Abstinence-only education — encouraging adolescents to wait until marriage for sex — is making a comeback under President Trump .
In a marked departure from the previous administration, conservatives at the Department of Health and Human Services (HHS) are putting an emphasis on abstinence to reduce teen pregnancy rates.
“We definitely are seeing a shift,” said Kelly Marcum, a government affairs legislative assistant at the Family Research Council in Washington, which supports abstinence-only education.
“We’re really excited to see that the administration is giving some tools back to us to keep pushing that fight.”
So far, the administration has encouraged organizations applying for Title X federal family planning funds to include in their programs a “meaningful emphasis” on “the benefits of avoiding sex” when communicating with adolescents and to use programs that don’t “normalize sexual risk behaviors.”
The Trump administration also plans to release its first report early this summer as part of a $10 million research project looking at ways to improve sex education programs, with a focus on the impact of “sexual delay.”
And HHS officials last year cut short federal grants for organizations participating in former President Obama’s Teen Pregnancy Prevention Program, which supporters of abstinence-only education have said is ineffective.
All of those policy changes were overseen by Valerie Huber, an HHS official who had been the president of Ascend, a group previously called the National Abstinence Education Association.
“As public health experts and policymakers, we must normalize sexual delay than we normalize teen sex, even with contraception,” Huber said in 2016 while president of the organization.
“We believe youth deserve the best opportunity for a healthy future.”
Additionally, at the urging of groups supporting abstinence, Congress has tightened the requirements for receiving federal funding for abstinence-only programs and is expected to approve an increase of funding in an upcoming spending bill.
In contrast, Obama’s HHS poured resources into comprehensive sex ed, which can include lessons on contraception, disease prevention, healthy relationships and abstinence, and slashed funding for the abstinence-only programs that proliferated under the George W. Bush administration.
“I think this current administration is listening to parents on this issue. The previous administration really made it a partisan issue, unfortunately,” Marcum said.
“This shouldn’t be a partisan issue, but it was made into one. The messaging was that the conservatives wanted to impose their morals on others and tell kids not to have sex and that was very unfortunate.”
Supporters of comprehensive sex ed, however, say abstinence-only programs are ineffective and ideologically motivated. They say the programs failed under the Bush administration.
“We know from a body of evidence that abstinence-only programs don’t provide a full range of medically accurate and non-stigmatized education around contraception use,” said Jesse Boyer, senior policy manager at the Guttmacher Institute, a research and policy organization that opposes abstinence-only programs.
“It seems like we’re at a point where it’s important than ever to support education that provides a full range of sexual health information and education rather than reverting back to the failed practices that we wasted than $2 billion on over the past three decades.”
Advocates of comprehensive sex ed worry about the effect a shift toward abstinence-only education could have on plummeting teen pregnancy rates.
In 2015, there were about 23 births per 1,000 girls aged 15 to 19, a record low for the U.S., compared to 41 births per 1,000 girls in 2007.
“The unplanned teen pregnancy rate is at its lowest since 1990, but it’s hard to see how that trend will continue under Huber’s vision,” said Debra Hauser, president of Advocates for Youth, a sexuality education advocacy group in D.C.
Led by Huber’s Ascend, abstinence-only education has over the past few years been rebranded as “sexual risk avoidance education,” an approach proponents say mirrors other public health models that encourage the avoidance of a risk, like cigarette use.
These changes were reflected in a spending deal Congress passed in February. The $75 million Title V abstinence-only program was renamed “sexual risk avoidance education” (SRAE) and included new requirements that organizations receiving funding emphasize and prioritize the message that waiting until marriage to have sex is the best action.
While the programs still have to teach contraception, they can’t distribute it or demonstrate how it’s used.
Funding in recent years for these programs has also crept up, rising from $55 million to $85 million in fiscal year 2016.
And in a long-term spending deal likely to be approved later this month, the Senate has recommended a $10 million increase for a competitive grant for entities teaching SRAE, which would bring the total to $25 million.
Proponents of abstinence-only education are still pushing for changes at HHS and through Congress.
Ascend and other proponents of SRAE want to boost funding even for these programs and for other agencies, like the Centers for Disease Control and Prevention, to help “normalize sexual delay.”
They hope HHS redirects the $101 million in funding for Obama’s Teen Pregnancy Prevention Program to abstinence-only programs, something that can be done through a funding opportunity announcement, which is expected in the coming months.
“We’ve been really encouraged by the willingness of the administration to objectively look at what’s working and what’s not in sex education,” said Mary Anne Mosack, who took over as president of Ascend following Huber’s departure.
“It’s really our youth who are hanging in the balance, and we certainly can’t continue to do what’s been done.”