Commentary Sexual Health

With New Trump HHS Hire, Abstinence-Only Reboot Gets a Champion

Martha Kempner

Valerie Huber runs an organization that promotes abstinence only until marriage. Now she's been tapped for a key U.S. Department of Health and Human Services post, where she will likely promote a misguided idea of abstinence as poverty reduction.

When the Trump administration took office in January, advocates for sexuality education worried that there would be a resurgence of the failed abstinence-only-until-marriage programs that dominated the last Republican administration.

There was hope, though, because President Donald Trump had never mentioned abstinence-only education, and the thought of a thrice-married, proud-of-his-playboy-days man condemning sex outside of marriage seemed too hypocritical even for this White House.

These hopes have now been dashed. Trump’s budget in late May proposed about $160 million in funding for abstinence-only-until-marriage programs over two years.

Perhaps more telling, however, was the announcement earlier this week that Valerie Huber, a prominent leader of the abstinence-only-until-marriage movement, has been named chief of staff to the as-yet-unappointed assistant secretary of health within the U.S. Department of Health and Human Services (HHS). At HHS, she will help run the Office of Adolescent Health. This is especially concerning because Huber has been instrumental in attempts to remake ineffective abstinence-only-until-marriage programs into poverty-reduction programs.

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Huber previously served as Ohio’s abstinence education coordinator and is now president and CEO of Washington, D.C.-based Ascend, formerly the National Abstinence Education Association.

Huber’s hiring puts an opponent of comprehensive sexuality education in an influential position. The assistant secretary for health oversees not just the Office of Adolescent Health but also the Offices of Population Affairs (OPA), Research Integrity, Women’s Health, and Minority Health, among others. As chief of staff, Huber could feasibly influence the Teen Pregnancy Prevention Program (which her organization has led the charge to defund) and OPA’s Title X program, which provides reproductive health services and contraception to low-income women.

Chitra Panjabi, president and CEO of the Sexuality Information and Education Council of the United States, said in a statement: “The people served by the programs within the HHS Office of the Assistant Secretary deserve more than a science-denialist who has built a career on perpetuating fear, shame, and stigma of sexuality for our nation’s young people.”

Ascend’s website hints about the possible directions of Huber’s future leadership. It says that Ascend works to gives teens “access to the skills, information and encouragement to avoid all sexual activity, hopefully until they marry. We believe that helping teens eliminate–not simply reduce–sexual risk is the right thing to do.”

It is now painfully clear that we will probably be going back to the days when the federal government openly approved of sexuality education curricula that used petal-less roses, dirty tape, cups of saliva, and melted snacks to tell young women they are no longer beautiful and “pure” after they’ve had sex. Back to the days when sexuality education taught that young women must be sexual gatekeepers who check male desires. Back to the days of telling all young people that heterosexual marriage should be everyone’s ultimate goal. And back to the days of mentioning contraception only to say it frequently fails.

I used to say that abstinence-until-marriage programs were a social agenda masquerading as teen pregnancy prevention. But study after study has shown they failed to help teens delay sex in the long term or prevent pregnancy. In fact, some programs—specifically those that required virginity pledges—were found to decrease condom and contraception use among teens, instead putting them at increased risk for pregnancy and sexually transmitted diseases.

Facing evidence that such programs were ineffective and even harmful, abstinence proponents have in recent years rebranded their programs with a new name—sexual risk avoidance. But it’s the same tactics—using misinformation or questionable research—with an updated focus: reducing poverty.

Ascend believes that “Sexual Risk Avoidance (SRA) programs focus on preventing the well-documented factors that lead to poverty and offer practical and effective solutions for addressing this persistent societal concern.”

Teen parents are, in fact, more likely to live in poverty than their peers who have children at a later age. But suggesting that avoiding all sex until marriage will prevent you from being poor later in life is an extreme message not based in research.

