Health

This Is How We Are Spending Billions On The Sexual Mis-Education Of America’s Youth

CREDIT: Shutterstock/Dylan Petrohilos

In early February, Kelly Wortham’s sixth-grade son brought home a letter from Jarrett Middle School in Springfield, Missouri. The letter, from the Missouri State University School of Social Work, informed Wortham and other parents at Jarrett that their children were “being invited to take part in an abstinence-based education program designed to reduce teen pregnancy in southwest Missouri.”

The program, the letter assured, “is designed to teach teens about the benefits of choosing abstinence and how to better communicate with parents/guardians, families, and peers.” The course would use “Choosing the Best,” a self-described “abstinence-focused” curriculum published by a Georgia-based company of the same name. Unless Wortham and her husband chose not to sign the letter and consent to the program, it would be taught to their son in the upcoming month.

Wortham, concerned by what her son might be taught in their “deeply conservative state,” contacted the school and asked to see the curriculum. “We were told by the principal, the vice principal, and the health teacher that this was an abstinence-centered course but not abstinence only,” she explained. “And that generally nobody had a problem with it but we were welcome to review the materials.”

A few days later, Wortham received an email from a Jarrett Middle School employee encouraging her to “preview information about the curriculum” on its website, www.choosingthebest.com. Wortham and her husband took a look. “It gave us both almost a negative visceral response,” she recalled. “We were looking at the [curriculum for older students], where they help you find your soulmate. It’s just stuff that really seemed to use the language of shaming and applying a Christian morality on something that from our perspective should really be about human sexuality and science. It made us very nervous.”

Letter the Worthams received. Courtesy of the Springfield School District.

Letter the Worthams received. Courtesy of the Springfield School District.

Wortham and her husband also sought out research on the effectiveness of abstinence-focused programs. It didn’t take them long to find troubling information: “The more we dug, the more we uncovered,” she said.

At first glance, Choosing the Best’s website looked legitimate. It explicitly called its curriculum “research-based,” and included links to “medical accuracy” and “results” pages. The site’s FAQs listed two medical organizations — The American College of Pediatricians (ACP) and the Medical Institute for Sexual Health — that endorsed the abstinence-centered model. But the Worthams soon uncovered disturbing research about both groups. In a subsequent interview with the Springfield News-Leader, Kelly called the curriculum “fear-based” and assserted: “The medical groups that sponsor it are hate groups.”

The American College of Pediatricians seemed to have a particularly egregious track record. The organization produces the “Facts About Youth” website, which outlines the “health risks of the homosexual lifestyle” and advocates for “change therapy … for patients seeking to change unwanted homosexuality and develop their heterosexual potential.”

In 2010, the director of the National Institutes of Health condemned the ACP for distorting “scientific observations to make a point against homosexuality” and pulling “language out of context from a book I wrote in 2006 to support an ideology that can cause unnecessary anguish and encourage prejudice.” And, according to the Southern Poverty Law Center, the ACP “often serves as a supposedly scientific source for groups pushing utter falsehoods about LGBT people.”

The Medical Institute for Sexual Health (MISH), whose founder, Joe McIlhaney, served as George W. Bush’s advisor while he was governor of Texas and on his Presidential Advisory Council on HIV/AIDS, has the seemingly innocent stated mission of “aligning and disseminating scientific data that promotes optimal health and wellness.” But according to an article by Jessica Valenti, the Institute is a “hard-core abstinence-only organization” with an advisory board that “reads like a Who’s Who of purity pushers.”

One of MISH’s advisory board members is David Hager, the author of As Jesus Cared for Women: Restoring Women Then and Now, whose former wife alleged that he repeatedly raped her. The organization’s website features blog posts with titles including: “Anal Sex: A Dangerous Trend,” “Oral Sex: No Big Deal?” “Six Bad Reasons to Have Sex,” and “Dropping the A-Bomb: Abstinence.”

After reviewing Choosing the Best’s website and its related materials, the Worthams collected their research and wrote a detailed email to Jarrett Middle School’s principal and health teacher, urging them to reconsider the curriculum. “Presenting this information could cause untold psychological harm to your students for years to come,” they warned. “Kids of single-parent or non-traditional homes could be made to feel bad. Kids who are already struggling with their sexual identities will very likely be made to feel even worse. Kids who are already sexually active will be marginalized. If you read this material and learn more about the people who created it and what their beliefs are — I expect it will scare you and upset you as much as it did us.”

