This document discusses various aspects of teen sexuality, including physical, emotional, and social development during adolescence. It covers topics like puberty and physical changes, sexuality and romantic relationships, sexual behaviors, pregnancy and STIs. The document notes the complexity of factors influencing teen sexuality, such as media, peer influence, family relationships and communication. It emphasizes the importance of open communication between parents and teens to promote healthy sexuality.

1. Teen Sexuality
Lisa Allred, LCSW
506 Human Behavior
NCSU Graduate School of Social Work

2. Characteristics of Sexually Healthy Teens
• Appreciates and values own body
• Takes responsibility for own behaviors
• Is knowledgeable about sexuality issues
• Communicates effectively with family about many
issues, including sexuality
Carol Peterson, MS, RN, Wyoming Health Council

3. Characteristics of Sexually Healthy Teens
• Seeks and understands information about parent’s values and
considers them when forming own values
• Interacts with both genders in appropriate and respectful ways
• Expresses love and intimacy in developmentally appropriate
ways
• Able to evaluate personal readiness for mature sexual
relationships
Carol Peterson, MS, RN, Wyoming Health Council

7. Sexual Behavior
• The U.S. has the highest teen pregnancy rate in the
Western industrialized world (4x higher) even though the levels of
teen sexual activity in these countries are about the same
• On average, young people have sex for the first time at about age 17, but
they do not marry until their mid-20s. This means that young adults may be
at increased risk for unintended pregnancy and STIs for nearly a decade or
longer
www.education.com

9. Warning: Construction in progress
• Your teens brain is still developing
• Decision making: sometimes mature, sometimes childish
• Risk taking: brain immaturity can result in impulsiveness
• Relationships: moving a little closer to friends and away from
family
www.childwelfare.gov/preventing

10. Physical Changes of Adolescence
• Puberty: period of rapid physical changes in early adolescence during which
the reproductive organs mature
• Onset between 8 to 14 years; 2 years earlier in girls
• Triggered by release of pituitary gland hormones
• In males, cause testes to increase testosterone production
• In females, cause ovaries to increase estrogen levels
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

11. Physical Changes During Puberty:
Primary Sex Characteristics
• females:
• thicker vaginal walls
• larger uterus
• enlarged labia
• vaginal secretions
• menarche around age 12 to 13; age has fallen
• males:
• larger prostate, penis, seminal vesicles, and testes
• 1st ejaculation around 13
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

12. Physical Changes During Puberty:
Secondary Sex Characteristics
• both sexes:
• pubic hair,
• growth spurt (earlier in girls)
• genitals enlarge
• axillary oil-secretion
• females: - males
• breast buds • voice deepens
• voice changes • facial hair
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

13. Physical changes during puberty
secondary
primary
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

14. Early Adolescence (12-14)
• Physical Appearance and Body – group influences clothing, makeup, hair;
pre-occupied with physical appearance
• School, Work and Career Interests – not important; focus on present & near
future (here & now)

15. Middle Adolescence (14-17)
• Sexuality and Romantic Attachments – females and males enter puberty;
shyness, blushing, modesty, interest in privacy; masturbation; concerns about
“normal” development; sexual curiosity
• Independence – self-involvement; alternate between unrealistically high
expectations and poor self-concept

16. Middle Adolescence (14-17)
• Emotions and Affect – periods of sadness and emotional withdrawal from
parents; use diaries
• Relationships – protest parental involvement; lowered opinion of parents;
high degree of conflict; parents “don’t know anything”; peer group and
youth culture very important

17. Middle Adolescence (14-17)
• Physical Appearance and Body – extremely focused and concerned with own
appearance; sense of being a “stranger in their own body”
• School, Work and Career Interests – intellectual interests gain importance;
greater capacity for setting goals

18. Middle Adolescence (14-17)
• Sexuality and Romantic Attachments – concerns about sexuality and sexual
attractiveness; increased interest in opposite sex; frequently changing short-
term relationships; emotional connections expressed as “love and passion”

19. Late Adolescence (17-19 to 23)
• Independence – ability to make independent decisions; self-reliant
• Emotions and Affect – ability to delay gratification is a key developmental
milestone; more developed sense of humor; ability to gain insight into own
emotions and behaviors

20. Late Adolescence (17-19 to 23)
• Relationships – greater concern for others; recognition of parents as a
resource.
• Physical Appearance and Body – sexual development complete –
comfortable in own skin.

