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A.C. Green’s Game Plan is a fear- and shame-based abstinence-only-until-marriage program for students in grades seven through ten. A.C. Green is a former professional basketball player who publicly announced his own intentions to remain abstinent until marriage and became a nationally recognized speaker on the topic. The curriculum, originally written in 2001 by Scott Phelps and Libby Macke, uses sports as a metaphor for life decisions. There is also a Spanish version of the curriculum, El Plan de Juego. SIECUS reviewed the 2007 English version.

This curriculum is produced and distributed by Project Reality, one of the original abstinence-only-until-marriage organizations. According to its website, “In addition to providing materials and curricula for Title V, SPRANS, and Community-Based Abstinence Education grantees, Project Reality also provides teacher trainings, assembly speakers, and parent education programs in order to effectively communicate the abstinence message to youth.”[1] Project Reality has produced other curriculum including Navigator, Facing Reality, and I Can Do That!
 
SIECUS’ reviews of curricula are based on the Guidelines for Comprehensive Sexuality Education, K-12 which were developed by a task force of professionals from the fields of education, medicine, youth services, and sexuality education. The Guidelines are a framework for comprehensive sexuality education programs and represent a consensus about the necessary components of such programs. Abstinence is one of the 39 topics included in the Guidelines.
 
As is typical of abstinence-only-until marriage curricula, Game Plan provides limited information on human sexuality, instead relying on brainstorms, exercises, and stories designed to impress upon youth the importance of abstinence. It provides no information on puberty, anatomy, human reproduction, sexual orientation, or cultural differences regarding sexuality. Game Plan does contain some detailed information on sexually transmitted diseases (STDs) that is accurate and that cites reliable sources. However, the information is presented in a misleading manner. In addition, the curriculum presents very little information on condoms or other forms of contraception and focuses the brief discussions it does include on failure rates.
 
Throughout the curriculum, Game Plan relies on negative messages, distorts information, and presents biased views on marriage, sexual orientation, and family structure. In addition, the curriculum is structured in such a way that does not allow students to think critically about these issues or bring alternative points of view into classroom discussions.
 
Relying on Negative Messages
 
While the immediate goal of some sexuality education programs is to delay the initiation of sexual intercourse (possibly until marriage) or increase the use of pregnancy- and disease-prevention methods, many programs also have the long-term goal of promoting sexual health. Because abstinence-only-until-marriage programs are often the only formal setting in which young people learn about sexuality, the information and messages in the curricula can have a lifelong impact on how they view sexuality.
 
Abstinence is an integral part of any comprehensive sexuality education program. SIECUS’ Guidelines suggest that students be told that abstinence from sexual intercourse is the most effective method of preventing pregnancy and STDs, including HIV. The Guidelines include a number of age-appropriate messages about abstinence for students such as: “Young teenagers are not mature enough for a sexual relationship that includes intercourse”; “Abstinence from intercourse has benefits for teenagers”; and “Teenagers in romantic relationships can express their feelings without engaging in sexual intercourse.”
 
Instead of presenting this kind of balanced, complete picture of both abstinence and sexual activity, Game Plan puts forth exaggerated messages about both the benefits of abstinence and the inevitable dangers of sexual activity. The result is that students are instilled with fear and misunderstandings about sexual activity as well as unrealistic expectations of abstinence.
 
Messages of Fear—Trying To Scare Students
 
In an effort to scare students into abstaining from sexual activity, Game Plan names numerous physical and psychological consequences of premarital sexual activity. The student handbook poses the question: “If you were to choose to be sexually active, is it possible that some things may happen to you that you didn’t expect?” Students are then told to brainstorm the possible negative consequences in each of these four categories: “Physical, Emotional, Mental, and Social” (Game Plan, p. 26). Suggested answers include:
 
Physical: Pregnancy, STDs, AIDS, infertility, cervical cancer.
Emotional: Feeling used, empty, low self-esteem, lonely, broken hearted, angry, bitter, depressed.
Mental: Stress, worry, fear, regret, memories, pressure, confusion, distraction.
Social: Bad reputation, loss of friends, rumors, gossip, poor grades, withdrawal, parental conflict (Game Plan, Coach’s Clipboard, p. 26).
 
The curriculum explains, “surveys show that most teens who have had sex wish that they hadn’t. Why do you suppose this is?” (Game Plan, p. 25). Suggested answers include: “Emotional pain results because they thought they would feel loved, but they weren’t. They may feel used or get a bad reputation” (Game Plan, Coach’s Clipboard, p. 25).
 
Early on, the curriculum likens premarital sex to drinking and driving with the story of Tom who made the decision to get into a car with a friend who had been drinking. Students are told that they were in an accident and Tom is now confined to a wheelchair. To emphasize parallels between this story and the decision to have premarital sex, the teacher draws train tracks on the board with three arrows leading off the tracks labeled sex, alcohol, and drugs. “It could be alcohol, it could be drugs, it could be sex. Tom made one bad decision and it made a huge difference in his life—he got derailed, and didn’t end up where he wanted to go” (Game Plan, Coach’s Clipboard, p. 9).
 
To further underscore the message that premarital sex is inevitably harmful, the curriculum makes the analogy of sex being like fire:
 
What is the purpose of fire?
·         In a fireplace, fire is beautiful and gives warmth to a home.
·         Outside of the fireplace, it can cause serious harm.
What about sex?
·         In a marriage relationship, sex can be beautiful.
·         Outside of marriage, it can cause serious harm (Game Plan, Coach’s Clipboard, p. 11).
 
This focus on the inevitable negative consequences of premarital sexual behavior is clearly designed to scare students rather than educate them. There is no evidence that premarital sex leads to everything from bitterness to a loss of friends.
 
Messages of Shame—Instilling Guilt
 
In addition to providing seemingly endless information about the negative consequences of premarital sexual activity, Game Plan also utilizes a variety of tactics to suggest that teens should feel guilty, embarrassed, and ashamed of sexual behavior.
 
