Los Angeles As the Bush administration prepares to earmark millions of dollars for sex education that stresses abstinence, a debate has erupted among researchers and teachers over whether such programs steer teen-agers away from intercourse but toward other forms of risky sexual activity.
Some researchers say that many teen-agers have come to believe that abstinence means only refraining from intercourse. But while the alternative behaviors eliminate the risk of pregnancy, they still expose youths to sexually transmitted diseases.
Advocates of abstinence education say their programs are responsible for a long-term drop in the nation's teen-age pregnancy rate, but critics say that attitude is too narrowly focused and leaves many teen-agers with misinformation.
For example, a recent survey by the Kaiser Family Foundation, a national health philanthropy, found that one-quarter of sexually active 15- to 17-year olds believed oral sex posed no risk of HIV infection and another 15 percent did not know that a person could become infected that way.
The attitude of many teen-agers was typified by a 16-year-old San Fernando Valley girl who told a recent panel discussion on teen-age sex: "I consider myself a virgin, and I've had oral sex. My definition of abstinence is no penetration."
Last month, in his "Call to Action to Promote Sexual Health and Responsible Sexual Behavior," U.S. Surgeon General David Satcher advocated sex education that emphasizes abstinence but is thorough and begins early in life.
"School sexuality education is a vital component of community responsibility," Satcher said in the report, noting that families vary widely in their ability and willingness to discuss sex with their children.
On the heels of the report, the administration announced $17 million in new grants for abstinence-only education programs, part of a plan to increase federal funding for such programs to the level devoted to more comprehensive sex education, which includes providing information on contraception.
"The concern is creating parity for abstinence-only education," said Kevin Keane, assistant secretary for public affairs at the U.S. Department of Health and Human Services. "I know a lot of critics say (abstinence-only education) hasn't been proven to work. Well, it hasn't been proven not to work either."
The surgeon general's report said so few abstinence-only programs have been scientifically evaluated that no one can say whether they work.
By contrast, several studies of more comprehensive sex education programs cited in Satcher's report indicate that giving teens information about contraception does not increase sexual activity
The dispute and the increase in funding has only widened the gulf between advocates of teaching only abstinence in sex education classes and those who prefer a more diverse approach.
Abstinence-only advocates say comprehensive sex education places too much emphasis on alternatives to intercourse.
"They have defined these behaviors as being abstinence," said Libby Gray, a spokeswoman for Project Reality, a Golf, Ill.-based nonprofit organization that has been advocating abstinence-only sex education in public schools since 1985.
"We really stress that any type of sexual contact can and does lead to disease. ... What we're saying is anything that leads up to intercourse is not abstinence," she said.
But supporters of comprehensive sex education contend that the abstinence-only movement is deliberately vague.
"I think what's unfortunate about the abstinence-only approach is that it does not generally define abstinence for young people," said Tamara Kreinin, president and chief executive officer of the Sexuality Information and Education Council of the United States, a New York City-based organization.
Referring to the pledge millions of teen-agers have taken to remain virgins until marriage, she said, "I think some of these teen-agers are trying to adhere to the abstinence message by saying 'If I don't have vaginal intercourse, I've adhered to this and I'm OK."'
Teen-agers themselves often offer surprising assessments of the intimacy of various sex acts, as suggested by the comments from adolescents on the recent Los Angeles panel, convened by the Media Project, a partnership of the Kaiser Family Foundation and Advocates for Youth, a nonprofit organization that provides sexual health information and training to organizations that deal with young people.
For instance, some teens said they consider "heavy kissing" more intimate than oral sex.