What is Love?

In July last year I wrote about a guide for parents by the Family Education Trust(aka Family & Youth Concern) about Sex and Relationships Education (SRE). Not content with trying to cause fear and loathing in parents, now they have written a leaflet for teenagers called What is Love?

The leaflet would be easily dismissed as the work of yet another small but vocal Christian group trying to impose their moralistic values on young people were it not being sent to all secondary schools.

For anyone unfamiliar with the FET, run by Norman Wells, it's a Christian organisation with a certain not entirely unexpected agenda. There is no mention of faith in the leaflet, however. Is that because the FET has realised young people don't like being preached at and is trying to be covert?

So what is love? In a nutshell, love is just saying no to the ugly sex until you are safely up the aisle. Or terrible, terrible things will fall upon you.

The leaflet is full of super advice. Here's a selection of it:

'First of all, we need to recognise that not all love is true. There is such a thing as false love and many people confuse it for the real thing'.

Because young people respond so well to being patronised... With any luck, most of them will stop reading at this point.

What is this false love? It's 'physical attraction, infatuation or lust'.

Just in case you've never heard of lust, there's a helpful definition: 'Lust is the longing to use another person for the fulfilment of your own selfish desires... You will never find love through sexual encounters based on lust. Lust will leave you empty, frustrated and unfulfilled every time'.

Just in case we can't understand that, there's a case study about Tom and Jen who spend a lot of time chatting online and texting and 'who find in each other the fulfilment of their sexual desires'. Call me cynical but I strongly suspect they are Made Up. It sounds to me like they're having a pretty good time. But no, their relationship is doomed to fail because they are being Selfish.

Poor Tom and Jen don't know that true love 'will last a lifetime', it is 'more powerful than the strongest feelings and emotions'. Huh? Love is not a feeling or emotion?

So what should they do? 'When you truly love someone, you will keep yourself exclusively for them. This is one of the reasons why sexual intimacy belongs in marriage'.

Here we go. The abstinence message. Once more, with feeling: all the evidence says abstinence teaching doesn't work.

The Government has been consulting on guidelines for SRE. The second reading of the Bill is on 11 February 2011. The consultation document clearly states that 'research evidence does not support the use of an approach to sex and relationships education that only teaches abstinence' and 'that schools should use a range of evidence-based teaching methods'. Has the FET squeaked in under the wire before the Government guidelines are finalised in case abstinence-only teaching is banned and no school would be allowed to use or distribute this leaflet?

SRE is not just about sex, it covers all kinds of relationships and how to negotiate them, how to cope with bullying, how to be a responsible adult and so on.

In the document for parents about sex education, the FET mixes propaganda with what I shall charitably call factual inaccuracies, such as: there is no good evidence against abstinence, that teenage pregnancies are rising therefore sex education doesn't work and should be abandoned, that there are moral absolutes, that homosexuality is not a 'normal and natural lifestyle'. The FET believes that 'young people do not need to learn about a wide range of 'sexualities' and sexual behaviours; they do not need detailed information about the full range of contraceptive methods and they do not need to be presented with a menu of sexual options from which they can make 'informed choices' when they feel they are 'ready' to become sexually active'. He adds that 'there are some sexual practices that it may be better not to know anything about at all, at any age'.

The FET policy is to treat young people like mushrooms - keep them in the dark and throw horseshit at them.

The parents' guide also states that: 'Modern sex education is characterised by a lack of honesty...'

That's an interesting definition of 'honesty' from an organisation that has a rather malleable relationship with the truth and evidence.

What's more, saying that sex belongs only in marriage and is only for reproduction isn't going to play too well with the very many children of single parents.

Research (as opposed to made-up stuff) shows that young people want honest, complete, fact-based sex education from people they trust, as Dr Petra Boynton has written about.

The message that postponing sex until you're ready is a good one but for most people, that won't be after they're married. Far better to teach young people how to negotiate sex so that it is pleasurable and safe rather than just telling them not to do it, which leaves them utterly unprepared when it does happen.

