Failure to Launch: Obama’s New Teen Initiative Can Be Fixed, and Here’s How

William Smith and James Wagoner

Preventing teen pregnancy is incredibly important. But unintended pregnancy among teens is not the only sexual and reproductive health issue facing our nation's youth.

President Obama’s Fiscal Year 2010 budget is to be
applauded.  The President has proposed an
end to abstinence-only-until-marriage funding as we have known it for the
better part of the last decade.  This marks
a significant change in direction, one that finally brings science and evidence
back into government policy. His leadership on this new direction will be
essential in the coming negotiations with Congress.

He has also offered up a new initiative that has become the
source of much discussion among advocates and between these same groups and the
White House.  The President seeks to
reallocate the funding previously spent on abstinence-only-until-marriage to teen
pregnancy prevention in a "silo-ed" approach that will inhibit the comprehensive
approaches needed to address the challenges facing teens today. 

Preventing teen pregnancy is incredibly important.  But unintended pregnancy among teens is not
the only sexual and reproductive health issue facing our nation’s youth.  We also have an epidemic of sexually
transmitted diseases among youth and every hour, at least one young person
acquires HIV in our country.  These and
other adverse outcomes of unprotected sexual activity among youth–outcomes that may result simultaneously in one act of intercourse–are the
consequences of a complex set of circumstances representing the failure of our
nation to strategically and systemically provide the education and information
young people need to make responsible decisions about their sexual health. This
is why our organizations, Advocates for Youth and the Sexuality Information and
Education Council of the United States (SIECUS), have been staunch advocates
for a much broader approach to these and other issues, through efforts that empower
young people to make good and healthy decisions now and throughout their
lifetimes. 

From a sexual and reproductive health perspective, vertical
or silo-ed programs don’t work.  In fact,
if persistently high teen pregnancy and sexually transmitted disease rates,
including HIV, prove anything, it is that addressing these outcomes separately
has consistently failed.

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SIECUS and Advocates for Youth, along with nearly 200 of our
nation’s leading health organizations, are seeking change that breaks from this
mold. That is why, during the 2008 election and subsequent transition, for
example, this large and informal coalition strongly advocated for deep
investments by the new Administration in comprehensive sex education, rather
than solely on one aspect of a broader problem. 
Comprehensive sex ed provides teens with information and life-skills
training that will reduce teen pregnancy and sexually transmitted infections while
addressing other aspects of sex and sexuality, such as responsibility, respect,
mutual consent, identification of abusive or controlling relationships, and
other critical skills. 

Comprehensive
sex ed is an approach that has been shown to be effective, for which Americans have consistently shown
support in poll after poll, and which promotes prevention and good health across a range of outcomes rather than only one outcome.  So while
the proposed new initiative is a step in the right direction, there is a great
deal of consensus among the groups who have been working on these issues for
decades that some changes are necessary to achieve maximum benefits in regard
to improving reproductive and sexual health, which in turn will contribute to
reduced health care and social costs. 

This week, more than 175 organizations reiterated the need
to do better and sent letters to the White House and Congressional
appropriators
toward this end.  These
letters underscored that just a few simple modifications to the President’s proposed
initiative can achieve what is needed.

First, expand the scope of the program.  The current teen pregnancy
prevention language must be expanded to include other proven interventions that
address sexually transmitted diseases and HIV/AIDS.   To do otherwise hamstrings this initiative
before it even gets off the ground.  By
supporting language that is inclusive of additional approaches, we can bring to
scale comprehensive programs that meet the diverse needs of all young people in
all communities, including lesbian, gay, bisexual, transgender, and questioning
youth whose needs fall wholly outside of the narrow teen pregnancy prevention
framework.  Admittedly, this step alone hardly
gets us out of the "disaster aversion" silos, but we have to work with what has
been so far advanced by the White House and these few additional words can at
least ensure that broader interventions are supported.

Second, make schools a priority.  By prioritizing schools, the new initiative
can help ensure smart and multi-faceted investments toward a sustainable legacy
to improve the health of our nation.

Over the past several years, significant policy shifts and
the adoption of evidence-based programming in schools have created a unique and unprecedented
opportunity to support a systemic change.  The tired arguments that schools cannot do
this are outdated.  Dozens and dozens of
school districts are at the ready but need resources to make it happen.  By assisting schools in institutionalizing
comprehensive programs aimed at helping improve adolescent sexual behaviors, we
can provide the needed educational information to the widest range of teens. The
current language excludes important public entities, such as schools, from
accessing funds. 

Third, ensure effective implementation.  According to the Administration’s current plan,
all of the funding for these efforts rests within a single agency within the
Department of Health and Human Services, one which currently oversees
abstinence-only-until-marriage programs. While we believe this agency can and
should play an important role in supporting community and faith-based
organizations, the agency does not have the necessary experience or
infrastructure to improve school-based programming.  Investments must be made through agencies
that have a public health framework, existing structures and relationships with
schools, and a proven record of the necessary support services to help ensure
success.  For example, allocating some
funding under the new initiative to the Centers for Disease Control and
Prevention (CDC), which already has established working structures with our
nation’s state and local educational entities, will save the government from "recreating
the wheel" – a process that all too often plagues good intentions.

This is not about semantics. 
We need to create a bold new investment that can be sustained beyond
electoral cycles, Administrations, and the occupant of the White House at any
given time.  We need a lasting commitment
with lasting effects. As currently written, the new teen pregnancy initiative
does not represent that bold, new investment. 

But it can.

Congress and the White House must listen to the chorus of
consensus within the majority of the advocacy community and support the changes requested by the broad
community of advocates and experts engaged in this issue.  Given that the White House rejected the initial
requests to specifically support sex education, these few modifications seem
hardly too much to ask.

Without these changes, the much-sought after end
of abstinence-only-until-marriage programs will not result in the ushering in of the
first ever federal program supporting comprehensive sex education about which President Obama spoke so eloquently during his campaign.  Instead, it will be the same emphasis on teen
pregnancy prevention, launched a dozen years ago by the Clinton Administration,
which was easily highjacked by social conservatives after the mid-term
election.  The result: more disjointed
patchwork prevention programming that fails our youth and blows with the
political winds. 

We have a chance to do something fundamentally different
this time around but the first step is a critically important one and has to be
placed on terra firma.  The job of advocacy groups is to push for a
firm foundation that will withstand changing political winds and to
differentiate that foundation from the thin layer of top soil that can easily
be washed away.

The President’s budget launched us in a new and important
direction. Now we just need to make sure that we arrive at the right
destination.

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