Oral Sex Behaviors among Teens

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About half of teens ages 15 to 19 report having ever engaged in oral sex with an opposite-sex partner. Among teens who have never had sexual intercourse, about one in seven girls, and one in six boys, report having ever engaged in oral sex with an opposite sex partner.

Importance

Many activities other than vaginal sex––including oral sex––are common expressions of human sexuality[1]; however, there is ambiguity in what behaviors teens identify as “sex” or “abstinence”. For example, in a 2007 study, only about 20 percent of university students considered oral-genital contact to be “sex."[2] And, among a sample of youth aged 14-19, roughly 70 percent agreed that someone who had engaged in oral sex was still a virgin.[3] About one in seven teens who have not had sexual intercourse report having ever engaged in oral sex with an opposite-sex partner (17 percent of males, and 13 percent of females), based on analyses of the 2006-10 National Survey of Family Growth.

More youth engage in oral sex than in vaginal sex, and oral sex often precedes vaginal sex.[4] This is likely because teens consider oral sex to be more acceptable than vaginal sex and to have fewer consequences––health, emotional, or social––than vaginal sex.[5] In fact, a substantial minority of teens is completely unaware of any health risks associated with oral sex.[6],[7] This perception of low risk was listed as one reason why youth engage in oral sex. However, the most common reasons listed by these youth for engaging in oral sex were: for pleasure, to improve their relationship, and for popularity or their reputation.[8]

Efforts aimed to reduce risky sexual behavior among adolescents have given minimal attention to oral sex compared with vaginal sex.[9],[10] While oral sex by itself does not pose a risk for pregnancy, it can lead to a number of sexually transmitted infections, including HIV, herpes, and oral HPV.[11],[12],[13],[14] Yet, research finds that only nine percent of teens who engaged in oral sex reported using a condom.[15] This suggests that adolescents need counseling and education about the STI risk associated with all sexual behaviors, including oral sex.[16],[17]

Trends

95_fig1Comparisons with published national analyses of oral sex among males in the 1995 National Survey of Adolescent Males (NSAM),[18] show a slight decline between 1995 and 2006-10 in oral sex experiences among never-married male adolescents.  Overall, in 1995, 39 percent of never-married males ages 15 to 19 had ever given oral sex, and 49 percent had ever received oral sex, compared with 34 percent and 46 percent, respectively, in 2006-10. (Figure 1, Appendix 1)

Among males who had not had sexual intercourse, there was no change in the proportion  reporting ever receiving oral sex (15 percent in both 2006-10 and 1995). (Figure 1) However, oral sex among never-married teen males who had ever had sexual intercourse increased: 68 percent had ever given oral sex in 2006-10, compared with 61 percent in 1995; 87 percent had ever received oral sex in 2006-10, compared with 77 percent in 1995.  (Figure 1, Appendix 1) Given these trends, the slight decline overall in oral sex is likely related to the decline in the proportion of males ages 15 to 19 who have had sexual intercourse.[19]

Differences by Sexual Experience

95_fig2Slightly less than half of all teens ages 15 to 19 report having engaged in oral sex (48 percent of males, and 46 percent of females, in 2006-10).  Teens ages 15 to 19 who have not had sexual intercourse are less likely to report ever engaging in oral sex (17 percent of males, and 13 percent of females, in 2006-10), compared with 89 percent of male teens, and 84 percent of female teens, ages 15 to 19, who have had sexual intercourse.  (Figure 2)

 

 

Differences by Gender

95_fig3As noted above, males and females report similar levels of any oral sex experience.  (Figure 2)

There are some gender differences, however.  Among all teens, females are marginally more likely than males to report ever giving oral sex to a partner (39 versus 35 percent, respectively, in 2006-10), while males are more likely to report receiving oral sex (47 and 42 percent, respectively).  (Appendix 2) Among teens who have ever had sexual intercourse, males are also more likely than females to report ever receiving oral sex (87 versus 79 percent, in 2006-10).  Among teens who have not had sexual intercourse, there is a similar disparity: 15 percent of males report receiving oral sex, compared with 10 percent of females. (Figure 3)

