The Worth the Wait series includes curricula for grades six, seven, and eight, and high school. Each curriculum in the series includes information on sexually transmitted diseases, puberty, sexual abuse, abstinence, relationships, and laws related to sexuality. The high school curriculum includes eight sections: “Let's Talk about Character Development,” “Developing Skills for Life,” “You Decide,” “Teens, Sex, & the Law,” “Considering Health Risks,” “The Impact of Teen Pregnancy,” “Risky Behaviors and You,” and “Developing Healthy Relationships.”
Worth the Wait, written by Dr. Patricia J. Sulak, an obstetrician/gynecologist and professor at Texas A&M Health Science Center, is published and distributed by the Scott & White Sex Education program. The Scott & White Sex Education Program is part of the Scott & White Memorial Hospital and Clinic, the main teaching hospital for Texas A&M Medical School. It provides abstinence-only-until-marriage materials and training in 31 school districts in central Texas, reaching 30,000 students. The stated goal of the program is to educate “adolescents and adults on the ramifications of adolescent sexual activity including the medical, social, economic, and legal consequences.”
The Scott & White Sex Education Program receives federal abstinence-only-until-marriage funding through the Community-Based Abstinence Education funding stream and both state and federal funds through Title V, Section 510(b) of welfare reform legislation and designs its curriculum to comply with the federal definition of abstinence education (see box below).
SIECUS curriculum reviews 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. The Guidelines include 39 topics important to sexual health; abstinence is one of these topics. 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”; and “Abstinence from intercourse has benefits for teenagers.”
Worth the Wait does incorporate important topics suggested by the Guidelines, such as puberty, anatomy, sexual abuse, and legal issues related to sexuality, and the curriculum is based on reliable sources of data. Despite these strengths, Worth the Wait relies on messages of fear, discourages contraceptive use, and promotes biased views of gender, marriage, and pregnancy options.
Relying on Negative Messages
Formal sexuality education offered in schools, community centers, or faith-based institutions often represents the only opportunity that young people have to learn facts about sexuality and explore values regarding sexual activity and relationships. The messages they receive in these programs contribute to their sexual health not only as adolescents, but also as adults. Rather than present a balanced, complete picture of both abstinence and sexual activity, Worth the Wait employs negative, fear-based messages and ineffective teaching tools to discourage sexual activity.
Messages of Fear and Shame—Trying to scare students and make them feel guilty
Worth the Wait focuses on the negative repercussions of sexual activity; it discusses the possibility of unintended pregnancy and STDs, including HIV and goes on to blame teen sexual behavior for all sorts of individual and societal problems. Students are told that sexual activity leads to depression, suicide, and divorce later in life, and that “teenage sexual activity can create a multitude of medical, legal, and economic problems not only for the individuals having sex but for society as a whole.” (Worth the Wait, Section 6-20.3) The curriculum then explains that HIV and STDs are a burden on the healthcare system and that out-of-wedlock pregnancy is a contributor to poverty and reliance on government assistance. To underscore this burden on society, the curriculum tells teens that in 1994 selected STDs cost the U.S. $16,638,000,000 (Worth the Wait, Section 5-17) and that “young people ages 17 or less having children costs America $29 billion a year.” (Worth the Wait, Section 6-10) Although it is important for young people to understand the impact of STDs and unintended pregnancy on society, this presentation seems designed to instill fear and guilt rather than to educate students.
Messages of fear and shame are also evident in the story of “The Town Statue.” The curriculum explains that a mayor of a small town had a beautiful statue placed in a park, and told the townspeople that the lustrous golden metal would turn “a putrid shade of green if handled too much.” A year after the statue was erected, the mayor held a celebration in honor of the statue, only to find that the golden statue had turned green, because everyone had thought that “one touch would not hurt.” The story ends with the statement, “what each person thought was a harmless touch turned into the total destruction of a beautiful statue.” (Worth the Wait, Section 2-27) The curriculum makes a quick analogy to sexual activity: “sex is special. When someone is able to save this gift for his/her wedding night, it is a gift that is irreplaceable. However, if a person has had numerous partners and numerous sexual encounters, sexual activity loses its special quality.” (Worth the Wait, Section 2-27) Like much of the curriculum, the story portrays sexual activity as a destructive and harmful force and implies that those who have had sex outside of marriage are tainted—they have gone from lustrous and beautiful to a “putrid shade of green.”