Not surprisingly, there is no mention of love between people of the same sex in the leaflet.

But what happens if we ignore you, oh wise ones?

'Where a sexual relationship is pursued to express passing feelings and emotions, it is ugly and destructive and will lead to misery and regret'. And of course you will get an STI.

This is starting to sound like a 70s teen slasher movie, the sort where a bunch of teenagers get together and anyone who dares to have sex gets killed by the possibly dead guy in the mask while the virgins survive. Maybe starring Jamie Lee Curtis.

Why do we need such sage words now?

'Young people today often expect to have a series of short-term relationships before they finally settle down with someone for life. Such casual relationships frequently prove to be a training ground for divorce rather than for happy and fulfilling marriages. But it hasn't always been like that, and it doesn't have to remain like that'.

Where is the evidence to back up these statements? It really isn't hard to look things up these days and get some statistics to back up your arguments. Except when they don't exist.

In what time and place were young people all chaste? In the Victorian era when the orphanages were bursting at the seams with illegitimate babies and an estimated 10% of the urban population had syphillis which, in one part of London, also killed 57% of infants? In Mediaeval times which needed legislation like the Special Bastardy Act of 1235? After the war when we were celebrating the survival of British Values? Compare the rates in 1945 with before and after here. Or maybe the FET is thinking about some other lost time and place, like Narnia.

Finally, there are some handy tips for finding true love. One of them is:

'It's a good test to ask yourself 'How does he treat his mum?' or 'How does she treat her dad?' It is quite likely that they will treat you the same way'.

This is deeply deeply creepy in many ways.

So hey kids - Don't do the ugly sex. Don't think about sex. Don't learn about sex. Sex is only ever to make babies after you get married. And don't enjoy it too much even then - which you probably won't if you've never learnt anything about it.

With any luck, the leaflets will get no further than the bins of schools around the country.

The evidence against abstinence stacks up

According to a recent report by the Centres for Disease Control in America, the rates of teenage pregnancy and STIs increased under the Bush administration (2001-2009) - despite its massive funding of abstinence programmes. There is a summary of the report here.

Janet Collins of the CDC commented that: "It is disheartening that after years of improvement with respect to teen pregnancy and sexually transmitted diseases, we now see signs that progress is stalling and many of these trends are going in the wrong direction."

The report found that 88% of pregnancies in 15-17 year olds were unplanned. Rates of chlamydia, gonorrhea and syphillis were significantly up. Nearly a quarter of women aged 15-19 had HPV in 2003-4 and a third of adolescents had not received birth control instruction by the age of 18.

The blame cannot be laid entirely at the door of Bush's pro- abstinence stance, but evidence points strongly towards it. When he was governor of Texas in the 1990s, he spent $10 million a year on abstinence education. The state still had the fifth highest teen pregnancy rate in the US.

Under his presidency, the spending continued, despite much evidence that it didn't work, including one report by the Guttemacher Institute. This states that a 9 year, $8 million evaluation of federally-funded abstinence-only-until-marriage programmes had no beneficial impact on young people's sexual behaviour. By the end of his presidency, over $1 billion had been spent.

Two other interesting findings from the CDC report are that nine out of ten states with the highest increase in teenage births voted Republican in 2000 and 2004. Also, young Hispanic women have sex less often than others but give birth more. One possible reason for this is that the vast majority of them are Catholic and are receiving even less encouragement to use birth control.

George Monbiot has an article about the CDC report in The Guardian where he writes that: A study published by the American Journal of Public Health found that 86% of the decline in adolescent pregnancies in the US between 1991 and 2003 was caused by better use of contraceptives. Reduced sexual activity caused the remainder, but this "ironically … appears to have preceded recent intensive efforts on the part of the US government to promote abstinence-only policies". Since those intensive efforts began, sexual activity has increased.

