Morals in Education Sex Education Contributors: Claire Abe Karen Anderson Caitlin Bank Amanda Bodwin Katie DeFazio

WHERE IS THE CONSISTENCY? In America, we live in a divided country when it comes to Sex Education Some kids receive no information, some receive minimal information to prepare them for the real “thing”, and others rely solely on media or are told “just to say no” to sex. WHERE IS THE CONSISTENCY? http://www.guttmacher.org/pubs/journals/3018898.html

Chart from Guttmacher Institute

Background History of Sex Education Programs Concerns around the growing numbers of unintended teen pregnancies in the 1970s and later HIV/AIDS in the 1980s led conservative policymakers in the federal government to create taxpayer funding for abstinence-only-until-marriage education programs starting during the Reagan Administration in 1981 (Sexuality Information and Education Council of the United States, 2014). In 1996, Section 510 of Title V of the Social Security Act was passed that mandated federal funding for abstinence only education (AOE). This explicitly forbid schools that received AOE education funding from teaching about contraception methods (Jeffries, Dodge, Bandiera, & Reece, 2010).

Background History Continued... Grant funding for AOE became available in 1998, but by 2009, 25 states rejected the funding (Doan & McFarlane, 2012). During this period, millions of dollars were put into funding AOE programs, yet no independent study could verify any significant findings of the effectiveness of AOE. This in addition to the lack of accurate information about sexuality, sexual health, and preventative measures caused a movement for comprehensive sexuality education. Federal funding for AOE programs expired in 2009 but was reinstated in 2010 at a two thirds reduced funding level and continues today. Also in 2010, the Obama Administration’s Affordable Care Act introduced the Personal Responsibility Education Program (PREP) that replicates effective, evidence-based program models and provides funding for comprehensive sex education (Sexuality Information and Education Council of the United States, 2014). States can now choose which program to implement and receive federal funding.

ABSTINENCE-ONLY SEX EDUCATION

Abstinence Education under Social Security Act Title V Sec. 510 (2) For purposes of this section, the term “abstinence education” means an educational or motivational program which— (A) has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity; (B) teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; (C) teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems; (D) teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity; (E) teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; (F) teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society; (G) teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and (H) teaches the importance of attaining self-sufficiency before engaging in sexual activity.

Proponents of Abstinence as part of “Character-based Sex Education”: Lickona (2004) calls for abstinence to be a part of “character-based sex education” that schools should implement. This would include the following points: 1.Abstinence is “the only medically safe, emotionally healthy, and morally responsible choice for unmarried teens” 2.The physical, emotional, and ethical limitations of condoms 3.Abstinence “is the best marriage preparation” – and serves the individual, future spouse & children, community and country 4.Abstinence develops “self-discipline, respect, care, and other important qualities of character” 5.“If you haven’t waited in the past, you can make a different choice in the future” (p. 106)

Boonstra (2009) evaluated the research on abstinence programs for the Guttmacher Policy Review and highlighted the following studies: −In 1996, the ‘Federally Funded Adolescent Abstinence Promotion Programs: An Evaluation of Evaluations, concluded that “the quality of the AFLA evaluations funded by the federal government vary from barely adequate to completely inadequate.”’ (pp. 7-8) −Congress required an evaluation of AOE programs and in 2000, after following 2000 teens for up to six years after taking part in four model AOE programs, Mathematica Policy Research found that these programs did not produce a “statistically significant beneficial impact on young people’s sexual behavior” (p. 8) −In 2009 researcher Douglas Kirby of the National Campaign to Prevent Teen and Unplanned Pregnancy argued that “there does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence, or reduces the number of sexual partners.” (p. 8) Regardless of the dirth of research demonstrating AOE’s effectiveness, federal and state funding continued to grow from 1996 until 2008. Recently, there was a study that suggests AOE might have potential in delaying sexual intercourse in young teens.

Research supporting efficacy of Theory-based Abstinence Education Jemmott, Jemmott & Fong (2010) studied the results of 662 African American 6th and 7th graders offered randomized abstinence-only and comprehensive sex ed. interventions. A smaller percentage in the abstinence-only group reported sexual intercourse 24 months after the intervention (33%) than in those receiving comprehensive interventions (~42%). See a chart of their results on the following slide. While some looked on this as vindication of AOE programs, the authors of the study were quick to point out some differences in their approach and AOE as defined under Title V.

