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March 29, 2005
Ends, Means, and Sex Education
Over at my regular blog, I have posted regularly about the failures of abstinence-only sex education and the need for a more comprehensive sex education program in the US that includes, at the very least, free and anonymous availability of birth control. I've made this argument purely on empirical grounds - such programs work in country after country where the rates of teen pregnancy, abortion and sexually transmitted diseases are far lower than in the US. Some of my readers have suggested that for many social conservatives, they simply don't care about the practicality of what works and what doesn't, that they would rather preach moral purity and watch teen pregnancy and STDs go up than to take the practical step. Now here comes Joe Carter, a prominent evangelical blogger, to confirm that suggestion. In a post responding to several questions, here is Joe's answer to this one:
4. If it could be demonstrated that comprehensive sex education and actively encouraging contraceptive use measurably decreased the number of teenage pregnancies and abortions, would you throw your support behind these options? (Put another way, what's more important to you: cutting the number of abortions, or cutting sexual activity?)
In other words, do the ends justify the means? I don't think they do nor do I think many people are truly that Machiavellian. After all, sterilization would also measurably decrease the number of teen pregnancies and abortions. The problem with "comprehensive" (i.e., nonjudgemental) sex education and the encouragement of contraceptives is that it treats teenagers as if they were simply statistics. If the overall reduction in social ills is reduced then it was worth the individual cost, right?
I certainly don't see it that way. Teens look to adults for guidance on how they should live. But much, if not most, of the time they will simply ignore what they are told. That doesn't mean we should stop telling them the truth or give up on encouraging virtuous behavior. We should treat them as morally accountable persons.
The primary reason I don't take a utilitarian approach to reducing sexual activity is because it ignores the effects on the individual level. I truly believe - and have seen it confirmed hundreds of times - that teens who have sex outside a lifelong monogamous relationship are bound to have some degree of emotional, physical, and psychological damage. That is why I can't support such unethical policies. What's important to me is the person, not just the negative consequences of bad choices.
The first part of his answer strikes me as nonsensical. The question, "Does the end justify the means?", is a nonsense question unless you spell out what the ends and means are in this particular situation. Everyone believes that some ends justify some means, including Joe Carter, and that doesn't make them "Machiavellian". More importantly, the question could as easily be turned around and asked in the other direction: does the end of moral purity for a small percentage justify the means of withholding accurate information about and access to birth control methods that would help the larger group avoid potentially life-altering consequences should they choose to have sex?
Study after study has shown that comprehensive sex education, including access to condoms and other forms of birth control, reduces the rates of teen pregnancy, abortion and STDs enormously. Studies also show that abstinence-only sex education, while it may delay the onset of sexual activity by a few months on average (though more than 90% of those who make virginity pledges do not honor them), significantly decreases the use of condoms and other forms of birth control when kids do become sexually active, resulting in a spike in all three negative consequences. This is hardly a surprise given that the rules on receiving funding for abstinence-only sex ed require that the programs do not even mention contraception other than to point out their failure rates. Meanwhile, our European neighbors are having far greater success with programs of comprehensive sex education, including free and anonymous access to birth control and sexual health services, including pregnancy and STD testing. They also have mass media campaigns encouraging safe sex on television.
The result? The rates of teen pregnancy, abortion and STDs are all far higher in the US than in any European nation, and I mean far higher. No other nation has per capita rates even half that of the US, and in the case of the Netherlands, generally considered the best sex education in the world, the numbers are staggering. Despite widespread perception that the Netherlands is a land of inquity and sexual permissiveness, the US rates of pregnancy and abortion are a full seven times higher than the Netherlands. Dutch teenagers also have fewer partners on average than American teenagers, and start having sex almost two years later on average. The notion that comprehensive sex education will lead to rampant teen sexual activity is clearly false, as the US has much higher rates of such activity than any other Western nation as well.
The effects of abstinence-only sex education have been predictable. Since Congress began funding such programs, the number of schools that make birth control information available in sex education classes has dropped enormously. Fewer than half of our public schools now provide information on how to obtain birth control. Our children need accurate and comprehensive information about sex education. They should of course be taught that the only 100% sure way to avoid pregnancy and disease is abstinence. But they also must have accurate information about not only how to obtain birth control but how to use it correctly, and on the importance of using it every single time and in redundant ways. Anything less than that is writing off the lives of our children and dooming far too many of them to often irreversible damage.
