Just Saying No

Charity leaders debate merits of teaching teenagers to avoid sex

In Miami, 59 boys and girls from some of the city’s most troubled neighborhoods have just

finished attending a summer camp where they read Anne of Green Gables and other classics for children, took field trips, and followed up on topics discussed in a yearlong school program that stresses the value of family and academic success. Run by a nonprofit group called ReCapturing the Vision, the program’s main goal is to ensure that girls don’t get pregnant.

At the same time, in Florida and elsewhere across the country, middle- and high-school students in a Girls Inc. program were being taught ways to stay in school and avoid becoming mothers while teenagers.

Both programs deliver a similar message: Abstinence is the safest protection from pregnancy and sexually transmitted diseases. But after that the programs differ. ReCapturing the Vision tells students to avoid all sex before marriage, and asks them to sign a vow that they will do so. Girls Inc. provides teenagers with explicit instructions about birth-control devices, including how to use a condom.

The difference in approach is part of a long-running argument among charities and foundations over how best to reduce the number of teenage pregnancies and sex-related diseases in the United States.

Controversy Over Federal Funds

The debate is now surfacing once again as Congress is being asked to decide whether federal money that goes to ReCapturing the Vision and other efforts to promote abstinence should be expanded or eliminated, and whether sex-education financing should be directed at programs that provide instruction on birth control. Private grant makers are following government actions closely, and a couple of foundations that have for decades promoted comprehensive sexual-education programs have also started to put money into abstinence-until-marriage programs.

At stake is much more than tens of millions of dollars in government aid to nonprofit groups. Today, one in every 11 girls in the United States age 15 to 19 becomes pregnant. Figuring out what will work best to reduce those numbers is made harder by a dearth of reliable studies that compare the success rates of abstinence programs with other prevention efforts, though several foundations are now sponsoring a $3.4-million research project that is expected to provide meaningful findings by 2005.

A new complication in the debate over government financing was added last month when a federal court halted money to several Louisiana abstinence programs. The court said it was concerned that many of the government grantees were explicitly promoting religious reasons for avoiding sex until marriage and violating the Constitution’s requirement that government and religion stay separate.

Surprising Results

ReCapturing the Vision was founded in 1994 by a high-school teacher, Jacqueline Jones Del Rosario, while she was getting her master’s degree in education. She said she was skeptical that students would be responsive to the abstinence message, but she decided to see what would happen and was encouraged by the overwhelmingly positive feedback she received from participants.

Close to 6,000 students have enrolled in ReCapturing the Vision’s yearlong program, and she says only one has become pregnant while in the program.

Emphasizing that students should focus on fulfilling their dreams rather than on the boy or girl in the next row is more effective than showing youngsters how to use birth-control devices, says Ms. Del Rosario. Teaching youngsters about such devices condones sexual activity, she says. Instead, she says, young people need teachers to say firmly that sex must be avoided. “They deserve someone to intervene and say, ‘You know what, you are worth more than this,’” she says.

Financing ReCapturing the Vision has gotten easier in recent years, largely because of help from the federal government. Most of the organization’s $1.3-million budget came from a government program that started doling out $50-million a year in 1998 to abstinence-until-marriage programs as part of the sweeping welfare overhaul. Some 900 programs, mostly run by nonprofit groups, use that money to teach young people the social, psychological, and health benefits of abstaining from sexual activity.

The money is channeled to nonprofit groups through the states, which must provide $3 for every $4 provided by the federal government. Grantees must pledge to talk about failure rates in any discussion of contraception and never show youngsters how to use it. They must also stress that sex should only occur among married couples, and that sexual activity outside of marriage is likely to have harmful psychological and physical effects.

Two other federal programs provide a total of nearly $70-million for additional abstinence-education efforts, and Congress is now considering whether to heed President Bush’s request to provide at least $33-million a year more to abstinence programs.

But groups like Girls Inc., which does receive $500,000 a year from the Centers for Disease Control and Prevention, mainly for HIV education, hope to persuade Congress to change the types of pregnancy-prevention programs that can receive support. They say abstinence-until-marriage programs don’t go far enough to protect youngsters, instill fear and shame about sex, and insult people for whom marriage is not a desirable option. They would like lawmakers to stop providing any more federal money for abstinence programs until it is proven that such programs are effective. They also are lobbying for money for groups that offer birth-control instruction.

“It’s very complicated to get through high school without becoming a parent or without getting a sexually transmitted disease,” says Heather Johnston Nicholson, director of research at Girls Inc. “Our job is to make sure that young people know that they are safer with a condom.”

Welfare Law

The debate over sex education is just one of the many contentious topics that are expected to arise as Congress gets ready to review the nation’s welfare laws. Although it is not clear whether Congress will finish a welfare measure before the November elections, lawmakers have begun drafting legislation that would extend and revise a landmark law that President Clinton signed in 1996.

Conservative groups pushed hard to persuade Congress to finance abstinence grants, arguing that reducing the number of out-of-wedlock births among teenagers was essential to reducing the number of people who needed government welfare benefits and that promoting abstinence was the best way to do that. While many abstinence programs are aimed at children from low-income families, it is too early to tell whether the money for abstinence is making a dent in the welfare rolls.

Many liberal groups said they felt such programs were unrealistic when the abstinence funds were approved, since half the nation’s teenagers already were engaging in intercourse, and it seemed unlikely that a large percentage would change their minds.

“Young people need strong abstinence messages to push back the time they become sexually active, and they need strong information about contraception because the majority will become sexually active by their later teen years,” says James Wagoner, president of Advocates for Youth, in Washington. “To argue otherwise and to deny young people critical health information is really to put ideology before public health and common sense.”

