Article: Limiting Family Planning for the Poor

Last week President Bush appointed Dr. Eric Keroack to serve as the Assistant Secretary of Health and Human Services for Population Affairs. This position is primarily responsible for overseeing the Office of Family Planning, which is charged with providing access to contraceptive information and supplies to low-income individuals. But Dr. Keroack has a long-standing opposition to contraception and abortion. Through this appointment, President Bush will severely limit contraceptive information and choices to many of America's poorest women.

Dr. Keroack was previously the medical director of "A Woman's Concern," a non-profit organization operating crisis-pregnancy centers in Massachusetts. According to its literature, A Woman's Concern works to encourage "abortion-vulnerable women" to go through with their pregnancies. The organization characterizes contraceptives as "demeaning to women." Consequently, A Woman's Concern doesn't provide information regarding birth control at its clinics, and advocates sexual abstinence until marriage.

It appears as if Dr. Keroack's chief qualification, in the eyes of President Bush, for his new position is his strong support for abstinence-only sex education. In a presentation at the 2003 International Abstinence Leadership Conference he indicated, "Pre-Marital Sex is really modern germ warfare." And in 2004, while criticizing the American Medical Association's support for comprehensive sex education, Dr. Keroack proclaimed, "For the first time, we have found a high quality sexual education that has actually begun to reverse these deadly trends - abstinence education. Why would we want to stop it?"

Since taking office the Bush administration has channeled more than $600 million into abstinence-until-marriage sex education programs. Yet no scientific study to date has demonstrated that curriculums that only promote abstinence actually curtail teenage sex. In 2001 the National Institute of Child Health and Human Development released a monumental study of approximately 100,000 teenagers who had taken an abstinence pledge. The study found that after 18 months most broke the pledge by engaging in sexual intercourse. And since they didn't plan on doing so, the majority failed to use contraception.

Still, Dr. Keroack has maintained, "Abstinence education is the first mechanism that has actually made a positive impact on the devastation caused by the errant sexual education programs of the 1970s and 1980s." But there's simply no evidence to support this. Last year, the Texas Department of Health conducted a review of abstinence-only sex education programs in that state. The review concluded that the programs had "little impact" on teenagers' behavior. In fact, the review found that girls in the ninth grade were actually five percent more likely to engage in sex after being exposed to an abstinence-only curriculum. And boys in the tenth grade were 15 percent more likely to engage in sex after participating in abstinence-only classes.

The Office of Family Planning is mandated to provide a broad range of acceptable and effective family planning methods and services. Given this responsibility it's troubling that A Woman's Concern, the pregnancy centers Dr. Keroack previously supervised, has repeatedly been accused of deceptive practices. The attorney general for Massachusetts has received numerous complaints in the past two years from women who maintained that they were misled by the pregnancy centers. The complaints indicate that women were told by A Woman's Concern that they perform abortions, but once the women arrived for their appointments they were accosted and told that they were "killing [their] babies."

Dr. Keroack used the clinics to pioneer his technique of showing ultrasound images of fetuses to women to encourage them not to have abortions. He previously compared this technique to car repairs. In a letter written to the Massachusetts legislature in 2001 Dr. Keroack maintained, "Even Midas lets you look at your old muffler before they advise you to change it." It's difficult to believe that someone so biased can impartially oversee the federal government's provision of contraceptive services.

Equally controversial, Dr. Keroack has compared teenage sexual activity to drug use. In 2001 he theorized that engaging in sex prevents teenagers from developing emotional relationships, owing to an overproduction of the hormone oxytocin. According to a paper co-written by Dr. Keroack, "Just as in heroine addiction, the person involved will experience sex withdrawal and will need to move on to a new sex playmate." But the scientific community rejected his theory, largely because it was not based on research conducted on teenagers, but rather on small rodents found on the Great Plains.

The Office of Family Planning oversees a yearly budget of $288 million and operates a national network of approximately 4,600 clinics, providing reproductive health services to five million persons annually. For more than 30 years these family planning clinics have played an important role in ensuring access to contraceptive services for low-income and uninsured women at no cost or at a reduced cost. Under the direction of Dr. Keroack, the services and information provided by the clinics will substantially decrease. President Bush has demonstrated a calloused disregard for the nation's poor with this appointment.