Sexual Decision Making

Sexual decision making and the outcomes of those decisions are impacted by substance use and life circumstances.

Youth are more able to make sexual decisions that are right for them when:
  • They are provided with objective, factual, and up to date information.
  • They have the opportunity to develop values and practice skills.


I’m getting pretty stressed cuz I think Taylor is going to break up with me. Taylor says we’ve been together long enough. I think Taylor is sick of waiting for me to have sex. What bothers me the most is being reminded that I did it with Jae so why not with Taylor too? I guess that’s a fair point. But that was a long time ago and I didn’t really like it. Everyone keeps telling me that if someone really loves you, they wait. But what if time’s up and Taylor does break up with me? Maybe I should just get drunk, do it and get it over with. Besides, I’m older now and should probably like it, right? I don’t know why I’m waiting anyway.

Sexual Decision Making

 For street involved and other high risk youth, the decision to have sex may be made because of life circumstances.

For example, some youth have sex:
  • Because they had sex with that person before and believe that they have to.
  • To feel safe.
  • To avoid conflict.
  • To keep a relationship.
  • For money, drugs or a place to sleep.

Youth may need support recognizing that sex is about choice.

People have the right to choose to:
  • Have sex or not.
  • Set personal boundaries and limits.
  • Make sexual decisions sober.
  • Talk to a partner about limits and safety.

Good to know

 Although people have the right to choose sex, sometimes that choice is taken away. Youth who are in an abusive relationships may be involved in a situation where setting a sexual limit, suggesting condoms or using birth control could put their safety at risk. For more information on relationships, click here.

Supporting youth to know if they are ready for sex

Being “ready for sex” is more than about feeling sexually aroused and having a person to have sex with. Sexual readiness is about physical, emotional, and relationship readiness.

To help youth make their own healthy decisions, service providers can:
  • Provide up to date and factual information.
  • Provide opportunities to build and practice skills and consider values.
  • Offer resources.
  • Ask questions.
  • Avoid implying what youth “should” do.
  • Recognize that having sex may be a healthy choice for some clients.

Questions about the body

  • Are you healthy enough to have sex?
  • Do you have an STI?  Does your partner?  Have you been tested?
  • Have you talked about and accessed STI protection?
  • If pregnancy is a concern, have you talked about and accessed contraception?
  • Are you sober?  Are they?
  • Can you handle an STI or pregnancy?

Questions about emotions and values

  •  Do you really want to have sex?
  •  Do you have a positive self-image and good self-esteem?
  •  How would this activity fit in with your personal, religious or family values?
  •  How will you feel the next day?

Questions about relationships

  • Are you feeling pressured by your partner? Someone else? Yourself?
  • Is everyone able to set, communicate and respect boundaries?
  • Is there mutual trust, respect and care?
  • Do you share similar values and goal about sex?
  • How will this affect your relationship with this person? Will this affect your other relationships?
  • Is this activity legal?

Social Media, Pornography and Sexting

 Social media, sexting and pornography influence the sexual decision making of youth. It’s important to teach youth how to analyze and interpret the media and how to fact check so that they can understand the influence on their decisions.

Social Media

is any online, digital or mobile communication platform where users communicate with other users.


is when people send or receive sexual pictures, messages or videos by cell phone or mobile device.


is sexually explicit media showing genitals or sexual activity with the purpose of sexually arousing the viewer.

Good to know

Youth use of pornography, especially by those without strong media and porn literacy may: 1,2
  • Impact self-image.
  • Increase risky sexual behaviors.
  • Cause people to see girls and women as sex objects and men as sexual aggressors.
  • Lead to unrealistic or unhealthy attitudes and expectations about sex, relationships, bodies, and gender roles.
  • Change how the brain and body work together for sex.

Good to know

Social media, sexting and pornography may have legal considerations such as:1,2
  • When people under 18 take or send nude pictures of themselves, it can be considered creating and/or distributing child pornography.
  • If the person they send it to is also under the age of 18, it can be considered as providing pornography to children.
  • Police may lay charges for cyberbullying harassment, hate speech and sharing sexual pictures of someone without their consent.