Theory-based Abstinence-Only Intervention from the study of Jemmott, Jemmott & Fong (2010) Incorporates: •Effective aspects of HIV/STI risk reduction •Research on population and behavior change theory •Motivations of participants •Skill building activities Does not: •use ‘moralistic’ tones –i.e. ‘wait until ready’ not ‘wait until marriage’ •Stress the inadequacies of condoms

Comments on Jommett, Jommett & Fong (2010) findings: “A common concern about abstinence-only interventions is that they have the unintended effect of reducing condom use, ie, that children exposed to such interventions are subsequently less likely to use condoms if they have sexual intercourse. [20,21,36] However, a randomized controlled trial [37] and a literature review [38] found no effects of abstinence interventions on condom use. Similarly, in this trial the abstinence-only intervention participants did not differ in self-reported consistent condom use compared with the control group. “The results of this trial should not be taken to mean that all abstinence-only interventions are efficacious. This trial tested a theory-based abstinence-only intervention that would not meet federal criteria for abstinence programs and that is not vulnerable to many criticisms that have been leveled against interventions that meet federal criteria. [19,20,36] It was not moralistic and did not criticize the use of condoms. Moreover, it had several characteristics associated with effective sexual risk-reduction interventions. It was theory-based and tailored to the target population based on qualitative data and included skill building activities. It addressed the context of sexual activity and beliefs about the consequences of sexual involvement derived from the target population.” (p. 158)

Weaknesses of Abstinence Only Education • Abstinence Only Education (AOE) curriculum presents incomplete, one-sided, often inaccurate information using fear and moral shaming tactics instead of data to push the abstinence-only-until-marriage agenda. • AOE will often exaggerate the risk and misrepresent consequences without providing important strategies of prevention beyond abstinence. • There is no credible evidence that proves that effectiveness of AOE • AOE curriculum does not teach any information on contraception methods. Many youth are not educated on the many health issues that are preventable if contraception was taught. As a result: ◦Youth ages 13-24 account for over one-fourth of the approximate 50,000 new HIV infections diagnosed each year. ◦ 15-24 year-olds account for about 50% of the estimated 20 million new STDs contracted each year. (Sexuality Information and Education Council of the United States, 2014)

COMPREHENSIVE SEX EDUCATION

What is Comprehensive Sexuality Education (CSE)? Comprehensive sexuality education helps students gain a positive view of sexuality, provides them with complete sexual health information, strategies, and skills, and encourages them to make sound decisions in the present and in the future. Comprehensive sexuality education has 4 main goals: 1. To provide accurate information on human sexuality 2. To help students develop and understand their own personal attitudes, values, and beliefs about sexuality. 3. To support the development of relationship and interpersonal skills to students. 4.To help youth exercise their responsibility in regards to sexual relationships, which includes addressing abstinence, peer pressure to enter into sexual activity, and the use of contraception. (Community Action Kit, 2014)

Proponents of Comprehensive Sex Education In a 2006 position paper published in The Journal of Adolescent Health Santelli, Ott, Lyon, Rogers, and Summers argue that abstinence should be encouraged as a healthy option for teenagers, but that “Providing ‘abstinence only’ or ‘abstinence until marriage’ messages as a sole option for teenagers is flawed from scientific and medical ethics viewpoints.” (p. 83) They examine the efficacy, ethical aspects, and health implications of abstinence-only sex education.

Santelli et al. (2006) findings: •“Efforts to promote abstinence, when offered as part of comprehensive reproductive health promotion programs that provide information about contraceptive options and protections from STIs have successfully delayed initiation of sexual intercourse.” •“Abstinence-only programs are ethically problematic, being inherently coercive and often providing misinformation and withholding information needed to make informed choices.” •“Abstinence-only education programs provide incomplete and/or misleading information about contraceptives, or none at all, and are often insensitive to sexually active teenagers.” •“Federally funded abstinence-until-marriage programs discriminate against gay, lesbian, bisexual, transgender and questioning youth, as federal law limits the definition of marriage to heterosexual couples.” (p. 83)

Research comparing AOE with CSE Kohler, Manhart, and Lafferty (2008) studied 1719 never- married, heterosexual 15-19 year-olds who took part in the National Survey of Family Growth and compared those who received abstinence-only, comprehensive, and no formal sex education. They found that: •“Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.” •“Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD.” (p. 344)

In their review of the research and literature, Kohler, Manhart & Lafferty (2008) also reported: “Our study is not the only recent work to suggest that abstinence-only education may not reduce sexual behaviors among teens. A randomized controlled trial of four federally funded abstinence programs found no significant decrease in number of partners or risk of STD and pregnancy, and no delay in sexual debut. Similarly a systematic review of 13 trials found that abstinence-only programs were not associated with reductions in sexual risk behavior or diagnosis of STDs. Another review showed that all but one of 11 programs that taught about contraception resulted in no increase in sexual activity. Other studies have shown that sexual activity is not increased with teaching about condoms and HIV/AIDS. (p. 350)

