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A pair of new scientific reviews conclude that abstinence-only-until-marriage programs (AOUMs) not only fail to protect kids, but also violate their human rights.
Published online yesterday in the Journal of Adolescent Health, the study reviews looked at the use, prevalence, and impact of AOUMs in U.S. classrooms and internationally based on the most up-to-date research in the field. Authored by the Society for Adolescent Health and Medicine and a team of researchers from Columbia University, the University of North Carolina, the Guttmacher Institute, and the Children’s National Medical Center at George Washington University, among others, both reviews found that AOUMs have consistently been “a failure” in deterring teens from risky behaviors, and have gobbled up millions of dollars and learning-hours along the way.
Overall, the groups concluded that AOUMs, which are the only form of sexual and reproductive education in a number of U.S. cities and towns, have been ineffective at delaying teen sex or reducing sexual risk behaviors, and often do substantially dis-serve young learners in other ways. According to the expert groups, those ways include violating adolescent human rights, stigmatizing or excluding certain groups therein, reinforcing “harmful” gender stereotypes, withholding medically accurate information, and thereby undermining public health programs.
In a press release from Columbia University’s Mailman School of Public Health, the researchers explained that such programs frequently ignore LGBTQ+ and other student groups in their framework and culture, and have been “widely rejected by health professionals” for failing to provide useful, science-based information on sexual health practices.
Co-author Leslie Kantor, vice president of Education at Planned Parenthood Federation of America, and an assistant professor of Population and Family Health at Mailman, commented that “Young people have a right to sex education that gives them the information and skills they need to stay safe and healthy.” She continued, “Withholding critical health information from young people is a violation of their rights. Abstinence-only-until-marriage programs leave all young people unprepared and are particularly harmful to young people who are sexually active, who are LGBTQ, or have experienced sexual abuse.”
“While abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail,” Santelli said. “These programs simply do not prepare young people to avoid unwanted pregnancies or sexually transmitted diseases.”
The researchers also noted that, given the “rapidly rising age” at which folks around the world are getting married, people are increasingly spending more of their youths with ‘single’ status, and aren’t waiting for their nuptials to start learning about the sexual side of relationships, and of themselves.
Hiroo Yamagata
The researchers noted that the spread of AOUMs in recent years has created meaningful setbacks to the development and efficacy of HIV prevention, sex education, and family planning programs at home and worldwide. According to reviewed data, the number of schools requiring study of human sexuality fell from 67% in 2002 to just 48% by 2014, with rates of required HIV prevention education dropping from 67% to 41% in the same period. Meanwhile, the number of students who report having had some instruction on birth control methods has fallen by close to 25% since the mid ’90s.
And while numerous studies over the past couple decades have suggested that AOUMs, unlike comprehensive sex education programs, are ineffective, Congress has continued pouring precious funds into the former. Researchers reported that more than $2 billion has been spent on domestic abstinence-only programs between 1982 and 2017, and $1.4 billion in foreign aid for AOUMs. At present, domestic funding for such programs is $85 million per year, and states are prohibited from using the funds to discuss contraception, except to focus on its failure rates.
“Adolescent sexual and reproductive health promotion should be based on scientific evidence and understanding, public health principles, and human rights,” Santelli added. “Abstinence-only-until marriage as a basis for health policy and programs should be abandoned.”
Ginny Ehrlich, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, commented by email that the research provides “an extremely valuable synthesis” of hundreds of individual studies and over a decade of research suggesting firmly that AOUMs haven’t been achieving their namesake goal.
“All of our young people deserve the information and tools they need to avoid an unplanned pregnancy, [and] the evidence is clear; there are more than 40 quality sex education programs that show that they reduce teen pregnancy and/or related sexual risk behaviors, including delaying sex, increasing use of contraception, and reducing the number of sexual partners,” Erlich wrote. “And 79 percent of people in the United States–across party lines–believe that teens should receive more information about abstinence and birth control and sexually transmitted infections. It only stands to reason that even those who believe strongly that teens should wait to have sex should prioritize results and evidence over ideology.
Rev. Marie Alford-Harkey, President and CEO of the non-profit Religious Institute, which works with thousands of religious leaders in support of “comprehensive sexuality education,” also praised the researchers’ insights and recommendations. By email, she commented that the work demonstrates how giving young people accurate, thoughtful info and guidance on moral decision-making “is both honest and effective at promoting sexual health and safety.”
She also noted that the expert reviewers denounced an “immoral” decision by the Trump Administration to cut funding to 81 Teen Pregnancy Prevention Programs, which have historically been far better at protecting students than AOUMs.
