By Erin Steele
Killeen Daily Herald
Coach Karen Koehler leaned against her desk Thursday morning, staring out at the sea of Shoemaker High School students in her second-period health class.
Earlier in the day, she concluded her lesson on the dangers associated with tobacco.
Now it was time to talk about sex.
It was the first time this semester Koehler had delved into the topic of Worth the Wait, an abstinence-based sex-education curriculum used by the Killeen and Copperas Cove Independent School Districts. The program teaches that abstinence is the healthiest choice for adolescents and focuses on the risks associated with sex.
You will see what happens when things go wrong, Koehler told her class. You will see the direct results of sexual activity.
Like pictures? asked a student.
Like pictures, Koehler said, a response met by a chorus of ewwwws on the front row.
You know, when they first said abstinence, I didnt know if that was going to work. I didnt figure you could come out and say, Dont do this, its not good for you, Koehler said. But I think we need to teach kids what we want them to do.
Its clear that abstinence is the message of choice when it comes to teens and sex. The debate over sex education centers around whether that message is getting through and if it should be the only one provided.
Some studies such as the one published in the 2004 Journal of Adolescent Health, which abstinence-based education advocates refer to as proof that the programs work show a marked decline in teen pregnancy.
Other studies, such as the report released by U.S. Rep. Henry Waxman, D-Calif., on Dec. 1, 2004, question the effectiveness and accuracy of abstinence-only education.
It really depends on which study you look at, said DeEtta Culbertson with the Texas Education Agency. One group will say one thing, and one group will say another.
Worth the Wait was developed in 1996 by Dr. Patricia J. Sulak, an obstetrician/gynecologist at Scott & White Memorial Hospital and Clinic.
Killeen and Copperas Cove are only two of the 50 school districts that use the Worth the Wait sex-education curriculum.
Sulak designed and developed Worth the Wait in conjunction with Scott & White, in response to what she felt was the lack of an organized sex-education program in school systems. This year, more than 100,000 students in Texas will participate in the program.
More kids seem to be getting the message of waiting. The government has documented less kids having intercourse in high school; teen pregnancy rates in Texas have gone down, Sulak said. Kids who are in high school, Ill ask them, Are you having sex? and theyll say, Im waiting.
While Texas currently has the fifth-highest rate of teen pregnancy in the country, according to teenpregnancy.
org, the rate of teen pregnancy in Bell County has declined.
In 1992, the rate of pregnancy for girls ages 13-17 was 44.9 percent, according to the Texas Department of State Health Services. In 2003, Bell County reported a teen pregnancy rate of 27.4 percent. The rate was lowest in 2001, at 25.8 percent.
Federal funding for abstinence-only sex education has more than quadrupled since 1996, when then-President Bill Clinton signed into law welfare changes that included $50 million for programs focusing exclusively on abstinence.
The fiscal year 2006 budget proposed by President Bush who was governor of Texas when the state made abstinence-based sex education mandatory for public schools in 1995 allots $206 million for abstinence initiatives. In support of the initiative, money for abstinence-only programs will increase to $270 million by 2008.
Texas is one of the largest recipients of federal funding for abstinence-only sex education, with about $7 million provided annually.
Worth the Wait receives money under Title V through the Texas Department of State Health Services, as well as federal grants from the Health and Resources Administration, Maternal Child Health Bureau. The program is now in its second year of a three-year funding cycle, receiving just shy of $800,000 annually.
The funding became available in 1996, but the big funds were not awarded until 2000, Sulak said. You have to put a program into effect for five to 10 years before you can really see an effect.
The governments national evaluation of abstinence programs has been delayed, but is expected sometime next year. A study determining the effects of Worth the Wait will be released the first week of December, Sulak said, sounding confident the results will be positive.
Lets face it how many programs are written by a hospital associated with a medical school? Sulak said. The program gives kids the facts. We dont present mixed messages. We tell kids that when they have sex, bad things can, and unfortunately do, happen. Abstinence is the only 100-percent foolproof method.
