Sexual Abstinence

Abstinence, choosing not to have sexual intercourse, is a common practice all over the world. Historically, abstinence has probably been the single most important factor in preventing pregnancy. Women and men of all ages deliberately choose to abstain. Abstinence is a normal, common, and acceptable alternative to sexual intercourse.

Although some use only sexual behavior to express their affection, sexual expression does not have to include intercourse. Most have a more expansive view of romance and find that pursuits other than intercourse give them pleasure and meaning. A walk with someone on the beach or watching a movie together are activities many find just as meaningful as sex. A "no" to sexual activity can also be a "yes" to deeper communication and mutual appreciation.

Human nature is such that sexual activity is intimately linked to one's emotional and psychological state. The ability to control one's sexual urges is part of human nature and also an important distinction between humans and animals. The practice of abstinence enables couples to exercise fidelity within a relationship. Many find that sexual activity is best when accompanied by the deep commitment of marriage and openness to the possibility of children. Not everyone is ready for this kind of commitment and total self-giving. For this reason, many women and men choose to abstain.

Abstinence is superb contraception, not to mention everyone's first method. Yet many unmarried couples find it easier said than done. For young people especially, it might be easier if high pressure situations, like automobile back seats or empty dorm rooms, are avoided. Abstinence is the only way to assure that pregnancy will not occur. It is also the only sure way to prevent the spread of sexually transmitted diseases, such as AIDS.

Top 10 Objections to Abstinence Education

1. “There’s little evidence that “abstinence-until-marriage” programs work. How can we expect them to now be effective?”

Critics of abstinence education often assert that there are no “abstinence-until-marriage” programs that have proven to be effective in reducing teen sexual activity. Moreover, the assertion is made that “abstinence plus” or “comprehensive” programs (which typically incorrectly present birth control and abstinence as equally effective risk-reduction strategies) have proven to be effective. The truth is that a number of abstinence-until-marriage programs have demonstrated significant results in reducing sexual activity among young people. However, many of these programs have not utilized sophisticated studies with control groups and peer-reviewed publications because of the expense and time needed to conduct these rigorous studies. Fortunately, several new, scientifically designed abstinence-until-marriage program studies will be published in 2003.³

Currently, there are a number of research-based, abstinence-until-marriage programs that have demonstrated significant reductions in teen sexual activity, including:

Choosing the Best – Studies conducted by the Northwestern University School of Medicine from 1994-1996 on the effectiveness of Choosing the Best with more than 3,800 middle school students in 49 Illinois middle schools demonstrated:⁴

75 percent of all students indicated an intention to be abstinent until marriage.

60 percent of sexually active students indicated an intention to be abstinent in the future.

54 percent of recently sexually active students were no longer sexually active a year later. Click here for more detail on CTB research results.

Virginity Pledge Programs – Dr. Michael Resnick reported in the Journal of the American Medical Association that “abstinence-pledge” programs are dramatically effective in reducing sexual activity among teenagers in grades 7 through 12.⁵ Based on a large national sample of adolescents, the study concludes, “Adolescents who reported having taken a pledge to remain virgins were at significantly lower risk of early age of sexual debut…. And when compared to a control group, the level of sexual activity was one-fourth the level of their counterparts who had not taken a pledge.⁶

Not Me, Not Now – A community-wide, mass media and education abstinence intervention program in Monroe County, New York decreased the sexual activity rate of 15 year-olds in the county from 46 percent to 31 percent and the pregnancy rate for girls aged 15 to 17 from 63 pregnancies per 1,000 girls to 49 pregnancies per 1,000 – a 22 percent reduction. The teen pregnancy rate fell more rapidly in Monroe County than in comparison counties in upstate New York, and the difference in rate of decrease was statistically significant.⁷

Operation Keepsake – An abstinence program for 12- and 13-year-old predominately black or Hispanic children in Cleveland, Ohio was effective in reducing sexual activity in the total population reaching statistical significance among both sexually experienced and inexperience students.⁸

