Despite New Branding, Abstinence-Only Programs Have Same Old Problems

Laura D. Lindberg, Rutgers School of Public Health Heather D. Boonstra, Guttmacher Institute
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First published on The Hill:

Abstinence outside of marriage has long been U.S. social conservatives’ battle cry. Now their allies in Congress and the Trump administration are moving aggressively to reshape policy accordingly, whether it’s by cancelling evidence-based adolescent pregnancy prevention efforts or rebranding discredited abstinence-only programs.

These policy shifts away from evidence and toward an ideological agenda would mean fewer federal dollars available for programs that can support sex health education. Not only would this restrict information about contraception, but would also prevent education and skill-building around healthy relationships, communication, consent, and dispelling gender stereotypes that are critical to addressing sexual violence and harassment as elevated by the #MeToo movement. Young people deserve better.

A little history: In 2010, the federal government drastically cut back spending on abstinence-only-until-marriage programs, heeding overwhelming scientific evidence that these programs were not only ineffective at their goal, but potentially harmful to young people. But in the years since, social conservatives in Congress have once again put ideology over evidence, funneling ever-growing amounts of taxpayer dollars into abstinence-only programs. That push is now going into overdrive with new messaging, like renaming the abstinence-only state grant program a "Youth Empowerment Program."

Abstinence-only-until-marriage programs, as the name suggests, hammer home the message that refraining from sex outside of marriage is the only acceptable behavior for people of all ages, and adolescents in particular. In pursuit of that goal, these programs ruthlessly withhold important sexual health knowledge, provide medically inaccurate and incomplete information, and perpetuate stigma around sex, sexual health, and sexuality. Consider the following:

  • Abstinence-only programs violate ethical principles. Medical ethics hold that individuals should have access to the information they need to make healthy and responsible decisions. By perpetuating inaccurate or incomplete information, abstinence-only programs are a classic case of "information manipulation"—an attempt to misuse information to influence individual choice. This is why leading medical organizations have taken strong stances against abstinence-only programs.
  • Abstinence-only programs ignore and marginalize many young people. Pushing abstinence until marriage as an exclusive message does not in any way support sexually active adolescents and those who are already pregnant or parenting. These programs often promote harmful gender stereotypes, and they marginalize and systematically ignore the needs of marginalized groups, including LGBTQ young people. This, too, runs counter to medical ethics and basic human rights.
  • Abstinence-only programs fail to accomplish their stated purpose. Setting aside other serious concerns, these programs are ineffective at their primary goal of getting young people to abstain from sex prior to marriage. Rigorous research accumulated over the past 20 years has consistently shown that abstinence-only programs are not effective at preventing pregnancy, HIV or other STIs. They also do not have an overall impact on age at first sexual intercourse, number of sexual partners, or other behaviors. And yet, more than $2 billion in federal funds has been squandered on them in the last 35 years.
  • Abstinence-only proponents are trying to hide the facts by rebranding the same failed programs. Conceding that the case against abstinence-only-until-marriage programs has gained traction, these programs’ most ardent proponents gave their efforts a complete makeover. Abstinence-only proponents are now also relying on a new name to describe their approach, "sexual risk avoidance," and phrases like "evidence-based" and "youth-empowerment" when in reality the core of these programs remains the same.

In spite of these inherent flaws, the Trump Administration and social conservatives in Congress continue to call for dramatic increases in funding for abstinence-only-until-marriage programs. This is in line with other ideological attacks on sexual and reproductive health and rights, like attempts to gut the Title X national family planning program, undermine the Affordable Care Act’s birth control benefit, or "defund" Planned Parenthood.

All of this is deeply alarming given how much progress we have made in supporting and empowering young people to make informed decisions about their own sexual health. Rates of adolescent pregnancy, most of which are unintended, are at historic lows and there is strong evidence that these declines were driven by improved contraceptive use.

Ultimately, young people have a need and right to complete and accurate information to support their healthy sexual development as adolescents, and throughout their lives. Rigorous scientific evidence—and young people themselves—tells us that abstinence-only-until-marriage programs, no matter the packaging, won’t get us there.

Both authors are with the Guttmacher Institute. Laura Lindberg is a Principal Research Scientist and Heather Boonstra is the Director of Public Policy.

First published on The Hill.