Romantic Relationships 317SIDEBAR 9.2: Does Abstinence Only Work?
During the last decade, the federal government has spent more than $1.5 billion on abstinence-
only-until-marriage education among upper elementary and middle-school children (Young,
2009). There are a number of tenets of abstinence only education, the most notable of which
are (1) abstinence of sex until marriage is the expected standard, and (2) sexual intercourse out-
side of marriage is associated with harmful psychological and physical consequences. There is no
mention made of contraception or condoms, except with respect to failure rates.
In 2005 to 2006, four- to six-year follow-up data were evaluated from programs in Virginia,
Florida, Wisconsin, and Mississippi that had randomized students to abstinence only education or
a control group that did not receive this program (Trenholm et al., 2007). Results showed no group
differences in sexual behavior—49% of students in both groups had remained abstinent. The age of
sexual initiation was the same in both groups. There was also no group difference in unprotected
sex, which was surprising given that other research has shown that those who pledge abstinence
are less likely to use contraception when they break their pledges. Another study in which teens
were randomly assigned to an abstinence-only program or not had similar findings—no difference
in age at first sexual activity, no difference in unprotected sex, and no difference in the number of
sexual partners (Trenholm et al., 2008). A small study of African American students contrasted
abstinence only and comprehensive sex education with a control group and showed a modest ef-
fect for abstinence only programs to delay sex but only comprehensive sex education programs
reduced the number of sexual partners (Jemmott, Jemmott, & Fong, 2010). A study of over 12,000
15- to 19-year-olds showed that those who had had comprehensive sex education were less likely
to get pregnant than those who had received abstinence only or no formal sex education (Kohler,
Manhart, & Lafferty, 2008). Those who had had comprehensive sex education also were slightly
less likely to have engaged in sex than the other two groups. A review of the literature has shown
that there is little evidence for the effectiveness of abstinence-only programs and some evidence for
potential harm (Ott & Santelli, 2007). By contrast comprehensive sex education programs delay the
initiation of sex and reduce risky sexual behaviors.
In terms of the negative consequences of sexual intercourse among adolescents, it is note-
worthy that there is little evidence that premarital sex is associated with poor health outcomes,
unless the sex was forced, prepubertal, or with a relative (Else-Quest, Hyde, & DeLamater, 2005).
For females, negative consequences are more likely if the relationship dissolves soon after sex
and if the relationship lacks any kind of emotional commitment (Meier, 2007). However, in the
vast majority of cases, sexual intercourse among adolescents is not associated with negative men-
tal health outcomes. It seems unreasonable to have a program aimed at teaching that sexual in-
tercourse is reserved for marriage when the vast majority of Americans have had premarital sex.
By age 44, 95% of people have had sex before marriage (Finer, 2007). Given the high rates of
sexual activity before marriage and the fact that the United States has the highest rates of teen
pregnancy among developed countries, abstinence only education without information on effec-
tive contraceptive use seems to be a fairly irresponsible approach. Ott and Santelli (2007) suggest
that abstinence only education programs violate the human rights of adolescents by withholding
important information on contraception.
Sex education in schools is more likely to be opposed by people who are religious and
Hispanic (Chappell & Maggard, 2010). Yet, formal sex education seems to be associated with
delaying sex and using birth control when youth first have sex—and this is especially the case
among African American women (Mueller, Gavin, & Kulkarni, 2008).M09_HELG0185_04_SE_C09.indd 317 6/21/11 12:40 PM