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Demographics
In this section, we offer selected statistics regarding U.S. youth, together with a few statistics focused on New York State. Links and endnotes will connect you to rich resources for further information. These pages are updated periodically.

Demographics: Sexual Health

For background and context, see Understanding Sexual Development and Sexual Health. Percentage of HS Students Who Have Ever Had Sexual Intercourse

Sexual Orientation

Awareness of romantic attraction typically begins prior to puberty [1]. Sexual attraction, behavior, and identity are not always aligned: a person primarily attracted to women may also have sexual contact with men and may or may not identify as gay, bisexual, or straight. This fluidity may be true of both adolescents and adults, and is seen more frequently among females [2].

Among youth age 15-19, according to data from the 2006-2008 National Survey of Family Growth (NSFG) [3]:

  • 11% of girls have had a same-sex partner in their lifetime, and 10% report having had a same-sex partner within the last year.
     
  • 5% of boys have had a same-sex partner in their lifetime, and 4% report having had a same-sex partner within the last year.
Among youth age 18-19 [3]:
  • 82% of women described themselves as attracted only to the opposite sex, 9% mostly to the opposite sex, 5% equally to both, 1% mostly to the same sex, and 1% only to the same sex, with 1% unsure.
     
  • 90% of women identified with the term "heterosexual or straight"; 2% "homosexual, gay, or lesbian"; and 6% "bisexual."
     
  • 92% of men described themselves as attracted only to the opposite sex, 6% mostly to the opposite sex, 1% mostly to the same sex, and 1% only to the same sex, with less than 1% unsure.
     
  • 97% of men identified with the term "heterosexual or straight"; nearly 2% "homosexual or gay"; and 1% "bisexual."
Most lesbian, gay, bisexual, and/or transgender students experience harassment at school. In 2013, 85% of LGBTQ middle and high school students reported verbal harassment, 39% physical harassment, and 19% physical assault. About half had heard homophobic remarks from teachers or other school staff [4]. Boys who are perceived to be gay or feminine are especially likely to face intense stigma [3]. The presence of Gay-Straight Alliance clubs within a school setting has been demonstrated to foster a safer environment [2, 4].

Most lesbian, gay, and bisexual youth achieve health and well-being at levels similar to those achieved by heterosexual youth, though many face higher risks for violence and rejection [2].

Romantic Relationships and Sexual Experience

About one in three 13-year-olds has had a romantic relationship (not necessarily sexual), and the number naturally increases with age: By age 17, 70% report having had a special romantic relationship within the last 18 months [5]. Despite relatively high levels of conflict in adolescent romantic relationships, most youth report a sense of equal power, decision making, and emotional support within their relationships [5].

Interest in romantic and sexual contact typically begins around age 11-14 [6]. Adolescent sexual behaviors most often occur within romantic relationships [5], or with friends or ex-partners [7]. Most teens age 15-19 have first heterosexual sex with a partner with whom they are "going steady," but the numbers are quite different for girls (70%) and boys (52%) [8]. Sexual activity that goes beyond kissing and other "light" behaviors may be associated with depression and other problems in early adolescence when these behaviors are uncommon. However, these problems are not associated with sexual activity in late adolescence within the context of a romantic relationship [5].

Sexual Behaviors

Vaginal Intercourse

An analysis of the 2006-2010 National Survey of Family Growth (NSFG) found that among youth age 15-19, 43% of females and 42% of males had had heterosexual vaginal intercourse [8]. In 2013, just under half (47%) of high school students reported having had sexual intercourse at some point in their lives (38% in New York State), and 34% were currently sexually active (had sexual intercourse at least once in the three months before taking the survey) [9]. In New York State, fewer than one-third of high school students (28%) were currently sexually active [9]. On average, youth in the U.S. first have sexual intercourse at age 17 [10]. Over 80% of adolescent women age 15-21 who report lesbian/bisexual identities or same-sex attractions report having had sex with men [3].

