Kate Julian | The Atlantic

America Has a Drinking Problem

2021-06-01T06:00:00-04:00

Photograph by Chelsea Kyle; Prop Stylist: Amy Elise Wilson; Food Stylist: Sue Li

This article was published online on June 1, 2021.

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Few things are more American than drinking heavily. But worrying about how heavily other Americans are drinking is one of them.

The Mayflower landed at Plymouth Rock because, the crew feared, the Pilgrims were going through the beer too quickly. The ship had been headed for the mouth of the Hudson River, until its sailors (who, like most Europeans of that time, preferred beer to water) panicked at the possibility of running out before they got home, and threatened mutiny. And so the Pilgrims were kicked ashore, short of their intended destination and beerless. William Bradford complained bitterly about the latter in his diary that winter, which is really saying something when you consider what trouble the group was in. (Barely half would survive until spring.) Before long, they were not only making their own beer but also importing wine and liquor. Still, within a couple of generations, Puritans like Cotton Mather were warning that a “flood of RUM” could “overwhelm all good Order among us.”

George Washington first won elected office, in 1758, by getting voters soused. (He is said to have given them 144 gallons of alcohol, enough to win him 307 votes and a seat in Virginia’s House of Burgesses.) During the Revolutionary War, he used the same tactic to keep troops happy, and he later became one of the country’s leading whiskey distillers. But he nonetheless took to moralizing when it came to other people’s drinking, which in 1789 he called “the ruin of half the workmen in this Country.”

Hypocritical though he was, Washington had a point. The new country was on a bender, and its drinking would only increase in the years that followed. By 1830, the average American adult was consuming about three times the amount we drink today. An obsession with alcohol’s harms understandably followed, starting the country on the long road to Prohibition.

What’s distinctly American about this story is not alcohol’s prominent place in our history (that’s true of many societies), but the zeal with which we’ve swung between extremes. Americans tend to drink in more dysfunctional ways than people in other societies, only to become judgmental about nearly any drinking at all. Again and again, an era of overindulgence begets an era of renunciation: Binge, abstain. Binge, abstain.

Right now we are lurching into another of our periodic crises over drinking, and both tendencies are on display at once. Since the turn of the millennium, alcohol consumption has risen steadily, in a reversal of its long decline throughout the 1980s and ’90s. Before the pandemic, some aspects of this shift seemed sort of fun, as long as you didn’t think about them too hard. In the 20th century, you might have been able to buy wine at the supermarket, but you couldn’t drink it in the supermarket. Now some grocery stores have wine bars, beer on tap, signs inviting you to “shop ’n’ sip,” and carts with cup holders.

Actual bars have decreased in number, but drinking is acceptable in all sorts of other places it didn’t used to be: Salons and boutiques dole out cheap cava in plastic cups. Movie theaters serve alcohol, Starbucks serves alcohol, zoos serve alcohol. Moms carry coffee mugs that say things like This Might Be Wine, though for discreet day-drinking, the better move may be one of the new hard seltzers, a watered-down malt liquor dressed up—for precisely this purpose—as a natural soda.

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Even before COVID-19 arrived on our shores, the consequences of all this were catching up with us. From 1999 to 2017, the number of alcohol-related deaths in the U.S. doubled, to more than 70,000 a year—making alcohol one of the leading drivers of the decline in American life expectancy. These numbers are likely to get worse: During the pandemic, frequency of drinking rose, as did sales of hard liquor. By this February, nearly a quarter of Americans said they’d drunk more over the past year as a means of coping with stress.

Explaining these trends is hard; they defy so many recent expectations. Not long ago, Millennials were touted as the driest generation—they didn’t drink much as teenagers, they were “sober curious,” they were so admirably focused on being well—and yet here they are day-drinking White Claw and dying of cirrhosis at record rates. Nor does any of this appear to be an inevitable response to 21st-century life: Other countries with deeply entrenched drinking problems, among them Britain and Russia, have seen alcohol use drop in recent years.

Media coverage, meanwhile, has swung from cheerfully overselling the (now disputed) health benefits of wine to screeching that no amount of alcohol is safe, ever; it might give you cancer and it will certainly make you die before your time. But even those who are listening appear to be responding in erratic and contradictory ways. Some of my own friends—mostly 30- or 40-something women, a group with a particularly sharp uptick in drinking—regularly declare that they’re taking an extended break from drinking, only to fall off the wagon immediately. One went from extolling the benefits of Dry January in one breath to telling me a funny story about hangover-cure IV bags in the next. A number of us share the same (wonderful) doctor, and after our annual physicals, we compare notes about the ever nudgier questions she asks about alcohol. “Maybe save wine for the weekend?” she suggests with a cheer so forced she might as well be saying, “Maybe you don’t need to drive nails into your skull every day?”

What most of us want to know, coming out of the pandemic, is this: Am I drinking too much? And: How much are other people drinking? And: Is alcohol actually that bad?

The answer to all these questions turns, to a surprising extent, not only on how much you drink, but on how and where and with whom you do it. But before we get to that, we need to consider a more basic question, one we rarely stop to ask: Why do we drink in the first place? By we, I mean Americans in 2021, but I also mean human beings for the past several millennia.

Let’s get this out of the way: Part of the answer is “Because it is fun.” Drinking releases endorphins, the natural opiates that are also triggered by, among other things, eating and sex. Another part of the answer is “Because we can.” Natural selection has endowed humans with the ability to drink most other mammals under the table. Many species have enzymes that break alcohol down and allow the body to excrete it, avoiding death by poisoning. But about 10 million years ago, a genetic mutation left our ancestors with a souped-up enzyme that increased alcohol metabolism 40-fold.

This mutation occurred around the time that a major climate disruption transformed the landscape of eastern Africa, eventually leading to widespread extinction. In the intervening scramble for food, the leading theory goes, our predecessors resorted to eating fermented fruit off the rain-forest floor. Those animals that liked the smell and taste of alcohol, and were good at metabolizing it, were rewarded with calories. In the evolutionary hunger games, the drunk apes beat the sober ones.

But even presuming that this story of natural selection is right, it doesn’t explain why, 10 million years later, I like wine so much. “It should puzzle us more than it does,” Edward Slingerland writes in his wide-ranging and provocative new book, Drunk: How We Sipped, Danced, and Stumbled Our Way to Civilization, “that one of the greatest foci of human ingenuity and concentrated effort over the past millennia has been the problem of how to get drunk.” The damage done by alcohol is profound: impaired cognition and motor skills, belligerence, injury, and vulnerability to all sorts of predation in the short run; damaged livers and brains, dysfunction, addiction, and early death as years of heavy drinking pile up. As the importance of alcohol as a caloric stopgap diminished, why didn’t evolution eventually lead us away from drinking—say, by favoring genotypes associated with hating alcohol’s taste? That it didn’t suggests that alcohol’s harms were, over the long haul, outweighed by some serious advantages.

