President Trump's proposed budget for the 2019 fiscal year includes many things: Cuts to social programs like Medicare and Medicaid, increasing the country's defense spending, slashing the food assistance program, and privatizing from federal airports to the International Space Station. (And much, much more.) No one expects the proposal to become law since it's just a blueprint outlining the administration's moral and financial priorities.
One of the components of the administration's moral agenda is the allocation of $75 million so the Health and Human Services Department can fund abstinence-only "and personal responsibility" sex-education programs. And that could have harmful repercussions for students across the country.
"At the federal level, there's not a mandate for sex ed or abstinence-only [education],"Jesseca Boyer, senior policy manager at the Guttmacher Institute, told Refinery29. "But where the federal government directs funding has a huge ripple effect on the policies that happen at the state, local, school district, and individual schools levels."
Since there's no universal standard for what sex education in the U.S. should entail, it can take many forms: Abstinence-only programs exist in many schools across the country, but comprehensive sex ed as we know it — one that teaches about things like birth control and sexually transmitted infections (STIs) — can also either mention or put an emphasis on abstinence anyway.
It shouldn't come as a surprise that the administration, famous for pushing back against reproductive rights and women's healthcare, would prioritize abstinence-only education: Trump's 2018 budget proposal called for a a $277 million investment to “extend abstinence education and personal responsibility education program” between 2018 and 2024, he appointed longtime abstinence-only advocate Valerie Huber to the HHS, and in the summer the administration cut the funding for teen pregnancy prevention programs and research.
Abstinence-only-until marriage programs (AOUMs), which heavily focus on "family values," teach young people that their only correct and moral path is delaying having sex until they're married. Students are taught that abstinence is the only surefire way to avoid physical consequences like unintended pregnancies or STIs, but also psychological and social consequences, too.
But the issue is that by focusing only on abstaining from pre-marital sex, these programs fail to address topics such as contraception, sexual orientation, safe sex practices, and healthy relationships. Some of AOUMs also engage in teaching affirmative consent and violence prevention in ways that perpetuate gender stereotypes, such as putting the onus on young women to be in control of young men's sexual behaviors.
Abstinence-only advocates argue that comprehensive sex education can lead to "promiscuity" and that AOUMs programs can curb that. But research has found that the main issue with teaching students only about abstinence is that it doesn't stop them from having sex — if anything, they just engage in unsafe, unhealthy practices.
"There are decades of research — whether that's meta-analysis or trials looking at whether or not abstinence-only intervention results in the type of outcome that proponents want, that it's young people delaying sex until marriage," Boyer said. "Time and time again, research has shown that these interventions are ineffective at that very singular goal, even removing other things like unintended pregnancies or HIV and other STIs. Just looking at the goal of delaying sex, the program fails on its own metrics."
A study published in the Journal of Adolescent Health last fall focused on the spread of AOUM programs in schools across the country. Researchers found that between 2002 and 2014 the number of schools that required human sexuality to be taught dropped from 67% to 48%. In the same period, the rate of schools with HIV prevention education programs went from 67% to 41%. And according to the study, since the mid '90s, the number of students who say they've been taught about contraceptive methods fell roughly 25%.
The Centers for Disease Control and Prevention, which recently looked into the scientific evaluations from 23 abstinence-only programs and 66 comprehensive risk reduction (CRR) programs, found inconclusive evidence on whether abstinence-only education helps young people delay having sex. But what it has found is that a comprehensive sex-ed programs had positive effects on when teens begin to have sex and its frequency, whether they use protection or not, whether they face STIs and unintended pregnancies, among other markers.
Research has found that in states such as Texas, where 60% of school districts have abstinence-only programs, the lack of comprehensive sex-ed is one of the factors that have led to the state's remarkably high teen pregnancy rate, which is between 40% and 50% higher than the national average.
But even though researches have called AOUMs programs a failure, many still advocate for abstinence-only education. That means that organizations like the Christian public policy ministry Family Research Council are happy with President Trump's budget priorities.
"FRC is pleased to see President Trump’s administration adopting a standard public health model of risk avoidance for this issue. We don’t promote risk reduction messages to youth regarding other risky behaviors such as drinking or drug use. We promote avoidance messages," Kelly Marcum, legislative assistant, told Refinery29 in a statement.
She continued, "We should teach youth to avoid risky sexual behaviors as the optimal approach to avoid the emotional and physical risks associated with sexual activity. Given the ten to one ratio in which the government is already funding sexual risk reduction programs over sexual avoidance programs, we think a renewed emphasis on sexual risk avoidance education policies by the Administration is warranted."
According to the Guttmacher Institute, in the last two decades the federal government has spent about $2 billion on abstinence-based education. Boyer, the senior policy manager at the organization, said that under the administration of President George W. Bush there was a significant increase on funding for these programs and when President Barack Obama came into office, his administration didn't completely move away from funding AOUMs but it was combined with a push for evidence-based adolescent health programs.
As Americans wait until later and later to get married (if they do end up getting married at all), the possibility of abstaining from sex until marriage seems increasingly unrealistic. And in any case, research has found that on average teens begin to have sex at around 17 or 18 — a trend that has remained steady since the early 1990s.
The Trump administration should understand that allowing students to receive comprehensive sex education — one that includes training on birth control, STIs, affirmative consent, and other issues — is likely to be the most beneficial for them. That way they'll have the information necessary so they can engage in healthy behaviors, when and if they decide to begin to have sex.