The issue is of tremendous importance, not only because of the implications for the well-being of individuals throughout their lives. It is also important because faith in the health benefits of abstinence has been a guiding principle in official U.S. policy over the last decade.
As noted by Bogart and colleagues (2007, p. 290):
This belief in the benefits of abstinence was codified in Section 510 of Title V of the 1998 Social Security Act, which established an appropriations program for abstinence education (U.S. Department of Health & Human Services, 1998). To receive federal funds for abstinence education, such programs are required, for example, to teach youth that the benefits of abstinence include “social, psychological, and health gains,” and that “sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects.”
Of course, these assumptions need to be examined empirically (that is, scientifically) to justify their use as the basis for government policy that determines what young people are being taught in public schools. Yet, only a small number of studies have really even tackled this issue. Furthermore, the ones that have been conducted are limited in their value.
Here’s where an in-depth understanding of scientific methods is very useful. To be a good “consumer” of scientific research, you need to be familiar with the various ways of conducting psychological research. Otherwise, the wrong conclusions may be drawn about the meaning of results that are obtained. Most of the available studies are cross sectional, meaning that they have looked at differences across different people at one point in time.
Cross-sectional studies have in fact found that individuals who are abstinent in adolescence tend to have lower levels of psychological problems. That is, they have “fewer symptoms of depression, stress, conduct disorder, and substance abuse or dependence” (Bogart et al., 2007, p. 290).
The problem with studies based on a group of people at one point in time, of course, is that the research does not reveal the long-term effects of behavior on well-being. Moreover, it is not clear in such studies what causes what. It may be that adolescents who are suffering from stress, difficulties in life, or psychological problems are more likely to engage in sexual behavior, rather than sexual behavior leading to such problems. What are needed are longitudinal studies, those that keep track of the same individuals over a long period of time.
Even the few available longitudinal studies that have been conducted, however, suggest that abstinence during adolescence is associated with better adult mental health. The problem that Bogart and her colleagues have with these studies is that they did not examine factors occurring during the teenage years that are related to both mental health problems and adolescent sexual behavior at the same time. That is, certain conditions occur for teenagers that are known to be linked to both psychological problems during adolescence and a greater likelihood of engaging in early sexual behavior.
It is likely that someone who is troubled as an adolescent will be more likely to have psychological problems later in life as an adult. This person may also be more likely to have engaged in sexual behavior as an adolescent. Therefore, the link between teenage sexual behavior and later adult psychological problems may be due to their mutual connection to the factors that caused them to be troubled as adolescents. The early sexual behavior may not have actually caused the adult psychological problems. This confusion about what causes what in a scientific study is known as confounding. In this situation, it is impossible to know conclusively that one early factor (teenage sex) actually caused a later outcome (adult psychological problems) because of the possibility that some other factor (family problems as a teenager) caused the adult psychological problems.
The study by Bogart and her colleagues is a fine example of a high-quality longitudinal study. They examined a very large group of people (1,917 to be exact) over a 16-year period, starting in middle school at age 13. The final measure of mental health therefore was obtained when the study participants were 29 years old. Another strong point of the study is that an extremely high proportion of individuals examined at age 13 remained in the study at age 29. Beyond the advantage of assessing health over an extended time, factors known to be associated with psychological well-being were also evaluated in the study. These factors occurring during adolescence were (a) educational prospects for participants, (b) the quality of family bonding and parent-child relationships, and (c) the level of rebelliousness, unconventional attitudes and behavior, and substance abuse exhibited by the adolescents.
The first factor that was examined was educational prospects. Research has indicated that, especially for girls, the educational achievement of parents and the educational accomplishments and aspirations of the girls themselves, are associated with lower levels of early sexual behavior, childbirth, and marriage. Girls with greater educational prospect may delay getting involved in sex and relationships so that they can devote their energy and resources to advancing their professional goals. Furthermore, higher socioeconomic status is related to better mental health in adolescence, as well as in adulthood. Greater educational attainment is likewise associated with greater socioeconomic level.
The second factor evaluated in the study was the quality of the family environment and parent-child relationships. Features of family life such as stability in the home, good parent-child communication, and high quality parent-child relationships are linked to greater likelihood of abstinence. The quality of the family environment is additionally associated with greater psychological health and well-being.
The third factor was adolescent rebelliousness and unconventional attitudes and behavior, including substance abuse. These characteristics have been found to relate to both a greater likelihood of early sexual behavior and lower psychological health.
Because all of these factors are associated not only with early sexual behavior, but also with psychological well-being, any one of them could explain why sexual behavior correlates with mental health. It may be that early sexual behavior itself does not lead to poorer mental health. One of the three factors instead may cause both early sexual behavior and poorer mental health.
Sexual behavior was defined in the study as engaging in either penile-vaginal or penile-anal intercourse. Abstinence was defined as not engaging in either of these behaviors before the age of 19 years.
As for the results of the study, it was found that, for women, remaining abstinent prior to 19 was associated with greater mental health at age 29, as previous studies have also found. However, no such link was found for men.
The next step in the analyses was to see if the three other factors explained the relationship between abstinence and mental health for women. When the educational prospects of women as adolescents were taken into account, the association between abstinence and mental health disappeared (meaning, it was no longer statistically significant). Similarly, taking into account the quality of family environment as an adolescent, along with respondents’ rebelliousness, reduced the association between abstinence and mental health, but did not eliminate it completely. All three factors explained a substantial amount of the overlap between abstinence and mental health for women.
The finding that educational prospect eliminated the connection between abstinence and mental health suggests that girls’ educational potential leads to both abstinence and to later mental health, rather than abstinence causing later mental health. Bogart and her colleagues (2007) conclude that “girls who are uninvolved in school, have weak family backgrounds, and exhibit unconventionality may have poor adult mental health, whether or not they abstain from sex in adolescence.”
The results of this high-quality study strongly indicate that adolescent sexual behavior is unrelated to later mental health for men. Furthermore, adolescent sexual behavior is not likely a cause of poorer psychological health for women. Rather, disadvantages and risks associated with the early environment lead to later problems in psychological adjustment. Bogart and her colleagues suggest that programs designed to help adolescents should focus on these background and environmental factors rather than specifically on sexual behavior.
Bogart, L. M., Collins, R. L., Ellickson, P. L., & Klein, D. J. (2007). Association of sexual abstinence in adolescence with mental health in adulthood. Journal of Sex Research, 44, 290-298.
U.S. Department of Heath & Human Services. (1998). Understanding title V of the Social Security Act. Retrieved August 14, 2006, from ftp://ftp.hrsa.gov/mchb/titlevtoday/UnderstandingTitleV.pdf