President Obama has cut funding to abstinence-only programmes but the National Abstinence Education Association is still pressing for funding, as is the Abstinence Clearing House with its links to all the 'evidence' for abstinence working. Some groups blame the failure on underfunding and say that programmes did not go far enough.

There's a good summary of pro-abstinence responses here. Some groups are now trying to rebrand themselves, talking about a 'holistic approach' and 'healthy lifestyle choices' in an attempt to claw back funding. One Christian blogger blames the increases in teen pregnancy on the media, and says rates would have been much worse were it not for Bush. She also says that rates are much higher in Europe, a sign of our moral bankruptcy - so the US is not doing so badly after all. Dogma and ideology continue their battle against science and evidence.

However, even though Obama appears to be on the right track in his own country, many US funded HIV/AIDS initiatives in the third world are still promoting abstinence, particularly PEPFAR, as I reported here. The latest partners in that initiative include pro-abstinence religious groups.

Too Much Too Soon - Fear and Loathing in Sex Education

Norman Wells of the Family Education Trust has written a guidance document for parents about the Government's proposed plans for sex education - now called PSHE - and has whipped up a predictable reaction in The Telegraph, The Mail and The Express.

The FET's website makes no overt mention of religion, it promotes 'family values'. But reading between the lines, it is clear where these values come from. Wells writes that sex is not intended to be just about the joining of two bodies together, but the joining of two lives. In the context of faithful, lifelong marriage, sexual intimacy expresses the total self-giving of a husband and wife to each other.

If sex is intended to be anything, who is doing the intending? Once the hand of God becomes clear, what follows is pretty inevitable.

Alongside the propaganda, there are a lot of factual inaccuracies, many of which appear to have been directly copied from the Christian Medical Forum's submission to BCAP that I wrote about recently (and also here). They both claim, for example, that there is no good evidence against abstinence, that condoms are not 100% effective and therefore should not be promoted at all, and that STIs and teen pregnancy are rising therefore sex education doesn't work. One of the FET trustees is Stammers - who wrote one of the papers the CMF cited in its submission.

It is true that STIs and teen pregnancy are a serious problem (although pregnancy is not as much of a problem as certain groups make out, as I mentioned in the previous link). It's also true that sex education is far from what it could be and that parents need to be much more involved and supported. This is hardly a new issue - anyone remember The Specials' Too Much Too Young? 

However. And it's a big however.

Wells' guidance is dangerously misleading. Its main target is not just the Government's plans for PSHE, it is sex itself. The usual mix of fear and loathing that has infected hard-line Christians since St Paul is in full flow here. Early on he says that behind plausible-sounding arguments and innocuous-sounding words there is a specific agenda at work to undermine the role of parents and to tear down traditional moral standards. Sex education is an ideological battlefield on which a war is being waged for the hearts and minds of our children.

This emotionally over-wrought opening sets the tone for the whole guidance. As if he doesn't have his own agenda. Frequent use of the word 'children' rather than 'teenagers' ups the emotional ante too.

Wells' three main points are:

1. Parents should teach children about sex
2. Sex should only ever happen within marriage
3. Anyone who suggests otherwise (including the Government) is destroying the moral fabric of society.

His concern is that making PSHE statutory in the curriculum would inevitably reduce the influence of parents over what is taught. His modus operandi is to scare parents that the Government (who let's face it, most Telegraph, Express and Mail readers did not vote for) is going to turn their children into rabbits - pregnant, infected rabbits merrily having abortions with the schools colluding to keep parents in ignorance until society comes crashing down around us. I am not exaggerating.

It is a parent's right, he maintains, to teach children about sex in accordance with their religious beliefs. That's the parent's beliefs, not the child's. They should have the right to take children out of PSHE classes.

Parents should speak about sexual matters with modesty and restraint.  If the child's entire education consists of the parent saying 'no sex before marriage' then that is all they will learn. Any misinformation the parent gives, knowingly or not, will be all the child has to go on. Presumably there will be some additional information on the wedding night about what goes where.

