Medical Examiner

No More Virginal

Spend $1 billion on abstinence education. Get nothing.

Ohio Gov. Ted Strickland

In the past decade, the federal government has spent more than $1 billion on programs that promote abstinence as the only healthy choice to make about sex before marriage. Last week, the government’s own long-term evaluation of the initiatives, required by Congress in 1997, showed that these programs seem to accomplish essentially nothing. That’s right: Nada. Students in the programs were no more likely to abstain from sex than their peers. And if they did lose their virginity, they tended to do so at the same average age and have the same number of sexual partners as other students did. As Rep. Henry Waxman, D-Calif., put it, “In short, American taxpayers appear to have paid over 1 billion federal dollars for programs that have no impact.”

The new study, rigorously conducted by Mathematica Policy Research Inc. on behalf of the government, should be the death knell for abstinence-only programs, which have also drawn criticism for perpetuating gender stereotypes, spreading medical inaccuracies, and ignoring the separation of church and state. While the Bush administration shows few signs of rethinking this pet project, a growing number of states have begun to wise up, rejecting millions in federal funding because they come with abstinence strings attached. The problem is that even larger sums of federal money now bypass state governments and flow directly to community abstinence groups, often in the form of multiyear grants, with little or no oversight. It’s up to Congress to stanch this ooze.

The Mathematica study is long-term and has scientific bona fides that are hard to dispute. The researchers focused on four abstinence-only education programs—in Virginia, Florida, Wisconsin, and Mississippi—that received federal money through a program called Title V. Beginning in 1999, the researchers randomly assigned more than 2,000 students either to receive or not to receive abstinence-only instruction, in addition to whatever else they did in school. Then in 2005-06, when the students were on average 16½, the researchers surveyed both groups about their sexual attitudes, knowledge, and behavior. Remarkably, those who’d gotten the abstinence-only ed—some as often as every school day for up to four years—did not behave differently than their peers.

The abstinence-taught teens were no more likely to abstain from sex or even to wait longer before losing their virginity. (In both groups, those who’d had sex did so for the first time at an average age just shy of 15.) The abstinence-taught kids knew as much as the others about the risks of unprotected sex and the consequences of sexually transmitted diseases and were just as likely to use a condom. That’s the good news—though it’s contradicted by previous work by sociologists Peter Bearman and Hannah Brückner that suggested kids who pledge to be abstinent until marriage are less likely to protect themselves with condoms if and when they do have sex.

Undeterred by the Mathematica findings—”new and diverse abstinence programs have grown around the country” since the research began in the 1990s, the Department of Health and Human Services said in a statement—President Bush has asked for $191 million for abstinence education for fiscal year 2008, an increase of $28 million over this fiscal year.

But the states may refuse to take the money that flows through them. States are required to match 75 percent of the funds they receive for abstinence ed through Title V, and this can jeopardize other priorities. Also, teaching abstinence must be the “exclusive purpose” of programs paid for out of this federal pot. Programs cannot promote the use of condoms or contraception, and they must tell kids that sex outside of marriage is “likely to have harmful psychological and physical effects.” Given that the public is largely unconvinced by this rigid approach—and that government reports reveal medical inaccuracies in abstinence curricula, not to mention this month’s evidence that abstinence-ed doesn’t make kids more abstinent—it’s no wonder that more and more governors are choosing to bail.

Ohio Gov. Ted Strickland announced recently that his state would withdraw from Title V for the coming year, rejecting more than $1 million in federal funds and also freeing about $500,000 in the state budget. (As a spokesman explained, “[I]f the state is going to spend money on teaching and protecting kids, the governor believes it is better to spend it in a smarter, more comprehensive approach.”) New Jersey, Wisconsin, Connecticut, Rhode Island, Montana, and Maine have also pulled out or plan to do so by the end of the year. (And California never participated to begin with.) The Sexuality Information and Education Council of the United States, a policy and advocacy group, estimates that together, these eight states are turning down about $11 million of the total $50 million allocated to the Title V program.

But the rest of that $50 million is only part of the problem. In 2000, another federal cookie jar opened. Community-Based Abstinence Education, as the initiative is now called, channels money directly to community groups rather then through state governments. And starting last year, the grant processes and rules were changed. Now participants have to focus less on measurable public health goals and more on chastity as a form of moral virtue. Programs “must not … refer to abstinence as a form of contraception,” but should teach that “abstinence reflects qualities of personal integrity and is honorable,” according to the new guidelines. (Programs should also teach students to watch out for corrupt classmates, avoiding “parties where sexually active peers are likely to attend.”) The length of grants was increased to five years, which means fewer opportunities for oversight. And so far, Congress hasn’t helped either. Congressional earmarks to abstinence-only groups, like the Abstinence Clearinghouse and the Medical Institute, continue apace.

Now that the Democrats are in control, they need to crack down. The current funding for Title V expires in June and, given this latest study, should expire for good. As for money that flows directly to community groups, Congress could cut this, too, despite the five-year grants, to decrease the number of new grants offered or possibly reduce payments to existing grantees. Now that the government has collected its own evidence that teaching about abstinence doesn’t make kids less sexually active, it’s time to redirect money to comprehensive sex ed. The kind that teaches kids to protect themselves with condoms and is much more likely to do some good.