Versions of this idea have recently bubbled up at academic conferences and in scholarly journals and anthologies (largely to the credit of the British anthropologist Robin Dunbar). Drunk helpfully synthesizes the literature, then underlines its most radical implication: Humans aren’t merely built to get buzzed—getting buzzed helped humans build civilization. Slingerland is not unmindful of alcohol’s dark side, and his exploration of when and why its harms outweigh its benefits will unsettle some American drinkers. Still, he describes the book as “a holistic defense of alcohol.” And he announces, early on, that “it might actually be good for us to tie one on now and then.”

Slingerland is a professor at the University of British Columbia who, for most of his career, has specialized in ancient Chinese religion and philosophy. In a conversation this spring, I remarked that it seemed odd that he had just devoted several years of his life to a subject so far outside his wheelhouse. He replied that alcohol isn’t quite the departure from his specialty that it might seem; as he has recently come to see things, intoxication and religion are parallel puzzles, interesting for very similar reasons. As far back as his graduate work at Stanford in the 1990s, he’d found it bizarre that across all cultures and time periods, humans went to such extraordinary (and frequently painful and expensive) lengths to please invisible beings.

In 2012, Slingerland and several scholars in other fields won a big grant to study religion from an evolutionary perspective. In the years since, they have argued that religion helped humans cooperate on a much larger scale than they had as hunter-gatherers. Belief in moralistic, punitive gods, for example, might have discouraged behaviors (stealing, say, or murder) that make it hard to peacefully coexist. In turn, groups with such beliefs would have had greater solidarity, allowing them to outcompete or absorb other groups.

Around the same time, Slingerland published a social-science-heavy self-help book called Trying Not to Try. In it, he argued that the ancient Taoist concept of wu-wei (akin to what we now call “flow”) could help with both the demands of modern life and the more eternal challenge of dealing with other people. Intoxicants, he pointed out in passing, offer a chemical shortcut to wu-wei—by suppressing our conscious mind, they can unleash creativity and also make us more sociable.

At a talk he later gave on wu-wei at Google, Slingerland made much the same point about intoxication. During the Q&A, someone in the audience told him about the Ballmer Peak—the notion, named after the former Microsoft CEO Steve Ballmer, that alcohol can affect programming ability. Drink a certain amount, and it gets better. Drink too much, and it goes to hell. Some programmers have been rumored to hook themselves up to alcohol-filled IV drips in hopes of hovering at the curve’s apex for an extended time.

His hosts later took him over to the “whiskey room,” a lounge with a foosball table and what Slingerland described to me as “a blow-your-mind collection of single-malt Scotches.” The lounge was there, they said, to provide liquid inspiration to coders who had hit a creative wall. Engineers could pour themselves a Scotch, sink into a beanbag chair, and chat with whoever else happened to be around. They said doing so helped them to get mentally unstuck, to collaborate, to notice new connections. At that moment, something clicked for Slingerland too: “I started to think, Alcohol is really this very useful cultural tool.” Both its social lubrications and its creativity-enhancing aspects might play real roles in human society, he mused, and might possibly have been involved in its formation.

He belatedly realized how much the arrival of a pub a few years earlier on the UBC campus had transformed his professional life. “We started meeting there on Fridays, on our way home,” he told me. “Psychologists, economists, archaeologists—we had nothing in common—shooting the shit over some beers.” The drinks provided just enough disinhibition to get conversation flowing. A fascinating set of exchanges about religion unfolded. Without them, Slingerland doubts that he would have begun exploring religion’s evolutionary functions, much less have written Drunk.

Which came first, the bread or the beer? For a long time, most archaeologists assumed that hunger for bread was the thing that got people to settle down and cooperate and have themselves an agricultural revolution. In this version of events, the discovery of brewing came later—an unexpected bonus. But lately, more scholars have started to take seriously the possibility that beer brought us together. (Though beer may not be quite the word. Prehistoric alcohol would have been more like a fermented soup of whatever was growing nearby.)

For the past 25 years, archaeologists have been working to uncover the ruins of Göbekli Tepe, a temple in eastern Turkey. It dates to about 10,000 B.C.—making it about twice as old as Stonehenge. It is made of enormous slabs of rock that would have required hundreds of people to haul from a nearby quarry. As far as archaeologists can tell, no one lived there. No one farmed there. What people did there was party. “The remains of what appear to be brewing vats, combined with images of festivals and dancing, suggest that people were gathering in groups, fermenting grain or grapes,” Slingerland writes, “and then getting truly hammered.”

Over the decades, scientists have proposed many theories as to why we still drink alcohol, despite its harms and despite millions of years having passed since our ancestors’ drunken scavenging. Some suggest that it must have had some interim purpose it’s since outlived. (For example, maybe it was safer to drink than untreated water—fermentation kills pathogens.) Slingerland questions most of these explanations. Boiling water is simpler than making beer, for instance.

Göbekli Tepe—and other archaeological finds indicating very early alcohol use—gets us closer to a satisfying explanation. The site’s architecture lets us visualize, vividly, the magnetic role that alcohol might have played for prehistoric peoples. As Slingerland imagines it, the promise of food and drink would have lured hunter-gatherers from all directions, in numbers great enough to move gigantic pillars. Once built, both the temple and the revels it was home to would have lent organizers authority, and participants a sense of community. “Periodic alcohol-fueled feasts,” he writes, “served as a kind of ‘glue’ holding together the culture that created Göbekli Tepe.”

Things were likely more complicated than that. Coercion, not just inebriated cooperation, probably played a part in the construction of early architectural sites, and in the maintenance of order in early societies. Still, cohesion would have been essential, and this is the core of Slingerland’s argument: Bonding is necessary to human society, and alcohol has been an essential means of our bonding. Compare us with our competitive, fractious chimpanzee cousins. Placing hundreds of unrelated chimps in close quarters for several hours would result in “blood and dismembered body parts,” Slingerland notes—not a party with dancing, and definitely not collaborative stone-lugging. Human civilization requires “individual and collective creativity, intensive cooperation, a tolerance for strangers and crowds, and a degree of openness and trust that is entirely unmatched among our closest primate relatives.” It requires us not only to put up with one another, but to become allies and friends.

As to how alcohol assists with that process, Slingerland focuses mostly on its suppression of prefrontal-cortex activity, and how resulting disinhibition may allow us to reach a more playful, trusting, childlike state. Other important social benefits may derive from endorphins, which have a key role in social bonding. Like many things that bring humans together—laughter, dancing, singing, storytelling, sex, religious rituals—drinking triggers their release. Slingerland observes a virtuous circle here: Alcohol doesn’t merely unleash a flood of endorphins that promote bonding; by reducing our inhibitions, it nudges us to do other things that trigger endorphins and bonding.

Over time, groups that drank together would have cohered and flourished, dominating smaller groups—much like the ones that prayed together. Moments of slightly buzzed creativity and subsequent innovation might have given them further advantage still. In the end, the theory goes, the drunk tribes beat the sober ones.

