simplebooklet thumbnail

of 0
342 CHAPTER 12
Sexual Behavior During Infancy and Childhood
What common patterns characterize emerging sexuality during
childhood?
What is the nature and meaning of sex play with friends during
childhood?
The Physical Changes of Adolescence
What major physical changes accompany the onset of puberty in
boys and girls?
How do the physical changes of adolescence affect sexuality?
Sexual Behavior During Adolescence
What behavior patterns are characteristic of teenage sexuality?
What trends have been evident in adolescent coital activity over the
last several decades?
Adolescent Pregnancy
What are the major trends in and causes and implications of teenage
pregnancy in the United States?
What strategies might be effective in reducing teenage pregnancy?
Sex Education
How can parents provide valuable and effective sex education for
their children?
How does sex education inuence young people’s sexual
experimentation?
342
© Paul Steel
12
Sexuality During Childhood
and Adolescence
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence343
343
My earliest recollection of an experience that could be labeled as sexual in
nature involved thrusting against the pillow in my crib and experiencing some-
thing that felt really good, which I now believe must have been an orgasm
(actually, I remember doing this many times). I was probably around 2 at the
time, give or take a few months. What is odd about these early experiences is
that I distinctly remember sleeping in my parentsbedroom but never being
reprimanded for this “self-abuse” behavior. Either my parents were very heavy
sleepers, or they were very avant-garde in their view of sex. Knowing my par-
ents, I presume the former is true. (Authors’ files)
In many Western societies, including the United States, it was once common to view
the period between birth and puberty as a time when sexuality remains unexpressed.
However, as many of you can no doubt attest from your own experiences, the early
years of life are by no means a period of sexual dormancy. Perhaps you can even recall
sensual or sexual experiences similar to the quoted account that date from the early
years of your life. In this chapter, we outline many of the common sexual experi-
ences and behaviors that take place during the formative years from infancy through
adolescence.
Sexual Behavior During Infancy
and Childhood
Research over the last several decades has clearly demonstrated that a variety of behav-
iors and body functions, including sexual eroticism, develop during infancy and child-
hood. In some ways sexuality is especially important during this period, because many
experiences during these formative years have a great effect on the future expression of
adult sexuality.
In this section we briey outline some typical sexual and sensual behaviors that
occur during infancy and childhood.
Infant Sexuality
For most people the capacity for sexual response is present from birth (Newman,
2008; Thanasiu, 2004). In the first 2 years of life, a period generally referred to as
infancy, many girls and boys discover the pleasures of genital stimulation (Yang et
al., 2005). As reflected in the quotation from our files that opened this chapter, this
activity often involves thrusting or rubbing the genital area against an object, such
as a doll or a pillow. Pelvic thrusting and other signs of sexual arousal in infants,
such as vaginal lubrication and penile erection, are often misinterpreted or unac-
knowledged. However, careful observers have noted these indicators of sexuality in
the very young (Ryan, 2000; Thanasiu, 2004). In some cases both male and female
infants have been observed experiencing what appears to be an orgasm (Newman,
2008). The infant, of course, cannot offer spoken confirmation of the sexual nature
of such reactions, but the behavior is so remarkably similar to that exhibited by
sexually responding adults that little doubt exists about its nature. Alfred Kinsey
and his associates, in their book on female sexuality, detailed the observations of a
mother who had frequently seen her 3-year-old daughter engaging in unmistakably
masturbatory activity:
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
344 CHAPTER 12
Lying face down on the bed, with her knees drawn up, she started rhythmic pelvic
thrusts, about one second or less apart. The thrusts were primarily pelvic, with the
legs tensed in a fixed position. The forward components of the thrusts were in a
smooth and perfect rhythm, which was unbroken except for momentary pauses dur-
ing which the genitalia were readjusted against the doll on which they were pressed;
the return from each thrust was convulsive, jerky. There were 44 thrusts in unbroken
rhythm, a slight momentary pause, 87 thrusts followed by a slight momentary pause,
concentration and intense breathing with abrupt jerks as orgasm approached. She
was completely oblivious to everything during these later stages of the activity. Her
eyes were glassy and fixed in a vacant stare. There was noticeable relief and relax-
ation after orgasm. (Kinsey et al., 1953, pp. 104–105)
Kinsey also detailed references to male infant sexuality:
The orgasm in an infant or other young male is, except for lacking of ejaculation,
a striking duplicate of orgasm in an older adult. The behavior involves a series of
gradual physiologic changes, the development of rhythmic body movements with
distinct penis throbs and pelvic thrusts, an obvious change in sensory capacities, a
final tension of muscles, especially of the abdomen, hips, and back, a sudden release
with convulsions, including rhythmic anal contractions—followed by the disappear-
ance of all symptoms. A fretful baby quiets down under the initial sexual stimu-
lation, is distracted from other activities, begins rhythmic pelvic thrusts, becomes
tense as climax approaches, is thrown into convulsive action, often with violent arm
and leg movements, sometimes with weeping at the moment of climax. (Kinsey et
al., 1948, p. 177)
It is impossible to determine what such early sexual experiences mean to infants, but
it is reasonably certain that these activities are gratifying. Many infants of both sexes
engage quite naturally in self-pleasuring unless such behavior produces strong negative
responses from parents or other caregivers.
Clearly, an infant is unable to dierentiate sexual pleasure from other forms of sen-
sual enjoyment. Many of the natural everyday activities involved in caring for an infant,
such as breast-feeding and bathing, involve pleasurable tactile stimulation that, although
essentially sensual in nature, produces a genital or sexual response (Frayser, 1994; Mar-
tinson, 1994).
Childhood Sexuality
What constitutes normal and healthy sexual behavior in children? This is a difficult
question for which we have no definitive answer; the data on childhood sexuality are
scarce. Research in this area is limited by a number of factors, not the least of which is
the difficulty of obtaining financial support for basic research on childhood sexuality,
and federal guidelines in the United States either prohibit such studies or make them
considerably difficult to conduct. Some years ago, a team of researchers surmounted
some of these obstacles to research in the United States by interviewing a large sam-
ple of primary caregivers (all mothers) of children, ages 2 to 12. The results of this
informative study are described in the Spotlight on Research box, Normative Sexual
Behavior in Children: A Contemporary Sample.
People show considerable variation in their sexual development during childhood,
and diverse inuences are involved (Bancroft, 2003). Despite these dierences, however,
certain common features in the developmental sequence tend to emerge. As we outline
our somewhat limited knowledge of some of these typical behaviors, keep in mind that
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence345
345
each persons unique sexual history can dier in some respects from the described
behaviors. It is also important to realize that, other than reports from primary
caregivers, most of what we know about childhood sexual behavior is based on
recollections of adults who are asked to recall their childhood experiences. As we
noted in Chapter 2, accurately remembering experiences that occurred many years
earlier is quite dicult.
A child can learn to express her or his aectionate and sensual feelings through
activities such as kissing and hugging. e responses the child receives to these
expressions of intimacy can have a strong inuence on the manner in which he or
she expresses sexuality in later years. e inclinations we have as adults toward
giving and receiving aection seem to be related to our early opportunities for
warm, pleasurable contact with signicant others, particularly parents (DeLama-
ter & Friedrich, 2002; Newman, 2008). A number of researchers believe that chil-
dren who are deprived of contact comfort” (being touched and held) during the
rst months and years of life can have diculty establishing intimate relationships
later in their lives (Harlow & Harlow, 1962; Prescott, 1989). Furthermore, other
research suggests that aection and physical violence are, to some extent, mutu-
ally exclusive. For example, a study of 49 separate societies found that in cultures
where children are nurtured with physical aection, instances of adult violence are
few. Conversely, high levels of adult violence are manifested in those cultures in
which children are deprived of physical aection (Prescott, 1975).
Childhood Masturbation
Infants fondle their genitals and masturbate by rubbing or thrusting their genital
area against an object, such as a pillow or a doll, but the rhythmic manipulation
of the genitals associated with adult masturbation generally does not occur until
a child reaches the age of 21/2 or 3 years old (DeLamater & Friedrich, 2002;
Kaestle & Allen, 2011).
Masturbation is one of the most common and natural forms of sexual expression
during the childhood years (anasiu, 2004). e study described in the Spotlight on
Research box reported that approximately 16% of mothers observed their 2- to 5-year-
old children masturbating with their hands (Friedrich et al., 1998). Various other stud-
ies indicate that approximately one third of female respondents and two thirds of males
reported having masturbated before adolescence (Elias & Gebhard, 1969; Friedrich
et al., 1991). In one study of college students, a slightly larger percentage of women
respondents (40%) than men respondents (38%) reported masturbating before reach-
ing puberty (Bancroft et al., 2003). A review of numerous studies of childhood sexuality
revealed that a substantial proportion of people of both sexes experience rst orgasm
before puberty, often via masturbation (Janssen, 2007).
Parental reactions to self-pleasuring can be an important inuence on develop-
ing sexuality. Most parents and other primary caregivers in American society tend
to discourage or prohibit such activities and may even describe them to other adults
as unusual or problematic. Comments about masturbation that pass from parent to
child are typically either nonexistent or often negative. ink back to your youth. Did
your parents ever express to you that they accepted this activity? Or did you have an
intuitive sense that your parents were comfortable with self-pleasuring in their chil-
dren? Probably not. Most often, a verbal message to stop doing that, a disapproving
look, or a slap on the hand is the response children receive to masturbation. ese
gestures may be noted even by a very young child who has not yet developed language
capabilities.
Enjoying sexual intimacy as an adult may
be related to childhood experiences of
warm, pleasurable contact, particularly with
parents.
© Michael Newman/PhotoEdit
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
346 CHAPTER 12
How can adults convey their acceptance of this natural and normal form of self-
exploration? One way to begin is by not reacting negatively to the genital fondling that
is typical of infants and young children. Later, as we respond to children’s questions
about their bodies, it may be desirable to mention the potential for pleasure that exists
in their genital anatomy (“It feels good when you touch it”). Respecting privacy—for
example, knocking before entering a child’s room—is another way to foster comfort
with this very personal activity. Perhaps you may feel comfortable with making specic
accepting responses to self-pleasuring activity in your children, as did the parent in the
following account:
SEXUALHEALTH
Psychologist William Friedrich and his colleagues (1998)
at the Mayo Clinic interviewed a large sample of mothers
regarding sexual behaviors they had observed in their chil-
dren. Sexual behaviors were reported for 834 children, ages
2 to 12, who were screened for the absence of sexual abuse.
The mother informants were asked how often they had
seen their children displaying 38 different sexual behaviors
over the past 6 months. When 20 or more mothers reported
observing a specic behavior, Friedrich and his associates
considered it a developmentally normal form of childhood
sexual expression. We outline some of the key ndings of
this important study in the following paragraphs.
A wide range of sexual behaviors were observed at
varying levels of frequency throughout the entire age
range of children. As shown in
Table 12.1, the most fre-
quently observed sexual behaviors were self-stimulation,
exhibitionism (often exposure
of private body parts to another
child or adult), and behavior
related to personal boundaries,
such as touching their mother’s
or other women’s breasts.
Sexually intrusive behaviors—
such as a child putting his or
her hand on another child’s
genitals—were observed less
frequently.
The frequency of observed
sexual behaviors was inversely
related to age, with overall
frequency peaking at age 5 for
both sexes and then declin-
ing over the next 7 years.
The
observed decline in sexual
behaviors after age 5 does not
necessarily suggest that chil-
dren actually engage in fewer
sexual behaviors as they grow
older. Rather, Friedrich and his colleagues suggested that
it is likely that children become more private about sexual
expression as they mature. Furthermore, older children
spend more time with their peers, and thus there are fewer
opportunities for parental observation.
Ethnicity was not signicantly related to the reported
childhood sexual behaviors. There was, however, a positive
association between maternal attitudes toward sexuality
and frequency of observed sexual behaviors. Mothers who
described themselves as having a “relaxed” approach to
such things as family nudity and sleeping and/or bathing
with their children reported higher levels of sexual activity
in their children.
Friedrich and his colleagues concluded that overt
sexual behavior, particularly in young children, appears to
be a normal part of development.
