By Greg Pfundstein
We have been receiving some nasty emails and a few comments at our Facebook page, most of which charge that we are stupid. Presumably people think we are stupid because they think they know something about comprehsive sex ed or abstinence sex ed that we don't know. In general, the implication is that any intelligent person would know that comprehensive sex ed works and abstinence education doesn't work. If you don't know that, you are stupid.
So, are we stupid?
I was looking again at the research today as I prepared to answer these charges. Turns out I had forgotten how much I already knew about how limited the effectiveness of comprehensive sex ed is and about how abstinence education has been shown to be more effective on several important metrics, such as teenage pregnancy rates. Here is what I wrote for another website, nyc41percent.com, several months ago, long before the sex ed mandate came down from on high
When well over half of pregnancies are unplanned, and 41% of pregnancies end in abortion, it is time to rethink the current approach to sex education in New York City.
Doesn’t New York City teach comprehensive sex education in its schools? If so, why are there so many unintended pregnancies amongst young people in New York City? According to the New York City Department of Education’s website, the City recommends Health Smart and Reducing the Risk for use as comprehensive sex education in New York City schools.1 But according to an evaluation of the Reducing the Risk program, the program is not effective in decreasing the rate of pregnancy:
“During the 18 months of follow-up, there was no statistically significant difference between the treatment and comparison groups in the proportion of students who became pregnant or made someone pregnant. This finding reflects the fact that the curriculum did not have a significant impact upon unprotected intercourse among all students; rather, it affected only those who had not initiated intercourse prior to the program, and in this group the pregnancy rates among treatment and comparison students were too small to be statistically meaningful.”2
But what is the alternative? Hasn’t abstinence education been proven not to work? Traci Perry, spokesperson for Planned Parenthood, recently said that “Abstinence [education] by itself has been proven to be ineffective.” Unfortunately, this statement is misleading. It is true that one study of the earliest abstinence education programs failed to show effectiveness.3 But the authors of that study admitted that the four programs evaluated were not considered “state-of-the-art.” Furthermore, the four to six year follow up period used by the evaluation is far longer than the 18 month follow up period used to establish the effectiveness of the Reducing the Risk program used by the NYC Department of Education. A four to six year follow up period is a high standard for measurement of the effectiveness of an intervention.
The truth is that some abstinence education, or risk avoidance, programs do work: as of 2010, there were 17 different programs which were shown to have statistically significant results by independent evaluators, and in 15 of those cases the results of the evaluations have been published (publication is pending in the other two cases). One study conducted in Philadelphia by J.B. Jemmott using four different models for comparison (safer sex [contraception only], comprehensive [abstinence plus contraception], abstinence only, and control) found that while the abstinence intervention reduced the rate of sexual initiation among the sixth and seventh graders participating compared to the control group, the “safer sex” program actually led to a higher rate of sexual debut among participants compared to the control group. The comprehensive program had slightly better results than the control group. Perhaps more interestingly, while neither the safer sex intervention nor the comprehensive intervention significantly increased condom use, the abstinence intervention had no negative effect on condom use.4
Other studies of abstinence based risk avoidance programs show decreases in pregnancy rates in the schools or counties where the studies were conducted, and several show that participants who were already sexually active before the intervention were more likely to remain abstinent afterward, a result which Reducing the Risk was unable to attain.
Some argue that there is only one valid approach to sexuality education: risk reduction through contraception. But the evidence suggests that risk avoidance approaches can be at least as effective as risk-reduction approaches. With a situation as dire as the situation in New York City, maybe it is time to consider other approaches to sexuality education in New York.
Evidence is on our side. If people are willing to challenge their received assumptions, they will find that the party-line approach that has prevailed for nearly three decades is based on a false assumption: comprehensive sex education just doesn't work as advertised.
2 Douglas Kirby, Richard P. Barth, Nancy Leland and Joyce V. Fetro, “Reducing the Risk: Impact of a New Curriculum on Sexual Risk-Taking,” Family Planning Perspectives,Vol. 23, No. 6 (Nov. - Dec., 1991), pp. 253-263.
3 Christopher Trenholm, Barbara Devaney, Kenneth Fortson, Melissa Clark, Lisa Quay, and Justin Wheeler, “Impacts of abstinence education on teen sexual activity, risk of pregnancy, and risk of sexually transmitted diseases,” Journal of Policy Analysis and Management, Volume 27, Issue 2, (Spring 2008) pp. 255–276.
4 J.B. Jemmott, L.S. Jemmott, and G.T. Fong, “Efficacy of a theory-based abstinence-only intervention over 24 months,” Archives of Pediatrics and Adolescent Medicine, Vol. 164, No. 2 (February 2010) pp. 152-159.