Benefits of Delaying Sexual Debut - The Institute for Youth ...

Benefits ofDelaying Sexual Debutthe Institute for Youth Development

AcknowledgementsThe Institute for Youth Development(IYD) is a non-partisan, non-profitorganization that promotes acomprehensive message to youth in theUnited States (U.S.) and around the worldto avoid five harmful risk behaviors thatare inextricably linked: alcohol, drugs, sex,tobacco, and violence. IYD believes thatchildren and teens, provided withconsistent and sound messages, are capableof making the right choice to avoid theserisk behaviors altogether, especially if theyare empowered by strong parent andfamily connections.What we at IYD have sought to do is tohelp youth navigate adolescence bycommunicating the best possible messagethat research has provided. The documentyou are about to read, entitled the Benefitsof Delaying Sexual Debut, focuses on thearea of adolescent sexual development andthe positive association abstinence has onthe physical, mental, social, and financialhealth outcomes of young people in theU.S. This compilation of research consistsof the latest medical and scientific data,and presents the benefits of postponing sexin the context of healthy relationships, withits impact on the future well-being ofyoung people.This piece would not be possible withoutthe hard work of those in the abstinenceeducationinitiative at IYD. I would firstlike to acknowledge Christopher Doyle,lead author, researcher, and graphicdesigner.Christopher’s perseverance inseeing this work to its completion wasintegral to the creative process. His insightin all aspects of this comprehensiveoverview will undoubtedly benefit allthose who work in the field of youthdevelopment.Secondly, I would like to recognize MaryOliver and Eva McGann, both of whomcontributed their many years of publichealth, education, and youth developmentexperience to the content of this work.They also played a vital role in the work’sconception, and contributed to the finalediting process.Last but not least, I would like to gratefullyacknowledge and dedicate this piece toPeter Moore, who lost his battle withcancer in November of 2007. Peter was anessential figure in the editing process, andtirelessly devoted many of his last weeksof work at IYD to analyze and proofreadevery word of this writing.Sincerely,Shepherd SmithPresidentThe Institute for Youth Development

Table of Contents3……………Section I: Adolescent Sexual Trends in the United States3………………………Why Abstain? The Consequences of Early Sexual Debut3………………………Background: Abstinence Education in the United States4………………………Most Parents and Adolescents Favor an Abstinence Message5……………………………..Values Systems Often Dictate Behavior6……………………………..Television and Movies6……………………………..Music7……………………………. Internet7……………………………. Fast Food and Beverages7 …………………………….Retail8……………Section II: Physical Health Benefits8……………………….Teenage Pregnancy9……………………….Sexually Transmitted Diseases11……………………...Adolescent Condom Use12……………………...Interconnectedness14.………….Section III: Mental Health Benefits14 ……………………..Adolescent Brain Development17……………………...Psychological/Emotional Damage and Depression18……………………...Suicide20…………..Section IV: Financial Benefits20………………………Teen Sexual Activity, Educational Investment, andAcademic Performance22……………………....Personality and Self-Control as an Indicator of AcademicSuccess24………………………Teenage Sex, High School Dropout, and Delinquency25…………...Section V: Healthy Relationships25………………………Characteristics of Healthy Relationships26………………………Adolescent Dating: Influences, Processes, and Outcomes26………………………Identity Formation and Intimacy28 ……………………...Influences and Outcomes of Early and Steady Dating29………………………Dating Violence and Abuse31………………………Stable Marriage and Family32………………………Cohabitation, Marital Disruption, and Infidelity36………………………Marital Bonding37………………………Correlation between Virginity and Adult Marital Stability38………………………Marriage and Well-Being41………………………Conclusion

IntroductionThis work explores a large body of peerreviewedliterature and addresses thebenefits of delaying sexual debut in thecontext of physical, mental, and socialhealth. It also considers the economic andfinancial advantages gained by avoidingearly sexual debut, as well as the impactabstinence has on future fidelity, maritalstability, and healthy relationships. It willexamine the level of academicachievement youth are likely to reachwhen they make healthy choices, as well asshowing the interconnectedness thatabstinence has on overall life achievementand wellness.Recent data in the United States (U.S.)indicates encouraging trends for youngpeople choosing to abstain from sex. Thepercent of youth who have ever engaged insexual intercourse declined from 54.2percent in 1990 1 to 46.8 percent in 2005, 2with teen birth rates also decreasing by 35percent in the same period. 3 However, asignificant proportion of adolescents stillengage in sexual intercourse, and studiesreveal that those who initiate sex at anearly age often experience worse health,lower educational attainment, and lesseconomic productivity later in life thantheir abstaining peers. 4 Although teenagersrepresent only one quarter of the sexuallyactive U.S. population, they account fornearly half of all new cases of sexuallytransmitted diseases (STDs). 5 Additionally,the U.S. has one of the highest teenagepregnancy rates among developedcountries. 6Why Abstain? The Consequences ofEarly Sexual DebutStudies show that when adolescentsexperience sexual debut at an early age, thegreat majority wish they had waited untilthey were older. Those who have early sexare more likely to suffer partner violence,STDs, psychological harm, and depression;more likely to experience early pregnancyand low academic achievement; and muchmore likely to face unstable marriage anddivorce. These alarming facts have spurredpublic health experts and lawmakers toadvocate delaying sexual debut as a meansof primary risk prevention – a message thatemerges primarily in the form ofabstinence education.Background: Abstinence Education inthe United StatesAbstinence education (or abstinence-untilmarriage)teaches the advantages ofpostponing sexual activity until one is ableto absorb the responsibilities that result,and encourages youth to avoid all sexualactivity outside of marriage. Federalfunding for abstinence education hasincreased, largely because of the growingnumber of medical professionals, publichealth officials, sociologists, psychologists,sexual educators, teachers, parents, andadolescents who recognize that delayingsexual debut until one is older or marriedprovides the best physical, mental,financial, and social health outcomes.Currently, the federal governmentpromotes abstinence education as theexpected standard for all school agechildren through three grant programs. 7First, the Adolescent and Family Life Act,conceived in 1981 as Title XX of thePublic Health Service Act, offers bothdemonstration and research grants forpublic and private non-profit organizationsthat provide care and prevention programsto adolescents in the range of 9-14 years;in 2006, the Office of Population Affairsallocated $30.7 million for these3

abstinence education programs. 8 Second,the 1996 welfare reform law created theTitle V abstinence education block grant tostates, totaling about $50 million annually.This grant (which may soon bediscontinued) allows public schools toteach abstinence in sexual educationclasses, and requires participating states tomatch every four dollars of federalassistance with three state dollars. 9 Thefinal funding stream occurred in 2000 withthe creation of the Community-BasedAbstinence Education (CBAE) grant(originally known as SPRANS) within theDepartment of Health and Human Services(HHS). The purpose of CBAE, whichmanaged $113 million in 2006, is to fundpublic and private abstinence educationprograms for adolescents age 12-18. 10 ∗Most Parents and Adolescents Favor anAbstinence MessageTwo recent national surveys reveal theopinions of parents and students regardingthe message they desire in sexualeducation. The first survey, conducted in2007 by the National Campaign to PreventTeen and Unplanned Pregnancy, askedparents and teenagers,“how important doyou think it is for teens to be given a strongmessage that they should not have sex untilthey are at least out of high school?” Asthe following charts show, over 90 percentof parents and teenagers agree thatreceiving a strong abstinence message isvery important or somewhat important. 11∗ The Centers for Disease Control and Prevention,Division of Adolescent and School Health (CDC-DASH)also funds Nongovernmental Organizations (NGOs) toprovide capacity-building assistance for abstinenceeducation organizations. For more information, see:http://www.cdc.gov/HealthyYouth/partners/ngo/index.htm4

The second survey, conducted in 2007 byZogby International, interviewed 1,002parents of children ages 10-16. Whenasked a series of questions regardingsexual instruction, an overwhelmingmajority of parents supported the messagesof abstinence education. The poll foundthat 9 out of 10 parents agree that beingsexually abstinent is best for theirchildren’s health and future, with 8 in 10strongly agreeing. Additionally, 8 out of 10parents think sex education in publicschools should emphasize abstinencerather than contraception. 12Values Systems Often Dictate Behavior:Society’s Inconsistent Messages to Teenson SexualityAs the surveys above indicate, both parentsand young people believe that the bestchoice for teens is to abstain from sex untilthey are older. However, the majority ofmessages targeted to adolescents contradictthese values. Recent content analysisshows that 70 percent of the televisionprograms favored by adolescents containsexual content, 13 and research alsoindicates that heavy exposure to media sexgives teens a false perception of thefrequency of sexual activity in the realworld. 14Casual and recreational sex permeatesAmerican culture: from popular music,cable television, the world wide web, andmotion pictures, to retail clothing, fastfood, and soft drinks. Advertisers knowthat teenagers are very receptive to theirsex-saturated messages; in fact,adolescents ranked the media as the secondleading source of information about sex,after school sex education programs. 15Research shows that mass media influencethe behavior of young people; for example,in 2008 the National Institutes of Healthreleased the results of a study that includeda media content analysis (music, movies,magazines, television programs, Internetsites, and newspapers) of 3,000 twelve tofourteen-year-olds in North Carolina, as5

well as a longitudinal in-home survey of1,000 African American and white teens.The study also did qualitative researchwith 20 adolescents, interviewing them indepthabout their media habits. Theanalysis found frequent sexual content, butlittle sexual health content in the mediathat teens use most often. Results showed alongitudinal relationship between exposureto sexual content and earlier sexualinitiation among adolescents. 16It is important to understand that the mediadoes not necessarily cause adolescents totake sexual risks, but rather, the outcomemay depend on what the message is, whoreceives it, and how it is interpreted. Forexample, a 2007 study focusing ontelevision content found that therelationship of television viewing to sexualbehavior depends on the type of sexualmessages viewed, the sexual outcomeconsidered, and the gender of theadolescent. 17 Though it may be difficult todetermine the extent that mass mediainfluences young people, the sexualmessages broadcast to teens seem to havemore negative than positive correlations.Consider the following:Television and MoviesA recent study found that adolescents whowatch two hours of television per day, withno content monitoring from parents, havehigh rates of sexual initiation. 18Almost one-third of airtime on television’sfamily hour (8-9 P.M.) consists of sexualreferences. 19 With over 8 references perhour, sexual content during the prime-timefamily hour has quadrupled since 1976. 20The majority of daytime television consistsof soap operas and talk shows that areheavy on sexual content. Popular withadolescents, these shows portray nonmaritalsex and unusual sexual habitsregularly. 21A 2004 study by the Parents TelevisionCouncil analyzed Music Television’s(MTV) Spring Break coverage and foundthat in 171 hours of programming, anaverage of 9 sexual scenes, approximately18 sexual depictions, and 17 instances ofsexual dialogue or innuendo werebroadcast per hour. 22In a study comparing various levels ofexposure to sexual content on television,adolescents who viewed the most sex (90 thpercentile) were more than twice as likelyas those who viewed the least sex (10 thpercentile) to initiate sexual intercourseduring the subsequent year. 23The average American adolescent viewsnearly 15,000 sexual references ontelevision every year, but only 170 concernabstinence, self-control, birth control, orthe risk of STDs and unwantedpregnancy. 24A recent study analyzing the most popularfilms in the past 20 years found that nearlyone-third of the movies (32 percent) had atleast one depiction of sexual intercourse.In 89 percent of the sexual depictions, noclear consequence of the sex wasportrayed, and when pregnancy was apossible outcome, 98 percent of the sexualdepictions failed to use or discuss any formof birth control. 25 MusicA recent analysis of the most popularforms of entertainment among adolescentsfound sexual content to be more prevalentin popular music lyrics than in any othermedium, including television, movies6