But this rosy story about how alcohol made more friendships and advanced civilization comes with two enormous asterisks: All of that was before the advent of liquor, and before humans started regularly drinking alone.

Photograph by Chelsea Kyle; Prop Stylist: Amy Elise Wilson; Food Stylist: Sue Li

The early Greeks watered down their wine; swilling it full-strength was, they believed, barbaric—a recipe for chaos and violence. “They would have been absolutely horrified by the potential for chaos contained in a bottle of brandy,” Slingerland writes. Human beings, he notes, “are apes built to drink, but not 100-proof vodka. We are also not well equipped to control our drinking without social help.”

Distilled alcohol is recent—it became widespread in China in the 13th century and in Europe from the 16th to 18th centuries—and a different beast from what came before it. Fallen grapes that have fermented on the ground are about 3 percent alcohol by volume. Beer and wine run about 5 and 11 percent, respectively. At these levels, unless people are strenuously trying, they rarely manage to drink enough to pass out, let alone die. Modern liquor, however, is 40 to 50 percent alcohol by volume, making it easy to blow right past a pleasant social buzz and into all sorts of tragic outcomes.

[From the September 2016 issue: Caitlin Flanagan on how helicopter parenting can cause binge drinking]

Just as people were learning to love their gin and whiskey, more of them (especially in parts of Europe and North America) started drinking outside of family meals and social gatherings. As the Industrial Revolution raged, alcohol use became less leisurely. Drinking establishments suddenly started to feature the long counters that we associate with the word bar today, enabling people to drink on the go, rather than around a table with other drinkers. This short move across the barroom reflects a fairly dramatic break from tradition: According to anthropologists, in nearly every era and society, solitary drinking had been almost unheard‑of among humans.

The social context of drinking turns out to matter quite a lot to how alcohol affects us psychologically. Although we tend to think of alcohol as reducing anxiety, it doesn’t do so uniformly. As Michael Sayette, a leading alcohol researcher at the University of Pittsburgh, recently told me, if you packaged alcohol as an anti-anxiety serum and submitted it to the FDA, it would never be approved. He and his onetime graduate student Kasey Creswell, a Carnegie Mellon professor who studies solitary drinking, have come to believe that one key to understanding drinking’s uneven effects may be the presence of other people. Having combed through decades’ worth of literature, Creswell reports that in the rare experiments that have compared social and solitary alcohol use, drinking with others tends to spark joy and even euphoria, while drinking alone elicits neither—if anything, solo drinkers get more depressed as they drink.

Sayette, for his part, has spent much of the past 20 years trying to get to the bottom of a related question: why social drinking can be so rewarding. In a 2012 study, he and Creswell divided 720 strangers into groups, then served some groups vodka cocktails and other groups nonalcoholic cocktails. Compared with people who were served nonalcoholic drinks, the drinkers appeared significantly happier, according to a range of objective measures. Maybe more important, they vibed with one another in distinctive ways. They experienced what Sayette calls “golden moments,” smiling genuinely and simultaneously at one another. Their conversations flowed more easily, and their happiness appeared infectious. Alcohol, in other words, helped them enjoy one another more.

This research might also shed light on another mystery: why, in a number of large-scale surveys, people who drink lightly or moderately are happier and psychologically healthier than those who abstain. Robin Dunbar, the anthropologist, examined this question directly in a large study of British adults and their drinking habits. He reports that those who regularly visit pubs are happier and more fulfilled than those who don’t—not because they drink, but because they have more friends. And he demonstrates that it’s typically the pub-going that leads to more friends, rather than the other way around. Social drinking, too, can cause problems, of course—and set people on a path to alcohol-use disorder. (Sayette’s research focuses in part on how that happens, and why some extroverts, for example, may find alcohol’s social benefits especially hard to resist.) But solitary drinking—even with one’s family somewhere in the background—is uniquely pernicious because it serves up all the risks of alcohol without any of its social perks. Divorced from life’s shared routines, drinking becomes something akin to an escape from life.

Southern Europe’s healthy drinking culture is hardly news, but its attributes are striking enough to bear revisiting: Despite widespread consumption of alcohol, Italy has some of the lowest rates of alcoholism in the world. Its residents drink mostly wine and beer, and almost exclusively over meals with other people. When liquor is consumed, it’s usually in small quantities, either right before or after a meal. Alcohol is seen as a food, not a drug. Drinking to get drunk is discouraged, as is drinking alone. The way Italians drink today may not be quite the way premodern people drank, but it likewise accentuates alcohol’s benefits and helps limit its harms. It is also, Slingerland told me, about as far as you can get from the way many people drink in the United States.

Americans may not have invented binge drinking, but we have a solid claim to bingeing alone, which was almost unheard-of in the Old World. During the early 19th century, solitary binges became common enough to need a name, so Americans started calling them “sprees” or “frolics”—words that sound a lot happier than the lonely one-to-three-day benders they described.

In his 1979 history, The Alcoholic Republic, the historian W. J. Rorabaugh painstakingly calculated the stunning amount of alcohol early Americans drank on a daily basis. In 1830, when American liquor consumption hit its all-time high, the average adult was going through more than nine gallons of spirits each year. Most of this was in the form of whiskey (which, thanks to grain surpluses, was sometimes cheaper than milk), and most of it was drunk at home. And this came on top of early Americans’ other favorite drink, homemade cider. Many people, including children, drank cider at every meal; a family could easily go through a barrel a week. In short, Americans of the early 1800s were rarely in a state that could be described as sober, and a lot of the time, they were drinking to get drunk.

Rorabaugh argued that this longing for oblivion resulted from America’s almost unprecedented pace of change between 1790 and 1830. Thanks to rapid westward migration in the years before railroads, canals, and steamboats, he wrote, “more Americans lived in isolation and independence than ever before or since.” In the more densely populated East, meanwhile, the old social hierarchies evaporated, cities mushroomed, and industrialization upended the labor market, leading to profound social dislocation and a mismatch between skills and jobs. The resulting epidemics of loneliness and anxiety, he concluded, led people to numb their pain with alcohol.

The temperance movement that took off in the decades that followed was a more rational (and multifaceted) response to all of this than it tends to look like in the rearview mirror. Rather than pushing for full prohibition, many advocates supported some combination of personal moderation, bans on liquor, and regulation of those who profited off alcohol. Nor was temperance a peculiarly American obsession. As Mark Lawrence Schrad shows in his new book, Smashing the Liquor Machine: A Global History of Prohibition, concerns about distilled liquor’s impact were international: As many as two dozen countries enacted some form of prohibition.

Yet the version that went into effect in 1920 in the United States was by far the most sweeping approach adopted by any country, and the most famous example of the all-or-nothing approach to alcohol that has dogged us for the past century. Prohibition did, in fact, result in a dramatic reduction in American drinking. In 1935, two years after repeal, per capita alcohol consumption was less than half what it had been early in the century. Rates of cirrhosis had also plummeted, and would remain well below pre-Prohibition levels for decades.

