Abstinence

These stereotypes do more than just offend anyone who is male or happens to respect or care for males -- they defeat the supposed purpose of the ad: sex education. "One of the biggest challenges [in sex ed] getting young people to unlearn gender stereotypes around sex," Knox points out. But, keep in mind, SexReally.com hired traditionalist Laura Sessions Stepp, an outspoken supporter of retro relations between the sexes, as a writer and podcaster, so it's unlikely they're much bothered by such stereotypes.

Douthat, on the other hand, is all, "Well, yeah, ab-only ed doesn't work, but comprehensive sex ed doesn't either, so let's call the whole thing off." (I paraphrase.) He cites Berkeley sociologist Kristin Luker's "When Sex Goes to School" and a 2001 Guttmacher Institute survey that found "most studies of school-based and school-linked health centers revealed no effect on student sexual behavior or contraceptive use." In fact, says Douthat, family and community values seem to have the greatest impact on teens' sexual behavior, ergo, "This is the real problem with federal financing for abstinence-based education: It drags the national government into a debate that should remain intensely local." 

"If the federal government wants to invest in the fight against teenage pregnancy," he continues, "the funds should be available to states and localities without any ideological strings attached. (And yes, this goes for the dollars that currently flow to Planned Parenthood as well as the money that supports abstinence programs.) Don’t try to encourage Berkeley values in Alabama, or vice versa." That's a nice thought (as Amanda Marcotte snarked on Twitter, "We'll let your kids be perverts, if you let our kids be tortured and shamed"), but there are a few glaring problems with it. 

I'll start with what should be a fairly conservative-friendly argument: The consequences of teens' sexual behavior aren't borne only by their respective communities. According to a report by the National Campaign to Prevent Teen Pregnancy, teen childbearing cost U.S. taxpayers (combining state, local and federal taxes) about $9.1 billion in 2004. In Mississippi, the state with the highest teen birth rate, the total cost was estimated at $135 million, 49 percent of which was federal money. (In New Hampshire, the state with the lowest teen birthrate, the total cost was $18 million, with 44 percent federal costs.) Teen pregnancy rates are among the "predictors and risk factors associated with welfare dependence," according to the Department of Health and Human Services, and there's substantial overlap between states with high teen birthrates and states that get a lot more out of the federal kitty, including for entitlement programs, than they put in. Mississippi, for instance, gets back $2.02 for every dollar it sends to Washington, while New Hampshire gets back only 71 cents.

So it's swell to say that this should be an "intensely local" issue, but it's just not. I mean, I'm a bleeding heart liberal who looks at the numbers and thinks poverty is the obvious common denominator, and I'd be happy to see even more money go to services that actually help people. But I also think reducing the number of unwanted pregnancies -- among teenagers and adults -- is a worthy goal for a lot of reasons, one of which is that it might free up some tax dollars. Conservatives are supposed to like things that save money, right?

Next, let's go back to that Guttmacher report Douthat mentions. While its overall message is indeed that social norms have a greater impact on behavior than any sex ed programs, we need to talk about which social norms are having what kind of impact. "If a group has clear norms for (or against) sex or contraceptive use, then adolescents associated with this group will be more (or less) likely to have sex and use contraceptives," writes author Douglas Kirby. "Innumerable studies demonstrated that the norms of individuals to whom teenagers are attached (e.g., family members, close friends and romantic partners) were strongly related to and consistent with the adolescents' own sexual and contraceptive behavior." Sexual and contraceptive behavior. Kids might be somewhat less likely to have sex if everyone around them is constantly talking about how sinful and dangerous it is, but that doesn't mean none of them will -- and if their parents, preachers and pals are also telling them that contraceptives are sinful, dangerous and/or ineffective, that's going to sink in, too. I haven't read Luker's book, but in her New York Times review of it, Judith Shulevitz wrote, "[I]f the notoriously inconclusive data on sex education show anything, it’s that teaching abstinence makes it more likely that young people will have unsafe sex once they start having it." Lo and behold, even with those strong anti-sex community values, teen birthrates are highest in the most religious states. (Mississippi's No. 1 for both; New Hampshire is the 48th most religious state.) Religious prohibitions against contraception aren't the only factor there, but they're one plausible explanation.

