I wonder if we will ever know how many American kids got pregnant or contracted sexually transmitted diseases (STDs) because of a decade of a failed national health policy: abstinence-only programs. Thankfully, we seem to be regaining our senses and will once again resort to science to guide public health policy related to sex education.


A scientific study

This positive development is discussed in some detail in the May 7, 2008 issue of JAMA  (Vol. 299, No. 17, p. 2013-15). Here is a brief summary:

In 2007, Mathematica Policy, Inc., a nonpartisan research firm (oh, how sad it is that it must be pointed out that a research firm is nonpartisan) published the results of its controlled trial of abstinence-only programs. For its study, Mathematica surveyed more than 2,000 elementary and middle school students who were followed into high school. Sixty percent of these young people were in programs identified by abstinence-only proponents as “ideal programs”, 40% were controls—in other words, a best case vs worst case scenario.

The conclusion: The abstinence-only programs “had absolutely no measurable impact on initiation rates [first time sex], age of first intercourse, number of partners, number of pregnancies, births, or STDs.” In other words, not one of the major hoped for outcomes of these programs was obtained. Hmmm. Once again, it seems hormones have trumped the best intentions of some wishful thinkers. Lest you think the “dose” of the programs was not intensive enough, the study points out that “in some of these cases, kids sat through 3 years of mandatory abstinence-only classes.”


Science-based sex education

At long last, medical organizations are once again talking about the need to have REAL (science-based) sex education, as opposed to programs driven by ideology. The Society for Adolescent Medicine states that “abstinence-only as a basis for health policy and programs should be abandoned.” The American Psychological Association, the AMA, the National Association of School Psychologists, the American Academy of Pediatrics, and the American Public Health Association have all criticized abstinence-only approaches. Thank heavens.

Our kids need a great big dose of reality when it comes to sex. And it is this: Sexual desire is a powerful driver of young (and old) people’s behaviors. Hey, y’all, don’t you remember what it was like when you were teens? We are finally acknowledging that it is better to know what you can do to protect yourself from the life-long consequences of unprotected sex instead of muddling through ignorant of the facts of life, so to speak.


What about the Dutch?

One of the most interesting aspects of the JAMA article is a comparison of U.S. approaches to sex education compared to what happens in the Netherlands. The JAMA article states that the U.S. has one of the highest rates of teen pregnancy in the Western world and the Netherlands has one of the lowest.

Abstinence-only programs are not part of Dutch public health policy. In the Netherlands, adolescent girls can get birth control pills confidentially and those aged 16 or older have access to government-subsidized clinics where they can get abortions without parental consent. Despite, or perhaps because of, these progressive policies, the teen pregnancy and abortions rates in the Netherlands are among the lowest in the world.

In a study comparing parental attitudes about teenage sexuality in the U.S. vs the Netherlands, researcher Amy Schalet, Ph.D, interviewed parents of teens in both countries. She found dramatic differences in attitudes. U.S. parents worried about their teens getting carried away by emotions they “mistake for love”. Dutch parents believed their children could fall in love, pace their sexual development, and (lordy, lordy) use contraceptives when they (the teens) deem themselves ready for intercourse.


The bottom line

In the U.S., the government spent the last decade behaving like a strict surrogate parent to our teens: controlling information about alternatives to abstinence, making it hard for comprehensive sex education programs to get funded, and substituting religious ideology for science. Thank heavens we are finally moving on and are ready, once again, to base our public health programs on science, real, honest to goodness science. Whoopee!