Since 1988, there has been a steady decline in the number of teens (age 15-19) who have engaged in penile-vaginal intercourse [8]; however, this does not necessarily indicate that other forms of sexual activity are decreasing.

Heterosexual Oral Sex [3]

  • Among young women age 15-19, 45% have had oral sex with a male.
  • Among young men age 15-19, 48% have had oral sex with a female.

Heterosexual Anal Sex [3]

  • Among young women age 15-19, 11% have had anal sex with a male.
  • Among young men age 15-19, 10% have had anal sex with a female.

Same-Sex Oral or Anal Sex [3]

  • Among young women age 15-19, 11% have had "oral sex or any sexual experience" with a female.
  • Among young men age 15-19, 3% have had oral or anal sex with a male.
Youth who are white or have a higher socio-economic status are more likely to engage in heterosexual oral or anal sex than are youth of other groups [11].

Condoms and Contraceptives

Among sexually active students, condom use at most recent sexual intercourse increased from 46% in 1991 [12] to 60% in 2013 (63% in New York State [9]). Most teens use a condom or other form of contraception the first time they have sexual intercourse (78% of sexually experienced females, 85% of males) [10]. Among sexually active students nationally, in 2013, black males reported the highest levels of condom use (73%) [9]. In that same group, 9% of females and 7% of males reported using condoms together with another form of birth control [9].

According to the 2006-2010 NSFG, the most popular form of birth control among teen women age 15-19 is the condom (used at least once by 96% of sexually experienced females), followed by withdrawal (57%) and the pill (56%). Young women also indicated having at some point used the following contraceptive drugs or devices: injectables such as Depo-Provera (used by 20% of sexually experienced women age 15-19), periodic abstinence/rhythm method (15%), emergency contraception (14%), the contraceptive patch (10%), and the contraceptive ring (5%) [8].

Use of long-acting reversible contraceptives (LARCs) -- IUDs and implants -- has increased among young women age 15-24, but remains low at 5% [13].

Access to Services

Among sexually experienced young women (age 15-24), use of family planning services increased between 1995 and 2002,then declined for several years. Rates were more stable in the period 2006-2010, but did not return to the utilization levels seen in 2002 [14].

Risky Behaviors

Male adolescents are more likely than females to be exposed to or engage in certain risky sexual behaviors, including sexual intercourse before age 13 (as reported by high school students: 8% males and 3% females in 2013), and having four or more sexual partners in their lifetime (17% male high school students; 13% female high school students) [9].

Although it carries an especially high level of risk for HIV and STDs, anal sex among adolescents is often unprotected [15] as is (lower risk) oral sex [16].

Adolescent Pregnancy, Abortion, and Birth Rates

Adolescent pregnancies are largely, but not entirely, unplanned: 82% are unintended. The highest rates of unintended pregnancy are among young adult women in their early twenties [17]. Women of color also experience disproportionately high rates of unintended pregnancy, but pregnancy rates among black and Hispanic teens are declining steeply [18].

Between 1990 and 2010, the pregnancy rate among women age 15-19 declined 43% to a rate of 126.6 pregnancies per 1,000 sexually experienced teen women, the lowest rate in over 30 years [18]. The rate more commonly cited includes all female teens, not just those who have had sex -- that rate fell to 58 per 1,000 in 2010 [18]. About 6% of all females in this age group became pregnant [18]. Among teens, 18-19 year old women have disproportionately high rates of pregnancy [18]. Teens who identify as lesbian, gay, or bisexual have higher rates of pregnancy involvement than heterosexual teens [2].

Most pregnancies among teens end in birth (60%), while 26% end in abortion and 14% in miscarriage (2010 data) [10]. The teen abortion rate (15 abortions per 1,000 women age 15-19 in 2010) declined by 66% between 1988 and 2010 [18]. In New York State, where over half of teen pregnancies end in abortion, the abortion rate has also declined [18]. While most women (including teens) who have abortions do so in the first trimester of pregnancy, teens are overrepresented among women who have abortions at 13 weeks or later [19].