The Worthams are far from the only parents whose children will be taught courses developed by Choosing the Best. The company produces one of the most popular “abstinence-focused” curricula in the country, reaching upwards of four million students in at least 44 states and three countries. It’s commonly used in states that receive Title V funding, a federal program that provides matching grants to states that agree to implement abstinence-only-until-marriage programs, despite scientific evidence that these programs don’t meet their stated goals of delaying teens’ sexual activity.

In April, Congress quietly increased Title V abstinence-focused funding for the first time in the program’s nearly two-decade tenure. The boost, which was slipped into a bipartisan Medicare “doc fix” bill, provides Title V with an additional $50 million over a period of two years — a move applauded by abstinence-education advocates for its potential to help Choosing the Best expand its reach.

In 2014, according to public records obtained ThinkProgress, Title V grant recipients in at least 16 states used Choosing the Best. In the Worthams’ state of Missouri, Choosing the Best received $13,973 in the 2013-2014 grant year from Missouri State University, a 2014 Title V grant recipient. In Mississippi, the company received more than $19,000 from the Mississippi Alliance of Boys & Girls Clubs, the state’s sole 2014 Title V recipient, and in Virginia, another 2014 Title V recipient, The Virginia’s Abstinence Education Program, expended $24,334 to Choosing the Best. In Virginia, Louisiana, and Mississippi, the curriculum was so popular that it was the only one used among Title V grant recipients in 2014.

The funding hike is troublesome to comprehensive sexual education advocates, many of whom critique abstinence-focused programs for reinforcing harmful stereotypes and spreading misinformation about sexual activity. According to Nora Gelperin, the director of sexuality education and training at Advocates for Youth, Choosing the Best is “definitely towards the end of one of the worst curricula I’ve seen, mostly because of its insidious message. They do a good job of covering up some of the most egregious elements of their curriculum and making it seem like a nice shiny package with a bow.” She elaborated: “When you start to look at it more closely, there’s just fear and shame.”

Following The Money To Abstinence-Focused Education

For decades, Congress has provided federal funding for abstinence-only education in public schools. In 1996, Section 510 of the Welfare Reform Act, also known as Title V, allocated $50 million annually to states that agreed to implement abstinence-focused programs. Though states can — and do — reject the funds (California, for instance, was one of the first states to decline, largely because of in-state evaluations concluding that the programs were ineffective), states that do choose to opt-in to the Title V program are required to match federal funding at 75 percent, and then distribute the funds to sub-grantees, which can include county and state health departments, schools, community-based organizations, faith-based organizations, and more.

Source: “The Content of Federal Funded Abstinence-Only Education Programs,” House Committee on Government Reform minority staff report, December 2004

Source: “The Content of Federal Funded Abstinence-Only Education Programs,” House Committee on Government Reform minority staff report, December 2004

Between 1996 and 2006, federal funding for abstinence-only education programs flourished, most notably under the George W. Bush administration. In 2005, federal spending on abstinence-focused programs climbed to about $170 million — more than double what was spent in 2001 under the Clinton administration’s final budget. All told, from 1996 to 2010, Congress pumped more than 1.5 billion taxpayer dollars into abstinence-focused programs, even as evidence against them mounted.

According to Nicole Cushman, the executive director of Answer, a sexuality-education organization based at Rutgers University, abstinence programs are not just out of step with the scientific evidence — they’re also “stigmatizing to young people who are already sexually active. One of the things that is so glaring when you actually look at a lot of these curricula is that they seem to be completely ignoring the fact that there’s a huge percentage of young people in the classroom who are already sexually active,” she pointed out. “Emphasizing that having sex before marriage leads to harmful mental health and social and psychological consequences is just not true.”

Abstinence-focused programs — sometimes called abstinence-education, abstinence-only-until-marriage, or “abstinence-centered” programs — promote abstinence until marriage and emphasize the physical and psychological benefits of refraining from premarital sex. Often, they espouse socially conservative and stereotypical messages about gender, marriage, and sexuality; positioning young men as impulse-driven “boys who will be boys” and girls as sexual gatekeepers who will likely regret their decisions about premarital sex.

In one activity from Choosing the Best’s 9th and 10th grade edition, a girl named Robin remarks: “After I had sex the second time, it made me feel horrible. First of all, I didn’t enjoy it, and second I thought ‘what are you doing to yourself’?”

Choosing the Best JOURNEY (2009), Student Manual, pg. 43

Choosing the Best JOURNEY (2009), Student Manual, pg. 43

In the same exercise, the character Sarah concludes: “Every time I had sex I was giving away a piece of my heart. I was giving away something I could never get back. I didn’t know that every time I had sex I was losing my objectivity … I found myself making excuses for the bad behavior of my boyfriends. I felt used and empty … I started hating myself.”

