General Articles

Society for Adolescent Medicine Denounces Abstinence-Only as Medically and Ethically Indefensible

In a new position paper, the Society for Adolescent Medicine (SAM) examined federal abstinence-only-until-marriage policy and determined that such programs are an infringement on young people’s basic human right to the highest attainable standard of health.1 The authors recommend that federal funding for the programs be redirected to comprehensive, medically accurate sexuality education. Acknowledging that abstinence is a healthy choice for teens and a worthwhile behavioral goal, they clearly explain that “the problem is not the ‘abstinence,’ the problem is the ‘only.’”2

Proponents of abstinence-only-until-marriage programs often argue that abstaining from all sexual activity until entering a mutually monogamous marital relationship is the only certain way to prevent unintended pregnancy or sexually transmitted disease (STD). Indeed, Title V of the 1996 Social Security Act, which lays out the eight-point federal definition of “abstinence education,” requires any organization receiving federal funding for abstinence-only programming to emphasize this.3 The SAM article rebuts this argument, revealing that abstinence as a sole prevention strategy often fails. In the U.S. the median age of first intercourse for women and men is somewhere between age 17 and 18, whereas, the age at first marriage is closer to 25 for women and 27 for men.4

The paper enumerates the ways that abstinence-only-until-marriage programming fails to meet the needs of young people, specifically sexually experienced and LGBTQ youth. The authors explain that these programs, which withhold information about contraception in an attempt to coerce young people into abstinence, may actually “cause teenagers to use ineffective (or no) protection against pregnancy and STIs.”5In relation to LGBTQ young people, the paper counsels “abstinence-only sex education classes are unlikely to meet the health needs of GLBTQ youth, as they largely ignore issues surrounding homosexuality (except when discussing transmission of HIV/AIDS), and often stigmatize homosexuality as deviant and unnatural behavior.”6

Despite this critique and others, such the report released by Representative Henry Waxman (D-CA) in December of 2004 which found overwhelming misinformation and medical inaccuracies in the most used abstinence-only-until-marriage curricula, federal funding for these programs is continually increasing. In Fiscal Year 2006, Congress has increased funding to $178 million.

In addition to domestic funding, the U.S. government is also funding abstinence-only-until-marriage programs as HIV-prevention efforts in sub-Saharan Africa, the Caribbean, and Asia as part of the President’s Emergency Plan for AIDS Relief (PEPFAR).7The SAM position paper suggests that these programs may have even less efficacy in international settings where they have become a source of misinformation and censorship, and may have even reduced access to condoms.8

“Domestically or abroad, these programs have no public health value and can no longer serve as a substitute for medically accurate comprehensive sexuality education,” commented William Smith , vice president for public policy at the Sexuality Information and Education Council of the United States (SIECUS). “We applaud the Society for Adolescent Medicine’s recommendation that the U.S. government quit infringing on young people’s human rights and begin funding comprehensive sexuality education instead of abstinence-only-until-marriage programs,” continued Smith.


  1. John Santelli, et al., “Abstinence-Only Education Policies and Programs,” Journal of Adolescent Health 38 (2006), pg 83-87.
  2. Cheryl Wetzstein, “Government Urged to End Abstinence-Only Education,” The Washington Times , 6 January 2006, accessed 16 January 2006, <>.
  3. Section 510(b) of Title V of the Social Security Act, P.L. 104-193
  4. Santelli.
  5. Ibid.
  6. Ibid.
  7. Ibid.