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56. Other educators have pointed out the implicit inaccuracy of the impression these slides leave: unfortunately, one of the most common STDs, chlamydia, is asymptomatic.
57. Teaching Fear, 8.
58. Medical Institute for Sexual Health, National Guidelines for Sexuality and Character Education (Austin, Tex.: Medical Institute for Sexual Health, 1996), 82.
59. Saint Augustine, Confessions (Oxford: Oxford University Press, 1991), 24-25.
60. Medical Institute for Sexual Health, "National Guidelines," 89.
61. "HIV: You Can Live without It!" (Spokane, Wash.: Teen-Aid, Inc., 1998), 33.
62. Margaret Atwood, The Handmaid's Tale (New York: Houghton Mifflin, 1986), 24.
63. Scales and Roper, "Challenges to Sexuality Education," 70.
64. Irving R. Dickman, Winning the Battle for Sex Education, pamphlet (New York: SIECUS, 1982); Debra Haffner and Diane de Mauro, Winning the Battle: Developing Support for Sexuality and HIV/AIDS Education, pamphlet (New York: SIECUS, 1991); Teaching Fear.
65. The ad ran in the New York Times, April 22, 1997, the Los Angeles Times, April 28, 1997, as well as the West Coast editions of Time, Newsweek, and People during that month.
66. "Trends in Sexual Risk Behaviors among High School Students—U.S. 1991-97," Morbidity and Mortality Weekly Report 47 (September 18, 1998): 749-52. Teens may be doing better than adults. "Most Adults in the United States Who Have Multiple Sexual Partners Do Not Use Condoms Consistently," Family Planning Perspectives 26 (January/February 1994): 42-43.
67. Susheela Singh and Jacqueline E. Darroch, "Adolescent Pregnancy and Childbearing: Levels and Trends in the Developed Countries," Family Planning Perspectives 32 (2000): 14-23. The government recorded the lowest number of teen pregnancies in 1997: 94.3 per thousand women ages fifteen to nineteen, a drop of 19 percent since 1991. Most of those pregnancies are among eighteen- and nineteen-year-old women. In 1999, the U.S. teen birth rate hit its lowest level since recording began in 1940. Of every thousand teenage women, 4.96 gave birth. Centers for Disease Control and Prevention National Center for Health Statistics, National Vital Statistics Report 4, no. 4 (2001).
68. About three-quarters of girls use a method the first time; as many as two-thirds of teens say they use condoms regularly—three times the rate in 1970. Long-acting birth control injections and implants have also gained popularity among teens. "Why Is Teenage Pregnancy Declining? The Roles of Abstinence, Sexual Activity and Contraceptive Use," Alan Guttmacher Institute Occasional Report, 1999. The National Campaign to Prevent Teen Pregnancy asked teens themselves the main reason they thought teen pregnancies had dropped in the last decade. Of 1,002 youths surveyed, 37.9 percent named worry about AIDS and other STDs; 24 percent credited a greater availability of birth control; and 14.9 percent said the decline was due to more attention to the issue. Only 5.2 percent named "changing morals and values," and 3.7 percent said, "Fewer teens have sex." With One Voice: American Adults and Teens Sound Off about Teen Pregnancy (Washington, D.C.: National Campaign to Prevent Teen Pregnancy, 2001).
69. Singh and Darroch, "Adolescent Pregnancy and Childbearing."
70. "Teen Pregnancy 'Virtually Eliminated' in the Netherlands," Reuters Health/London news story (accessed through Medscape), March 2, 2001.
71. "United States and the Russian Federation Lead the Developed World in Teenage Pregnancy Rates," Alan Guttmacher Institute press release, February 24, 2000.
72. J. Mauldon and K. Luker, "The Effects of Contraceptive Education on Method Use at First Intercourse," Family Planning Perspectives (January/February 1996): 19.
73. J. C. Abma et al., "Fertility, Family Planning, and Women's Health: New Data from the 1995 National Survey of Family Growth," Vital Health Statistics 23, no. 19 (1997).
74. Peggy Brick et al., The New Positive Images: Teaching Abstinence, Contraception and Sexual Health (Hackensack, N.J.: Planned Parenthood of Greater Northern New Jersey, 1996), 31.
75. Peter Bearman, paper presented at Planned Parenthood New York City's conference Adolescent Sexual Health: New Data and Implications for Services and Programs, October 26, 1998; Diana Jean Schemo, "Virginity Pledges by Teenagers Can Be Highly Effective, Federal Study Finds," New York Times, January 4, 2001.
76. Lantier, "Do Abstinence Lessons Lessen Sex?"
77. "Trends in Sexual Risk Behaviors among High School Students—United States 1991-1997," Morbidity and Mortality Weekly Reports 47 (September 18, 1998): 749-52.
78. Abma et al., "Fertility, Family Planning, and Women's Health."
79. It is important to point out that, in spite of these declines, nearly two-thirds of teen births resulted from unintended pregnancies. Abma et al., "Fertility, Family Planning, and Women's Health."
80. "Adolescent Sexual Health in the U.S. and Europe—Why the Difference?" Advocates for Youth fact sheet, Washington, D.C., 2000.
81. Schemo, "Virginity Pledges by Teenagers."
82. It is impossible to find a forthright statement that abstinence-plus education meaningfully delays teen sexual intercourse. Its evaluators have been able to find out only that, for instance, if you want to delay intercourse, you should start classes before kids start "experimenting with sexual behaviors." And all studies show that sex ed does not encourage earlier intercourse. J. J. Frost and J. D. Forrest, "Understanding the Impact of Effective Teenage Pregnancy Prevention Programs," Family Planning Perspectives 27 (1995): 188-96; D. Kirby et al., "School Based Programs to Reduce Sexual Risk Behaviors: A Review of Effectiveness," Public Health Reports 190 (1997): 339-60; A. Grunseit and S. Kippax, Effects of Sex Education on Young People's Sexual Behavior (Geneva: World Health Organization, 1993).
83. S. Zabin and M. B. Hirsch, Evaluation of Pregnancy Prevention Programs in the School Context (Lexington, Mass.: D.C. Heath/Lexington Books, 1988); Institute of Medicine, The Best Intentions: Unintended Pregnancy and Well-Being of Children and Families (Washington, D.C.: National Academy Press, 1995).
6. Compulsory Motherhood
1. This law, the first gate to open in the gradual spilling away of federally protected abortion rights, was reauthorized in every subsequent Congress; its constitutionality was upheld three times. In 1993, after a long battle, it was "liberalized" to add exceptions for rape and incest. But while the government paid for a third of abortions from 1973 to 1977, it now pays for almost none. Marlene Gerber Fried, "Abortion in the U.S.: Barriers to Access," Reproductive Health Matters 9 (May 1997): 37-45.