Masturbation is common among U.S. adolescents, although a larger proportion of males than of females masturbate, according to analyses of data from a national survey of 14–17-year-olds.1 Additionally, males and females who masturbate have higher odds than those who do not of engaging in sexual activity with a partner, although only males who masturbate have elevated odds of using a condom during intercourse. Overall, 74% of males and 48% of females reported ever having masturbated. Their odds of reporting partnered sexual behaviors were about 4–5 times those of other adolescents (odds ratios, 4.2 for males and 4.5 for females); males who masturbated had higher odds than other males of using a condom (8.5).
These findings come from analyses of data from the 2009 National Survey of Sexual Health and Behavior, a population-based, cross-sectional study, to assess adolescents’ solo and partnered sexual behaviors. Investigators obtained the data from online questionnaires administered to a nationally representative sample of randomly selected teenagers from March to May of 2009. Demographic data were stratified and weighted to reflect population-based estimates.
Participants were asked about their history of masturbation, defined as having "stimulated your body for sexual pleasure, whether or not you had an orgasm" (ever, during the past year and during the past three months), and about their sexual behavior with a partner (oral, vaginal and anal sex) during the past year. Participants also were asked which partnered sexual experience had been their most recent; if they answered vaginal or anal intercourse, they were asked if they had used a condom.
A total of 820 adolescents participated: 414 males and 406 females. Ninety-three percent described themselves as heterosexual; 47% of males and 46% of females were in a romantic relationship at the time of the survey.
Higher proportions of males than of females had masturbated ever (74% vs. 48%) and in the past 90 days (58% vs. 36%). Moreover, males had masturbated more frequently than females during the past year: Forty-nine percent reported having masturbated at least twice a week, compared with 23% of females. Among both genders, the proportions who ever had masturbated increased with age: Sixty-three percent of males and 43% of females aged 14 ever had masturbated, compared with 80% and 58%, respectively, of 17-year-olds. However, age-related increases in the prevalence of recent masturbation occurred only among males.
In logistic regression analyses with adjustments for partner status and age, masturbation in the past year was positively associated with the likelihood of sexual behavior requiring a partner (odds ratios, 4.2 for males and 4.5 for females). Those who masturbated had increased odds of having engaged in vaginal intercourse (4.3 and 2.1), given oral sex (4.1 and 5.5) and received oral sex (3.0 and 3.2). Females who had masturbated in the past year also had elevated odds of having engaged in partnered masturbation (8.4) and anal intercourse (14.0). However, the odds for condom use among those whose last sexual encounter included vaginal sex were elevated only for males who had masturbated (8.5).
The investigators note some study limitations. The findings do not explore reasons for adolescent masturbation or how it may inform adolescent sexuality and sexual development. The youngest participants were aged 14, and a more complete picture of masturbation will require data from younger ages. Moreover, interpretations of the definition of masturbation may vary among males and females according to how they experience sexual pleasure. Finally, the study may reveal a volunteer bias, since adolescents whose parents permitted their participation in the study may differ from those whose parents did not.
Nevertheless, the investigators conclude that the high prevalence of masturbation and its relationship to other sexual behaviors highlights its importance in adolescent sexuality. Noting the stigma of masturbation, the investigators underscore the need for health care providers to incorporate education about it into adolescent patient care.—A. Kott