Manufacturing dissent

Ezra Klein quotes from the American Sociological Association's statement on gay parents to contradict Scalia's statement that sociologists disagree about whether gays make good parents.  I think that he could go one further.  Scalia is probably taking Mark Regnerus's recent study as evidence of dissent within sociology.  Problems with Regnerus's study have been covered extensively, due to the e.g., defining gay parents as parents who have ever had a same-sex relationship, no matter how short-lived, as well as the conservative funding sources. The right comparison is obviously between children of stable same-sex and stable opposite-sex relationships, rather than between children of unstable same-sex and children of stable opposite-sex relationships. 

Scalia may hold a view common among conservatives that academic consensus derives more from liberal bias than from knowledge, so are only interested in findings contrary to liberal views.  Like many, I would call that cherry-picking, but conservatives seem to regard it as a necessary corrective.  It's a huge problem, and it's why there seems to be a red reality and a blue reality.

Two similar examples in my research areas:

Out of ~12 studies on virginity pledges, 2 find that pledges work, and those are the ones quoted by conservatives, especially because the first study found that pledges work (Bearman and Bruckner 2001 in American Journal of Sociology).  I reanalyzed B&B's data using better methods and found pledges didn't work. 

Out of hundreds or thousands of studies on condoms' effectiveness in preventing STIs, one prominent study (Zenilman 1995) found that people who reported condom use still got STIs.  Zenilman concluded that the subjects had over-reported their condom use; right-wingers said the study proved condoms don't work, which resulted in CDC being ordered to remove information about condoms from their website during the Bush administration. 

The biggest examples are global warming and Keynesian economics.  In red reality, the 0.3% of scientists who "don't believe" in global warming matter more than the 99.7% who do, and Scalia's discounting of the academic consensus on gay marriage is just the tip of the melting iceberg. 

Birth control and the sexual revolution

Birth control, something practiced by nearly 100% of women, was once uncontroversial. Now, almost inexplicably, opposition to birth control has exploded.

Once upon a time, there were pro-choice Republicans. Now, not only has this breed become extinct, but it's no longer enough to oppose abortion. Birth control is now considered suspect.

It seems baffling to see such a reversal so suddenly. Social conservatives accept the standard narrative about the sexual revolution --- oral contraception allowed premarital sex, which caused the sexual revolution --- and they oppose it. Next step will be to reduce condom access, not just in schools, but also in stores, such as requiring them to be behind the counter and perhaps having age limits.

Telling kids to act as though the sexual revolution had not occurred, and teaching them that contraception is dangerous and ineffective --- abstinence only sex education --- didn't reverse the sexual revolution. The Congressionally mandated evaluation found that abstinence-only sex education did not decrease premarital sex. That failure was particularly embarrassing because some comprehensive sex education programs that teach about birth control decrease premarital sex.

Social conservatives' assumption may be that if birth control caused the sexual revolution, reducing birth control access might reverse the sexual revolution.

Unfortunately, they're wrong. Even before the advent of birth control, attitudes began to favor sex within loving non-marital relationships in the late 1940s and 1950s, as documented by sociologist Ira Reiss in his 1967 book, The Social Context of Premarital Sexual Permissiveness. (The entire book is available online for free at that link, and I highly recommend it.)

Even if there had been no oral contraceptive, there would have still been a sexual revolution. After all, in a society where sex within loving relationships is accepted, certainly people will find a way. For instance, withdrawal is only slightly less effective than condoms. The modern IUD is safe and effective. Diaphragms are safe and effective, if they are used without spermicide which could increase STI risk. And these methods may even be superior to hormonal contraception.

Elsewhere in this blog, I have spoken about shortcomings of oral contraception, according to my Second Wave feminist bias towards non-systemic, barrier methods of contraception. And I've spoken about problems with hookups, or as Reiss would say, permissiveness without affection.

Even if the conventional narrative were true, and birth control somehow caused the sexual revolution, it is not necessarily possible to reverse course and return to no premarital sex. How far will social conservatives go in attempting to reverse gains from the feminist movement?

Is parents' aversion to teens' sexuality an extension of incest norms?

Amy Schalet has an op-ed today about parents allowing a teen to have their boyfriend/girlfriend sleep over. I think she's right that it's partially related to sex education, but I think that answer is too facile.