Differences by Type of Oral Sex

In 2006-10, slightly less than half of males (47 percent) and females (42 percent) reported they had received oral sex.  Smaller percentages (35 percent of males and 39 percent of females) said they had given oral sex. (Appendix 2) Males who reported that they have had sexual intercourse were much more likely to report receiving than giving oral sex (87 versus 69 percent), while males who had not had sexual intercourse were almost twice as likely to report receiving than giving oral sex (15 versus 8 percent). Differences among females were smaller. Among females, those who have had sexual intercourse were slightly more likely to report receiving than giving oral sex (79 versus 73 percent), but there was no such pattern among female teens who had not had sexual intercourse. (Figure 3)

Differences by Age

95_fig4Overall, older teens (ages 18 to 19) are about twice as likely as younger teens (ages 15 to 17) to report any oral sex experience (66 versus 37 percent, among males in 2006-10, and 64 versus 32 percent among females).  (Appendix 2)    A similar, though less pronounced, pattern exists among teens who have not had sexual intercourse, with 19 percent of older females reporting any oral sex experience, compared with 11 percent of younger females. Among male teens, the figures are 20 and 16 percent, respectively. The prevalence of oral sex experience among teens who have had sexual intercourse also differs by age:  92 and 85 percent, respectively, for older and younger males, and 89 and 76 percent for older and younger females. (Figure 4)

Differences by Race and Hispanic Origin[20]

95_fig5Among female teens who have never had sexual intercourse, non-Hispanic whites are the most likely to report both giving and receiving oral sex (14 percent have given oral sex, compared with four percent of Hispanics and six percent of black teens; 11 percent have received oral sex, compared with seven percent of Hispanic teens and nine percent of blacks). Among male teens who have never had sexual intercourse, blacks are less likely than their Hispanic and white peers to have given or received oral sex (five percent have given oral sex, compared with 10 and nine percent, respectively, among Hispanic and white teens; 14 percent have received oral sex, compared with 16 percent, each, among Hispanics and white teens). (Figure 5) Among adolescents who have had sexual intercourse, whites, both male and female, are the group most likely to have given or received oral sex, followed by Hispanics, then black adolescents. (Appendix 4)

Differences by Family Structure

Among males who have never had sexual intercourse, those who lived with two biological or adoptive parents at age 14 are somewhat less likely to report they have had any oral sex experience (15 percent) than are adolescent boys who lived in any other family structure at that age (22 percent). Among females who have never had sexual intercourse, those who lived with two biological or adoptive parents at age 14 are somewhat more likely to report that they have had any oral sex experience (15 percent) than are adolescent girls who lived in any other family structure at that age (11 percent). (Appendix 3)

However, among adolescents who have had sexual intercourse, those who lived with two biological or adoptive parents at age 14 are somewhat more likely to report that they have had any oral sex experience (92 percent among males, and 86 percent among females) than are adolescents who lived in any other family structure at that age (85 percent among males, and 83 percent among females). (Appendix 4)

Differences by Poverty Level

95_fig6Overall, male and female teens from families with incomes above 300 percent of the poverty line are more likely than those close to or below the poverty line to have oral sex experience.  Among adolescents who have had sexual intercourse, 86 percent of males from families below the poverty line have had any oral sex experience, compared with 93 percent of males from families with incomes 300 percent or more of the poverty level.   Similarly, females from families with incomes below the poverty line are less likely than females from families with incomes 300 percent or more of the poverty level to report any oral sex experience (77 versus 92 percent).  (Figure 6)

A similar pattern exists among teens who have not had sexual intercourse: oral sex experience is more common among those from families with the highest income levels, although the pattern is less consistent. (Figure 6)

State and Local Estimates

None available.

International Estimates

None available.

National Goals

None.

