Sex Ed with Lots of Pretty Graphs
January 12, 2011
I was surprised to hear Bristol Palin introduced as a teen advocate (or spokesman – I don’t remember the wording used). What could she possibly be an advocate for, I thought. So, I checked, and found out she is an advocate for teen abstinence and is an Ambassador for the Candie's Foundation. Well, that’s a worthy cause, I guess. But wait? Doesn’t she have a kid? That didn’t make much sense to me, but I figured I should do a little research before scoffing at her and Candie.
I didn’t realize what I was getting into.
There are 3 main sections to this article. First is some detailed information on funding, second, and probably the more interesting part, is some compiled data from teen surveys on sex-ed programs from the Sex Etc. website, and third is a small part stating my opinion on the topic. It is not necessary to read all sections if you are not interested in one or two of them.
Sexual Education in our schools is a complex issue. Of course it is, right, since everything having to do with our schools is complex. That is what you get when the policies and funding that impact individual schools comes from so many different sources; national, state and local governments as well as other organizations, school boards and teachers unions.
The chart below shows funding sources for schools by state. It is showing overall funding; not just funding for sex education and is simply meant to show the variability across states. Each bar represents a state. The state with the lowest local funding is Hawaii and the highest is Nevada. You can see that Federal funding is relatively small, it is also fairly consistent from state to state, while state and local funding varies quite a bit.
Title V, Section 510 A-H criteria 2
(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.
Types of Sex Ed Programs
There are several different terms commonly used to describe sex-ed programs; Abstinence-Only, Abstinence-Plus and
Comprehensive. These program types are used differently depending on who is using them, it seems, so I would like to define them for my purposes here.
The most important definition for Abstinence-Only, because it dictates federal funding, comes from Title V, Section 510 of the Social Security Act provides 8 teaching objectives (A-H criteria) programs must follow to receive funding. The A-H criteria can be seen in the bar to the right.
Abstinence-Plus interventions promote sexual abstinence as the best means of preventing pregnancy and STIs, but also encourages condom use and other safer-sex practices for those sexually active.3
As far as I can tell the terms Comprehensive and Abstinence-Plus are used interchangeably. However, there is a worthwhile distinction that I think is worth making. Therefore, I would like to define Abstinence-Plus as a more basic program (promoting abstinence and teaching about contraceptives) and Comprehensive, as its name suggests, a more detailed program (teaching not only abstinence and contraception, but also might include topics such as alternative sexual activities, communication, emotional components of sexuality, and GLBT issues.
I haven't seen any programs that I would categorize as Pro-sex, however it is an attitude out there that is at times expressed. This attitude can be expressed in several ways; stating that sex is a natural, healthy and positive component of our lives, saying that contraceptives make sex safe (rather than safer), and the belief that the only criteria for having sex should be that a person is ready for it.
Because of the great number of variables involved, it is very difficult to compare different programs. Student variables include gender, age, school, state, socioeconomics, etc., but then there are also program variables, such as program message, quality and quantity of information provided, and the time at which the program is provided.
Unfortunately, the debate about effectiveness of programs tends to take place only based upon a program's abstinence message. There are so many other important variables when it comes to sex-ed programs that this simple duality is unfortunate.
The chart below attempts to place programs in a matrix that includes both the abstinence message and the level of information provided. There is a big difference between a program with a high level of information versus a low level of information, even if they have the same message about abstinence. A low level Abstinence-Only program (that would fall in the Abstinence-Only box) might only spend one hour in 8th grade telling kids not to have sex. In comparison a high level Abstinence-Only program (Program A for instance) might provide 8 hours of education spread out over the student's career teaching them why they shouldn't have sex. In doing so, the program might describe to the student the physical and mental benefits of abstinence, encourage them to examine how pregnancy or STIs might impact their future plans, have discussions about the their feelings and emotions regarding sexuality, and ways to improve their ability to communicate to peers and parents. So, despite having the same abstinence message, these two programs are quite different and would likely have very different results.
Let's look at another program example. Program B has a weak abstinence message and provides little information so may once again, be a single class in 8th or 9th grade and only provide basic information on STIs and contraception. If we compared Program A with Program B, we might find Program A to be a far more effective program, but its effectiveness might not have anything to do with the abstinence message, but rather, its depth and breadth of information provided.
