Adolescent sexuality

Source: Wikipedia, the free encyclopedia.

Adolescent sexuality is a stage of

age-of-consent laws.[2]

Sexual activity in general is associated with various risks and this is heightened by the unfamiliar excitement of sexual arousal, the attention connected to being sexually attractive, and the new level of physical intimacy and psychological vulnerability created by sexual encounters.

Contraceptives specifically reduce the chance of teenage pregnancy
.

Development of sexuality

Adolescent sexuality begins at puberty. The sexual maturation process produces sexual interest and stimulates thought processes. Subsequent sexual behavior starts with the secretion of

anterior pituitary gland. These hormones target the sexual organs and begin their maturation. Increasing levels of androgen and estrogen have an effect on the thought processes of adolescents and have been described as being in the minds "of almost all adolescents a good deal of the time".[4]

Though most female adolescents begin their sexual maturation process in normal, predictable ways, there may be concerns by parents and clinicians if the following become evident:

Views on sexual activity

One study from 1996 documented the interviews of a sample of

junior high school students in the United States. The girls were less likely to state that they ever had sex than adolescent boys. Among boys and girls who had experienced sexual intercourse, the proportion of girls and boys who had recently had sex and were regularly sexually active was the same.[6] Those conducting the study speculated that fewer girls say they have ever had sex because girls viewed teenage parenthood as more of a problem than boys. Girls were thought to be more restricted in their sexual attitudes; they were more likely than boys to believe that they would be able to control their sexual urges. Girls had a more negative association in how being sexually active could affect their future goals. In general, girls said they felt less pressure from peers to begin having sex, while boys reported feeling more pressure.[6]

A later study questioned the attitudes of adolescents. When asked about abstinence, many girls reported they felt conflicted. They were trying to balance maintaining a good reputation with trying to maintain a romantic relationship and wanting to behave in adult-like ways. Boys viewed having sex as social capital. Many boys believed that their male peers who were abstinent would not as easily climb the social ladder as sexually active boys. Some boys said that for them, the risks that may come from having sex were not as bad as the social risks that could come from remaining abstinent.[7]

Concepts about loss of virginity

In the United States, federally mandated programs started in 1980 and promoted adolescent abstinence from sexual intercourse, which resulted in teens turning to oral sex, which about a third of teens considered a form of abstinence in a study.[8]

Until their first act of sexual intercourse, adolescents generally see virginity in one of the following ways: as a gift, a stigma, or a normal step in development. Girls typically think of virginity as a gift, while boys think of virginity as a stigma.[9] In interviews, girls said that they viewed giving someone their virginity as like giving them a very special gift. Because of this, they often expected something in return such as increased emotional intimacy with their partners or the virginity of their partner. However, they often felt disempowered because of this; they often did not feel like they actually received what they expected in return and this made them feel like they had less power in their relationship. They felt that they had given something up and did not feel like this action was recognized.[9]

Thinking of virginity as a stigma disempowered many boys because they felt deeply ashamed and often tried to hide the fact that they were virgins from their partners, which for some resulted in their partners teasing them and criticizing them about their limited sexual techniques. The girls who viewed virginity as a stigma did not experience this shaming. Even though they privately thought of virginity as a stigma, these girls believed that society valued their virginity because of the stereotype that women are sexually passive. This, they said, made it easier for them to lose their virginity once they wanted to because they felt society had a more positive view on female virgins and that this may have made them sexually attractive. Thinking of losing virginity as part of a natural developmental process resulted in less power imbalance between boys and girls because these individuals felt less affected by other people and were more in control of their individual sexual experience.[9] Adolescent boys, however, were more likely than adolescent girls to view their loss of virginity as a positive aspect of their sexuality because it is more accepted by peers.[9]

Behavior

Prevalence of sexually experienced 15-year-olds[10]
Country Boys (%) Girls (%)
Austria 21.7 17.9
Belgium 24.6 23
Canada 24.1 23.9
Croatia 21.9 8.3
England 34.9 39.9
Estonia 18.8 14.1
Finland 23.1 32.7
France 25.1 17.7
Greece 32.5 9.5
Hungary 25 16.3
Israel 31 8.2
Latvia 19.2 12.4
Lithuania 24.4 9.2
North Macedonia 34.2 2.7
Netherlands 23.3 20.5
Poland 20.5 9.3
Portugal 29.2 19.1
Scotland 32.1 34.1
Slovenia 45.2 23.1
Spain 17.2 13.9
Sweden 24.6 29.9
Switzerland 24.1 20.3
Ukraine 25.1 24
Wales 27.3 38.5

