Federal agency orders funding emphasis on abstinence in teen pregnancy prevention
Sex ed advocates worry this will hurt the very people the program is intended to help
In one video, a bearded young man sits with an inflatable penis on a shelf behind him and talks frankly about sexually transmitted infections. In another, a young Muslim woman comfortably delves into steps and options to consider should viewers ever think they’re pregnant. In a third, a teenager who goes by “they” and “them” pronouns offers insights into the topic of gender identity.
This collection of live videos, and the hashtag #SexEdLive, appeared Monday on the Facebook page for Advocates for Youth, a national reproductive and sexual rights organization that champions full access to health information for young people.
Youth activists with the group introduced the live video initiative in response to a “Sex Ed Sit Out” protest earlier this week in which parents vowed to pull their children out of schools in opposition to sex education classes. The videos were part of their effort to fill the knowledge gaps.
But the timing of the videos served a second, unanticipated purpose: They were released on the heels of the Trump administration’s announcement of funding priorities to combat teenage pregnancy. Under the revised model, programs that focus on abstinence education will be favored with federal grant money.
Advocates for sexual education fear that the losers will be the teenagers the administration is purporting to help.
A form of ‘whiplash’
In 2010, under President Barack Obama, the US Department of Health and Human Services’ Office of Adolescent Health launched the Teen Pregnancy Prevention Program to funnel grant money to programs and innovations proven to help reduce teen pregnancies.
The goal was to replicate a wide range of evidence-based initiatives, explained Jesseca Boyer, a senior policy manager at the Guttmacher Institute, a leading research and policy organization focused on sexual and reproductive health. Grant recipients included programs offering comprehensive sex ed and incorporating lessons about both abstinence and safe sex, as well as programs to encourage youth development, child and parent communication, HIV prevention and more.
Conservatives have long railed against the program, claiming it’s misguided and ineffective, but with the election of President Donald Trump, it’s come under heavier fire.
The push for increased focus on abstinence is no surprise, given that the chief of staff for the office that oversees the program is Valerie Huber, who before joining Health and Human Services headed Ascend, a national pro-abstinence organization.
“It’s been an interesting road for sex education with this administration,” said Diana Thu-Thao Rhodes, the director of public policy at Advocates for Youth. Between this battle for comprehensive sex ed and matters like reproductive health access, she feels like every day she and other allies experience some form of “whiplash.”
In two versions of the federal budget, the Trump administration tried to eliminate the Teen Pregnancy Prevention Program altogether, Rhodes said, but Congress continued to fund it.
Last summer, the administration announced that it would prematurely terminate grant funding for 81 recipient programs, which focused on comprehensive sex ed. The move, which cut the support two years early, inspired a number of lawsuits. Last week, a judge in one of the cases ruled against the administration, deeming the early termination of the funding – which had already been granted – unlawful.
“We are disappointed with the ruling,” Health and Human Services spokeswoman Caitlin Oakley said at the time. “As numerous studies have shown, the Teen Pregnancy Prevention Program is not working. Continuing the program in its current state does a disservice to the youth it serves and to the taxpayers who fund it. Communities deserve better, and we are considering our next steps.”
Meantime, though, teen birth rates have continued to drop to record lows.
A report released Wednesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics says the US birth rate for mothers ages 15 to 19 fell 57% from 2000 through 2016. Looking specifically at births to females ages 10 to 14, researchers found a decline from 8,519 births in 2000 to 2,253 in 2016. The report showed that delayed and decreased sexual activity played a role, as did effective use of contraception by those who were sexually active.
“I’m sure everyone is lining up to take credit for the decline,” said Dr. Michael Cackovic, an ob-gyn who specializes in maternal fetal medicine at Ohio State University Wexner Medical Center.
“Religious groups would like to say girls aren’t having sex,” he said. “But the availability of contraception and the availability of long-term contraception are probably the biggest reasons for the historic drop.”
Words that confuse
Friday’s funding announcement for the Teen Pregnancy Prevention Program suggests a new tactic by Health and Human Services to disable the program, Advocates for Youth’s Rhodes said.
“Instead of eliminating [the program] completely, they’re rewriting and reimagining what the program will be,” she said. “They’re trying to dismantle it from the inside out.”
Up to $83 million will be available to public and private organizations, according to the latest announcement. In an email Wednesday, Health and Human Services said that the opportunities “are open to a broad field of teen pregnancy prevention organizations and approaches.”
But digging into the lengthy paperwork, totaling nearly 200 pages, it’s clear that an emphasis will be made on “sexual risk avoidance” – which the Guttmacher Institute’s Boyer wrote in a policy review is simply a rebranded term for abstinence-only.
In addition to emphasizing a delay in sexual activity, there’s a call for “sexual risk reduction,” which includes the cessation of sexual activity among teens who’ve become sexually active.
Boyer suggests that this terminology about risk reduction and avoidance is both confusing and dangerous. These phrases are commonly used in public health prevention strategies for risk-taking behaviors like illicit drug use or cigarette smoking, she wrote.
“But sexual activity is not like many other risky behaviors, which can be prevented altogether. By contrast, sexual activity is a natural and healthy part of being human,” she said. “By withholding life-saving sexual health information and skills, abstinence-only programs do nothing to prepare young people for when they will become sexually active and systematically ignore the needs of those who are already sexually active.”
What young people want
It was a high school teacher who recognized the needs of Sadie Hernandez, now 23, and her classmates. The teacher secretly showed them the Planned Parenthood website so they could learn about contraception. Making herself available to her students to answer questions was something the teacher did on the sly, out of fear of repercussions from administrators.
Hernandez, who grew up in Brownsville, Texas, remains grateful that an adult took a risk to talk to her and her peers. She went on to become an activist in reproductive health work. Today, she lives in Austin and works as a digital organizer for Planned Parenthood.
She was also one of the youth activists who appeared Monday on the Advocates for Youth Facebook page, where she addressed those who are sexually active and discussed ways to avoid risks, including unwanted pregnancies and unhealthy relationships.
“Sex can be super great, especially if you’re with somebody you trust,” she said in her video. “But regardless of who your partner is, sex comes with risks.”
Join the conversation
When she rattled off types of contraception that are out there, she gave a “shout out to the Depo shot,” or Depo-Provera, a birth-control injection administered every three months. “That’s what I use. I love it.”
She also cautioned viewers to take control of their own sexual health and to not do anything they don’t want to do.
It’s this sort of candor that young people want and need, Hernandez said Tuesday. She’s met too many people who have medically incorrect information, which is why the Trump administration’s efforts concern her.
“I honestly think it’s a misuse of taxpayer money,” she said. “Abstinence-only education demonizes sexual activity and makes young people afraid to go out and ask for help.”
For that reason, she and her peers will keep talking.