Abby McElroy was age 15 when a guest speaker in her high school sex education class told her and her classmates that they should think of themselves as tape.

The speaker walked around the classroom demonstrating that the more you stick and then peel tape off of different surfaces, the more it loses its stickiness. “They told us that we were the tape,” McElroy told Rewire.News, “and every time we slept with someone or had sex with them, we were giving them our stickiness, and we could never get that back.”

The guest speakers who visited McElroy’s class that day were from Amnion Pregnancy Center, a crisis pregnancy center (CPC) in Drexel Hill, Pennsylvania. Crisis pregnancy centers (CPCs) are anti-choice clinics that sometimes pose as health-care providers but are unregulated and often provide false, misleading information meant to dissuade pregnant people from getting abortions.

On Monday, two prominent medical organizations, the Society for Adolescent Health and Medicine (SAHM) and the North American Society for Pediatric and Adolescent Gynecology (NASPAG), published a joint position paper that describes how CPCs can harm young people—including through sex education programs. The paper, published in the Journal of Adolescent Health and Journal of Pediatric and Adolescent Gynecology, includes recommendations for governments—which often provide funding to CPCs—as well as for school boards and districts, which invite CPCs into sex-ed classrooms across the country.

“It can be difficult to distinguish between CPCs and healthcare clinics that provide safe, comprehensive care, especially online,” Dr. Maria Trent, president of SAHM, said in a press release. “Health professionals should help young people recognize CPCs and the limitations of CPC services and facilitate access to quality, unbiased sources of information, care, and resources.”

Among the six position statements SAHM and NASPAG detail in the paper is one that would specifically target the tactics that McElroy experienced in her sex ed class. The organizations “discourage school boards and administrators from outsourcing sexuality education to CPCs or any entity that does not provide complete and medically accurate information or that provides sexual and reproductive health information that is inconsistent with recommendations of professional medical organizations and medical standards of care.”

In addition to the tape analogy, McElroy said the Amnion speakers warned students about what they called “the steep slope of arousal,” and the “side effects” of sex—which they said included STDs, unplanned pregnancy, and “emotional baggage.” She says the speakers also gave students false information about oxytocin, sometimes known as the “love hormone,” because it is released when humans bond with each other.

“They told us that humans have a limited amount of oxytocin,” McElroy said. “They told us that if we have many romantic partners and show them physical affection, we will use up our oxytocin on them, and especially if we have sex with them …. And then when we find our forever partner, we won’t be able to show them the true complete love that we would have if we’d stayed abstinent.”

McElroy said she came out of the class scared about how she would form a bond with someone or have a healthy relationship in the future, but that after a summer of research on CPCs, she realized that much, if not all, of the information she learned in health class was misleading or false.

In their paper, SAHM and NASPAG oppose the faith-based, abstinence-only-until-marriage programs CPCs employ because they don’t provide accurate information about contraceptives and condoms, often focusing exclusively on failure rates and side effects. Additionally, evidence shows that abstinence programs “are not effective at delaying sexual activity and reducing sexual risk behavior,” and may even cause harm. Evidence suggests “young people who take virginity pledges are less likely to use condoms and contraceptives at first intercourse and have higher rates of human papillomavirus and nonmarital pregnancies,” according to the paper.

Despite the mountains of evidence that show how ineffective and often misleading abstinence-only programs are, only 17 states require that sex ed be medically accurate, according to the Guttmacher Institute, a research and policy organization focused on sexual and reproductive health. Some states also have dangerous laws on the books.

Samantha Dercher, federal policy director at the Sexuality Information and Education Council of the United States (SIECUS), told Rewire.News that six states still have what are called “no promo homo” laws, which ban the inclusion of homosexuality in sex education or in the classroom. If it is mentioned, the laws state that educators have to emphasize that it’s not an appropriate or healthy lifestyle.

“The problem is that we have this patchwork of sex ed laws and policies in this country, and that’s what’s failing to provide young people with a rudimentary foundation in sex ed,” Dercher said, “which makes them even more susceptible to the messaging from crisis pregnancy centers, who are specifically seeking out young people, people who might not be as informed, low-income people—that’s who they’re targeting with this misinformation.”

Crisis pregnancy centers are able to open more clinics and reach more young people in part because of the funding they receive from the federal and state governments. As a result, SAHM and NASPAG encourage governments “to only support programs that provide adolescents and young adults experiencing or at risk for unplanned pregnancy with medically accurate, unbiased, and complete health information,” including information about FDA-approved methods of contraception and all pregnancy options, including abortion.

Dercher noted that the Trump administration tried to end the Teen Pregnancy Prevention Program and instead give $277 million to abstinence-only programs, though a federal judge blocked the effort. The Trump administration also awarded $1.7 million of Title X federal family planning grants to Obria Group, a network of CPCs, for 2019.

Gabriel Mann, communications manager at NARAL Pro-Choice Ohio, told Rewire.News that CPCs in the state are funded through the sale of “Choose Life” license plates, but they’re also largely funded through the state’s budget. The 2019 budget earmarked $7.5 million in taxpayer dollars to fund Ohio’s crisis pregnancy centers for the next two years, according to the Columbus Dispatch.

Mann noted that CPCs pose a unique threat in states like Ohio, where they outnumber abortion providers and often position their clinics right next door to health clinics that provide abortions. NARAL Pro-Choice Ohio found in a 2013 investigation of CPCs that if someone walks into one of them and says they have an appointment, the staff won’t say “you’re looking for the place next door.” Instead, they will sign you in and take you to a room, Mann said. Picking the wrong door could mean someone misses an appointment with a real doctor, potentially delaying a procedure long enough to require a surgical abortion instead of a medication abortion, “or maybe the entire added level of complication puts the whole procedure out of reach for that person just by putting that fake clinic next door to the real clinic,” Mann said.

SAHM and NASPAG also urge companies that own digital platforms and search engines to implement practices that prevent CPCs from misrepresenting themselves online and in advertising.

Tamya Cox-Touré, regional director of public policy and organizing for Planned Parenthood Great Plains, said that in places like Oklahoma, young people may also Google to find the providers near them. In Oklahoma, where there are only three abortion providers, the nearest provider would likely be a CPC.

One CPC in Oklahoma also advertises on the radio, saying, “‘You get to make a choice,’ and really kind of emphasizing the word choice,” Cox-Touré told Rewire.News, even though CPCs don’t include abortion as an option in their counseling for pregnant people. Other CPCs in the state advertise on billboards like any other health clinic, so “it is no surprise that people would not know that they are not going to a regulated healthcare provider,” she said.

Lastly, SAHM and NASPAG encourage health professionals and departments to educate themselves and young people so that they can identify accurate health information, while also being aware of the “limitations of CPC services.”

As for McElroy, her story shows how the public may respond when they find out what CPCs teach. In 2018, when McElroy was a senior in high school, she presented her health-class experience to her school board, which was unaware that Amnion—which did not respond to a request for comment from Rewire.News—was a part of the school’s sex ed curriculum. The board banned Amnion, and other schools in the area followed suit.