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How Casual Sex Can Affect Our Mental Health

We're finally learning what hookups do to our psyche, for better or worse.

Key points

  • For both men and women, sex with a casual stranger bodes poorly for mental health and self-esteem.
  • Research shows those who were not depressed before had more depressive symptoms and loneliness after engaging in casual sex.
  • More men than women are willing to report they had casual sex in the last month, according to one study.
Monkey Business Images/Shutterstock
Source: Monkey Business Images/Shutterstock

With the gap between puberty and entry into marriage getting ever wider, more “emerging adults" are turning to casual encounters as a way to express and satisfy their sexual needs.

In a comprehensive review of the status of research on casual sex, Kinsey Institute researcher Justin Garcia and his team from Binghamton University (2012) concluded that “Hookups are part of a popular cultural shift that has infiltrated the lives of emerging adults throughout the Westernized world” (p. 171).

And yet hookups pose a significant threat to the physical and psychological health of these young individuals.

In addition to the known risks of contracting STDs, developing unwanted pregnancies, and being raped or otherwise assaulted, people who engage in casual sex may suffer emotional consequences that persist long after the details of an encounter are a dim memory. On college campuses, where brief sexual liaisons are prevalent, unanticipated results can jeopardize a student’s career. In the workplace, the results can be just as disastrous, if not more so.

It’s difficult enough to conduct research on sexual behavior. It's even more challenging when the topic is sexual relationships outside the context of long-term relationships. Regret, faulty memory, and shame or embarrassment can taint or limit people’s self-reports—while, at the same time, others exaggerate their encounters in the opposite direction.

Despite our 21st-century reality, many of our social norms remain tied to 20th-century sensibilities. The old double standard still looks down on women, but either glorifies or fails to blame men who make a habit of having frequent, uncommitted sex. As Garcia and colleagues point out, there may be a biological basis to the greater acceptance of casual sex among men, but there’s no way to separate biology from sociocultural influences given that the two are so tightly intertwined—and will forever remain so.

Setting aside the issue of gender differences for the moment, what do we know about those unintended emotional consequences of short-term sexual liaisons?

As reviewed by Garcia and his co-authors, there are plenty. For one, there’s the discomfort factor. Despite the flood of media messages that hookups are okay, if not desirable, people may still feel that they’ve done something that violates their own internal standards. Feeling perhaps pressured to get involved because "everyone else is," they may develop performance anxiety, ironically setting the stage for future sexual dysfunction. Other common reactions include regret, disappointment, confusion, embarrassment, guilt, and low self-esteem, although other individuals certainly report feeling proud, nervous, excited, and desirable or wanted. (Feelings tended to be more positive before and during a hookup, and more negative afterward.)

Researchers examining the mental health associations of hookup sex also report that participants who were not depressed before showed more depressive symptoms and loneliness after engaging in casual sex.

(Another set of risk factors involves non-consensual sex. In one study reported by Garcia and colleagues, approximately half the young women surveyed said they'd had a nonconsensual sexual encounter, and alcohol and other substances were more likely to be factors in nonconsensual sex.)

The majority of the studies on hookups and well-being reported by Garcia and his team were based on small samples, typically drawn from individual college campuses. But an article by Sacramento State University psychologist Melina Bersamin, to be published in an upcoming issue of the Journal of Sex Research, is based on a multi-campus study led by Miami University psychologist Seth Schwartz (Bersamin et al., in press). I am also an author of this very interesting investigation, which included data from over 3,900 undergraduates at 30 campuses around the United States. All of the participants in the Bersamin et al study were heterosexual (as is the case for the majority of research on this topic), and came from multiple ethnic backgrounds and social classes. We asked participants to indicate how many times, during the past 30 days, they had sex with someone they knew for less than a week. To measure well-being, we asked participants to rate their self-esteem, degree of life satisfaction, their general sense of positive functioning (“psychological well-being”), and feelings of self-actualization (“eudaimonic” well-being). To tap into feelings of psychological despair, we asked participants to report on feelings of depression, general anxiety, and social anxiety.

Our results showed that a relatively high percentage of students had engaged in casual sex within the past month (11%), with more men (18.6%) than women (7.4%) stating they had done so. This difference is typical of those reported in casual sex research and could reflect a genuine, biologically-based sex difference. Alternatively, the difference could reflect differing socialization influences affecting the degree of comfort with admitting to hookup encounters.

As we predicted, people who engaged in more hookups had greater psychological distress. College students who recently engaged in casual sex reported lower levels of self-esteem, life satisfaction, and happiness compared to those who had not had casual sex in the past month. And students who recently engaged in hookups had higher distress scores as indicated by levels of depression and anxiety. In contrast to the notion that men are okay with casual sex but women are not, we did not find gender differences in the relationships between casual sex and either distress or well-being. For both men and women, true hookup sex—with a casual stranger rather than a romantic partner or “friend with benefits"—seemed to bode poorly for mental health and self-esteem. Of course, this was a correlational study. We don’t know whether poor mental health caused individuals to be more likely to engage in casual sex or whether, as was shown in studies reviewed by Garcia, poor health resulted from casual sex. On the positive side, due to the large size of our sample, we were better able than other researchers to institute statistical controls, particularly in terms of the inevitable errors that occur when measuring these sensitive psychological constructs.

The only way to begin to tease out directionality in the casual sex/mental health conundrum is by conducting longitudinal studies, though even those will not be perfect. People who seek out casual-sex opportunities, particularly those who do so under the influence of alcohol or drugs, may be fighting off persistent feelings of loneliness, depression, and social anxiety that they hope to eradicate or reduce through brief encounters that grant them momentary closeness.

Our findings suggest that even though gender norms, biology, or some combination of the two may lead men to be more likely to seek (or at least to report seeking) casual sex, there are similar connections for women between hookups and mental health. Moreover, the fact that we defined casual sex in the way that we did (with a stranger within the past month), it is possible that we were tapping into a population at particularly high risk due to high levels of impulsivity. At that level, mental-health factors may trump socialization or biology to wipe out gender effects.

The upshot: We need to pay more attention to hookups at all levels, from the young men and women who gravitate toward these relationships, to parents, college administrators, and mental health professionals. If you’re someone who’s been involved in casual sex, our findings, and those reported by Garcia and collaborators, suggest that you might want to think about how your sexual behavior might affect, and be affected by, your psychological well-being. We all seek gratifying and fulfilling intimate partnerships, and by knowing the benefits and risks of short-term encounters, you’ll increase your own chances of making these relationship goals come true.

Copyright Susan Krauss Whitbourne, Ph.D. 2013


Bersamin, M., Zamboanga, B. L, Schwartz, S. J., Donnellan, M. B., Hudson, M., Weisskirch, R. S., Kim, S. Y., Agocha, V. B., Whitbourne, S. K., & Caraway, S. J. (in press). Risky business: Is there an association between casual sex and mental health among young emerging adults? Journal of Sex Research.

Garcia, J. R., Reiber, C., Massey, S. G., & Merriwether, A. M. (2012). Sexual hookup culture: A review. Review Of General Psychology, 16(2), 161-176. doi:10.1037/a0027911

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