Study Shows Intelligent Conversation with Caring Adults Helps Teenagers Make Healthy Decisions

Several people have asked me what I think of the study that found one abstinence-only program to be effective in delaying sex for middle school students. See coverage from the Washington Post, the Salt Lake Tribune, and the New York Times. Here’s my response:

• This study looked at the effectiveness of just one program. It's not a comprehensive study of what abstinence-only has come to mean in this country, meaning that we must not generalize the findings to abstinence-only education overall.

• The program studied did not follow the definition of abstinence-only under the guidelines for federal funding.:

o They taught students to be abstinent until ready to have sex -- not abstinence until marriage. They did not condemn sex outside of marriage.

o They discussed with students the pros and cons of deciding to have sex. This conversation can be useful and powerful -- and could not have occurred openly and honestly in federally-funded abstinence-only programs.

o The program was not sex negative and moralistic. Furthermore, they used only medically accurate information about condoms and contraception. Often, abstinence-only programs inaccurately present failure rates in order to discourage condom usage and scare students into feeling there is no such thing as safer sex.

All of these aspects of the program make it particularly hard to believe it in any way representative of what abstinence-only implies in practice.

• What did the control programs teach? The coverage reveals very little about the programs used for comparison. So-called comprehensive sex education can be fantastic — and can also be taught poorly and ineffectively, especially if taught for a study designed to disprove it. From news coverage, it seemed as if the control programs focused on teaching health information, with perhaps very little opportunities for discussion and emotional processing. If so, they do not represent the myriad of comprehensive sex education programs focused on supporting the development of social and emotional skills that can help teenagers stay healthy and safe.

• Let's take a step back and look at our goals in teaching sex education. The coverage cited growing rates of unwanted pregnancy and STIs among teenagers. Decreasing these rates is a public health priority. However, the results of this study showed that the program did not have any effect on frequency and consistency of condom use. To quote directly from the abstract of the study itself: “Abstinence-only intervention did not affect condom use.” What the coverage calls evidence of success is evidence that the program delayed the onset of sexual activity for a certain percentage of participants. But when these teenagers to start to have sex, they need to know how to use and learn about condoms and contraception. If they don't, they're at risk for the very same unwanted pregnancies and STIs that we need to prevent.

I don't want to discount the specific program studied per se; I do want to temper the myth that we now have scientific evidence in favor of abstinence-only education. We do not. What we might have, however, if we pursue this research further using responsible methods, is a demonstration of the power of training caring adults to facilitate intelligent conversations