In 1995, the Texas Department of Health wrote a letter to McIlhaney's institute criticizing a slide presentation he'd been showing throughout the state. It included a detailed slide-by-slide critique, prepared by two doctors, a registered nurse and the director of the state's HIV/STD Epidemiology Division, that pointed out a number of distorted, downright false and "ridiculous" statements in McIlhaney's lesson. "Some of the data presented suffers from investigator bias," the letter said. "Dr. McIlhaney's presentation tended to report the outlier data as 'proof' that condoms don't work rather than present those reports in the context of the entire data set. The only data that was reported in the presentation are those which supported his bias on the topics he addressed. Intellectual honesty demands that he present all the data."

Yet even as the Texas Department of Health was criticizing McIlhaney's program, the state's governor, George W. Bush, was embracing it.

"When he was governor of Texas, he promoted and lobbied for and pushed abstinence-only education," says Fred Peterson, a professor of health education at the University of Texas at Austin, who trains instructors to teach comprehensive sexual education classes. McIlhaney was and is a "major player" in Bush's abstinence agenda, says Peterson. He's also a beneficiary -- his Medical Institute for Sexual Health has received $1.5 million in federal contracts related to abstinence education and STD research.

"He's very close politically and probably personally to George W. Bush," Peterson says. "I remember that Dr. McIlhaney did a statewide conference on abstinence-only education, and Governor Bush was the first speaker. Now, Bush has appointed McIlhaney to a major policymaking position."

Peterson, who's met McIlhaney on several occasions, describes him as a nice man and a gentleman, but one who never presents his findings in venues where they might be debated. "Dr. McIlhaney never presented papers at scientific conferences in front of his own peers where he would be challenged and questioned," he says. "His viewpoint was always presented at churches and public forums that did not include scientists, academicians and physicians."

McIlhaney couldn't be reached for comment, but Joe Webb, CEO of the Medical Institute for Sexual Health, defends the organization's scientific integrity. "We're not a religious organization, we're a medical educational organization," says Webb. "Every scientist brings presuppositions to his or her work. We try to be aware of our presumptions in terms of the research and science we're doing. We do have values commitments, just like any person would, but first and foremost, we have to be accurate."

Often, though, the doctors associated with the Medical Institute seem to put their "values commitments" ahead of hard evidence. One member of the institute's advisory board is W. David Hager, the author of a book called "As Jesus Cared for Women: Restoring Women Then and Now." Hager has suggested prayer as a cure for premenstrual syndrome and, in private practice, refused to prescribe contraception to unmarried women. In 2002, Bush appointed Hager, whom Time Magazine called "scantily credentialed," to head an FDA panel on women's health policy, but after a public outcry, he was merely made a member of the panel.

As the Union of Concerned Scientists report points out, there's no evidence at all that the policies pushed by the institute reduced pregnancy rates in Texas. "Unfortunately, despite spending more than $10 million on abstinence-only programs in Texas alone, this strategy has not been shown to be effective at curbing teen pregnancies or halting the spread of HIV and other sexually transmitted diseases," it says. "During President Bush's tenure as governor of Texas from 1995 to 2000, for instance, with abstinence-only programs in place, the state ranked last in the nation in the decline of teen birth rates among 15- to 17-year-old females. Overall, the teen pregnancy rate in Texas was exceeded by only four other states."

The evidence on abstinence-only programs from elsewhere hasn't been much more promising. Last year, the Minnesota Department of Health evaluated the state's five-year, $5 million abstinence-only program and found that it hadn't reduced sexual activity among teenagers at all. Instead, over a year, the rates of sexual activity among students taking the abstinence course doubled, from 5.8 percent to 12.4 percent, which corresponded to the rate of sexual activity among teens statewide. The evaluators found a "lack of fit between the program and kids who face complex problems in their lives and are most at risk for sexual activity."

Rebecca Maynard, a professor of education and social policy at the University of Pennsylvania, is the project director and principal investigator for a study of abstinence-only programs commissioned by the U.S. Department of Health and Human Services. The results won't be out until 2006, but when asked if there's any evidence that abstinence-only programs work, Maynard says, "There's not much evidence that they do or that they don't." Still, Maynard says that she hasn't come across any scientifically inaccurate information in the curricula she's evaluated (though she notes that she's not a medical scientist).

Yet the government virtually mandates that abstinence-only education exaggerate the risks of sex by requiring federally funded programs to teach that "sexual activity outside the context of marriage is likely to have harmful psychological and physical effects." (By this logic the sexual behavior of most Americans has caused them psychological and physical harm, since the overwhelming majority of Americans have sex before they get married.) As a review of popular abstinence-only curricula conducted by the Sexuality Information and Education Council shows, many programs do this by telling students that premarital sex is likely to ruin their relationships and perhaps their lives.

"Unmarried couples who become sexually active tend to stop communicating on all levels," teens are warned in the student workbook for the Reasonable Reasons to Wait program. A workbook for Choosing the Best Path includes this question: "Circle the item(s) that can be totally eliminated through the use of a condom? Infertility, isolation, jealousy, poverty, heartbreak, substance abuse, AIDS, pregnancy, cervical cancer, genital herpes, unstable long-term commitments, depression, embarrassment, meaningless wedding, sexual violence, personal disappointment, suicide, feelings of being used, loss of honesty, loneliness, loss of personal goals, distrust of others, pelvic inflammatory disease, loss of reputation, fear of pregnancy, disappointed parents, loss of self-esteem, leaving high school before graduation."

The answer, according to the teachers guide, is "None."

Then students are instructed to "cross out the item(s) that can be eliminated by being abstinent until marriage.

According to the teachers guide, the correct answer is "All."

This kind of education hasn't been shown to stop kids from having sex, though it has delayed them. That in itself is a good thing -- most experts believe it's healthier for teenagers to lose their virginity later rather than sooner. The problem is that when they do have sex, these teenagers may be less likely to use condoms. According to a 2001 study published in the American Journal of Sociology, students who'd signed public "virginity pledges," a key component of many abstinence-only programs, had sex an average of a year and a half later than their peers. Yet when they did have sex, they were a third less likely to use contraceptives.

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