Another issue that she doesn't mention in her op-ed: parents' aversion to thinking about teens' sexuality may also be about incest norms. I have known Dutch young adults who had their opposite sex parent sleep with them when the parent came to visit, and that would never be done in the US as well. Many Americans would find this unusual, at minimum.

Even the most liberal parents are comfortable with their teens' having premarital sex but hope that won't be until after the teens go away to college, and they are uncomfortable teaching their teens about condoms because they're afraid that sends the wrong message that sex now is okay. One question is whether the key ingredient there is the developmental stage represented by being 18 and at college, or whether the key is being AWAY at college. Are parents of boarding school teens relatively accepting with their teens having sex at age 16 since they're out of the house?

Conversely, what many Americans find strange about virginity pledges is how they violate incest norms by drawing the wrong kind of parental attention to teens' sexuality, such as this piece also this week in the NYT. (As an aside, the author also exhibits an all/nothing view about her "purity ring", saying that for awhile she felt that she had to take it off once she had sex, thus making her sexuality even less private than it would have been in a more liberal setting.)

Certainly in some cases, there's a prudery element, but I think it's a broader cultural phenomenon about whom Americans are comfortable talking about sex with, possibly relating to incest norms, which seem to differ between here and the Netherlands.

Commitment devices versus treatments

Andrew Gelman has an interesting point in a blog entry about religious commitment devices, such as a WWJD bracelet. He says that the bracelet is not a treatment, but rather it goes along with a set of behaviors and commitments, and it's a sign of that. This issue of commitment devices applies as well to my virginity pledge work: like the WWJD bracelent, the pledge may not be an intervention, but rather it could be a sign that someone has a certain identity, so the pledge itself isn't important.

Conversely, Gelman's argument could be critiqued on the grounds that there are folks who have the set of attitudes and behaviors, some of whom have the bracelet and others of them who don't, and conceivably, it would be possible to balance the two groups and get a treatment effect. Whether the treatment effect of wearing a WWJD bracelet could possibly be meaningful is a good question.

More thought needed.

Vows, oaths, and pledges

Rabbi Marc Angel explains why virginity pledges don't work, although he's talking about loyalty oaths in Israel, and why they are a bad idea: "To those who are loyal to Israel, oaths are not necessary. To those who are not loyal, oaths won't help."

Public vs. private virginity pledges

The abstinence movement has been marked by grand gestures, and yet Melanie Bersamin found that teens who promise themselves to abstain until marriage are more likely to delay sex, while teens who take virginity pledges are not likely to delay sex. I gave a presentation about virginity pledges recently, so when I read the following, I thought of it:

The first tablets of the Ten Commandments, given with so much drama, were
destroyed. The second tablets, given privately and quietly, survived and became
the spiritual foundation of the people of Israel.

The Me'am Lo'ez points to the moral of this story: the really important and
lasting things in life are often done by individuals in privacy, through their
own exertions. Things done with much publicity may not be as permanent. (Marc Angel)

Perhaps the virginity pledge movement was a victim of its own success: the public nature of the pledges, the 1.5 billion in abstinence funding, and the attempts to seem trendy may have been the sound and fury signifying nothing of the first ten commandments.

Abstinence-only music videos.

Washington City Paper features Top Five Abstinence Only music videos as well as a music video about the Christian Side Hug.

The potentially most negative video for STD prevention, "Ain't NO safe way" shows a couple in a drive-through. The man says no on the grounds that sex is dangerous. The woman holds up a condom saying vacantly as if hypnotized, "If they give these out in school, it must be safe." Her eyes widen further, unblinking, crazed, as she intones, "Don't worry. It's SAFE." "Safe" echoes in the background. Heavy metal music starts with "Wages of Sin = DEATH" on TV screens blinking in the background. (The boy says no, and gets out of the car, and the girl drives away disappointed.)

All five of these fall into the shaming language of "lose" and "take" virginity, and one girl even telling her friend "you should be ashamed" for having sex, as well as the ethnic stereotypes: many feature black women saying no to black men, and none feature Asians (who are disproportionately represented among virginity pledgers, but the stereotype is that they have no problem saying no.) Nor do they include black men turning down women.

