Bay Windows - April 26, 2007
Ethan Jacobs, ejacobs@baywindows.com

"I can tell you that the most recent sexuality workshop we did with them, we talked about anatomy, and there was over half of the youth who were there who were completely unable to identify parts of their own sexual anatomy," said Flaherty. "Well over half just had no idea whatsoever."

Gov. Deval Patrick announced this week that the Department of Public Health (DPH) will not apply for a federal abstinence-only education grant for the coming fiscal year, effectively ending the two-year experiment of state-sponsored, federally funded abstinence education begun under Patrick's predecessor, Mitt Romney. While proponents of comprehensive sex education greeted the decision as the removal of a barrier to teaching young people about safer sex, condom use and birth control, those working with LGBT young people say the bigger problem is that whether LGBT youth are attending schools with comprehensive sex education or no sex ed at all, they are not getting the information they need to make informed decisions about sex.

Flaherty runs the sexuality education programs for BAGLY, one of 14 Alliances of Gay and Lesbian Youth (AGLYs) around the state receiving DPH funding to do targeted sexuality and safer sex education to LGBT youth. She said most of the youth who come to BAGLY arrive with a basic understanding that condoms offer protection against HIV infection, although she said she is unsure if they get this information from their schools, from peers, or from other sources. But she said they often have little knowledge about other STDs and how to prevent them.

Flaherty said she is unsure how many of the BAGLY youth who attend school have had sex-ed classes, but she said even those who have gone through sex ed got little information out of it compared to their straight peers because the classes were designed with heterosexual students in mind. She said youth tell her that discussion of lesbian, gay and bisexual sexuality is often limited to an isolated lesson on alternative sexualities, and there is no discussion of transgender sexuality.

"Those who are in school who want to know more about sex and sexuality that reflects their own identity ... aren't getting any information about that, because that's not being taught in schools, how to have a healthy queer sexuality," said Flaherty.

Sophie Godley, deputy director of programs for AIDS Action Committee, agreed, saying that young men coming to AIDS Action's Men's Action Life Empowerment (MALE) Center, a community center for gay and bi men, have gotten little practical information out of their schools' sex education programs. They may know the basics about condom use and safer sex, but they have no skills on how to talk about and insist on having safer sex when entering the bar scene for the first time.

"What we know from the young men who come to the MALE Center is it's one thing to have the information and it's another to have the skills to practice it," said Godley.

John Auerbach, commissioner of DPH, said that in addition to rejecting the federal abstinence funding, DPH will also be expanding its efforts to support comprehensive sex education, including LGBT-inclusive education. All decisions about sex education in Massachusetts are made at the local level, meaning that individual school districts, and in some cases the principals of individual schools, make decisions about whether or not to have sex ed, how to fund it and what material to include in the curricula. As a result, neither DPH nor the Department of Education knows how many schools around the state are doing sex education. But even during the years when the state was supporting abstinence-only education, Auerbach said DPH was also creating and distributing materials to schools focusing on comprehensive sex ed. Under the Patrick administration Auerbach said he expects those efforts will expand, including the creation and distribution of LGBT inclusive materials.

"My expectation is that work will become stronger now and that there will be more aggressive efforts to promote curricula and to promote their active use in school and community settings," said Auerbach.

As for the state's abstinence-only grant, Auerbach said the administration made the decision not to seek federal funds for the program this year because they agree with the critics of abstinence-only education, including many of the state's HIV/AIDS, pro-choice, and women's health organizations, that claim that there is no way to hold abstinence-only courses in the schools without negatively impacting comprehensive sex ed.

"We do agree, and in fact that exact [rationale] is what prompted the administration to tell the federal government that it would no longer be accepting the funds. Because as a health department, when we do education on sexuality we believe it's important to include an abstinence message. A message about abstinence is particularly important for young people. However, an abstinence-only message leads to doing that education without providing very important information to young people that is useful to them" in protecting themselves against diseases and unwanted pregnancies, said Auerbach.

He said in addition to that concern, one of DPH's objections to the program is that it provides no information about LGBT sexual health or relationships. According to guidelines from the Administration for Children and Families, programs receiving federal funds to do abstinence-only education must teach that "a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity" and that sex outside of that context "is likely to have harmful psychological and physical effects." And since the guidelines were drawn up at the federal level, that definition of marriage excludes same-sex couples.

"In order to accept the federal funds for the abstinence education, the curriculum needs to be a federal curriculum, and the content of that is proscribed very tightly, and within that content there's never any mention of GLBT populations," said Auerbach.

The Patrick administration's decision not to seek the federal abstinence grant for the coming fiscal year does not mean that abstinence-only education programs will vanish from Bay State public schools. The federal grant to states for abstinence-only education is one of two sources of federal funding for abstinence-only education. The other source, the Community-Based Abstinence Education (CBAE) grant, goes directly from the federal government to organizations doing abstinence-only education. Healthy Futures, the Dorchester-based abstinence education program that has received $800,000 in federal funds from the state over the past two years to do abstinence-only education in the schools, also receives an annual $600,000 CBAE grant to do that work, according to Healthy Futures program director Rebecca Ray. But the loss of the state grant means that the state itself will no longer be promoting Healthy Futures's work.

The Patrick administration's rejection of abstinence-only funding comes at a time when the abstinence-only education movement is facing serious questions about its effectiveness. On April 13 the U.S. Department of Health and Human Services released a study of four different federally funded abstinence programs that found that youth who went through the programs were no more likely to remain abstinent than their peers. The study also found that youth who went through the programs had the same number of partners as their peers and began having sex at the same age. Contrary to the claims of opponents of abstinence-only education, students who went through the program were no more likely to have unprotected sex than their peers. But by emphasizing the failure rates and limitations of condoms without discussing their benefits, the abstinence-only programs appear to have had a negative impact on young peoples' attitudes toward condoms. Youth who participated in the abstinence-only programs were more likely than their peers to believe that condoms offer no protection against HIV.

