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Does Sex Education Affect Adolescent Sexual Behaviors and Health?

Joseph J. Sabia

Abstract
This study examines whether offering sex education to young teenagers affects several measures of adolescent sexual behavior and health: virginity status, contraceptive use, frequency of intercourse, likelihood of pregnancy, and probability of contracting a sexually transmitted disease. Using data from the National Longitudinal Study of Adolescent Health, I find that while sex education is associated with adverse health outcomes, there is little evidence of a causal link after controlling for unobserved heterogeneity via fixed effects and instrumental variables. These findings suggest that those on each side of the ideological debate over sex education are, in a sense, both correct and mistaken. Opponents are correct in observing that sex education is associated with adverse health outcomes, but are generally incorrect in interpreting this relationship causally. Proponents are generally correct in claiming that sex education does not encourage risky sexual activity, but are incorrect in asserting that investments in typical school-based sex education programs produce measurable health benefits. 2006 by the Association for Public Policy Analysis and Management INTRODUCTION The prevalence of sex education courses in Americas schools has grown substantially during the last several decades. In 1979, 47 percent of all 17-year-olds had taken a sex education course (Oettinger, 1999). By 1994, nearly 90 percent had been offered such a class.1 During this same time period, the pregnancy rate of 15- to-17-year-olds rose from 32.3 per 1,000 women to 37.2 per 1,000 women (Alan Guttmacher Institute, 2004). These trends have led some policymakers to speculate on whether sex education causes adolescents to engage in promiscuous sexual behavior. The aim of this study is to explore the sensitivity of the relationship between sex education and adolescent sexual behaviors to unobserved heterogeneity. Sex education programs are of interest to policymakers for several reasons. First, sex education is viewed as an informational policy tool designed to reduce the future costs of teen pregnancy, as well as the costs of sexually transmitted diseases. Several studies have found that teen childbearing is associated with a modest decline in human capital attainment or future earnings (see, for example, Angrist & Evans, 1999; Bronars & Grogger, 1994; Hoffman, Foster, & Furstenberg, 1993; Klepinger,
1 This estimate was obtained via weighted data from Wave I of the National Longitudinal Study of Adolescent Health.

Journal of Policy Analysis and Management, Vol. 25, No. 4, 783802 (2006) 2006 by the Association for Public Policy Analysis and Management Published by Wiley Periodicals, Inc. Published online in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/pam.20208

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Lundberg, & Plotnick, 1999; Rosenzweig & Wolpin, 1995).2 Given that adolescents tend to imprecisely estimate the probability of teen pregnancy (see, for example, Forrest & Singh, 1990; Walker, 2001), sex education is viewed as a policy mechanism to enhance human capital accumulation. Second, while decisions about whether, when, and in what form to offer sex education have traditionally been the domain of local school boards and state legislatures, the federal government has become increasingly involved in funding these programs. During President George W. Bushs first term, spending on abstinenceonly sex education rose from nearly $80 million in Fiscal Year (FY) 2001 to $137 million in FY 2004. The proposed abstinence budget for FY 2007 is $204 million. However, despite the recent focus on abstinence funding, the greatest proportion of sex education funding is allocated to comprehensive, contraception-inclusive sex education. In FY 2002, $653 million was allocated for such programs. Thus, attention to sex education has become an important national political issue. Third, there is theoretical ambiguity as to the true impact of sex education, driving a passionate debate among policymakers. Advocates of sex education argue that a teenagers decision to become sexually active is largely independent of schoolbased sex education. They insist that sex education is necessary to provide contraceptive information to teens so as to reduce the probability of unwanted pregnancy should they choose to engage in sexual intercourse. Foes of sex education argue that exposure to contraceptive-based sex education will increase sexual activityand potentially increase the likelihood of pregnancyby signaling to teens that sex is socially acceptable and by lowering the cost of contraception. Hence, opponents tend to support either no school-based sex education or abstinence-only sex education. Credible estimates of the impact of sex education programs will contribute to a clearer understanding of this debate. Empirical work on the impacts of sex education has been hampered by the lack of nationally representative datasets that measure the time at which students are offered sex education, and the difficulty in disentangling policy impacts from correlations due to unobserved heterogeneity. Consequently, estimates of the impacts of sex education on teen sex-related outcomes vary considerably. This paper resolves some of the differences in the literature by comparing estimators that make different assumptions about selection into treatment. I analyze data from the National Longitudinal Study of Adolescent Health (Add Health) for students enrolled in seventh, eighth, or ninth grade in the 19941995 academic year. I examine how the offer of sex education affects several key outcomes: virginity status, use of birth control, pregnancy, frequency of sexual intercourse, and infection with sexually transmitted diseases (STDs). The empirical findings of this study suggest that a causal interpretation of crosssection estimates of the relationship between sex education and adolescent sexual behaviors would result in the nave conclusion that sex education causes adverse health outcomes, such as increased sexual activity and unchanged or decreased use of contraceptives. After controlling for selection on observables via propensity score matching and selection on unobservables via fixed effects and instrumental variables, I find little evidence that sex education is associated with changes in most adolescent sexual behaviors and health outcomes. While there is some evidence that family planning-focused sex education is associated with higher exit rates from virginity relative to other forms of sex education, there is no evidence that this form of sex education affects rates of unprotected sex or pregnancy. Taken together, these findings suggest
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While recent studies exploiting natural experiments (Hotz, McElroy, & Sanders, 2005; Hotz, Mullin, & Sanders, 1997) find little evidence of a causal link between teen pregnancy and lower future earnings. The children of single teen parents may also be adversely impacted by the absence of two adult, married parents.

