Abstract
Adolescent Sexual Decision Making:
At the Intersection of Health Beliefs and Gender Ideals
This work offers an examination of the sexual decision making of adolescents. Specifically, this research seeks to understand the factors that prevent adolescents from consistently acting to protect themselves from unwanted pregnancy and sexually transmitted diseases. Borrowing the Health Belief Model from the public health literature, I consider the role of health beliefs (e.g., feeling susceptible to pregnancy or STDs) in predicting preventive health behaviors, such as the use of birth control. The social performance of gender is also highly salient in the decisions adolescents make regarding sex. I argue that the desire to conform to traditional ideals of femininity and masculinity often results in sexual decision making that puts adolescent health at risk. Health beliefs and gender ideals thus represent two competing forces that adolescents must balance in making decisions about their sexual behavior. To understand the balance of health beliefs and gender ideals in adolescent sexual decision-making, I first conducted interviews with a sample of 25 adolescents. I explored adolescents' experiences with school-based sex education, discussions with parents about sex, views of sexuality in the media, and the influence of peers in sexual decision making. I then undertook a statistical analysis of the National Longitudinal Study of Adolescent Health to determine how the Health Belief Model is modified by the inclusion of gender, cues to action (representing sources of gender socialization), and gender ideals. I used this modified Health Belief Model to examine sexual abstinence, the timing of the transition to sexual intercourse, having engaged in non-romantic sexual intercourse, and the use of birth control at first and most recent intercourse. My statistical results confirm that the Health Belief Model is modified by gender, as different health beliefs are significant predictors for females' and males' behavior. In addition, many of the cues to action operate differently by gender; for example, exposure to media increases the sexual risk behavior of young men, while school-based sex education generally reduces young women's sexual risk behavior. Adherence to gender ideals is also strongly associated with sexual risk behavior, confirming the hypothesis that both health beliefs and gender ideals shape adolescent sexual decision making.
