Final Thoughts

The type of sex education that should be taught in the US has been a major topic of debate and will probably continue to be contentious for years to come.

Some people believe that teaching young people about contraceptives encourages both early sexual activity and numerous partners. Thus, there has been considerable funding support for abstinence-only education from both the Federal government and at the State level.

However, the data suggests that abstinence-only is not the best type of sex-ed, and Texas provides a good example. As noted at the beginning, 83% of Texas schools teach either no sex-ed or abstinence-only education,60 and yet Texas is 5th in the nation for teen pregnancies and 3rd for HIV rates.61 Clearly, we would be doing better if abstinence-only education was the best program.

Texas is just one state though, and we should look at the nation overall and see if the same trend holds true for all 50 states.

It does.

In a peer reviewed 2011 paper by Drs. Stanger-Hall and Hall, they concluded that even after accounting for other factors, “The more strongly abstinence is emphasized in state laws and policies, the higher the average teenage pregnancy and birth rate. States that taught comprehensive sex and/or HIV education and covered abstinence along with contraception and condom use (level 1 sex education; also referred to as “abstinence-plus”), tended to have the lowest teen pregnancy rates, while states with abstinence-only sex education laws that stress abstinence until marriage (level 3) were significantly less successful in preventing teen pregnancies.”62

This doesn’t mean it’s wrong to emphasize abstinence—just that it alone is not enough to protect young people. Sooner or later young people will become sexually active, and in this case ignorance can be fatal, even for those who remained virgins until marriage.63

We are not saying that lack of comprehensive sex education is “the” only cause either. Clearly high teen pregnancy rates also correlate with socioeconomic status64, minority status65, and religiosity66. But these things are less easily addressed by changes in policy, whereas we can change what we teach in schools.

Nor are we saying that gains have not been made. In fact, teen pregnancy is at a historic low, and the rates have fallen in all 50 states,67 largely due to improved contraceptive use.68 It remains true, however, that states like Texas, New Mexico, Mississippi, Arkansas, Louisiana, Oklahoma, Kentucky and West Virginia are way behind everyone else and still lead the nation and the developed world in teen pregnancy rates.

Our main goal here has been to provide education on the various contraceptive options that are available, and we hope we have at least started that discussion between you and your partner. However, there are many additional topics that can be covered in a marital education class.

As one example, we did not cover the human reproductive system, but are hoping the basics were covered in biology class. If not, provides basic terminology and explanations, as well as 2D interactive diagrams and some 3D diagrams that allow you to rotate and zoom on the various organs in the reproductive system. These are pretty cool and provide excellent anatomical education.

We also didn’t cover sex, and if you are from a school wholly lacking sex-ed, that could be a significant oversight. Assuming you get past that hurdle, we didn’t cover pregnancy, childbirth, or parenting either, and sooner or later these are life-changing issues that many couples will face.

Another important topic not covered here is communication. How can one even get to using a condom for protection if one is too embarrassed to discuss the topic with a partner? Actually, how can a couple resolve any problems if they are not good communicators? Communication is vital to your relationship and to your health and safety.

However, such topics are beyond the scope of this little book, which seeks to leave you with only two messages:

  1. Treble-Up: use 3 forms of birth control.
  2. Vote for Abstinence-plus-Marital Education and help reduce teen pregnancy and STD rates in your state.

Endnote 60

Conspiracy of Silence: Sexuality Education in Texas Public Schools in 2015-2016, available online at


Endnote 61

See The HIV/AIDS Epidemic in the United States: The Basics, by the Henry J. Kaiser Family Foundation (2017), available online at


Endnote 62

Stanger-Hall K.F. & Hall, D.W., Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S, PLoS One, 6(10): e24658 (2011), available online at


Endnote 63

American Teens’ Sexual and Reproductive Health, by the Guttmacher Institute (2016), available online at (“On average, young people in the United States have sex for the first time at about age 17 but do not marry until their mid-20s. During the interim period of nearly a decade or longer, they may be at heightened risk for unintended pregnancy and STIs. . . The proportion of teens having sexual intercourse before age 15 has declined in recent years.”) (cited omitted).


Endnote 64

Penman-Aguilar, A., et al., Socioeconomic Disadvantage as a Social Determinant of Teen Childbearing in the U.S., Public Health Rep. 128(Suppl 1): 5–22 (2013), available online at (“This review suggests that unfavorable socioeconomic conditions experienced at the community and family levels contribute to the high teen birth rate in the U.S.”).


Endnote 65

See What Is Behind the Declines in Teen Pregnancy Rates? Guttmacher Policy Review, 17(3) (2014), available online at (“wide disparities in pregnancy rates by race and ethnicity persist, with rates among both black and Hispanic teens remaining twice as high as among their non-Hispanic white peers.”).


Endnote 66

Strayhorn J.M. & Strayhorn J.C., Religiosity and teen birth rate in the United States, Reproductive Health 6:14 (2009), available online at (“With data aggregated at the state level, conservative religious beliefs strongly predict U.S. teen birth rates, in a relationship that does not appear to be the result of confounding by income or abortion rates. One possible explanation for this relationship is that teens in more religious communities may be less likely to use contraception.”).


Endnote 67

See What Is Behind the Declines in Teen Pregnancy Rates? Guttmacher Policy Review, 17(3) (2014), available online at (“After years of increases in the 1970s and 1980s, the teen pregnancy rate peaked in 1990 and has declined steadily since. Today, teen pregnancy, birth and abortion rates have reached historic lows. What is more, teen pregnancy rates have fallen in all 50 states and among all racial and ethnic groups.”).


Endnote 68

Id. (“the decline in teen pregnancy since 2003 had little or nothing to do with teens’ delaying sex. . . .the decline in teen pregnancy in recent years can be linked to improvements in teens’ contraceptive use.”).

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