The temperance movement had an even more lasting result: It cleaved the country into tipplers and teetotalers. Drinkers were on average more educated and more affluent than nondrinkers, and also more likely to live in cities or on the coasts. Dry America, meanwhile, was more rural, more southern, more midwestern, more churchgoing, and less educated. To this day, it includes about a third of U.S. adults—a higher proportion of abstainers than in many other Western countries.

What’s more, as Christine Sismondo writes in America Walks Into a Bar, by kicking the party out of saloons, the Eighteenth Amendment had the effect of moving alcohol into the country’s living rooms, where it mostly remained. This is one reason that, even as drinking rates decreased overall, drinking among women became more socially acceptable. Public drinking establishments had long been dominated by men, but home was another matter—as were speakeasies, which tended to be more welcoming.

After Prohibition’s repeal, the alcohol industry refrained from aggressive marketing, especially of liquor. Nonetheless, drinking steadily ticked back up, hitting pre-Prohibition levels in the early ’70s, then surging past them. Around that time, most states lowered their drinking age from 21 to 18 (to follow the change in voting age)—just as the Baby Boomers, the biggest generation to date, were hitting their prime drinking years. For an illustration of what followed, I direct you to the film Dazed and Confused.

Drinking peaked in 1981, at which point—true to form—the country took a long look at the empty beer cans littering the lawn, and collectively recoiled. What followed has been described as an age of neo-temperance. Taxes on alcohol increased; warning labels were added to containers. The drinking age went back up to 21, and penalties for drunk driving finally got serious. Awareness of fetal alcohol syndrome rose too—prompting a quintessentially American freak-out: Unlike in Europe, where pregnant women were reassured that light drinking remained safe, those in the U.S. were, and are, essentially warned that a drop of wine could ruin a baby’s life. By the late 1990s, the volume of alcohol consumed annually had declined by a fifth.

And then began the current lurch upward. Around the turn of the millennium, Americans said To hell with it and poured a second drink, and in almost every year since, we’ve drunk a bit more wine and a bit more liquor than the year before. But why?

One answer is that we did what the alcohol industry was spending billions of dollars persuading us to do. In the ’90s, makers of distilled liquor ended their self-imposed ban on TV advertising. They also developed new products that might initiate nondrinkers (think sweet premixed drinks like Smirnoff Ice and Mike’s Hard Lemonade). Meanwhile, winemakers benefited from the idea, then in wide circulation and since challenged, that moderate wine consumption might be good for you physically. (As Iain Gately reports in Drink: A Cultural History of Alcohol, in the month after 60 Minutes ran a widely viewed segment on the so-called French paradox—the notion that wine might explain low rates of heart disease in France—U.S. sales of red wine shot up 44 percent.)

But this doesn’t explain why Americans have been so receptive to the sales pitches. Some people have argued that our increased consumption is a response to various stressors that emerged over this period. (Gately, for example, proposes a 9/11 effect—he notes that in 2002, heavy drinking was up 10 percent over the previous year.) This seems closer to the truth. It also may help explain why women account for such a disproportionate share of the recent increase in drinking.

Although both men and women commonly use alcohol to cope with stressful situations and negative feelings, research finds that women are substantially more likely to do so. And they’re much more apt to be sad and stressed out to begin with: Women are about twice as likely as men to suffer from depression or anxiety disorders—and their overall happiness has fallen substantially in recent decades.

In the 2013 book Her Best-Kept Secret, an exploration of the surge in female drinking, the journalist Gabrielle Glaser recalls noticing, early this century, that women around her were drinking more. Alcohol hadn’t been a big part of mom culture in the ’90s, when her first daughter was young—but by the time her younger children entered school, it was everywhere: “Mothers joked about bringing their flasks to Pasta Night. Flasks? I wondered, at the time. Wasn’t that like Gunsmoke?” (Her quip seems quaint today. A growing class of merchandise now helps women carry concealed alcohol: There are purses with secret pockets, and chunky bracelets that double as flasks, and—perhaps least likely of all to invite close investigation—flasks designed to look like tampons.)

[From the April 2015 issue: Gabrielle Glaser on the irrationality of Alcoholics Anonymous]

Glaser notes that an earlier rise in women’s drinking, in the 1970s, followed increased female participation in the workforce—and with it the particular stresses of returning home, after work, to attend to the house or the children. She concludes that women are today using alcohol to quell the anxieties associated with “the breathtaking pace of modern economic and social change” as well as with “the loss of the social and family cohesion” enjoyed by previous generations. Almost all of the heavy-drinking women Glaser interviewed drank alone—the bottle of wine while cooking, the Baileys in the morning coffee, the Poland Spring bottle secretly filled with vodka. They did so not to feel good, but to take the edge off feeling bad.

Men still drink more than women, and of course no demographic group has a monopoly on either problem drinking or the stresses that can cause it. The shift in women’s drinking is particularly stark, but unhealthier forms of alcohol use appear to be proliferating in many groups. Even drinking in bars has become less social in recent years, or at least this was a common perception among about three dozen bartenders I surveyed while reporting this article. “I have a few regulars who play games on their phone,” one in San Francisco said, “and I have a standing order to just refill their beer when it’s empty. No eye contact or talking until they are ready to leave.” Striking up conversations with strangers has become almost taboo, many bartenders observed, especially among younger patrons. So why not just drink at home? Spending money to sit in a bar alone and not talk to anyone was, a bartender in Columbus, Ohio, said, an interesting case of “trying to avoid loneliness without actual togetherness.”

Last August, the beer manufacturer Busch launched a new product well timed to the problem of pandemic-era solitary drinking. Dog Brew is bone broth packaged as beer for your pet. “You’ll never drink alone again,” said news articles reporting its debut. It promptly sold out. As for human beverages, though beer sales were down in 2020, continuing their long decline, Americans drank more of everything else, especially spirits and (perhaps the loneliest-sounding drinks of all) premixed, single-serve cocktails, sales of which skyrocketed.

Not everyone consumed more alcohol during the pandemic. Even as some of us (especially women and parents) drank more frequently, others drank less often. But the drinking that increased was, almost definitionally, of the stuck-at-home, sad, too-anxious-to-sleep, can’t-bear-another-day-like-all-the-other-days variety—the kind that has a higher likelihood of setting us up for drinking problems down the line. The drinking that decreased was mostly the good, socially connecting kind. (Zoom drinking—with its not-so-happy hours and first dates doomed to digital purgatory—was neither anesthetizing nor particularly connecting, and deserves its own dreary category.)

As the pandemic eases, we may be nearing an inflection point. My inner optimist imagines a new world in which, reminded of how much we miss joy and fun and other people, we embrace all kinds of socially connecting activities, including eating and drinking together—while also forswearing unhealthy habits we may have acquired in isolation.

