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Overview FY08


Sexuality Education and Abstinence-Only-Until-Marriage Programs in the States:
An Overview
Fiscal Year 2008 Edition
At the sixth publication of the SIECUS State Profiles, the community of advocates dedicated to comprehensive sexuality education is on the edge of exciting progress. President Obama recently signed into law the first-ever cut to abstinence-only-until-marriage programs in our nation’s history. More importantly, our new President is a vocal supporter of moving our nation’s agenda away from failed and ideological initiatives such as abstinence-only-until-marriage programs and toward more evidence-based interventions. The President has called for age-appropriate and medically accurate comprehensive sex education for all school-aged children and was a co-sponsor of the federal comprehensive sex education bill, the Responsible Education About Life (REAL) Act, when he served in the United States Senate. And, today, leadership on this issue is not just coming from the White House but also comes from around the country. Cities like Pittsburgh are jettisoning the failed policy of abstinence-only-until-marriage and nearly half of the states are leading the way toward better sex education by declining the Title V abstinence-only-until-marriage funds for which they are eligible, thus leaving nearly $23 million in unspent funds sitting in the Treasury as states await a policy shift and funds for evidence-based programming. 
SIECUS delivers this edition early in 2009 with a clear mission: to end all federal funding for abstinence-only-until-marriage programs and to work toward significant and genuine federal investment in comprehensive sex education.  
This edition pinpoints the most egregious examples of why federal abstinence-only-until-marriage programs must end. Throughout this publication, we highlight the worst grantees, those that exist almost entirely on the federal dollar, those using curricula riddled with fear and shame or blatant misinformation, and those grantees with deep connections to the far Religious Right.
Major Fiscal Year 2008 HIGHLIGHTS
  • The number of states without any federal abstinence-only-until-marriage funding continues to grow. Up from four in Fiscal Year 2007, there are now seven states in this 2008 Fiscal Year edition without any federal abstinence-only-until-marriage funding whatsoever: Delaware, Idaho, Minnesota, Montana, Rhode Island, Vermont, and Wyoming. 
  • Texas received the highest amount of federal funding: $14,289,087
  • The majority of abstinence-only-until-marriage funding continues to be concentrated in southern states with more than half of all federal funding ($82,267,900) directed into these 16 states.
  • Crisis Pregnancy Centers (CPCs) in 20 states received federal abstinence-only-until-marriage funding in the amount of at least $19,102,209.[1] Illinois distributes the most funds ($1,944,620) to crisis pregnancy centers (CPCs).
  • Thirteen percent of all CBAE grantees heavily rely on the federal abstinence-only-until-marriage funding, as it makes up over 50 percent of their budgets.
  • Forty-nine hospitals and local health departments continue to participate in federally-funded abstinence-only-until-marriage programs despite the years of evidence showing that these programs have no value in promoting positive public health outcomes.
Federal Abstinence-Only-Until-Marriage Funding Streams
Despite the evidence against abstinence-only-until-marriage programs, three federal funding streams continue to support these programs. In Fiscal Year 2008, they added up to $176 million divided between the Adolescent Family Life Act (AFLA) at $13 million, Title V abstinence-only-until-marriage funding at $50 million, and Community-Based Abstinence Education (CBAE) programs at $113 million.
States Question the Title V Program   
At the first publication of the State Profiles, only three states were out of the Title V abstinence-only-until-marriage program: California, Maine, and Pennsylvania. While Pennsylvania has flip-flopped not once but twice back into the program, many other states have joined these pioneers.
This publication documents that as of March 2009, nearly half the states are no longer participating in the Title V abstinence-only-until-marriage program. These states are: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Idaho, Iowa, Kansas, Maine, Massachusetts, Minnesota, Montana, New Jersey, New Mexico, New York, Ohio, Rhode Island, Vermont, Virginia, Wisconsin, and Wyoming. The District of Columbia’s participation remains uncertain as its application has been given only conditional approval by the Department of Health and Human Services. HHS asked the District to modify its proposal to more closely comply with the rigid ideological restrictions of the program. The District has indicated that its application will not be altered and is awaiting further word.
