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 15 percent of both boys and girls 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 (15 percent of males and females), based on analyses of the 2011-13 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 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 is one reason youth give for why they engage in oral sex. However, the most common reasons listed by these youth for engaging in oral sex were as follows: for pleasure, to improve their relationship, and for popularity or their reputation.[8] Efforts aiming 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 and 46 percent, respectively, in 2006-10. In 2011-13, both proportions increased slightly, and were 38 and 49 percent, respectively. (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 1995 and 14 percent in 2011-13). (Figure 1) However, oral sex among never-married teen males who had ever had sexual intercourse increased: 71 percent had ever given oral sex in 2011-13, compared with 61 percent in 1995; 88 percent had ever received oral sex in 2011-13, 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_fig2Approximately half of all teenagers, ages 15 to 19, report having engaged in oral sex (51 percent of males, and 47 percent of females, in 2011-13). Teens who have not had sexual intercourse are less likely to report ever engaging in oral sex (15 percent of males, and 14 percent of females, in 2011-13), compared with 91 percent of males, and 87 percent of females, 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, although females and males are equally likely to report ever giving oral sex to a partner (39 and 38 percent, respectively, in 2011-13), males are more likely than females to report receiving oral sex (49 and 45 percent, respectively).  (Appendix 2) Among teens who have ever had sexual intercourse, females are also more likely than males to report ever giving oral sex (76 versus 71 percent, in 2011-13). Among teens who have not had sexual intercourse, there is also a disparity: 10 percent of females report giving oral sex, compared with 8 percent of males. (Figure 3)

Differences by Type of Oral Sex

In 2011-13, slightly less than half of males (49 percent) and females (45 percent) reported they had received oral sex. Smaller percentages (38 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 more likely to report receiving than giving oral sex (88 versus 71 percent), while males who had not had sexual intercourse were almost twice as likely to report receiving than giving oral sex (14 versus 8 percent). Among females, differences were smaller:, those who have had sexual intercourse were slightly more likely to report receiving than giving oral sex (76 versus 71 percent), but there was no such pattern among females 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 40 percent, among males in 2011-13, and 64 versus 36 percent among females). (Appendix 2) A similar, though less pronounced, pattern exists among teens who have not had sexual intercourse, with 18 percent of older males reporting any oral sex experience, compared with 14 percent of younger males. Among female teens, there was no significant difference by age. The prevalence of oral sex experience among teens who have had sexual intercourse also differs by age: 93 and 88 percent, respectively, for older and younger males, and 90 and 82 percent for older and younger females. (Figure 4)

Differences by Race and Hispanic Origin[20]

95_fig5Among female teens who have ever had sexual intercourse, non-Hispanic whites are the most likely to report both giving and receiving oral sex (88 percent have given oral sex, compared with 73 percent of Hispanics and 38 percent of black teens; 90 percent have received oral sex, compared with 81 and 70 percent of Hispanic and black teens, respectively). Among male teens who have had sexual intercourse, blacks are less likely than their Hispanic and white peers to have given oral sex (50 percent have given oral sex, compared with 67 and 81 percent, respectively, among Hispanic and white teens). White males teens are also more likely than their Hispanic peers to receive oral sex (93 versus 80 percent). (Figure 5) Among adolescents who have never had sexual intercourse, there are no significant differences in reports of oral sex by race or Hispanic origin. (Appendix 3)

Differences by Poverty Level

95_fig6Overall, 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. For example, 34 percent of female teens who live in poor families have given oral sex, compared with 50 percent of those whose family incomes are at least three times the poverty line. Male teens who are in families between two and three times the poverty line are the least likely to have given oral sex: 25 percent, compared with between 38 and 42 percent of their poorer and richer peers. (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, 2006-10, and 2011-13: 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, 2006-10, and 2011-13: 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: Selected Years, 1995-2013

Given oral sex Received oral sex
1995 2002 2006-10 2011-13 1995 2002 2006-10 2011-13
Total1 38.6 38.4 34.3 37.5 49.4 51.2 46.2 48.5
Hispanic 36.8 35.5 35.3 37.4 43.6 47.3 47.5 43.7
Non-Hispanic white 41.8 44.2 37.6 41.4 50.8 52.9 46.3 51.8
Non-Hispanic black 20.5 20.5 25.9 34.4 47.1 56.6 48.2 58.6
Have not had sexual intercourse1 11.7 12.8 8.4 8.3 15.4 20.7 15.4 14.0
Hispanic 8.7 5.4 10.1 11.5 9.6 14.8 15.7 11.9
Non-Hispanic white 12.8 15.1 9.2 7.4 16.7 22.9 16.5 15.6
Non-Hispanic black 1.1 5.9 4.5 9.3 5.6 19.9 13.0 15.2
Have had sexual intercourse1 60.8 65.5 68.4 70.7 77.4 83.5 86.5 87.5
Hispanic 57.4 59.7 63.5 66.5 68.3 73.2 82.9 79.6
Non-Hispanic white 70.5 80.4 82.0 80.4 84.6 90.2 93.0 92.7
Non-Hispanic black 26.1 28.2 39.9 50.1 59.1 75.6 71.5 86.0
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, 2006-10, and 2011-13: 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: 2011-2013