Abstinence by Choice – Targeting 7th, 8th and 9th grade students in the Little Rock area of Arkansas, the program reduced the sexual activity rates of girls by 40 percent and the rate of boys by 30 percent when compared with control groups of students.⁹

Teen Aid and Sex Respect – An evaluation in three school districts in Utah showed that these programs together reduced the rate of initiation of sexual activity among at-risk high school students by more than a third when compared to a control group of similar students.¹⁰

A closer analysis of published studies on the effectiveness of “abstinence plus” or “comprehensive” programs (programs that typically incorrectly emphasize contraceptive use on an equal level of risk elimination as abstinence) indicate a lack of true effectiveness in reducing teen sexual activity. For example:

CAS – A holistic “abstinence-plus program” developed by Carrera, and targeted for 13- to 15- year-old, high-risk teens, was evaluated in 12 inner-city sites. By the end of the study, 63 percent of the program participants had had sex and, when compared to control groups of comparable teens, there were no significant differences in the initiation of sex, use of condoms, self-reported grades, delinquency and drug use. However, program girls were significantly more likely to use Depo-Provera (birth control patch) at last intercourse, producing a significant reduction in pregnancy and births.¹¹

Reducing the Risk – An “abstinence-plus” program evaluated in 13 California high schools with 429 9th and 10th graders in the program group. When compared to a randomly assigned control group of 329 high school students, there were no significant differences in reducing teen pregnancy, reducing unprotected sex, frequency of sexual activity and use of birth control. The reported "success" of the program was based on results that occurred within a smaller subgroup of this study. It was found that when you evaluated the subgroup of students who had not had sex at the beginning of the program eighteen months later, they had initiated having sex 24% less than students in the control group.¹²

2. “Polls show that parents prefer a comprehensive (contraceptive-based) approach to sex education. Shouldn’t we offer what the parents want for their teens?

The poll most often cited was commissioned in 1999 by SIECUS and Advocates for Youth and conducted by Hickman-Brown Research, Inc. of 1,050 adults nationwide. Comprehensive sex education advocates cite the statistic that:

“Eight out of 10 American adults support the inclusion of information on abstinence and contraception in sexuality education courses for students in grades 9-12”.¹³

The question that was asked of parents to solicit this response was:

“Some people believe that whether or not young people are sexually active, they should be given information to protect themselves from unplanned pregnancies and sexually transmitted diseases. Other people believe that telling young people about birth control and sexually transmitted diseases only encourages them to have sex. Which comes closer to the way you feel?”.¹⁴

This question to parents is clearly misleading, in that it suggests there is a form of contraceptive “protection” to eliminate the risks of unplanned pregnancies and STDs. In reality, this is not true. There is no form of protection to eliminate these risks, except abstinence. In terms of preventing pregnancies, condoms break and slip off and have an average 14 percent failure rate.¹⁵ Additionally, studies have proven that even when teenage girls are informed about contraception, they are significantly less likely than older women to practice contraception consistently over the course of a year, and are more likely to practice contraception sporadically or not at all.¹⁶

The 2001 NIH study of condom effectiveness in protecting against STDs stated that, although condoms can reduce the risk of HIV and gonorrhea in women to men if used consistently and correctly 100 percent of the time, condoms “do not protect against HPV (Human Papilloma Virus/genital warts),” an incurable STD that can lead to cervical cancer. Additionally, the study found no evidence to indicate that condoms could effectively prevent infection from genital herpes, another incurable disease, or chlamydia, a common STD that often has no symptoms and, when untreated, can lead to pelvic inflammatory disease, infertility, and ectopic pregnancies.¹⁷

Effective abstinence programs, such as Choosing the Best, do provide information about birth control — including abstinence — showing the failure rates of these methods (except abstinence) in preventing both pregnancy and STDs. However, unlike “abstinence-plus” or “comprehensive” programs, Choosing the Best does not advocate or demonstrate contraceptive use. CTB programs provide objective, factual information about contraceptives that they, at best, offer only limited risk reduction and protection from disease and pregnancy. Abstinence provides total risk elimination from disease and pregnancy.