In fact, whether stated in terms of beauty, character, or morality, Worth the Wait repeatedly implies that teens who remain abstinent are simply better than their sexually active peers. For example, the teacher background section states that, “self-control, modesty, good judgment, courage, wisdom, and respect for self and others are a few of the character traits required in waiting to have sex.” (Worth the Wait, Section 1-5) Messages such as these create an underlying dichotomy portraying those who wait to have sex until they are married as virtuous and good, and those who do not as flawed and unhealthy.
We must remember that 47% of all high school students and 61% of high school seniors have engaged in sexual activity, and it is therefore likely that some of Worth the Wait 's participants will be sexually active. It is unfair and inappropriate to imply that these teens lack self-respect and self-control and are incapable of maintaining a long-term relationship. Moreover, it is inaccurate to imply, as Worth the Wait does, that all people agree that sexual activity outside the context of marriage is wrong. While this is a value held by many, it is certainly not universal in today's society.
Nonetheless, the curriculum continues with this good vs. evil dichotomy by vilifying prior generations and blaming the “loosening” of sexual mores for the problems of today. The curriculum depicts the 1960s as an era of recklessness and characterizes the world prior to the sexual revolution as ideal, explaining that sex in marriage was the norm and that both pregnancy outside of marriage and divorce were rare occurrences. It explains that sex was a private matter and there were only two prevalent STDs. In contrast, Worth the Wait states that after the sexual revolution, sex outside of marriage became commonplace, as did divorce and unmarried teen pregnancy. Sex became a public topic of conversation, HIV/AIDS was discovered, along with other incurable STDs, and abortion became common. The curriculum then posits a new sexual revolution in which people take a stand for abstinence until marriage. (Worth the Wait, Section 1-4)
One exercise tells students they are members of the ‘Millennial' generation (born in the 1980s through the 1990s) and compares them with the Baby Boomers (born in the mid-1940s through the mid-1960s) and Generation Xers (born in the late 1960s through the late 1970s). In its description of these generations, the curriculum states, “Gen Xers do not have a very good reputation and have been described as a ‘splintered and alienated youth culture in which social rules seemed pointless.'” (Worth the Wait, Section 1-4) In direct comparison, the curriculum goes on to state, “Millennials are…‘beginning to manifest a wide array of positive social habits that older Americans no longer associate with youth, including new focus on teamwork, achievement, modesty, and good conduct.'” (Worth the Wait, Section 1-4) Worth the Wait is blatantly painting a negative picture of prior generations in order to motivate students to become “better” people.
Not everyone believes that the changes that occurred in the 60s and 70s, which also included increased civil rights for women and African Americans, were entirely negative. While it is important for young people to recognize changes in society and differences among eras, it is not constructive to blame current problems on prior social norms or vilify previous generations, which, it is worth noting, are made up of students' parents, teachers, and family members. Worth the Wait could better serve students by inspiring and encouraging youth to fulfill their potential without demeaning others.