RESEARCH
SPOTLIGHT ON
Normative Sexual Behavior in Children: A Contemporary Sample
TABLE 12.1 Percentage of Mothers Who Reported Observing Sexual
Behavior in Their Children at Least Once in the Preceding 6-Month Period
Males, Age (in Years) Females, Age (in Years)
Observed Behavior 2–5 6–9 10–12 2–5 6–9 10–12
Touches sex parts in public 26.5 13.8 1.2 15.1 6.5 2.2
Touches sex parts at home 60.2 39.8 8.7 43.8 20.7 11.6
Touches other child’s sex parts 4.6 8.0 1.2 8.8 1.2 1.1
Touches adult’s sex parts 7.8 1.6 0.0 4.2 1.2 0.0
Touches breasts 42.4 14.3 1.2 43.7 15.9 1.1
Shows sex parts to children 9.3 4.8 0.0 6.4 2.4 1.1
Shows sex parts to adults 15.4 6.4 2.5 13.8 5.4 2.2
Masturbates with hand 16.7 12.8 3.7 15.8 5.3 7.4
Masturbates with toy/object 3.5 2.7 1.2 6.0 2.9 4.3
Talks about sex acts 2.1 8.5 8.9 3.2 7.2 8.5
Puts mouth on breasts 5.7 0.5 0.0 4.3 2.4 0.0
Knows more about sex 5.3 13.3 11.4 5.3 15.5 17.9
SOURCE: Adapted with permission from “Normative Sexual Behavior in Children: A Contemporary
Sample,” by W. Friedrich et al., Pediatrics, Vol. 101, p. e9, Copyright 1998.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence347
347
One day my seven-year-old son joined me on the couch to watch a football game.
He was still in the process of toweling off from a shower. While he appeared to
be engrossed in the activity on the screen, I noticed one hand was busy strok-
ing his penis. Suddenly his eyes caught mine observing him. An uneasy grin
crossed his face. I wasn’t sure how to respond, so I simply stated, “It feels good,
doesn’t it?” He didnt say anything, nor did he continue touching himself, but
his smile grew a little wider. I must admit I had some initial hesitancy in openly
indicating my approval for such behavior. I was afraid he might begin openly
masturbating in the presence of others. However, my fears were demonstrated
to be groundless in that he continues to be quite private about such activity. It is
gratifying to know that he can experience the pleasures of his body without the
unpleasant guilt feelings that his father grew up with. (Authors’ files)
Another concern, voiced in the previous anecdote, is that children will begin mastur-
bating openly in front of others if they are aware that their parents accept such behavior.
is also is a reasonable concern. Few of us would be enthusiastic about needing to
deal with Johnny or Suzy masturbating in front of Grandma. However, children are
generally aware enough of social expectations to maintain a high degree of privacy in
something as emotionally laden and personal as self-pleasuring. Most of them are much
more capable of making important discriminations than parents sometimes acknowl-
edge. In the event that children do masturbate in the presence of others, it would seem
reasonable for parents to voice their concerns, taking care to label the choice of location
and not the activity as inappropriate. An example of how this situation can be handled
with sensitivity and tact is to say to the child, I know that feels good, but it is a private
way to feel good. Let’s nd a place where you will have the privacy you need” (Planned
Parenthood Federation of America, 2002, p. 12).
Many children masturbate. Telling them to stop this behavior rarely eliminates it,
even if such requests are backed with threats of punishment or claims that masturbation
causes mental or physical deterioration. Rather, these negative responses most likely
succeed only in greatly magnifying the guilt and anxiety associated with this behavior
(Singer, 2002).
Childhood Sex Play
Besides self-stimulation, prepubertal children often engage in play that can be viewed
as sexual (Sandnabba et al., 2003; Thanasiu, 2004). Such play takes place with friends
or siblings of the same sex or other sex who are about the same age (Thanasiu, 2004).
It can occur as early as the age of 2 or 3 years, but is more likely to take place between
the ages of 4 and 7 (DeLamater & Friedrich, 2002). Alfred Kinsey and colleagues
(1948, 1953) noted that 45% of the females and 57% of the males in their sample
reported having these experiences by age 12. In other research, 61% of a sample of
American college students reported engaging in one or more forms of sex play with
another child before age 13 (Greenwald & Leitenberg, 1989), 83% of Swedish high
school seniors (81% of males, 84% of females) acknowledged engaging in childhood
sex play prior to age 13 (Larsson & Svedin, 2002), and 56% of a group of adult pro-
fessionals remembered engaging in activities perceived as sexual with other children
before age 12 (Ryan et al., 1988). The activities ranged from exhibition and inspection
of the genitals, often under the guise of playing doctor, to simulating intercourse by
rubbing genital regions together. Although most adults, particularly parents, tend to
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
348 CHAPTER 12
react to the apparent sexual nature of this play, for many children the play aspects of
the interaction are far more significant than any sexual overtones.
Curiosity about what is forbidden probably plays an important role in encouraging
early sexual exploration. Curiosity about the sexual equipment of others, particularly
the other sex, is quite normal (DeLamater & Friedrich, 2002; anasiu, 2004). Many
day-care centers and nursery schools now have bathrooms open to both sexes so that
children can learn about sex dierences in a natural, everyday way.
Besides showing interest in sexual behaviors, many children in the 5–7 age range
begin to act in ways that mirror the predominant heterosexual marriage script in our
society. is is apparent in the practice of playing house, which is typical of children of
this age. Some of the sex play described earlier occurs within the context of this activity.
By the time children reach the age of 8 or 9, there is a pronounced tendency for boys
and girls to begin to play separately, although romantic interest in the other sex may
exist at the same time (DeLamater & Friedrich, 2002; O’Sullivan et al., 2007). Further-
more, despite an apparent decline in sex play with others, curiosity about sexual
matters remains high. is is an age when many questions about reproduction and
sexuality are asked (Gordon & Gordon, 1989; Parsons, 1983).
Most 10- and 11-year-olds are keenly interested in body changes, particularly
those involving the genitals and secondary sex characteristics, such as underarm
hair and breast development. ey often wait in eager anticipation for these signs
of approaching adolescence. Many prepubescent children become extremely self-
conscious about their bodies and may be reticent about exposing them to the view
of others. Separation from the other sex is still the general rule, and children of
this age often strongly protest any suggestions of romantic interest in the other sex
(Goldman & Goldman, 1982).
Sex play with friends of the same sex is common during the childhood years
(DeLamater & Friedrich, 2002; Sandnabba et al., 2003). In fact, during this time,
when the separation of the sexes is particularly strong, same-sex activity is probably
more common than heterosexual encounters (DeLamater & Friedrich, 2002). In
most instances these childhood same-sex encounters are transitory, soon replaced
by the heterosexual relationships of adolescence (Reinisch & Beasley, 1990). Nev-
ertheless, for some of these children, sex play with friends of the same sex can reect
a homosexual or bisexual orientation that will develop more fully during adoles-
cence and adulthood. However, youthful same-sex experiences in and of themselves
rarely play a determinant role in establishing a homosexual orientation (Bell et al.,
1981; Van Wyk, 1984). We encourage parents who become aware of these behav-
iors to avoid responding in a negative fashion or labeling such activity as homo-
sexual in the adult sense.
It is clear that self-discovery and peer interactions are important during child-
hood development of sexuality. ese factors continue to be inuential during the
adolescent years, as we will discover later in this chapter. But rst we turn our atten-
tion to the physical changes that accompany the onset of adolescence.
The Physical Changes of Adolescence
Adolescence is a time of dramatic physiological changes and social-role development.
In Western societies it is the transition between childhood and adulthood that typi-
cally spans the period between ages 12 and 20. Most of the major physical changes of
adolescence take place during the first few years of this period. However, important
and often profound changes in behavior and role expectations occur throughout this
phase of life. By cross-cultural standards, adolescence in our society is rather extended.
Assume that you are a parent of a 7-year-old
and that one day you nd your child playing
doctor with a playmate of the same age of
the other sex. Both have lowered their pants,
and they seem to be involved in visually
exploring each other’s bodies. How would
you respond? Would you react differently
according to the sex of your child?
Critical Thinking Question
Rob Melnychuk/Taxi/Getty Images
The physical changes of adolescence
are rapid and often eagerly anticipated.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence349
349
In many cultures (and in Western society in preindustrial times),
adult roles are assumed at a much earlier age. Rather than under-
going a protracted period of child-adult status, the child is often
initiated into adulthood upon reaching puberty.
Puberty (from the Latin pubescere, to be covered with hair”) is a
term frequently used to describe the period of rapid physical changes
in early adolescence. e mechanisms that trigger the chain of devel-
opments are not fully understood. However, we do know that the
brain coordinates the physical changes that occur during puberty and
that the hypothalamus plays an especially important role in this pro-
cess (Westwood, 2007). In general, when a child is between 8 and 14
years old, the hypothalamus increases secretions that cause the pitu-
itary gland to release larger amounts of hormones known as gonado-
tropins into the bloodstream (Westwood, 2007). ese hormones
stimulate activity in the gonads, and they are chemically identical in
boys and girls. However, in males they cause the testes to increase
testosterone production, whereas in females they act on the ovaries to
produce elevated estrogen levels. From the age of 9 or 10 years, the levels of these gonadal
steroid hormones begin to increase as the child approaches puberty (Bancroft, 2003). Girls
typically enter puberty at age 10 or 11, whereas boys experience puberty a little later, at an
average age of 12 years (Westwood, 2007). In the United States, 15% of girls begin puberty
by age 7 (Newman, 2011). Research has demonstrated that overweight girls tend to enter
puberty at an earlier age than the norm for girls (Diaz et al., 2008).
In response to higher levels of male and female hormones, external signs of characteristic
male and female sexual maturation begin to appear. e resulting developments—breasts;
deepened voice; and facial, body, and pubic hair—are called secondary sex characteristics.
Growth of pubic hair in both sexes and breast budding (slight protuberance under the nip-
ple) in girls are usually the earliest signs of puberty. A growth spurt also follows, stimulated
by an increase in sex hormones, growth hormone, and a third substance called insulin-like
growth factor 1 (Caufriez, 1997). A deciency in growth hormone levels is associated with
short stature in youth, a condition that can be remedied by the administration of growth
hormone during puberty (Collett-Solberg, 2011; Root et al., 2011). e growth spurt even-
tually terminates, again under the inuence of sex hormones, which send signals to close
the ends of the long bones. External genitals also undergo enlargement; the penis and testes
increase in size in the male, and the labia become enlarged in the female (
Figure 12.1).
e only event of puberty that is clearly dierent in boys and girls is growth. Because
estrogen is a much better facilitator of growth hormone secretion by the pituitary gland
than is testosterone, as soon as a girl starts to show pubertal development, she starts to
grow more quickly. Even though the magnitude of the pubertal growth spurt is roughly
equal in both sexes, it begins about 2 years earlier in girls (Westwood, 2007). is is
why the average 12-year-old girl is considerably taller than her male counterpart.
Under the inuence of hormone stimulation, the internal organs of both sexes
undergo further development during puberty. In girls the vaginal walls become thicker,
and the uterus becomes larger and more muscular. Vaginal pH changes from alkaline to
acidic as vaginal and cervical secretions increase in response to the changing hormone
status. Eventually, menstruation begins; the rst menstrual period is called menarche
(discussed in Chapter 3). Initial menstrual periods can be irregular and can occur with-
out ovulation. Some adolescent girls experience irregular menstrual cycles for several
years before their periods become regular and predictable. Consequently, methods of
birth control based on the menstrual cycle can be particularly unreliable for females in
this age group. Most girls begin menstruating around the age of 12 or 13, but there is
widespread variation in the age at menarche (Chumlea et al., 2003).
Many children nd the play aspects of interactions such as
this one more important than any sexual overtones.
