When the talk is about sex, clinical psychologist Cindy Hatch has noticed a decided trend among teenagers coming to her office in Bridgeville over the past five to eight years.
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"First they were telling me more frequently that they were having oral sex, because they thought it was safe sex," Hatch said. "And then, more recently, they've started telling me they know it isn't safe, that they know you can get sexually transmitted diseases from it, but that it's still OK, because it's not really sex."
Now, a big new national survey is confirming what Hatch and other mental health professionals and sex education experts have known for years: Oral sex has become commonplace among teens.
According to the National Center for Health Statistics in Hyattsville, Md., 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. Among 18- to 19-year-olds, that figure increases to about 70 percent.
The report, released yesterday, is the most comprehensive national survey of teen sexual behaviors ever released by the federal government. Until now, researchers, policy-makers and politicians could only cite anecdotal evidence or small samples to gauge sexual activity among teens.
A much smaller study of 92 students in grades seven through 12, done by the Pennsylvania Coalition to Prevent Teen Pregnancy a few years ago, found the same numbers as in the larger federal study, with more than half of the girls and boys reporting they had engaged in oral sex, said Toni Felice, vice president of applied research at the Family Health Council in Oakland.
But the new federal study is "groundbreaking because the sample is so large," she said.
The reports' findings are also seen by those who work with young people as one more sign that young women are more sexually confident than they used to be. A release by the center six months ago, based on the same survey results, showed that slightly more girls than boys have intercourse before they turn 20. In addition, other national data indicate that the same proportion of high school girls and boys have sex only one time with a particular person or have relationships with others with whom they are not romantically involved.
"This is a point of major social transition," James Wagoner, president of Advocates for Youth, a Washington-based reproductive health organization, said Wednesday. "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."
The data also underscore the fact that, unlike their parents' generation, many young people, particularly those from middle- and upper-income white families, simply do not consider oral sex a big deal.
"Teens will tell you they don't particularly enjoy it," said Hatch. "And they'll say it's no big deal, that it's a way to avoid doing anything else, and they do it because it's so commonplace."
In fact, 30 years ago, the reverse was true, noted Felice: Intercourse was regarded, relatively speaking, as more ordinary, while oral sex was seen as far more intimate.
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."
Indeed, oral sex "doesn't hold the same level of intimacy as intercourse does" for teens, added Mary Anne Poutous, director of community education for the Family Health Council. "Intercourse is seen as taking you to a different level emotionally whereas oral sex carries a lot less investment in a relationship, at least the type of relationship teens say they don't necessarily want."
The new report is sure to reignite debate over abstinence-only programs, which have received increased funding by the Bush administration in recent years but have been criticized as inadequate by supporters of sex education programs, which include information about contraception and basic sexual health.
Supporters of such abstinence-only programs say they have resulted in young people delaying intercourse, but opponents say they simply have led young people to substitute other risky behaviors. The new data shows that nearly one in four virgin teens has engaged in oral sex.
Claire Brindis, the federal study's author, says many teenagers have fully accepted the idea that postponing intercourse is a good idea. When they weigh the advantages and disadvantages of intercourse versus other forms of sex, they decide that they are far more at risk with intercourse, both because of pregnancy and the greater risk of disease.
Hatch says the real issue facing those who work with teens is getting to the question of why sex is perceived as so commonplace today.
"It has no meaning for kids. When I was 13, it was an enormous big deal. It's not now. It's almost as if the word has gotten out that it's not dangerous or as 'bad' as intercourse," she said, noting that for those who support abstinence-only programs, like herself, "we really have a lot more to do."