Thursday, February 15, 2007

Why Abstinence Education Doesn't Work

Sex-Ed has been on been on my mind a bit lately. Maybe because there's been some discussion in the news of whether information on homosexuality should be part of Sex-Ed curriculum, or maybe because there's all sorts of talk about teen sex coming out of Texas with the whole HPV vaccination thing. I dunno. But for some reason it's been on my mind.

When I think about Sex-Ed I'm drawn to the question of whether abstinence-only education can ever work. I don't think there are too many people out there who dispute that abstinence itself is the most effective way to cut down on unwanted teen pregnancies, the spread of STD's, and the general emotional turmoil that can be caused by the sex-having of those who are not yet mature enough for said sex-having. Unfortunately, most evidence out there demonstrates that abstinence-only education isn't an effective way to create more abstinence.

Well, I guess I don't know if that's true. Maybe abstinence-only education does create more abstinence. But compared to Sex-Ed that includes birth control/safe-sex education, abstinence-only education isn't an effective way of reducing teen pregnancies, and the spread of STD's. There's really two variables going on here.

Let's call variable X the number of teens having sex, and variable Y the number of teens having protected sex. In a world with no Sex-Ed the number of X and Y are both depressingly high. In a world where abstinence-only education is taught the number of Y decreases. I don't know about studies regarding the number of X though. Presumably that would decrease as well. In a world where birth control and safe-sex practices are taught the number of Y decreases to an even lower amount than in the abstinence-only world. Again, I don't know about actual numbers here.

To put this a little more clearly let's take a hypothetical class of 100 kids. Say we give them abstinence-only education, which effectively convinces 25 of the kids. That means 75 of them have sex. Of that 75, one third have safe-sex, meaning that there are 50 kids have unprotected sex. Now teach that same 100 kids about safe-sex in their Sex-Ed class, and the results might be quite different. We'll say that 90 of those 100 have sex, but of those 90, 75 use protection, meaning that there are only 15 kids having unprotected sex. Comparing those worlds shows that in abstinence only, 15 fewer kids have sex but 35 more have unprotected sex.

Of course, I've no numbers or evidence regarding this hypothetical. However, I think it's probably a pretty safe assumption that the number of teens having sex is lower in the abstinence-only world, even if the number having unprotected sex is higher. But that is just an assumption, and maybe there are facts out there that prove differently.

What we do know conclusively though is that teaching safe-sex is a more effective way of reducing the number of teens having unprotected sex. That means fewer teen pregnancies and fewer STD's. And therefore safe-sex education is considered to be a more effective form of sex-ed (though given the hypothesis above with the multiple variables I suppose one could argue whether it really is more effective).

What interests me is why abstinence-only education is less effective than safe-sex education. In my experience that's a question that hasn't really gotten enough attention. After all, if we could "fix" abstinence education, if we could make it as effective - or even more effective - than safe-sex education, then - given that abstinence is superior to stopping the spread of STD's and preventing teen pregnancy and even the emotional turmoil described above (which, let's face it, safe-sex doesn't prevent) - surely that would be the preferred method of education.

So what is it that makes abstinence-only education less effective? Quite simply that it does not exist. Sex-education, whether we like to admit it or not, extends far beyond the classroom. Sexual behavior is largely learned from society. Sure, we've all got some primal urge to mate, and even without any help from anyone else we'd eventually figure it out. But ultimately our sexual behavior - what is or is not taboo, the way we court and date and marry, the whole way we think about sex - is a product of our surroundings. Peer pressure is especially pertinent in our sex lives. The fact that it's "cool" is routinely a reason for teens to have sex. So is the idea that "everyone else is doing it."

This pressure doesn't come from our Sex-Education. Or at least it doesn't come only from our Sex-Education (it seems a likely possibility that a class which teaches teens how to have sex "safely" could be seen as tacitly condoning such behavior). Most of the pressure comes from our larger society; from TV and movies that make sex seem commonplace and casual. From magazines, and jokes, and so on and so forth. The fact of the matter is that we learn from all of this. This larger societal message undercuts any effectiveness that abstinence-only education could have, and instead sends a strong counter-message that sex should be had by any and everyone, whenever there's some attraction.

Now I don't want to seem like some sort of prude who wants to censor all these sorts of things (I'm not, and I don't). Yes, I think all of these things contribute to the problem, and certainly undermine abstinence-only education. But to be perfectly frank, I think the bigger problem lies with the lack of a strong voice supporting abstinence. If there were a significant effort in the media to portray successful and happy abstinence attempts that would be a wonderful boost to those trying to wait until marriage (just one of the reasons I loved The 40-year-old Virgin).