Considering the severe fiscal and budget woes of nearly every state in the Union, the continued rejection of these funds is not just a matter of interest, but a strong statement that many states need funding for programs that work, not money for failed abstinence-only-until-marriage programs. We believe that most states will continue to take principled stands based on evidence and not fall for the carrot of abstinence-only-until-marriage money that continues to be dangled before them, in the hopes that fiscal desperation might drive them back into the failed and collapsing abstinence-only-until-marriage industry.
Unfortunately, two states opted back into the failed program for Fiscal Year 2009: Pennsylvania and Tennessee. In September 2008, both of these states rejoined the Title V abstinence-only-until-marriage program, for vastly different reasons. The Department of Health in Tennessee has remained committed to an abstinence-only-until-marriage approach to run alongside its evidence-based teen pregnancy prevention programs. Its rejection of the funds was purely logistical (a decision made based on the short duration of Title V grants) and staff at the state department of health made it clear that once the reauthorization of the funding lasted for more than a year, the state would re-apply.
Pennsylvania’s second change of heart was a different story. Despite strong objections from state advocates and Pennsylvania’s leading newspapers, Governor Ed Rendell (D) changed his mind yet again and submitted an application. Three papers across the state wrote strong editorials opposing the Governor’s flip-flop: the Philadelphia Daily News, the Philadelphia Inquirer, and the Pittsburgh Post Gazette.[2] The Post Gazette summed up the Governor’s decision this way: “A decision by the state Health Department to seek federal funds for abstinence-only sex education programs flies in the face of past practice, state policy, a wise trend in the opposite direction and solid research. It’s not a good idea.”[3]
With such strong opposition to accepting the funding, the Governor’s decision is not fully understood. And, Claudine Battisti, the director of communications for Pennsylvania’s Department of Health (DOH), only added to this confusion saying, “Obviously, the DOH knows that the best approach is comprehensive sex education.”[4]
 The question now turns to why other states have not joined their peers, as it becomes politically safe and remains the most appropriate response to a program proven ineffective and dangerous to young people. 
A few states, such as Georgia, Illinois, South Carolina, and Texas, host the abstinence-only-until-marriage industry leaders. Their presence combined with the conservative tendencies of these states, and, in many cases their regions, may have special influence on decision makers. Illinois, however, seems to have become an island unto itself as neighboring states of Wisconsin, Iowa, and Minnesota have all made principled stands against the Title V abstinence-only-until-marriage program. 
Other states remain in the program for clearly ideological reasons, such as Utah, whose support for abstinence-only-until-marriage policies is strongly codified into law. In states such as Florida the decision may be more for political reasons. The Title V abstinence-only-until-marriage dollars are highly diversified and a large number of sub-grantees heavily rely on the funding to sustain their organizations. The state’s rejection of the Title V funding would mean pulling the plug on these organizations. And finally, some states remain because the funding amount they receive is so small that it makes the implementation of actual programs difficult. Thus, these states rather use the money to produce small, seemingly harmless media programs. 
The Future of Title V on Shaky Ground
The Title V abstinence-only-until-marriage program was originally authorized for five years, 1998–2002. While it has received numerous funding extensions it has never been officially reauthorized. In 2008, the program was extended through June 30, 2009, and received another $50 million in federal funds for Fiscal Year 2009. 
Upon this extension, ACF issued a Request for Proposals (RFP) for Fiscal Year 2009. The  mandated requirements in the RFP were the same as they had been in the previous RFP from FY2007: states must operate within the A–H federal definition of “abstinence education.”[5] (ACF did not issue an RFP for Fiscal Year 2008, instead it just asked each participating state to submit a letter testifying that there were not going to be any material changes to its program.)
