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. Author manuscript; available in PMC: 2022 Feb 1.
Published in final edited form as: J Child Fam Stud. 2021 Jan 20;30(2):338–349. doi: 10.1007/s10826-020-01896-x

Resources for teens’ health: Talk with parents and extended family about sex

Jennifer M Grossman 1, Alicia D Lynch 2, Lisette M DeSouza 3, Amanda M Richer 3
PMCID: PMC7996344  NIHMSID: NIHMS1676712  PMID: 33776392

Abstract

Communication with family members about sex can protect teens from risky sexual behavior, but most research focuses on teens’ communication with parents. Extended family members may also be a source of sexual socialization to support teens’ health, but teens’ perspectives on communication with extended family about sex have been little explored. The current study aims were to examine similarities and differences in the frequency and content of teens’ communication with extended family and parents about sex and to assess whether the content of this communication differs based on teens’ gender. This cross-sectional study used structural equation models (SEM) to analyze survey data from 952 11th and 12th graders (55% Female, 52% Latinx) in the United States. The study assessed three types of family talk about sex: Communication about Risks of Sex addresses negative consequences of sex, communication about Protection involves ways teens can guard against pregnancy and sexually transmitted infections and Relational Sex communication addresses sex within the context of a close relationship. We found that teens were as likely to report talk with extended family members as parents about sex. Teens’ conversations with parents were more focused on sexual risk and protection while conversations with extended family focused on relational sex topics. Girls were more likely to engage in protection and relational sex communication with extended family, while boys talked more often with parents about these topics. These findings highlight the potential of extended family to support teens’ healthy development.

Keywords: adolescent sexual health, family communication, extended family, parents, gender, sexual socialization

Risky sexual behaviors leave teens vulnerable to sexually transmitted infections (STIs) and unplanned pregnancy (Kann et al, 2016), and half of all new STIs are acquired by young people ages 15–24 (Satterwhite et al., 2013). Communication with family members about sex can protect teens from risky sexual behavior (Guilamo-Ramos at al., 2012; Murry, McNair, Myers, Chen, & Brody, 2014; Usher-Seriki, Smith Bynum, & Callands, 2008). Conversations between teens and parents about sex include topics such as abstinence, safer sex, sexually transmitted infections, and sexual values (Stidham-Hall, Moreau, & Trussell, 2012; Wright, 2009). However, half of teens report no conversations with their parents about sex (Robert & Sonenstein, 2010), suggesting a need to explore other supportive resources for talk about sex. A growing body of research suggests that close to half of teens talk with extended family members (i.e. non-parental family) about sex, such as siblings, aunts, uncles, and cousins (Harper et al., 2012; Teitelman, Bohinski & Boente, 2009). Initial research suggests that conversations with extended family about sex may support teens’ sexual health (Grossman, Lynch, Richer, DeSouza, & Ceder, 2019; Grossman, Tracy, Richer, & Erkut,, 2015). Research also suggests that teens’ conversations with parents about sex are shaped by teens’ gender (Bulat, Ajduković, & Ajduković, 2016; Deutsch & Crockett, 2016; Widman, Choukas-Bradley, Noar, Nesi, & Garrett, 2016). Despite the large number of teens who talk with extended family about sex and the potential of these conversations to support teens’ health, little is known about the similarities and differences in communication with parents and with extended family members or the role of teens’ gender in these conversations.

Sexual socialization theory provides a framework to understand how teens and their families talk about sex and the messages conveyed through these conversations. Sexual socialization refers to “the process through which an individual acquires an understanding of ideas, beliefs and values, shared cultural symbols, meanings and codes of conduct.” (Shtarkshall, Santelli, & Hirsch, p. 116, 2007). Conversations about sex provide a mechanism through which families socialize teens about their expectations and values about sex and relationships (Deutsch & Crockett, 2016; Kuhle et al., 2015). These sexual socialization messages are often transmitted through parents (Shtarkshall et al., 2007; Ward, 2003), who teens see as key influences on their sexual decision-making (Albert, 2010). Extended family may also play a role in sexual socialization as high numbers of teens report talking with extended family about sex and relationships (Harper et al., 2012; Teitelman et al., 2009) suggesting the need to explore extended family as an additional source of sexual socialization.

Multiple factors may interfere with teen-parent communication about sex (Robert & Sonenstein, 2010). Some parental barriers include: 1) limited sexual health knowledge, 2) believing adolescents are not ready to talk about sex, 3) parental discomfort discussing sex, and 4) gender, racial/ethnic and religious factors which may inhibit these conversations (Malacane & Beckmeyer, 2016). Parents may also believe that their child does not want to hear what they have to say (Pariera, 2016). On the other hand, teens may avoid talk with parents about sex due to fear they will disappoint their parents or be judged by them (Crohn, 2010). Some teens also describe conversations with parents as awkward or uncomfortable (Grossman, Richer, Charmaraman, Ceder, & Erkut,, 2018; Grossman, Jenkins, & Richer, 2018,). Additionally, teen and parent gender and sexual orientation may inhibit family communication. For example, fathers rarely talk with their daughters about sex (Wright, 2009). Some parents also avoid talking about sex with sexual and gender minority teens due to their discomfort talking about same-sex sexuality (LaSala, 2015) and their lack of knowledge about these issues (Rose, Friedman, Annang, Spencer, & Lindley, 2014; Newcomb, Feinstein, Matson, Macapagal, & Mustanski, 2018). Teens also may be more comfortable talking with people outside the family about sex and often report more conversations with peers than parents about this topic (Secor-Turner, Sieving, Eisenberg, & Skay, 2011; Whitfield, Jomeen, Hayter, & Gardiner, 2013).

