2017 - 2019

Principal Investigator: Jennifer Grossman, Ph.D.

Project Staff: Linda Charmaraman, Ph.D., Lisette DeSouza, Ph.D., Lorena Estrada-Martinez, Ph.D., Alicia Doyle Lynch, Ph.D., Amanda Richer, M.A.

Project Manager: Ineke Ceder

Funded by: National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health & Human Development

Project Goal

The goal of this project was to understand how teens and their families (both parents and extended family) talk about sex and relationships, and whether and how this communication can support teens' healthy development. This project explored how family conversations about relationships support high school students’ health, delay sex, and reduce teen pregnancy. The ultimate aim of research on extended family sexuality communication is to support teens’ healthy decisions so they can remain in school.

The Youth Risk Behavior Survey found that by 12th grade 60% of Massachusetts teens have had sex (2015). Research shows that talking with parents about sex can protect teens from risky sexual behavior, such as early sex or sex without a condom. However, half of teens and parents don’t talk with one another about sex and relationships, in part due to teens’ concerns that their parents might judge them or worry about their sexual behaviors. Many teens are reluctant to talk with their parents about sex and may seek out other family members as a more comfortable option. Indeed, over half of teens report that they talk with extended family members, such as grandparents, aunts and uncles, older siblings and cousins. These conversations can provide a unique opportunity for relatives to share tools that can protect teens from early sex, STIs, and pregnancy. Talking with extended family is particularly relevant for Black and Latinx teens for whom extended family often has a major influence in childrearing. However, little is known about the topics of teens’ conversation with these family members, the messages and values family members share with teens, and how these conversations influence teens’ health.


This study included a 1-time survey of 11th and 12th-grade students in the Fall of 2017. Survey items included teens’ reports of the content, frequency, and quality of conversations about sex and relationships with family members, and questions about their own sexual attitudes, beliefs, and behaviors. This study also included phone interviews with 30 adult family members about how they talked with teens about relationships and what resources would support health-promoting conversations with teens.

Relevance for Practice

Family conversations about sex are important to students’ academic success as they can prevent risky sexual behavior which can lead to teen pregnancy and school-drop-out. The project aimed to provide schools and curriculum developers with direction on whether and how to include family members in health education programs, for example through home-based activity assignments. Providing resources and support for teens’ health-promoting communication with family members may be especially important among diverse families where extended family members may play key childrearing roles.


The research team found that almost half of the teens they surveyed are talking to extended family about dating, sex, and relationships. They found that teens who talked with extended family about protection from sexually transmitted diseases and teen pregnancy had sex with fewer people. And while extended family members may play a somewhat different role than parents in teens' sexuality communication, family members showed a largely common set of values. These findings suggest that extended family can play a role in supporting teens' sexual health, particularly when teens feel uncomfortable talking with parents. 

Through interviews with adult family members, the researchers identified four themes in sexuality communication: why adolescents talk to extended family about sex and relationships, family engagement in the conversations, consistency of family messages, and family communication about adolescents. Family members varied in how they interacted with teens and one another regarding these conversations. For example, some participants described family coordination of sexual messages to the teen, while others reported no family communication about this topic. This highlights the need to examine family communication about sex and relationships in the context of a larger family system, rather than only within one-on-one relationships.

The research team also found significant gender differences in Hispanic teenagers' talk about sexuality with mothers and fathers. In other words, Hispanic teen girls were more likely to talk with their mothers about sex, while Hispanic teen boys were more likely to talk with their fathers. The content of the communication, the family member they talked to, and the gender of the teenager all contributed to whether that communication protected them from risky sexual behavior.

In an analysis that compared heterosexual and non-heterosexual teenagers' survey responses, the researchers found that mothers offered more messages about sexual protection methods to their non-sexual minority teens, and fathers talked less with sexual minority teens about risks of sex and relational sex. Male sexual minorities reported talking to more family and extended family members, while female and non-binary sexual minorities confided in fewer family members or no one.

Findings from this study suggest that one size does not fit all when it comes to family communication about sexuality and relationships. Families of racial and sexual minority teens may approach these conversations in different ways, and all families vary in whether they coordinate the messages coming from parents and extended family. Overall, this research highlights the importance of understanding the complexities of sexuality communication within a family system and suggests that extended family can play a valuable role in that system. 


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