Posted by at March 29, 2005 12:38 PM
What Joe Carter may be saying is simply that having sex is a sin. The wages of sin are eternal damnation. If their are side effects of sin in this life such as STDs and unwanted pregnancies so be it. The sinner must pay for their sins. Spreading sex education and birth control around allows sinners to mix with christian society unnoticed, like little demons polluting the message and the seed.
Joe Carter doesn't care one bit about the children. He cares about condeming the 'sinners' and not only condemning them but displaying them to society to enforce his message.
Unfortunately it is societal demons like Carter that influence parents and legislators. Carter and his ilk are a pariah on a thinking society and they are the spawn of most of societies darkest memories.
Posted by: tb at March 29, 2005 02:04 PM | permalink
I'd be hesitant to draw many 'causation conclusions' from European sex education. I think their low teen pregnancy and abortion rates are at least partially attributable to differences in culture and demographics. For instance, if you were to account for differences in immigration, would that affect the results? I'm not sure, but it'd make me cautious.
Either way, I like this: "They should of course be taught that the only 100% sure way to avoid pregnancy and disease is abstinence. But they also must have accurate information about not only how to obtain birth control but how to use it correctly. . ."
Posted by: Joshua Claybourn at March 29, 2005 02:28 PM | permalink
Saying that the teen pregnancy rate has declined because of "traditional" birth control methods is somewhat misleading unless you have some sort of control group in which this is the only meathod taught, just as saying the same for abstinence only education would be misleading.
Overall, I think the telling fact is the percentage of unmarried teenage girls becoming pregnant. In the 1950s, when it was more common for younger girls to be getting married, the unmarried teen pregnancy rate was only 13%. In 2000, it was 79%. Is this because the girls in the 1950s were using more or better birth control, or being taught more about it? I doubt it. It's because they were being taught from home, church, school and friends that having sex before marriage was wrong. As our moral standards have loosened, unmarried teenage pregnancies have skyrocketed. Giving them more reasons to go out and have sex is not the answer.
And before anyone here claims that I "don't care about the kids" like you're claiming about this other person, keep in mind that I work in a crisis pregnancy care center. I see what works and doesn't work for these kids, and I'm here to tell you that handing out condoms like they were candy doesn't work.
Posted by: Drew at March 29, 2005 02:47 PM | permalink
Drew,
Where was it suggested that we should be "handing out condoms like they were candy"? No one has suggested anything as absurd as handing out flavored condoms in homeroom and telling kids to "go wild" while the teacher goes outside for a smoke.
Your strawman does nothing to advance the discussion.
Posted by: Michael LoPrete at March 29, 2005 02:55 PM | permalink
I have no idea what you are referring to as "strawman". If you aren't suggesting handing out condoms and other forms of "non-abstinence" (for lack of a better term) birth control, then what are you suggesting? You're saying that abstinence doesn't work, I'm saying that it does. Check the numbers.
Posted by: Drew at March 29, 2005 03:06 PM | permalink
tb,
Wow, that's alot of hate you got there buddy.
I disagree with Joe, but I think that one signifigant difference between the US and Europe is the mixed messages kids get about sex from a very early age. Americans live in a strange culture that bombards us with sex, yet hasn't come to grips with it as it relates to our predominantly Judeo-Christian heritage. For that reason, I'm not sure that more and better sex ed will make up for the contradictions inherent in our culture.
Still, I think that one of the biggest disservices we do is towards young girls in that we don't teach them the emotional and psycological factors that make having sex more than just a fun way of touching another person. Abstinence programs don't address these issues either. As a Christian, I think it's a responsibility to prevent as many of the evils that go along with teenage sexuality as possible. If we really don't want kids to have abortions, we should provide realisitic solutions to preventing unwanted pregnancy. If we don't want people scarred for life by STDs, that the least we can do is provide the information to help kids be responsible in preventing them.
Posted by: Foppa21 at March 29, 2005 03:09 PM | permalink
I have to be reading this wrong, but I can't figure out where. A couple posts up, Drew stated "In the 1950s, when it was more common for younger girls to be getting married, the unmarried teen pregnancy rate was only 13%. In 2000, it was 79%."
I read that as saying that in 2000, 79% of unmarried teen girls became pregnant. Having been a high school and college student and not seen, you know, 80% of the people I know become pregnant, I find this very hard to believe. Am I reading this wrong?
Posted by: Balta at March 29, 2005 03:22 PM | permalink
Yes, I'm sorry. I guess what was going through my brain sounded better than what was coming out my fingers.
In 1950, 13% of teenage pregnancies were to unwed mothers. In 2000, 79% of teenage pregnancies were to unwed mothers. Teenage being defined as 15 to 19.