Unfortunately, many parents do not realize the extent and nature of today’s STDs or the limitations of condoms to prevent these infections. During the 1960s, there were only two STDs, syphilis and gonorrhea – both curable with penicillin. Today, there are more than 25 STDs, and as we have described above, many of these are viral, incurable, and can seriously affect a person’s life.¹⁸ Our experience has shown that once parents are informed of these facts, they adamantly support abstinence education for their teens.

3. “Isn’t abstinence-until-marriage education fundamentally about ‘scare tactics’ that teach teens to be terrified about ever having sex?”

Comprehensive (contraceptive-based) sex education advocates often claim that showing students age-appropriate slides of common STDs is a “scare tactic”. The fact is, four million teens contract an STD every year – approximately one out of four of those that are sexually active, which qualifies as a serious medical epidemic and crisis.¹⁹ Therefore, every effective means should be utilized to help young people realize the serious nature of these diseases, some of which are incurable and even life threatening. In the same way that driver education uses pictures of car accidents to help young people realize and prevent the consequences of careless driving to avoid accidents and deaths, age-appropriate STD slides help young people realize the serious consequences of diseases that can be eliminated by choosing abstinence.

Although a presentation of STDs is included in both CTB LIFE (for high school) and CTB PATH (for upper middle school), it represents only one out of eight content sessions. In addition to discussing the emotional and physical consequences of pre-marital sex, CTB also discusses the importance of re-channeling energy into developing and pursuing worthwhile personal goals and enhancing healthy relationships.

4. “Isn’t teaching abstinence to teens unrealistic? Isn’t part of being a teen experimenting with sex?”

Normal adolescent curiosity is a part of growing up, and the media message that pre-marital sex is natural, normal, fun and has no consequences has a powerful influence on young people. However, when given the facts concerning the physical and emotional risks of sexual activity and the rewards of being abstinent, (e.g. being able to pursue goals and dreams, often not possible with an unplanned pregnancy or disease) the majority of teens today are choosing abstinence. The most recent 2001 CDC Youth Surveillance Survey indicated that 54 percent of teens today have not had sex, compared with 45 percent in 1990. Additionally, of teens who are sexually experienced (have had intercourse at least one time), approximately 25 percent are currently abstinent (have not had sex within the last three months).²⁰ Thus, the majority of teens are not having sex, and that number is increasing.

We know that not every teen will abstain from having sex, just as not every teen who knows the risks of smoking will choose not to smoke. However, the goal of abstinence education is to give teens the facts about the negative emotional and physical consequences of having pre-marital sex, as well as the benefits of waiting, so that they can make an informed choice about their sexual behavior. Studies have consistently confirmed that when students complete the Choosing the Best program, the overwhelming majority of those students, even those who have previously been sexually active, will choose abstinence until marriage. Click here for detailed research results on CTB.

5. “Doesn’t abstinence-until-marriage education in effect simply tell teens to ‘just say no?’ Is that really enough?”

Effective abstinence education programs are multi-dimensional and cover a number of critical topics in helping equip teens to make the only choice – abstinence until marriage – that eliminates the risk of STDs, negative emotional effects, and teen pregnancy. Choosing the Best curricula provide content in nine areas: Risks (emotional, STDs, teen pregnancy), Rewards (decision making, goal setting, marriage planning), Relationship Education (friendships, understanding guys and girls, healthy vs. unhealthy relationships, preventing sexual abuse), Alcohol (dangers of mixing alcohol and sex), Refusal Skills (setting boundaries, developing verbal skills and assertiveness skills), Pledge (making a commitment to abstinence), Character Development (responsibility, self-respect, courage, perseverance, compassion, respect), Parent Involvement (parent training and homework interviews), and Building Self-esteem (being totally unique, one of a kind, assertiveness skills).

6. “Isn’t abstinence-until-marriage education guilty of withholding facts by not providing information about birth control?”

