Comprehensive Sex Education in Public Schools

Comprehensive Sex Education in Public Schools:

A Matter of Public Health

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Abstract

The present research focuses mainly on the existence of comprehensive sex education in public schools—or the lack thereof—and its impact on sexual behaviors and practices among youth, and consequently, on the overall sexual health of teenagers and young adults. It surveys common practices in Europe and compares them to those of the United States with the objective of confirming the author’s theory that comprehensive sexual education leads to less pregnancies and sexually transmitted infections among teenagers. Additionally, it questions the ethicality of the current disinformation campaign that is upheld in American public schools through the abstinence-only-until-marriage program which manipulates information and spreads falsehoods about the efficacy of contraceptive and barrier methods with the objective of discouraging teenagers from engaging in sexual activity.

Comprehensive Sex Education in Public Schools:

A Matter of Public Health

Throughout the twentieth century, America underwent a multitude of societal changes. Among those, the sexual revolution, rooted in the commercialization of birth control, has transformed the life of American men and women. In modern day’s society, young people stay in school longer and marry later. For a majority of Americans, the first sexual intercourse happens during adolescence and before marriage. With sexually transmitted infections and teen pregnancy rates skyrocketing in the last part of the twentieth century, sex education became a social concern. Since then, numerous groups have raised apprehensions about teenagers receiving information on sexuality and contraception arguing that it is promoting sexual activity and encouraging youngsters to engage in promiscuous behaviors. However, because sexually transmitted infections lead to serious health problems including infertility and death, and teen pregnancies cost taxpayers substantial amounts of money, law makers should consider sex education as a matter of public health rather than as a moral issue, and make it a mandatory component of the state’s public education curriculum.

Teen Pregnancy rates

In the United States, teen birth rates have consistently gone down since their peak of the early 1990s. According to the Office of Adolescent Health division of the U.S. Department of Health and Human Services (HHS) in 2013, birth rates reached a historical low of 26.5 for every 1000 teenage female ages 15-19. More than half the 59.9 rate of 1990, the 2013 data demonstrates great improvement in one of the country’s greatest scourge of the twentieth century (HHS, 2015). However encouraging the data may be when compared to past performances, when put side by side with other developed countries’ teen birth rates, the United States appears to be lagging behind. The “adolescent fertility rate” of the United States is closer to that of Eastern European and Middle Eastern countries than that of other high income nations (The World Bank, 2015). The teenage birth rates of Canada, France, Australia, Germany and Sweden for the year 2013 are respectively 14, 6, 11, 3, and 6 (The World Bank, 2015). Comparatively, the teenage birth rates of the Russian Federation, Romania, Pakistan, Turkey, and Iran for the same year are 26, 31, 27, 29, and 31 respectively (The World Bank, 2015).

Teen Pregnancy Rates Among European Nations Relative to their Sexual Education and Sexual Health Policies

A study conducted by the Guttmacher Institute that observed sexual behaviors among teenagers in Great Britain, Canada, France, and Sweden, which all offer comprehensive sex education programs, revealed that the two best performing countries—Sweden and France—offer broad social programs that comprise low-cost medical care and contraception (Friedman, 2005, p. 769; Issues & Controversies, 2007). Moreover, most European countries do not solely offer—but widely promote—the use of contraception among teenagers. The Guttmacher Institute claims that those nations exhibit “societal acceptance of sexual activity among young people” and that “sexuality is seen as normal and positive, but there is widespread expectation that sexual intercourse will take place within committed relationships” that are described as “mutually monogamous” (as cited in Friedman, 2005, p. 769).

In a variety of studies complimentary to that of the Guttmacher Institute, Advocates for Youth, which sponsors study tours to select European countries to better understand the reason behind their achievements in youth sexual health, found that European countries generally have more openness towards sexuality and provide their people—including teenagers—with greater and easier access to sexual health information and contraception (Friedman, 2005, p. 769). Such differences in education, health, and social policies between that of the United States and those of the countries cited as exemplar may explain the discrepancies in teenage fertility rates observed. Thus, if the United States wants to further reduce its teenage birth rate and reach a level that is comparable to that of other high income nations, perhaps it should base its sexual education and sexual health policies on those of well-performing countries.

Abstinence-Only Programs

In response to the exponential increase in teen pregnancy rates, the federal government passed in 1996 a piece of legislation upholding and funding “abstinence-only” sex education programs. As part of the Temporary Assistance for Needy Families Act, the Section 510(b) of Title V put into effect a new “federal funding stream” in the form of grants allocated to states that accepted the standard to promote abstinence-only-until-marriage and present it to students as the only way to prevent unwanted pregnancies and sexually transmitted infections (Sexuality Information and Education Council of the United States SIECU, n.d.; Friedman, 2005). States that accepted federal funding for the abstinence-only program were required to match up to 75% of the federal grants received with state funds. Then, states were responsible for the allocation of funds to sub-grantees which include organizations such as schools, faith-based organizations, county and state health departments, and others.

