Sex & Relationships

What Happens When States Say No to Abstinence-Only Education?

Rejecting abstinence-only funding is only one part of the movement to empower young people. There's much more to do.

The numbers have reached a tipping point: 25 states have rejected federal Title V funds for abstinence-only programs, including traditionally conservative states such as Wyoming and Alaska. And eighty percent of them said no because of research revealing that the ineffectiveness of ab-only programs puts U.S. teenagers at risk, says the Sexuality Education and Information Council of the United States (SEICUS). Citing the same evidence, individual school districts from Cleveland to Washington, D.C., are rejecting financial bribes to teach an abstinence-only curriculum in favor of a more comprehensive curriculum.

No doubt this is reason to cheer. But rejecting abstinence-only funding is only one part of the movement to educate and empower young people; we also need to pro-actively normalize comprehensive, medically-accurate sexuality education in American schools.

"Turning back ab-only funds won't stop ab-only teaching," said Bill Smith, SEICUS vice president for public policy. "At least, it's not a guarantee."

Despite the momentum against ab-only funds, Smith said that there hasn't been a proportional uptick in comprehensive sex ed programs -- and there won't be one if there continues to be no federal investment. Ab-only curricula took their hold in U.S. classrooms precisely because of the strong funding structure for those programs, Smith said.  It's not merely the absence of ab-only funding that will translate into comprehensive sex ed programs; rather, comprehensive programs need a strong funding structure of their own in order to be normalized. After all, up-to-date and accurate textbooks and teacher training don't come free even to the most well-intentioned school districts.

While the Cleveland Metropolitan School District and Pittsburgh Public Schools are among the relatively few districts that are finding ways to support more comprehensive sex education, the question is: how much more comprehensive are they? Are the sex ed programs in these pioneering districts truly medically accurate and age appropriate? Or do alternative funding and curriculum models carry their own set of restrictions and limitations?

The Cleveland Model

The Cleveland Metropolitan School District launched a K-12 comprehensive program in 2006, a program that Smith points to as "probably further advanced and more progressive" than any other in the country.

It started in 2006 when Cuyahoga County leaders decided to re-allocate TANF and City of Cleveland dollars away from an abstinence-only curriculum and towards a comprehensive one. County commissioners made the shift as a response to community leaders and parents who showed them the evidence of the link between the district's ab-only program and the county's troubling health statistics.

"That was a leadership position the county took," said Laureen Tews Harbert, program director of Cleveland's AIDS Funding Collaborative.

The more comprehensive curriculum was funded almost entirely by TANF dollars in its first year, according to Marsha Egbert, senior program officer of The George Gund Foundation, a Cleveland-based private nonprofit that provides operating support for the new curriculum. But CMSD couldn't rely on TANF: it only had three years of support that incrementally diminished each year. The three-year window for TANF funding expired in December 2008.

"The short term time frame on the TANF support accelerated our effort to bring support for the program fully in house," said Egbert.

CMSD evolved its model into one of diversified funding, including private support, and internal capacity.

"At first, we delegated the sex ed teaching to outside, specially-designated professionals responsible for this course alone," Harbert said. "That was costly. The model evolved, with a concerted effort, to train health and PE teachers to be responsible for the bulk of the curriculum."

Training existing staff makes CMSD's sex education a more sustainable model, Harbert added.

Further, CMSD replaced lower TANF funds with support from The George Gund Foundation and The Cleveland Foundation. CMSD also partners with Harbert's AIDS Funding Collaborative for the annual evaluation of the new curriculum. The City of Cleveland continues to provide funding as well through community development block grants.

"Having a variety of funders who have a stake in the program speaks well for its future success and the community buy-in," Harbert said. "At the same time, building our internal capacity for comprehensive sex ed makes us more sustainable because we're less dependent on outside support."

So what does Cleveland's program look like? Is it really comprehensive?

Formally called the Responsible Sexual Behavior Education Initiative, the Cleveland model appears to be one of the only K-12 integrated sex education programs (that is, a program that builds on each previous year), if it's not the only. According to Egbert, the curriculum includes information about contraceptive use, sexually transmitted diseases, and a "tremendous amount on emotional and social development, including refusal skills and negotiation skills. That to me is a critical part. Students can get the facts, but it's important to teach ways for them to make the facts work in their lives."

As well, the Cleveland program partners with the nonprofit Scenarios USA, which uses scriptwriting and film to "capture the voices of reproductive health and sex topics," Egbert said. Fifteen million people each year see the short films from Scenarios USA at film festivals, in schools, and on television.

How, though, is the Responsible Sexual Behavior Initiative working?

