Psychological effects

Those who have first sexual intercourse before 15 have higher rates of mental illness. In one study of 273 sexually active California teens, those studied reported both positive and negative consequences of their sexual activity. According to the paper "We tend to focus on the health consequences of having sex, like pregnancy and STIs, but we also need to talk to them about all the emotional consequences." According to Harvard Medical School's O'Connell, adolescents "often haven't achieved the emotional, even neurological, maturity necessary for making autonomous and self-aware sexual choices." Emotional, social and cognitive development continues well past adolescence.

Depression and emotional distress
Longitudinal research has shown "a significant association between teenage sexual abstinence and mental health." In a broad analysis of data from the National Longitudinal Study of Adolescent Health, researchers found that engaging in sex leaves adolescents, and especially girls, with higher levels of stress and depression. "Depression, anxiety and increased stress accompany the abuse of alcohol and drugs also observed in sexually promiscuous teens."

Research has found "a dramatic relationship" between sexual activity among adolescents and "multiple indicators of adolescent mental health. Compared to abstainers, membership in any of the risk clusters was associated with increased odds of depression, serious thoughts about suicide, and suicide attempts." Sexually active girls are more vulnerable to depression, suicidal ideation, and suicide attempt than sexually active boys, but there is little difference between boys and girls who are not sexually active. Risk for depression is "clearly elevated" for the sexually active of either gender.

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.”

Experts recommend that sexually active adolescents be screened for depression and be "provided with anticipatory guidance about the mental health risks of these behaviors." Professors at the University of California recommend that parents and health professionals help teens prepare for and cope with the emotions attached to sex.

Researchers at Brown University have found that cutting is linked to higher levels of risky sex among teenagers. Psychologist Lori G. Plante states that "habitual cutting is a way of managing intense emotional distress. It makes sense that the level of impulsivity and risk taking would also be higher in these teens." Plante believes that cutting, even once, is "a warning sign that they are overwhelmed in some way."

Casual sex
Casual attitudes amongst adolescents toward sex and oral sex, in particular, "reflect their confusion about what is normal behavior", according to Sabrina Weill, author of The Real Truth About Teens & Sex.

When adolescents engage in casual sexual relationships, they proceed toward adulthood with a lack of understanding about intimacy. James Wagoner, president of Advocates for Youth, worries that "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." In US News & World Report, physician Bernadine Healy states, "Both as doctor and mother, I can't help but believe that our anything-goes society, in which impulses are immediately satisfied and sex is divorced from love and bonding, is simply not healthy physically, emotionally, or spiritually."

When taking part in hookups, "the kids don't even look at each other. It's mechanical, dehumanizing", according to psychologist Marsha Levy-Warren.

Some studies appear to show "what many teens come to find out on their own: Even if sexual activity seems casual, it often is not", according to Bill Albert, deputy director of the nonprofit National Campaign to Prevent Teen Pregnancy. "A casual hookup on a Friday night might not feel that way a month down the road." When having casual sex teens are "pretending to say it's just sexual and nothing else. That's an arbitrary slicing up of the intimacy pie. It's not healthy", according to Paul Coleman, psychologist and author of The Complete Idiot's Guide to Intimacy. Depression, alcohol abuse, anorexia, and emotional disturbance can all afflict adolescents as a result.

Mark O'Connell has written that the "explosion of sex without meaning" among American teens "is deeply symptomatic. Emotional deadness, disengagement, and constriction are increasingly the norm. (Oral sex is, after all, 'just something to do.') 'Sexual addiction,' our term for moving from sexual experience to sexual experience without ever being satisfied, is prevalent. Meanwhile, for many kids precocious sexuality represents not freedom and experimentation but is a byproduct frequently seen with sexual trauma: compulsively driven activity that both expresses and aims to manage the effects of chronic intrusion and overstimulation."

Relationships
Even when teens are in a romantic relationship, sexual activities can become the focus of the relationship. Not only are such relationships less sustained, they are often not monogamous and they have lower levels of satisfaction than relationships that do not have sexual activities as their focus, according to W. Andrew Collins, child psychology professor at the University of Minnesota.

David Walsh, from the National Institute on Media and the Family, thinks that when adolescents engage in casual sexual relationships they do not develop skills such as trust and communication that are key ingredients in healthy, long-lasting relationships.

In purely sexual relationships, adolescents pick up "a lot of bad habits" and don't learn "to trust or share or know how to disagree and make up", according to Laura Sessions Stepp, author of Unhooked: How Young Women Pursue Sex, Delay Love, and Lose at Both. They become jaded and as a result later in life, they have trouble forming adult relationships, according to Levy-Warren. "They don't learn to build that emotional intimacy before they get physically intimate. In the long term, that develops bad relationship habits," according to adolescent gynecologist Melisa Holmes, author of Girlology: Hang-Ups, Hook-Ups and Holding Out.

Males and females experience sex differently. Males are more able to shrug off a one-night stand, but "girls are more confused afterward... and in general suffer a loss of self- esteem," according to Carrie Lukas of the Independent Women's Forum. However, by the time a young man has reached his early twenties, his girlfriend or his wife will become his primary emotional caregiver. If he cannot establish an emotional relationship with a woman, who does view sex as connected to intimacy, then he is more likely to become depressed, commit suicide or die from illness.

Experts worry that when teens have sex before they're ready then they undervalue the experience and that leads to a cynical view later on. "I think they can develop a kind of negative attitude about life in general, that things aren't that special and they aren't that wonderful and what's the big deal about a lifelong commitment and a family commitment?" said Linda L. Dunlap, a psychology professor at Marist College. "They're disappointed, probably because they weren't mature enough to understand the meaning of it, and it's kind of made them kind of cold to the idea of commitment in other ways."

Oral sex
Teens believe that oral sex is less risky to their emotional and physical well being than vaginal sex, but experts at the University of California do not believe this conclusion is warranted. They found that oral sex, as well as vaginal sex, was associated with negative consequences.

With regards to oral sex, it is almost always the boys who receive it and the girls who give it. When girls provide oral sex "they do so without pleasure, usually to please their boyfriend or to avoid the possibility of pregnancy." This paradigm has entitled boys and disempowered girls, putting girls at a disadvantage. Adolescents who engage in oral sex but not intercourse report fewer problems with sexually transmitted diseases, guilt, and their parents, but also less resulting pleasure, self-confidence or intimacy with their partners.

Of adolescents engaging in oral sex only, girls were twice as likely as boys to report feeling bad about themselves and nearly three times as likely to feel used. Boys who engaged in oral sex were more than twice as likely as girls to report feeling more popular and confident.

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