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Get Real

Illinois doesn't directly fund sex ed in schools. But it does provide almost the entire budget of the Glenview-based Project Reality, whose abstinence-only curriculum, offered to schools for free, misleads kids about birth control and STDs.

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"You don't want to get pregnant!" shouts the young woman standing before an applauding congregation in the Shining Star Missionary Baptist Church at 103rd and Vincennes. "You don't want to get an STD! Be abstinent!"

Taylor Moore, a junior at Kenwood Academy, makes clear that she practices what she preaches. She puts her hand to her throat, where a silver ring hangs on a chain. "This is a purity-vow ring," she says, "which will be given to my husband when I get married." The crowd murmurs approval.

After the service Moore tells me there's no point in dating--God has ordained a husband for her, and the man will show up when the time is right. In the meantime she has no interest in learning about contraception. If someone gave her a condom she'd be insulted. "It's saying, well, you can't control yourself," she says. "Animals can't control themselves, so you're an animal, basically."

Moore is a teen spokesperson for Project Reality, a nonprofit organization based in north-suburban Glenview that's a national leader in abstinence-only sex education. It teaches kids that sex belongs only in marriage, and it doesn't discuss contraception unless it's to describe how various methods fail.

This is an increasingly common lesson in Illinois classrooms, and Project Reality is one of its biggest and most influential promoters. According to its own figures, it publishes textbooks and produces educational videos that last year reached more than 100,000 schoolchildren in more than 500 Illinois schools, as well as kids in 23 other states. And it's growing fast, reaching tens of thousands more Illinois kids each year, thanks in part to generous government funding for abstinence programs that allows it to offer classroom materials and teacher-training workshops for free. In March the Chicago branch of Planned Parenthood and the Illinois Caucus for Adolescent Health released a survey of 335 Illinois sex-ed teachers; it found that 39 percent of them rely on free classroom materials.

The rise of abstinence-only programs, a cause supported by the right, has turned the state's classrooms into a battleground in the culture wars, with liberals charging that the approach is judgmental and unrealistic. They want government funding for their own brand of sex ed. In March Senator Carol Ronen, a Democrat from Chicago, sponsored a bill that would counter the $2.8 million the federal government gave the state for abstinence-only programs last year with $2.5 million in state money for comprehensive sex education, which combines lessons about abstinence with detailed information about contraception.

Libby Gray Macke, director of Project Reality, says comprehensive sex ed offers a dangerous "mixed message," especially for young people. She argues that when it comes to sex, kids will be safest and healthiest if they learn one unwavering rule: wait for your wedding day.

Project Reality was founded in 1985 by Kathleen Sullivan, a longtime conservative activist. It received generous federal funding from the beginning, starting with a $391,000 grant. The money went to promote abstinence using Sex Respect, which would become one of the most widely used abstinence-only curricula in the nation.

Sex Respect became the target of lawsuits filed by people who believed the use of its materials in public schools violated the constitutional principle regarding the separation of church and state. In 1992 a group of parents and activists in Shreveport, Louisiana, sued the local school board for using Sex Respect texts, claiming they contained religious references and medically inaccurate information. Among the passages they objected to: "No one can deny that nature is making some kind of comment on sexual behavior through the AIDS and herpes epidemics" and "Attend worship services regularly." The parents won, and the school board was required to black out the offending material.

Project Reality stopped using Sex Respect in 1993 after a falling out with the curriculum's writer. It had begun to develop its own materials--with the help of dramatic increases in federal funding for abstinence-only programs. In 1996 Congress attached a provision to the welfare-reform bill earmarking $250 million annually for abstinence education; states had to come up with matching funds for roughly three-fourths of what they got. Conservatives argued that funding abstinence-only sex ed would discourage teen pregnancy and out-of-wedlock births, reducing the public burden of "welfare moms." To get the federal funds, a program had to have "as its exclusive purpose teaching the social, physiological, and health gains to be realized by abstaining from sexual activity." It also had to teach that "a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity" and that "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects." In 2001 the Bush administration used the same guidelines to create a new stream of funding for abstinence education, setting aside $80 million, a figure that jumped to $167 million in 2005.