Virtual virginity pledge

There's an ivirginity pledge application for the iphone catering towards the British virginity pledge audience. The bloggers have already had a field day speculating on what kind of activity this virtual purity ring will prevent. Interesting that it's a British group. Wonder if American groups will follow.

Evangelical Christianity and self-selection

Evangelical Christians have the goal that everyone within their fold adhere to norms such as abstinence from premarital sex. Clergy and active congregants adhere to the norms most of the time, but many evangelical teens have sex lives only slightly more conservative than the average American or European teenager. I've long wondered whether the reason for this discrepancy is that evangelical Christianity includes many people who, for whatever reason, are unlikely to adhere to all the norms.

Comparing religions can only be done in the spirit of "All models are wrong, but some are useful", so with that in mind I thought about religious self-selection in the context of some youtube videos making their way around some progressive Jewish blogs with enthusiasm and modern Orthodox blogs with hesitant, tepid approval, apparently spurred by an article in the Forward, a US Jewish newspaper.

This is a fantastic video of a secular Israeli girl band called "Woman of Valor" (Prov. 31) singing "Open our eyes to your Torah, cause us to cleave to your commandments, and unite our hearts in love and awe of your name" a line from the liturgy repeated over and over*. They also sing "On the rivers of Babylon" (Psalm 137) and "The angel who saved me" (Genesis 48). In the US, I would guess that this would be fairly standard evangelical Christian popular music, but in Israel it is Tel Aviv secular, performed at the Gay Pride parade, and so extremely exciting and outrageous**.

If the evangelicals are including the equivalent of the Tel Aviv secular who obviously connect to some aspect of the Bible and yet for whatever reason are not interested in some of the religious norms, programs like virginity pledges may reach only the Jerusalem religious who would abstain anyhow.

-------

(*) It begins "That we shouldn't ever be bashful or ashamed or stumble." There's also a rap segment in the middle that isn't a text also about connecting with the divine.

(**) Comments on the video are outraged. My translation of some of them:
- If they really believed what they sung, they would dress differently and they wouldn't dance like that and they would seem even slightly like daughters of Israel. G-d should have mercy on us, what a desecration of G-d's name.

- When someone sings to open our eyes to your Torah and be caused to cleave to your commandments when she is, pardon me, half naked is really not respectful. It's like going to the synagogue to pray in a bathing suit. Does that seem right? It's like the Maimonides's example of going into a ritual bath holding an impure reptile, doing something good but in an improper manner.

- I don't understand the connection between the meaning of the text and the clothing. They say they want to be open to G-d's commandments and they are not fully dressed.

MBAs and evangelical teens both take pledges

I was waiting for someone to make this comparison between virginity pledges and the pledges some business schools are offering to help their students not grow up to become Bernie Madoff and the subprime mortgage industry.

Truth be told, we don't know whether pledges and other one-time events affect behavior in general, but the common sense view that character is built slowly and reinforced over time would seem to prevail. We don't have as much knowledge about hidden areas of life such as sex and white collar crime, but we all know that New Year's resolutions can be helpful but not decisive.

The next stage in this comparison I'm still waiting for: a good stand-up routine comparing MBAs and evangelical teens, speculating on how you could do joint events to encourage both not having premarital sex and not becoming white collar criminals.

If banishing from the city doesn't work. . . no kissing until marriage

I love the title of this article True Lips Wait. A 22 year old is quoted as saying her first kiss was after the church wedding service in front of 200 people. That's about the age of marriage until which many evangelicals really do wait until marriage.

It's the clichee movie ending, but still it seems unusual (in my wine glass stomping Jewish perception) to kiss as a de facto part of a religious ceremony at all. But especially for someone who hadn't kissed at all before to have their first kiss in front of so many people, it seems particularly unusual to share such an intimate thing as one's first kiss with 200 people.

(I wonder when kissing at the end developed. Do any other religions kiss right after the ceremony? Which branches of Christianity? Variants of Eastern Orthodox? Are there any types of Protestantism that don't?)

Pastor calls to end virginity pledges

A Christian clergy member calls for churches to stop using abstinence pledges. Amusingly, one of his criticisms is that they are "pharisaical".

(In fact the Pharisees would not allow them: pledges have always been forbidden by rabbinic law!)

