Law & Courts

Sex Education Looms in Health-Care Overhaul

‘Abstinance-only’ and ‘comprehensive’ programs are in federal contention.
By Mary Ann Zehr — November 20, 2009 4 min read
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Includes updates and/or revisions.

Whether sex education for teenagers should focus on abstinence from sexual activity or fully address the use of contraceptives has emerged as a topic in the debate in Congress over a health-care overhaul.

Advocates of differing approaches to sex education are watching whether Congress will come down on the side of paying for what are widely called “abstinence-only programs,” which President Barack Obama proposed eliminating in his fiscal 2010 budget, or of financing only what are known as “comprehensive” programs.

Observers say the debate over what kind of sex education programs are most effective is likely to generate some sparks among legislators, but so far it has been overshadowed by other issues, such as how the legislation will address funding for abortion.

The health-care bill the U.S. House of Representatives passed last month doesn’t authorize any funding for abstinence-only programs. Rather, it contains $50 million for what advocates call comprehensive sex education. Such programs may seek to delay initiation of sex, but they also stress contraceptive use and aim for young people to decrease the number of partners they have, among other goals.

But the Senate Democratic leadership later unveiled a health-care bill that authorizes $50 million to restore funding for abstinence-only sex education. The proposed legislation is a compromise between measures from the Senate Health, Education, Labor, and Pensions Committee and the Senate Finance Committee.

The Finance Committee had adopted an amendment, sponsored by Sen. Orrin Hatch, R-Utah, that called for funding for abstinence-based programs. The measure also contained $75 million for comprehensive sex education programs.

Senate Inclusivity

Both provisions—the $50 million for abstinence-based programs and the $75 million for comprehensive sex education—are now part of the Democratic leaders’ bill. The bill approved by the Health, Education, Labor, and Pensions Committee didn’t authorize funding specifically focused on sex education.

Valerie J. Huber, the executive director of the Washington-based National Abstinence Education Association, which represents organizations that provide such education, said that federal funding for programs focused on abstinence, begun during the Clinton administration, needs to be retained so that educators can effectively teach a prevention message to youths.

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“While contraceptives may reduce the risks for sexually transmitted diseases or getting pregnant, only abstinence prevents it,” she said.

Ms. Huber noted, however, that she doesn’t like to use the term “abstinence only” to describe the kind of programs she supports because they do include discussions about contraceptives. Still, she said, the discussion is within a context of “why it’s better to abstain.”

William A. Smith, the vice president for public policy for the Sexuality Information and Education Council of the United States, a Washington-based nonprofit organization that provides education about sexuality and sexual and reproductive health, contends that comprehensive sex education programs are more effective than abstinence-based ones in reducing risky sexual behavior.

“These new programs will have a strong emphasis on abstinence and delaying sexual activity,” he said, “but they also give young people the full range of information that we know young people need.”

He added, “It’s morally wrong to provide an abstinence-only-until-marriage message for sexually active kids.”

The birthrate for 15- to 19-year-olds increased in 2007, the most recent year for which data are available, for the second year in a row, after a 14-year continuous decline, according to the National Center for Health Statistics.

Medical Opinion

The U.S. Department of Health and Human Services last month awarded a contract to the Princeton, N.J.-based Mathematica Policy Research to conduct an eight-year random-assignment evaluation of approaches to preventing teenage pregnancy. The evaluation will aim to document effective ways to reduce teenage nonmarital sexual activity, pregnancy, and the spread of sexually transmitted diseases. One of the subcontractors for the evaluation is the National Abstinence Education Association.

Just last month, a panel of medical experts concluded that sex education programs that teach contraceptive methods and safer sexual practices decrease teenagers’ risky sexual behavior and curtail the spread of sexually transmitted infections. The same panel found that not enough evidence exists to determine the effectiveness of programs that primarily promote abstinence as a means of birth control and protection against disease.

The conclusions were issued by the Task Force on Community and Preventive Services, a volunteer body of public-health and disease-prevention experts, whose members are appointed by the director of the federal Centers for Disease Control and Prevention, in Atlanta.

In a statement sent via e-mail to Education Week, Sen. Hatch acknowledged a lack of consensus by researchers on the effectiveness of abstinence-only education programs. “One thing is for certain,” he said. “Most parents, when given a choice, want their school-age children to remain abstinent.”

He cited a 2008 analysis by the Heritage Foundation, a Washington think tank, as evidence that Congress should fund abstinence-only education. Out of the 21 studies of abstinence-based education reviewed by the Heritage Foundation, he said, 16 were found to have statistically significant positive results in delaying early sexual activity.

Ms. Huber of the National Abstinence Education Association said it’s expected that the sex education programs embedded in the legislation would predominantly be carried out by schools, usually in health classes.

Typically, she said, schools might invite educators focusing on contraceptives to provide part of the program, and educators focusing on abstinence the other part.

A version of this article appeared in the December 02, 2009 edition of Education Week as Sex Ed. Looms in Health-Care Overhaul


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