Teen Sex: Who? What? When? And What Would Change Look Like?


Part One of this series, “More Teen Virgins? Not So Fast!,” examined new data on teen sexual behavior and suggested that the media’s fascination with the rising number of virgins is off-target at best.  As promised, in Part Two, we will start by taking an even closer look at what the data is telling us about teen sexual behavior. 

When, Who, and How Often Do Teens Have Sex

The question of “when” teens have sex most often refers to the age at which young people begin having sex.  Again, even though they are one demographic for the purposes of most surveys, when it comes to societal acceptance of their sexual behavior, 15-year-olds and 19-year-olds are nothing alike.  In fact, even teens themselves have different standards based on age.  Teenagers in the U.S. found that 68 percent of male teenagers and 60 percent of female teenagers agreed that it was okay for unmarried 18-year-olds to have sex if they have strong affection for each other, but only 39 percent of males and 27 percent of females said the same about 16-year-olds. (To give teens credit for behaving true to their beliefs, the percentages of teens that are having vaginal intercourse at 16 match these numbers pretty well.) 

Of course, we all hear stories about super-young teens having sex, which send shivers down the spines of middle school parents everywhere, but for the most part it is not the youngest that are having sex. Sexual Behavior 20062008 found that the proportion of females who had engaged in vaginal sex rose steadily as they aged; 23 percent of 15-year-olds, 34 percent of 16-years-old, 44 percent of 17-year-olds, and 62 percent of 18- to 19-year-olds.  The numbers are similar when it comes to oral sex which jumps from 23 percent among 15-year-old girls to 63 percent among females ages 18 and 19.  Males also become more experienced with age.  The percentage of males who have had vaginal intercourse jumps from 21 percent at 15 to 66 percent at 18 and 19, and whereas 27 percent of 15-year-old boys have had oral sex, by the time they are 18 and 19, 70 percent have done so.

As for the “who is having sex,” or more accurately “whom they are having sex with,” believe it or not, most teens are experimenting with sex in the context of a relationship.  While today’s teens are portrayed as unable or unwilling to really bond with another person and interested in sex but not relationships, the data suggest otherwise.

In fact, only 14 percent of females and 25 percent of males described their first partner as “just friends” or someone they had just met.  And, according to Teenagers in the United States the most common first partner for vaginal intercourse (for 72 percent of females and 56 percent of males) is someone with whom they were “going steady.” According to the National Survey of Sexual Health and Behavior (NSSHB), more than two-thirds of females 14 to 17 reported that the last time they had received oral sex, given oral sex, or had penile-vaginal intercourse their partner had been a boyfriend/
girlfriend. A substantial proportion of males (49 percent), however, did report receiving oral sex from a partner other than a boyfriend/ girlfriend. Dennis Fortenberry, professor of pediatrics at Indiana University and one of the authors, explains:

“It is true that a fair number of teens report sexual interaction with someone they’ve only just met but the majority of the time they do not have vaginal intercourse.”  

In fact, when it comes to vaginal intercourse, most teens do not have a large number of partners.  Teenagers in the U.S. (which limited its data to vaginal intercourse) found that most teenagers (26 percent of females and 29 percent of males) had had 2 lifetime partners and that only a few (14 percent of females and 16 percent of males) had had more than 4 partners in their lifetime.  The number of partners does not increase drastically when you also take oral and anal sex into account.  Sexual Behavior 20062008 found that 23 percent of 15- to 19-year-olds had 1 lifetime oral sex partner, 8 percent had 2 such partners, 16 percent had 3-6 partners, 4 percent had between 7 and 14 partners, and only 1 percent had more than 15. 

And finally, let’s discuss how often.  Most teens are also not having sex all that frequently.  While 42 percent of never-married teens had ever had vaginal intercourse, only 30 percent had done so in the three months prior to the survey, and only 25 percent had done so in the prior month.  The NSSHB had similar findings.  While 21 percent of all teenagers 14 to 17 had engaged in vaginal intercourse in their lifetime only 14 percent had done so in the 90 days prior to the study.    

