Is 'abstinence only' education effective?

YES
Rebecca Ray:
Any other message is irresponsible

Abstinence-until-marriage education programs are essential. Not only do they educate teens about the physical and emotional risks of adolescent sexual activity, they also explain the benefits of abstinence and provide the skills necessary to make abstinence an informed and real choice.

Despite two decades of extensive education promoting the use of condoms, sexually transmitted disease (STD) rates have continued to rise. Although condoms are most effective at preventing transmission of HIV, their effectiveness against other STDs varies considerably. And condoms do nothing to protect teens from the emotional impact of sex.

Polls show that two out of three sexually active teens regret having sex—this, despite the emphasis in sex-ed programs on “readiness.” Adolescents have not developed the kind of abstract thinking that guides most adults, and their identities are not yet fully formed. This makes them vulnerable to long-term, negative emotional effects from early sexual relationships. Teens know this at some level. Something resonates with students when I talk about emotional bonding in a sexual relationship; the classroom gets silent every time. They understand that sharing something so special and intimate with someone affects a person’s heart at a deep level. Not every individual whose sexual relationship has ended will experience severe emotional pain, but it is far too common to merit promoting the use of condoms and frank sexual discussions as the solution to problems resulting from adolescent sexual activity.

Abstinence education programs do more than just legitimize the decision to wait for sex; they teach that abstinence until entering a faithful, lifelong relationship is the healthiest life choice. Students often tell me that sex is expected in relationships. As a result, sex happens by default, not through an active choice. Teens need to hear that abstinence is a viable alternative and be encouraged to make that choice.

Leaving it up to teens to decide “what’s right for them” is selling them short. We know what is best for their emotional and physical health—for them to abstain from sexual activity until they are in a faithful, lifelong relationship. As educators, we are responsible for informing them of this reality and equipping them to make the choice to be abstinent.

Teens know when adults have given up on them, when their attitude is, “We all know you’re going to have sex anyway.” And teens respond well to high standards, which demonstrate faith in their ability to achieve those standards. Abstinence education does just that, and it prepares teens to make healthy relationship choices that will give them the greatest chance for happy, fulfilling relationships as adults.

Rebecca Ray is the director of Healthy Futures, an abstinence-education program in Boston. She received a master’s in public health from Boston University.

NO
Helen Ramirez-Odell:
It’s a half-solution that puts students at risk

Abstinence education is an essential part of a comprehensive sex education program. But abstinence-only education denies students potentially life-saving information and fails to acknowledge that most students will become sexually active as young adults.

In the United States through December 1999, the number of young adults between the ages of 20 and 29 who were reported to have AIDS totaled 123,579. It is believed that most of these young adults were in their teens when infected with the virus that causes AIDS. There are at least 20 sexually transmitted diseases (STDs), according to federal health officials, and recent studies show that people in the 15 to 24 age range accounted for half of newly diagnosed STDs in 2000—more than 9 million total cases. Teen pregnancy continues to be higher in the United States than in other developed countries. However, the rate has declined since 1990, and one group attributes 20 percent to decreased sexual activity and 80 percent to the more effective use of contraceptives.

Against this backdrop, abstinence-only programs are a questionable-at-best effort to try to keep students safe by convincing them that sex outside marriage is physically and psychologically harmful. Students may be asked to take a pledge to remain abstinent until marriage. According to one recent study released in March at the National STD Prevention Conference, 88 percent of 12,000 teenagers who took an abstinence pledge reported having sexual intercourse before they married. Although they delayed intercourse for up to 18 months, when they became sexually active, those who signed pledges were less likely to use condoms and less likely to seek medical help for STD infections than their peers.

And abstinence-only education falls short of what parents want and expect from their public schools. The Kaiser Foundation reported that one-third of parents surveyed in its “Sex in the ’90s” study said that adolescents should be told to have sex only within marriage; an overwhelming majority also said that schools should teach adolescents how to get tested for HIV/AIDS and other STDs (86 percent), how to talk to a partner about birth control and STDs (77 percent), how to use condoms (71 percent) and where to get and how to use other birth control methods (68 percent).

Students should be encouraged to delay sexual activity until they are physically and emotionally ready for a mature sexual relationship and can handle the responsibilities this entails. But they also need medically accurate information about disease prevention, contraception, testing and treatment services. That means schools need a comprehensive sex education program that is abstinence-based, an approach that gives students the information they need to be healthy and safe.

Helen Ramirez-Odell, RN, is a certified school nurse in the Chicago public schools and serves on the review committee for the system’s Family Life and AIDS Education program.