magazines, and newspapers. 26About 40 percent of popular songs in themid-1990s included sexual references. 27Youth who listen to music containingdegrading sexual content are more likely toinitiate sexual activity, regardless ofbackground characteristics such asprevious sexual experience and othersocioeconomic variables. 28InternetIn 2006, the pornography industry in theU.S. exceeded the combined revenues ofABC, CBS, and NBC, with internet pornbringing in $2.84 billion. 29 With 89 percentof U.S. web pages (244,661,900 total)containing sexually explicit material, it isno surprise that American teens have“unparalleled access to hardcorepornography with just a few keystrokes.” 30A 2007 study found that up to 90 percentof adolescents have been exposed tosexually explicit materials online. In asurvey of 1,501 children, those looking forpornography were also more likely toreport delinquent behavior and substanceabuse the previous year. Adolescentsseeking explicit material online alsoexperienced higher rates of depression. 31Fast Food and BeveragesIn 2005, Burger King began an internetadvertising campaign by launching awebsite with hidden sexual messages. Thehomepage, www.coqroq.com, includedphotos of young girls with captions such as“Groupies love the Coq.” 32In 2003, the fruit drink brand Snapplechanged its marketing campaign in anattempt to reach a younger audience, withadvertisements aired on MTV, ESPN, andthe Cartoon Network – stations that attractadolescents. As the beverage is known forits combination of fruit flavors, onecommercial depicts youth of different agesdressed in fruit costumes. The young fruitare encouraged to “combine with otherfruits…these urges are perfectly natural.So experiment. Explore. Even play thefield. When fruits join together, it's a veryspecial thing.” The fruit-love spoof endswith a shot of a banana and an apple in asexual position. 33 RetailVictoria’s Secret mannequins depictsexual, nude, and semi-pornographicmaterial in their store displays. Viewableto any passer-by, the artificial womencatch shoppers’ eyes with lustful glances.A Washington Post story describes thescene in one northern Virginia mall:Inside the store was a display ofone scantily clad femalemannequin crawling towardanother who reclined on a left hipand leaned back on both hands.A spokesman for the company that ownsVictoria’s Secret commented: “What wedo with all of our marketing is to displaythe products that we sell, which islingerie.” 34Abercrombie & Fitch’s (A&F) storesdisplay soft core pornography on theirwalls, designed specifically for teenagersand young adults. Even more graphic is thecatalog offered at the check-out line,featuring semi-nude models portrayed insexual situations. A&F’s website bombardsthe viewer with overtly sexualized imagesof barely-clothed models promoting thestore’s youthful sexy image. 35 7

Delaying sexual debut has a considerableimpact on the physical health outcomes ofadolescents. Youth who abstain fromsexual activity avoid the consequences thatdirectly result from a non-maritalpregnancy, as well as the potential lifelongimplications of STDs. The indirectcomplications of early sexual debutinclude other negative health outcomes,such as increased vulnerability to partnerviolence (to be explored later), elevatedrisks of HIV/AIDS, and a higherprobability for other risk behaviors(interconnectedness).Teenage PregnancyThe latest figures on teenage pregnancyfrom the National Center for HealthStatistics, which computes the sum of livebirths, fetal losses, and induced abortions,indicate that in the year 2002, 76.4 per1,000 females ages 15-19 becamepregnant. 36 In 2006, the teenage birth raterose for the first time in 14 years, to 41.9births per 1,000. This three percent risewas accompanied by an eight percentincrease in unmarried childbearing amongall women, the largest in females ages 25-29. 37Using data from the National Survey ofFamily Growth (a five wave longitudinalstudy of roughly 10,000 women betweenthe ages of 15-44), the two charts belowshow the increased risk threateningadolescent females who experience earlysexual debut. Beginning sexual activity ata later age reduces the risk that a teenagerwill experience a non-marital pregnancyand non-marital birth; both events thatpose a significant physical health challengefor adolescent girls, not to mention thephysical demands that are required to raisea child once it is born.In the first chart (below), a female whowaits until the age of 26 to have sex ismore than four times less likely toexperience a non-marital pregnancy than ifshe sexually debuts at the age of 13-14.Similarly, the second chart (next page)shows that the probability of a sexuallyactive 13-14 year-old female having a nonmaritalbirth is almost 5 times greater thanif she waited until around 23 to have sex. 38 8

Percent of Se xually Active Women Age 15-44100%80%60%40%20%0%Beginning Sexual Activity at a Later Age Reduces the Odds of Non-Marital Childbearing43.04%39.65%27.32%20.59%12.15%9.13%8.35%8.92%Under 12 13-14 15-16 17-18 19-20 21-22 23-25 26 or olderAge of First Voluntary Sexual IntercourseSource: National Survey of Family Growth (Adapted from The Heritage Foundation, 2004)Sexually Transmitted DiseasesIn 2008, the Centers for Disease Controland Prevention (CDC) estimated that onein four (approximately 26 percent or 3.2million) girls in the U.S. between the agesof 14 and 19 are infected with at least oneof the most common STDs (humanpapillomavirus, chlamydia, herpes simplexvirus, and trichomoniasis).39 This data addsto what we already know, that about 19million new STD cases occur annually,almost half among young people ages 15-24. 4024. 40 41A number of reasons explain why youthcontract STDs at such alarming rates.Many adolescents initiate sexualintercourse too soon, and their inability tocomprehend the associated risks41mayresult in failure to use appropriatecontraception; 42 for example, in 2005, 34percent of sexually active high schoolstudents failed to use a condom at lastintercourse. 43 Adolescents are also likely tohave more sex partners at earlier ages, andsexually active teenagers are oftenreluctant to obtain STD services.44 Finally,young people in the U.S. frequently usealcohol and other drugs, 45 which increasetheir likelihood of engaging in high-riskbehaviors such as sex without a condom. 46The age at first intercourse has a strongassociation with a person’s number oflifetime sexual partners, and the moresexual partnerships one has, the greater therisk of contracting an STD.47 Researchshows that adolescents who experienceearly sexual debut have poorer overallhealth and more STDs, 48 while anincreased number of sexual partners placesthem at risk for HIV/AIDS. 49 Consideringthat new sexual partnerships amongadolescents increase the incidence of STDinfection, 50initiating sex at a later agedecreases the probability of acquiring anSTD. In the first chart on the next page, amale is 74 percent likely to have 6 or moresexual partners by age 20 if he has firstintercourse by age 14. However, if hewaits until age 17 or older to have sex, his9

Number of Lifetime Sexual Partners among Sexually Active Male Teensat age 20Likeliness of Sexual Partners100%80%60%40%20%0%74%15%2%9%48%17%27%8%10%18%30%42%14 or younger 15-16 17 or olderAge at First Sexual IntercourseSource: U.S. Department of Health and Human Services (2000)6 or more partners4-5 partners2-3 partners1 partnerNumber of Lifetime Sexual Partners among Sexually Active Female Teensat age 20Likeliness of Sexual Partners100%80%60%40%20%0%10%34%13%58%6 or more partners32%28%4-5 partners2-3 partners15%1 partner28%45%25%10%2%14 or younger 15-16 17 or olderAge at First Sexual IntercourseSource: U.S. Department of Health and Human Services (2000)10

chance of accumulating that many partnersdrops to 10 percent. Similarly, in thesecond chart, a female has a 58 percentchance of having 6 or more sexual partnersby age 20 if she has first intercourse by age14. However, if she waits until at least 17to have sex, her chance of accumulating asmany sexually partners decreasesdramatically. 51Adolescent Condom UseAdolescent condom use furtherexacerbates their vulnerability to STDs,mainly because of the inconsistent andincorrect use during teen sex. Rankingcontraceptives by effectiveness over thefirst 12 months of use, one study foundthat the typical method failure rate formale condoms was 15 percent. 52 However,the problem with adolescent condom usedoes not primarily lie in the method failurerate, but rather, the user failure rate.Research indicates that females report lessconsistent condom use than males; 53 forexample, one study found that youngwomen reported consistent use only 50percent of the time. 54 Adolescent malesfare a little better, as recent data suggeststhat two-thirds use condoms consistently. 55However, other studies demonstrate thatdue to incorrect use, the user failure rate ofcondoms can be as high as 70 percent. 56Similarly, a 2007 survey at Kent StateUniversity reveals that only 30 percent ofsexually active college students regularlyuse condoms during sexual intercourse. 57Percentage of Condom Use Error Among Late Adolesecent Males80%70%60%50%40%30%20%10%0%74.50%61.40%59.60%43.20%42.80%Mean % Occurred30.40%Source: Sexually Transmitted Diseases, 29(9), 200215.30%13.20%Did not check condom for visibledamageDid not check expiration dateDid not discuss condom use with partnerbefore sexDid not change condom when switchingbetween vaginal, oral, or anal sexPut condom on after starting sexPut condom on wrong side (had to flipover)Took condom off before sex was overCondom slipped off while withdrawingpenis11