My former colleague, Monica Rodriguez, president of the Sexuality Information and Education Council of the United States (SIECUS), would chastise me for this section, which, while satisfying the requirements for a lead paragraph in a local news article, may very well have missed the point.

“We are way too focused on who is sticking what body part where and how often,” she says, “but without understanding the relationship between the two people this is not all that informative.” 

Logan Levkoff, sexologist and author of Third Base Ain’t What it Used to Be, agrees:

“I don’t care so much about what they’re doing as I do about why they are doing it.  Are they making smart, healthy decisions about sex and learning about their own bodies and their partners bodies?” 

Unfortunately, the research is light on questions that would help us put these behaviors into perspective. About the closest we get is a question on the NSFG that asks teens to recall how they felt about the first time they had sex.  According to Teenagers in the U.S., 47 percent of never-married females ages 15 to 17 said they had mixed feelings about the first time they had sex “part of me wanted it to happen at the time and part of me didn’t” though a similar number (43 percent) said they “really wanted it to happen at the time.”  Not surprisingly, the older a teen was when she first had sex, the more likely she was to say she really wanted it to happen.  And though never-married teen males were more likely to report they “really wanted it to happen” (62 percent), the same trend holds true for guys; those who waited until they were at least 15 to 17 were more likely to say this. 

If we change our goal from preventing all teen sex to preventing sex that teens will regret later, we can work to make sure that all teens wait until the right experience (the one that they “really wanted to happen at the time”) comes along.  Fortenberry suggests that rather than just concentrating on whether teens had sex, we should be worried about whether the sex was “safe and consensual,” and whether it “served them, their pleasure, and their relationship.”

Are they Being Responsible?

Though questions about pleasure are rare, we do ask about whether it was safe in as much as we ask a lot of question about contraceptive use. In this arena, young people actually tend to behave better than their adult counterparts. 

Teenagers in the U.S. found that 84 percent of sexually active, never-married female teenagers used contraception at their most recent intercourse; 55 percent used a condom, 31 percent the pill, and 21 percent used both a condom and a hormonal method (the pill, the shot, the patch, and the contraceptive ring are all hormonal methods).  Sexually active, never-married males reported even better rates of contraceptive use; 93 percent used some method at last intercourse with 79 percent using condoms, 39 percent the pill, and 35 percent both a condom and a hormonal method. 

The data on contraceptive use at first intercourse was also encouraging as 79 percent of sexually active, never-married females and 87 percent of their male peers used some form of contraception the first time they had vaginal intercourse. This is a particularly important statistic because research has shown that using a contraceptive method at first sex is a good indicator of future use.  In fact, Teenagers in the U.S. found that teen females are almost twice as likely to have a birth before reaching age 20 if they did not use a contraceptive method at their first sex. 

The news on condom use is also good; 95 percent of sexually active, never-married teenagers report having used a condom at some point and it is the most common contraceptive used both at first intercourse and most recent intercourse.  Use of condom at first intercourse among sexually active, never-married males actually increased from 71 percent in 2002 to 82 percent in 2006–08. Perhaps the most impressive statistic about condoms, however, is that among those never-married males who had had sex within the month prior to the survey 71 percent of males used condoms 100 percent of the time. Obviously we would want that number to be closer to 100 percent of males 100 percent of the time (and we definitely want to see improvement in this for their female counterparts only 51 percent of whom could say the same thing) but this is a good start. 

That said, there were no significant changes in the percent of teenaged females or males using contraception at first intercourse or most recent intercourse.  In fact, the increases in contraceptive use that had been seen between 1995 and 2002 did not continue.  One has to wonder if our unique and seemingly single-minded emphasis on getting teens to avoid (or delay) sexual activity has gotten in the way of encouraging teens to be responsible when they do become sexually active.

YES, BUT…

At this point, having read all of my good news on teens behaving responsibly, I would not be surprised if you paused and asked, “Okay, but, if they’re behaving so well, why are rates of teen pregnancy and STDs still so high.” 

It is a fair question and the answer is both simple and very complicated.