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that the schools that adopt sex education programs for younger teens are serving students with the highest unobserved propensity to engage in risky sexual activity. Moreover, these results provide little evidence to support the claim that typical schoolbased sex education programs have important measurable health effects. LITERATURE The most exhaustive review of the empirical literature on sex education was conducted by Kirby (2001), who examined program evaluations that used both experimental and quasi-experimental methods.3 From his thorough review of the literature, he reached three broad conclusions. First, there is little empirical evidence that abstinence-only sex education programs influence teenage sexual behavior, though Kirby notes that such studies are sparse. Second, sexuality and HIV prevention programs do not hasten the onset of sexual activity and, in some cases, may actually delay first intercourse and increase contraceptive use.4 And finally, shortterm curricula, whether abstinence-only or contraceptive-based sex education programs, have little or no impact on teen sexual behavior. Intensive, long-term programs with specific, clear goals and well-trained instructors tend to have the largest behavioral effects. Among the programs that have had the most notable behavioral effects are those that have focused on developing teens social skills, such as sex resistance skills or negotiation/communication skills. While many of the experimental evaluations described by Kirby have a high degree of internal validity, many do not have high external validity because the programs are targeted toward specific at-risk populations. Moreover, many of the reviewed quasi-experimental studies have failed to adequately control for non-random participation in sex education programs, thereby diminishing internal validity. This study contributes to this literature by carefully applying quasi-experimental methods to a nationally representative dataset so as to offer more credible estimates of the effect of sex education. Much of the empirical work on sex education has estimated policy impacts using cross-sectional data (see, for example, Dawson, 1986; Ku, Sonenstein, & Pleck, 1992, 1993; Marsiglio & Mott, 1986). Several studies have found that exposure to sex education is associated with first intercourse at earlier ages and greater contraceptive use (Dawson, 1986; Ku et al., 1992, 1993; Marsiglio & Mott, 1986). Other studies have attempted to differentiate between types of school-based sex education policies. Ku et al. (1992, 1993) find that teaching sex resistance skills is associated with a lower frequency of intercourse, fewer numbers of sexual partners, and a lower probability of intercourse among male teens. Bearman and Bruckner (2001) find that students who take virginity pledges delay intercourse by 18 months relative to those who do not, but also are more likely to engage in unprotected sex when they do have intercourse. Though each of these studies makes an important contribution to the literature by estimating the effects of heterogeneous treatments, the results are suspect due to the potential for endogeneity bias. A few studies have used a randomized controlled evaluation technique to evaluate program impacts (for example, Aarons et al., 2000). Though randomized experiments of this form may have higher internal validity than cross-section studies using observational data, the generalizability of their findings is often suspect. For
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See also Kirby et al. (1994) for a review of the earlier sex education literature. Kirby (2001) cites, for example, the experimental evaluations of the Reducing the Risk program; Safer Choices: Becoming a Responsible Teen; Making a Difference: An Abstinence Approach to STD, Teen Pregnancy, and HIV/AIDS Prevention; and Childrens Aid Society-Carerra program. The Childrens Aid Society Program was a comprehensive program focusing on both sexual and non-sexual youth-related issues.

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example, in the Aarons et al. study, the sex resistance program evaluated was implemented in disproportionately black and economically disadvantaged urban areas. It is not clear that this program would have similar effects if it were adopted by schools with a more heterogeneous student population. Oettinger (1999) presents one of the most careful analyses of the impact of sex education using data from the National Longitudinal Survey of Youth 1979. His study was the first to present a theoretical model to explain how sex education affects teen sex choices. Using a proportional hazard model and controlling for family-level unobserved heterogeneity, he finds that exposure to a sex education course in the late 1970s increases the hazard of exiting virginity for females. This paper contributes to the sex education literature in four important ways. First, by comparing cross-section estimators to propensity score matched, difference-in-difference, and instrumental variable estimators, I am able to inform the extent and direction of selection bias. Second, in contrast to Oettingers use of retrospective data from the 1970s, I examine exposure to sex education in the mid-1990s, which is arguably more relevant to policymakers because the cultural environment has changed over the past several decades. Third, I estimate the impact of heterogeneous treatments, focusing on the impact of family planning-inclusive sex education versus other forms of sex education. And finally, while most previous studies have focused on the effects of specialized types of sex education programs, this study examines the effects of typical school-based programs that are implemented nationally. DATA The data used for this analysis come from the National Longitudinal Study of Adolescent Health (Add Health), a school-based, nationally representative longitudinal survey conducted in the 19941995 school year (baseline), the 19951996 school year (one-year follow-up), and again in 2001. Students, parents, and school administrators are interviewed for this study. I use data on 4,621 seventh, eighth, and ninth graders in 19941995, the population for whom junior high school-level sex education is targeted. The mean age of this sample is 14.3 years. There are five sex-related outcomes of interest for this paper: virginity status, contraceptive use at most recent intercourse, pregnancy, intercourse frequency, and sexually transmitted disease infection.5 Table 1 presents weighted means and standard deviations of dependent variables by gender, race, and age; the means of the dependent variables conditional on adolescents being sexual active are also presented.6
Students were given computers with headphones, allowing them to anonymously respond to sensitive questions so as to minimize reporting error. Respondents were assured that interviewers would never see their responses, nor would anyone be able to link their answers with their names. The Add Health survey items corresponding to these outcomes are as follows. Virginity status is measured by the following survey item: Have you ever had sexual intercourse? When we say sexual intercourse, we mean when a male inserts his penis into a females vagina. Contraceptive use is measured with the following survey item: Did you or your partner use any method of birth control when you had sexual intercourse most recently? Questions on frequency of intercourse were asked in Add Healths relationship supplement. Adolescents were asked, About how many times have you and [your partner] had sexual intercourse since [your date of first intercourse]? Pregnancy items were straightforward. Adolescents were also asked about sexually transmitted infections. The survey asked them, Have you ever been told by a doctor or nurse that you had: chlamydia, syphilis, gonorrhea, HIV or AIDS, genital herpes, genital warts, trichomoniasis, or hepatitis B? 6 However, the analysis to follow will not examine the effect of sex education on the conditional probability of pregnancy, STD infection, or contraceptive use. Credible estimates of this would require formally modeling selection into sexual activity via a Heckman-type model as well as addressing the endogeneity of sex education programs. This studys contribution is shedding light on the latter issue.
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Table 1. Weighted means and standard deviations of dependent and selected independent variables. (1) All Unconditional Dependent Variables First intercourse 0.176 (0.381) Intercourse frequency 1.26 (11.90) Pregnancy 0.026 (0.160) Recent unprotected sex 0.066 (0.248) Sexually transmitted disease 0.006 (0.076) (2) Females 0.161 (0.367) 1.33 (8.98) 0.015 (0.123) 0.067 (0.250) 0.005 (0.069) (3) Males 0.190 (0.393) 1.18 (14.20) 0.037 (0.188) 0.065 (0.246) 0.007 (0.082) (4) 8th GR 0.173 (0.378) 0.485 (4.19) 0.026 (0.158) 0.060 (0.238) 0.002 (0.040) 2.80 (9.75) 0.147 (0.356) 0.349 (0.478) 0.010 (0.095) 0.885 (0.320) 0.675 (0.468) 14.38 (0.606) 0.144 (0.351) 0.271 (0.445) 25.33 (5.60) 1,415 (5) (6) White Non-White 0.144 (0.351) 1.42 (13.27) 0.016 (0.124) 0.057 (0.232) 0.003 (0.057) 8.98 (26.71) 0.123 (0.328) 0.389 (0.488) 0.021 (0.144) 0.807 (0.395) 0.705 (0.456) 14.32 (1.00) 0.225 (0.418) 25.54 (5.29) 3,268 0.276 (0.447) 0.718 (5.68) 0.056 (0.230) 0.095 (0.293) 0.016 (0.125) 2.64 (10.57) 0.203 (0.403) 0.342 (0.475) 0.057 (0.232) 0.766 (0.424) 0.590 (0.492) 14.39 (1.14) 0.586 (0.493) 0.475 (0.500) 25.47 (6.49) 1,353

