Gender Differences in Sexual Behaviors and Their Relevance to Mental Health among High School Students with Sexual Experience in South Korea

We explored gender differences in sexual behavior, and their relevance to mental health among high school students in South Korea. This study was based on data from the 14th Korea Youth Risk Behavior Web-Based Survey (2018). The subjects were 2460 high school students who reported sexual experiences. Student′s t-test, ANOVA, and Rao-Scott chi-squared test were performed to identify the significance of the differences. Boys had earlier sexual debuts (Rao-Scott χ(2) = 53.55, p < 0.001), a lower frequency of using contraceptives (Rao-Scott χ(2) = 26.57, p < 0.001), and lower rates of sex education in school (Rao-Scott χ(2) = 11.20, p = 0.004). With respect to mental health factors, there was a difference in suicidality according to sexual risk behaviors, with a stronger association found in boys. In girls, there was an association between pregnancy experiences and suicidal ideation (Rao-Scott χ(2) = 9.90, p = 0.003), plans (Rao-Scott χ(2) = 17.25, p < 0.001), and attempts (Rao-Scott χ(2) = 23.11, p < 0.001). Our findings suggest differences by gender and age group in the association between sexual behavior and mental health. It is necessary to devise a sex education strategy for adolescents considering gender and early versus late adolescent development period.