History of Federal Funding
Major government funding for Abstinence-Only education was initiated by a 1996 welfare reform law4 which inserted into the Social Security Act, the Title V, Section 510 Abstinence Education Program. There had been funding prior to that through the AFLA Program, but it was a relatively modest 13 million a year, compared to the 50 million a year granted by Section 510.5
An additional stream of Abstinence–Only funding, the Community-Based Abstinence Education Program (CBAE) was created in 2000.6 Programs receiving this funding had to adhere to the A-H objectives laid out in the Title V Section 510 program. First year funding for CBAE was 20 million but grew over the years to a high of 113 million.5
Not long after the introduction of the Section 510 abstinence program, Congress authorized a study to be done on the effectiveness of Abstinence-Only programs. This study undertaken by Mathematica Policy Research, Inc. conducted over a 9 year period (1998-2007) concluded that a youth in one of the Abstinence-Only programs examined were “no more likely than those in the control group to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners”.7 Put simply, they were not working.
President Obama pledged during his campaign to reduce unintended pregnancies. In an effort to do so he cut funding to these Abstinence-Only Programs which were not working – The CBAE and AFLA programs were both eliminated in the Consolidated Appropriations Act, 2010. Simultaneously, Obama created two new Sexual Education programs, both evidenced based, meaning that grantees are required to prove that their programs actually work (imagine that – don’t we have a word for that sort of thing – science or something like that – I have forgotten after so many years of ignoring things like evidence and facts – you know those winged serpent demon spawns from hell – okay, so I am a tad biased).
Meanwhile, The Title V, Section
510 Abstinence funding program had expired and so for a brief time, all federal
abstinence funding had been eliminated.
Senator Orrin Hatch, however, managed to work a provision into the 2010 health care reform bill which reinstated the Section 510 abstinence funding.8
The two programs initialized by Obama are the Personal Responsibility Education Program (PREP)9 and the Teen Pregnancy Prevention program (TPP).10 The chart above shows how they are organized. At first glance it may seem strange to have two separate programs running through the same department, however, the two programs have a distinction. The Office of Adolescent Health which runs the TPP program focuses on teen pregnancy prevention. The PREP program which is run by the Administration for Children and Families (ACF) also focuses on teen pregnancy, but additionally has an adult preparation component (e.g. financial literacy, educational and career success).
Both programs have the bulk of
their money go towards evidenced based programs, but each also provides funds
for innovative strategies (e.g. experiments). The TPP program also funds some community-wide projects through its innovative projects funding stream. These community-wide projects are collaboratively run by the OAH and the CDC.11
I only spent a little bit of time on the Foundation's website. Their efforts seem to primarily be focused on spreading their message through advertisements on TV and in magazines. Being that I am not a teenage girl I have not been exposed to their ads enough to be able to comment on them. Personally, I don't really agree with their choice of role models. Not only Bristol Palin as their ambassador, but their clothing line features clothes 'designed' by Britney Spears, neither one of whom would I want my teenage daughter looking up to (if I had one). The most useful part of their site, to me, was a link to the website Sex Etc. which I will be talking about next.
Sex Etc. is billed as "sex education by teens, for teens". One of the parts
of their site is a section where teens can tell their story – which includes
answering some short questions, as well as filling out a survey that asks what was in
their sex-ed programs and what they thought should have been in them. Here is a shot of one survey. Please note that "Manual stimulation" is a modified form of their original phrasing.
It’s pretty easy to find statistics on teen sexuality but it is usually just compiled data, so you don’t normally get to see the raw data or the personal stories, which is what makes the Sex Etc. site so interesting. Furthermore, it seems that much of the statistics collected about teen sexuality are often “what have you done” questions rather than “what do you think” questions. Too often it seems that kids' voices are left out of the debate, and so I thought it would be interesting to compile the survey answers to see if maybe it would provide some insight into what kids think.
