In the 1980s and 1990s, concerns about teen pregnancy voiced by policymakers and pundits helped garner support for welfare reform – as the public reached a consensus that teen pregnancy contributes to poverty and was encouraged by overly lenient welfare programs. Resulting welfare changes in the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 imposed strict lifetime limits on the number of months a poor family can receive assistance while making it harder for impoverished families to qualify and remain eligible for aid. This policy was supposed to reduce welfare dependency by promoting work, reducing out-of-wedlock and adolescent pregnancies, and promoting marriage.

However, studies show that the age at which a person gives birth is not causally related to poverty or negative health outcomes for the parent or child. Teen pregnancy is a symptom of poverty, rather than its cause. While the 1996 law is credited with reducing the welfare rolls, experts argue that it has also increased the number of Americans living in at the deepest level of poverty. Declines in adolescent pregnancy cannot be attributed to that policy shift. If anything, welfare reform may have increased the rate of adolescent pregnancies among welfare recipients.

Welfare Reform and Shifting Perspectives on Teen Pregnancy

After the 1996 passage of welfare reform, conversations about teen pregnancy that had previously included attention to urban conditions, unemployment, inadequate health care, and the shortcomings of public education turned to an almost-exclusive focus on adolescent sex and the personal and moral failings it supposedly represents. My research examines political discourse, popular culture, and national and local efforts to prevent teen pregnancies to better understand why teen sex and childbearing remain central to popular culture and policy debates, despite research showing that teen pregnancy is a symptom of poverty and not a cause. I further examine why there has not been a reevaluation of welfare policy despite the documented shortfalls of earlier reforms. And I also probe how these two phenomena may be related.

Moral arguments have featured prominently in debate about adolescent sex since the 1970s, when teen pregnancy was first named as a special problem. Before the 1996 welfare legislation, however, the moral aspect was one of many. Only since then have the personal moral responsibilities of teen parents become the only lens through which responses are discussed.

Who Shapes Images of Teen Pregnancy and Why?

Some of the same voices that narrowed the discussion of welfare reform in the 1990s still shape discussions today. In 1996, the National Campaign to Prevent Teen Pregnancy (recently renamed Power to Decide) was founded as a counterpart to welfare reform. Power to Decide remains influential and is guided by leaders who helped popularize the overly-narrow view that teen pregnancy is largely a moral issue. In addition to helping enact welfare reform, these politicians and social scientists changed the debate about teen pregnancy. But to what end?

By studying shifts in public portrayals of teen pregnancy as a problem in national debates and in the activities, social media output, and television contributions of Power to Decide, I discovered that the moralized focus has specific effects:

• It removes teen pregnancy from the context of welfare. Whereas the issue was almost exclusively part of political debates about the welfare system in the 1980s and 1990s, in subsequent decades it is discussed primarily within debates about sex education and abortion.
• It paints the issue as an equal-opportunity problem. No longer is teen pregnancy represented as primarily plaguing Black and Latina communities. In shows like 16 and Pregnant, which has a mostly white cast, as well as in online games with multicultural characters and public service announcements with high-profile celebrities such as Bristol Palin, teen pregnancy is now publicly portrayed as equally affecting all races and classes.
• It depicts burdens of teen pregnancy as primarily physical and emotional. Stress on the pains of childbirth and the strains of parenthood for young relationships displaces earlier discussions of the potential impacts of teen pregnancy on a young person’s economic self-sufficiency and educational attainment.

Such shifts in public discussion fail to account for race, class, and the importance of social institutions in shaping the rate and experience of adolescent pregnancy. If U.S. systems of education, welfare, taxation, criminal justice, and health care are not portrayed as contributing to this problem, they will be left out of proposed solutions. The current focus on personal morality avoids addressing any societal roots or remedies. Instead, politicians and advocates informed by the rhetoric of the 1996 welfare reform offer attractively packaged information about sex and morality – often safely conveyed on the Internet – as their response to teen pregnancy. Questions of racism, inequality, and the inadequacies of the social safety net do not arise. In effect, public framings of teen pregnancy as a personal and moral problem blink at systematic racial disparities and leave low-income Americans vulnerable as inequalities widen.

Better Approaches

Focusing on teen pregnancy as a moral failing distracts citizens, policymakers, and advocates from addressing the real problems in young people’s lives. Instead, the priorities should be:

• Reducing discrimination against pregnant young women and young parents in schools.
• Providing comprehensive sex education and reproductive health care to all young people, not in the name of stigmatizing certain pregnancies but to equip adolescents with the knowledge and tools to make informed choices about sex and reproduction.

• Replacing earlier failed welfare programs with economically redistributive measures to help people in difficult life circumstances – and boost the resources of marginalized communities.