Continued: “Although one study found later sexual debut was associated with abstinence-only virginity pledging, the majority of adolescents who made virginity pledges ultimately broke their “promise” and engaged in sexual intercourse before marriage [17]. In addition the risk for STD was not significantly different between pledgers and non-pledgers, and sexually active pledgers were significantly less likely to use condoms at first sex than were non-pledgers. Similarly our data comparing abstinence-only and comprehensive education revealed no significant difference in initiation of sexual intercourse, while detecting a decreased likelihood of teen pregnancy among those who received comprehensive education. This suggests that preteens and teens who receive abstinence-only education may engage in higher risk behaviors once they initiate sexual activity.” (Kohler, Manhart & Lafferty, 2008, p. 350)

Strengths of Comprehensive Sex Education • Comprehensive sexuality education (CSE) provides complete, evidence-informed, medically accurate, and developmentally-age-appropriate information on sexual health. • CSE provides knowledge and skills necessary to avoid STDs and unintended pregnancy. • CSE allows students to access the information they need to make an informed decision around their beliefs and values regarding sex. • Programs like CSE can include information on both abstinence and contraceptives and has been found effective in helping delay sexual activity and increases the use of contraceptives (Sexuality Information and Education Council of the United States, 2014).

ETHICAL ISSUES AROUND SEX EDUCATION

Why is Sex Education an Ethical Issue? • Abstinence-only-until-marriage may be an expected standard and Comprehensive Sexuality Education (CSE) can go against many students' and families' religious, cultural, or personal beliefs. • Because many religions believe in abstinence-only-until-marriage, and are against homosexuality, abortion, and contraception, the information taught in the CSE curriculum is contrary to these beliefs and does not take into account religious values. • Parents have a right to decide and have input on what information their children are being exposed to, especially regarding morals, ethics, and values. Parents should be included in a balanced and fair process of deciding on sex education curriculum (Lickona, 2004). Schools that decide to implement any sex education curriculum without parent involvement undermines the parents and their family’s values or religious beliefs. • While not statistically proven, proponents of abstinence-only education state that CSE is unethical because they believe it will increase sexual activity and the resulting negative consequences in youth.

Ethical Issues Continued... • The US Supreme Court ruled in the First Amendment that public schools must be neutral in all matters regarding religion. Therefore it cannot promote nor inhibit religion, and must stay neutral between religion and non-religion (Nord & Haynes, n.d.). Therefore if schools are teaching abstinence-only-until-marriage curriculum which is based on many religious ideological values, is this then excluding secular values by not allowing the teaching of comprehensive sex education? • Additionally, is it problematic that the federal government gives taxpayers’ money to schools to implement AOE with a specific restriction that they cannot teach about contraceptives, which is a secular approach to sex education? • By allowing students to opt out of CSE, are we putting them in danger of risky behavior and consequences that CSE is trying to help students avoid. Furthermore, does it become a public health issue that we are putting others at risk by not teaching our students about safe sex and the prevention of HIV and other STDs through contraceptives (Simson & Sussman, 2000)? • On the other hand, if we forced the implementation of CSE, are we then coercing students to do something that is forbidden or to refrain from something that is mandated by their religion (Simson & Sussman, 2000)?

Attempts at Solutions There are multiple issues revolving around the sex education controversies. Regardless of what each state requires to be taught, there will always be some parents who push back and are unhappy with the way sex education is designed in their child’s school.

Public Controversies Regarding Abstinence Only vs. Comprehensive Sex Education •Anytime a subject as sensitive and complicated as sex education is discussed, there will inevitably be controversies surrounding it. •The approach in which we teach sex education can be seen differently between specific family dynamics, cultures, religions, and even generations; all are entities present within any given community. •When differences do come up it is imperative that all parties involved remain ethical, compassionate, and cooperative while a solution is developed. State Law is usually the deciding factor in most public controversies.

Public Controversies •Complaints from Parents –Kathy Dawson, mother of Emily Dawson, from Edmonton, Canada filed a legal complaint against a two day Abstinence-Only sex education seminar in which the instructor allegedly taught that, “60 percent of boys carry the HPV sexually transmitted infection under their fingernails, gonorrhea can kill you in three days, and that girls should dress modestly to avoid inflaming boys” (Simons, 2014). –This matter occurred during the 2013-2014 school year and the final actions have yet to be decided. This situation has caused a wave of concern amongst schools and their decisions in which sex education programs to implement based on content, instructional procedures, and underlying tone.

