An influx of funding for abstinence-only-until-marriage programs leads to a decade of policy changes.

A decade ago, the federal government has a small pot of money--roughly four million dollars each year--for abstinence-only programs. In 2003, abstinenceonly-until-marriage programs are supported by over $120 million in federal dollars and $37.5 million in state-raised funds. 1 Since 1996, when the federal government quietly instituted a massive increase for abstinence-only-untilmarriage funding, government support for these unproven programs has totaled more than $700 million.

Due to ever-increasing federal funding for abstinenceonly-until-marriage programs, and effective support and advocacy from social conservatives, the last decade has seen more restrictive abstinence-only-until-marriage sexuality education laws on the state-level, and a proliferation of abstinenceonly-until-marriage programs funded through federal block grants. While school districts and individual schools still have significant latitude in crafting their own policies for sexuality education, the federal incentives and guidance regarding abstinence-only-until-marriage have changed the landscape of sexuality education in the United States.

Despite this unprecedented support, proponents of comprehensive sexuality education have not been silent.The public remains unwaveringly supportive of comprehensive sexuality education. Some states and schools have found ingenious ways to resist the pressure to institute abstinence-only-until-marriage policies or to make them work without using fear and shame-based curricula. And we are seeing positive trends both legislatively and locally that promise to grow stronger and become more widespread in the coming years.

A BRIEF HISTORY OF SEXUALITY EDUCATION IN THE UNITED STATES

In 1912, the National Education Association called for teacher training programs in sexuality education and in 1919 the White House Conference on Child Welfare said that "sex instruction.. is more properly a task of the school." In 1940, the U.S. Public Health Service called sexuality education in schools an "urgent need" and in the 1950s the American School Health Association and the American Medical Association developed programs and pamphlets, respectively, in family life and sexuality education.

Then, starting in the 1960s, opposition to sexuality education began to gain momentum. In the 1970s, socially conservative groups filed lawsuits in attempts to bar sexuality education in schools. The suits were based on alleged constitutional violations but failed because parental "opt-out" provisions allowed parents to take their children out of the classes. In addition, the courts found no violations of the Establishment Clause of the First Amendment, the clause which has been interpreted to guarantee separation of Church and State. (2)

When AIDS entered the picture in the 1980s, sexuality education was once again embraced by many. The federal Centers for Disease Control and Prevention (CDC) began funding HIV education and state policies mandating HIV/AIDS education were established.

Still, in 1981, opponents of comprehensive sexuality education finally met with success. A federal abstinenceonly funding stream was created with the quiet enactment of the Adolescent Family Life Act (AFLA). AFLA was. touted by its proponents as an alternative to the Title X Family planning program which was seen by conservatives as promoting teen sexual activity, and undermining traditional values. AFLA established funding for programs that would "promote chastity and self-discipline." Another goal of AFLA was to promote adoption over abortion as an option for young people. In other words, it was a "pro-family" approach to teen pregnancy prevention. However, in order to appease Senator Edward Kennedy (D-MA), the ranking member on the subcommittee under which AFLA was considered, a provision was included to provide support services to pregnant and parenting teens)

AFLA opened the door for sexuality education policies in the U.S. that have increasingly emphasized abstinence. Those who continued to oppose teaching sexuality education in schools found abstinence-only programs to be more palatable and began advocating for them with renewed vigor and success. In the more than two decades since AFLA was signed into law, the federal government has not only increasingly stressed abstinence, but it has increasingly stressed abstinence-only-until-marriage

THE FEDERAL GOVERNMENT INVESTS MORE MONEY

In a case of ideology triumphing over science during the last decade, the two largest federal funding streams for abstinence-only-until-marriage were created. (4) In 1996, abstinence-only proponents successfully created a $50 million per year entitlement program by slipping the provision into the popular Welfare Reform Law during the final drafting of the legislation, a process usually reserved for corrections and technical revisions. (5) As was the case with AFLA, there was little public or legislative debate.

Through Section 510(b) of Title V of the Social Security Act (hereafter Title V), states are eligible to receive federal funding for abstinence-only-until-marriage programs that have teaching abstinence as their "exclusive purpose." (See box on page 16 for the federal definition of "abstinence education.") States must then match every four federal dollars with three state-raised dollars.(6)

The strictest abstinence-only-until-marriage funding stream to date--the Special Projects of Regional and National Significance-Community Based Abstinence Education (SPRANS-CBAE) program--was established in 2000. While programs funded by Title V dollars cannot be "inconsistent" with any of the eight points in the federal definition of abstinence education, SPRANS-CBAE programs must address each of the eight points. SPRANSCBAE grants are made directly from the federal government to organizations rather than being disbursed by the state, as Title V grants are. In Fiscal Year 2003, funding for the SPRANS-CBAE program was $55 million, a massive increase from its original $20 million in Fiscal Year 2001.