Birth rates among teens have fallen steeply since 1991, and are now at historic lows for all age and racial/ethnic groups [20]. Between 1991 and 2013, birth rates declined 57% among teens age 15-19 (to 27 births per 1,000), with a 10% drop between 2012-2013 alone [20].

In New York State in 2013, there were 11,091 births to women age 15-19. Most births in this group were to Latinas (4,423), followed by non-Hispanic white teens (3,404) [21]. Pregnancy rates for New York State teens are 19 per 1,000 females age 15-17 (29 in NYC) and 60 per 1,000 females age 18-19 (89 in NYC) [22].

Sexually Transmitted Diseases (STDs) and HIV

Among the roughly 20 million new STD infections reported every year, half are found among young people (ages 15-24), although this age group makes up only 25% of people who are sexually experienced [23]. The most common STD is human papillomavirus, which is contracted at some point by nearly every sexually active person.

Over one million people in the U.S. are living with HIV, and 7% of these are youth age 13-24 [24]. In 2013, while only 14% of youth age 13-19 were black, black youth accounted for approximately 67% of HIV diagnoses in their age group [25]. The same was true among young adults (age 20-24): while 15% of youth age 20-24 were black, black youth carried 57% of the burden of HIV diagnoses.

Gay, bisexual, and other men who have sex with men are at high risk, and the risk is increasing among young men. In 2013, among males age 13-19, male-to-male sexual contact accounted for nearly 93% of diagnoses. Among females in the same age group, heterosexual contact accounted for 84% of diagnoses. Among teens with an HIV diagnosis, 81% are male and 19% are female [25].

Endnotes

[1]   McClintock, M. K., & Herdt, G. (1996). Rethinking puberty: The development of sexual attraction. Current Directions in Psychological Science, 5. Retrieved May 19, 2015, from
homepage.univie.ac.at/Michael.Berger/lit/McClintock.pdf
 
[2]   Saewyc, E. M. (2011). Research on adolescent sexual orientation: Development, health disparities, stigma, and resilience. Journal of Research on Adolescence, 21, 256-272. doi:10.1111/j.1532-7795.2010.00727.x
 
[3]   Chandra, A., Mosher, W. D., Copen, C., & Sionean, C. (2011). Sexual behavior, sexual attraction, and sexual identity in the United States: Data from the 2006-2008 National Survey of Family Growth. National Health Statistics Reports, 36. Retrieved May 19, 2015, from
permanent.access.gpo.gov/gpo21173/nhsr036.pdf
 
[4]   Kosciw, J. G., Greytak, E. A., Palmer, N. A. & Boesen, M. J. (2014). The 2013 National School Climate Survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation's schools. Retrieved May 19, 2015, from the Gay, Lesbian & Straight Education Network, from
glsen.org/sites/default/files/2013%20National%20School%20Climate%
20Survey%20Full%20Report_0.pdf

 
[5]   Collins, W. A., Welsh, D. R., & Furman, W. (2009). Adolescent romantic relationships. Annual Review of Psychology, 60, 631-652. doi:10.1146/annurev.psych.60.110707.163459
 
[6]   Smiler, A. (2013). Young men's sexuality: What's typical? Retrieved May 19, 2015, from
actforyouth.net/publications/results.cfm?t=rf_young-men_0913
 
[7]   Tolman, D. L. & McClelland, S. I. (2011). Normative sexuality development in adolescence: A decade in review, 2000-2009. Journal of Research on Adolescence, 21(1), 242-255. doi:10.1111/j.1532-7795.2010.00726.x
 
[8]   Martinez, G., Copen, C. E., & Abma, J. C. (2011, October). Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006-2010 National Survey of Family Growth. Vital Health Statistics 23(31). Retrieved May 19, 2015, from Centers for Disease Control and Prevention website
cdc.gov/nchs/data/series/sr_23/sr23_031.pdf
 