Prior research provides initial comparisons of the frequency and content of teens’ communication with parents and extended family about sex. One study found that teens reported similar likelihood of talking with parents (62%) and extended family (59%) about sex (Grossman et al., 2015). A study of parent and grandparent caregivers found that parents were more likely than grandparents to report not talking with teens about sexual issues (Cornelius and Xiong, 2015). More evidence is available about the content of teens’ communication with parents and extended family about sex. Teens talk with both parents and extended family about dating and relationships, safer sex, and teen pregnancy (George, Abatemarco, Terry, Yonas, Butler, & Akers, 2013; Harper et al., 2012). However, there may be differences in the sexual topics that parents and extended family members discuss with teens. Studies found that parents were more likely than extended family to talk with teens about delaying sex (Cornelius & Xiong, 2015; Grossman et al., 2018a). However, grandparents were more interested than parents in having open conversations with teens about sex (Cornelius & Xiong, 2015). Aside from these two studies, little research compares the content of teens’ talk with parents and extended family about sex and relationships.

Teens’ conversations with parents and extended family are important as they can support teens’ health (Grossman et al., 2019; Widman et al., 2016; Wright, 2009). A recent meta-analysis of three decades of research found that more frequent parent-teen conversations about sex were associated with fewer sexual risk behaviors, particularly for girls (Widman et al., 2016). Open and frequent parent-teen conversations about sex positively predict delay in teens’ first sex (Grossman, Tracy, Charmaraman, Ceder, & Erkut, 2014; Hutchinson and Montgomery, 2007) and lower number of sexual partners (Secor-Turner et al., 2011). These conversations are also associated with higher likelihood of teens’ talk about sexual issues with their romantic partners (Hicks, McRee, & Eisenberg, 2013; Widman, Coukas-Bradley, Helms, Golin, & Prinstein, 2014). Fewer studies assess health implications of teens’ talk with extended family about sex. A recent study of teens’ communication with extended family about sex found that for sexually active teens, talk with extended family about protection from STIs and pregnancy was associated with fewer sexual partners (Grossman et al., 2019).

When considering family communication and socialization related to expectations and values about sex, teens’ gender plays a key role. Research suggests that the content and frequency of parents’ talk with teens about sex and the effects of these conversations on teens’ sexual behavior are shaped by the teen’s gender (Deutsch & Crockett, 2016; Ritchwood et al., 2017; Widman et al., 2016). Through communication about sex, parents pass on gender-specific messages about conduct such as abstaining from sex, or utilization of protection methods (Shtarkshall et al., 2007; Ward, 2003). Specifically, parents are more likely to talk with their daughters than sons about delaying sex and how to avoid boys’ sexual advances (Kuhle et al., 2015) and are more likely to describe their early adolescent daughters than sons as not ready to talk about sex (Grossman et al., 2018b). Teens also view parents’ sexual attitudes as more permissive with sons and more protective with daughters (Guilamo-Ramos, Dittus, Jaccard, Goldberg, Casillas, & Bouris, 2006).

It is unknown whether extended family members follow similar gendered patterns of messages about sex in their conversations with teens as do parents. In general, extended family members take less traditional approaches to conversations with teens about sex than do parents (Cornelius & Xiong, 2015; Grossman et al., 2018a), so it may be that extended family communication about sex does not follow traditional gendered patterns that are seen with parents. Teens also perceive extended family to be less judgmental, more open connections for talking about sex than their parents (Teitelman et al., 2009). Research is needed to directly explore how messages about sex from extended family members vary by teens’ gender.

The current study expands our understanding of teens’ communication about sex with parents and extended family and how teens’ gender shapes these conversations. Our definition of extended family includes the larger family context of non-parental conversation partners in teens’ talk about sex: grandparents, uncles, aunts, older cousins, and siblings. We include siblings for two reasons: 1) studies differentiate siblings from parents in that they play more of a peer role in talking about sex than do parents (Harper et al., 2012; Wallace, Hooper, & Persad, 2014) and 2) research suggests commonalities between teens’ talk with siblings and cousins about sex (Harper et al., 2012; Teitelman et al., 2009). We define talk about sex to focus on three domains: Risks of Sex (i.e., STIs, teen pregnancy), Protection (i.e. using condoms), and Relational Sex (i.e. sex within a close relationship).

We address three research questions: 1) Are teens more likely to report talk with parents than extended family about sex? 2) Are there differences in the content of teens’ conversations with parents and extended family focused on Risks of Sex, Protection and Relational Sex? and 3) Does the content of teen-reported talk with parents and extended family about Risks of Sex, Protection and Relational Sex vary in relation to teens’ gender? Based on past research which identifies parents as the primary family resource for teens’ communication about sex (Albert, 2010), we hypothesize that teens will report more talk with parents than extended family about sex. Given parents’ focus of communication with teens on delaying sex (Cornelius & Xiong, 2015; Grossman et al., 2018a), we expect that teens will report more talk with parents than extended family about Risks of Sex, but not about Protection and Relational Sex. Finally, given prior research findings that parents are more likely to share messages with female than male teens about the importance of abstinence and delaying sex (Kuhle et al., 2015; Shtarkshall et al., 2007), we expect that female teens will report more frequent conversations with parents about Risks of Sex, whereas male teens will report more frequent conversations with parents about Protection and Relational Sex. Given the absence of research on gender differences in the content of teens’ talk with extended family, questions related to the role of gender in teens’ talk with extended family about sex are exploratory.