But my inner pessimist sees alcohol use continuing in its pandemic vein, more about coping than conviviality. Not all social drinking is good, of course; maybe some of it should wane, too (for example, some employers have recently banned alcohol from work events because of concerns about its role in unwanted sexual advances and worse). And yet, if we use alcohol more and more as a private drug, we’ll enjoy fewer of its social benefits, and get a bigger helping of its harms.

Let’s contemplate those harms for a minute. My doctor’s nagging notwithstanding, there is a big, big difference between the kind of drinking that will give you cirrhosis and the kind that a great majority of Americans do. According to an analysis in The Washington Post some years back, to break into the top 10 percent of American drinkers, you needed to drink more than two bottles of wine every night. People in the next decile consumed, on average, 15 drinks a week, and in the one below that, six drinks a week. The first category of drinking is, stating the obvious, very bad for your health. But for people in the third category or edging toward the second, like me, the calculation is more complicated. Physical and mental health are inextricably linked, as is made vivid by the overwhelming quantity of research showing how devastating isolation is to longevity. Stunningly, the health toll of social disconnection is estimated to be equivalent to the toll of smoking 15 cigarettes a day.

To be clear, people who don’t want to drink should not drink. There are many wonderful, alcohol-free means of bonding. Drinking, as Edward Slingerland notes, is merely a convenient shortcut to that end. Still, throughout human history, this shortcut has provided a nontrivial social and psychological service. At a moment when friendships seem more attenuated than ever, and loneliness is rampant, maybe it can do so again. For those of us who do want to take the shortcut, Slingerland has some reasonable guidance: Drink only in public, with other people, over a meal—or at least, he says, “under the watchful eye of your local pub’s barkeep.”

After more than a year in relative isolation, we may be closer than we’d like to the wary, socially clumsy strangers who first gathered at Göbekli Tepe. “We get drunk because we are a weird species, the awkward losers of the animal world,” Slingerland writes, “and need all of the help we can get.” For those of us who have emerged from our caves feeling as if we’ve regressed into weird and awkward ways, a standing drinks night with friends might not be the worst idea to come out of 2021.

This article appears in the July/August 2021 print edition with the headline “Drinking Alone.”

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Tell Your Kids the Truth About This Moment

2020-06-23T11:46:00-04:00

The October 1989 Loma Prieta earthquake struck Northern California, where I then lived, shortly after I turned 11. It was not the biggest upheaval in my life that year—my parents’ marriage had just ended—but discovering that, on a random Tuesday afternoon, the ground could start shaking hard enough to knock you over was a pretty close second. In the days that followed, I was obsessed with news about the disaster, especially the deaths it had caused. For months afterward, to my older sister’s embarrassment, I kept a weird little archive of newspaper and magazine coverage.

Earlier this year, before COVID-19, before George Floyd’s murder, before our lives slowed down and the news cycle sped up, I started thinking about how children respond to crises. In The Atlantic’s May cover story, on rising rates of childhood anxiety disorders, I argued that even pre-pandemic, various facts of contemporary American life had turned 21st-century childhood into a petri dish for anxiety. By trying to protect our kids from all discomfort, researchers and clinicians repeatedly told me, parents were inadvertently preventing them from learning to tolerate the stresses and worries that are an inevitable part of life. And when people can’t tolerate their anxious feelings, a large body of research shows, those feelings are more apt to metastasize into lasting mental-health problems.

As I researched these issues, my earthquake memories drew me to the pediatrician W. Thomas Boyce’s study of Loma Prieta’s effects on local children. To better understand how they were coping after the disaster, Boyce in 1989 asked kids to “draw the earthquake”—and found that “kids who drew darker scenes tended to stay healthy in the weeks that followed, while those who drew sunny pictures were more likely to come down with infections and illnesses.” Today, Boyce says, he believes that children who reckoned with the disaster more directly and honestly ended up better off, because when we talk about the things that scare us, “it makes them gradually less scary.”

As has been observed and observed and observed again, today’s parents are more likely than past generations of parents to bubble-wrap our children—to try to protect them from both physical danger and emotional discomfort. What’s been less widely discussed is how this insulation extends to disturbing facts about the outside world, and how much it’s motivated by parents’ own feelings of distress and guilt and anxiety. “It sometimes seems that the more overwhelming the world gets, the more adults try to blindfold children,” I wrote, adding that if we really wanted to prepare our children for difficult times, “we should talk candidly about worrisome topics.”

[Read: Becoming a parent in the age of Black Lives Matter]

But in recent weeks, I began to wonder: Does my earlier reporting still apply? Is “Don’t shield your kid from scary or sad or unjust things” good advice when those things stretch as far ahead as we can see, when just about everything—a pandemic, economic collapse, rampant racism, police brutality—is scary or sad or unjust? The short answer is, mostly, yes. As I’ve since dug deeper into the research about how children respond to crises, among them a parent’s impending death, natural disasters, violence, and racism, I’ve found more and more evidence that blindfolding doesn’t work and can actually hurt kids. At the same time, I’ve been closely following parents’ discussions about how to talk (or not talk) to kids about the tectonic shifts we’re now living through. Some of what I’ve observed, particularly some white parents’ justifications for why they have shielded their kids from the news of George Floyd’s murder and the response to it, is concerning from both a moral and a psychological perspective. But some of what I’ve seen is profoundly hopeful, with more and more adults starting to answer kids’ questions about everything from mortality to family finances to police violence more honestly, belatedly recognizing how much their kids notice, and having conversations that are overdue.

Let’s start with what would seem to be among the saddest, scariest situations a child might confront. Louise Dalton and Elizabeth Rapa, researchers in Oxford’s psychiatry department, study two very difficult questions: How do you tell a child her mother or father is dying? How, for that matter, do you tell a sick child that she herself will die? Last year, with the Oxford professor Alan Stein and colleagues, they published a pair of articles in The Lancet reviewing the research on how children respond to this news. The bottom line: Kids who have life-threatening illnesses—or whose parents do—fare much better when adults speak openly to them. Though this research wasn’t done with COVID-19 in mind, Dalton and Rapa believe that its morals apply directly to the current crisis, so they recently published a pair of follow-up commentaries arguing that honest communication is especially vital to kids’ mental health during the pandemic.

According to Dalton and Rapa, across countries and diseases, many parents try to keep their children in the dark. One Dutch survey, for example, found that even in cases of incurable pediatric cancer, nearly two-thirds of parents hadn’t discussed death with their children. However well-meaning the impulse to protect sick kids from distress, though, it appears to backfire: Other studies have found that children who receive little or late information about their diagnosis experience more anxiety and depression than children who are told more, and sooner. They’re also more apt to feel angry and betrayed.