Related Indicators

Definition

Beginning in 2002, the National Survey of Family Growth includes two questions about heterosexual oral sex experience. [a] The questions asked of males are: “Has a female ever performed oral sex on you, that is stimulated your penis with her mouth?”  and “Have you ever performed oral sex on a female?”  The questions asked of females are: “The next few questions are about oral sex. By oral sex, we mean stimulating the genitals with the mouth. Has a male ever performed oral sex on you?” and “Have you ever performed oral sex on a male?”   Ninety-nine percent of all teens surveyed provided a valid response to these questions.  If a respondent answered “yes” to either of these questions, they were included as having experienced “any oral sex”.

The 1995 data on oral sex experience among never-married teen males are from the 1995 National Survey of Adolescent Males.  In this survey, respondents were asked to respond “yes” or “no” to the following items about oral sex experience: “A female put her mouth on your penis (oral intercourse)” and “You put your mouth on a female’s vagina (oral intercourse).”

Note that differences in the questions asked of respondents could account for some of the trends reported.

Data Sources

Data for 2002 and 2006-10: Child Trends’ original analyses of the National Survey of Family Growth. We would like to thank staff from the National Center for Health Statistics for sharing their programming for sexual intercourse behavior data.

Data for 1995: Gates, G. J. & Sonenstein, F. L (2000). Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Family Planning Perspectives, 32(6). 295-304.

Raw Data Source

2002 and 2006-10: National Survey of Family Growth

http://www.cdc.gov/nchs/NSFG.htm

 

1995: National Survey of Adolescent Males

https://sites.google.com/site/cahjhsph/national-survey-of-adolescent-males

 

Appendix 1- Among Never-Married Teen Males, Ages 15 to 19, Percentage Who Reported Oral Sex with an Opposite-Sex Partner, by Type of Sex and Intercourse Experience: 1995, 2002, 2006-2010

1995 2002 2006-2010
Given oral sex Received oral sex Given oral sex Received oral sex Given oral sex Received oral sex
Total1 38.6 49.4 38.4 51.2 34.3 46.2
Hispanic 36.8 43.6 35.5 47.3 35.3 47.5
Non-Hispanic white 41.8 50.8 44.2 52.9 37.6 46.3
Non-Hispanic black 20.5 47.1 20.5 56.6 25.9 48.2
Have not had sexual intercourse1 11.7 15.4 12.8 20.7 8.4 15.4
Hispanic 8.7 9.6 5.4 14.8 10.1 15.7
Non-Hispanic white 12.8 16.7 15.1 22.9 9.2 16.5
Non-Hispanic black 1.1 5.6 5.9 19.9 4.5 13.0
Have had sexual intercourse1 60.8 77.4 65.5 83.5 68.4 86.5
Hispanic 57.4 68.3 59.7 73.2 63.5 82.9
Non-Hispanic white 70.5 84.6 80.4 90.2 82.0 93.0
Non-Hispanic black 26.1 59.1 28.2 75.6 39.9 71.5
1 Includes races not estimated separately.Sources: Data for 1995: Gates, G. J. & Sonenstein, F. L (2000). Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Family Planning Perspectives, 32(6). 295-304. Data for 2002 and 2006-10: Child Trends' analyses of the National Survey of Family Growth.

 

Appendix 2 - Among Males and Females Ages 15 to 19, Percentage who Report Oral Sex Experience, by Select Social and Demographic Characteristics: 2006-2010