Method

Participants

We collected surveys from 967 11th and 12th grade students from six urban high schools in New England in the United States. Nine surveys were excluded from analysis because students provided assent, but did not answer any of the questions and 6 surveys were excluded because students did not provide assent. As such, our final analytic sample included 952 surveys. Participants were on average 17.02 years old (SD=.94), and self-identified as 55% female, 44% male and 1% non-binary. For racial-ethnic background, 52% participants self-identified as Latinx, 16% Black, 16% White, 7% Asian, and 5% Biracial/Multiracial or other race/ethnicity (see Table 1 for sample descriptives). Eighty-seven percent of teens reported they were attracted to the opposite sex, 3% self-identified as attracted to the same sex, 8% to both males and females, 1% were “not sure” and less than 1% were attracted to neither sex. Fifty-eight percent of teens reported living in a two-parent household. Mothers’ or primary caregivers’ (when a mother was not present in the household) modal level of education was a high school diploma. Seventy-seven percent of participants reported that at least one of their parents had immigrated to the U.S.

Table 1.

Descriptives of Participant Sample (N=952)

Mean (or %) SD
Female 55% 0.50
Age 17.02 0.94
Mother’s Education 3.00 1.66
Religion 2.67 1.03
Parent Immigrant 77% 0.42
White 16% 0.37
Black 16% 0.37
Latinx 52% 0.50
Asian 7% 0.25
Biracial/Other 5% 0.23
2-Parent Household 57% 0.50
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Descriptives above illustrate the population of participants for the current study.

Sixty percent of teens reported talking with their mother about sex, 38% reported talking with their father, and 46% percent reported talking with an extended family member. When divided into mutually exclusive categories, 27% of teens reported talking to parents only, 37% reported talking to both parents and extended family, 11% reported talking to extended family only, and 25% reported talking to no family members For talk with extended family about sex, teens primarily. reported talking to older sisters (24%) and older female cousins (21%). Teens also identified older brothers (16%), aunts (13%) and older male cousins (10%) as partners in talk about sex. Fewer adolescents reported talking to grandmothers (7%), uncles (6%), grandfathers (1%) and godparents (1%).

Procedure

The study method and associated protocols were approved by the institution’s Institutional Review Board (Dec 19, 2016). Prior to administering the survey to the full analytic sample of 952 youth, we piloted the survey with ten high school students who provided verbal feedback regarding their perceptions of the survey. In response to their feedback, we edited the language of some questions and added additional indicators. The final survey had a 6th grade reading level, established by the Flesch-Kincaid Grade Level readability test.

We recruited six urban schools in New England for this study through school and district offices. We paid each school a $500 stipend for participation and assigned a study liaison responsible for data collection coordination. No incentives were given to individual participating students. Schools determined whether to use active parental consent or allow for a waiver of consent (i.e., passive consent) for teen survey participation. Four of the six participating schools selected waiver of documentation of parental consent (i.e., passive consent) while two schools selected active parental consent. In both conditions, schools distributed information to parents about the study, which was translated into families’ home languages.

Teens were asked to give their assent to participate before starting the survey. The survey was administered in classrooms on computers provided by the school or on tablets provided by the research team using the survey software program, Qualtrics. Students could complete the survey in English (n=894) or Spanish (n=58), and the survey took an average of 20–30 minutes to complete. The liaison for each school was responsible for collecting parent consent forms. Teachers were present in the classrooms during survey administration and researchers were available to answer participants’ questions. Participants were encouraged to keep their answers private from their teachers and from one another.

Measures

Communication about sex.

Participants were first asked which parent, and which extended family member they spoke to the most about sex. Next, based on the parent and extended family member the student identified, participants were asked questions about their talk with each of these individuals about sex. Three content areas of talk about sex were examined: Risks of Sex, Protection, and Relational Sex. Some items for these three scales were generated specifically for study purposes while others were adapted from the Parent-Adolescent Communication Scale (PACS) (Sales, Milhausen, Wingood, DiClemente, Salazar, & Crosby, 2008) and indicators reported in Eisenberg and colleagues’ (Eisenberg, Sieving, Bearinger, Swain, & Resnick, 2006) manuscript regarding teens’ talk with parents about sex. We used a likert response format of: 1 (“Never”), 2 (“Rarely”), 3 (“Sometimes”), 4 (“Often”) and 5 (“All the time”) for all items in the three subscales. Model fit statistics from a Confirmatory Factor Analysis (CFA) testing the presence of three direct communication scales suggested excellent fit (CFI = .97, TLI = .96, RMSEA = .07) for the proposed theoretical structure.

For all scales, participants were asked, “In the past year, how often have you and your parents/extended family talked about these topics.” The Risks of Sex scale assesses communication regarding the negative consequences of sex, such as “The dangers of getting a sexually transmitted disease” (4 items, α=.86). Sample average for Risks of Sex with parents was 2.33 (SD=1.36) and with extended family was 1.83 (SD=1.25). The Protection scale encapsulates communication about how teens can guard against pregnancy, STIs, and HIV/AIDS, such as “protecting yourself from HIV/AIDS” (3 items, α=.93). Average talk about Protection with parents was 2.73 (SD=1.48) and with extended family was 2.15 (SD=1.47). The Relational Sex scale measures communication in which sex is described as natural and appropriate within trusting relationships, such as “Its ok to have sex if it’s someone special to you” (3 items, α=.87). Average Relational Sex Communication with parents was 2.45 (SD=1.40) and with extended family was 2.08 (SD=1.37).

