Sexuality: Co-Facilitation Session

Normative Sexuality Development in Adolescence: A Decade in Review,

2000–2009

Deborah L. Tolman Hunter College

Sara I. McClelland University of Michigan

This review details a key innovation across the field of adolescent sexuality research over the last decadeFconceptualizing sexuality as a normative aspect of adolescent development. Anchored in a growing articulation of adolescent sexuality as having positive qualities and consequences, we provide an organizing framework for understanding sexuality as nor- mative and developmentally expected. Using this framework, we report on 3 specific areas of research that have developed ‘‘critical mass’’ over the past decade: new views on sexual behavior, sexual selfhood, and sexual socialization in the 21st century. We conclude by suggesting that the next step in the field of adolescent sexuality development is the explicit integration of ‘‘positive’’ dimensions of sexuality with risk management dimensions. Rather than navigating a binary between positive and risky, we propose characterizing the ‘‘both/and’’ quality of adolescent sexuality development as normative. This framework, we argue, encourages empirical research that assumes a wide range of strategies through which adolescents learn about themselves, their bodies, intimate partners, and relationships within contexts where they are required to both manage risks and develop positive patterns for adulthood sexuality. We conclude with considerations for future research and public policy.

A KEY INNOVATION

This review details a key innovation across the field of adolescent sexuality research over the last decadeFthat is, the conceptualization of sexuality as a normative aspect of adolescent development. Ad- olescent sexuality has long been equated with dan- ger (Moran, 2000), and researchers have often reflected this sentiment with their choice of research questions by pursuing studies of pregnancy, sexually transmitted infection (STI) risk, condom use, and, increasingly, sexual violence in the lives of adoles- cents. While risks associated with adolescent sexu- ality are essential to understand, this first decade of the 21st century witnessed the emergence of a critical mass of empirical studies reflecting an assumption that adolescent sexuality is a normal and expected aspect of adolescent development. We argue that this emerging body of research signals a sea change in how researchers (and the public) conceptualize ad- olescent sexuality, as well as its predictors, outcomes, and salient characteristics.

Over the last 30 years, researchers have advocated for unlinking adolescent sexuality from automati- cally assumed dangerous outcomes and pathology

(Bauman & Udry, 1981; Ehrhardt, 1996; Fine, 1988; Thompson, 1995). However, it has been over the last decade that, rather than the occasional lone voice in a chorus of concern, investigators produced a set of empirical studies which have developed earlier ob- servations about the limitations and costs of defining adolescent sexuality exclusively as a dangerous and risky set of behaviors and outcomes. Since 2000, this perspective has been both more fully articulated and utilized to guide a significant body of research.

At the start of the decade, Welsh, Rostosky, and Kawaguchi (2000) noted that sexuality was slowly becoming understood as integral to adolescent identity formation and that ‘‘[s]igns of a shift toward a more normative perspective ha[d] begun to ap- pear’’ (p. 119). In 2004, researchers from various disciplines gathered together in San Francisco, CA, for the ‘‘Cutting the Edge of Research in Adolescent Sexuality: Considering Normative Development’’ conference. That same year, The Sexuality Informa- tion and Education Council of the United States (SIECUS, 2004) published guidelines for compre- hensive sexuality educationFwidely approved by mainstream professional organizationsFwhich pre- sented six key concepts, including that ‘‘sexuality is a central part of being human’’ (p. 15) and emphasized developmentally appropriate sexuality education throughout a child and adolescent’s life in order to ensure that ‘‘[y]oung people explore their sexuality

r 2011 The Authors

Journal of Research on Adolescence r 2011 Society for Research on Adolescence

DOI: 10.1111/j.1532-7795.2010.00726.x

We wish to thank Christin Bowman, Amy Baker, and Jessica Lake for their extensive assistance with research, coding, and manuscript preparation.

Requests for reprints should be sent to Deborah L. Tolman, School of Social Work, Hunter College, CUNY Graduate Center, 129 East 79th Street, New York, NY 10075. E-mail: dtolman@ hunter.cuny.edu

JOURNAL OF RESEARCH ON ADOLESCENCE, 21(1), 242 – 255

as a natural process in achieving sexual maturity’’ (p. 20). In 2005 – 2006, two separate special issues in sexuality and developmental journals were pub- lished which argued for conceptualizing and defin- ing characteristics of ‘‘positive’’ adolescent sexuality development while also recognizing the challenges of making such a claim (Diamond, 2006; Russell, 2005a, 2005b). In one of these articles, Russell ex- plained that, ‘‘[t]he intense social regulation of both adolescence and sexuality makes this field a rich venue for academic interrogation, as well as a risky area of academic inquiry,’’ (2005a, p. 10).

Indeed, there has been both political and aca- demic anxiety concerning the most beneficial way to define adolescent sexuality over the past 10 years, especially given the context of abstinence-only sex education policies and the controversies over the science associated with them (see Fine & McClelland, 2006; McClelland & Fine, 2008b). However, there has also been tremendous progress in developing innovative research that addresses the development of healthy sexual attitudes, behaviors, relationships, and importantly, recognition that adult sexual out- comes are rooted in adolescence. Ten years after Welsh and colleagues’ observation about normative adolescent sexuality development, we find that a body of research has emerged and shows signs of growth.