Simply, most teenagers who got pregnant in 1950 were also married (as most people married younger back then).
Posted by: Drew at March 29, 2005 03:27 PM | permalink
Drew wrote:
Overall, I think the telling fact is the percentage of unmarried teenage girls becoming pregnant. In the 1950s, when it was more common for younger girls to be getting married, the unmarried teen pregnancy rate was only 13%. In 2000, it was 79%.
I'm not sure what these numbers are actually intended to represent. Surely not that 79% of teenagers in 2000 got pregnant. The percentage of teens who did get pregnant who were not married at the time? I don't see what the significance of that number is. Married or unmarried, becoming pregnant at 16 years old is a bad idea, I think we'd all agree. The telling fact, in my view, is the enormous disparity between the rates of teen pregnancy in the US and every other Western nation. Another telling fact would be the many studies that have shown that while abstinence-only sex ed may put off the age at which a teen might start having sex slightly (though again, over 90% of them do have sex before marriage regardless of whether they pledge not to), such programs show a significant decrease in the usage of condoms and other forms of birth control when they do start having sex. This obviously is a result of having not been taught anything about it, or how to obtain it, or how to use it.
The bottom line is this: over 90% of teenagers are going to have sex before they get married, and that is true even if they are taught abstinence-only. For that 90+%, would you rather have them using condoms or not using condoms? Anyone who would answer that they would rather have them not using condoms is simply not worth paying attention to. And anyone who answers that they would rather have them using condoms should be able to recognize that they will do so only if they are given access to them, education on the importance of using them, and education on how to use them.
Posted by: Ed Brayton at March 29, 2005 03:29 PM | permalink
But I think, given the figures that I quoted, it's not a given that over 90% of teenagers are going to have sex before marriage. If we go back to teaching basic morals instead of handing out birth control, that figure could drop dramatically. And it's not going to work if we only do it in a few isolated "test cases" because the rest of the world is busy bombarding them with the message that it's OK to go out and have sex whenever you want.
Am I saying that they shouldn't ever know how to use birth control? No. But what's it hurt to teach morals as well?
Posted by: Drew at March 29, 2005 03:43 PM | permalink
"Bruckner and Bearman have chosen to focus media spotlight on the question of virginity pledgers and STDs, claiming that individuals who make virginity pledges are just as likely to contract an STD as those who do not. However, the study actually found that virginity pledgers were 1/3 less likely to have an STD than those who did not make a virginity pledge. In addition, the study also found that individuals who made a virginity pledge are 1/2 as likely to become pregnant and are just as knowledgeable about contraception as those individuals who did not make a virginity pledge. Not surprisingly, Bruckner and Bearman neglected to highlight these pro-pledge findings."
http://aolsvc.news.aol.com/news/article.adp?id=20050318154909990013&cid=1291
"A leading abortion advocate in Congress opened up a can of worms last week when he released a report claiming that federally funded abstinence education programs are ineffective and rely on misleading science and information.
However, a look at a key anti-AIDS program in the African nation of Uganda points to solid success of how focus on abstinence can decrease infection rates."
(snip)
""There, a massive public education campaign was mounted ... and religious organizations were tapped to play key roles," Roberts explained.
"The results were impressive: the HIV infection rate in Uganda dropped from 15 percent to 5 percent. In 1991, 21 percent of pregnant women had the deadly HIV virus. Ten years later, that figure had dropped to 6 percent," Roberts wrote in the Times article.
In fact, only 6.2% of Ugandans in the 15-49 age group are now HIV-positive, compared with more than 15% in the early 1990s."
http://66.195.16.55/nat1019.html
Posted by: Drew at March 29, 2005 04:13 PM | permalink
Drew wrote:
But I think, given the figures that I quoted, it's not a given that over 90% of teenagers are going to have sex before marriage. If we go back to teaching basic morals instead of handing out birth control, that figure could drop dramatically. And it's not going to work if we only do it in a few isolated "test cases" because the rest of the world is busy bombarding them with the message that it's OK to go out and have sex whenever you want.
There are really two arguments here, I think. The first is that we should "go back" to "teaching morals". But your initial argument was really about teens getting married much younger, so their pregnancies weren't out of wedlock. But that brings many problems with it. Getting married younger means a much higher divorce rate, for instance. Study after study has shown that those who marry and have children later divorce much less frequently than those who marry younger. That's one big reason why the divorce rate is so much higher in the so-called "red states", because they also tend to get married much younger. That surely isn't a healthy thing for the children produced.