In another study of late adolescent malesenrolled in college (mean age of 20.2),researchers found that large numbers ofmales used condoms incorrectly in avariety of ways, significantly jeopardizingtheir effectiveness (see chart on previouspage). 58Another concern with condoms is that theydo not offer the same protection against allsexually transmitted infections (STIs). ∗With 100 percent correct and consistentuse, studies show that condoms reduce therisk of HIV transmission by 85-95percent, 59, 60 but they do not offer the sameprotection against sexually transmittedbacterial infections such as chlamydia,gonorrhea, and syphilis, nor do theyprotect against STIs that can be transmittedthrough oral sex or skin-to-skin contact,such as genital herpes and the humanpapillomavirus (HPV). 61 Additionally,females who experience early sexual debutare more likely to contract bacterial STIssuch as HPV 62 and pelvic inflammatorydisease. 63 Due to their biological makeup,young women have a higher amount ofcolumnar cells exposed on the cervix.Until girls mature, the concentration ofthese cells cause more vulnerability toSTIs, which could lead to the cervicalcancer associated with HPV. 64∗ Sexually transmitted diseases (STDs)result from damage caused by sexuallytransmitted infections (STIs) that haveprogressed. Although all STDs arepreceded by STIs, not all STIs result in thedevelopment of STDs. For furtherexplanation, visit the Medical Institute forSexual Health (MISH) website at:http://www.medinstitute.org/content.php?name=stivstiInterconnectednessIn 2004, young people ages 13-24 made up13 percent of all those diagnosed withHIV. 65 Considering that half of all newSTD cases each year occur among youngpeople, and that the presence of an STDcan increase the chance of contracting orspreading HIV, 66, 67 adolescents who havemultiple sex partners at young ages face anincreased risk for other negative healthoutcomes.However, the interconnectedness ofmedical outcomes is not the only dangerthat plagues youth – high risk behaviors,including violence, delinquency, andsubstance use, are also associated withearly sexual debut. Research indicates thatsexual risk behaviors among adolescents,including having multiple sex partners,correlates with illicit drug use. 68 Forexample, among sexually active highschool students in the U.S., one-fourthreported using alcohol or drugs at lastintercourse. 69 Another study found thatadolescents with an increased number ofsexual partners are at greater risk foralcohol, tobacco, and marijuana use, aswell as dating violence, fighting, andcarrying weapons. 70 Moreover, researchshows that sexually active adolescents aremuch more likely to engage in a variety ofrisk behaviors than their virgin peers. 71The charts on the next page summarizethese results.For example, in this study, sexually activegirls between the ages of 12-16 had a 46percent probability for marijuana use;however, the girls who were virgins onlyhad a 6 percent chance. Similarly, forsexually active boys, their probability formarijuana use was 38 percent, compared toonly a 5 percent probability for the boyswho had not had sex by those ages.12

Behavior Risks & Association with Virginity/Nonvirginity in FemalesAges 12-16 (%)Attempted SuicideSuspended from SchoolArrested by PoliceRun from HomeConsiders Dropping SchoolRides w/ Drug-using DriverVirginNon-VirginOther DrugsMarijuanaCigarettesAlcohol0% 10% 20% 30% 40% 50% 60% 70% 80%Source: Pediatrics, Vol. 87(2), (1991)Behavior Risks & Association with Virginity/Nonvirginity in MalesAges 12-16 (%)Attempted SuicideSuspended from SchoolArrested by PoliceRun from HomeConsiders Dropping SchoolRides w/ Drug-using DriverVirginNon-VirginOther DrugsMarijuanaCigarettesAlcohol0% 10% 20% 30% 40% 50% 60% 70%Source: Pediatrics, Vol. 87(2), (1991)13

Adolescent Brain DevelopmentIn 1982, late Supreme Court Justice LewisPowell gave the majority opinion in thelandmark case Eddings v. Oklahoma,overturning the death sentence of a 16 yearold boy who murdered a police officer:Adolescents, particularly in theearly and middle teen years, aremore vulnerable, more impulsive,and less self-disciplined thanadults . . . because adolescents mayhave less capacity to control theirconduct and to think in long-rangeterms than adults. 72Fast-forward to the year 1999, where Dr.Jay Giedd of the National Institute ofMental Health is working on alongitudinal study of adolescent braindevelopment. Dr. Giedd used MagneticResonance Imaging (MRI) to determinethe amount of cortical gray matter andincreases in white matter among 145child and adolescent brains, ages 4 to 20years old. Dr. Giedd’s findings not onlyconfirmed Justice Powell’s opinion, but alsoprovided scientific explanation to countlessprofessionals and parents who have tried foryears to understand their spontaneous andsometimes irrational adolescents. Gieddfound that the prefrontal cortex, the part ofthe brain most associated with reasoning,making judgments, controlling impulses,and foreseeing consequences, is still quiteimmature during adolescence. As the graymatter gradually decreases and the whitematter increases, adolescents have increasedcapacity to use the very front region of theirbrain. The white matter, which allowsgreater access to the prefrontal cortex,increases with age, while the gray matter,which peaks at the age of 12.1 in males and11.0 in females, gradually decreases intoadulthood. 73 According to Giedd’s researchand other studies, 74 the prefrontal cortexdoes not fully mature until adolescents are intheir 20s.During adolescence, the brain experiencesthe most growth in three areas: the nucleusMaturation of the Adolescent BrainBrain MaturationBrain Functioning from Childhood to AdulthoodSouce: National Institute of Mental Health14

accumbens, amygdala, and the prefrontalcortex. The nucleus accumbens directs thebrain to seek reward by motivation; it isprimarily responsible for how much effortis put forward to achieve somethingdesirable. Young people often display anelevated degree of motivation when thereward is great enough, and utilize this partof the brain to realize their goal. Theamygdala is associated with the emotionalreactions often seen in adolescence; itexplains why teenagers can go from oneextreme to the other without being able tocontrol their response. Finally, theprefrontal cortex is the part of the brainthat makes rational decisions. Theimmaturity of the prefrontal cortex, whichis very common at this age, is theneurobiological explanation for whyadolescents exhibit poor judgment. 75Indeed, “neuropsychological studies showthat the frontal lobes are essential for suchfunctions as response inhibition, emotionalregulation, planning, and organization.Many of these aptitudes continue todevelop between adolescence and youngadulthood.” 76 As the diagram on theprevious shows, the nucleus accumbensand amygdala are utilized more duringadolescence, while the prefrontal cortex isnot mature enough for use until earlyadulthood.In a similar longitudinal study co-authoredby Giedd in 2004, MRI’s were used toscan 13 children over ten years. In thisstudy, Giedd found that the first areas tomature, the extreme front and back of thebrain, are those that use the most basicfunctions, such as processing the sensesand movement. The parietal lobes, whichare involved in spatial orientation andlanguage, come next. Finally the prefrontalcortex, which controls the more advancedfunctions such as the integration ofinformation from the senses, reasoning,and other “executive” functions, is the lastto mature. The diagram below is a visualconstruction of the MRI scans of thethirteen children, ages 5 to 20 years old.The red colors, pronounced more inchildren and early adolescents, indicatesmore gray matter, the blue colors, seenmore in adolescents closer to the age of 20,indicate less gray matter. As the graymatter gradually decreases with age,15

adolescents are able to utilize theirprefrontal cortex to make decisions, whilerelying less on the amygdala, the region ofthe brain that is associated withemotions. 77In another recent study that examined theamygdala region in the teenage brain, Dr.Deborah Yurgelun-Todd used MRIs toexamine 18 children between the ages of10-18 years of age, comparing them to 16adults. In the experiment, both groups wereshown pictures of adults and were asked todescribe the emotions on their faces. Whilethe subjects looked at the pictures,researchers traced their brain patterns tosee where the most activity occurred. Mostof the teens used the amygdala region ofthe brain while trying to guess theemotions of the faces, and consistently said“shocked, surprised, and angry” when thecorrect answer was “fear.” However, everyadult guessed “fear” correctly, and insteadof using the amygdala, they used theirprefrontal cortex. Interestingly, as the agesof children got older, their answers shiftedtoward using their prefrontal cortex, awayfrom the instinctual part of their brain. Dr.Yurgelun-Todd concluded from this studythat the amygdala generates reactions,rather than rational thought, whichsuggests that an immature brain leads toimpulsivity, or “risk-taking behavior.” 78So are teens biologically at a greater riskfor the harmful effects of early sex? Someresearchers, such as Cornell University’sB.J. Casey, seem to think so. “You need toengage in high-risk behavior to leave yourvillage and find a mate, and risk takingsoars at just the time as hormones driveadolescents to seek out sexual partners.”To understand what Casey describes asevolutionary factors causing teens to takerisks, one has to look at the nucleusaccumbens, the region of the brain thatdrives adolescents to seek reward. In theCornell study, researchers at Weill MedicalCollege measured brain activity by askingchildren, adolescents, and adults toperform easy tasks in return for small,medium, or large rewards when theyaccomplish them. When a medium or largereward was given, the nucleus accumbensreacted more strongly in teens than in theadults or children. However, when a smallreward was given, the adolescent responsein this region of the brain decreased belowthat of the adults or children in the study,“as if the small reward represented noreward at all in the teen’s view.”High risk activities such as sex, alcohol,tobacco, drug use, and delinquencyprovide teenagers with immediate rewards,but they also may have severeconsequences for mental health, such asaddiction, depression, and suicide. If teensare at a greater risk, how do parents,educators, and policymakers provideeffective prevention strategies to helpadolescents stay away from these harmfulactivities? “Adolescents have somefundamental qualities to them that are notvoluntary and not easily modified byrational, information-based interventions,”says Laurence Steinberg, a developmentalpsychologist at Temple University. Dr.Giedd of the National Institute of MentalHealth believes that merely explaining theconsequences of risky behavior andpushing adolescents towards “safe sex orpharmaceutical temperance” should not beexpected to succeed. “I don’t think we canfight the biology of wanting to take risksand trying on different identities . . . theseare good things. But how do you haveoutlets that don’t give teens STDs, caraccidents, drug abuse, or jail? As a society,we can give kids creative, positive outletsthat do not lead to irreversible mistakes.” 7916