Over the years Sullivan, who's seen as politically astute by both liberals and conservatives, garnered more and more federal abstinence money, and Project Reality's current director, Macke, is also proving adept at acquiring those funds. Of the $2.8 million in federal monies the state got last year, $1.2 million went to Project Reality. The organization, which has a yearly budget of around $1.3 million, also got a small federal grant to evaluate its high school programs, and in October it was awarded another federal grant to take its services to the District of Columbia and parts of New Mexico and Florida. Federal abstinence money also goes to around 30 other Illinois organizations, mostly social service agencies.

Liberals often say that the federal government has never directly funded comprehensive sex education; that's technically true, though it does fund HIV-prevention and safe-sex programs that are open to teens through agencies such as the Centers for Disease Control and Prevention. Nationwide, comprehensive sex-ed programs outnumber abstinence-only ones, but since the mid-90s abstinence-only programs have gained ground and are now in around 35 percent of schools. According to the March survey of Illinois sex-ed teachers, over a third of them taught that abstinence is the only way to avoid STDs and pregnancy, and about two-thirds didn't teach students how to use a condom or any other form of birth control.

Project Reality publishes and distributes two textbooks that are widely used in Illinois and other states: A.C. Green's Game Plan for middle school kids, named for the famously virginal NBA "Iron Man," and Navigator for high schoolers. They contain no explicit religious references and no judgmental statements about the AIDS and herpes epidemics. But groups such as the ACLU complain that abstinence-only programs sometimes contain a religious message, even if it's not overt. Navigator includes a testimonial from a woman named Pam Stengel about a teenage girl who was raped and decided not to have an abortion but to have the baby and put it up for adoption; Stengel turns out to have been that baby, and she says she wishes she could tell her biological mother, "Thank you for giving me life." Project Reality also sells a video for young children, You Are a Masterpiece, in which a honey-voiced female narrator explains that life begins at conception. Still, most sex-education experts would agree with a lot of the books' and videos' content, including the information on establishing boundaries in relationships, understanding the onslaught of sexual images in the media, setting goals for the future, and seeing abstinence as the only way to guarantee that you won't get pregnant or get infected with an STD.

Most of the time Project Reality's books are used by schoolteachers as part of their regular classroom lessons, but the organization also has a small corps of its own teachers who visit schools, often spending a couple hours a week for a few weeks going through one of the books. In August I sat in as one of those teachers, Jose Feliciano, went through a chapter in Game Plan with a group of middle and high school students at the Mooseheart School, a residential facility near Batavia for kids who've lost their parents or come from troubled homes. He asked them to put on their "imagination helmets" and twiddle the knobs. As they tentatively placed their hands on their heads he said, "Imagine yourself that you're going to the future, ten years down the line." The kids listed the things they hoped to have by then: an education, three kids, a house, an impact on someone's life, a car, a dog. Abstinence, Feliciano promised them, would make all these goals easier to achieve.

Among the Project Reality videos teachers can use is First Comes Love, in which a fit, square-jawed man identified as Dan calls six students to the front of the room, gives each of them a plastic cup and a package of Cheetos, and pours water into each cup. He tells them to munch on some Cheetos, take a sip of water, swish everything around in their mouths, and spit into the cup. Then trade cups. Then take a drink. The class explodes in nervous laughter. "You're not going to do it, right?" he says. "Why not, Jasmine?"

"That's nasty," she says, her eyes widening.

Dan turns to the class and says, "So when it comes to sexual activity, anything in one person's body gets transferred to another."

It's a harsh yet basically true message about STDs. But critics of Project Reality claim that in its zeal to discourage premarital sex it sometimes distorts the facts, especially when it comes to what kids who are choosing to have sex can do to protect themselves against pregnancy and disease.

Both Navigator and Game Plan include thorough descriptions of STDs and frank discussions of the consequences of teen pregnancy, but as the Navigator teacher's manual says, "Navigator does not promote the use of contraceptives for teens." In its discussion of teen pregnancy Game Plan says, "Is 'birth control' the answer? Consider this fact: Most unintended pregnancies (53%) occurred among women who were using birth control." Navigator cites the same statistic.