Also, back when teen pregnancy rates were still declining, the Guttmacher Institute found that although trends in contraceptive use were mixed, only about a quarter of the drop could be attributed to increased abstinence; the other 75 percent was the result of sexually experienced teens managing not to get pregnant. Furthermore, that report noted that "The greatest change is an increase in the proportion of sexually experienced teenagers who report having used a method at first sex." While that obviously doesn't tell us about long-term contraceptive use, a 2004 CDC report stated, "Teenagers who do not use a method of birth control at first intercourse are about twice as likely to become teen mothers as teens who do use a method at first intercourse." Twice as likely! So educating kids about contraception before they start having sex probably does matter, as it turns out! Oh, and about when they start having it? According to the National Campaign to Prevent Teen Pregnancy, 55 percent of Mississippi teens have had sex by ninth grade -- versus 27 percent of New Hampshire high school freshmen. Just FYI.

So, one really big problem with not encouraging Berkeley values in Alabama is that kids who grow up with Alabama values have babies at much higher rates. (Alabama has the No. 12 teen birthrate; California's No. 28.) Even if communities and families have more of an effect on teens' behavior than schools do, it is abundantly clear that kids growing up in environments where they learn something about sex and contraception beyond "Don't do it, and then you won't need it" are less likely to get pregnant. So, not for the first -- or 50th -- time, I have to ask: Do the folks who insist on keeping their children ignorant actually want to prevent teen pregnancies?

While it should go without saying that not every teen pregnancy is a sad story in the long run -- our president seems to have turned out all right, and Salon contributor Amy Benfer has written numerous times about the daughter she had at 16, whose awesomeness I can vouch for -- there's no question that it's in society's best interest (not to mention most teenagers') to reduce the number of them. There is no question that abstinence-only education doesn't help with that. And there is no question that in a nation where church and state are meant to be separate, public schools should favor curricula that offer comprehensive, scientifically accurate information over those that offer limited and sometimes false information based on a narrow, usually religious worldview. Deciding whether to tell schoolchildren the truth is not something that should be up to the discretion of local communities. As Bitch Ph.D.'s M. Leblanc put it, "As it turns out, kids have a right to a meaningful education ... What non-abstinence only education does is not lie to kids." So the thing is, determining the best way to educate children about sexuality and reproduction is not merely a matter of Alabama values vs. Berkeley values. It's a matter of good old-fashioned American values -- like preserving freedom of religion, helping all of our children get the best possible start in life, and above all, believing the truth is better than a lie.

 

In recent weeks, teenagers in Milwaukee have been inundated with promos for the imaginary film on hip local radio stations, during the commercial break for popular shows like "American Idol" and in big-screen previews. All come complete with a gravelly male voice-over and a creeping orchestral soundtrack. The final trailer features the requisite shots of blood, a screaming woman and a pale, wide-eyed child straight out of "Orphan." The general premise seems to be that a girl goes to a party alone, has sex with a boy, ends up pregnant, her father goes psycho, she has an excruciating labor, her child is, like, the devil's spawn or something, he grows up to become some sort of delinquent and she has him arrested.

The initial preview ended with "in theaters January," but subsequent edits of the trailer made it clearer that the previews were an end unto themselves with the following message: "Get pregnant as a teen and the next 18 years could be the hardest of your life." Then, a Web address flashes on-screen: BabyCanWait.com. At this point, I imagine a collective "oh, snap!" rising out of teenage moviegoers. That's right, kids, you just got punk'd -- or such is the hope of Gary Mueller, one of the admen behind the Serve Marketing campaign. "We're punking them," he told me over the phone.

This is the 15th anti-teen pregnancy campaign the company has done over the past three years for United Way's Healthy Girls program in Milwaukee. Past print ads included images of teen boys with pregnant bellies and a baby diaper with a brown "scratch-'n'-sniff" spot. He says the aim is to offer a contrast to high-profile young mothers like Jamie Lynn Spears and "deglamorize" teen pregnancy. Modeling young dudes after a bad Arnold Schwarzenegger movie and producing PSAs about dirty diapers are certainly ways to do that, and Mueller credits the decline in the city's teen pregnancy rate in part to their "aggressive and provocative" approach. But are these shock-and-awe tactics the best way to reach kids?

There is no denying that these campaigns are attention-grabbing -- and with the seventh-highest teen birth rate in the country, the city can't exactly afford to make a soft sell -- but I get hung up on the hyperbole in the "2028" ad blitz. The spots don't talk contraceptives (although at least the Baby Can Wait site does) and portray sex as an inevitably horrific event. Consider the press kit for the faux-film, which includes the following blurb from an anonymous reviewer: "Makes
2012
look
like
a
kiddie
movie." So, volcanic eruptions, devastating earthquakes and mega tsunamis are child's play compared to teen pregnancy? Raising a kid as a teenager may be tremendously difficult, but it doesn't rise to the level of a cataclysmic event or even necessarily a -- screech, screech, screech -- horror flick. My general feeling is that teenagers deserve our honesty and respect, and they are poorly served by adults' lies and distortions about sex and pregnancy (see: the massive failure that is abstinence-only education). 