The significant change to the FY09 application is the timeframe: states are submitting proposals for five years, rather than the one year for which the funding has been allocated. While this might suggest that the program has a secure future, it does not. Rather, this strategy of designing a five-year program extension seemed to be an effort by the Bush administration to ensure that the program would continue beyond its own reign. However, this technique has not worked: SIECUS’ research shows that the vast majority of states that have withdrawn from the failed program plan to continue to do so.
As of the middle of April 2009, several attempts have been made by a few extreme voices in Congress to extend the Title V abstinence-only-until-marriage program; but barring some extraordinary circumstances, the end of the program seems likely at the end of June. This may not immediately translate into every state shutting down its efforts, as states have a two-year time frame to expend any funds they received in the previous fiscal year, but it does mean that the decade-long, half-billion dollar boondoggle will end.
Diverse Organizations Receive Federal Abstinence-Only-Until- Marriage Funds
Title V
In Fiscal Year 2008, the states remaining in the program sub-granted Title V abstinence-only-until-marriage funds to 204 organizations. Larger states receive the most funding and tend to diversify the funds the most; Illinois, Georgia, Florida and Texas each have more than a dozen sub-grantees with Illinois having more than any other state.
 A majority of sub-grantees (56 percent) were community-based organizations, and nearly a quarter (23 percent) were medical centers or health departments. The other organizations receiving Title V abstinence-only-until-marriage dollars were schools and crisis pregnancy centers (CPCs)
CPCs are funded with Title V abstinence-only-until-marriage dollars in ten states; Illinois funds the most, followed by Missouri and West Virginia. 
Looking at all of the organizations funded by Title V abstinence-only-until-marriage dollars, 14 percent are faith-based, with the most located in Florida, Illinois, and Michigan. In fact, a majority of Florida’s sub-grantees are faith-based organizations. 
Several states do not sub-grant the funds; rather they use the money for statewide campaigns in one form or another. For example, in Louisiana, the Governor’s Program on Abstinence (GPA) is the sole grantee as is the Students Today Aren’t Ready for Sex (STARS) initiative in Oregon. Indiana, Mississippi, and Nebraska also choose not to sub-grant the funds, instead, they run media campaigns urging abstinence in young people. 
CBAE grants funded 193 organizations in 40 states, the District of Columbia and Puerto Rico in Fiscal Year 2008. Most of the grantees (65 percent) were community-based organizations. Another 16 percent were crisis pregnancy centers (CPCs). Florida, Illinois, and New Jersey have the most CBAE-funded CPCs. Hospitals and school districts are also recipients of CBAE funding. 
Of all CBAE grantees, nearly a quarter are faith-based, and 15 percent have connections to the abstinence-only-until-marriage movement. Additionally, 13 percent of all CBAE grantees heavily rely on the federal abstinence-only-until-marriage funding to run their organizations, as it makes up over 50 percent of their budgets.
       Though significantly smaller, organizations across the country also received abstinence-only-until-marriage funding from the AFLA program. Established in 1982 under the Reagan Administration, the AFLA program is the smallest of the three funding streams. Still, its inception initiated the cascade of federal funding for abstinence programming and enabled the emergence of today’s abstinence-only-until-marriage industry. The $13 million in AFLA funds, administered by the Office of Population Affairs (OPA) is currently divided between 42 grantees in 24 states and the District of Columbia. 
A majority (71 percent) of the grantees are community-based organizations. Eight grantees (19 percent) are faith-based. Other AFLA grantees include hospitals and schools. Unlike many Title V and CBAE grantees who receive more than one federal abstinence-only-until-marriage grant, most AFLA grantees do not take other federal abstinence-only-until-marriage dollars.
In 2008, OPA restructured the AFLA program, giving out fewer but larger grants. OPA awarded only four new AFLA grants in Fiscal Year 2008, each in the amount of $700,000 for five years. The newly-awarded AFLA grantees include Colorado State University in Fort Collins, Colorado, Communities in Schools of Georgia in Atlanta, Georgia, Northwest Family Services in Portland, Oregon, and To Our Children’s Future with Health in Philadelphia, Pennsylvania.