Indeed, abstinence-focused programs are required by law to have this focus. The passage of the Title V program included an eight-point definition of abstinence education, which governs programs that receive federal funding for Title V. In order to receive the funding, the definition specifies that an eligible program “has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity.” Programs also must emphasize that “a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity” and that “sexual activity outside of the context of marriage is likely to have harmful psychological and physical effect.”

Choosing the Best JOURNEY (2009), Student Manual, pg. 43

Choosing the Best JOURNEY (2009), Student Manual, pg. 43

Many abstinence-focused courses, including Choosing the Best, also include activities that imply sexually active unmarried teens are dirty, tainted, or unappealing. One exercise from Choosing the Best’s 2008 7th-grade curriculum, “A Mint for Marriage,” equates a used peppermint patty to someone who had premarital sex, instructing the teacher, after unwrapping a peppermint patty and passing it around the class, to tell students: “No one wants food that has been passed around and neither would you want your future husband or wife to have been passed around.”

Another activity from Choosing the Best’s 8th grade curriculum essentially compares sexually active students to spit, asking the class: “Why do we always want ‘pure’ for a future spouse?”

Source: Choosing the Best LIFE (2008), Leader Guide, p. 36

Source: Choosing the Best LIFE (2008), Leader Guide, p. 36

Source: Choosing the Best LIFE (2008), Leader Guide, p. 36

Source: Choosing the Best LIFE (2008), Leader Guide, p. 36

These activities have long roused the ire of comprehensive sex advocates, who finally saw federal funding for abstinence-focused education start to shift course in 2010. That’s when the Obama administration and a Democratic-controlled Congress eliminated funding streams for two of three federally funded abstinence-focused programs — the Community-Based Abstinence Education grant program (SPRANS–CBAE) and the abstinence-only-until-marriage portion of the Adolescent Family Life Act (AFLA) — and provided more financial support for evidence-based sex ed programs.

But even with those changes, abstinence education still gets propped up by federal dollars: The recent increase in Title V funding was implemented despite the consistent conclusion of both scientific research and Congressional reports that abstinence-only programs don’t meet their stated goals. Moreover, official reviews have also revealed that some abstinence-focused programs contain information that is patently false: A 2004 House Committee on Government Reform minority staff report in particular found that more than 80 percent of the abstinence-focused programs’ curricula reviewed contained “false, misleading, or distorted information about reproductive health” — including one course’s assertion that sweat and tears can transmit HIV/AIDS.

The 2004 report also zeroed in on Choosing the Best, concluding that the eighth-grade curriculum, Choosing the Best Life, contained 32 major errors and distortions of public health information and other Choosing the Best publications perpetuated harmful gender stereotypes. One exercise, which told the story of a knight who saved a princess from a dragon, reminded readers: “Occasional suggestions and assistance” from women “may be alright, but too much of it will lessen a man’s confidence or even turn him away from his princess.”

A few years later, abstinence-focused programs received another blow to their credibility. A 2006 report by the Government Accountability Office found that the Administration for Children and Families, which awards grants to abstinence-focused programs, “does not review its grantees’ education materials for scientific accuracy and does not require grantees of either program to review their own materials for scientific accuracy.”

Furthermore, in 2008, Congress held its first-ever hearing on abstinence-focused programs; gathering researchers and sexual health experts who talked about the ineffectiveness of the abstinence-focused programs and called for an end to their designated funding. The following year, the SPRANS–CBAE program received its first budget cut before the program was eliminated altogether in 2010.

As the tide began to turn against them, abstinence-focused proponents, well-aware of the dynamics at play — critical reports, increased scrutiny, and a new presidential administration — began rebranding their programs in a last-ditch effort to save face and hold onto federal funding. The fruits of that effort can be seen today: Many abstinence-focused programs, including Choosing the Best, now use scientific language and sexual health terms such as “evidence-based” and “medically accurate.”

Credit: http://www.choosingthebest.com/

Credit: http://www.choosingthebest.com/

“They have this entirely new name for the approach,” Cushman told ThinkProgress. “They’ve attempted to rebrand abstinence only as ‘sexual risk avoidance education.’ A lot of comprehensive programs are also referred to as risk reduction so by calling it risk avoidance they’re just borrowing that terminology … They’re essentially mimicking word-for-word the language around evidence-based approaches but they don’t actually have the evidence.”

