associated with teen sexual activity are well-known. Every day,
8,000 teenagers in the United States become infected by a
sexually transmitted disease. This year, nearly
3 million teens will become infected. Overall, roughly one-quarter
of the nation's sexually active teens have been infected by a
sexually transmitted disease (STD).
The problems of pregnancy and out-of-wedlock childbearing
are also severe. In 2000, some 240,000 children were born to girls
aged 18 or younger. Nearly all these teenage
mothers were unmarried. These mothers and their children have
an extremely high probability of long-term poverty and Welfare
dependence. Less widely known are the psychological and emotional
problems associated with teenage sexual activity. The
present study examines the linkage between teenage sexual
activity and emotional health. The findings show that:
When compared to teens who are not sexually active, teenage
boys and girls who are sexually active are significantly less
likely to be happy and more likely to feel depressed.
When compared to teens who are
not sexually active, teenage boys and girls who are sexually
active are significantly more likely to attempt suicide.
Thus, in addition to its role in promoting teen pregnancy and
the current epidemic of STDs, early sexual activity is a
substantial factor in undermining the emotional well-being of
DATA SOURCE AND METHODS
The data used in this analysis
are taken from the National Longitudinal Survey of Adolescent
Health, Wave II, 1996. This "Ad-Health" survey is a nationwide
survey designed to examine the health-related behaviors of
adolescents in middle school and high school. Its public-use
database contains responses from approximately 6,500 adolescents,
representative of teenagers across the nation. The survey is
funded by the National Institute of Child Health and Human
Development (NICHD) and 17 other federal agencies.
This Heritage CDA analysis
focuses on the link between sexual activity and emotional
well-being among teens in high school years (ages 14 through 17).
The Ad-Health survey asks students whether they have "ever had
sexual intercourse." For purposes of analysis, teens
who answered yes to this question are labeled as "sexually active"
and those who answered no are labeled as "not sexually
The survey also records the
emotional health of teens. Students are asked how often, in
the past week, they "felt depressed." They are provided with four
possible answers to the question: They felt
(a) Never or rarely,
(c) A lot of the time,
(d) Most of the time or
all of the time.
For purposes of analysis, the classification of depressed
is given tothose teens who answered yes to options "c" or "d"-that
is, they said they felt depressed a lot, most, or all of the time.
Thus, throughout the paper, the terms "depressed" or "depression"
refer to this general state of continuing unhappiness rather than
to a more specific sense of clinical depression.
SEXUAL ACTIVITY AND DEPRESSION
The Ad-Health data reveal
substantial differences in emotional health between those teens who
are sexually active and those who are not. As Charts 1 and 2
A full quarter (25.3 percent)
of teenage girls who are sexually active report that they are
depressed all, most, or a lot of the time. By contrast, only
7.7 percent of teenage girls who are not sexually active
report that they are depressed all, most, or a lot of the time.
Thus, sexually active girls are more than three times more likely
to be depressed than are girls who are not sexually
Some 8.3 percent of teenage
boys who are sexually active report that they are depressed all,
most, or a lot of the time. By contrast, only 3.4 percent of
teenage boys who are not sexually active are depressed all, most,
or a lot of the time. Thus, boys who are sexually active are more
than twice as likely to be depressed as are those who are not
Table 1 gives a
complete breakout of these data. Note that a full 60.2 percent of
sexually inactive girls report that they "rarely or never" feel
depressed. For sexually active teen girls, the number is far
lower: only 36.8 percent. Overall, for either gender, teens who are
not sexually active are markedly happier than those who are
The link between teen
sexual activity and depression is supported by clinical experience.
Doctor of adolescent medicine Meg Meeker writes, "Teenage
sexual activity routinely leads to emotional turmoil and
psychological distress…. [Sexual permissiveness leads]
to empty relationships, to feelings of self-contempt and
worthlessness. All, of course, precursors to depression."
Sexual Activity and Attempted Suicide
The Ad-Health survey
also asks students whether they have attempted suicide during the
past year. As Charts 3 and 4 show, the link between sexual activity
and attempted suicide is clear.
A full 14.3 percent
of girls who are sexually active report having attempted suicide.
By contrast, only 5.1 percent of sexually inactive girls have
attempted suicide. Thus, sexually active girls are nearly three
times more likely to attempt suicide than are girls who are not
Among boys, 6.0
percent of those who are sexually active have attempted suicide. By
contrast, only 0.7 percent of boys who are not sexually active
have attempted suicide. Thus, sexually active teenage boys are
eight times more likely to attempt suicide than are boys who
are not sexually active.
