Analysis Sexual Health

Sexting Teens Are Having Sex?!? It’s Not Exactly Big News

Martha Kempner

A new study in Pediatrics found sexting teens are more likely to be sexually active than their non-sexting peers. Before we lock up our teens or their smartphones, it's important to note that this study found a correlation. It did not find that sexting leads to sex.   

Once again, the headlines have jumped all over the sexting behavior of teens, implying that they are irresponsible, that sexting is some kind of gateway drug to sexual intercourse, and that parents should be afraid—very afraid. The latest headlines included: Sexting Linked to Sexual Activity in Teens, Teen Sexting Linked to Real World Risky Sexual Behavior, and Sexting Teens More Likely to Be Having Unprotected Sex. These headlines all reference a new study that appears in the October issue of Pediatrics. It found that teens who sext were more likely to be sexually active and more likely to have had unprotected sex than teens who did not sext. Before we panic and lock up our teens or their smartphones, it’s important to look closely at the study and remember that what it found was simply correlations, not causation. A part of me wants to say, “um duh,” or as a colleague put it, that’s kind of like a headline saying “Beer Linked to Drinking Among College Students.” The finding was neither particularly surprising, nor particularly enlightening. Still, we can look closely at the new report and see what it found.

The Study  

Researchers attached a secondary questionnaire to the Youth Risk Behavior Surveillance Survey (YRBS) that was given to high school students in the Los Angeles Unified School District, asking about their sexting behavior. The YRBS is an anonymous survey, so researchers could not connect the answers on the secondary survey to those on the complete YRBS. Therefore, their survey asked for demographic information and repeated some questions about sexual behavior. Unlike the YRBS itself, the secondary survey also asked students whether they considered themselves to be heterosexual, homosexual, bisexual, transgender, questioning, or unsure of their sexual orientation.    

The survey found:

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  • 75 percent of respondents reported owning a cell phone and using it every day.
  • More than 15 percent of respondents with cell phones reported ever sending a “sexually explicit message or photo.”
  • 41 percent of respondents with cell phones had ever had oral, vaginal, or anal sex, and 64 percent of these used a condom the last time they had sex.

Additional analysis by the researchers found:

  • African-American students were more likely than their peers to have sent sexts, as were students who identified as LGBTQ.
  • Students who knew someone who had sent a sext were 17 times more likely to have sent a sext themselves than their peers, who said they did not know anyone who had sexted.
  • Respondents who had sent a sext were statistically significantly more likely to have ever engaged in sexual intercourse and “exhibited a trend toward unprotected sex during their last sexual encounter.”

The authors conclude that this data “reveal that sexting is associated with physical sexual risk taking. Unlike work that has suggested that sexting is a low risk or healthy alternative to sexual risk taking, we find that there is a clustering of sexual risk behaviors which includes sexting.” 

The authors do note some limitations. First, they point out that their study took place in a large urban school district whose students may not be representative of students in most towns and cities across the country. They also note that they did not distinguish between oral, anal, and vaginal intercourse; nor did they define “sexually explicit” for respondents. This means different personal definitions could be at play. Most important, however, the authors remind us that they are “unable to conclude that sending sexts causes one to engage in sexual activity or engage in unsafe sex practices.”   

The Obvious Correlation

Anne Collier, executive director of, cautions us about giving this correlation too much weight. She says she does not find it surprising because, put simply, “sexting is a sexual practice.” It just makes sense that those kids who are sexting are the same ones (or a subset of the same ones) who are engaging in other sexual practices.   

I agreed that this one seemed a bit like a no-brainer but admitted that I was a little more alarmed by the correlation the authors found between sexting and unprotected teen sex. Collier said this was in keeping with previous research on online safety, which found that those kids who take risks online are the same kids who take risks of other kinds off line.

Still, she says that we shouldn’t sound the alarm because sexting is a relatively rare phenomenon. One previous study found that only 2.5 percent of teens had engaged in sexting. However, by including kids as young as 10 years old, that study likely underestimated the incidence of sexting among older teens, who are much more likely to engage in this behavior. Yet even this current study found this behavior only among 15 percent of teens who own phones.  

The Not-So-Obvious Risks

The authors of the Pediatrics study, however, argue that “sexting cannot be discounted as a potentially risky behavior solely on the basis of being a relatively low probably event.” While I agree that dangerous things are still dangerous, even if they are rare, I have a hard time wrapping my brain around the actual risks involved in sexting. Normally, when we talk about teen sexual behavior, the risks are obvious—teens can get pregnant or contract an STD. Since neither of these can happen just from hitting the send button—and there’s no proof that sending the sext causes teens to jump into bed—what risks are we really talking about?

I theorized that the biggest risk came from my own personal motto, the one that has prevented me from taking embarrassing or explicit photos of myself: “it always ends up on the Internet.” This is a bigger risk for the Anthony Weiner’s of the world, who are already living a public (and supposedly adult) life. But since I’ve been told that things never truly get erased from the Internet, I can imagine a tenth grader’s nude pictures, which were meant just for her boyfriend, following her to college and beyond. 

Collier said this was a possibility but not all that worrisome. In fact, a study from researchers at Bridgewater State University found that “74 percent of all the kids who sexted reported that to their knowledge, the picture(s) was never shown to anyone apart from the intended recipient.” Collier also says that teens have gotten smart and are not showing their faces along with the picture of their body part—be it breasts or buttocks.

