Denying the Right to Reach Adulthood in Good Health:
How Bush Administration Policies are Affecting Young People Worldwide

Secondary school girls in Benin City, Nigeria at an after-school session on health and body image led by IWHC colleague Girls' Power Initiative.

The Context:
Global and Domestic Realities
There are 1.2 billion people ages 10 to 19 living in the world today, the largest generation of adolescents in history. Thirty-four percent of new HIV infections occur in young men and women aged 15 to 24. Over the next decade, over 100 million girls will be married while they are still children. More than 4.4 million 15- to 19-year-old girls seek abortions every year, 40 percent under unsafe conditions.  

Here in the United States, the pregnancy rate is the highest in the industrialized world-ten times more than in the Netherlands or Switzerland. Of the 900,000 U.S. teenagers who become pregnant every year, eight in 10 say their pregnancies were unintended. Girls who give birth often receive little or no prenatal care, are likely to drop out of school, and risk having low-birth-weight babies with subsequent health problems.

Despite these realities, a number of current U.S. policies deny adolescents their right to full and accurate information on sexuality and reproduction, and limit their access to the respectful, confidential, and comprehensive healthcare they require to reach adulthood in good health. These policies are endangering young people-and particularly young women-at home and abroad, sacrificing their health needs and human rights in favor of unproven programs that fail to recognize the realities of young people's lives.

Opposing Real Sex Ed at Home
Evidence has found that young people who receive comprehensive sexuality education become sexually active later than other teens, have fewer partners, and are more likely to use contraceptives when they do have sex. That's why 8 out of 10 U.S. parents support such quality programs for their children.

Yet religious fundamentalists have continuously objected to the teaching of sex education, and when they failed to sway the American public, they began pushing so-called "abstinence-only-until-marriage" instruction in place of the previously successful combination strategy of abstinence; relationship negotiating skills; and information on the benefits of contraception, including condoms, in preventing unintended pregnancy and sexually transmitted infections (STIs), including HIV/AIDS.

Initially, the federal government gave limited funds to the new and unproven abstinence-only approach, which withholds public health information from young people, and instituted a set of measures to assess the effectiveness of the abstinence-only programs. But the Bush administration, aided by allies in Congress, has dramatically loosened the evaluation requirements, while consistently requesting significant increases in funding. After 10 years and $1.5 billion of public funds sunk into these programs, there remains no reliable evidence that abstinence programs delay the initiation of sex or reduce teen pregnancy.

A study on a Minnesota abstinence program found that over the course of one year the rate of those who said they were sexually active doubled and the rate of those who said they would probably have sex before finishing high school increased 7.5 percent. According to a November 2006 report by the independent Government Accountability Office, the government does not screen grantees to ensure that they produce medically accurate materials.  A recent comprehensive study (Mathematica 2007)  found that federal abstinence-only programs have no measurable impact in changing youth's behavior by increasing abstinence, delaying sexual initiation, or encouraging condom use. This and other research has so far prompted at least 14 states including California, Colorado, Maine, Ohio, Pennsylvania, Virginia and Wisconsin, to reject federal funding for abstinence-only education programs.

In addition to funding abstinence at the expensive of quality comprehensive programs, the Administration has also policed information and agencies that promote a comprehensive approach. Advocates for Youth (AFY), a nonprofit organization that supports comprehensive sex ed, has received government grants for 15 years without audit requests, but since the Bush administration took office, the organization has been audited three times. The most recent audit focused on AFY's support of a comprehensive approach to sexuality education, including, but not limited to, abstinence. And in 2002 the Centers for Disease Control and Prevention (CDC) altered information on its website in order to reflect the Administration's rigid adherence to abstinence-only policies. "Programs that Work," a resource for educators that described sexuality education curricula effective in reducing risky behavior among adolescents, disappeared. "Facts about Condoms and their Use in Preventing HIV Infection," was replaced by a version emphasizing abstinence and condom failure rates, and missing the section on correct condom use.

Denying Lifesaving Information Abroad
Erasing real sex ed from the domestic policy agenda is harmful enough, but in the developing world, denying information can be deadly. In developing countries half of the people infected with HIV/AIDS every day are between the ages of 15 and 24, and in many countries, pregnancy is the leading cause of death for adolescent girls. Comprehensive sexuality education and quality reproductive health care give young people the tools they need to protect themselves from sexually transmitted infections (STIs) and unplanned pregnancies.

In May 2002 at the UN General Assembly Special Session on Children, the Bush administration allied itself with Saddam Hussein's Iraq, Iran, Libya, Sudan, Syria, and the Vatican in order to try to prevent young people under 18 from receiving information about sexual abuse, birth control, condoms, and reproductive healthcare, including HIV/AIDS prevention. Their initiative failed, but ideologues have found other ways in the past four years to advance their agenda and impose their beliefs on the world's most vulnerable young women and men.

U.S. delegations at UN meetings on a range of issues, including HIV/AIDS, sustainable development, and women, have repeatedly opposed young people's right to comprehensive sexuality education and reproductive health care in favor of an exclusive focus on abstinence. And under the President's $15-billion Emergency Plan for AIDS Relief in Africa, the Caribbean and Vietnam, at least one-third of all prevention funds are designated for abstinence-until-marriage programs. Such programs fail to help young women whose husbands are HIV-positive, or young women forced to trade sex for food in order to survive. Unless prevention programs reflect the challenges and realities they face, HIV/AIDS rates among young people will continue to increase.

There is a ray of hope. The requirement that one-third of global HIV prevention funds be spent on abstinence-until-marriage programs has been lifted for one year, following the recommendations from the Governmental Accountability Office and the Institutes of Medicine.  This reform was signed into law as part of the FY2008 Foreign Operations appropriations bill.  During the 2008 reauthorization of the global HIV/AIDS programs, advocates will try make this change permanent.

What You Can Do>>

Take action. Congress has before it several pieces of legislation that would make a real difference in the education and services available to young people. They need to hear from their constituents that you want these bills passed - and to put effort into it. For information on this legislation visit Stay Informed, Take Action, our congressional factsheet. Click here for more information about IWHC's commitment to youth health and rights.

Stay informed. For information about other Bush administration policies that are undermining women's and young people's health worldwide, visit Bush's Other War, our regularly updated factsheet.

Donate to IWHC. IWHC's partners worldwide are working in innovative ways to provide young people with the information and healthcare they need to reach adulthood in good health. We also support a number of organizations and networks led by young people themselves. By supporting us, you will strengthen our support for these groups. Click here to make a contribution.

Spread the word. You can email this page to a friend by clicking on the link in the top right corner.

This factsheet last updated in February 2008. For more information, contact Whitney Welshimer at 212-979-8500 or wwelshimer@iwhc.org.