What is “abstinence only” sex education?

In p. 9↵the 1980s, with high rates of abortion, pregnancy, and childbearing outside of marriage, sexually transmitted diseases, and other evidence of teenagers engaging in sexual intercourse, many politicians and religious leaders became more vocal in promoting “abstinence only” education as a substitute for sex education in schools. Abstinence programs advocate no sex before marriage—and, on the whole, also omit any information about birth control, safe sex, and sexual ­orientation. During the administration of President George W. Bush, federal funding for “abstinence only” education grew rapidly.

Social scientists have tested the efficacy of “abstinence only” education, including a targeted evaluation sponsored by the US Department of Health and Human Services in 2007, and have found that such programs have actually not delayed sexual activity. The average age of “sexual debut” was the same for abstinence-until-marriage participants and control groups: fourteen years, nine months. Students who take “virginity pledges” while in the program end up much less likely to use contraception when they do become sexually active. Not surprisingly, then, as many educators and social scientists have pointed out, abstinence programs do not reduce rates p. 55↵of sexually transmitted diseases (STDs). In fact, education ­programs that withhold information about STDs, together with a medical care system that often does not test adolescents for these diseases, end up harming young people. (States with abstinence-only sex education policies have the highest rates of STDs among adolescents, and states with no mandates for abstinence had the lowest rates of infection among this group.) Forty percent of chlamydia cases (an STD that disproportionately affects women under twenty-five) result in pelvic inflammatory disease (PID) and one in five of the resultant cases of PID causes infertility, a condition that disproportionately affects poor and minority women.¹

One recent study showed that inner-city middle school students in Philadelphia did delay their “sexual debuts” after having participated in an abstinence program, although the curriculum in this case did not focus on abstinence until marriage. Instead, it stressed comprehensive sex education and concepts like delaying sexual activity until maturity and promoted abstinence as a strategy for avoiding teen pregnancy and STDs rather than for moral or religious reasons. Similarly, in 2012, Mississippi decided to reassess its longtime commitment to “abstinence only” education when its teen pregnancy rate remained the highest in the nation.

The American Medical Association, American Public Health Association, the Society for Adolescent Medicine, and other major health organizations have all stated official support for comprehensive sex education designed to reduce sexually transmitted disease and out-of-wedlock or teenage pregnancies.

When did “life begins at conception” emerge as an important idea in reproductive politics?

Aristotle and St. Augustine both asserted that the human soul could not exist within an unformed body, a perspective that governed thinking about both the fetus and early abortion for p. 56↵centuries. In 1869, however, Pope Pius IX asserted the Catholic Church’s censure of both early term and later abortions, and by the end of the nineteenth century, many American physicians engaged in the campaign to criminalize abortion argued that fetal life begins at fertilization. Nevertheless, for decades after that, US law associated “fetal personhood” with “viability,” the point at which the fetus could live independently outside the woman’s body.

In the mid-twentieth century, developments within the field of embryology clarified that fetal life predated fetal movement and that “viability” was merely one of a number of developmental stages. By 1960, in a significant legal turnaround, eighteen states had awarded damages in cases where a fetus had been harmed or killed, giving legal weight to the idea that fetal life was independent from the pregnant woman’s life, even before viability. In the context of the Cold War and the ascendancy of Freudian-influenced cultural and psychological theories, a number of American writers associated the concept of the fetus as a person with key American values such as individualism and equality.² Also in this period, and particularly after Roe v. Wade, other religious groups in addition to Catholics, drawing on these medical, legal, and cultural developments, began to date “fetal personhood” at conception, not viability. When “fetal personhood” emerged as a concept, and technology provided fetal imagery, the anti-abortion platform increasingly denied a distinction between the “unborn” and the “born” and began to define abortion as murder.

What relationship does the anti-abortion movement claim with the nineteenth-century abolitionist movement?

Some proponents of the anti-abortion movement have claimed that their cause and the movement to end slavery are both freedom struggles. The fetal person, they argue, is a “slave in the womb,” unfree due to unjust laws of a nation that denies the humanity of the fetus in the same way that laws justifying the p. 57↵slavery regime denied the full humanity of enslaved Africans. Some anti-abortion activists argue that both the beliefs and strategies of the nineteenth-century abolitionist movement are models for those working to end legal abortion, highlighting the religious and church-based aspects of both movements; the shared belief in the need to change a sinning culture through widespread conversion; and the use of strategic organizing around the country to achieve the movements’ ends.

