Abstinence-only sex education (also known as sexual risk avoidance education) is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. In contrast, comprehensive sex education covers the use of birth control and sexual abstinence.
Evidence does not support the effectiveness of abstinence-only sex education. It has been found to be ineffective in decreasing HIV risk in the developed world. It does not decrease rates of sexual activity or unplanned pregnancy when compared to comprehensive sex education.
The topic of abstinence-only education is controversial in the United States, with proponents claiming that comprehensive sex education encourages premarital sexual activity, and critics arguing that abstinence-only education is religiously motivated and that the approach has been proven ineffective and even detrimental to its own aims.
Description Abstinence education teaches children and adolescents to abstain from sexual activity, and that this is the only certain method of avoiding pregnancy and sexually transmitted infections (STIs). With a heavy focus on the importance of "family values", programs also teach that abstinence until marriage is a standard by which to live. Since 2019, the federal government has spent $110 million annually on abstinence-only sex education.
In the U.S., states may apply for federal funding of abstinence-only sex education programs from either Title V, the Adolescent Family Life Act (AFLA), and/or Community-Based Abstinence Education (CBAE). To be eligible for funding, programs must satisfy requirements given under the Social Security Act, which is reproduced here verbatim:Social Security Act, Section 510 (2) For purposes of this section, the term "abstinence education" means an educational or motivational program which—
(A) has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity; (B) teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; (C) teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems; (D) teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity; (E) teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; (F) teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child's parents, and society; (G) teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and (H) teaches the importance of attaining self-sufficiency before engaging in sexual activity.Funding, which began in the 1980s, has continued to increase since its inception, though support for the programs and legislation surrounding them has become dependent upon the current administration. For example, George W. Bush administration increased federal funding for abstinence-only programs (the only type funded even under the previous Clinton Administration), while the Obama administration reversed the emphasis and provided more federal dollars for comprehensive sex education. President Donald Trump cut grants to comprehensive sex education and proposed increased funding for abstinence-only education. Increased funding continued through the Joe Biden administration.
Effectiveness Systematic reviews of research evaluating abstinence-only sex education have concluded that it is ineffective at preventing unwanted pregnancy or the spread of STIs, among other shortfalls. The American Academy of Pediatrics has recommended against the use of abstinence-only sex education because it has been found to be ineffective, and because the media frequently conveys information about non-abstinence.
STI transmission
A 2015 meta-analysis found that abstinence-focused programs had no effect on the likelihood of contracting STIs.
A Cochrane systematic review suggests that abstinence-only education neither increases nor decreases HIV risk in high-income countries. In the developing world there is a lack of evidence of effect. In 2008, Douglas Kirby reviewed the evidence for the effectiveness of abstinence-only education programs and found little evidence to justify the use of such programs. A 2011 meta-analysis found that it was ineffective at reducing the risk of HIV infection among adolescents. Abstinence education has also been found to include misleading medical information and exclude potentially life-saving information about sexual risk reduction. A 2016 study found "that state-level abstinence education mandates have no effect on teen birth rates or abortion rates, although we find that state-level policies may affect teen sexually transmitted disease rates in some states."
Pregnancy Evidence does not support abstinence-only-until-marriage sex education. Research in the United States has found that abstinence-only education is related to increases in teen pregnancy and teen birth rates. Comprehensive sexual education on the other hand leads to a reduction in teenage birthrates. The decline of teenage pregnancy rates during 1995–2002 were largely due to improved contraception, and the reduction in pregnancy risk among teenagers aged 18 or 19 is due to less unprotected sex.
A 2010 report by the Guttmacher Institute pointed out that pregnancy rates for teens 15–19 reversed their decline in 2006, near the peak of the Abstinence Only campaign in the United States.Table 1.0,"U.S. Teenage Pregnancies, Births and Abortions: National and State Trends and Trends by Race and Ethnicity." , downloaded 20100127.
While sex education has been linked to a delay in the first time having sex, abstinence-only programs specifically have not shown this link, and do not seem to influence if or when young people begin having sex.
Society and culture
Support Proponents of abstinence-only sex education argue that this approach is superior to comprehensive sex education because it emphasizes the teaching of morality that limits sex to that within the bounds of marriage, and that sex before marriage and at a young age has heavy physical and emotional costs.PBS, February 4, 2005 Religion & Ethics Newsweekly, Episode 823 Retrieved on 2007-14-03 In addition, abstinence programs often teach young people that pleasure in sex is most likely to be found within marriage, and therefore, that they should wait to engage in sexual activity until they are married. Abstinence generally places a great emphasis on the importance of the institution of marriage, which some proponents believe allows young people to grow and develop as individuals.
Proponents suggest that comprehensive sex education encourages premarital sexual activity among teenagers, which should be discouraged in an era when HIV and other incurable STIs are widespread and when teen pregnancy is an ongoing concern. According to the Guttmacher Institute, the AFLA, or Adolescent Family Life Act, was a five year-program with costs estimated around $250 million. Many supporters of abstinence-only education do so out of the belief that comprehensive guides to sex or information about contraceptives will ultimately result in teens actively pursuing and engaging in sexual activities, while others oppose the endorsement of contraception for religious reasons. Adults may view teenagers as less intelligent and less responsible, and unable to control themselves due to their hormones. As a result, a teenager's sexual desire is something that needs to be controlled,Fields, J (2012). "Sexuality Education in the United States: Shared Cultural Ideas across a Political Divide". Sociology Compass: 1–14 dividing the teens into two separate categories in the minds of adults: "the innocent and the guilty, the vulnerable and the predatory, the pure and the corrupting."Fields, p. 6
Opposition Opponents and critics, which include prominent professional associations in the fields of medicine, public health, adolescent health, and psychology, argue that such programs fail to provide adequate information to protect the health of adolescents. Not only is information inadequate, but opponents believe that young people have the right to receive comprehensive information about how to protect themselves and their sexual health. Accurate information is especially important since, although some supporters may claim that abstinence is an effective method, it has been found that a small percentage of people actually practice it.
Some critics also argue that such programs verge on religious interference in secular education. Opponents of abstinence-only education dispute the claim that comprehensive sex education encourages teens to have premarital sex.Douglas Kirby, Ph. D.: Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy. National Campaign to Prevent Teen Pregnancy, 2001. Homepage of the study. The idea that sexual intercourse should only occur within marriage also has serious implications for people for whom marriage is not valued or desired, or is unavailable as an option, particularly LGBT people living in places where same-sex marriage is not legal or socially acceptable.Nancy D. Polikoff, Beyond straight and gay marriage: valuing all families under the law; Politics, Culture and Society Series, Beacon Press, 2008 , Debran Rowland, The boundaries of her body: the troubling history of women's rights in America, SphinxLegal, 2004, , Abstinence-only education is often criticized for being overly heteronormative, idealizing the institution of heterosexual marriage to the denigration of queer relationships. In addition, the heteronormativity of abstinence-only education, as well as the focus on marriage, means that members of the LGBT community will never receive formal information about how to practice safe sex, which is problematic, since they are already at an increased risk for STIs.
According to Advocates for Youth, abstinence-only sex education distorts information about contraceptives, including only revealing failure rates associated with their use, and ignoring discussion of their benefits.Effective Sex Education, Brigid McKeon, 2006; The language surrounding medicine and health is construed as being both objective and value free. This objectivity is then adopted by conservative politicians and campaigners to assert authority which historically holds its basis in religion.