21. Late Adolescence (17-19 to 23)
• School, Work & Career Interests – ability to process ideas and express them
in words; ability to compromise; increased level of concern for the future;
ability to set goals and follow through
• Sexuality & Romantic Attachments – concern with developing serious
relationships; capacity for sensitivity, caring and sensual love

22. Sexual Behavior: Masturbation
• By the end of adolescence, almost all males, and
¾ of females have masturbated
• Safe sexual release
• Learn about self
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

23. Sexual Behavior: Everything but
intercourse
• Physical contact excluding intercourse (i.e., kissing, touching, manual
stimulation, oral-genital stimulation)
• Oral-genital activity has increased
• How far to go often an issue
• Learning about sexual intimacy
• Technically can “stay a virgin”
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

24. Factors that Predispose Teens to Early
Intercourse
• Low SES/poverty
• Family conflict/marital disruption/single-parent or reconstituted family
• Low parent education and supervision
• Substance abuse
• Low self-esteem, hopelessness
• Poor academic performance
• Exposure to TV w/high sexual content
• Previous sexual abuse
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

25. Factors that Predispose Teens to Later
Intercourse
• Higher SES
• Religious beliefs
• Spiritual interconnectedness w/friends
• Good relationship with parents, and perception of parental disapproval of teen
intercourse
• Good school performance
• Late onset of puberty
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

26. Sexual Behavior During Adolescence
• The Sexual Double Standard
• More restrictive standards are applied to women
• Recent evidence suggests that double standard exists but may be diminishing
• Males
• focus of sexuality = conquest
• peers reinforce aggressive & independent behaviors
• Females
• focus of sexuality = relationship
• dilemma: need to appear sexy to attract males, but not “easy”
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

27. Socialization Funnels
Intimacy Funnel
Intercourse
Non-coital
sexual
activity
Kissing
Commitment Funnel
Marriage
Engagement
Dating

28. Comparing the Two Funnels
• Females more interested in going down Commitment
Funnel so males typically control how far and how fast
• Males more interested in going down Intimacy Funnel so
females typically control how far and how fast

29. Comparing the Two Funnels
• Males and females will use one funnel to bargain for the other.
Females give SEX to get LOVE and males give LOVE to get SEX
• The earlier you enter the funnel, the LONGER you have to deal
with fighting gravity and the less equipped you are to assertively
communicate (or even know what to communicate)

30. Comparing the Two Funnels
• The longer you date one person the more slippery the funnel becomes
• It is easier to break off a relationship than to go back up a funnel
• Once you have gone down the funnel, future funnels are more slippery
• Going down the Intimacy Funnel gives females a different reputation
than males

31. Teens and Sex: Complex factors at play
• Age at which puberty begins has been getting earlier
• Early puberty is associated with early initial sexual intercourse
• Adolescents experience a strong drive for intimacy
• Tobacco, alcohol, drug and sexual experimentation is common
• Sexual activity among teens increases when they perceive that their peers are
also sexually active

32. Teens and Sex: Complex factors at play
• Media plays a very strong role in adolescents’ concept and view of sexuality
(TV, music, music videos, radio, the internet, movies, magazines, etc.). Sex is
used to sell almost everything in our society!
• Discussion of sensitive subjects with teens is difficult and there is often lack
of communication between parents and teens

33. Teens and Sex: Complex factors at play
• Sexual Desire & Sexual Response
• Females: “ruining reputation” or “staying pure”
• Males: sexual appetite as underlying “evil” that gets them (and
girls) into trouble
• Teens often frightened and ashamed; lots of misinformation
• Adults rarely engage in honest conversations with teens about
these normal responses

35. Sex: What they need to know by early teens
• Correct names and functions of male and female sex organs
• Puberty and how the body changes
• Menstruation
• Sexual intercourse and the risk of pregnancy and STI, including HIV
• Family values about dating, sexual activity, cigarettes, alcohol, drugs
www.healthychildren.org

36. Talking to Teens About Sex:
Once is not enough!
• Talks should center around social and emotional aspects of sex and your values
• When is it ok to kiss?
• How will I know when I am ready to have sex?
• Should I have sex before marriage?
• Reliable birth control
• Is oral sex really sex?
• If I say “no” will I lose my relationship? How do I say “no”?
• What do I do if someone tries to force me to have sex?
www.healthychildren.org

37. Consent
• Insist on Active Consent
• Consistent verbal and nonverbal body language
• Discussing it before you do it--- if you aren’t mature enough
to talk about it, you shouldn’t be doing it
• To give consent you must know what you want to do, articulate it,
and have your choice respected

38. Types of Questions Your Teen Might Ask
• Knowledge Questions
• What is a condom?
• Be factual and calm
• If you don’t know the answer, look up together

39. Types of Questions Your Teen Might Ask
• Values Questions
• Is it ok to have sex before marriage?
• Indicate that teens are trying to figure out what they
believe in
• Important part of adolescence