Additionally, the role of violence has been a point of debate within both movements. After the Fugitive Slave Law of 1850 was passed, many formerly pacifist abolitionists adopted the position that violence had a legitimate role in attacking the institution of slavery. When abolitionist John Brown, who advocated armed insurrection as a tactic for ending slavery, led the violent attack on the arsenal at Harpers Ferry in 1859, few abolitionists objected. Many accepted Brown’s characterization of himself as an “avenging angel of the Lord.” In the years after the legalization of abortion, over 1,800 anti-abortion activists committed violent attacks against abortion facilities and staff, claiming, like Brown, that violence was justified in the fight for a righteous cause, in the name of the country’s salvation.

What is “Feminists for Life” (FFL)?

Feminists for Life, one of the first national anti-abortion organizations, was founded in 1972, soon after individual states began to overturn their anti-abortion statutes and the year before Roe v. Wade. FFL presents itself as pro-life and pro-women, and describes the group’s mission as promoting progressive solutions for women and families and as standing for justice, nondiscrimination, and nonviolence. The core purpose of FFL is to oppose legal abortion and to eliminate social and economic conditions that press women to end their pregnancies. Every abortion, according to FFL, is a statement that American society has failed women, who, as a group, deserve better than to have to end a pregnancy.

Feminists p. 58↵for Life considers itself a nonpolitical organization. Though its anti-abortion position often puts it into alignment with conservative groups, its stance for enhanced public spending in the interests of mothers and children puts the organization at odds with those same groups. Abortion rights groups, while sometimes supporting public policies to enable poor women to reproduce if they choose to, question FFL’s belief that a lack of adequate resources and support are the only grounds on which women decide to terminate a pregnancy and question whether it is possible to be a “feminist” with an agenda about what “all women” must do regarding any matter, including their fertility. Additionally, FFL places its anti-abortion position within the tradition of the sentiments of a great chain of early American feminists, such as Susan B. Anthony. Critics note, however, that Anthony and her contemporaries opposed abortion chiefly because they saw it as a practice undermining women’s chastity, the preservation of which was one of women’s few claims to moral authority—a distinctly nineteenth-century perspective.

How are attitudes and policies regarding gays and lesbians as parents evolving in the United States?

Americans’ attitudes toward both homosexuality and families headed by same-sex or LGBTQI (lesbian, gay, bi-sexual, transgender, queer, intersex) persons have been trending positive for some years, especially among persons younger than thirty-five. Still, recent polls have shown that up to two-thirds of Americans do not consider a cohabiting same-sex couple raising children to constitute “a family,” and at least half of Americans believe that states should not permit gays and lesbians to adopt (although Florida is the only state that bans adoption by same-sex couples). As of 2012, the District of Columbia and a growing group of states including Connecticut, New York, Iowa, Massachusetts, New Hampshire, Washington, p. 59↵Maryland, Maine, and Vermont, allows same-sex marriage though in some of these states, the matter may not be settled.

Meanwhile, about one-quarter of same-sex couples are raising children. Some demographers suggest this involves as many as 9 million children in the United States. In recent years, courts have come to consider a parent’s sexuality irrelevant in making a child-custody decision, and most recent academic studies have found no significant associations between sexual orientation and parenting skill or child adjustment.³

What is a “conscience clause”?

Almost all states allow individual health care providers and health care institutions the right to refuse to provide abortion services, although fifteen states allow private health care institutions alone this right. A small number of states including Arizona, Arkansas, Georgia, Idaho, Mississippi, and South Dakota allow pharmacists to refuse to provide services related to contraception; this provision often focuses on emergency contraception—that is, medication administered during a short period after unprotected sex. Almost one-third of the states allow health care providers to refuse to provide sterilization services. Many state legislatures continue to consider bills dealing with these matters, so laws governing provision of reproductive health services are continually shifting.

“Refusal” or “conscience” clauses allow providers to opt out of providing pharmaceuticals or services if doing so runs against their religious or moral beliefs. Laws permitting the opt-out are constitutionally valid because they are designed to accommodate the religious beliefs of providers, though the laws must include an exception if the woman’s life or health is at risk. Most states (or boards that regulate pharmacists’ professional conduct) require that if a pharmacist refuses to dispense contraceptives, he or she must refer the woman to another pharmacy. Conscience clauses can create a burden for women in rural areas with few reproductive health p. 60↵care providers and pharmacies, raising the possibility of an ­impermissible “undue burden.” The courts have also dealt with questions about whether conscience clauses can constitute an undue hardship for a pharmacist’s employer who might lose business because of the employee’s refusal to dispense contraceptives. Opponents of conscience clauses also raise issues about whether, over time, providers of medical services might invoke such clauses to justify their refusal to provide care or medications in cases where they judge the illness—for example, a sexually transmitted infection—to have been contracted in the process of an activity they deem sinful.