What is more likely is that the photo gets distributed to the whole school, becoming a scandal that plagues the young person for her entire time at that school and brands her a slut. The real harm here, Collier says, is the “emotional harm and violation of trust” that led to the picture becoming public in the first place. She imagines the young woman who is either flirting, messing around, or just bored, sending a picture of her breasts to her boyfriend without even realizing the emotional risk she is taking. If that boyfriend makes the picture public, it can do a lot of emotional damage. 

The other risk that we have talked about before is the legal threat that lingers because child pornography laws have not yet caught up to teens’ behaviors. Certain sexts, even those that are both voluntarily sent and received, can be illegal. While we have seen cases of young people prosecuted for sexting, it seems that law-enforcement officials are now less likely to punish teen sexters, and lawmakers are working to reform regulations to be more understanding of the current environment.

The truth is, most sexts have few, if any, consequences to either the sender or the recipient. The Bridgewater study found that 79 percent of sexters said it caused no problem for them. 

The Sexual-Harassment Link

This is not to say that sexting is a completely innocent and innocuous behavior. Just as some teens are using text technology as a new method of flirting, others are using it as essentially a new method of sexual harassing a peer. The Bridgewater study found that for girls “about half of sexting may be coercive.” Elizabeth Englender, the author of that study, explains that “the risk of discovery or social conflict is much more likely if the sexting was pressured or coerced.”

Coerced sexting is also more likely to be correlated with other issues, such as “excessive anxiety, dating violence, and digital self-harm,” which Englander describes as “taking on false roles to pretend to cyber-bully themselves and thereby to gain the attention and sympathy of others, usually peers.” She goes on to point out, however, that “Pressured-sexters were significantly more likely to report having had problems during high school with excessive anxiety and prior dating violence.”

Once again, sexting is part of a group of behaviors but not the cause of the problems. 

The Takeaway

Collier thinks that rather than scaring parents and teens about the danger of all sexting, we should focus our messages to young people on the possible coercive aspect of this behavior. It is important to make sure that young people understand sexual harassment, and the harm it can cause. Moreover, they need to understand that giving in to such harassment will not provide gains to them in the long run—in popularity, social capital, or easing of social anxiety. As explains: “Even if they’re in a fog of believing they might get to go out with someone viewed as really popular if they yield to pressure to send the person a sext, they’re less likely to [yield] if they know that pressure is sexual harassment.”

While the current study doesn’t necessarily provide any huge revelation about sexting, it is important that we continue to research this relatively new sexual behavior and understand how it relates to what else young people are doing on their phones, online, and in their bedrooms. And it’s important that we provide young people with honest information that doesn’t aim to scare them but instead helps them think critically about the emerging issues associated with this sexual behavior.

News Sexual Health

State With Nation’s Highest Chlamydia Rate Enacts New Restrictions on Sex Ed

Nicole Knight

By requiring sexual education instructors to be certified teachers, the Alaska legislature is targeting Planned Parenthood, which is the largest nonprofit provider of such educational services in the state.

Alaska is imposing a new hurdle on comprehensive sexual health education with a law restricting schools to only hiring certificated school teachers to teach or supervise sex ed classes.

The broad and controversial education bill, HB 156, became law Thursday night without the signature of Gov. Bill Walker, a former Republican who switched his party affiliation to Independent in 2014. HB 156 requires school boards to vet and approve sex ed materials and instructors, making sex ed the “most scrutinized subject in the state,” according to reproductive health advocates.

Republicans hold large majorities in both chambers of Alaska’s legislature.

Championing the restrictions was state Sen. Mike Dunleavy (R-Wasilla), who called sexuality a “new concept” during a Senate Education Committee meeting in April. Dunleavy added the restrictions to HB 156 after the failure of an earlier measure that barred abortion providers—meaning Planned Parenthood—from teaching sex ed.

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Dunleavy has long targeted Planned Parenthood, the state’s largest nonprofit provider of sexual health education, calling its instruction “indoctrination.”

Meanwhile, advocates argue that evidence-based health education is sorely needed in a state that reported 787.5 cases of chlamydia per 100,000 people in 2014—the nation’s highest rate, according to the Centers for Disease Control and Prevention’s Surveillance Survey for that year.

Alaska’s teen pregnancy rate is higher than the national average.

The governor in a statement described his decision as a “very close call.”

“Given that this bill will have a broad and wide-ranging effect on education statewide, I have decided to allow HB 156 to become law without my signature,” Walker said.

Teachers, parents, and advocates had urged Walker to veto HB 156. Alaska’s 2016 Teacher of the Year, Amy Jo Meiners, took to Twitter following Walker’s announcement, writing, as reported by Juneau Empire, “This will cause such a burden on teachers [and] our partners in health education, including parents [and] health [professionals].”

An Anchorage parent and grandparent described her opposition to the bill in an op-ed, writing, “There is no doubt that HB 156 is designed to make it harder to access real sexual health education …. Although our state faces its largest budget crisis in history, certain members of the Legislature spent a lot of time worrying that teenagers are receiving information about their own bodies.”

Jessica Cler, Alaska public affairs manager with Planned Parenthood Votes Northwest and Hawaii, called Walker’s decision a “crushing blow for comprehensive and medically accurate sexual health education” in a statement.

She added that Walker’s “lack of action today has put the education of thousands of teens in Alaska at risk. This is designed to do one thing: Block students from accessing the sex education they need on safe sex and healthy relationships.”

The law follows the 2016 Legislative Round-up released this week by advocacy group Sexuality Information and Education Council of the United States. The report found that 63 percent of bills this year sought to improve sex ed, but more than a quarter undermined student rights or the quality of instruction by various means, including “promoting misinformation and an anti-abortion agenda.”

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

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Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.


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