Birth control

In 2002, a survey was conducted in European nations about the sexual behavior of teenagers. In a sample of 15-year-olds from 24 countries, most participants self-reported that they had not experienced sexual intercourse. Among those who were sexually active, the majority (82.3%) had used

contraception at last intercourse.[10]

A nationally representative Danish study found that teenage girls who use the most common form of birth control pills, combination birth control pills with both estrogen and progestin, are 80% more likely to be prescribed an antidepressant than girls who were not taking birth control.[11][12] Girls who take progestin-only pills are 120% more likely.[12] The risk of depression is tripled for teenage girls who use non-oral forms of hormonal contraception.[12]

Adolescent sexual functioning: gender similarities and differences

Lucia O'Sullivan and her colleagues studied adolescent sexual functioning: they compared an adolescent sample with an adult sample and found no significant differences between them. Desire, satisfaction and sexual functioning were generally high among their sample of participants (aged 15–21). Additionally, no significant gender differences were found in the prevalence of sexual dysfunction.[13] In terms of problems with sexual functioning mentioned by participants in this study, the most common problems listed for males were experiencing anxiety about performing sexually (81.4%) and premature ejaculation (74.4%). Other common problems included issues becoming erect and difficulties with ejaculation. Generally, most problems were not experienced on a chronic basis. Common problems for girls included difficulties with sexual climax (86.7%), not feeling sexually interested during a sexual situation (81.2%), unsatisfactory vaginal lubrication (75.8%), anxiety about performing sexually (75.8%) and painful intercourse (25.8%). Most problems listed by the girls were not persistent problems. However, inability to experience orgasm seemed to be an issue that was persistent for some participants.[13]

The authors detected four trends during their interviews: sexual pleasure increased with the amount of sexual experience the participants had; those who had experienced sexual difficulties were typically sex-avoidant; some participants continued to engage in regular sexual activity even if they had low interest; and lastly, many experienced pain when engaging in sexual activity if they experienced low arousal.[13]

Another study found that it was not uncommon for adolescent girls in relationships to report they felt little desire to engage in sexual activity when they were in relationships. However, many girls engaged in sexual activity even if they did not desire it, in order to avoid what they think might place strains on their relationships.[14] The researcher states that this may be because of society's pressure on girls to be "good girls"; the pressure to be "good" may make adolescent girls think they are not supposed to feel desire like boys do. Even when girls said they did feel sexual desire, they said that they felt like they were not supposed to, and often tried to cover up their feelings. This has been cited as an example of how societal expectations about gender can impact adolescent sexual functioning.[14]

Gender disparities in oral sex among adolescents

There are gender differences in the giving and receiving of oral sex. One study demonstrated that young men expected to receive oral sex more than young women expected to receive it, with 43% of men and 20% of women expecting to receive it.[15] Additionally more young men reported having oral-penis contact over oral-vulva contact with a different gender.[16] Young men also receive more frequent oral sex than young women. One study with U.S. college students reported 62% of female participants were more likely to report giving oral sex more than they received it.[17] However similar proportions of young men and women report having experienced oral sex.[18]

In Brazil

The average age Brazilians lose their virginity is 17.4 years of age, the second-lowest number in the countries researched (first was Austria), according to the 2007 research finding these results, and they also ranked low at using condoms at their first time, at 47.9% (to the surprise of the researchers, people of lower socioeconomic status were far more likely to do so than those of higher ones). 58.4% of women reported that it was in a committed relationship, versus solely 18.9% of men (traditional Mediterranean cultures-descended mores tend to enforce strongly about male sexual prowess equating virility and female quality being chastity and purity upon marriage), and scored among the countries where people have the most positive feelings about their first time, feeling pleasure and more mature afterwards (versus the most negative attitudes coming from Japan).[19]

In another research, leading the international ranking, 29.6% of Brazilian men lost their virginity before age 15 (versus 8.8% of women), but the average is really losing virginity at age 16.5 and marrying at age 24 for men, and losing virginity at age 18.5 and marrying at age 20 for women.[20] These do not differ much from national figures. In 2005, 80% of then adolescents lost their virginity before their seventeenth birthday, and about 1 in each 5 new children in the country were born to an adolescent mother,[21] where the number of children per women is solely 1.7 in average, below the natural replacement and the third lowest in independent countries of the Americas, after Canada and Cuba.