Messages of shame are effectively dramatized in an exercise called “Candy in the Bag.” The teacher gives each student a piece of plastic-wrapped hard candy and tells them to unwrap it, put in their mouths for a few seconds, and then wrap it back up in the wrapper. The teacher then collects the re-wrapped candy and mixes it with candy from an unopened bag. A volunteer is then asked to choose a piece of candy from the bag without looking and eat it. The student inevitably refuses (the instructor is told to stop them if they try to eat the candy) and the instructor asks the class what the point of the illustration was. The curriculum suggests that “The point is, they didn’t know whether or not the candy they were picking was already ‘used’ or not” (Game Plan, Coach’s Clipboard, p. 39).
 
This activity is located in the section on STDs. Teachers are also supposed to emphasize that STDs are often asymptomatic and that it’s impossible to tell whether someone has an STD by looking at them. While this is a useful message, it is entirely unnecessary to compare sexually active students to saliva-covered candy and refer to them as “used” to make the point.
 
Dismissing Sexually Active Students
 
In fact, throughout the curriculum the authors continually compare sexually active students to those who have chosen to remain abstinent. Their opinions are clear: abstinent students have self-control, self-respect, and have a bright future while those who have chosen to become sexually active lack control, values, or respect, and face certain hardship.
 
The curriculum relies on A.C. Green as an example of someone who chose abstinence and explains, “A.C. Green attributes much of his success to a decision that he made as a teenager and has kept to this day. ‘I made a decision…I resolved not to be with a woman until I married’” (Game Plan, p. 6). The curriculum explains, “following rules isn’t just about avoiding consequences, it’s also about respecting yourself and others. When you choose to practice self-control, you win” (Game Plan, p. 30). It goes on to ask students, “a person who demonstrates self-respect and confidence by choosing not to be sexually active is often respected by others as well. Why do you suppose this is?” (Game Plan, p. 47). A quote from A.C. Green himself underscores this point: “It isn’t that I don’t want to have sex or don’t think about it, but my self-respect never fails me…” (Game Plan, p. 26).
 
The curriculum tells students that, “teens who choose abstinence are probably more likely to control themselves and make good decisions in other areas because they have demonstrated self-control by not getting involved sexually. They have developed a good habit by being abstinent and have shown how they are committed to their goals and dreams” (Game Plan, Coach’s Clipboard, p.73). According to the curriculum, those teens that chose abstinence are not just helping themselves but society as a whole: “By choosing abstinence, they will join a growing number of young people who are helping to improve this situation and make our country a better and healthier society” (Game Plan, Coach’s Clipboard, p. 33).
 
It is important to emphasize that abstinence from sexual activity has benefits for teenagers and remains the safest choice for preventing pregnancy and STDs. Unfortunately, Game Plan seems to focus on the implication that teens who are sexually active are less worthy than their abstinent peers.
 
This tone is particularly evident in the “true stories” that the curriculum presents to the student. These stories consistently illustrate the idea that sexually active young people are unhealthy, lack self-control, and have impure motives. The story of Tina and Steve is just one example:
 
Tina began to pressure Steve for sex. He had been abstinent and was planning to save sex for marriage. One night when they were alone, she told him that if he truly loved her he would prove his love to her by having sex with her. He refused and left the house. Their relationship ended shortly afterward. Two months later Steve learned that Tina was already pregnant on that night when she was trying to get him to have sex with her. Tina became a single mother at age 18 (Game Plan, p. 11).
 
In a similar example, Game Plan tells the story of Maria:
 
Maria had been sexually active since she was 14. Maria really didn’t want to have sex but she ended up becoming sexually active because her boyfriend pressured her and some of her friends were having sex. Maria, at 16, has now had sex with three different guys. She feels bad about herself and sometimes drinks or uses drugs to cover up her depression. Maria wishes she could start over again (Game Plan, p. 44).
 
Again the curriculum implies that sexually active young people lack self-esteem and self-control in all areas of their lives. The curriculum goes on to tell young people, “by encouraging abstinence for Maria, friends are also helping Maria lower her risk factors for depression, alcohol, and drug use in the future” (Game Plan, Coach’s Clipboard, p. 44). This seems to suggest a causal relationship between sexual activity and depression, alcohol, and drug use. Although many sexually active teens may experience depression or use alcohol and drugs, there is no legitimate scientific research that supports the idea that sexual activity is the cause of these problems.
 
Adults need to take depression and substance use among young people very seriously. However, it does teens a disservice to present sexual activity as the cause of these problems or suggest that abstinence is a cure. Today’s teens lead complex lives and may be dealing with issues such as parental divorce, domestic violence, sexual abuse, eating disorders, sexual orientation, lack of parent and community support, or undiagnosed mental illness. Suggesting that abstinence is the cure for all of Maria’s problems is an oversimplification that may give students unrealistic expectations of the benefits of abstinence. Game Plan would better serve students by suggesting that Maria would benefit from counseling to help her deal with all of the issues in her life.
 
It is important to remember that, according to recent studies, 48 percent of all high school students have had sexual intercourse.[2] It is therefore likely that an average group to which this curriculum is presented will contain at least several sexually active teens. It is inappropriate and potentially harmful for education programs to imply that these teens lack self-control or self-respect or to suggest that they are less worthy of love, trust, and respect. This can only be damaging to these students and serve to alienate them from their peers and the program.
 
Secondary Virginity
 
Game Plan does acknowledge that some teens will have already been sexually active through frequent references to secondary virginity. The curriculum’s introduction explains to teachers that “… the best message that we can give to teens is that ‘regardless of what has already happened in your life you are still valuable and special, and you can start over again’” (Game Plan, Coach’s Clipboard, Introduction, unnumbered page).
 
In the section entitled “Starting Over… A New Beginning,” the student handbook explains: “Starting over is the decision to stop having sex and to wait to have sex until you are married. People choose to start over for a variety of reasons.” Students are then asked: “How do you think choosing to start over would help someone feel better emotionally?” The suggested answers include: “It will help them, because they are telling themselves that they are worth it, that they will no longer put themselves at risk, physically or emotionally. It will help their self-esteem and their future” (Game Plan, Coach’s Clipboard, pg. 46). Teachers are told that “the concept of starting over should be stressed here—that although physical virginity is gone, students can start over emotionally by choosing abstinence” (Game Plan, Coach’s Clipboard, p. 46).
 