NORMATIVE ADOLESCENT SEXUALITY DEVELOPMENT

We use the term ‘‘normative’’ as an organizing frame for studying adolescent sexuality development, be- cause it allows for integration of the ‘‘positive’’ sex- uality frame called for by other researchers (Diamond, 2006; Russell, 2005a), but also draws at- tention to the developmental nature of sexuality development (i.e., what it means to become a healthy sexual adult). Normative has been defined as, ‘‘per- taining to the average or expected behavior patterns of a group or community’’ (Barker, 1995). By em- phasizing sexuality as expected and normative, we aim to discern the types of research generated within this set of assumptions. We forward the idea that the normative quality of adolescent sexuality signals that sexuality is a developmental phenomenon; this does not mean, however, that we are advocating for normative timelines or benchmarks, such as the ideal time to begin sexual activity. Instead, we use this term to highlight the qualities of sexuality develop- ment, which are necessarily rooted in the adolescent years and thereby important for researchers to un- derstand. While use of terms such as ‘‘normal’’ and

‘‘normative’’ are complex and contested, we have chosen to use the concept of normativity as a way of signaling this major shift in the last decade. We be- lieve this key advance has significantly challenged, and thus altered, the basic assumptions within the field and that this perspective of normative sexuality development is evident not only in the questions researchers ask but in their methods and presenta- tion of findings as well.

In addition to normative, the emergence of the term ‘‘sexuality development’’ (as opposed to ‘‘sex- ual development’’) reflects the theoretical and em- pirical developments of the last decade. Originally used to document the development of physiological stages, more recent research in this field has ad- dressed the intertwining physiological and psycho- logical processes involved in developing as a sexual person at various developmental moments over the course of an adolescent’s life. Early in the decade, Tolman (2002) argued for the importance of con- ceptually expanding what has been called sexual development into the broader, more comprehensive construct of ‘‘sexuality development.’’ This shift has been made possible, in part, by an expanded ap- proach to sexuality itself.

In this review, we report on new arenas of knowledge about adolescent sexuality that have emerged from the growing application of this inno- vative lens. The current discussion is a focused re- view that grew out of a larger comprehensive review of research done in the field of adolescent sexuality from 2000 to 2009. We generated a list of 31 English language journals that regularly published articles from 2000 to 2009 on issues related to adolescent sexuality across a range of disciplines including psychology, public health, sociology, adolescence, women’s studies, and sexuality studies. From this set of journals, 710 abstracts were identified, retrieved, and coded. We developed codes based on the themes that emerged from the abstracts rather than bringing a set of theoretically derived codes to the data. From the initial set of 25 codes, we constructed themes for more careful analysis by grouping the codes based on similarity, relevance, and theoretical relation- ships. From this body of literature, we identified the growing trend for researchers to assume that ado- lescent sexuality is normative rather than distinctly pathological or problematic.

Within this more specific body of research, we identified three domains: new perspectives on sexual behaviors, sexual selfhood, and sexual socialization in the 21st century. Taken in turn, each represents an important aspect of recent empirical research: sexual behaviors emphasizes the behavioral aspects of

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sexuality, sexual selfhood represents the internal de- velopment of the individual, and finally, sexual so- cialization represents the social contexts in which adolescents develop sexual knowledge and experi- ences. While these three areas overlap conceptually and each works necessarily in tandem with the other two, we highlight these areas as distinct in order to illustrate how different levels of analysis are impor- tant within this field as it continues to develop.

Lastly, we discuss the role of the National Longi- tudinal Study of Adolescent Health (Add Health) as a major domain of adolescent sexuality research over the past decade. The impact of this U.S.-based, fed- erally funded, nationally representative, longitudinal study has been immense, and no discussion of ado- lescent sexuality research in the last decade would be complete without inclusion of research from this data set. One of the only studies that has collected data on adolescents and their peers, romantic part- ners, families, schools, and neighborhoods, Add Health has provided an unparalleled ability to ex- amine sexual relationships, behaviors, and risk management in the lives of adolescents as they age from 12 onwards. Toward the end of our discussion, we review how this study mirrors both the trends we have identified in the larger body of literature re- garding normative sexuality development and ten- sions that continue to exist within the field of adolescent sexuality.

While far from representing the entirety of re- search on adolescent sexuality, this major sea change of normativity warrants a focused review. Thus, this review of the research on adolescent sexuality is purposefully not a comprehensive dis- cussion of the enormous literature on the topic of adolescent sexuality, which still is constituted pri- marily by a focus on preventing sexual risk taking (i.e., having unprotected intercourse) and negative sexual outcomes (i.e., adolescent pregnancy, STIs). There are a number of excellent reviews available that cover important aspects of research on ado- lescent sexuality: for reviews of adolescent sexual behaviors and development, see Diamond and Savin-Williams (2009); contraception and condom use by adolescents, see Santelli, Morrow, Anderson, and Lindberg (2006); sexual risk taking and alcohol, see Halpern-Felsher, Millstein, and Ellen (1996); religiosity and sexual behavior, see Rostosky, Wil- cox, Wright, and Randall (2004); abstinence policies and sex education in schools, see Lindberg, Santelli, and Singh (2006); Santelli et al. (2006); abstinence education evaluation, see Kirby (2002, 2007); Smith, Steen, Spaulding-Givens, and Schwendinger (2003); adolescent relationships, see Collins,

Welsh, and Furman (2009); Giordano (2003). We conclude this discussion by suggesting an integra- tive approach to adolescent sexuality development and research.

