U.S. Tells Teen Girls Worldwide to Just Say No
The Bush administration, which has blocked payments to the United Nations Population Fund because of unfounded reports that American money was going to abortion in China, opened a new front in its opposition to international family planning efforts this month.
This time, in meetings surrounding the United Nations Special Session on Children, the American delegation tried to parlay its "abstinence-only" sex education plan into international policy.
The bid to give prominence to a "just say no" policy on adolescent sex was defeated by a majority of nations this time. Yet women's health experts, inside and outside the United Nations, fear that the issue will sooner or later resurface, and say Washington's campaign can only hurt girls in the poorest nations.
In the developing world, pregnant girls are most often married, sometimes at 10 or younger, or are the victims of sexual coercion and trafficking, said Adrienne Germain, president of the International Women's Health Coalition, based in New York.
Promiscuous behavior is not the issue. Sex education is not a moral question but often a matter of life or death, especially now that AIDS has begun to affect girls and women in sharply rising numbers in Africa and Asia, outstripping the spread of the disease among men, experts said.
Moreover, pregnancy is the leading cause of death for young women ages 15 to 19 in poor countries, according to UNICEF, the United Nations Children's Fund. Many die because they are physically too young to be mothers. But their societies give them no choice.
"Abstinence-only sex education is a very negative position that the U.S. is taking, which need not be imposed on other countries," Germain said.
U.S. Leads Abstinence-Only Campaign
Tommy Thompson, the U.S. Secretary of Health and Human Services who led the United States delegation at the Special Session on Children from May 8 to May 10, is among Bush administration officials who have emphasized abstinence as a preventive measure not only for unwanted pregnancies but also for the spread of sexually transmitted diseases. In April, a House of Representatives committee voted to continue an abstinence-only sex education program in the United States at a cost of $50 million a year. Broader sex education programs cannot draw on those funds.
Speaking at a news conference during the United Nations special assembly, Anne Peterson, Assistant Administrator of the U.S. Agency for International Development's Bureau for Global Health, said that the administration's aim was to prevent many diseases as well as teen-age pregnancies, both internationally and on the domestic front. She said that there was clear evidence that delaying the onset of sexual activity was an integral part of a successful health program. She added that the administration advocated raising the age of marriage around the world to avoid adverse health consequences from early births when abstinence was not possible.
Opponents of the Bush formula say that the United States encourages other nations and the Vatican to advocate this policy in international gatherings.
Among these opponents are the International Planned Parenthood Federation, Catholics for a Free Choice and Protestant church groups that oppose the tenets of the religious right.
Jennifer S. Butler, Associate for Global Issues for the Presbyterian United Nations Office, says that Algeria, Egypt, Iran, Libya, Nicaragua, Pakistan and Sudan are among those counties working in concert with the United States on issues of sex education and the reproductive health rights of women.
Early Marriage Common in Many Nations
Statistics from a variety of United Nations agencies and other international organizations provide a picture of adolescent motherhood in the developing world. They show that 82 million girls between the ages of 10 and 17 living in developing countries will be married before their 18th birthdays. Young women ages 15 to 19 are twice as likely to die in childbirth than are women in their 20s and those under 15 are five times as likely not to survive pregnancy.
More than 4.4 million adolescents in the 15-to 19-year-old age group have abortions every year, according to the United Nations Population Fund. The agency estimates that 40 percent of them are unsafe and frequently extremely crude operations.
Young women are considered especially at risk in sub-Saharan Africa and South Asia. A report from the Mahbub ul Haq Human Development Center in Islamabad, Pakistan, said that over 200,000 women across South Asia -- comprising Bangladesh, Bhutan, India, Maldives, Nepal and Sri Lanka as well as Pakistan -- die in pregnancy and childbirth every year.
"Norms of early marriage continue to predominate and a large majority of girls become mothers before the age of 20," said the report, "Human Development in South Asia 2000: The Gender Question."
It found that, at least in Pakistan, women did not have enough knowledge or authority in a family to demand contraceptives until they reached their 30s.
Germain said that young brides in parts of Africa and Asia tend to be married to men considerably older and that these men have often had multiple heterosexual or homosexual experiences, raising the risk of sexually transmitted diseases including AIDS. Because girls forced into early marriages usually cannot attend school and are under family pressure to produce children, they do not have the opportunity or time to learn about sexuality, contraception and disease, she said.
"In Nigeria, a girl often can't even get prenatal care without her husband's permission," said Germain, a former Ford Foundation director in Bangladesh who has helped to set up clinics for women there. "Married teen-age girls are the most oppressed."
Barbara Crossette is a former New York Times correspondent in India and the author of three books on Asia.