Challenging Dogma - Fall 2009

Thursday, December 17, 2009

Does Abstinence Really Work or Should Teenagers be Taught about Safe Sex?- Adrienne Robinson

I. Introduction
Sexual education teaches youths in middle school and high school about safe sex practices, the reproductive system, pregnancies, sexual transmitted diseases and infections, HIV and AIDS, abstinence, and other issues related to or affected by sexual activities. In fact, studies have shown that simply being in school reduces sexual risk-taking behavior and dropping out appears to increase unsafe sexual activities (Kirby 27). Programs in school which teach adolescents to stay in school, strive for higher education, and encourage them to succeed and feel attached to school, may postpone their onset of sex, increase contraceptive use, and decrease pregnancy (Kirby 28). If youths enjoy school, they will most likely apply what they are learning to benefit their future rather than engaging in destructive behaviors.
Contrary to some belief, students taking sex education are not more likely to be exposed to sexual activities, yet they are more likely to use protection and are less likely to become pregnant (Furstenberg 1331). Learning about sex does not promote the sexual behavior of teenagers, since they seem to be more influenced by their peers than anyone else. In fact, the rejection by an adolescent’s peer group may possibly predict early onset of sexual intercourse (Brendgen 2070). “Sex education programs reduce the level of sexual activity, and that they supplement, rather than undermine, the influence of parents” (Furstenberg 1332). Apparently knowing about the risks associated in having sex affects the youths’ decisions to not take those risks. In addition, a large number of adults favor sex education that discusses condom and birth control (Kirby 31). If schools refrained from teaching sex education, youths would not be subject to the proper and effective ways to practice safe sex to prevent STDs and pregnancies.
Parents for Truth is a national abstinence campaign founded by parents and sponsored by the National Abstinence Education Association focused on preventing schools from teaching sex education and promoting abstinence as the only effective way to avoid the negative impacts of sexual behavior (Parents). This campaign fails as a successful public health intervention because it deals with an individual’s rational decision-making, it does not take into account societal or external determinants, and it sees adolescents as planning to behave rather than acting out spontaneously. Furthermore, an alternative intervention would be one that utilizes the sexual health model, the marketing theory, and the psychological reactance theory.
II. Critique of Parents for Truth
A. Parents for Truth sees Adolescents as Behaving Rationally
Parents for Truth want schools to teach youths to refrain from having sex by believing the adolescents will make rational decisions when they are in the presence of engaging in sexual activities (Parents). The campaign does not take into account that people behave irrationally even if they know the consequences of their behavior. The students will obviously know that not having sex is the only sure way to protect them against diseases and pregnancy, but once they are placed in that situation, they may act out in ways that suit their context and benefit them in that moment.
The campaign assumes adolescents will behave rationally through the fundamental attribution error, in that the youths will behave in ways based on their character and not by their context. Parents for Truth want schools to teach kids that sex before marriage is “optimal” and “realizes that ‘having sex’ can potentially affect a lot more than the sex organs of teens, but can also have emotional, psychological, social, economic, and educational consequences” (Parents). The campaign trusts that the youths will be engrained with this message; therefore behaving in rational ways since being abstinent will define who they are. It is an error to attribute one’s behavior to their character and not to the context because the context in which someone is presented into has everything to do with the way one makes judgments.
Parents for Truth uses the health belief model as the basis for their intervention. The model “proposes that a person will take action concerning a health condition determined by the person’s readiness to take action and by the perceived benefits of action weighted against the perceived costs of barriers” (Salazar 129). In teaching abstinence, the youth will be prepared to cease from having sex because he or she will realize there are many more benefits from the abstinent behavior than barriers in performing it. The perceived barriers might include the pressures to fit in or not disappointing the other person who wants to have sex. Nevertheless, the program teaches youths to avoid “inappropriate sexual advances by developing skills to make good decisions to avoid or get out of a dangerous, unhealthy, or abusive relationship” (Parents). The youth will analyze his or her perceived susceptibility to contracting an STD or another disease if he or she has sex and its perceived severity of the disease to the perceived benefits of abstinence, with the intention to refrain from engaging in sex (Edberg 36). This ideology focuses on individual and rational behavior, in that each time a youth is subject to having sex, this process will take place to ensure he or she will practice abstinence. However, an individual, particularly an adolescent does not rationally think about the costs of having sex when they are in a sexual or hot state of mind since they may be run by hormones.