THREE AREAS OF RESEARCH

Empirical research that has explored the idea of normative adolescent sexuality development is or- ganized into three main areas in this review. First, we report on research reflecting new views on sexual behavior, including research on adolescent sexual repertoires, nonprocreative sexual behavior, and virginity as a ‘‘new’’ sexual behavior. Second, we cover the empirical developments in sexual selfhood, which includes aspects of sexual subjectivity, iden- tity, and gender as well as the development of a self who imagines him/herself (in the present or the fu- ture) as having intimate relationships and/or expe- riencing sexual pleasure. Third, we discuss the empirical research on sexual socialization in the 21st century, presenting research that has examined the social contexts in which adolescents learn about sex and about how to be sexual individuals. This work stands in contrast to studies that seek to identify negative social influencesFa major interest in the last 10 years, especially with the advent of new technologies. We discuss the various ways that re- searchers have approached this question of social- ization within families and peers as well as relational and nonrelational contexts of sexuality.

NEW PERSPECTIVES ON SEXUAL BEHAVIORS

What constitutes a sexual behavior? The last decade saw this question driving research in adolescent sexuality, pressing for interrogation of what ‘‘counts’’ as sex by teens and in research settings (Sanders et al., 2010). Research in the last decade reflects a growing recognition that sexual behaviors include a range of possible activities, leading to the in- creased need to be precise when referring to sexual behaviors. For example, ‘‘penile-vaginal intercourse’’ (PVI) has emerged as a specific term as other forms of intercourse (oral and anal) are recognized with their own unique questions and concerns. While much of this review covers heterosexual intercourse behaviors, in part, because of a continuing heterosexist bias in behavioral research on adolescent sexuality, studies that focus exclusively on same-sex sexual behavior are reviewed elsewhere in this issue (Saewyc, 2011). What unites this body of research on sexual behav- iors is a growing interest in documenting the psy- chological and developmental dimensions of sexual

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behaviors rather than assuming that adolescent sex- ual behavior is a route to psychological and physical damage.

In the last decade, oral sex has been acknowl- edged as part of what Fortenberry and colleagues have called adolescents’ ‘‘sexual repertoires’’ (e.g., Hensel, Fortenberry, & Orr, 2008), that is, the range of behaviors about which they develop knowledge and make choicesFan idea first suggested by Smith and Udry in 1985 but elaborated only in the last decade. There has been an emerging body of knowledge about oral sex, picking up where Newcomer and UATUdry (1985) left off in their long-standing study published over 20 years ago. Adolescents’ perceptions of oral sex, especially whether they consider it sex, have been a focus of study (McKay, 2004; Prinstein, Meade, & Cohen, 2003). Halpern-Felsher, Cornell, Kropp, and Tschann (2005) found that relative to vaginal intercourse, young people perceived oral sex to be less risky, more acceptable, less of a threat to their beliefs, more likely for them, and that a greater number of their peers have had it than vaginal sex. Brady and Halpern-Felsher (2007) found in a longitudinal study of early adolescents that those engaging in oral sex only versus both oral and vag- inal intercourse were less likely to become pregnant or have an STI, feel guilty or used, have their rela- tionship become worse or get in trouble with their parents about sex.

At the beginning of the decade, concern that girls may be providing oral sex to boys as a way to ‘‘stay abstinent,’’ that is, to avoid PVI, may have been driving the emergent study of oral sex (e.g., Remez, 2000). However, this pattern has not been found. Hensel et al. (2008) tracked sexual behaviors among primarily African American adolescents using sex- ual diaries to identify sexual trajectories and how oral sex fit into them. They found that oral sex oc- curred before, simultaneously, or concurrent with intercourse rather than as a substitute. What has been shown as a new trend among adolescents in regards to oral sex seems to be about expectations. For example, some research indicates that oral sex is less of a ‘‘choice’’ behavior and more of an expected behavior, especially fellatio. For example, Kaestle (2009) found that in Wave 3 of the Add Health study, a greater proportion of young women versus men had engaged repeatedly in sexual activities they disliked (12% vs. 3%) and were more likely than men to report repeated participation in these activities (odds ratio, 3.7), primarily fellatio and anal sex.

Other studies have found differential associations for oral sex versus vaginal sex among adolescents, including parental communication and behavior-

specific normative beliefs (Bersamin, Walker, Fisher, & Grube, 2006). Bay-Cheng, Robinson, and Zucker (2009) found in retrospective reports by college wo- men on heterosexual experiences in adolescence that compared with intercourse, erotic touching, manual stimulation, and fellatio were less predictive of young women’s subjective perceptions of desire, wanting, and pleasure.

More recently, research has examined the role and expectations surrounding anal sex. Lescano et al. (2009) found that among 1,348 ‘‘at-risk’’ 15 – 21-year- olds in three cities, 16% reported recent anal sex. For males only, sexual orientation related to recent het- erosexual anal sex; for females, variables associated with power imbalances in sexual encounters and relationships were identified. In a study of African American young women, DiClemente et al. (2009) found that those who reported anal intercourse (10%) had elevated overall sexual risk behavior.