The curriculum routinely assumes that the decision to become sexually active is one born out of low self-esteem, a lack of self-control, and inherent character flaws. It seems to suggest that all sexually active teens should feel bad about their decisions and about themselves. While it is possible that some teens may have had negative experiences with sexual behavior, instilling guilt does nothing to help them cope with such experiences. In addition, it is possible that sexually active teens have had consensual, safe, and protected sexual experiences for which they feel neither guilt nor shame. Suggesting that they should feel bad could serve to produce emotional distress where there was none.
 
Sexual Behavior—Portraying Sex as an Uncontrollable Force
 
Game Plan makes an attempt to provide young people with a positive view of sexual activity (provided that it takes place within the context of marriage). The curriculum explains in large letters that “Abstinence doesn’t mean: Sex is bad. Abstinence means: Sex is good” (Game Plan, p. 10). Unfortunately, the messages about sexual arousal, sexual behaviors other than intercourse, and sexual abuse do not support this positive idea, but instead portray sex as an unmentionable, scary force that is outside of teenagers’ control.
 
Sexual Arousal
 
In portraying the decision to be sexually active outside of marriage as the result of low self-esteem or a lack of self-control, Game Plan seems to suggest that sexual arousal and desire are signs of character flaws as opposed to healthy sexual development. Moreover, after telling students that they should not give in to pressure because premarital sexual behavior is shameful and leads to a plethora of negative consequences, Game Plan suggests that sexual arousal is a power that young people cannot control.
 
In a section called “Offensive Strategy,” the curriculum asks students, “what makes it difficult for the couple to stop?” Suggested answers include: “Their hormones, the fact that as they go further, they may want to go even further and have sex.” In keeping with the sports theme, the curriculum uses the analogy of a track runner, and asks students, “if a sprinter is running a 100 yard dash, is it possible to stop at 95 yards without going through the tape at the finish line?” The answer: “It is difficult for the runner to stop because he/she has gained so much momentum. He/she will have to try really hard to stop before going through the tape. It is possible to stop, but very difficult” (Game Plan, Coach’s Clipboard, p. 72).
 
The same page includes a continuum of sexual behavior printed on a line that goes from light pink to deep red. The continuum includes: “Holding Hands -> Hugging -> Kissing -> Deep Kissing -> Sexual Activity -> Sexual Intercourse” (Game Plan, p. 72). The teacher tells students, “in order to avoid STDs, pregnancy or emotional trauma, it is important to think ahead about where you will draw your line. Remember that all sexual activity has an effect on emotions” (Game Plan, Coach’s Clipboard, p. 72).
 
In one exercise, “The Rope,” the teacher brings in a length of rope designed to represent the continuum of sexual activity. A girl is given the “holding hands” end of the rope while a boy is asked to take the other end. The teacher explains that “the further someone goes down the rope, the more bonded they are to the other person and the more difficult it becomes to stop.” The girl is told to put her hands at her side and hold the rope on one elbow. She is then told to begin moving down the rope line turning as she goes so that the rope wraps around both of her arms holding them at the side of her body. The teacher asks the students, “how does this illustration show what happens to us when we choose to become sexually active?” The answers include: “Outside of marriage, sexual activity, like rope, can cause someone to become bound to the person emotionally and less able to make good decisions and say ‘No’ to sex” (Game Plan, Coach’s Clipboard, p. 73).
 
Portraying sexual behavior as a force outside of students’ control is in direct conflict with the goal of helping young people make responsible decisions, including the decision to remain abstinent. Students need to know that at any point in a relationship, regardless of past sexual behavior, they have the right and the ability to set their own sexual boundaries.
 
Sexual Behavior
 
In addition to portraying sexual arousal as an uncontrollable force, the curriculum portrays sexual behavior other than intercourse as a source of shame. Within the definition of abstinence, the curriculum explains that “sexual activity refers to any type of genital contact or sexual stimulation including, but not limited, to sexual intercourse” (Game Plan, p. 10). On the continuum of sexual behavior, “sexual activity” falls firmly in the dark red zone between “deep kissing” and “sexual intercourse.”
 
Unfortunately, the curriculum does not give students the opportunity to further understand these behaviors or to differentiate between safe behaviors (such as massage) and potentially risky behaviors (such as oral sex)—all of which, without further explanation, seem to fit into this broad category of “sexual activity.” Recent studies suggest that young people are engaging in a wide variety of sexual behaviors. For example, one study found that 82 percent of adolescents and young adults (ages 15 to 24) who had engaged in sexual intercourse reported having also engaged in oral sex. In addition, 12 percent of adolescents and young adults who had never engaged in sexual intercourse reported having engaged in oral sex. The study also found that 18 percent of males and 33 percent of females ages 15 to 17 reported using oral sex to avoid having intercourse.[3] Clearly young people need help dealing with the complicated issues of sexual behavior.
 
Game Plan misses valuable opportunities to provide this help. Instead, the curriculum merely continues relying on messages of fear and shame: “Many teens think that as long as they do not engage in sexual intercourse, they will retain virginity and not be at risk to ruin their reputation, get an STD, or get pregnant. Many are surprised by the shame and guilt they may experience after engaging in intimate sexual behavior. They may also feel that they were being used in a relationship for sexual gratification alone” (Game Plan, Coach’s Clipboard, p. 45).
 
Virginity Pledges—Asking Students to Promise Purity
 
Game Plan, like many fear-based, abstinence-only-until-marriage curricula, includes a virginity pledge, in which students vow to remain abstinent until they marry. At the end of the Student Handbook, there is an action list which includes the following pledge: “In order to protect my future and help me accomplish my goals, I choose to be sexually abstinent from this day forward until marriage” (Game Plan, p. 77).
 
Research has found that virginity pledges could help a select group of young people delay intercourse under certain circumstances. Pledges taken by an entire class as part of a lesson or presentation, however, were not effective. Moreover, even when they work, pledges help this select group of adolescents delay the onset of intercourse for an average of 18 months—far short of marriage.
 
