Incidence and Consequences of Sexual Activity*

Sexual Activity of American Adolescents

  • Over the past three decades adolescent sexual activity has declined slightly.  The Centers for Disease Control (CDC) report that the percent of all high schools students who ever had sexual intercourse declined from 54% in 1991 to 48% in 2007.1
  • However, by the age of 18 nearly two-thirds of the adolescents have had sexual intercourse or engaged in oral sex according to the National Institutes of Health.
  • The age at first intercourse for teenagers dropped sharply during the 1960’s and 1970’s, leveled off during the 1980’s and 1990’s, and decreased slightly for the first time during the last decade.

Contraceptive Use

  • Among sexually active teens, rates of contraceptive use have increased slightly to about 60%, but nearly 20% report not using contraception correctly or consistently and 20% report never using contraception.2

Pregnancy Rates among Teens

  • The U.S. teen pregnancy rate (e.g., the number of pregnancies per 1,000 females aged 15-19) declined 28% from 117 pregnancies (per 1000 teens) in 1990 and to 84 (per 1000 teens) in 2000.
  • The teen abortion rate (i.e., the number of abortions per 1,000 females aged 15-19) has steadily declined from 34 per 1,000 in 1994 to 23 per 12 1,000 in 2003.2
  • About 10% of American teens become pregnant each year resulting in a yearly average of 820,000 mostly unplanned and unwanted pregnancies.3
  • About 50% of teen pregnancies result in live births with about 6%-8% given up for adoption; 35%-40% of teen mothers terminate their pregnancies by abortion, and about 15% result in miscarriages or still births.
  • Thus, most pregnant teens keep their babies and begin young adulthood as poor, under-educated, single parents.4 The National Center for Health Statistics reported in December 2008, that after a 14-year period of decline, births to teenagers (15-19 year olds) rose 3% during 2005 to 2006. This may be an anomaly or a problematic forecast.
  • Most recent government data (2006) indicates the America’s teen pregnancy rate rose 3% leading to a 4% increase in live births to teen mothers and a 1% increase in teens who select abortion to terminate pregnancy.

Dating and Sexual Activity

  • Also, nearly half of 11-14 year olds have been in a dating relationship; and the earlier a youth begins dating, the sooner sex starts and the more lifetime partners the teen will have.
  • There has been an 18% increase in the numbers of 11-14 year olds who have had sex over the past decade.
  • Recent data indicate that teen dating violence has increased: 20% of dating teens have been hit, slapped, kicked or punched by a partner; 33% of girls worry about physical and psychological abuse from their partners, and 22% of teens have been pressured to do sexual behaviors that were unwanted.5

What is Sex?

When teens are asked in surveys and interviews, “What is sex?” their answers vary considerably.

  • The majority of teens report that oral sex, anal sex, and mutual masturbation do not qualify as sex.6 Although less than half of teenagers have had sexual intercourse, 10% of teens have had anal sex and 55% have given or received oral sex.7
  • These non-coital behaviors can have adverse mental and physical health consequences including shame and guilt, loss of self-respect, acquiring a sexually transmitted infection (STI) including HIV, gonorrhea, chlamydia, genital warts, and herpes.8
  • A broader definition of sexual activity is: Any activity involving intimate contact between individuals that involves arousal, stimulation, and/or a response by at least one of the participants.9

Sexually Transmitted Infections

  • 25% of adolescents have at last one sexually transmitted infection. This amounts to approximately 4,000,000 infected teens each year.
  • 20% of all new AIDS cases are to adolescents or young adults.
  • There are 20 common STI currently in the adolescent and young adult community. The most common STI is chlamydia (1,250,000 new cases each year) with the highest incidence in the 15-19 year olds.
  • Most women and men are asymptomatic for the disease; they have it but don’t know it, so they seek no treatment.
  • The most likely side effects of chlamydia are: infertility, cervical cancer, ectopic pregnancy and Pelvic Inflammatory Disease (PID).
  • Other common STIs include: Human Papilloma Viruses (HPVs), Genital Warts, Herpes, Trichomoniasis, Gonorrhea, Vaginal yeast infections, Bacterial vaginitis, Syphilis, Hepatitis B/C and HIV/AIDS.
  • STIs can be passed from mother to fetus before or during birth. Some infections of the newborn are successfully treated, but others may cause a baby to be permanently disabled or even die. 11a
  • The symptoms of STIs can be subtle, and yet the consequences can be very significant.  Learn more.