Heather Boonstra, the director of public policy at the Guttmacher Institute, a think tank that closely tracks issues of reproductive health, says the change was partially because of “the success we had politically” advocating for comprehensive sex ed classes.

“Our mantra, being able to say ‘none of these programs worked, this is a waste of taxpayer dollars,’ I think that really hurt them. And so they are trying very hard to package themselves as evidence-based,” Boonstra said.

Abstinence education proponents haven’t been shy about their rebranding efforts: The National Abstinence Education Association lists “Rebranding the abstinence message to provide positive representation in the public square” as one of its “Strategic Objectives.” In a 2009 briefing on Capitol Hill intended to “debunk misconceptions” about abstinence education, Valerie Huber, the president and CEO of the National Abstinence Education Association (who was suspended from the Ohio Department of Health’s abstinence-only program after being found guilty of ethics violations), explained that abstinence education “is not a ‘just say no’ message,” but rather, “a holistic message that prepares and gives students all of the information they need in order to make healthy decisions.”

For sexual education researchers and advocates, the mounting evidence against abstinence-focused programs highlights the absurdity — and futility — of the decades-long sex ed debate. “At the extreme end you could lock kids up in a closet for five years and they would remain abstinent,” Boonstra observed. “And it would work! But young people have a human right to this information.”

Inside Choosing The Best: What Are They Teaching?

Meanwhile, Kelly Wortham was becoming increasingly frustrated with Jarrett Middle School’s response to her concerns. After sending the school a detailed email outlining her reservations about the curriculum, she heard back from Robert Kroll, Jarrett’s principal. “Thank you for the email,” he replied. “I plan to take the time to read over your concerns and research this weekend. Unfortunately, I have not had the time to explore all of your thoughts yet … I hope to respond to you soon.”

Wortham says she never heard back from Kroll. She also never signed the waiver that would grant her son permission to begin Choosing the Best’s course in the upcoming month. “And the next thing we knew, my son was getting a packet of busywork and was told to hang out in the library while the rest of the kids were going through the curriculum,” she recalled.

It’s hard to know precisely what her son’s peers learned in the course. ThinkProgress requested a copy of the Choosing the Best curriculum utilized in 2014 by the Springfield School District from Missouri State University, one of the state’s Title V grantees in 2014. However, Missouri State declined to supply the records, saying that “the requested curriculum is not subject to Missouri’s sunshine Law, as per Mo. Rev. Stat. § 610.021(14).”

On May 19, ThinkProgress requested a copy of the most up-to-date curriculum for grades 8, 9, 10, 11, and 12 from Choosing the Best but did not hear back. A source provided ThinkProgress with copies of Choosing the Best’s 2008 and 2009 curriculum for 6th through 12th graders: Choosing the Best WAY, PATH, LIFE (8th), JOURNEY, (9th and 10th), and SOUL MATE (11th and 12th), respectively.

Like its website, Choosing the Best’s books are nicely packaged and savvily marketed. “If you just on the surface look at the curriculum, part of the reason it’s so successful and so broadly spread, it’s very difficult for anybody just doing a surface read to really pick out anything wrong with the program,” Wortham pointed out.

Indeed, many attribute Choosing the Best’s widespread use to its “research, evidence-based” presentation. “Their marketing is phenomenal,” added a former school administrator with expertise in sexual health education who wished to remain anonymous. “They have great graphics and videos and nice pictures. And the way it’s organized for teachers makes it really easy to use — you just follow the script.”

Choosing the Best’s website, which boldly displays the words “research-based” in blue font on its homepage, features photos of grinning students, doctors in lab coats, and a page of glowing testimonials. An anonymous teacher says her “students LOVED it! They told me they were dying to get to my class to find out what we were gonna be doing that day.”

Credit: http://www.choosingthebest.com/

Credit:

On the same page, former Rep. Phil Gingrey (R-GA), gushes: “As a member of the U.S. House of Representatives committed to a high standard of personal integrity, I am pleased to enthusiastically endorse and support a school-based sexual abstinence instructional program that is getting tremendous results … It could not have come at a more critical time in our society.”

Gingrey may believe in the merits of abstinence-focused programs and, in particular, Choosing the Best. But he has also received thousands of dollars in campaign contributions from Choosing the Best’s CEO and president, Bruce Cook, over the course of his career.

Cook served on the Georgia Board of Human Resources from 2003 to 2007, and in 2006 was appointed by then-Governor Sonny Perdue (R) — who also penned a glowing testimonial of Choosing the Best — to serve on the board of the Department of Community Health. Perdue also received a $1,000 contribution from Cook for his 2006 campaign. In 2004, Cook showed up at an abstinence education conference funded by the Department of Human Resources and used it as an opportunity to promote Choosing the Best’s curriculum, according to Creative Loafing.