In fact, virginity pledges may be detrimental to some teens. The study also found that those young people who took the pledge were one-third less likely to use contraception when they did become sexually active then their peers who had not pledged.[4]  Further research has confirmed that although some students who take pledges delay intercourse, ultimately they are equally as likely to contract an STD as their non-pledging peers.[5]
 
Far from providing a solution to the complex problems of unintended pregnancy and disease transmission, these simplistic pledges are undermining the use of contraception among teens, potentially exposing them to greater harm.
 
In addition, these pledges are not appropriate for all students, as they show blatant disregard for gay and lesbian students who cannot legally marry in most of this country.[6] Signing this pledge is tantamount to agreeing to a lifetime without sexual behavior. It is unfair and unrealistic to ask a junior high or high school student to make such an agreement.
 
Finally, it is important to note that it is not the place of any educational program to mandate choices for students. Instead, students must make their own decisions based on their personal values, the values of their family, and the values of their community. By endorsing the pledge and suggesting that students use class time to sign it, the teacher is putting undue pressure on students. Education programs should foster critical-thinking and decision-making skills rather than pressuring students to make one choice.
 
Distorting Information
 
Unlike many abstinence-only-until-marriage curricula, Game Plan contains very little information about topics related to sexuality such as puberty, reproduction, or contraception. The information contained in the curricula is limited to brief discussions on STDs and condoms. Although, for the most part, the information is accurate and cites reliable sources, it is presented in a distorted way that is likely to mislead or confuse students.
 
Sexually Transmitted Diseases—Misleading Students
 
Game Plan goes into detail about a number of STDs. In these discussions, however, the curriculum provides misleading information, does not adequately explain disease transmission, and focuses on worst-case scenarios. In addition, the information provided about STDs builds on the messages of shame that run throughout the curriculum and may ultimately discourage young people from seeking much-needed STD testing and treatment.
 
Focusing on the Worst
 
In a discussion entitled “Avoiding the Penalties,” Game Plan consistently focuses on the worst possible outcomes of STDs without providing young people with adequate information on transmission.
 
The curriculum simply states that “Any kind of sexual activity can spread STDs from one person to another” (Game Plan, p. 32). According to the curriculum, “sexual activity” includes any type of “sexual stimulation.” Given that such a broad definition could easily encompass masturbation in front of a partner, petting with clothes on, or a particularly good foot massage, this statement is neither accurate nor informative to students. Students would be better served by an open and honest discussion of the level of risks associated with a variety of sexual behaviors.
 
Instead, the curriculum focuses much of its discussion about STDs on the long-term, and often preventable, problems associated with STDs. Students are told that, “left untreated, STDs can have serious long-term health consequences, especially for women. Chlamydia and gonorrhea can lead to pelvic inflammatory disease which can cause infertility…. The risk for these diseases and their consequences are especially high for teens” (Game Plan, p. 32). While this is accurate and important information, Game Plan misses the opportunity to explain to students that Chlamydia and gonorrhea can be treated with antibiotics before causing pelvic inflammatory disease (PID) and that PID can be treated with antibiotics before causing infertility.
 
The curriculum also focuses heavily on the link between HPV and cervical cancer. “[Cervical] cancer may be detected and treated, however, recent statistics indicate that more women die each year from HPV cervical cancer than from AIDS” (Game Plan, pg. 37). Again, this is accurate information that nonetheless fails to provide students with the knowledge they really need.
 
According to a report by the Centers for Disease Control and Prevention (CDC), the majority of HPV infections resolve themselves spontaneously and do not lead to any long term consequences. The report explains: “While infection with high-risk types [of HPV] appears to be ‘necessary’ for the development of cervical cancer, it is not ‘sufficient’ because cancer does not develop in the vast majority of women with HPV infection.”[7]
 
Discouraging Testing and Treatment
 
The CDC report on HPV also emphasizes the importance of routine screenings for pre-cancerous cells using the Pap test. The CDC estimates that approximately half of the cases of cervical cancer that occur each year will occur in women who have never had a Pap test and an additional 10% will occur in women who were not screened in the last five years.[8]
 
Students need to be told that STDs are a serious public health issue and that regular screening is essential. Game Plan does tell teachers that “...if girls have been sexually active they should receive a Pap smear in order to detect any possible precancerous tissue” (Game Plan, Coach’s Clipboard, p. 37). While this is a start, it is not nearly enough. Young women should understand that they need to begin having regular Pap tests once they become sexually active or turn 18, and all young people need to know that STD screenings are vital for all sexually active individuals.
 
For the most part testing is simply overlooked throughout the discussion on STDs. Students are not told what testing for STDs entails or where they can access testing services. Some of the information given may discourage testing. For example, girls are told that “some STDs such as gonorrhea and Chlamydia are more difficult to detect in girls than in boys” (Game Plan, p. 33). Although this comment is likely meant to explain that STDs can be asymptomatic and many young women will not know they have one, it may lead students to believe that even healthcare providers have difficulty detecting these problems in young women.
 
In addition, the curriculum seems to hold a negative view of those individuals who seek testing. A quote by A.C. Green, for example, states: “When some of my teammates went in for testing of HIV, I didn’t go. I knew I was disease free. The way I’ve chosen is the best way” (Game Plan, p. 39).
 
In choosing abstinence, A.C. Green made a responsible decision consistent with his values. It is clear, however, that not all of his NBA teammates chose to remain abstinent. Instead of looking down on these teammates, A.C. Green could set a positive example by applauding their decision to be tested for HIV.
 
Game Plan would better serve students by relying less on fear and shame and instead providing information on how students can access reproductive health care throughout their lives.
 
Condoms and Contraception—Exaggerating Failure
 
Game Plan provides very little information on condoms and almost none on other forms of contraception. When discussed, the curriculum exaggerates failure by suggesting that condoms cannot protect against STDs, that contraception does not adequately protect teens against pregnancy, and that no contraceptive method can prevent the emotional consequences that are associated with premarital sexual activity.
 
Disease Prevention
 
The curriculum states, “condoms are hailed today as the answer to sexually transmitted diseases (STDs) and unwanted pregnancies. The facts are, however, that condoms don’t always prevent pregnancy and are ineffective against some of the most common, and most serious, STDs, such as human papillomavirus” (Game Plan, p. 36).
 