Virginity Pledges—Asking students to promise purity
Like many other abstinence-only-until-marriage curricula, Worth the Wait includes a virginity pledge at the end of the program. Teachers ask students to reflect on the possible negative consequences of sexual behavior outside of marriage and urge them to pledge abstinence. The teacher's script suggests that students be told, “consider how having sex as an unmarried teenager might prevent you from accomplishing your goals,” and then given a pledge card. (Worth the Wait, Section 8-44) The card reads: “Starting today, I _________ (name) pledge to abstain from sexual activity until marriage, as this is the only proven way to protect myself from out-of-wedlock pregnancy and STDs. I am Worth the Wait.” (Worth the Wait, Section 8-43)
The teacher background section states, “research has shown that teenagers who sign abstinence pledges are much less likely to have intercourse.” (Worth the Wait, Section 8-43) Although the curriculum points to a reliable study, its analysis is inaccurate. In truth, the study indicated that pledges only worked in situation where a limited number of students participated. Pledges taken by an entire class were ineffective. When pledges do work, pledgers delay sexual activity for an average of 18 months longer than their peers who had not pledged. More importantly, pledgers were less likely to use contraception when they did become sexually active and were equally likely to become infected with an STD as their non-pledging peers. In addition, pledgers who remained “virgins” (did not engage in vaginal intercourse) were more likely to have engaged in oral and anal sex than non-pledging “virgins.” Contrary to Worth the Wait 's suggestion, virginity pledges are clearly not an answer to the problems of teen pregnancy and STD transmission.
In addition, having youth pledge abstinence until marriage is not appropriate for all teens. Young people who are gay or lesbian cannot legally marry in this country. Asking them to pledge to a lifetime of abstinence is unfair and unrealistic. Like their heterosexual peers, these teens need viable and effective methods of preventing disease and Worth the Wait fails to provide these.
Sexual Arousal—Portraying sex as an uncontrollable force
Throughout the curriculum, Worth the Wait consistently depicts sexual arousal as a power that young people cannot control. Rather than encouraging students to identify boundaries and develop the skills they need to respect these, the curriculum portrays sexual activity as a slippery slope with no return, and suggests students need to avoid it completely.
In one lesson students are taught that intimacy follows a strict order of progression and are shown the following stages:
The teacher then explains the significance of the order by going over each stage. Step nine, “hand to body,” is described with the statement, “arousal makes it difficult to stop progression,” and step ten, “mouth to breast,” is described with the statement, “rapid progression through the next few steps is common.” (Worth the Wait, Section 8-13)
In addition to depicting sexual arousal as an uncontrollable force, this list omits oral sex, a growing concern for health educators, as recent research shows that teenagers are not aware of the risks involved, such as STD transmission. While a handout asks students to place oral sex in this progression, the curriculum provides no feedback or additional information on the topic. Moreover, this exercise does not provide room for students to discuss the possibility that in some relationships sexual behavior may take other forms or progress in different orders and as such misses a critical opportunity to help teens explore responsible sexual decision making.
Instead, Worth the Wait provides students with illogical analogies and over-simplified advice. The curriculum suggests “physical affection NOT allowed” as the appropriate guideline for dating. To underscore the need for such an absolute rule, the teacher is instructed to read the following story aloud:
They say that if you put a frog into a pot of boiling water, it will leap out right away to escape the danger; but if you put the frog in a kettle that is filled with water that is cool and pleasant, and then you gradually heat the kettle until it starts boiling, the frog will not become aware of the threat until it is too late. The frog's survival instincts are geared towards detecting sudden changes. (Worth the Wait, Section 2-26)
The curriculum relates this story to sexual activity by saying “getting involved in a physical relationship with someone can be like the pot of boiling water. First, you start kissing and then hands start roaming and then, oops! Sex just kind of happens!” (Worth the Wait, Section 2-26) This is perhaps the most dangerous message teens can be given about sexual activity: by suggesting that teens have no control over their actions, it actually discourages them from making wise sexual decisions and taking responsibility for their actions.
Young people need to know that at any point in a relationship, and at any point during sexual activity, they have the right and the ability to set their own sexual boundaries and that it is their responsibility to do so.
Worth the Wait's information on STDs and contraceptive options is more accurate and current than many other abstinence-only-until-marriage curricula. Nonetheless, its discussion of the topic includes potentially misleading information and emphasizes failure rates in an apparent attempt to undermine teens' confidence in these methods.