Table 2 displays the intercorrelations between the ten items used to measure talk about sex as well as their correlations with teen and parent demographic variables.

Table 2.

Intercorrelations between items in the three sexual communication scales and demographic characteristics

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
1. Protection 1 --
2. Protection 2 0.95 --
3. Protection 3 0.79 0.79 --
4. Risks 1 0.77 0.75 0.70 --
5. Risks 2 0.65 0.64 0.76 0.75 --
6. Risks 3 0.42 0.41 0.41 0.52 0.49 --
7. Risks 4 0.74 0.75 0.69 0.75 0.63 0.48 --
8. Relational 1 0.67 0.66 0.65 0.70 0.63 0.43 0.59 --
9. Relational 2 0.62 0.63 0.62 0.64 0.60 0.37 0.54 0.79 --
10. Relational 3 0.64 0.64 0.66 0.66 0.61 0.38 0.55 0.73 0.77 --
11. Female 0.00 −0.01 0.01 0.01 0.03 0.12 0.01 0.04 0.01 0.03 --
12. Age 0.14 0.14 0.06 0.05 0.04 0.00 0.12 0.12 0.10 0.08 −0.03 --
13. Mother’s Ed −0.08 −0.07 −0.05 −0.05 −0.08 −0.12 −0.09 −0.13 −0.09 −0.07 −0.07 −0.18 --
14. Teen Religion 0.08 0.08 0.07 0.08 0.08 0.16 0.13 0.10 0.07 0.04 0.07 0.02 0.03 --
15. Parent Immig −0.08 −0.06 −0.04 −0.06 −0.01 0.07 −0.04 −0.05 −0.03 −0.09 0.01 0.06 −0.13 0.22 --
16. White −0.08 −0.08 −0.08 −0.04 −0.10 −0.09 −0.05 −0.06 −0.03 −0.04 0.04 −0.06 0.07 −0.17 −0.56 --
17. Black 0.02 0.02 0.03 0.02 0.04 0.07 0.00 0.02 0.00 0.05 −0.04 0.03 0.16 0.19 0.07 −0.19 --
18. Latinx 0.13 0.14 0.14 0.06 0.11 0.04 0.10 0.12 0.09 0.08 −0.03 0.11 −0.25 −0.03 0.33 −0.51 −0.44 --
19. Asian −0.10 −0.11 −0.11 −0.07 −0.07 −0.06 −0.10 −0.10 −0.07 −0.10 0.05 −0.03 0.02 0.00 0.12 −0.13 −0.11 −0.30 --
20. Biracial/Other −0.07 −0.07 −0.08 −0.03 −0.05 0.03 −0.04 −0.07 −0.05 −0.05 0.03 −0.15 0.12 0.07 −0.01 −0.12 −0.10 −0.28 −0.07 --
21. 2-Parent Household −0.05 −0.06 0.01 −0.02 0.02 0.09 0.00 −0.09 −0.06 −0.08 0.02 −0.06 0.00 0.08 0.12 −0.01 0.02 −0.06 0.12 0.02 --
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*Protection 1= Protection from STD; Protection 2= Protection from HIV; Protection 3= Protection to avoid pregnancy; Risks 1= Risks of sex: dangers of STDs; Risks 2= Risks of sex: negatives of pregnancy; Risks 3= Risks of sex: sex is bad for social life; Risks 4: Risks of sex: symptoms of STDs; Relational 1=Relational sex: sex ok between consenting partners; Relational 2= Relational sex: sex ok with someone special; Relational 3= Relational sex: sex is human nature.

In a separate question, participants were asked “Select all the people in your family you have talked to about sex or relationships in the past 12 months.” This question was followed by a list of parents and extended family members (e.g., mother, father, grandmother, grandfather, aunt, uncle, older sister, older brother). This question was used to describe teens’ larger family network of talk about sex.

Control variables.

To reduce the possibility of omitted variable bias, we included a series of control variables in each analytic model. Our seven control variables were selected to reduce the risk that findings related to our primary hypotheses were better explained by unobserved variable bias. Control variables were selected for inclusion if prior research documented a statistically meaningful relationship between the control variable and the content or frequency of sexual communication. If the variable was categorical, it was included only if all sub-groups were adequately represented (or, alternately, all subgroups could be meaningfully grouped into an alternative category).

We coded teens’ gender as male (0) or female (1). In all, 6 participants identified as “Neither male nor female” and 7 participants identified as “Not sure.” Given the small size of these groups, we lacked statistical power to look at these youth separately or make any conclusions regarding their sexual communication. At the same time, we did not wish to exclude these youth entirely from the analysis. As such, through the use of FIML, we were able to impute gender in a non-binary manner. That is, individuals who were missing gender were not imputed necessarily as a “1” (female) or “0” (male), rather, we allowed gender to be imputed at any value between 0 and 1.