It may come as little surprise, then, that Choosing the Best was used by more than half of Georgia’s 2014 Title V sub-grant recipients, according to public records obtained by ThinkProgress.

Choosing the Best, which is based in Georgia, is “definitely part of our state fabric,” Kim Nolte, the president and CEO of the Georgia Campaign for Adolescent Power & Potential, told ThinkProgress. “We come across Choosing the Best as the primary [curriculum] that we see. It got a foothold from Bruce Cook having that high up position.”

Choosing the Best critics say the curriculum relies heavily on fear-based messages about premarital sex and biased views of sexuality and marriage. “If [CTB] would just make their curriculum more medically accurate, we would endorse them,” the former school administrator who wished to remain anonymous remarked. “But their messaging is what we’re concerned about. When I reviewed the materials I was like, ‘this is misleading for young people.'”

“CTB uses shame and guilt throughout in an effort to manipulate learners into remaining abstinent, especially girls. The curriculum communicates repeatedly that people who have sex before they are married (47 percent of all high school students) lack value and dignity. Research reinforces the fact that feelings of shame and guilt can cause long-term, negative psychological consequences and that boys and girls process and respond to shame differently,” a paper by the sexual education organization Answer concludes.

ThinkProgress contacted Choosing the Best about the criticisms of its curriculum. In an email, a representative from the organization referred us to the FAQ page on the website, which refers to a question about whether its programs are fear-based. Choosing the Best’s response is: “No! Organizations that strongly oppose abstinence education of any kind, such as Planned Parenthood and SEICUS, often make the false claim that programs such as Choosing the Best are ‘fear-based.’ Sometimes they claim that Choosing the Best programs contain ‘exaggerated facts about STDs and/or condom failure rates.’”

Eva Bolt-Ezell, a rising sophomore in Springfield, Missouri, took Choosing the Best in 8th and 9th grade. She said she was “offended” by the courses: “It’s really obvious that they’re trying to scare us into being abstinent,” she remarked. “It’s really biased, and it’s sexist a lot of the time too. With the girls they say they need to respect themselves, and it’s a love thing, and they don’t ever say that to the boys. And I think that’s a really offensive way of teaching. It was more, ‘the boys can do what they want, but the girls, they need to be respectful and be good!’”

Eva’s mother, Anna Bolt-Ezell, was surprised to learn her daughter took the course in her 9th grade health class. “It’s crazy to teach abstinence to high schoolers as far as I’m concerned,” she scoffed. “That seems dangerous.”

Other parents recounted similar stories. After Kelly Wortham’s son was delegated to the library during Choosing the Best class time, she started reaching out to local parents, asking if they had also dealt with the curriculum. “One of my friend’s daughters was told when she asked, ‘well, what if I’ve already had sex?’ she was basically told the analogy of used bubble gum — nobody wants to chew used bubble gum,” Wortham said. “The way it was presented to these kids was almost like it should be something they should be ashamed of. There were several little things like that made my husband and [me] shiver. The biggest things that really bothered us and our friends were stories that they had specifically around, for lack of a better description, the slut-shaming. You know, ‘you shouldn’t wear clothes like this,’ ‘you shouldn’t wear short skirts,’ ‘what are boys going to do?’ and ‘if you kiss a boy and he touches you where you don’t want to be touched, it’s your fault for letting him kiss you.’”

An exercise in Choosing the Best’s 2008 seventh-grade edition, entitled “A Rose With No Petals” instructs a teacher to “Hold up a rose. Talk about the petals and how they add color and fragrance to the rose. Hand the rose to a student, asking that student to pull off a petal and pass it to another student, who also pulls off a petal. Continue passing the rose around until there are no more petals. At the end, hold up the rose. Say: ‘The rose is similar to someone who is having casual sex. Each time a guy or girl has casual sex, they are giving away a very personal part of themselves. Ultimately, this may cause a person to lose their sense of personal value and self-respect. Let’s learn more about some of the possible negative emotional consequences of having sex.’”

Choosing the Best PATH (2008) , Leader Guide, p. 7

Choosing the Best PATH (2008) , Leader Guide, p. 7

A Choosing the Best spokeswoman told ThinkProgress that the most up-to-date curriculum does not include the rose petal or dirty mint activity. “We believed there was the potential for them to be misunderstood and we found better ways to engage the kids and present the principles that, for example, having greater numbers of casual sex partners increases health risks” she explained.