Parents for Truth believe that the students will take what they learned in the abstinence program and effectively apply it to real life situations in a rational and well thought out way. Yet, human beings are not rational, and they make many judgments based on dynamic behaviors, not always acting in ways they intend to act. The abstinence program merely teaches youths to not have sex and does not provide any information on what to do if they wish to have sex or partake in other nonsexual activities, such as community youth service programs, which have been known to reduce early and unprotected sex among high-risk young urban adolescents (O’Donnell 180). Parents for Truth see youths as living in a vacuum, taking in information about abstinence without wanting to participate in other activities that would distract them from having sex.
B. Parents For Truth does not take into account Societal or External Determinants
The Parents for Truth Campaign assumes students will abstain from sex, regardless of any other influences in their lives. This is a narrow and single-minded approach to teach adolescents about not having sex, and it does not take into consideration the multitude of factors that persuade youths into performing sexual activities. For instance, adolescents learn mainly from their peers, parents, teachers, and the media about sex (Bleakley 47). An abstinence program will not solely affect a youth into avoiding sex because it does not provide any information on the forces which are more likely to encourage sexual behavior among adolescents. The Parents for Truth campaign wrongly states that parents are the single most important factor in a child’s decision-making and are three times more influential than their peers (Parents). They are more frequently to turn to their friends of the opposite sex and dating partners than anyone else in understanding sexuality (Sprecher 18). Also, “adolescents may perceive sexual behavior as a way to become popular, and girls with low self-esteem may be especially vulnerable to engaging in early sexual intercourse to achieve social acceptance” (Brendgen 2074). Parents for Truth does not recognize any of these factors, which have a profound effect on how adolescents will behave sexually instead of listening to abstinence programs taught at school.
Given that the Parents for Truth campaign is based on the health belief model, which mainly focuses on an individual making a cost-benefit calculation about whether or not to abstain from sex, there is no concern for the external or social influence that will allow these calculations to vary (Edberg 38). Apparently, the adolescent is set on his or her decision to not have sex even if there are strong influences which will convince them to do otherwise. The model assumes the adolescents will not be affected by outside sources, since they will absorb the material taught by the abstinence program on how to avoid sexual activities. Nevertheless, “external rewards” have an important impact on the way an individual behaves (Edberg 38). These external rewards include freedom, independence, control, identity, and rebellion (Siegel 68). If having sex promotes the core values critical to adolescents, such as acceptance and freedom, these youths are most likely going to engage in sexual behaviors.
Authority figures also have a great deal of influence on the sexual behaviors of adolescents. If parents approve of their youths having sex, adolescents may be more likely to initiate sex if they are virgins, and they have an increased tendency to use birth control (Jaccard 1429). “When parents learn that their child has engaged in sex, they decide that the child needs to be prepared for safer sex, so they convey approval of the use of birth control to their child” (Jaccard 1426). Parents know that not telling their child to do something does not imply that their child will not do it, and in order for them to behave safely they encourage the use of contraceptives. Studies also show that adolescents whose parents had a higher education were less like to have ever had sexual intercourse, yet those families with a higher income had an increased number of sexual partners and an increased frequency of sexual intercourse but a decreased probability of pregnancy (Santelli 1586). This indicates that one’s family structure is another determinant on how an adolescent will behave sexually, another societal factor that is not taken into account by the Parents for Truth campaign.
C. Parents for Truth Assumes Adolescents will Plan to be Abstinent Rather than Behave Spontaneously
The Parents For Truth Campaign teaches adolescents the value of being abstinent and supposes these youth will grasp what they learn and plan to use it when they come across sexual encounters. The campaign states that abstinence campaigns will show adolescents how to “develop skills to make good decisions and to set goals for the future by taking realistic steps to reach them” (Parents). However, it does not describe the specific actions that are needed in order to achieve these goals. In reality, these adolescents are most likely to behave in spontaneous ways that suit the moment they are in, either by choosing to have sex or not. Although they may plan to not have sex, a situation may arise where they might change their mind because they are in a relationship or they simply want to have sex. However, the Parents for Truth campaign inaccurately goes so far to state that “using a condom does not make sex safe” (Parents). Since the abstinence program will not teach them how to practice safe sex, the adolescents are more prone to engage in unprotected sex, believing the condom offers no protection. Planning to behave a certain way does not entail an individual will follow through with it, which is another incorrect idea of human behavior.
