Challenging Dogma

...Using social sciences to improve the practice of public health

Saturday, April 21, 2007

Abstinence-Based Approaches to Reducing Teen Pregnancy: A Psychosocial Critique of How Virginity Pledge Programs Fail - Jacqueline Lamberto

By failing to address the broad and varied social and societal context in which teens live and draw from to make personal life decisions, Virginity Pledge Programs fall short as effective teenage pregnancy interventions by setting teens up for failure and neglecting to empower young people to make informed decisions about their health and lifestyle behavior.

Virginity Pledges and Their Lack of Empowerment
There are numerous adaptations of virginity pledges, but in essence, they are promises young people make to remain abstinent until marriage and are the cornerstone of most abstinence-only-until-marriage programs (1). Over a billion dollars has been poured into abstinence-only programs by the federal government, despite the fact that no abstinence-only-until-marriage program has been proven effective. Even more alarming and of significant importance, recent evidence (discussed later in depth), indicates that virginity pledge programs specifically may be having a negative effect on the health of the young people (1). In short, these negative health outcomes can be attributed to the lack of empowerment that virginity pledges offer those who are instructed by them to make informed and knowledgeable decisions about their own sexual practices. Virginity pledges undermine the use of contraception and disease-prevention methods, creating the stage for huge negative health implications for teens (1).

Setting Teens up for Failure
Virginity pledges set teens up for failure with their all or none approach to reduce teenage pregnancy. In accordance with the Social-Cognitive theory and the concept of self-efficacy, if someone believes that they will not succeed in a health behavior change, they are likely to not even make an attempt to make that change. Self-efficacy refers to an individual’s perception of their own ability to reach a certain goal. This theory reasons that people will be more inclined to attempt tasks if they believe they will be successful in accomplishing them (2). Therefore, if teens do not feel this is a reasonable strategy that they can succeed in – either due to the fact that they are no longer virgins, because they simply do not agree with the beliefs invoked by virginity pledges or they believe that resisting from sexual activity is a challenge they can’t win - they are extremely unlikely to take or keep the pledge. This means that if teens take the pledge and have sex before marriage, they’ve failed. If they decide not to take the pledge, they are failures. If they don’t know how to protect themselves from pregnancy or disease, or to effectively communicate their needs with their partner, public health fails in protecting the health of our young people and communities, although it is these young people who will suffer from the consequences the most.

More Harm Than Good
For teens who may participate in sexual acts other than vaginal sex believing that they are remaining virgins, this is another opportunity for teens to engage in risky sexual behaviors. Assuming that these teens will practice safe sex is an assumption that should not be made, as the virginity pledge programs give them no instruction or information on how to do so. For example, researchers have found that among young people who have not had vaginal intercourse, pledgers are more likely to have engaged in both oral and anal sex than their non-pledging counterparts (3). Among this same group of “virgins,” both male and female pledgers are six times more likely to have had oral sex than non-pledgers, and male pledgers are four times more likely to have had anal sex than non-pledgers (3).

If a teen has already had sexual intercourse or chooses to be in a sexually intimate relationship, not only does the essence of the virginity pledge not apply to them, there is no advice given for what to do in these circumstances to avoid pregnancy or prevent sexually transmitted diseases. Supporting this argument, one study found that young individuals who had taken the pledge were one-third less likely to use any form of contraception when they did become sexually active compared to their peers who had not taken the pledge (4). Thus, virginity pledges diminish the likelihood of future contraception use.

This behavior can be explained, at least in part, by cognitive dissonance theory. This theory states that individuals have a tendency to seek consistency among their beliefs and attitudes, otherwise referred to as cognitions. If there is a perception of incompatibility between two cognitions, dissonance occurs and the individual will take actions necessary to eliminate that dissonance (5). If someone is feeling conflicted about the beliefs invoked by taking a virginity pledge, and their own desire to have sexual intercourse before marriage, they may resolve that dissonance in beliefs by dismissing the virginity pledge altogether and become sexually active, perhaps even recklessly or carelessly. These individuals may identify so strongly then with the fact that they are a pledge breaker or non-pledge maker, and no longer a virgin, that they put themselves in the extreme other category of “failure,” “sexual deviant,” or promiscuous. Once they have made that leap and are planted firmly in the “sex camp,” they may feel that their actions moving forward have little or no implications because they have already dissociated themselves from the beliefs of the virginity pledges or the idea that they may succeed in keeping the oath. It then can become likened to when dieters have a few cookies and convince themselves that they have already ruined their diet, so why not have the whole bag? Teens who break the pledge and become sexually active may think, I’ve already done away with the barrier that was supposed to protect me from pregnancy and STDs and made the decision to no longer identify with virginity pledges, I might as well keep engaging in sexual activities, enjoy it, and experiment with it. If they believe their only chance at avoiding pregnancy or disease was abstinence, then they are very unlikely to seek contraception or demonstrate health-seeking behaviors, as idea which is supported by research. Not only are “pledgers” less likely to use condoms than their non-pledging peers, they are less likely to seek medical care and treatment for STDs, which furthers the rate of STD transmission. Not surprisingly, the researchers discovered then that in communities with higher proportions of pledgers, the overall STD rates were significantly higher (3).