Although the media portrayal of sex is important, the role of parents is an even more essential piece of the puzzle. I'm saddened by the number of times I've heard people say that there is simply no stopping teen sex. I've heard parents say, "The fact is, if they want to have sex, they're going to, and there's nothing I can do to stop it." And while that statement might prove technically true, it's ultimately a defeatist attitude that simply enables more teen sex (and therefore more teen pregnancies and STDs and emotional turmoil). This defeatist attitude says that even if people want to wait until marriage they won't be able to, so we might as well give in and abandon abstinence. And that creates a void, where no one is carrying the banner of abstinence. And with no one carrying that banner... well, it's a self-fulfilling prophecy.

What this defeatism ignores is that parents - and friends and teachers and role models and everyone in society - can have a huge effect on what teens want. A strong voice preaching the value of abstinence can go a long way towards creating a desire in teens for abstinence. And that's what abstinence education is really about: letting teens know the value of abstinence, giving them hope that they can achieve it if they want to. More important to that goal is not the education the kids receive, it's the voices they hear from those around them. Of course, abstinence-only education could certainly help too.

But in the world we live in, with a pervasive media voice that says "sex is casual, everywhere, irresistible" and with a defeatist attitude that says "resistance is futile", abstinence-only eduction doesn't really exist. And of course, if it doesn't really exist, then that explains why abstinence education doesn't work.

Players only love you when they're playing


Ben said...

This has to be the most interesting, fair-minded approach to the subject I've ever read. I agree with it 100%.

Personally, I learned about abstinence from my parents and my church. And...frankly...from knowing that my older brother got his girlfriend pregnant when he was 17.

the marvelous patric said...

girls generally avoided me in high school. and college. and now.

it hasn't really been a problem for m.

Zhubin said...
This comment has been removed by the author.
Zhubin said...

And here I was, all giddy that you had accepted the uselessness of abstinence education! Then you go and conclude that it just needs to be extended. This argument assumes that abstinence has some sort of social value, or at least a value outside of the personal.

I would argue the exact opposite: abstinence-only education has no place in an effective sex education program. It is not "defeatist" to accept that teenagers (or anybody) are going to have sex before marraige; it is an acknowledgement that sex is an important and personal part of life, and that each person has the right to approach it their own way.

Abstinence-only education (and I include religious instruction) promotes an unnatural and internally-contradictory view of sex as both sacred and sinful, which usually results in either unhealthy sexual repression or tremendous undeserved guilt for doing it.

If you ask me, a little more honesty and openness about sex would eliminate its taboo/"cool" status, and greatly reduce our national and media obsession with it.

Matthew B. Novak said...

Ben - Thank you.

Patric - I think it's genetic and that we pretty much got stuck with the same gene, and the Laura came along and was immune to it.

Zhubin - I was really trying to avoid a discussion of the value of abstinence (other than the question of effectiveness in pregnancy/STD/emotional turmoil prevention)(which surely you admit it does more effectively than any safe-sex practice, right?)

You're right, everyone has a right to approach sex in their own way, and maybe abstinence isn't for everyone. I can accept that. That's why I'm not promoting abstinence-only education (I'm saying there is a role for abstinence education, but not abstinence-only education). But at the same time I'm not "assuming" a social value of abstinence; quite simply, abstinence has value, both as a safe-sex practice (there's your social value) and as a high form of personal sexual expression and fulfillment (which, extrapolated out from individual to individual has some social value, just as any other personal good).

I think you're probably right to be concerned that an abstinence-only education is myopic, and often leads to a distortion of what sex really is and is about. But at the same time, I don't agree that abstinence education necessarily creates that contradictory "sacred and sinful" tension, (though I like the observation). I think that when the abstinence view is taught with any amount of nuance a very healthy sex life is more likely the result. Unfortunately that nuance isn't taught often enough, and yeah, a lot of people end up with sexual repression and/or an overload of guilt.

I'm also concerned that you're taking it too far the other way. It seems that in your dismissal of abstinence-only education you go too far in demeaning abstinence itself. In labeling abstinence "unnatural" you are coming perilously close to promoting an equally "unnatural" view of sex that diminishes its meaning and leads to promiscuity. A view that dismisses abstinence also dismisses how personally fulfilling it can be to wait until marriage and to have only partner.

Finally, you say that "sex is an important and personal part of life, and that each person has the right to approach it their own way." But I've got to ask you; how many teens having sex out there are honestly approaching it their own way? Not many. And I think that is what is defeatist about dismissing abstinence; it says not that teens will have sex because it is what they personally want and are prepared for, instead it says teens will have sex because the peer pressure it too much and teens today are too weak-willed to exercise their right to appraoch sex their own way.

Jeff said...

"Show the average American teenage male a condom, and his mind will turn to thoughts of lust."

"Show the average American teenage male a lug wrench, and his mind will turn to thoughts of lust."

Good post, Matt. I have a question for the boodle: in a world where abstinence-only education were possible, we would likely face something of a tradeoff - lower rates of teen sex but higher rates of unwanted pregnancy and sexually transmitted disease. Is this a tradeoff that you would be willing to make?

Zhubin said...

