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Volume 4, Number 1
Spring 2006

The State of Sex Education in North Carolina:  Is Abstinence-Only Education Working?*


Rebecca Bach
Duke University

    In 1995 Rep. Robin Hayes introduced a bill requiring that public schools in North Carolina teach an abstinence-only sex education curriculum.  Despite heated debates, both the house and the senate passed the bill.  As a result, since the 1996-97 academic year, over 100 out of the 117 school systems in North Carolina have taught abstinence-only until marriage in their healthy living/sex education courses.

    The goals for my presentation this morning are threefold.  First I will provide a brief overview of the historical and political context of North Carolina’s decision to offer Abstinence-Only Sex Education.  Next, I will describe my research strategy and some of the challenges involved in collecting information regarding sex education in the schools.  Finally I will offer some observations and preliminary results on the effects of abstinence-only sex education in North Carolina.

    Political battles over sex education in the United States are nothing new.  According to Janice Irvine (2002), public battles over sex education have been ongoing since the 1960’s.  The early battles tended to focus on whether or not public school was an appropriate venue for sex education. At the time many parents insisted that the proper forum for sex education was the family rather than the public school. The battle for introducing sex education in schools was won primarily due to the efforts of Mary Calderone and her colleagues who in 1964 formed the Sexuality Information and Education Council of the United States (SIECUS) to promote sex education (Irvine 2000).  SIECUS is still in existence today and is largely responsible for developing the concept of comprehensive sexuality education.  Their comprehensive approach can be seen at their web site

    In the mid-1990’s the United States experienced a rebirth of a conservative political agenda regarding sexuality.  A number of conservative congressional candidates had successfully run on “family values” campaigns.  Dr. Jocelyn Elders was forced to resign her position as surgeon general of the United States for her now infamous comments about masturbation. And, national attention was drawn to what was described as an epidemic of teen pregnancy. For many, teen pregnancy was identified as the root of the welfare problem in the United States.  Welfare reform was begun and the Aid to Families with Dependent Children (AFDC) program, which had been a centerpiece of the welfare program, was replaced by a program that was aimed at reducing the numbers of families receiving public assistance, Temporary Assistance to Needy Families (TANF).

    It is in this political context that what is referred to as "abstinence-only" education received its first major federal funding. In 1996 conservative members of Congress quietly included a provision in section 510 of the Social Security Act guaranteeing $50 million annually over five years for abstinence-only education grants to the states.  Federal funding for abstinence-only education has continued and, if you have looked at President Bush’s new budget, you may have noted that Abstinence-only education continues to be a high priority. In the current budget year this program has three times the funding it had in 2001. 

    Currently, in public school sex education there are three basic approaches or models: Comprehensive sexuality education, Abstinence-Only sex education, and Abstinence-But sex education in which abstinence is taught as the preferred choice, but some information about contraception and disease prevention is provided as well.  According to the Guttmacher Institute, only 14% of school systems have a policy to teach abstinence as just one option within a broader, comprehensive educational program.  35% of school systems in the United States have abstinence only programs.  The remaining 51% have chosen the middle road by offering Abstinence, but program (Alan Guttmacher Institute 2005).   It is significant to note that all three of the models of sex education use abstinence education as a foundation they vary primarily with regard to how much additional information they provide.

    The political debate over sex education in North Carolina began in the state house of representatives in June 1994 with an attempt to add a provision in the state’s budget to allow the state Department of Environment, Health and Natural Resources to use $100,000 to purchase Maryland’s Campaign for our Children. The Campaign for our Children uses billboards, posters, television and radio advertising with slogans like “Abstinence makes the heart grow fonder”, “Virgin – teach your kids it’s not a dirty word” and “A baby costs 474 dollars a month –how much is your allowance?” (Miller 1994).    Most of the debate centered on Representative Robin Hayes proposed amendment to provide funds for up to twelve school systems to apply for grants to teach abstinence in the schools. (Miller 1994)  In his argument for the abstinence grants, Hayes stated, “we are teaching comprehensive sex education.  We have condoms, dental dams, role playing, all of this going down into 7th grade.  This is not something we need to be doing to the exclusion of sexual abstinence until marriage,” (Miller 1994).

