Having worked with teens for nearly two decades, I know they engage in sexual behaviors that put them in the way of harm, whether or not they have received any sex education. In my opinion, abstinence-only sex education programs put adolescents at risk for a variety of problems.

Teens grow up bombarded by sexual messages in the media that mostly tell them sex is always great and sex is "what it's all about." As they explore their new sexual feelings, they are highly receptive to this "sex education" from the media. They need guidance from sources other than the media and their peers to help them understand the emotions and physical feelings they are experiencing.

For women, the average age of first intercourse occurs about 7.9 years before the average age of marriage; for men, it is 9.4 years before marriage (Centers for Disease Control and Prevention [CDC], 2006). Clearly few Americans wait until marriage to have sex. The question is, does abstinence-only education provide the necessary guidance to help teens remain healthy until marriage and "approved" sexuality? Recent data from Santelli, Ott, Lyon, Rogers, and Summers (2006) show that it does not:

* Those who take "virginity pledges" (promoted by the abstinence-only approach) do delay first intercourse but rarely wait until marriage. When they do choose to have sex, their rates of contraceptive use are lower, and their rates of sexually transmitted infections (STIs) are higher than those who receive comprehensive sexuality education. This tells us that abstinence-only education inadvertently increases risk for teens when they eventually become sexually active.

* Teens practicing "abstinence" often engage in myriad sexual behaviors that they assure themselves are not "sex" because vaginal intercourse does not occur. These behaviors, including oral, anal, and homosexual sex, put them at risk of STIs. Teens practicing abstinence are less likely to know their STI status, therefore increasing the chances that they may go untreated and infect a partner.

One reason that abstinence-only education does not help teens practice safer sexual behavior when they do engage in sex is the content of the curriculum. In 2004, a congressional committee examined the content of abstinence-only curricula and found that 11 of 13 curricula contained false, misleading, or distorted information about contraceptive effectiveness and the risks associated with abortion (Santelli et al., 2006). Withholding information or teaching information that conflicts with scientific evidence in an effort to coerce teens towards abstinence not only puts teens at risk but also is unethical.

Compare this with another high-risk activity that emerges during adolescence - driving. Surely, we would never withhold information about seatbelt availability or efficacy in an attempt to make teens drive within the speed limit. By contrast, abstinence-only sexuality education withholds information and tools that adolescents need to explore their sexuality in a safe and healthy manner, focusing instead on the harm that could befall them if they have sex while ignoring available precautions. Not telling adolescents about sexual realities like contraception, STI risks, and the complexities of sexual relationships is like putting them behind the wheel without a seatbelt. Sexuality education should be just that, education about healthy sexuality.

Comprehensive sex education can certainly include both the option of abstinence until marriage and the necessary guidance to explore sex in a safe, healthy, and respectful manner, but teenagers need all of the healthy guidance and safety measures available so they can get in the driver's seat and make good decisions.

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