Despite their recent exclusion of those two activities, Choosing the Best has employed strong rhetoric for decades. A 1993 version of Choosing the Best contended that “there is a greater risk of a condom failure than the bullet being in the chamber,” according to a 1998 Guttmacher Institute report. The curriculum also included a video which featured a student asking: “What if I want to have sex before I get married?” “Well, I guess you’ll just have to be prepared to die,” a teacher replied. “And you’ll probably take with you your spouse and one or more of your children.”

What’s The Actual Evidence On Choosing The Best?

As the Worthams highlighted in their email to Jarret’s principal and health teacher, they were particularly vexed by two things. The first was the organization’s inclusion of the Medical Institute for Sexual Health and the American College of Pediatricians, the socially conservative medical groups listed as endorsing “abstinence-centered” education on Choosing the Best’s website. The second was something that’s regularly repeated by critics of abstinence-focused programs: Evidence suggests that they simply don’t work.

For years, researchers have concluded that abstinence-only courses are ineffective, and can actually make students less healthy. A 2007 study published in the British Medical Journal found that “abstinence only programmes do not effectively encourage abstinent behaviour but instead are ineffective for preventing or decreasing sexual activity among most participants.” Researchers attributed the declines in the U.S. teen pregnancy rate to improved contraception use, as opposed to a decrease in sexual activity, and found the rates of pregnancy and sexually transmitted diseases (STDs) among participants in abstinence-only-until-marriage programs were unaffected by the programs.

Moreover, research suggests that abstinence-promoting programs that withhold information about contraceptives can actually increase the risk of pregnancy and contraction of STIs for young people. A 2009 study published in Pedriatrics concluded that youth who participated in “virginity pledges” were as likely as nonpledgers to have premarital sex, but “less likely to protect themselves from pregnancy and disease before marriage.” And a 2004 study by Columbia University researchers found that nearly 90 percent of teenagers who took chastity pledges not only had premarital sex, but were less likely to use condoms and get tested for sexually transmitted infections than teenagers who had not taken the pledges.

Choosing the Best abstinence pledge. Choosing the Best JOURNEY (2009), Student Manual, p. 48

Choosing the Best abstinence pledge. Choosing the Best JOURNEY, Student Manual, p. 48

Though Choosing the Best calls itself “evidence-based” on its website, the curriculum is not included on the U.S. Department of Health and Human Services’ list of 37 “evidence-based” pregnancy prevention programs, a distinction it quietly notes on its FAQ page. In order to be included on the list, researchers at Mathematica Policy Research, an independent research organization, identify, assess, and analyze studies conducted on programs intended to reduce teen pregnancy rates.

The organization does not appear concerned about its omission on the list.

“Students (and teachers) contact us continually to tell us what an incredible and positive difference the CTB program has made in their (or their students’) lives,” a spokeswoman for Choosing the Best said. “Interestingly, if you look at the programs that are currently on the DHHS list of “evidence-based” programs, you’ll find that many of those programs DO NOT HAVE SIGNIFICANT RESULTS BEYOND THE SHORT TERM. In fact, some only have short-term results among subgroups.”

A number of studies on Choosing the Best have been submitted as part of the evidence review for the list of federally-approved teen pregnancy prevention programs conducted by the organization. But none of them has made the cut. Dr. Brian Goesling, the associate director of human services research at Mathematica, says this is because “none of the studies have met the review criteria for both methodological quality and evidence of program effectiveness.”

Despite this, Choosing the Best continues to brand itself as evidence-based, even measuring itself against Dr. Douglas Kirby’s criteria for evidence-based programs. Kirby is one of the world’s leading researchers on sexuality education, who concluded that “there does not exist any strong evidence that any abstinence program delays the initiation of sex” in a prominent 2007 report.

The letter Kelly Wortham’s son brought home in February, informing parents that Choosing the Best would be taught at Jarrett Middle School, attested that “an independent evaluation, funded by the U.S. Department of Health and Human Services, showed that Choosing the Best decreases teen sexual activity by 47 percent.”

That study, which is also widely promoted on Choosing the Best’s website, was conducted by Dr. Stan Weed and funded by a federal SPRANS–CBAE grant, the robust abstinence-only-until-marriage funding stream that was eliminated in 2010. According to a 2008 article by National Coalition of STD Directors (NCSD) Executive Director William Smith, Weed has evaluated more than 100 abstinence-focused program, but “has just one — ONE — peer reviewed and published study in a refereed journal showing abstinence-only-until-marriage programs can have a modest impact among seventh graders in delaying sex.”

