Can Creativity Get Teens to Reject Sex?

July 28, 2003 — -- When the Abstinence Clearinghouse convention hit Las Vegas last month, the chastity-promoting group turned a Sin City tradition on its ear. Instead of the cards prostitutes use to sell their services, volunteers handed out cleaner versions: "Good girl" cards.

On one side are six wholesome young women, including a bride. Flip the card over and there are messages that condoms aren't always safe and that married people have more money, longer lives and better sex.

"We walk up to girls and guys and pass out cards about STDs. We feel they need to know how at risk they are," said Leslee Unruh, president of the Sioux Falls, S.D.-based Abstinence Clearinghouse. "These kids are out there and society is selling sex, sex, sex. Who's selling virginity? We are."

The Abstinence Clearinghouse was so happy with how good girl cards went over in Las Vegas that it's taking them to New Orleans, another city known for sin, Unruh said. Abstinence groups in Brazil have also inquired about the cards, she said.

Times are good for abstinence promoters like Unruh. With a booster in the White House, wait-until-marriage programs are flourishing in communities and school districts. Yet the debate over whether they work, or are merely the ideological tool of religious conservatives, rages on stronger than ever.

Abstinence Backers Hit Jackpot

President Bush has proposed spending $135 million on abstinence education next fiscal year, more than double spending from just five years ago.

This month, $15 million in new abstinence grants went out to community-based groups, faith-based organizations and school systems. And another round of abstinence grants will be made this fall.

In announcing the latest grants, Health and Human Services Secretary Tommy Thompson summed up the administration's approach to sex education: "When adolescents become sexually active, it can have negative effects on their physical and emotional health."

Federal and state governments have put more than $700 million into abstinence education since 1996, according to one estimate. More than one-third of U.S. high schools now teach abstinence until marriage and 700 abstinence programs exist nationwide.

Abstinence-only programs are becoming more common, even though polls have found that a large majority of Americans favor sex education programs that include information about birth control. A 1999 Kaiser Family Foundation poll showed 79 percent said schools should give students information about "birth control and safer sex."

Ideology vs. Science?

Opponents of abstinence-only programs have their own explanation for the trend.

"You've got a political and ideological agenda at play here," argues James Wagoner, president of Advocates for Youth. "Frankly, there's a lot of lack of awareness that has been exploited for a major ideological campaign that has nothing to do with public health. Young people have become a political football in the culture wars."

Advocates of sex education that includes birth control information say abstinence-only backers not only ignore public opinion, but defy scientific data as well.

Wagoner's group recently reviewed 25 years of existing research on 150 sex ed programs and found 19 that have been proven to reduce teen pregnancies and STDs or cause at least two beneficial changes in sexual risk behaviors.

Despite their proven effectiveness, Wagoner said, none of the sex education programs are eligible for federal funding because they include information about condoms and contraception — even though 12 of the programs promote abstinence by delaying sexual initiation.

Teen sexual activity and pregnancy rates both declined over the 1990s, but these declines happened before the federal government's significant investment in abstinence-only-until-marriage programs, Wagoner adds.

Teens and the Failure Rate

But abstinence-only supporters say those who push condoms on teenagers underestimate the effectiveness of wait-until-marriage messages as well as the harmful effects of premarital sex on teenagers.

Adolescents need to understand that no birth control method is 100 percent effective, they say, especially when used by teens, who are more likely to use them incorrectly.

Take birth control pills, says Dr. Patricia Sulak, an obstetrician/gynecologist and contraceptive researcher. Virtually foolproof birth control when used right, teens experience failure rates with the pill of up to 30 percent, she said.

And condoms, which in the general population fail to prevent pregnancy up to 16 percent of the time, are "horrible" for teens, Sulak said. "These people are out there telling kids just use a condom. Are they crazy? There are no data that show condoms are the answer," she said.

Sulak also serves as the medical director of the Scott & White Sex Education Program, which advocates abstinence for teens and has developed a sex education curriculum used by more than 30 school districts called "Worth the Wait."

"Worth the Wait" does not talk about religion or morality, Sulak says — it talks about facts. "When kids have sex early, bad things can and do happen," she said. "I'm not anti-contraception, but even the really good ones fail. We give [teens] that information."

Premarital Sex or Purity Beads?

But critics maintain not enough information is being shared with kids.

To be eligible for millions in federal dollars, programs must satisfy stringent criteria, including having abstinence promotion as the sole purpose, teaching that not having sex until marriage is the only way to avoid unwed pregnancy and diseases, and stating that "a mutually-faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity."

For those who say they want a more comprehensive approach to sex ed, these requirements are a bit much.

"No one would tell young people that," said Adrienne Verrilli of the Sexuality Information and Education Council of the United States, a group that supports abstinence education that includes information about birth control and condoms. "I don't think in the face of HIV and STDs that that's the message we should send to young people. It doesn't mean they won't have sex. They'll just have sex without a condom."

While the debate rages on over whether the abstinence-only message can prevent pregnancy and disease, the pro-chastity brigade is hitting the beaches. This time, they're toting "purity beads" — an antidote for the beads girls apparently get in some "spring break" communities for losing their virginity in the sun and sand. Girls who take the purity beads agree to stay chaste.

Amid conflicting signals, Unruh of the Abstinence Clearinghouse says such education campaigns can help young people make the right decision.

"Mostly the girls that take them are virgins and it sends them a strong message that they're doing the right thing," she said. "We met a young girl who is 14 years old. She went to a local place to get birth control pills and bought a thong bikini and was planning to lose her virginity. It's not that controversial. Many are grateful."