Sex and the Early Teen: What is Going On?

If there's one age group that parents wring their hands over, it's teenagers between the ages of fourteen and seventeen. They are in the throes of adolescence, which often means they are moody, private, likely to take risks, and likely to challenge authority and conventions. One day they behave like five-year-olds, the next like mature adults.

Most teenagers have entered puberty, and are actively exploring their sexuality, and it can be a profoundly confusing time.

Below, two adolescent health experts discuss what parents and their middle adolescent children need to know about sex and sexuality.

What is one of the primary concerns among teenagers, as their hormone levels are increasing and they are beginning to see changes in their bodies?

DAVID BELL, MD: One of the main things teenagers want to know is that everything is normal. They're comparing themselves a lot with their peers, and part of the process is to figure out what's normal and what's not.

JENNIFER JOHNSON, MD: There's a lot of comparing of naked bodies among kids, they're thinking, "What's he look like, compared with what I look like?" That's what happens in the showers in the gym. Of course, no one admits to looking at anybody else, but they do it because they're coming to terms with their new body and seeing it compared with other people's bodies. It's really important.

In terms of sexual development, is masturbation normal at this time?

JENNIFER JOHNSON, MD: Yes, I think the majority of kids have masturbated, especially by the time they've reached the ages of sixteen or seventeen. Most kids do it, regardless of what they've been told about it.

Medically, we know that masturbation is perfectly safe and, in fact, can be a very healthy outlet for these strong sexual drives that kids are experiencing.

Are wet dreams normal at this age as well?

DAVID BELL, MD: Yes. During their sleep at some point during puberty, boys may have a nocturnal emission, or a "wet dream." Basically, it's the release of semen or sperm during the night, during their sleep.

Is this disturbing for some boys?

DAVID BELL, MD: Yes. And that's one important reason for parents to have a discussion with their teenage boys about wet dreams before they happen, just as we do with females before their first period, to prepare them for it. If a boy does not know what a wet dream is, he may think he urinated in the bed, and that can be devastating.

Is same-sex experimentation normal at this time as well? How common is it?

JENNIFER JOHNSON, MD: We don't have a lot of information about how common same-sex experimentation is. But certainly when and if it does happen, it's very normal. Again, it's a way for teenagers to assess their own growth, and compare themselves to their peers.

DAVID BELL, MD: I think it is important both for parents and for the teenager not to label their sexual orientation based on episodes like these.

JENNIFER JOHNSON, MD: Right. Sexual orientation is often still emerging in adolescents, and sometimes it changes during a person's life. It's important to differentiate sexual orientation from sexual behavior, because guys and girls may have same-sex sexual experiences and be completely heterosexually oriented.

By the same token, boys and girls who are gay may have heterosexual relationships, including intercourse, and not have homosexual experiences until later in life.

Are children between the ages of fourteen and seventeen having sex? What does the research tell us?

JENNIFER JOHNSON, MD: The national data show that by the time teenagers are in their senior year of high school, about 60%, maybe 70% of boys have had sex, and probably about 50% of girls have had sex. By 'sex', they mean oral sex or intercourse.

So if you want to view it strictly in behavioral terms, having sex in high school is, in our society, a normative behavior, meaning more people do it than don't.

Do you find that kids who want to abstain from sex feel comfortable in abstinence? Or do they feel a lot of pressure to be sexually active?

JENNIFER JOHNSON, MD: In some schools, there are very, very strong abstinence movements, and the cool thing to do is to say you're not going to have sex. But it varies a lot from teenager to teenager and from peer group to peer group.

One thing that is very certain is that the behavior in a peer group is the indication of the level of risk for a member of that group. If my daughter is hanging around with girls who smoke and drink beer at parties, I know that she in danger, because certain risk behaviors, like smoking, are linked with the initiation of sexual activity.

DAVID BELL, MD: There's also data from the Adolescent Health Survey that shows that the more connected teenagers are to either their family, to school, or to extracurricular activities, the safer they are in their relationships and behaviors.

What are the statistics on contraception use among sexually active teenagers?

JENNIFER JOHNSON, MD: One of the recent nationally representative surveys of teenagers found that, in contrast to the 1970s, almost two-thirds of teenagers use contraception the first time they have sex. That is a far cry from the 10-20% that we were seeing in the Seventies.

Is this increase a result of education campaigns?

JENNIFER JOHNSON, MD: Yes, I think so. Kids know about birth control and why it's important to use it. And, in general, they have access to at least condoms.

Teenagers may not ask their parents directly for information about sex, but do they want to hear what their parents have to say on the subject?

DAVID BELL, MD: I think, in some respects, yes, they do, but it's a delicate balance of when and how to deliver the information.

Sometimes the adolescent will ask about sex in reference to a friend. That opens up an opportunity for the teenager to share their own values and thoughts.

JENNIFER JOHNSON, MD: Parents need to know what's going on in these areas. On the other hand, I think it's important for parents to recognize that teenagers are becoming independent and they do, to some extent, have rights to privacy. They do have the right to have time alone in their room without anybody being in there.

That doesn't mean that parents can't talk to kids. But rather then just telling them what you think, you may open the door a lot better if you ask their opinion too.

I also think it's really important for parents to spend time with their teenager. It is very helpful, in terms of keeping communication open and demonstrating your commitment, if you do something together that you both enjoy doing.

DAVID BELL, MD: Some of the best conversations with your teenager come at unexpected times, whether riding in a car or on a camping trip...it's not this formal, sit-down talk about the birds and the bees.