Effective, research-based abstinence programs, such as Choosing the Best, do provide information about birth control — including abstinence — showing the failure rates of these methods (except abstinence) in preventing both pregnancy and STDs. However, unlike “abstinence-plus” or “comprehensive” programs, Choosing the Best does not advocate or demonstrate contraceptive use. CTB programs provide objective, factual information about contraceptives that they, at best, offer only limited risk reduction and protection from disease and pregnancy. Abstinence provides total risk elimination from disease and pregnancy.

7. “Why shouldn’t we teach teens about abstinence, but then also teach them about contraceptives?”

On the surface, this seems reasonable. To paraphrase a speech given by Dr. Wade Horn (Assistant Secretary for Children and Families, U.S. Department of Health and Human Services), teaching about both abstinence and birth control seems, at first blush, like a sensible position, presenting more information, both sides, and allowing for a “free choice.” But if you step back and think about it, to teach teens about abstinence and in the same breath, discuss birth control as an acceptable option, is a mixed message with serious consequences. For example, we teach children that using illegal drugs is wrong. We don’t say, “Well, you really shouldn’t, but if you do, you really should know how to clean your needles.” We teach children that shoplifting is wrong. We don’t say, “Well, you really shouldn’t do it, but if you do, here’s how you can do this without getting caught.”

Douglas Kirby, in his research on a sex education program called "Reducing the Risk", which emphasized both abstinence and using condoms, found it was easier to influence teens to be abstinent than to use condoms.²¹ The facts about pregnancy and STDs, as well as the emotional consequences of premarital sex, are so compelling that we do a disservice to teens if we dilute the abstinence message by presenting “protected” sex as a viable, and equally attractive, risk reduction option. An established parenting fact is that teens receiving a mixed message tend to only hear the least restrictive portion of the message; i.e. “Don’t drive my new car, but if you do, make sure you use seat belts and gas it up” becomes “it’s OK to drive my new car”. Mixed messages work in no other area of child-parenting communication, nor will they work here. The intent is to encourage total risk elimination through abstinence until marriage.

8. “Isn’t waiting until marriage too strict a requirement? What about kids who don’t want to get married or who will do so later in life?”

The only way to eliminate the risk of an STD is to be abstinent until you enter into a mutually monogamous relationship as is typically found in marriage, with an uninfected partner, and remain faithful in that relationship for the rest of your life. The emotional effects of being involved with someone sexually and then having that relationship end can be devastating, regardless of age. Even if a person has reached an age where they are emotionally more mature and better able to cope with these effects, the physical risks of STDs are still present – regardless of age – and can significantly affect a person’s health and life. Postponing sex until a teen is out of high school does not eliminate, or in some cases, even reduce the risk. A recent survey of single women aged 20 to 25 showed that more than one-half had contracted HPV, the disease that can cause cervical cancer, which kills more than 4,800 women each year.²²

It would be nice to be able to tell teens that if they wait until they’re out of high school, or some “magical” age, that they would not have to deal with the physical or emotional consequences of premarital sex, but unfortunately this simply isn’t true. Sex can be an expression of love that, within the context of a mutually monogamous and lifelong relationship such as marriage, is the ultimate way to share personal intimacy and eliminate the risk of disease.

9. “Does abstinence-until-marriage education address homosexuality?”

Abstinence-until-marriage education is about encouraging teens to eliminate the risks of sexual behavior. All teens need this message, regardless of their sexual orientation.

10. “Isn’t abstinence-until-marriage education fundamentally about religious conviction?”

Although some teens who choose abstinence may also be influenced by their personal religious convictions, abstinence-until-marriage education is about making healthy choices to be free from the risks of STDs, unplanned pregnancy and negative emotional consequences. It is about being free to pursue future dreams and goals, regardless of religious preference or conviction. Abstinence-until-marriage education is about health for our teens.

¹The Social Security Administration, Title V of the Social Security Act, Section 510, “Separate Program for Abstinence Education” 2 (A-H), (Baltimore, MD: The Social Security Administration).

²American Cancer Society, Inc., Surveillance Research, Cancer Facts & Figures, 2002.

