...About Abstinence Education
And Choosing The Best
There are many inaccuracies about abstinence education and/or Choosing the Best that have circulated in the media and on websites of organizations which fundamentally oppose abstinence education. Below you will find the facts, beginning with a clarification of terms:
“Abstinence only” sex education – This is a legislative term for sex education materials that meet the federal definition of abstinence education, established in section 510 of the 1996 Welfare Reform Act (also referred to as “Title V”), outlined in conditions A-H.1 (Click here to view conditions A-H in detail.) Choosing the Best meets the criteria specified in A-H. Promoting abstinence is the exclusive purpose of Choosing the Best and other authentic abstinence programs.
“Comprehensive” or “Abstinence-plus” sex education – The primary purpose of comprehensive sex education is to promote contraceptive use—particularly condom use—among teens. In recent years, abstinence has been added to these curricula, often in the form of a single session as opposed to a major theme or emphasis, with some of these programs now referring to their materials as “abstinence plus.”
- The term “abstinence-plus” for these materials is significantly misleading. Studies have shown that these programs typically devote less than 5% of their time to promoting abstinence while the majority of the time continues to be focused on promoting contraceptive use. In fact, comprehensive or so called “abstinence plus” programs devote six times more content to the goal of promoting contraceptive use than to the goal of promoting abstinence.2
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1. “What evidence is there that Choosing the Best programs work?”
An independent evaluation of Choosing the Best programs conducted by Dr. Stan Weed between 2002 and 2004 indicated a statistically significant 47 percent decline in the initiation of sex among those students receiving Choosing the Best versus a comparison group who did not receive the program. The study, funded by the Department of Health and Human Services, included Choosing the Best WAY, PATH, and LIFE. Here’s how it worked: 7th, 8th and 9th grade students in a south metro Atlanta high school and its feeder middle school received either Choosing the Best abstinence education or the regular health textbook abstinence education curriculum that complied with state guidelines. Students were administered a detailed survey prior to the study and again 12 months later. Three hundred eighteen students were able to be tracked and matched at the pre-test and 12 month follow-up and had usable sexual activity status data. After one year, results among those students in the Choosing the Best program versus those being taught from the health textbook indicated a 47 percent lower rate of sexual activity. There were also statistically significant improvements in attitudes toward delaying sexual intercourse among the Choosing the Best participants. These results are consistent with earlier research studies. For view the full research report, please visit http://www.choosingthebest.org/research_results/index.html
Additionally, an ambitious and rigorous evaluation of the Choosing the Best 9th grade classroom curriculum was initiated in September 2009. The primary objective of the study is to evaluate the efficacy of Choosing the Best in preventing sexual involvement among high school students. The two-year study is considered a “gold standard evaluation” because it uses a randomized, controlled study design. The pre and post-test data collected from the six participating schools show that students who received Choosing the Best demonstrated significant improvement on 1) intentions to be abstinent 2) attitudes about abstinence and 3) refusal skills. To read more about these preliminary results, click here. [PDF, 125KB]
2. What about the Mathematica study that indicated certain abstinence programs didn’t work?
A recently released study by Mathematica on four abstinence programs found no change in behavior versus a control group. These results do not accurately reflect on the effectiveness of abstinence education as a whole because this study evaluated only 4 out of over 700 abstinence programs available. These 4 programs were also some of the first ever developed and all abstinence programs, including those evaluated, have improved substantially since this study was initiated in 1999. Further, children received these programs during either elementary or early middle school with no follow-up, illustrating the necessity of consistent, year-by-year abstinence instruction through-out middle school and early high school.3 For more information about the limitations of the Mathematica study, please see www.medinstitute.org.
Abstinence education works!
- According to the CDC, there has been a 13% decrease nationwide in teens having sex between 1991 and 2005, which coincides with an increase in abstinence education4.
- Increased abstinence is responsible for the majority of the nationwide decline in teen pregnancies5.
- A number of peer-reviewed published studies show that abstinence education can decrease sexual initiation, increase abstinent behavior among sexually active teens and/or decrease the number of partners among sexually active teens6.
Prior to 1994, comprehensive (contraceptive based) education was the norm in the state of Georgia for at least a decade. As a result, in the early 1990s, Georgia had one of the highest teen pregnancy rates in the nation. Since 1994, after the state adopted a policy mandating abstinence education in schools, the teen pregnancy rate in Georgia has declined dramatically. The latest data shows that pregnancy rates among Georgia teens aged 15-17 have fallen from 68 (per 1000) in 1994 to 36 in 2005, a decrease of 46% over the past 11 years. In a joint press release, Georgia Senators Saxby Chambliss and Johnny Isakson praised Georgia’s abstinence education programs. “It is important to offer programs that encourage Georgia’s youth to make healthy and wise choices,” Senator Isakson said. “Abstinence education has contributed greatly in helping Georgia teens make the right decisions.”
