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The National Sexual Behavior, Attraction, and Identity Study and NC Teens

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Last week, the CDC released their National Health Statistics Report on Sexual Behavior, Sexual Attraction, and Sexual Identity in the United States: Data from the 2006-2008 National Survey of Family Growth.  Basically, it’s the federal government’s big periodic survey of how people identify themselves and what they’re doing – “in bed”.  The survey has gotten some news attention, but a deeper reading provides some interesting considerations for parents, health educators, and others who care about adolescent sexual health.

Abstinence Continues to Grow

Most headlines have focused on the increased practice of abstinence: The new study showed 27% for boys and 29% for girls ages 15-24 reported never having engaged in sexual behavior of any kind. In 2002, that same number was 22%.

So why the increase in abstinence? No data is provided, and different news reports have posed different (unscientific) hypotheses: that there’s more societal acceptance of sexual diversity (including choosing abstinence), that teens have more going on in general and therefore less time and opportunity to have sex, that ‘Millennials’ are intensely concerned with making the “right” choices… Many scientists smartly refused to speculate.

What we do know is this: The percentage of teens and young adults reporting abstinence has been growing since the 1980s, long before the trend toward abstinence-only-until-marriage education began. And, many evidence-based sexuality education curricula are proven to help teens delay sex.

Where the new study is especially helpful for North Carolina is in looking at teens’ participation in oral sex and in the general findings around sexual identity and same sex sexual behavior. These help us answer questions that are not included in North Carolina-specific health behavior surveys.

Oral Sex

The national survey confirms what many health educators already know: oral sex is fairly common among teens. For 15 year olds, 27% of boys and 23% of girls have engaged in oral sex with someone of the opposite sex. This number rises to 70% of boys and 63% of girls in 18-19 year olds. (See the section on North Carolina teens below for an interesting caveat to all of this…)

The survey shows teens tend to have oral sex before they have vaginal intercourse – in fact, half of teens indicate that they had had oral sex before having had vaginal intercourse.  And, those who waited longer to start having vaginal intercourse were more likely to have had oral sex. Of young adults who had waited until after age 20 to have sex, 70% had participated in oral sex. This means that delayed sexual debut does not mean teens are completely abstinent.

The data on oral sex offer important information for parents and health educators:

  • It’s important that sexuality education classes include a broad discussion of sexual behaviors, including oral and anal sex, as well as associated risks.
  • When discussing abstinence as an expected standard – whether as a family standard or as the standard for all schoolchildren, as listed in the Healthy Youth Act – it’s important to fully define abstinence.
  • In examining the effectiveness of the Healthy Youth Act, it will be tempting to only look at teen pregnancy rates. This data, which proves the prevalence of oral sex, points to the need to look at trends STI rates and health behaviors as additional markers of success.  

 Same Sex Sexual Behavior and Sexual Identity

As with oral sex, North Carolina-specific surveys do not ask teens about their sexual identity or same sex sexual behaviors. It may be unrealistic to gather such data: The national survey makes note of the fact that sexual identity and same sex activity numbers in teens tend to be underreported since many teens are in the process of developing a better sense of identity and may also be hesitant to report behavior they see as embarrassing.

Overall, the data show that 2% of boys and 10% of girls ages 15-17 report engaging in any same sex sexual behavior.

What may be most interesting for health educators, though, is the important reminder that sexual identity does not correlate perfectly with sexual behavior. In other words, teens who are engaging in same sex sexual activity may not self identify as lesbian, gay, or bisexual.

It may be tempting for schools to avoid discussions of same sex behavior or to say, “there aren’t any gay kids in this class.” The national survey shows the importance of discussing same sex behavior even in a class that is (or seems to be) comprised entirely of heterosexual teens.

Sexual Behavior in North Carolina Students

Here’s the grand caveat: The national survey data is not North Carolina-specific. We do know from other studies, however, that North Carolina students tend to be more sexually experienced and sexually risky than their national peers.

Here’s a full write-up comparing North Carolina Youth Risk Behavior Survey data to National Youth Risk Behavior Survey Data.

Just a few highlights (or, perhaps more appropriately, lowlights):

  • More North Carolina 12th graders have had sex: 68%, compared with 62% of their peers nationwide.
  • More North Carolina students have been forced to have sex: 10% of all NC 12th graders, compared with 7.5% of their peers nationwide. (And, if you want a really sad stat, 20% of Latina 12th graders have been forced to have sex.)
  • North Carolina students start having sex earlier that their national peers: 7.5% had sex for the first time before age 13, compared with 5.9% nationwide.
  • More North Carolina students have had 4 or more sexual partners, a key risk factor for both pregnancy and STD/HIV transmission: 25% of NC 12th graders have had sex with 4+ partners, compared with 20.9% of their national peers.

It would be a wise move for the Department of Public Instruction to include questions about same sex behavior and oral sex in their Youth Risk Behavior Survey. It’s reasonable to assume that if North Carolina teens are riskier than their peers when it comes to vaginal intercourse, then they are also taking risks with oral sex and same sex sexual behavior. It’s also true – and unfortunate and dangerous - that health educators and parents often feel less equipped and less supported in addressing these behaviors in the classroom and at home.

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