A 2013 report through national statistics of students of the last grade before high school, aged generally (86%) 13–15, found out 28.7% of them already had lost their virginity, with both demographics of 40.1% of boys and 18.3% of girls having reduced their rate since the last research, in 2009, that found the results as 30.5% overall, 43.7% for boys and 18.7% for girls. Further about the 2013 research, 30.9% of those studying in public schools were already sexually initiated, versus 18% in private ones; 24.7% of sexually initiated adolescents did not use a condom in their most recent sexual activity (22.9% of boys, 28.2% of girls), in spite of at the school environment 89.1% of them receiving orientation about STDs, 69.7% receiving orientation of where to acquire condoms for free (as part of a public health campaign from the Brazilian government) and 82.9% had heard of other forms of contraceptive methods.[22]

In Canada

One group of Canadian researchers found a relationship between self-esteem and sexual activity. They found that students, especially girls, who were verbally abused by teachers or rejected by their peers were more likely than other students to have sex by the end of the Grade 7. The researchers speculate that low self-esteem increases the likelihood of sexual activity: "low self-esteem seemed to explain the link between peer rejection and early sex. Girls with a poor self-image may see sex as a way to become 'popular', according to the researchers".[23]

In India

In

HIV/AIDS among adolescents, increase the number of unwanted pregnancies and abortions, and give rise to conflict between contemporary social values. Adolescents have relatively poor access to health care and education. With cultural norms opposing extramarital sexual behavior, R.S. Goyal fears "these implications may acquire threatening dimensions for the society and the nation".[24]

Motivation and frequency

Sexual relationships outside marriage are not uncommon among teenage boys and girls in India. In a random study of 100 couples, the best predictor of whether or not a girl would be having sex is if her friends were engaging in the same activities. For those girls whose friends were having a physical relationship with a boy, 84.4% were engaging in the same behavior. Only 24.8% of girls whose friends were not having a physical relationship had one themselves. In urban areas, 25.2% of girls have had intercourse and in rural areas 20.9% have. Better indicators of whether or not girls were having sex were their employment and school status. Girls who were not attending school were 14.2% (17.4% v. 31.6%) more likely to be having sex; for girls who were employed this number was 14.4% (36.0% v. 21.6%).[24]

In the Indian sociocultural milieu girls have less access to parental love, schools, opportunities for self-development and freedom of movement than boys do. It has been argued that they may rebel against this lack of access or seek out affection through physical relationships with boys. While the data reflects trends to support this theory, it is inconclusive.[24] The freedom to communicate with adolescent boys was restricted for girls regardless of whether they lived in an urban or rural setting, and regardless of whether they went to school or not. More urban girls than rural girls discussed sex with their friends. Those who did not may have felt "the subject of sexuality in itself is considered an 'adult issue' and a taboo or it may be that some respondents were wary of revealing such personal information."[25]

Contraceptive use

Among Indian girls, Goyal claims that "misconceptions about sex, sexuality and sexual health were large. However, adolescents having sex relationships were somewhat better informed about the sources of spread of STDs and HIV/AIDS."[24] While 40% of sexually active girls were aware that condoms could help prevent the spread of HIV/AIDS and reduce the likelihood of pregnancy, only 10.5% used a condom during the last time they had intercourse.[24]

In the Netherlands

According to Advocates for Youth, the United States' teen pregnancy rate is over four times as much as it is in the Netherlands.[26] In comparison, in the documentary, Let's Talk About Sex, a photographer named James Houston travels from Los Angeles to D.C. and to the Netherlands.[27] In the Netherlands, he contrasts European and American attitudes about sex. From the HIV rates to the contemplations of teen parenthood in America, Houston depicts a society in which America and the Netherlands differ.

Most Dutch parents practice vigilant leniency,[28] in which they have a strong familial bond and are open to letting their children make their own decisions.

Gezelligheid is a term used by many Dutch adolescents to describe their relationship with their family. The atmosphere is open and there is little that is not discussed between parents and children.

Amy Schalet, author of Not Under My Roof: Parents, Teens, and the Culture of Sex discusses in her book how the practices of Dutch parents strengthen their bonds with their children. Teenagers feel more comfortable about their sexuality and engage in discussion with their parents about it. A majority of Dutch parents feel comfortable allowing their teenagers to have their significant other spend the night.[29]

Same-sex attractions among adolescents

Adolescent girls and boys who are attracted to others of the same sex are strongly affected by their surroundings in that adolescents often decide to express their sexualities or keep them secret depending on certain factors in their societies. These factors affect girls and boys differently. If girls’ schools and religions are against same sex attractions, they pose the greatest obstacles to girls who experience same sex attractions. These factors were not listed as affecting boys as much. The researchers suggest that maybe this is because not only are some religions against same-sex attraction, but they also encourage traditional roles for women and do not believe that women can carry out these roles as lesbians. Schools may affect girls more than boys because strong emphasis is placed on girls to date boys, and many school activities place high importance on heterosexuality (such as cheerleading).[30] Additionally, the idea of not conforming to typical male gender roles inhibited many boys from openly expressing their same-sex attraction. The worry of conforming to gender roles did not inhibit girls from expressing their same-gender preferences as much, because society is generally more flexible about their gender expression.[30]

