Committee on School Health
Greg Fox, MD, Chair
Teaching Abstinence or Ignorance?
Wednesday, January 3, 2007
PATRICIA FLANAGAN & ANDREW SNYDER
AS PHYSICIANS, we have a duty to provide our patients with accurate information regarding their health-care needs. But what about Rhode Island schools and the education they provide to thousands of students each year? Do schools have a similar responsibility to teach accurate information? Our guess is that most everyone would answer yes: Schools are charged to educate, not to misinform. How then would you feel to learn that our schools were not only teaching inaccurate information, but that such information has the potential to endanger lives?
Unfortunately, that’s exactly what will happen now that the state Department of Education has decided to allow a curriculum developed by Heritage of Rhode Island back into our schools. The Department of Education issued an advisory in March alerting Rhode Island schools that a curriculum developed by Heritage was inconsistent with statewide education standards requiring instruction on sexuality, HIV, and sexually transmitted diseases to contain “accurate information.” At that time, the department made clear that the Heritage program “should not be offered as part of the public school health curriculum in Rhode Island schools.”
Fast forward to November, when the Department of Education went back on its promise to keep teens safe and healthy and announced that the Heritage curriculum could once again be taught in our schools. Heritage claims to have addressed the earlier problems in the curriculum; however, even a brief review of the material highlights major problems.
The Journal reported this news under the headline: “Sex ed that promotes abstinence is approved” (Dec. 4). The major concern about this curriculum is not that it promotes abstinence. Abstinence is an important and developmentally appropriate behavior. Many Rhode Island youths are abstaining from sexual activity and this should be encouraged. The concern is that it does not teach young people how to effectively protect themselves from the unwanted consequences of sexual activity when they eventually become sexually active. Worse yet, it imparts wrong information, using scare tactics to dissuade youth from using condoms and contraceptives if they are or should they become active.
The “improved” curriculum continues to contain inaccurate information concerning the effectiveness of condoms at preventing sexually transmitted diseases. It states that condoms only protect against chlamydia and gonorrhea 50 percent of the time, when the Centers for Disease Control and Prevention acknowledges that condoms “provide an essentially impermeable barrier.” But it doesn’t stop there: Heritage also gets the facts wrong when discussing condoms and pregnancy prevention. The curriculum says couples relying on condoms to avoid pregnancy have a 15 percent chance of becoming pregnant within a year. The World Health Organization cites that couples that consistently and correctly use condoms have only a 3 percent chance of unintended pregnancy. These examples are not trivial. By grossly misrepresenting the efficacy of condoms, Heritage hopes to dissuade young people from sexual activity. Unfortunately, it risks dissuading them from making responsible choices to properly protect themselves.
Heritage doesn’t just want teens to abstain from having sex. It teaches that sex is only appropriate within the confines of marriage, and Heritage is willing to use more than faulty and misleading statistics to scare teens into this goal. The emphasis on marriage as the only acceptable means for a sexual relationship and a pathway to improved health and happiness leaves many students in the cold. Gay and lesbian students, whom the state will not let marry, are taught that for them sex is never appropriate, while students living in non-traditional households (divorced, single parent, etc.) are left made to feel inadequate in their own home situations.
Discriminating against teens is obviously harmful, but failing to provide factual and complete information about sexual health can have lifelong consequences. Too many sexually active teens in Rhode Island do not have the information or the access that will help them prevent the unintended consequences of their actions. In 2005, there were 1,907 pregnancies among Rhode Island teens, and 1,117 babies were born to Rhode Island teens. Rates of sexually transmitted diseases such as chlamydia and gonorrhea are steadily rising in Rhode Island, and the highest age-specific rates are among 15-24-year-olds. Nationally, an estimated one-half of all new HIV infections occur among people under age 25, with the majority contracted through sexual intercourse.
Letting Heritage back in the schools has consequences far beyond a couple of incorrect facts. Teens need accurate information to help them make healthy lifelong decisions. Good research shows that sexuality education that includes both abstinence and information on contraception leads to delay of onset of sexual activity among those not yet active as well as improved responsible use rates of condoms and contraception among those who are or who choose to become sexually active. If the Department of Education cares about the health and safety of teens it should more carefully scrutinize the programs taught in our schools and once again remove Heritage from our classrooms. Teens and parents in Rhode Island deserve better.
Patricia Flanagan, M.D., is director of the Teen-Tot Clinic at Hasbro Children’s Hospital and current president of the Rhode Island Chapter of the American Academy of Pediatrics. Andrew Snyder, M.D., is a past president.