Dependent Variables Conditional on Sexual Activity Intercourse frequency 6.22 8.34 4.27 (22.50) (22.96) (19.89) Pregnancy 0.149 0.112 0.194 (0.356) (0.396) (0.396) Recent unprotected sex 0.373 0.415 0.339 (0.484) (0.493) (0.474) Sexually transmitted disease 0.033 0.030 0.036 (0.179) (0.170) (0.186) Selected Independent Variables1 Student offered sex ed 0.798 (0.402) Parental disapproval sex 0.678 (0.467) Age (years) 14.33 (1.04) Black 0.131 (0.338) Single parent 0.281 (0.450) Mothers age at birth (years) 25.50 (5.59) N2 4,621
1 2

0.797 (0.402) 0.769 (0.422) 14.26 (1.02) 0.134 (0.341) 0.284 (0.451) 25.53 (5.50) 2,405

0.799 (0.401) 0.589 (0.492) 14.40 (1.06) 0.129 (0.335) 0.279 (0.449) 25.48 (5.67) 2,216

Weighted means and standard deviations of other independent variables available upon request. Sample sizes for unconditional means. The sample sizes for conditional means can be calculated as the product of the unconditional sample size and the percentage of sexually active adolescents.

Approximately 16 percent of females and 17 percent of males reported they were no longer virgins, with more non-whites than whites (27.6 percent v. 14.4 percent) reporting having sexual intercourse at least once. Virginity information reported in Add Health compares favorably to other large nationally representative datasets. For example, the 1995 National Survey of Family Growth and the 1995 National Survey of Adolescent Males find that 24 percent of 15-year-old females and 27 percent of 15-year-old males were sexually active. This compares to 28 percent of 15year-old females and 30 percent of 15-year-old males in the Add Health sample. Almost 7 percent of the sample had engaged in unprotected sex at their most

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recent intercourse, with over one-third of sexually active adolescents not using contraception at most recent intercourse. A pregnancy was reported by 3 percent of the sample; among sexually active adolescents, approximately 15 percent reported a pregnancy. The mean number of times individuals in the sample reported engaging in sexual intercourse with a romantic partner was 1.3 (with a median of zero). Only a small percentage reported having a sexually transmitted disease (approximately 1 percent). The key explanatory variable of interest is whether the adolescent had been offered sex education in school.7 Approximately 80 percent of the students in the sample had been offered sex education at the time of their interview, with over 90 percent attending schools that offer sex education at some point during a students tenure. While not included in Table 1, but available upon request, a wide set of control variables are used in the analysis. Kirby (2001) reports that the key determinants of risky teen sexual behavior include measures of community disadvantage; family structure and economic disadvantage; family, peer, and partner attitudes and behaviors; characteristics of teens themselves, including biology, detachment from school, other behaviors that put young people at risk, emotional distress, and sexual beliefs, attitudes, and skills. The choice of right-hand-side variables is motivated by this synthesis of the literature. The control variables I use include dummy variables for age, race, and gender, AHPVT score (an aptitude test administered by Add Health), household income, school location, school size, whether the adolescent is attending a public school, urbanicity, religious attendance, weight perception, alcohol consumption, age of mother at birth of adolescent, whether the family is receiving AFDC, mothers educational attainment, mothers labor force participation, presence of older siblings, perceived parental attitudes about sex, whether the parent has spoken to adolescent about sex, and various measures of family structure. There are two important data limitations that hamper this studys analysis. First, Add Health does not provide data on whether students have received sex education in a particular grade, but rather whether sex education is offered. Thus, the estimates presented in this study are intent-to-treat estimates. The extent to which intent-to-treat estimates provide an unbiased estimate of the effect of the treatment on the treated will depend upon both substitution bias and dropout bias.8 Dropouts are one important concern. It is a common practice for schools with sex education courses to have opt-out options, whereby parents may choose to take their children out of such a class. Thus, in the presence of parental selection decisions associated with adolescent sexual behaviors, estimated treatment effects may be biased. However, a California-based study indicated that just two percent of parents withheld students from sex education when it was offered (Kenney & Orr, 1984). Moreover, a 1999 nationally representative survey of school superintendents reported that only five percent of local communities are divided on their school districts sex education policies, and only one percent are generally opposed to them (Landry, Kaeser, & Richards, 1999). This suggests that much of the selection into treatment occurs when parents and local school boards choose whether, in which grade, and what type of sex education course to offer.
School administrators were asked, Does your school offer sex education, or family life education, or education about human sexuality and/or AIDS or other sexually transmitted diseases? Administrators were also probed for the grade in which students are offered sex education. 8 Substitution bias might be a problem if untreated students receive treatment from an alternate source. Thus, I include controls for the presence of older siblings and parent-child discussions of sex. Dropout bias might be a problem if treated students drop out of treatment and do not receive sex education.
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A second limitation of the data is the lack of information on sex education course content. Given the policy debate over the potential differences in the impacts of contraceptive-focused versus abstinence-focused sex education, this is an important limitation. However, the Add Health data do contain information on other schoollevel sex-related programs from which the focus of a sex education course may be inferred. School administrators are asked whether the school provides or refers students to family planning services, family planning counseling, or treatment for sexually transmitted diseases. Schools that provide or refer students to such services and have sex education courses are also likely to have contraceptive information offered in their sex education classes. While an interaction of school policies provides an imperfect measure of sex education course content, it will allow for the differentiating of potentially heterogeneous treatments. METHODS Dawson (1986), Marsiglio and Mott (1986), and Ku, Sonenstein, and Pleck (1992, 1993) estimate the impacts of sex education using cross-sectional data. In vector notation, these models generally take the following form: Yij xi Sij
ij

