OP-ED: “Abstinence” is perfect according to law—Or is it?

Tamsen Valoir, PhD

The Texas Education Code 28.004 states that “abstinence from sexual activity, if used consistently and correctly, is the only method that is 100 percent effective in preventing pregnancy, sexually transmitted diseases.”  In truth, abstinence is not 100 percent effective against any of these things.

Nor is Texas alone in propagating the myth.  Federal law codifies the myth saying that it is “only certain way” to prevent disease and pregnancy, and Michigan, Oregon, and Alabama law provide something similar.  To be fair, even Planned Parenthood is helping to propagate this perfection myth, and they at least should know better.

Unfortunately, abstinence is not effective in cases of rape.  If the lifetime estimates of rape or attempted rate are as high as 1 in 5 for women and 1 in 59 for men—that is not an insignificant risk.

Further, many sexually transmitted infections or “STIs” can be, and often are, transmitted by ways other than sex.  STIs can be transmitted by kissing, skin-to-skin contact, and by shared needles to name a few of the many methods of transmitting an STI.  Babies can even be born with an STI.   In fact, after a period of decline, there has been a recent “sharp increase” in the number of babies born with congenital syphilis in the US.

Nor is there general agreement as to what counts as abstinence.  A 2007 study found that 60% of college students did not consider oral-genital contact as having sex, and another 1999 study found that 19% of Americans believed that penile-anal contact did not count as sex either.   In spite of this lack of uniformity as to the meaning of abstinence, neither the Texas nor the Federal law defines abstinence, allowing young people plenty of personal leeway in defining it.

Teaching young adults that abstinence is 100 percent effective is false, and can have dangerous consequences.  In fact, Texas has the third highest HIV rates in the nation. The reasons are complex, but teaching no sex-ed or abstinence-only in 83% of Texas schools is likely a contributing factor, as is propagating the myth that abstinence is perfect.

While we have seen reductions in teen pregnancy in Texas, we still have the fifth highest teen pregnancy rate of the 50 states, and the highest rate of repeat teen pregnancies.  Further, the US has the highest rate of teen pregnancies in the developed world.  In fact, there are 93 countries with teen pregnancy rates better than Texas!  Texas is only doing better than developing countries, such as Mexico, South Africa, and Egypt.  Further, in some counties lacking reproductive health care clinics, pregnancies and abortions are on the rise—a disturbing trend where the US and global rates are decreasing.

Further, 54% of all pregnancies in Texas are accidental, which is significantly higher than the 45% national average. This suggests that a lack of family planning and disease prevention knowledge is not just an issue for teens—adults are making the same mistakes.

Perhaps it’s time to amend our laws so they don’t propagate the dangerous myth that abstinence perfectly prevents pregnancy and disease.  In fact, there are no 100% effective methods.  While the legislature is at it, perhaps we could mandate education on disease prevention, instead of leaving it optional in Texas.

Given the conservative nature of the Texas state government (66% of the legislature is Republican), mandating a comprehensive sex education program is probably not in our near future.  But, perhaps a middle way could advance Texas and other southern states towards the goal of reducing STI and teen pregnancy incidence.   Treble-Up is a grassroots organization that has offered a “marital education” program—mid-way between comprehensive sex education and the abstinence-only programs common in Texas schools.

Treble-Up provides a free booklet on their website on family planning and disease prevention.  The book is written in the context of marriage and avoids controversial topics, such as homosexuality and transgenders.  It provides an easy-to-read summary of each type of family planning and disease prevention method, beginning with fertility awareness based methods, which are approved of by the Catholic Church.  Barrier methods, hormonal methods, and the new long acting reversible contraceptives, known as “LARCs” are also discussed, along with permanent methods, such as tubal ligation and vasectomy.  Actual failure rates of each type of family planning method are provided, ranging from 24% for fertility awareness methods, to 14% for condoms, 9% for the pill, and less than 1% (but not zero) for LARCs and sterilization.

Also provided is a discussion of the most common reasons for failure, as well as detailed instructions for use and for reducing the failure rate.  Given that all forms of contraception—even sterilization—sometimes fail, suggestions to double-up or treble-up on the various forms are made, and methods that cannot be combined are noted.  The organization’s name “Treble-Up” and their slogan “Use Three forms of Birth Control” derive from this concept of using three complementary types of protection.

STIs are on the rise in the US, some by double digits.  The Centers for Disease Control estimate that at any one time there are 110 million cases of STDs in the US when herpes and human papillomavirus infections, which are not tracked by the agency, are included.   If about 1 in 3 Americans has an STI and 60% of young people think oral sex is not sex, then abstinence until marriage will fail to protect many young couples.  Thus, even couples that remain “virgins” until marriage still need to know how to plan their families and how to avoid disease.   If the legislature won’t embrace comprehensive sex education, perhaps “abstinence-plus-marital” education will be more palatable.