“Stan Weed is a ‘researcher’ who has done several evaluations of abstinence-only-until-marriage programs including CTB [Choosing the Best],” Monica Rodriguez, the president and CEO of the Sexuality Information and Education Council of the United States (SIECUS), said in an email. “His studies/evaluations are almost always released as stand alone publications — never in recognized, peer-reviewed, scientific journals. That is not a coincidence.”

A 2008 study of abstinence-focused programs, conducted by Weed, was reviewed by Mathematica, which concluded that the program “did not establish baseline equivalence for the final analysis sample.”

In an email, Weed told ThinkProgress he is “pretty much retired” and declined to address specific questions about his methodology.

Choosing the Best also regularly refers to a 2012 study by Dr. Lisa Lieberman, an associate professor in the department Health and Nutrition Sciences at Montclair State University. The study looked at the impact of Choosing the Best among ninth-graders in six Georgia public schools, randomly assigning four schools with the ninth grade Choosing the Best curriculum (taught by trained CTB staff) and two schools with their usual abstinence-focused textbook.

The study found that Choosing the Best had only a short-term impact: For students who were virgins at the pretest, it delayed sexual activity for less than six months. Then, they were just as likely as the other students tested to have sex. “From my perspective that’s a very limited finding,” Lieberman told ThinkProgress.

“The moment the study came out, they put out a press release that was incorrect,” she added. “They said that Choosing the Best reduces teen sex. I said ‘no, it doesn’t reduce teen sex. … Nobody stopped having sex. It delayed the onset, but it didn’t reduce sex. You can’t say that! I was banging my head against the wall to make sure that they understood the findings correctly, so that what they wrote would be correct.”

Choosing the Best doesn’t see it that way. On the organization’s FAQ page, they cite the study as proof that the program is “evidence” and “research-based.”

“They are completely misrepresenting themselves,” Lieberman told ThinkProgress after reviewing the FAQ page. “And there’s not a whole lot I can do about it, but they are. They’re misrepresenting themselves.”

Lieberman didn’t hesitate when asked about Choosing the Best’s use of the term evidence-based to describe the research.

“It drives me crazy,” she said. “I’ve lost sleep over it. I really have.”

The Roots Of Sexual Education Opposition

Debates about the merits of comprehensive sexual education have been raging for decades. As Janice M. Irvine explains in her book, Talk about Sex: The Battles Over Sex Education in the United States, an opposition movement coalesced around early efforts to integrate sexual education into the classroom in the 1960s, particularly after the founding of the SIECUS in 1964. The free-spirited, socially liberal political climate of the 1960s helped foster an alliance between alienated, aggrieved conservatives and Evangelical Christians, many of whom were drawn to socially conservative views of sexuality.

“It would turn out that the rightwing politics of morality would have an enormous appeal for many who had been disquieted by the instabilities of transition to a more sexualized society,” Irvine wrote. “Fears of a sexual revolution were in the air. When Ronald Reagan condemned ‘sexual orgies and behaviors so vile I cannot describe them,’ he deployed sex as a metaphor to mobilize broad, inchoate cultural anxieties.”

Among religious conservatives, the integration of sexual education in public schools became a potent symbol of society’s moral decay. Two groups — the Christian Crusade and the John Birch Society — emerged as prominent leaders in the fight against sex ed, while activists from SIECUS became the targets of a fervent, and sometimes threatening, opposition movement.

Mary Calderone, the founder of SIECUS, recalled her anxieties in a quote excerpted in Irvine’s book: “Sometimes I would go to some central United States town and wonder if I was going to be shot at. Because there was violence in the air …You’d wonder if you were going to be attacked at that time. Because a lot of people would think they were doing a martyr’s job by killing this kind of woman who threatened them.”

In 1968, the Christian Crusade published a broadly disseminated pamphlet, entitled: “Is the School House the Proper Place to Teach Raw Sex?” In the handout, authors drew a parallel between sex and the threat of communist indoctrination: “[If] the new morality is affirmed,” they speculated, “our children will become easy targets for Marxism and other amoral, nihilistic philosophies.”

Still, by the 1980s, sexual education in the classroom enjoyed broad public support. Again, social conservatives lashed out against comprehensive programs, and lobbied policymakers to support abstinence-only education programs.