(1)

where Yij is the outcome of teenager i in school j, xi is a vector of observables, is the return on observables, Sij is an indicator variable for whether teen i is offered sex education in school j, is the cross-section estimator of the policy impact, and ij is the independently and identically distributed (iid) error term. The cross-section estimator ( ) will only yield an unbiased estimate of the effect of the treatment on the treated if, conditional on observables, the mean outcome of untreated adolescents were equivalent to the mean outcome that treated teenagers would have had if they not been treated. This identification assumption will be violated if there is non-random participation in sex education via either selection on observables or selection on unobservables. Selection on Observables If there is insufficient common support on observables among treated and untreated adolescents, then the cross-section estimate may be biased because of selection on observables. I address this potential selection problem via propensity score matching. This is accomplished by constructing matched samples of treated and untreated teenagers based on observable characteristics. Following Rosenbaum and Rubin (1983) and Imai (2003), I estimate a probit model of whether a teenager is offered sex education: qic (xi zc ) (2)

where qic is the propensity score of student i in community c, ( ) is the standard normal distribution, xi is a vector of individual-level characteristics, zc is a vector of community-level characteristics, and and are estimable parameters.9
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Community characteristics may be important covariates in estimating the probability of being offered sex education because local economic conditions and social attitudes will likely influence school districts decisions. For example, communities with fewer religious ties and more liberal attitudes may be more willing to support school-based sex education.

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The process of matching treated adolescents with comparison adolescents is as follows: First, each student is assigned a propensity score (qic) from the above pro bit estimation. Then, each treated teenager is matched with a comparison teenager of the same sex, race, grade, and age10 who has the nearest propensity score. The nearest propensity score is defined as the minimum of |qic(x,z) qbc(x,z)| where the subscript i denotes the treated teenager and b denotes the comparison teen. I match with replacement, which permits the same untreated teen to be matched to more than one treated teen.11 Then, I estimate mean differences in adolescent sexual behaviors between treated and untreated adolescents. Selection on Unobservables Even if there is common support among treated and untreated adolescents, if there are school-level or individual-level unobservables that are correlated with both sex education and adolescents sexual behaviors, then the cross-section or propensity score matching (PSM) estimator will yield a biased estimate of the effect of treatment on the treated. For example, if a popularly elected school board enacts a sex education program because the board observes that their students are promiscuous, or have more permissive sexual attitudes themselves, and these characteristics are unobservable to the researcher, then a cross-section estimate of the impact of sex education on adolescent sexual behaviors may be biased. Selection on unobservables is addressed in two ways: individual fixed effects and instrumental variables. The longitudinal nature of Add Health data allows the estimation of difference-indifference models.12 The underlying identification assumption of this model is that while selection into sex education may depend on time-invariant individual-level, community-level, or school-level observables and unobservables, selection is not based on unobservables that change over time and are correlated with changes in sexual activity. This model will allow the baseline rate of sexual activity to differ across treated and untreated adolescents, but assumes unobserved time trends are the same across treated and comparison individuals. However, if school districts have unobserved information on when students are transitioning into sexual activity and time the availability of their courses accordingly, then individual fixed effects estimates could be biased. An alternate method of addressing selection on unobservables is to estimate the average treatment effect via instrumental variables. This requires exogenous variation in treatment that is uncorrelated with adolescent sexual behaviors except through sex education. Finding a credible instrument for sex education is difficult

10 For exact matching, race is defined simply as white or non-white. Dummies for whether the teenager is Black or Hispanic are included as explanatory variables in the propensity score estimation. Teenagers are matched by age within six months. 11 This technique is more flexible to datasets with smaller samples and permits each treated teen to be paired with his closest match, without restricting the set of matches. Moreover, there is little evidence that matching without replacement yields estimates that are different from, more precise than, or more efficient than matching with replacement. 12 Adolescents are observed in periods t (baseline) and t (one-year follow-up) and the offer of sex edu0 1 cation occurs in period t, where t0 t t1. Thus, I compare changes in sexual behaviors of adolescents who are not offered sex education in consecutive grades with changes in sexual behaviors of adolescents who are not offered sex education in period t0, but have been offered sex education by period t1. The difference-in-difference sample is constructed via propensity score matching (as described above) to ensure that I compare changes in sexual behaviors of comparable adolescents. Moreover, I control for several time-varying observable characteristics, described below.

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inasmuch as sentiments associated with treatment may also be associated with sexrelated outcomes. One plausible instrument that may provide exogenous variation in sex education is the size of school budgets. Because sex education is viewed by many school boards as less necessary than other traditional academic requirements, smaller budgets may induce schools to eliminate, shorten, combine, or delay sex education sources. For example, in the midst of a budget crisis in 2003, the Coordinated School Health Program in the Massachusetts Department of Education (DOE) lost $24 million in funds allocated for its Health Protection Fund. A state DOE official reported that as a result, many districts might have to reduce their number of health teachers and their hours worked, thus inducing schools to cut back on sex education (Jacobs, 2003). While exogenous differences in school budgets may impact the availability of sex education, we would not expect budgets to impact the sexual behaviors of adolescents, after controlling for income and other communitylevel observables. While the Add Health data do not include direct information on school budgets, they do contain school- and community-level observables that are expected to be strongly correlated with public school budgets: the proportion of the population in the census tract aged 3 years and older in elementary or high school that are enrolled in private school, the proportion of individuals in the census tract that comprise never married single men without children, the proportion of teachers in the school that have masters degrees or higher, and the proportion of votes in the county cast for the Democratic presidential candidate in 1992. Regions with higher proportions of never married men or with a greater preference for private schools would be less likely to fund larger public school budgets. Individuals living in districts with more Democratic voters are expected to support larger school budgets. And, finally, schools that hire a greater share of teachers with advanced degrees are more likely to have larger budgets to pay their salaries. To the extent that these instruments provide exogenous variation in the offer of sex education, we will be able to expunge endogeneity bias in estimating its effects. RESULTS Table 2 present OLS and PSM estimates of the relationship between sex education and five sex related outcomesvirginity status, unprotected sex at most recent intercourse, pregnancy, intercourse frequency, and sexually transmitted diseases for the full-sample of 4,621 seventh, eighth, and ninth graders using wave 1 data. Separate models for females and males are estimated (models 2 and 3) to allow for heterogeneous program impacts by gender. Separate models for eighth graders and 14-year-old eighth graders are estimated (models 4 and 5) to ensure that pooled cross-section estimates are not driven by unobserved age or grade effects. For all models except for intercourse frequency, linear probability models are used; for intercourse frequency with a romantic partner, tobit models are estimated.13 Each

13

Alternate probit and logit specifications produced results similar to linear probability results presented here. The tobit model for intercourse frequency assumes that a single behavioral equation governs both the process for initiation of sexual activity and the process for the frequency of sexual activity conditional on being sexually active. If this is untrue, then a tobit specification may be inappropriate. However, when I condition the intercourse frequency equation on being sexually active and estimate the model via OLS, I generally find that sex education is associated with higher frequency of sexual intercourse.