There is no need even to teach children the correct names for body parts because all parents talk to their children about their bodies when they wash and dress them from their earliest days and are well able to decide whether to use the proper biological terms or other names for their private parts. So it's fine for a child to grow up thinking it has a woo-woo? Or that 'down there' is something no nice child ever talks about, let alone looks at or - heaven forfend - touches?

Many parents do not feel confident or comfortable talking about sex and schools need to give them full support. However, the religious position is that this support comes from faith, not the classroom - unless schools are free to peddle the religious line too. Wells' main reason for wanting sex education to come from God (via the parent) is that this will instil morality, not facts. He rails against the Government outlines: there is no recognition of moral absolutes and... young people are not to be given any clear moral direction... there is no such thing as objective right and wrong. 

Well, that's because there isn't. Only the most religious believe that there are divinely handed-down moral absolutes. And what are these moral values? Homophobia is quite clearly one of them; it is casually strewn throughout the guidance as PSHE will, he claims, equate marriage with same-sex civil partnerships and ... assume that both types of relationships are of equal benefit and stability... it is almost certain that homosexuality will be presented as a normal and natural lifestyle choice.

So what should young people be taught?

Wells does not want them given any information they could use because it is not informed choices we should be aiming for, but wise, moral and lawful choices.  It's the old argument that if you tell them about it, they will rush out and do it. Even mentioning the word 'gay' will of course instantly turn a child from the straight and narrow.

Wells is so anti-choice it's not funny. Contrary to the prevalent view among sex educators, young people do not need to learn about a wide range of 'sexualities' and sexual behaviours; they do not need detailed information about the full range of contraceptive methods; and they do not need to be presented with a menu of sexual options from which they can make 'informed choices' when they feel they are 'ready' to become sexually active. Modern sex education is characterised by a lack of honesty, a lack of modesty, a lack of any moral framework worthy of the name, and a lack of respect for marriage as the proper context for sexual expression.

A lack of honesty? Is keeping young people in ignorance honest? Not only does it risk their health, it also means that they are likely to pick up what sex knowledge they do get in the playground or through experimentation.

He continues: Teenagers need to be taught that reproduction is one of the primary functions of sexual intercourse and sex should therefore be set in the context of a faithful, lifelong relationship (ie marriage), which provides the most stable environment in which to raise children. 

Wells believes that if parents teach about sex in a (Christian) moral, modest and respectful way, this will prompt young people to save themselves until marriage (that word 'saved' again). Abstinence is the only way. This stance is woefully ignorant of human nature and teenage nature in particular. A bit of a moral lecture, maybe some praying and some vague information about the mechanics of sex (if they're lucky) is hardly going to quench teenage hormones. And is terrifying them with the wrath of God really going to produce mature, healthy and responsible adults?

My particular favourite part of the guidance is there are some sexual practices that it may be better not to know anything about at all, at any age. Sadly, he does not go into any further details.

There is much more to say about this pernicious document. The excellent Dr Petra Boynton will be analysing it in her blog.

Lying for Jesus? :2 Condoms

Following on from my previous post, the second part of the Christian Medical Fellowship's submission to BCAP concerns condom advertising on TV.


They note that the Government's Independent Advisory Group on Sexual Health and HIV wrote to BCAP requesting a review of scheduling restrictions on condom advertising, noting that the UK had the highest teenage pregnancy rate in Europe and spiralling rates of sexually transmitted infections.


First off, it's western Europe. Secondly, as a PubMed article shows, such claims about pregnancy have been inflated by the media: International comparisons suggest that the rate is moderate and that the past six decades have seen a decline rather than a rise (...) We believe that the selective reporting of international and time comparisons by public policy makers results in a 'manufactured risk' and has more to do with moral panic than with public health.


This does not bode well for what follows. But back to the CMF with an open mind. Things can only get better.


