Monica is seventeen years old. When I met her in January, she was seven months pregnant with her second child. Her fifteen-month-old girl, Anevaeh, wandered through the room with a purple pacifier in her mouth. Monica should have been preparing to graduate from high school. Instead, she was finishing tenth grade. She and her nineteen-year-old boyfriend, Thomas, swore that they usually used condoms, which they acquired free from their local Planned Parenthood clinic. But twice, when they were caught in the heat of the moment without a supply, they took their chances. Both times Monica got pregnant.
Monica had no illusions about how it had happened. “I got sex ed in school,” she said, sitting on a queen-size bed in the couple’s cramped apartment, located on the second story of her parents’ house, in Austin. “Maybe in fifth or sixth grade.” She received additional instruction in middle school as part of her probation for possession of marijuana. But certain details were still unclear; for instance, she had the mistaken notion that condoms would not help protect her from HIV.
“I learned what gonorrhea and chlamydia look like,” she told me. “The teachers didn’t say if there were cures. I think there were some STDs they wouldn’t talk about.” She didn’t recall any official discussions about pregnancy in her school. Most of what she knew she learned from her teenage girlfriends, the majority of whom were already mothers.
Monica’s situation is more common in Texas than in any other state. Texas ranks number one in teenage births, which, all told, cost taxpayers at least $1 billion a year. (Twenty-four percent of those births are not the girl’s first delivery.) While the number of teenage births in Texas is actually going down of late, it is decreasing at a slower rate than the nation’s at large. And 52.5 percent of Texas teens are having sex, compared with the national average of 47 percent. Rates of HIV/AIDS infection among teens are currently on the rise. Texas ranks fifth in teenage pregnancy (a number even more disconcerting in light of the fact that the U.S. ranks near the top in this category among developed nations).
To confront these challenges, Texas has become a leader in abstinence education. Thanks in part to the efforts of powerful advocates, from George W. Bush to the Medical Institute for Sexual Health (MISH), based in Austin, the state has endorsed abstinence education as its primary agent to combat teenage sexual activity. Texas now gets more money through Title V, a stream of federal funding for abstinence programs, than any other state, more than $4.5 million a year. The Texas Education Code, written by the Legislature, lists directives with regard to sex education. One states that in the classroom, abstinence must be given more attention than any other approach; another requires that it be presented as the only method that is 100 percent effective at preventing pregnancy, STDs, HIV/AIDS, and the “emotional trauma associated with adolescent sexual activity.” These two directives haven’t been terribly controversial. Whether “emotional trauma” results from adolescent sexual activity is debated (studies suggest that activity is a consequence—not a cause—of mental health problems), but critics rarely belabor this point. Health care workers agree that it would be good if teenagers remained virgins.
More problematic is what isn’t taught. No law mandates that methods of contraception be included in sex ed classes, and nowhere in the code is condom instruction encouraged. Teachers in Texas who do promote condom use must cite “actual use” rates of condom effectiveness, not theoretical rates (more on that later). Only one of the four state-approved high school student health textbooks uses the word “condom,” and that book reaches only a small percentage of the Texas market. Because the language of the code does not insist on condom instruction, schools are free to leave it out. Garnet Coleman, a Democratic state representative from Houston who has been on the House Committee on Public Health since 1993, explained to me, “Abstinence-only wasn’t the intent of the legislation, but it de facto became that.”
“What I say we do is absent education,” said David C. Wiley, the president of the American School Health Association and a professor of health education at Texas State University. “I have never met anyone in all my fifty years that has ever had a comprehensive sex ed program in their schools—ever. We are raising generation after generation of sexually illiterate adults.”
And the situation is getting worse. Over the past thirty years, the age of the average female at the time of her first menstruation has decreased (about one month per decade), while the age of a person at the time of his or her first marriage has increased (by at least three years). At the same time, children are becoming sexualized earlier than ever before. Recently, Abercrombie & Fitch marketed thong underwear emblazoned with the phrases “wink, wink” and “eye candy” for “tweens”—consumer marketing—ese for seven- to twelve-year-olds. Kids trying to navigate this terrain want to hear from their parents about sex, but only about half of them do. More often, they pick up their information (and misinformation) from magazines, television, the Internet, and their peers. Without a sex ed curriculum in the classroom that works, these kids, and the taxpayers who end up footing the bill for their mistakes, are extremely vulnerable.
In the next decade, teenage mothers like Monica will become even more typical. Projecting a change in racial and ethnic composition and an increase in the teenage population, the Texas Department of State Health Services anticipates “serious implications for the patterns and trends in adolescent pregnancy.” As the crisis worsens, local school boards will become desperate for solutions to prevent teen pregnancy and disease. Proponents of abstinence programs claim that they have the answer; those who support comprehensive sex ed fundamentally disagree. The question is, What works?
The Texas State Board of Education adopts new health textbooks every eight to ten years. Since the content of