Public Controversies •Disputes Between Parents –In St. Charles, Missouri, parents of middle school aged children, Tim Schmidt and June Tiller, disagree on the textbook used for their children’s sex education class (USA Today, http://www.usatoday.com/story/news/nation/2014/05/06/parents-angry-graphic-sex-education- book/8755185) reports: •Tim Schmidt stated, “It has a lot of explicit drawings. Cartoon images, life-like cartoon images. A look of nudity. It actually shows people having sex." •June Tiller commented, “I feel like if the school teaches them this, and they have this information available, it's very important, and it will help keep them safe.” - Tim Schmidt felt that the text book, “Perfectly Normal” presented too much of an explicit, comprehensive sex education approach and preferred for the curriculum to be modified into more age appropriate content. While Tiller and other parents accepted the book, Francis Howell School District did remove the text from classrooms but arranged for the book to remain available in the library as a resource for parents.

Public Controversies •Within School Communities –School board members in Franklin County, North Carolina ordered chapters on sexual behavior, contraception and AIDS and other sexually transmitted diseases (STDs) cut out of its health textbook for ninth graders. –The deleted material, the board said, did not comply with a new state law requiring public schools to teach abstinence until marriage in their comprehensive health education program for students in kindergarten through ninth grade (Donovan, 1998). –School Board members in Vista, California voted to replace a Comprehensive Sex Education program with "Sex Respect: The Option of True Sexual Freedom," a fear-based, abstinence-only curriculum. –When the board's current attorney warned that "Sex Respect" might not meet California State guidelines because it included misleading and inaccurate information, was racially biased, and supported specific religious beliefs, School Board members hired a new attorney to create modifications to the “Sex Respect” curriculum that would bring it into compliance with state law (Pardini, 1998).

Public Controversies •Issues Occurring Between Faculty and Schools –Finding public records of disputes between faculty members and schools is a difficult task. There are a few possible reasons why teachers do not actively speak out against the sex education curriculum and approach their school has chosen to implement: •Teachers feel the obligation to be compliant with their place of employment’s procedures and philosophies •Creating possible discordance between faculty members •Drawing the School Board’s attention and a potential intervention with Council members •The implementation of Sex Education is typically a matter of state policy and therefore questioning it could result in legal action •Fear of losing their jobs

Implementing Sex Education

Suggestions to Teachers Must-Do’s BEFORE unit Open communication with parent before, during, and after sex education unit. Pre-discussion with parents regarding all topics covered. Allow for parent/student opt out Facts and statistics provided to parents regarding benefits of sexual education. Parent encouragement to supplement at home with the family’s religious values and beliefs Begin communication with your administrator to obtain support on the upcoming unit.

Suggestions for Teachers who find themselves in various Sex Education controversies Parent View #1: “Waiting until marriage to have sex ‘is the way God intended it to be.’ That’s how it’s taught in the Bible and those rules were not written for no reason (Masland, n.d.).” Religious Values ignored in a comprehensive sex education curriculum: Abstinence Homosexuality Abortion Birth Control and Contraception

Teacher Response to Parent View #1 “16% of teens have had sex by age 15, compared with one-third of those aged 16, nearly half (48%) of those aged 17, 61% of 18-year-olds and 71% of 19-year-olds”. We can not ignore the fact that students are having premarital sex and they need some education on preventative measures. We don’t teach our values, we teach everyone’s values – Teach without judgment. Values Clarification – “Students should act responsibly in this sense: they should survey their options, consider the consequences (on themselves and on others), and then act in a way that maximizes whatever it is that they value most (Nord and Haynes, n.d.).” Students should be taught about alternatives fairly including the major moral issue of religion – abortion and contraception. All of the major voices must be included in the discussion. Take a middle ground approach: Teach abstinence, but also the technological know-how with birth control and condoms. By teaching abstinence only, we as educators are not taking a wholesome approach nor teaching all viewpoints on the topic. Parents can supplement and reiterate religious values at home.

Suggestions for Teachers who find themselves in various Sex Education controversies Parent view #2: “Young people are going to learn about sex and our question has to be where do we want them to learn? From the media? From their friends? Or do we want them to learn from an educated responsible adult? (Masland, n.d.)” Parent concerned with a lack of deep and appropriate understanding of all aspects of sex education. They desire a more comprehensive education on the following: STDs/HIV Contraception options Abortion Homosexuality

Teacher Response to Parent View #2 There is currently a lack of curriculum/structure regarding sex education from a district, state, and federal level. What is enough and what is not enough? How are teachers able to make the decision without district support? Sex education teachers typically lack background education and knowledge on allowing them to provide adequate materials and lessons on all perspectives on sexuality issues. Where is the boundary between home/parent and school/teacher educational responsibilities?

