Sex Education: Abstinence Only Doesn’t Fit the Bill

We recently started a series of articles to explain health care jargon and contextualize the information so all Minnesotans can engage in the broader discussion about health care. The previous article in the series described the current state of women’s health access and abortion in Minnesota.

Comprehensive sex education is so important, because it helps teens make responsible decisions to keep them safe and healthy. Comprehensive sex education can improve sexual health behaviors, as well as delay the onset of sexual incidence in a way that abstinence only programs have not accomplished historically. This is done by giving young people all of the tools they need to not only perform safe sex with contraception, but also teaching relationship skills to ensure that they approach sex with maturity and responsibility. This includes information on healthy relationships, abstinence, contraception, STIs and HIV/AIDS, and pregnancy. Minnesota law requires that all schools teach a sex education class that covers: information about sexually transmitted infections, HIV/AIDS education, and that abstinence is the only 100% effective method of avoiding unplanned pregnancies, STIs, and HIV/AIDS. Minnesota law also requires that all information be technically accurate.

Minnesota is one of 24 states to mandate sex education, one of 34 states to mandate HIV education, and it isn’t one of the states to require that schools depict same-sex relationships negatively. Minnesota also has lower teen pregnancy rates and rates of STIs like gonorrhea, chlamydia, and HIV than the average American teen or young adult. Sex education and sex related outcomes aren’t perfect in Minnesota, but they could be much worse.

Unfortunately, parents can opt their children out of a curriculum if they don’t agree with the content. This historically has allowed for school districts to teach the bare minimum beyond abstinence. Abstinence-only sex education is wholly inadequate in terms of impeding sexual activity, reducing STIs, and preventing unplanned pregnancies. A 2004 US Congressional report found that most abstinence-only curricula were misleading about contraceptive efficacy, overstated the risk of abortion, and promoted dated gender roles and social stereotypes. A 2008 study found that abstinence-only sex education had no correlation with teen pregnancy, and it did not reduce the likelihood of having vaginal sex, while comprehensive sex education reduced the likelihood of both. Meanwhile, there is a correlation between the rising STI rates in Minnesota and abstinence-only education, while comprehensive sex education can lower long-term STI rates. Additionally, claims that including contraceptives in sex education promote teen sex are misguided and ultimately counterproductive (this includes similar claims that the HPV vaccine somehow condones teen sex).

Today, sexual education courses in Minnesota could do more to educate teens on comprehensive sex education. Many schools focus more on the effects of unplanned pregnancies and the symptoms of STIs rather than how to correctly use contraception, explaining the importance of affirmative consent, or including lessons about non-heterosexual sex.

Without comprehensive statewide sex education, young Minnesotans often aren’t prepared for sexual activity, both during grade school and afterwards. The Minnesota Department of Health conducts a statewide survey of students to measure several behaviors, including sexual and reproductive health. In 2012, MDH published a hugely comprehensive report detailing sexual health, and some of the results speak to the lack of preparation of Minnesota students for engaging in sexual activity. The study found that the primary source of information regarding sex came from friends, not sex education programs. This doesn’t necessarily mean that friends are ill-informed, or that schools and teachers are the best source of sexual information (especially considering the uneven state of sex education), but the behaviors of students and young adults in Minnesota did not indicate a complete understanding of sex.

For instance, seniors in 2010 who were sexually active reported that they always used condoms during sex only 45% of the time, the lowest rate since 2001. Despite more widespread use of other contraceptives like birth control pills, IUDs, and contraceptive implants, condoms are still important not only as contraceptive devices, but also as the primary means of protection from STIs. On a related note, chlamydia rates continued to rise for Minnesota teens since 2007, while gonorrhea rates dropped from 2007 to 2011 before spiking again in 2013. These outcomes have had a significant cost to Minnesota, and there is evidence to suggest that better sex education would save Minnesota millions of dollars a year, and investing in family planning services can help as well.

Finally, sex education is a life-long exercise. Sex education needs to shift with changes in societal views of sexual orientation and gender identity, increasingly nuanced views of consent and sexuality, recognition of racial, ethnic, and geographic disparities in health care, and new pharmaceutical and contraceptive technologies. Banning the instruction of how to use contraception, or imposing heteronormative sex education on LGBTQ students doesn’t serve anyone positively, while learning about sex in school is one of the single best chances to teach Minnesotans about safe sex. After high school, opportunities to learn more about sex might not occur often, and they could be completely by chance. With all of the changes that come with time, technology, and understanding, sex education is truly a lifelong endeavor, one that needs to start off as comprehensively as possible. As a part of that lifelong education, getting a periodic influx of new information can better inform sexual behaviors well after we’ve left school.