Similarly, trying to shield children from the news that parents are sick doesn’t usually work. Kids are quite attuned to their parents’ emotional states, and can typically tell that something’s up. And unfortunately, as Dalton and Rapa emphasized when I spoke with them recently, they tend to hide what they’ve gleaned—even when they’re feeling upset and anxious about it. “So parents think that the children don’t know,” Dalton said. “Everyone’s pretending everything’s normal, even when it’s far, far from normal, and far, far from okay.” Worse, the conclusions children draw are in many cases even worse than the truth. This is especially true for younger children, who are egocentric and prone to magical thinking. “The only thing possibly worse than your mother dying,” Rapa said, “is your mother dying and you thinking it was your fault.” One boy whose grief particularly haunts her believed that he had caused his HIV-infected mother’s death by being naughty one day. “That,” she added, “is the worst secret in the world to try and hold on to: I’ve done something that caused my mum to die.” When parents do forge ahead with difficult conversations, however, the results tend to be the opposite of what they had feared. “Children who reflected back on it said, ‘It made me trust my parents. It’s brought us together,’” Dalton told me. “They didn’t see it as the devastating event their parents feared.”

How might all this relate to, say, COVID-19? Well, if kids are closely attuned to unexplained and unprecedented parent behavior, and you’re a kid whose mom is outside attacking the family groceries with bleach, something she never once did in your preceding eight years on this planet, you may not believe her when she says everything’s good and you don’t need to worry about the coronavirus.

[Read: Dear Therapist: What’s your advice to parents whose kids are stuck at home during the coronavirus lockdowns?]

A similar logic applies to racism. Whether or not their parents talk about it, kids are perceptive; they notice racial disparities. If you don’t talk to them about the historical and societal causes of what they see, various experts told me, they’ll draw their own conclusions, likely harmful ones. As Kenya Hameed, a neuropsychologist at the Child Mind Institute, put it, “If a black child keeps seeing people that look like her marginalized, oppressed, in trouble with the law, dying, she may conclude that black people are bad, that she’s bad.” Hameed notes that this is one reason black families tend to be proactive about talking about race: Their children’s mental health depends on it. But white families are more likely to take the opposite approach, and their silence has a steep price.

This last part should go without saying; white parents’ reticence about race is old news. More than a decade ago, Po Bronson and Ashley Merryman’s best seller NurtureShock offered a particularly vivid case in point—research by Brigitte Vittrup, who is today a professor of child development at Texas Woman’s University. It was notable less for what Vittrup set out to find—whether videos with multicultural characters could affect white children’s racial attitudes—than for the obstacle she bumped into: the kids’ parents. Of the 99 white families Vittrup recruited for the study, five backed out after the first visit to the research lab, with two volunteering that they didn’t want to discuss race with their children. Those who remained weren’t much different on this count; the overwhelming majority had never discussed skin color, stereotypes, or discrimination with their child. Most notably, when Vittrup explicitly directed them to have in-depth discussions with their children about race, only 10 percent complied; the rest raised the topic with their child in passing or not at all.

As Vittrup and other researchers have discovered, white parents’ silence on race can be motivated not only by animus but by a stew of other messy feelings: paralysis, fear, anxiety, hope that if you don’t acknowledge the problem, it will go away. The latter belief is particularly misguided; when she surveyed the white kids in her study, she found that whatever white parents may have hoped to achieve by downplaying race, their kids were far from color-blind. Instead, many appeared to have come up with their own explanations for why white people and black people didn’t spend much time together. Almost half of them doubted whether their parents liked black people, and they also had significantly less positive attitudes about black people than about white people.

Not quite a year and a half after Loma Prieta, in March 1991, a group of white Los Angeles Police Department officers was caught on video beating a 25-year-old black man named Rodney King. I was 12, and I watched with waves of panic, then rage, as they kicked and clubbed him. I’ve thought of that tape many times in the weeks since George Floyd’s murder, and I’ve wondered: Would I have let a 12-year-old watch it, and all that followed?

Since my childhood, and especially since the 9/11 attacks, the research on how kids respond to catastrophes and other tragic news events has multiplied—and it shows just how much children take in, even when parents don’t talk to them. Before 9/11, the thinking was that a child’s risk of emotional problems following a mass tragedy depended largely on proximity to its epicenter. According to the bull’s-eye theory, as it was known, children with no direct exposure to a catastrophe were unlikely to experience much lasting distress. But as Jonathan Comer, a psychology professor at Florida International University and one of the country’s leading experts on childhood anxiety, recently explained to me, 9/11 upended both the idea that those close by were doomed to trauma and the idea that children farther away would be unscathed. “We had kids at Stuyvesant High School, right across from Ground Zero, who showed remarkable resilience although they were there,” Comer said. “And we had large proportions of kids in the outer boroughs who were not directly exposed to the Twin Towers, yet showed extraordinary difficulties in mental health.”

In the months and years that followed, Comer told me, psychologists identified two powerful factors that, in addition to personal and family exposure, accounted for the wide range in children’s difficulties after 9/11. One was prior trauma. The other was exposure to media coverage of the attacks: The more news coverage kids saw, the more likely they were to experience psychological problems. This conclusion has since been replicated with other disasters, such as hurricanes. And, in a particularly heartbreaking finding, a study last year reported that the more time African American adolescents spent watching viral videos of police killings, the more likely they were to suffer from depression and PTSD symptoms. (Some observers wonder if this might have contributed to the especially sharp rise in black youth suicides in recent years.)

Not surprisingly, Comer is adamant that parents should be careful about exposing kids to threat-oriented news coverage—though of course, it’s far simpler to shelter a little kid from news of a distant hurricane than a teenager from viral videos. But he is also quick to note that he’s not advocating a retreat from reality; avoiding distressing topics is also bad, as he discovered studying the aftermath of the 2013 Boston Marathon bombing and manhunt. In its implications for local children, the week following the attack had strange similarities to the early response to the pandemic: the abrupt closure of schools, a stay-at-home order, a sense that venturing outside was dangerous. Comer wasn’t surprised to find that, as with past disasters, large doses of media coverage were harmful to kids. More notable was what he found at the opposite extreme: Children whose parents attempted to hide what was going on had some of the worst mental-health outcomes. “Kids did worse when families pretended everything was normal,” Comer said. “These families didn’t want to upset their kids, so they didn’t talk about why they were staying home. But when parents show that something is too scary to talk about, that makes it feel even scarier.”

Child therapists I’ve spoken with make much the same point, and add that parents’ own fears are an underappreciated part of the problem—and on a range of topics, so are their biases. Samantha C. Sweeney, a psychologist in Washington, D.C., told me that when white parents avoid the topic of race, they’re not only trying to spare their kids discomfort; quite often, they are profoundly uncomfortable. “Many parents were themselves raised to believe that a ‘color-blind’ approach is best, so they haven’t done their own internal exploration around race,” she said. Not talking about it, she continued, “shields parents from having to recognize that the past is present and from admitting that racism still exists because white people help it to exist—and not just those white people, but all white people, the parent included.”