The source of this information is the Alan Guttmacher Institute, a nonprofit that researches sexual and reproductive health. "The statistic as cited is taken out of context," writes Rebecca Wind, spokesperson at the institute, in an e-mail. "As originally written, this statistic illustrates the effectiveness of contraception. Nearly half of unintended pregnancies (47%) occur among the 7% of women who do not use any contraception, while the remainder (53%) occur among the 93% of women who were using birth control."

Neither textbook offers any information about birth-control methods or their effectiveness. "No contraceptive device is guaranteed to prevent pregnancy," states the Navigator teacher's manual. That's true, but the degree of protection can be very high. The Guttmacher Institute has found that in the first year of taking the pill the failure rate with "perfect use" is 0.3 percent. With "typical use"--which includes occasionally forgetting to take it--the failure rate is 8 percent.

Used right, condoms can also provide good protection. In 2000 the National Institutes of Health, along with a group of other federal agencies, convened a panel to evaluate existing research on the effectiveness of condoms. According to one clinical trial, when couples had used them consistently and correctly for six months pregnancy occurred 1.1 percent of the time. The rate was higher for people who were less experienced in using condoms. The National Survey of Family Growth looked at couples in their first year of using condoms and found that with "typical use"--which includes condoms breaking, slipping off, or being used inconsistently--the woman got pregnant 14 percent of the time. In their second year of using condoms that rate dropped by half.

Both Navigator and Game Plan show labels typically found on condom packages, which include the instruction to "read directions and warnings on carton." Navigator's teacher's manual asks, "What kinds of things have warnings?" The recommended answer: "Things that are dangerous." Project Reality head Macke says condoms give kids a false sense of confidence: "They have the impression that if they use them nothing will happen. There is still a risk. We feel it's important to point out the truth."

Navigator includes a page of charts labeled "Just the Facts." One chart shows an increase in condom use over a 13-year span. Another shows an increase in the rate of chlamydia infection over roughly the same period. The teacher's manual says, "If condoms were effective against STDs, it would be reasonable to expect that an increase in condom usage would correlate to a decrease in STDs overall--which is not the case. Rather, as condom usage has increased, so have rates of STDs." According to the Centers for Disease Control and Prevention, chlamydia rates have indeed gone up, but the number of cases of gonorrhea has declined to the lowest level on record in the United States.

Navigator also has charts showing, correctly, that the highest rates of gonorrhea and chlamydia occur in people ages 15 to 19. It asks, "How do you explain the fact that the age group reporting the highest rates of condom usage also have the highest rates of chlamydia and gonorrhea?" The answer stated in the teacher's manual: "There are many possible reasons for this phenomenon, including condoms being used inconsistently or incorrectly and condoms breaking or slipping. Some STDs are transmitted by skin-to-skin contact on areas not covered by a condom." It's true that some STDs are transmitted skin to skin, but the book offers no evidence that the people who got infected were using condoms.

One of Navigator's case studies is "Sherri," who was relying on condoms for protection but developed cervical cancer after becoming infected with human papillomavirus, or HPV. This is a common sexually transmitted disease: the CDC reports that at least half of sexually active men and women will get a genital HPV infection at some point in their lives. There are more than 100 strains of HPV, 30 of which are sexually transmitted. According to the CDC, "Most people who become infected with HPV will not have any symptoms and will clear the infection on their own." But it emphasizes that some strains cause genital warts and cancer.

Regular Pap tests allow doctors to catch cervical cancer early enough to treat it, but Sherri's story doesn't mention this, though Project Reality's manuals do state the importance of getting tested for STDs in general. The teacher's manual for Game Plan quotes the panel sponsored by the National Institutes of Health: "There was no epidemiologic evidence that condom use reduced the risk of HPV infection." It doesn't include the second half of that sentence: "But study results did suggest that condom use might afford some protection in reducing the risk of HPV-associated diseases, including warts in men and cervical neoplasia in women."

The Game Plan teacher's manual also has a chart showing that the NIH panel found that studies on whether condoms protect against trichomoniasis, chlamydia, herpes, syphilis, and gonorrhea in women were inconclusive. It doesn't say that the panel noted that some of the studies weren't thorough or well designed, or that the panel's report states, "The Panel stressed that the absence of definitive conclusions reflected inadequacies of the evidence available and should not be interpreted as proof of the adequacy or inadequacy of the condom."