© Jo Browne/Mick Smee/Getty Images
puberty
A period of rapid physical changes in
early adolescence during which the
reproductive organs mature.
gonadotropins
Pituitary hormones that stimulate
activity in the gonads (testes and
ovaries).
secondary sex characteristics
The physical characteristics other than
genital development that indicate
sexual maturity, such as body hair,
breasts, and deepened voice.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
350 CHAPTER 12
e median age at menarche for all girls in the United States and other developed
nations, 12.43 years, has remained stable for the last 50 years (Segal & Stohs, 2007).
Only 10% of U.S. girls are menstruating by age 11.1 years, but by age 13.75 years, 90%
are menstruating (Chumlea et al., 2003). ere are, however, signicant dierences
in the ages at menarche for dierent racial and ethnic groups in the United States, as
described in the following Sexuality and Diversity discussion.
SEXUALITY and DIVERSITY
American Ethnic Diversity in Age at Menarche
An analysis of menstrual status data obtained from a nationally representative sample
of 2,510 girls, ages 8 to 20 years, found significant ethnic differences in age at menarche
(Chumlea et al., 2003). This analysis provided estimates of the median ages at which
10%, 25%, 50%, 75%, and 90% of the population had attained menarche for each of
three ethnic samples: White Americans, African Americans, and Hispanic Americans.
The data, summarized in
Table 12.2, reveal that African American girls start to men-
struate earlier than girls in the other two ethnic groups. This difference is significant
when compared with White girls at the age levels at which 10%, 25%, and 50% of the
girls had started menstruating. In terms of statistical significance, Hispanic American
girls began menstruating earlier than White girls only at the 25% level.
TABLE 12.2 Age at Menarche (in Years) for Selected Percentiles
of U.S. Girls
Percentile
10% 25% 50% 75% 90%
Ages by race
White 11.32 11.90 12.55 13.20 13.78
African American 10.52 11.25 12.06 12.87 13.60
Hispanic American 10.81 11.49 12.25 13.01 13.69
Overall median age 11.11 11.73 12.43 13.13 13.75
SOURCE: Adapted with permission from “Age at Menarche and Racial Comparisons in U.S. Girls,
W. Chumlea et al., Pediatrics, Vol. 111, pp.110–113, Copyright 2003.
Acne
Underarm
hair
Breast
development
Rounded
body
contours
Pubic hair
Enlargement
of uterus,
clitoris,
labia
Menstruation
Acne
Beard
Voice change
Underarm hair,
chest hair,
muscle
development
Pubic hair
Enlargement
of penis,
scrotum, testes
Ejaculation
Pituitary
Adrenal
glands
Ovaries
Testes
Figure 12.1 Hormonal changes dur-
ing puberty, triggered by the influence
of the hypothalamus over the pituitary
gland, stimulate rapid growth and
the development of secondary sex
characteristics.
© Cengage Learning
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence351
351
In boys the prostate gland and seminal vesicles increase noticeably in size during
puberty. Although boys can experience orgasms throughout childhood, ejaculation is
not possible until the prostate and seminal vesicles begin functioning under the inu-
ence of increasing testosterone levels. Typically, the rst ejaculation occurs a year after
the growth spurt has begun, usually around age 13, but as with menstruation, the tim-
ing is highly variable (Janssen, 2007). e initial appearance of sperm in the ejaculate
typically occurs at about age 14 (Wheeler, 1991). ere appears to be a period of early
adolescent infertility in many girls and boys following initial menstruation or ejacula-
tion. However, this should not be depended on for birth control. In some males sperm
production occurs in the early stages of puberty, and even the rst ejaculation can con-
tain viable sperm.
Voice changes caused by growth of the voice box (larynx) occur in both sexes, but
they are more dramatic in boys, who often experience an awkward time when their voice
alternates between low and high pitches. Facial hair in boys and axillary (underarm)
hair in both sexes usually appear approximately 2 years after pubic hair does. Increased
activity of oil-secreting glands in the skin can cause facial blemishes, or acne.
Many of these physical developments are sources of concern or pride to the ado-
lescent and his or her family and friends. Feeling self-conscious is a common reaction,
and individuals who mature early or late often feel particularly self-conscious. Recent
research indicates that early maturing girls experience signicantly higher levels of social
anxiety than girls who mature within a normative time frame (Blumenthal et al., 2011).
Social changes also take place. Boy–girl friendships often change, and adolescents
are likely to become—at least temporarily—more homosocial, relating socially primar-
ily with members of the same sex. is phase does not last very long, however. e
period of adolescence is marked not only by physical changes but also by important
behavioral changes. In the following pages, we look at some important areas of adoles-
cent sexual behavior.
Sexual Behavior During Adolescence
Adolescence is a period of exploration, when sexual behaviorboth self-stimulation
and partner-shared stimulation—generally increases. However, the results of the
NSSHB Survey, which included adolescents in its national probability sample, indi-
cate that teenage sexual behavior is somewhat less pervasive than it is often portrayed
by the media. In fact, At any given time point, most adolescents are not engaging in
any sexual behavior, with the possible exception of masturbation (Fortenberry et al.,
2010, p. 314). Although much of teenage sexuality is a progression from childhood
behaviors, a new significance is attached to sexual expression. We will look at some
areas in which important developments occur during adolescence, including the sexual
double standard, masturbation, noncoital sex, development of ongoing relationships,
intercourse, and homosexuality.
The Sexual Double Standard
Although children have been learning gender-role stereotypes since infancy, the empha-
sis on gender-role differentiation often increases during adolescence. One way that
gender-role expectations for males and females are revealed is through the existence of
a sexual double standard: different standards of sexual permissiveness for women and
men, with more restrictive standards almost always applied to women (Abbey, 2011;
England, 2010; Lyons et al., 2011). As we will see in Chapter 14, the double standard
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
352 CHAPTER 12
can influence both male and female sexuality throughout our lives. Sexually emerging
teenagers often receive the full brunt of this polarizing societal belief. However, evi-
dence gathered in recent years indicates that the sexual double standard is diminishing
among adolescents and adults in North America, especially among women (Coontz,
2012; Davidson et al., 2008; Lyons et al., 2011).
Because the double standard continues to aect adolescent sexual behavior, let us
briey consider some of its potential inuences. For males the focus of sexuality may be
sexual conquest. Young men who are nonaggressive or sexually inexperienced are often
labeled with highly negative terms such as sissy. On the other hand, peers often provide
social reinforcement for stereotypically masculine attitudes and behaviors; for example,
approval is given to aggressive and independent behaviors. For some young men, telling
their peers about their sexual encounters is more important than the sexual act itself:
My own self-image was at stake. There I was—good-looking, humorous, ath-
letic, liked to party—but still a virgin. Everybody just assumed that I was an
expert at making love. I played this role and, without a doubt, always implied,
“Yes, we did, and boy, was it fun. (Authors’ files)
For females the message and the expectations are often very dierent. e following
account illustrates one womans view of both sides of the double standard:
It always seemed so strange, how society encouraged virginity in girls but it
was okay for boys to lose theirs. I came from a large family, with my brother
being the oldest child. I remember when word got around how much of a play-
boy my brother was (he was about 18). My parents were not upset, but rather
seemed kind of proud. But when my sisters and I were ready to go out, our
parents became suspicious. I can always remember how I felt and how if I ever
became a parent I wouldn’t allow such an inequality and emphasis on female
virginity. (Authors’ files)
Many girls face a dilemma. ey may learn to appear sexy to attract males, yet they
often experience ambivalence about overt sexual behavior. If a young woman refuses to
have sex, she may worry that boyfriends will lose interest and stop dating her. But if she
engages in sex, she may fear that she has gained a reputation for being easy.
Masturbation
Although a significant number of teenagers do not experience sexual intercourse by the
age of 19, many masturbate. As we saw earlier in this chapter, masturbation is a com-
mon sexual expression during childhood. The NSSHB Survey found that masturbation
was considerably more common than partnered sexual activities during adolescence (Her-
benick et al., 2010a). During adolescence the behavior tends to increase in frequency. Mas-
turbation frequency rates among females are notably lower than among males for all age
groups, including adolescents. The NSSHB Survey reported that about 26% of females,
ages 16–19 years, reported solo masturbation during the previous month. A comparable
figure for males in the same age range was approximately 60%. By age 19 about 66% of
females and 86% of males had engaged in solo masturbation (Herbenick et al., 2010a).
Masturbation can serve as an important avenue for sexual expression during adoles-
cence (Kaestle & Allen, 2011). Besides providing an always available outlet for sexual
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence353
353
tension, self-stimulation is an excellent way to learn about ones body and its sexual
potential. Teenagers can experiment with dierent ways of pleasuring themselves,
thereby increasing their self-knowledge. is information may later prove helpful dur-
ing sexual interaction with a partner.
Noncoital Sexual Expression
Noncoital sexual expression provides an important way for many couples to relate to
one another, often as an alternative to intercourse. Noncoital sex refers to erotic physi-
cal contact that can include kissing, holding, touching, manual stimulation, or oral–
genital stimulation—but not coitus. Perhaps one of the most noteworthy changes in the
pattern of noncoital sexual adolescent behaviors involves oral sex. A number of recent
surveys have shown that the incidence of oral–genital stimulation among teenagers has
risen significantly (Brady & Halpern-Felsher, 2007; Halpern-Felsher et al., 2006). The
NSSHB Survey found that while oral sex was relatively uncommon among young teens
ages 14 and 15, by age 19 over 62% of females and 59% of males had been on the receiv-
ing end of oral sex with a partner of the other sex (Herbenick et al., 2010a).
A recent survey of more than 600 high school students in California found evidence
of a predictive relationship between oral and vaginal sex. Teenage participants who had
experienced oral sex by the end of the 9th grade were three times more likely to have
engaged in penile–vaginal sex by the end of the 11th grade as compared to youth who
delayed their experience with oral sex until the end of the 11th grade (Song & Halpern-
Felsher, 2011).
Many teenagers consider oral sex to be more acceptable in dating situations and sig-
nicantly less risky than coitus in reference to health, social, and emotional consequences
(Brady & Halpern-Felsher, 2007; Knox et al., 2008). Unfortunately, many teens seem to
be unaware of the potential health risks associated with oral sex, including transmission
of infections like genital herpes, gonorrhea, and HIV (see Chapter 15).
For some young people noncoital sex is highly valued because it provides perceived
opportunities to experience sexual intimacy while technically maintaining virginity.
However, the very notion of virginity is problematic for a number of reasons. Most
important, dening virginity as the absence of a single act (coitus) perpetuates the twin
beliefs that “real sex” equals penile–vaginal intercourse and that virginity involves only
heterosexual coitus. What about lesbians, gay men, and heterosexuals who have not
experienced coitus but who engage in other forms of sexual behavior, such as mutual
masturbation, oral–genital, oral–anal, penile–anal, and genital–genital contact? Are
these individuals all “technically virgins”? What about women whose only experience
with penile intromission occurred during an act of rape? Are they no longer virgins
despite their lack of consent?
e very idea that people can engage in virtually every conceivable form of sexual
interaction but one and still remain virgins seems to be a questionable (antiquated?)
concept. Perhaps it is time to begin de-emphasizing the term virgin, which is both value
laden and exclusive.
Ongoing Sexual Relationships
Despite the lingering double standard, data indicate that early sexual experiences, both
coital and noncoital, are now more likely to be shared within the context of an ongoing
relationship than they were in Kinsey’s time. Studies conducted in the United States
have shown that from early to late adolescence the percentage of teens involved in
romantic relationships approximately doubles from about 30% in early adolescence to
Critical Thinking Question
From your point of view, what constitutes the
denition of a “virgin”?
noncoital sex
Physical contact, including kissing,
touching, and manual or oral–genital
stimulation—but excluding coitus.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
354 CHAPTER 12
approximately 70% in late adolescence (Overbeck et al., 2003). Furthermore, contem-
porary adolescents are most likely to be sexually intimate with someone they love or to
whom they feel emotionally attached (Cheng & Landale, 2011; Overbeck et al., 2003).
