|Abstinence Goes Global: The U.S., the Right Wing, and Human Rights|
American Sexuality Magazine, Volume 1, No. 6
Summary: Discusses the Bush administration's determination to promote abstinence programs in lieu of comprehensive sexuality education both domestically and internationally, and analyzes abstinence programs from a human rights perspective.
A range of organizations have pointed out that the administration is making vital public health decisions based not on scientifically proven fact, but on ideology. From AIDS organizations to the ACLU, groups in the U.S. have argued that abstinence-only programs constitute a lethal form of censorship by withholding information on methods known to prevent HIV and STI (sexually transmitted infection) transmission.
Most organizations are currently focused on U.S. domestic concerns about abstinence-only education and funding. However, it is also vital to consider the global arena, where the U.S. administration exports its sectarian ideology and morality, primarily through restrictions on foreign assistance funds and the policy positions of U.S. delegations at the United Nations. Both domestically and internationally, scientifically sound arguments could be strengthened by use of a human rights perspective, namely one that rests on the ideas enshrined in the Universal Declaration of Human Rights and other internationally agreed instruments that all people have the right to information, to education, to enjoy the benefits of scientific progress, to be free from discrimination, to freedom of expression and to enjoy the highest attainable standard of health. Taken together, these and other standards form the basis of international human rights law. The denial of these rights (and others) in relation to public health threatens each person's right to life and constitutes an infringement of international law for which governments, including the current U.S. administration, must be held accountable.
Human rights organizations are especially well positioned to address abstinence-only programs as a rights issue. In doing so, they could hold governments accountable for human rights violations inherent in the implementation of many abstinence-only programs, which are enforced through discriminatory and moralistic restrictions on what can and cannot be taught or discussed. They could build coalitions between domestic and international groups concerned with public health and discrimination. They could also capitalize on the opportunity to develop their own advocacy positions on gender and health.
The people who have the most to gain from collaborative work grounded in human rights analysis are those who need and want information but are denied accurate, scientifically proven information about disease prevention and transmission, condom use, and contraception. While false and misleading information about health jeopardizes the well-being of all people, certain groups are at particular risk when accurate information is censored, altered or withheld. These include women and young people (particularly girls) and people who are already marginalized, including sex workers, lesbian, gay, bisexual and transgender people, and people who inject drugs.
Agenda: Policy without Proof
In this administration, the desire to "make abstinence work" trumps the human right to life. The consequences of these skewed priorities are deadly, especially as young people constitute one of the groups with the most rapidly rising rates of HIV infection. U.S. polices are, in effect, eliminating one of the only tools available that can save people's lives: information.
In Congress, right-wing policy makers such as Rep. Chris Smith (R-NJ) and Rep. Joseph Pitts (R-PA) have worked to ensure that programs with no medically-proven effectiveness have been funded. Political pressure also has been used to de-fund family planning programs (such as the United Nations Family Planning Association). HIV prevention and other sexuality education programs have been audited when their work was seen to stray from the abstinence-only line. While there is a growing list of organizations that have been targeted, two examples are worth noting: San Francisco's Stop AIDS program faced over a year of continuous federal reviews, and Advocates for Youth endured three audits in one year.
One of the more egregious examples of Congressional efforts to promote abstinence-only ideology in the international arena is directly pegged to fighting the AIDS pandemic. Even though the U.S. administration called for $15 billion to fight AIDS in Africa and the Caribbean, the congressional budget appropriations process shows this commitment to be subject to conservative ideological constraints. Congress earmarked one third of prevention funds to programs that promote abstinence-only ideology, and reduced funding for comprehensive prevention efforts that have shown positive results.
Members of Congress and the administration in part justify this allocation of funds by touting the success of abstinence programs in Uganda, even though public health officials in Uganda and elsewhere question the validity of those claims. The Lancet medical journal recently reported that increased condom use also contributed to the decline in prevalence rates, and that conclusions crediting only the abstinence portion of Uganda's AIDS prevention programs are based on scientifically unsound data collection and manipulation of numbers (The Lancet, Parkhurst, July 6, 2002).
Policies from Washington are fundamentally flawed because they ignore the realities of millions of people, particularly women and girls, all over the globe. Abstinence is meaningless for many women and girls who have limited or no power to negotiate condom use or to resist violence by male partners or strangers. There are 82 million young women in developing countries currently between the ages of 10 - 17 who will marry before their 18th birthdays. It is foolish to insist that these young women "just say no" to sex demanded by their older and more powerful husbands. In many scenarios, it is the husbands who have the power to abstain; too often, they don't and their young wives can't.
U.S. and Abstinence
at the UN
At the UN General Assembly Special Session on Children in 2002, the U.S. delegation, which included FRC and CWA, tried to block international consensus on comprehensive sexuality education and related services for young people. In an official written explanation of its position, the delegation emphasized its "commitment to programs that address ... the need to stress the practices of abstinence, of delaying sexual initiation, monogamy, fidelity and partner reduction..." to prevent HIV infection. In its positions, the U.S. delegation supported myopic and moralistic domestic policies that sought to position abstinence as the only worthwhile method of reducing transmission.
In 2002, over thirty Asian countries voted against conservative U.S. positions at an important regional meeting on population and development in Bangkok. At the end of the meeting, the entirely isolated U.S. delegation issued an official statement on the final agreed document. The statement repeats the language from the earlier meeting on children and adds that the "United States made every effort to insert language in the document reaffirming the importance of abstinence" and "remains disappointed" that the assertion that "abstinence is the healthiest choice for unmarried adolescents" was deleted from the final text.
There is clear progress domestically, as well. Human Rights Watch compiled a bold and first-of- its-kind report critiquing abstinence-only programs in Texas. Rep. Henry Waxman (D-CA) recently issued a report criticizing the administration's persistent misuse and manipulation of science. Whistleblowers within the National Institute of Health and the Centers for Disease Control tell of being pressured to alter or suppress scientifically accurate information. And AIDS service organizations have begun to decry the prioritization of abstinence in U.S. global AIDS funding.
The right wing has been very effective at melding its domestic and global strategies. Progressive organizations and social movements must do the same, and with urgency. Using a human rights lens to critique abstinence-only programs and the manipulation of valid scientific data would go a long way in fostering effective coalitions. Coalitions of human rights organizations, and sexual and reproductive health and rights organizations, must increasingly take their fight to global and UN levels to protect gains already won.
Organizations working in domestic and international arenas would do well to build on one another's analyses and work together to challenge the current administration's "make abstinence work" philosophy, and to expose its strong links with conservative extremist advisors. We must do this by deploying a variety of rights-based arguments and by making a renewed and passionate commitment to linking the domestic to the global.
Cynthia Rothschild is the former Program Officer in the International Policy Program of the International Women's Health Coalition, and is based in New York.
This article was originally published in an issue of American Sexuality Magazine devoted to the "abstinence-only" debate. Click here to access the full issue online. Reprinted with permission.