Slightly more than half of American teenagers ages 15 to 19 have engaged in oral sex, with females and males reporting similar levels of experience, according to the most comprehensive national survey of sexual behaviors ever released by the federal government.
The report released yesterday by the National Center for Health Statistics shows that the proportion increases with age to about 70 percent of all 18- and 19-year-olds. That figure is considerably higher for those who also have engaged in intercourse.
Several leaders of organizations that study or work with youth expressed surprise at the level of girls' participation. "You assume that females are more likely to give, males more likely to receive," said Jennifer Manlove, who directs fertility research for the organization Child Trends. "We were surprised that the percentages were similar."
A report by the center nine months ago, based on the same survey, showed that slightly more girls than boys have intercourse before they turn 20. In addition, other national data indicate that the proportion of high school girls who have one-night stands, as well as nonromantic sexual relationships, equals boys.
"This is a point of major social transition," James Wagoner, president of Advocates for Youth, a reproductive health organization, said yesterday. "The data are now coming out and roiling the idea that boys are the hunters and young girls are the prey. It absolutely defies the stereotype."
Joe McIllhaney Jr., chairman of the Medical Institute for Sexual Health, said the new data confirm trends he has seen as a physician, but he has doubts about some of Wagoner's conclusions. "I question how much girls enjoy" oral sex, he said."I'd like to know a whole lot more about the pressure boys put on girls."
The data also underscore the fact that many young people -- particularly those from middle- and upper-income white families -- simply do not consider oral sex to be as significant as their parents' generation does. "Oral sex is far less intimate than intercourse. It's a different kind of relationship," said Claire Brindis, professor of pediatrics at the University of California at San Francisco. "At 50 percent, we're talking about a major social norm. It's part of kids' lives."
Bill Albert, communications director for the National Campaign to Prevent Teen Pregnancy, put the generational difference this way: "We used to talk about sex in terms of first base, second base and so on. Oral sex was maybe in the dugout." The news for parents, he said, is that they must broaden the discussions they have with their children about sex and be more specific. "If they want their teens to abstain from sex, they need to say exactly what they want their kids to abstain from."
The entire survey, administered in 2002 and 2003, includes a variety of findings about sexual behaviors among 15-to 44-year-olds. For example, almost 11 percent of young women ages 15 to 19 said they had had some kind of sexual experience with a female partner, a figure that also held true for 15-to-44-year-old women in general. Proportions of men reporting same-sex activities were lower.
The findings on oral sex among teens are sure to stir debate over abstinence-only sex education. Supporters of such programs say they have resulted in young people delaying intercourse, but opponents say they also have led young people to substitute other behaviors, especially fellatio and cunnilingus. The new data tend to support this view, showing that nearly one in four virgin teens has engaged in oral sex.
Many teenagers have fully accepted the idea that postponing intercourse is a good thing to do, Brindis said. When they weigh the advantages and disadvantages of intercourse vs. other forms of sex, they decide that they are far more at risk with intercourse, because of possible pregnancy and the greater risk of infection. Teens also consider oral sex more acceptable in their peer group than vaginal sex.
"They're very smart about this issue," Brindis said, "but they may not have been given a strong enough message about the risks of oral sex. Maybe we need to do a better job of showing them they need to use condoms." Oral sex has been associated in clinical studies with several infections, including gonorrhea, syphilis, herpes and the human papillomavirus, which has been linked to cervical cancer. Condoms and other forms of contraception can be used to decrease the health risks of oral sex, but few teens use them.
"If a substantial number of young people are having oral sex, as these numbers indicate, this is a big concern," said Kristin Moore, president of Child Trends, which analyzed the center's most recent findings.