Life Is Not Just a Bowl of Condoms
The Liberal Vogue in Sex Education Doesn't Really Protect Our Kids
By Douglas J. Besharov
This article originally appeared in The Washington Post, May 1, 1994.
A BOWL of condoms sits on the principal's desk, telling adult
visitors that things have changed since their generation attended high school.
How much? In 1970, way back at the dawn of the sexual revolution, 30 percent of
17-year-old girls reported that they had had sex at least once. By 1988, the
figure had risen to over 50 percent. The rise among 15-year-old girls was more
startling, from less than 5 percent to almost 26 percent.
Increased sexual activity, unfortunately, has not been accompanied
by adequate contraception. One out of four sexually active teenagers does not
regularly use any contraceptive according to the U.S. National Center for Health
Statistics' National Survey of Family Growth. Among the most disadvantaged
teens, three out of four don't. The result is more than 1 million teen
pregnancies a year, resulting in about 400,000 abortions, 130,000 miscarriages
and 500,000 live births -- nearly two-thirds out of wedlock.
Many people think that the problem would be reduced if
contraceptives were simply more available and affordable. Surgeon General
Joycelyn Elders, for example, recently gave a speech in which she said that
Medicaid must have been developed by a "white male slave owner" because "it
fails to provide services to poor women to prevent unwanted pregnancies, and
this failure contributes to poverty, ignorance and enslavement."
If only it were that simple. There is, for example, no clear
connection between spending on family planning services and contraceptive use,
let alone teen pregnancies. Although public funding for family planning declined
in the 1980s, the total number of women using public clinics apparently stayed
about the same or even rose a bit. More importantly, contraceptive use
increased, even among poor teens.
The issue is non-use -- not availability. Almost all young people
have access to at least one form of contraception. Condoms are freely
distributed by family planning clinics and other public health services. Edwin
Delattre, dean of Boston University's School of Education and an opponent of
condom distribution programs in public schools, found that free condoms were
available at eight different locations within a 14-block radius of one urban
Teenagers can also obtain contraceptives such as pills and
diaphragms from family planning clinics free of charge or on a sliding fee
scale. In all states, teenagers can use clinic services without parental
consent. According to the Alan Guttmacher Institute, 60 percent of sexually
active female teens use clinics to obtain contraceptive services, while only 20
percent of women over 30 do so. There are also free services under Medicaid,
though to use them a teenager must present the family's Medicaid card.
If availability were the issue, non-use would not be the problem
it is among college students. A study conducted at the University of Maryland,
for example, found that 50 percent of the girls who sought a pregnancy test at
the school's health center had not used a contraceptive the last time they had
sex. The reasons cited by these college students? "I knew it was risky, but I
took a chance" (62 percent); "I didn't think I'd have sex at the time" (56
percent); and, "I'm not really very sexually active" (46 percent). Lack of
contraceptive availability was not cited as a factor by the study.
Hollywood does not help. In the immensely popular movie "Pretty
Woman," Richard Gere is presented with a rainbow of condoms by a street
prostitute, only to grandly wave them away. Condoms were not mentioned -- or
shown -- again in any of the film's intimate scenes. The message is clear: Real
men don't use condoms.
Sex education was supposed to change all this. Almost all American
teens are now instructed in reproduction and contraception. Many of these
courses are poorly taught, but research indicates that even the best ones have
little or no impact. An evaluation of 14 programs by the federal Centers for
Disease Control (CDC), for example, found that they had no impact on whether
students initiated sex, the frequency of sex or the use of any form of birth
Condom distribution programs are the newest idea for changing teen
behaviors. They are now in almost 400 schools, including those in the District
and at T.C. Williams High School in Alexandria. Their underlying purpose is to
erase Victorian notions about morality and young people's embarrassment about
condoms -- and thus encourage their use. But that's precisely why social
conservatives and many parents oppose them so strenuously. They think that
having condoms displayed in various public places will make sex among teenagers
Most people might accept this trade-off -- if there were any
evidence that such programs change teen behavior for the better. But there is
none. According to a 1994 study sponsored by the CDC, the most that can be said
of condom distribution programs is that "well designed programs may increase
condom use . . . while poorly designed programs may not." The point is, no one
knows. All the programs imaginable cannot deal with one vital truth: Many
teenagers are simply not ready for sexual relationships; they do not have the
requisite emotional and cognitive maturity. Adolescents who cannot remember to
hang up their bath towels are just as unlikely to use contraceptives. Too-early
sex should be actively discouraged.
Many of today's adults grew up testing the bounds of sexual
freedom, so they feel that trying to discourage sexual activity would be
hypocritical. Single parents who themselves are sexually active feel doubly
uncomfortable. For example, when Clinton administration officials met recently
to design a strategy to combat teen pregnancy, one senior official advocated
increasing the availability of birth control for teens by saying, "We can all
admit we enjoyed the pleasures of premarital sex."
