The debate over sex education is raging anew. A national study made alarming headlines: one in four sexually active teens and young people was found to have a sexually transmitted disease (STD). The news prompted calls for better sex education. The unsettled question: What kind of sex education is good sex education?

The duel between proponents of comprehensive sex education and abstinence-only programs continues as organizations such as the Guttmacher Institute publish updated research on the status of teens’ sexual health across the country. A look at the status of sex education, the latest research, and the key role parents play in a child’s sexual behavior can help make more sense of the issues.

From the moment “sex ed” was introduced in the early 1900s, it has been controversial. Initially unveiled in the schools as an effort to curb venereal disease, the focus eventually shifted to preventing teenage pregnancy. The arrival of the AIDS epidemic in the 1980s upped the ante and brought a new sense of urgency to keep kids safe.

 Sex education laws

Though there is no federal sex education law, the fine print of a health legislation law passed in March 2010 restores $250 million over five years for states to sponsor abstinence-education. While most states have laws about sex education, those that agreed to teach abstinence can receive annual amounts of $78,526 to $4.9 million over the next five years. While the majority of states allow parents to pull their children out of sex education class, each state has different requirements for sex and HIV education. You can look up the status of your state at the Guttmacher Institute’s website, which updates monthly.

Abstinence vs. comprehensive sex education

The explosive growth of programs that advocate abstinence for unmarried people has been supported by the past three administrations. Initially fueled by government funding from the Clinton administration’s welfare reform legislation, the Bush administration gave more than $100 million a year in direct federal funding and about $50 million a year in federal money that had been funneled through the states. The Obama administration has continued the trend with the aforementioned health bill, which will spend federal money on programs aimed at preventing pregnancy and STDs by encouraging students to avoid sex.

What is taught in comprehensive vs. abstinence programs

A comprehensive program typically

• Teaches that sex is natural and healthy and how to make responsible decisions about sexuality
• Teaches that abstinence is the only 100 percent effective form of birth control
• Explains medical details of STDs and HIV
• Provides information about the health benefits and side effects of all contraceptive methods as a means to prevent pregnancy and reduce the risk of contracting STDs or HIV/AIDS
• Covers a variety of topics, such as relationships, communication skills, health, and societal expectations
• Includes factual information on abortion, sexual orientation, and sexually transmitted diseases without promoting religion

An abstinence-only program typically

• Teaches that abstaining from sexual activity has social, physiological, and health gains
• Teaches that sex outside of marriage has harmful psychological and physical consequences and that abstinence is the expected standard of sexual activity
• May or may not discuss condoms or other birth control. If it does, it is usually with an emphasis on failure rates; however, in order to be funded federally, the program must provide medically accurate and balanced information.
• Omits topics such as abortion and sexual orientation
• Teaches communication skills so that teens can keep from being pressured into sex
• Explains the importance of attaining self-sufficiency before engaging in sexual activity

Middle-ground programs

Hybrid sex education programs have evolved in an effort to find a compromise between the two camps. These include Abstinence-Plus Education, which emphasizes the abstinence component in a comprehensive sex education program. A recent study found that up to two-thirds of comprehensive programs for sexually active teens had positive behavioral effects, such as delaying or reducing sexual activity, reducing the number of sexual partners, or increasing contraceptive use.

Simulate what it’s like to have a baby

Both comprehensive programs and those that emphasize abstinence may incorporate a more pragmatic approach to try to convince kids to delay sex. Students are required to carry eggs in a basket or a sack of flour around for a certain period of time to try to understand how having a baby would affect their lives. Recently, more and more companies are producing simulated robotic infants that need to be quieted, comforted, changed, burped, and fed. Realityworks, an experiential learning technology company, has produced a RealCare baby that is a computerized simulator with an unpredictable nature. When it cries at random times day or night, the student parent has to figure out what the baby needs: feeding, burping, rocking, or a rediapering. If the baby gets rough treatment or a parent misses a cry, a microprocessor records the exact time and specific mishandling.

RealCare Baby is costly (more than $750 for each baby) but has been used as a Sex Ed tactic at many schools. Is it a gimmick or does it work?

RealCare Baby is based on a learning theory about adolescents: Kids of this age believe they are unlikely to get pregnant and underestimate the difficulties if they do. There’s some evidence that computerized infant simulators have been shown to have a significant positive effect compared to curriculum alone or baby stand-ins such as eggs or sacks of flour. However, there’s a lot less evidence that the teens made the jump from taking care of a baby to postponing sexual activity. (Editor’s note: “Baby Think It Over” has become part of RealityWorks.)

Using RealCare Baby in the context of other lessons may be the most powerful way to bring home the responsibility of rearing a child. Incorporating lessons in math about the cost of caring for a child, for example, might reinforce a lesson learned from carrying a simulated baby around for a few days.

Which sex ed approach is best?

A study published by the American Academy of Pediatrics reported in January, 2009 that they had found no difference in the sexual behavior of virginity pledgers and closely matched nonpledgers. In fact, while having the same occurrence of premarital sex and STDs, pledgers were less likely to protect themselves from pregnancy and disease before marriage. The ultimate conclusion was that taking virginity pledges — such as those from abstinence-only programs — may decrease the likelihood of taking precautions during sex. Since this was not a strong correlation to abstinence-only programs directly, more rigorous research is needed on the effectiveness of these programs.

The first national survey comparing the effects of the two types of sex education found in 2008 that students who got comprehensive sex education are half as likely to become teen parents as those who got abstinence-only instruction or no sex education. In the survey, taken by researchers at the University of Washington and published in the Journal of Adolescent Health, teens between 15 and 19 years old who had comprehensive sex education were no more likely to have sex than those who had abstinence-only classes. Neither comprehensive nor abstinence-only instruction had much effect on the odds that student would be infected with an STD.

What should a concerned parent do?

Parents play a major role in influencing a child’s sexual behavior. As the report sponsored by the National Campaign to Prevent Teen and Unplanned Pregnancy points out, teens’ own sexual beliefs, values, attitudes, and intentions — not the kind of sex education they get in school — are the most strongly related to their sexual behavior. And parents play a key role in shaping those attitudes. That makes the pregnancy of a high-profile teen actress a teachable moment. Talking about sex can be tough for parents, but there is a wealth of research pointing to its importance.

If you need help with your talking points, check the advice from the American Academy of Pediatrics or even our recent statistics on sexual health on talking to kids about sex — from preschool through the teen years. Here are other ways you can get involved in what your child learns about sex and when:

• Stay informed about sexual health issues by reading and talking to other parents and your family doctor. That way you can learn about the pressures on young people that didn’t exist when you were a teen!
• Find out what your school teaches your child about sex and in what grade.
• Find out where your school board and school board candidates stand on the issue.

Keep up-to-date on state legislation that governs the way sex education is taught.