Letter from the Editor: Abstinence-Only-Until-Marriage Education ~ What is at Stake in the Debates? 

In 2001 the Surgeon General of the United States, Dr. David Satcher, initiated a national dialogue to increase awareness about sexual health and responsible sexual behavior. What have we learned since the surgeon general's call to action? What have researchers and practitioners discovered about the impact of abstinence-only-until-marriage programs? Many service providers and researchers agree that two years after the Surgeon General's Call to Action, the jury is still out about whether abstinence-only-until-marriage delays sex or reduces teen pregnancy. American Sexuality magazine strives to present a diversity of informed positions from both community based advocates and researchers. "Sex ed" has long been a controversial topic in the United States. How is it best to educate young people about sex and sexuality? The issue provokes emotions and opinions from all sides of the debate. With enhanced federal funding to abstinence-only-until-marriage programs,  both domestically and internationally , today the stakes are higher than ever. How do youth, families and communities get the information they need and the resources to implement that information? What are the global implications of U.S. funding priorities and what are the human rights impacts of these policies? In this issue of American Sexuality magazine we focus renewed attention on these contentious issues.

Abstinence-Only-Until-Marriage vs. Comprehensive Sexuality Education ? What's the Difference and What Works?

Abstinence-only programs maintain that abstinence from all sexual activity is the only morally correct option for unmarried young people. Comprehensive sexuality education programs emphasize the benefits of abstinence but also teach about contraception and disease-prevention methods. SIECUS and Advocates for Youth detail the differences between these approaches in "Toward a Sexually Healthy America." The federal government has also created an eight-point definition of abstinence, "A-H," to which programs must adhere in order to receive federal funding. Both definitions are included in this issue of American Sexuality.

Douglas Kirby, a leading researcher in the field of adolescent sexual behavior, has analyzed abstinence-only programs in detail. He writes in this issue of American Sexuality that "the jury is still out." He finds that "there do not currently exist any abstinence-only programs with strong evidence that they either delay sex or reduce teen pregnancy." This does not mean that abstinence-only programs are not effective, nor does it mean that they are effective...the great diversity of abstinence-only programs combined with very few rigorous studies of their impact, (means that) there is simply too little evidence to know whether abstinence-only programs delay the initiation of sex. The authors in this issue concur.

However, while the jury may still be out on the effectiveness of abstinence-only programs, the media continues to herald the "just say no" proposition. Newsweek (December 2002) declared that today's youth have embarked on a new, chaste, "sexual revolution," the antithesis of that of a prior generation. Martha Kempner, in this issue, suggests that "revolution" may not be the most accurate way of describing this phenomenon. She documents the rise of the abstinence-only movement in the U.S. and how its proponents have forwarded their agenda. Federal and state governments have increased funding for abstinence-only programs and the U.S. administration has made abstinence-only its official policy. According to Kempner, however, the tides may be turning as communities and educators insist on "medically accurate" sexuality education. The Alan Guttmacher Institute, for example, reports that over the course of the 1990s, there was a reduction in teen pregnancy. The report concludes that the "best strategy for continuing the declines in teenage pregnancy levels is a multifaceted approach."

Most Youth Want and Need Information:  Listening to the Voices of Young People

How do young people define "abstinence?" What are the sexual practices that fall into, or outside of, their definitions? In a recent flurry of media accounts in national newspapers, oral sex among teenagers appeared to be on the increase. The findings in "Oral Sex Among Adolescents: Is it Sex or is it Abstinence?" underscore the need to listen to the perspective of youth. Adults do not really know what behaviors teenagers consider to be "sex" and, by the same token, what they consider to be its opposite, abstinence.  In "Listen Up ~ Youth Talk about Sex and Abstinence," excerpts from interviews with young people show how youth are grappling with the complexities of these issues, at times making much more sophisticated arguments than national pundits and politicians.

Knowledge is Power: Families and Communities Need Support

For young people, as for adults, knowledge is power. The Surgeon General's call to action, excerpted here, highlights that not all families and communities are equally empowered to make use of the scientific information currently available. While parents should guide a child's sexuality education, families differ in their level of knowledge and comfort in discussing such issues, making school education a vital component in providing equity of access to information. Dr. Satcher believes that "churches and other community settings can play a role in providing such education." But what are the obstacles that community based organizations face when it comes to sexuality education and abstinence-only debates?

Planned Parenthood Federation of America, an organization at the forefront of reproductive issues for the greater part of the last century, has seen many changes in the U.S. political climate as well as cultural values about sexuality. In "Promoting Healthy Sexuality in an Era of Abstinence-Only Programs," Michael McGee finds that few educators have a community mandate to help young people develop healthy and satisfying sexual lives. If organizations that fund sexuality education programs focus only on changing the negative outcomes of intercourse, McGee asks, how do educators promote sexual health?

The "negative outcomes" of intercourse,  primarily STD transmission and unintended pregnancy, have often been at the center of the debate about sexuality education in the U.S. In "Citizenship Lessons: Sexuality Education in the United States," Jessica Fields and Celeste Hirschman describe that abstinence-only programs also convey messages about sexual identity. Federal guidelines mandate that sexual expression is safe only within the confines of monogamous heterosexual marriage. How are people who do not fit this model, including lesbian, gay, divorced, or widowed parents,  denied the right to live healthy sexual lives?

U.S. Abstinence-Only Policies Have a Global Impact: Sexuality and Human Rights

Our current global condition demands that we think beyond the borders of the U.S. Funding to fight the spread of HIV/AIDS around the world may be on the increase, but there are specific regulations attached to U.S.-supported projects. In "Abstinence Goes Global: The U.S., the Right Wing and Human Rights," Cynthia Rothschild describes how U.S. policies impact the global sphere and how advocates are embracing human rights. At both the international and domestic level, adovates are trying to ensure that disenfranchised people around the world receive the education they need.

From local school board meetings to United Nations conferences, the debate about abstinence-only-until-marriage vs. comprehensive sexuality education continues to fuel debate. The difference between abstinence-as-an-educated-choice versus abstinence-as-the-only-choice continues to test our cultural values.