Between 1996 and 2010, the federal government paid over one-and-a-half billion dollars in grants to fund abstinence-only sex education programs through Title V, the Community-Based Abstinence Education grant program, and the abstinence-only-until-marriage portion of the Adolescent Family Life Act. In 2010, the Obama administration eliminated the Community-Based Abstinence Education grant program and the abstinence-only-until-marriage portion of the Adolescent Family Life Act. The Title V abstinence-only-until-marriage program, which expired in 2009, was revived through a health-care reform package in 2010; it was allocated 50 million dollars per year for five years (2010-2014) (SIECU, n.d.).

Abstinence-Only Programs and the Separation of Church and State

In 2000, Congress passed a law that allowed states to allocate funds to private organizations, inter alia religious groups (Friedman, 2005, p. 775). Since then, after funds were allotted to states, the latter were free to choose who to distribute it to. This provision is problematic as it can be deemed unconstitutional; because states were able to allocate federal funding to faith-based organizations so long as they were promoting abstinence-only programs, tax-payer dollars were used to finance religious organizations, yet this is infringing on the separation-of-church-and-state clause of the Constitution.

On May 16th, 2005, The American Civil Liberties Union and Jenner & Block LLP filed a lawsuit against Mike Leavitt, Secretary of U.S. Department of Health and Human Services, Wade Horn, Assistance Secretary for Children and Families, and Harry Wilson, Associate commissioner, Administration on Children, Youth and Families for violation of the Establishment Clause of the First Amendment of the U.S. Constitution through funding of the abstinence education program provided by Silver Ring Thing (American Civil Liberties Union ACLU, 2005). The suit was based on Silver Ring Thing’s mission statement which says that it offers students “a personal relationship with Jesus Christ as the best way to live a sexually pure life” as well as the contents of their abstinence program as a whole (ACLU, 2005). As part of their program, the Silver Ring Thing gifts the students who take the pledge to remain abstinent until marriage with a Christian Bible and the said “silver ring” which is engraved with a quote from the New Testament (Friedman, 2005, p. 778).

On February 23rd of the following year, the ACLU announced that a settlement was signed by both parties. The settlement states that the Defendants were not to fund the abstinence education program of the Silver Ring Thing in its current form, and in the event that Silver Ring Thing reapplies for grants during fiscal years 2006 through 2008, Defendants must ensure that Silver Ring Thing discloses how it plans to make use of the federal funds and monitor such spending, as well as ensuring that the program is adhering to 45 C.F.R. Part 87 (2005), which “specifically prohibits the use of federal funds to support inherently religious activities” (ACLU, 2006).

Falsehoods and Misleading Information Regarding Contraceptive and Barrier Methods Contained in Abstinence-Only Curriculums

In order to receive federal dollars, the schools accepting to put forth abstinence-only curriculums have to follow strict guidelines: educators cannot talk about condoms or other contraceptive methods except to report failure rates. However, the failure rates communicated to students through the abstinence-only programs are biased because there is no distinction made between correct use failure rates and inconsistent or incorrect use failure rates. As argued by Macaluso et al. (1999), in a majority of condom failure rate reports, the failure rate disclosed is not consistent with breakage or defect rate of the device itself (as cited in Planned Parenthood Federation of America PPFA, 2011), and it is misleading potential users as to the actual effectiveness of condoms as both a contraceptive and a barrier method. In fact, the Centers for Disease Control (CDC) reports (1998) an actual breakage rate of 2% when condoms are used properly (as cited in PPFA, 2011). Moreover, in “Contraceptive Efficacy,” Trussell states that when condoms are used consistently and correctly by a sexually active couple, a woman has less than 3% chance of becoming pregnant within a year (Advocates for Youth, 2007).

The rates publicized through abstinence-only programs, which oscillate around 15%, give students the erroneous impression that condoms are ineffective. As a comparison, one can think of the use of cycling helmets: it is reasonable to assume no parent would tell their child that helmets are not reliable because they are not 100% effective in preventing injuries and that the only way to prevent injuries is to refrain from cycling altogether. That is what abstinence-only programs are teaching U.S. children: the only way to avoid unwanted pregnancies and sexually transmitted infections is abstinence. Although such affirmation is true, it is inappropriate to mislead students by manipulating the information that is given to them, and it is irresponsible to presume—or hope—that they will indeed abstain from engaging in sexual activity.