Started by Religious Groups

Before the big infusion of federal funds in 1998, most abstinence programs were run with private money by conservative religious and anti-abortion groups that promoted abstinence until marriage as part of their missions. The availability of the abstinence grants has helped spur many new groups to run programs for kids from elementary through high school. The offerings range from brief lectures to regular academic courses, held in schools that ask outside groups for help in delivering them. In some states, they are replacing existing sex-education classes entirely.

Many of the federally financed programs meet after school, combining tutoring, recreation, and a nutritious snack with messages on abstinence.

Often, abstinence groups run separate programs for boys and girls. Some have their own staff members who teach the course, while others train schoolteachers to deliver it for them as part of a class the teachers already offer or as a separate elective. In many of the programs, students make a pledge to abstain from sex until they are married, which in cases where the student has already been sexually active means becoming what the programs call a “secondary virgin.”

The message for those who have already had sex: “You can make decisions now based on what you know and what you want out of life from this day forward,” says Anne M. Badgley, president of Heritage Community Services, a Charleston, S.C., group that offers one- to two-week courses in 50 schools in the state. “They can see that decisions they make today take them to their future.” About one-third of her group’s $3-million annual budget comes from federal and state programs to support abstinence.

Some programs go beyond the schools. ReCapturing the Vision, for instance, sends social workers to visit participants’ homes once a month, to be sure that the family life is strong and to provide referrals for counseling and other services when needed.

Focus on Schools

Long before the 1996 welfare overhaul, federal aid was available for organizations that provide birth-control instruction to young people. Some $266-million is being provided this year for programs that nonprofit groups and others run, but unlike many of the abstinence efforts, those programs must be held in clinics, not schools.

Some groups that support the use of birth control have managed to get abstinence money by setting up separate programs that don’t show young people how to use contraception. But birth-control advocates say that doesn’t go far enough: that the schools are the best place to provide instruction on sexuality issues, including training about contraceptives.

“We know that young people look to a knowledgeable adult for information and conversation so we need to give them some options, and the schools are the place where we find the most young people,” says Tamara Kreinin, president of the Sexuality Information and Education Council of the United States, in New York.

Showing Results

Groups seeking to expand federal aid for programs that provide instruction in the use of birth control say their success rates prove that they deserve more money. For instance, Girls Inc. says a national study of its programs that combine birth-control instruction and abstinence education found that teenagers ages 15 to 17 who completed the program were half as likely to have sex and one-third as likely to get pregnant in the year following it as those who participated less or not at all. Younger people, ages 12 to 14, who completed the program were half as likely to have intercourse as those who participated less or not at all.

Even though groups of all kinds can offer evidence of success, little side-by-side analysis has been done to show which approach works best.

The David and Lucile Packard Foundation, which spends $1-million a year to finance comprehensive sexuality-education programs for teenagers, is putting $2-million into a $3.4-million study to measure the impact of the Girls Inc. program that encourages abstinence but presents information about contraceptive use. The Annie E. Casey Foundation, Robert Wood Johnson Foundation, Smith Richardson Foundation, and Turner Foundation have contributed the rest of the money for the study.

The findings will be measured against a study of abstinence programs now being done for the federal government. “By running this evaluation on a parallel track, we may be in the position in 2005 to actually compare results,” says C. Tracy Orleans, a senior scientist at Robert Wood Johnson, and “provide some science to program decision making.”

The Johnson Foundation is one of several grant makers that have long supported comprehensive sex-education programs that show how contraception works. But like some other grant makers, it is also trying to see if abstinence education can produce results.

“There are many approaches to one situation, and what works for one set of people might not work for another,” says Gretchen Wolfram, a spokeswoman for the Lilly Endowment, which has awarded $160,000 since 1997 for an abstinence program in Indianapolis and more than $1-million since 1992 to Planned Parenthood of Greater Indiana, which offers detailed information about birth control.

Other foundations are putting even more into abstinence education. The Lynde and Harry Bradley Foundation, in Milwaukee, for instance, has given $845,000 since 1994 to the Best Friends Foundation, a Washington group whose program has become a model and been adopted in 22 cities.

Lobbying Congress

As lawmakers get down to business in reviewing the abstinence-education money, both sides are mobilizing to get their arguments out. The National Coalition to Support Sexuality Education, which includes 140 national groups that promote teaching of birth-control methods, says it hopes that federal rules will be changed to allow abstinence to be discussed along with instruction about contraception. For now, the Sexuality Information and Education Council of the United States has started a “no new money” campaign to persuade Congress not to authorize or appropriate any more funds for abstinence education.

Many of those groups are upset about a plan by Sen. Max Baucus, Democrat of Montana and chairman of the Senate Finance Committee, that would add $50-million a year to programs that promote abstinence first — but then allow instruction about birth control. While they are glad to see contraception getting a higher profile, they say they worry the plan would end up supporting more programs that omit instruction.

But leaders of abstinence groups are rallying to make the case that the government needs to spend more to encourage abstinence. Ms. Del Rosario, who testified before Congress in April to talk about the achievements of ReCapturing the Vision, says that plenty of money is already being spent to let youngsters know about birth control. What wasn’t available until the government started supporting groups like hers, she says, was another voice urging youngsters to abstain from the immediate gratification of sex in favor of long-term fulfillment.

She says she knows others disagree, but she is confident that by persuading young people to resist sex and focus on other goals, she is rescuing many lives from failure and sorrow. Says Ms. Del Rosario: “What I am really doing is reclaiming a generation.”