A new ‘‘sexual behavior’’ that emerged for study in the last decade was virginity; that is, the active choice to not engage in sexual behavior. While im- plicitly assumed a positive moment in sexuality development, research about virginity has shown that it can lead to a variety of consequences. This is evident in studies of sexual trajectories of ‘‘pledgers’’ (Thomas, 2009) versus those who ‘‘left’’ abstinence (Blinn-Pike, Berger, Hewett, & Oleson, 2004) and characteristics of those who postponed sexual initia- tion (Gray et al., 2008) or retracted pledges (Rose- nbaum, 2006). Studies of ‘‘primary’’ and ‘‘secondary’’ abstinence or being a ‘‘reborn virgin’’ identified what differentiates these groups. For instance, Loewenson, Ireland, and Resnick (2004) found that among males, ‘‘secondary’’ virgins were more likely to have caused a pregnancy.

Adolescents themselves do not consider absti- nence and sexual activity to be opposing constructs, such that positive abstinence attitudes and intentions may not have robust effects in preventing sexual activity (Masters, Beadnell, Morrison, Hoppe, & Gillmore, 2008). Woody, Russel, D’Souza, and Woody (2000), in study of 18 – 21-year-olds, found that noncoital sex was common among both virgins and nonvirgins, with ‘‘total abstainers’’ having had fewer opportunities for sexual activity, and half of those who reported having ‘‘c[o]me close to intercourse [pvi]’’ also reported proceeding with noncoital sex. Among the ‘‘intercourse’’ group, sig- nificantly more females than males reported less positive emotional reaction, poorer outcomes, and a lower evaluation of their decision than did males. Framing abstinence as an important behavioral strategy, Santelli et al. (2006) argued that abstinence

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as the ‘‘sole option’’ for healthy sexual behavior in adolescence is ethically as well as scientifically problematic.

SEXUAL SELFHOOD

In the last decade, a body of knowledge about the sexual motivations and sexual desire of adolescent girls and women has emerged and quickly grown. This interest in young female sexuality has roots in the larger feminist project of reclaiming female sex- uality (Fine, 1988; Vance, 1984). This body of work largely constituted the early roots in describing ad- olescent sexuality as a normative process that is af- fected by sociopolitical and biological changes (Tolman & Diamond, 2001).

Tolman’s (2002) research on adolescent girls’ ex- periences of sexual desire identified a complicated landscape of social, material, and personal dilemmas that characterized girls’ diverse experiences negoti- ating their sexuality. This research laid the ground- work for new questions about female adolescent sexuality that were explored quantitatively as well as qualitatively and using mixed methods. An innova- tive direction in the past decade has been a new body of research on the development of a sexual self-con- cept (O’Sullivan, Meyer-Bahlburg, & McKeague, 2006) and sexual subjectivity (Horne & Zimmer- Gembeck, 2005, 2006). Researchers working with these concepts have investigated the relationships between sexual identity formation, sexual decision making, and sexual behaviors and outcomes. For ex- ample, O’Sullivan et al. (2006) found associations between sexual self-concept and early adolescent girls’ intentions to engage in intercourse and orien- tation to engage in sex in the near future. Others have investigated how sexual subjectivityFdefined as having a sense of entitlement to sexual pleasure and sexual safetyFinteracted with intraindividual and psychological well-being (e.g., Impett & Tolman, 2006; Phillips, 2000). The development of the Female Sexual Subjectivity Inventory enabled Horne and Zimmer- Gembeck (2006) to find that among adolescent girls, sexual subjectivity was associated with self-esteem and resistance to sexual double standards.

In the field of sexuality development, and sexual identity more specifically, one of the major shifts over the past decade has been the reconsideration of sexual orientation development for the cohort born in the 1990s. Savin-Williams (2005) and Diamond (2008) have articulated the shifting and often unsta- ble nature of sexual identification for adolescents. Both have studied self-identification processes in young people, how these identities relate to same-

and different-sex sexual behaviors, and how they change over time. Other researchers have taken up these same questions and replicated Savin-Williams and Diamond’s critical stance on assuming a linear process (e.g., Friedman et al., 2004). The past decade has seen a paradigmatic shift from conceptualizing a ‘‘gay teen’’ to a more nuanced discussion of ‘‘sexual minority youth,’’ an extremely diverse group who may at times adopt a gay, lesbian, bisexual, or no specific sexual identity, may be actively questioning their identity, may engage in same-sex sexual activ- ities, and/or may report same-sex attractions (Cohler & Hammack, 2006). Alternatively, Russell, Clarke, and Clary (2009) found that the labels of gay, lesbian, and bisexual remained relevant for contemporary adolescents and that this cohort was not in fact ‘‘postgay’’ as some had speculated. Still others have found that difficulties in developing an ‘‘integrated LGB identity’’ led to poor psychological adjustment and sexual risk taking (Rosario, Scrimshaw, & Hunter, 2009). These questions about identity have not been solely rooted in questions of sexual or psychological risk due to an LGBT identity but in the larger question of how young people become gendered and develop sexual identities.

One of the most important shifts seen in the previous decade has been around conceptualizing psychological motives for sexual activity and rela- tionships among adolescents. Defining adolescents as capable of positively motivated sexuality has contributed to an upsurge of research on adolescents as a whole, beyond a particular focus on girls and young women. Across all adolescents, there has been interest in active decision making about having sex, having sex early (usually considered before age 16), and having sex for the first time (L’Engle, Brown, & Kenneavy, 2006; Woody, D’Souza, & Russel, 2003) as part of a more expansive developmental process. Each of these areas of research places sexual decision making in the hands of young people rather than identifying and evaluating negative influences on them and sets out to understand this process from the perspective of young people themselves (e.g., Michels, Kropp, Eyre, & Halpern-Felsher, 2005). This body of research has developed a new image of the young person who is making dynamic decisions re- garding his or her sexuality.

