Problematic Sexual Behaviors in Children and Adolescents

As parents, how do we distinguish normal sexual behavior from problematic sexual behavior in our children and adolescents, and when is it time to seek out a professional opinion? Well according to the National Center on the Sexual Behavior of Youth (NCSBY):

"There is no clear line that separates normative from problematic sexual behavior. Sexual behavior in childhood and adolescence occurs on a continuum, from typical, to concerning, to problematic."

Problematic sexual behaviors include a wide range of behaviors.

  • Problematic self-touch or self-stimulation (such that it causes physical harm or damage, is excessive, and/or occurs in public in spite of interventions),
  • Non-intrusive and repetitive sexual behaviors (such as preoccupation with nudity, surreptitiously looking at others when they are naked, frequently showing private parts to others, preoccupation with pornography, especially child or violent media, sexting, offensive sexualized language),
  • Sexual touching without permission or consent, such as poking, rubbing or squeezing,
  • Sexual interactions with others (such as, digital-genital contact, oral-genital contact, sexual behavior that involve penetration) which are developmentally inappropriate or illegal,
  • Distributing youth produced sexual images, such as through texting,
  • Sexual contact with animals, and
  • Coercive or aggressive sexual contact or penetration.

Guidelines for Identifying Problematic Sexual Behaviors
Professionals should be concerned when children's sexual acts or behaviors have one or more of the following characteristics:

  • Occur frequently or more frequently than expected,
  • Take place between children of widely different ages or developmental stages (such as a 12-year-old who acts out with a 4-year-old, or a 15-year-old with a 10-year-old),
  • Occur between children of different capacity, for example, disparate physical size and strength or intellectual abilities or a position of authority,
  • Are associated with strong, upset feelings, such as anger or anxiety/fear,
  • Cause harm or potential harm (physical or emotional) to any child,
  • Do not respond to typical parenting strategies (such as, instruction and supervision), and
  • Involve coercion, force, or aggression, or threats thereof, of any kind

Problematic sexual behaviors are in contrast to normative sex play. Yet, some statistically normative sexual behaviors are considered problematic or even illegal due to familial, religious, cultural, or societal variations in attitudes regarding acceptable sexual behaviors in youth. Sometimes, sexual behaviors that do not involve others and occur in private, such as masturbation, may be considered problematic by some individuals or groups. Generally, sexual behaviors that do not involve others are not considered problematic, unless they are injurious, preoccupying, or interfere with other aspects of healthy development.

The NCSBY identifies normative sexual behavior (sexual play that is normal and healthy) as follows:

  • Occur spontaneously and intermittently,
  • Are not the sole focus of children's play, the interest in sex play is balanced by other interests and activities,
  • Involve children who are willing to engage in OR are generally light hearted and playful,
  • Are agreed upon (that is, no child is objecting to the behavior),
  • Do not cause any of the children strong uncomfortable feelings, such as anger, shame, fear, or anxiety,
  • Are not coercive, and
  • Often decrease with appropriate caregiver intervention when the child receives nurturing instructions to stop the behaviors

Sex Play Among Children

  • Occurs among children of similar age and ability who know and play with each other, rather than between new acquaintances or strangers,
  • Often occurs between children of the same-gender and can include siblings,
  • Is a common occurrence in childhood, and
  • Among preschool aged children sex play may include showing private parts to other children and touching other children's private parts in an exploratory way.

In particular, typical sexual behaviors of younger children do not include more advanced adult-like sex behaviors.

In adolescents, some "normative" sex behaviors that include more advanced sex activities may be defined as problematic and illegal by family or cultural norms or state and federal laws.

As a licensed clinician who specializes in the evaluation and treatment of problematic sexual behaviors (PSB), I would like to encourage parents, other family members and those of the educational community to simply become aware of the contrast between normal and problematic sexual behaviors.

Rockingham Family Counseling Clinic works with youth and their families in providing a variety of services which include:

1. Sexual assessment and evaluation of problematic sexual behavior in children and adolescents.

2. Court ordered psycho-sexual evaluations and treatment as recommended.

3. Parent education on how to supervise and help your child maintain healthy sexual boundaries.

4. Providing both individual and family support for change.

5. Provides assistance and liaison with various State agencies as well as providing placement resources as needed.

Wayne Hansen, MS, LMFT, LADC


For further information and/or reference please check out the NCSBY website from which the source of this information was gathered.

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