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 48.3 34.7 46.5 46.2 39.3 41.9
Age
15-17 36.9 23.8 34.8 31.9 26.3 27.7
18-19 66.2 51.8 64.7 64.2 55.7 59.7
Race/ethnicity
Hispanic 50.9 35.6 47.8 42.5 33.6 37.6
Non-Hispanic white 48.0 37.4 46.1 50.0 44.9 44.9
Non-Hispanic black 49.7 25.7 48.2 40.5 28.1 38.7
Maternal Education
Less than high school 47.4 31.7 45.6 48.2 39.3 43.7
High school/GED 50.4 35.9 48.6 47.5 40.8 41.2
Some College 46.8 33.9 45.8 49.9 42.9 47.3
At least a bachelor's degree 47.0 34.7 44.4 39.1 33.4 35.3
Family structure at age 14
Respondent lived with 2 biological/adoptive parents 43.8 32.3 42.1 41.6 36.0 36.9
Other family structure 55.8 38.6 53.7 53.4 44.6 49.8
Poverty level of income
Below poverty 49.2 36.1 47.8 42.4 35.3 38.0
100-199% of poverty 42.6 29.2 41.9 43.0 37.1 40.0
200-299% of poverty 48.6 32.0 47.7 49.8 43.1 44.0
300% or more of poverty 52.2 39.7 48.3 51.7 44.1 47.2
Source: Child Trends' analyses of the National Survey of Family Growth.

 

Appendix 3 - Among Males and Females, Ages 15 to 19, Who Have Not Had Sexual Intercourse,  Percentage who Report Oral Sex Experience, by Select Social and Demographic Characteristics: 2006-2010

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 17.1 8.4 15.4 13.4 10.4 9.8
Age
15-17 16.0 7.5 14.3 11.2 8.2 8.5
18-19 20.3 11.4 18.6 18.8 15.8 13.1
Race/ethnicity
Hispanic 17.5 10.1 15.7 9.1 4.0 7.2
Non-Hispanic white 18.3 9.0 16.4 16.1 13.7 11.3
Non-Hispanic black 15.3 5.1 13.8 10.1 6.5 8.6
Maternal Education
Less than high school 13.1 6.3 12.2 15.1 7.8 12.2
High school/GED 14.1 6.0 12.4 13.9 11.4 8.2
Some College 17.9 8.7 17.0 10.8 8.9 8.8
At least a bachelor's degree 20.7 11.2 18.3 14.7 12.2 11.3
Family structure at age 14
Respondent lived with 2 biological/adoptive parents 14.7 7.7 13.8 14.5 11.6 10.3
Other family structure 22.3 10.0 18.9 10.9 7.8 8.6
Poverty level of income
Below poverty 17.3 11.0 16.6 8.6 5.3 6.9
100-199% of poverty 12.4 4.2 12.1 9.0 7.3 6.2
200-299% of poverty 16.0 6.1 15.6 18.4 15.5 11.7
300% or more of poverty 21.6 11.5 17.2 19.8 15.9 15.4
Source: Child Trends' analyses of the National Survey of Family Growth.

 

Appendix 4 - Among Males and Females, Ages 15 to 19, Who Have Had Sexual Intercourse, Percentage who Report Oral Sex Experience, by Select Social and Demographic Characteristics: 2006-2010

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 88.9 68.7 86.7 84.1 72.7 78.9
Age
15-17 85.2 61.3 81.9 75.7 64.5 68.4
18-19 91.6 74.2 90.2 89.3 77.8 85.4
Race/ethnicity
Hispanic 87.9 63.9 83.1 80.2 67.1 72.1
Non-Hispanic white 94.6 81.9 92.9 92.5 83.9 87.0
Non-Hispanic black 73.5 40.0 72.1 68.0 47.7 65.5
Maternal Education
Less than high school 83.1 58.2 79.8 75.6 65.5 69.8
High school/GED 89.6 68.1 87.6 83.4 72.2 76.4
Some College 88.2 69.8 86.8 87.3 75.5 84.2
At least a bachelor's degree 91.9 74.7 89.2 88.2 76.1 83.1
Family structure at age 14
Respondent lived with 2 biological/adoptive parents 91.8 72.9 88.7 85.6 75.6 79.8
Other family structure 85.4 63.8 84.3 82.5 69.9 77.9
Poverty level of income
Below poverty 85.7 64.7 83.2 77.0 66.0 69.5
100-199% of poverty 87.9 66.7 86.3 83.1 77.2 80.0
200-299% of poverty 88.2 63.4 86.8 88.4 77.2 83.7
300% or more of poverty 92.8 77.3 89.9 91.9 79.6 87.4
Source: Child Trends' analyses of the National Survey of Family Growth.