Psychological/Emotional Damage andDepressionMedical and psychiatric professionals havelong pointed out the dangers associatedwith early sexual debut and thepsychological damage it causes. InEpidemic: How Teen Sex is Killing OurKids, Dr. Meg Meeker argues thatadolescents who engage in sex at youngages routinely experience emotionalturmoil. Teens may attempt to fill unmetneeds through sexual escape, and theyoften fall into a trap of seeking lovethrough sex, even if that sexual experienceis not positive. This in turn can result in avicious cycle, and perhaps a psychologicalcondition called repetition/compulsion.This condition causes adolescents to seekthe illusion of satisfaction in sex orsubstance abuse, with the idea thattemporary relief will satisfy their needs. Asa result, many adolescents sink further intodepression. 80Over the past 20 years, the rate ofpsychological symptoms in adolescentsand children has increased from 7 to 18percent. 81 Research indicates thatdepression is common duringadolescence, 82 yet health professionals areoften unable to determine causalrelationships between adolescent riskbehaviors and subsequent psychologicaldisorder. Associations between early sexand depression are sporadic in pubertalboys, with symptoms typically limited tothose who exhibit high-risk behaviors.While changes in hormones accompanyingthe onset of menarche have been shown toelevate depression in girls, 83 those whoengage in early sexual activity are alsomore likely to experience psychologicalsymptoms, 84 even if the sex isexperimental (as opposed to multiplecasual sexual encounters).Depression in sexually active youth canalso be attributed to the casual nature oftheir sexual relationships. Adolescents whoexperience early sexual debut are morelikely to engage in intercourse with casualpartners, 85 and the resulting encounters areoften superficial, based on desire orphysical attraction; spontaneous, andimpulsive. 86 Casual sex is more likely toharm the female psyche than the male, as itmay alter a girl’s social context and inducestress by changing her self-perception. 87 Itmay further damage females, especiallyconsidering the importance they place onthe emotional investment and intimacy thatresults from sexual intercourse. 88 Thesebrief sexual encounters often fail to meetthe needs of the female, leaving a deepemotional void.Commenting on the impact of romanticrelationships on female adolescents, Dr.Susan Nolen-Hoeksema, professor ofpsychology at the University of Michigan,said: “Something about dating andrelationships can be toxic to girls’health.” 89 A National Longitudinal Surveyof Youth study of 959 adolescentsexamined gender differences regardingearly sexual intercourse and subsequentdepression. While no consistent adverseeffects were seen in males, the study foundthat multiple factors contribute todepression in females, including earlysexual intercourse, failure to use birthcontrol, and child bearing. 90 In a NationalInstitutes of Health study, girlsexperimenting with sex were nearly fourtimes more likely to have symptoms ofdepression than those who abstained. Thestudy asserts that “both substance abuseand sexual activity may alter a girl’s socialcontext, which could induce stress and/orchange self-perceptions, both of whichcould contribute to depression.” 9117

16Risk of Depression Among Sexually Active Male and Female Adolescents(Compared to Abstainers)1412Odds Ratio1086MalesFemales420Sex ExperimentersSmokers and SexAlcohol and SexSex and Drug UseHeavy Substance Use and SexMultiple Sex PartnersSex for Drugs or MoneySource: Archives of Women's Mental Health, 9(3), (2006)High Marijuana use & SexTwo recent studies also show the genderdifferences in depression among sexuallyactive adolescents – both use data from theNational Longitudinal Study of AdolescentHealth (Add Health), which has a sampleof more than 20,000 adolescents in grades7-12. The first study (see graph above)found that compared to abstainers, theodds of females experiencing depressivesymptoms were high with any sexualactivity, while the odds of sexually activemales exhibiting depressive symptomswere high only when combined with heavysubstance use. 92Similarly, another recent study shows thatgirls who merely experiment with sex anddrug use face the same risk of depressionas boys who display high-risk behavior; itis important to note that pre-existingdepression did not predict risk behavior ineither gender. 93SuicideSuicide is the third leading cause of deathamong adolescents ages 15-19, 94 andresearch indicates that compared toabstainers, youth who engage in earlysexual activity are more likely tocontemplate and attempt to take their ownlives. 95 In a previously mentioned study,sexually active girls ages 12-16 were over4 times more likely, and sexually activeboys were nearly 2 times more likely, toattempt suicide, compared to theirabstaining peers (see graphs under“Interconnectedness”). 9618

Researchers analyzing the Add Healthstudy, which asks students if they haveattempted suicide during the past year,have also found sexual activity to be a riskfactor in adolescent suicide. A recent studyusing Wave I of the Add Health data foundthat, compared with youth who abstained,adolescents who engaged in risk behaviors,including sexual activity, were more likelyto have thoughts of and to attemptsuicide. 97 Another study analyzing Wave IIof the Add Health data found that sexuallyactive girls were nearly three times andsexually active boys were eight times morelikely to attempt suicide than abstainers(see chart below). 98Attempted Suicide and Sexual Activity among Teenage Boys and GirlsP ercen t w h o A ttem p ted S u icid e inPast 12 Months16%14%12%10%8%6%4%2%0%14.30%5.10%6%Girls and Boys Ages 14-170.70%Source: National Longitudinal Survey of Adolescent Health, Wave II,1996 (Adapted from The Heritage Foundation, 2003)Sexually Active(Girls)Not SexuallyActive (Girls)Sexually Active(Boys)Not SexuallyActive (Boys)19

One of the best predictors of financialsuccess in the U.S. is an individual’s levelof lifetime academic achievement.Generally, those who enroll and succeed inhigher education enjoy high rates of returnto their investment. 99 Consider thefollowing chart of median income earningsby level of education in 2003. As the chartshows, higher levels of educationcorrespond to greater annual income.Median Income Earnings by Level of EducationProfessional Degree$59,500$49,900$79,400$96,700Doctoral DegreeMaster's DegreeBachelor's Degree$37,600$35,600$30,900$21,600Associate DegreeSome College, NoDegreeHigh School Graduate$0 $20,000 $40,000 $60,000 $80,000 $100,000Not a High SchoolGraduateMedian IncomeSource: U.S. Bureau of the Census,Adapted from College Board (2004)Teen Sexual Activity, EducationalInvestment, and Academic PerformanceEarly sexual debut is generally not viewedas a direct cause of poor academicachievement; however, making bettergrades or having higher educationalaspirations is associated with thepostponement of sexual intercourse. 100Indeed, “the practice of sexual abstinenceis likely to serve as a protective barrierwhich insulates the teenager fromdisruptive and negative influences andenables the teen to better focus on theimmediate academic performance andlonger-term life goals.” 101Sexual activity, as it relates to educationalinvestment and academic performance,must be examined in the context of theadolescent’s perceived environment, selfawareness,value system, adherence toconventional standards of behavior, andsocietal and familial influence. Selfawarenessand perceived environment playimportant roles in this process. Ifadolescents realize the academicenvironment is not compatible with sexualactivity, performance and school belongingdecline, and focus is placed elsewhere.Thus, early sexual debut may havenegative affects on adolescent academicperformance by luring them fromeducational pursuits to sexual activities,with their immediate reward. 102 20

Sociologist Richard Jessor’s problembehavior theory suggests that sexuallyactive adolescents may disconnect fromconventional institutions such as family,school, and religious organizations becauseof the socially undesirable status of theirdeviant behavior. In Problem Behavior andPsychosocial Development: a longitudinalstudy of youth, Jessor defines problembehavior as that which is “undesirable bythe norms of conventional society and theinstitutions of adult authority, and itsoccurrence usually elicits some kind ofcontrol response.” According to Jessor,adolescents who engage in a problembehavior, such as sexual activity,experience a redefinition in relationshipwith their perceived environment, resultingin the stigma of a ‘sexually active’ socialstatus. 103A recent study based on this theory foundthat youth who engaged in sexualintercourse experienced greater parentalproblems, reduced religious participation,and decreased school belonging.Adolescents who initiated and continuedsexual behavior were likely to experiencedeteriorating relationships withconventional institutions such as family,school, and church, due to the change intheir perceived environment and thesocietal response received from theirproblem behavior. 104 Indeed, society’sresponse may cause adolescents to turn tounconventional groups for support andaffirmation, such as their sexually activepeers, who are unlikely to supportacademic pursuits. 105 Thus, the negativeresponse from society may be the principalreason why some sexually activeadolescents perform poorly in school.Studies suggest that early sexual activitymay conflict with academic achievement,and at the very least, lead youth to becomeinvolved in a problem behavior syndromethat stands in the way of their education. 106Among white students, research has foundsexual activity to predict lower investmentin future educational plans and declines inacademic achievement. 107 Studies thatanalyze minorities show that sexuallyexperienced students are more likely tohave lower grade point averages (GPA)than abstainers, 108 and are also more21

likely to be involved in other riskbehaviors, 109 which may be associated withlow school performance. 110 A recent studyusing data from the National Survey ofChildren (a three-wave multistage stratifiedprobability sample of over 2,000 U.S. children)found that adolescents who were virginswere more likely to have highereducational goals and academicachievement when compared to those whoinitiated sex. As the graph on the previouspage shows, the second wave of interviewsfound that most of the adolescents (ages12-17) were virgins (n=1004). At the thirdwave of interviews, the late adolescents(ages 18-22) who had remained virgins(n=197) achieved better academic rankingsand had higher educational goals. 111Personality and Self-Control as anIndicator of Academic SuccessImpulsiveness and self-control representtwo traits within an adolescent’spersonality that may determine thepotential to succeed in academicendeavors, as well as their likeliness toengage in problem behavior. Studies havefound impulsiveness and sensation-seekingto be associated with a number of risktakingbehaviors among adolescents,including delinquency, 112 substance use, 113suicide, 114 and violence. 115 Impulsivenessis defined as those who do and say thingswithout thinking and act on the spur of themoment without being aware of the riskinvolved. Sensation-seeking is defined asthose who are aware of risks but areprepared to take those risks. 116In a General Theory of Crime, sociologistsMichael Gottfredson and Travis Hirschiassert that “people lacking in self-controlwill tend to be impulsive, insensitive,physical (as opposed to mental), risktaking,shortsighted, and pursue immediatepleasures that are not criminal,” such asengaging in illicit sex and having childrenoutside of marriage. 117Recent evidence links impulsiveness withadolescent sexual behavior. In a study of3,000 adolescents, sensation-seekers andimpulsive decision-makers, compared tothose without these traits, were morelikely to engage in sexual intercourse. 118 Inanother study, low levels of self-controlpredicted sexual behavior, higher numbersof sexual partners, and casual sex amongyoung respondents (as opposed to sex in acommitted relationship). 119 Other researchindicates that adolescents with low levelsof self-control are more likely to besexually active and have a higher numberof sexual partners, 120 and that girls withhigh levels of impulsiveness are morelikely to experience early sexual debut andsex with multiple partners. 121Sociologist Roy Baumeister argues thatindividuals with high levels of self-controlhave better interpersonal relationships,stronger families, fewer psychologicalproblems, and higher self-esteem. Selfcontrol,says Baumeister, involves threemain ingredients. The first is standards, orknowing exactly what one wants, whichmakes impulsive behavior unlikely:“Uncertain or conflicting goals underminethe basis for self-control and make peoplemore susceptible” (to impulsive behavior).The second is monitoring, or keeping trackof one’s behavior: “When people lose trackof their behavior, self-control breaksdown.” The third is the capacity to change,or the ability to alter oneself, whichinvolves the will to “surpass the power ofthe impulse.” 122For those who regulate their behavior, selfcontrolhas the ability to increase incapacity, improving gradually andstrengthening over time. Indeed, the22