A recent study of several hundred college freshmen found that 80% of female and
66% of male respondents indicated that a primary motivation for engaging in sexual
relations was having a boyfriend/girlfriend they loved (Patrick et al., 2007). Another
recent national study of more than 8,000 adolescents found that most youth established
an ongoing romantic relationship by late adolescence and that romantic events, such
as holding hands, kissing, and publicly acknowledging themselves and their partner as
being a couple, generally occur before sexual interaction takes place. is investigation
also reported that this tendency to establish a secure base through romantic interactions
prior to sexual sharing was consistent across several ethnic groups, including Asian,
White, Hispanic, and Black adolescents (O’Sullivan et al., 2007).
Recent changes in the attitudes and behaviors of both sexes appear to show a merg-
ing of attitudes regarding sexual activity. Teenage women seem to be more comfort-
able with having sex with someone for whom they feel aection rather than believing
they must save themselves for a love relationship. At the same time, adolescent males
are increasingly inclined to have sex within an aectionate or loving relationship rather
than engaging in sex with a casual acquaintance or stranger, which was once typical for
adolescent males (Laumann et al., 1994; O’Sullivan et al., 2007). Nevertheless, casual
sexual relationships via “hook-ups (see Chapter 7) are also relatively common among
adolescents (George et al., 2006; Puentes et al., 2008).
An emerging social phenomenon, adolescent sexting, is receiving considerable atten-
tion from legal scholars and legislature ocials. We discuss this rapidly evolving social
trend in the next section.
Adolescent Sexting
Recently many states in America have struggled to cope with sexting (Melby, 2011).
Sexting—sending sexually suggestive photos or text messages via the Internet, cell phones,
or other electronic devices—is often associated with teenagers. However, it is probably
more common among young adults as revealed by a recent report from the PEW Research
Center’s Internet and American Life Project that reported sexting to be most common
among people ages 18 to 29 (Parker-Pope, 2011). Nevertheless, to date legal scholars have
focused primarily on sexting by minors. Some observers of this trend describe the racy
photos exchanged during youthful sexting as self-produced child pornography. Other
commentators are adamantly opposed to establishing sexting as a crime out of concerns
about First Amendment rights and fear that defining sexting as an offense will sweep reck-
less but not criminal youth into the court system (Hoffman, 2011).
Some states have sought to dene sexting as a criminal oense and other states have
allowed charging youthful practitioners of sexting with a misdemeanor, which provides the
option of diversion programs and subsequent purging of their legal records. For example,
New Jersey is debating a legislative bill that would route all rst-oense juveniles charged
with sexting to an educational diversion program. Other states take dierent approaches
to sexting by juveniles. In Nebraska, youths who forward a risqué image may be punished
while the creator of the image is not charged. Some states advocate charging minors who
produce the image as well as those who forward it. North Dakota supports legal sanc-
tions for anyone shown to have circulated a sexually suggestive photo with the intention of
humiliating the teenager depicted in the photo (Homan, 2011). Several states (such as
Florida, Texas, and New Jersey) have decriminalized sexting, instead opting to levy small
nes or require several hours of community service (Melby, 2011).
Many adolescents form caring
relationships with each other.
© Vincent Besnault/Getty Images
sexting
Sending sexually suggestive photos
or text messages via the Internet, cell
phones, or other electronic devices.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence355
355
States disagree not only about who should be prosecuted but also about how to
dene the images sent via sexting (Duncan, 2011). Some legal scholars argue that pros-
ecution should occur in the case of lewd and lascivious” images while other legal experts
consider any nude images to be a violation. As we shall see in Chapter 18, legal experts
have struggled for decades trying to dene pornography, which no doubt encompasses
lewd and lascivious” in the minds of some politicians and legal experts. e viewpoint
that all nude images are lewd or pornographic is especially susceptible to First Amend-
ment challenges.
Sexting sometimes involves images or messages sent between an adult and a minor.
For example, a 32-year-old female high school teacher in Arizona was recently arrested
for sending sexual photos of herself to a 16-year-old male student (Younger, 2011).
Ocials in many American states continue to discuss and debate the nature of legal
transgressions that involve sexting—who should be punished and what factors may inu-
ence how criminal charges are levied. We will watch closely as the practice of sexting evolves
along with the response of legal scholars and state ocials to this aspect of technology.
Sexual Intercourse
A frequently quoted statistic in sex research is the number of people in a given category
who have engaged in “premarital sex. As a statistic in sex surveys, premarital sex is
defined as penile–vaginal intercourse that takes place between partners before they
are married. However, the term premarital sex is misleading for two reasons. First, as
a measure that is frequently used to indicate the changing sexual or moral values of
American youth, it excludes a broad array of noncoital heterosexual and homosexual
activities. For some people, abstaining from coitus before marriage might not reflect
a lack of sexual activity. Second, the term premarital has connotations that may seem
highly inappropriate to some people:
I really hate those survey questions that ask, Have you engaged in premarital
sex?What about those of us who plan to remain single? Does this mean we will
be engaging in “premarital sex” all of our lives? I object to the connotation that
marriage is the ultimate state that all are supposed to evolve into. (Authorsfiles)
Because of these limitations, we avoid using the term premarital sex in subsequent
discussions. We now turn to some of the available data on sexual intercourse during
adolescence; then we look at two related areas—adolescent pregnancy and the use of
contraceptives.
Incidence of Adolescent Coitus
Even though many contemporary teenagers have not experienced sexual intercourse,
the results of 13 nationwide surveys reveal a strong upward trend in adolescent coitus
from the 1950s through the 1970s (
Table 12.3). Results of the more recent of these
surveys (and other surveys) suggest that this upward trend has leveled off and even
decreased somewhat over the last two decades (National Center for Health Statistics,
2011). Data from the National Youth Risk Behavior Surveys (YRBSs) for the years
1995, 1999, 2001, 2005, 2007, and 2009, presented in
Table 12.4, indicate that from
1995 to 2009 the overall percentage of high school students in the United States who
had ever had sexual intercourse declined somewhat for all grade levels. The prevalence
of condom use during last sexual intercourse among sexually active high school stu-
dents increased somewhat during this 14-year period.
Teenagers often engage in sexting
with a cell phone.
© David J. Green/Alamy
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
356 CHAPTER 12
TABLE 12.4 Percentage of U.S. High School Students Who Reported Sexually Risky Behaviors, 19912009
Grade Survey Year Ever Had Sexual
Intercourse (%)
Four or More Sexual Partners
During Lifetime (%)
Currently Sexually
Active (%)
Condom Use During Last
Sexual Intercourse (%)
9 1995 36.9 12.9 23.6 62.9
1999 38.6 11.8 26.6 66.6
2001 34.4 9.6 22.7 67.5
2005 34.3 9.4 21.9 74.5
2007 32.8 8.7 20.1 69.3
2009 31.6 8.8 21.4 64.0
10 1995 48.0 15.6 33.7 59.7
1999 46.8 15.6 33.0 62.6
2001 40.8 12.6 29.7 60.1
2005 42.8 11.5 29.2 65.3
2007 43.8 13.4 30.6 66.1
2009 40.9 11.7 29.1 67.8
11 1995 58.6 19.0 42.4 52.3
1999 52.5 17.3 37.5 59.2
2001 51.9 15.2 38.1 58.9
2005 51.4 16.2 39.4 61.7
2007 55.5 17.0 41.8 62.0
2009 53.0 15.2 40.3 61.4
12 1995 66.4 22.9 49.7 49.5
1999 64.9 20.6 50.6 47.9
2001 60.5 21.6 47.9 49.3
2005 63.1 21.4 49.4 55.4
2007 64.6 22.4 52.6 54.2
2009 62.3 20.9 49.1 55.0
SOURCE: Adapted from Centers for Disease Control (1998, 2000b, 2002, 2006a, 2008a, 2010i).
TABLE 12.3 Percentage of Adolescents Who Reported Experiencing Coitus by Age 19
Study Females (%) Males (%)
Kinsey et al. (1948, 1953) 20 45
Sorenson (1973) 45 59
Zelnick & Kantner (1977) 55 No males in survey
Zelnick & Kantner (1980) 69 77
Mott & Haurin (1988) 68 78
Forrest & Singh (1990) 74 No males in survey
Sonenstein et al. (1991) No females in survey 79
Centers for Disease Control (1996) 66
a
67
a
Centers for Disease Control (2000b) 66
a
64
a
Centers for Disease Control (2002) 60
a
61
a
Centers for Disease Control (2006a) 62
a
64
a
Centers for Disease Control (2008a) 66
a
63
a
Centers for Disease Control (2010i) 65
a
60
a
a
Percentages reporting having had intercourse by their senior year (usually age 17 or 18).
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence357
357
Evidence indicates that the leveling o in adolescent coital rates has not been as
pronounced among young teenagers. Data from a number of studies indicate that over
the last several decades there has been a trend toward experiencing rst coitus at an
earlier age in both sexes, and this trend is consistent across a diverse range of ethnic
groups (Allen & Forcier, 2011; Centers for Disease Control, 2010i). However, dierent
American ethnic groups vary in their experiences with adolescent sex. ese dierences
are described in the following Sexuality and Diversity discussion.
SEXUALITY and DIVERSITY
American Ethnic Diversity in Adolescent Sexual Experiences
A variety of studies have consistently reported that African American teenagers are more
likely to engage in adolescent coitus than either White or Hispanic American teenagers
(Cavazos-Rehg et al., 2011; Centers for Disease Control, 2010i). For example, a nationwide
study reported that African American high school seniors were significantly more likely
than Hispanic American seniors and White American seniors to have experienced sexual
intercourse (Centers for Disease Control, 2010i). The results of this study, summarized in
Tabl e 12.5, also rev ealed tha t A f rican Amer ic an yout h tend to ha ve th eir initial expe ri-
ences with intercourse at an earlier age than either Hispanic American or White youth.
TABLE 12.5 Ethnicity and Percentage of Adolescents Reporting Having Had Sexual Intercourse
Males Females Males and Females Combined
White (%) Black (%) Hispanic (%) White (%) Black (%) Hispanic (%) White (%) Black (%) Hispanic (%)
By 12th
grade
39.6 72.1 52.8 44.7 58.3 45.4 42.0 65.2 49.1
Before
age 13
4.4 24.9 9.8 2.2 5.6 3.7 3.4 15.2 6.7
SOURCE: Centers for Disease Control (2010i).
ese ethnic dierences in adolescent sexual experiences could be related more to
economic status than to race or ethnicity. Poverty is a strong predictor of sexual activity
among adolescents (Kissinger et al., 1997; Singh & Darroch, 2000). Teenagers from the
least auent segments of American society are more likely to engage in sexual activ-
ity than are those from more auent classes, and African Americans and Hispanic
Americans are often less auent than White Americans. Furthermore, studies indicate
that African American adolescents raised in more auent homes are signicantly more
likely to abstain from sexual intercourse than are their poorer counterparts (Leadbeater
& Way, 1995; Murry, 1996).
e trend in both sexes toward having intercourse at an earlier age is a source of
considerable concern for many social scientists and health practitioners. Numerous
studies have linked early sexual intercourse with increased risk for adverse health out-
comes, including unintended pregnancy, delinquency, reduced educational attainment,
increased probability of exposure to HIV and other sexually transmitted infections
(STIs), and increased number of lifetime sexual partners (Andru & Wentland, 2012;
Cheng & Landale, 2011; Pearson et al. 2012).
Reasons for Engaging in Adolescent Coitus
A number of conditions motivate teenagers to engage in sexual intercourse. An accel-
erated output of sex hormones, especially testosterone, increases sexual desire and
arousability in both sexes. Some adolescents are motivated by curiosity and a sense of
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
358 CHAPTER 12
readiness to experience intercourse. About half the men and one fourth of the women
in the NHSLS reported that their primary reason for engaging in their initial coital
experience was curiosity and feeling ready for sex (Laumann et al., 1994). Many teen-
agers consider sexual intercourse a natural expression of affection or love (O’Sullivan
et al., 2007). Almost half the women and one fourth of the men who responded in the
NHSLS reported that affection for their partner was the primary reason for engag-
ing in first intercourse (Laumann et al., 1994). A push toward adult” behaviors, peer
pressure, pressure from dating partners, and a sense of obligation to a loyal partner are
other reasons that adolescents engage in coitus (Lammers et al., 2000; Rosenthal et
al., 1999).