Endnotes


[a] Prior to 2006, the survey questions for males were “Has a female ever put her mouth on your penis (also known as oral sex or fellatio)?”  and “Have you ever put your mouth on a female’s vagina (also known as oral sex or cunnilingus)?”  The questions asked of females were: “Has a male ever put his mouth on your vagina (also known as cunnilingus or oral sex)? and “Have you ever put your mouth on a male’s penis (also known as fellatio or oral sex)?”


[1]Lindberg, L., Jones, R., & Santelli, J. (2008). Noncoital sexual activities among adolescents. Journal of Adolescent Health, 43(3). 231-238.

[2]Hans, J. D., Gillen, M., & Akande, K. (2010). Sex redefined: The reclassification of oral-genital contact.  Perspectives on Sexual and Reproductive Health, 42(2). 74-78.

[3]Bersamin, M. M., Fisher, D. A., Walker, S., Hill, D. L., & Grube, J. W. (2007). Defining virginity and abstinence: Adolescents' interpretations of sexual behaviors. Journal of Adolescent Health, 41(2). 182-188.

[4]Lindberg, L., Jones, R., & Santelli, J. (2008). Op cit.

[5]Halpern-Felsher, B. L., Cornell, J. L., Kropp, R. Y., & Tschann, J. M. (2005). Oral versus vaginal sex among adolescents: Perceptions, attitudes, and behavior. Pediatrics, 115(4). 845-851.

[6]Ibid.

[7]Ibid.

[8]Cornell, J. L. & Halpern-Felsher, B. L. (2006). Adolescents tell us why teens have oral sex. Journal of Adolescent Health, 38(3). 299-301.

[9]Remez, L, 2000.

[10]Halpern-Felsher, B. L., Cornell, J. L., Kropp, R. Y., & Tschann, J. M. (2005). Op cit.

[11]Edwards, S. & Carne, C. (1997). Oral sex and the transmission of non-viral STIs. Sexually Transmitted Infections, 74(2). 95-100.

[12]Hawkins, D. A. (2001). Oral sex and HIV transmission. Sexually Transmitted Infections, 77(5), 307-308.

[13]Boekeloo, B. O. & Howard, D. E. (2002). Oral sexual experience among young adolescents receiving general health examinations. American Journal of Health Behavior, 26(4), 306-314.

[14]D'Souza, G., Agrawal, Y., Halpern, J., Bodison, S., & Gillison, M. (2009). Oral sexual behaviors associated with prevalent oral human papillomavirus infection. Journal of Infectious Diseases, 199(9), 1263-1269.

[15]Leichliter, J. S., Chandra, A., Liddon, N., Fenton, K. A., & Aral, S. O. (2007). Prevalence and correlates of heterosexual anal and oral sex in adolescents and adults in the Unites States. Journal of Infectious Diseases, 196(12), 1852-1859.

[16]Hans, J. D., Gillen, M., and Akande, K. (2010). Op cit.

[17]Lindberg, L., Jones, R., & Santelli, J. (2008). Op cit.

[18]Gates, G. J. & Sonenstein, F. L. (2000) Heterosexual genital sexual activity among adolescent males: 1988 and 1995. Family Planning Perspectives, 32(6). 295-304.

[19]Child Trends Databank. (2012). Sexually experienced teens.  Child Trends DataBank.  Retrieved from http://www.childtrends.org/?indicators=sexually-experienced-teens.

[20]Hispanics may be any race.  Estimates of whites and blacks in this report do not include Hispanics.

 

Suggested Citation:

Child Trends Databank. (2013). Oral sex behaviors among teens. Available at: http://www.childtrends.org/?indicators=oral-sex-behaviors-among-teens

 

Last updated: December 2013