The Game Plan authors have made some changes since SIECUS reviewed the 2001 edition. In the previous edition, the curriculum used deceptive graphs to imply that an increase in STDs between 1982–1995 was linked to an increase on condom use over the same period of time (Game Plan, 2001 edition p. 35).  The graphs are gone, but the curriculum still works hard to make the case against condoms by scrutinizing condom “warning labels” and making the point that “‘safe sex’ isn’t ‘safe’” (Game Plan, Coach’s Clipboard, p. 34).
 
Game Plan also provides a chart in the teacher’s edition that references the results of a 2001 report by the National Institutes of Health. Some of the now outdated results of this report are then used to question condom effectiveness. The curricula quotes the report’s finding that “No epidemiologic evidence that condom use reduced the risk of HPV infection,” but in June 2006 new research showed that young women who used condoms were 70% less likely to contract HPV.[9] Previous research has also shown that “latex condoms provide an essentially impermeable barrier to particles the size of HPV” and that “studies of HPV infection in men demonstrate that most HPV infections are located on parts of the penis that would be covered by a condom.”[10]
 
In reference to other STDs, the report points out that more research is required to determine whether and/or how condoms prevent STDs other than HIV and gonorrhea. While it is true that more research is needed, implying that condoms do not provide protection from many STDs because epidemiologic evidence is unavailable is inaccurate. In fact, the CDC states that latex condoms are “highly effective” in preventing the transmission of HIV and “can reduce the risk of other sexually transmitted diseases, including discharge and genital ulcer diseases.”[11]
 
Pregnancy Prevention
 
The authors’ opinion of condoms and other contraceptives is very clear: “Game Plan does not promote the use of contraceptives for teens. No contraceptive device is guaranteed to prevent pregnancy. Additionally, students who do not choose to exercise self-control to remain abstinent are not likely to exercise self-control in the use of a contraceptive device” (Game Plan, Coach’s Clipboard, p. 27).
 
Once again the curriculum is discounting sexually active teens by suggesting that they lack self-control and will not be able to use contraception reliably. It is unconscionable for an education program to deny young people vital information about pregnancy and disease prevention simply because the authors disapprove of the decisions those students have made.
 
The authors go on to suggest that contraception does not work:  “Among sexually active teenage girls, aged 12-18, 20% of oral contraceptive users become pregnant over a mere six months. For persons under the age of 18, condoms were found to fail 18.4% of the time after one year of use” (Game Plan, p. 27).
 
To fully understand research on condom and oral contraceptive effectiveness, students must understand the difference between method failure and user failure. Method failure refers to failure that results from a defect in the product. Method failure of oral contraceptives is very rare and is estimated to occur in only 0.3 percent of couples using oral contraception consistently and correctly during the first year of use.[12] Method failure of the male condom is also very rare and is estimated to occur in only two percent of couples using condoms consistently and correctly during the first year of use.[13]
 
In truth, condom failures are most often caused by errors in use, such as the failure of couples to use condoms during every act of sexual intercourse. It is, therefore, important to look at the data on typical use or user failure. User failure is calculated by looking at 100 couples who use condoms as their primary method of birth control over the course of a year. About 15 of these couples will experience an unintended pregnancy during the first year of condom use. It is important to remember that these couples may not have been using condoms or may have been using condoms incorrectly during the act of intercourse that resulted in an unintended pregnancy. To further put this in perspective, it helps to look at other contraceptive methods. For example, 25 percent of women using periodic abstinence as a method of birth control will experience an unintended pregnancy within the first year as will 85 percent of those using no method.[14]
 
Rather than distort the facts, Game Plan would better serve students by explaining that there are many methods of contraception that can provide protection against unintended pregnancy and that there are steps that sexually active individuals can take (such as using contraception consistently and correctly) to decrease the chances that they will experience an unintended pregnancy.
 
Condoms, Contraception, and Emotional Consequences
 
To further underscore the idea that condoms and other contraceptive methods are useless to young people, Game Plan returns to the consequences of premarital sexual activity that were previously stated. A quote by A.C Green states, “even more widespread than disease are the emotional scarring and deep wounds that come out of broken relationships. No matter how strong a condom is, it won’t protect you from a broken heart” (Game Plan, p. 36).
 
Students are then asked to refer back to the emotional, mental, and social consequences of premarital sex that they brainstormed about earlier and decide if condoms could provide protection from things such as: “Feeling Used, Empty, Low Self-Esteem, Lonely, Broken Hearted, Angry, Bitter, Depressed, Stress, Worry, Fear, Regret, Memories, Pressure, Confusion, Distraction, Bad Reputation, Loss of Friends, Rumors, Gossip, Poor Grades, Withdrawal, Parental Conflict” (Game Plan, Coach’s Clipboard, pp. 26 & 35).
 
Condoms were never intended to protect teens against everything from confusion to poor grades. They were intended to protect against pregnancy and STDs, and years of scientific research shows that, when used consistently and correctly, they are very good at both. In fact, condoms are up to 98 percent effective in preventing pregnancy and research has shown that using a condom for HIV prevention is 10,000 times safer than not using a condom.[15]
 
Game Plan’s coverage of condoms seems to be based on unsound logic suggesting that if young people believe condoms do not work they will not engage in sexual behavior. Telling students that condoms don’t work will not stop them from having sexual intercourse. It may, however, stop them from using condoms when they do become sexually active, thereby putting them at increased risk for STDs and unintended pregnancy.
 
Promoting Biases
 
In addition to relying on inaccurate information, Game Plan is based on a number of underlying biases and assumptions about marriage, sexual orientation, and family structure. Presenting these biases as universal truths does little to inform students and instead fosters myths and misunderstandings.
 
The Marriage Mandate—Promoting One Lifestyle
 
Game Plan discusses sexual behavior and abstinence exclusively in terms of marital status with the clear message that any sexual activity outside of marriage is morally wrong as well as physically and emotionally dangerous. The curriculum explains: “If teens wait until ‘later’ but not until ‘marriage,’ they are still subject to all the risk factors associated with sex outside of marriage. The only difference is that those risk factors will come ‘later’” Game Plan, Coach’s Clipboard, p. 11).
 