The Parents for Truth campaign also utilizes the theory of reasoned action in that the abstinence program will cause adolescents to rationally weigh the value of potential outcomes from not having sex with the attitudes of others, especially their parents, before intending to practice abstinence (Edberg 39). The model emphasizes that attitudes predict behavior in that “people think about what they are going to do before they do it” (Edberg 39). While the students are learning about abstinence in school, they may come to the conclusion they will not have sex, but when they are actually in that situation, their emotions may take charge or they may have contradicting attitudes. In this model, “time between intent and action is not considered” (Edberg 42). Youths may feel they want to practice abstinence one day but the next they may change their mind, yet the model does not imply how long the intent to behave lasts. In addition, “some youth may have all the needed knowledge and skills regarding contraception, but may simply lack the motivation to avoid pregnancy, while others may lack the knowledge, attitudes, or skills but have connections with adults, a belief in the future, and the motivation to avoid pregnancy” (Kirby 57). Adolescents will not all behave similarly, and they have distinct attitudes and beliefs that constantly change. Thus it is an error to attribute all adolescents will behave accordingly and plan to abstain from sex. This is not to say that some will practice abstinence, however the abstinence program will not be the deciding factor. It will be the spontaneous and irrational decisions of the adolescents who are influenced by their peers and society.
III. An Alternative Intervention to Parents for Truth
An effective public health intervention to teach adolescents about sex is one that combines abstinence and safe sex practices (Kirby 56). Youths want to know all “the facts and then to be left to make their own educated decision” (Hicks 4). A one-sided approach that preaches to youths about the negative aspects of having sex will not adequately entice them to practice abstinence. Therefore, a sex education program that addresses both positive and negative aspects of safe sex and abstinence will provide compelling and accurate information to guide adolescents in the sex decision process.
A. The Use of the Sexual Health Model Addresses Many Aspects of Sexual Behavior that will be Beneficial to Adolescents
The sexual health model is an approach to sexuality focusing on communication, sexual identity and culture, sexual anatomy, safe sex, challenges, body image, masturbation and fantasy, positive sexuality, intimacy and relationships, and spirituality (Robinson 47). Adolescents should not be persuaded to believe that having sex is wrong, but should be taught that sex is a natural behavior which should be explored after becoming knowledgeable about the risks and benefits. It is worth mentioning that the reasons adolescents may wish to have sex are mainly because of intimacy or desire with their partner (Dawson 230). These young people may feel the need to seek intimate relations in order to feel self worth and validation (Dawson 230). Therefore, it is necessary for sexual education programs to incorporate emotional feelings associated with sex under a positive self image. “Sexual behaviors, whether risky or safe, may serve a range of psychological functions that have little to do with health protection and disease avoidance” (Cooper 1528). Adolescents care more about being accepted by their peers than about protecting themselves from an illness, so an intervention should not primarily focus on STD and AIDS prevention.
In the sexual education program centered on sexual behavior as well as abstinence, it is necessary “to strengthen decision making around safer sex within the wider context of intimacy” (Robinson 50). Those programs emphasizing interpersonal communication skills among adolescents who wanted to be intimate with their partners were more effective in increasing safer sex behaviors over programs that merely focused on the technical skills (Cooper 1529). Adolescents have complex issues surrounding sex, and they are going to apply what they learn only if they can benefit from it. Youths will learn the precautionary measures in expressing intimacy, which will encourage them to practice safe sex compared to just learning how to use a condom. Still, if they want to refrain from having sex, they should be taught to effectively communicate their feelings, while also understanding what it means to be intimate. Masturbation can be taught as an alternative way to express intimacy since it is ultimately as safe as abstinence (Robinson 50). “Encouraging masturbation as a normal adjunct to partnered sex can decrease the pressures on women to engage in penetrative sex with their partners more frequently than they have desire and arousal for” (Robinson 50). Including the topic of masturbation in the sexual education program will broaden the adolescents’ knowledge on other ways to practice abstinence.
The adolescent years are a difficult time for youth because they struggle with how their bodies look, and this might cause them to engage in sexual behaviors to promote their self worth. They may use sex to escape, avoid, or minimize negative emotions or threats to their self esteem (Cooper 1531). Thus, the sexual health model encourages a positive body image through a “culturally sensitive manner” (Robinson 49). The media also has a great impact on the way adolescents view themselves, and it is estimated that adolescents watch on average 3 hours of television per day, and the degree to which sex is displayed has increased over time (Sprecher 46). The messages portrayed by the media can negatively affect the youths’ attitudes toward sex by accepting “the notion of one, narrow standard of beauty” (Robinson 49). When applying the sexual health model in the comprehensive sex education programs it will be tailored to adolescents, and it will teach them how to perceive their bodies in positive ways despite what the media represents.
