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Why we should care that many teens experience sexual difficulties

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There is a wealth of information about the sexual activities, unwanted pregnancy rates and sexually transmitted infection patterns seen in adolescent girls and boys. As a society, we have become preoccupied with the role of social media on a young person's sexuality and on their sense of sexual self-esteem. However, one domain of sexuality that we know little about is in regards to the sexual difficulties that adolescents experience.

By the time they are in 11th grade, three fourths of Canadian teenagers have engaged in genital fondling and half have engaged in oral sex or vaginal intercourse, according to 2006 study. Yet, a recent study carried out at the University of New Brunswick focusing on 260 sexually active 16 to 21 year olds found that more than half reported a sexual problem. Of those, half experienced significant distress from the sexual difficulty. Nearly a quarter of the male participants reported difficulties with erectile functioning, the same number experienced low sexual desire, and 11 per cent reported problems with orgasms (often reaching orgasm too quickly). Among the female sexually active adolescents, nearly a quarter reported low sexual desire and difficulties reaching orgasm were also common.

As with adults, relationship factors predicted which of the youth were more likely to experience a sexual concern. Among males, not being in a relationship, or being in a relationship of shorter duration increased their sexual problem rate; among females, having lower relationship satisfaction was associated with more sexual problems.

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In another study carried out at the Université de Montréal on 1,400 adolescent young women, a staggering 20 per cent of the sexually active females reported vaginal pain with the majority of sexual intercourse encounters. Because so few adult women consult a health professional about their chronic vaginal pain, the study authors concluded that many young women likely experience it for years before receiving a diagnosis.

Why should we be concerned with these high rates of sexual difficulties in adolescents?

Firstly, it is likely that sexual problems in adolescence can persist well into adulthood, unless addressed.

Secondly, teens are sexually active in spite of the high rates of sexual concerns. Some developmental psychologists have documented some sexually active young women may be engaging in sex for reasons other than their own pleasure. These female youths may be particularly prone to low sexual desire – a common sexual problem in adult women.

Third, traditional scripts such as "the sexual double standard" suggest that men should be sexually ready and potent, which may create unreasonable expectations and resulting anxiety if the adolescent male also has sexual concerns. Because anxiety is a known inhibitor of sexual response, adolescents can get into a vicious cycle of anticipatory anxiety leading to sexual problems, which in turn, further escalates the anxiety.

Finally, sexual problems are highly correlated with negative mood, anxiety, markers of physical health and overall quality of life. If an adolescent experiences sexual problems, they may also be at a higher risk of negative mental and physical health.

So, what can be done?

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  • Health care providers should ask adolescent patients if they are sexually active, and if they are, also ask about any sex-related difficulties.
  • Resources for adolescents experiencing sexual problems need to be developed and made accessible. Canadian sites such as sexualityandu.ca and the Sex Information & Education Council of Canada (sieccan.org) are excellent resources.
  • Become aware of your own sex-related myths and stereotypes that perpetuate inaccurate views of sexuality in youth. For example, the belief that young people are in their “sexual prime,” that adolescents experience spontaneous and bountiful sexual desire, and that relationships are unimportant to youth today are misleading and harmful.

Lori Brotto is an associate professor of gynecology at the University of British Columbia and a registered psychologist. You can find her at brottolab.com and follow her on Twitter @DrLoriBrotto.

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