STATES WEIGH IN

This decade has seen tremendous change in sexuality education policy on the federal level. Abstinence-only-until-marriage policy is widely accepted and promoted by the current President and leadership in Congress.This has heightened the attention paid to this topic and states have been given great incentives to follow the federal government's lead.

State Policies. State policies on sexuality education range from broad, general mandates about what subjects must be taught, to specific mandates about topics and messages. While school districts have historically been free to make decisions about specific content, the last decade has seen a steady erosion of that freedom, particularly if federal or state dollars are used to fund sexuality education.

States often have mandates requiring sexuality and/or sexually transmitted disease (STD) education. In fact, 39 states and the District of Columbia require that students receive some instruction about sexuality education, or HIV/AIDS and STDs. (7) Twenty-two of the those states and the District of Columbia require that students receive sexuality education and HIV/STD education, and 17 require only HIV/STD education. (8)

Ten years ago, the vast majority of states did not give much detail about what such courses must include. Today, however, many states also place content requirements on sexuality, HIV/AIDS, and STD education. Twenty-two states require that if sexuality education is taught, abstinence must be stressed and eight states require that it at least be covered. (9) When STD education is taught, 26 states require that abstinence be stressed and seven require that it be covered. (10) In comparison, contraception must be covered in 19 states when STD education is taught, and in 14 states when sexuality education is taught. (11) An additional four states, however, authorize localities to cover contraception, but require them to include failure rates or effectiveness and failure rates among adolescents. (12) Finally, Utah prohibits the "advocacy or encouragement of the use of contraceptive methods or devices" and prohibits teachers from answering students' questions in a way that would contradict that requirement. (13)

States Adopt Abstinence-Only-Until-Marriage. After passage of the 1996 Welfare Reform Law, states were in the unenviable position of having to decide whether to accept the Title V federal funds and subsequently find state-raised funds for programs that have abstinenceonly-until-marriage as their "exclusive purpose." Recognizing the predicament faced by states, a state health official said: "States don't have that many programs that match this definition; the programs don't exist." (14) Just a few years later, however, that statement is no longer true.

Every state in the country receives some federal funding for abstinence-only-until-marriage programs. (15) However, as SIECUS recommended when Title V was first enacted, some states choose to use their federal funds for programs that do not rely on fear- and shame-based messages. Instead, they choose to teach some of the more innocuous elements of the federal government's eightpoint definition.

Maine and Massachusetts, for example, direct their funds to media campaigns. (16) The theme of Maine's media campaign is parent-child communication about sexuality. Massachusetts' media campaign is targeted at males and females 10-14 years of age, males 15-17 years of age, and parents of teenagers. Its message is simply, "You don't have to do it." The campaign aims to increase parent-child communication, encourage youth to delay the onset of sexual activity, and educate young men about the risks of early sexual activity.

Oregon uses its Title V money as part of a larger comprehensive sexuality education program in the context of STARS (Students Today Aren't Ready for Sex), a program which focuses on 6th graders, and three other programs that focus on elementary-schoolaged children.

THE ABSTINENCE-ONLY-UNTILMARRIAGE TREND IN SCHOOLS

State and local curriculum standards are not within the federal government's authority to legislate (four federal laws prohibit the federal government from dictating the content of community education programs (17). Nonetheless, conservative federal legislators have found ways, by pulling the purse strings and restricting and defining the scope of state and local health policy, to effectively encourage strict abstinence-only-until-marriage courses over comprehensive approaches to sexuality education. Over the past decade, this federal support for abstinence-only-until-marriage programs has dramatically changed the landscape of sexuality education across the country.

A 1988 survey of public school teachers of sexuality education in grades seven through 12 conducted by the Alan Guttmacher Institute, found that one in 50 used an abstinence-only curriculum. (18) In 1999, another survey of the same subset found that the percentage had increased to one in four. (19)

Another Alan Guttmacher Institute survey conducted in 1998 also illustrated the impact government directives have had on school policy. In that survey, 48 percent of school superintendents cited state directives as the most important factor in determining their sexuality education policy. In addition, 17 percent cited school boards, and 18 percent cited special committees. (20) In a 1999 Kaiser Family Foundation survey, 88 percent of public secondary school principals reported that school districts and local governments had at least "some influence" on their school's sexuality education curricula. (21) More importantly, 70 percent indicated that state government had "some influence" or a "great deal of influence," and 31 percent indicated that the federal government's abstinence-only funds had some influence. (22) Eightyfive percent of school principals said that the content of sex education was subject to local or state guidelines and 43 percent said that the guidelines were strict. (23)

