Oral Sex
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Headline

Among teens ages 15 to 19 who have not had sexual intercourse, almost one in four report having ever engaged in oral sex with an opposite sex partner (24 percent of males and 22 percent of females in 2002), based on analyses of the 2002 National Survey of Family Growth (NSFG). (See Figure 1)

Importance

The prevalence of oral sex, especially within middle school populations, has received extensive media coverage.¹ However, until recently, little nationally representative data on this prevalence has been available. Many teens consider oral sex to be more socially acceptable than vaginal sex² and some teens define oral sex as abstinent behavior and/or choose oral sex as a way to avoid vaginal sex.^3,4 Some studies show that teens think oral sex has fewer negative health consequences than vaginal sex, and a substantial minority of teens is completely unaware of any health risks associated with oral sex.^5,6 However, engaging in oral sex is associated with sexually transmitted infections, including HIV.^7,8,9 Despite this danger, few teens use a barrier method to protect themselves against health risks associated with oral sex, and health clinics generally have given minimal attention to oral sex, compared with vaginal sex.^10,11

Trends

Compared with published national analyses of oral sex among males in the 1995 National Survey of Adolescent Males (NSAM),¹² there has been no increase in oral sex experiences among never-married males ages 15 to 19 between 1995 and 2002. 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 38 percent and 51 percent, respectively, in 2002. (See Table 1) However, in 2002, a greater proportion of never-married teen males ages 15 to 19 who had not had sexual intercourse reported ever receiving oral sex (21 percent in 2002 versus 15 percent in 1995). (See Figure 2) Oral sex among never-married teen males who had ever had sexual intercourse also increased from 1995 to 2002: 66 percent had ever given oral sex in 2002, compared with 61 percent in 1995; 84 percent had ever received oral sex in 2002, compared with 77 percent in 1995. Note that the stable overall trend in oral sex is due in part to an overall decline in the proportion of males ages 15 to 19 who have had sexual intercourse. Trend data are not available for females.

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Differences by Sexual Experience

More than one-half of all teens ages 15 to 19 report engaging in oral sex (55 percent of males and 54 percent of females in 2002). About one-fourth of teens ages 15 to 19 who have not had sexual intercourse report ever engaging in oral sex (24 percent of males and 22 percent of females in 2002), compared with 88 percent of male teens and 83 percent of female teens ages 15 to 19 who have had sexual intercourse. (See Figure 1)

Differences by Type of Oral Sex

In 2002, approximately one-half of both males (52 percent) and females (50 percent) reported they had received oral sex. Smaller percentages (39 percent of males and 44 percent of females) said they had given oral sex. (See Figure 3)

Differences by Gender

Males and females report similar levels of any oral sex experience; in 2002, 55 percent of teen males and 54 percent of teen females reported engaging in oral sex. (See Figure 1)

Some gender differences, however, do exist. Among all teens, females are marginally more likely than males to report ever giving oral sex to a partner (44 percent versus 39 percent, respectively, in 2002). (See Figure 3) Among teens who have ever had sexual intercourse, males are more likely than females to report ever receiving oral sex (84 percent versus 77 percent, in 2002). (See Table 4) Among teens who have not had sexual intercourse, there are no gender differences in oral sex experience. (See Table 3)

Differences by Age

Overall, older teens (ages 18 to 19) are substantially more likely than younger teens (ages 15 to 17) to report any oral sex experience (70 percent versus 44 percent, respectively, among males in 2002 and 72 percent versus 42 percent, respectively, among females in 2002). (See Table 2) A similar finding exists among teen females who have not had sexual intercourse, with 35 percent of older teens reporting any oral sex experience, compared with 18 percent of younger teens. (See Figure 4) Similarly, among males who have not had sexual intercourse, 18-to-19-year olds are marginally more likely to report any oral sex than 15-to-17-year olds (31 percent versus 21 percent, in 2002). Oral sex experiences of teens who have had sexual intercourse do not differ by age.