Or not. They continue that: The presupposition in this proposal is that more condom advertising to an ever wider range of young people will reduce unintended pregnancy and offer some protection against sexually transmitted infections. Briefly, the evidence shows, instead, a correlation between the government's policy of increasing promotion of contraception and the very rises Baroness Gould [of the AIG] notes. (..) The negative effect of the 'message' trumps any possible positive medical benefits. (my bold)


Does the evidence show that promoting contraception correlates directly with an increase in STIs? It could well be that there are other confounding factors involved, for instance that contraception is not being promoted in the most effective way or that there are reasons for promotions being ignored. Did the rise occur before, during or after the promotion? Or it could be that the evidence doesn't show that at all. No trumps on the table just yet.


The CMF conclude that: Further promotion of condom advertising to children aged 10-16 is unnecessary and unethical.


Why is it unethical? Two papers are cited in defence of their assertion. One is Are condoms the answer to rising rates of non-HIV sexually transmitted infection? No by Stephen Genius. This is a response to a previous piece called Are condoms the answer to rising rates of non-HIV sexually transmitted infection? Yes by Steiner and Cates.


The Steiner/Cates article is a balanced one citing strong evidence that condom use is effective in reducing STIs and unwanted pregnancy but making it very clear that condoms are not the whole story; better sex education about risk avoidance and reduction is essential, with condoms as part of the package. It warns that We need to focus on ensuring consistent and correct condom use rather than denigrating condoms as being less than perfect.


However, Genius' response does just that. His basic position is that condoms cannot be the definitive answer to sexually transmitted infection because they provide insufficient protection against transmission of many common diseases [such as] "Skin to skin" and "skin to sore" infections.


But no one is saying that they are. As all students are taught right from the start - answer the question in front of you, not some other question that you've prepared better for.


Ironically, Genius states early on that A fundamental tenet of medicine is adherence to scientific fact and experiential evidence to develop treatments and programmes that maximise and sustain health and later that Political correctness and ideological interests need to be usurped by sound science. But then he proceeds to cherry-pick data that back up his anti-condom stance. He doesn't even address the main point of the piece he is responding to, which is that condoms can work as part of an educational package. His response is that any package must be a moral one only.


Genius' other objection is that many people do not bother with condoms or do not use them properly, particularly if they are drunk or have taken drugs: protection is usually compromised by compliance issues, incorrect use, or mechanical failure. One of the supportive responses to his article adds that When you talk to young people, it is still considered uncool to carry condoms with you.


So his two arguments against promoting condoms are that they don't protect and most people don't use them properly anyway (which is irrelevant if they don't work).


Instead of recognising that the rising rate of infection is a complex problem, Genius is against anything at all that may reduce risk except for abstinence because: The more that sexual behaviour is trivialized, the greater will be the numbers of those involved in casual behaviour. The correct strategy is to promote responsible sexual choices by young people and television can have great power for good here (...) Those for whom condom knowledge is relevant will find it anyway, and the ever increasing trivialization of sexual behaviour will damage more and more children and young people.


Rather than seeing condom adverts as a way to make condom use more acceptable and more widespread, he disingenuously and consistently tries to discredit condoms to give his moral position some scientific authority. His simple solution to a complex situation is: Just say No.


His other point about condom knowledge being easy to find is the same point that the CMF make about abortions, which I dealt with in the last post.


This promotion of abstinence and warnings about 'trivializing' sex is based on as little reality as the Catholic Church's attempt to prevent teenage girls having the HPV vaccine because it would encourage them to have sex. After protests they reluctantly allowed the vaccine as long as no sex ed accompanied it, thus leaving them vulnerable to every other kind of infection, along with pregnancy.


The second article the CMF cite in support of their submission is written by Stammers, a trustee of Family Education Trust and Challenge Teams UK; both charities provide abstinence centred sex education packages to secondary schools in the UK. He is also a (volunteer) web doctor for Love for Life, the largest provider of abstinence centred sex education to schools in Northern Ireland, and did paid consultation work for them in the past.


