Sexually Active Teenagers Are More Likely to Be Depressed and to Attempt Suicide
by Robert E. Rector, Kirk A. Johnson, Ph.D., and Lauren R. Noyes
Center for Data Analysis Report #03-04
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 sexually active.
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 American teenagers.
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 active.”
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 depressed
(a) Never or rarely,
(c) A lot of the time, or
(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 show:
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 active.
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 sexually active.
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 sexually active.
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 activity.
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 sexually active.
Teens Express Regrets over Sexual Activity
The significantly 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 one.
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.
The dissatisfaction 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.
Moreover, theoretical 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 active.
Until recently, 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 adults.
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:
The primary 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.
Such abstinence 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 Foundation.