In a study done by Dawson, Shih, de Moor, & Shrier (2008), the authors used daily diary methods to assess the range of reasons why adolescents had sex and found a number of associations between psychological well-being and the reasons stated by the young people; for example, female youth with higher impulsivity ratings reported that their moti-

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vations were less driven by intimacy/desire reasons. Similarly, Robinson, Holmbeck, and Paikoff, (2007) found that among their sample of African American adolescents, males were more likely to report self- esteem enhancement as a reason for having sex, and for those who sought self-esteem through sex, there was also less consistent condom use. There is cur- rently a dearth of research on these decision pro- cesses for LGBT adolescents, who are not often framed as motivated toward sexual activity by any- thing other than their sexual identity (see Saewyc, 2011). Another example is a study by Impett and Tolman (2006), in which they assessed late adoles- cent girls’ motives for engaging in sex and their level of sexual satisfaction with their most recent sexual experience. Using sexual self-concept to operation- alize sexual subjectivity, the authors found that those young women (ages 16 – 19) who reported higher rates of sexual self-concept and greater approach (positive) versus avoidance (negative) motives also reported greater sexual satisfaction.

SEXUAL SOCIALIZATION IN THE 21st CENTURY

The contexts which impact adolescent sexual risk have been operationalized in various ways, including the role of neighborhoods (Averett, Rees, & Argys, 2002), parental communication (Miller & Whitaker, 2000), religion (Manlove, Logan, Moore, & Ikramul- lah, 2008), and the overall developing recognition of the role of culture as a shaping factor. Understanding adolescent sexuality experiences and processes in context is consistent with the emergence of the per- spective across the study of adolescence in the last decade that development is a highly social pro- cessFeven biological processes do not occur in a vacuum (Collins, 2003; Russell, 2005a)Fopening the larger question of what helps to create an optimal result, not only what ruins a life or stops bad things from happening.

Peers and Sexual Socialization

The role of peers in socializing young people in sexual norms, attitudes, and behaviors is considered an effect of an assumed normative developmental process of adolescents’ shift away from families and toward peers, but the types and range of the role of peers are not yet well understood. Peer networks have, over the last decade, been examined as a complex method of socialization shaping sexuality development through a number of mediating mechanisms. A line of research that has persisted

into this decade is how perceived peer sexual experience has been found to be influential in adolescents’ sexual decision making (e.g., Santelli et al., 2004). Bearman, Moody, and Stovel (2004) examined the structure of adolescent romantic and sexual networks in a sample of more than 800 ad- olescents from the Add Health study to identify the micromechanisms of social networks (i.e., the rela- tionships and number of links between individuals in a group), leading to new models of STD trans- mission, sexual behavior influence, and communi- cation of social and sexual norms. They found that prior models of disease diffusion did not suffi- ciently account for temporal changes or the ante- cedents that preceded partner choice. They explained that the implications of their findings are that adolescents exist within networks that differ from adults’, and, as a result, their intimate and sexual choices hinge on ‘‘collective assessment of their personal choices’’ (Bearman, Moody, & Stovel, 2004, p. 79). By considering the characteristics of adolescent sexual relationships as deeply informed by social norms and peer scrutiny, the researchers were able to more accurately model the impact of peer partnerships and consider interventions that assume sexual networks for all adolescents rather than focusing on those who are considered ‘‘high risk.’’

In a significant study much discussed and often erroneously represented in public at the time of its publication, Bearman and Brückner (2001) examined the effect of social networks to track the impact of virginity pledges. Evaluating the effect of these pledges on the likelihood to transition to first sexual intercourse, they found that, initially, those who pledged abstinence were more likely to delay first intercourse. However, when they took the specifics of social group contexts into account, they found that pledging delayed intercourse only in contexts where there were some, but not too many, pledgers. Their interpretation was that the pledge worked in con- texts where group membership constituted an identity in the particular school context. Thus, to be effective, pledging had to be pervasive enough to constitute group membership, but not so pervasive that it was no longer a distinguishing characteristic (Bearman & Brückner, 2001). In a subsequent study they found that ‘‘promise-breakers,’’ pledgers who did not in fact wait until marriage for sex, were less likely than their peers to use contraception at first intercourse and just as likely, over time, to contract an STI (Brückner & Bearman, 2005). Together, these examinations of social networks mirrored a per- spective of adolescent sexuality that is not merely

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contaminated by peers but in process and consti- tuted by interactions, which both help and hinder its healthy development.

Hooking Up

Increasingly, people are wondering whether teens are hooking up (i.e., having sex outside of relational con- texts). This question holds an implicit acknowledge- ment that there is a social contract about what is an expected or appropriate context in which adolescents might express sexuality: ‘‘monogamous-enough’’ re- lationships. A new concern, especially for girls, is expressing sexuality without a relational ‘‘net’’ (i.e., Shalit, 2007). Yet despite the public discourse sug- gesting a widespread phenomenon among adoles- cents, the small body of research on the topic challenges this public impression and demonstrates that the term ‘‘hooking up’’ as used by adolescents of varying ages is itself a moving target.