In fairness to Lifetime, the movie's official description calls it the "story of a fictional 'pregnancy pact' set against the backdrop of actual news reports"; they're not claiming the pact itself was real. But the surprising popularity of the film reminds us just how much we all wanted it to be, back in June of 2008. As Ellen Goodman wrote shortly after the girls' agreement was revealed to be non-existent: "The tale of the pregnancy pact led all the usual suspects to cast all the usual blame. It was because the state rejected abstinence-only funds. No, it was because the school couldn't dispense condoms. It was because the celebrity culture bred Jamie Lynn Spears wannabes. No, it was because the town was in the economic dumps. It was because the school had day care. No, it was because of an 'absolute moral collapse.'" Teenage pregnancy is a handy, bipartisan peg for any number of pet peeves and potential moral panics, so it's hard to resist writing about such a dramatic instance of it even before you have all the facts. (I did.)

I was reminded of that this morning when I saw several bloggers mention a new Guttmacher Institute report offering "the first documentation of what experts have suspected for several years, based on trends in teens' contraceptive use -- that the overall teen pregnancy rate would increase in the mid-2000s following steep declines in the 1990s and a subsequent plateau in the early 2000s." In 2006, the most recent year for which we have data, the teen pregnancy rate rose by 3%, the first increase in more than a decade. As Salon contributor Lynn Harris said in her superhero guise:

2006: Let's plot that on a timeline of SURELY UNRELATED events in U.S. history. Aha: Turns out a long-term decline in teen pregnancy -- due in part to increased contraceptive use among teens -- flattened out and then reversed... what's this? The decline reversed at the same time that the Bush administration and Congress ramped up funding for rigid abstinence-only-until-marriage programs that are prohibited from discussing the benefits of contraception. Coincidence, or...?  Yeah, gotta be coincidence.

Now, I find it entirely believable that crappy sex ed is to blame for the spike in teen pregnancy, and I'll take any opportunity to remind anyone who will listen that abstinence-only education does not work. But the fact is, yes, it could still be a coincidence at this point. Even in the Guttmacher's press release, director of domestic research Lawrence Finer notes, "It is too soon to tell whether the increase in the teen pregnancy rate between 2005 and 2006 is a short term fluctuation, a more lasting stabilization or the beginning of a significant new trend, any of which would be of great concern." And I'll lay dollars to donuts that the same people who characterized the imaginary Gloucester pact as the result of an "absolute moral collapse" -- or of high school day care centers or reckless celebrity culture (at least before Bristol Palin replaced Spears as the poster girl for young motherhood) -- are now rushing to explain the increase in teen pregnancies with theories that fit their own beliefs. Meanwhile, no one knows for sure if the 2006 numbers were anything more than a blip.

Those of us who believe that sexually active human beings of all ages deserve honest information about sex, readily available contraception and support for their reproductive choices do have the facts on our side. Abstinence only education doesn't work. Contraception makes an enormous difference. By their late teens, at least three-fourths of Americans have had sexual intercourse, whether their parents, pastors and principals are happy about it or not. And according to RH Reality Check, "The overwhelming evidence demonstrates that sex education that teaches both the benefits and limitation of birth control does not increase teen sexual activity. In fact, several curricula have shown this approach to delay early sexual involvement and increase use of birth control among already sexually active teens." There's plenty of evidence to support a push for comprehensive sex education and making contraception as widely available as possible -- and indeed to support they hypothesis that the increase in abstinence-only sex ed is responsible for an increase in teen pregnancies, especially given the plateau preceding it. Despite his note of caution, Finer adds,"Either way, it is clearly time to redouble our efforts to make sure our young people have the information, interpersonal skills and health services they need to prevent unwanted pregnancies and to become sexually healthy adults." It's always time for that. But until a clear pattern has been established over longer than one year, the most we can honestly say about claims that Bush administration policies led directly to a spike in teen pregnancies is that they're inspired by a true story.

 

To which Winfrey said, "It's kinda cute," indicating in no uncertain terms that she found it, in fact, not at all cute.

Super-tense niceties out of the way, Winfrey asked Palin about her new Fox contract, extracting what sounded like it might have been a nugget of insight when she asked the former governor if the TV gig meant the end of her political career. Palin responded that "I'm not closing any door that maybe I find open in the future, and thankfully the Fox network has allowed me to keep that door open for whatever maybe political is in my future." (Don't blame me, I only transcribe.)