The differences in
emotional health between sexually active and inactive teens are
clear. However, it is possible that the differences in emotional
well-being might be driven by social background factors rather than
sexual activity per se. For example, if students of lower
socioeconomic status are more likely to be sexually
active, the greater frequency of depression among those teens might
be caused by socioeconomic status rather than sexual
To account for that
possibility, additional analysis was performed in which race,
gender, exact age, and family income were entered as control
variables. This means that each teen was compared to other teens
who were identical in gender, age, race, and income.
The introduction of
these control or background variables had virtually no effect
on the correlations between sexual activity and depression and
suicide. In simple terms, when teens were compared to other teens
who were identical in gender, race, age and family income, those
who were sexually active were significantly more likely to be
depressed and to attempt suicide than were those who were not
Teens Express Regrets over Sexual
lower levels of happiness and higher levels of depression among
sexually active teens suggest that sexual activity leads to a
decrease in happiness and well-being among many, if not most,
teenagers. This conclusion is corroborated by the fact that the
majority of sexually active teens express reservations and
concerns about their personal sexual activity.
For example, a recent
poll by the National Campaign to Prevent Teen Pregnancy asked
the question, "If you have had sexual intercourse, do you wish
you had waited longer?" Among those teens who reported
that they had engaged in intercourse, nearly two-thirds stated
that they wished they had waited longer before becoming sexually
active. By contrast, only one-third of sexually active teens
asserted that their commencement of sexual activity was appropriate
and that they did not wish they had waited until they were older.
Thus, among sexually active teens, those who regretted early sexual
activity outnumbered those without such concerns by nearly two to
As Table 2 shows,
concerns and regrets about sexual activity are strongest among
teenage girls. Almost three-quarters of sexually active teen girls
admit they wish they had delayed sexual activity until they were
older. Among sexually active teenage girls, those with regrets
concerning their initial sexual activity outnumbered those without
regrets by nearly three to one.
and regrets expressed by teenagers concerning their own sexual
activity is striking. Overall, a majority of sexually active
boys and nearly three-quarters of sexually active girls regard
their own initial sexual experience unfavorably-as an event they
wish they had avoided.
While the association
between teen sexual activity and depression is clear, that
association may be subject to different theoretical
interpretations. For example, it might be that depressed teenagers
turn to sexual activity in an effort to assuage or escape their
depression. In this interpretation, the link between sexual
activity and depression (presented in Table 1) might be caused by a
higher level of sexual activity among those who are already
depressed before commencing sexual activity. Thus, depression might
lead to greater sexual activity rather than sexual activity's
leading to depression.
In limited cases,
this explanation may be correct; some depressed teens may
experiment with sexual activity in an effort to escape their
depression. However, as a general interpretation of the
linkage between depression and teen sexual activity, this
reasoning seems inadequate for two reasons.First, as Table 1
shows, the differences in happiness and depression between sexually
active and inactive teens are widespread and are not the result of
a small number of depressed individuals. This is especially true
for girls. Second, the fact that a majority of teens express
regrets concerning their own initial sexual activity strongly
suggests that such activity leads to distress and emotional turmoil
among many, if not most, teens.
Hence, the most
likely explanation of the overall link between teen sexual activity
and depression is that early sexual activity leads to emotional
stress and reduces teen happiness.
questions about whether teen sexual activity leads to depression
or, conversely, whether depression leads to teen sexual
activity should not distract attention from the clear message that
adult society should be sending to teens. Teens should be told that
sexual activity in teen years is clearly linked to reduced personal
happiness. Teens who are depressed should be informed that sexual
activity is likely to exacerbate, rather than alleviate, their
depression. Teens who are not depressed should be told that sexual
activity in teen years is likely to substantially reduce their
happiness and personal well-being.
Sexual activity among
teenagers is the major driving factor behind the well-publicized
problems of the high incidence of teenage STDs and teen
pregnancy. The analysis presented in this paper also shows that
sexual activity is directly connected to substantial problems among
teens regarding emotional health.
Teenagers of both
genders who are sexually active are substantially less likely to be
happy and more likely to be depressed than are teenagers who
are not sexually active.