Curricula Trends
The abstinence-only-until-marriage industry has now had decades of support from federal funds and continues to produce a plethora of curricula and materials for use in abstinence-only programs across the country many of which are also supported by federal funds. 
The most popular curricula remain the Choosing the Best series, A.C. Green’s Game Plan, and WAIT (Why Am I Tempted?) Training. Choosing the Best, for example, is used extensively in Southern states, which may have to do with its Georgian roots. SIECUS tracked its use in at least 11 southern states. We tracked Game Plan in 17 states.
Each of these curricula has been around for many years and as such they have been revised numerous times. While they continue to rely on messages of fear and shame and the assumption that any sexual behavior outside of heterosexual marriage is immoral, they have answered some of the criticism that organizations, including SIECUS, have leveled at them over the years. Most notably, they have removed much of the inaccurate medical information that they once contained. In many cases, however, instead of replacing it with accurate science they have just eschewed hard information altogether and become even more focused on promoting extreme right-wing ideology.
The continued influx of federal dollars has also allowed smaller organizations to create curricula that are often used only within a small geographic region. As these curricula are less well publicized and, therefore, subject to less review by organizations such as SIECUS, they still read like the original drafts of Choosing the Best and Game Plan; plagued by fear, shame, and inaccuracy. 
This year SIECUS reviewed two such curricula; Healthy Image of Sex (HIS), and Reasonable Reasons to Wait (RRTW). The faith-based HIS curriculum was co-authored by Sheri Few, who is President of both Few Consultations and South Carolina Parents Involved in Education (SC PIE), a CBAE grantee in South Carolina. HIS is used by three federally funded abstinence-only-until-marriage programs in South Carolina. RRTW is used throughout the South including in the states of Virginia, Alabama, and Florida.
HIS compares premarital sex to “powerful stuff.” The student workbook contains a picture featuring a sports car, a syringe, a gun, fire, and an airplane nearing the Twin Towers. It asks students: “What happens when these powerful things [are used in healthy and unhealthy ways: Plane—consider the Twin Towers; Cars—consider when used by children under age or people on drugs; Guns—when used by people who are not trained or do not have authority, or for play by children; Fire—when played with or when not in a safe place.” This exercise concludes by saying that “Like many things with potential great benefits, sex can be damaging as well. Marriage is the safe place, outside of marriage is dangerous.”[7]
Similarly, RRTW likens premarital sex to drug and alcohol use and notes that just because other people are doing it, students should not compromise their values. “No matter how many people accept a dumb idea, it is still a dumb idea.” Two of the examples used to illustrate this point are: 
“Slavery—At one point in our country’s history, a majority of people believed it was acceptable to own slaves. They were wrong. It took civil war, as well as a lot of time to help people see this.”   
“Hitler—There were people in Germany and other places who went along with his plan to exterminate “inferior” people. When the reality of this was made known, near the end of World War II, people’s mind changed.”[8]
RRTW also includes blatantly inaccurate information such as the suggestion that AIDS can be transmitted through skin-to-skin contact. 
Nonetheless, a single evaluation of RRTW has become the cornerstone of the abstinence-only-until-marriage industry’s defense of its programs. The study’s authors concluded that “abstinence programs can achieve significant reductions in teen sexual initiation.”  Not only did the study have severe methodological flaws, but this achievement is not as impressive as it may sound. The students in the study were 7th graders, (12–13 years old) and the success of the program was based on whether these students remained abstinent for one year. In 2001 (when the evaluation was conducted), only 6.6 percent of high school students reported having sexual intercourse for the first time before the age of 13.[9] Given that the average age of first sexual intercourse is 16.9 for men and 17.4 for women, keeping 12 or 13 year-olds abstinent for one year is admirable, but no great feat.[10]
Tracking the Opposition
This year’s State Profiles pay particular attention to those grantees with ties to the larger abstinence-only-until-marriage industry. Our research found 42 grantees with connections to the abstinence-only-until-marriage industry, either through conference attendance, using their leaders as guest speakers, or helping the industry leaders advertise. Grantees were most frequently connected to two of the industry leaders: the Abstinence Clearinghouse and the National Abstinence Education Association (NAEA).
