Sex, science and statistics

A couple of weeks ago, I ran across yet another news story about how young people no longer date—they just have friends with benefits—and how those hookups are liable to lead to emotional and psychological damage.

But recent research suggests that picture may be wrong. Published in the December issue of Perspectives on Sexual and Reproductive Health, the new research was based on surveys answered by a diverse group of more than 1300 Minnesotans in their late teens and early 20s. Not only were the majority of these people having sex within a relationship, but whether they were or not had no bearing on their mental health. The casual-sex havers were every bit as happy and healthy as the kids who were only doing it with a committed partner.

So who's right? To find out, I turned to a couple of experts in teen sex and sex education. At the heart of this apparent discrepancy, they told me, are big differences between the way scientists study sexual behavior and the way that information gets presented to the general public.

For instance, let's go back to that question of casual sex. An older paper that found 78% of young people had at least fooled around with a stranger or acquaintance during their college years. So it was surprising when the Minnesota study turned up just 8% of respondents who's last partner was a casual acquaintance, and another 12% who were in a relationship, but not an exclusive one.

That's a big difference, but the reason behind it should be instantly apparent to any current or former teenager. At least, any who have been to a slumber party. It's as simple as the difference between of-the-moment gossip and a game of "Have You Ever". The Minnesota survey asked people to categorize their most recent sex partner. The earlier study asked whether they'd ever, at any time, got all up on someone they didn't know very well.

Both are legitimate questions. The problem is that they're often reported by the media as being the same question. And neither "Have you ever?" nor "What are you doing right now?" is really a great stand-in for the far more important, "What do you normally do?"

"I think people stereotype teenagers sometimes," said John Santelli, M.D., a pediatrician and adolescent health specialist who chairs the Heilbrunn Department of Population and Family Health at the Mailman School of Public Health at Columbia University. "I don't think hookup situations are the norm for young people. Serial monogamy is very common among youth. The 20% in this study who weren't in committed relationships, I'd be willing to bet that many were between relationships, or in the process of forming one."

Far more thorny is the question of whether casual sex, or any sex outside marriage, is emotionally harmful. That basic idea is stated as a fact in federally funded abstinence education programs, Dr. Santelli told me. But most scientists don't think it's so clear-cut. Dr. Santelli, as well as adolescent sexuality researcher Douglas Kirby, Ph.D., told me that teen sex and mental health are more of a chicken/egg conundrum—and which came first depends a lot on how old you are.

Correlations between sex and poor mental health do turn up for very young teenagers—people younger than, say, 14—Dr. Santelli and Kirby told me. But you can't separate that from the fact that sex at that age, particularly for girls, is more likely to be coerced—and being pressured or forced into sex you really didn't want to have can cause mental health problems on its own. Dr. Santelli also pointed out that children who have been abused at home are more likely to start having sex early. Again, you can't look at any depression or addiction those kids have later and say that early sex was the clear cause.

Kirby said the same holds true for slightly older teens—people who were younger than 17 when they started having sex.

"Young people who are risk takers, more non-conventional, or challenging of social norms, they're more likely to have sex between the ages of 14 and 17. They're also more likely to smoke cigarettes, try alcohol, use drugs, be less attached to school, drop out, etc.," Kirby said. "Again, it's not the case that sex leads to all those things. It's that these people who are less connected to family and school are engaging in a wide variety of risk-taking behaviors and sex is just a part of that."

The median age for when Americans lose their virginity is 17. After that, Dr. Santelli and Kirby told me, studies show there's no longer any real correlation between poor mental health and sex. Whether you have it or not, your psychology isn't effected. The Minnesota study backs that up, they said, and goes one step further by showing that who you have sex with doesn't really matter, either.

Again, the problem is that media seldom make distinctions between situations that represent cause-and-effect and those that are simply correlated.

The result is that we, as a society, aren't addressing the things older teenagers and young adults really need to know, Dr. Santelli said. Americans start having sex at 17 and get married around 27, he said, but abstinence-based programs are presented as though getting married right out of high school is still the norm.

"We aren't providing realistic social models to young people. We need a healthy cohabitation program in America. And healthy relationship education," Dr. Santelli said. "We just say how wonderful marriage is. Abstinence programs are aimed toward getting you married at 20, not supporting you and helping you make healthy and smart choices as a single 20-something. We don't really support long-term, non-married monogamy. Which is a pretty good choice for many young people."