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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 high school.

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 control.

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 seem commonplace.

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 feelings."

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 Public Affairs.

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