Weirdest, though, was that while Winfrey seemed perfectly willing to go after Palin for her coiffure, she didn't challenge her when she described her new Fox job as an opportunity to get back to the "who, what, when, where and why of reporting, just stating the facts, gathering the information, providing it to the viewers and letting them decide what their opinion would be ... ratcheting back to the simplicity of what journalism should be about."

Instead of pointing out that Fox News was probably airing a story about how un-American it was for the Obamas to keep a Portuguese water dog in the White House or something, Oprah just said, "Absolutely." Yes, she really did. And she went on: "When I was in journalism school, that was what was emphasized, the who, what, where and why, and it seems like that's been lost now."

WTF, Oprah?

Later, Oprah and Sarah were joined by Bristol, a teen who, less than a year ago, was telling Fox News' Greta Van Susteren the who, what, where, when and why of how abstinence was "not realistic at all." She has since, thanks to her willingness to walk through any door that opens for her mother, become an advocate of premarital abstinence.

At first, Oprah seemed content with softball questions about the rigors of teen motherhood. (Bristol bathes Tripp. A lot.) But then Oprah began to press Bristol on her public vow never to have sex again before marriage -- a vow that Oprah admitted made her "bristle" when she read it.  "When you make the statement that I'm absolutely, positively not going to have sex and I guarantee it," Oprah said, "you don't think you're setting yourself up?"

"No, I don't," Bristol said, hands clasped on her lap.

To which Oprah responded, "Well, all right, good luck to ya on that."

Oprah wasn't quite ready to leave the topic yet, and so she dug in a bit more on the subject of abstinence in general. "One out of three teenagers are having sex by the time they're 18 years old," she began. "I'm wondering if [abstinence] is a realistic goal."

Interesting word choice, O: "realistic." Don't think the significance of those four syllables were lost on the Palins, who jumped in, eager to clarify.

"I think she's talking about herself, personally," said Sarah.

"Yeah," said Bristol, hand touching her breastbone now, "it's a realistic goal for me."

Oprah wasn't getting anywhere, a point she had to finally cede.  "OK, I was going to give you a chance to retract or" -- and here she made a pantomime gesture that might best be described as "walking it back" -- "and not say categorically I guarantee I'll never have sex until I'm married, but if you wanna hold to that, then may the powers be with you."

"Hey, does that mean you're going to get married young?" Palin asked, nudging her daughter playfully. To which her daughter rolled her eyes. "I don't know, Mom."

And an awkward laugh was shared by all.

In the end, the interview wasn't controversial or horrifying or entertaining so much as it was intensely ... odd. To which all I can say is: WTF, Oprah?

No surprise there, right? After all, the "hear no evil, do no evil" approach to sex has gotten quite the bad rap in recent years. But the panel, the Task Force on Community Preventive Services, did come to another rather surprising conclusion: There's "insufficient evidence to determine the effectiveness" of the abstinence-only approach with regards to the reduction of teen pregnancy and STD transmission. In other words, there isn't enough reliable or consistent data to make any conclusions about its benefits or harms. That's because outcomes "differed substantially" from study to study and the panel, in cooperation with the Centers for Disease Control and Prevention, found it "hard to determine the explanation for the observed differences." The jury -- well, this particular jury, at least -- is still out.

Generous as this conclusion may seem to vocal opponents of abstinence-only education, its supporters aren't too happy with the results. Two members of the CDC Community Guide have issued a minority report claiming that the panel's recommendations "fail to acknowledge the effectiveness of abstinence education" and "make comparative effectiveness claims about [comprehensive risk reduction] versus AE that are based on weakly supported assumptions." Unfortunately, the dissenting report bases its claims on evidence that has not yet been cleared for release to the public, so there's no way to scrutinize its claims. Randy Elders of the CDC responded in the Washington Post by saying that "all of those points were considered by the task force" and that their criticism reflects "a fundamental misunderstanding of a systematic review process." He explained, "The whole point of what we are doing is to aggregate data from as many studies that are critical to answering the question. What they were doing was chopping up the evidence into very fine subsets to poke holes."

Debates over the effectiveness of various sex ed approaches have always been contentious, but that is especially true right now because there is a tremendous amount on the line: Congress is currently mulling President Obama's proposal to allocate government funds only to sex ed programs that are scientifically shown to work. Based on this report, at least, abstinence-only would be out.