Background on Sexuality Education

Currently, sexuality education programs in the United States can be divided into two distinct types:

Abstinence-Only Programs
According to the mission statement of the Abstinence Educator's Network, "sexual feelings are normal and real, but sexual behavior is controllable. Learning self-control is essential for good health and a positive goal for many reasons in one's life…. Sexual abstinence is the only medically safe and morally responsible choice for unmarried teenagers." "Abstinence-only" programs assert that abstinence until marriage is the only responsible and acceptable sexual behavior, and therefore only abstinence should be taught in schools. These programs do not address issues such as sexual health, sexual orientation or sexual protection.

Abstinence-Plus Programs
Comprehensive sexuality education programs, known as abstinence-plus programs, encourage abstinence until marriage as the most effective protection from unplanned pregnancies and sexually transmitted diseases (STDs). However, these programs also recognize the realities of sexuality and behavior among teenagers, and address issues relating to contraception and safer sex, peer pressure, and other issues of sexuality, such as homosexuality.1

Contraception in Public Schools
The availability of contraceptives in public schools, to some, is seen as a basic component of sexuality education. While parents certainly have primary responsibility for rearing their children, sometimes children are more comfortable seeking counsel from others, and not all parents are comfortable or willing to discuss sexuality issues with their children. An informed, accessible, confidential health care provider, such as a school nurse, can serve this important role. In light of the current reality of teen sexuality, many believe that school nurses, other school health providers or sexual health educators should follow up these conversations by discussing birth control options, explaining how to use a condom properly and, when approached by a student who has decided to have sexual relations, ensure that the student has a condom.

Making condoms available in public schools is not a simple matter, however, and the cases on the issue are divided. Courts have tended to defer to local school boards' decisions and allow condom distribution programs to stand, but legislators have tended to restrict school boards' powers and prohibit such programs from being instituted. The debate revolves around rights, responsibilities, and potential liability. It also revolves around the messages teens receive from such programs.

Decisions regarding contraceptive distribution in the schools are made at many different levels - federal, state and local. It is a hotly contested issue within state governmental bodies and school boards across the country, as well as within the courts. Such cases includeCurtis v. School Committee of Falmouth, 652 N.E.2d 580 (Mass. 1995), cert. denied, 516 U.S. 1067 (1996), in which the Supreme Judicial Court of Massachusetts found in favor of the school's right to distribute condoms. The court held that voluntary condom distribution programs in junior high and high schools did not unconstitutionally infringe upon parents and students' right to familial privacy, parental liberty, and exercise of religious freedom.

Arguments for Abstinence-Only Sexuality Education Programs
Many religious and conservative political groups have waged strong campaigns in favor of abstinence-only programs. Not long ago, the True Love Waits campaign gained national attention, and the media focused on such images as a stack of virginity pledges reaching the top of a football stadium dome in Texas. Many of these programs began as curricula for religious schools, but other groups joined in and enlarged the campaign to address the public school system.

The common argument against comprehensive sexuality education is that educating students about contraception, sex before marriage, different types of sex, etc., simply encourages them to have sex, and that only education focused solely on abstinence will lower the rates of teenage pregnancy and preserve the sanctity of marriage. Many religious organizations and schools also strongly oppose the idea of including discussions of homosexuality, bisexuality and transgender issues into sexuality education curricula because they have moral or religious objections to recognizing the existence or legitimacy of anything other than heterosexuality.

Arguments for Abstinence-Plus Sexuality Education Programs
According to the latest Center for Disease Control (CDC) data, 61 percent of graduating high school seniors have had sex. The CDC also found that AIDS is a leading cause of death among Americans 25 to 44 years old, and every year three million teens-about one in four sexually experienced teens-acquire STDs. The Alan Guttmacher Institute reports that each year almost 1 million teenage women-10 percent of all women aged 15 to 19 and 19 percent of those who have had sexual intercourse-become pregnant.

According to the American Journal of Public Health, in one study of urban students in the ninth through the twelfth grades, more than one third of virgin male and female adolescents had engaged in some form of heterosexual genital sexual activity in the past year: 29 percent of virgins had engaged in masturbation of a partner of the opposite gender; 31 percent had been masturbated by a partner of the opposite gender; 9 percent had engaged in fellatio with ejaculation with a partner of the opposite gender; 10 percent had engaged in cunnilingus with a partner of the opposite gender; and 1 percent had engaged in anal intercourse with a partner of the opposite gender.

Much of the support for abstinence-plus programs comes from statistical data regarding the effectiveness of abstinence-plus programs and the ineffectiveness of abstinence-only programs, in terms of their affect on rates of intercourse, contraction and spread of STDs and pregnancy. Contrary to the argument made by abstinence-only advocates, studies have shown that abstinence-only programs do not deter or delay sexual activity, nor do abstinence-plus programs encourage or increase sexual activity. In fact, a 1997 United Nations report examined 22 HIV/AIDS and abstinence-plus sexuality education programs and found that the programs were effective in delaying the onset of sexual activity, reducing the number of sexual partners, and decreasing the incidence of sexually transmitted disease and unplanned pregnancy.

A great number of Americans support the findings of these various studies. In a 1996 study, 79 percent of adults in the U.S. supported the provision of comprehensive sexuality education in schools (62 percent were "strongly" in favor). Nearly 60 percent of voters agreed that abstinence may be an unrealistic expectation for adolescents, and that comprehensive sexuality education is needed.2 To combat the arguments of the religious right, a poll was taken of PTA presidents in North Carolina. Of these presidents, comprised of over one-third who identify themselves as born-again or fundamentalist Christians, 93 percent believe that the curriculum should include both abstinence and contraception education.

There are fewer findings regarding the approval ratings for including homosexuality, bisexuality and transgender issues in abstinence-plus programs. However, advocates of such inclusion argue that because these are issues faced by a great number of American youth, and because discussing these issues promotes diversity and tolerance, these issues should be a part of school sexuality education programs.3

In December of 2004, Representative Henry Waxman (D-CA) released a study showing that eleven out of the nation’s thirteen most popular abstinence-only education curricula were riddled with inaccuracies, skewed statistics, and scientifically unfounded data. His research found cases where lessons claimed HIV/AIDS could be transmitted through sweat and tears; that condoms failed to protect against HIV transmission as much as thirty-one percent of the time; that a 43-day-old fetus is a “thinking person”; and that touching a person’s genitals could result in pregnancy.

Sexuality Education in Canada: A Basis for Comparison
Abstinence-only sexuality education programs are more prevalent in the United States than in Canada; in Canada, comprehensive sexuality education programs are the established norm. While Canadian provincial governments ultimately have jurisdiction over education issues, both the provincial mandates and the Canadian federal mandates call for comprehensive sexuality education in public schools. In the western provinces of Alberta and Saskatchewan, several local school boards have enacted programs that resemble abstinence-only sexuality education, despite the fact that comprehensive sexuality education is mandated. Aside from these exceptions, Canadian sexuality education is overwhelmingly comprehensive in nature. Canadian programs encourage abstinence while also addressing issues of sexual health, contraception, protection from STDs and differing sexual orientations. According to the Sex Information and Education Council of Canada (SIECCAN), Canadian teen pregnancy rates are significantly lower than those in the Unites States, and many attribute such differences to the efficacy of Canada's comprehensive sexuality education programs. In the upcoming months, the Alan Guttmacher Institute is expected to publish a report on the effectiveness of sexuality education and access to reproductive health in the United States and Canada.