Researchers such as

Lisa Diamond are interested in how some adolescents depart from the socially constructed norms of gender and sexuality. She found that some girls, when faced with the option of choosing "heterosexual", "same-sex attracted" or "bisexual", preferred not to choose a label because their feelings do not fit into any of those categories.[31]

Sexually transmitted infections

Adolescents have the highest rates of sexually transmitted infections (STIs) when compared to older groups. Sexually active adolescents are more likely to believe that they will not contract a sexually transmitted infection than adults. Adolescents are more likely to have an infected partner and less likely to receive health care when an STI is suspected. They are also less likely to comply with the treatment for an STI. Coinfection is common among adolescents.[5]

An STI can have a large negative physiological and psychological effect on an adolescent. The goal of the pediatrician is for early diagnosis and treatment. Early treatment is important for preventing medical complications and infertility. Prevention of STIs should be a priority for all health care providers for adolescents. Diagnosis of an STI begins the evaluation of concomitant STIs and the notification and treatment of sexual partners. Some states in the US require the reporting of STIs to the state's health department.[5]

Media influence

Modern media contains more sexual messages than was true in the past and the effects on teen sexual behavior remain relatively unknown.[32] Only 9% of the sex scenes on 1,300 of cable network programming discusses and deals with the potentially negative consequences of sexual behavior.[33] The internet may further provide adolescents with poor information on health issues, sexuality, and sexual violence.[34]

A study on examining sexual messages in popular TV shows found that 2 out of 3 programs contained sexually related actions. 1 out of 15 shows included scenes of sexual intercourse itself. Shows featured a variety of sexual messages, including characters talking about when they wanted to have sex and how to use sex to keep a relationship alive. Some researchers believe that adolescents can use these messages as well as the sexual actions they see on TV in their own sexual lives.[35]

The results of a study by Deborah Tolman and her colleagues indicated that adolescent exposure to sexuality on television in general does not directly affect their sexual behaviors, rather it is the type of message they view that has the most impact.[36] Gender stereotypes enacted in sexual scenes on TV were seen to have a large effect on adolescents. Girls felt they had less control over their sexuality when they saw men objectifying women and not valuing commitment. The study discussed the risk of women internalizing this message and spreading the idea that it is okay to be weak and answer to men all the time. However, girls who saw women on TV who refuted men's sexual advances usually felt more comfortable talking about their own sexual needs in their sexual experiences as well as standing up for themselves. They were comfortable setting sexual limits and therefore held more control over their sexuality. Findings for boys were less clear; those who saw dominant and aggressive men actually had fewer sexual experiences.[36]

However some scholars have argued that such claims of media effects have been premature.[37] Furthermore, according to US government health statistics, teens have delayed the onset of sexual intercourse in recent years, despite increasing amounts of sexual media.[38]

A 2008 study wanted to find out if there was any correlation between sexual content shown in the media and teenage pregnancy. Research showed that teens who viewed high levels of sexual content were twice as likely to get pregnant within three years compared to those teens who were not exposed to as much sexual content. The study concluded that the way media portrays sex has a huge effect on adolescent sexuality.[39]

Teenage pregnancy

Adolescent girls become fertile following the

contraception) can lead to pregnancy. The pregnant teenager may then miscarry, have an abortion, or carry the child to full term
.

Pregnant teenagers face many of the same issues of childbirth as women in their 20s and 30s. However, there are additional medical concerns for younger mothers, particularly those under 15 and those living in developing countries. For example, obstetric fistula is a particular issue for very young mothers in poorer regions.[40] For mothers between 15 and 19, risks are associated more with socioeconomic factors than with the biological effects of age.[41] However, research has shown that the risk of low birth weight is connected to the biological age itself, as it was observed in teen births even after controlling for other risk factors (such as utilisation of antenatal care etc.).[42][43]

Worldwide, rates of teenage births range widely. For example,

developing world, teenage pregnancy is usually within marriage and does not carry such a stigma.[46]

Legal issues

Worldwide ages of consent for heterosexual sex by country
  – 12
  – 13
  – 14
  – 15
  – 16
  – 17
  – 18
  – must be married
  – no data available