Review of "Hooked: New Science on How Casual Sex is Affecting our Children."-Chapter 1

Chapter 1 begins by laying out exactly what sex is: a loving bond between one man and one woman in a committed relationship.  Wait, what?

Here is their formal definition of sex (emphasis mine):

"Sexual activity is any intimate contact between two individuals that involves arousal, stimulation, and/or a response by at least one of the two partners."-Hooked page 16

Not too bad until you start to pick up on the recurring themes.  Language like "two shall become one," "lifestyle choice," and other traditionally Christian phrases appear throughout the chapter.  The words gay, lesbian, bisexual, asexual, queer, trans-, and homosexual appear in aggregate exactly 0 times throughout the entire book.  Masturbation gets a one sentence dishonorable mention.  In fact the conspicuous absence of anything other than monogamous heterosexual relationships is troubling.  It puts a lot of normal sexual behavior outside of the norm by definition.  I think this framing of what healthy sex is is not scientific but purely ideological.  The prejudging statement that a more sexually active and open society indicates a "decline" (page 11) also says a lot about the authors' views on sexuality.

Then we get into some things I can agree completely with:

"When one is forced or coerced to have sex, it is not good.  When sex is used to accomplish favors or to influence another, it is not good.  When sex is used for financial gain, used abusively, or used to humiliate another, it is not good.  When sex results in an unplanned, nonmarital pregnancy or a sexually transmitted infection, it is not good.  And when sex produces feelings of regret, depression, suicidal ideation and other emotional problems, it is not good." - Hooked page 18

Agreed.  Rape = bad.  Harassment = bad.  Abuse and coercion = bad.  STIs and unplanned pregnancy = bad (though I'm still not sure about the term nonmarital pregnancy).  Guilt ridden, depression inducing sex = bad.

I have yet to see however what any of this has to do with safe, sane, consensual sex.  Maybe it's just me, but the word consent kinda negates all of the rape, coercion, and abuse stuff.  So how is this relevant to the discussion?


Now we get into the meat of the chapter.  Hooked claims that sex outside of marriage is linked to depression and suicide.

"The study showed that both boys and girls who have had sex are three times more likely to be depressed than their friends who are still virgins.  The study accounted for other factors in the lives of the young people, ensuring an accurate comparison with their peers.  The girls who became sexually active were three times more likely to have attempted suicide as their virgin friends, while the sexually active boys were fully seven times more likely to have attempted suicide." - Hooked page 20

This statement is grossly misleading.  The primary study they cite is a piece by the Heritage Foundation, a conservative think tank whose mission statement is to "formulate and promote conservative public policies based on the principles of free enterprise, limited government, individual freedom, traditional American values, and a strong national defense."

The study is a meta-analysis of data from the National Longitudinal Survey of Adolescent Health.  If the data is to be believed (and I have very little reason to doubt) there is a strong correlation between being sexually active and at risk for depression/suicide. What the study doesn't show is any causal link, which is what Hooked strongly implies above.

Three other studies are cited to support this statement and each is more damning than the last.

1. Adolescent depression and suicide risk:Association with sex and drug behavior. By Hallfors et al
This study was looking at "combined sex and drug use behaviors" along with other high risk behaviors as a screening for depression.  They found out that depressed people were more likely to engage in risky behavior, not that sex leads to depression.

2. Adolescent First Sex and Subsequent Mental Health. By Meier
Here is a very telling quote from abstract (emphasis mine):

"While some adolescents experience mental health decrements, the majority of those who had first sex did not. This finding highlights the importance of considering contingencies when investigating the effects of life events on mental health." 

The study also carefully explains that a number of contingencies including "timing relative to age norms, romantic relationship factors, and gender" interacted to impact the few cases that did have negative mental health outcomes.  It's not a simple case of did they have sex or not.

3. Temporal Associations Between Depressive Symptoms and Self-reported Sexually Transmitted Disease Among Adolescents. By Shrier et. al.

This study used the same data as the Heritage Foundation study and found a similar (though slightly lesser) correlation between STDs and depression.  

But then they said this: 

"Compared with nondepressed youth, depressed children and adolescents have poor social relationships and may be more emotionally reactive in peer relationships, factors that may contribute to increased STD risk behavior."  

And this (emphasis added):

"Depressed individuals may also use sexual risk behaviors as part of a coping response to their depressive symptoms. Research has suggested that men, in particular, tend to purposively turn their attention away from depressive symptoms and onto neutral or pleasant activities, such as sexual intercourse. Less is known about the coping responses of adolescents but some research suggests that by early to middle adolescence, boys exhibit distractive coping styles that are similar to those of adult men."

The study strongly suggests that people who are depressed turn to sex (as well as other very pleasurable activities) in an attempt to alleviate their depression.

These studies do not show at all that sex leads to depression. If anything they suggest that depression leads to riskier sexual behaviors. It is entirely dishonest for Hooked to represent sex as a contributor to suicide.

Finally, the chapter concludes with a little JAQing off to more studies that don't quite say what Hooked says they say.  They ask three questions about the study results and then do not answer them:

1. "Why are those who were not virgins when they married more likely to divorce than those who remained abstinent until marriage?"- Hooked page 20

I was unable to access the full text of study unavailable, but appears to use virginity at age 18 as measure, not virginity until marriage. So unless everyone in the study got married at 18 it's irrelevant to the question above. Besides, other research indicates that 95% of those virgins at 18 will still have premarital sex.

2. "Why are sexually active adolescents more likely to be depressed than their abstaining peers?"- Hooked page 20

Same study, same problem. Also see above rant about depression correlations.

3. "Why do married couples report higher levels of sexual satisfaction than unmarried individuals with multiple sexual partners?"- Hooked page 20

No grounds for comparison maybe? I jest but there is another major problem with them using this book to make their point: it doesn't.  A quote from the source:

"The data show that about 88 percent of married people said they received great physical pleasure from their sexual lives...People who were dating and having sex together also were overwhelmingly physically pleased and emotionally satisfied, but, again, slightly less so than the people who were living together."

Bet that second part wouldn't fit in with the book's message too well. The satisfaction does drop off to about 60% for people who were married WITH SOMETHING ON THE SIDE! If you have something on the side it's probably because you weren't satisfied with your partner. I again quote the book:

"Of course, a lack of physical or emotional satisfaction may be what led them to find another partner in the first place, so we cannot say which came first, dissatisfaction or infidelity."

I would have much more respect for hooked if it had included that bit. There is a grain of truth to the question: multiple partners at the same time was correlated with dissatisfaction. They just conveniently left out the part that marriage also didn't matter one way or the other.  Being married made very very little difference to happiness in either the single partner or multiple partner situation.

If this chapter is any indication it will be a very slow read since I will have to read every source for myself. The authors have already lost my trust that they will report studies accurately.

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Next: Chapter 2: Meet the Brain (Part 1: Dopamine)
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