“New York abstains. Courteously.”

This is rather long, but I haven’t blogged in awhile. So…. dig it.

Interesting stuff going on right now. One of the topics that caught some recent buzz is the issue of abstinence-only education—long in the public’s eye, as it remains a point of contention across political parties and only recently lost its federal funding this year in favor of a more inclusive type of sex ed. I think most rational people can agree that some form of sex ed is entirely necessary in order to raise our children to be fully aware of their bodies and how not to crash, burn, and holy fuck, destroy the hell out of themselves. Like giving them a map through a land mine field, the more informative the map, the less likely they are to step on one and… blow their genitals to smithereens. Excellent metaphor, Meg. Moving on…

Deciding on which map to use is its own issue. According to recent news sources (possibly released a little too conveniently after Obama’s 2010 cutting out the federal funding for previously failing abstinence-only programs), University of Pennsylvania School of Medicine recently announced the news of a study detailing an intervention in which an abstinence-only education method proved somewhat more effective than comprehensive sex education in a trial Penn Medicine had conducted to measure success in delaying the onset of sexual activity in pre-teens.

This is actually pretty big news in the debate over effective methods in reducing unwanted pregnancy and sexually transmitted infection (STIs). This study has noteworthy significance, mainly due to conservative groups having pushed adolescent abstinence-only sex ed for years, mostly with the backing of the Bush administration’s massive grants and funding programs for this type of health education (though it bears noting it was initially established before his first term).

Established in 1996, massive federal funding was granted to abstinence-only health courses (rather than comprehensive sex ed), which were and are widely known to be highly ideological and largely morality-based, teaching kids only abstinence until marriage. This gets especially hairy when considering it alienates whole groups of people, like those who do not choose to get married, or homosexuals, who sadly aren’t even permitted to marry in the majority of states. And they tend to portray sex in an often off-putting, negative light, not allowing any discussion of contraceptives or prophylactics.

As SIECUS reports, “While these programs often replace more comprehensive sexuality education courses, they rarely provide information on even the most basic topics in human sexuality such as puberty, reproductive anatomy, and sexual health.” Yikes. This is a problem, as these are all issues central to the health of the adolescent and, therefore, any person they decide to love up, married first or not. This is why the Obama administration cut federal funding for abstinence-only in 2010 in favor of comprehensive sex ed programs, which not only feature abstinence education, guidance, and promotion, but sexual health and sexual protection information to prepare students for when they do decide to engage in sexual activity.

For an informative breakdown of the differences between comprehensive sex ed programs and abstinence-only programs, SIECUS details a nice chart for your reference, though bear in mind it is generalized.

Before continuing, I should state my purpose in discussing this issue, as it happens to be one particularly close to my heart. Considering that I am and have always been a firm supporter of comprehensive sex education, and also noting that I have proudly worked for Planned Parenthood, I want to make it clear that my aim is not to promote some liberal ideology about how this issue should be taught in a perfect world. Rather, it is because of my tremendous concern for the sexual and emotional health of our adolescents (and adults) that I support comprehensive sex ed as the proven most efficacious method of reducing the heartbreak of abortions or unwanted pregnancy and the danger of sexually transmitted disease. Cause I’ve seen it. Since everyone does not belong to the same religion or set of moral standards—nor should we be arrogant enough to think everyone everywhere should share our own personal beliefs—I think ideology over science is pretty pointless. And in the case of something as life-impacting as sexual health—damaging on an unconscionable scale.

It is because I value science over unyielding ideology that I don’t criticize this study. I don’t. Although I would like to see a detailed public breakdown of their testing and research before I can say that about their methods (for instance: I’d like to know how they account for margin of error or circumstance, since these children are submitting self-reports of a very sensitive nature which may contain untruths; or how many 12-15 year-olds do you know have sexual opportunities readily available to them at convenient times? Lord knows I didn’t. Well, not many.), I do maintain praise for the purpose behind and conclusion of this study. Any scientific study—the word is scientific, not “morally founded”—devoted to the best ways to reach kids with messages on abstaining from destructive decisions is positive and very worthwhile. I do criticize, however, the way many media sources are construing the findings of this particular study and what these media propose the findings mean.

Many news sources, of course, strive for sensationalism and creating a stir; this isn’t lost on anyone of intellect. Creating a stir yields greater debate, yields continued headlines, yields increased circulation. Woot. And even less credible sources often strive to boost an agenda by picking over and selecting only certain facts to give their readers a hazy understanding of information, figuring that most people will not go directly to the source and see what data has officially been released. Right? Right. (Or some that shall not be named strive to bolster a conservative agenda and address a puerile desire to yell “Told ya so!” at the first potential opportunity. That part contains my own bias and observations, and you can quote me.)

