OPINION

They'll abstain if they're given good reasons

After learning about a congressional report offering evidence that many widely used abstinence-only courses grossly overestimate the failure rates for condoms, the seventh-grade students at one of the schools where I teach were perplexed. “Well, if these courses are supposed to be health education,” asked one, “why would anyone want to give wrong information about something as important as preventing AIDS?” Another added, “Are they trying to tell kids not to bother using condoms when they need them because they're useless anyway?” “None of this makes sense!” said a third. “Condoms can save lives.” To which another retorted, “Well, maybe it's sex they're against, not AIDS!” Many educators and parents I work with scratch their heads, too, when they learn that hundreds of millions of federal and state dollars are being spent on abstinence-only programs, in which contraception may be mentioned only in the context of its failure rates. Teachers and parents raise some important questions: Can abstinence-only be the best way to protect the nation's children against pregnancy and disease when we know, as Friday's National Center for Health Statistics report shows, that just under half of all teenagers have already had sexual intercourse? What's more, there is no evidence to prove that abstinence-only teaching actually keeps anyone abstinent, while numerous studies have demonstrated that more comprehensive programs do result in postponement and more responsible behavior. Parents are also confused about why abstinence-only came to be our government's official policy, since 85 percent of adults in the United States favor a comprehensive approach.

If 30 years of experience in this field has taught me one thing, it is that when talking with our children about sex, we need to make sure that we educate rather than dictate and that our approach is based on scientific evidence. Only then can we hope to arm young people against the escalating social and cultural pressures they face. Many parents tell me that counseling children is not that easy. Adults I work with who readily understand the logic of what is referred to as the abstinence-plus approach (one that encourages postponement and also provides information about other methods of preventing unwanted pregnancy and disease) still worry about sending a mixed message: “Don't do that — but if you do, be sure to use a condom.”

But there is another way to counsel teenagers that I know they don't find confusing at all: “First and foremost, we love you, and we want you to be safe. The best way to be safe is to abstain. And, for people who choose not to abstain there are steps they can take to lower the risks.” Teenagers don't hear that as a Do/Don't message, but as straightforward evidence of how much adults care about their well-being and about how we expect them to take these decisions very seriously. The abstinence-only legislation signed into law in 1996 is by no means the federal government's first foray into the field of sex education. During the first half of the 20th century, the government actually advocated strongly for sex education through, for example, Public Health Service conferences. Support for this position was also on the rise among private organizations, including the American Medical Association, the National Education Association and the American School Health Association. There have always been people strenuously opposed to school-based programs for a variety of personal and religious reasons. By the mid-20th century, with new and growing visibility and acceptance of sex instruction in schools, some opponents began to organize themselves politically. They began to attack local schools and school districts in a systematic and sometimes vociferous fashion, openly characterizing sex education as a conspiratorial scheme designed to “demoralize youth, divide parents from children, and increase sexual activity among adolescents.” With the emerging AIDS crisis in the 1980s, these local groups — working with several highly sophisticated and recognized groups such as the Eagle Forum, Concerned Women for America, Focus on the Family and the Family Research Council — were uniquely positioned to take an active role in the shaping of school-based curricula. Capitalizing on the escalating fear of the disease, they shifted their strategy from keeping sex education out of the schools entirely to instituting abstinence-only teaching throughout the entire country. In other words, abstinence-only teaching was not suddenly born out of the desire to prevent AIDS or teenage pregnancy. AIDS provided the context and pretext for launching abstinence-only education as a national priority. Don't get me wrong: I think the emphasis on abstinence in recent years has gone a long way toward making it a more acceptable option for young people. There is no question in my mind that abstinence — as in the delay or postponement of sexual intercourse — is the prudent choice for anyone not yet ready to take on the physical, social, emotional and moral responsibilities inherent in the act of intercourse, or for anyone whose personal or religious values dictate that the proper place for this behavior is only within the context of marriage. I have yet to meet a responsible health educator who does not make these points clearly in his or her teaching. However, the mandatory guidelines in the federal abstinence-only program reveal a very different agenda. Teachers in schools where these federal dollars are accepted are not permitted to frame abstinence or postponement as a recommended choice in the service of one's health, but as an obligatory state of being until marriage. In other words, abstinence is not to be portrayed as a means to an end (good health) but as an end in itself. The ultimate goal of the program is to promote premarital chastity rather than premarital health. I meet parents all the time who confuse these concepts and as a result can't frame a clear message. They feel stuck. I suggest that first they have to decide: Do I want to give a message that emphasizes chastity before marriage over other considerations, or do I want to frame abstinence in the sense of postponement until a young person is able to handle the responsibilities involved? There is often much soul-searching involved in facing this question, but it is the key to communicating effectively.

Parents for whom the chastity message is the right one need to articulate persuasively the personal or religious reasons behind their beliefs. They'll also need to prepare themselves for equally persuasive counter-arguments that their children, especially the older ones, may offer. Parents who want to impart a postponement message can develop their case around the developmental, health, social, ethical and relationship issues they view as paramount. In either case, children are served well by parents who present well-supported views. Schools can best help by not taking sides and by ensuring that a wide range of parental views are treated with respect. One of the challenges that all educators face is distinguishing religious teaching from health education. Individuals who believe in the doctrines associated with a particular religion do so as part of their faith in God, and they often consider that all morality stems from these deeply held beliefs. Were sexually transmitted infections suddenly out of the picture and preventing unwanted pregnancy a matter of putting a substance in the tap water, my hunch is that backers of abstinence-only would continue to insist on that approach. Health education is a different matter. As an applied science, it is based on the most current evidence-based data available. It must also be objective: A health educator must not choose to eliminate or slant information — and certainly not potentially life-saving information — as a way of proving or promoting his or her beliefs. Similarly, health educators can't “work backwards.” That is, they can't begin with a preconceived notion of what is the right course of action for every person under every circumstance and then create curricula designed to meet that end. An approach such as abstinence-only education — which dictates the correct answer even before the first question is asked — is antithetical to the educational process. Let's be clear, too, that quality health education is never “values free” — as if education of any kind could ever be values free. It endeavors to help individuals understand themselves and their personal or religious values, because informed decision-making is never purely about external facts. Good health education strives to highlight and reinforce core moral values, such as honesty, respect, caring and responsibility, as they relate to healthy choices.

There is much concern in the public health community that abstinence-only programs leave those young people who ultimately choose not to abstain in a dangerous information vacuum. I see an equally dangerous moral and ethical vacuum, because they are also left without guidance on how to apply the values they have absorbed to the sexual situations in which they will find themselves. How ironic that in the name of “morality” we may diminish young people's ability to think and behave ethically. I have no problem whatsoever with the concepts of chastity, religion or religious instruction. Each has its place, and I often bring religious views into classroom discussions because they are essential to understanding ourselves and the cultural and political landscape of American society. My problem is with religion and indoctrination masquerading as public education, and with chastity masquerading as abstinence. And make no mistake, teenagers have a kind of built-in radar for sensing when adults are trying to manipulate them — including those savvy 12- and 13-year-olds in my seventh-grade classroom the other day. Once they realize that what adults are telling them is in any way disingenuous, they stop listening, no matter how good that advice may be.

So let's stop calling the federal government's approach to sex instruction “abstinence-only education” and start calling it what it really is: chastity-only advocacy. And let's not expect that it will provide the kind of balanced, accurate information that our children need and deserve.

Deborah M. Roffman
12 December 2004

http://www.washingtonpost.com/ac2/wp-dyn/A56850-2004Dec11?language=printer

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