The manual also cites the panel's conclusion that "consistent condom use decreased the risk of HIV/AIDS transmission by approximately 85%," then adds, "meaning that there is a 15 percent relative risk for heterosexual transmission of HIV/AIDS with consistent condom usage." It doesn't explain that the panel culled this finding from studies of couples in which one partner already had HIV.

"We didn't really get into the logistics of the studies," says Macke. "We felt like the teachers could read the study themselves." She points out that Game Plan lists an Internet address for the full report. "We're not trying to downplay the fact that there is some effectiveness involved."

In her view, Project Reality doesn't need to emphasize the protection condoms do afford, because kids can get plenty of information about them in our sex-saturated culture. She also argues that programs that do teach kids how to use condoms are inappropriate and much too sexually explicit. As evidence, she cites examples from a text for an HIV-prevention curriculum, "Be Proud! Be Responsible!" The teacher's manual suggests that students "brainstorm ways to increase spontaneity and the likelihood they'll use condoms. . . . Examples: store condoms under mattress, eroticize condom use with a partner, use condoms as a method of foreplay. . . . Think up a sexual fantasy using condoms. . . . Act sexy/sensual when putting the condom on. . . . Hide them on your body and ask your partner to find it. . . . Tease each other manually while putting on the condom."

This, says Macke, is what organizations such as the Chicago Planned Parenthood are promoting for Illinois schools. "Be Proud! Be Responsible!" is indeed on a Planned Parenthood list of 30 recommended sex-education curricula, though that list also includes "Smart Moves," which Planned Parenthood says "has a single message of avoiding sex, drugs, alcohol and tobacco"; "The Dynamics of Relationships," which is designed to help kids develop social skills; and "Postponing Sexual Involvement," designed for teens and their parents. Planned Parenthood also encourages teachers to review materials to make sure they're appropriate.

Sex outside marriage, Project Reality stresses, has emotional consequences and can be destructive. Navigator features a story about a young woman named Kimberly who was sexually abused by an older friend at the age of 12 and whose later sexual relationships made her feel "empty and hurt and broken." Sex with a college boyfriend, Jared, is no better: "I didn't feel loved by having sex with him--I felt like he took something from me," she says. "I asked him what he would do if I got pregnant and he said he would come visit once in a while but otherwise he had goals and dreams he wanted to pursue in life. I realized his plans really didn't include me. . . . Fortunately, I wasn't pregnant, but the next time Jared came over he brought a condom. I looked at him with disgust because he was only thinking about himself. I grabbed the condom and threw it across the room telling him to get out of my house." In the end she decides to save sex for marriage, restoring her "confidence and . . . hope for the future."

Both Navigator and Game Plan emphasize that premarital sex can lead to depression, anger, bitterness, and a "bad reputation." In First Comes Love a motivational speaker warns an auditorium full of high school students not to play "condom roulette," and someone else says that even if condoms protect you from disease or pregnancy some of the time, they "don't protect the heart." Another Project Reality video, Teen Sexually Transmitted Disease: The Rules Have Changed, states that teen sex increases the likelihood of suicide.

In 2003 the Heritage Foundation, a conservative think tank, did a study using data from the federally funded National Longitudinal Study of Adolescent Health, which tracked 20,000 12- to 18-year-olds, beginning in 1995 and following up with them in 1997 and 2002. Heritage looked at 2,800 14- to 17-year-olds and found that the ones who were sexually active, especially girls, were more likely to be depressed and to attempt suicide. But it offers no hard evidence that having sex caused their depression or their suicide attempts.

Supporters of abstinence-only curricula don't seem to be asking what the psychological effects are of telling sexually active teens that having sex before marriage will give you a bad reputation or that sex is like drinking someone else's spit-out bits of Cheetos. Or what the effects are of telling gay and lesbian teenagers that sex is permissible only inside marriage. Project Reality's textbooks don't discuss homosexuality. Macke says that if students have questions about their sexual orientation, teachers should refer them to counselors or their own "family values."

Masturbation isn't discussed either. Macke says it too should be addressed within families.