FAQ: Pediatrics paper

1. What's the connection between virginity pledges and abstinence education? All you know is that these people took pledges; they may not have been in abstinence education at all.

I looked at abstinence pledges taken in 1995 to about April 1996, at the beginning of the pledge movement. The first abstinence pledges were in 1993, True Love Waits (TLW) pledges from the Southern Baptists: a 6 hour curriculum over 6 weeks, and about half of program participants signed the pledge, according to Rev. Hester, and these numbers have not changed over the program's lifetime. School abstinence programs, the Silver Ring Thing (SRT), and other pledge programs did not exist at the time. I'm not aware of any casual virginity pledge programs from the time, but if there were, it seems unlikely that many participants would sign pledges or continue to identify with the pledges long enough to identify themselves as virginity pledgers on a survey. (Over half of the pledgers from the first two years of TLW retracted their pledge within a year after reporting it.)

2. Who's included in the study outcomes?

The same proportion of pledgers and similar non-pledgers got married five years after pledging, but because married couples are at low risk of STDs, I looked at only singles when looking at condom and birth control use. Whether or not married people use condoms and birth control has virtually no impact on public health. Married people were, however, included in every other outcome: oral and anal sex, STD test results, etc.

3. Even the non-pledgers didn't use condoms at perfect rates. Why not?

About 54% of non-pledgers used condoms "most of the time" or "always", versus 42% of non-pledgers. But there are 46% of non-pledgers who are not using condoms "most of the time." When you are dealing with entire populations, one can't expect perfection or even close to it, and yet when you move an indicator for an entire population by even a few percentage points --- increasing the proportion of people who use condoms, take statins, eat enough vegetables --- it can have an enormous impact. Looking at a range of behaviors, the proportion of people who don't make the "most beneficial" choices is really staggering, and the health and economic system just has to learn to work around these choices to encourage the best behavior. Unfortunately there just doesn't seem to be a condom equivalent of automatic enrollment in retirement plans.

4. Delaying sex is good for teens. Doesn't that mean we should have more abstinence education?

See my oped in the Baltimore Sun.

5. I have idea X for a sex education plan. Will it work?

The National Campaign to prevent teen and unplanned pregnancy has a great publication called Emerging Answers that describes sex education programs that work and lists characteristics of successful programs. It's available here.

6. The public health world says that any sex is okay as long as it involves condoms, and seems to assume that teens are "sexually incontinent" and that "chastity's relevance to contemporary culture ranks with that of buggy whips and slide rules.". Isn't teaching teens about birth control like telling them that we expect them to have sex? Shouldn't we teach higher standards?

First, I think the language is terrific: "sexually incontinent" is a punchy phrase and buggy whips and slide rules is vivid and sharp.

On the substance: Delay is clearly best. The public health world finds unequivocally that people with younger sexual initiation are at higher risk for STDs (higher risk for chlamydia and gonorrhea persists to about 17 or 18, high risk for HPV I understand persists into early 20's), less likely to use birth control, more likely to have a large age difference with their partner (sketchy and unsafe), and that two thirds of teens who have had sex say they wish they had waited. Correct and consistent use of condoms protect completely against fluid-transmitted STDs such as chlamydia, gonorrhea, and HIV, but condoms protect against contact-transmitted STDs such as HPV and herpes only to the extent that they cover.

On the other, see my oped in the Baltimore Sun.

7. The study is "liberal ideology disguised as science" (quote of head of Illinois Right to Life): it looks at 16 and 17 year old abstinence pledgers, instead of younger ones who are at the crucial ages to take pledges.

It's ironic that an abstinence proponent is irked at the subject group restrictions because many abstinence proponents are actually the ones responsible for limiting the study's ability to look at younger adolescents. My data comes from a multi-million dollar project funded by Congress, and when this study was being debated in Congress, many social conservatives objected to asking questions about their attitudes towards and knowledge about sex and birth control to adolescents ages 12-14 (e.g., "Would you feel guilty if you had sex?" and about 50 other questions). These questions are crucial factors in understanding why someone pledges, so I had to omit the 12-14 year olds since they were not asked these questions.

I also took out anyone who had had sex, so these kids at an average age of 16 had not yet had sex and few had much sexual experience at all, so the generalization that it's important to get them while they're young doesn't apply to the same extent.

