Refocusing sex ed

Some teen advocacy groups are up in arms over new rules released this summer requiring federally funded teen pregnancy prevention programs to focus on abstinence until marriage and teach kids about their bodies. In late June, the Department of Health and Human Services stopped funding 53 groups that allegedly normalize teen sex outside of marriage, prompting several groups, including an arm of Planned Parenthood, to sue.

Critics of the new rules say the federal Teen Pregnancy Prevention Program, created by Congress in 2010 during the Obama administration, helped contribute to the national decline of teen birth rates. Changing the program, they claim, could reverse that trend. But conservatives say the program might not have actually been successful and argue the new guidelines could fill an important gap in sex education curriculum.

More than $100 million in federal funding goes toward the TPP program every year. Many grant recipients partner with public and private schools to teach sex education in an effort to reduce rates of teen pregnancy. According to the pro-abortion Guttmacher Institute, 46% of Americans aged 15-19 have had sex at least once.

Under the Biden and Obama administrations, many of the TPP program grantees approached sex education with a philosophy known as sexual risk reduction. The approach assumes teenagers will have sex, so sex education should focus on teaching them to do it safely. “Those are the kind of programs where you hear about being taught how to put a condom on a banana and where kids are learning about different kinds of fetishes,” said Grace Emily Stark, editor-in-chief at Natural Womanhood, a Texas-based nonprofit that advocates natural family planning and promotes fertility awareness and body literacy for women and girls.

Before the defunding effort, two branches of Planned Parenthood received a total of more than $1.5 million per year through the program. The first Trump administration tried to overhaul the program, but a court overruled the changes.

Last summer, the second Trump administration tried again: It issued a notice clarifying the federal government’s policies for recipients. “‘Age appropriate’ programs for minors do not contain material that depicts, describes, exposes or presents obscene, indecent, or sexually explicit content,” it said. The letter also noted that grant recipients may not offer instruction in “ideological content” such as teaching that people can choose their own gender.

The new TPP program guidelines issued this June require recipients to teach sexual risk avoidance by encouraging minors to abstain from sex until marriage. They also emphasize body literacy education. This gives adolescents “the tools to understand how their bodies work in a state of health so that they can protect their current health and their health and fertility in the future,” Stark said.

According to the guidelines, recipients should teach about both male and female reproductive health. The female module must include instruction about menstrual cycles and warning signs of infertility, while the male module must include the significance of testosterone and “the physiology of arousal,” per the guidelines.

Stark says that education focusing on reproductive health is sorely lacking in the United States. “We have the appalling reality in the U.S. and around the world that it takes eight to 10 years for a young woman to get a diagnosis for endometriosis,” Stark said. “And by and large, it’s because women are not taught what’s normal for their cycles.”

Diane O’Toole, executive director of Boston Pregnancy Center, believes sex ed programs tend to focus too much on contraception and not enough on how the body works. “There’s a huge disconnect in the clients that come through our doors who are sexually active and then surprised that they’re pregnant,” she said.

Instead of focusing only on contraceptives and consent, programs should teach teens about their reproductive health to empower them to make wise decisions in the long run, said Grace Stark. “Birth control will help you not get pregnant, but it’s not going to do anything for you when you want to get pregnant,” she said.

But Stark added that body literacy education goes beyond equipping teenagers to be parents when they do get married, saying that it also shows them their worth and dignity.

Critics say the TPP program overhaul contradicts the goal of reducing unintended teen pregnancies. “Defendants have abandoned the evidence-based efficacy approach required by Congress,” Planned Parenthood and other groups said in their lawsuit against HHS. They argue that falling teen pregnancy rates since 2010 are partly due to the program’s influence.

The teen pregnancy rate has been falling since the 1990s, though, so it’s unclear how much the TPP program contributed to that, said Melanie Israel, a visiting fellow at the Heritage Foundation. She also said the TPP program hasn’t had glowing results even under Democratic administrations. Israel argued that, since a court overruled the first administration’s overhaul, it’s not fair to say the Trump administration’s approach doesn’t work. “If we are going to be spending millions upon millions upon millions of dollars on programs like this, let’s demand excellence,” she said.

If the Trump administration had its way, it would eliminate the TPP program—just as it proposed in its 2027 budget. “There is no evidence that these specific programs have contributed to this historic decline in teen pregnancy, which is now at an all-time low,” the budget read.

But Israel said ending the program is unlikely, as it would require congressional approval. “The next approach is OK—if this program is going to continue existing right now, we’re going to make sure that we’re funding organizations and entities that align with our priorities,” she said.

The new guidelines, with their focus on body literacy, claim to more closely match the program’s stated goal of reducing teen pregnancy. The document reads, “Studies indicate that girls who receive body literacy education are much more likely to remain abstinent compared to their body-illiterate peers, suggesting that knowledge and self-understanding support protective behaviors.”

The updated rules certainly align with the administration’s priorities. According to the Office of the Assistant Secretary for Health, which distributes the grants, the agency will not support any program that promotes “content that encourages, normalizes or promotes sexual activity for minors.”

Kristen Miele is the founder of Sex Ed Reclaimed, a curriculum for Christian families. She believes consistent talks about sex happen best at home, but she said Christians can still advocate for better federal programs and celebrate the changes. “Preventing unintended teen pregnancy is something Christians should care about,” she said. “And we should care about what is effective because we want young people to understand the weight of sex, because we believe sex matters.”

Changes to the TPP program mirror updates this year to the Title X family planning grant. That program will also emphasize body literacy education to “help patients move beyond symptom-focused care toward informed, preventive, and restorative approaches to reproductive health,” according to the Department of Health and Human Services.

But it’s unclear how long the TPP changes will be in effect. The lawsuit filed last month requests the court declare the new guidelines unlawful.

“I think that would be a shame,” said Natural Womanhood’s Grace Stark. “A world in which a [teenage] girl has a body literacy education … she’s not hit over the head with the reality of waning fertility in her late 30s, which is something a lot of women are experiencing right now.”