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Disrupting What You Think You Know: Sex and the Teen Brain

Disrupting What You Think You Know: Sex and the Teen Brain

By Karin Coyle, PhD | December 19, 2016
Senior Research Associate, ETR

ETR is delighted to announce the release of our report on the 2016 Kirby Summit. If you work with adolescents to address sexual and reproductive health, I strongly encourage you to check it out.

Here’s why. We deliberately designed this invited Summit to challenge and disrupt what we thought we knew about adolescent health behaviors.

Our field currently has a broad selection of evidence-based programs geared towards preventing HIV, other STD and unplanned teen pregnancy. I believe these have contributed to declining rates of teen pregnancy and childbearing in the U.S. over the past two decades. But there is a lot we still don’t understand, and more we could do to make these programs better. That’s where the Kirby Summit comes in.

Report on the 2016 Kirby Summit

Peterson, A. J., Coyle, K. K., Guinosso, S. A., Christopher, D.E., and Charles, V. E. 2016. Sex and the teen brain: Disrupting what we think we know. Scotts Valley, CA: ETR Associates. 

Looking at Intersections

This invited summit brought experts in the sexual and reproductive health (SRH) field into the same room as experts in developmental neuroscience. Surprisingly, despite the apparent overlaps in these arenas, these two groups have not spent a lot of time talking to one another.

We hoped that in the intersection between our fields, we could discover some new ways of thinking about sexual health education for adolescents. Insights were flowing in all directions during the convening, and I believe everyone left with richer understandings in their areas of expertise.

Partners in the Kirby Summit

The 2016 Kirby Summit was organized by ETR, with support from the Packard, Grove and Hewlett Foundations. The Summit would not have been possible without the Kirby Summit Advisory Group, Ahna Suleiman and the rest of the Summit participants.

Three Key Messages

Three key themes emerged over the course of the Summit. Each of these suggests new ways we can think about developing and/or adapting SRH programs.

Key Message 1: Developmental changes matter

Programs and theories that focus on teens must address developmental changes in adolescence, including how social, emotional and cognitive processing influence decision-making.

Developmental changes in adolescent brains lead to an increase in behaviors that seek novelty and sensation. More than children or adults, adolescents make behavioral choices based on anticipated and actual rewards. This means they are strongly motivated by social and affective experiences that haven’t been well addressed either in current SRH programs, or in the theories on which they are based.

Many of our SRH programs aim to increase rational decision-making for adolescents by teaching models to weigh the pros and cons and engage in multi-step processes for making choices about sex and contraception. We engage young people in practicing those skills in a classroom setting and allow them to reflect on how they’ll use the skills outside the classroom. But once in exciting or arousing situations—with peers, friends, a partner, or when they’re having sexual feelings themselves—they’re likely to be far more motivated by the immediate rewards before them.

What can we do about it? One idea is to encourage young people to practice skills in more emotionally-heightened contexts, like with friends or a partner. Another idea is to give young people a chance to feel motivated about something they feel strongly about. For example, the TRUTH Campaign leverages adolescents’ developing autonomy by encouraging them to rebel against the tobacco companies.

A disruption example: Let’s find an analog to the TRUTH Campaign in the SRH world that helps young people feel more strongly motivated to protect their sexual health.

Key Message 2: Relationships are fundamental

Relationships are a fundamental context for adolescent sexual health.

Adolescents experience an increased interest in relationships and social status, both as a part of exploring their own place in the social world and as a consequence of neurological changes in their brains. As a result, adolescence is a perfect time for learning about relationships—both through formal education and through direct experience.

SRH programs often address healthy and unhealthy elements of relationships, but we can do more to support young people as they create, sustain, and end relationships. Further, because most adolescent sexual behavior occurs within a relationship, we can approach content and skills in SRH programs differently, by addressing relationships as one of the key contexts for making decisions about sex, consent and contraception.   

A disruption example: Identify relationship behaviors that promote healthy choices and connections. Help young people learn about them early as they’re developing new friendships, then build on them as young people begin to experience romantic relationships.

Key Message 3: Create and use a productive scaffold

Multiple support systems are essential to scaffold youth through positive growth and development.

It was clear from conversations at the Summit that young people benefit from supportive adults who provide scaffolding to guide them toward more productive and positive risks. Scaffolding is active adult guidance and support that gradually decreases as young people practice greater independence and competence with new skills and/or roles.

This approach allows youth to take risks, experience failures, and grow while staying connected to their support systems. For example, as adults, we don’t always embrace adolescent relationships as important development experiences, yet relationship challenges and break-ups are key opportunities for supporting youth as they learn and experience relationship behaviors that will carry into adulthood. 

A disruption example: Provide guidance for parents that supports them in scaffolded learning, allowing them to build connectedness without stifling normal adolescent exploration.

Practical Recommendations: Read the Report

I’m excited about the new directions articulated by the participants in the Summit, and energized by the challenge of translating developmental neuroscience to SRH programs. Take a look at the full report to learn more about our key messages and  recommendations for researchers, program developers and implementers, trainers and funders. We look forward to engaging with others on this exciting pathway.


Karin Coyle, PhD, is a senior research scientist at ETR who specializes in the development and evaluation of health prevention programs, particularly HIV, other STD and pregnancy prevention. She can be reached at

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