[Read: Now I understand why my parents were so strict]

Parents may avoid other topics, such as the pandemic, because they don’t know what’s going to happen next, and they don’t want to frighten their child by admitting it. Emily Aron, a child psychiatrist and professor at Georgetown University, notes that this misunderstands what children actually need. “There are going to be questions that parents won’t have an answer to,” she told me. “Say that. Sometimes, we feel overcome by our kids’ emotions, and we really want to answer the question or fix whatever they’re upset about. But part of parenting is just helping them sit with their feelings and bearing witness to what they’re going through. That may not seem like what we think of as ‘parenting,’ but it’s comforting to a child.”

All of this raises an interesting possibility: By curing us of the delusion that we can fix all problems and explain away all uncertainty, could our anxiety-ridden moment lead to less anxious parenting? In her forthcoming book, A Good Time to Be Born: How Science and Public Health Gave Children a Future, the pediatrician Perri Klass describes how the world—and with it, parenting—has been transformed by declining infant and child mortality over the past century. “In my grandmother’s lifetime, most people would have lost either a child or a sibling,” she told me recently. “What was parental anxiety like back then—when a sore throat could be scarlet fever and a child could die from it? And why has losing that unthinkable level of danger not led to less parental anxiety today?”

One reason, Klass believes, is that parents—especially privileged ones—keep elevating expectations for health and safety. Once vaccinations were more or less universal, attention turned to the next frontier in child safety, and the next—car seats, prevention of sudden infant death syndrome, bike helmets. In her book, Klass points to these campaigns as pediatric triumphs. But driving down deaths has had some unrecognized effects on what is expected of parents. “It results in a worldview that says, ‘If you do everything right, your kid will be safe.’ When a child gets hurt somehow, people now ask, ‘Was she in a car seat?’ ‘Was she wearing a helmet?’ We all wonder, could this have been prevented? My grandmother thought of the world as essentially unsafe, so I don’t think she felt that same pressure. If a kid got hurt in the street, people didn’t think it was the parent’s fault.” (To which I’d add: An even more pernicious aspect of this development is that it absolves society of responsibility for children’s welfare—with the result that even as affluent parents spend heavily on their children’s safety, other children are left to suffer the profoundly unsafe conditions associated with poverty and trauma.)

“To create a sense of security for children,” Klass told me, “you do not have to promise that you have superpowers. You don’t have to say, ‘I will never die.’ To help them feel secure, you can rely on old-fashioned things: children’s books—including ones from the unsafe world of 100 years ago—routines, rituals, certain kinds of affection. All of these can be very comforting. You don’t have to guarantee certainty.” In children’s stories of earlier eras, Klass noted, dying is a part of life, and uncertainty is one of the few givens (see among many other examples Little Women and Betsy-Tacy, both of which matter-of-factly feature death without being about it). In contemporary kids’ books and films, as in contemporary kids’ lives, disease and death are rare. This is partly because many modern parents steer clear of upsetting content—but as Klass pointed out, it’s also because art imitates life, and at least until recently, fatal illness hasn’t been much of an issue in the average kid’s life. Equally to the point, it hasn’t been an issue in modern parenting.

“When we talk to kids about hard questions, we’re forced to acknowledge that the world isn’t safe,” Klass observed. “Maybe we have wanted to think that it is.” And, as the past few months have made clear, maybe that wish has been not only misguided, but self-defeating. Maybe parenting can be easier—less exhausting, less guilt-inducing, less anxious-making—if we remember that some things are out of our control: Sometimes people get sick and die for no good reason; sometimes the ground shifts underfoot without warning.

In acknowledging to our kids that life is neither perfectly secure nor perfectly just, maybe we will find that we don’t have to choose between nurturing them and being honest with them, between raising happy people and good ones, between doing right by our families and right by the world. White silence has not rendered white kids color-blind—to the contrary. Regardless of their race, children are not stupid. They see segregation, they see discrimination, they see the world around them; they just don’t know how it got that way. We cannot hide the bad news. The choice we have is whether to leave kids alone with it, or to help them make sense of it and hopefully change it.

What Happened to American Childhood?

2020-04-14T06:00:00-04:00

Updated at 10:30 a.m. ET on April 17, 2020.

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Imagine for a moment that the future is going to be even more stressful than the present. Maybe we don’t need to imagine this. You probably believe it. According to a survey from the Pew Research Center last year, 60 percent of American adults think that three decades from now, the U.S. will be less powerful than it is today. Almost two-thirds say it will be even more divided politically. Fifty-nine percent think the environment will be degraded. Nearly three-quarters say that the gap between the haves and have-nots will be wider. A plurality expect the average family’s standard of living to have declined. Most of us, presumably, have recently become acutely aware of the danger of global plagues.

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Suppose, too, that you are brave or crazy enough to have brought a child into this world, or rather this mess. If ever there were a moment for fortifying the psyche and girding the soul, surely this is it. But how do you prepare a child for life in an uncertain time—one far more psychologically taxing than the late-20th-century world into which you were born?

To protect children from physical harm, we buy car seats, we childproof, we teach them to swim, we hover. How, though, do you inoculate a child against future anguish? For that matter, what do you do if your child seems overwhelmed by life in the here and now?

You may already know that an increasing number of our kids are not all right. But to recap: After remaining more or less flat in the 1970s and ’80s, rates of adolescent depression declined slightly from the early ’90s through the mid-aughts. Shortly thereafter, though, they started climbing, and they haven’t stopped. Many studies, drawing on multiple data sources, confirm this; one of the more recent analyses, by Pew, shows that from 2007 to 2017, the percentage of 12-to-17-year-olds who had experienced a major depressive episode in the previous year shot up from 8 percent to 13 percent—meaning that, in the span of a decade, the number of severely depressed teenagers went from 2 million to 3.2 million. Among girls, the rate was even higher; in 2017, one in five reported experiencing major depression.

An even more wrenching manifestation of this trend can be seen in the suicide numbers. From 2007 to 2017, suicides among 10-to-24-year-olds rose 56 percent, overtaking homicide as the second leading cause of death in this age group (after accidents). The increase among preadolescents and younger teens is particularly startling. Suicides by children ages 5 to 11 have almost doubled in recent years. Children’s emergency-room visits for suicide attempts or suicidal ideation rose from 580,000 in 2007 to 1.1 million in 2015; 43 percent of those visits were by children younger than 11. Trying to understand why the sort of emotional distress that once started in adolescence now seems to be leaching into younger age groups, I called Laura Prager, a child psychiatrist at Massachusetts General Hospital and a co-author of Suicide by Security Blanket, and Other Stories From the Child Psychiatry Emergency Service. Could she explain what was going on? “There are many theories, but I don’t understand it fully,” she replied. “I don’t know that anyone does.”

