Published Online: October 31, 2006
Published in Print: November 1, 2006, as GAO Opinion Renews Debate on Abstinence-Only Programs

GAO Opinion Renews Debate on Abstinence-Only Programs

A recent opinion issued by a congressional watchdog agency has stoked debate over what schools should be telling students about condom use.

Recipients of federal grants to promote abstinence-until-marriage sex education must include “medically accurate” information about condoms or risk violating a federal law, according to the Oct. 18 advisory legal opinion by Gary L. Kepplinger, the general counsel of the Government Accountability Office. He did not examine specific programs, and so did not say whether specific grant recipients were in violation.

The U.S. Department of Health and Human Services, which oversees the sexual-abstinence grant programs through its Administration for Children and Families, disagreed with the opinion. However, HHS officials contend that while its grantees are not required under a federal statute to discuss condoms and contraception, many programs already do, and in a medically accurate way.

The GAO’s opinion renews questions about the controversial federal grant program for abstinence education, which was funded at $163 million in fiscal 2006. President Bush has requested $191 million for the program for the 2007 fiscal year, which began Oct.1. Congress has not finished work on the 2007 spending bill that includes the budget of the Health and Human Services Department.

Supporters and opponents of abstinence education contend that the other side is spreading medical misinformation by stressing, or downplaying, the failure rates of condoms and other birth- control methods in preventing pregnancy or sexually transmitted diseases.

Some States Reject Funds

At issue in the GAO opinion is a provision in the Public Health Service Act that addresses human papillomavirus, a leading cause of cervical cancer, and sexually transmitted diseases in general. The statute says that educational materials produced by the Health and Human Services Department and its grantees “shall contain medically accurate information regarding the effectiveness or lack of effectiveness of condoms in preventing the [sexually transmitted disease] the materials are designed to address.”

Abstinence-until-marriage programs fall under that requirement, the GAO says, because such programs are supposed to include information on disease as a physical consequence of sexual activity. HHS’ contention that the programs are not about sexually transmitted diseases is “not persuasive,” Mr. Kepplinger writes.

The GAO inquiry was instigated by Rep. Henry A. Waxman of California and other congressional Democrats. Rep. Waxman has long been an opponent of abstinence-only sex education, saying many of the programs contain medical falsehoods.

In an Oct. 18 statement, Rep. Waxman said: “All federally funded programs for teens should provide medically and scientifically accurate information. [The GAO’s] finding today will contribute to ensuring that abstinence education programs meet this standard.”

Wade F. Horn, the assistant secretary for children and families in the HHS Department, oversees the abstinence education grants. In an interview, he said that though abstinence education programs do not have to discuss contraception, they must do so in a medically accurate way if they choose to broach the subject.

For instance, if a program were to say that condoms provided no protection against disease or pregnancy, that is a medically inaccurate statement, he said.

“I don’t believe [grantees] are required to provide information about condoms,” he continued. “I also think that most of them do. The major message they give is that condoms do not provide 100 percent safety against the risks of pregnancy or sexually transmitted disease, and that’s medically accurate. I don’t think most of the programs are silent on the matter.”

Mr. Horn oversees two programs that relate to abstinence education. The Community Based Abstinence Education grants grew from $55 million in fiscal 2002 to $113 million in fiscal 2006. The Title V formula grant to states, which apportions money for state agencies to disburse for abstinence education programs, has been funded at a steady $50 million since 1997.

Four states have rejected some of the federal funding available for abstinence education, saying that the government rules attached to the money are too strict. Most recent was New Jersey, which last week rejected $800,000 of such funds because of the restrictions on discussing contraception, the Newark Star-Ledger reported.

Marcia Papst, the vice president of marketing for Choosing the Best Publishing, an Atlanta-based recipient of a federal abstinence education grant, said her group’s publications contain information about condom effectiveness. But “we do not advocate or promote condom use,” she said.

The National Abstinence Leadership Council, a group of abstinence education curriculum providers, released a letter last week saying that its members were committed to medical accuracy in their programs. The council’s members said the information in their programs comes from government publications and other reputable sources.

Basis For Lawsuit?

But William Smith, the vice president for public policy at the Sexuality Information and Education Council of the United States, or SIECUS, based in New York City, said that abstinence education programs continue to be rife with misinformation. Other abstinence programs skirt the issue, he said, by not talking about contraception at all. Federal health officials have shown no intention of penalizing grant recipients, he said.

“They just dismiss it,” Mr. Smith said. “They don’t seem to care.”

The GAO opinion is not binding on the Health and Human Services Department.

“My understanding is that the GAO legal opinion is just that, a legal opinion,” Mr. Horn said.

However, the department’s disregard of the GAO opinion could make it a target for legal action, Mr. Smith said.

“If they do not come into compliance with federal law, they will be in court,” Mr. Smith said. “I think the [legal opinion] indicates the Administration for Children and Families is falling down on the job.”

PHOTO: Mississippi schoolchildren release balloons on the state Capitol steps in Jackson last May, as part of an annual sexual-abstinence-education rally led by the state department of human services.
—Rogelio Solis/AP

Vol. 26, Issue 10, Page 7

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