Factors That Predispose Teenagers to Early or Late Onset of Coitus
Researchers have identified several factors that appear to predispose young adoles-
cents to engage in sexual intercourse while very young or to delay coitus until they are
older. Various psychosocial factors have been shown to be potentially powerful pre-
disposing conditions for early onset of coitus. These include poverty, family conflict
or marital disruption, teens living in single-parent or reconstituted families, parents’
lack of education, lack of parental supervision, substance abuse (especially alcohol),
low self-esteem, and a sense of hopelessness (Cavazos-Rehg et al., 2011; ODonnell
et al., 2006; Regnerus & Luchies, 2006). Other predisposing factors that have been
identified include poor academic performance and low educational expectations
(Lammers et al., 2000; Steele, 1999), tolerance for antisocial behavior and associa-
tion with delinquent peers (French & Dishion, 2003), exposure to a diet of television
high in sexual content (Ashby et al., 2006; Chandra et al., 2008), and having been
sexually victimized (molested or raped) (Lammers et al., 2000). Adolescent females
who are involved with a partner who is several years older are much more likely to
experience coitus than females with same-age partners (Kaestle et al., 2002; Ryan et
al., 2008).
Research has also provided insights into the characteristics and experiences of
adolescents who choose to delay onset of sexual intercourse. A few studies suggest
that strong religious beliefs, regular religious service attendance, and spiritual inter-
connectedness with friends lessen the likelihood of early sexual intercourse (Cheng
& Landale, 2011; Davidson et al., 2008; Pearson et al., 2012). A survey of 26,000
students in grades 7–12 found that factors signicantly associated with postponing
coitus included higher socioeconomic status, good school performance, high parental
expectations, and adolescentsbelief that they had one or more adults in their lives
who cared about them (Lammers et al., 2000). Several other studies have also found
a positive link between delayed onset of teenage sexual activity and high-quality par-
ent–child relationships and communication (Akers et al., 2011; Hutchinson & Ced-
erbaum, 2011; Parkes et al., 2011). However, the growing role of the Internet in the
lives of adolescents may be adversely aecting parent–child relationships, as described
in the next section.
Adolescents Online: Social Networking and Communication
Currently most American adolescents have access to the Internet at home, many via
personal computers located in their bedrooms. Teenagers also use all kinds of mobile
devices, such as cell phones and iPads, to surf the Internet (Feldman, 2011). Accessing
social media sites such as MySpace and Facebook is one of the most common activities
of American youth (O’Keeffe & Clarke-Pearson, 2011). The emergence of varied kinds
of Web-based social media sources and methods of gaining access to these sources
has meant that exposure to sexuality, to sexual information, and to sexual images has
Assume that you are a parent of a teenager
who asks, “How do I know when I should have
sex?” What would you answer, and why?
Critical Thinking Question
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence359
359
substantially affected sexual attitudes and behaviors for this contemporary generation
of adolescents (Fortenberry et al., 2010, p. 306).
Teenagers engage in a broad range of online behaviors, including blogging (creat-
ing and maintaining personal Internet sites that allow their authors and others to post
content, thus creating a personal network), interacting and social networking with peers
in chat rooms, seeking health information, accessing pornography, researching topics
related to school assignments, posting personal proles on sites such as MySpace and
Facebook, and countless other online activities (Bleakley et al., 2011; Mitchell & Ybarra,
2009; O’Keee & Clarke-Pearson, 2011; Versteeg et al., 2009 ).
A number of social scientists have suggested that while adolescents often access
valuable information and support on various websites, electronic communication may
also be reinforcing peer communication at the expense of communication with par-
ents (Subrahmanyam & Greeneld, 2008, p. 119). However, the “Internet can also
strengthen family ties because it provides a continuously connected presence (Brown,
2011, p. 32). Family members can communicate with each other via cyberspace, and
young people away at college can maintain more contact with their parents by Skyping
and web-texting. A recent survey found that adolescents today feel closer to their par-
ents than did their older siblings (Brown, 2011).
Such online activities, in addition to having a potentially adverse impact on family
relations, often result in a decline in face-to-face communication with peers. ere-
fore, a possible consequence of the rise of online networking and communicating may
be a reduction in real-world interpersonal competence. In addition, troubled teens
who frequently access online sites such as Facebook and MySpace may experience
depression, especially if they are already dealing with low self-esteem (O’Keee &
Clarke-Pearson, 2011). Cyberbullying and exposure to inappropriate online content
are additional dangers that confront adolescents online (OKeee & Clarke-Pearson,
2011). Finally, contacts made in cyberspace can potentially endanger adolescents, as
described in Chapter 17.
On a positive note, social networking and interaction with strangers online may alle-
viate some of the negative eects teenagers experience as a result of social rejection in
the real world (Subrahmanyam & Greeneld, 2008).
Adolescent Multi-Person Sex
Recent evidence indicates that adolescent sexual interaction involving multiple simul-
taneous partners is an emerging public health concern (Rothman et al., 2011). Multi-
person sex (MPS), which may be either consensual or forced, increases health risks
of participants, who often engage in unsafe, condomless sex and who may be injection
drug users. (See Chapter 15 for a discussion of risks associated with injection drug use
and having sexual intercourse without the protection of condoms.)
National surveys that ask questions about adolescent sexual behavior do not collect
data about MPS, which appears to be an emerging phenomenon. One recent anony-
mous survey of 328 females, ages 14–20, reported that over 7% of the participants had
experienced MPS and that almost half of these incidents were accomplished by threats
or force (Rothman et al., 2011). In this study MPS was found to be associated with sev-
eral variables including sexual experience prior to age 15, having an STI, dating violence
victimization, child sexual abuse victimization, and recent exposure to pornography.
About a quarter of the participants in this survey reported that a current or former
boyfriend was involved in the MPS encounter.
Clearly more research needs to be directed toward this risky and/or exploitive
form of adolescent sexual behavior in an eort to better understand multi-person sex
among teens.
multi-person sex (MPS)
Adolescent sexual interaction involving
multiple simultaneous partners that
may be either consensual or forced.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
360 CHAPTER 12
Homosexuality
Various studies indicate that 6–11% of girls and 11–14% of boys report having expe-
rienced same-sex contact during their adolescent years (Haffner, 1993; Hass, 1979).
A recent survey of more than 17,000 adolescents found that about 1 in 10 teenag-
ers report having experienced sexual contact with same-sex partners (Pathela, 2011).
Most of these contacts took place not with older adults but between peers. These data,
or the behaviors they describe, do not entirely reflect later orientation. Same-sex con-
tact with the intent of sexual arousal can be either experimental and transitory or an
expression of a lifelong sexual orientation. Many gay and lesbian adolescents do not act
on their sexual feelings until adulthood, and many people with heterosexual orienta-
tions have one or more early homosexual experiences.
Gay, lesbian, and bisexual teenagers frequently encounter adverse societal reactions
to their sexual orientation (Savage & Miller, 2011). Consequently, they may nd it
especially dicult to become comfortable with their developing sexuality. Unlike many
other cultures in the world community, American society is not noted for embracing
the fact of adolescent sexuality, even the often assumed heterosexuality of its young
people. American teenagers who are at variance with the dominant heterosexual script
can therefore experience a double societal rebuke of both their sexual orientation and
the fact that they are sexually active.
For most gay, lesbian, and bisexual adolescents the process of reconciling their sexu-
ality with the expectations of their peers and parents can be a dicult and often painful
process that can create severe problems, including unusually high incidences of depres-
sion, loneliness, hostility toward others, substance abuse, and suicide attempts (DiFul-
vio, 2011; Hatzenbuehler, 2011; Pathela, 2011; Russell & Toomey, 2012). Not being
part of the crowd can be emotionally painful for teenagers, who often nd themselves
scorned by their peers (Poteat, 2008; see the Sex and Politics box,Antigay Harass-
ment/Bullying of Teenagers”). Adolescents who are suspected of being homosexual are
sometimes verbally abused, bullied, sexually harassed, or physically assaulted (Poteat,
2011; Rivers & Noret, 2008). Many lesbian and gay adolescents are unable to talk
openly with their parents about their sexual orientation. “Coming out, as discussed in
Chapter 9, is often a complex and dicult process. ose who do reveal their same-
sex orientation are sometimes emotionally (if not physically) forsaken by their families
(Dempsey, 1994; Frankowski, 2004), and they may eventually leave home, voluntarily
or otherwise, because their parents cannot accept their sexuality. Some gay, lesbian, and
bisexual teenagers even experience antigay violence at the hands of family members
(Saewyc et al., 2008; Safren & Heimberg, 1999). Even though parents often react with
disapproval and anger when they rst learn that their child is homosexual, many parents
eventually recover to the extent that they are able to maintain supportive relationships
with their children (LaSala, 2007, p. 50). Young people with a homosexual orientation
often nd it dicult to nd condants with whom they can share their concerns or nd
guidance (Espelage et al., 2008). Parents, ministers, physicians, and teachers often are
unable to oer constructive help or support. In addition, a society that generally fears
and rebukes same-sex orientations has traditionally provided few positive role models
for gay, lesbian, or bisexual teenagers, though that has been changing in recent years
with more prominent and positive gay and lesbian representation in the mass media.
It is apparent from this brief discussion that American gay, lesbian, and bisexual
adolescents often must achieve self-acceptance of their sexual orientation within the
context of powerful societal pressures not to accept and/or act on that orientation—
not an enviable task. Fortunately, people in the United States have gradually become
more accepting of behaviors that vary from the dominant scripts for sexual and gen-
der behaviors. Information about homosexuality is becoming increasingly available, as
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence361
361
is support for people with same-sex orientations. Some colleges and high schools in
the United States now provide a more accepting environment for the establishment of
support groups for gay and lesbian students. Nationwide, there are more than 3,000
Gay-Straight Alliances (GSAs) on middle school, high school, and college campuses
(Warbelow, 2008). GSAs are clubs composed of both homosexual and heterosexual
students who meet to exchange information, provide support to one another, and devise
strategies for changing antihomosexual attitudes in their schools. While the establish-
ment of these support groups is a welcome development, research indicates that public
Antigay Harassment/Bullying of Teenagers
SEX &
POLITICS
During 2010 there were four known cases of teenagers com-
mitting suicide after becoming targets of antigay harassment/
bullying (Crary, 2010). This deplorable situation has become
even more pronounced with the advent of cyber attacks
on gay teens. This problem was tragically exemplied by
the September 2010 death of Tyler Clementi, an 18-year-old
Rutgers University freshman who jumped to his death from
a bridge after his roommate used a secret webcam to record
and post on the Internet his sexual encounter with another
man. Clementi’s suicide focused national attention on victim-
ization of gays. In March 2012 Clementi’s roommate, Dharun
Ravi, was convicted on all counts of hate-crime charges. In
May 2012, he was sentenced to 30 days of jail time, 3 years
of probation, 300 hours of community service, and he was
ordered to undergo counseling (DiBlasio, 2012).
Currently most high schools, colleges, and universities
do not have effective programs in place to address antigay
harassment and bullying. According to a 2009 survey by the
Gay, Lesbian and Straight Education Network, an organiza-
tion that strives to improve the school environment for gay
students nationwide, over 80% of schools lack comprehensive
programs for addressing and countering antigay bullying.
This deciency is unfortunate because such programs have
been shown to reduce victimization of gay teens (Crary, 2010).
This issue has become something of a political football
with gay-rights supporters insisting on the implementation of
anti-bullying programs while conservative religious organiza-
tions and politicians oppose these measures, suggesting that
introducing such programs would be an unnecessary tactic
designed to manipulate teenagers’ beliefs about homosexu-
ality. We can only hope that school ofcials will recognize
antigay harassment and bullying as a human rather than a
political issue that needs to be addressed via effective pro-
grams that counter negative treatment of gay teens.
Teenagers march in the sixth annual
Gay/Straight Youth
Pride March in
Boston. Several thousand young
people took part in the rally,
demanding respect and declaring that
their sexuality is their own business.