Fournier said that the message of abstinence-only programs around condom use has a harmful impact on HIV prevention efforts among young people.

"Not talking about condoms except to emphasize their failure rate promotes ambivalence in young people to use condoms.... A program that promotes ambivalence about that protection is unconscionable," said Fournier. "For kids not to hear about the importance of condoms also builds on the idea that HIV is not something they need to worry about. And infection rates are two or three a day. Kids do need to worry about this."

Yet Rebecca Ray of Healthy Futures argues that critics of abstinence-only education have tried to distort people's perceptions of the work Healthy Futures does. She said the federal regulations around abstinence-only education do not prevent schools using the programs from also choosing to do more comprehensive sex ed. Healthy Futures is forbidden under the guidelines from talking about safer sex and the benefits of condoms, but Ray said some of the schools that use Healthy Futures also do more comprehensive sex ed at other points during the year. In fact, the state budget for the current fiscal year includes language specifying that the abstinence-only programs must be done in conjunction with comprehensive sex ed (see "Abstaining From Abstinence-Only," below).

Ray said she supports giving students both abstinence and comprehensive sex ed.

"I think the abstinence message should be given more prominence because in a typical comprehensive program it's given in passing at best... but I don't think that's the only message students should get," said Ray. She said programs should emphasize to students that abstinence is the ideal.

Ray also said Healthy Futures's curriculum is LGBT-inclusive. She said the program urges students to delay sex until they are in a "faithful, lifelong relationship," but does not specify that that relationship must be a heterosexual marriage. She said the program also tells students, particularly those at the high school level, that students can choose abstinence regardless of sexual orientation or sexual history.

Healthy Futures's open-ended definition of a lifelong relationship appears to be at odds with the federal regulations around abstinence-only programs. An Administration for Children and Families guidance document for programs receiving CBAE grants says that federally funded abstinence programs must specifically encourage abstinence until marriage, and it specifies that marriage in those programs "must be defined as 'only a legal union between one man and one woman as a husband and wife, and the word "spouse" refers only to a person of the opposite sex who is a husband or a wife.'"

Auerbach said it is unclear how many schools are doing comprehensive sex ed, but indications are that that number has shrunk over the past few years.

"We do know anecdotally [that] at a time of limited resources they're able to do less health education than they used to do and less than they'd like to do," said Auerbach.

Abstaining from abstinence-only

Gov. Deval Patrick signaled his decision to end state sponsorship of abstinence-only education in February with the release of his fiscal year 2008 (FY08) budget proposal. Under the list of federal grants that the state plans to receive Patrick removed the $700,000 in funding for the abstinence-only education grant.

Proponents of abstinence-only education were not willing to give up without a fight, however. Raymond Ruddy, president of the South Natick-based Gerard Health Foundation, hired lobbyist John Bartley to lobby the legislature to preserve the federal abstinence grant. The Gerard Health Foundation funds pro-life and abstinence education programs around the country, and in 2006 Ruddy paid Bartley $48,000 to lobby on behalf of abstinence programs in Massachusetts.

Ruddy's efforts paid off in the short term, with the House Ways and Means committee including the federal abstinence grant in its budget proposal. As in years past, the House budget also has a stipulation that the abstinence funding "shall be used only in conjunction with the teaching of comprehensive sexuality education."

Yet opponents of abstinence-only education argue that the federal guidelines around abstinence-only education make it impossible to use the funding without harming comprehensive sex ed efforts. A coalition of organizations including AIDS Action Committee, Planned Parenthood League of Massachusetts, NARAL Pro-Choice Massachusetts, the Massachusetts Alliance on Teen Pregnancy and the American Civil Liberties Union of Massachusetts, sent a letter last week to members of the House arguing that because of the tight federal guidelines around abstinence curricula, allowing any abstinence-only education to take place in the classroom will harm comprehensive sex ed efforts. They point to guidelines saying that abstinence-only programs can only discuss condoms in terms of emphasizing their failure rates, creating ambivalence among young people about whether or not to use them to prevent transmission of HIV.

"Unfortunately there really is no responsible way to use this funding anymore given the increasingly restrictive regulations around the [state abstinence grant] money," said AIDS Action associate director of public policy Deborah Fournier.

David Guarino, a spokesperson for House Speaker Sal DiMasi, said that language ensures that the abstinence-only message is not the only message young people participating in abstinence-only curricula hear.

"The language in the Ways and Means budget specifically says that any federal grants that are accessed can be used only in conjunction with a comprehensive sex education program," said Guarino.

The debate over whether or not to include the federal grant language in the budget may be a moot point with Patrick's announcement this week that DPH will not apply for the grant even if the language is included in the budget. Rebecca Ray, program director for Healthy Futures, the organization that receives both the state-based abstinence-only grant as well as a separate direct grant from the federal government, said she hopes Patrick will reconsider his stance.

"I certainly hope that Gov. Patrick will reconsider because I think that this program is providing a vital service to thousands of students in the community ... There are schools that are requesting our program because they want it there, and it would be a shame to take that away from the community," said Ray.

But Department of Public Health commissioner John Auerbach said despite their differences over whether or not to include the abstinence grant in the budget, the Patrick administration and House leadership are on the same page on the question of abstinence-only education. He said House leadership explained to DPH that their intent in adding the language stipulating that abstinence education must be part of a comprehensive approach was to make sure that the federal funding did not jeopardize the comprehensive sex ed efforts.

"So in fact that intent is very much consistent with our present policy," said Auerbach.

- Ethan Jacobs
070426
BY070401

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