Experts Say Just Preaching Abstinence Will Not Deter Teen-Age Pregnancy

A sexuality-education provision in federal welfare legislation may do more harm than good, many non-profit leaders say.

The provision, which was passed by Congress as part of the 1996 overhaul of the welfare system, requires that programs that receive earmarked federal funds teach youngsters that sexual activity outside of marriage can have harmful psychological and physical effects. In addition to disagreeing with that assessment, many experts who work with adolescents say the requirement is unlikely to help accomplish the goal of preventing adolescent pregnancy.

The provision authorizes $50-million a year over five years to states to be used for programs that fight teen-age pregnancy by focusing on abstinence and that do not include information on contraception as an alternative. The requirement took effect last fall. All 50 states applied for and received federal funds for the first year.

“From a public-health point of view, this legislation is irresponsible,” says Barbara K. Huberman, director of training and sexuality education at Advocates for Youth, a Washington charity devoted to issues that affect adolescents. “Ignorance does not lead to good decisions.”

What’s more, she adds, “The legislation demands that you tell people medically incorrect information that they could be psychologically and physically damaged if they don’t abstain. It’s of extreme concern to us that young people are going to be given this information.”

But the measure has passionate supporters, including conservative Christian groups like the Family Research Council.

“The literature shows that those who abstain from sex until marriage have a much greater likelihood of staying married for a longer period of time and also a greater likelihood of sexual satisfaction,” says Gracie Hsu, a policy analyst at the Family Research Council, which worked closely with the members of Congress who drafted the provision.

The controversy over abstinence-only education has heated up as experts search for new ways to reduce the high rate of pregnancy among adolescent girls. Nearly a million teen-age girls get pregnant each year, and about half give birth.

Teaching abstinence is one of several approaches that have grown in popularity in recent years. While authorities on both sides of the issue agree that it is important to teach kids that abstinence is the best way to avoid not only pregnancy but also sexually transmitted diseases, they argue over what other information to include — or omit.

“We don’t talk about contraception whatsoever,” says Ann Guthrie Hingston, national program director of the Best Friends Foundation, which runs a program that teaches adolescent girls to abstain from sex, drugs, and alcohol. The program, which operates in schools in Washington, D.C., and in school districts in 10 other cities, also teaches girls to support one another in resisting peer pressure. Each girl also has an adult mentor.

“This program exists to give girls the support they need so that they do not get involved in sex,” Ms. Hingston says.

But critics say that refusing to give teen-agers information about contraception ignores statistics showing that more than 50 per cent of kids are sexually active by age 17.

Beyond that, many experts say that the government is pouring money into an approach that has not yet proved to be successful in preventing teen-agers from becoming parents.

Brian L. Wilcox, director of the Center for Children, Families and the Law at the University of Nebraska, who has reviewed dozens of evaluations of abstinence programs, says that few evaluations are reliable and that none show that such programs have a lasting impact on the kids they reach.

He and other experts say more reliable evaluations need to be done to determine whether abstinence-only programs work.

The repercussions of the legislation could be widespread, says Debra Delgado, a senior associate at the Annie E. Casey Foundation who oversees an effort in five cities to get parents and other adults to talk to kids about sexuality issues and to promote contraception and safe sex among sexually active teen-agers.

“It’s going to have lingering effects for a very long time in terms of communities giving abstinence a priority so that eventually kids are not going to be getting the information they need,” Ms. Delgado says.

She and others also worry that a requirement that states match every four dollars they receive from the federal government with three of their own will result in money being diverted from more comprehensive teen-age pregnancy-prevention programs that include sexuality education and also work at getting kids to think about their future. Such programs have already shown in evaluations that they can work, she says.

In Indiana, for example, the state legislature decided to use more than $600,000 of $1.6-million reserved for comprehensive sexuality-education programs to match the $857,042 it received in federal abstinence funds.

“That pulled away severely needed state dollars from more comprehensive programs,” says Kathleen Baldwin, the director of education and training at Planned Parenthood of Central and Southern Indiana.

But, says Sally Goss, the adolescent-health coordinator for the Indiana State Department of Health, the state funds come with fewer restrictions than the federal funds.

Groups that apply for and receive federal funds must teach abstinence until marriage and cannot include information on the use of contraceptives. Groups that apply for and receive matching state funds must emphasize abstinence through the teen-age years but may also include information on birth control.

That approach has riled some proponents of the abstinence-only measure.

“We take the position that those programs are inconsistent with the intent of the law,” says Peter Brandt, a spokesman for the National Coalition for Abstinence Education, which is closely monitoring how each state is using its federal abstinence-only funds.

Mr. Brandt says the coalition, made up of 70 groups, including the Family Research Council and Focus on the Family, is also concerned that some states are pouring the bulk of their grant money into publicity campaigns promoting abstinence rather than into programs that teach kids directly about refraining from sex until marriage.

Other states are using the federal funds for abstinence programs aimed at young children rather than all teen-agers. Minnesota, for example, which is receiving $613,756 per year in federal money, is designing its programs for kids 14 and younger.

Some members of Congress are also concerned about how states are using the abstinence-only funds. Republican Congressman Bill Archer of Texas has asked the House Ways and Means Committee to hold oversight hearings later this year so that the Maternal and Child Health Bureau of the Department of Health and Human Services, which oversees the grant program, can respond to the concerns.

Other groups are also keeping a close eye on the impact of the provision. Ms. Haffner’s group received a $110,000 grant from the Henry J. Kaiser Family Foundation to study what kids learn in the programs and to seek feedback from the teachers involved in the programs, as well as from the children and their parents.

The federal government has earmarked an additional $6-million to evaluate the abstinence-only provision over the next five years, but some experts say that is taking a backward approach.

“It makes no sense that tens of millions of dollars are being made available without an iota of evidence that this approach works,” says Michael Carrera, who runs a respected pregnancy-prevention program at the Children’s Aid Society in New York. “It only demonstrates the power of political considerations and how little we think about young people.”