implication that self-control can befostered through discipline is vital to thepractice of abstinence. If adolescents learnto control their sexual impulses and focustheir attention on areas such as education,their ability to delay gratification mayresult in higher academic performance.In a longitudinal study of college students,improvement over a period of two weeksin the capacity to perform seeminglyunrelated tasks led to an increase in selfdisciplineto the initial exercise. In theshort term, the exertion of self-controlmade the subjects tired and fatigued.However, in the long term, the series ofexercises caused the individuals to be lessvulnerable to fatigue and to improve theirself-regulation. 123 Indeed, self-control canfunction like a muscle, increasing strengthand improving gradually over time withregular exercise. 12495Self-Discipline and IQ in 8th Grade Students90Final GPA8580751 2 3 4 5QuintilesHigh IQHigh Self-DisciplineSource: Psychological Science, 16(12), (2004)Research shows that students with selfdisciplineachieve better grades, 125 andhigh levels of self-control in children canpredict future success. In a recent study,researchers measured the ability of 4-yearoldsto defer gratification by promisingextra cookies if they could leave onecookie uneaten for a certain amount oftime. When the researchers surveyed the 4-year-olds ten years later, those whorestrained themselves previously werebetter at resisting temptation asadolescents. 126Not only does self-restraint predict futuresuccess, but it may also produce moreimmediate results for students at a varietyof educational levels. For example, arecent longitudinal study of 140 eighthgrade students found that those with highlevels of self-control outperformed theirpeers in report card grades, standardizedachievement-test scores, admission to acompetitive high school, and schoolattendance. As the graph above shows, thestudents with more self-discipline scoredtwo percentage points higher in final GPAwhen compared to those with high IQ. 127Finally, in a study of 201 college students,self-control (second only to high schoolGPA) was a better predictor of academicachievement than a number of othervariables, including scores on theScholastic Aptitude Test (SAT). 128 23

Teenage Sex, High School Dropout, andDelinquencyResearch shows that early parenthoodamong adolescent girls decreases theireducational attainment. 129 Althoughteenage parenthood has been associatedwith early sexual initiation in bothgenders, 130 the negative impact ofadolescent pregnancy in academicachievement is generally worse forfemales; for example, one study found thatonly 30 percent of dropout mothers returnand graduate high school. 131 Even thoughdropout mothers are likely to attain a GEDafter childbirth, 132 high school diplomascarry greater weight in future return forearnings. 133 Thus, teenage pregnancy is amajor obstacle to financial stability forfemale adolescents.According to the National Campaign toPrevent Teen and Unplanned Pregnancy,mothers who delay childbearing until theages of 20-21, compared to teenagemothers ages 17 or younger, earn anaverage of $84,000 more over the first 15years of motherhood, or $5,600annually. 134 Data on the financial outcomesof teenage fathers is not as clear; one studyfound that over an 18 year periodfollowing a birth to a mother age 17 oryounger, male partners earned an averageof $27,000 less than fathers of childrenborn to mothers age 20-21. 135 While someadolescent fathers may work more hoursand earn more money than non-parents inthe first few years after a child’s birth, theyare likely to experience lower educationalattainment, resulting in fewer earnings inthe long term. 136Whereas childbearing disrupts educationfor females, research indicates that maleswho initiate early sexual activity may beless likely to achieve academic success dueto their involvement in delinquent andother at-risk behaviors. 137 Delinquencymay diminish economic opportunities forsome adolescents, thereby reducing theirsocial and human capital. 138 One studyfound that early and persistent sex,especially among boys, was associatedwith alcohol use, delinquent behavior, andpoorer academic achievement. 139Studies based on the Add Health data havealso found associations between early sexand delinquency. One study found thatearly sex was associated with a higherprobability for suspension, unexcusedabsences, lower school-connectedness, andreduced aspirations to attend college. 140 Inother research based on Add Health,adolescents initiating sex before 13.7 yearsof age had an increased probability fordelinquency by 20 percent. However, if theadolescent was older than the average age(15.86) at first sex, his probability fordelinquency decreased by 50 percent. 141Still, other research on the same dataconcludes that uncontrolled genetic andenvironmental differences betweenfamilies may have more of an influence onlater delinquency than early sex alone. Inone study, same-sex twins were comparedto determine whether there weredifferences in delinquency for the twinwho had sex earlier. The twin pairs who,on average, had initiated sex earlier alsohad higher levels of delinquency in earlyadulthood. However, once between-familydifferences were controlled for, the twinwho had an earlier age of first sex actuallyhad lower levels of delinquency later inlife.” 142 Because correlation does notalways equal causation, future researchwill have to determine if early sex is theprimary influence for later delinquency, orwhether other factors, such as environmentand genes, are more responsible.24

Forming healthy relationships is anintegral part of adolescent sexualdevelopment, so much so that without rolemodels, children are vulnerable to sexuallyabusive relationships as they growolder. 143 Marriages that are free frompersistent strife and conflict havetraditionally served as models for healthyrelationships. 144 Indeed, children whoseparents are married are more likely toexperience better physical and mentalhealth, have higher levels of education andeconomic advantages, and avoid crime anddelinquency. Additionally, their chance fora healthy future marriage improves. 145Thus, determining the correlates of ahealthy relationship requires identifying itsqualities, while examining thecharacteristics that help create anenvironment in which it can function.Characteristics of Healthy RelationshipsIn his research on marriage, sociologistGraham Spanier identified the aspects ofmarital quality and marital stability to10assess the functionality and health of arelationship. The quality aspect isconcerned with its operation, or how thepartners feel about and are influenced bythe relationship. The stability aspect isdetermined by whether the marriage isterminated by divorce, separation,desertion, or annulment – spousal death bynatural means being the indicator of astable marriage. According to Spanier, theidea of two persons committing to eachother until natural death (stability)accounts for half of what he considers tobe healthy in a marriage. 146 In alongitudinal study analyzing satisfiedcouples, commitment was found to be vitalto the continuation and growth of themarital relationship, with over threefourthsof respondents listing this qualityas essential to their marital satisfaction. 147Additional research on long-termmarriages identified 10 importantcharacteristics that spouses possess:lifelong commitment and loyalty to one’sspouse were the most important. 148 Theresults are summarized below.LifelongCommitmentLoyalty to one’s spouseStrong moral valuesRespect for one’s spouse as one’s best friendCommitment to sexual fidelityA desire to be a good parentFaith in God and spiritual commitmentA desire to please and support one’s spouseBeing a good companion to one’s spouseWillingness to forgive and be forgiven25

Other research identifies marital quality,stability, and happiness as characteristicsof a healthy relationship, with an emphasison conflict resolution, communication, andthe need for intimacy and security. 149 Alongitudinal study of 124 newlywedcouples focused on conflict resolution,with results indicating that the first 3minutes of a conflict discussion werecrucial in predicting whether the couplewould eventually divorce. Husbands andwives in stable marriages expressed morepositive than negative emotions in thebeginning of the conflict (althoughemotions tended to become more negativeas the conflict progressed), indicating theability to work through maritalproblems. 150Adolescent Dating: Influences,Processes, and OutcomesAs illustrated above, research hasidentified specific characteristics that arevital to the health of a relationship,including communication, trust, honesty,respect, and emotional support. 151 Manyaspects of healthy relationships, however,are not inherent traits, but must be instilledas adolescents mature into young adults. 152Research shows that adolescents who feela personal connection to family are lesslikely to initiate early sexual intercourse, 153and policy makers regard the family ascritical to preventing adolescent riskbehaviors. Therefore, it is important thatparents educate, monitor, and support theirchildren as they explore romanticrelationships and begin dating.Dating has historically been recognized asone of the means by which adolescentsgain experience in romantic relationshipsand learn to become fully sexual beings. 154The process of moving toward mutualrelationships occur in a series of stagesfrom preadolescence through lateadolescence. Initial interactions betweenthe opposite sexes usually occur in mixedboy-girl groups; next, group dating begins,where several couples engage in datinglikeactivities together; finally, romanticrelationships begin to form. 155 The peergroup is especially important for early-midadolescents, as they rely heavily on theirsocial networks to provide the opportunityto seek partners. Foundational research onadolescents has identified two peerstructures thought to assist in the initialdating process; cliques (small groups ofsame-sex friends) and crowds (largegroups of mixed-sex networks). As severalsame-sex cliques join together and becomea mixed-sex crowd, the opportunity forboys and girls to engage in romanticrelationships occurs. 156Identity Formation and IntimacyAdolescent dating experiences areinfluenced by a number of processes andvary by degree of intimacy. As theadolescent continues to form an identity,dating must be examined in the context ofthis process. Some early romanticrelationships may occur as the result ofattempts to arrive at one’s personalidentity, and therefore disturb theadolescent’s growth into maturity. InIdentify and the Life Cycle, psychologistEric Erickson argued that “truepsychological intimacy can only occurafter the establishment of a strong sense ofpersonal identity, which must occur in asequence of crises along adolescence.” 157Research on relationship maturity explainsthe limited capacity for intimacy in threestages that accompany adolescence:self-focused, role-focused, and finally,individuated-connected.26

In the self-focused stage, one’s perspectivein a relationship is only concerned withhow it affects the self. There is littlecapacity for concern for others, andcommitment is seen in terms ofconvenience or dependency; intimacy is inthe early developmental stage, andcommunication is very limited. In terms ofsexuality, there is little perspective of sexas affectionate and emotional, and theunderstanding of another person’s sexualneeds is very limited.In the role-focused stage, a perspective ofothers as individuals in their own rightbegins to develop. Individualsacknowledge the importance of respectingtheir partner, and express care in theactivities expected in the role of romanticpartner. Communication improves, andsome sharing of feelings occurs, but sexualrelationships are still generally shallow.In the individuated-connected stage,individuals place emphasis on another’spoint of view and exhibit commitment tospecific partners with whom they share arelationship. High value is placed oncommunication as individuals engage inconflict resolution and discuss concreteand external topics, as well as those whichare centered on the relationship. Regardingsexuality, there is more of an emotionalexpression and intimate connection amongboth partners. 159As many adolescents are still in theprocess of forming their identity, they fallprimarily in the self-focused intimacystage, perhaps approaching the rolefocusedstage. 160 In the older teen years,adolescents begin to look for intimacy,companionship, affection, and socialsupport; however, in the early teen years,dating is more superficial – for fun andPercentage that have Dated90%80%70%60%50%40%30%20%10%0%Early and Middle Adolescents that have Dated84%74%54%71%Source: Journal of Adolescence, 21(6), (1998)Been on a group dateBeen on a date with justone personBeen on dates with manydifferent peopleGone steady for over 1monthrecreation, status among peers, andexploring attractiveness/sexuality. 158 In astudy of early and middle adolescents’dating experiences, seventy-one percenthad gone steady with at least one partnerfor over a month (see chart above).However, few had been involved in the“true and mutual psychological intimacy”that Erickson describes – this often eludesadolescents until they reach youngadulthood. 161 27