    In February of 1995, Hayes announced that he would introduce a bill to require that abstinence be the standard sex education approach in North Carolina’s public schools (Miller 1995a).  To lay the groundwork, he organized a public hearing with Abstinence program experts and with teenagers who promoted chastity vows.  One of the programs featured, Choosing the Best, was later criticized by the supervisor of the Sexually Transmitted Disease section of the Wake County Public Health Department (Miller 1995a).  Apparently, the Choosing the Best program provided information about sexually transmitted diseases that exaggerated the risks and seemed designed to transmit fear. 

    In May of 1995, the house passed Hayes’ bill requiring that abstinence programs replace comprehensive education in the schools.  Hayes said his program will “put a moral compass back in the schools and get teens past these mixed messages and answer the question of teenage pregnancy” (Miller 1995b).  He would later state that “this is where welfare reform starts –with abstinence until marriage.” (Simmons 1995).

    The North Carolina Senate also passed the bill, instructing the State Board of Education to adopt the new policy for the 1996-1997 school year. The state Board of Education however refused to purchase any of the abstinence programs suggested to them by the legislature because, according to Artie Kamiya, who is responsible for the state’s health education curriculum, they “overstated the risks of sex and were based on fear” (Simmons 1996).  “They also presented medical inaccuracies and false implications such as suggesting that students could get AIDS from French kissing and that the risk of using a condom was comparable to the risks of playing Russian roulette” (Simmons 1996).  Consequently, the Board of Education decided to design its own curriculum.

    The following guidelines are found on the North Carolina Department of Public Instruction’s official web site:

  • present factually accurate biological or pathological information that is related to the human reproductive system
  • focus on the benefits of abstinence until marriage and the risks of premarital sexual intercourse 
  • establish abstinence from sexual intercourse outside of marriage as the expected standard for all school-age children
  • offer positive reinforcement for abstinence 
  • provide opportunities that allow for interaction between the parent or legal guardian and the student
  • assure that students are aware of the difference between risk reduction through use of contraceptives and/or condoms and risk elimination through abstinence 
  • for any instruction concerning contraceptives or prophylactics, provide accurate statistical information on their effectiveness and failure rates for preventing pregnancy and sexually-transmitted diseases, including HIV/AIDS, in actual use among adolescent populations 
  • inform students of the current legal status of those homosexual acts that are a significant means of transmitting diseases, including HIV/AIDS
  • assure that students understand that a mutually faithful, monogamous, heterosexual relationship in the context of marriage is the best lifelong means of avoiding diseases transmitted by sexual contact, including HIV/AIDS 
  • be aware that the instruction in the use of and/or demonstration of condoms is a part of a comprehensive sex education program. Before a comprehensive sex education program is adopted, the local board of education shall conduct a public hearing and make all instructional materials (including any videos, a list of speakers, the readings, etc.) available for review by parents or legal guardians for at least 30 days before the public hearing and 30 days after the hearing. 
    As I followed the debates over sexuality education and observed the legislature pass the law, I had several reactions.  As a parent with children in the Durham Public Schools I wondered how this might effect my own children’s education.  As a citizen of North Carolina I was concerned about the impact of this law on North Carolina’s teen pregnancy rate, one that was already higher than the national average.  And, as a social scientist I thought, “Wow!  This is a field experiment occurring in our own social environment!  Someone should study this.”  Since the law allows for school systems to offer alternative sex education, if they hold public hearings and obtain community support, we have the possibility of comparing the efficacy of two approaches to sex education in the same state.

    So, several years later, here we are.  My research strategy is simple:

  1. Identify which school systems have held public hearings and are now offering alternative sex education programs.
  2. Examine how the populations of the counties in which these school systems are located differ from those offering the state-mandated abstinence-only sex education. 
  3. Compare teen pregnancy and STD rates in the counties having schools with abstinence-only education with those counties having schools that offer alternative or abstinence-plus sex education. 
  4. Determine which sex education program is more effective in preventing teen pregnancy and inhibiting the spread of sexually transmitted diseases.

