Science has not been kind to the Bush administration’s abstinence-until-marriage programs in the last 12 months. Three large-scale studies in 2007 found that federally funded chastity promotion has no effect on teen behavior. The latest of these, released in November by the bipartisan National Campaign to Prevent Teen and Unintended Pregnancy, noted that none of the abstinence-only programs studied "delays the initiation of sex, hastens the return to abstinence, or reduces the number of sexual partners." Then in December, the Centers for Disease Control and Prevention (CDC) announced that the teen pregnancy rate had risen 3 percent in 2006, the first increase after a 14-year decline. On March 11, the CDC announced that 26 percent of young women ages 14 to 19 have a sexually transmitted disease (STD), a figure that a CDC spokesperson called "epidemic."
But political appointees at Bush’s U.S. Department of Health and Human Services (HHS) have long been preparing a counterattack. In 2005 they directed the agency to begin investing in an alternative approach to assessing abstinence program performance: pay local programs to partner with evaluators to report on their program’s effectiveness. HHS abstinence grantees are required to use at least 15 percent of their grants—about $23,000 of taxpayer money per year for the average program—to do these self-evaluations.
That investment has paid off. Grantees are using the money to produce and distribute evaluation reports designed to convince voters and politicians that their programs work. As evidence, most of these reports cite teens’ more positive attitudes toward abstinence after participating. ATM Education, a grantee in northwestern Ohio, developed a glossy four-page brief that concludes, "ATM Education’s evaluation results are positive throughout. These positive results prove that abstinence education does work." The document reports double-digit increases in the number of youth agreeing (after taking ATM’s abstinence course) that "having sex outside of marriage can cause depression," "having sex now will negatively affect my marriage in the future," and "abstinence is choosing to stay away from behaviors that could hurt me."
The East Texas Abstinence Program’s evaluation report notes increases in the proportion of students agreeing after the program that abstinence would "make it a lot easier" to get a good education, make "future marriage a lot easier," and make a future career "a lot easier."
The evaluation of the New Jersey- based Best Friends/Best Men Program states that significantly more 6th through 8th graders who took the program’s abstinence course agreed afterward with statements like "sex before marriage makes it harder for good marriage/family life" and "sex as a teen makes it harder to grow and develop emotionally/morally."
Douglas Kirby, who authored the National Campaign to Prevent Teen and Unintended Pregnancy study, is one of the leading experts on evaluating teen reproductive health programs. He says the research shows that changes in values, intentions, and attitudes are "better than nothing." But they are not "extremely highly related to behavior…. So change in those alone would not be strong evidence, it would be very weak evidence that the programs change behavior…. You can look outside and say ‘there’s a cloud out there, it might rain.’ That is true, but there are clouds out there sometimes and it doesn’t rain." So an abstinence program that says it works because it changes teenagers’ views is comparable to a school that asserts it is successful because it improves attitudes toward studying. In both cases, what really matters are outcomes.
Worse, the evaluation reports show that, to change teens’ minds, abstinence programs are continuing to misrepresent science. For years, reproductive health advocates have protested the use of taxpayer funds to teach teens false and misleading information. "This information is given to young people under the guise of being education. So if an abstinence grantee is giving erroneous information in health class, it means that a young person is less prepared for life," says Marcela Howell of Advocates for Youth, which favors comprehensive sexuality education.
The HHS grantee evaluation reports confirm that the Administration continues to ignore those complaints.
ATM Education’s assertion that having sex outside marriage causes depression is based on a 2005 study published in the American Journal of Preventive Medicine. It indicated an association between teen girls having sex and their subsequent depression; the finding did not hold for boys. But ATM’s statement is much broader, proposing a connection between sex outside marriage at any age and depression. Asked to explain the discrepancy, ATM director Carol Wood believes that "there is a chance that even adults could experience that same depression because they realize that they are bonding to someone and there may or may not be any commitment there."
The East Texas Abstinence Program’s linkage of abstinence with better educational outcomes originated with a 2005 Heritage Foundation paper analyzing data from a large federally funded study of teen behavior. The paper’s key finding: "Teens who abstain from sex during high school years are substantially less likely to be expelled from school; less likely to drop out of high school; and more likely to attend and graduate from college." But the paper does not go so far as to assert that abstinence causes these positive educational outcomes. Heritage’s Christine Kim, a domestic policy analyst, admitted that other variables might have an effect, such as good parent-child communication: "[Controlling for all of the possible variables] is very hard to do overall…. That’s always going to be a question: How do we know it’s not something else that’s getting at these outcomes?"
Best Friends/Best Men Program director RoseMarie Peterkin said that she was not sure about the source of the program’s claim that premarital sex negatively affects subsequent marriage. Most studies do not support that assertion. The most recent was published in the May 2003 Journal of Marriage and Family and focused on women. It concluded that premarital sex or cohabitation with a woman’s future husband was not associated with an elevated risk of marital disruption. The study’s author concluded that the results suggested that neither premarital sex nor cohabitation by themselves indicated "either preexisting characteristics or subsequent relationship environments that weaken marriages."
But furthering science is not the aim of these self-evaluations as their real purpose is political. Tonya Waite, director of the East Texas Abstinence Program, says that because of her evaluation, "We get to go and show [school districts] the results. It’s really helped the teachers to see, wow, this is making a difference that we can show them on a year-to-year basis." And ATM director Wood says about her evaluation report, "I think it just offers credibility. It assures people that we have a program that makes a difference."
With about 160 grantees nationwide distributing similar evaluation reports, the Bush administration hopes that abstinence programs will be politically impossible to de-fund under a new president. And they may be right, given what has happened since Democrats took control of Congress in 2006. To the dismay of comprehensive sex education advocates, congressional Democrats used continued funding for abstinence programs to entice Republicans to support the multi-agency appropriations bill that the president signed on December 26. Earlier, to keep Republicans on board, Democratic Senator Frank Lautenberg dropped his amendment prohibiting federal funding for abstinence programs that taught "medically inaccurate information."
As a result, the federal funding equation in 2008 remains nearly the same as when Republicans last controlled Congress: about $175 million dedicated to abstinence-until-marriage programs and zero to comprehensive sex education. A few congressional Democrats have unsuccessfully introduced bills to address the disparity. Until that changes, it appears that U.S. rates of teen pregnancy and sexually transmitted disease will remain the highest in the industrialized world for the foreseeable future.
Steven Yoder lives in upstate New York and writes about child and family policy.