The argument hinges on the idea of “success sequencing,” which suggests that if people achieve certain milestones in a certain order, they will be less likely to be poor. Brookings Institution researchers Ron Haskins and Isabel Sawhill originated the concept with research that found people who graduated from high school, got a job, and waited until they were married and older than 21 to have a child were less likely to be living in poverty. Haskins explained: “Our research shows that of American adults who followed these three simple rules, only about 2 percent are in poverty and nearly 75 percent have joined the middle class (defined as earning around $55,000 or more per year).”

Ascend and other SRA supporters grabbed onto this research to spin their abstinence agenda. Don’t have sex before marriage, they say, and you won’t struggle economically.

Even if we assume that success sequencing is truly the way to get out or stay out of poverty (which we shouldn’t), there are some obvious flaws with using it to promote abstinence. You can follow the plan of graduating first, getting a job next, and not having kids until you’re over 21 and married without remaining abstinent. Having sex does not prevent doing any of these things or even change the order. Furthermore, this argument ignores the advent of extremely effective birth control methods.

Ascend’s leadership clearly realizes that the leap from success sequencing to abstinence is pretty big. Critics can—and do—easily argue that providing teens with long-acting reversible contraception (LARC) could help them. To get around this, the organization’s fact sheet on success sequencing argues “while LARC is highly effective in preventing pregnancy, it offers no protection against the many other possible consequences of teen sexual activity including healthy family formation and reaching future goals.”

It goes on to suggest that early sexual behavior is responsible for life outcomes from depression to divorce. The relevancy of the research used to support these assertions for U.S. adolescents is questionable at best; one study was conducted among young teenagers in Sweden, and another focused on those who have sex before age 14 (a relatively small proportion of sexually active adolescents).

J. Dennis Fortenberry, an expert in adolescent sexual behavior and professor of pediatrics at Indiana University, told Rewire in an email: “Taken together, neither of these studies make a cogent case for bad life outcomes [for those with] onset of partnered sexual relationships in middle and later adolescence. Earlier onset at 14 and younger still looks to be more often a response to neglectful/harsh/violent parenting and social environments, and the longer-term consequences are very likely embedded in the parenting and social context.”

There’s another problem with using success sequencing to turn abstinence programs into poverty prevention. Simply put: The theory is flawed. Political commentator Matt Bruenig explained in a Demos post that steps one and two—graduating high school and getting a job—are doing all the work of keeping poverty at bay. The truth is that if you get and maintain a full-time job with a living wage and benefits such as insurance, you will likely not be poor.

As obvious as this is, it’s not easy and it’s not equal. Success sequencing seems to ignore the fact that those living in poverty are already at a tremendous disadvantage in the quest for a middle-class life. Many of the people in Haskins and Sawhill’s research who followed these steps and ended up in the middle class were middle class in the first place. They had better education and more opportunities after high school.

Success sequencing also fails to account for institutional racism in this country. In fact, in later research, the Brookings Institution itself later acknowledged that success sequencing usually only works if you’re white.

Nevertheless, SRA supporters continue to use it as a justification to bring back abstinence programs, and it has already made its way into official government language under Congress and the Trump administration. The Consolidated Appropriations Act of 2017, for example, sets aside $15 million for sexual risk avoidance programs and notes that such programs should, among other things, “teach the benefits associated with self-regulation [and] success sequencing for poverty prevention.” The same language is in Trump’s proposed budget, which funds abstinence-only programs for poverty reduction while cutting legitimate anti-poverty efforts such as food stamp programs and Medicaid.

Debra Hauser, president of Advocates for Youth, said in an email to Rewire: “This administration’s hypocrisy is only surpassed by its callousness. Young people don’t need sermons on chastity. They need economic and educational opportunities—the type of opportunities that build strong lives and strong communities.”

But the irony and hypocrisy are likely lost on Huber and the Trump administration. Whatever the president’s personal views or past behavior, Huber’s hire and his budget signal that he’s all-in for teaching young people that the only path to happiness is paved with premarital abstinence. And maybe petal-less roses and spit.

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