The books do say that all sexual activity is off-limits before marriage, a ban that includes "any type of genital contact or sexual stimulation." Macke concedes that this is a tall order for teenagers with raging hormones. She recommends that they redirect their urges into schoolwork or athletics and says they can acknowledge their sexual feelings by talking to trusted adults, seeking the support of their friends, and finding nonsexual ways to "communicate their love and respect." And she emphasizes that if they manage to hold out they'll be richly rewarded. An entire chapter of both Navigator and Game Plan is devoted to the benefits of marriage. The manual of Game Plan recommends teachers draw a diagram on the chalkboard showing that married sex offers "emotional bonding," "pleasure," and "fun."

The big question is, do abstinence-only programs work? Project Reality's programs have been evaluated by John Lyons of Northwestern University's medical school, who found that students who went through the curricula had a more positive view of abstinence. But the most telling studies go beyond teens' attitudes and look at their behavior.

One thorough assessment of sex-ed programs comes from the nonpartisan National Campaign to Prevent Teen Pregnancy. In a 2002 report called "Emerging Answers" researcher Douglas Kirby looked at a wide range of sex-ed programs. He says around 75 studies have been done in several countries on comprehensive sex-education programs. "The evidence is very strong that they do not increase sexual behavior," he says. "About two-thirds of all of them are effective, in that they have a positive effect on one or more behaviors." He says that no abstinence-only programs have been found effective but then they haven't been studied thoroughly enough yet.

Other researchers say there is some good evidence on abstinence-only programs. In March 2005 Hannah Bruckner, a sociologist from Yale, and Peter Bearman, chair of the sociology department at Columbia University, published a study on the effectiveness of virginity pledges using data from the National Longitudinal Study of Adolescent Health. They found that virginity pledges helped teenagers delay sex for about 18 months--a long time in the life of a teen--and that pledgers had fewer sex partners and got married earlier than those who didn't pledge.

But the researchers also found that pledgers and nonpledgers had similar STD infection rates and that the differences were statistically insignificant: among whites the rate was 2.8 percent for pledgers and 3.5 percent for nonpledgers, among Hispanics it was 6.7 percent and 8.6 percent, and among African-Americans 18.1 and 20.3 percent. In part this was because pledgers were less likely to use contraceptives the first time they had sex. For example, 40 percent of boys who pledged used condoms, compared with 59 percent of boys who didn't pledge. There was also evidence that pledgers were "less aware of their STD status" before the researchers tested them. Nonpledging girls were twice as likely as their pledging peers to go to a clinic to get tested for an STD. And perhaps most telling, 61 percent of pledgers had premarital sex before the end of the study (compared to 90 percent of nonpledgers).

When this study came out the Heritage Foundation quickly analyzed the same data, and in June it announced that the Bruckner-Bearman study was misleading and inaccurate. The Heritage analysis found that the difference between the STD rates of pledgers and nonpledgers was statistically significant and that there was "a broad array of positive outcomes associated with virginity pledging," including fewer teen pregnancies and out-of-wedlock births. No outside scientist has yet resolved the dispute, but it's worth noting that to date the Heritage report hasn't been peer-reviewed or submitted for publication in a scientific journal, standard procedure for scientific papers if their findings are to be seen as credible.

The outcome of this debate matters, because kids are desperately in need of sex education that works. Teen pregnancy has declined steeply--33 percent from 1991 to 2004--but the U.S. still has the highest teen-pregnancy rate of any Western industrialized nation. Across the country Hispanics and African-Americans are at particular risk. Illinois has the tenth-highest Hispanic teen birth rate and the third-highest African-American rate.

STDs are also a growing problem: one in four sexually active kids ages 15 to 19 gets an STD each year. And the rates of STDs among African-American teens in Illinois are staggering: they account for 58 percent of AIDS cases among adolescents, 74 percent of gonorrhea cases, 56 percent of chlamydia cases, and 84 percent of syphilis cases. Critics of abstinence-only programs argue that it's simply wrong to steer these kids away from using condoms if they're going to have sex.

On a humid morning in August at Sullivan House Alternative High School, a low-slung building on the city's far south side, Rose Harding is teaching a parenting class for four 17-year-olds. Spider (the students' names in this section have been changed) is lying on a cot resting his head on his arm. He has a baby daughter. Derek has two children, and Anita is pregnant and has a child at home. Only Phillip isn't a parent.