Manning, Giordano, and Longmore (2006) found that while half of sexually active teens had sexual partners they were not dating, those having sex out- side of relationships were partnering with friends or ‘‘exes.’’ One third of these hook ups were associated with hopes or expectations that a relationship would ultimately ensue. The authors concluded that rather than painting sex outside relationships as bad or negative, a more nuanced set of questions is required about the function of ‘‘hooking up.’’ Kaestle and Halpern (2005) compared sexual activity among adolescents in romantic relationships with friends, acquaintances, or strangers. Knowing a ‘‘hook up’’ partner as friend versus an acquaintance was protec- tive against sexual intercourse for males and females; for females, sexually active relationships with partners they had not known romantically were less likely to include discussions of STIs or contraception and less likely to use consistent birth control, while prero- mantic social ties did not play a statistically significant role for outcomes with males (see also McCarthy & Casey, 2008). Korobov (2006), in a study of nonrela- tional male sexuality, found that it was a resource for boys in constructing masculine identities.

Romantic Relationships and Sexuality

Before the last decade, adolescent romantic rela- tionships were recognized only implicitly as sites for risky or dangerous (heterosexual) behaviorFmostly theorized as a predictor of negative sexual outcomes (Nathanson, 1991). While research on adolescent romantic relationships as a normative dimension of adolescent development has emerged (e.g., Furman,

Brown, & Feiring, 1999), this field has only recently addressed questions of sex and sexuality within the contexts of adolescent romantic relationships (Bou- chey & Furman, 2003; Collins et al., 2009; Florsheim, 2003). There were several investigations of romantic relationships as a potentially positive, protective, and expected feature of adolescent sexuality in the last decade (Risman & Schwartz, 2002; Rostosky, Galliher, Welsh, & Kawaguchi, 2000). For example, Welsh, Haugen, Widman, Darling, and Grello (2005) fol- lowed 21 male/female couples (14 – 21 years old) who were dating for a minimum of 4 weeks. They found that kissing and desiring a romantic partner corre- lated positively to relationship satisfaction and com- mitment, as well as variations in associations between sexual intercourse and relationship qualities by age, whereby being younger was negatively associated with frequency of intercourse and relationship qual- ity. Gender did not moderate the link between sexual behavior and relationship quality.

One study addressed intimacy in adolescent ro- mantic relationships and evaluated it as a possible ‘‘positive motivation’’ for sexual behavior. Ott, Mil- stein, Ofner, and Halpern-Felsher (2006) evaluated adolescents’ goals for intimacy, sexual pleasure, and social status within a romantic relationship, as well as their expectations that sex would lead to these goals. Among ninth graders, they found that intimacy was valued the most, then status, then pleasure. Girls valued intimacy significantly more and pleasure sig- nificantly less than boys, while those with more sex- ual experience valued both intimacy and pleasure more than those who were sexually inexperienced. Sexually experienced girls (but not boys) valued so- cial status less than those with no sexual experience. Girls and sexually inexperienced adolescents had lower expectations that sex would meet their goals than did males and sexually experienced adolescents.

Media and Sexual Socialization

The media has long been a potent source of sexuality information for young people and feared as a quasi- or even replacement for parental influence. Before the last decade, ‘‘media’’ had been operationalized primarily as music and music videos, television, and movies. As media formats changed over the last decade, newer interactive forums available on the Internet, including social networking sites and chat rooms, have been studied (i.e., Wolak, Finkelhor, Mitchell, & Ybarra, 2008). The influence of violent imagery in a range of media (movies, video games), and in the last decade especially, media culture’s increasing sexualization of

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young girls have been primary questions for adoles- cent sexuality development.

Like all media impact research, studies evaluating the effects of seeing sexual media are plagued by a ‘‘chicken or egg’’ challengeFare adolescents who watch sexual media more ‘‘sexual’’ to begin with and thus drawn to it, or are they curious or uninten- tionally exposed and thus imposed upon by it (Brown, 2002)? Consonant with the overall move in developmental research to apprehend young people not as ‘‘empty vessels’’ but as active, agentic con- sumers and producers of culture, research on media as sexual socializer expanded beyond studying iso- lated effects in the last decade. For instance, Brown (2002) developed the concept of the sexual media diet as part of a media ‘‘identity toolkit’’ that ado- lescents utilized to explore the self; she suggests that media can serve as a kind of sexual ‘‘super peer.’’ The presence of parents is one of the few moderating factors in associations between viewing sexual me- dia and sexual attitudes and to some extent behavior; however, as children become adolescents, they are much less likely to consume media with their par- ents (Schooler, Kim, & Sorsoli, 2006).

This decade witnessed an increasingly fine- grained analysis of the roles of gender, race, and class when assessing various media and sexual so- cialization (Ward, 2003; Ward, Hansbrough, & Walker, 2005). Researchers have found that media which convey traditional gender roles are associated with endorsement of more traditional perspectives regarding male and female sexuality (Kim et al., 2007; Rivadeneyra & Lebo, 2008; Ward et al., 2005). The research has found associations between non- behavioral negative sexual outcomes (endorsement of coercion in heterosexual relationships, negative attitudes about sex, and the potential for mutuality in sexual relationships) and media images reflecting scripts in traditional gendered relational practices. With increasing availability of pornography on the Internet, the question of whether porn inflates or creates vulnerability to engaging in or experiencing unwanted sex has been considered. In one study of adolescents aged 14 – 19, ‘‘active’’ and ‘‘passive’’ sexual violence and unwanted sex and porn were correlated with reading porn more strongly linked to active sexual violence, while being a boy was found to be protective against passive sexual violence, and some effects of viewing porn on passive unwanted sex were also found among girls (Bonino, Ciairano, Rabaglietti, & Cattelino, 2006).

