The Teen Definition of Sex
The generational divide between baby-boomer parents and their teenage offspring is sharpening over sex.
Oral sex, that is.
More than half of 15- to 19-year-olds are doing it, according to a groundbreaking study by the Centers for Disease Control and Prevention.
The researchers did not ask about the circumstances in which oral sex occurred, but the report does provide the first federal data that offer a peek into the sex lives of American teenagers.
To adults, "oral sex is extremely intimate, and to some of these young people, apparently it isn't as much," says Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy.
"What we're learning here is that adolescents are redefining what is intimate."
Among teens, oral sex is often viewed so casually that it needn't even occur within the confines of a relationship. Some teens say it can take place at parties, possibly with multiple partners. But they say the more likely scenario is oral sex within an existing relationship. (Related story: "Technical virginity" becomes part of teens' equation)
Still, some experts are increasingly worrying that a generation that approaches intimate behavior so casually might have difficulty forming healthy intimate relationships later on.
"My parents' generation sort of viewed oral sex as something almost greater than sex. Like once you've had sex, something more intimate is oral sex," says Carly Donnelly, 17, a high school senior from Cockeysville, Md.
"Now that some kids are using oral sex as something that's more casual, it's shocking to (parents)."
David Walsh, a psychologist and author of the teen-behavior book Why Do They Act That Way?, says the brain is wired to develop intense physical and emotional attraction during the teenage years as part of the maturing process. But he's disturbed by the casual way sex is often portrayed in the media, which he says gives teens a distorted view of true intimacy.
"When the physical part of the relationship races ahead of everything else, it can almost become the focus of the relationship," Walsh says, "and they're not then developing all of the really important skills like trust and communication and all those things that are the key ingredients for a healthy, long-lasting relationship."
"Intimacy has been so devalued," says Doris Fuller of Sandpoint, Idaho, who, with her two teenage children, wrote the 2004 book Promise You Won't Freak Out, which discusses topics such as teen oral sex.
"What will the impact be on their ultimately more lasting relationships? I don't think we know yet."
Casual attitude is worrying
Child psychology professor W. Andrew Collins of the University of Minnesota says a relationship "that's only about sex is not a high-quality relationship."
In a 28-year study, Collins and his colleagues followed 180 individuals from birth. His yet-to-be-published research, presented at a conference in April, suggests that emotionally fulfilling high school relationships do help teens learn important relationship skills.
The researchers did not specifically ask about oral sex, he says. But relationships that are focused more on sex tend to be "less sustained, often not monogamous and with lower levels of satisfaction."
Terri Fisher, an associate professor of psychology at Ohio State University, says oral sex used to be considered "exotic." After the sexual revolution of the 1960s, it was viewed as a more intimate sexual act than sexual intercourse, but now, in young people's minds, it's "a more casual act."
Beyond shock, many parents aren't sure what to think when they discover their children's nonchalant approach to oral sex.
"It doesn't cross your mind because it's not something you have done," Fuller says. "Most parents weren't doing this (as teenagers) in the way these kids are."
But if parents are looking for reasons to freak out, the health risk of oral sex apparently isn't one of them. Teenagers and experts agree that oral sex is less risky than intercourse because there's no threat of pregnancy and less chance of contracting a sexually transmitted disease or HIV.
"The fact that teenagers have oral sex doesn't upset me much from a public health perspective," says J. Dennis Fortenberry, a physician who specializes in adolescent medicine at the Indiana University School of Medicine.
"From my perspective, relatively few teenagers only have oral sex. And so for the most part, oral sex, as for adults, is typically incorporated into a pattern of sexual behaviors that may vary depending upon the type of relationship and the timing of a relationship."
Data don't tell whole story
A study published in the journal Pediatrics in April supports the view that adolescents believe oral sex is safer than intercourse, with less risk to their physical and emotional health.
The study of ethnically diverse high school freshmen from California found that almost 20% had tried oral sex, compared with 13.5% who said they had intercourse.
More of these teens believed oral sex was more acceptable for their age group than intercourse, even if the partners are not dating.
"The problem with surveys is they don't tell you the intimacy sequence," Brown says. "The vast majority who had intercourse also had oral sex. We don't know which came first."
The federal study, based on data collected in 2002 and released last month, found that 55% of 15- to 19-year-old boys and 54% of girls reported getting or giving oral sex, compared with 49% of boys and 53% of girls the same ages who reported having had intercourse.
Though the study provides data, researchers say, it doesn't help them understand the role oral sex plays in the overall relationship; nor does it explain the fact that today's teens are changing the sequence of sexual behaviors so that oral sex has skipped ahead of intercourse.
"All of us in the field are still trying to get a handle on how much of this is going on and trying to understand it from a young person's point of view," says Stephanie Sanders, associate director of The Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University, which investigates sexual behavior and sexual health.