Right away, the card are on the table this time. But again, let us not jump to conclusions before looking at the evidence. Being a Christian does not preclude being a good scientist...


Stammers position is that abstinence taught by parents is the answer, the only answer. He thinks, rather quaintly, that 'saved sex' is a more useful term than abstinence and asserts that: The false assumption that "young teens will have sex anyway" is an insult to many young people who have the capacity to rise to a far more effective challenge than just "use a condom every time".


He also says that Of course, to be involved in this way, parents have to be with their children and claims that the lower rate of single parenthood in the Netherlands is an important factor in the lower rate of teenage pregnancy.


This all fits neatly with the CMF'S own stated position that they are advocating marriage as God's intention for human sexual relationships.


So, saved sex and happy families will save society. Not condoms or sex education. Don't do it until you're married, then stay married and teach your children not to do it either. Easy.


Responses to this article in the BMJ are mixed, some in support of the moral stance, some pointing out the flaws in Stammers' argument and his biased starting point. To pick just one of the responses that challenge him:


Stammers' editorial on sex education raises a number of interesting public health issues. However, in the light of our recent investigation into abstinence-based programmes for HIV prevention in high-income countries, several of his assertions appear flawed on key methodological principles.


Recent research also contests Stammers' suggestion that declines in adolescent pregnancy rates (specifially, US adolescent pregnancy rates) are primarily attributable to delayed first sex.


It is interesting to note the contradiction between Stammers' suggestion that sex education studies assessing condom use make "false claims of success", and his acceptance of attitudinal outcomes of an abstinence-only programme trial as indications of "greatly enhanced" effectiveness.

The most methodologically rigorous systematic reviews to date have documented no behavioural or biological evidence that abstinence-only programmes can reduce sexual risk with respect to HIV infection or pregnancy, as compared to a range of control groups. (my highlighting, references to support this extract in the link above)


Flawed methodology, out of date information, cherry picking and pot calling the kettle black, then.


Whereas the part of the CMF submission dealing with abortion made overtly (and unsubstantiated) medical claims against it, this section tries to prohibit or severely limit condom adverts on moral grounds, using a spurious efficacy argument. At best, this is a muddled message; the efficacy of condoms is entirely separate from the moral question but the submission mixes the two. Not only that, the submission itself does not use the A word even though it is the principle message of the two papers. Why not, if this is their real agenda? Perhaps because it would undermine their attempt to appear scientific.


The CMF's moral recipe also appears ignorant of teenage behaviour. Teenagers do not need encouragement to have sex. Some do resist, for whatever reason, but it cannot be assumed that they will. For those who don't, there must be a safer way.


The CMF's preaching is masked as concern for teenagers and for society - the ever increasing trivialization of sexual behaviour will damage more and more children and young people - in the same way that their abortion propaganda indulged in hand-wringing about the dangers to women.



The mission is to save teenagers from themselves. The idea that the teenage sexual urge is something base to be overcome through the Grace of God is a primitive idea, harking back to Calvin and nodding to Descartes with his mind/body dualism. It also has echoes of Freud's concept of the id, the dark and lusty part of our nature to be smacked into submission if we are to be socialized (and, in religious terms, saved - that word again). And then there is the fear/hatred of sex that has permeated religion ever since St Paul. If you must have sex, wait until you're married and then do it only for procreative purposes, never ever for recreational ones. It is easy to caricature the CMF position because they lay themselves open to it with their disingenuous submission and their questionable evidence. But this should not distract from the real dangers that their position entails.



Unbiased commentators recognise that condoms are not the whole answer and that this is a complex issue; they see condoms as an essential part of a package based on evidence and real life, not just religious wishful thinking.

Addendum: Dr Petra Boyton has written in her latest blog about intitatives to reduce teenage pregnancy, something the CMF think are a waste of time.