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 51.0 37.8 48.8 47.1 39.4 44.6
Age
15-17 39.9 27.3 37.7 35.5 27.8 33.3
18-19 66.3 52.2 64.0 63.7 56.0 60.7
Race/Hispanic origin
Hispanic 48.9 38.0 44.5 46.3 38.7 43.0
Non-Hispanic white 53.7 41.7 52.0 51.3 48.0 48.3
Non-Hispanic black 61.0 34.7 58.8 39.6 19.7 37.8
Maternal Education
Less than high school 53.0 45.7 50.8 45.8 37.9 44.3
High school diploma/GED 54.1 33.3 51.8 39.9 35.2 38.0
Some College 54.9 41.2 51.6 56.1 46.5 54.3
At least a bachelor's degree 43.8 35.2 42.9 44.9 36.3 39.6
Family structure at age 14
Lived with 2 biological or adoptive parents 47.4 36.3 46.1 42.0 35.9 39.3
Other family structure 57.6 40.4 53.7 54.2 44.3 51.8
Poverty level of income
Below poverty 51.3 38.0 47.3 41.8 33.9 39.4
100-199% of poverty 51.9 38.8 50.0 43.3 37.0 39.9
200-299% of poverty 42.8 25.4 42.2 50.4 43.3 49.2
300% or more of poverty 53.7 42.0 52.3 59.8 50.3 57.0
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: 2011-2013

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 15.4 8.3 14.0 14.5 9.5 11.8
Age
15-17 14.5 8.1 12.9 15.0 9.8 12.8
18-19 17.9 8.9 16.7 12.9 8.7* 9.0*
Race/Hispanic origin
Hispanic 15.2 11.5 11.9 13.5* 9.4* 9.9*
Non-Hispanic white 15.7 7.4 15.6 13.2 11.8 10.2*
Non-Hispanic black 19.6 9.3* 15.2 15.5 5.8* 13.6
Maternal Education
Less than high school 16.2* 13.0* 13.1* 12.6* - 10.8*
High school diploma/GED 16.9 6.6 16.9 7.5* 4.9* 4.8*
Some College 18.5* 9.6* 16.7 18.4 13.4* 16.3
At least a bachelor's degree 12.0 6.8 10.2 18.9* 10.8* 15.2*
Family structure at age 14
Lived with 2 biological or adoptive parents 14.2 8.2 12.6 11.5 7.0 8.6*
Other family structure 18.4 8.6 17.0 19.8 13.9* 17.5
Poverty level of income
Below poverty 17.6 11.2* 15.6 12.2* 8.7* 11.2*
100-199% of poverty 12.6 6.0* 10.6 11.7 9.2 6.9*
200-299% of poverty 14.4* 3.6* 14.2* 13.2* - -
300% or more of poverty 15.9 9.4 14.8 24.9* 11.2* 21.3*
- Data not available.* Estimate unreliable due to small sample (relative standard error is greater than 30%).

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: 2011-2013

Males Females
Any oral sex Given oral sex Received oral sex Any oral sex Given oral sex Received oral sex
Total 90.8 70.7 87.5 87.1 76.2 84.5
Age
15-17 87.9 63.8 84.2 82.2 69.1 79.6
18-19 93.0 75.8 89.9 90.3 80.9 87.8
Race/Hispanic origin
Hispanic 86.1 67.0 80.2 84.6 72.5 81.3
Non-Hispanic white 96.5* 80.6 92.8 93.3* 88.0 90.2*
Non-Hispanic black 87.0 50.5 86.1 70.9 37.9 69.6
Maternal Education
Less than high school 88.1* 74.9 84.4 83.7 72.0 83.3
High school diploma/GED 89.4 58.5 84.9 78.0 71.0 76.6
Some College 93.9* 74.5 88.6 93.9 79.5 92.2*
At least a bachelor's degree 91.5 78.6 91.5 91.4* 81.9 83.3
Family structure at age 14
Lived with 2 biological or adoptive parents 92.1 74.3 90.8 88.6 80.4 86.2
Other family structure 89.1 65.8 83.0 85.5 71.8 82.8
Poverty level of income
Below poverty 85.7 65.0 79.3 83.0 69.2 78.3
100-199% of poverty 91.6* 72.0 89.8* 85.7* 74.8 84.7*
200-299% of poverty 83.8* 58.1 81.7* 90.9* 79.5 91.0*
300% or more of poverty - 97.6* - 86.3* 89.7*
- Data not available.* Estimate unreliable due to small sample (relative standard error is greater than 30%).

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). Oral sex among adolescents: Is it sex or is it abstinence? Family Planning Perspectives, 32(6), 298-304.
[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. (2014). 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. (2015). Oral sex behaviors among teens. Available at: http://www.childtrends.org/?indicators=oral-sex-behaviors-among-teens

Last updated: November 2015
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