Each year, an estimated 800,000 people are trafficked globally, though the true number may be higher. In a quest to arm officials and stakeholders around the globe with more accurate and trusted data to better understand and address this global problem, the University of Georgia has established a new interdisciplinary center to combat human trafficking through research, programming and policy development.

The Center on Human Trafficking Research & Outreach will be housed in the School of Social Work, and David Okech, an associate professor at the school, will serve as the center’s first director. This collaborative effort aims to identify better ways to measure the prevalence of trafficking while crafting real-world solutions to best equip nongovernmental organizations and policymakers with the tools and information they need to combat trafficking.

Joining Okech in driving research and program development at the center are Nathan Hansen, a professor of health promotion and behavior at the College of Public Health, Tamora Callands, an assistant professor of health promotion and behavior at the College of Public Health, Jody Clay-Warner, professor in the department of sociology in the Franklin College of Arts and Sciences, and Lydia Aletraris, an associate research scientist in the School of Social Work. They have been part of the African Programming and Research Initiative to End Slavery, known as APRIES, which is providing the foundation for the transition into a center.

“Science is always a building block,” Okech said. “You build it up, and sometimes it’s big and sometimes it’s small, but you keep building. Through the center, we want to let the research speak for itself. If particular research or methodologies work, good, and if it doesn’t, then we need to think about what else could work because right now we don’t know what really works well in terms of estimation methods and generating reliable data that can inform anti-trafficking policies and programs.”

Faculty members across campus from law, political science, psychology, public health, social work and sociology as well as postdoctoral research associates and students all will be active in advancing the center’s mission in enhancing the science around measuring and monitoring the prevalence of human trafficking and implementing plus evaluating evidence-based programs and policies to reduce the problem.

“Human trafficking and modern slavery are large, complex problems that require solutions from multiple perspectives to address,” Hansen said. “Thus, a multidisciplinary center allows a variety of disciplines to work together on these problems. Further, locating this center at the University of Georgia allows access to the broader university community, including many talented and motivated faculty and students, who can contribute to finding solutions to these issues.”

“Having a center will enable us to take all of our collective expertise, knowledge and skills, and package it in a way where we can get this information out to those who need it,” Callands said. “This will be a center that will benefit from the connections we have, the work we’re doing and the lessons learned, enabling it to be successful. That means sharing information with others, and providing trainings, programming and other resources to advance this important work.”

It’s the culmination of a years-long effort by Okech and his team to advance efforts to not only better understand and track global human trafficking and human slavery, but also curb this epidemic of cruelty.

Estimating the Prevalence of Trafficking

Okech has been instrumental in guiding the success and growth of APRIES, securing close to $24 million in implementation research funding from the Program to End Modern Slavery at the U.S. Department of State Office to Monitor and Combat Trafficking in Persons since 2018. Research, policy and programming work is being done in Guinea, Sierra Leone and Senegal. In Brazil, Costa Rica, Morocco, Pakistan, Tanzania and Tunisia, the center is collaborating with U.S.-based and local  researchers to test and validate the existing methods of human trafficking prevalence estimation through the Prevalence Reduction Innovation Forum program.

“As far as we know, this is the first time that researchers are applying and comparing more than one method to measure human trafficking prevalence on the same population,” Aletraris said. “The results from the Forum should be able to provide guidelines on which methods work best and why. This will be extremely helpful, not only for research on human trafficking, but for research on other hidden populations as well.”

By rolling APRIES into the center, its work will benefit from greater collaboration and an infusion of funding to help Okech’s team better monitor prevalence, while also developing effective interventions that are appropriate and customized for those who have been trafficked. The center will also expand its focus to include domestic trafficking, including trafficking here in Georgia as well as in other parts of the U.S.

Crucial to that work is eliminating that knowledge gap when it comes to prevalence. Without a practical understanding of the severity of the problem, it is difficult to craft solutions.

And while Okech said one distinct measurement of success for the center is a drop in the prevalence of human trafficking, he noted an initial increase could also be interpreted in several ways, including more public awareness leading to more reporting. This would indeed be a good thing but ultimately, efforts should lead to measurable and drastic reduction in human trafficking.

“Human trafficking is a multidimensional and complex problem,” Okech added. “It is important to address the root causes of trafficking by focusing on the drivers and facilitators of the phenomenon.”

Preparing Future Researchers

Also crucial to the center’s success is preparing the next generation of anti-trafficking researchers and advocates. As such, the center will offer an immersive learning experience to students across the university. Okech noted many programs and centers of study offer ample opportunity for research, but he and his team envision integrating students into nearly every facet of its operations.