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estimate presented in Table 2 comes from a separate regression model, which includes all of the above-mentioned control variables. While estimates of the association between other covariates and sex-related outcomes are not presented in Table 2, the findings are consistent with the previous literature on early teen sex. As expected, the probability of intercourse and pregnancy increases with age. Black and Hispanic adolescents are more likely to engage in early sex than their white counterparts. One of the strongest correlates of adolescent sexual activity is an adolescents perception that her parent strongly disapproves of her having sex at this point in her life. Adolescents living in families that attend religious services frequently are less likely to engage in sex than those who never attend services. And, consistent with work by Sen (2002), adolescents who report drinking alcoholic beverages are more likely to have engaged in early sex. Coefficients on these covariates are available upon request. The discussion to follow will focus exclusively on estimates of the impact of sex education on sexual behaviors and health outcomes. Cross-Section Estimates Ordinary least squares estimates. Ordinary least squares (OLS) estimates in Table 2 (columns 15) suggest strong evidence that sex education is associated with undesirable sex choices and adverse health outcomes. The first row indicates that the offer of sex education is associated with a 2.9 percentage point higher probability of exiting virginity (column 1). This is driven by the impact on males, for whom sex education is associated with a 4.1 percentage point higher probability of having ever engaged in intercourse (column 3). The results in columns 4 and 5 suggest that the estimates from the pooled data are not driven by unobserved grade or age effects.14 The positive association between sex education and engaging in sexual intercourse is consistent with findings in Dawson (1986), Marsiglio and Mott (1986), Ku, Sonenstein, and Pleck (1992, 1993), and Oettinger (1999). In the second row, OLS estimates also show that sex education is associated with no change or an increased likelihood of engaging in unprotected sex at most recent intercourse. The third row shows consistent evidence that sex education is associated with a higher probability of pregnancy; sex education is associated with a 1 to 3 percentage point increase in the likelihood of pregnancy. The final two rows of cross-section estimates reflect that sex education is associated with no difference or a higher frequency of intercourse with a romantic partner, and with no significant difference in the probability of STD infection. Taken together, the findings in columns 15 of Table 2 suggest that sex education is associated with adolescent health behaviors that most policymakers would deem undesirable and unintended. However, a causal interpretation of OLS estimates may not be appropriate. If there is insufficient common support on observable characteristics between treated and untreated adolescents, or if there are unobserved characteristicssuch as unmeasured propensity for sexual activity or promiscuitycorrelated with risky sexual behaviors and the offer of sex education, then the identification assumption underlying the cross-section model will be violated. Propensity score matching estimates. To address the potential problem of selection on observables, I match each treated adolescent with an untreated teen, as
14 I also estimate models separately for seventh and ninth graders. For seventh graders, the estimated coefficient on sex education is 0.29 and is significant at the 10% level. For ninth graders, the estimated coefficient is 0.000 and is insignificant (p-value of 0.99).

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Table 2. OLS and PSM estimates of relationship between sex education and adolescent sexual behaviors for full sample1. OLS Estimates1
(2) Females Males 8th Grade All Females Males (3) (4) (6) (7) (8) (5) 14yo 8th GR

PSM Estimates2
(9) 8th Grade (10) 14yo 8th GR

(1)

All

First intercourse

Recent unprotected sex

Pregnancy

Intercourse frequency2

Sexually transmitted disease

0.029** (0.014) 0.005 (0.010) 0.021*** (0.005) 10.71 (7.71) 0.003 (0.004) 4,621 0.023 (0.020) 0.017 (0.015) 0.012* (0.007) 5.91 (7.29) 0.006 (0.005) 2,405 0.049 (0.034) 0.023* (0.013) 0.024*** (0.006) 8.10 (15.83) 0.003** (0.002) 7,070

0.041** 0.106*** 0.102*** (0.021) (0.029) (0.033) 0.005 0.055*** 0.044* (0.014) (0.018) (0.024) 0.031*** 0.019* 0.031* (0.007) (0.012) (0.017) 25.14 44.42** 46.57** 3 (16.43) (18.20) (19.60) 0.000 0.006 0.001 (0.006) (0.005) (0.001) 2,216 1,415 9,16

0.022 (0.038) 0.015 (0.021) 0.005 (0.011) 2.57 (17.47) 0.001 (0.002) 3,690

0.076 0.087 0.096*** (0.053) (0.060) (0.038) 0.031** 0.058*** 0.042*** (0.015) (0.010) (0.012) 0.042*** 0.026*** 0.024*** (0.007) (0.006) (0.008) 34.62 44.84** 28.26 (32.34) (21.83) (18.96) 0.006** 0.001 0.001 (0.003) (0.001) (0.001) 3,380 2,570 1,692

***

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significant at the 1% level; ** significant at the 5% level; *significant at 10% level. All OLS models include controls for individual-level, family-level, and community-level observables mentioned in the text. 2 Frequency models are estimated via tobit; all others are estimated by linear probability model. 3 Model includes those aged 1415-years-old, as tobit model failed to converge with the sample restricted to 14-year-olds. 4 The sample sizes in the DDPSM models are larger than the sample sizes in the OLS models because adolescents are matched with replacement. Hence, some untreated adolescents are matched to more than one treated adolescent. Standard errors are clustered at the individual-level.