“Not only are abstinence-only-until-marriage sexuality education programs ineffective, as this research shows, but they also violate the religious value of honesty, the moral agency of young people, and the dignity of worth of all people,” Alford-Harkey continued. “These programs do a disservice to our communities by propping up one narrow religious view of sexuality and withholding from young people vital information about their bodies and their sexual and reproductive health.”
She added, “We believe that sexuality is God’s life-giving and life-fulfilling gift [and] advocate for sexuality education that provides medically and scientifically accurate information, helps young people develop the capacity for moral discernment, and challenges harmful stereotypes and misinformation about gender roles and LGBTQ people.”
Abortion - Abortion Clinics, Abortion Pill, Abortion Information 
Northern Ireland’s Department of Health has declined to issue new guidance on abortion to doctors and other health professionals because “there has been no change to the law on abortion”. This is despite the fact that the situation clearly has changed since women from the region can now access free, NHS abortions in England.
This stubborn refusal to recognise the reality of women’s reproductive healthcare needs is concerning because it ignores the fact that, at present, GPs in Northern Ireland are not permitted to purchase procedures outside Northern Ireland “that would be illegal in Northern Ireland”. This prohibition clearly needs to be updated to take account of the new situation.
Since the end of June, women from Northern Ireland can receive free NHS abortions through self-referral to the British Pregnancy Advisory Service or Marie Stopes; these agencies will then recoup the costs from the Equalities Office. Leaving aside the cost, financial and emotional, of having to travel for healthcare, this should work well for women who need an abortion mainly because they do not want to be pregnant.
But a small minority of women need, for medical reasons, to have their terminations in a hospital setting. With only 16 abortions carried out in Northern Ireland by health professionals in 2014-15 and again in 2015-16, clearly women with a range of health issues are not able to access legal abortions in Northern Ireland. Until now, they have had to take their chances in organising their own terminations at clinics that are not equipped to deal with serious medical conditions.
If nothing else, GPs need to be informed of care pathways through which these women can end their pregnancies in hospitals where all their medical needs can be met. It was to help such women that the idea of NHS-funded abortions for women from Northern Ireland first arose.
After the 1997 general election, hopes were high that the 1967 Abortion Act would be extended to Northern Ireland, particularly since both Tony Blair and Mo Mowlam, then secretary of state for Northern Ireland, had voted while in opposition for the extension of the act. However, it soon became clear that women’s rights were to be sacrificed to the “peace process”. Mowlam later admitted she “would have liked to have done something” for women in Northern Ireland but could not – for fear of “stirring up the tribal elders”.
Together with Voice for Choice, campaigners in Northern Ireland began to look at free NHS abortions as a stopgap measure that would reduce the inequality of access a little.
In February 1999, Maria Fyfe, then Labour MP for Glasgow Maryhill, wrote to Mowlam about abortion law in Northern Ireland. Adam Ingram, then a minister of state in the Northern Ireland Office, replied on Mowlam’s behalf on 10 March 1999. He wrote: “You raised the possibility of arrangements being introduced to enable GP fundholders and their purchasing authorities in Northern Ireland to fund terminations of pregnancy carried out elsewhere in the United Kingdom. I understand that such arrangements would not be possible in the case of fundholders who … are specifically prohibited from purchasing treatment for their patients outside Northern Ireland which would be illegal in Northern Ireland, such as termination of pregnancy.” (Of course, termination of pregnancy is the only treatment available in the NHS which would be illegal in Northern Ireland.)
The Northern Ireland assembly has shown itself incapable of dealing with the reality of abortion in the region. Debates have tended to be high on anti-abortion rhetoric and low on practical approaches to the reality of women’s lives in the 21st century. For almost 20 years now, Westminster has looked the other way. Indeed, a letter sent at the end of June from Justine Greening, the minister for women and equalities, to MPs – setting out the government’s proposal to provide NHS abortions to women from Northern Ireland – ended with an assurance that “none of this changes the fundamental position that this is a devolved issue in Northern Ireland … This announcement does not change that position”.
Women in Northern Ireland continue to be discriminated against. Westminster cannot devolve human rights; it remains the guarantor of such rights despite devolution. The (non-)response of the Northern Ireland Department of Health to the changed situation reinforces the view that Stormont is incapable of bringing women’s rights into the modern era and ensuring full reproductive healthcare in local hospitals.
The move to give everyone access to NHS abortions in Britain is a step in the right direction, but it is only the first step. Now Westminster needs to act to end half a century of inequality for women in Northern Ireland.
https://www.theguardian.com/commentisfree/2017/aug/22/women-northern-ireland-abortion-reproductive-rights-westminster-change-law?utm_content=buffer06596&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer