Context counts: long-term sequelae of premarital intercourse or abstinence.

An individual's first sexual experience is a highly salient and meaningful event, with potential to shape sexual scripts and the affect associated with sexual expression. Using data from the National Health and Social Life Survey, we tested abstinence-only advocates; assertions that premarital sex results in psychological and physical harm such as sexual dysfunction, sex guilt, poor health, sexually transmitted diseases, and poor life satisfaction. The first vaginal intercourse was premarital in 82.9% of the sample. Average age at first intercourse was 17.7 years. Relationship status as first intercourse was not consistently associated with later psychological or physical health outcomes. If the first experience was prepubertal, forced, with a blood relative or stranger, or the result of peer pressure, drugs, or alcohol, poorer psychological and physical health outcomes in adulthood were reported consistently. There is little evidence that premarital sex per se is disastrous for later sexual functioning or sex guilt; insofar as first sexual experiences are related to later functioning, the context of the experience is the crucial element.