Throughout the curriculum, marriage is not only presented as the only positive venue for sexual activity but as the ultimate goal. In keeping with the sports metaphor, the section on marriage is called “Winning the Prize” and teens are told, “It’s the big day. You have trained all your life for this day—your wedding day” (Game Plan, Coach’s Clipboard, p. 59). The curriculum asks students to “take a moment to imagine what your wedding day could be like, if you were to get married” (Game Plan, p. 58). In one exercise, entitled “I Will Wait for You,” students are instructed, “if you would like to, write a letter to your future spouse in the space below. Tell them your hopes and dreams and goals. If you have decided to save sex for marriage, let them know why” (Game Plan, p. 68).
 
Game Plan explains the importance of marriage by having teachers draw two triangles with love at the base, marriage in the middle, and sex at the peak. The first is right-side-up resting on its base while the second is inverted resting on its peak. The teacher then explains that “many people think that it is ok to have sex without the commitment of marriage. But what happens if the top of the triangle tries to act as the base of the triangle. It falls over. Without the steady commitment of marriage and the basis of love, sexual activity can not hold the relationship” (Game Plan, Coach’s Clipboard, p. 53).
 
The curriculum then explains the benefits of marriage. Students are told that “marriage helps form a foundation for family life and has many benefits for individuals and society as a whole” (Game Plan, p. 58). They are then asked to brainstorm about why faithfully married people report more satisfaction with their sex lives than couples who aren’t married. Answers include: “Their trust, love, and respect for each other makes their physical relationship more enjoyable,” “They are emotionally bonded to each other,” and “Their lifelong commitment to each other means they don’t have to worry about STDs” (Game Plan, p. 60).
 
Game Plan acknowledges that some students may not plan to get married. Students are told that “not everyone wants to get married or will get married” (Game Plan, p. 58). The curriculum goes on to say, “whether your Game Plan includes getting married or not, the character qualities learned in this chapter will help you in life.” Teachers, however, seem to be encouraged to promote marriage. They are told, “It is important to stress that although some students may not want to marry, most students will want to marry and have a family someday.” Teachers are also told to “acknowledge that while some students may have a negative perception of marriage, married life has many benefits to individuals and to society” (Game Plan, Coach’s Clipboard, p. 58).
 
Although it is important to help young people explore their feelings on marriage, Game Plan does so in a limited and directive manner that presents marriage as the only appropriate way of life and suggests that individuals who choose otherwise are making the wrong decision for themselves and society. Again, it is not the place of education programs to mandate choices for students.
 
Gay and Lesbian Students—Ignoring Young People In Need
 
The focus on marriage as the ultimate goal underscores the fact that this curriculum is written exclusively for heterosexual students. The authors seem to assume that all students in the class, and all people in the world for that matter, are heterosexual. Throughout the curriculum all “true stories” refer to male-female couples, as do all references to sexual activity. For example, students are told, “the only safe sex is in a marriage relationship where a man and a woman are faithful to each other for life” (Game Plan, p. 38).
 
Although the curriculum acknowledges that some students may not be interested in marriage, the fact that most gay and lesbian students cannot legally marry in this country is never mentioned. The curriculum suggests that teachers should “encourage students that it is wise to keep their options open. Our ideas often change as we mature. Also, even if the person doesn’t marry, abstinence is still the safest, healthiest lifestyle” (Game Plan, Coach’s Clipboard, p. 11). The curriculum then has students brainstorm about why some teens might not want to get married. Suggested answers include: “Afraid of divorce, don’t think marriage works, want to be on my own, never seen a happy married, my parents weren’t married, don’t see the purpose of marriage” (Game Plan, Coach’s Clipboard, p. 58). It is telling that the possibility that some students may be gay or lesbian and can therefore not legally marry is not one of the anticipated answers in this exercise.
 
In addition, by suggesting that the only safe sex is in marriage and that abstinence remains the healthiest choice for those individuals who do not marry (presumably into adulthood), the curriculum is essentially telling gay and lesbian young people that they can never have a safe or healthy sexual relationship.
 
Gay and lesbian youth, especially young men who have sex with men, are at increased risk for STDs, including HIV. Newly released HIV incidence data from the CDC shows that 53% of new infections occur in men who have sex with men and a disproportionate number of those infected are Black and Latino youth.[16] Studies have also shown that lesbian, gay, bisexual, and transgender young people are disproportionately affected by other problems such as mental health issues and homelessness.[17] 
 
It is clear that these young people need programs that can help them handle the complexities of growing up gay, lesbian, bisexual, or questioning their sexual orientation. Therefore, programs written exclusively for heterosexual students are not appropriate for a classroom setting. Such curricula will only further marginalize and alienate these students and may put them at increased risk of engaging in those behaviors that expose them to STDs and unintended pregnancy.
 
Family Structure—Depicts Non-Traditional Families as Troubled
 
The focus on marriage extends into discussions in which Game Plan seems to suggest that a married, two-parent family is the only appropriate environment in which to raise children. Teachers are instructed to “discuss with the students how a happy marriage can create a positive environment for raising children. List some benefits for children of being raised in a stable, loving home with parents who are married” (Game Plan, Coach’s Clipboard, p. 64). The authors’ views on the appropriate family structure also become clear through the stories that they share with students. “Together Forever” is Dan and Griska’s story:
 
We saw each other for the first time on October 12, 1989. We were married on April 6, 1991. Our first child was born on January 14, 1994. First comes love, then comes marriage, and then came Aileena, Rey-Nathan, Stephen, Ethan, and Evan in the baby carriage. Following the hidden wisdom in that schoolyard chant will hopefully give our children a foundation on which to build their lives (Game Plan, p. 64).
 
The story continues, telling students that the reason Dan and Griska overcame the “broken homes” they grew up in and achieved marital success was their “self-control, discipline, and respect.” The implication is that if students or their parents can’t replicate the family structure of the “schoolyard chant” they must be lacking in these qualities.
 
It is unfair to put the burden of family structure on students who, as children, have no control over their current family situation. There are many reasons that students may live in a family that does not match the “ideal” model. Young people may have single parents, divorced parents, step-families, parents in gay and lesbian partnerships, deceased parents, or they may live in a family where grandparents or other adults are raising the children. Suggesting that these students will face a lifetime of difficulty and that their families are inferior will likely cause feelings of hurt, anger, shame, and embarrassment.
 