B. The Use of the Marketing Theory can be used to Implement a Sexual Education Program that is Based on what Adolescents want
The marketing theory can be applied to a sexual education program by finding out what youths want and then redefining and creating a program that fulfills their needs and wants by appealing to their core values (Siegel 45). A successful intervention would be one that addresses freedom, independence, control, identity, and rebellion (Sigel 68). Instead of developing a program to satisfy the parents’ expectations, it will be more advantageous to implement a program through understanding the attitudes and behaviors of the adolescents. By realizing the motives driving adolescents to have sex, an effective intervention can be put to use. These motives for adolescent sexual behavior may include “(a) appetitive self-focused motivations, such as having sex to enhance physical or emotional pleasure (b) aversive self-focused motives, such as having sex to cope with threats to self-esteem (c) appetitive social motives such as having sex to achieve intimacy; and (d) aversive social motives such as having sex to gain approval” (Cooper 1530). Rather than focusing on the individual’s sexual decision making, it is beneficial to recognize these societal based motives, which are more essential and have a profound impact on an individual’s attitudes toward sex.
A public health intervention, such as Parents for Truth loses trust because it delivers negative messages and invokes fear about engaging in sex (Evans 16). The comprehensive sexual education program must include positive implications for not having sex rather than associating STDs and AIDS with sexual activities, while also incorporating safe sex practices. For instance, the programs can stress the adolescents’ control and freedom in their lives by not having sex or by practicing safe sex. Hence, the programs are offering something beneficial in return for engaging in the health behavior, which is more appealing to adolescents then promoting disease with sex (Evans 16).
C. The Social Reactance Theory can be used in a Sexual Education Program by Increasing Compliance and Deflecting Reactance
When adolescents feel threatened, they act out in ways to suppress their fears by engaging in rebellious behaviors. The social reactance theory explains that “when people think that a freedom is threatened they experience reactance, a motivational state aimed at restoring the threatened freedom” (Silvia 277). An abstinence intervention which encourages adolescents to not have sex jeopardizes their freedom and control in their lives that may result in them engaging in unsafe sexual activities. In one study, adolescents receiving abstinence-only education initiated sex at the same mean age and had the same number of partners as those adolescents who had not received any sexual education (Kuehnel 1243). By telling the youths to not do a behavior, it is in a way violating their right to choose how to live their lives. They then react by restoring their freedom in doing the behavior they are not supposed to do. In fact, students who only learn to abstain from sex are less likely to believe that condoms effectively prevent STDs compared to those youth receiving no messages about sex (Kuehnel 1243). To prevent adolescents from reacting in unsafe sexual practices, it is beneficial to use comprehensive sexual education programs that teach kids to perform behaviors which support their freedom to choose whether or not to have sex.
In order to deflect the reactance of adolescents, the sexual education program should include teachers who are similar and attractive to the students (Silvia 282). Youths relate more to people who they like, leading to a greater compliance in the sexual education they teach. A teacher who is young and understands the adolescents will explicitly get the message across more effectively than teachers who are older and are seen as authority figures. Adolescents may perceive negative messages from older and dissimilar teachers as threatening, causing them to have a reactance, while the same messages delivered by the younger and similar teacher are seen as persuasive as normal messages (Silvia 283). Teachers who verbally abuse youths may cause them to have sexual intercourse at an early age because “rejection by valued socializing agents such as teachers might lower children’s motivation to conform to the conventional and nondeviant expectations put for by these agents” (Brendgen 2073). The adolescents are reacting in a rebellious manner because the teachers threatened them through verbal abuse. To facilitate compliance and avert reactance, similarity is the most important factor in persuading adolescents to apply healthy sexual behaviors.
IV. Conclusion
The Parents for Truth campaign preaches abstinence and is flawed because it assumes adolescents are rational decision-making individuals, it does not hold accountable societal or external determinants which greatly affect the attitudes of adolescents, and it teaches youths to plan to stay abstinent, while not taking into consideration the spontaneity and unpredictability of human behavior. An alternative intervention is one that combines a comprehensive sexual education program with ideas of abstinence. The sexual health model uses a variety of aspects regarding sexuality to help broaden the program, the marketing theory implements what the adolescents want rather than what parents or the school want them to learn, and the psychological reactance theory is applied to encourage youths to comply, rather than react to positive messages taught by teachers who are similar to them.


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