Youth age ranged from 14–21 and was measured continuously. We assessed teens’ race/ethnicity by presenting teens with a list of eight racial/ethnic categories and asking them to select the category or categories that best described them. We coded teens who selected multiple categories as “multiracial.” The racial/ethnic groups with sufficient power to be modeled separately were Asian, Black, Latinx, and White. We grouped all other individuals into a category labelled “Other.” Differences between all racial/ethnic groups were explored in our analysis. In the manuscript, we selected White as the omitted group because the majority of race-related differences identified in the structural equation models (SEM) were in relation to White youth. We assessed household structure as a dichotomous measure which we coded as “1” if the teens reported that their primary residence was comprised of two parental figures and “0” if the teen reported not living with two parental figures. We measured teens’ religiosity using a single item that asked teens to describe how important religion is in their life on a scale ranging from 1 (“Very Unimportant”) to 4 (“Very Important”). Teens also reported their mothers’ education using a 6-point scale ranging from “less than a high school diploma” to “a degree after college.” Parent immigrant status was coded as “1” if one or both parents were not born in the U.S. and “0” if both parents were born in the U.S.

Data analyses

We addressed research question 1 using multilevel logistic regression modeling. All other research questions were approached within a multiple group SEM framework. Within the SEM framework, we modeled the three communication scales (Risks of Sex, Protection, and Relational Sex) as latent variables. All other variables were treated as observed. To examine differences between parent and extended family sexual communication, we stacked the dataset such that each participant’s data were broken into two rows – one row contained a teen’s responses in relation to communication with his/her parent and a second row contained responses related to communication with his/her extended family member. To distinguish between parents and extended family, we created a single dichotomous indicator that had a value of “1” if the row contained data regarding communication with an extended family member and “0” if the row contained data regarding communication with a parent. This process allowed us to freely test for differences between the frequency and content of extended family and parental sexual communication. Missing data were minimal and were managed using Full Information Maximum Likelihood (FIML) estimation. Sixty-one percent of participants had no missing data and an additional 29% were missing only one or two data points. We conducted all analyses in the Lavaan package (version 0.6–3) in R (Rosseel, 2012).

Results

Differences in the frequency of teens’ talk with parents and extended family about sex

To address research question 1, we examined differences in the frequency with which teens identified extended family versus parents as sexual communication partners by creating a variable in which teens were given a value of “1” if they indicated they spoke with extended family about sex and a value of “0” if they did not. We repeated this same process for parents. Given that we were working in a stacked dataset, this process created a single indicator representing whether the teen engaged in talk with the individual (extended family or parent) who was represented in each row. We used this variable as our dependent variable in a multilevel logistic regression model (with communication partner nested within teens). Next, we observed whether there was a significant relationship between our dichotomous indicator representing whether the individual was an extended family member or a parent and the dependent variable. Our dichotomous indicator representing communication partner (parent versus extended family) did not significantly predict whether the teen reported talk with the individual about sex (β =−.15 SE=.12, p =.20). In all, this result suggests that teens identify extended family members as at the same rate that they identify parents as partners in talk about sex. Complete results of the multilevel logistic regression model can be found in Table 3.

Table 3.

Multilevel logistic regression model examining differences in the frequency of talk with extended family members versus parents about sex (N=952)

Estimate SE Z p-value
Communication Partner (Ext. Family vs. Parent) −0.15 0.12 −1.28 0.20
Female 0.35 0.13 2.73 0.01
Age −0.06 0.08 −0.77 0.44
Mother’s Education 0.02 0.04 0.54 0.59
Religion 0.09 0.06 1.35 0.18
Parent Immigrant −0.26 0.19 −1.36 0.17
Black −0.28 0.24 −1.15 0.25
Latinx 0.20 0.21 0.94 0.35
Asian −0.86 0.30 −2.84 0.00
Biracial/Other −0.33 0.31 −1.05 0.30
2-Parent Household 0.75 0.14 5.38 0.00
Intercept 0.32 1.33 0.24 0.81
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Differences in the content of teens’ talk with parents and extended family about sex

To address research question 2, we used multiple group SEM to examine differences in the content of extended family and parent talk about sex by regressing the three latent indicators of talk about sex (Risks of Sex, Protection, and Relational Sex) on all covariates. In the first model (Model 1, Constrained), we constrained the intercepts of parental and extended family talk about sex to be equal. In the second model, we allowed the intercepts to freely vary (Model 1, Unconstrained).

After generating the constrained and unconstrained models, we assessed the quality of model fit for the constrained and unconstrained models using traditional SEM model fit indices including Chi-Square, CFI, TLI, RMSEA, and SRMR. All indices suggested excellent model fit for both the constrained and unconstrained models (see Table 4). Next, we assessed changes in model fit in the constrained versus unconstrained model. When we constrained the intercepts of the three sexual communication scales (Risks of Sex, Protection, and Relational Sex) to be equal across parents and extended family, changes in the model chi-square value suggested a significant reduction in the model fit for the constrained model when compared to the unconstrained model. When an unconstrained model has significantly stronger model fit statistics than a model in which the intercepts of latent variables are constrained to be equal, this suggests that the intercepts are not, in fact, equal, and should be allowed to freely vary. To discern how the latent intercepts of sexual communication were different for parents and extended family, we compared the latent means of parent and extended family communication. We found that the latent means of extended family communication about Risks of Sex (β= −3.52 SE=1.89, p < .05) and Protection (β= −4.78 SE=1.40, p < .01) were significantly lower than the latent means of parents, suggesting that extended family members were less likely than parents to talk with teens about Risks of Sex and Protection. However, there were no differences in the latent means of parental and extended family Relational Sex (β=−1.65 SE=1.89), p > .05), suggesting extended family and parents were equally likely to talk with teens about Relational Sex. We included the complete list of factor loadings and estimated latent means (intercepts) for parents and extended family in Table 5.