8. Aren't you a liberal youth homosexuality promotion group? (The first comment.)

No.

9. Should this be the death knell for abstinence-only? Should the item be cut from the budget because
it is clearly wasteful?

Cutting the $200 million may be unnecessarily risky: redefining the program as abstinence-plus would preserve the funding. If the program were entirely cut out, it might not be replaced with effective sex ed.

10. Where does it say that programs may measure virginity pledges and don't have to be medically accurate?

From the GAO study on abstinence education.

Less than 5% of the total federal abstinence budget goes to programs required to be accurate: these come from a different funding mechanism than the program that grew so rapidly since its creation in 1996. Also, some states require the curricula to be accurate; if these states are among the 25 states still getting abstinence funding (originally all 50 were applying for this funding), they review the curricula independently.


11.
"Abstinence-only" is an unfair term: it implies that the curricula are simplistic just say no, but our program does more than that.


That's not a question. Addressing the point, though, the 8 part definition of abstinence-only education in the law requires one-sided education: by definition, abstinence programs have the exclusive purpose of showing the benefits of abstaining from sex. Abstinence programs can teach people to plan their lives and negotiate and all kinds of great personal development lessons, and that's great, but they cannot teach people the benefits of using condoms: they can only say where condoms fail. That is, they can say condoms do not protect fully against HPV and herpes (which is true). Because virtually no abstinence programs are required to be medically accurate, they can also say untrue things such as that condoms do not protect against HIV. They cannot say that correctly used condoms protect completely against chlamydia and other fluid-transmitted STDs, or teach how to use condoms correctly.

Media coverage of Pediatrics paper

I had my last media interview today, so here's the final list of coverage of the Pediatrics paper.


Professional Journals:
British Medical Journal
American Psychological Association Monitor: Coming

TV:
Today Show
(Columbus ABC TV - consulted)
[WJZ TV Baltimore]

Radio:
WABC New York: Curtis Sliwa Show
KFBK Sacramento.
Family News in Focus Radio
KGO AM San Francisco: ABC News
KPCC Air Talk.: 30 minute call-in show.
Colombia La FM Radio: largest radio station in Colombia
Newstalk Radio, Dublin
Fox News Radio: WINK Fort Meyers, KFAB Omaha, KCMO Kansas City, WGST Atlanta, KOGO San Diego
Doctors' Radio: 1 hour call-in show on xm/sirius satellite radio.
[CBS News Radio]
Indiana Public Radio: Sound Medicine: Coming 2/8/09.

Print:
Washington Post
Reuters
British Medical Journal
New Scientist
Bloomberg
Time Magazine
US News and World Report
Christianity Today
[USA Today]
Baptist Press

OpEds:
Ellen Goodman, Boston Globe
Kathryn Lopez, Washington Times
William McGurn, Wall Street Journal
Cheryl Wetzstein, Washington Times: She also mentions my advisor and collaborators' study.

Web: written or audio
CNN.com: Top 3 emailed article.
Huffington Post
Christian Post
Health.com: this is the original of what CNN used, but the CNN one got broader coverage.
Health Day
Health News
MedPageToday.com: with audio
Time Magazine Q and A
FoxNews.com
World Health News Today (video): coming?


Based on the abstract:
Medical News Today
Web MD

Non-peer-reviewed research

I'm disappointed that former director of the NIH
Bernadine Healy is citing non-peer-reviewed research. A director of the NIH should know better.

Specifically, she cites of Robert Rector and colleagues at the Heritage Foundation. I read the paper when it came out and found two things notable.

First, research papers are always named with a descriptive title that at best suggest their conclusions to maintain objectivity. The title of their paper was a headline: "Teens who take virginity pledgers have markedly improved life outcomes."

Second, it was extremely thin on both psychological theory and statistics, without which no one can be sure that they didn't just seek out factors that yield the results they want without correction. Given that the paper had a headline rather than a title, the idea that the conclusions preceded the study is not particularly far-fetched.

The advantage of matching on the other hand ensures that you can't search for results: you get a match and once you settle on that being the right match, then you find out what the results are.

Baptist Press article

Today's article in the Baptist Press gives my views a surprising amount of space: the writer just put my email responses to her questions in the middle of her article. I'm glad I checked my spelling!