[9]   Centers for Disease Control and Prevention. (2014, June 13). Youth risk behavior surveillance--United States, 2013. Morbidity and Mortality Weekly Report, 63(4). Retrieved May 19, 2015, from
cdc.gov/mmwr/pdf/ss/ss6304.pdf
 
[10]   Guttmacher Institute. (2014, May). Fact sheet: American teens' sexual and reproductive health. Retrieved May 19, 2015, from
guttmacher.org/pubs/FB-ATSRH.html
 
[11]   Lindberg, L. D., Jones, R., & Santelli, J. S. (2008). Non-coital sexual activities among adolescents [Electronic version]. Journal of Adolescent Health. Retrieved May 19, 2015, from
guttmacher.org/pubs/JAH_Lindberg.pdf
 
[12]   Centers for Disease Control and Prevention. (2012). Trends in HIV-related risk behaviors among high school students - United States, 1991-2011. Retrieved May 19, 2015, from
cdc.gov/mmwr/preview/mmwrhtml/mm6129a4.htm?s_cid=mm6129a4_w
 
[13]   Branum, A. M., & Jones, J. (2015). Trends in long-acting reversible contraception use among U.S. women aged 15-44. NCHS data brief, no 188. Retrieved May 19, 2015, from
cdc.gov/nchs/data/databriefs/db188.htm
 
[14]   Hall, K. S., Moreau, C., & Trussell, J. (2012). Continuing social disparities despite upward trends in sexual and reproductive health service use among young women in the United States. Contraception, 86(6), 681-686.
 
[15]   Dake, J. A., Price, J. H., McKinney, M., & Ward, B. (2010). Midwestern rural adolescents' anal intercourse experience. Journal of Rural Health, 27(2). doi:10.1111/j.1748-0361.2010.00330.x
 
[16]   Halpern-Felsher, B., Cornell, J., Kropp, R., & Tschann, J. (2005). Oral versus vaginal sex among adolescents: Perceptions, attitudes, and behavior. Pediatrics, 115(4), 845-851. doi:10.1542/peds.2004-2108
 
[17]   Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: incidence and disparities, 2006. Contraception, 84, 478-485. doi:10.1016/j.contraception.2011.07.013
 
[18]   Kost, K., & Henshaw, S. (2014, May). U.S. teenage pregnancies, births and abortions, 2010: National trends by age, race and ethnicity. Retrieved May 19, 2015, from
guttmacher.org/pubs/USTPtrends10.pdf
 
[19]   Jones, R. K. & Finer, L. B. (2011). Who has second-trimester abortions in the United States? [Author version]. Retrieved May 19, 2015, from
guttmacher.org/pubs/journals/j.contraception.2011.10.012.pdf
 
[20]   National Campaign to Prevent Teen and Unplanned Pregnancy. (n.d.). National & state data. Retrieved May 19, 2015, from
thenationalcampaign.org/data/landing
 
[21]   New York State Department of Health. (n.d.). Table 6a: Live births by race/ethnicity, birthweight and mother's age, New York State 2013. Retrieved May 19, 2015, from
health.ny.gov/statistics/vital_statistics/2013/table06a.htm
 
[22]   New York State Department of Health. (n.d.). Table 27: Total pregnancy rate by age and resident county New York State - 2013. Retrieved May 19, 2015, from
health.ny.gov/statistics/vital_statistics/2013/table27.htm
 
[23]   Centers for Disease Control and Prevention. (2013, February). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved May 19, 2015, from
cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf
 
[24]   Centers for Disease Control and Prevention. (2012, November). HIV among youth in the U.S. Retrieved May 19, 2015, from
cdc.gov/vitalsigns/hivamongyouth/
 
[25]   Centers for Disease Control and Prevention. (n.d.). HIV surveillance in adolescents and young adults [Slide set]. Retrieved May 19, 2015, from
cdc.gov/hiv/library/slideSets/
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