    As with most research projects focused on sexuality, my plan was easier said than done and I soon found myself facing a series of challenges.   After weeks of contacting various administrators in the North Carolina Department of Public Instruction (DPI), I was told that no one was keeping a list of school systems that had held hearings and were offering alternative sex education.  After a few more calls, I received an email with a list of school districts that the DPI thought were offering alternative sex education.  However, this list came with several disclaimers as to its accuracy. 

    As my undergraduate research assistant, Alia Henderson, and I tried to confirm the list by contacting each of the school systems we encountered more obstacles.  Some schools on the list denied having ever contacted DPI on this issue and adamantly asserted that they were teaching abstinence-only sex education.  Whether this response was based on fear or truth is not clear.  Still others tried to avoid responding to me, by referring me to others, who referred me to others, etc.  In some cases we had to resort to searching the archives of the local newspapers to find out if the local school system had held a hearing and adopted an alternative sex education curriculum.

    It became obvious in my conversations with school administrators that there were differences in interpretation of the law and in some cases a gap between the policy and what was actually going on in the classroom.  Who teaches sex education in our schools?  Since it is part of the health curriculum, the job often goes to one of the school physical education teachers or coaches.  Frequently they are inadequately prepared for and uncomfortable with the task of providing sex education.  And, some teachers are so afraid of violating the state law that they err on the side of providing even less information than the law allows. 

    Moreover, I learned by observing what occurred in Durham and Wake County school systems, that there is often more to the story than just whether or not the local school board holds a hearing.  Durham County Schools decided soon after the change in the law that they would not teach the state’s abstinence-only sex education.  But, holding hearings and getting parental input dragged out the often contentious process of adopting an alternative program.  As a result the school system went without any sex education program for nearly 18 months.

    Wake County accepted the state mandate for abstinence-only education until November, 2002 when they voted to expand their sex education program in order to teach middle school children more about contraceptives and to include a section on tolerance for gays and lesbians.  They also decided to offer an elective health class in high school that would include comprehensive sex education.  Just 13 months later, a newly elected school board voted to return to the policy of teaching abstinence –only until marriage.

    After attempting to confirm the list of school systems provided by the DPI, I ended up with a list of some 10 school systems located in 8 counties (Buncomb, Caldwell, Durham, Guilford, Jackson, New Hanover, Orange, and Person).  I imagine that many of you could predict at least some of the counties on this list  as they contain several of the state’s large urban areas.  For instance, Buncomb county is home to the Asheville school system and the Greensboro school system is found in Guilford county.   Nonetheless there are a few surprises on this list (e.g. Person and Caldwell counties) and a few interesting omissions such as the Wake county and the Charlotte-Mecklenberg school systems.

Table 1

Selected Demographic Data (means) for Counties Offering Abstinence-Only and Abstintence-Plus Sex Education

Abstinence Only
Abstinence Plus
% College Degree*
Physicians per 1,000**
% Poverty*

    In comparing the two sets of schools systems we find that the school systems offering alternative education tend to be found in counties that differ significantly from the other 92 counties in North Carolina.  These 8 counties on our list have lower rates of poverty on average and have higher median household incomes.  Moreover, these counties have a higher percentage of residents with at least a bachelor’s degree.   In addition, we found that these counties have more physicians per capita than the counties offering Abstinence-only sex education.  (This finding is particularly interesting considering the AMA is one of many professional associations that endorse comprehensive sex education.)

    Looking first at the national scene we find that North Carolina has a higher teen pregnancy rate than the nation as a whole.  In fact, in 1996, when the North Carolina law came into effect, just 10 states had higher adolescent pregnancy rates than North Carolina.  Throughout the United States, teen pregnancy rates have steadily declined since they peaked in 1990. The teen pregnancy rate for the United States declined from 96 to 84 between 1996 and 2000, a 12.5% decrease during this period.  In North Carolina the teen pregnancy rate went from 103 in 1996 to 95 in 2000, a decrease of just 8% during the same period.

    We turn now to the North Carolina data. 

    The graph is a comparison of the teen pregnancy rates of the counties in 1995 and again in 2003.  Prior to the enactment of the Abstinence-only law the two sets of counties had pregnancy rates that were not very dissimilar.  The Abstinence-only counties reported teen pregnancy rates ranging from 32-142/1000, with a mean 92.  For the Abstinence-plus counties the range is 42-127 with a mean of 84.  Although there is a difference of 8 between the means of the two sets of counties, the difference is not statistically significant.