³Mathematica Policy Research, Inc., The Evaluation of Abstinence-Education Programs Funded Under Title V, Section 510, Interim Report (Princeton, NJ: Mathematica Policy Research, April 2002).

⁴John T. Vessey, Ph.D., “Evaluation Studies: Abstinence Evaluation Report 1994-95” and “Evaluation Studies: Longitudinal Study 1995-96” (Evanston, IL: Northwestern University Medical School, 1996).

⁵Michael Resnick, M.D., et al., “Protecting Adolescents from Harm: Findings for the National Longitudinal Study on Adolescent Health,” Journal of the American Medical Association, Vol. 278 (September 10, 1997).

⁶Ibid, p. 830.

⁷Andrew S. Doniger, “Impact Evaluation of the ‘Not Me, Not Now’ Abstinence-Oriented, Adolescent Pregnancy Prevention Communications Program, Monroe County, New York,” Journal of Health Communications, Vol. 6 (2001), pp. 45-60.

⁸Elaine Borawski et al., Evaluation of the Teen Pregnancy Prevention Programs Funded through the Wellness Block Grant (1999-2000), Center for Health Promotion Research, Department of Epidemiology and Biostatistics, Case Western Reserve University, School of Medicine, March 23, 2001.

⁹Stan E. Weed, Title V Abstinence Education Programs: Phase I Interim Evaluation Report to Arkansas Department of Health, Institute for Research and Evaluation, October 15, 2001.

¹⁰Stan E. Weed, Predicting and Changing Teen Sexual Activity Rates: A Comparison of Three Title XX Programs, report submitted to the Office of Adolescent Pregnancy Programs, U.S. Department of Health and Human Services, December 1992.

¹¹Philliber, Kaye, Herrling, The National Evaluation of the Children’s Aid Society Carrera-Model Program to Prevent Teen Pregnancy, Philliber Research Associates (Accord, NY: May 2001).

¹²Kirby, Barth , Leland and Fetro, “Reducing the Risk: Impact of a New Curriculum on Sexual Risk-Taking,” Family Planning Perspectives Vol. 23, Number 6, November/December 1991, pp. 253-263.

¹³Advocates for Youth and the Sexuality Information and Education Council of the United States (SIECUS), Poll on America’s Attitudes toward Sexuality Education, conducted by Hickman-Brown Research for Advocates and the Council (Washington, DC: Hickman-Brown, March 1999).

¹⁴Ibid.

¹⁵The Medical Institute for Sexual Health, “Condom Quiz: Frequently Asked Questions About Condoms,” Sexual Health Update, Fall 2000.

¹⁶The Alan Guttmacher Institute, “Teen Sex and Pregnancy” Fact Sheet (New York and Washington, DC: The Alan Guttmacher Institute, 1999).

¹⁷Centers for Disease Control and Prevention: National Prevention Information Network, “STD Prevention – Common STDs and the Organisms That Cause Them” with information from the Institutes of Medicine Report, “The Hidden Epidemic: Confronting Sexually Transmitted Diseases, 1996”; the National Institutes of Health, National Institute of Allergy and Infectious Diseases (NIAID), Office of Communications fact sheets, 1998; and the CDC fact sheet, “The Challenge of STD Prevention in the United States, 1996.”

¹⁸Centers for Disease Control and Prevention, “Trends in STDs in the United States, Magnitude of Epidemics Overall,” Tracking the Hidden Epidemics 2000, February 13, 2002.

¹⁹Kaiser Family Foundation, MTV, and TEEN PEOPLE, “What Teens Don’t Know About STDs Puts Them at Risk,” March 8, 1999.

²⁰Centers for Disease Control and Prevention, “Youth Risk Behavior Surveillance – United States, 2001” in Morbidity and Mortality Report, June 28, 2002/51 (SS04) 1-64.

²¹Ibid. [“Reducing the Risk: Impact of a New Cirruculum on Sexual Risk-Taking”]

²²American Cancer Society, 2002.