"Clearly, we need more information about what young people think is appropriate behavior, under what circumstances and with whom," Sanders says. "Now we know a little more about what they're doing but not what they're thinking."
The $16 million study, which took six years to develop, complete and analyze, surveyed almost 13,000 teens, men and women ages 15-44 on a variety of sexual behaviors.
Researchers say that the large sample size, an increased societal openness about sexual issues and the fact that the survey was administered via headphones and computer instead of face to face all give them confidence that, for the first time, they have truthful data on these very personal behaviors.
"There is strong evidence that people are more willing to tell computers things, such as divulge taboo behaviors, than (they are to tell) a person," Sanders says.
More analysis needed
Researchers cannot conclude that the percentage of teens having oral sex is greater than in the past. There is no comparison data for girls, and numbers for boys are about the same as they were a decade ago in the National Survey of Adolescent Males: Currently, 38.8% have given oral sex vs. 38.6% in 1995; 51.5% have received it vs. 49.4% in 1995.
Further analyses of the federal data by the private, non-profit National Campaign to Prevent Teen Pregnancy and the non-partisan research group Child Trends find almost 25% of teens who say they are virgins have had oral sex. Child Trends also reviewed socioeconomic and other data and found that those who are white and from middle- and upper-income families with higher levels of education are more likely to have oral sex.
Historically, oral sex has been more common among the more highly educated, Sanders says.
Is intimacy imperiled?
The survey also found that almost 90% of teens who have had sexual intercourse also had oral sex. Among adults 25-44, 90% of men and 88% of women have had heterosexual oral sex.
"If we are indeed headed as a culture to have a total disconnect between intimate sexual behavior and emotional connection, we're not forming the basis for healthy adult relationships," says James Wagoner, president of Advocates for Youth, a reproductive-health organization in Washington.
Oral sex might affect teenagers' self-esteem most of all, says Paul Coleman, a Poughkeepsie, N.Y., psychologist and author of The Complete Idiot's Guide to Intimacy.
"Somebody is going to feel hurt or abused or manipulated," he says. "Not all encounters will turn out favorably. ... Teenagers are not mature enough to know all the ramifications of what they're doing.
"It's pretending to say it's just sexual and nothing else. That's an arbitrary slicing up of the intimacy pie. It's not healthy."
A survey of more than 1,000 teens conducted with the National Campaign to Prevent Teen Pregnancy resulted in The Real Truth About Teens & Sex, a book by Sabrina Weill, a former editor in chief at Seventeen magazine. She says casual teen attitudes toward sex - particularly oral sex - reflect their confusion about what is normal behavior. She believes teens are facing an intimacy crisis that could haunt them in future relationships.
"When teenagers fool around before they're ready or have a very casual attitude toward sex, they proceed toward adulthood with a lack of understanding about intimacy," Weill says. "What it means to be intimate is not clearly spelled out for young people by their parents and people they trust."
Although governmental and educational campaigns urge teens to delay sex, some suggest teens have replaced sexual intercourse with oral sex.
"If you say to teenagers 'no sex before marriage,' they may interpret that in a variety of ways," says Fisher.
Talk is crucial
Experts say parents need to talk to their kids about sex sooner rather than later. Oral sex needs to be part of the discussion because these teens are growing up in a far more sexually open society.
Anecdotal reports for years have focused on teens "hooking up" casually. Depending on the group, teens say it can mean kissing, making out or having sex.
"Friends with benefits" is another way of referring to non-dating relationships, with a form of sex as a "benefit."
But not all teens treat sex so casually, say teens from suburban Baltimore who were interviewed by USA TODAY as part of an informal focus group.
Alex Trazkovich, 17, a high school senior from Reisterstown, Md., says parents don't hear enough about teen relationships where there is a lot of emotional involvement.
"They hear about teens going to the parties and having lots and lots of sex," he says. "It happens, but it's not something that happens all the time. It's more of an extreme behavior."
Teens and oral sex
Heterosexual oral sex among teenagers ages 15 to 19 varies by age and gender, with older teens more likely to engage in intercourse.
percentage of teens who have had intercourse and their ages:
15 - 25.1%
16 - 37.5%
17 - 46.9%
18 - 62.4%
19 - 68.9%
15 - 26.0%
16 - 39.6%
17 - 49.0%
18 - 70.3%
19 - 77.4%
percentage of teens who have had oral sex and their ages:
15 - 35.1%
16 - 42.0%
17 - 55.7%
18 - 65.4%
19 - 74.2%
15 - 26.0%
16 - 42.4%
17 - 55.5%
18 - 70.2%
19 - 74.4%
Source: 2002 National Survey of Family Growth, Centers for Disease Control of Prevention
Source: USA Today. Written: 10/19/05.