Early romance does not fulfill all of thefunctions of adult relationships – forexample, it is uncommon for adolescentsto turn to their partner for support orprovide care giving; what may beimportant is simply having such arelationship, especially if the partner ispopular. 162 Indeed, affiliative and sexualbehavior are thought to appear first withromantic partners; the attachment and caregiving systems usually are expected toemerge later in development, in longertermrelationships. 163 Consequently, theseare signs that identity formation is stillunderway, and the potential for intimacy islimited. Therefore, parents and familymembers should recognize the nature ofadolescent romance and developappropriate guidelines to assist theirchildren in the dating process.Influences and Outcomes of Early andSteady DatingDating relationships, while sociallyacceptable, afford adolescentsopportunities to engage in sexual activity,and may even motivate them to becomesexually active. 164 Early dating(specifically steady dating) is associatedwith sexual activity among young people,as it provides the social structure for suchactivity to take place. A majority ofadolescent sexual encounters occur whiledating, and research shows that teensengage in sex very quickly in their firstromantic relationship. 165 In one study,nearly one in three teens had sex in thesame month or before their datingrelationship began, and another thirty-fivepercent experienced sexual debut withinthe first three months of theirrelationship. 166The attitudes and behavior of those closestto the adolescent (e.g., parental andfamilial structure) exert a great deal ofinfluence in the dating and sexual initiationprocess. Research shows that whilecoercive and over-controlling parents maycause adolescents to rebel and initiate sexat earlier ages, monitoring, especiallybefore the onset of puberty, may have apositive effect on virginity. 167 Siblings andother family members may also have asignificant role in this process. In a studyof 455 minority adolescent girls, thenumber of sexually active influences(including girlfriends and sisters) wereassociated with the girl’s sexual attitudes,sexual status, and for virgins, their sexualinitiation intentions. 168As mentioned previously, peer networksare very important in the dating process, as“the timing of adolescents’ first intercourseis determined, in part, by the norms forsexual behavior and the perceived valuesof youths’ friendship groups.” 169 Indeed,young people’s beliefs regarding theirfriends’ sexual activity may have moreinfluence on their sexual behaviors thanthe actual practice of those peers. 170 In alongitudinal study of urban minority boys,perceptions of peer sexual involvementwere associated with sexual behavior andpredicted future sexual activity.Adolescents in the study who thought thatfew of their friends were engaging in sexwere less likely to be sexually involvedcompared to those who thought that manyof their friends were having sex. 171 28

Percentage of Students who Reported Sexual Activity in Ninth Grade(by relationship status in 7th grade)40%35%30%25%20%15%10%5%0%BoysGirlsSource: Perspectives on Sexual and Reproductive Health,38(2), 2006No RelationshipSame-ageboyfriend/girlfriendOlder boyfriend/girlfriendResearch shows a strong associationbetween early dating and sexual activity.Indeed, adolescents who begin dating at anearly age are likely to date more frequentlyand have early steady relationships,develop permissive attitudes concerningpremarital sex, and have multiple sexualpartners in the future. 172 One study foundthat early adolescents involved in steadydating relationships were five times morelikely to be sexually experienced thanthose who were not steady daters. 173Another recent study following the datingpatterns of middle school students foundrelationship status at grade seven predictedsubsequent sexual activity two years later,especially if the student had an olderboyfriend or girlfriend. As the graph aboveshows, boys who had an older girlfriendwere nearly twice as likely and girls whohad an older boyfriend were overfour times as likely to report sexualactivity two years later.Dating Violence and AbuseDating violence and abuse are another riskfactor for early daters, and are quitecommon among adolescent relationshipsthat involve sex – in fact, recent dataindicates that about one in five sexuallyactive girls have a history of datingviolence. 174 Although adult men are farless likely than women to be the victims ofrelationship abuse, 175 some evidencesuggests that males face a higher risk fordating violence when they are younger.Data from the following two nationallongitudinal studies show relationshipabuse among adolescent male and femalevictims, as well as abuse among adolescentfemales only.29

Adolescents Experiencing Abuse in Romantic RelationshipsReported sexual intercourse (3,205) Did not report sexual intercourse (3,343)50%40%30%20%10%0%37%19%Anyviolence29%18%10% 13%Insult you inpublicSwear atyou5%1%Threatenwithviolence11%5%Push orshove youSource: Journal of Adolescent Health, 35(5), (2005)Data from the National Longitudinal Survey of Adolescent Health, Wave II4% 1%Throwsomething atyouAnalyzing 6,548 adolescents in Wave II ofthe National Longitudinal Study ofAdolescent Health, violent victimizationwas more likely to occur in adolescentromantic relationships that included sexualintercourse, compared to relationships thatdid not. Results of this study also indicatethat engaging in sex increases the risk ofpartner violence for male and femalevictims, and that a majority of violence,including verbal abuse, came after, ratherthan before the sex (see graph above). 176Female Adolescents Experiencing Physical Abuse in a Dating Relationship in the Past12 Months17.70%20%15%10%5%2.70%Sexually ExperiencedNot SexuallyExperienced0%Source: Pediatrics, 114(2), (2004)Analyzing data from the National YouthRisk Behavior Survey (sample of 6,864female adolescents), another study foundthat sexually active adolescent femaleswere more than four times more likely tobe abused than girls who did not have sexin the previous year. Additionally, girlswho reported experiencing dating violencein the previous year were 50 percent morelikely than their peers to have sexually30

debuted before the age of 15, and werealmost twice as likely as their peers toreport having 3 or more sexual partners inthe previous 3 months (see graph onprevious page). 177Finally, girls are often pressured, coerced,and even forced to engage in sex beforethey desire, usually because their partnersare substantially older. Indeed, researchindicates that early adolescent females’first sexual partners are much older, andconsequently, greater problem behaviorsare associated with these girls. 178 Forexample, one study found that compared togirls who dated boys their own age, the oddsof a 13 year-old girl having sexualintercourse was six times higher if herpartner was six or more years older thanher. 179 Additionally, a recent study foundthat girls who have sex with an older partnerare at a higher risk for acquiring an STD. 180As the chart below displays, forced sexamong adolescent females is more likely tooccur among younger girls. 181Forced Sex Among Female Teenagers100%90%80%70%60%50%40%30%20%10%0%13 andyounger14 andyounger15 andyounger16 andyounger17 andyounger18 andyoungerSource: Alan Guttmacher Institute (1994)19 andyoungerVoluntaryintercourse onlyBoth voluntary andinvoluntaryintercourseInvoluntaryintercourse onlyStable Marriage and FamilyThe formation of a stable marriage andfamily is in many ways the product of ahealthy relationship. A study following14,000 American adults over a period of 10years found that marital status was one ofthe most important predictors ofhappiness. 182 Additionally, children infamilies whose parents are married havebetter emotional and physical health, havemore opportunities to achieve academically,and enjoy improved life outcomes. 183Thus, due to their ability to shape happinessand well-being, marriage and family aretwo of the most important institutions insociety, and the existence of healthyrelationships within these institutions is akey factor that determines its vitality. Laterin this section, marriage’s contribution to ahealthy lifestyle will be explored, but first,the destructive effects that early sexualdebut and cohabitation have on the healthof relationships will be examined.31

Cohabitation, Marital Disruption andInfidelityIn the year 2000, the U.S. Bureau of theCensus estimated that about 4.9 millionunmarried heterosexual couples wereliving together, constituting about 9percent of all coupled households in theU.S. Comparing this total to the year 1960,the rate of cohabitating couples hasincreased about 10 times ∗ over fortyyears. 184 As the graph shows, there hasbeen a sharp increase among those who arerejecting marriage for the alternative ofcohabitation. Larry Bumpass, one of theleading sociologists on the subject, assertsthat more than half of persons in their 30shave lived with a romantic partner outsideof marriage, and more than 50 percent ofrecent marriages were preceded by acohabitation. In a study using data from theNational Survey of Families Households,Bumpass found that the decline in havinglived in a marriage-like relationship (e.g.,cohabitation) by a given age was less thanthe decline in marriage experience by thatage. Whereas the percentage of evermarriedbefore age 20 declined 49 percentbetween 1970 and 1985, the percentage ofever having cohabited before 20 declinedby just 20 percent. 185 Indeed, most of therapid decline in marriage has been offsetby increasing cohabitation, as “youngpersons are setting up joint housekeepingalmost as early in their lives as beforemarriage rates declined.” 186 As the graphon the next page shows, over the course of50 years, the age at first marriage hasincreased by 25 percent in women (5.1years) and 20 percent in men (4.5 years).U.S. Cohabiting Couples, 1960-2000 (Heterosexual)54Millions32101960 1970 1980 1990 2000Source: U.S. Bureau of the Census (2000)∗When taking into consideration thepopulation growth in the U.S. between1960-2000, the rate of cohabiting coupleshas increased about 6.5 times.32