In 1981, under the Reagan administration, the Adolescent Family Life Act (AFLA) was signed into law, as part of Title XX of the Public Health Service Act. It was the first instance of federal government support for abstinence-only education. AFLA provided support to programs that promoted chastity and premarital abstinence and discouraged abortion, designating crisis pregnancy centers as grantees. It also “provided the seed money to create curricula and laid the groundwork for the widespread expansion of abstinence-only programs as funding increased in the mid-1990s,” according to a 2008 article in Sexuality Research and Social Policy.

Federal support for abstinence-only education expanded in 1996, when the Welfare Reform Act was signed into law — but declined with the Obama administration cuts.

“The funding landscape had been moving in such a positive direction, so it was really alarming and disconcerting to us when funding for Title V increased during the recent reauthorization,” Answer’s Nicole Cushman observed. Still, sexual education experts, including Leslie Kantor, the vice president of education at Planned Parenthood Federation of America, say while they were disappointed to see Title V funding increase, they weren’t exactly surprised.

For years, conservative members of Congress have doggedly advocated for abstinence education funding, positioning funding for abstinence-focused programs, as ThinkProgress previously reported, “as somewhat of a bargaining chip.” In 2010, during the battle over health care reform, Republicans also restored funding for Title V.

“In the end, this is a very basic story about politics,” Kantor pointed out, “And the fact that the Republicans took control, there was no doubt that there was at least going to be an attempt and likely a successful attempt to move funding back up for abstinence programs. There’s not a lot of mystery about why that happened.”

Still, as she observed earlier this year, “it’s going to be very challenging to actually get rid of abstinence-only programs.”

What Do Americans Want For Their Children?

Bill Albert, the chief program officer of the National Campaign to Prevent Teen and Unplanned Pregnancy National Campaign, says there’s a simple way to think about the unrelenting controversy over sexual education: “In the unfortunate ongoing battle between abstinence and contraception, the American public is squarely in the side of science,” he asserted. “They want to invest their money in things that have evidence of success.”

The National Campaign, which has conducted extensive polling on Americans’ attitudes towards federal funding for teen pregnancy prevention programs, found that 74 percent of adults aged 18 or older support federal money going to programs that have been shown through careful evaluation to either delay sex, improve contraceptive use, and/or prevent teen pregnancy. Moreover, 69 percent of adults 18 and over believe that teens should be getting more information about both the value of delaying sex and contraception. “They are seen as complementary, not contradictory, strategies,” Albert added.

And yet, American taxpayers who want to invest their money in programs that have been proven to work continue to see an ideologically driven imposition of programs that have no track record of success, under the false pretense of being evidence-based.

That was certainly the message conveyed when Kelly Wortham, after connecting with other local parents, took to Change.org to lobby the Springfield Public School District to adopt a comprehensive sexual education program using SIECUS-recommended guidelines. “We sort of reached out there to say, ‘hey, does anybody else, do you guys know what this stuff is?’” Wortham said. “And the overwhelming response by people with like minds, was: ‘Oh yeah that’s crap, and we don’t let our kids attend either.’ They pulled their own kid out, but nobody had complained.”

When Wortham asked if they would sign a petition urging the school to adopt a new curriculum, “they were like ‘yeah of course!’” she said.

The petition, which has received 194 signatures, generated enough buzz for the Springfield News-Leader to pick up the story. “Let’s have science-based education without thinly-disguised religious bias and distortion,” one petition signer wrote. “The information being taught does not stick to the medical facts, and bends them somewhat. Discussion of relationships and morality does not belong in a health class,” another added.

Of course, not all feedback was positive. “Are your kids ready to be a dad or mom? Those are the possible conquence [sic] of having sex — I know my teen is not ready he has to be reminded to feed the dog could only imagnine[sic] my child with a baby,” a man commented on the Springfield News-Leader article. “This is just another example for the need for real school choice. If a parent want their child to abandon God’s commandments about sexual morality then with school choice that would largely be permitted. However if a parent wishes to encourage their child to pursue sexuality as the Holy Bible comands[sic], then they could do so with out [sic]someone the administration trying to violate their child pursuit,” another chimed in.

Still, not long after the petition’s release and subsequent article, the Springfield Public School District decided to drop the Choosing the Best curriculum for the following year and adopt a new policy on teaching human sexuality.

“After the petition came out and after the article who came out, there were people who were saying thank you and high-fiving us and saying good job.” said Wortham. “And that included teachers in the school, school counselors, people that we didn’t even know that would come up to us and say, ‘Wow, thank you so much. Somebody finally did something.’”

UPDATE JUL 2, 2015 1:37 PM

This has been updated to reflect data requested from The Office of Louisiana Youth for Excellence regarding Title V funding.

Share Update