Intricately Linked with Religious Ideology
The concept of waiting to have sex until entering a “biblical marriage relationship” is a faith based approach lacking in cultural competency. Not all teens are religious or hold the same belief system as the one invoked by the pledge. Making the pledge then becomes a meaningless and non-applicable suggestion in their view. Even for those pledges that have been reworded and do not explicitly mention the word “biblical” in their oath, at least two rather large assumptions are still being made that stem from a faith-based perspective.
The first assumption is that these young individuals value marriage as the only venue in which to express true commitment and physical love for their significant other, a belief held by many religions. Considering the percentage of adolescents who enter romantic relationships, date, fall in love, and/or become sexually active every year both domestically and internationally, and the fact that this behavior is condoned and viewed as a societal norm by a large majority of the US population and perpetuated in our media (turn on just about any TV show if you’re still not convinced), it is unrealistic to assume that teens value marriage as the only commitment worthy of sexual intimacy.

The second rather large assumption is that all individuals are heterosexual, or that the only acceptable sexuality is heterosexuality. Young gay and lesbian people do not have the right to marry in this county (with the exception of Massachusetts), and asking them to take a life-long vow of abstinence is not only unrealistic but extremely unjust. While pregnancy may not be a worry for homosexual teens, the transmission of sexually transmitted diseases and the establishment of responsible heath-seeking behaviors are very valid concerns. Virginity pledges offer no tools for how to engage in healthy, responsible, and protective sexual behaviors.

Adolescents: Rebellion, Peer Pressure and Biological Changes
Adolescents characteristically desire to do things they are instructed not to as an act of rebellion and establishment of personal identity. A pledge to not have sex may invoke the exact opposite response intended. In addition, this effect can be greatly magnified when a large number of adolescents feel strongly about a belief, attitude or behavior and may have considerable influence over their peers, both directly and indirectly. Teens may directly peer pressure one another to partake in certain attitudes or beliefs, or individuals may feel that pressure as a collective coming from their social surroundings and peer groups. To strengthen the conditions against abstinence, the surge of reproductive hormones that occurs as a natural and necessary part of sexual and reproductive maturity happens during the teenage years. This influx of new hormones have a variety of consequences, some of them being an increased libido, as well as changes in the brain as it is continuing to develop. As these changes are going on in the brain, risk taking behavior is increased, and inhibitions are lowered.

If all of these factors are combined, the end result could be a large number of teens with elevated libidos, low inhibitions, and high risk-taking behavior who rebel against the idea of virginity pledges, engage in sexual activity, and feel they are supported by their peers in doing so. Adding to this, those that choose to partake in the virginity pledge may feel like outcasts or socially unacceptable, which can add to the torment often characteristic of teenage years, and possibly even sway them to abandon the pledge, longing for acceptance from others.

In conclusion, virginity pledges are a failed public health approach as they neglect to empower young people to make safe, informed decisions about sex, are lacking in cultural competency, and have complete disregard for psychological, social and biological factors that greatly influence adolescent behavior and decision making.

1. Sexuality Information and Education Council of US: Public Policy
Office, Fact sheet. ‘I swear I won’t!’ A brief explanation of Virginity
Pledges. 2005.
2. Bandura A. Social Cognitive Theory: An agentic perspective. Annual
Review of Psychology 2001; 52:1-26.
3. Peter Bearman and Hanah Brückner, “After the promise: The STD
consequences of adolescent virginity pledges,” Journal of Adolescent
Health 2005; 36.4: 271-278.
4. Peter Bearman and Hanah Brückner, “Promising the Future: Virginity
Pledges and the Transition to First Intercourse,” American Journal of
Sociology 2001; 106.4: 859-912.
5. Festinger L. A Theory of Cognitive Dissonance. Stanford, CA: Stanford University Press, 1957.

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