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Comprehensive Sex Ed. v. Abstinence Ed.

The sex ed. debate clarified.

(Excerpt from Raising Teens With Sexual Self-Control by Karen Kropf)

There are a lot of misconceptions about what "Comprehensive Sex Education (CSE)” actually means, and what gets measured to reach the conclusion that it works.  If you assume the goal of school-based sex education is to reduce the number of teen pregnancies and decrease the transmission of infections, you would be wrong.

The GOAL of Comprehensive Sex Ed. is: To reduce number of unprotected sex acts.

Let me translate that for you:  A CSE program is deemed effective even if teens who were NOT having sex before the program ARE having sex afterward — as long as they’re using condoms.  

Think that through.  Teens who weren't taking any risks at all BEFORE participating in the sex ed. program, are taking sexual risks AFTER the program.  More teens are at risk, but somehow this program is considered “effective.”  


Here’s something else that may surprise you:  CSE funding isn’t tied to lowering rates of pregnancy and STDs.  Not at all.  It doesn't make sense though, right?  If a sex education program failed to reduce the number of pregnant and/or infected teens, then their funding should be cut off, right?  Isn’t that how researchers find out what works?  

Nope!  As it happens, government-funded programs aren’t even REQUIRED to measure how often the recommended protection failed.  There is a built-in supposition that protection protects!  “Of course protection protects!” they say.  Why bother to measure that?!  

The sad reality is, when pregnancy and infection rates are measured, NO school-based Comprehensive Sex Education program has ever been shown to:

  • Decrease teen pregnancy or STD rates for any group for any period of time.

  • Increase the number of teens who use condoms consistently for more than 3 months.

  • Increase both the number of teens who were abstaining and the number of teens using condoms. (1)

 

But here's the REALLY funny part — the people who develop and sell Comprehensive Sex Ed. programs are the SAME people the government PAYS to determine which sex ed. programs ARE effective! 

I’m not kidding.  

CSE program developers (using tax dollars to fund their research) decide what the content of a sex education program should be, and which statistical information is relevant.  Included with the program purchase is an evaluation service to track the outcomes they want to measure.

They sell the programs to school districts across the country, which pay for them with more tax dollars.  When the CSE is complete, the program developers evaluate the results and agencies like the Centers for Disease Control or the National Institutes for Health publish a report on which programs were found to be effective.  

Let me put it another way.  You design a widget.  You own all the companies which produce any part of your widget.  You also own all the companies who rate widget-effectiveness.  People buy your widgets. You send your employees to evaluate if the widgets performed as expected.  You produce a report which proves your widgets are the Best Widgets Ever.  The government publishes your report.  Media outlets with one accord announce every widget made by anyone else is inferior to your widget!

Welcome to my
world.  

It never surprises me when a report evaluating sex education shows “Abstinence Education doesn't work, but Comprehensive Sex Ed. does!”  

I have to admit, not ALL the blame can go to CSE program developers who have rigged the system or the organizations who promote their biased findings.  Part of the blame has to fall on the naiveté of abstinence educators and developers.  Because the truth is, most abstinence programs don’t even measure condom use.  

Let me explain why.  The goal of an abstinence program is to instruct teens how to avoid giving in to their sexual impulses.  Since the point is NOT to act on those impulses, lessons devoted to telling students how to procure and use condoms when they DO give in would be counter-productive.  

It would be like saying, “No cookies before dinner, it will spoil your appetite.  And make sure you give some to your sister!”

But remember the goal of CSE is: To reduce the number of acts of unprotected sex. 

Therefore, CSE analysts measure program effectiveness by asking participants, "Are you using condoms and birth control?" 

If your program had successfully taught students how to delay gratification and master sexual self-control… if your students were behaving as instructed… they would answer, "No, we are not using condoms and birth control."

TA-DA!  “There's your proof!” say critics of Abstinence Education.  Abstinence doesn’t work because it doesn't INCREASE the number of teens using protection!  Silly abstinence educators.

While what to measure is hotly disputed, advocates on both sides of the sex education debate do agree on a few things, 

  1. Teens are controlled by their emotions. 

  2. Teens are impulsive.  

  3. Teens are incapable of accurately predicting the future.  

 

Both sides concede these 3 basic facts.  This is how teens are.  Where the two camps diverge is how to deal with those facts.  

Protection-advocates want to modify teen behavior.  They want to reduce the physical risks of sexual activity by training teens to consistently and correctly use condoms and contraception.  Protection-advocates assume teens will be impulsive.  Their perspective is: "We can't do anything about it, and there's nothing wrong with teens having sex as long as they are responsible."  They assume teens will have sex no matter what.  

Therefore, the sex educator’s job is to minimize the impact of adolescent sexual activity on the rest of us.

Abstinence-advocates also want to modify teen behavior.  They want to reduce all the risks of sexual activity by training teens to resist sexual impulses instead of acting on them.  Abstinence-advocates also assume teens will be impulsive.  However, their perspective is:  “Impulsiveness is a character flaw which adversely affects every aspect of life.  Learning impulse control, while difficult, will have positive effects in every aspect of life — including sexual behavior.”  

The abstinence educator’s job, therefore, is to train teens how to control their urges.

Protection-advocates want to start teaching about condoms and birth control as early as possible, long before teens think about engaging in sexual activity.  Abstinence-advocates want to educate teens about how powerful their sexual desires will be and train them to control that passion, as early as possible, long before they might become sexually active.  

Unfortunately, for the sake of pithy marketing campaigns, each side has simplified their message to its essence:

  • Be safe.  Use a condom.

  • The safest sex is no sex.

 

The possibility that every single teen will adopt and either one of these behaviors perfectly is unrealistic.  Adults do teens a disservice by making a complex, life-changing decision so trivial.  It’s also a disservice to imply sex is something to fear.  Control, yes.  Fear, no.  