Age at First Marriage in the U.S. (1955-2005)30Age282624222026.9 27.125.525.324.523.5 23.322.6 22.821.120.620.2MenWomen1955 1965 1975 1985 1995 2005Source: U.S. Bureau of the Census (2006)The reasons young people delay marriagefor the alternative of cohabitation varybetween cultural, economic, and socialfactors. The impact of cohabitation on thedeclining rates and quality of marriage,however, is not as clear. One explanationis the increasing prevalence of divorceresulted in a questioning of the institutionof marriage; marriage was viewed as afragile relationship, and the possibility ofdivorce become a concern for manyindividuals. Thus, many Americansadjusted to the uncertainty of marriage byopting for cohabiting unions without legalimplications. As a result, some sociologistsexpected that a rise in cohabiting unionswould act as a training mechanism,strengthening marriage due to thedissolution of less compatible couples,with the stronger cohabiting relationshipseventually resulting in quality maritalrelationships. However, this theory hasbeen discredited, as cohabiters’ futuremarital relationships have been associatedwith a number of problems, includingdivorce. 187 In turn, two subsequent theorieslinking cohabitation to marital dissolutionhave resulted: causality and selectivity.Causality asserts that cohabitation weakenscommitment to marriage as an institution.If those who cohabit find this arrangementprovides a compatible lifestyle, theirpreference for marital union may decline.A dissolution of cohabitation could alsoreinforce the view that intimaterelationships are fragile and temporary,thereby reducing the expectation thatmarriage is a lifetime relationship andcommitment, which could be expressed inan increased acceptance of divorce forcohabiters in future maritalrelationships. 188Selectivity asserts that cohabiters have lesscommitment to marriage and differ frompersons who do not live with their partnerbefore marriage. They have more liberalattitudes about the permanence ofmarriage, are more willing to take risks, or33

have qualities that make them poormarriage material (e.g., have troubleholding a job, drug or legal problems,fiscal irresponsibility, or personalityproblems). 189 Thus, because cohabitation isoften viewed as a trial relationship, it mayattract persons who are, on average, moreaccepting of the termination of intimaterelationships. In turn, this tendency islikely to carry over to a greater acceptanceof divorce within future maritalrelationships.Selection may play a role in future maritaldissolution among cohabiters, especiallywhen taking into consideration a numberof variables, including their parents’divorce experiences and other backgroundcharacteristics. However, selection seemsto have a weaker association among themajority, as nearly three-quarters ofcohabiters expect to marry their partner(see graph above), and in only 10 percentof cohabiting relationships does neitherpartner intend to marry.Indeed, the research supporting selectivitymaintains that cohabiters are likely to havea predisposition against marriage;however, data indicates that the vastmajority of these individuals intend tomarry their partner. For example, ofsingles who expect to cohabit in the future,more than 80 percent say that they woulddo so in order to “make sure they arecompatible before getting married.” 190In a study using data from the NationalSurvey of Families and Households, whichincludes over 13,000 individuals involvedin cohabiting and marital relationships,cohabitation was associated with greatermarital conflict, lower quality of marriage,poorer communication, less commitmentto marriage, and more individualistic viewsof marriage among wives. Additionally,cohabiters perceived a greater likelihood ofdivorce when compared to couples that didnot cohabit before marriage, and longercohabitation was associated with a higherprobability of divorce. 191 Indeed, studieshave found cohabitation to be a causalinfluence for divorce, 192 as research showsthat women incur a greater chance ofmarital disruption when they cohabitate orhave their first sexual experience with aman whom they do not marry. 193 34

Infidelity Among Married and Cohabiting Men and Women% Unfaithful in Past Year20%16%12%8%4%4%16%1%8%Married MenCohabiting MenMarried WomenCohabiting Women0%Source: The Social Organization of Sexuality (1994)Further examination reveals thatunfaithfulness among partners is high incohabitation, giving these relationships thepotential to act as a breeding ground forinfidelity in future marriages. Analyzingsexual attitudes and behavior from 3,432Americans surveyed in the National Healthand Social Life Survey, living togetherbefore marriage raised the net odds ofmarital infidelity by 39 percent, even whencontrolling for sexual values and frequencyof attendance at religious services –variables that usually distinguish marriedcouples from cohabiting couples.As the graph above shows, the NationalHealth and Social Life Survey (“NationalSex Survey”) found that men were morelikely to be unfaithful to their partnersthan women. However, cohabiting womencheated at higher proportions than marriedwomen, and were about 8 times morelikely to be unfaithful (8 vs. 1 percent),while cohabiting men were about 4 times(16 vs. 4 percent) more likely to beunfaithful than married men. 194Indeed, research based on the NationalSurvey of Women found that cohabitingwomen were 5 times more likely (20percent) to have a secondary sex partnerwhen compared to married women (4percent). While married and cohabitingcouples express a similar desire for sexualexclusivity among their partners (98.7 vs.94.6 percent), married couples are far morelikely to remain faithful. 19535

Marital BondingThe process of pair bonding assists incementing the marital bond betweenhusband and wife, and is universal in allhumans. 196 Also defined as amorousness(or sexual love), pair bonding is a powerfulbiological impulse that is intensified by asurge of the chemical oxytocin duringsexual orgasm in both sexes. 197 Oxytocinkeeps the male near the female and in aposition to help care for their young.Women release it in heavy doses duringchildbirth and lactation to assist in bondingbetween a mother and her baby. 198 Apotent hormone – especially when releasedduring sexual activity – it is as if the brainsenses, “now I’m with someone I care forand trust,” so it releases chemicals thatfoster those feelings. 199 In a study of about200 male students, oxytocin was found toincrease levels of trust. In the experiment,subjects were placed in a simulatedinvestment-type game in which they wereasked to make certain monetary risks withanother player. In the placebo group thatdid not receive a dose of oxytocin, only 21percent of the subjects showed themaximum level of trust, however, in thegroup that received the dose of oxytocin,more than twice that amount (45 percent)showed the maximum trust level. 200Because pair bonding intensifies andgrows with duration, especially inwomen, 201 it is important that sexualactivity occur in the confines of amonogamous marriage; otherwise, theamorous attachment could be misplacedwith a partner other then one’s spouse(e.g., cohabitation and multiple premaritalsexual partners). Research on evolutionaryattachment describes marriage as the“cultural overlay of human pair bonding.”From a biological perspective, pairbonding in males has been associatedhistorically with a systematic sharing ofprovision and protection from the male tothe female and her offspring; thebreakdown of this pattern of maleprovisioning signals overall societaldisintegration. 202 Therefore, adolescentsexual activity outside of the properbiological context of marriage not onlyresults in the disruption of the pair bondingprocess, but also indicates a major problemwithin the society in which it takes place.Adolescent dating relationships are brief induration, yet are often characterized byintense frequency of contact. Althoughthese types of romantic relationships arenot unusual in the adolescent stage, partnerselection tends to be misguided, with mostrelationships ending prematurely. 203Considering that adolescent girls and boystend to differ when it comes to desire andcapacity for deep levels of intimacy,concepts of romance, and interest incommitment, the occurrence of pairbonding in adolescent romanticrelationships can be toxic, especially infemales. Women tend to view relationshipsmore in terms of investments and rewards– if she perceives that he is not making asimilar investment, the rewards of sexualintercourse are greatly diminished and thewoman is left feeling “used.” 204Research shows that a woman is likely tohave her most intense love with her firstsexual partner. 205 In a longitudinal study ofpost-adolescent college students, womenreported more love for a man if he was herfirst sexual partner. Similarly, menreported greater love for a woman who losther virginity with him than with a previouspartner. 206 36

Correlation between Virginity andAdult Marital StabilityThe sharp rise of cohabitation in the past25-30 years has been accompanied by anincrease in permissive attitudes andbehaviors regarding premarital sex. Asmore couples have removed sexualintimacy, child-rearing, and sharing ahome from their traditional places withinmarriage, infidelity and maritaldysfunction have taken their toll onAmerican society, with divorce rates atrecord highs. In 2001, the National Centerfor Health Statistics estimated that 43percent of all first marriages in the U.S.ended in divorce within the first 15years. 207 One explanation for this trend isthe destructive effects that premarital sexand cohabitation have on adolescents priorto marriage.As premarital sex and cohabitation havebecome a normal part of the courtshipprocess in U.S. society, having thesemultiple cohabitations and premaritalsexual partners may weaken the maritalbond by heightening awareness of thealternatives to one’s marital partner assources of sexual intimacy andfulfillment. 208 As a consequence, pairbonding is greatly disturbed amongadolescents who experience multiple andearly sexual partnerships. In a studyanalyzing the National Survey of FamilyGrowth, non-virgin women faced a muchhigher risk of divorce than women whowere virgins when they first marrried. 209 Ina similar study, among women whodivorced, dissolution rates were higher forthose who initiated sexual activity beforemarriage. 210 Additionally, data from theNational Longitudinal Survey of Youthindicate that among 18 year-old men andwomen, those who were virgins were twiceas likely to stay married as those who weresexually active. 211Finally, a study by sociologist JayTeachman (mentioned previously) wassignificant in that findings included a riskmeasure for both premarital sex andcohabitation. As the graph below shows,women who cohabited with a man otherthan their eventual husbands had a 33percent higher probability for divorce.Premarital Sex and Cohabitation Among WomenLikelihood for Divorce(%)120%100%80%60%40%20%0%Source: Journal of Marriage and theFamily, 65(2), (2003)Cohabited with a manother than husbandFirst sex with man otherthan husband37

However, for women who sexuallydebuted with men other than theirhusbands, the chance of divorce increasedby 114 percent. Indeed, for these women, itis not their cohabitation that is associatedwith marital dissolution; rather, it is thepresence of at least one other sexuallyintimate relationship prior to marriage. 212Marriage and Well-BeingHealthy relationships in marriage not onlybenefit society by providing a safe andnurturing atmosphere for children, but theyalso provide considerable benefits to eachspouse. These benefits are found, in mostpart, in the life-long partnership ofmarriage; they are attributed to a betteroverall quality of life, or what is alsoknown as an individual’s well-being. Wellbeingis defined as “a good or satisfactorycondition of existence; a statecharacterized by health, happiness, andprosperity.” 213 Thus, by following the threecriteria in the preceding definition, theresearch below will demonstrate how theinstitution of marriage contributes to anindividual’s overall well-being.Three perspectives explain the associationof marriage with well-being. The first andmost common refers to the social supportand social integration of marriage –individuals who are embedded in networksof supportive and helpful people tend tohave better physical and emotional healthand higher levels of life satisfaction. Thesecond perspective refers to thesociological view of the self. According tothis theory, the value of commitment inmarriage is favorable only because itreinforces the importance of oneself; thevital role of self in the committedrelationship therefore strengthens one’ssense of identify and self-worth. The finalview is the selection perspective, whichasserts that happy and healthy people tendto get married and stay married, whilethose who are not well-adjusted or haveproblematic personalities tend to divorceor never marry. However, due to the manystudies linking marriage to a person’s wellbeing,even after controlling for selectionfactors that would otherwise explain thisrelationship, the selection theory holdslittle weight. 214 Indeed, the data revealsthat there is something about marriageitself that moves people toward a healthierway of life. 215First examining physical health, researchdemonstrates that married men andwomen, on average, have better healthoutcomes than single or divorcedindividuals. In a study that followed thelifestyles of individuals as they moved inand out of marriage, behaviors thatgenerally lead to unhealthy outcomes wereabandoned for healthier ways of livingonce the individual married. 216 Forexample, as young men begin to viewthemselves as husbands and fathers, theytend to moderate their alcoholconsumption prior to marriage andcontinue to drink less into their first year ofmarriage, with levels stabilizing after thefirst year. 217Not only do husbands alter their ownlifestyles, but they also benefit from a wifewho monitors them. In a survey of over6,000 couples, wives discouraged theirhusbands from engaging in unhealthybehaviors such as smoking, drinking, andeven speeding while driving. Wives alsoprepare more nutritious meals, encouragegood sleeping habits, and schedulephysician appointments and monitor theirhusband’s compliance with doctor’sorders. 218 Additionally, a recent studyanalyzing data from the Health andRetirement Survey of Americans, which38