First, they’re not perfect.  Teens are behaving well— in many cases, better than adults— but they are not behaving perfectly.  For example, an earlier analysis of NSFG data on contraception use for both young people and adults found that only 81 percent of teen women who are “at risk of an unintended pregnancy” were using contraception during the month they were interviewed for the study.  (The NSFG labels most women who had had intercourse in the past 3 months as “at risk.” The only women who are considered “not at risk” are those who were currently pregnant, trying to get pregnant, sterile for health reasons, had never had intercourse, or had not had intercourse in the last 3 months.)  So we know they are not using methods consistently.  What we don’t know is whether they are using their reported method correctly.  Fortenberry suggests that teens may be having:

“Trouble with access, trouble with cost, trouble with adherence.  The truth is that a lot of the methods are a little hard to put up with even for adult women.”

And, while the news on condom use among teens is particularly encouraging, in order to prevent STDs, young people have to be using condoms consistently (every time, which we know they are not doing) and correctly (which we have no way of truly tracking).  Dr. Anajali Chandra, the lead author on Sexual Behavior 20062008, also points out that teens, like adults, rarely use condoms for oral sex.  While it may not be that today’s teens are having more oral sex than their parents, the risks have definitely gone up: 

“The difference is that today there is more meaningful risk of STDs, some of which, like Herpes and HPV, can be transmitted quite effectively through saliva.  What used to be invisible is no longer invisible or consequence-free.” 

Second, we have to remember that teens are not all the same.  While we might like to attribute all of their behavior to their youth or their raging hormones, in truth it is much more complicated than that.  The disparities in health, wealth, and education that exist in communities have significant impact on young people.  The data show differences in sexual behavior and outcomes based on race/ethnicity, socio-economic status, and family structure, among other characteristics.  For example, Teenagers in the U.S. found that both female and male teenagers whose mothers had their first birth as a teenagers, and those who did not live with both parents at age 14, were more likely to be sexually experienced than those whose mothers had their first birth at age 20 or older, and those who lived with both parents at 14.  In order to fully address teen pregnancy and STDs, we need to understand and fix many of these underlying issues.

Finally, and most importantly, we’re not helping.  As Monica Rodriguez explains:

“By just focusing on what we believe as the negative aspects of their behavior we send teens a clear message that nothing they do will ever be good enough which undermines their efforts to be responsible and in the end also undermines our goals of helping them grow up to be healthy, independent adults.”

Teens in Europe have similar levels of sexual activity but they have substantially lower pregnancy rates.  Many believe that this is because adults in Europe tend to approach teen sexuality from an entirely different perspective; as a normal part of growing up.

The experts I spoke to agree that it’s time we change our views and our messages as well. Fortenberry suggests that we reject the idea that virginity is important in anyway and start viewing sexual behavior as a healthy part of growing up, “We want them to develop skills and an understanding and we have to engage the fact that they have sex as part of the fact that we want them to be safe.” Rodriguez adds that we have to give them more credit for what they are doing right and figure out ways to support them and build on their strengths. At a minimum, she says this means, “More education that is realistic and meets their needs and more access to sexual health services, including contraception.”

WHAT WOULD CHANGE LOOK LIKE

Before I knew him, my husband was part of a peer education group that would go into high schools and provide sexual assault prevention programs.  He always said that the moment he got the young people in the audience (young men in particular) to listen to him was the moment he pointed out that he wasn’t going to say “I don’t want you to have sex,”  he was simply going to say, “I only want you to have good sex.”

What if we were to adopt a similar tone?  Instead of saying we want young people not to have sex, we go on the record as saying “we want young people to have good sex.”  Sex that is safe, consensual, non-exploitative, and dare I say, pleasurable.  How would our conversations with young people change if this were our underlying message?  How would our education programs and our public policies change?  How would our media messages change?  There is no doubt that this is a political landmine, and some will argue, possibly rightfully, that doing so will actually undermine efforts to improve sexual health among adolescents. Others will say, it’s time to stop be scared of the politics and the opposition.

This is something that RH Reality Check is going to explore in the coming months as we ask experts in adolescent health and sexuality education to reframe the issue for us. One thing is for sure, if we make these changes, “more virgins,” will never be our only good news again. 

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Follow Martha Kempner on twitter: @MarthaKempner