Sure, but adults need to distinguish between what they did as
older teens (usually they had finished high school and were either working or in
college) and the confused and often exploitative situations faced by today's
young teens. Many teens, especially those from disadvantaged backgrounds, are
under enormous pressure to become sexually active -- and are given almost no
support when they don't want to. Marion Howard, a professor of obstetrics and
gynecology at Emory University, surveyed 1,000 teenage girls in Atlanta. When
asked what subject they most wanted to learn about in sex education, 82 percent
said they wanted to know "how to say no without hurting the other person's
The image most older people have about the initiation of teen sex
is that of a young male, his hormones at full throttle, importuning his
girlfriend who is holding back. Recent research, however, paints a far bleaker
picture of some relationships in impoverished neighborhoods. A much noted study
by University of Pennsylvania sociologist Elijah Anderson, for example,
describes a sexual game in which young girls are lured into having sex by
promises of love and marriage from older males. Because the inner city has a
dearth of good jobs, he argues, peer groups emphasize sexual prowess as evidence
of manhood, with babies serving as proof. Anderson studied an African-American
community, but his colleague, Patricia Stern, found comparable behaviors in a
low-income white neighborhood.
Birth data from California confirm just how widespread those
troubling liaisons are. In 1990, more than half the fathers of the children born
to 11- to 15-year-old girls were 19 or older, reports Mike Males of Occidental
College. More depressing, among mothers ages 11 and 12, the fathers were, on
average, 10 years older.
This is not sexual freedom for contemporary Romeos and Juliets,
but sexual exploitation of younger girls by older males, plain and simple. So
trying to help young people postpone sexual intercourse until after high school
graduation is not a case of misguided prudery. It empowers them. At the same
time, the clock cannot be turned back to the innocent 1950s. Sexual mores have
probably changed permanently, at least for older teens. Hence, society needs to
send a dual message: Young people should delay having sex. But if they do have
sex, they should use protection.
Currently, most sex education courses do not take a stand on teen
sexual activity; instead, they use what is called a values-clarification
approach. "They tell you that you shouldn't feel forced to have sex, that you
should have sex only when you want to -- when you are ready for it," recalled
one local 15-year-old boy who attends an exclusive private school in the
District. In many places, this same message is delivered to 13-year-olds and
17-year-olds alike, with no mention of how to decide when one is "ready." The
lesson? If you are not having sex, you must not be mature enough.
An increasing number of sex education programs reject this
leave-it-to-the-kids-to-decide approach. Instead, they have adopted the message
about delayed sex and safe sex -- and it seems to work. Carefully controlled
evaluations by Howard and other researchers have documented dramatic changes in
teen behavior. In one study, junior high school students in Atlanta were about
40 percent less likely to have initiated sex one year after the program. In
another study, high school students in California were about 25 percent less
likely to have initiated sex 18 months after the program.
Ironically, these "abstinence plus" programs, as they are called,
seem to have a greater impact on contraceptive use than do traditional programs.
In both of the studies mentioned above, sexually active teens were almost 50
percent more likely to use contraception if they had participated in the
program. Why? Perhaps because the focus on abstinence sends a secondary message
about the seriousness of sexual relationships.
"Abstinence plus" programs tend to share certain characteristics.
They focus on setting peer norms: Not everyone is "doing it," and you don't have
to either. For example, the "Postponing Sexual Involvement" curriculum in
Atlanta constantly reinforces the theme that teens under 16 are not able to
fully understand the implications of their actions and, more specifically, that
they are too young to have sex. Rather than have adults lecture the junior high
students, "socially successful" 11th-grade boys and girls lead each class. One
female leader noted, "I just don't think teens think. I hate to say that." She
and a male peer stand up before the class and reenact a dating situation.
Holding her hands, he says, "Come on. Your parents won't be home for a while.
You know I find you attractive. You said you love me." She asks the class, "What
should I say?" They respond in unison, "No!" The male tries to wear her down
with line after line and she practices different ways to say the same answer:
"No, I am not ready. I don't want to have sex. If you really love me, you would
understand that." Then each student practices with one of the counselors.
No one, however, should expect such programs to be more than
partial solutions. The sexual behaviors of teens -- as well as adults -- are
deeply rooted in contemporary social mores, aggravated for many by the despair
that attends extreme poverty. There are no villains here, only vexing problems.
Until all sides recognize this, efforts to combat teen pregnancy will be
condemned to controversy -- and irrelevancy.
Douglas Besharov is a resident scholar at the American Enterprise
Institute and a visiting professor at the University of Maryland School of
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