Sexually Transmitted Diseases—Misleading students
Most of the information about STDs included in Worth the Wait is referenced to reliable data sources such as the Centers for Disease Control and Prevention (CDC). In fact, the teacher background section is taken almost verbatim from a CDC publication entitled, T racking the Hidden Epidemics 2000: Trends in STDs in the United States. The STD lesson consists of student handouts that list the type of infection, symptoms, consequences, prevalence, and treatment options for several common STDs, and games and activities are used to review this information. Worth the Wait's discussion of this subject is thorough and includes important, and often omitted, information about the possibility of transmitting STDs through oral and anal sex.
While the information is more complete and accurate than expected, the curriculum does include some information that may give students a false impression of the prevalence and health consequences of certain STDs. For example, on the student handout describing syphilis, the number of new cases per year is listed as 70,000, when in fact there were only 7,177 cases reported in 2003. Worth the Wait also includes bacterial vaginosis (BV) in its information on STDs. While BV has been shown to be related to sexual activity, it is not necessarily sexually transmitted . In fact, BV can develop without the occurrence of sexual contact, and is also linked to douching. Students can certainly benefit from learning about BV and other common gynecological conditions, however, presenting it as an STD rather than a vaginal infection is misleading.
In addition, the curriculum tells students that Pelvic Inflammatory Disease (PID) is caused by Chlamydia and gonorrhea. While it is true that untreated Chlamydia and gonorrhea can result in PID, the student handout omits this important distinction and as such misses the opportunity to stress the value of getting tested for STDs. In fact, testing is only addressed once in the curriculum. The teacher script for a PowerPoint slide about renewed abstinence states, “if you have had sex, you should see a healthcare professional.” (Worth the Wait, Section 6-20.53) Clearly this is insufficient, as all teens need to understand the vital importance of routine STD screenings as well as the details of what to expect and how to find health care providers. This information is essential to a lifetime of maintaining sexual health.
Consistent with its overall theme of abstinence until marriage, Worth the Wait discusses the consequence of STDs as they relate to finding a future spouse. The curriculum states:
An obvious example would be if you become infected with an STD like herpes. Later in life, when you do get married, you could pass on this STD to your new spouse. On the other hand, you may date someone who treats you respectfully and politely. This type of dating experience will lead you towards finding a spouse who will hopefully treat you in the same manner. It will also teach you how important it is to treat others respectfully and will probably serve as a reminder to you that you need to treat those around you with respect. (Worth the Wait, Section 8-6)
By limiting the scope of this discussion to marriage, the curriculum once again ignores those students who will never marry, including young people who are gay and lesbian. Moreover, this statement is yet another example of portraying individuals who become sexually active before marriage as disrespectful and unworthy. Such attempts to pass off conservative social values and messages of shame as public health facts undermine what could be a very useful lesson on STDs.
Contraceptive Options—Emphasizing failure rates and discouraging use
Unlike most abstinence-only-until-marriage programs, Worth the Wait offers an in-depth examination of a variety of contraceptive options. The curriculum details how each method works and discusses its proper use in a PowerPoint presentation. While the information provided is accurate and important, the curriculum's emphasis on failure rates and misuse by teens may ultimately discourage young people from using contraception. In fact, the lesson is titled “Why Contraceptives are not the Answer for Teens.”
Nonetheless, Worth the Wait, provides important information about contraception, including condoms. Unlike many abstinence-only-until-marriage curricula, Worth the Wait acknowledges that condoms can reduce the risk of HIV and stresses the importance of correct and consistent condom use. The curriculum concedes, “if adolescents choose to become sexually active, they must understand that consistent and correct condom use is essential and critical to reduce, but will not eliminate, their risk of pregnancy and HIV.” (Worth the Wait, Section 6-20.40) Such positive and accurate statements, however, are undermined by a clear emphasis on failure.