“They’ll be involved in writing manuscripts for publications and grant applications. They will be involved in engaging with various stakeholders so they can grasp the problem holistically as well as the array of solutions to mitigate the problem,” he said. “They’ll be involved in meetings with local government officials so they can understand how policy is made. They’ll be involved with our programs so they can see and experience how such initiatives are run.”

Egg and sperm donations in the United States have long proceeded under the cloak of secrecy. Twenty-five years ago, when I first started interviewing patients who used donors to conceive a child, many intended parents struggled with whether eventually to tell their child about the nature of his or her conception. While some professionals in the fertility industry advised that this was a parent’s personal decision, others encouraged disclosure, and still others recommended never telling a child how they were conceived. The last approach dovetailed with the industry standard that required donor anonymity. In subsequent years, my research has led me to conclude that mandatory donor anonymity is problematic – not only for the children conceived with donor help, but also for donors themselves and the people who created their families with donor assistance.

After a boom in the late 1980s and 1990s, the use of donor sperm and eggs continues to expand in the United States – and increasing numbers of donor-conceived adults are going to want access to their biological information, including access to the identities of the people who helped create them. The United Kingdom has abolished donor anonymity. Why has the United States not followed suit?

How Does Anonymity Affect Donors and Donor-Conceived Children?

Many professionals in the fertility industry maintain that mandatory open donor identity would reduce the number of people willing to come forward to provide eggs and sperm. In countries that have national registries and have abolished donor anonymity, these fears have not borne out. In the United Kingdom, the Human Fertilisation and Embryology Authority reports that the number of sperm donors has increased since anonymity was banned; and since ending donor anonymity, Australia and Sweden have also seen increases in donors volunteering.

In the United States, given that donors are compensated – indeed, egg donors are substantially compensated – the financial incentive alone is enough to ensure that people will still come forward to provide gametes for other people’s children, even if their identity is revealed to the children born from their gametes. Many donors prefer an end to anonymity. In my current research project, I have to date interviewed over 90 donors and collected 190 online surveys. Only a handful of egg donors, I find, want to remain anonymous in perpetuity – yet the majority reported they were told anonymity was their only option.

Many sperm and egg donors go to great lengths to meet their genetic children, turning to DNA tests, online registries, and ancestry websites in their searches. Meanwhile, the first generation of children conceived via banked sperm or donated eggs are now young adults, who have their own feelings about donor conception and their own desires for forging connection, or not, with their donors. Some experienced emotional fall-out from being told later in their childhood they were donor-conceived or discovering it themselves after having the truth was concealed for of their lives.

In my conversations with donor-conceived people, those who seemed most at ease were told at a young age and continued to hear their conception story as they matured. People who were told as adolescents or later, or discovered the “secret” on their own, report feeling a sense of betrayal at having been lied to by the parents they were supposed to be able to trust. For families who decided not to inform their donor-conceived children, the secrecy appears to have been largely rooted in the stigma and shame many people feel about infertility and the inability to have a biological child.

Dealing with the Downsides of Anonymity Falls to Individuals

In a quest for identity, many donor-conceived adults report using a combination of techniques to find their donors. Some sign up on registries, such as the Donor Sibling Registry. This service charges a $200 lifetime fee for donors and donor-conceived people to sign up and search for matches, using the donor identification numbers that clinics, sperm banks, or egg donation agencies assign. Others have turned to free online sites – such as donorconception.com – that help donors, donor-siblings, and donor-conceived children find each other by combining donor information, direct-to-consumer genetic tests, and ancestry registries.

Essentially, anonymity is already obsolete; U.S. policy simply has not caught up with modern technology. The rise of direct-to-consumer genetic testing increases the likelihood of donor-conceived children finding their genetic parents, whether the donor wants that to happen or not. If anyone in a donor’s family does a test and registers on a website like ancestry.com, chances are good a donor-conceived child can find them. While such consumer testing and ancestry sites do raise privacy concerns about the public availability of genetic information, they make it virtually assured that anyone can be found.

The Need for a Donor Registry

Many fertility industry professionals have voiced concerns about how a registry would function given U.S. patient privacy law. The industry’s fear that registries reduce donors has not borne out in other countries that have implemented them. And by now, offering anonymity as an option misleads prospective donors into believing that their privacy can be guaranteed, when it cannot. With anonymity increasingly a non-viable option, it is time to consider establishing a national registry for egg and sperm donors. Not only would such a registry make it easier for people to find biological kin, it could also provide other advantages:

• A registry could keep track of the number of live births per donor in the same geographic area, to reduce the risk of unions between donor-conceived biological siblings.
• For egg donors, a registry could track completed egg donation cycles to reduce the risk of donors going through more cycles than is considered safe.
• A registry would allow researchers to track egg donor health to better understand complications and give women considering egg donation more information for their decisions.