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described above.15 The results in columns 610 of Table 2 suggest that selection on observables does not appear to substantially bias OLS estimates. While the relationship between sex education and first intercourse (row 1) appears to be weaker after propensity score matching, the coefficients remain positive and the association for 14-year-old eighth graders is still significant. The findings on recent unprotected sex (row 2) appear to be stronger, with positive and significant coefficients in four of the five models. The pregnancy and intercourse frequency estimates (rows 3 and 4) also remain quite similar to OLS estimates. For STDs (row 5), I actually find that sex education is associated with a higher probability of sexually transmitted infections for males, in contrast to no significant association in the OLS estimates. Taken together, PSM estimates suggest that a more careful method of assuring common support on observables does not result in estimates that are substantively different from more traditional OLS estimates.16 However, these estimates will only be unbiased estimates of the effect of treatment on the treated if there are no unobservable characteristics associated with sex education and measured sex-related outcomes. Difference-in-Difference Estimates Difference-in-difference models utilize the longitudinal nature of the Add Health data, using information from waves 1 and 2. To be included in the sample for the difference-in-difference estimation, I require the youth to have both a pre- and postpolicy measure of his behavior.17 This requires a substantial reduction in the sample, from 4,621 to 947, driven mostly by the necessity of dropping those observations that received sex education in the earliest time period and did not have a credible pre-program outcome measure. In this sample, no adolescents received sex education in seventh grade, some have been offered sex education in eighth grade, and some have been offered it in ninth grade. Thus, the difference-in-difference analysis exploits differences in the timing of sex education to isolate treatment effects. Weighted means and standard deviations of key variables at baseline (t0) are similar to those presented in Table 1 and are available upon request.
15 I find that relative to comparison teenagers, treated students are significantly more likely to be enrolled in public schools, to live in urban areas, to live in the northeast, to have mothers who gave birth to the respondent at younger ages, to attend religious services infrequently, and to be white. They are also more likely to live in counties with higher proportions of Democratic voters and to live in states with more generous welfare benefits. After matching with replacement, I estimate the mean differences in sex-related outcomes between treated and untreated adolescents. These findings are presented in Table 3. Note that the sample size used in Table 3 is larger than that used in Table 2. This is because matching was done with replacementhence, the same untreated teenager may be matched to more than one treated teen. There are 1,046 untreated adolescents that are available to be matched; 33 percent are matched zero times, 23 percent are matched once, 13 percent are matched twice, 13 percent are matched three or four times, and 18 percent are matched more than five times. Thus, the standard errors are clustered at the individual level to reflect the number of unique person observations used in the estimation. 16 The findings in Table 3 are robust to choice of model specification used to estimate propensity scores. Changes in exact matching criteria or matching on propensity scores alone does not lead to results that differ substantially from what is presented. After matching, means of key covariates used to match are identical among treated and untreated adolescents. 17 In results not presented here, I estimate the probability of entering the difference-in-difference (DD) sample from the cross-section sample. Male and female students are each more likely to be included in the DD sample if they are Hispanic, attend school in an urban area, and live in the southern region of the United States. All students and males are more likely to enter the sample if they have higher Add Health Picture Vocabulary Test (AH-PVT) scores. Hence, I re-estimate cross-section estimates, with special attention to these covariates.

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Columns 15 of Table 3 present OLS estimates on the selected sample to allow comparisons with the difference-in-difference estimators discussed below. Separate models are estimated by race to test whether there are race-specific differences in program effects. With the exception of the pregnancy outcome, the OLS findings in Table 3 are generally similar to those in Table 2. As in Table 2, the results again show that sex education is generally associated with higher probabilities of engaging in sexual intercourse, having unprotected sex, and contracting an STD. From row 1 we see that sex education is correlated with a 7.3 percentage point higher probability of sexual intercourse, driven by a higher probability for whites and males. In contrast to the sample used in Table 2, however, I find no significant association between sex education and the probability of pregnancy. While the power of the design for the difference-in-difference sample is substantially weakerperhaps accounting for the insignificance of pregnancy findingsOLS estimates still detect positive associations between sex education and some adverse sexual behaviors. Next, treated and untreated adolescents are matched by nearest propensity score and difference-in-difference models (DDPSM) are estimated to control for selection on time-invariant, individual-level unobserved characteristics that may be correlated with sex education and measured sexual outcomes. These models control for several time-varying observables including religious attendance, parental disapproval of sex, weight perception, welfare receipt, mothers employment status, and alcohol consumption, though the findings are robust to inclusion or exclusion of these covariates. The sample sizes in columns 610 of Table 3 are slightly larger than those in columns 15 because adolescents are matched with replacement, resulting in some untreated teens matched to more than one treated teen; standard errors are clustered on the individual. In contrast to the findings in columns 15, DDPSM estimates suggest little evidence that sex education is associated with changes in adolescent sexual behavior. While the percentage of treated adolescents who had ever engaged in sexual intercourse increased 10.0 percentage points (from 17.7 percent before treatment to 27.7 percent after treatment), the change in the percentage of untreated adolescents who exited virginity was not statistically different. There is also little evidence that sex education increased rates of unprotected sex, pregnancy rates, frequency of intercourse, or sexually transmitted diseases. In fact, sex education is associated with a marginally significant 10.3 percentage point decline in the rate of unprotected sex at recent intercourse among whites, a finding consistent with Dawson (1986), Marsiglio and Mott (1986), Ku, Somerstein, and Pleck (1992, 1993), and Aarons et al. (2000). In the final row of Table 3, I find no evidence that sex education has any impact on reports of STDs. The DDPSM estimates in Table 3 differ from the family fixed effects estimates of Oettinger (1999), who found that sex education was associated with higher rates of first intercourse. The difference in findings between these two studies may be attributed to several sources. First, if exposure to treatment within families is not randomly assigned on based unobservablesthat is, if parents choose to expose their most atrisk child to sex education and withhold such treatment from their less promiscuous childthen models using family fixed effects may be biased toward adverse health outcomes. A second reason for the differences in findings may be due to changes in teaching technology and in the cultural environment from the 1970s to the 1990s. In the 1970s, sex education may have had a stronger signaling effect due to the lack of sexual information available cheaply through the Internet, television, movies, and magazines. In the 1990s, much of the sex-related information taught in sex education classes is quite cheaply available to adolescents outside of the classroom.

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Table 3. OLS and DDPSM estimates of relationship between sex education and adolescent sexual behaviors for restricted sample1. OLS Estimates1
(2) Females (3) Males (4) White (5) Non-White (6) All (7) Females (8) Males

DDPSM Estimates2
(9) (10) White Non-White

(1) All

First intercourse

Recent unprotected sex

Pregnancy

Intercourse frequency3

Sexually transmitted disease

N4

0.024 0.073** (0.036) (0.047) 0.040* 0.023 (0.023) (0.029) 0.013 0.016 (0.011) (0.018) 3.71 12.4 (8.67) (8.59) 0.010 0.016* (0.008) (0.009) 947 488 0.036 (0.063) 0.058 (0.050) 0.058* (0.029) 3.79 (4.19) 0.001 (0.022) 351 0.016 (0.042) 0.054 (0.043) 0.011 (0.011) 2.08 (2.20) 0.005 (0.003) 1,096 0.004 (0.054) 0.014 (0.025) 0.021 (0.013) 2.23 (3.14) 0.007 (0.005) 578

