Parents who find a sex-based text on their teenager's phone should be on the lookout for other problems in their child's life, a new evidence review suggests.
Teens who share sexually explicit images are much more likely to be involved in other troubling activities, including unsafe sex, alcohol and drugs.
"The kids who are sexting are engaging in a lot of other risky behaviours," said senior researcher Sheri Madigan, a child development expert from the University of Calgary in Alberta, Canada.
"We found that youths who were sexting were approximately four times more likely to be also engaging in sexual intercourse, five times more likely to have multiple sexual partners, and half as likely to be using contraception," she continued.
Also, sexting teens were:
- Twice as likely to have symptoms of depression and anxiety.
- Two and a half times more likely to be smoking or engaging in delinquent behaviours like stealing or vandalism.
- More than three times as likely to be using alcohol or drugs.
But the findings are particularly troubling in light of a 2018 study led by Madigan that found one out of four teens is receiving sexts, and one out of seven is sending them.
Other risky behaviours
Results from the new review line up with what is already known about teens and sexting, said Sameer Hinduja, co-director of the Cyberbullying Research Center at Florida Atlantic University.
"Many risky behaviours among youth tend to occur in a constellation," he said. "If a teen experiments with one risky behaviour, that teen typically has experience with other risky behaviours."
For this study, Madigan and her colleagues collected and combined data from 23 previous studies on sexting, involving nearly 42 000 teenagers.
They found significant links between sexting and sexual activity, risky sexual behaviour, symptoms of mood disorders, drug and alcohol use, smoking and delinquency.
Further, they found that associations between sexting and either sexual behaviour or mood disorders were stronger in younger adolescents, compared to those in their later teens.
It's not clear whether sexting leads to these behaviours, or whether kids inclined to take risks are also more likely to sext, the researchers added. They noted the findings could not prove causation; it only showed an association.
What parents should do
It's very possible that sexting is a gateway that could lead to more experimentation with sex, Madigan said.
"I think sometimes sexting is an initiation into greater sexual behaviour," she said. "Sometimes kids use sexting as a starting point. People have called it the modern-day version of flirting."
But other research also has found that when teens are sexting within the confines of a committed relationship, they are not more likely to be engaging in substance abuse and other risk-taking activities, Madigan added.
Those associations are more often found in "youth who are sexting as a method of flirting or sexting in a more casual way", she said.
So what should parents do?
Hazing and cyberbullying expert Susan Lipkins said the "pat answer" is to remind children that anything they share over the internet is out of their control and could be used against them.
Kids will do what they want
Parents should start teaching their kids about privacy and consent as early as possible, even before they have a phone, she and Madigan advised.
Such conversations should include discussion of "what-if" scenarios, Madigan said: What if someone sends you a photo? What if you're asked to send a nude of yourself? What if someone tries to coerce you into sexting? What if you share a nude with a boyfriend or girlfriend and then you break up?
"But the truth is, the kids will learn all that, they will memorise it and repeat it back to you, and then they will do whatever they want," said Lipkins, a psychologist in Port Washington, New York.
The best thing adults can do is create a system for reporting sexts and other cyberbullying behaviour, one that is anonymous and allows for verification of complaints, she said.
Otherwise, it's really in the hands of the teens themselves, she added.
"The kids themselves have to decide they don't want to participate," Lipkins said. "'We're not going to pass that photo along. No, I don't want it on my device. No, I don't want to get in trouble for having it. No, it is inappropriate, it is disrespectful to whomever, and I'm not going to participate in this behaviour.' When they can say that and protect each other and themselves, that's when it's going to end."
The new report was published in JAMA Pediatrics.
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