While about half of school principals said that subjects related to sexuality education had been a topic at a public debate or discussion, most of the time (58 percent) no change in curricula resulted. (24) Finally, only 31 percent of schools reported experiencing a discussion about whether to teach an abstinence-only curricula. (25) This is consistent with SIECUS' finding that strict abstinence-only-untilmarriage programs are finding their way into schools with little or no debate, virtually unnoticed. (26)

SOME POSITIVE TRENDS

On the Federal Level. The federal government's support and guidance for abstinence-only-until-marriage programs are effective because of the funding made available to states and organizations through AFLA, Title V, and SPRANS-CBAE.

Proponents of comprehensive sexuality education are trying to create similar federal funding streams for comprehensive sexuality education. In 2001, the Family Life Education Act was introduced in the U.S. House of Representatives and had 89 bipartisan co-sponsors. The bill would have authorized $100 million for comprehensive sexuality education. It will be re-introduced this year in both the House of Representatives and the U.S. Senate.

In 2002, the Title V abstinence-only-until-marriage program was up for reauthorization. While more than one year later, reauthorization is still pending, the House of Representatives did pass a version of the bill in 2002 that would have continued the Title V program without changes. The good news is that for the first time the merits of abstinence-only-until-marriage programs were debated in a Committee in the U.S. House of Representatives. Advocates of comprehensive sexuality education helped draft three amendments to the bill, all of which unfortunately failed.

The first amendment, proposed by Jane Harman (D-CA), would have followed the Republican-inspired dictum that states should have some flexibility in crafting their own programs. The Harman amendment proposed that while leaving the strict eight-point definition in place, states would also be permitted to design other interventions to best meet the programmatic needs in their states. The second amendment was offered by Lois Capps (D-CA) and would have added language to Title V requiring funded programs to be medically accurate. Finally, Henry Waxman (D-CA) proposed an amendment that would have required funded programs to be proven effective as a condition of funding. These strategies will likely be revisited as Title V reauthorization is again considered this year.

Mirroring a positive trend in the states, a bill has been introduced in the U.S. House of Representatives that would require sexuality education to be medically accurate. Rep. Luis Gutierrez (D-IL) introduced H.R. 802 in February 2003. The bill would prohibit any elementary or secondary school receiving federal funds from providing information that is not medically accurate in human development or sexuality education course material.The bill is in committee and no additional action has been taken.

On the State Level. In the last decade, many states have embraced the federal government's incentives to establish abstinence-only-until-marriage programs. In fact, many states have adopted laws which contain some or all of the federal government's strict eight-point definition of "abstinence education." Fortunately, some states have also resisted the strict guidance. A positive legislative trend in the last decade has been the introduction of medical accuracy and comprehensive sexuality education or family life education bills as a way of countering the abstinence-only-until-marriage watershed.

Because of the propensity of some abstinence-only-until-marriage curricula to use medically inaccurate information, many states have introduced legislation that would require that any sexuality education taught in the state be medically accurate. A decade ago, hills like this would have seemed preposterous. Now, however, they are needed as an effective way to at least ensure that young people are receiving truthful information about sexuality, as well as disease and pregnancy prevention. Since the beginning of 2003, 15 bills that address medical accuracy requirements have been introduced in state legislatures. (27)

WHAT CAN WE EXPECT IN THE FUTURE?

Since AFLA came into being in 1981 one of the biggest concerns about abstinence-only-until-marriage programs involves religious content. In 1985, a U.S. District Court found AFLA to be unconstitutional because of its violation of the Establishment Clause, which requires separation of church and state. In 1993, 12 years after filing suit, an agreement was reached which placed conditions on administration of the grants and the AFLA grantees for five years. Specifically, the settlement required AFLA grantees to submit curricula to the Department of Health and Human Services for review and "consideration of whether the curricula teach or promote religion and whether such materials are medically accurate." A decade later, in a case in Louisiana, religion was again the subject of a lawsuit in which abstinence-only-until-marriage programs, this time funded through the Title V block grants to states, were found to be violating the Constitution. The last decade, which started with a judicial decision finding that abstinence-only programs were unconstitutionally promoting religion, ended with a similar decision. Apparently, the lesson has not been learned. The unconstitutional promotion of religion is one of the issues to watch in the coming decade.