The Changing View of Professionals on Teen Sexual Activity

Today many developmental psychologists, as well as medical and mental health professionals believe that teen sex is neither inappropriate nor untimely–just an inevitable outcome of growth and development.10 Teen sex, once thought to be premature and harmful, is now considered socially acceptable and normative (i.e., if it’s consensual, with similar age peers, and steps are taken to avoid STIs and pregnancy).11 A few academics even propose that casual sex (i.e., hooking up), “does not appear to be detrimental to adolescents’ psychological functioning.”12

The current view in adolescent psychology focuses on helping teens achieve healthy and safer sex. For example, one researcher suggests that adolescents should become “sexually competent”.13 This requires the teen to: (a) consistently use contraceptives, (b) avoid anal intercourse, (c) limit the number of partners to a few, (d) shun casual sex, and (e) eschew alcohol use in combination with sex.

The Problem: Most teens lack adult judgment and emotional control and are unlikely to execute all five strategies. This contemporary perspective assumes that teens are something they are not: mature adults. Other psychologists who believe that adolescents have a “right” to sexual expression fail to appreciate the maxim that “with rights come responsibilities,” and this responsibility requires advanced cognitive skills and emotional maturity that adolescents do not yet possess.14

There is currently no evidence that sexually-experienced teens have better developmental outcomes (e. g., emotionally, socially, intellectually, or physically) than abstinent teens. There is no published research showing that early sexual experience leads to more positive adult outcomes–such as better mental health, higher sexual satisfaction in marriage, or less divorce–when compared to married adults who had little or no adolescent sexual experience.  There is data to suggest the contrary.

*Adapted from “Flying High: Helping Teens Choose Abstinence” by Douglas Abbott, PhD. Synthesis Press, 2011

References

  • 1. Centers for Disease Control. “Sexual Risk Behaviors”. Retrieved online 15 May 2009 from http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm
  • 2. Guttmacher Institute. Facts on American Teens’ Sexual and Reproductive Health, September 2006, Guttmacher Institute. Retrieved online 15 May 2009 from http://www.guttmacher.org/ pubs/fb_ATSRH.html
  • 3. Klein, J. D. (2005). Adolescent pregnancy: Current trends and issues. Pediatrics, 116, 281-286.
  • 4. Borkowski, J. G, Farris, J. R., Whitman, T., Carothers, S., & Weed, K. (2007). Risk and Resilience, Adolescent mothers and their children grow up. New: Psychology Press. McLanahan, S. S., & Sandefur, G. (1994). Growing up with a single parent: What helps? What hurts? Cambridge, MA: Harvard University Press.
  • 5. Kaiser Family Foundation. U.S.Teen Sexual Activity. Retrieved 15 May 2009 from http://www.kff.org/youthhivstds/upload/U-S-Teen-Sexual-Activity-Fact-Sheet.pdf. Crapo, M. (2009). Teen dating violence and dating awareness. Retrieved online 11 June 2009 from http://crapo.senate.gov/issues/teen_dating_violence.cfm
  • 6. Bersamin, M. M., Fisher, D., Walker, S. & Grube, J. (2007). Defining virginity and abstinence: Adolescent’s interpretations of sexual behaviors. Journal of Adolescent Health, 41(2), 182-188.
  • 7. Centers for Disease Control. “Sexual Risk Behaviors”. Retrieved online 15 May 2009 from http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm. Gates, G. & Sonenstein, F. (2000). Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Family Planning Perspectives, 32, 295-403.
  • 8. Buffardi, A., et al. (2008). Moving upstream: Ecosocial and psychosocial correlates of sexually transmitted infections among young adults in the United States. American Journal of Public Health, 98, 1128-1136.
  • 9. Medical Institute for Sexual Health, Hooked available at http://www.medinstitute.org/products/item14.cfm.
  • 10. Irwin, C. (2004). Adolescent sexuality and reproductive health: Where are we in 2004? Journal of Adolescent Health, 34, 353-355. Levine, J. (2002). Harmful to minors: The perils of protecting children from sex. Minneapolis, MN: University of Minnesota Press.
  • 11. Steinberg, L. (2005). Adolescence, 7th Edition, Chapter 2: Cognitive Transitions. Boston, MA: McGraw Hill. Also Santrock, J. W. (2007). Adolescence. NY: McGraw-Hill.
  • 11a. STI Sources: Retrieved on 2 Nov. 2011 from http://www.chw.org/display/PPF/DocID/22764/router.asp and http://www.agapeprc.org/std.php and http://www.cdc.gov/std/stats/
  • 12. Monahan, K.C., & Lee, J. M. (2008). Adolescent sexual activity: Links between relational context and depressive symptoms. Journal of Youth and Adolescence, 37, 917-927.
  • 13. Gross, K. H. (2009). Adolescent sexual competence: A paradigm shift. Family Science Review, 14, 23-37.
  • 14. Savin-Williams, R. C. (2005). The new gay teenager. Cambridge, MA: Harvard University Press. Levine, J. (2002). Harmful to minors: The perils of protecting children from sex. Minneapolis, MN: University of Minnesota Press.