My beef with many of these news sources is the way they have glazed over the information of this study in order to make the findings seem more significant or shocking than they are. For example, many of the sources I’ve read or listened to—at least 15 or so, including the wording of the Penn State press release—have given very spotty details and the vaguest terms, which make it easy to overlook what they’re actually reporting. Make sure to pay attention to the wording when you’re reading about this or listening to it. A random example from the one of the print samplings:

CNS News:

The study found that an abstinence-only message was significantly more successful in getting pre-teens to delay the onset of sexual activity than was a “health-promotion control intervention” – or general risk-reduction effort…

There was a 33 percent reduction in self-reported sexual intercourse from the abstinence-only group, compared to the control group, by the end of the study. Of the students who reported that they were sexually active during the study, there were fewer reports of recent sexual activity from the abstinence-only intervention participants (20.6 percent) compared to the control participants (29.0 percent)… After two years, one-third of the abstinence-only group reported having sex, compared to one-half of the control group.

First of all, like many other news sources, this source doesn’t go on to state what the control group actually was, aside from a “’health-promotion control intervention” – or general risk-reduction effort.” Wow. Seek out a more detailed news article, if this is all they’re giving you. A better article will tell you that this “general risk-reduction effort” from the control group wasn’t pertaining to sex at all, just general health.

See the New York Times:

In Dr. Jemmott’s research [author John B. Jemmott III, PhD, professor of Communication in Psychiatry and of Communication at the University of Pennsylvania’s School of Medicine and Annenberg School for Communication], only about a third of the students who participated in a weekend abstinence-only class started having sex within the next 24 months, compared with about half who were randomly assigned instead to general health information classes or to classes teaching only safer sex. Among those assigned to comprehensive sex-education classes, covering both abstinence and safer sex, about 42 percent began having sex.

Or just pick up the Reuters article:

African-American sixth- and seventh-graders who completed the eight-hour program, which involved a series of brief activities and games (and no lecturing), were one-third less likely to start having sex in the next two years compared to their peers who took part in a similar program that targeted health issues unrelated to sex…

Jemmott and his team assigned 662 children to this [abstinence-only] program; an eight-hour “safer sex only” program designed to promote condom use; an eight- or 12-hour intervention combining both approaches; or a control group in which children underwent an eight-hour educational program on health issues unrelated to sex.

So what to take away from this is a more complete picture of the facts. Yes, this study showed that this particular abstinence-only program was about 9% more effective than the comprehensive sex ed program in preventing sex among 12 and 13-year-olds as they matured over two years, and that’s a significant finding since it contradicts numerous studies that have been done previously about the utter failure of abstinence-only programs nearly across the board. But rather than vaguely letting you make the assumption that the control group in this study is the comprehensive sex-ed group, a more detailed news source tells you that the control didn’t teach sex ed at all, just general health.

So, okay, that makes perfect sense. 12 and 13-year-olds not being taught sex ed whatsoever would logically be more likely to engage in sexual activity than those who had been effectively taught about the dangers of unwanted pregnancy and HIV, etc. Cool. At least we may have stumbled onto an abstinence-promotion system that works for reducing the early onset of sexual activity, which—if proven through more trials and testing—could help accomplish half the battle toward a sexually healthy youth. HALF the battle. The other half is preparing them for when they do decide to be active.

We need to remember that “this is the first randomized controlled study to demonstrate that an abstinence-only intervention had reduced the percentage of adolescents who reported any sexual intercourse for a long period.” So much more development needs to go into this in order to determine its effectiveness over other groups of adolescents, whether it works throughout the rest of the teen years (this is an enormous variable), what specifically about the way it was taught makes it most effective, etc.

The danger in the doing cartwheels over this one study is that findings can easily be twisted by certain ideologues in order to lead to the destruction of certain comprehensive sex ed methods we have found, through dozens of other trials over years of research, to be the most effective and health-consciously responsible. So again, do remember to put the discussions of this article in context, if your news source hasn’t for you.

For instance, as Jemmott says of his study: ““It is extremely important to find an effective intervention that delays sexual activity; the younger someone is when they have sex for the first time, the less likely they are to use condoms.” Absolutely true. But it is also imperative to find an effective intervention that teaches about condoms too, because when someone doesn’t have any helpful information on the benefits of condoms when they have sex for the first time… the less likely they are to use condoms, too. In fact, they are not likely.