The Abstinence Clearinghouse serves as a hub for abstinence-only-until-marriage providers across the country. The mission of the Abstinence Clearinghouse is, “To promote the appreciation for and practice of sexual abstinence (purity) until marriage through the distribution of age appropriate, factual, and medically-referenced materials.”[11] The Abstinence Clearinghouse’s medical advisory board is comprised of over 60 health professionals who do not promote or prescribe contraception for unmarried teens.[12] The organization has close ties to the Alpha Center, a crisis pregnancy center founded in 1984. The two organizations share office space, and both were founded and continue to be run by Leslee Unruh.
Over the years, the Abstinence Clearinghouse and Ms. Unruh have been accused of misconduct in several cases. In 1987, Unruh was investigated by authorities after being accused of persuading young women to carry their pregnancies to term and give their babies up for adoption in exchange for money. The Alpha Center pleaded “no contest” to a handful of charges, and paid a $500 fine as part of a plea bargain in which 19 charges, including four felonies, were dropped.[13]
In 2005, Representative Henry Waxman (D-CA) asked the Government Accountability Office (GAO) to investigate the Abstinence Clearinghouse’s $2.7 million contract with the Department of Health and Human Services (HHS) to review abstinence-only-until-marriage curricula. Waxman noted that the Abstinence Clearinghouse has “a strong ideological bias and a history of ignoring scientific evidence that challenges its positions” and suggested that the organization “appears to have a significant conflict of interest because it earns fees from abstinence-only resource providers whose curricula it is being asked to evaluate.”[14]
Most recently, in July 2006, Citizens for Responsibility and Ethics in Washington (CREW) filed an Internal Revenue Service (IRS) complaint against the Alpha Center and the Abstinence Clearinghouse. The complaint suggests that the organizations have violated federal tax law by endorsing candidates and failing to report lobbying efforts. The IRS complaint outlines several examples of violations, including Ms. Unruh’s efforts to lobby lawmakers on behalf of a South Dakota law, that she authored, which would have banned all abortions in the state.[15]
Numerous grantees across the country are affiliates of the Abstinence Clearinghouse. As affiliates, these organizations have access to a network of nearly seventy abstinence-only-until-marriage organizations. Affiliates gain access to resources, including abstinence-only-until-marriage curricula and invitations to the Abstinence Clearinghouse conference, self-titled as the “most prestigious abstinence-until-marriage event of the year.”[16]
The NAEA is a newer organization and serves as the lobbying arm of the abstinence-only-until-marriage industry. The NAEA has kept busy in the last year stirring up its membership after the March 2008 launch of the “Parents for Truth” campaign. This campaign, an obvious effort to deflect attention away from the collapse of abstinence-only-until-marriage programming, went on the attack against more comprehensive programs. The campaign featured an advertisement and website meant to scare parents into believing that the content of comprehensive sexuality education is inherently inappropriate.  Many grantees are NAEA members who advertise this campaign and keep State Pages updated continuously as they “Track the Opposition.” 
It is interesting to note that this year also saw the end of one of the original leaders of the abstinence-only-until-marriage industry, Project Reality, which has produced and distributed abstinence-only-until-marriage curricula for well over a decade. Project Reality produced some of the more popular curricula including Facing Reality, Game Plan, and Navigator. On December 15, 2008, Project Reality announced that it would be merging with the Abstinence Marriage and Education Partnership, a far younger organization started by Scott Phelps, who got his start in Chicagoland crisis pregnancy centers. Phelps, the co-author of the both Game Plan and Navigator, and the author of a new curriculum called Aspire. Live Your Life. Be Free., will assume leadership of the combined force. Mr. Phelps is also a founding member of the National Abstinence Education Association (NAEA). 