Teenagers of both
genders who are sexually active are substantially more likely to
attempt suicide than are teenagers who are not sexually
society provided teenagers with classroom instruction in "safe sex"
and "comprehensive sex education." In general, these
curricula fail to provide a strong message to delay sexual
activity, fail to deal adequately with the long-term emotional and
moral aspects of sexuality, and fail to provide students with the
skills needed to develop intimate loving marital relationships as
Over the past five
years, there has been a growth in abstinence education programs
that stand in sharp contrast to "safe sex" curricula. The best
abstinence education programs teach:
importance of delaying sexual activity,
That human sexual
relationships are predominantly emotional and moral rather
than physical in character, and
That teen abstinence
is an important step leading toward a loving marital
relationship as an adult.
education programs are uniquely suited to meeting both the
emotional and the physical needs of America's youth.
Robert E. Rector is
Senior Research Fellow, Kirk A. Johnson, Ph.D., is
Harry and Jeanette Weinberg Fellow in Statistical Welfare Research
in the Center for Data Analysis, and Lauren R. Noyes is Director of
Research Projects in Domestic Policy at The Heritage
As noted in the text,
this analysis utilized Wave II data from the National Longitudinal
Survey of Adolescent Health, a survey that was fielded between
April and August 1996. The National Longitudinal Survey
of Adolescent Health is a nationally representative survey designed
to assess the health and risk behavior of America's youth.
Sensitive questions of sexual activity and the like were asked in
the child's home through an audio computer-assisted self-interview
process. Parental consent was required before adolescents were
allowed to participate. This analysis is concerned with the
relationship between depression/suicide and sexual activity for
individuals of ages 14 to 17 (high school-age adolescents). To that
end, data from the following questions were used to gauge sexual
activity, suicide attempt, and depression:
Question H2CO2-"Have you ever had
sexual intercourse? When we say sexual intercourse, we mean
when a male inserts his penis into a female's vagina."
H2SU2-"During the past 12 months, how many times did you actually
Depression: Question H2FS6-"How often was each
of the following true during the past seven days? …You felt
If an adolescent
responded affirmatively to the "ever had sexual intercourse"
question, he or she was coded as "sexually active," and vice
versa. The suicide attempt variable was recoded as a "yes/no"
variable: "yes" if the respondent had attempted suicide at least
once and "no" otherwise. Respondents were coded as "being
depressed" if they said that they were depressed "a lot of the
time" or "most of the time or all of the time." They were coded as
"not depressed" if they responded that they were depressed "never
or rarely" or "sometimes." The data were rejected if the
respondent did not give a usable answer to any of the
questions; for example, if a respondent refused to answer the "ever
had sexual intercourse" question, he or she was eliminated from the
The statistical analysis took two forms.
First, a basic correlation analysis showed that there is a positive
and highly statistically significant relationship between
sexual activity and depression/suicide attempt. Put another
way, sexually active adolescents are more likely to be both
depressed and suicidal. Both correlations are highly
statistically significant at more than a 99.9 percent
While demonstrating that a correlation
relationship exists is valuable information, more
important are the differences in the observed incidences of
depression and suicide attempt among these adolescents. Table 3
shows the results of the statistical analysis that compared
the percentage of adolescents who had been depressed or
suicidal, based on sexual activity or lack thereof. The
statistical significance level was then estimated for each
statistic. In all cases, the difference between each pair of
percentages is significant at the 95 percent level or higher. The
differences are, by and large, more pronounced for young women than
young men, but the relationship still holds.
As a final check of the analysis, a pair
of logistic regressions was conducted to ascertain whether these
results are being influenced by the socioeconomic factors of
race, income, and age. When depression or attempted suicide are
treated as dependent variables, and sexual activity, gender, age,
race, and income are included as independent variables, the odds
ratio (or predictive impact) of the sexual activity variable on the
dependent variables remains statistically indistinguishable
from a model that only includes the sexual activity variable.
In short, sexual activity is a key independent predictor of
depression and attempted suicide.
Finally, the Ad-Health survey utilizes a
complex sample design in collecting the data, so any
confidence interval statistic must be adjusted in order to
take the sample design into consideration. To do this, the
Ad-Health database was subjected to a "jackknife" procedure that
corrected the standard errors of the statistics generated. In order
to facilitate this analysis, the WesVar Complex Samples
Version 4.2 software, developed by Westat, was used. Although the
means, percentages, and correlation coefficients themselves do
not change, the probability statistics (and their underlying
standard errors, etc.) are corrected to take into
consideration the sample design.
Teenage sexual activity is an issue of widespread national
concern. Although teen sexual activity has declined in recent
years, the overall rate is still high. In 1997, approximately 48
percent of American teenagers of high-school age were or had been