0.105** (0.051) 0.050* (0.035) 0.006 (0.014) 12.3** (4.75) 0.010 (0.016) 459

0.087** (0.043) 0.028 (0.023) 0.002 (0.011) 1.12 (8.25) 0.012 (0.008) 599

0.017 (0.053) 0.100 (0.088) 0.006 (0.017) 0.738 (0.625) 0.004 (0.004) 518

0.014 (0.043) 0.103* (0.059) 0.010 (0.015) 2.81 (2.53) 0.004 (0.003) 738

0.008 (0.067) 0.064 (0.066) 0.011 (0.016) 0.802 (0.814) 0.009 (0.008) 358

***

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Journal of Policy Analysis and Management DOI: 10.1002/pam Published on behalf of the Association for Public Policy Analysis and Management

significant at the 1% level; ** significant at the 5% level; *significant at 10% level. All OLS models include full set of control variables described in the text and Table 2. 2 All DDPSM models include controls for the following time-varying covariates: religious attendance, parent disapproval of sex, weight perception, welfare receipt, mother's employment status, and alcohol consumption. 3 Frequency models are estimated via tobit; all others are estimated by linear probability model. 4 The sample sizes in the DDPSM models are larger than the sample sizes in the OLS models because adolescents are matched with replacement. Hence, some untreated adolescents are matched to more than one treated adolescent. Standard errors are clustered at the individual-level

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Table 4. DDPSM estimates of effects of family planning-inclusive sex education1. (1) All Else First intercourse Recent unprotected sex Pregnancy Intercourse frequency N
***significant 1

(2) Other Sex Ed. 0.086** (0.041) 0.018 (0.043) 0.020 (0.020) 5.18 (3.11) 412

(3) No Treatment 0.008 (0.067) 0.043 (0.037) 0.018 (0.020) 1.11 (2.06) 512

0.036 (0.050) 0.016 (0.034) 0.020 (0.017) 0.995 (1.91) 614

at the 1% level; ** significant at the 5% level; *significant at 10% level. All models include controls for time-varying covariates described in Table 3.

The DDPSM estimates in Table 3 suggest that selection on time-invariant unobservables may bias cross-section estimates toward adverse health behaviors. This reflects that the types of junior high schools that are adopting sex education programs, particularly for its younger students, may be those with sexually at-risk students.18 Heterogeneous Treatments In the preceding analysis, sex education has been assumed to provide homogeneous information to adolescents. This may not be the case. A 1999 survey of secondary sex education teachers found that 23 percent had taught abstinence as the only way of avoiding pregnancy (Darroch, Landry, & Singh, 2000). Thus, while the vast majority of sex education classes provide information on contraception, some classes may focus on other aspects of sex. I use the interaction of sex education and family planning services as a proxy for family planning-intensive sex education. Of students in the sample, 26 percent are offered family planning-intensive sex education, representing 47 percent of all students who are offered any sex education. Table 4 presents DDPSM estimates of the impact of family planning-intensive sex education. I construct three comparison groups, represented by each of the three columns: (1) students not receiving family-planning sex education, (2) students receiving non-family planning sex education, and (3) students receiving no sex education. I find that relative to no family-planning focused sex education (column 1) or no sex education (column 3), family-planning focused programs are not associated with significant changes in first intercourse rates, unprotected sex rates, pregnancy rates, or intercourse frequency rates. However, I do find evidence that relative to other forms of sex education (column 2), adolescents who receive family planning-intensive sex education have a higher rate of exit from virginity. This finding may reflect that family planning-focused sex education reduces the costs of sex

18 Oettinger (1999) discusses the potential biases caused by measurement error in the reporting of teens sexual activity, but reports little evidence in the NLSY79 data to suggest that the bias is systematic by exposure to sex education. Ashenfelter and Krueger (1994) note that measurement error can accentuate bias in fixed effects models relative to cross-section models. However, there is little evidence to suggest substantial misreporting by school administrators on a schools offer of sex education and/or that measurement error in students sexual outcomes is systematically correlated with the offer of sex education.

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Table 5. IV Estimates of effects of sex education1. (1) All First intercourse Hansen overID test (p-value) recent unprotected sex Hansen overID test (p-value) pregnancy Hansen overID test (p-value) F-test of joint significance of exclusion restrictions N
*** 1

(2) Females 0.024 (0.153) p 0.38 0.006 (0.077) p 0.13 0.032 (0.056) p 0.08 14.04*** 486

(3) Males 0.284** (0.083) p 0.79 0.002 (0.088) p 0.57 0.005 (0.004) p 0.16 17.81*** 455

(4) White 0.071 (0.103) p 0.73 0.024 (0.064) p 0.06 0.066 (0.042) p 0.55 25.81*** 592

(5) Non-White 0.271 (0.174) p 0.07 0.061 (0.161) p 0.17 0.016 (0.074) p 0.78 13.38*** 349

0.147 (0.093) p 0.52 0.009 (0.059) p 0.57 0.052 (0.036) p 0.33 34.03*** 941

significant at the 1% level; ** significant at the 5% level; *significant at 10% level. All models include controls for individual-level and family-level observables. 2 Exclusion restrictions include percentage of teachers with Masters degrees, percentage of individuals in census tract aged 3 who attend private elementary or high schools, the percentage of never married men, and the countys share of votes cast for Bill Clinton in 1992.

relative to non-contraceptive focused sex education, which may proxy for abstinence focused sex education.19 This may occur by reducing the costs of contraception (that is, by providing condoms) or by reducing the stigma costs of sex. However, I find no evidence that family planning-inclusive sex education increases rates of unprotected sex or pregnancy. Instrumental Variables Estimates In addition to concerns about the power of the DDPSM design, another important concern with the findings in Tables 3 and 4 is that the identification assumption of these models is violated because unobserved time trends are different for treated and untreated adolescents. This may occur because local school boards have information on when students will be transitioning out of virginity and time their sex education courses accordingly. To test the robustness of the DDPSM findings, I estimate the average treatment effect via instrumental variables (IV). Table 5 presents IV estimates of the relationship between sex education and adolescent sexual behaviors.20 IV models explicitly control for reverse causality, whereby adolescent sexual behaviors and health outcomes could affect schools decisions to adopt sex education programs. In contrast to the OLS estimates and generally consistent with the DDPSM estimators in Table 3, IV estimates suggest little evidence that sex education is associated with changes in adolescents sexual behavior. IV estimates reflect that sex education is not associated with statistically different probabilities of first intercourse, recent unpro19

In results not presented here, I use information on local abstinence sentiment to examine whether nonfamily planning focused sex education serves as a credible proxy for abstinence-focused sex education. Estimation results from these alternative specifications produce results similar to those presented in column (2) of Table 4. 20 First stage regression models are available upon request.

