Term Paper on "Abstinence vs. Contraception"

Term Paper 17 pages (5382 words) Sources: 17 Style: APA

[EXCERPT] . . . .

Abstinence vs. Contraception

Over the last thirty years, a vociferous debate has arisen over the relative merits of abstinence-only education vs. contraception, with public policy and debate often falling far short of the reality. On the one side are politicians and religious groups arguing that abstinence is the only sure way to prevent unwanted pregnancies and the transmission of sexually transmitted diseases, and as such should represent the core focus of any sexual awareness campaign. On the other side of the debate are those researchers arguing that abstinence is not only unpractical, but ineffective, and that the only proven way to reduce unwanted pregnancies and the transmission of sexually transmitted diseases is through educating the public about the proper use of contraceptives, and especially condoms. In order to get to the bottom of this debate and shed light on an issue intentionally clouded by one side, this study examined the arguments in support of abstinence-only sex education and one oft-cited example of a supposedly successful implementation of an abstinence program in Uganda before discussing a number of studies comparing the relative effectiveness of abstinence vs. contraception over the last three decades. After considering the arguments in favor of abstinence as a practical sexual education focus and comparing the effectiveness of abstinence and contraception programs, it became clear that contraception is the only effective option, and furthermore, that abstinence-only programs actually increase the likelihood of unwanted pregnancies and STD transmission, because while participants are just as likely as other groups to engage in sexual activity, they are much less likely to use contraception or protection from STDs due to their enforced ignorance of such methods.

The question of relative effectiveness is not an abstract consideration; to the contrary, the deployment of sexual education programs which stress abstinence have increased over the last thirty years while evidence for their effectiveness has failed to materialize over this same period. In 2001, Gold and Nash ("State-level policies on sexuality, STD education") found that "in examining the evolution of federal, state and local policy together, it is clear that abstinence promotion has truly taken hold as a matter of education policy in the United States and is being reflected in classroom education," having begun "on a small scale in 1981 with the enactment of the Adolescent Family Life Act" before being expanded by Congress and state legislatures. The two largest expansions of abstinence-only legislation following the AFLA were "a major freestanding program of abstinence-only education grants to the states, enacted as part of welfare reform in 1996; and a separate abstinence-only set-aside for community organizations (including those that are faith-based) within the maternal and child health (MCH) block grant" adopted in 2000. Consider the results from a 1999 study that does not even include the programs and initiatives begun under the second Bush administration:

Among the 69% of public school districts that have a district-wide policy to teach sexuality education, 14% have a comprehensive policy that treats abstinence as one option for adolescents in a broader sexuality education program; 51% teach abstinence as the preferred option for adolescents, but also permit discussion of contraception as an effective means of protecting against unintended pregnancy and disease (an abstinence-plus policy); and 35% (or 23% of all U.S. school districts) teach abstinence as the only option outside of marriage, with discussion of contraception either prohibited entirely or permitted only to emphasize its shortcomings (an abstinence-only policy). (Landry, Kaeser, & Richards, 1999, p. 280).

Thus, an overwhelming majority of school districts focused on abstinence-plus or abstinence-only sexual education, even though the efficacy of such programs had not been proven by any kind of reasonable metric.

That these impositions of abstinence-only legislation occurred at the same time as the political ascendancy of the religious right in America (first with Ronald Reagan's reign as president and then a decade later with George W. Bush) is no coincidence, because abstinence-only education is undeniably rooted in Christian conceptions of human sexuality. As Gresle-Favier (2004, p. xiii-xv) notes, "contemporary debates over abstinence education are representative of [a] 'clash' between a conservative and religious view of society and a more liberal and secular one," with the former favoring a restrictive approach to sexuality that considers anything other than heterosexual intercourse in the context of a marriage as morally deficient, while the latter simply assumes that "as long as sexual acts are consensual and responsible, they are considered legitimate." This should not be interpreted simply as an "attack" on religion, but rather as a means of understanding the fundamentally different goals of either side in this debate and the implications those goals have on either side's preferred focus.

From the more liberal and secular perspective, sexual activity or inactivity are regarded as equally worthwhile, with the only concern being the safety and health of those who do choose to engage in sexual activity. Thus, the subsequent support for contraception and contraception education arises out of evidence suggesting that these methods are most effective for ensuring the safety and health of those engaging in sexual activity (evidence that is considered in more detail later on in this study). From the conservative and religious perspective, any sexual activity outside of a heterosexual marriage is considered morally deficient and socially unacceptable, so the goal of sexual education should be to preclude this sexual activity rather than ensure the health and safety of those engaging in it. Thus, supporters of abstinence-only education need no evidence to justify their support, because abstinence is the goal in and of itself, rather than the means of achieving a larger social goal. In short, abstinence-only education is about morality, whereas contraception is about health, and the two have wildly different objectives, something that becomes clear when considering the arguments in favor of abstinence-education more closely.

Collins, Alagiri, and Summers (2002) discuss the "many different groups across the United States advocating for abstinence-only sex education in the schools," finding that the majority of them advocate the same positions and claims:

These and other proponents of abstinence-only education argue primarily that sex before marriage is inappropriate or immoral and that abstinence is the only method which is 100% effective in preventing pregnancy and STIs. Many such groups emphasize that condoms are not fool-proof in preventing pregnancy or STIs, and that sexual activity outside marriage can result in "serious, debilitating, and sometimes, deadly consequences." In addition, many abstinence only advocates are deeply concerned that information about sex, contraception and HIV can encourage early sexual activity among young people. These advocates credit the decrease in teenage pregnancy largely to the advancement of the abstinence-only message. (p. 12).

This decrease is undeniable; "from 1991 to 2001, the teenage birth rate declined significantly across the country," and "during that same decade, 1991-2001, vital statistics data show the percentage of U.S. high school students who ever had sexual intercourse and the percentage who had multiple sex partners also decreased" (Perrin & Bernecki DeJoy, 2003, p. 445). However, "the United States continues to have the highest teen pregnancy rate of all industrialized nations," and attributing this decline to abstinence programs assumes much more than the data warrants. In fact, even if this decline could be attributed to abstinence education, it still would not be very good evidence in support of the theory, because the United States' "teen pregnancy rate has declined less steeply than in other developed countries during the last thirty years," the majority of which "promote a 'Planned Parenthood' type of sexual education" (Perrin & Bernecki DeJoy, 2003, p. 445, & Gresle-Favier, 2004, p. ix). Because abstinence advocates are so committed and so impervious to reason or evidence, it is necessary to break down each of the major claims one by one in order to show how completely abstinence has failed as a public policy.

In making the case for abstinence, the claim "that abstinence is the only method which is 100% effective in preventing pregnancy and STIs" is most often trotted out first, because at first glance it appears the most unassailable position (Collins, Alagiri, & Summers, 2002, p. 12). It is of course true that the only way to ensure that one never becomes pregnant or contracts an STD/STI is to abstain from sex completely, but the idea that this fact can serve as the basis for a public policy is ludicrous, because it completely disregards the most basic realities of human behavior, especially when it comes to estimating and mitigating risk. Furthermore, that this fact is ever used as justification for abstinence-only education represents a gap in the argument, because it makes the leap from "abstinence is the only foolproof way to avoid pregnancies and STDs" to "abstinence should be the only (or at least most prominent) method of avoiding pregnancy and STDs taught to adolescents," without taking into account the reality of human sexual behavior. It pretends to hold public policy up to a nearly impossible standard, in that any mitigation effort must be 100% successful in order to be worthy of funding or implementation.

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