Worth the Wait states at least ten different times that condoms have not been proven to be effective at preventing many STDs and emphasizes that they are not 100% effective at preventing pregnancy. In explaining condom failure, Worth the Wait tells student that 15 out of every 100 condom users will get pregnant each year and stresses that condoms have the highest pregnancy rate of any of the leading birth control methods available. This explanation is potentially very misleading to students.
To fully understand condom 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 the male condom is very rare and is estimated to occur in only three percent of couples using condoms consistently and correctly during the first year of use.
In truth, condom failure is usually caused by errors in use, most often the failure of couples to use a condom 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 14 of these couples will experience an unintended pregnancy during the first year. It is important to remember that these couples may not have been using a condom or may have been using a condom incorrectly during the act of intercourse that resulted in an unintended pregnancy. To put this in perspective, it helps to look at other contraceptive methods. For example, 26% of women using periodic abstinence as a method of birth control will experience an unintended pregnancy within the first year as will 85% of those using no method.
Without providing this important explanation, Worth the Wait goes on to states, “if condoms often fail in preventing pregnancy, which can only occur during the time of the month when a woman is ovulating, how often will they fail in preventing STDs that can be contracted any day of the month? As you can figure out, if condoms frequently fail in preventing pregnancy, they can also frequently fail in preventing STDs!!!” (Worth the Wait, Section 6-20.35)
While failure rates for condoms depend heavily on whether couples use them consistently and correctly, it is inaccurate to imply that failure rates change depending on whether couples are trying to prevent pregnancy or disease. Research shows that when used consistently and correctly latex condoms are highly effective in preventing pregnancy and reducing the risk of STDs.
Worth the Wait continues to discourage condom use by suggesting that individuals, particularly teens, are simply incapable of using condoms correctly and that even when used correctly condoms “can never protect someone from the emotional problems that can result from multiple sexual partners and premature sexual activity.” (Worth the Wait, Section 6-20.41) Once again the curriculum clouds a scientific presentation with fear and shame.
The author seems to assume that if adolescents believe that condoms and other contraceptive methods are ineffective, they will abstain from sexual activity. There is no reason to think that this is true. Such inaccurate information may instead discourage teens from using these important prevention methods when they do become sexually active, thereby putting them at increased risk for unintended pregnancy and STDs, including HIV.
According to the Guidelines, one of the main goals of sexuality education is to provide an opportunity for young people to question, explore, and assess their own and their community's attitudes about sexuality. This can help young people understand
their family's values, develop their own values, and improve critical-thinking skills. Rather than providing this important opportunity, however, Worth the Wait promotes specific viewpoints about gender, marriage, sexual orientation, and pregnancy options.
Gender—Fostering myths and stereotypes
An entire lesson is devoted to identifying differences between men and women. The teacher is instructed to read aloud from several pages of information documenting gender differences in behavior, emotional development, conflict management, brain size, intellectual capacity, and communication skills. The curriculum explains that “males, for instance, are usually better at spatial reasoning than females…Males' superior skills in this area give them an advantage in math, engineering, and architecture.” (Worth the Wait, Section 5-11) Students are also told “new research data says that many basic male-female differences are innate, hardwired and not the result of condition.” (Worth the Wai t, Section 5-11)
This emphasis on basic gender differences seems designed to underscore the notion that men and women view sexuality in entirely different ways. The curriculum informs teachers and students, “teen males tend to view sexual relationships as casual while females view these relationships as steady or regular. Males will often have their first intercourse experience with a woman to whom he feels no particular attachment while females tend to have their first sexual experience with a man they love and may want to marry.” (Worth the Wait, Section 5-11) It goes on to say that males “typically felt their female partners expected some form of materialism (e.g. dinners, entertainment) in exchange for sex.” (Worth the Wait, Section 5-11) Worth the Wait then asks students to brainstorm the differences between girls and boys. Possible answers include:
• Don't want to talk about feelings/personal relationships
• Take on responsibility as adults – strive for excellence, compete, show self-discipline
• Enjoy pleasing sexual partner, conquest, relief of tension
• Casual sexual relationships
• Don't think sexual urges controllable
• Think sexual partners expect form of materialism
• Express emotions well – develop interpersonal skills better
• Have ability to compromise, be kind, have friends
• Emotional closeness very important
• Take relationships seriously
• Believe can control sexual urges
This lesson subtly reinforces a societal double-standard that suggests that men want casual sex from any and all women and that women do not desire sex as much as they feel the overwhelming need to be loved. In so doing, the curriculum places all of the responsibility for refusing sexual activity on the shoulders of young women.