They're watching a Will Smith movie while they wait for Crystal Jacobs of ABJ Community Services and Christian Community Health Services, who's spent the past several years teaching an abstinence-only curriculum to teens through local organizations and in the Chicago Public Schools. Harding is all for safe sex. "We need condoms in here," she says. But then she adds, "I was just grateful to get programs this year." Besides, she thought, her students might take away some "positive messages" from a class on abstinence.

Battered copy of Game Plan in hand, Jacobs steps into the darkened classroom. Reluctantly, Anita turns off the movie, and the kids drag their chairs into a circle.

Jacobs, who's already gone through several chapters of the book with the class, settles into her seat. "Today we're going to be talking about consequences," she says. "Physical, emotional, social."

"I'm feeling you all the way," says Spider.

Jacobs asks the kids what happens when you try to play football without any rules.

"Crushed," says Phillip.

"In the hospital," says Spider.

"It's the same thing with sex," says Jacobs, explaining that when you have sex without rules you can get STDs. "We're talking about cancer. Cancer of the penis. A lot of times we have sexually transmitted diseases which can go untreated. We're talking about AIDS. We put that in a category by itself. Now I ask you, how would this affect your life?" No one says anything. "Cancer," she says.

"You talking about having it?" says Spider.

"Yes."

"Your child could have it too?" he says. "That would mess up his life."

"I speak as a single parent," says Jacobs. "It's a heavy burden. Ninety-seven percent of the time I don't matter. That's how I feel."

"I still feel that way," says Anita.

"Can babies have an effect on our finances?" says Jacobs.

Anita looks hard at her. "Yeah," she says.

"It's not cost-efficient to be a single parent," Jacobs says.

"Been wearing these flip-flops all summer," says Anita, looking down at her feet.

"It has an effect on our education," says Jacobs. "You want to be with your age group. Why should you miss your prom?"

"I don't even care about that anymore," says Anita. "I just miss sleep."

"I miss sleep," says Spider.

"You have to do what you're supposed to do when you're supposed to do it," says Jacobs. "That's how to be successful in life." She moves on to the next topic. "Emotional. How did somebody make you feel when you was engaged in this sexual activity?"

"Hurt," says Derek.

"Lonely?" says Harding.

"No, no, no," says Spider. "I ain't never been through nothing like that."

As the class goes on he shakes his head more and more. At one point Harding says disgustedly, "At the beach they let everything out. They're having sex in the water."

"Aw, yeah," says Spider, laughing.

"Sex is only honorable in marriage," Jacobs says primly.

"Who told you that?" says Spider.

"It's relig--I'm not allowed to bring that in," she says. "It's a mutually monogamous relationship. If I want a man to look I want to leave something for the imagination. It would be biblically sound, but I don't go into that. But most religions teach that it's inside marriage. Let's go to the hood." The boys snicker. "You want to holler at a female who's tight, who you know she ain't been out there. That's what you want, right?"

"Aw, yeah," says Spider.

"Just maybe she wants that too," says Jacobs, smiling.

"How you know that?" says Spider. "She's probably thinking about someone else right now." The boys break into raucous laughter.

"That stuff in the Bible," says Spider, looking thoughtful, "maybe that's true, but we don't really know. Why not go with what you know?"

"Sex is not a public event," says Jacobs. "That same young lady you looking for, pure and sweet? She's looking for you."

During this discussion Anita has kept her head down. Later Harding says the girl's father is in jail, and her mother's an addict, so she's living with her boyfriend.

"You talking about innocent," says Spider. "I don't want that."

"How do you feel about abstinence?" says Jacobs.

"I don't tell no one how I feel," says Spider.

At the end of the class Harding leans back in her chair looking relieved. She says that in the past when she's brought someone in to teach sex education, students have walked out. For many of them it was already too late. "They already know they have HIV," she says. "Their friends, their neighbors died from gangs and drugs. They don't care about death."

Spider has been standing nearby listening. "I'm going to die anyway," he says, and smiles.

Art accompanying story in printed newspaper (not available in this archive): illustration/Brian Gubicza.

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