Philliber Research Associates, the external evaluator of the effectiveness of Cleveland's sexuality education, indicates in its 2007-2008 report that the program reached 26,326 K-12 students. Health and PE teachers newly trained for sexuality education were rated highly for their abilities to teach about dating, gender roles, HIV/STDs prevention, reproductive anatomy, decision-making skills, puberty, and pregnancy prevention.

However, those same teachers were rated as "least able to teach" about community resources, sexual abuse prevention, and sexual orientations. They also were described as "less comfortable discussing" condom use, sexual intercourse, and sexual orientation with students.

The evaluation also indicates that after participating in the new Cleveland curriculum, significantly more students disagreed with the statements, "I would have sex with someone even if I really don't want to" and "If a partner refused to wear a condom, I would probably give in and have sex with him/her."

Compared to students who hadn't yet participated in the programs, those who participated in Cleveland's sexuality education showed significantly improved knowledge and skill sets across all grade levels.

"There's still a lot of work to be done" in making the program fully comprehensive, said Egbert. "Particularly in making the different parts of the program mesh. But we're committed to improving the program each year."

Such a commitment is wonderful news for Cleveland, and especially the city's young people. But what stands out is the rarity of its curriculum. Even with its gaps, there is no other one like it in the nation-even in those school districts that are re-evaluating ab-only funding and programs. Egbert noted that when Cleveland first set out to develop its K-12 comprehensive curriculum, it found no models existed-not in school-based forms that were rigorously evaluated, at least.

Piecing Together Models

Harbert noted that Cleveland's K-12 curriculum for age-appropriate sex education was so uncommon, administrators had to piece together a new model based on four different model curriculums to create one that was evidence-based and age-appropriate.

"It does seem like we've received a number of inquiries from other school districts about our model," Harbert said. "Our research shows we're pretty unique in offering this -- there's just not a lot of models out there."

Curriculum for any school district is accepted or rejected by the school district. According to Howell, districts often hire someone who is a curriculum specialist to implement guidelines. Without strong models of sex ed syllabi, it's easy for even well-intentioned districts to have holes in their curriculum. 

Pittsburgh's "Abstinence-Plus"

Meanwhile, Pittsburgh Public Schools, for example, is a district that announced just weeks ago that it'll move away from its model of abstinence-only-until-marriage and begin teaching "about contraception, dating and alternative lifestyles ... (as well as) sexual orientation, marriage and life commitments, sexual dysfunction, sexual abuse and gender roles," reports the Pittsburgh Tribune-Review. Citing the city's high teen pregnancy rate, the new policy passed the school board with an 8-1 vote.

"The change in Pittsburgh happened because parents called into question what their kids are being taught," Smith said. "Which shows you how attention paid to the issue is how change happens."

It's a positive step towards better educating students. However, this more comprehensive model is uneven. Described as "abstinence-plus," the program will still emphasize abstinence as the best choice for students and will not distribute or demonstrate contraceptives or contraception methods.

Developing a Comprehensive Model

Champions of comprehensive sex ed are working to remedy such a patchy application of comprehensive sexuality education by developing model curricula. Advocates for Youth, for example, offers sample lesson plans on its website that indicate what kids should be learning at each age. It includes plans for teaching about body image, addressing discrimination, reducing sexual risk, and discerning your own values about your sexuality.

More expansively, SEICUS, Advocates for Youth and Answer pulled together national leaders in December 2008 for a Future of Sex Education project. The task? "To develop national guidelines for what we mean with comprehensive sex education," Smith said.

These national guidelines -- which will include information about contraception, sexual orientations, gender identity, sexual abuse, and, yes, even choosing abstinence -- continue to be developed in collaboration.

In the meantime, advocacy organizations are focused on convincing governments to redirect abstinence-only funds to support the kind of comprehensive sex ed programs that are proven to reduce teen pregnancy and STDs.

States can take the initiative.

California is recognized for never having accepted ab-only funds from the federal government, but rather prioritizing comprehensive education with a law that, according to Marcela Howell, vice-president of Advocates for Youth, says that districts don't have to teach sex ed, but if they do, they must include particular information -- like STD treatment and prevention and the effectiveness of all FDA-approved contraceptives -- that is part of the comprehensive vision.

States can plug the hole in federal investment by taking responsibility for its own dollars. "The State of Florida squandered its own $17 million spent on ab-only since 2002," Smith said. "If they can invest $17 million in ab-only programs, they can spend it on a more comprehensive program."

For the most wide-ranging impact, national organizations turn their attention to top.

"What we're like to see is, under a new Congress, under a new White House with a president who's made a commitment to comprehensive sex education, we have a very simple ask: Stop funding the bad programs and start funding the good ones," Howell said.