Challenging Dogma

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

Saturday, April 21, 2007

Depriving Teenagers of An Education: Why Abstinence Only Education Fails to Prevent Teenage Pregnancy - Stephanie Wood

The United States Lags Behind

Although teenage pregnancy rates in the United States have continued a steady—if slow—decline since 1990, the United States still has the highest rate of teenage pregnancy among industrial nations (1). The United States has responded to this problem through various interventions, one of the most controversial being abstinence only until marriage education. Since 1996, the Federal Government has been funding abstinence only until marriage education programs in the states through Section 510(b) of Title V of the Social Security Act (2). The Federal Government gives money for abstinence only education to states that agree to adhere to eight guidelines. One guideline mandates that programs teach that abstinence is the only certain way to avoid pregnancy and sexually transmitted infections (2). While most people would agree with this, the controversy lies in denying teenagers education on ways to protect themselves if they do decide to have sex. Some of the other guidelines, like one mandating that students be taught that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity, have also been a source of debate (2).

Funding abstinence-only-until-marriage education programs is not the way for the United States to lower its teenage pregnancy rate to that of other industrialized nations. Abstinence only education is inherently flawed because it fails to take into account other societal factors teenagers’ life, like friends, culture, family structure, and even teenagers’ cognitive development. When these other factors are considered, it becomes clear why abstinence only education fails to lower teenage pregnancy rates.

Friends Influences and Credibility

One of the most important problems with abstinence only education is that it fails to consider one of the biggest influences on teenagers’ decision-making processes: their friends. Teenagers spend much more time absorbing cultural ideas about sex through the media and socializing with their peers than they do in health class. Not only is the sheer amount of time spent around peers greater than the time spent in health class, but the value placed on the opinions of their peers is greater(3). Conformity to peer pressure is greater in adolescence than in childhood or early adulthood (3). Also, adolescents are more likely to have sex when their peers approve and when they believe their peers are also having sex (4).

The value adolescents place on the opinions of their peers ties in with the idea of normative social influence. Normative social influence states that a person will conform to obtain the rewards that come from being accepted by a group of people, while at the same time avoiding rejection from that group of people (5). Finding social acceptance is an important goal for adolescents, so simply being accepted by others is a reward in and of itself (3). All groups establish norms—standards of behavior that apply to all group members--and adolescent groups are no different (4). Although most teens do not have sex simply in order to be accepted into a group, the normative social influence makes pre-marital sex a norm in the high school
culture (3).

When discussing normative social influence it is not only important to consider the possible rewards from being accepted by others, but it is also important to consider what could come from rejection. Peer rejection, especially in adolescence, can be an important obstacle in development (4). Rejection in adolescence can lead to loneliness and disliking school (4).
Peer pressure or influence is not always going to have an effect on teenagers’ behaviors, but it is most likely to have an effect when the standards for an appropriate behavior are not clear (4). This judgment method is applicable to teenagers’ decision making about whether to become sexually active or not. For example, students who learn abstinence only education are taught that having sex is immoral and damaging. At the same time, they are exposed to images in popular culture that say that sex outside of marriage is pleasurable and normal. In a situation like this, teenagers will look to their friends to help them find the answers.

Abstinence only education is also lacking because it fails to consider the elements of persuasion: communicator, content, channel of communication, and audience (5). The communicator, whoever is communicating the message, affects how the message is received. The most important factor about the communicator is credibility (5). Credibility is influenced by perceived expertise and perceived trustworthiness. Although health teachers may be perceived as experts, they may not be perceived as trustworthy.

Another important element of persuasion is the audience. Important factors to consider when discussing the audience are age and thoughtfulness. Teenagers are more likely to be skeptical of adults, and are less likely to think rationally about the messages they receive (3). Abstinence only education fails to analyze the ways that the elements of communication impact its message, and thus leaves most adolescents looking to each other in forming ideas about sexual behavior.

Irrationality in Decision Making

The fact that teenagers do not always make rational decisions also contributes to abstinence only education’s failures. Abstinence only education relies on the idea that when presented the possible consequences of pre-marital sex, teenagers will analyze them rationally and will stay abstinent to prevent those consequences. Adolescents are indeed cognitively more mature than pre-teenagers and are in some ways equipped to think rationally. This new cognitive ability, however, does not usually translate to decisions making skills (3). Thinking rationally involves assessing the pros and cons of each choice, assessing the likelihoods of different outcomes, and evaluating whether or not the choice would meet their goals (3). Proponents of abstinence only education expect teenagers to function in this manner, which is exactly the opposite of how teenagers think.

Abstinence only educators try to relate adolescents’ current sexual choices not only to short term consequences like pregnancy and sexually transmitted infections, but also to long term consequences. Some of these long term consequences that abstinence only educators espouse include how becoming a young parent might negatively affect the rest of adolescents’ lives, and also a claim that pre-marital sex will ultimately leave people emotionally unfulfilled. Teenagers have difficulty looking beyond the present moment. Although they may have goals, teenagers often cannot make clear connections between their current behaviors and their future goals—even goals that are not very far in the future (6).

Abstinence only education also fails to have an impact on adolescents because of the illusion of invulnerability. The illusion of invulnerability is something that happens in adolescence, and involves feelings of invincibility within teenagers (4). Teenagers tend to deny reality when making decisions about behaviors that could possibly cause harm (6). Research even exists that shows that adults often operate under this illusion of invincibility—believing that people can get pregnant if they have sex without protection, but it will not happen to them—but that adolescents operate under this illusion more intensely (6). Not only do teenagers believe in this illusion, but the more teenagers believe in this illusion, the more times they engage in risky behavior, and the less likely they are to change their beliefs (6).