Table 4.

Model fit indices

Model x2 df p CFI TLI RMSEA (95% CI) SRMR
Model 1, Unconstrained 415.20 202 0.00 0.975 0.96 0.04 (.03–.05) 0.03
Model 1, Constrained 435.30 209 0.00 0.973 0.96 0.04 (.04–.05) 0.03
Model 2, Unconstrained 415.21 202 0.00 0.975 0.96 0.04 (.03–.05) 0.03
Model 2, Constrained 450.84 223 0.00 0.985 0.97 0.04 (.03–.05) 0.03
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Table 5.

Model 1: Structural Equation Model Parameters

Parent Communication Extended Family Communication
Risks of Sex ~ Unstd. (SE) Std. Unstd. (SE) Std.
Female −0.12(0.13) −0.10 0.17(0.12) 0.14
Age −0.06(0.04) −0.05 0.08(0.07) 0.07
Mother’s Education −0.13(0.04)** −0.11 −0.02(0.04) −0.02
Religion 0.15(0.07)* 0.12 0.09(0.06) 0.08
Parent Immigration −0.41(0.19)* −0.33 −0.37(0.17)* −0.30
Black 0.43(0.25) 0.35 0.45(0.23)* 0.37
Latinx 0.44(0.21)* 0.36 0.44(0.19)* 0.36
Asian −0.05(0.35) −0.04 0.09(0.28) 0.07
Biracial/Other 0.15(0.33) 0.12 0.15(0.28) 0.13
2-Parent Household −0.10(0.14) −0.08 −0.08(0.12) −0.06
Intercept 0.00 (.00) −3.52(1.35)**
Protection ~
Female −0.33(0.14)* −0.24 0.22(0.13) 0.16
Age −0.03(0.03) −0.02 0.18(0.08)* 0.13
Mother’s Education −0.12(0.04)** −0.09 −0.01(0.04) −0.01
Religion 0.11(0.07) 0.08 0.09(0.06) 0.06
Parent Immigration −0.64(0.20)** −0.46 −0.63(0.19)** −0.45
Black 0.62(0.26)* 0.45 0.66(0.25)** 0.48
Latinx 0.78(0.22)** 0.56 0.72(0.21)** 0.51
Asian 0.06(0.36) 0.05 0.21(0.30) 0.15
Biracial/Other 0.32(0.35) 0.23 0.26(0.30) 0.18
2-Parent Household −0.15(0.15) −0.10 −0.14(0.13) −0.10
Intercept 0.00 (.00) −4.78(1.40)**
Relational Sex ~
Female −0.13(0.13) −0.11 0.26(0.12)* 0.20
Age 0.04(0.08) 0.03 0.08(0.07) 0.07
Mother’s Education −0.12(0.04)** −0.10 −0.06(0.04) −0.04
Religion 0.12(0.07) 0.10 0.05(0.06) 0.04
Parent Immigration −0.48(0.18)** −0.40 −0.42(0.18)* −0.33
Black 0.27(0.24) 0.23 0.52(0.24)* 0.41
Latinx 0.42(0.20)* 0.35 0.43(0.20)* 0.34
Asian −0.13(0.33) −0.11 0.16(0.29) 0.12
Biracial/Other 0.06(0.32) 0.05 0.08(0.29) 0.06
2-Parent Household −0.30(0.14)* −0.25 −0.18(0.13) −0.14
Intercept 0.00 (.00) −1.65(1.89)
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Gender-based differences in the content of talk with parents and extended family about sex

To examine whether there are gender-based differences in how parents and extended family communicate with teens about sex (research question 3), we compared a model in which the paths from gender to sexual communication were constrained to be equal for males and females to a model in which the paths for males and females were freely estimated. We assessed the quality of model fit for the constrained and unconstrained models using traditional SEM model fit indices including Chi-Square, CFI, TLI, RMSEA, and SRMR. All indices suggested excellent model fit for both the constrained and unconstrained models. Our comparison of chi-square model fit statistics (see Table 4) showed that the unconstrained model demonstrated superior model fit, suggesting that the content of extended family and parental talk about sex is different for males and females. Table 6 provides the model parameters for the SEM model. After establishing that there was a significant difference in how parents and extended family talk with male and female teens, we next compared the factor loadings between teen gender and the three sexual communication latent variables in the parent and extended family communication models. Results showed that male and female participants were equally likely to report talking with parents and extended family about Risks of Sex (β=−.25 SE=.18, p > .05). However, female participants were more likely to report talk with extended family about Protection (β=−.49 SE=.19, p < .01) and Relational Sex (β=−.36 SE=.18, p < .05) while male participants were more likely to report talk with parents about these topics (see Table 6). In all, these results suggest that parents and extended family members are having different conversations about sex with male and female teens. Female teens tend to talk with extended family members about Protection and Relational Sex while male teens are more likely to talk with parents about these topics.

Table 6.