Still, the curriculum goes on to suggest that couples who make a marriage work are stronger and better people. For example, students are told: “Give an example of commitment.” Suggested answers include: “A mother taking care of her sick child; a friend helping another friend out with a problem; sticking with something even when you feel like quitting; remaining married for life; choosing abstinence until marriage” (Game Plan, Coach’s Clipboard, p. 53). The curriculum also states, “the differences between a successful marriage and an unsuccessful one are the qualities that are practiced by each of the spouses…. In a successful marriage, spouses make it through the tough times because they have committed themselves to marriage and are working to develop the qualities you have indicated as being important” (Game Plan, Coach’s Clipboard, p. 59).
 
Again, it is important to remember that many young people today have parents who have chosen to get divorced for a variety of reasons. It is inappropriate for an education program to suggest that these adults lack character or values. Rather than presenting one family structure as ideal, Game Plan would better serve students by acknowledging that young people come from a variety of families and that regardless of structure, families can be a source of love and support.
 
Teaching Methods
 
Game Plan contains 8 lessons: “I Got Game!: Making a Game Plan for Your Life”; “TV Time-Out: What’s Up With Sex in the Media?”; “Rules of the Game: Why Boundaries Matter”; “Avoiding the Penalties: The Risks and Consequences of Sex Before Marriage”; “Half-Time: It’s Never Too Late to Start Over Again”; “Building Your Team: The Importance of Choosing Your Friends”; “Winning the Prize: Looking at Marriage as a Goal”; and “Game Time: Making It Work.”
 
Each lesson contains several sections. The teacher facilitates a discussion, presents facts and new ideas, and leads the class in experiential activities. The students are encouraged to take what they have learned home and discuss it with their parent or guardian. At the beginning of each chapter, there is a “Parent Link” section with questions for students to ask their parents.
 
Curricula Strong Points—Including Parents and Analyzing the Media
 
One strength of the Game Plan curriculum is the dedication to involving parents. For each section, there are several questions that students are encouraged to take home and discuss with their parents. SIECUS believes that parents are, and should be, the primary sexuality educators of their children and applauds Game Plan for promoting parental involvement and recognizing the importance of a family’s personal values.
 
In addition, Game Plan includes a section entitled “TV Time-Out” designed to help students examine the difference between the media’s portrayal of sex and reality, make the connection between media and profit, and consider media influence in their lives. Young people are bombarded with messages about sexuality in music, movies, television, and magazines and it is important that education programs help them decipher and understand these messages. SIECUS applauds Game Plan for undertaking this necessary task.
 
Dictating to Students—Preventing Critical Thinking
 
According to the authors, “Game Plan is written in a simple question-and-answer format in order to help students discover for themselves that abstinence until marriage is the safest, healthiest lifestyle” (Game Plan, Coach’s Clipboard, Introduction, unnumbered page). Unfortunately, the brainstorming activities scattered throughout the curriculum seem to be designed to lead students to one opinion rather than actually promote critical thinking.
 
For example, students are asked to brainstorm about the negative consequences of sexual activity in each of four categories: “Physical (What can happen to my body); Emotional (How I feel about myself); Mental (What I now think about); and Social (How it affects my relationships with family and friends).” Students are told, “We will be discussing the positive benefits of sex in marriage in Chapter 7. This exercise is to help us understand the possible negative ramifications of our actions if we choose to have sex outside of marriage” (Game Plan, Coach’s Clipboard, p. 26). Although this may appear to be a brainstorm, it is based on the belief that sex outside of marriage is wrong and the assumption that inevitable negative consequences exist in each of these categories.
 
The authors of Game Plan seem to realize that some students may question this premise. Teachers are told, “some students will ask, ‘Why are we just supposed to list the bad things? Sex can make you feel good too.’” The suggested response is, “yes, sex can be terrific. However, for teenagers there is so much that can go wrong. Often we don’t think about the possible negative consequences. It is important for us to examine all of the possible consequences that may be harmful in the future for those who are sexually active” (Game Plan, Coach’s Clipboard, p. 26).
 
Although Game Plan does acknowledge that sex can be terrific, the curriculum nonetheless encourages teachers to squelch the critical thinking of young people and put them back on task, naming only negative consequences. Students would be better served by an open and honest dialogue that allowed them to examine the positive and negative aspects of sexual activity as well as their own views and the views of their families and communities in regard to sexual activity outside of marriage.
 
Experiential Exercises—Dramatizing Fear and Shame
 
In addition to brainstorming exercises, Game Plan attempts to underscore the messages contained in each of its lessons by using experiential exercises. While such exercises are a very important part of any learning experience, many of the specific activities included in this curriculum simply dramatize the messages of fear and shame that run throughout the program.
 
In an exercise entitled “Emotional Bonding,” for example, six volunteers are called (three boys and three girls). The teacher shows the class two pieces of clear tape, saying, “these two pieces of tape represent two people that have saved themselves sexually for their spouse in marriage. These two people get married and sex helps to bond them together for life.” The teacher then puts the two pieces of tape together and says, “see how these two pieces of tape are now bonded together? If we tried, we could not pull them apart because the glue on the tape is so strong.” The teacher then takes two more pieces of tape and asks the volunteers to roll up their sleeves. The tape is then placed on the arms of two of the volunteers, ripped off, and placed on the arm of the next volunteer. This continues down the line of volunteers.
 
At the end of this demonstration, the teacher asks students if the tape sticks as well “as it is passed from person to person?” The teacher then puts the two used pieces together and points out that these do not stick as well, explaining: “Sex has a unique bonding capability. As a person has sex with more and more people, the bonding lessens, just like the bonding on the tape lessens. Sex, in marriage, with one person for life, acts as a positive bonding agent between the couple. Someone who chooses to remain sexually active before marriage risks the lessening of this bonding capability of sex. Someone who stops being sexually active, and remains abstinent until marriage, allows the bonding capability to work the way it is meant to” (Game Plan, Coach’s Clipboard, p. 46).
 