Abstinence only education clearly fails to understand the developmental barriers that may lead adolescents to ignore their education, but it also fails to understand the needs of adolescents. As part of their development, teenagers have a very strong need for self-determination (6). Self-determination theory proposes that people are more motivated to make a behavior change when they believe they are doing it for personal, internal reasons, rather than for external reasons (6). Self-determination is especially a driving force during adolescence, because this is the time when people try to become more autonomous, and separate their will from the will of their parents and other authority figures (3). Self determination could be a barrier to the message of abstinence only education because students may feel like their teachers’ morals are being imposed on them, and may be likely to rebel (6).

Family Structure, Culture, and an Inability to Relate

Abstinence only education may also be difficult for some teenagers to truly grasp. One of abstinence education’s teachings is that in order to stay healthy and fulfilled, one must remain abstinent until married. Children may not observe this behavior in their homes if their parents are divorced, unmarried, homosexuals who cannot legally marry, or are part of some other family structure. This constitutes a substantial portion of the population. In 2005 the percentage of children up to age 17 who lived with a single parent, non married parents, or no parents was 33% . The 67% of children who lived with married parents includes parents who have divorced and remarried (7). These figures show that more than 33% of children age 17 and under live with a parent who they know either had sex outside of the confines of marriage, or who at least does not necessarily see marriage as a life long commitment.

Social Cognitive Theory says that knowledge acquisition and learning come from the observation of certain models (8). These models can be from the culture at large (specifically the media) or through interpersonal relationships, especially parent-child relationships. Observation of these models will teach children social rules and how to act in certain situations (8). The theorist who developed Social Cognitive Theory, Albert Bandura, said that children’s judgments of what behaviors are acceptable and what behaviors are unacceptable largely comes from observation, particularly of their parents (8). As part of Social Cognitive Theory, learners observe the consequences of the observed behavior, and will usually consider those consequences when making decisions about their own behavior. In Bandura’s famous Bobo doll experiment, children were shown a series of videos in which an adult would punch the doll in different ways. In some of the videos, the adult was reprimanded for hitting the doll. When children were shown the video of the adult being reprimanded, they were more likely to refrain from that behavior. But, if the children saw the adult enjoying hitting the doll, the children were much more likely to also hit the doll (8). This same theory can be applied to learning more complex attitudes, like attitudes towards sexual behavior (8). For example, if children observe their parents in a non-traditional family structure, and their parents still appear happy, the attitude that non-traditional family structures are acceptable will be reinforced. In this case, the children’s model—their parents—appears rewarded for the observed behavior.

There is no reason to believe that sexual attitudes and behaviors are learned in a different way than any other attitudes, and thus Social Cognitive Theory would still apply to the formation of sexual attitudes and behaviors (9). Attitudes regarding pre-marital sex are largely influenced by parents, and after parents, attitudes regarding pre-marital sex are influenced by modeling in the culture at large (9). As mentioned earlier, if adolescents are still confused about how to behave and what they really think, they will look to their peers for guidance. Clearly, if pre-marital sex has been modeled as an acceptable behavior, abstinence only educators are really fighting a difficult battle to convince teenagers to wait until they are married.

Implications for the Future

While schools, parents, and lawmakers debate the morality of what should be taught in sex education, teenagers are getting pregnant. Public health practitioners should embrace a new strategy for reducing the astronomical rates of teenage pregnancy in the United States. As part of adolescent development, teenagers strive to be respected and treated as adults. If sex educators tell teenagers the whole truth, and treat teenagers in a non-judgmental and non-condescending way, sex education will be more effective. Sex educators would be considering the teenager’s development, background, values, as well as the elements of persuasion, and teenagers would likely be more receptive. Abstinence based sex education teaches that abstinence is the only completely effective way to prevent pregnancy, but also teaches the variety of other ways to prevent pregnancy, and ways that teenagers can access them. Although abstinence based sex education certainly would have some problems of its own to work out, it seems like a promising way to incorporate the factors that abstinence only education neglects. Whatever the program, it is clear something needs to change in sex education so that adolescent development, upbringing, and influences are considered.


1. Ventura S. et al. Recent Trends In Teenage Pregnancy in the United States, 1990-2002. Hyattsville, MD: National Center for Health Statistics. 2. Advocates for Youth. Abstinence-Only-Until-Marriage Programs: History of Government Funding. Washington, DC: Advocates for Youth.
3. Berk L. Development Through the Lifespan. Boston, MA: Allyn and Bacon, 2007.
4. Kail R. Children and Their Development. New York, NY: Prentice Hall, 2007
5. Myers D. Social Psychology. New York, NY: McGraw Hill, 2005.
6. Hall P. et al. Risky Adolescent Sexual Behavior: A Psychological Perspective for Primary Care Clinicians. New York, NY: Medscape.
7. Forum on Child and Family Statistics. Family Structure and Children’s Living Arrangements. Washington, DC: Forum on Child and Family Statistics.
8. Mazur J. Learning and Behavior. Englewood Cliffs, NJ: Prentice Hall, 1994.
9. Barker L. Learning and Behavior: Biological, Psychological, and Sociocultural Perspectives. Upper Saddle River, NJ: Prentice Hall, 1997.

Labels: , ,


Post a Comment

Subscribe to Post Comments [Atom]

<< Home