Intended for healthcare professionals


US state rejects federal funding for abstinence only sex education

BMJ 2005; 331 doi: (Published 29 September 2005) Cite this as: BMJ 2005;331:715
  1. Janice Hopkins Tanne
  1. New York

    The liberal northeastern state of Maine has decided not to accept federal funding for school sex education because the federal programme requires teachers to promote abstinence until marriage and mutual faithfulness afterwards rather than provide comprehensive sex education. California and Pennsylvania have also rejected funding for abstinence only sex education.

    The American Civil Liberties Union has launched a national campaign to urge officials in 18 states to reject abstinence until marriage education. It said many abstinence only programmes contained inaccurate information.

    Maine turned down $165 000 (£93 000; €137 000), nearly a third of its “family life education” budget for school sex education.

    Dora Anne Mills, Maine's director of public health, said that rules about what states can tell young people—if the states wanted federal funding—had become more restrictive since the funding law was passed in 1996.

    • The rules to be taught about sexual abstinence outside marriage are:

    • Abstinence provides social, psychological, and health gains;

    • Abstinence is the expected standard for all school age children;

    • Abstinence is the only certain way to avoid pregnancy out of wedlock, sexually transmitted diseases, and associated health problems;

    • Mutually faithful monogamy in the context of marriage is the expected standard of human sexual activity;

    • Sexual activity outside marriage is likely to have harmful psychological and physical effects; and

    • Bearing a child out of wedlock is likely to have harmful consequences for the child, its parents, and society.

    Lessons must also teach young people how they can reject sexual advances and how consuming alcohol and drugs increases their vulnerability. They must also teach the importance of “achieving self sufficiency” before engaging in sexual activity.

    When the funding law was first passed, Dr Mills said, states could use federal funds to focus on just some of the main points. Maine prepared television advertisements urging teenagers to postpone sexual activity and to achieve self sufficiency before engaging in sex. However, she said states are now required to emphasise all eight points equally to get federal funds.

    “This completely violates our comprehensive approach to family life education,” she said. Maine's “family life education” programme dates back 20 years and has been endorsed by Democratic, Republican, and independent governors and by the state legislature. The programme is taught from kindergarten through to the 12th grade (the last year of high school) at appropriate levels. It includes learning about body parts, about puberty, and refusal skills.

    When the programme began, Maine had one of the highest rates of pregnancy among white teenagers in the nation. Since then it has seen the steepest decline in numbers of teenage pregnancies in the country: from 3000 in 1985 to 1600 at present. Maine has also seen a steep decline in abortions.

    “This has been a tremendous public health success,” Dr Mills said. She called it “quite shameful” that funds for the comprehensive approach had diminished.”


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