But Pat Stone, the education director for Planned Parenthood of Central Texas, believes abstinence-only sex education is far from foolproof.
According to a study conducted by the Kaiser Family Foundation, the Kennedy School of Government and National Public Radio, 46 percent of parents believe abstinence-plus sex education should be taught in schools, compared to the 15 percent who support abstinence-only. An additional 36 percent believe comprehensive sex education should be on the lesson plan.
Stone said the numbers speak for themselves.
I think theres a very big difference between what the public and parents know children need and what politicians think they need, Stone said. There are always going to be people who say abstinence-only is simple and theres not a mixed message. But we on the comprehensive side believe that doesnt respect kids rights to complex information. I think they can make smarter decisions if they have the whole story.
Stone emphasized that comprehensive sex education includes abstinence as part of its curriculum, in addition to information on how to properly use contraceptives.
Weve had kids who have come in and said, I dont want condoms, because their health classes say they dont work, Stone said. Thats kind of a self-serving thing to say to kids; its innacurate. I think with the increased age of marriage in this country (the average age is 26), leaving young men and women uninformed for probably the next 10 years is a disservice. When is it going to be OK to talk about contraceptives?
The increased federal funding adds to the problem, Stone said, convincing schools to keep a sex-education program that is unpopular with parents.
Schools have their plates full with testing and the complexities of their students, and the idea that someone can walk in and hand them a neat package is appealing, Stone said. Public education has its hands full right now.
State Rep. Diane Delisi, R-Temple who co-authored the bill that made abstinence-based sex education mandatory in Texas said her belief in the importance of abstinence-only sex education stemmed from concerns over teens contracting the human papilloma virus (HPV), which cannot be entirely prevented by condom use. Some types of HPV can cause cervical cancer if left untreated.
About 5.5 million new genital HPV cases occur each year, which composes approximately one-third of all new sexually transmitted disease (STD) infections.
The only thing that can protect a young girl from this very prevalent STD is abstinence, Delisi said. It is extremely important that young girls do not have sexual experiences until their bodies have matured; its just a threat to their health.
She said that her efforts regarding abstinence-only sex education have always been rooted in science, as well as social factors. Delisi added that when she took office in 1991, Bell County had the highest rate of teen pregnancy (in girls ages 12-16) than any other county in Texas.
There are many who disagree with abstinence education and argue that it is a conservative issue, that it is not soundly based on science, Delisi said. I have the data that I have worked on for years, so I am able to refute that argument at every turn. It is a disservice to young girls to allow them to think they can have sexual experiences at an early age without endangering their bodies.
Opponents of abstinence-only education worry that there simply isnt enough solid proof that the mandated programs work and certainly not enough evidence to justify the substantial increase in federal funding.
With something as serious and important as preventing teen pregnancy, we need to be smart and strategic about how we spend limited tax dollars, said Sarah J. Wheat, the executive director of NARAL Pro-Choice Texas. The fact that the White House has really pushed to expand funding for these programs when we dont have any proof they have reduced teen pregnancy and STDs is irresponsible.
Wheat said she fully supports abstinence as one facet of a comprehensive education. But much of the support for abstinence-only sex education is based on confusion, she said, as many of the terms surrounding sex education can be misleading.
Without knowing the details and just hearing the word abstinence, I think people often say, Thats great, I absolutely support abstinence, Wheat said. They dont seem to realize that schools are deliberately not teaching their students about contraception.
Karen Flowers, the program coordinator for the Texas Department of State Health Services Abstinence Education Program, said the effectiveness of abstinence-only sex education will likely remain open for debate.
I think sometimes its difficult for that evolution to happen, Flowers said. Sometimes, we dont know what works, and I think thats true with abstinence education. Its still defining itself.
Contact Erin Steele at email@example.com