Model 2: Structural Equation Model Parameters

Parent Communication Ext Family Communication
Risks of Sex~ Unstd. (SE) Std. Unstd. (SE) Std.
Female −0.08(0.14) −0.07 0.17(0.12) 0.14
Age 0.17(0.08)* 0.14 0.08(0.07) 0.07
Mother’s Education −0.10(0.04)* −0.08 −0.02(0.04) −0.02
Religion 0.16(0.07)* 0.13 0.09(0.06) 0.08
Parent Immigrant −0.40(0.19)* −0.32 −0.36(0.17)* −0.30
Black 0.46(0.25) 0.36 0.44(0.23)* 0.37
Latinx 0.45(0.21)* 0.36 0.43(0.19)* 0.36
Asian −0.05(0.35) −0.04 0.08(0.27) 0.07
Biracial/Other 0.21(0.33) 0.17 0.15(0.27) 0.13
2-Parent Household −0.05(0.14) −0.04 −0.07(0.12) −0.06
Protection ~
Female −0.27(0.14) −0.20 0.22(0.13) 0.16
Age 0.30(0.09)** 0.21 0.18(0.08)* 0.13
Mother’s Education −0.07(0.04) −0.05 −0.01(0.04) −0.01
Religion 0.12(0.07) 0.09 0.09(0.06) 0.06
Parent Immigrant −0.63(0.20)** −0.45 −0.63(0.19)** −0.45
Black 0.65(0.25)* 0.47 0.66(0.25)** 0.47
Latinx 0.79(0.22)*** 0.57 0.72(0.21)** 0.51
Asian 0.06(0.36) 0.05 0.21(0.30) 0.15
Biracial/Other 0.40(0.34) 0.29 0.26(0.30) 0.18
2-Parent Household −0.07(0.15) −0.05 −0.14(0.13) −0.10
Relational Sex~
Female −0.10(0.13) −0.08 0.26(0.12)* 0.20
Age 0.21(0.08)** 0.18 0.08(0.07) 0.07
Mother’s Education −0.09(0.04)* −0.07 −0.06(0.04) −0.04
Religion 0.13(0.06)* 0.11 0.05(0.06) 0.04
Parent Immigrant −0.47(0.18)** −0.39 −0.42(0.18)* −0.33
Black 0.28(0.23) 0.24 0.52(0.24)* 0.41
Latinx 0.42(0.20)* 0.35 0.43(0.20)* 0.34
Asian −0.13(0.33) −0.11 0.16(0.29) 0.12
Biracial/Other 0.10(0.31) 0.08 0.08(0.29) 0.06
2-Parent Household −0.26(0.13) −0.22 −0.18(0.13) −0.14
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Discussion

Consistent with prior research (Flores & Barroso, 2017) mothers were the most common communication partners identified by teens in our sample. However, almost half of teens reported talk with extended family. Given differences in how teens talk with parents and extended family about sex (Grossman et al., 2018a), communication with both parents and extended family (reported by 37% of this sample) may provide protective effects beyond talk with a single family member, an area which would benefit from exploration in future research. In contrast, 25% of teens reported talking with no family members about sex. More comprehensive assessment of which adults teens talk to about this topic could help to identify key non-family resources for teens and help to distinguish teens who do not talk with family about sex from those who do not have any adult resources for talk about sex.

Our findings show that adolescents are as likely to talk with extended family as parents for communication about sex. While theory identifies parents as key agents of sexual socialization for their children (Shtarkshall et al., 2007; Ward, 2003), our findings suggest that extended family also communicate with teens about sexual values. Furthermore, extended family members fill a niche role in sexual socialization of teen girls and their learning about protection and relationships. These results suggest the importance of extended family as part of teens’ social networks (Jones, Zalot, Foster, Sterrett, & Chester, 2007; Pernice-Duca, 2010) to support their healthy development. Our findings also suggest that researchers and educators addressing teen health should be attentive to the important role of extended family in the lives of youth.

Our findings for research question 1 ran counter to our expectations that teens would report more communication with parents than with extended family about sex. This finding indicates that extended family as well as parents provide an opportunity for family members to socialize teens about sex and suggests a need to expand the parental focus of research and practice to include the larger family system. The high frequency of teens’ talk with extended family in our sample may in part reflect the large proportion of immigrant families and parents with less education among our participants, as extended family have shown to be particularly important supports for families with limited access to resources, including immigrant families (e.g., Barnett, Scaramella, Neppl, Ontai, & Conger, 2010; Hayes, Blake, Darensbourg, & Castillo, 2015).

Our hypothesis for Research Question 2 was partially confirmed. Teens reported more talk with parents than extended family about risks of sex, which is consistent with prior research that indicates that parents focus their communication with teens on delaying sex (Grossman et al., 2018a). It also fits with teens’ perceptions that extended family may be more open and less focused on abstinence than parents in conversations about sex (Cornelius & Xiong, 2015). However, contrary to our expectations, teens were more likely to talk about protection with parents, and equally likely to talk with extended family and parents about relational sex. These findings are inconsistent with research that shows that parents may underestimate their adolescents’ sexual activity (Mollborn & Everett, 2010) which may hinder their focus on protection methods for sexually active teens (Grossman et al., 2018b). It is possible that parents of teens late in high school may adjust their expectations to address teens’ potential for sexual activity for this age group. It would be helpful to explore whether parents’ accuracy in estimating their teens’ sexual behavior varies across age, racial/ethnic group, or immigration status in future research. It may also be the case that comfort in sharing messages about how sex is okay within the context of a close relationship is lacking for both parents and extended family members, perhaps due to worries that this message could encourage teens to have sex.