Other strategies to watch for include continuing legislative efforts to require medical accuracy and comprehensive sexuality education. Legislative efforts on the other side--requiring abstinence-only-until-marriage-are also likely to increase.

As a poll by the Othmer Institute found, people are often appalled when they learn what abstinence-onlyuntil-marriage programs are teaching our young people. (28) As mainstream America gets involved, the next decade could be one of great successes for advocates of adolescent sexual health.

References

(1.) Before 1996, when Title V was enacted, the federal government provided money for abstinence-only. With Title V. however, the definition of" abstinence-only education" included specific references to mar riage. Any federal funding for abstinence after 1996, therefore, is referred to as -abstinence-only-until-marriage" funding to recognize that significant switch in policy.

(2.) See Citizens for Parental Rights v. San Mateo County Board of Education, 124 Cal. Rptr. 68 (Cal. Ct. App. 1975), appeal dismissed, 425 U.S. 908 (1976); Hobolth v. Greenway, 218 N.W.2d 98 (Mich. Ct. App. 1974); Hopkins v. Hamden Board of Education. 289 A.2d 914 (Conn. C.R 1971). appeal dismissed, 305 A.2d 836 (Conn. 1973); Medeiros v. Kiyosaki, 436, 478 P2d 314 (Haw. 1970); and Cornwall v. State Board of Education, 428 E2d 471 (4th Cir.), cert. denied, 400 U.S. 942 (1970).

(3.) See R. Saul, "Whatever Happened to the Adolescent Family Life Act?" The Guttmacher Report. Volume 1, No. 2. http://www.guttmacher.org/p pubs/journals/gr010203.html accessed on July 27, 2003.

(4.) It is important to note that there, is no methodologically sound, peer reviewed research demonstrating that abstinence-only-until-marriage programs are effective at reducing sexual activity, and teen pregnancy among young people.

(5.) See "Exclusive Purpose: Abstinence-Only Proponents Create Federal Entitlement in Welfare Reform," SIECUS Report, 24. No. 4 (1996).

(6.) All states but California currently accept Title V federal funding for abstinence only programs.

(7.) State Policies in Brief" Sexuality Education, The Alan Guttmacher Institute.July 1, 2003.

(8.) Ibid.

(9.) Ibid.

(10.) Ibid.

(11.) Ibid.

(12.) Ibid. Florida also authorizes localities to teach about contraception.

(13.) Ibid.

(14.) C. Wetzstein, "Search Begins for 'Say No' Programs," The Washington Times, January 16. 1997.

(15.) While California has rejected the Title V funds, organizations within the state are recipients of SPRANS-CBAE grants.

(16.) Maine also enacted one of the most comprehensive family life education bills in the country in 2002.

(17.) The Department of Education Organization Act (Section 103a), the Elementary and Secondary Education Act (Section 14512), Goals 2000 (Section 319(b)). and the General Education Provisions Act (Section 438).

(18.) See R. Benson Gold and E. Nash. "State Level Policies on Sexuality. STD Education"The Guttmacher Report,Volume 4, Number 4, pp. 4-7.

(19.) Ibid.

(20.) Landry, et al., "School District Policies on Abstinence Promotion and on the Provision of Information about Contraception," Family Planning Perspectives,Volume 31, Number 6, pp. 280 286.

(21.) National Survey of Public Secondary School Principals on Sex Education, (Menlo Park. CA: Kaiser Family Foundation. 1999).

(22.) Ibid.

(23.) Ibid.

(24.) Ibid.

(25.) Ibid.

(26.) See M. Kempner,"Trends 1999-2000 Sexuality Education is Debated as Restrictive Programs Gain Popularity," SIECUS Report,Volume 28, Number 6.

(27.) Senate Bill 1142 in Arizona; Senate Bill 71 in California: House Bill 136, Senate Bill 876, and House Bill 872 in Hawaii; Senate Bill 99 in Illinois; House Bill 1862 in Indiana; House Bill 468 in Iowa: House Bill 323 in Massachusetts: House Bill 4646 in Michigan; House Bill 2772 in New Jersey: House Bill 554 in New Mexico: House Bill 8599 in New York; House Bill 873 and Senate Bill 618 in North Carolina; House Bill 6070 and Senate Bill 863 in Rhode Island; House Bill 1178 and Senate Bill 5314 in Washington State: and House Bill 2907 in West Virginia.

(28.) Othmer Institute 2002 poll of 800 adult voters nationwide. Conducted by Lake Snell Perry & Associates. See http://www.oth merinstitute.org/press/press5.html.

Kate B. Smith, J.D. Siecus Assistant Director of Public Policy