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Most research on emerging adult sexuality has focused on narrow aspects of sexual health, primarily investigating the determinants of adverse sexual health consequences such as unintended pregnancy and sexually transmitted infections (STIs). However, individuals and their partners experience positive sexual health outcomes such as physical pleasure and intimacy that also define their sexual health. This dissertation applies a positive youth development (PYD) perspective to elucidate the adolescent contexts, attitudes, and behaviors that contribute to holistic sexual health in emerging adulthood (a period of increased independence and greater social acceptability of sexual exploration). I used data from the National Longitudinal Study of Adolescent to Adult Health to: 1) identify constructs of developmental assets during adolescence (grades 7-12) that align with PYD and examine sociodemographic differences, and 2) explore the implications of PYD for seven outcomes representing holistic physical, emotional, and social aspects of sexual health among emerging adults (ages 18-26). Four latent constructs of PYD—confidence, autonomy, parental bonds, and community bonds—captured the positive personal and contextual attributes of adolescence that contribute to healthy development. Different population subgroups of youth reported varying degrees or perceptions of these PYD assets. In longitudinal models, strong bonds with parents in adolescence were associated with increased reciprocity of love between partners, and with increased enjoyment of oral sex and reduced risk of unintended pregnancy (among females only) in emerging adulthood. Autonomy was also associated with increased enjoyment of oral sex among females in emerging adulthood. Among emerging adults in current relationships lasting 3 months or longer, community bonds in adolescence were also related to increased enjoyment of oral sex for females, and increased love for partner and relationship quality for both males and females. Findings support the importance of PYD, particularly positive bonds with parents, for holistic sexual health in emerging adulthood. Notably, this expands the range of well-being indicators linked to positive parent-child relationships. Results add to the literature by identifying the developmental assets that promote long-term sexual health, and also those that might be lacking for some youth, all to inform sexual health promotion efforts that work to enhance multidimensional aspects of well-being.

This study utilizes data from 18,392 respondents (aged 12–19) in Wave 1 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to provide a detailed descriptive analysis of U.S. adolescents’ desired behaviors in their ideal romantic relationships. Age, gender, and ethnic group differences in the desire for—and preferred sequence of—a set of activities that could occur in a hypothetical romantic relationship were explored within subsets of heterosexual (n=17,274) and sexual minority adolescents (n=1,118). Non-sexual behaviors were more commonly desired compared to sexual behaviors. The typical desired behavioral sequence was: holding hands, going out alone, telling others they were a couple, kissing, saying “I love you,” sexual touching, and finally having sex. Overall, more similarities than differences emerged across groups, with some notable differences in the percentages who desired sexual behaviors. Results provide a nuanced picture of adolescent relationship scripts, with implications for education and prevention.

Objectives: To determine if sequence of sexual initiation (i.e., initiating oral-genital, anal, or vaginal sex first) predicts subsequent levels of depressive symptoms. Methods: Data come from Waves I-IV of the National Longitudinal Study of Adolescent Health. Multiple linear regression models are used to assess the association between sexual initiation sequence and subsequent depression. Interactions between sequence of initiation and stressful life events (SLEs) are also examined. Results: In comparison to females who initiated vaginal sex first, as the number of SLEs increased, initiating anal sex first is associated with an increase of 2.65 in the number depressive symptoms (ranges from 0-27). Conclusions: Findings suggest that how adolescents begin their sexual lives may have important implications for mental health outcomes. Failure to include oral-genital and anal sex in studies of adolescent sexual behavior may undermine efforts to understand how patterns of early sexual behavior contribute to the high rates of depression among adolescents.