The curriculum justifies the discussion on gender differences by repeatedly stating that these differences have been documented in research studies and by admitting that there are individual exceptions to these rules. Nonetheless, students are not challenged to question the nature, validity, or origin of these gender stereotypes, or to explore how such stereotypes may affect sexual relationships. Such a presentation is detrimental to all young people by limiting their options, influencing their behavior, and coloring their expectations for future relationships. Instead, students need to learn that both men and women are sexual beings and are equally responsible for making decisions regarding sexual activity and relationships.
The Marriage Mandate—Promoting one lifestyle
The creators of Worth the Wait have received money from two of the federal government's dedicated funding streams for abstinence-only-until-marriage programs, and other schools and organizations that receive these funds use the curriculum. Therefore, Worth the Wait must teach that “a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity,” and that “sexual activity outside the context of marriage is likely to have harmful psychological and physical effects.”
In keeping with this requirement, Worth the Wait devotes an entire lesson, entitled “Planning for a Healthy Marriage,” to promoting marriage for all people. In this lesson, students complete handouts in which they describe the perfect spouse and conditions for an ideal marriage. The curriculum states that, “the purpose of this lesson is to encourage students to think about their future and what kind of individual they want to marry.” (Worth the Wait, Section 8-33) This lesson seems based on the assumption that all students aspire to marriage, and in so doing discounts gay and lesbian individuals who are unable to marry, as well as the very real possibility that some students simply do not wish to marry.
To further encourage marriage, the curriculum includes a list of its benefits and explains that married people enjoy “more satisfaction with sexual lives” and “more sex.” According to this lesson, married people are “twice as likely to be happy” and less likely to “attempt suicide.” (Worth the Wait, Section 8-3) The background section on healthy marriages explains this by saying that “marriage improves the feeling of emotional well being that couples feel because they have a sense that their lives have meaning and purpose.” (Worth the Wait, Section 8-32) Implied in such statements is the notion that without marriage life has no meaning or purpose.
The curriculum furthers this dichotomy between happy and responsible married people and their less worthy peers in a discussion about cohabitation: “Couples who cohabitate: value marriage less; do not want to be responsible for one another; are less faithful to their partner than married couples; are not as happy; [and] are more likely to get divorced.” (Worth the Wait, Section 8-35.10) The teacher script explains that “some people have decided to live together before they get married or in place of getting married. Often you will hear reasons such as we want to make sure we are compatible, or we want to make sure it will work out. Cohabitation or living together, however, doesn't improve one's chances for a successful marriage.” (Worth the Wait, Section 8-35.10)
The curriculum's focus seems misplaced as few high school students must decide whether to move in with a partner. More importantly, however, opposition to cohabitation is clearly not a universally held value as 11 million Americans reported living with a partner outside of matrimony in 2000. Once again, the curriculum is presenting one opinion as truth rather than allowing students to explore their values and the values of their parents and communities.