Finally, we found gender differences in teens’ reported talk with parents and extended family about sex supporting our hypothesis for Research Question 3. As we expected, female participants reported more frequent conversations with parents about Risks of Sex, while male participants reported more frequent conversations with parents about Protection and Relational Sex. These findings fit with theory and research indicating that parents pass on traditional sexual socialization messages to their children (Shtarkshall et al., 2007, Ward, 2003). However, findings that female participants were more likely to report communication with extended family than parents about Protection and Relational Sex suggests that conversations with extended family may provide opportunities for girls to get a range of support and information related to sex that is less limited by traditional gender expectations than communication with parents. Research suggests that parents often pass on similar messages to their own children to those they learned from their parents (Kniveton & Day, 1999; Lehr, Demi, DiIorio, & Facteau, 2005). It may be that extended family members feel less tied than parents to messages about sex that are passed down from parent to child in their families.

Limitations and future directions

Several limitations of this study should be considered. This study’s data are cross-sectional, which does not allow for causal inference. The frequency, content, and gender-role messages of teens’ talk with parents and extended-family may change as teens develop. A cross sectional dataset also limits the ability to account for historical-cultural effects which may related to patterns of talk about sex (e.g., changing norms about sexuality). Longitudinal research is needed to assess continuity and change in teens’ talk with parents and extended family about sex, and how this communication might differ with historical-cultural changes. The specific demographics of the sample also shape study findings. This study included a majority of Latinx participants most of whose parents were immigrants. The high number of immigrant families in this sample provides a unique lens to a population whose family communication with teens about sex is under-studied. This is an important population to understand, as more acculturated Latinx teens are at higher risk for STIs and risky sexual behaviors than teens who are less acculturated (Du and Li, 2015). Further, less recent immigrants to the United States may have more family talk with teens about sex compared to more recent immigrants (Deutsch & Crockett, 2016; Espinoza 2019). Future research could explore to what extent the current study findings generalize to other populations and provide more investigation of the role of acculturation in family communication about sex. In addition, future research would benefit from reports of family talk about sex from parents and extended family members as well as teens. Our small and diverse sub-sample of teens who identified as sexual and gender minorities did not allow for separate analysis of teens in these groups. Further research would benefit from exploring extended family talk about sex for these groups. Given documented complexities of family talk about sex for sexual minority youth (e.g., LaSala, 2015; Newcomb et al., 2018) and disproportionate vulnerability to sexual risk behavior for sexual minority and non-binary teens (Kann et al., 2016), future research is needed to understand family communication for teens from both groups. Our survey asked participants to respond to questions about the extended family member they talked with the most about sex or relationships. This enabled us to obtain in-depth information about a teen’s talk with a single extended family member about sex, but did not allow for further exploration of teens’ potential communication with multiple extended family members or the content of this communication. Future research would benefit from a more complete investigation of teens’ talk with larger family networks about sex and to assess whether patterns found in this study fit with teens’ talk with multiple extended family members. Finally, while participants were encouraged to keep their survey responses private and researchers were available to answer participants’ questions, it is possible that teacher monitoring of survey administration may have biased study results due to participants’ discomfort with teachers’ presence during survey completion.

Practical implications

These findings suggest the importance of including extended family in sex education interventions in order to support adolescents’ health. Health education programs often include parents as a resource to support health-promoting family communication about sex (Planned Parenthood League of Massachusetts, 2017; Tortolero et al., 2010), but miss opportunities for extended family involvement. By working with adolescents to identify trusted adults in their families as partners for talk about sex, programs can take advantage of extended family as resources who are not traditionally included in sex education programs. Our research also suggests a need to educate parents about the importance of providing teen girls with a broad range of information about sex, which goes beyond a focus on abstinence. It is particularly important for parents to share information with their teens about protection methods, given parents’ tendencies to under-estimate teens’ sexual activity (Mollborn & Everett, 2010).

Conclusions

This research highlights the active role that extended family play in talking with teens about sex. An expanded model is needed that recognizes extended family members as additional conversation partners for teens’ talk about sex, particularly among Latinx adolescents. While preliminary research suggests that this communication can support teens’ sexual health (Grossman et al., 2019), further research is needed to assess how the teens’ communication with extended family about sex can protect teens from risky sexual behavior, and how these family members can be integrated into health education programs. Extended family may be particularly important for girls, whose parents may not provide them with a full range of information and support related to sex, but instead conform their communication to traditional sexual socialization messages. It is also unclear whether extended family members experience similar barriers to parents in talking with teens about sex, such as worry that talking with teens about sex will encourage their sexual activity. Exploration of extended family members’ experiences of talking with teens about sex is needed to understand what resources and supports they need to communicate in health-promoting ways with teens about sex.

Highlights.

  • Teens were just as likely to talk with extended family as parents about sex.

  • Extended family members were more likely than parents to talk with girls about protection methods and relational aspects of sex.

  • Parents may not give teen girls a full range of information about to sex, often sharing traditional gendered sexual socialization messages.

  • It is important for parents to talk with teen girls about using protection.

  • Including extended family in sex education program can be a resource for teens, especially for girls.

Footnotes

The authors have no conflicts of interest. This research involved human participants, but not animals. Informed consent forms were distributed to parents/guardians of all adolescents in participating schools. Consent forms were translated into families’ home languages.

Contributor Information

Jennifer M. Grossman, Wellesley College, 106 Central Street, Wellesley MA 02481

Alicia D. Lynch, Lynch Research Associates, Natick, Massachusetts

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