A Changing Picture of Teen Sexuality Puts UW Study on JAH’s Distinguished Dozen

Teenage sexuality in the United States is shifting. A study by University of Washington Department of Epidemiology PhD candidate Kendall Lawley and colleagues at UW and the Centers for Disease Control and Prevention (CDC) titled “Trends in Sex of Sex Partners and Sexual Identity Among US Adolescents, 2015–2021,” (CDC) tracks the shifts in both sexual identity and sexual behavior among American high schoolers. The paper was recently selected for the Journal of Adolescent Health’s (JAH) annual Distinguished Dozen, a list compiled each year by the journal’s editors to spotlight twelve studies they consider essential reading in the field of adolescent health. 

The study draws on data from the Youth Risk Behavior Survey (YRBS), a nationally representative, biannual CDC survey administered to students in grades 9–12 that tracks a broad range of health behaviors and experiences. Lawley and her co-authors analyzed four waves of YRBS data spanning 2015 to 2021, encompassing more than 61,000 students. Their aim was to examine trends over time in the difference between who teenagers say they are and who they’re actually having sexual contact with. Adolescence is a period of active identity formation, and it is not unusual for behavior and self-understanding to be out of sync during that process. A teenager may engage in same-sex sexual contact before identifying as gay or bisexual, or identify as a sexual minority while having only opposite-sex partners. Capturing both dimensions, rather than treating one as a proxy for the other, is what makes the study’s approach distinct. 

“What surprised me most is that some of our findings seemed to contradict some of the existing literature,” Lawley says. Some results that differed from earlier reports included an increase in the proportion of male adolescents reporting same-sex sexual contact, and a decline in female adolescents reporting no sexual experience. Lawley attributes part of that divergence to the study’s scope: where much prior research has focused specifically on sexual intercourse, the 2025 study examined sexual contact more broadly, capturing a fuller picture of teenagers’ actual experiences.  

The scope of teenage sexuality can have bigger health implications because different types of sexual contact carry different risks, and programs built on incomplete data may leave some teenagers without information that would be most relevant to them. Either way, someone can fall through the gap. “Even if sexual intercourse might not be increasing among adolescents,” Lawley says, “an increase in other forms of sexual contact could still pose some risk for STI transmission, meaning that only asking about sexual intercourse might not provide a full picture of what’s going on for teens.”  

The study also found meaningful separation between how teens identify sexually and the sex of the partners they report having sexual contact with. This takeaway carries important implications for how sexual health education and policy are designed. “A primary takeaway from the study is that sexual identity and sexual behavior are not necessarily interchangeable constructs,” Lawley says. “Inclusive sex education is so important because we are seeing these differences between sexual identity and sexual contact for many adolescents. Young people can benefit from education around safer sex practices, regardless of sexual identity.” The findings of the study have parents, educators, and policymakers confronting an important question: What matters more, someone’s sexual identity or the behaviors they might engage in? The answer to this question can influence education polices and health interventions for adolescents.  

The findings also speak to broader shifts in how young people understand and express their identities. The data show patterns consistent with research indicating that LGBTQ+ youth are coming out at younger ages—evidence, Lawley hopes, of greater acceptance and space for self-discovery. “Adolescence is an important time for identity exploration,” she says, “and these findings might reflect that young people are more commonly given the space and freedom to be themselves now than in previous decades.” At the same time, the study found that male participants were more likely to have missing responses to the sexual contact question, a pattern that may reflect the greater social stigma attached to male same-sex behavior. 

Rather than waiting for teenagers to declare an identity before offering relevant health information, Lawley sees inclusive education as a baseline that serves young people wherever they are in their own process of self-discovery. “I hope for the opportunity for teens to have access to information that is relevant to them,” she says, “regardless of how they perceive their own identity, how other people perceive their identity, and who they may or may not be engaging in sexual contact with.”