Divorce and Family Structure—Depicting non-traditional families as troubled
The curriculum also paints a very negative picture of divorce. For example, a PowerPoint slide describes ill effects of divorce:
For Better or Worse:
• Divorce has long-term effects
• People get hurt
• Children suffer the long-term consequences
• More likely to live in poverty
• Don't do as well in schools
Although this discussion is designed to make young people think of their future relationships, it would not be surprising if many students thought instead of their parents. A large proportion of students are undoubtedly growing up in families that have gone through a divorce, and it is neither fair nor helpful to suggest that they will face more difficult lives than their friends with married parents.
Unfortunately, Worth the Wait provides similar messages to young people from single parent homes. A PowerPoint slide script states, “having children outside of marriage creates many problems, not only for the child, but for the mom and dad as well.” (Worth the Wait, Section 8-35.7) Single parenting is portrayed as a social ill and one of the primary causes of poverty.
It is unreasonable to put the burden of family structure on students who, as children, have no control over their current family situation. There are many reasons including divorce, death, desertion, cohabitation, and gay and lesbian partnerships, that students may live in a family that does not match the ideal model espoused by Worth the Wait . Suggesting that these young people will face a lifetime of difficulty will only serve to distress and alienate many students.
Pregnancy Options—Mandating choices
Worth the Wait 's biases are perhaps the most noticeable in its discussions on teen pregnancy. The curriculum clearly depicts abortion as physically and emotionally harmful and favors adoption in the event a teen becomes pregnant. The teacher background states, “the teenager, family, child, and even society will suffer the consequences of adolescent pregnancies.” (Worth the Wait, Section 6-10) It is important for teens to understand the great difficulties and challenges that accompanying teen parenthood, however, it is not productive to stigmatize those individuals as the cause of social problems. Some students in the classroom may already be pregnant or parenting a child, have friends or family members who are teen parents, or be the son or daughter of a teen parent. Worth the Wait would better server students by promoting strategies that aim to reduce unintended teen pregnancy in a manner that does not stigmatize or condemn all teen parents.
Worth the Wait also opposes abortion. It emphasizes possible negative consequences of abortion without providing any resources or supplemental information. A student handout that describes several possible risks and/or side effects of abortion procedures states, “equally as serious as the physical risks/side effects can be the emotional impact of abortion. ‘Some women may feel guilty, sad, or empty while others may feel relief that the procedure is over. Some women have reported serious psychological effects after their abortion, including depression, grief, anxiety, lowered self-esteem, regret, suicidal thoughts and behavior, sexual dysfunction, avoidance of emotional attachment, flashbacks, and substance abuse.'” (Worth the Wait, Section 6-8) This message is clearly intended to deter adolescents from considering abortion as an option should they face an unintended pregnancy.
In contrast, Worth the Wait heralds adoption as the best option for women facing an unintended pregnancy. The student handout starts with the quote, “‘women who make adoption plans for their children are heroes…a woman who chooses an adoption plan for her child should be seen as the most unselfish, courageous, loving person in our society'” (Worth the Wait, Section 6-9) The handout then goes on to provide several resources for placing a baby up for adoption. It is interesting to note that no similar resources are provided for students who wish to consider abortion.
It is important for educational programs, especially those used widely in public schools, to respect the diversity of opinions and provide unbiased information on all pregnancy options. Worth the Wait does not adhere to this standard of educational programming.
Worth the Wait utilizes a variety of teaching methods, including brainstorming activities, worksheets to be completed in class and at home, interactive games, PowerPoint presentations, and lectures with follow-up discussions. It also provides student handouts on some topics. While some aspects of the curriculum make use of effective teaching tools, overall the lessons do not include an opportunity for critical thinking or the development and clarification of personal values.
Curriculum Strong Points—Involving parents, defining abstinence, and addressing peer pressure and the media
The curriculum does incorporate some effective and productive teaching methods. For example, at the end of each section, students complete a worksheet with their parents, which must be signed and returned. SIECUS believes that parents are, and should be, the primary sexuality educators of their children and applauds Worth the Wait for promoting parental involvement and recognizing the importance of a family's own values.