He continues, “Abstinence-only interventions may have an important role in delaying sexual activity until a time later in life when the adolescent is more prepared to handle to consequences of sex. This can reduce undesirable consequences of sex, including pregnancy and sexually transmitted infections like HIV/AIDS.” Yes. They should hold off until they can make more mature decisions about sexual protection. That is the value of teaching abstinence in sex ed. But with abstinence-only programs, where are they learning all these accurate and appropriate sexual decisions to make when they become adults? Nowhere? Through the grapevine? From less-informed sources? Think about the things you heard about sex before you were taught. If I have sex standing up, I can’t conceive, right? …Is that not right? Like, everyone says that’s right. Right?

What makes this abstinence-only program in Penn State’s study stand out as effective is that it isn’t promoting waiting until marriage like many morally based or religious programs that have gone before it; it merely teaches waiting until you’re ready to have sex. “Several critics of an abstinence-only approach said that the curriculum tested did not represent most abstinence programs. It did not take a moralistic tone, as many abstinence programs do. Most notably, the sessions encouraged children to delay sex until they are ready, not necessarily until married; did not portray sex outside marriage as never appropriate; and did not disparage condoms.” And if you think it’s a little shaky to merely say “until you’re ready,” at least this study shows it seems to work much better than what’s been previously taught in abstinence-only programs.

Another surprising finding was that “the theory-based abstinence-only curriculum [in this study] appeared to be as effective as a combined course and more effective than the safer-sex only curriculum in delaying sexual activity…None of the curricula had any effect on the prevalence of unprotected sexual intercourse or consistent condom use.”

Not something we’d like to hear, especially about comprehensive sex ed which does teach about using the condoms, but this actually makes sense, too, if you think about it. Allowing that the reason behind delaying sex until maturity is that immature sexually active adolescents have a lesser likelihood of weighing the consequences of sex and a lesser likelihood of having a healthy concept of their own mortality or sexual danger (and thus of feeling the need to sexually protect themselves), it is entirely necessary to teach effective abstinence information to children to guide them in holding off until they are mature enough to make responsible decisions. And that is where this new study proves exceedingly useful—possibly showing us a way to teach abstinence in an engaging and effective way. It is a critical part of sexual education. But this abstinence approach needs to then be tossed into the bowl with comprehensive sex ed and made into a beautiful comprehensive sexual health… salad—oh so good for you, and all the better for the variety of ingredients. Yeah, go with me on the metaphors. Try using some yourself today. It’s not easy what I do, people.

“The study’s authors — John B. Jemmott III, Loretta S. Jemmott and Geoffrey T. Fong — cautioned that abstinence programs are not an effective long-term solution… A common shortcoming of behavior-change interventions is that efficacy is demonstrated in the short term but disappears at longer-term follow-up,” the report said. “This may particularly be a problem for abstinence interventions. Unlike many risk behaviors (e.g., cigarette smoking, drug use), sexual intercourse is an age-graded behavior; the expectation is that people will eventually have sexual intercourse.”

True enough. This study was measuring people having sex under the age of 15. When they grow up a little into their sexual primes, they will need more to go off: “Wagoner, president of Advocates for Youth, said that in his opinion, the abstinence program does not go far enough toward helping youths who are sexually active make informed choices about contraception. He would like to see federal funding for programs aimed at abstinence and safe sex… “If you’ve got 24 percent of your class that’s sexually active, what about them?” Wagoner asked. In addition, he said, “OK, you’re 12. You’ve abstained until 14. What about the next five years?””

And this is the point—until an abstinence-only program is 100% effective in delaying sex until maturity, it leaves the remaining adolescents who opt to have sex (in this case, roughly 30% of the students, and who knows how many more over the following two years) in the dark. Kids usually lack the maturity to make responsible decisions with sex, which is why messages urging abstinence should certainly be perfected, taught, and promoted. Hopefully this delays early sexual intercourse. But then what happens when those kids who’ve only benefited from abstinence-only education finally reach this maturity where they’re able to make decisions in their best interest? Who will have given them the accurate knowledge to protect themselves adequately? The answer is likely no one, without the additional support of comprehensive sex education. If this is redundant on my part, it’s because it sooo bears repeating.

Comprehensive sex education teaches students the value of abstinence and then reaches out to the ultra-important goal of any of these programs that are worth their salt—STI protection and the avoidance of unwanted pregnancy. If you only teach them to delay sex for a few years but then deny them accurate information about their sexual health and protection options, when they finally do have sex—and they will—they will be a far greater risk to themselves and anyone with whom they come into sexual contact. Hopefully this study teaches us ways to fine-tune the abstinence promotion part, since pop media—magazines, advertisements, movies, TV, and pretty much anything online—make this abstinence message terribly difficult to nail into the head of an impressionable early adolescent. And hopefully everyone can benefit from how effective comprehensive sex ed can be with possibly some new approaches included in it.

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