The XX Factor

Fewer Teens (Especially White and Rural Ones) Are Learning About Birth Control

This won’t be on the test.

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Despite a shift in federal policy away from abstinence-only sex education in recent years, fewer U.S. teens are getting formal instruction about birth control methods. A new data analysis from the Guttmacher Institute found that 60 percent of girls aged 15-19 reported learning about birth control in 2011-13, down from 70 percent in 2006-10. The proportion of teen boys who reported receiving formal instruction about birth control fell from 61 percent to 55 percent during those periods.

The report drew its data from the 2006-10 and 2011-13 National Survey of Family Growth. In addition to declines in birth control education among teen girls, researchers found that, between 2006-10 and 2011-13, the population of girls taught about STIs, HIV/AIDS, and saying no to sex dropped, too. The most precipitous declines occurred in communities outside major metropolitan areas.

Even though programs to prevent teen pregnancy have received more federal funding in recent years, their scope may not be broad enough to have had a significant national impact, researchers say. Abstinence-only sex education programs still get support to the tune of $75 million from the federal government, though Barack Obama cut that spending from his proposed 2017 budget. During the time periods covered by Guttmacher’s analysis, the proportion of teen girls who were taught about saying no to sex but not about birth control grew from 22 to 28 percent.

Birth control education has been waning across the U.S. for some time. The new report notes that, in 1995, 81 percent of teen boys and 87 percent of teen girls said they’d gotten formal instruction on the topic. In less than two decades, those numbers fell by more than 25 points each. Teen pregnancy rates peaked in 1990 and have fallen sharply since, most drastically in states that provide comprehensive sex education, perpetuate cultural attitudes that discourage teen parenthood, and have accessible contraception services.

Numbers released this week from the Centers for Disease Control and Prevention show that births among Hispanic and black teens have fallen by almost half in the past decade, though the rates are still twice as high as that for white teen girls. The new Guttmacher analysis found that the drop in birth-control education was most drastic among white girls, 71 percent of whom said they’d been taught about birth control in 2006-10, compared with 57 percent in 2011-13. The proportion of Hispanic teen girls who learned about birth control dropped just one point in that time period, from 68 percent to 67 percent, and the proportion of black girls actually rose from 68 percent to 69 percent. This discrepancy could be explained by the concentration of teens of color in cities, where comprehensive sex-ed has remained more consistently available, and the focus of teen pregnancy prevention programs on black and Hispanic teens.

Colorado has found a more direct way to prevent teen pregnancy: providing young women with free or low-cost long-acting reversible contraception like intrauterine devices. These devices can last for years—and are much easier for young people to use than condoms or daily oral contraceptives—but a prohibitive up-front cost makes them an unattractive option for many teens and low-income women. Colorado’s program was funded by donors and foundations for years and saw enormous success—between 2009 and 2014, the birth rate among young women aged 15-19 dropped 48 percent, and the birth rate among women aged 20-24 dropped 20 percent. Conservatives have fought the program and denied it an increase in state funding in 2015, but its unassailable benefit to the state convinced Colorado lawmakers to give it $2.5 million for the 2016-17 fiscal year.

Delaware has followed Colorado’s lead with a free-LARC program of its own, and other states are expected to follow suit as legislators and public-health officials consider its drastic impact. Giving teens free IUDs may be a move too progressive for some states, especially those in more socially and politically conservative regions where teen pregnancy rates are often the highest. There, a simple boost for disseminating information about birth control methods would be a welcome baby step.