Media researchers in this last decade also exam- ined how media can support young people’s sexu- ality development (Bay-Cheng, 2001; Bay-Cheng,

et al., 2009; Ward & Friedman, 2006). Analyses of on- line environments documented processes adoles- cents use to search out peers, ask questions about sexual topics, and construct sexual identities (Suzuki & Calzo, 2004). For example, in their analysis of teen chat rooms, Subrahmanyam, Greenfield, and Tynes (2004) found that online spaces provided safer en- vironments than the teenage participants found elsewhere in their lives in which they learned to exchange information with peers and to explore their emerging sexuality.

THE NATIONAL LONGITUDINAL STUDY OF ADOLESCENT HEALTH

One of the most important resources for research in this area since 2000, the National Longitudinal Study of Adolescent Health (Add Health) has provided un- paralleled data on the lives of U.S. adolescents. In addition, this study provides evidence of the shift from an exclusive focus on sexual risk and an emerging conception of sexuality development as normative that we have been discussing. Funded by NIH in 1994, Add Health (Harris, 2009) has been the source of hundreds of studies on adolescent sexuality. Because of its longitudinal and nationally representa- tive design, it is the largest study of its kind. Currently in its fourth wave of data collection, the study includes a series of detailed questions concerning sexual be- haviors and outcomes; thus, it offers the opportunity to test models that have high explanatory power, even for subsamples that are overlooked or hard to evaluate in smaller studies. Here we consider the intersection of Add Health and this emergent perspective on ado- lescent sexuality development.

Primarily, the design of Add Health has made possible more robust study of sexual risk (i.e., preg- nancy and STD risk: Ryan, Franzetta, Manlove, & Schelar, 2008; condom use: Santelli, Lindberg, Abma, McNeely, & Resnick, 2000; and intimate partner violence: Whitaker, Haileyesus, Swahn, & Saltzman, 2007). Yet some questions about sexuality that were not solely grounded in a risk perspective have been investigated, for example, the relationship between love and sexual activities (Kaestle & Halpern, 2007). Some researchers using Add Health data have been able to demonstrate that associations between de- mographic characteristics and negative sexual out- comes are not uniformly causal and have identified, instead, possible trajectories of adolescent sexuality development. For example, Spriggs and Halpern (2008) examined three waves of data from Add Health, observing the relationship between age of sexual debut and depression. While they found that

ADOLESCENT SEXUALITY 249

depressive symptoms were associated with earlier sexual debut among female adolescents, this rela- tionship did not hold for either males or for females as the sample aged into emerging adulthood. Simi- larly, McGee and Williams (2000) examined whether low self-esteem predicted ‘‘health compromising’’ behaviors in a sample of 9 – 13-year-olds but found no relationship between self-esteem and early sexual activity.

In an extensive study using Add health data (O’Sullivan, Cheng, Harris, & Brooks-Gunn, 2007), researchers compared trajectories of social, romantic, and sexual events within adolescent relationships among White, Asian, Hispanic, and Black 12 – 21- year-olds. They found that social and romantic events were far more common than, and preceded, sexual events; Asians and Hispanics provided lower rates of sexual events compared with Whites and Blacks. Santelli, Lowry, Brener, and Robin (2000) of- fered an important new approach to the study of these ‘‘key determinants’’ by demonstrating that factors other than socioeconomic status and race/ ethnicity have more potent predictive power when examined within the full spectrum of possible pre- dictors using Add Health.

The ability as well as the interest on the part of investigators to use the Add Health data to examine sexual outcomes apart from risk-based assessments has, unfortunately, been limited. Because of ideologi- cal and political ‘‘squeamishness about . . . adolescent romance and sexual behaviors’’ (Collins, 2003, p. 3), there is a paucity of information in the Add Health data set for posing research questions about norma- tive adolescent sexuality framed to include potentially positive processes rather than exclusively as averting negative ones. Yet there has been a small body of re- search examining sexuality development questions and what researchers have referred to as ‘‘positive’’ sexual outcomes. In 2005, Dennison and Russell ar- gued that the Add Health data can and should be used to increase our understanding of positive sex- ual[ity] development; that is, adolescent sexuality must not only be framed in terms of risk and danger but must include qualities of sexual well-being, in- cluding entitlement to pleasure, efficacy in achieving pleasure, and subjective experiences of enjoyment (Diamond, 2006; Russell, 2005a, 2005b; Wight et al., 2008). Kaestle and Halpern (2007), for example, ex- amined the role of emotional commitment in the types of sexual behaviors engaged in and found the degree of love (e.g., ‘‘a lot’’) was associated with specific sexual behaviors (e.g., increased rates of anal sex).