includes persons between the ages of 51and 61, found that married persons,compared to cohabiting, divorced, andwidowed, had the lowest rates of incidenceand morbidity for each of the majordiseases surveyed, as well as the lowestrates of functional disability. 219The social support theory also relates tothe mental, psychological, and emotionalhealth of married persons. Onelongitudinal study found that becomingand staying married is associated withlower levels of depression (especiallyamong men) and lower levels of alcoholconsumption among women. 220 In anotherstudy that analyzed data from the NationalSurvey of Family Households, marriedindividuals who became divorced orseparated, those who continued to bedivorced or separated, and those who nevermarried (all non-cohabiters) all reportedhigher levels of depressive symptoms thanpersons that stayed in their unions. On theother hand, the never married/nevercohabited individuals who transitioned intomarriage exhibited less depression. 221Individuals who are married, especiallymen, rely heavily on the emotional andpsychological support that a spouseprovides for their well-being. In fact, onestudy found that divorced men and womenare more than twice as likely to take theirown lives. 222 Indeed, “divorce has thepotential to create considerable turmoil in aperson’s life; while marital dissolutionbenefits some individuals, it leads others toexperience temporary decrements in wellbeing,and forces others on a downwardtrajectory from which they might neverrecover fully.” 223Research also shows that widowers,especially men, are much more likely tocommit suicide than married persons. Asthe graph below shows, white men who arewidowed are 14 times more likely tocommit suicide than married men. The ratefor a widowed black man is about eighttimes higher, while white women whosehusbands have died are about 4 times more250Suicide Among Men and Women in the U.S. Age 20-44 (1991-1996)Rate Per 100,00020015010050Never Married,SingleMarriedWidowedDivorced0White Men Black Men White WomenSource: American Journal of Public Health, 92 (9), 200239

likely to take their own lives than marriedwomen. Indeed, by protecting andimproving psychological well-being, thesocial support of marriage also improvesphysical health and survival. 224Married couples are also more likely to befinancially well off; compared tocohabiting couples and divorced/singleindividuals, married persons save more,build more wealth, and receive morefinancial transfers from their older familymembers. 225 Economists Joseph Luptonand James Smith also found considerabledifferences in net worth between marriedand non-married persons; their researchshows that in 2003, the median Americanmarried couple had a net worth of$132,000. A typical divorcee was onlyworth about $34,000, while never marriedindividuals were a little better off at$35,000. Additionally, a typical marriedAmerican couple about to retire hadaccumulated about $410,000, compared to$167,000 for those who had never married,and $154,000 for those who haddivorced. 226Now that well-being has been defined, thisfinal study measures the level of wellbeingamong married, cohabiting, andsingle adults. In the study, subjective wellbeingis characterized as the relativelystable attribute that reflects the extent towhich a person experiences positive lifeoutcomes and has favorable views ofthemselves and their lives, with the twocomponents of life satisfaction and generalhappiness used as determinants. Marriedpersons were found to have the highestlevel of well-being, followed by, in order,those who were cohabiting, datingsomeone steadily, dating multiple partners,and not dating. Even after controlling forrelationship happiness, married individualscontinued to have the highest level ofsubjective well-being; results that reinforcethe social support and integrationperspective (see graph below). 227 40

ConclusionToday’s adolescents have an array ofchallenges before them that previousgenerations never faced. Fifty years ago,there were only a handful of STIs; today,sexually active teens are at risk foracquiring over two dozen. At the sametime, the age at first marriage has steadilyrisen by 20-25 percent, cohabitations haveincreased 6.5 times, and sex beforewedlock has become the norm, not theexception. If that’s not enough, combinethe 24 hour media circus with a billiondollar internet pornography industry,Victoria’s Secret at every shopping mall,and Hollywood’s sex-saturated messagesbroadcast in your living room, and youhave a sex-on-demand culture beingdigested by our children every day.As this review of literature shows, therange of benefits that postponing sex offersyoung people is scientifically proven, butin order for adolescents to embrace thismessage these concepts need to becommunicated effectively and often withinpublic education. Surveys indicate thatparents desire an abstinence message fortheir children; however, U.S. culture issimply not reinforcing this value, making itdifficult for youth to understand thereasons why they should wait for sex.Thus, educational strategies should focuson the following conclusions that can bedrawn from the benefits of delaying sexualdebut.Premarital sex has a negative impact onthe physical health of adolescents, andtypically hurts girls more than boys.Although sexually active young men are atrisk to acquire STIs, females (especiallyyounger girls) are more vulnerable to theseinfections because of their biologicalmakeup. Girls are also more likely tosuffer physical abuse in sexualrelationships, and research indicates thatadolescent females have a higherprobability of contracting an STI whentheir romantic partner is substantiallyolder. Typically, girls do not report usingcondoms as consistently as boys; andneither gender’s brain is developed enoughto make reasoned, future-orienteddecisions about contraception. Girls alsotend to pay a much higher price than boyswhen it comes to teenage pregnancy, asthey are often left to carry and raise thechild on their own.Some of these physical consequences mayalso play a role in the psychological healthoutcomes of sexually active youth. Forexample, adolescent girls who areabandoned by their boyfriend afterlearning of a pregnancy may becomedepressed with the prospect of raising achild alone. Women also tend to makemore of an emotional investment inromantic relationships, which could leadthem down the path of seeking lovethrough sex; this in turn may result in thevicious cycle of repetition/compulsion. Onthe other hand, boys typically sufferpsychological symptoms only whencombining sexual activity with other highrisk behaviors, such as drug and alcoholuse; and both genders are more likely tothink about and commit suicide if theyhave initiated sex, especially those at ayoung age. However, if young people waitto have sex until marriage they avoid theserisks, and stand to benefit from the socialand financial advantages that abstinenceoffers.One of the best social outcomes thatresults from abstinence is the occurrenceof healthy relationships. When adolescentschoose to wait they avoid premaritalsexual bonds with other partners. This in41

turn makes them far less likely to getinvolved in cohabitations, which is a majorrisk factor for future marital infidelity anddivorce. Healthy marriages also benefit thewell-being of each spouse (especiallymen), and provide a nurturingenvironment for children.Another social benefit that stems fromabstinence is increased financial stability.When adolescents avoid childbearingoutside of marriage they are able to focustheir attention on educational pursuits andfuture careers without having to sacrificethe time and money that a familydemands. Although research has notdemonstrated a clear causal relationshipbetween early sex and delinquency, manystudies show that when teenagers abstainthey are less likely to get enmeshed in aproblem behavior syndrome that includespoor academic performance, substanceuse, and other risk behaviors. It may verywell be that abstinence acts as a protectivebarrier, insulating teenagers from an arrayof harmful behaviors that have thepotential to create future problems.Although the data is not clear for everysingle outcome, research doesdemonstrate that delaying sexual debuthas a significant impact on the physical,psychological, financial, and socialhealth of young people. Parents andpolicy makers alike should continue toembrace abstinence as a primary messagefor sexual education, develop strategiesbased upon the existing data, whilebuilding upon new research thatcontinues to evolve in adolescent sexualhealth.References1 Centers for Disease Control and Prevention: Morbidity andMortality Weekly Report (January 1992). Sexual Behavioramong High School Students -- United States, 1990, 40(51-52),885-888.2 Centers for Disease Control and Prevention: Morbidity andMortality Weekly Report (June 2006). Surveillance Summaries:Youth Risk Behavior Surveillance -- United States, 2005.55(SS05), 1-108.3 Hamilton B.E, Martin J.A, & Ventura S.J. (2005). Births:Preliminary data for 2005. National vital statistics reports; 55.Hyattsville, MD: National Center for Health Statistics.4 Warren, C.W, Kann L., Small, M.L., Santelli, J.S., Collins,J.L., & Kolbe, L.J. (1997). Age of initiating sexual health-riskbehaviors among high school students in the United States.Journal of Adolescent Health, 21(4), 225-31.5 Weinstock, H., Berman, S., & Cates, W., Jr. (2004). Sexuallytransmitted diseases among american youth: Incidence andprevalence estimates, 2000. Perspectives on Sexual andReproductive Health, 36(1), 6-10.6 Singh, S., & Darroch, J.E. (2000). Adolescent pregnancy andchildbearing; levels and trends in developed countries. FamilyPlanning Perspectives, 32, 14-23.7 Family and Youth Services Bureau (ACF-HHS). LegislativeAuthority: A-H Guidelines on Abstinence (Community BasedAbstinence Education). Retrieved August 29, 2006, fromhttp://www.acf.hhs.gov/grants/open/HHS-2006-ACF-ACYF-AE-0099.html.8 U.S. Department of Health and Human Service, Office ofPopulation Affairs. Retrieved July 23, 2007 fromhttp://opa.osophs.dhhs.gov/titlexx/oapp.html.9 Fears, C.S. (2004). Reducing Pregnancy: Adolescent FamilyLife and Abstinence Education Programs. The Library ofCongress: Congressional Research Service, Domestic SocialPolicy Division Order Code RS20873.10 Family and Youth Services Bureau (ACF-HHS). Fact Sheet:Community-Based Abstinence Education Program. RetrievedDecember 14, 2006, fromhttp://www.acf.hhs.gov/programs/fysb/content/abstinence/community.htm.11 Albert, B. (2007). With One Voice 2007: America’s Adults andTeens Sound off About Teen Pregnancy. Washington, D.C.National Campaign To Prevent Teen Pregnancy.12 Zogby International. Survey of Parents of Children Age 10-16,3/27/07-4/5/07. Retrieved June 13, 2007 from:http://www.abstinenceassociation.org/docs/zogby_questionnaire_050207.pdf.13 Kunkel, D., Eyal, K., Finnerty, K., Biely, E., & Donnerstein,E. (2005). Sex on TV4: A Biennial Report to the Kaiser FamilyFoundation. Santa Barbara, California. Henry J. Kaiser familyFoundation.14 Buerkel-Rothfuss, N., & Strouse, J.S. Media exposure andperceptions of sexual behaviors; the cultivation hypothesismoves to the bedroom. In: Greenberg BS, Brown JD, Buerkel-Rothfuss N, eds. Media, Sex, and the Adolescent. Cresskill, NJ:Hampton Press; 1993: 225-247.15 The Kaiser Family Foundation. The 1996 Kaiser FamilyFoundation Survey on Teens and Sex: What They Say TeensToday Need to Know, And Who They Listen To. Menlo Park,California; June 1996.16 Brown, J. (2008). The Teen Media Study: Overview ofFindings and Implications for Further Research on Teens, Sex,and the Media. Paper presented at the annual meeting of theInternational Communication Association. Retrieved from:42

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