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Differences by Race and Ethnicity

Among all teens, non-Hispanic black males are less likely than Hispanic and non-Hispanic white males to have ever given oral sex (21 percent versus 37 percent and 45 percent, respectively). (See Figure 5) Among females, Hispanics are less likely than non-Hispanic whites to have any oral sex experience (47 percent versus 58 percent). Furthermore, non-Hispanic white teen females are more likely than Hispanic and non-Hispanic black teen females to have ever given oral sex (51 percent versus 34 percent and 25 percent, respectively) and Hispanic teen females are less likely than non-Hispanic white teen females to report ever receiving oral sex (41 percent versus 53 percent). (See Table 2)

Differences by Maternal Education

Teens whose mothers have low levels of education (less than high school) are less likely to report any oral sex experience than teens whose mothers have higher levels of education. For example, among teen males, 43 percent of those whose mothers did not finish high school have any oral sex experience, compared with 60 percent of those whose mothers completed high school or obtained a GED, 57 percent of those whose mothers completed some college, and 53 percent of those whose mothers obtained a bachelor's degree or higher. Females did not show a similar trend. (See Table 2)

Differences by Family Structure

Among all teens, those who lived with two biological or adoptive parents at age 14 are somewhat less likely to report that they have had any oral sex experience (53 percent of males and 52 percent of females) than teens who lived in any other family structure at that age (60 percent of males and 59 percent of females). In addition, 49 percent of males living with two biological or adoptive parents at age 14 have ever received oral sex, compared with 57 percent of those living in another family structure. (See Table 2, Table 3, and Table 4)

Differences by Poverty Level

Overall, 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. Fifty percent of teen males from families below the poverty line have any oral sex experience, compared with 60 percent of teen males from families with incomes 300 percent or more of poverty. Similarly, teen females from families below the poverty line and within 100 percent to 199 percent of poverty are less likely than teen females from families 300 percent or more of poverty to have any oral sex experience (50 percent and 46 percent versus 64 percent). (See Figure 6)

Similar patterns exist among teens who have had sexual intercourse and those who have not: oral sex experience is more common among teens from families with the highest income levels.

Related Indicators

Sexually Active Teens, Sexually Experienced Teens, Condom Use

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State and Local Estimates

None available

International Estimates

None available

National Goals

None available

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What Works: Programs and Interventions that May Influence this Indicator

Click here to view examples of programs and interventions that research has evaluated for this indicator. View programs

Research References

¹Remez L, Oral sex among adolescents: Is it sex or is it abstinence?, Family Planning Perspectives, 2000, 32(6): 298-304.

²Halpern-Felsher BL, Cornell JL, Kropp RY, & Tschann JM, Oral versus vaginal sex among adolescents: Perceptions, attitudes, and behavior, Pediatrics, 2005, 115: 845-851.

³Remez, L, 2000.

⁴Hoff T, Greene L, & Davis J. National survey of adolescents and young adults: Sexual health knowledge, attitudes and experiences. Menlo Park, CA: The Henry J. Kaiser Family Foundation, 2003.

⁵Ibid.

⁶Halpern-Felsher BL, Cornell JL, Kropp RY, & Tschann JM, 2005.

⁷Edwards, S., & Carne, C. (1997). Oral sex and the transmission of non-viral STIs. Sexually Transmitted Infections, 74, 95-100.

⁸Hawkins, D. A. (2001). Oral sex and HIV transmission. Sexually Transmitted Infections, 77, 307-308.

⁹Boekeloo, 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.

¹⁰Remez, L, 2000.

¹¹Halpern-Felsher BL, Cornell JL, Kropp RY, & Tschann JM, 2005.

¹²Gates GJ, & Sonenstein FL, Heterosexual genital sexual activity among adolescent males: 1988 and 1995, Family Planning Perspectives, 2000, 32(6): 295-304.

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Definition

The 2002 National Survey of Family Growth includes two questions about oral sex experience. The questions asked of males are: "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 to females are: "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)?" Ninety-nine percent of all teens surveyed provided a valid response to these questions. If a respondent answered "yes" to either of these questions, we coded them 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 definitions of oral sex could account for some of the trends reported.

Data Source

Data for 2002: 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 on sexual intercourse.

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

Raw Data Source

2002: National Survey of Family Growth
http://www.cdc.gov/nchs/nsfg.htm

1995: National Survey of Adolescent Males
http://www.nichd.nih.gov/cpr/dbs/res_national3.htm

Approximate Date of Next Update

Unknown

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