    In 2003, 7 years after the state law came into effect, the Abstinence-only counties have pregnancy rates ranging from 20-104 with a mean of 66, indicating a considerable decline (28%) from the 1995 rate.  The Abstinence-plus counties have a teen pregnancy rate of 49/1000 in 2003.  These counties experienced a decline in the mean teen pregnancy rate from 84-49, or a 42% decline over the 8- year period.  Moreover, the gap between the two sets of counties, those with schools offering abstinence-only sex education versus counties with schools offering more comprehensive sex education is larger than in the period prior to the change in the state law. In 2003, the difference between these two sets of counties is now statistically significant (p<.02).

    At this preliminary stage of my research I hesitate to make any definitive statements about the effectiveness of Abstinence-only sex education versus Abstinence-plus or more comprehensive sex education.  I am in the process of collecting data on the rates of sexually transmitted diseases at the county-level and hope that these data will shed more light on the issue of effectiveness of one program versus the other.  However, a few observations can be made at this juncture.

  • Clearly teen pregnancy rates in North Carolina and the nation have declined considerably over the 10-year period in question.  One interpretation is that the Abstinence-only message has been successful in reducing teen pregnancy.  On the other hand, since North Carolina’s teen pregnancy rate has not declined as much as the United States as a whole, it is difficult to identify a causal link between Abstinence-only education and a lower teen pregnancy rate. 
  • In North Carolina the counties in which Abstinence-plus programs are used have experienced a greater decline than counties utilizing the Abstinence-only curriculum.  And, according to a recent survey by the Centers for Disease Control, 75% of teens in North Carolina have intercourse prior to graduating from high school. This fact alone leads me to believe that providing comprehensive information about the use and effectiveness of contraception to prevent disease and pregnancy would likely be more effective than the Abstinence-only programs, particularly for the high school age student.
  • A recent review of the contents of 13 of the most frequently used Abstinence-only programs funded by the federal government, undertaken by Sen. Henry Waxman’s office, found that a majority of the programs contained false and misleading information, including the idea that sweat and tears can transmit HIV, and that humans have 48, rather than 46 chromosomes (Committee on Government Reform 2004). 
  • With regard to policy recommendations pertaining to sex education in our schools, I would suggest that the current system of Abstinence-only until marriage sex education is not having the intended effect.  And, I would recommend that we move toward providing our children with more information regarding their sexuality, rather than relying on a “Just Say NO” message that is inconsistent with societal trends. Instead of having legislators making decisions regarding public school curricula related to sexuality, our children would be better served with a curriculum designed by parents, educators and public health professionals, all of who tend to support a more comprehensive program than is currently in place. 

*This paper was the 2005 Presidential Address of the North Carolina Sociological Association.


Committee on Government Reform (2004).  "The Content of Federally Funded Abstinence-Only Education Programs." United States House of Representatives.

The Alan Guttmacher Institute (2004). "U.S. Teenage Pregnancy Statistics: Overall Trends, Trends by Race and Ethnicity and State-by-State Information."  New York: Guttmacher Institute.

The Alan Guttmacher Institute (2005).  Sex Education:  Needs, Programs and Policies.  New York:  Guttmacher Institute.

Irvine, Janice M. (2002).  Talk About Sex:  The Battles Over Sex Education in the United States. Berkeley:  University of California Press.

Miller, Mary E. (June 22, 1994).  "Abstinence campaign approved," Raleigh: News and Observer.

Miller, Mary E.  (February 16, 1995a).  "Abstinence debated for N.C. sex classes,"  Raleigh: News and Observer.

Miller, Mary E.  (May 4, 1995b).  “House passes bill to change approach to sex education,” Raleigh: News and Observer.

Simmons, Tim.  (August 27, 1995).  “Assembly pushing abstinence lessons,”  Raleigh: News and Observer.

Simmons, Tim (May 2, 1996).  “Abstinence now focus of state’s sex education,” Raleigh:  News and Observer.

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