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Adolescent sexuality

Michelle Forcier, MD, MPH
Section Editor
Diane Blake, MD
Deputy Editor
Mary M Torchia, MD


From Aristotle's early treatises on sexual desire to Sigmund Freud's theories of psychosocial development, adolescent sexuality has been a controversial topic for virtually every generation. As the 21st century unfolds, society will continue to be challenged by adolescent sexual behavior and its consequences. Although medical providers often discuss adolescent sexuality in terms of "risk," it is important to remember that sexuality, sexual behaviors, and sexual relationships are an important and necessary part of human development. Paradigms of adolescent sexuality are broadening from risk to well-being, from targeted to comprehensive efforts, and from increasing knowledge to building skills [1]. Responsible sexual behavior (eg, delaying initiation of sexual intercourse, choosing caring and respectful partners, increasing the use of condoms, and using effective contraception) is an important public health issue. The United States Healthy People 2020 goals include improved pregnancy planning and spacing; prevention of unintended pregnancy; promotion of healthy sexual behaviors; and increased access to quality services to prevent sexually transmitted diseases and their complications [2,3]. The World Health Organization and other agencies interested international health also identify adolescent-friendly health services as a worldwide priority [4,5], with 70 percent of more than 1 billion youth (10 to 19 years) living in developing countries [6].

Among adolescents in the United States:

Young women reach puberty and sexual maturity (eg, breast development, menarche) at earlier ages than ever [7]. (See "Normal puberty" and "Definition, etiology, and evaluation of precocious puberty".)

Approximately 40 percent of high school youth report having had sexual intercourse, and 30 percent report being currently sexually active [8]. Prevalence of sexual activity increases with age, rising from 24 percent in 9th graders to 58 percent in 12th graders.

Trends (from 1991 to 2015) in the Youth Risk Behavior Survey (YRBS) indicate that [8]:

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Literature review current through: Nov 2017. | This topic last updated: Nov 12, 2017.
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