Dr. Stuart Brown, director of the Georgia Division of Public Health, also credited abstinence education for the state’s sharp decline in teen pregnancies and births.7 As the most widely used abstinence education program in Georgia, Choosing the Best, along with other programs, has undoubtedly played an important role in the state’s success. Over half of all Georgia middle school students have received Choosing the Best.
3. “Is Choosing the Best medically accurate?”
Yes. The Administration for Children, Youth and Families (ACYF) within the U.S. Department of Health and Human Services (HHS) has completed a thorough and objective review of the medical and scientific information in Choosing the Best programs and found them to be medically accurate.
Choosing the Best is committed to providing medically accurate information. Choosing the Best curricula contain facts gathered from the most reliable and current sources of information available, such as peer-reviewed, published journals and government agency publications. Because new medical studies and conclusions are always becoming available, Choosing the Best updates materials annually to reflect the latest information. Additionally, Choosing the Best has established a Medical Advisory Board, a team of medical experts that review and approve Choosing the Best curricula.
4. “Does Choosing the Best provide any information about contraception?”
Choosing the Best does educate about contraceptives; however, CTB does not advocate or demonstrate contraceptive use. Contraceptive methods are presented with data about failure rates with respect to pregnancy and sexually transmitted diseases. Choosing the Best shows, for example, that when used consistently, condoms are most effective at reducing the risk of HIV but are less effective in protecting against STDs such as chlamydia, herpes, and HPV,8 which can cause cervical cancer. The facts presented are supported by the CDC, illustrating the CDC’s conclusion that “condom use cannot guarantee absolute protection against any STD”9 and teaching that only abstinence offers complete, 100% protection against both STDs and pregnancy.
5. “Why doesn’t Choosing the Best promote and demonstrate contraceptive use?”
The philosophy behind true abstinence education and Choosing the Best is that teen sex is significantly problematic, even if contraception is used, based on the still present risk of STDs, pregnancy, and negative emotional consequences. Therefore, teens need to receive a very focused and compelling message that abstinence until marriage is by far their best choice for their health and futures. As part of this message, Choosing the Best helps teens understand why contraception is not the solution: At best, contraception can only reduce certain physical risks; the idea of “safe sex” is a myth; and abstinence is the only way to completely eliminate the physical and emotional risks associated with premarital sex. Only when armed with these facts can teens can make the best choice about their sexual behavior. Interestingly, Douglas Kirby, in his research on a program called “Reducing the Risk,” which promotes both abstinence and using condoms, found it was easier to influence teens to be abstinent than to use condoms.10
6. What is the biggest difference between Choosing the Best and typical comprehensive sex education programs?
There are numerous differences (see table below). For example, while Choosing the Best teaches teens that abstinence is clearly their best choice, “comprehensive” sex education programs teach teens that either being abstinent or having sex is equally acceptable, as long as contraception is used. Comprehensive programs focus on teaching contraceptive use while downplaying the benefit of abstinence primarily because they believe: 1)teen sex is inevitable; 2)promoting abstinence is wrong because it teaches “values;” 3)teen sex, as long as contraception is used, is unproblematic. On the contrary, informed teens can and do choose not to have sex. The number of teens having sex has declined dramatically over the past decade and the majority of teens today—53 percent—have not had sex.11 Further, promoting abstinence is first and foremost a health, not a “values”, issue. The evidence is clear that the potential physical and emotional risks associated with teen sex are significant, regardless of whether or not contraception is used.
A 2007 government report found that comprehensive sex education programs are ineffective and offensive. For more information about the content of comprehensive sex education programs, please see Straight from the Source: What so-called “comprehensive sex education programs actually teach America’s youth.” (PDF, ~65k)
ABSTINENCE vs. COMPREHENSIVE Sex Education
| ABSTINENCE (Choosing the Best) |
COMPREHENSIVE (Contraceptive Based) | |
| Emphasis on abstinence | Choosing the Best devotes nearly 70% of page content to promoting abstinence; other abstinence programs on average devote 54%.12 | Devote less than 5% of their page content to abstinence. Allocate six times more content to the goal of promoting contraception than to the goal of promoting abstinence.13 |
| Focus | Risk elimination. (abstinence) | Risk reduction. (contraceptive use, especially condoms) |
| Message | Focused. (Abstinence until marriage is clearly the BEST choice.) | Mixed. (EITHER abstinence OR having sex with a condom are equally good choices; or, abstinence is marginally better than having sex with contraception.) |
| Philosophy | a) Teen sex and/or casual sex is problematic, even if contraception is used, based on risk of STDs, pregnancy, and negative emotional consequences. | a) As long as contraception is used, teen sex and/or casual sex is unproblematic. There are no potential negative emotional consequences. |
| b) Armed with full information about the risks of teen sex and the benefits of abstinence, teens CAN and DO choose to refrain from having sex. (The majority of teens today—53%—have not had sex.13) | b) Teen sex is expected and inevitable. | |
| Behavioral Goal | Delayed sexual initiation or “renewed virginity.” | Increased contraceptive use, especially the condom. |
Parents strongly support abstinence education over comprehensive sex education.