Unfortunately the surveys were
answered in 2 different ways. Some
students answered the 2nd part (should be covered in my sex ed) with
what wasn’t taught but should have been while other students answered the 2nd
part with what should have been taught whether it was taught or not. Therefore, for each topic, there are 4
different responses; the topic was taught, was taught and should be taught,
wasn’t taught but should be taught, and should not be taught. Because of this, it is not always possible to
tell if a topic was taught that a student thought should not have been taught. That sounds really confusing. I hope it isn't. Below are the graphs showing the results. For some notes about the process see the notes section.12
For the most part I think the topic listings for the survey are good. There are a lot of topics and they seem pretty clear. However, there is no separate listing for Birth Control, which I don't understand. There is the topic, Talking to Partner about Birth Control, which might touch upon the topic. The topic on STDs also might discuss birth control. It could be that Pregnancy Options is meant to discuss birth control, but I really take that category to mean options for what to do once already pregnant. Birth control is a major topic, not only with a variety of options, but also variability in effectiveness between preventing STDs and pregnancy, and so would seem to warrant its own category.
It isn't really necessary to talk about every single category separately and so I have grouped some of them together based upon similarities and/or having nearly identical results
I consider Menstruation and Wet Dreams to be basic anatomy topics. I am a little surprised as well that Basic Anatomy isn’t one of the topics. You know, the basic things like “this is a penis, this is a vagina.” Perhaps it is assumed that those basics are always taught (though, I doubt they always are).
From a health aspect, Menstruation is probably more important than Wet Dreams and so I can see why it is more commonly taught, but in terms of children understanding changes to their bodies, teaching about Wet Dreams is equally important. Of course, 87% of surveys were filled out by females, so that could also be the reason for male body changes rating lower than female changes.
There are three topics in this category that are related; Masturbation, Different Kinds of Sex, and Manual Stimulation. And once again the results are a little strange to me. In comparing Different Kinds of Sex (DKS) with Manual Stimulation (MS) you can see that DKS is taught more often and has fewer students who think it shouldn’t be taught than MS. This would seem to suggest that MS is a more taboo subject than anal and oral sex to both students and educators.
For both categories, GLBT Issues
and Same Sex Feelings, 75% of respondents thought those topics should be taught
if they weren’t. These results are
encouraging, if they truly are representative of the student population as a
whole, but to be honest, they seem a bit high.
Communication and Feelings
There are 6 categories dealing with communication and with emotional aspects of sexuality and relationships; Talking to Partner, Ready for Sex, Talking to Parents, Talking to Partner about BC, Healthy Relationships, and Normal Body Development.. All 6 of the graphs were very similar and so I’m only showing two of them here. These topics were taught between 25-33% of the time, while there was only a very small percentage of students who felt like they shouldn’t be taught. It seems clear from these results that students are not getting nearly as much guidance as they need and want.
With as many rapes and sexual assaults that take place in this country I really wish the Rape/Sexual Assault topic was covered more often (although, I guess it was the 5th most covered topic). The low number of students thinking it should not be taught suggests that students recognize how important the topic is.
To me, the Online Dating/Flirting result was the most surprising, as the 2nd most topic students thought should not be taught. One possibility is that students hear so much about it that they just get tired of hearing about it. Another possibility is that so much of students’ lives are now online and they do not want anything intruding upon it. It is also, worrisomely, possible that students just don’t see it as being that dangerous.
Pregnancy and STDs
It is good that STDs are so well covered. At least kids will know what infections they can get, whether or not they have any idea what to do about preventing them. I am a little skeptical about how often Pregnancy Options were taught. There is no way to tell if all options were taught or only a couple. I’m a bit doubtful that half of all students were given abortion information in their sex-ed class.
Abstinence-Only proponents should feel encouraged that few students thought Abstinence should not be taught. They should, however, also take note that BY FAR, Abstinence-Only, was the topic students most thought should NOT be taught.
I’m sure everyone is now dying to know my position on sex ed – okay, well, maybe at least one of you is. My position is actually incredibly simple – If it is an opinion, don’t teach it, if it is information, then teach it. Easy, eh? So let’s do some examples.
See how easy that is? Let's try another one.
Okay, so maybe that’s a little too simplistic. I do have three more specific ideas about how I think sex-ed programs should be designed.
1. There is a world of difference between 6th grade and 12th grade. Sex-ed programs should be spread out over a students career and probably equal at least an hours worth per grade level, for a minimum of 6-8 hours.