Every sex educator wants to modify teen behavior.  But if you have ever been a teen or known a teen, it should not come as a surprise that impulse-control is extremely difficult!  

Achieving this goal would be a lot easier if there was a consistent message across all strata of society.  If the soccer coach emphasized abstinence, and the neighbors didn’t give their child condoms, and the school regularly encouraged impulse control, then mastering their urges would be much easier for teens.

But that's not how it is and it’s extremely unlikely to happen any time soon.  What is much more likely is that you will be a lone voice in their world.  One lone voice of truth asserting:  

  • Teen sex has the potential to produce long term relational consequences that adolescents can't comprehend, foresee or predict.  

  • Condoms/pills/shots do NOT provide the same level of protection as not having sex at all.  

  • Some people who say they want to keep teens "safe" from sexual consequences are motivated by personal or financial gain.

 

As I have already pointed out, the debate over sex education has been condensed into these two choices:
        1)    Prevent teens from getting birth control
        2)    Provide teens with birth control

The adversaries of Positively Waiting claim abstinence-advocates want to prevent teens from learning about contraception. It’s not true.  In all my years in this field, I have never met an abstinence educator who wanted to pretend there’s no such thing as birth control.  Every abstinence educator I know wants adolescents to have access factual information that will help them make good decisions.  

It’s not telling teens birth control exists that abstinence-advocates like Positively Waiting object to!  It’s telling them that using protection is just as safe as not having sex.  Even the Centers for Disease Control won’t put a specific value on how effective any device is against sexually transmitted infections.  Their language is extremely vague.  CDC Factsheets on STDs, for instance, say only  “Correct and consistent use of latex condoms can reduce the risk of getting infected.” (2)

Reduce?  By how much? 10%?  50%?  1%?

I wish “Be safe, use protection” was the only institutionalized myth to confront and dismantle.  But there are so many more!

MYTH #1:  Oral sex eliminates the need to use condoms.  Totally false.  Most STDs will happily thrive in the mouth and throat.

MYTH #2:  You're "safe" if you both get tested before you have sex.  The fact is some STDs don’t have a test.  A person can say, "I go to the clinic every three months, so I'm clean."  But what if they have an STD for which there is no test?  What if they hooked up with an infected person last night?

MYTH #3:  Teen pregnancy is the problem which requires the most attention.  Is it?  Almost a million teen girls in the States do become pregnant every year.  But that there are about NINE Million new sexual infections ever year!  Pregnancy only lasts a few months, but Herpes is forever.  The estimated direct cost of treating STDs is $16 billion per year.  But those billions don’t include indirect costs like lost wages and productivity, the cost of treating infants who contract mom’s sexual infection, etc.(3)

MYTH #4:  If you're on the Pill, you don't have to worry about using condoms.  Totally false!  No chemical form of birth control provides any protection whatsoever from STDs.  Some studies show young women using birth control are actually more likely to get infected. (4)

MYTH #5:  You can tell if someone is infected.  Most teens, after seeing pictures of diseased genitals in the advanced stages, think, "I'm sure I’ll notice if a guy’s penis looks like a pickle."  But it is universally accepted that about 80% of the time STDs have NO symptoms.  

[Just FYI, I've had both doctors and clinicians tell me they routinely skip testing test for Herpes unless there is a visible sore to culture.  There is a blood test which can identify a Herpes carrier, but nothing can be done about it if the test is positive.  Clinics don’t routinely do this test because patients who hear ‘You have Herpes’ take up a lot of chair time.] 

MYTH#6:  You can trust the people who give you free birth control and condoms.  Excuse me?!  The same clinic whose INCOME is tied to treatment services?!  A clinic receives government funding to offer their curricula, provide contraception and condoms, but they are simultaneously receiving government funding for pregnancy-related and STD screening services.  (How is that NOT a conflict of interest?)

Sadly, even after their multi-week sex ed. unit, many of these myths will still persist in the minds of teens.  In part, because the scientific data is very complicated.  But also because adolescent brains aren’t capable of applying it.  They can’t take in information, weigh it and then predict the outcome of their behavior.  

The information gets watered down to the catch phrase:  "Be safe.  Use a condom.”  In a teenager’s mind, this sounds exactly the same as, "Be safe, don't smoke."  Nobody dies immediately from smoking a cigarette.  They know the risks increase over time.  

So “Be safe, use a condom” gets processed as: Don’t have sex with a lot of people when you're young.

It takes a well-developed pre-frontal cortex to understand it is possible to get pregnant, or become infected from a single sex act.  But even after their “safe sex” indoctrination, some teens will still respond, "Thanks for telling me all this stuff.  I'm definitely going to slow down." 

Please hear me, Mom, Dad: your teen needs more than just a sex education class at school.  Not more data, but a new way to THINK.  

 

~*~*~*~*~*~*~
Footnotes:

  1. Joe S. McIlhaney, M.D. and Freda Mckissic Bush, M.D.  Hooked: New Science on How Casual Sex Is Affecting Our Children  Northfield, 2008

  2. CDC STD FactSheets: Correct and consistent use of latex condoms can reduce the risk of getting infected.  View at http://www.cdc.gov/std/

  3. Owusu-Edusei K, et al. The estimated direct medical cost of selected sexually transmitted infections in the United States, 2008. Sex Transm Dis 2013; 40(3): pp. 197-201. 

  4. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2502624; and Charles S. Morrison, et al., “Hormonal Contraceptive Use, Cervical Ectopy, and the Acquisition of Cervical Infections,” Sexually Transmitted Diseases, September 2004 Vol. 31, No. 9, p. 561-567.