Make no mistake; we are witnessing a fundamental paradigm shift in Washington, DC and in states and communities across the country when it comes to our nation’s approach to sex education. But as progress comes, we can be equally sure that the rhetoric of the abstinence-only-until-marriage industry is likely to get even more heated and desperate. These extreme voices will seek to keep tax-payer dollars despite the fact that they do not work and that they violate basic mainstream American values by censoring information and presenting mistruths as fact. We must be prepared for the dishonest attacks that most certainly will come against anything that goes beyond the narrow ideological frame of abstinence-only and marriage promotion. More importantly, though, as federal support for the abstinence-only-until-marriage industry vanishes, we have an opportunity to make sure we hold our government accountable for turning its support toward a more comprehensive approach to sex education that is supported by the evidence and the American public. Neither of these outcomes is certain, but if the Obama administration is serious about science and evidence, not ideology, setting the standard for policy, then abstinence-only-until-marriage is out and a more comprehensive approach to sex education is in.

[1] While a crisis pregnancy center in North Dakota received Title V abstinence-only-until-marriage funding in Fiscal Year 2008, SIECUS was unable to determine the exact amount of funding received by the sub-grantee.
[2] “Abstinence-Only? Abstain Please!,” Philadelphia Daily News, 22 August 2008, accessed 15 September 2008,
<;!category=opinion;&randomOrd=082208052959>; “Abstinence-Only Sex Ed: An abrupt change,” Philadelphia Inquirer, 1 September 2008, accessed 15 September 2008, <>; “Loose behavior: The state is wrong on abstinence-only funds,” Pittsburgh Post-Gazette, 2 September 2008, accessed 15 September 2008, <>.
[3] “Loose behavior: The state is wrong on abstinence-only funds.”
[4] Isaiah Thompson, “Rendell applies for abstinence-only money from feds,” Philadelphia City Paper, 28 August 2008, accessed 3 September 2008, <>.  
[5] Department of Health & Human Services, Administration for Children and Families, “State Abstinence Education Grant Program (AEGP) for FY 2009 through FY 2013,” 18 July 2008, accessed 18 July 2008, <>.
[6] Northwest Family Services, application to the Administration for Children and Families, 2006, p. 14. 
[7] Healthy Image of Sex (HIS), Teacher’s Manual, Version I, p. 9.
[8] Reasonable Reasons to Wait: Keys to Character, Student Workbook, (Chantilly, VA: A Choice in Education, 2002–2003), p. 39.
[9] Jo Anne Grunbaum, et al., “Youth Risk Behavior Surveillance – United States, 2001,” Surveillance Summaries, Morbidity and Mortality Weekly Report 51.SS-04 (28 June 2002): 1-64, accessed on 2 October 2008, <>.
[10] For more information on this study see, SIECUS’ Research Update: Marginally Successful Results of Abstinence-Only Program Erased by Dangerous Errors in Curriculum, SIECUS, at
[11] Home Page, Abstinence Clearinghouse, accessed 3 October 2008, <>.
[12] Myra Batchelder, “Who Is Leslee Unruh?,” 5 October 2006, accessed 3 October 2008, <>.
[13] Ibid.
[14] Danielle Knight, “Bias Claimed in U.S. Abstinence-Only Review,” US News and World Report, 8 October 2005, accessed 13 February 2007.  
[15] “CREW Files IRS Complaint Against Anti-Choice Abstinence-only Orgs—Alpha Center and National Abstinence Clearinghouse,” Citizens for Responsibility and Ethics in Washington, Press Release published 26 July 2006, accessed 13 February 2007, <>.
[16] “Affiliate Center,” Abstinence Clearinghouse, accessed 23 November 2008, <>.
National Coalition to Support Sexuality Education National Coalition to Support Sexuality Education