Public policy and adolescent sexual behavior in the United States.

Abstract

Legislative acts and judicial rulings in the US in the last 2 decades have gradually broadened the rights of teenagers to obtain family planning services, abortion services, and sexual information. Despite this progress, adolescent pregnancy continues to be a major problem, and sex education for teenagers is highly inadequate. During the 1960s some progress was made concerning the rights of minors in sexual matters, but it was not until the 1970s that the courts fully recognized that mature minors had the right to obtain reproduction health services and family planning information without parental consent and that immature minors also had a right to these services, with the consent of an alternate adult, in the absence of parental consent. During the 1970s the federal government expanded its role in providing assistance for pregnant adolescents and in financing sex related programs for teenagers. In 1978 the Adolescent Health Services and Pregnancy Prevention and Care Act provided for the establishment of the Office of Adolescent Pregnancy Programs in the Public Health Service. The new office was assigned the task of coordinating the 85 federal programs aimed at helping pregnant teenagers and adolescent parents. By the late 1970s family planning services were available for most teenagers, and this improved accessibility led to a decrease in the adolescent pregnancy rate, most notably among black teenagers, and a reduction in the number of illegitimate births, especially among white adolescents. Although the courts recognized the rights of teenagers to receive sex education, progress in providing sex education programs in the public school has been minimal. Most states permit local jurisdictions to decide whether or not to provide sex education courses in their public schools. At the present time, only 31 states have policy statements concerning sex education, and only 4 states require sex education course. A recent sample survey of public high schools found that only 36% of the schools provided a course, or a course unit, in sex education, and in most of these schools, students were not required to take the course. Efforts must be made to rectify this situation in light of the extensiveness of adolescent sexual problems in the US. The proportion of young teenagers who engage in sexual activity is increasing, and the use of contraception among young teenagers is totally inadequate. In 1976 there were 780,000 premarital pregnancies among teenagers, and most teenage mothers leave school. Little is known about male adolescent sexual behavior, yet many teenagers rely on male contraceptive methods. Recent retrenchment in the financing for federal programs, and the efforts of the conservative right wing to curtail adolescent access to family planning services, threatens the progress made during the 1970s.