AP Photo/Michael Dwyer
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
362 CHAPTER 12
school districts across the United States are still largely remiss in addressing the needs
of gay, lesbian, and bisexual students (Crary, 2010; Rienzo et al., 2006).
Internet chat rooms and message boards can be especially helpful sources of sup-
port and constructive information for gay, lesbian, and bisexual teenagers. In addition,
in recent years homosexuality has become more visible and has been portrayed in a
more positive light in the media. Several prominent entertainment and sports celebrities
who have openly acknowledged their homosexuality are now available as potential role
models. (See Chapter 9 for more detailed information about homosexuality and the
media and the gay Internet community.) We hope that increasing societal acceptance of
homosexuality, together with more positive role models and media portrayals, will help
make this time of life easier for adolescents with homosexual orientations.
The Effect of AIDS on Teenage Sexual Behavior
Many health professionals are concerned that American teens are particularly at risk
for becoming infected with HIV, the virus that causes AIDS (Trepka et al., 2008). Var-
ious surveys have shown that most adolescents in the United States are familiar with
the basic facts about AIDS and are aware that high-risk activities can lead to transmis-
sion of HIV. Unfortunately, even though most teens know the basic facts about HIV/
AIDS, this knowledge has not resulted in behavior changes in many teenagers. Several
studies of high-school–age and college-age youths suggest that because most teenagers
do not believe that they are at risk for contracting HIV, most do not significantly alter
their sexual behavior to avoid infection (Feroli & Burstein, 2003; Trepka et al., 2008).
e notion of the “personal fable(Elkind, 1967) is relevant to a consideration of
adolescent risk taking and sexual behavior. Adolescents are particularly susceptible to
a kind of cognitive egocentrism, an illusionary belief pattern in which they view them-
selves as somehow invulnerable and immune to the consequences of dangerous and
risky behavior (Feroli & Burstein, 2003). us many adolescents continue to engage in
high-risk sexual behaviors, not because they are ignorant about HIV/AIDS and other
STIs but because they falsely view themselves as being at very low (or no) risk of suer-
ing negative consequences (Feroli & Burstein, 2003). Also, research suggests that having
a friend who engages in unprotected sexual intercourse increases the likelihood that a
teenager will also engage in unprotected intercourse (Kim et al., 2011).
Behaviors that put young people at risk for HIV infection include engaging in inter-
course without condoms; using alcohol, cocaine, and other drugs that impair judgment,
reduce impulse control, and thus increase the likelihood of hazardous sexual activity;
sharing needles with other intravenous drug users; exposing themselves to multiple sex-
ual partners; and choosing sexual partners indiscriminately (Dariotis et al., 2011; Gross-
bard et al., 2007; Trepka et al., 2008). e continuing trend toward a younger age of
rst intercourse is disturbing because people who begin sexual activity by age 15 tend to
have signicantly more lifetime sexual partners than those who begin having sexual inter-
course at an older age (Cheng & Landale, 2011). (Exposure to multiple sexual partners is
a high-risk sexual behavior, as discussed in Chapter 15.) Furthermore, young adolescent
females who have their initial sexual experiences with older male partners are more likely
to engage in unprotected, risky sexual behavior in adulthood (Senn et al., 2011).
With the growing awareness that teenage women are at risk for HIV infection (and
other STIs), most family clinic counselors now encourage clients, even those on birth
control pills, to regularly use condoms to protect themselves against STIs. Unfortunately,
this advice is often unheeded, for a variety of reasons. Many young women and their part-
ners are unwilling to deal with the minor inconvenience of condoms when they believe
that they are already adequately protected from an unwanted pregnancy (Ott et al., 2002;
SEXUALHEALTH
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence363
363
Zimmerman et al., 2007). A study of 436 sexually active adolescents found that con-
dom use among teenagers who used birth control pills was much lower than condom use
among adolescents who did not use oral contraceptives (Ott et al., 2002).
Adolescent Pregnancy
The incidence of births to teenagers in the United States has declined steadily from its
peak in 1991. In 2009 the birthrate for U.S. teens was 39.1 births per 1,000 females, a
37% decrease from 61.8 births per 1,000 teenage females in 1991 and the lowest rate
of teen births ever recorded (Centers for Disease Control, 2011g). Even though adoles-
cent birthrates in the United States have declined, the still alarmingly high rate of teen-
age pregnancies and births, especially among African American and Hispanic teens,
continues to be an urgent social concern. Among Western industrialized nations, the
United States has the highest rate of teen pregnancy (Allen & Forcier, 2011; Akers et
al., 2011). Approximately 750,000 unmarried American adolescents become pregnant
each year, and 80% of these pregnancies are unintended. This adolescent pregnancy
rate is as much as nine times higher than in other developed countries and two to
four times higher than in several Western European nations whose age-specific levels
of teenage sexual activity are comparable to those in the United States (Splete, 2011;
Winik, 2008). This finding raises the obvious question of whether contraception is
significantly underused or misused by adolescents in the United States. We address
this issue in a later section of this chapter.
At the time of this writing, eorts are under way in Congress to reduce or eliminate
federal funding for programs that focus on reducing teen pregnancy. ese eorts are
described in the Sex and Politics box, U.S. Congress Considering Measures to Reduce
Teen Pregnancy Prevention Programs.
As described in Chapter 10, females ages 16 and younger are currently required to
obtain a prescription for EC, whereas older women can access this medication over the
counter without a prescription. In November 2010 the Center for Reproductive Rights
led a legal brief charging the U.S. Food and Drug Administration (FDA) with being
in contempt for not complying with a March 2009 court order to end age restrictions
on EC. In passing this order the court supported evidence that there are no valid medi-
cal contraindications for EC use in female adolescents (Brakman, 2011). In 2011 the
FDA recommended lifting the restrictions on access to EC by teenagers 16 and younger.
Unfortunately, the Obama administration overruled the FDA and elected to continue
requiring EC prescriptions for teenage females 16 and younger.
U.S. Congress Considering Measures to Reduce Teen Pregnancy
Prevention Programs
SEX &
POLITICS
On February 11, 2011, the Appropriations Committee of the
U.S. House of Representatives proposed severely cutting
or completely eliminating funding for several programs
designed to reduce adolescent pregnancy.
This position
is clearly antithetical to efforts to prevent teen pregnancy
and stands in marked contrast to President Obama’s 2012
budget proposal released on February 14, 2011. The Obama
proposal provides hundreds of millions of dollars for
evidence-based teen pregnancy prevention programs.
Hopefully, these efforts by the Republican-controlled
House to undermine the Obama administration’s efforts to
fund science-based approaches to preventing teen preg-
nancy will not succeed and thereby put the ongoing Ameri-
can success story of reduced adolescent pregnancy at risk.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
364 CHAPTER 12
Negative Consequences of Teenage Pregnancy
The cited statistics on teenage pregnancy represent a great deal of human suffering. A
pregnant teenager is more likely to have physical complications than a woman in her
20s. These complications include anemia, toxemia, hypertension, hemorrhage, miscar-
riage, and even death (American Academy of Pediatrics, 2006). Adolescent pregnancy
is also associated with prenatal and infant mortality rates that are markedly higher
than the rates among older pregnant women (American Academy of Pediatrics, 2006;
Centers for Disease Control, 2011g).
Pregnant teenagers are also at especially high risk for STIs because of a likely reduc-
tion in the use of condoms, which are no longer needed to prevent pregnancy. Research
indicates that less than 30% and perhaps as few as 8% of sexually active pregnant adoles-
cent women use condoms consistently during intercourse (Byrd et al., 1998; Niccolai et
al., 2003). ese ndings are disturbing because the resultant increase in susceptibility
to STIs during pregnancy can have negative health consequences for both the youthful
mother and her baby.
A teenager’s unintended pregnancy and the decision to keep her child often have
a serious negative eect on her education and on her nancial resources (American
Academy of Pediatrics, 2006; Cavazos-Rehg et al., 2011). Although it is now illegal
to bar pregnant teenagers and teen mothers from public school, a large number of
these young women drop out of school, and many do not return (Centers for Disease
Control, 2011g; Harrison et al., 2012). Faced with the burden of child-care duties and
the limitations of inadequate education, teenage mothers are often underemployed or
unemployed and dependent on social services agencies (Paukku et al., 2003; Shearer
et al., 2002). Furthermore, low education levels and limited employment skills often
thwart the eorts of these young mothers to obtain economic independence as they
move beyond their teenage years.
e negative eect of adolescent pregnancy is further exhibited in the lives of the
resulting children. Teenage mothers often provide parenting of a lower quality than
adult mothers do (Coley & Chase-Lansdale, 1998; Stier et al., 1993). In addition, the
children of teenage mothers are at greater risk of having physical, cognitive, and emo-
tional problems than are the children of adult mothers (Cavazos-Rehg et al., 2011; Cen-
ters for Disease Control, 2011g). ese children of young mothers are also more likely
to demonstrate decits in intellectual ability and school performance than are children
of older mothers (Cavazos-Rehg et al., 2011; Harrison et al., 2012).
Use of Contraceptives
Despite the physical, economic, lifestyle, and emotional stress of pregnancy and par-
enthood—and despite the availability of birth control today—many sexually active
American teenagers do not use contraceptives consistently or effectively (Barclay,
2010; Reece et al., 2010b; Scott et al., 2011). Furthermore, many adolescents do not
use any contraception at all the first few times they have sexual intercourse (Centers
for Disease Control, 2012b).
A recent national survey revealed that in 2009, 60% of sexually active male teens and
44% of sexually active female teens used condoms during their last intercourse experi-
ence (Centers for Disease Control, 2011g). e NSSHB found that adolescent men used
condoms during 79% of their last 10 vaginal intercourse experiences whereas only 58%
of teen women reported using condoms during their previous 10 involvements in vagi-
nal intercourse (Reece et al., 2010b). Findings from the NSSHB do support a consensus
among sexologists that there is a denite trend among adolescents to increasingly use con-
doms during penile–vaginal intercourse (Fortenberry et al., 2010; Reece et al., 2010b).
Approximately 750,000 unmarried
American teenage women become
pregnant each year. Many experience
considerable hardship as a result of
their pregnancy.
© David Young-Wolff/PhotoEdit
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence365
365
For many sexually active teenagers the use of hormonal contraceptive methods (pills or
injectables) alone or in combination with condoms remains low (Centers for Disease Con-
trol, 2011g). However, recent research provided encouraging evidence that the percentage
of male teens who use condoms during their initial experience with intercourse is on the
rise—71% in 2006 and 85% in 2010 (National Center for Health Statistics, 2011).
Many teenagers wait months after becoming sexually active to seek birth control
advice, and some never seek counsel. Misconceptions about possible health risks associ-
ated with some contraceptive methods, fear of the pelvic exam, embarrassment associated
with seeking out and/or purchasing contraceptive devices, and concerns about conden-
tiality keep many teenagers from seeking birth control advice (Guttmacher Institute,
2006; Iuliano et al., 2006). In reality, most American obstetrician-gynecologists are will-
ing to provide contraceptives to adolescents without notifying their parents (Lawrence
et al., 2011a).
Several factors or personal attributes have been found to be associated with ado-
lescents use or nonuse of birth control. Teenage women who experience infrequent
intercourse are likely to be ineective contraception users (Glei, 1999; Klein, 2005).
Furthermore, teenage women whose partners are several years older are signicantly less
likely to use birth control than are their peers who have partners closer in age (Ryan et
al., 2008; Senn et al., 2011). Being involved with an older partner may result in reduced
power in a sexual relationship and reduced control over contraceptive decision-making”
(Manlove et al., 2004, p. 265). Adolescents who experience intercourse at an early age
are less likely to use contraception than are their peers who delay intercourse onset
(Manlove & Terry-Humen, 2007; Ryan et al., 2007).
Research also indicates that sexually active adolescents in close, loving relationships
are less likely to use condoms to prevent pregnancies and STIs than those in casual rela-
tionships (Reece et al., 2010b). is nding suggests that teens in close relationships may
prioritize trust, romance, and love over concerns about unwanted pregnancies and STIs
and thus engage in risky sexual behaviors (Zimmerman et al., 2007). Inequities in power
within intimate relationships often reduce a teenage womans ability to eectively negoti-
ate condom use (Silverman et al., 2011). Many sexually active young women believe that
they lack the right to communicate about and/or control aspects of their sexual interac-
tion with men, and thus lack of sexual assertiveness is often associated with inconsistent
contraceptive use (Manlove & Terry-Humen, 2007; Rickert et al., 2002).