The Ethical Dilemma There is a current dilemma that exists between “abstinence only until marriage” and a comprehensive sex education. In public schools, do we teach abstinence and the idea of waiting until marriage to have sex? OR Do we provide facts and details through a comprehensive sexual education without regards to religion expecting parents to supplement with their own religious values and beliefs at home?

Solutions to the Dilemma Religious Stance “Abstinence until marriage” mindset teaches children not to have sex as the only way to avoid becoming pregnant and getting sexually transmitted diseases. There is no discussion of contraceptives and is religiously motivated.

Solutions to the Dilemma Secular Stance Provide students with a comprehensive education regarding all avenues of sex allowing students to make an educated decision regarding their sexual actions.

Middle Ground Solution: What would an adequate sex education curriculum look like? Age appropriate – begin with health and anatomy in upper elementary and progress towards abstinence, birth control, and other controversial conversations regarding sexual education in high school including moral guidance. (Nord and Haynes, n.d.) Take moral and religious views seriously – fair discussion on all viewpoints. “The best way to do so is to implement character-based sex education” (Lickona, 2004).

Citations Community Action Kit. (2014). What is comprehensive sexuality education? Retrieved from http://www.communityactionkit.org/index.cfm Doan, A. E., & McFarlane, D. R., (2012). Saying no to abstinence-only education: An analysis of state decision-making. Publius: The Journal of Federalism, 42(4), 613-635. Donovan, P. (1998). School-based sexuality education: the issues and the challenges. Family Planning Perspectives, 3(4). Jeffries, W. L., Dodge, B., Bandiera, F. C., & Reece, M. (2010). Beyond abstinence-only: Relationships between abstinence education and comprehensive topic instruction. Sex Education, 10(2), 171-185. Guttmacher Institute. (2014, July 1). State policies in brief: Sex and HIV education. Retrieved August, 2014, from http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf Kohler, P. K., Manhart, L. E., & Laferty, W. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health, 42, 344-351. Retrieved July, 2014. Lickona, T. (2004). Character matters: how to help our children develop good judgment, integrity, and other essential virtues. New York: Simon & Schuster. Masland, M. (n.d.). Carnal knowledge: The sex ed debate. msnbc.com. Retrieved July 31, 2014, from http://www.nbcnews.com/id/3071001/ns/health-childrens_health/t/carnal-knowledge-sex-ed-debate/#.U9qBlDog-P8 Nord, W., & Haynes, C. (n.d.). The Communitarian Network: The Relationship of Religion to Moral Education in the Public Schools. The Communitarian Network. Retrieved July 31, 2014, from http://www.gwu.edu/~ccps/pop_moral.html Pardini, P. (1998). Fed mandate abstinence-only sex ed. Rethinking Schools Online, 12(4). Retrieved from http://www.rethinkingschools.org/restrict.asp?path=archive/12_04/sexmain.shtml

Citations Continued... Santelli, J., Ott, M. A., Lyon, M., Rogers, J., & Summers, D. (2006). Abstinence-only education policies and programs: A position paper of the Society for Adolescent Medicine. Journal of Adolescent Health, 38, 83-87. Retrieved August, 2014. Sexuality Information and Education Council of the United States. (2014). A brief history of federal funding for sex education and related programs. Retrieved from http://www.siecus.org/index.cfm?fuseaction=page.viewPage&pageID=1341&nodeID=1 Sexuality Information and Education Council of the United States. (2014). Support comprehensive sex education & adolescent sexual health promotion. Retrieved from http://siecus.org/_data/n_0001/resources/live/CSEFactsheet.pdf Simons, P. (2014, July 10). Simons: christian sex ed in public schools an infringement of human rights, say Edmonton mother, daughter. The Edmonton Journal. Retrieved from http://www.edmontonjournal.com/Simons+Christian+public+schools+infringement+human+rights+Edmonton+mother+daughter/10015901/story.html Simson, G. J., & Sussman, E. A. (2000). Keeping the sex in sex education: The First Amendment’s religion clauses and the sex education debate. Review of Law and Women’s Studies, 9, 265-297. USA, Social Security Administration. (n.d.). Social Security Act Title V Sec. 510 (b) Separate program for abstinence education. Retrieved from http://www.ssa.gov/OP_Home/ssact/title05/0510.htm USA Today. (2014, May 6). Some parents angry about graphic sex education book. Retrieved from http://www.usatoday.com/story/news/nation/2014/05/06/parents-angry-graphic-sex-education-book/8755185/