Worth the Wait should also be praised for defining abstinence. A PowerPoint slide clearly states, “Abstinence is not having sex (vaginal, oral, or anal sex, or outercourse).” (Worth the Wait, Section 6-20.44) Many abstinence-only-until-marriage curricula promote abstinence without sufficiently explaining what this means. Incomplete definitions can lead to confusion, and SIECUS applauds the authors for recognizing this and being straightforward with young people.
In addition, the curriculum spends a significant amount of time discussing peer pressure and the importance of being assertive. Students need an opportunity to develop character traits and skills that will enhance their ability to make responsible decisions based on their personal values. The influence of the media is also discussed at length, and students are encouraged to analyze how various media sources influence adolescents' attitudes and behavior.
Curriculum Drawbacks—Preventing critical thinking
While Worth the Wait employs a variety of teaching methods, few, if any, of the lessons promote individual critical-thinking skills. For several brainstorming activities, such as the brainstorm on differences between girls and boys, answer keys are provided. Rather than encourage students to identify and define their own values, the curriculum outlines correct responses and dictates biased views. In addition, Worth the Wait has little faith that adolescents are able to think critically on their own. In both the teacher background section and student handout, the curriculum asserts that teens rely on emotional reactions and adults rely on logic. (Worth the Wait, Section 3-9 and Section 5-6) This message implies that students are incapable of making decisions by themselves. Adolescence is a crucial time for encouraging critical thinking and personal values clarification in order to develop those skills for adulthood.
Effective sexuality education programs provide accurate information in an unbiased manner and encourage students to think critically for themselves in order to define their own values and beliefs regarding sexuality. To do so, curricula must recognize and respect diversity of opinion, orientation, family structures, and values. Unfortunately, Worth the Wait fails to incorporate these critical components and instead promotes a biased perspective and presents opinions as universal truths. Ultimately, Worth the Wait falls far short of meeting the needs of young people so that they may develop the skills and knowledge necessary to become sexually healthy adults.
This curriculum review was written by Kirsten deFur, SIECUS intern, and Martha Kempner, director of public information.
 “What We Are About, What We Aren't About,” Worth the Wait, www.iamworththewait.org/intro.html, accessed 27 July 2005.
 National Guidelines Task Force, Guidelines for Comprehensive Sexuality Education, Kindergarten —12 th grade, 3 rd edition (New York: SIECUS, 2004), accessed 19 September 2005, <http://www.siecus.org/pubs/guidelines/guidelines.pdf>.
 Jo Anne Grunbaum, et. al., “Youth Risk Behavior Surveillance-United States, 2003,” Surveillance Summaries, Morbidity and Mortality Weekly Report 53.SS-2 (21 May 2004): 1-95, accessed 28 January 2005, http://www.cdc.gov/nccdphp/dash/yrbs/ .
 P. Bearman and H. Bruckner, “Promising the Future: Virginity Pledges and the Transition to First Intercourse,” American Journal of Sociology 106.4 (2001): 859-912.
 P. Bearman and H. Bruckner, “After the promise: The STD consequences of adolescent virginity pledges.” Journal of Adolescent Health 36.4 (April 2005): 271-278.
 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.
 Fact Sheet: The Truth About Adolescent Sexuality (New York: SIECUS, 2004).
 Tracking the Hidden Epidemics 2000: Trends in STDs in the United States; Answers to the Most Frequently Asked Questions, (Atlanta, GA: Centers for Disease Control and Prevention (CDC), 2000).
 Trends in Reportable Sexually Transmitted Diseases in the United States, 2003: National Data on Chlamydia, Gonorrhea, and Syphilis. (Atlanta, GA: Centers for Disease Control and Prevention (CDC), 2004).
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 Worth the Wait, Section 1-19, Section 5-21, Section 5-49, Section 5-54, Section 6-18, Section 6-20.35, Section 6-20.36, Section 6-20.37, Section 6-20.42, and Section 6-26.
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