There's an interesting quote from Rev. Ross, the co-creator of the virginity pledge: "We know of no secular or even religious campaign that is as comprehensive and life-encompassing in its approach to moral purity [as the True Love Waits pledge]."

That seems far-fetched. Both Jewish and Muslim religious law bar men and women from any affectionate physical contact or from being alone together. Certainly those are more comprehensive. If more than 50% of those who keep the laws marry having never had any kind of sex (an upper bound of virginity pledges' effectiveness) --- and I think that's likely --- they are also more effective.

Abstinence satire

1. My study inspired this funny satire of abstinence education: "Abstinence Education Not Working; Conservatives Shifting Focus to High School Marriages"

BROOKLYN, New York, 2009-01-05 — Following a recent study showing that vows of celibacy had no effect on pre-marital sex, conservative groups are now shifting to a program they are calling 'Get Married Early and Have Lots of Sex.'

...

In its official response to the proposed changes, the ACLU complained that the program would strengthen the institution of marriage, reduce the number of abortions, and impair Americans' ability to have sex with underage teenagers.

2. Alert reader Jonathan Liu (I've always wanted to use that phrase) sent this ad for Passionex: "self control in a bottle". Slogans: "Because now is not the time"; "Just because it fits doesn't mean it goes there."

"Passionix™ is the innovative new solution to the passions that can override the judgment of our youth and lead them into temptation."

It's part of an intricate web of a ministry spoof called Citizens of Virtue. Which looks half real.

Waves of coverage

I don't know why I didn't notice the waves of coverage before, but it helps to be aware to have appropriate talking points for each wave.

1. Factual articles: motivation for paper, what it adds, main findings, conclusion, take-away point. Mostly in print media.

2. Reaction articles and 5-10 minutes radio interviews. Presumably people have already seen the factual articles in whole or part, so findings are presented briefly by someone else. They want to know findings in 1 sentence, take-away point in 1-2 sentences, why for each finding. Then they ask a bunch of questions well beyond the scope of your paper, and if you answered the questions as asked you would be speculating, so you need things to say that you are qualified to say related to their questions.

My favorite question from a radio interview, "Do couples who have sex have better relationships than couples who don't have sex?" I still don't know what I could have said.

Special interest press will pick out a tangential issue and expand on it so it seems like your study was about the background issue.

3. Call-in shows are like radio interviewers with more personal examples. The personal examples may line up exactly with your take-home points, which is extremely gratifying, or they may be interesting but something you only have anecdotal experience with.

4. Reactions to reactions: Party X raises objection Y. Talking point: One 20 word quote if it's a reasonable objection.


The hardest part, I find, is expanding the limits of what one can say. Medical journal papers are so extremely circumscribed, while press coverage asks about all kinds of issues that one could never justifiably publish in a medical journal without a whole separate study that one didn't do, so you just have to quote literature over and over.

Teaching birth control less controversial than thought?

1. The CDC removed information about condoms from its website several years ago, but it just returned the information.

2. I've been corresponding with one of the leaders of the virginity pledge movement, an evangelical minister. In his most recent email, he said that he thinks that virginity pledge leaders are probably all over the map on the question of teaching birth control in schools. That is, they want to encourage abstinence, but that's independent of what they think schools should teach in sex education class. Very refreshing!

I wish I'd known that when I was being ranted at by a Fox News Radio host about how schools "emasculate parents" by teaching birth control. I did tell a Fox News website writer. I'm curious how that will come out.

3. An article about an AME church in Albany that switched from abstinence-only to abstinence-plus approaches.

Sending messages to kids

Only one radio station so far has really pushed this "if you teach birth control, kids get the wrong message" idea. In fact, over 90% of parents, and even Sarah Palin, say kids should learn birth control in schools. Afterwards I looked at their webpage, which has a button at the very top for a "Babes Page", and an ad immediately after this segment had a couple of adults making sexual innuendo before going to a home improvement store. What kind of message is that sending to kids?

I don't mean to be all "This is a feminist bookstore; we have no humor section.", but which one is more salacious: the Maxim Hot 100 or a condom demonstration in the style of an airline instructional video?

The officially religious contexts are at least consistent. The Southern Baptists have no Babes Page.


(Btw, an amusing Israeli one for the Hebrew speakers.)