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tected sex, or pregnancy in 14 of 15 models. Only for adolescent males is there some evidence of a positive relationship between sex education and the probability of engaging in first intercourse, though the magnitude is implausibly large. Thus, while imprecisely estimated, the IV estimates suggest that sex education has little measurable health effects. One caveat to the interpretation of IV results is the concern that the instruments could be directly correlated with adolescent sexual behaviors.21 While the Hanson overidentification test suggests that the instruments are generally valid, this test is not especially powerful. Thus, one should exercise some caution in interpreting these estimates. In summary, the DDPSM and IV estimates generally provide consistent evidence that unobserved heterogeneity biases OLS estimates of the effect of sex education on adolescent sexual behavior toward adverse health outcomes. This suggests that schools that offer sex education to younger junior high school students serve students with the greatest unobserved propensity to engage in risky sexual behavior. POLICY CONCLUSIONS The fierce policy debate over school-based sex education often involves passionate arguments about whether there are unintended adverse health consequences of exposure to such programs. While proponents suggest that sex education is necessary to provide contraceptive information to adolescents to combat teen pregnancy and sexually transmitted diseases, opponents counter that such courses will only encourage promiscuity by destigmatizing sex or by providing low-cost contraception. The empirical findings of this study show that while there is strong evidence that sex education is associated with adverse health outcomessuch as lower rates of virginity and higher rates of unprotected sexthere is less evidence of a causal link. After controlling for non-random participation in sex education via fixed effects and instrumental variables, I find that sex education has few behavioral effects. When heterogeneous types of sex education are examined, I find some evidence of unintended effects of family planning sex education on short-run virginity rates. Relative to other types of sex education programs, exposure to family planningfocused sex education is associated with an increased likelihood of exiting virginity. Despite these results, I do not find that exposure to family-planning focused sex education is associated with increased rates of unprotected sex or increased pregnancy rates.22 Taken together, the results of this study suggest little evidence that school-based sex education has measurable adverse health effects for teens. As importantly, I do not find any consistent empirical evidence that sex education achieves its intended goals of delaying first intercourse, encouraging contraceptive use, or preventing pregnancy.23 Thus, if the policy goal of sex education is to encourFor example, a higher proportion of teachers with a masters degree could directly impact adolescent sexual behavior if more highly educated sex education teachers more effectively transmit information and/or values. Similarly, a higher proportion of votes for Bill Clinton in 1992 could suggest more liberal attitudes toward sex, directly impacting teen sex choices. I tested the sensitivity of IV estimates to the inclusion of additional exclusion restrictions: parental attitudes toward schooling, local economic conditions, and state sex education requirements. The results remain generally unchanged from those presented in Table 5. 22 Moreover, in results not presented here using wave 3 Add Health data, I find that family-planning focused sex education is not associated with any change in virginity rates or pregnancy rates by age 17. Thus, there do not appear to be any long-run effects. 23 In results not presented here, I also find little evidence that sex education is significantly associated with lower rates of unprotected sex or pregnancy among the sexually active population, though the sample sizes for these difference-in-difference models are quite small.
21

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age adolescents to make smarter sex decisions, there is little evidence that investing resources in typical sex education programs yield measurable sex-related benefits. This study suggests that those on each side of the ideological debate over sex education are, in a sense, both correct and mistaken. Opponents of sex education are correct in observing that sex education is associated with adverse health outcomes, but they are generally incorrect in interpreting this relationship causally. The correlation they observe is mostly due to schools with the most sexually at-risk adolescents choosing to offer sex education programs to them. Proponents are generally correct in asserting that sex education does not encourage risky sexual activity, but are incorrect in suggesting that investments in typical school-based sex education programs produce important measurable health benefits. In fact, there is little evidence that sex education reduces rates of virginity, unprotected sex, pregnancy, frequency of intercourse, or STDs. One explanation for the absence of sex education effects is that there are many alternate sources of sex information for teens. If junior high school-level sex education does not provide any new information, then its value-added may be small. A second explanation for these findings is that during the 1990s, most schools may have adopted short-term curriculum strategies with regard to sex education. Kirby (2001) finds that short-run interventions typically have little impact on adolescent health behaviors. If, as expected, most schools were not adopting comprehensive, long-term sex strategies for teens, it should not be surprising that there are few detectable program effects. The results of this study should not be interpreted to suggest that no sex education programs can impact adolescents sex decisions. Rather, the findings suggest that typical school-based sex education programs adopted across the country tend not to have measurable health effects. Atypical programssuch as long-term, repeated, intensive, abstinence-only, or comprehensive-based sex education coursesmay have intended, or perhaps, unintended effects. However, typical sex education programs do not. This study has highlighted the importance of accounting for non-random participation in sex education programs when estimating treatment effects. While this study has carefully applied quasi-experimental methods on observational data to estimate the effects of heterogeneous types of sex education programs, large-scale social experiments would provide an alternate method of convincingly addressing difficult selection issues. Mathematica Policy Research, Inc. and the University of Pennsylvania are currently conducting an experimental analysis of abstinence-only sex education programs in Virginia, Florida, Mississippi, and Wisconsin. The results of the Mathematica study will be an important contribution to policymakers understanding of the causal impacts of sex education programs with specifically detailed curricula. A final implication of this studys findings is that local or state control over schoolbased sex education may be preferable to federal control, considering that unobserved school-level or individual-level heterogeneity is an important determinant of adolescent sexual behavior. Because parents and local school boards are likely to have more complete information on students characteristics than will state or federal officialswho will likely be limited to data such as those used in this study local officials might better be able to select sex education programs that minimize harm to their respective adolescent populations. JOSEPH J. SABIA is Assistant Professor in the Department of Housing and Consumer Economics at the University of Georgia, Athens, GA.

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ACKNOWLEDGMENTS
This paper has benefited from useful comments from Elizabeth Peters, Dean Lillard, J.S. Butler, Steve Coate, Don Kenkel, Kara Joyner, and A. Sinan Unur. I am grateful to seminar participants at Cornell University, Texas A&M, Abt Associates, the University of AlabamaBirmingham, and the University of Georgia. Finally, thanks to three anonymous referees, Maureen Pirog, and Jan Blustein for helpful suggestions. This research uses data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by grant P01-HD31921 from the National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Persons interested in obtaining data files from Add Health should contact Add Health, Carolina Population Center, 123 W. Franklin Street, Chapel Hill, NC 27516-2524 (http://www.cpc.unc.edu/addhealth/contract.html).

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