Second, I don't think we can posit a connection between kids being "bombarded" with sexual messages and teen pregnancy. By all accounts, the Netherlands and most of the rest of Europe treats sex far more casually than we do. Nudity on television is not the taboo it is here, nor are prostitution or pornography. Yet those nations have far lower rates of teen pregnancy, and their teens start having sex later in life, than American teens. There's obviously a lot more going on than just that.
Am I saying that they shouldn't ever know how to use birth control? No. But what's it hurt to teach morals as well?
The only ones who are advocating teaching only one perspective are those who advocate abstinence-only sex ed. As I argued above, they should certainly be taught that abstinence is the only 100% sure way of avoiding pregnancy and disease. But stopping there is insane and, literally, deadly for our kids. The only 100% sure way to avoid being in a car accident is to stay out of cars, but we still spend money to educate people about using seatbelts.
Posted by: Ed Brayton at March 29, 2005 04:38 PM | permalink
Drew-
The link you gave on the Bruckner and Bearman study is actually a press release from a pro-abstinence group. You can find the press release on their website here. Furthermore, the press release is quite dishonest in its portrayal of the findings of the Bruckman/Bearman study. For instance, the release says:
Bruckner and Bearman have chosen to focus media spotlight on the question of virginity pledgers and STDs, claiming that individuals who make virginity pledges are just as likely to contract an STD as those who do not. However, the study actually found that virginity pledgers were 1/3 less likely to have an STD than those who did not make a virginity pledge.
This is, quite simply, a lie. The 1/3 difference was not between pledgers and non-pledgers, it was between consistent and inconsistent pledgers. The rates between pledgers and non-pledgers was statistically a wash (3.5 and 3.3). More importantly, the data they chose to focus on only involved white adolescents and did not include HPV. In other words, the abstinence group is cherry picking the data and misrepresenting it as well. Even worse is this statement:
Among the many studies which document the success of abstinence education, the CDC's AD-Health Study shows that teens who take virginity pledges are happier and healthier than teens who are sexually active.
The problem with this is that the AD-Health Study is the Bruckman/Bearman study. It is that exact study, which was funded by the CDC, from which Brucknam and Bearman took their data. Peter Bearman is one of the study designers. You can see the actual study, rather than biased press releases about it, here
Here is another study with similar results:
The first evaluation of programs used throughout the state has found that students in almost all high school grades were more sexually active after abstinence education. Researchers don't believe the programs encouraged teenagers to have sex, only that the abstinence messages did not interfere with the usual trends among adolescents growing up.
"We didn't find what many would like for us to find," said researcher Buzz Pruitt of Texas A&M University. He and his colleagues discussed their data this week with state health authorities in Austin, who sponsored the research...
Among the findings in the Texas study: About 23 percent of the ninth-grade girls in the study already had sexual intercourse before they received any abstinence education, a figure below the national average. After taking an abstinence course, the number among those same girls rose to 28 percent, a level closer to that of their peers across the state.
Among ninth-grade boys, the percentage who reported sexual intercourse before and after abstinence education remained relatively unchanged. In 10th grade, however, the percentage of boys who had ever had sexual intercourse jumped from 24 percent to 39 percent after participating in an abstinence program. (link)
Posted by: Ed Brayton at March 29, 2005 05:14 PM | permalink
Ed,
The difference between the United States and Europe that I am trying to highlight is not the amount of access to sexually explicit material, but the fact that Europe is a post-Christian society compared to America being a predominantly Christian society. That plays a huge role in the attitudes Europeans have towards sex compared to Americans. I don't think European teen girls are as sexualized as their American counterparts. Compare the styles of dress and general sexual precociousness of American pre-teens compared to European girls of the same age. It isn't even close. I don't have an answer as to where this difference comes from. Maybe someone here has an idea.
Posted by: Foppa21 at March 29, 2005 05:43 PM | permalink
The case of Uganda cited by Drew also has some severe factual problems. First and foremost, the Uganda plan is not just an Abstinence-only plan. In fact, it is an ABC Plan: Abstinence, Be faithful, Condoms. All 3 are encouraged, not just abstinence. And at least 1 study who's results were released last Feb. found that in a survey of some 10,000 Ugandans, both the Abstinence and the Faithful parts were having very limited effects: the rate of adultery was going up and the rate of abstinence was going down. On the other hand, condom use was still high, and the rate of new infections was declining as that rate went up.
In other words, the Abstinence and Faithful parts of the ABC plan are basically negatively correlated with the rates of infection, suggesting that the huge part of that variance has to be due to the increased condom use.