Oh, I have no problem with sex education that includes abstinence. When you wrote "abstinence-only education" I assumed you meant sex education that teaches only abstinence.

Obviously I disagree with the value you put on abstinence, and your view of sex as something that can be diminished if done "promiscuously." But of course, that's my personal view of sex, which holds no value greater than your own.

I don't know how many teens have sex out of a personal decision or peer pressure, but then again, how many teens do anything that isn't influenced by peer pressure? I don't consider it as big a problem as you, because I don't consider pre-marital sex to be a mistake in and of itself. So long as we teach them about contraception and protection against STDs, then whatever.

Matthew B. Novak said...

I was writing specifically about sex education that teaches only abstinence, not just sex-ed that includes it. I think my responset went to the part of your first comment where you accused me of wanting to expand abstinence-only education. I think there are two things going on here; first, I was writing about how abstinence-only education doesn't reall exist and the fact that maybe if it did really exist it could be effective. Second, I think that discussion got conflated to support for an expanded abstinence-only program, which I don't support. So I want to clarify: I think that abstinence-only education could hypothetically work in an expanded form, but in the real world, where we live, I think we need to teach safe-sex pratices, but I'd love to see a greater emphasis on abstinence.

I'm also a bit curious here about your views on sex. You really don't think that the meaning of sex (both to the individual and to the relationship) can be diminished if people are being promiscuous? Is sex more meaningful if the two people are in love? Or is that completely irrelevant?

I'm also a bit perplexed by your take on peer-pressure inspired sex not really being a problem. In your last post you really seemed to be on the each-person-has-the-right-to-approach-it-their-own-way wagon. I get that, and I can support that view. My concern with teen sex is largely that it is peer-pressure inspired, which undercuts the approach-it-in-the-own-way idea. If people are doing it because others are, then they are per se not approaching it their own way. I'm not opposed to teen sex just because I think premarital sex can be a mistake, but really because I think it's inspired by the wrong motivation. I expected you to have a problem with that too, given your last response. What gives?

And finally, while I understand that we have different takes on the value of sex, would you acknowledge that waiting until marriage and only having one partner can be a personally fulfilling approach to sex? Or would you say that people who think of that as fulfilling are somehow wrong/deluded? I guess what I'm getting at here is: are our views of sex different on a personal level (for me, waiting was great, for you it doesn't have the same value) or are you holding a less relative view (I acknowledge that abstinence might not be personally fulfilling for some, and would be for others. Do you feel the same way?)

Zhubin said...

Personally, no, I don't think the "meaning" of sex is diminished through frequency ("promiscuity" is a bit too derogatory for my tastes). Sure, it's more meaningful if you're doing it with someone you love, but so is bowling.

That being said, of course, that's only my personal opinion of sex. Like I said before, it's a deeply private matter, and everyone has their own valid approach to it. If I were to suggest that mine is objectively more valid than your abstinence, I would be 1) wrong, and 2) a tremendous asshole who needs to mind his own business.

To the extent that teens (or anyone) engages in sexual activity out of peer pressure, of course I'm troubled by that. The thing is, at that age, peer pressure is very powerful, not just regarding sex but everything, and teens need to find their own way through it. We can teach the value of independence and thinking for oneself, but learning who you are in the sea of peer conformity is just a natural part of growing up. Some will give in to peer pressure and regret it, but as long as they're not indoctrinated with guilt, they'll only grow from the experience.


Of course abstinence first, but what happens in a moment’s choice can change lives forever!! What do you do when abstinence isn’t enough? Although I believe that it is a parent’s duty to teach the importance of abstinence, it is not enough. I believe absolutely in teaching sex education. I also believe that it is my duty as a parent of three girls to determine when it is time for birth control regardless if they have become sexually active or not!! We can not always be with our children. Yes we can hope that our children have taken on some of our values. We teach them that sexual intercourse is to be shared between two people who love each other, and who are married. In a teenagers logic one might believe that he or she is truly in love and because they are young we won’t allow them to get married thus giving them the same consent as two people who are in love, and married. I am a parent that takes all precautions as to what, where and who, my child is with? I know that it is not enough. I know at some point there will be a window of opportunity and when my speeches of values and abstinence fail what will I be left with? (Birth control) I have been told it is though I am saying that it is aright to have sex by this decision. I argue with that by saying “I didn’t wake up one morning and decide to put my daughters on birth control, but I will watch for every sign, and I will hope they will come to me. If they do not then I will go to them, and together we will determine if this is what needs to be.” I am asked “How can you do that?” “How can I not?” I vowed that I would always protect my children and in this decision I believe that’s exactly what I am doing. I teach my girls, abstinence is best, and the effects of teenage pregnancy, and that birth control does not prevent diseases, and even give them an easy way out of uncomfortable situations that they find them selves trapped in. When for one moment we are parted and they are left to journey on their own I will have made sure that the screams of a hungry baby will not be the sounds that wake them!
A mother of three