2. Break up the full curriculum into topical chunks; For example, have sections on basic anatomy, contraception, STIs, emotional aspects of sexuality and relationships, abstinence, and communication skills. Doing so would allow students and parents the option of opting out of parts of the program.
3. Offer program components to multiple grade levels. Perhaps the more basic sections are offered to all 7th, 8th, and 9th graders, while the more mature topics are offered to grades 10th and above. The point being that students can mature at very different rates and having the program in such a way would give students and parents the ability to decide age-appropriateness for themselves.
I have not examined individual sex-ed programs very closely. I’m sure my ideas are nothing new but figured I’d throw them out there.
1. Zhou, L. (2010). Revenues and Expenditures for Public Elementary and Secondary Education: School Year 2007–08 (Fiscal Year 2008) (NCES 2010-326). U.S. Department of Education. Washington, DC: National Center for Education Statistics. Retrieved January 10, 2010 from http://nces.ed.gov/pubs2010/2010326.pdf
2. Social Security Act, Title V, Section 510. Retrieved January 10, 2010 from http://www.ssa.gov/OP_Home/ssact/title05/0510.htm
3. Some basic information and resources about Abstinence-Plus can be found at the website http://www.abstinenceplus.info/ which is run by the group Medical Resources for Better Community Health.
4. The welfare reform law was the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA).
5..Data for Abstinence-Only education from Sexuality Information and Education Council of the United States (SIECUS). "Dedicated Federal Abstinence-Only-Until-Marriage Funding by Year (1982–2010)." Retrieved January 10, 2010 from http://www.siecus.org/index.cfm?fuseaction=Page.ViewPage&PageID=1259
6. The program originated as the Special Projects of Regional and National Significance–Community-Based Abstinence Education (SPRANS–CBAE). Grants were awarded directly to state and local organizations. Originally administered by the Department of Health and Services, Maternal and Child Health Bureau it was transferred to the Administration for Children and Families (ACF) in FY2005.
7. From Mathematica Policy Research, Inc. website, “Evaluation of Abstinence Education Programs Funded Under Title V, Section 510.” http://www.mathematica-mpr.com/family_support/abstinence.asp
8. Stein, Rob. "Health bill restores $250 million in abstinence-education funds." The Washington Post [online]. March 27, 2010. Available at: http://www.washingtonpost.com/wp-dyn/content/article/2010/03/26/AR2010032602457.html. Accessed January 11, 2011.
9.The National Campaign to Prevent Teen and Unplanned Pregnancy has a very good description of the PREP program as well as other resources about the project. http://www.thenationalcampaign.org/federalfunding/prep.aspx.
A list of grantees can be found here (also includes TPP grants): http://www.hhs.gov/news/press/2010pres/09/teenpregnancy_statebystate.html
10.The National Campaign to Prevent Teen and Unplanned Pregnancy has a very good description of the TPP program as well as other resources about the project. http://www.thenationalcampaign.org/federalfunding/tier1and2_grants.aspx
A list of grantees can be found here:
11. Information about the Community-Wide initiatives can be found at the CDC website:http://www.cdc.gov/TeenPregnancy/PreventTeenPreg.htm
and a list of programs receiving funding here: http://www.cdc.gov/TeenPregnancy/State-Community-Orgs.htm
12. The survey contained 20 categories - some were a bit long - I shortened them to make things easier. Below shows the original and shortened forms just in case their was any confusion (only the categories shortened are shown).
I did not include all surveys that were filled out. A few I tossed out because they seemed to have been not taken seriously. Also, I only included 15 of the New Jersey surveys. Sex Etc. is associated with Rutgers University (which is in New Jersey) and staffed largely by students who attend New Jersey schools. The number of surveys filled out by New Jersey students was proportionally distorted because of this. Because states can be so different from one another, I didn’t want one state’s peculiarities to disproportionately influence the results. In total, I included 261 surveys.
Originally, I had hoped to examine different perspectives based upon gender, but only 13% (35 out of 261) of the surveys were filled out by males, so I did not feel that the comparison would be very effective. Still, it would be an interesting issue to explore.
A few books on Sexual Education
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