40. Types of Questions Your Teen Might Ask
• Is this Normal? Questions
• My girlfriend says her breasts are not the same size. Is
this normal?
• Might be about physical or emotional development
• Might be asked about friends or classmates

41. Other Tips for Talking to Teens
• More frequently and frankly sexual matters are discussed the easier it will be to
discuss them
• Use media to initiate conversations
• Focus on making decisions and understanding consequences
• May be easier to discuss “friends” who are having issues
• Avoid letting your values dictate teen’s sexual identity
• Talk in the car (don’t have to look at each other)
• Text your teen- reinforce conversations

42. Sexual Orientation
• For teens questioning sexual orientation, adolescence can be scary, lonely and
threatening
• Safety: 45% of gay men and 20% of lesbians reported being victims of verbal and
physical assaults in high school
• Emotional health: gay and bisexual youth may have a higher risk of suicide
• Physical health: gay and lesbian youth may have a higher risk of substance use and
eating disorders
• Educate yourself: www.pflag.org, www.glsen.org, www.gsanetwork.org
www.kidshealth.org

43. LGBTQ Teens
Process of “Self Identifying” Has Four Stages:
1. Acknowledges being or feeling “different” as
child/early teen;
2. Identity confusion (non-heterosexual but not
sure if LGBT);
3. Identity assumption (self identifies & comes
out);
4. Commitment stage (identifies as LGBT in all
aspects of life)

44. STIs and Teen Sexual Behavior
• People under 25 account for 50% of new HIV infections
• Most teens know the basic facts about AIDS and other
STDs, but falsely believe that they are not at risk
• 5% of all adolescents contract an STD

45. Adolescent Pregnancy
• 1 in 5 sexually active teens becomes pregnant each year
• Of these: 51% result in live births, 35% in induced
abortion, and 14% in miscarriage or stillbirth
• Impacts teen mother's and baby’s physical health
• Impacts SES and education
• Impacts quality of parenting
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

46. Contraception Use and Teens
• Teens less likely to use BC consistently or correctly; Why?
• Lack of adequate knowledge about BC options
• Abstinence-only sex education programs in schools
• Planning ahead implies loose morals?
• Fear of pelvic exam; embarrassment about seeking BC
• Less stable relationships
• Difficulty communicating with partner
• Positive note: contraceptive use among teens is higher today than it was 10 - 20 years
ago.
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

47. Contraception Use and Teens
• More likely to use BC
• In stable relationship; good communication w/partner
• Able to communicate with parent about BC
• Feel competent and have good self-esteem
• Have families which stress personal responsibility
• Have access to BC info
• Good performance in school and have well-educated parents
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

48. Contraception Use and Teens
• Less likely to use BC
• Not in stable relationship; sporadic intercourse
• Teen females involved w/older (3+ yr) partner
• Teens who have sex at earlier ages
• When intercourse occurs after alcohol use
• Lack of sexual confidence & assertiveness (esp. in teen women)
http://www.byteboss.com/view.aspx?id=3608362&name=chp12_ss_child_adolescence

49. Sexting
• “I’ll show you mine, you show me yours” has always happened
• The medium makes it scary
• Odds of teen becoming sexually active slightly higher when sending sext
messages
• Could see it as an opportunity to discuss sex prior to them having it
• Nothing on the internet ever truly goes away
• Snapchat not safe b/c can take screen shot
http://parenting.blogs.nytimes.com

50. Resources
• www.startstrongidaho.com
• www.healthychildren.org
• www.childwelfare.gov/preventing
• www.twoofus.org
• http://teenrelationships.org
• http://healthfinder.gov
• www.girlshealth.gov
• www.hhs.gov
• www.hhs.gov/ash/oah
• www.stopalcoholabuse.gov
• http://pubs.niaaa.nih.gov
• www.sexetc.org
• www.teenrelationships.org
• www.loveisrespect.org
• www.kidshealth.org

51. Work/Life Reader Lists
• LGBT teen reader list by Work/Life
• Puberty reader list by Work/Life
• Teen sexuality for parents reader list by Work/Life

52. Resources Added
• http://goodmenproject.com/families/the-healthy-sex-talk-teaching-kids-consent-
ages-1-21/ (how to teach kids about consent throughout childhood and
adolescence)
• http://www.guttmacher.org/statecenter/spibs/spib_OMCL.pdf (overview of
consent laws for minors by state)
• http://www.kidpower.org/library/article/yes-means-yes-consent-and-protecting-
sexual-safety/ (more good stuff on consent)
• https://partnerships.ucsf.edu/sites/partnerships.ucsf.edu/files/images/SexualHealt
hToolkit2010BW.pdf (toolkit for health providers with great info)