Teen girls’ sexual orientation doesn't always match their sexual behavior

A survey coauthored by a UBC professor showed that, although lesbian and bisexual girls are more likely than straight girls to have female sexual partners, one in five lesbian girls and four in five bisexual girls reported that their most recent sexual partner was male.

Nearly 3,000 girls aged 13-18 in the United States were asked about their sexual orientation, what type of sex they are having, with whom and whether they talk to their partners about contraception as part of a recent study co-authored by UBC nursing professor Elizabeth Saewyc. In particular, the team of researchers sought to understand the sexual behaviours of lesbian, bisexual, queer and questioning girls. But researching sexual behaviour in adolescents isn’t easy.

The main sources of data on adolescent sexual behaviour are school-based health surveys that often don’t include enough questions about sex to give researchers a comprehensive picture. It’s difficult to even ask questions about sex in the first place.

We need to talk about what sexual and gender identity mean and what sex looks like for lots of different people.

— Michelle Ybarra, president of the Center for Innovative Public Health Research

“The biggest challenge is convincing adults that it's okay to ask kids questions like these,” said lead author Michelle Ybarra, president of the Center for Innovative Public Health Research in San Clemente, California. Saewyc agreed, pointing to how sex education in some places in the United States often consists of promoting abstinence while contraception or protection against STIs can be left out of the conversation. Moreover, people hold varied opinions on when the right time is to start teaching young people about sexual health. So asking questions about what adolescents know and do when it comes to sex can make adults uncomfortable, especially if they’re thinking “young people don’t need to know this yet or aren’t doing it yet.”

“A lot of young people aren't sexually active. But we need to know that,” said Saewyc. “But among those who are sexually active, what are their issues and what are their needs and how can we make sure that people have the education they need in advance of when they need it?”

That’s what this study, published in Journal of Adolescent Health, sought to understand.

With the results showing that lesbian and bisexual girls often have sex with male partners, the researchers noted that labels don't always match behaviour.

“It's really important to remember that sexual orientation labels are really about who you are attracted to and sometimes young people will have sexual behaviour that doesn't align with that for lots of reasons,” said Saewyc, explaining that girls may still be questioning their sexual orientation or feel pressured to be sexual with someone they may not be attracted to.

Ybarra stressed the need to make sex education more inclusive and expand it even beyond the technical aspects of protection and contraception. “We need to talk about what sexual and gender identity mean and what sex looks like for lots of different people,” said Ybarra.

We need to have sexual health education that's inclusive of everyone in the room so that we talk about birth control and barriers for all kinds of sex for all young people.

— Elizabeth Saewyc, UBC nursing professor

“We need to have sexual health education that's inclusive of everyone in the room so that we talk about birth control and barriers for all kinds of sex for all young people,” added Saewyc.

The survey also revealed that few girls discuss contraception and protection with their sexual partners. Only about a third of lesbian teens talked about using condoms or dental dams with their most recent sex partner, compared to almost two-thirds of bisexual teens and almost three-fourths of heterosexual teens.

Saewyc pointed to a common misconception about sex between girls that because there is no risk of pregnancy, there is no need to use barriers. They may forget that sexually transmitted infections are still a risk or they aren’t aware that some STIs can be symptomless, which means that people may be unknowingly sharing infections with their sexual partners.

As studies have shown that young adults are the group at highest risk of contracting STIs, Saewyc emphasized the importance of thorough and informative sex education that provides people of all sexual orientations with knowledge of the options they have. She said that teens also need to be taught about consent, sexual harassment and where how they can access help if they experience sexual harassment or violence.

That’s where studies like Saewyc and Ybarra’s come in — they are needed to understand whether teens are uninformed about certain aspects of their sexual health and how that affects their sexual behaviour. Thier research can help explain rates of sexually transmitted infections and unintended pregnancy.

“It's important for us to understand what are the behaviours that might be putting young people at risk for unintended pregnancy or sexual transmitted infections and how can we make sure they have the adequate information they need to make healthy decisions,” explained Saewyc.