Risk Sexual Behavior Among Youth in Correlation with Teen Pregnancy Rates and Sexually Transmitted Infections Rates

The Adolescent and School Health division of the CDC monitors health-risk behaviors among teenagers around the country. The data collected for the year 2013 demonstrates that high-school students in Texas engage in risk sexual behavior in greater proportions than those of the rest of the country. For the year 2013, the data collected establishes that 46% of high school students and 63% of 12th-grade students in Texas declared having engaged in sexual intercourse, which is consistent with the results observed for the country as a whole. However, when it comes to the use of contraceptive methods and barrier methods among sexually active high school students, the state of Texas is lagging behind. As reported by the CDC, 47% of Texas high school students who were sexually active declared that they did not use a condom during their last sexual intercourse—compared to 41% for high school students in the country. Likewise, the percentage of students who did not use a contraceptive method to prevent pregnancy prior to their last sexual intercourse was 80% in Texas and 75% in the U.S (CDC, 2013). The data presented by the CDC regarding sexual behaviors among youth in Texas is consistent with the teenage birth rates in the state—which are higher than those of most of the country. With a teenage birth rate of 41 per 1000 female ages 15-19 in 2013, Texas placed fifth-to-last among all 50 states, and its rate equated to more than one-and-a-half times that of the U.S.

Summary

In light of the data presented, it appears as like there is a strong link between comprehensive sexual education, the accessibility and affordability of health care and contraception, as well as openness towards defining and teaching youth about healthy sexual behaviors. Thus, by denying Texas’ youth access to enlightening medical information, legislators are putting large numbers at risk of unwanted pregnancies and of contracting health threatening sexually transmitted infections. Therefore, with the goal of further reducing the teenage pregnancy rate of the U.S. and reducing the spread of sexually transmitted infections, it is imperative to provide both abstinence as well as comprehensive sex education to all students attending public school in America.

References

Advocates for Youth. (2007). The truth about abstinence-only programs. Publications. Retrieved from http://www.advocatesforyouth.org/storage/advfy/documents/fsabstinenceonly.pdfAmerican Civil Liberties Union. (2005, May 16). ACLU Challenges Misuse of Taxpayer Dollars to Fund Religion in Nationwide Abstinence-Only-Until-Marriage Program. Retrieved from https://www.aclu.org/news/aclu-challenges-misuse-taxpayer-dollars-fund-religion-nationwide-abstinence-only-until-marriageAmerican Civil Liberties Union. (2006, February 23). Settlement Agreement in ACLU of Massachusetts v. Secretary of U.S. Department of Health and Human Services. Retrieved from https://www.aclu.org/sites/default/files/field_document/srtsettlementagreement.pdf

Centers for Disease Control and Prevention. (2013). Youth online: high school YRBS. Youth Risk Behavior Surveillance System (YRBSS). Retrieved from https://nccd.cdc.gov/youthonline

Friedman, J. (2005, September 16). Teen sex. CQ Researcher, 15(32), 761-784. Retrieved from http://library.cqpress.com/Illes, J. (2012, November). Young sexual citizens: reimagining sex education as an essential form of civic engagement. Sex Education, 12(5), 613-625. http://dx.doi.org/10.1080/14681811.2011.634152

Ingham, R. (2005, November). ‘We didn’t cover that at school’: education against pleasure or education for pleasure? Sex Education, 5(4), 375-388. doi:10.1080/14681810500278451

Issues & Controversies. (2007, July 6). Teen Pregnancy: does learning about birth control in school help prevent teen pregnancy? Infobase Learning. Retrieved from http://icof.infobaselearning.com/recordurl.aspx?wid=99152&ID=2142

Planned Parenthood Federation of America, Inc. (2011). The Truth About Condoms. Retrieved from http://www.plannedparenthood.org/files/9313/9611/6384/truth_about_condoms.pdf

Santelli, J. (2008, October). Medical accuracy in sexuality education: ideology and the scientific process. American Journal of Public Health, 98(10), 1786-1792. doi: 10.2105/AJPH.2007.119602

Sexuality Information and Education Council of the United States. (n.d.). A History of Federal Funding for Abstinence-Only-Until-Marriage Programs. Retrieved from http://www.siecus.org/index.cfm?fuseaction=page.viewpage&pageid=1340&nodeid=1The World Bank. (n.d.). Adolescent fertility rate (births per 1,000 women ages 15-19). Data. Retrieved from http://data.worldbank.org/indicator/SP.ADO.TFRT/countriesU.S. Department of Health & Human Services. (2015, May 29). Trends in teen pregnancy and childbearing. Office of Adolescent Health. Retrieved from http://www.hhs.gov/ash/oah/adolescent-health-topics/reproductive-health/teen-pregnancy/trends.html