In a 2007 national Zogby poll:
- Parents preferred their child receive abstinence education over comprehensive sex education by a 2:1 margin.
- 8 out of 10 parents think it’s important for their teen to wait until they’re married to have sex.
- 8 out of 10 parents want schools to emphasize promoting abstinence over contraceptive use.
- Parents overwhelmingly support the abstinence education approach toward discussing contraception:
- 9 out of 10 parents want their teens to be taught how often condoms fail to prevent pregnancy based upon typical use and about the limitations of condoms in preventing specific STDs.
- 8 out of 10 parents think teens will not use a condom every single time.
- 2 out of 3 parents think the “wait to have sex” message ends up being lost when programs demonstrate and encourage the use of contraception.
7. “Isn’t abstinence education fundamentally about ‘scare tactics’ that teach teens to be terrified about ever having sex?”
Comprehensive sex education advocates often claim that showing students age-appropriate slides of common sexually transmitted diseases is a “scare tactic.” Yet four million teens contract an STD every year.15 This is why every effective resource should be utilized to help young people realize the serious nature of these diseases, some of which are incurable and life threatening. All facts presented are sourced from research published in peer-reviewed journals and are confirmed by the Centers for Disease Control (CDC). Although a presentation of STDs is included in Choosing the Best LIFE, PATH, and JOURNEY, it represents only one out of eight content sessions.
Along with educating about the risks of premarital sex, Choosing the Best educates students that abstaining from sex as a teenager offers incredible freedom—freedom to pursue goals, dreams, and to enjoy being a teenager—and that sex is wonderful and appropriate in the context of marriage. Choosing the Best also addresses the needs of students who have already been sexually active by teaching that students can still choose—and benefit from—choosing abstinence from this day forward (i.e., “renewed virginity”)
8. “Isn’t teaching abstinence to teens unrealistic? Isn’t part of being a teen experimenting with sex?”
Normal adolescent curiosity is a part of growing up, and the media message that pre-marital sex is expected, fun and has no consequences has a powerful influence on young people. However, when given the facts concerning the physical and emotional risks of sexual activity and the rewards of being abstinent – being able to pursue goals and dreams, often not possible with an unplanned pregnancy or disease – the majority of teens today are choosing abstinence. Recent reports from the Centers for Disease Control and Prevention show that the rates of teen sexual activity have dropped by nearly 14 percent between 1991 and 2003,16 and that 53 percent of the decline in teen pregnancy is a result of increased abstinence.17
Choosing the Best knows that not every teen will abstain from having sex, just as not every teen who knows the risks of smoking will choose not to smoke. However, the goal of abstinence education is to help teens understand that abstinence is best for their health and future. Abstinence education provides teens with the facts about the negative emotional and physical consequences of pre-marital sex, as well as the benefits of waiting, empowering them to make an informed choice about their sexual behavior.
9. “Doesn’t abstinence education in effect simply tell teens to ‘just say no?’ Is that really enough?”
Effective abstinence education programs are multi-dimensional and cover a number of critical topics in helping equip teens to make the only choice – abstinence until marriage – that eliminates the risk of STDs, negative emotional effects, and teen pregnancy. Choosing the Best offers five age appropriate programs for middle and high school students and provides sex and relationship education content in nine areas: Risks (emotional, STDs, teen pregnancy), Rewards (decision making, goal setting, marriage planning), Relationship Education (friendships, understanding guys and girls, healthy vs. unhealthy relationships, preventing sexual abuse and date rape), Alcohol (dangers of mixing alcohol and sex), Refusal Skills (setting boundaries, developing verbal skills and assertiveness skills), Pledge (making a commitment to abstinence), Character Development (responsibility, self-respect, courage, perseverance, compassion, respect), Parent Involvement (parent training and homework interviews), and Building Self-esteem (and appreciating unique qualities, interests, or skills).