Many youth choose to use digital media, including porn, sexting and social media. Teaching media literacy can help youth make good media and sexual decisions. Media literacy includes understanding that:

  • Nothing you do or see on the internet is private, even if you are alone and it feels private. Others can access, store and share what you say and do.
  • Nothing you do on the internet is temporary; even if you think you have deleted it or it seems to disappear, it’s stored in the computer memory and on a server.
  • It’s important to set the same boundaries, communicate and treat other people the same way in the digital world as in the real world.
  • If you see or read something on the internet or social media, even if you think you weren’t supposed to see or read it, it’s important to tell a trusted adult.
  • It’s normal to be curious about sexuality and to explore and express your sexuality in a variety of ways that might include media.
  • Real-life people aren’t like porn characters or social media celebrities.
  • Sex cannot feel like porn looks because porn is fantasy story, told by actors playing roles and told using special effects and editing.
  • Sexual fantasy is fantasy because it’s not things that people usually do or like.
More tips for talking to youth about media literacy can be found here.


Sexual activity without consent is sexual assault.

Consent is:

  • Needed for every sexual activity, every time.
  • Everyone understanding what they are consenting to.
  • Checking in with partners and accepting that people can change their mind at any time.

People cannot give consent if they are:3

  • High or drunk.
  • Forced, threatened, bribed, intimidated, or offered rewards to do something sexual.
To learn more about consent laws in Canada, go to:
When discussing sexual consent with youth, they may:
  • Come up with many “what if” scenarios trying to find a loophole in consent laws.
  • Talk about what they find confusing such as someone giving mixed messages like refusing to say yes, but continuing to make out. 

To see an entertaining video that addresses many of these “what ifs,” click here.

You can support youth to come up with scripts on how to respond to confusing messages like “I like and respect you and don’t want to keep going until I am sure I understand what you are ok with.”

Keep in mind that youth need specific and concrete discussion of consent.

Good to know

People under 18 can access many medical services including contraception, STI testing and treatment and abortions, without parent permission if they are a mature minor.

This means they are able to make informed decisions and understand the:


Consequences of treatment.

Consequences of not having the treatment.3


It is important to use gender neutral language when discussing consent and sexual assault because people of any gender can be sexually assaulted and people of any gender can be perpetrators of sexual assault.

Substance use and sexuality

In adolescence, the pleasure center of the brain develops before the judgment center resulting in teen risk-taking. 

Risk-taking involving substance use is common in youth. Substance use can lead to more dangerous risks such as having risky sex.

Good to know

A significant number of youth report they used drugs or alcohol before they had sex the last time.


Some youth believe marijuana is not harmful because of the legalization marijuana in Canada. Presenting research based information about marijuana can support youth who might be feeling unsure about use to challenge their assumptions.4

Impact of substance use on sexual health

Because substances affect youth differently than adults, youth may experience more serious, longer-lasting or even permanent effects from use.

Substance use may result in:5
  • Reduced communication skills which impact the ability to set and understand sexual boundaries.
  • Decreased fine motor skills and coordination which may impact correct condom use.
  • Poor memory which may impact the ability to take the birth control pill at the right time.
  • Sex at an early age and/or unprotected sex.
  • Multiple sexual partners.

Good to know

Alcohol and street drugs do not change how hormonal birth control works, but clients who use substances may find it difficult to use those products correctly. For example, for birth control pills to work properly, they need to be taken about the same time every day. This is not always realistic for some users.

Good to know

 Despite what some youth believe, Viagra and similar products do not increase the sex drive or improve erections in those without cardiovascular disease. When taken by a person that was not prescribed the medication, or when taken by a person in a way other than prescribed, these medications can cause serious injury or even death.6

For more information on substance use, please visit:
For more information about sexual decision making, see:
For more information on consent and support, see:
1Quadara, A., El-Murr, A., & Latham, J. (2020). The effects of pornography on children and young people. Research summary – December 2017. Retrieved from, 
2Owens, E. W., Behun, R. J., Manning, J. C., & Reid, R. C. (2012). The impact of internet pornography on adolescents: a review of the research. Sexual Addiction & Compulsivity, 19(1-2), 99-122. (2019). Understanding consent for sex: What it means for you. Retrieved from, (2020). Cannabis is often one of the first drugs a teen is offered. Retrieved from,  
5CDC. (2018). Substance use and sexual risk behaviors among youth. Retrieved from,
6 Pfizer. (2015). How does Viagra work? Retrieved from