Two recent studies look at the growing popularity--and regional variations--of "abstinence only" policies in the public schools.
Two recent studies look at the growing popularityand regional variationsof "abstinence only" policies in the public schools.
For a third of our nation's public school children, sex education focuses on a single theme: No sex outside of marriage. Period. Some of these children hear about contraception in class, but only in terms of its ineffectiveness in preventing pregnancy and sexually transmitted diseases. Others don't hear about it at allat least not in a classroom setting. That's the word from a recent Alan Guttmacher Institute study published in the November/ December 1999 issue of Family Planning Perspectives, the official publication of Planned Parenthood. The study, conducted in 1998, is the first nationwide look at sex ed policies at the school district level.
A similar study by the Kaiser Family Foundation, conducted in 1999 and released at year's end, echoes those findings. Nearly two-fifths of middle school and junior and senior high principals report that "abstinence only" is their schools' main message. Although the Guttmacher researchers focused on data from school districts while the Kaiser report surveyed school principals directly, the two studies came to similar conclusions. Together, they give us our first real look at how the "abstinence" philosophy has transformed sex education in the schools.
It all started in 1996, when Congress (as part of a welfare reform measure) established a $250 million, five-year fund to support state educational efforts aimed exclusively at promoting abstinence until marriage. Every state but two, California and New Hampshire, has accepted the funds. A study by the Sexuality Information and Education Council of the United States (SIECUS) predicted last year that, by the end of 2002, state and federal governments will have spent nearly half a billion dollars on abstinence only education.
Advising students to abstain from sexual activity and talking to them about contraceptives are not necessarily mutually exclusive. In fact, 58 percent of the principals surveyed by Kaiser describe their sex ed programs as "comprehensive," based on the researchers' definition: "Young people should wait to have sex, but if they do not, they should use birth control and practice safer sex."
The Guttmacher survey also finds that a majority of public school children54 percentattend schools that combine the two approaches, albeit to varying degrees. Unlike the Kaiser team, the Guttmacher researchers divided the abstinence/contraception classifications into two categories: comprehensive and abstinence-plus. Only 9 percent of students are in districts that meet the Guttmacher team's definition of "comprehensive" sex ed: treating abstinence as one option in a broader sex ed program. But 45 percent are in districts with abstinence-plus policies, which "treat abstinence as the preferred option for adolescents, but also permit discussion about contraception as an effective means of protecting against unintended pregnancy and disease."
Because of variations in enrollment, statistics based on the number of school districts and those based on the number of students don't equate. While 69 percent of school districts have specific sex education policies, for example, those districts collectively enroll 86 percent of public school kids; conversely, the 31 percent with no official policy (each school, or each teacher, makes decisions about sex ed instead) represent the remaining 14 percent. Among districts with sex ed policies, 14 percent have comprehensive programs, 51 percent teach abstinence-plus, and 35 percent teach abstinence-only.
Contrary to what you might expect, small districtsthose with fewer than 5,000 studentsare less likely than their medium or large counterparts to teach abstinence-only. Less surprisingly, when it comes to sex education, geographical location is more telling than whether a district is in a metropolitan, suburban, or rural area. In the Northeast, for instance, abstinence is the main message in just 20 percent of the districts with sex ed programs, compared with 55 percent of Southern districts.
Guttmacher researchers David J. Landry, Lisa Kaeser, and Cory L. Richards note that "while a growing number of US public school districts have made abstinence education a part of their curriculum, two-thirds of districts allow at least some positive discussion of contraception to occur." As the same time, the researchers found that one district in three "forbids dissemination of any positive information about contraception, regardless of whether their students are sexually active or at risk of pregnancy or disease."
Landry, Kaeser, and Richards cite a study documenting public approval of access to birth control for sexually active young peopleand numerous studies showing that most adults favor sex education programs. Few existing studies, the researchers note, show the abstinence-only approach to be effective in delaying young people's sexual initiation. At the same time, they point to "the growing weight of evidence" that comprehensive programs are most effective in discouraging sexual experimentation among youths and promoting contraceptive use when sexual activity begins.
A close look at the Kaiser study, however, raises questions about how far-ranging some "comprehensive" curricula really are. Nearly six in 10 principals apply that label to their school programs, but advising sexually active students to use contraception is different from providing specific details about condoms and other methods. Just 45 percent say their programs include information on how to useand obtainbirth control, and only 39 percent cover the how-tos of condom use.
How is sex education policy determined within a school district? In the Guttmacher study, nearly half the districts with specific policies identify state directives as most influential. Much less influential are special school board advisory committees and school board actions, at just 18 and 17 percent, respectively.
When asked about factors with any influence, three out of four cite state directives, close to two- thirds name board action, and more than a third point to special committees. Teacher and community support for abstinencetogether named by about a third of the districtsplays a significant role; another third say that educators and municipal leaders advocate a broader approach. According to the respondents, in more than half the districts with specific policies the community is "generally silent" about sex education.
Nearly nine Kaiser respondents in 10 say that "local government or school district" wields "some" or considerable influence, and three out of four say their sex education teachers use standard materials provided by the district. Seven in 10 say the same about state government. Asked about decisions regarding the content of the school's sex ed curriculum, 88 percent of the principals say teachers are somewhat or very involved; 72 percent point to school board or school administrators, 68 percent say parents are involved. Fifty-four percent of the principals say they themselves have participated in such decisions, but only 20 percent identify local politicians as being somewhat or very involved.
Abstinence-only sex education may be a hot political topic, but it's still not the choice of most schools, the Kaiser Family Foundation concludes. While districts with recent policy changes have been more likely to embrace rather than reject a curriculum that stresses abstinence, the Guttmacher researchers add, most choose to focus on abstinence-plus rather than abstinence-only.
Helen Lippman. What are they teaching in sex ed these days. Medical Economics 2000;8:79.