10. “Isn’t waiting until marriage too strict a requirement? What about kids who don’t want to get married or who will do so later in life?”
The only way to eliminate the risk of an STD is to be abstinent until you enter into a mutually monogamous relationship as is typically found in marriage, with an uninfected partner, and remain faithful in that relationship for the rest of your life. The emotional effects of being involved with someone sexually and then having that relationship end can be devastating, regardless of age. Even if a person has reached an age where they are emotionally more mature and better able to cope with these effects, the physical risks of STDs are still present – regardless of age – and can significantly affect a person’s health and life.
Postponing sex until a teen is out of high school does not eliminate, or in some cases, even reduce the risk. A recent survey of single women aged 20 to 25 showed that more than one-half had contracted HPV, the disease that can cause cervical cancer, which kills nearly 4,000 women each year.18 It would be nice to be able to tell teens that if they wait until they’re out of high school, or some “magical” age, that they would not have to deal with the physical or emotional consequences of premarital sex, but unfortunately this simply isn’t true.
11. “How does Choosing the Best respond to the 2004 report by Rep. Henry Waxman (D-CA) that claimed abstinence education contains inaccurate information?”
Choosing the Best is committed to providing medically accurate information. Choosing the Best curricula contain facts gathered from the most credible and current sources of information available, such as peer-reviewed, published journals and government agency publications. Because new medical studies and conclusions are always becoming available, Choosing the Best updates materials annually to reflect the latest information. Additionally, Choosing the Best has established a Medical Advisory Board, a team of medical experts that review and approve all curricula.
Mr. Waxman’s attempt to discredit abstinence-focused sex education is a disservice to our nation’s teens. Mr. Waxman is an aggressive and longstanding opponent of abstinence education and according to an October 2006 congressional review of the Waxman Report, it “fails to offer a fair and accurate assessment of abstinence education programs” and is “riddled with errors, half-truths and mischaracterizations.” The review, conducted by the U.S. House of Representatives Committee on Government Reform further states, “By any reasonable standard, it [the Waxman Report] cannot be considered a definitive statement on abstinence education and should not be taken as such.”
The congressional review found that in addition to inaccurately portraying the reviewed abstinence curricula, the Waxman Report also misrepresents the effectiveness of abstinence education and the high level of support for the abstinence message among parents and teens alike. “In recent polls, over 90 percent of teens and adults believe that teens should be given a strong abstinence message not to have sex until they are at least out of high school. Nearly 80 percent of parents think teens should be taught to delay sexual activity until marriage on in an adult relationship leading to marriage.”
To view the full Congressional Review of the Waxman report, please click here.
Click here to view our press release summary regarding the Congressional Review of the Waxman report, or to read the point-by-point response to each mention of Choosing the Best by Waxman.
12. “How does Choosing the Best respond to criticisms that “abstinence programs don’t work” based on the results of a commonly cited study about the effectiveness of virginity pledges?” [“After the promise: the STD consequences of adolescent virginity pledges” conducted by Hannah Bruckner and Peter Bearman]
This study found that teens who took abstinence pledges delayed the onset of sexual activity by 18 months but that those who broke their pledge were less likely to use contraceptives. First, Choosing the Best was not included in this study and the results of this research in no way reflect the effectiveness of Choosing the Best. Secondly, making a pledge is only one element of an abstinence education program. In order to be most effective, a pledge must occur in the context of a thorough and compelling abstinence program such as Choosing the Best. However, Bearman and Bruckner’s study only evaluated pledging in general—the context in which the pledge was made was not considered. For example, a student might have made their pledge during a complete abstinence curriculum, or while experiencing an hour long assembly, or after being merely stopped in the hall. Based on the design and methodology of this study it is impossible to make any conclusions about the effectiveness of either a particular abstinence program or complete abstinence programs in general.
There is much evidence that abstinence education works. For more information, please see the response to question #2 above.
13. “Does Choosing the Best address homosexuality?”
Choosing the Best programs do not include any references to homosexuality. Abstinence education is about encouraging teens to eliminate the risks of sexual behavior. All teens need this message, regardless of their sexual orientation.
14. “Isn’t abstinence education fundamentally about religious conviction?”
Choosing the Best programs do not include any references to religion. Abstinence education is about health for our teens. Although some teens that choose abstinence may also be influenced by their personal religious convictions, abstinence education is about making healthy choices to be free from the risks of STDs, unplanned pregnancy and negative emotional consequences. It is about freedom to pursue future dreams and goals, regardless of religious preference or conviction.