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Trump Administration Pushes Abstinence in Teen Pregnancy Programs

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© Marc Piscotty for The Washington Post, via Getty Images The Trump administration’s new rules explicitly encourage programs that emphasize “sexual risk avoidance.”

By PAM BELLUCK, The New York Times

The Trump administration has issued new rules for funding programs to prevent teenage pregnancy, favoring those that promote abstinence and not requiring as rigorous evidence of effectiveness.

While the funding announcement, issued Friday by the Department of Health and Human Services, does not exclude programs that provide information about contraception and protected sex, it explicitly encouraged programs that emphasize abstinence or “sexual risk avoidance.”

Other programs that promote “sexual risk reduction” will be considered, the announcement said, though for those, too, it mentioned an “emphasis on cessation support,” a phrase many involved in teen pregnancy programs interpreted as urging sexually active teenagers to stop having sex.

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“What’s noticeably absent in those things you must talk about is that if the young person continues having sex, here is the information you must have about contraception and sexually transmitted diseases,” said Andrea Kane, vice president of policy and strategic partnerships for Power to Decide, a national group working to prevent unplanned pregnancies. “They talk about skills to avoid sex and return to not having sex. It doesn’t really leave any opening for those young people who continue having sex and how we help them prepare for their futures.”

The Health and Human Services Department declined an interview request to discuss the announcement.

Groups that have been receiving federal money had been bracing for a change in the rules since last year, when Valerie Huber, a leader of an abstinence education advocacy organization, was named chief of staff to the Department of Health and Human Services official who oversees adolescent health. Shortly before she was appointed, Ms. Huber wrote in an opinion piece that the best message for young people was “to avoid the risks of teen sex, not merely reduce them.” She described the Obama administration’s approach as one that “normalizes teen sex.”

The new rules also move away from a requirement that most organizations receiving federal money choose from a list of approaches that have been shown in at least one rigorous evaluation to be effective at changing some sexual behavior, such as reducing pregnancy rates or rates of sexual activity.

Under Obama administration guidelines, organizations awarded most of the grants had to use curriculums that were on an evidence-supported list. Under the new guidelines, they simply have to comply with more general requirements like “support personal attitudes and beliefs that value sexual risk avoidance.”

Jon Baron, vice president of evidence-based policy at the Laura and John Arnold Foundation, a nonpartisan foundation, said the new approach is like “starting from ground zero as if nothing has been learned. Until you have an evaluation of an actual program that people are showing up for and an actual curriculum and actual people teaching it, you really don’t have reliable evidence.”

Abstinence programs have often failed to change teenage sexual behavior. A 2007 study of four such federally funded programs, for example, found “not even a hint of an effect on sexual activity, pregnancy or anything,” Mr. Baron said. Still, the Obama administration’s menu of “evidence-based programs” included three abstinence programs.

Last summer, the Health and Human Services Department told the 81 organizations that were receiving a total of $89 million a year from the agency that their five-year pregnancy prevention grants would end in June 2018, two years early. Several of the organizations sued to keep their funding, and last week, the first judge to rule on any of the cases decided that the South Carolina Campaign to Prevent Teen Pregnancy was entitled to receive the rest of its five-year grant.

Projects sponsored by the South Carolina organization, like most of those begun under the Obama administration’s Teen Pregnancy Prevention Program, teach about contraception and sexually transmitted diseases in addition to abstinence, and at least one of the South Carolina programs received federal permission to supply condoms in places like a bowling alley and barbershops.

On Monday, Beth De Santis, chief executive of the South Carolina Campaign to Prevent Teen Pregnancy, said she hopes the new rules will allow for the types of comprehensive sex education programs that her organization has found effective.

Federal officials are now “very much into avoiding sex altogether,” Ms. De Santis said. “That is something that has been very clear from this administration and they’re not making a secret of that.”

But, she continued, she hopes her organization’s programs will comply with the new administration’s definition of “sexual risk reduction.”

“Our next step will be to work with them on whether or not they agree that some of the programs that we already have can be approved,” she said. “I do think they have given us an opportunity to find a way to continue to do the work we do.”

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