What if Congress Says “Know” to Abstinence-Only?

After 13 years and more than a billion dollars, abstinence-only-until-marriage programs are facing the axe. Cong. David Obey (D-WI) may soon deliver the final sentence.

After thirteen years and more than a billion dollars, the budget axe is raised over abstinence-until-marriage programs.  The President and the Speaker of the House have passed judgment. Appropriations Chair, David Obey (D-WI), may deliver the last reading of the final sentence. I won’t be among those asking him for a stay.

For thirty years I have worked with community advocates and health care professionals to insure that young people in the United States have access to accurate age-appropriate sex education and to reproductive health care – just like young people in most other developed countries. Not only have we failed in our efforts to provide knowledge-based comprehensive sex education, most of our schools regressed to “Just Say ‘No’” approaches based on denying full information about sexual risks, consequences, and primary reproductive health prevention. Opponents of comprehensive sexuality education not only succeeded in repressing good school-based reproductive health curricula at the local level, they managed to win federal funds that displaced many good programs with demonstrably ineffective programs and ideological propaganda.

This axe will certainly fall, but a new incarnation in the form of a redefined pitch for federal funding for “Abstinence-centered” programs is already in play.  In fact, repackaged “Abstinence-centered” programs are busily developing marketing approaches and preparing grant proposals for the President’s new teen pregnancy prevention initiative – the one that supposedly displaced Abstinence-only-until-marriage funding. On May 11th on Wisconsin Public Radio, Wisconsin’s Abstinence Coalition executive director and member of the National Abstinence Education Association (NAEA) board, Sally Ladky, expressed the national strategy to maintain their federal funding stream.

The strategy is to co-opt the language of comprehensive sex education and the reincarnation is already complete.  Here are the major marketing elements as Ms. Ladky expressed them:

1)    “We’re about risk-avoidance.”

2)    “We are evidence-based.”

3)    “We’ve never called ourselves ‘abstinence-only’. We’re abstinence-centered. . . We do talk about contraception.”

4)    “Comprehensive sex education just talks about the physical – we’re more holistic than that.”

A November 2008 NAEA letter to then President-elect Obama prophesies the transfiguration as evidence-based, risk avoidance, abstinence-centered, holistic sex education that includes contraception.  (That’s a pretty good description of programs that I’ve been supporting for thirty years.)

When the Department of Health and Human Services removes abstinence-only restrictions from federal funding and instead requires that these funds be used to support evidence-based medically accurate teen pregnancy prevention efforts, the agencies sending in the Requests for Proposals will include the same agencies which are now receiving abstinence-only-until-marriage funds:

•    The crisis pregnancy centers that refuse to give out information about emergency contraception;
•    The ‘virginity pledges;’
•    The ‘abstinence clown;’
•    The folks who carefully explain the failure rates of condoms and contraceptives without explaining the infection and pregnancy rates when they’re not used.

As frustrating and perplexing as the reincarnation of abstinence-only-until-marriage programs will be, the principle of competition for grant funds is time-honored and broadly accepted. We would like to believe that the cards will be unmarked and the deck will not be stacked against comprehensive sex education. But if the NAEA has its way, there won’t be a fair deal.  In the May 11th WPR interview, Ms. Ladky says: “We’re looking for funding parity.  We think that each of us should have one-half of the funds.”

The advocates for abstinence-only-until-marriage programs argue that family planning funding, especially Title X, which provides medical services related to contraception, cancer prevention, and STD testing and treatment should be put into the pot with the sex education funds.  In other words, family planning funds should be added to the pot and the abstinence programs should be guaranteed half of the winnings before the cards are dealt.

Equating Title X family planning health care services with community and school-based sex education is problematic and unworkable.  Hundreds of thousands of women and men would potentially lose access to primary preventive reproductive health care. It is a cynical ploy to take funding away from Planned Parenthood and other family planning programs. The monumental irony in the “abstinence-centered” faithfuls’ request that half of the stakes be set aside for them before the game begins is that if abstinence-only-until-marriage and comprehensive sex education are both evidence-based and medically accurate – if both program models include risk reduction instruction such as contraceptive methods and condom use – on what distinction would the parity division of money be based?

It was simpler when comprehensive sex education advocates refused these funds and worked to eliminate them because they are sectarian and because they have been ineffectively used. After Congressman Obey carries out the Presidential budget sentence, advocates on both sides will compete for the redefined “common ground” teen pregnancy prevention funds — and it will require an act of faith to tell them apart.