Adolescent sexual debut and depressive symptoms in emerging adulthood

BACKGROUND: One rationale for current U.S. adolescent reproductive health policy is that premarital sexual debut, especially during adolescence, causes psychological harm. However, relevant data are limited in quantity and quality. Knowledge of longer-term psychological outcomes of adolescent sexual debut may enlighten this debate. METHODS: This study included persons who participated in Waves I and III of the National Longitudinal Study of Adolescent Health, who had not debuted before Wave I, and were age 18-22 at Wave III (n=5,299). Self-reported age at sexual debut was categorized as early adolescent (<16), typical adolescent (16 to 18), or post-adolescent (>18 and Wave III virgins). Participants self-reported frequency of feeling depressed in the prior week. Descriptive, bivariate, and multivariable logistic regression analyses stratified by gender were performed in Stata 9 using survey commands. RESULTS: Eighteen percent of youth initiated sexual intercourse early in adolescence, 50% experienced typical debut timing, and 32% did not debut in adolescence. Bivariate analyses revealed females with early and typical adolescent debut were significantly more likely to report Wave III depressive feelings than those with post-adolescent debut; for males, debut timing was unrelated to depressive feelings. In multivariate models controlling for age, race, adolescent family structure, parent education, and pre-debut depression, the association between adolescent sexual debut and Wave III depressive feelings for females became insignificant. CONCLUSION: When pre-debut depression is accounted for, sexual debut during adolescence is unrelated to adult depressive feelings. Reproductive health policy based on claims of psychological harm caused by adolescent sexual debut should be reexamined.