In sum, this large study of adolescents as they age from the seventh grade into adulthood has produced

tremendous insight into the sexuality development of young people, challenged long-held beliefs about the negative consequences of sexual experience, en- abled researchers to develop contextual models which allow for greater understanding of how ado- lescents are influenced by and influence one another, and ultimately highlight the areas of knowledge that deserve greater understanding, such as how young people evaluate the quality of their sexual experi- ences and how these appraisals and early experi- ences influence adulthood sexual and romantic relationships with partners.

CONCLUSION

For this review, we identified the emergence of normative adolescent sexuality as a conceptual framework in the empirical research on adolescence. We characterized this development as the significant departure and new direction of the last decade. We predicated the focus of this review on the growing articulation of the importance of understanding ad- olescent sexuality not only in terms of sexual risks and how to avert them but also of querying what enables and challenges the expected development of healthy sexuality in adulthood, previously posi- tioned as ‘‘positive sexual development.’’ We have suggested that the development of a normative framework for addressing adolescent sexuality de- velopment has produced research questions and methods with an eye toward recognizing the role of emergent sexuality as having potentially positive consequences and ultimately to increasing support for young people as they find their way as devel- oping sexual beings. While research on youth has continued to focus primarily on sexual behaviors, even behavioral questions expand within a norma- tive framing of sexuality and its development in adolescence. This view joins an emerging discourse of adult sexual health that incorporates aspects of sexuality beyond reproductive health and sexual function that continues to develop for adult men and women, reflected in a plethora of questions about sexuality beyond behavior and risk that are ex- panding into the study of adolescents (see Diamond & Savin-Williams, 2009).

We suggest pushing the calls for ‘‘positive’’ ado- lescent sexuality one step further. Calls for consider- ation of positive sexual development have constituted a move away from the pervasive problematizing of sexuality in terms of risk; however, this history has yielded an implicit binary of sexual risk and sexual possibility. While studies framing adolescent sexuality as ‘‘positive’’ diligently note, but do not necessarily

250 TOLMAN AND McCLELLAND

investigate, the risks associated with adolescent sex- uality, researchers continue to straddle this binary. We suggest a more explicit integration of these two di- mensions that incorporates both positive aspects and risk management and how they develop in tandem or dialectically at the individual, relational, and cultural levels into the overarching concept of sexuality de- velopment in adolescence. This ‘‘final’’ step will pro- vide a more comprehensive framework from which researchers can and should work without having to navigate the either/or binary of risky and positive outcomes. While we acknowledge the limits of ‘‘normative’’ due its potentially moralistic tones and implications of nonnormative, we believe its associa- tion with ‘‘expected’’Flinked with the increasing acknowledgement of diversity in so many realms of sexualityFsignals that part of adolescence is the very broad task of navigating how to become a healthy sexual adult.

We have fronted a relatively small body of the last decade’s research on adolescent sexuality; it remains the case that a great deal of research in this area is organized around assumptions that adolescent sex- ual risk should be the focus of inquiry and inter- vention. Researchers are not immune to social, funding, and professional pressures and are still of- ten asked by peer reviewers (and even sometimes required) to limit their research questions to those involving sexual risk assessment (Collins, 2003; Gardner & Wilcox, 1993). We are hopeful that iden- tifying that there is a critical mass of research on normative adolescent sexuality development will encourage researchers to ask the questions that emerge from this perspective. These might include questions about the intersections between sexual experience, the relational contexts in which those occur, and the individual biopsychosocial charac- teristics that make possible or challenge trajectories toward healthy sexuality in adulthood; about what boys’ experiences of sexuality and relationships are across adolescence; about how the sexualization of girls impacts adolescent sexuality development for both girls and boys; about how diverse adolescents balance positive possibilities and consequences with management of various forms of risk; and, at the cutting edge, about what newer notions about ado- lescent sexuality such as ‘‘entitlement’’ and ‘‘agency’’ are required as social contexts change more rapidly than ever before (Lamb, 2010).

We also argue that this integrative framework is necessary as adolescent sexuality research continues to influence public policy and public discourse, in which managing risky sexuality has trumped the basic human right to experience sexuality free from

harms. In order to create social change that enables young people to develop into sexually healthy adults, it is necessary for our research questions and designs to incorporate the social contexts in which sexuality develops and recognize those conditions that enable sexuality as a positive dimension of our humanity (Correa & Petchesky, 1994).

In 2006, Fine and McClelland elaborated a set of enabling conditions for the development of adoles- cent sexuality and introduced the term ‘‘thick desire’’ as a way to capture the political, social, and em- bodied aspects of sexuality development. They ex- plained, ‘‘[a] framework of thick desire locates sexual well-being within structural contexts . . . in which [young people] are able to imagine themselves as sexual beings capable of pleasure and cautious about danger’’ (McClelland & Fine, 2008a, p. 244). Thick- ening the body of knowledge that provides the nu- anced information about how sexuality develops in adolescence will provide the fuel to expand public discourse and public policies aimed at managing adolescent sexuality development. It will be vital to amplify a normative perspective to challenge the sense of a dangerous ‘‘outside’’ world that has yiel- ded, in young people’s lives and in research about them, an increasing role of monitoring and surveil- lance on the part of parents, schools, and public policies. When theorizing and studying only danger and sexual risk, researchers implicitly convey the notion that no one is paying attention and that with increased attention, young people would be safer (and less sexual). Thus, the normative paradigm that has taken root can provide not only important new information but a new stance toward young people in public discourse and policy making.

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