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The American College of Pediatricians released an updated statement on School-Based Sex Education in the United States and note that comprehensive sex education (CSE) in schools has been a failure.

They say CSE programs in America’s schools have failed to demonstrate long-term effectiveness in delaying sexual activity or increasing long-term condom and contraceptive use among sexually active youth.

The statement authored by Stan Weed, ; Irene Erikson, ; Russell Gombosi, MD; Michelle Cretella, MD note the alarming rise in sexually transmitted diseases based on data released in 2018 by the Centers for Disease Control and Prevention:

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, exceeding the previous year’s record high by over 200,000 cases. Comparing data from 2013 to that from 2017, the CDC found chlamydia remained the most common STD, and that 45 percent of the over 1.7 million cases were among 15- to 24-year-old females. Gonorrhea has risen 67 percent over that same time period, and the number of strains resistant to antibiotics is growing rapidly. Similarly, the diagnosis of primary and secondary syphilis, which are the most infectious stages of the disease, increased 76 percent. Gay, bisexual and other men who have sex with men (MSM) made up almost 70 percent of those cases.

“As pediatricians, we see firsthand the benefits of adolescent sexual abstinence, and the suffering caused by adolescent sexual activity. Sexually abstinent youth make healthier life choices and avoid the substantive physical, emotional and social harm caused by premature sexual activity,” Quentin Van Meter, MD, President of the American College of Pediatricians, said. 

The negative outcomes of adolescent sexual activity include, but are not limited to:

  • Teen pregnancy, out-of-wedlock births abortions
  • Sexually transmitted diseases (STDs) and resulting infertility
  • Sexual violence
  • Adolescent anxiety and depression
  • Adolescent suicide 
  • Poverty in adulthood

In contrast, school-based sexual risk avoidance (SRA) curricula, traditionally known as abstinence education, promote the primary public health principle of risk avoidance and, thereby, the highest attainable standard of health for all students. School-based SRA programs have been shown to significantly delay the onset of sexual debut among adolescents without diminishing condom use among those who are already sexually initiated.

They note that CSE purports to implement SRA and sexual risk reduction (SRR) as strategies within the same group of students when. In public health models, risk reduction is the second public health principle following risk avoidance that targets a smaller group of people already engaged in high-risk behavior.

They note this is likely one of reasons CSE has failed.

The school-based SRR (CSE) model targets the general teen population, rather than focusing on an individual intervention for those who are actually engaged in the risk behavior. This is a significant difference from the typical risk reduction model. The sexual risk reduction approach should focus on adolescents in school who are already sexually active, but instead is applied to the broader teen population. This sends the false message that “everyone is doing it”, which has the negative effect of normalizing teen sex as an expected standard for all students.

They also state:

The school-based SRR (CSE) model does not seek to move individuals who are engaged in sexual activity toward a renewed risk avoidance (abstinent) behavioral choice, as is true for other risk behavior programs.

SRR programs also tend to claim success when students are still engaged in the behavior which is not the case with the SRA approach.

ACPeds recommends the adoption of SRA education by all school systems, with classes beginning in middle school and continuing through high school.  They also endorse continued research on SRA programs, since, as with all education initiatives, ongoing research is necessary to document and monitor effectiveness.

“America’s young people deserve the best that we can give them; school-based sexual risk avoidance education is the best for children,” the statement concludes.

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