk of adolescent sexual activity or sexually transmitted diseases (STDs) as suggested by.... abstinence-only advocates. Teens who received comprehensive sex-ed had a lower risk of pregnancy and STD infection than teens who received abstinence-only or no sex education at all in the U.S. Even more staggering, “the more strongly abstinence is emphasized in state laws and policies, the higher the average teenage pregnancy and birth rate.”
And recent studies have also demonstrated that if you combine comprehensive sex-ed programs with free birth control you can dramatically reduce teen pregnancies and abortions while saving millions in tax dollars.
In a study published in the New England Journal of Medicine in 2014, teens who were educated about birth control and received free long-acting birth control devices were significantly less likely to get pregnant or to get an abortion compared to other sexually active teens. The annual pregnancy rate for teens aged 15 to 19 in the study was 3.4 percent, compared to 15.9 percent for all U.S. teens who are sexually active.
Based on such studies, Colorado decided to see if it would work there and launched the Colorado Family Planning Initiative. It's now known as the "Colorado Miracle." The Initiative employed a comprehensive strategy to address unwanted teen pregnancy.
Increase access to quality services. CFPI adopted a “no wrong door” approach that brought services to women wherever they might encounter the healthcare system. Grants to over 100 public health centers, including school-based and rural clinics, supported training for residents, advanced practice nurses, and others, allowing them to improve counseling and to insert (and remove) implants and IUDs. More flexible hours at these health centers improved access for working women. CFPI integrated family planning into primary care, labor and delivery, and post-abortion care.
Increase availability of IUDs and Implants. CFPI funding made all methods available with no co-pay, a standard that later would be incorporated into Obamacare (now on the chopping block, of course). Implants and IUDs are cheaper in the long run than other forms of birth control, especially if you include the costs associated with an unplanned pregnancy. But until recently, the up-front price of long acting contraceptives has made these methods unavailable to many women.
Promote healthy decisions and planning. Better access to better birth control doesn’t do much good if people don’t know about it, so the CFPI worked to normalize conversations about sexual health. Young Latinas, who have a higher-than-average teen pregnancy rate, talked with each other in culturally proficient after-school programs. Social service agencies offered sexuality workshops or provided onsite access to educators. A website, BeforePlay, offered practical information about contraception and sexual health, as well as specific resources available across the state.
Colorado outlined their results in a report titled, Colorado's success with long-acting reversible contraception (LARC). Highlights included:
- Teen birth rate was nearly cut in half.
- Teen abortion rate was nearly cut in half.
- Births to women without a high school education fell 38 percent.
- Second and higher order births to teens were cut by 57 percent.
- Birth rate among young women ages 20-24 was cut by 20 percent.
- Average age of first birth increased by 1.2 years among all women.
- Rapid repeat births declined by 12 percent among all women.
- Costs avoided: $66.1-$69.6 million.
As you might expect, despite objections from some religious conservatives, the Colorado State legislature extended funding for the project. Delaware is employing a similar program and many other progressive state legislatures are considering their own.
Part 2 of this Series on Conservative Myths is on Voter Fraud. Read it Here.
By: Don Lam, Curated Content