When Abstinence Advocates Attack

The women’s rights advocacy group Legal Momentum organized a hearing on Capitol Hill this Tuesday to publicize its newly released report, Sex, Lies & Stereotypes: How Abstinence-Only Programs Harm Women and Girls (pdf). The report was released as Congress is deciding whether to renew a controversial funding bill targeted at preventing HIV transmission overseas. The legislation is expected to loosen -- but not eliminate -- rules that prohibit the United States from giving money to any organization overseas that teaches anything other than abstinence-only sexual education.

While the hearing promised to be just another boilerplate Capitol Hill event, things got exciting when a handful of self-identified abstinence educators swept into the room. As Legal Momentum Staff Attorney Julie Kay read a litany of reasons why abstinence-only education is inefficient, harmful, and inaccurate as means for educating young people about sex, preventing the spread of sexually transmitted diseases, and preventing unwanted pregnancies, one man stood up and shouted, "Who here can admit that if you don't have sex you won't get an STD?" In fact, there are several ways to get an STD without having sexual intercourse -- such as through touching and oral sex. The human papillomavirus (more commonly known as HPV), for instance, can be transmitted through skin-to-skin contact.

Jennifer Heitel Yakush, a senior public policy associate at the Sexuality Information and Education Council of the United States (SIECUS), noted that "the first, second, and last" components of comprehensive sexual education should be about abstinence, but she emphasized that classes should also include information on how to correctly use condoms and other forms of contraception. Providing this information to young people is vital, Yakush said, so that whenever they do choose to become sexually active they will have all the information they need to remain healthy.

Abstinence-only education funding has a long history of bipartisan support. There are three ways that the programs are funded in the United States: the Adolescent Family Life Act, which was enacted under Ronald Reagan; a section of "welfare reform" legislated under Bill Clinton in 1996; and the Community Based Abstinence Education (CBAE) fund that was instituted in 2000.

Out of these three sources, CBAE has the most stringent rules. To receive money from the fund, a sexual-education program must teach an eight-point set of guidelines, which include lessons such as: “Sexual activity outside the context of marriage is likely to have harmful psychological and physical effects”; young people should know "how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances”; and why young people should attain “self-sufficiency before engaging in sexual activity.” Financial independence, Kay said, is at best irrelevant to sexual activity. Eight congressional representatives including Louise Slaughter (D-NY), Jim Moran (D-VA), and Henry Waxman (D-CA) have signed a letter asking for the end of CBAE funding. In the meantime, more than a dozen states have already rejected abstinence-only education funding because of the eight-point restrictions.

“The only success [abstinence-only education] had was a political success by pandering to the right wing,” Waxman said at the hearing. He argued that abstinence-only education programs are “demeaning” and harmful to women. “I think we ought to pull the plug on funding them,” he said to applause from the audience.

An attendee who identified herself as a "nurse" and an "abstinence educator" argued that it will just take time for abstinence-only education to work, and compared the teaching method to seat belt laws and anti-smoking campaigns. (Anyone want to call Ralph Nader and see if he’s in favor of abstinence-only education?)

She estimated that it would take at least 20 years for abstinence-only education to make an impact upon young people's sexual activity trends. Yakush noted that perhaps this woman was talking about research first conducted by Dr. Douglas Kirby, who released a report in 2001 called Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. His report, Yakush said, argued that “the jury was still out” on abstinence only education. But an updated report (pdf) released last year by Kirby -- a meta-analysis of all abstinence-only programs -- concluded that on the whole abstinence-only education is ineffective in delaying sexual initiation, reducing teen pregnancy rates, and stopping the spread of STDs. He found that the most effective way to prevent these trends were sex-ed programs that take a comprehensive approach that includes, but is not limited to, abstinence.

The self-described abstinence educator responded by arguing that the very phrase “abstinence-only” is a “pejorative term” and not an official one. Waxman disagreed. “I think you’re wrong about the legislation,” he said. In fact, the first the guidelines says CBAE "has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity." If that's not the definition of abstinence-only education, I don't know what is.

Legal Momentum's report found that CBAE's teaching guidelines included a host of stereotypes. For example, CBAE's emphasis on heterosexual marriage leaves out the LGBT individuals. When LGBT issues are included in abstinence-only curricula, they're often directly associated with spreading disease, Kay said. Clearly, the guidelines about "rejecting sexual advances" targets young women, who are seen as passive and "more likely to be in love" then men who are expected to be sexually aggressive and fear commitment. The danger in perpetuating these stereotypes is that young men and women who fall outside of sexual stereotypes feel marginalized.

Meanwhile, CBAE-style education contains "negative attitudes" toward condom use, often making misleading mathematical analysis to exaggerate condom failure rates. Young people who decide to engage in sexual activity are deterred from using condoms. After all, the reasoning goes, if condoms are viewed ineffective, why would young people use them? The most dangerous part of the teaching, Kay said, is that abstinence-only education suggests that marriage is an umbrella for protection. She pointed to one piece of abstinence literature that read, "If you want to be protected against STDs, just slip on one of these." Inside the card was a photograph of a wedding ring. A number of newly infected cases of HIV and other STDs are married women who believe they are in a monogamous relationship, but, in reality, are not.

Jamilla Taylor from the Center for Health and Gender Equity (CHANGE) spoke of harmful implications on women abroad who suffer from the funding restrictions on legislation enacted under the Bush administration called President's Emergency Plan for AIDS Relief (PEPFAR), the international aid designated to stop the spread of HIV/AIDS in places like Sub-Saharan Africa. PEPFAR is focused on a three-point method of prevention: "ABC: Abstain, Be Faithful, and use Condoms if you engage in risky behavior." Unfortunately this isn't particularly helpful to girls in countries like India, Nepal, and Nigeria, where it is common for young women to be married by age 10. In Ethiopia, Legal Momentum’s report says, it's common for girls as young as 7 or 8 to be married. Furthermore, funding for PEPFAR currently requires that a full 33 percent of funds be designated to abstinence education. The global AIDS prevention community has asked for the 33 percent requirement to be stricken from PEPFAR legislation when it is up for renewal this September. This emphasis on abstinence puts young women at great risk; young women aged 15 to 24 make up about 40 percent of new HIV infections worldwide. In southern African countries like Zambia and Zimbabwe, young women are six times more likely to be infected with HIV then men.

The renewed PEPFAR legislation, which Congress is expected to vote on in the next couple of weeks, more than triples the amount of funding allocated to HIV/AIDS prevention overseas. Still, PEPFAR prohibits its funding from use on contraception or abortion, but congressional negotiations have removed a restriction that requires countries to justify spending less than 50 percent of PEPFAR funds on the promotion of abstinence.

Overall, abstinence-only education has not only proven ineffective, but actually harmful to many women and men, especially when it is included as a mandatory element of foreign aid for preventing the spread of HIV and AIDS. Abstinence-only programs are ineffective at best, and deadly at worst, especially for young women who are at a higher risk biologically for contracting many STDs. Congressman Waxman is right: It’s time to pull the plug on abstinence-only education funding.

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