Although experiential exercises can be beneficial to students, rather than building critical thinking and negotiation skills, exercises such as this one simply serve to reinforce negative message about sexuality contained throughout Game Plan.
 
Conclusion
 
SIECUS originally reviewed the 2001 edition of Game Plan and has widely released a review of the curricula which found it to rely on messages of fear and shame, inaccurate and misleading information, and biased views of marriage, sexual orientation, and family structure. In reviewing this new 2007 edition, SIECUS was pleased to find that some of the very quotes and activities that we drew attention to in our review were removed or changed. 
 
For example, in the section on secondary virginity in the 2001 edition A.C. Green is quoted as saying, “even if you’ve been sexually active, it’s never too late to say no. You can’t go back, but you can go forward. You might feel guilty or untrustworthy, but you can start over again” (Game Plan, 2001 edition p. 45). SIECUS pointed out that the implication here is that sexually active young people are less trustworthy than their abstinent peers. 
 
Similarly, we chastised the authors for including an experiential activity called “The Rose.” In this activity students are shown three roses “beautiful, unique, and valuable—just like the students are.” One rose is left intact representing a young person who chooses to be abstinent. Another, which represents a sexually active young person, is passed around the room and students are instructed to pull off the petals. After it is passed back, the curriculum tells teachers to “explain that 10 years have passed, and now this person wants to get married. What does this person feel that he/she has left to give?” The same question is asked of the intact rose. The activity concluded with the teacher holding up all of the roses and saying: “The choice is yours to make. Which rose would you like to be?” (Game Plan, Coach’s Clipboard, 2001 edition, p. 12). SIECUS argued that this exercise was simply a dramatization of the program’s messages of shame which suggest that sexually active young people have “given away” everything about them that is valuable. Both the quote and the game have been removed from the latest draft.
 
Changes were also made to the section on condoms and contraception where SIECUS pointed out misleading information. As mentioned earlier, a graph that seemed to suggest a causal connection between increased condom use over time and increased cases of STDs was removed. The authors also thought better of including this misinterpretation of the facts: “Most unintended pregnancies (53%) occurred among women who were using birth control” (Game Plan, 2001 edition,  p. 27). As SIECUS pointed out, the actual statistic cited by Game Plan shows that more than 3 million unintended pregnancies occur each year. The 3 million women who use no contraceptives account for almost half (47%) of these unintended pregnancies. In contrast, the 39 million women classified as method users account for 53%.[18]
 
While we are pleased that the authors appear to have taken our criticisms to heart and that students exposed to the Game Plan program moving forward will read fewer messages of shame and confusing statistics, the changes are far too insubstantial to make a real difference. The curriculum continues to rely on fear, shame, and biases. It still fails to provide important information on sexual health including how students can seek testing and treatment if they suspect they may have an STD. And the format and underlying biases of the curriculum, which ultimately remain unchanged, do not allow for cultural, community, and individual values, and discourage critical thinking and discussions of alternative points of view in the classroom.
 
Despite slight changes, Game Plan falls far short of helping young people develop the skills and knowledge they need to become sexually healthy adults.


[1] Grantees, Project Reality (2007), accessed 30 September 2008, <www.projectreality.org/grantees/index.php?id=7>.
[2] Danice K. Eaton, et. al., “Youth Risk Behavior Surveillance — United States, 2007,” Surveillance Summaries, Morbidity and Mortality Weekly Report, vol. 57, no.SS-04, June 6, 2008, pp. 1-131, accessed at: <www.cdc.gov/nccdphp/dash/yrbs/>.
[3] T. Hoff, et al., National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences (Menlo Park, C A: Henry Kaiser Family Foundation, 2003), p. 14.
[4] P. Bearman and H. Brückner, "Promising the Future: Virginity Pledges and the Transition to First Intercourse," American Journal of Sociology, vol. 106, no. 4 (2001), pp. 859-912.
[5] P. Bearman, et al., “The Relationship Between Virginity Pledges in Adolescence and STD Acquisition in Young Adulthood,” American Journal of Sociology, vol. 110, no. 1 (2004), pp. 44-92.
[6] Recent legislation and court decisions in Massachusetts, California, and Connecticut have granted same-sex couples the right to marry in those states. Some legal and legislative challenges remain though and it is therefore unclear whether this right will be permanently guaranteed in these states or other states in the country.
[7] J. L. Gerberding, Report to Congress: Prevention of Genital Human Papillomavirus Infection, (Atlanta: Centers for Disease Control and Prevention, 2004), p. 6.
[8] Ibid, p. 17.
[9] Rachel L. Winer, et al., "Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women," New England Journal of Medicine, 354.25 (June 22, 2006): 2645-2654.
[10] Latex Condoms and Sexually Transmitted Disease—Prevention Messages, (Atlanta, GA: National Center for HIV, STD & TB Prevention, Centers for Disease Control and Prevention, [undated document]), p. 13.
[11] Male Latex Condoms and Sexually Transmitted Diseases, (Atlanta, GA: Centers for Disease Control and Prevention, 2003), accessed 29 September 2008, <www.cdc.gov/condomeffectiveness/latex.htm>.
[12] Robert A. Hatcher, et al., Contraceptive Technology, (New York, NY: Ardent Media, Inc., 2007), p. 24.
[13] Ibid.
[14] Ibid.
[15] Ibid; Ronald Carey, et al., “Effectiveness of Latex Condoms As a Barrier to Human Immunodeficiency Virus-sized Particles under the Conditions of Simulated Use,” Sexually Transmitted Diseases 19.4 (July/August 1992): 230.
[16] Estimates of New HIV Infections in the United States (Atlanta, GA: CDC, 2008), accessed 27 August 2008, <www.cdc.gov/hiv/topics/surveillance/resources/factsheets/incidence.htm>.
[17] Nicholas Ray, Lesbian, gay, bisexual and transgender youth: An epidemic of homelessness (New York: National Gay and Lesbian Task Force Policy Institute and the National Coalition for the Homeless, 2006).
[18] Facts in Brief, Contraceptive Use (New York, NY: The Alan Guttmacher Institute, 2004), accessed at: <http://www.agi-usa.org/pubs/fb_contr_use.pdf>.