Strong parent–child relationships that embrace healthy patterns of communica-
tion about everyday life, including sex and contraception, have been positively linked to
adolescent contraceptive use (Halpern-Felsher et al., 2004; Manlove & Terry-Humen,
2007). Experiencing academic success in school and having well-educated parents are
also associated with eective use of contraception (Klein, 2005; Manlove & Terry-
Humen, 2007). Research also indicates that adolescents raised in families that stress
personal responsibility for behavior tend to be eective users of birth control (Whitaker
et al., 1999; Wilson et al., 1994). Finally and perhaps most obviously, adolescents who
are the most knowledgeable about contraceptives are the most likely to use them consis-
tently and eectively (Lagana, 1999).
Strategies for Reducing Teenage Pregnancy
Many authorities on adolescent sexuality agree that educational efforts designed to
increase teenagers awareness of contraception and other aspects of sexuality would be
much more effective if they treated sexuality as a positive aspect of our humanity rather
than something that is wrong or shameful. In many Western European countries, where
teenage birthrates are dramatically lower than in the United States even though levels of
Critical Thinking Question
Should parents provide birth control devices
to their teenage children who are actively
dating or going steady? Why or why not?
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
366 CHAPTER 12
adolescent sexual activity are equal to or greater than those in America, sex is viewed as
natural and healthy, and teenage sexual activity is widely accepted. This stands in sharp
contrast to the United States, where sex is often romanticized and flaunted but also
frequently portrayed as something sinful or dirty that should be hidden.
We oer a list of suggestions for reducing teenage pregnancy rates in the United
States. ese suggestions were gleaned from a large body of research on adolescent
sexuality.
1. e American family planning clinic system and school-based health clinics need
to be upgraded and expanded to provide free or low-cost contraceptive services to
all adolescents who want them. Of equal importance is the need to publicize that
clinics maintain the condentiality of their clients.
2. e United States should follow the lead of several European nations in estab-
lishing a compulsory national sex education curriculum that is extended to all
grade levels. Safe expression of adolescent sexuality should be treated as a health
issue rather than as a political or religious issue. Research indicates that teenag-
ers who have been exposed to comprehensive sex education are considerably less
likely to become pregnant than those who have had no such education, especially
if exposure to sex education occurs before the young people become sexually ac-
tive (Masters et al., 2008; Zimmerman et al., 2008).
3. Adolescent boys must share responsibility for birth control measures. Eorts to
educate teenagers to prevent unwanted pregnancies must recognize that male at-
titudes are important for the practice and eectiveness of birth control. Adolescent
boys often consider birth control to be their partners’ responsibility. Sex education
programs should stress that responsibility for contraception is shared.
4. Condoms should be made readily available in middle schools and high schools.
e results of several studies conrm that distributing condoms in schools is
not associated with an increase in sexual frequency or younger age of sexual
debut (Vamos et al., 2008). is research indicates that school-based condom
availability can reduce teenage pregnancy and lower the risk of contracting
STIs, including HIV/AIDS. Educational eorts should be directed toward en-
couraging teens to use condoms correctly during every intercourse experience.
is is especially important because even when teens do use condoms, they
often use them incorrectly (for example, starting intercourse without a condom;
Barclay, 2010).
5. Adolescent–parent communication about sex must be increased. A nationwide
survey found that almost half (47%) of American youths ages 12–14 reported
that their parents exerted more inuence than others on their decisions about
sexual activity (Albert, 2004). A huge majority (87%) of these participants
indicated that they would be better prepared to postpone sexual activity and
avoid unplanned pregnancies if they could talk more freely and openly with
their parents about sex, especially the use of contraception to prevent pregnancy.
Unfortunately “many teens do not talk with their parents about ways to prevent
pregnancy” (Centers for Disease Control, 2011g, p. 419). is nding, together
with comparable results of other studies, strongly indicates that a key strategy
for reducing teen pregnancy is the development and implementation of programs
designed to enhance adolescent–parent communication about sex. One such
program, introduced as an after-school educational activity at middle schools in
southeast Texas, demonstrated that parents who are willing to openly discuss sex
with their children may be especially eective agents in eorts to reduce the rate
of teenage pregnancies (Lederman et al., 2008).
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence367
367
Sex Education
Many parents today want to contribute to the sex education of their children. Societal
values about sex are rapidly changing, and we all are exposed to contrasting opinions.
How much should children see, or how much should they be told? Many parents—
even some who are comfortable with their own sexuality—have difficulty judging the
best” way to react to their childrens sexuality.
Perhaps the information that we oer in the following paragraphs will help modify
some of this uncertainty. We do not profess to have the last word on raising sexually
healthy children, so we advise you to read this material with a critical eye. Along the way,
however, you may acquire some new insights that will aid you in your eorts to provide
meaningful sex education for your children, either now or in the future.
Answering Childrens Questions About Sex
Parents often ask us when they should start telling their children about sex. One
answer is, when the child begins to ask questions. It seems typical for children to
inquire about sex along with myriad other questions they ask about the world around
them. Research has indicated that by about age 4, most children begin asking ques-
tions about how babies are made (Martinson, 1994). What is more natural than to ask
where you came from? Yet this curiosity is often stopped short by parental response. A
flushed face and a few stammering words, a cursory Wait till your mother (or father)
comes home to ask that question, or Youre not old enough to learn about such things
are a few of the common ways that communication in this vital area is blocked before
it has a chance to begin. Putting off questions at this early age means that you may be
confronted with the potentially awkward task of starting a dialogue on sexual matters
at a later point in your childrens development.
It can be helpful for parents to include information about sex (when appropriate) in
everyday conversations that their children either observe or participate in. Accomplish-
ing this with a sense of ease and naturalness can increase the comfort with which the
children introduce their own questions or observations about sex.
If a child’s questions either do not arise spontaneously or get sidetracked at an early
age, there might be a point when you as a parent will feel it is important to begin to talk
about sex. Perhaps a good starting point is to share your true feelings with your child—
that possibly you are a bit uneasy about discussing sex or that maybe you are confused
about some of your own feelings or beliefs. By expressing your own indecision or vul-
nerability, you may actually make yourself more accessible. During this initial eort,
simply indicating your feelings and leaving the door open to future discussions may be
all that is needed. An incubation period is often valuable, allowing a child to interpret
your willingness to talk about sexuality. If no questions follow this rst eort, it might
be wise to select a specic area for discussion. Some suggested open-ended questions for
a low-key beginning include the following:
What do you think sex is?
What do you know about how babies are made?
What are some of the things that your friends tell you about sex?
How do you feel about the changes in your body? (for older children or early
adolescents)
Understandably, parents sometimes tend to overload a child who expects a relatively
brief, straightforward answer to his or her question. For example, 5-year-olds who
inquire,Where did I come from?” probably are not asking for a detailed treatise on
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
368 CHAPTER 12
the physiology of sexual intercourse and conception. It is probably more helpful to just
briefly discuss the basics of sexual intercourse, perhaps including the idea of potential
pleasure in such sharing. It is also a good idea to check to see whether your child has
understood your answer to his or her question. In addition, you might wish to ask if
you have provided the information that was desired and also to let the child know that
you are open to more questions. When young children want more information, they will
probably ask for it, provided that an adult has been responsive to their initial questions.
Some parents believe that it is inappropriate to tell their children that sexual interac-
tion is pleasurable. Others conclude that there is value in discussing the joy of sex with
their children, as revealed in the following account:
One evening, while I was sitting on my daughters bed talking about the day’s
events, she expressed some concern over her next-door playmates announce-
ment that her father was going to purchase a stud horse. Apparently, she had
been told to have me build a higher fence to protect her mare. Even though she
knew all about horses mating, she asked why this was necessary. I explained
the facts to her, and then she asked the real question on her mind: “Do you
and Mom do that?” to which I replied, “Yes.” “Do my uncle and aunt do that?”
Again, “Yes,which produced the final pronouncement, “I don’t think I’ll get
married. Clearly, she felt some strong ambivalence about what this sexual
behavior meant to her. It seemed very important that I make one more state-
ment—namely that not only did we do this but that it is a beautiful and pleasur-
able kind of sharing and lots of fun! (Authors’ files)
Reluctance to express the message that sex can be enjoyable can stem from parents
concern that their children will rush right out to nd out what kind of good times they
have been missing. ere is little evidence to support such apprehension. ere are,
however, many unhappy lovers striving to overcome early messages about the dirtiness
and immorality of sex.
Initiating Conversations When Children
Do Not Ask Questions
Some topics never get discussed, at least not at the proper time, unless parents are will-
ing to take the initiative. We are referring to certain aspects of sexual maturation that a
child may not consider until he or she experiences them. These include menstruation,
first ejaculation, and nocturnal (nighttime) orgasms. Experience with first menstrua-
tion or ejaculation can come as quite a shock to the unprepared, as revealed in the fol-
lowing two anecdotes:
I hadnt even heard of menstruation when I first started bleeding. No one was
home. I was so frightened I called an ambulance. (Authors’ files)
I remember the first time I ejaculated during masturbation. At first I couldn’t
believe it when something shot out of my penis. The only thing I could figure
is that I had whipped up my urine. However, considering earlier lectures from
my mother about the evils of “playing with yourself,” I was afraid that God was
punishing me for my sinful behavior. (Authors’ files)
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence369
369
It is important that youngsters be aware of these physiological changes before they
actually happen. Childrens natural curiosity about sex might cause them to discuss these
topics with friends, who are usually not the most reliable sources of information. It is
certainly better for parents to provide a more accurate description of these natural events.
Most young people prefer that their parents be the primary source of sex informa-
tion and that their mothers and fathers share equally in this responsibility (Brewster,
2012; Kreinin et al., 2001; Somers & Surmann, 2004). A recent national survey revealed
that about half of teen respondents had spoken with their parents about how to say no
to sex or about methods of birth control. Fewer teens (males, 27%; females, 44%) had
discussed both topics with their parents, and 38% of males and 24% of females had
not spoken about either topic with their parents (Centers for Disease Control, 2011g).
ese data indicate that teenagers often have diculty communicating with their par-
ents about sex, for a number of reasons. ese include embarrassment, concern that
their parents will assume that they are sexually active, and thinking that their parents
will not understand them (Lederman et al., 2008). Research indicates that parents also
often feel uncomfortable and experience diculty talking with their children about sex
(Byers, 2011; Shtarkshall et al., 2007). is dual discomfort of both children and par-
ents is unfortunate in that youth can benet greatly from candid discussions with their
parents about sex, as exemplied by the following anecdote provided by a young woman
enrolled in a sexuality class:
First my mother, and later my father, talked to me at separate times about sex.
I was enlightened by these conversations, and they created a closer bond and
increased confidentiality and trust among all of us. I was very thankful that both
of my parents talked with me about sex. I realized that they really cared about
my well-being, and I appreciated their efforts to say to me what their parents
did not say to them. (Authors’ files)
To the extent that parents do take an active role in the sex education of their chil-
dren, mothers are far more likely than fathers to fulll this function and girls are more
likely than boys to be recipients of parent communication about sex (Hutchinson &
Cederbaum, 2011; Tobey et al., 2011). Unfortunately, most American parents do not
provide adequate sex education to their children (Kreinin et al., 2001; Meschke et al.,
2000). Even where there is close and open communication between parents and chil-
dren, sex often is not discussed. Several studies have shown that friends, and to a lesser
extent the media, are the principal source of information about sex for young people in
the United States (Sprecher et al., 2008). us the gap created by lack of information in
the home is likely to be lled with incorrect information from peers and other sources
(Newman, 2008; Whitaker & Miller, 2000). is can have serious consequences; for
example, an adolescent may hear from friends that a girl will not get pregnant if she
has intercourse only now and then. Peers may also encourage traditional gender-role
behavior, and they often put pressure on each other to become sexually active. us the
challenge for parents is whether they want to become actively involved in their childrens
sex education, minimizing some of the pitfalls faced by children and adolescents who
turn to their peers for sex (mis)information.