There is also a specific problem with the actual statistic Drew cites. Can anyone out there think of a reason why the %age of people infected with AIDS may drop over a 10 year period? There's acutally a very good explanation for it; the people infected with the virus die off in less than 10 years if they don't get their hands on Western medicines. That was in fact by far the largest reason why the %age of the population infected declined.
Posted by: Balta at March 29, 2005 05:51 PM | permalink
Foppa wrote:
The difference between the United States and Europe that I am trying to highlight is not the amount of access to sexually explicit material, but the fact that Europe is a post-Christian society compared to America being a predominantly Christian society. That plays a huge role in the attitudes Europeans have towards sex compared to Americans. I don't think European teen girls are as sexualized as their American counterparts. Compare the styles of dress and general sexual precociousness of American pre-teens compared to European girls of the same age. It isn't even close. I don't have an answer as to where this difference comes from. Maybe someone here has an idea.
Well obviously there are other differences, and you may well have hit on one. Ironically, the puritanical strain in American culture may well lead to more teen sex than the more permissive European cultures. One of the reasons may well be that, while Americans are certainly bombarded with sexual imagery, it's also still seen as "taboo", which may well make it more enticing for teenagers in particular. In European cultures, where sex is treated far more casually and it's viewed as just a part of our nature, that enticement is lessened. That's one possible explanation, though I can't imagine how one might design a study to confirm it.
Posted by: Ed Brayton at March 29, 2005 06:01 PM | permalink
Ed,
I think you have hit on something regarding the taboo nature of sex in Europe vs. America. From my Christian perspective, it would be helpful if sex was viewed differently in America than it is currently. I wouldn't want to move towards the European model which I think is a factor in the demographic death of that continent.
Posted by: Foppa21 at March 29, 2005 06:39 PM | permalink
We have proven, in Indiana, that teachers cannot teach kids how to read, write, or calculate. What makes anyone think they can teach anything well?
Posted by: Anonymous at March 29, 2005 07:47 PM | permalink
From my vantage point here in the real world I can tell you what I've experienced... I have 2 daughters that have been given more information than I ever was, both spiritually and educationally, on sexual issues and yet one of them has gone on to make the same mistakes that I did. I have concluded that knowledge isn't the determining factor. It's a matter of their 'heart' condition. My errant daughter has come to see the truth in her own life now and has done a 180. Prayer can and does change things.
Posted by: jennie at March 29, 2005 11:42 PM | permalink
Anent Balta, AIDS in Africa is not the same as AIDS in the USA. The definitions are, of course, politically inspired for political reasons by CDC some time ago. AIDS itself is a politically correct term. Trivia question-what was it orginally called and why?
Posted by: Anonymous at March 30, 2005 03:35 AM | permalink
Foppa wrote:
I think you have hit on something regarding the taboo nature of sex in Europe vs. America. From my Christian perspective, it would be helpful if sex was viewed differently in America than it is currently. I wouldn't want to move towards the European model which I think is a factor in the demographic death of that continent.
I don't really see what attidues toward sex have to do with demographics. For starters, there isn't that much difference between similar social groups in Europe and USA (say white, educated, middle income). Then if you look at inside Europe, countries considered more liberal tend to have significantly higher fertility rates than the more conservative ones, for example Denmark at 1.74 and Spain at 1.28 (USA 2.08 for comparison.) The hotbed of liberal sexual attitidues, Iran, has a fertility rate of 1.82. That might be explained partly by the Iraq war in 80's, but we also have Tunisia at 1.70 and Turkey at 1.94. Poland, a deeply catholic and propably the most sexually conservative country in the continent with no legal abortion, has a fertility rate of 1.39.
All figures from CIA World Factbook.
Posted by: Teme at March 30, 2005 08:38 AM | permalink
For that 90+%, would you rather have them using condoms or not using condoms?
I'm in favor of what Ed is calling "comprehensive sex-ed," but I object to taking an attitude which says "teens are going to have sex, so all we can do is teach them to use condoms." (I know that's not exactly what Ed's saying...bear with me here.)
I think abstinence-only sex ed is a reaction to sex ed programs which convey (explicitly or implicitly) that it's normal and OK for high schoolers to be sexually active and that if you use a condom, everything will be just fine.
Personally, I think sex ed should clearly express the physical, emotional, and yes, moral advantages to abstinence in addition to measures for reducing the risk of pregnancy and STDs.
Posted by: Eric Seymour at March 30, 2005 01:38 PM | permalink