Positive parent–adolescent communication about sex has been linked to decreased
risk of contracting STIs, more eective and consistent use of birth control, and decreased
incidence of teenage pregnancies (Halpern-Felsher et al., 2004; Lehr et al., 2005; Stone
& Ingham, 2002).
Critical Thinking Question
Many people believe that sex education can
itself cause problems, because they think
that the more children learn about sex, the
more likely they are to experiment sexually.
Do you think this assumption is valid? If so,
do you believe that it is a good reason not to
teach children about sex?
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
370 CHAPTER 12
School-Based Sex Education
In response to the frequent lack (or insufficiency) of information from the home and
the inaccuracy of much of what children hear from peers, other social institutions in the
United States, especially schools, are attempting to provide sex education. However, the
quality and extent of school-based sex education programs vary considerably. Most efforts
to provide sex education in schools have utilized one of two principal approaches: compre-
hensive sex education and abstinence-only programs. Comprehensive sex education treats
abstinence as merely one option for youths in a curriculum that provides broad-based
information about such topics as sexual maturation; contraception; abortion; strategies
for effective decision making and for saying no to unwanted sex; STIs; relationship issues;
and sexual orientation. In abstinence-only programs, youths are instructed to abstain from
sex until marriage, and discussions of contraception are either prohibited entirely or per-
mitted only to emphasize the alleged shortcomings of birth control methods.
Various surveys reveal that while an overwhelming majority of parents and other adults
support including comprehensive sex education in schools, only a minority of U.S. schools
oer comprehensive sex education courses (Constantine et al., 2007; Trevor, 2002).
Public school sex education programs are often hampered by pressures from well-
organized and highly vocal minorities opposed to such education. In response to these pres-
sures, some school systems completely omit sex education from their curricula, and others
attempt to avert controversy by allowing only discussion of safe” topics, such as reproduc-
tion and anatomy. A recent national survey revealed that, in spite of limitations often placed
on school-based sex education, most teens indicated they had received “formal sex education
before age 18 years that either covered saying no to sex (females, 87%; males, 81%) or pro-
vided information on methods of birth control (females, 70%, males, 62%); 65% of females
and 53% of males received education on both topics (Centers for Disease Control, 2011g,
p. 417). Unfortunately, the interpersonal aspects of sexuality were often omitted from sex
education programs. We discuss the adverse impact of abstinence-based sex education in
American public schools in the Sex and Politics box, Abstinence-Only Sex Education.
In contrast to the dismal record of abstinence-only sex education, as outlined in the
Sex and Politics box, numerous studies provide strong evidence that comprehensive
sex education programs that stress safer sex and provide accurate information about
various contraceptive methods actually increase the use of birth control, reduce teenage
pregnancies, reduce high-risk sexual behavior, do not hasten the onset of intercourse
(and in some cases actually delay onset), do not increase the frequency of intercourse,
and do not increase the number of an adolescent’s sexual partners (in some cases they
reduce partner number; Cavazos-Rehg et al., 2012; Kirby, 2002; Masters et al., 2008;
Schaalma et al., 2004; Smith, 2005). Leading researchers in the eld of sex education
recently concluded that comprehensive sex education has demonstrated its eectiveness
in reducing negative sexual outcomes such as teenage pregnancy and STIs, whereas
abstinence-only programs have not” (Masters et al., 2008, p. 90).
Although opposition to sex education
in the schools continues, a huge
majority of parents support the idea.
© Will & Deni McIntyre/Photo Researchers, Inc.
Abstinence-Only Sex Education
SEX &
POLITICS
In 1996 the U.S. Congress allocated $250 million to fund
abstinence-only programs at a rate of $50 million per year
for the period 1998–2002 (Goodson et al., 2003). Federal
funding for abstinence-only programs grew steadily, from
$9 million to $176 million annually, between 1997 and
2007 (Masters et al., 2008).
To date over $1.5 billion federal
taxpayer dollars have been spent on such programs
(Herbenick, 2010a). What does research reveal about the
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Sexuality During Childhood and Adolescence371
371
efcacy of abstinence-only programs, largely funded by
taxpayers?
A number of comprehensive investigations of abstinence-
only programs have provided no substantial evidence that
such programs either delay the onset of sexual intercourse
(or other sexual behaviors) or signicantly change adoles-
cents’ attitudes about engaging in sexual relations (Kirby,
2008a; Masters et al., 2008; Marx &
Hopper, 2005; Smith,
2005). A recent comprehensive analysis of scientically
sound studies of abstinence-only programs revealed that
children exposed to this form of sex education were no more
likely to abstain from sex than those in a control group not
exposed to abstinence-only instruction. Furthermore, youth
assigned to either the abstinence-only or control group
conditions had similar numbers of sexual partners (Kirby,
2008a). In one recent study, widely reported by the media,
several hundred youths who took a virginity pledge, indicat-
ing their support of abstinence, reported a comparable level
of sexual intercourse before marriage to that of a group of
closely matched non-pledging youth in a longitudinal study
that assessed sexual experiences ve years after pledging
(Rosenbaum, 2009).
Programs that teach abstinence without also providing
essential information about sexual health, contraception, and
safer-sex strategies do little to reduce adolescent pregnancy
and the spread of STIs (Franklin & Dotger, 2011). It is now
exceedingly clear that a sex education curriculum based on
abstinence only “does not educate American adolescents
about safer sex practices and leaves a knowledge gap in
these adolescents that follows them into college” (Franklin &
Dotger, 2011, p. 199). Studies of adolescents in
Texas—a state
that has aggressively promoted an abstinence-only approach
in its schools, pronouncements, and policies—reveal that the
pregnancy rate among
Texas 15- to 19-year-olds is the highest
of all 50 states, and S
TI rates among adolescents are well
above national averages (Zenilman, 2006). In Texas, where
parental consent is necessary, it is very difcult for teenagers
to get contraceptives (Collins, 2011).
Lack of effective comprehensive sex education con-
tributes to a variety of other negative outcomes, including
sexual abuse, dysfunctional relationships, and inability
to achieve a satisfying sex life (Newman, 2008). Various
reviews reveal that a majority of the federally funded
abstinence-only programs are replete with inaccurate and
misleading information and often inject ideology into sex
education while failing to maintain a separation of science
and religion (Santelli, 2008;
Tauber et al., 2005).
Thankfully, due largely to the efforts of President
Obama and key players in his administration, “abstinence-
only sex education seems to have had—for the time being
at least—its moment in the sun” (Hess, 2011, p. 1080). In
2010 the federal funding for abstinence-only school sex
education programs was eliminated (Tucker, 2011). How
and why the abstinence-only approach to sex education
came to dominate school-based sex education for more
than a decade is the subject of an informative book, The
Politics of Virginity: Abstinence in Sex Education, written by
Alesha Doan and Jean Williams (2008).
Summary
Sexual Behavior During Infancy
and Childhood
e traditional view of infancy and childhood as a time
when sexuality remains unexpressed is not supported by
research ndings.
Infants of both sexes are born with the capacity for sexual plea-
sure and response, and some experience observable orgasm.
Self-administered genital stimulation is common among
both boys and girls during the rst two years of life.
e inclinations we have as adults toward giving and receiv-
ing aection seem to be related to our early opportunities
for pleasurable contact with others, especially parents.
Masturbation is one of the most common sexual expressions
during the childhood years. Parental reactions can be an
important inuence on developing sexuality.
Sex play with other children, which can occur as early as age
2 or 3, increases in frequency during the 5- to 7-year-old age
range.
Separation of the sexes tends to become pronounced by the
age of 8 or 9. However, romantic interest in the other sex
and curiosity about sexual matters are typically high during
this stage of development.
e ages of 10 and 11 are marked by keen interest in body
changes, continued separation of the sexes, and a substantial
incidence of homosexual encounters.
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
372 CHAPTER 12
The Physical Changes of Adolescence
Puberty encompasses the physical changes that occur in
response to increased hormone levels. ese physical devel-
opments include maturation of the reproductive organs and
consequent menstruation in girls and ejaculation in boys.
Sexual Behavior During Adolescence
e sexual double standard often pressures males to view
sex as a conquest and places females in a double bind about
saying yes or no.
e percentage of adolescents who masturbate increases
between the ages of 13 and 19.
An emerging social phenomenon, adolescent sexting,
involves sending sexually suggestive photos or text messages
via the Internet, cell phones, or other electronic devices.
Noncoital sexual expression is a common sexual behavior
among adolescents. Noncoital sex refers to erotic contact
that might include kissing, touching, manual stimulation, or
oral–genital stimulation—but not coitus.
Adolescent sexual expression is now more likely to take
place within the context of an ongoing relationship than it
was during Kinsey’s time.
A signicant increase in the number of both young men and
young women who experience intercourse by age 19 has
occurred over the last ve decades. is increase has been
considerably more pronounced among females.
Teenagers engage in blogging, social networking with peers,
seeking health information, accessing pornography, research-
ing school topics, and posting personal proles.
Adolescent participation in forced or consensual multi-per-
son sex (MPS) is an emerging public health concern. MPS is
associated with a variety of variables including experiencing
sex prior to age 15, having an STI, dating and/or child sexual
abuse victimization, and recent exposure to pornography.
During the 1990s and early 2000s, adolescent coital rates
leveled o and even decreased appreciably for all but young
teenagers.
Same-sex experiences during adolescence can be experi-
ments or an expression of permanent sexual orientation.
Adolescent Pregnancy
e United States has the highest rate of adolescent preg-
nancy in the industrialized West. In recent years the incidence
of adolescent pregnancy in the United States has fallen.
Approximately 750,000 unmarried U.S. adolescent females
become pregnant each year. Adolescent pregnancy is often
associated with social, medical, educational, and nancial
diculties.
Many adolescents who have intercourse do not use contra-
ceptives consistently or eectively.
e low rate of contraceptive use among U.S. adolescents
is related to a number of factors, including ignorance, false
beliefs, inadequate home- or school-based sex education,
misconceptions about health risks associated with some
contraception methods, embarrassment over acquiring con-
traceptive devices, concerns about condentiality, and lack of
communication with partners about birth control.
Strategies for reducing the teenage pregnancy rate in the
United States include upgrading the family planning clinic
system, establishing a compulsory national sex educa-
tion curriculum, educating males about their contracep-
tive responsibility, providing access to condoms in middle
schools and high schools, and increasing dialogue between
parents and children about sex.
Sex Education
One answer to the question of when to start discussing sex
with our children is when they start asking questions. If com-
munication does not spontaneously occur, it may be helpful
for parents to initiate dialogue, perhaps by simply sharing
their feelings or asking nonstressful, open-ended questions.
Some important topics—particularly menstruation, rst
ejaculation, and nocturnal orgasms—are rarely discussed
unless parents take the initiative.
Although most adolescents prefer their parents to be the
primary source of sex information, evidence indicates that
peers are considerably more likely than parents to provide
this information, often in a biased and inaccurate manner.
Even though an overwhelming majority of parents and other
adults support school sex education, only a minority of Amer-
ican schools oer comprehensive sex education programs.
Research indicates that comprehensive school-based sex
education programs increase the use of birth control, reduce
teenage pregnancies, reduce high-risk sexual behavior, do
not hasten the onset or frequency of coitus, and do not
increase the number of an adolescent’s sexual partners.
Log in to CengageBrain.com to access the resources your
instructor requires.
Go to CengageBrain.com to access Psychology
CourseMate, where you will nd an interactive eBook,
glossaries, ashcards, quizzes, videos, and more.
Also access links to chapter-related websites, including I
Wanna Know: Sexuality Information for Teens, Coalition for
Positive Sexuality, A Web Page by Teens for Teens, Guttmach-
er Institute, Hetrick-Martin Institute (HMI), Sex, etc., Teen-
wire, two websites sponsored by the American Social Health
Association, and Advocates for Youth.
Media Resources
Copyright 2012 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.