[From December 2015: Hanna Rosin on the Silicon Valley suicides]

One possible contributing factor is that, in 2004, the FDA put a warning on antidepressants, noting a possible association between antidepressant use and suicidal thinking in some young people. Prescriptions of antidepressants to children fell off sharply—leading experts to debate whether the warning resulted in more deaths than it prevented. The opioid epidemic also appears to be playing a role: One study suggests that a sixth of the increase in teen suicides can be linked to parental opioid addiction. Some experts have suggested that rising distress among preteen and adolescent girls might be linked to the fact that girls are getting their period earlier and earlier (a trend that has itself been linked to various factors, including obesity and chemical exposure).

Even taken together, though, these explanations don’t totally account for what’s going on. Nor can they account for the fragility that now seems to accompany so many kids out of adolescence and into their young-adult years. The closest thing to a unified theory of the case—one put forth in The Atlantic three years ago by the psychologist Jean M. Twenge and in many other places by many other people—is that smartphones and social media are to blame. But that can’t explain the distress we see in kids too young to have phones. And the more the relationship between phones and mental health is studied, the less straightforward it seems. For one thing, kids the world over have smartphones, but most other countries aren’t experiencing similar rises in suicides. For another, meta-analyses of recent research have found that the overall associations between screen time and adolescent well-being range from relatively small to nonexistent. (Some studies have even found positive effects: When adolescents text more in a given day, for example, they report feeling less depressed and anxious, probably because they feel greater social connection and support.)

A stronger case can be made that social media is potentially hazardous for people who are already at risk of anxiety and depression. “What we are seeing now,” writes Candice Odgers, a professor at UC Irvine who has reviewed the literature closely, “might be the emergence of a new kind of digital divide, in which differences in online experiences are amplifying risks among [the] already-vulnerable.” For instance, kids who are anxious are more likely than other kids to be bullied—and kids who are cyberbullied are much more likely to consider suicide. And for young people who are already struggling, online distractions can make retreating from offline life all too tempting, which can lead to deepening isolation and depression.

This more or less brings us back to where we started: Some of the kids aren’t all right, and certain aspects of contemporary American life are making them less all right, at younger and younger ages. But none of this suggests much in the way of solutions. Taking phones away from miserable kids seems like a bad idea; as long as that’s where much of teenagers’ social lives are transacted, you’ll only isolate them. Do we campaign to take away the happy kids’ phones too? Wage a war on early puberty? What?

Video: Kids Feel Pandemic Anxiety Too

I have been thinking about these questions a lot lately, for journalistic reasons as well as personal ones. I am the mother of two children, 6 and 10, whose lineage includes more than its share of mental illness. Having lost one family member to suicide and watched another ravaged by addiction and psychiatric disability, I have no deeper wish for my kids than that they not be similarly afflicted. And yet, given the apparent direction of our country and our world, not to mention the ordeal that is late-stage meritocracy, I haven’t been feeling optimistic about the conditions for future sanity—theirs, mine, or anyone’s.

[From September 2019: Daniel Markovits on how meritocracy harms everyone]

To my surprise, as I began interviewing experts in children’s mental health—clinicians, neuroscientists doing cutting-edge research, parents who’d achieved this unofficial status as a result of their kids’ difficulties—an unusually unified chorus emerged. For all the brain’s mysteries, for everything we still don’t know about genetics and epigenetics, the people I spoke with emphasized what we do know about when emotional disorders start and how we might head more of them off at the pass. The when: childhood—very often early childhood. The how: treatment of anxiety, which was repeatedly described as a gateway to other mental disorders, or, in one mother’s vivid phrasing, “the road to hell.”

Actually, the focus on anxiety wasn’t so surprising. Of course anxiety. Anxiety is, in 2020, ubiquitous, inescapable, an ambient condition. Over the course of this century, the percentage of outpatient doctors’ visits in America involving a prescription for an anti-anxiety medication such as Xanax or Valium has doubled.* As for the kids: A study published in 2018, the most recent effort at such a tabulation, found that in just five years, anxiety-disorder diagnoses among young people had increased 17 percent. Anxiety is the topic of pop music (Ariana Grande’s “Breathin,” Julia Michaels and Selena Gomez’s “Anxiety”), the country’s best-selling graphic novel (Raina Telgemeier’s Guts), and a whole cohort’s sense of humor (see Generation Z’s seemingly bottomless appetite for anxiety memes). The New York Times has even published a roundup of anxiety-themed books for little ones. “Anxiety is on the rise in all age groups,” it explained, “and toddlers are not immune.”

The good news is that new forms of treatment for children’s anxiety disorders are emerging—and, as we’ll see, that treatment can forestall a host of later problems. Even so, there is a problem with much of the anxiety about children’s anxiety, and it brings us closer to the heart of the matter. Anxiety disorders are well worth preventing, but anxiety itself is not something to be warded off. It is a universal and necessary response to stress and uncertainty. I heard repeatedly from therapists and researchers while reporting this piece that anxiety is uncomfortable but, as with most discomfort, we can learn to tolerate it.

Yet we are doing the opposite: Far too often, we insulate our children from distress and discomfort entirely. And children who don’t learn to cope with distress face a rough path to adulthood. A growing number of middle- and high-school students appear to be avoiding school due to anxiety or depression; some have stopped attending entirely. As a symptom of deteriorating mental health, experts say, “school refusal” is the equivalent of a four-alarm fire, both because it signals profound distress and because it can lead to so-called failure to launch—seen in the rising share of young adults who don’t work or attend school and who are dependent on their parents.

Lynn Lyons, a therapist and co-author of Anxious Kids, Anxious Parents, told me that the childhood mental-health crisis risks becoming self-perpetuating: “The worse that the numbers get about our kids’ mental health—the more anxiety, depression, and suicide increase—the more fearful parents become. The more fearful parents become, the more they continue to do the things that are inadvertently contributing to these problems.”

[Read: What the coronavirus will do to kids]

This is the essence of our moment. The problem with kids today is also a crisis of parenting today, which is itself growing worse as parental stress rises, for a variety of reasons. And so we have a vicious cycle in which adult stress leads to child stress, which leads to more adult stress, which leads to an epidemic of anxiety at all ages.

I. The Seeds of Anxiety

Over the past two or three decades, epidemiologists have conducted large, nationally representative studies screening children for psychiatric disorders, then following those children into adulthood. As a result, we now know that anxiety disorders are by far the most common psychiatric condition in children, and are far more common than we thought 20 or 30 years ago. We know they affect nearly a third of adolescents ages 13 to 18, and that their median age of onset is 11, although some anxiety disorders start much earlier (the median age for a phobia to start is 7).

Many cases of childhood anxiety go away on their own—and if you don’t have an anxiety disorder in childhood, you’re unlikely to develop one as an adult. Less happily, the cases that don’t resolve tend to get more severe and to lead to further problems—first additional anxiety disorders, then mood and substance-abuse disorders. “Age 4 might be specific phobia. Age 7 is going to be separation anxiety plus the specific phobia,” says Anne Marie Albano, the director of the Columbia University Clinic for Anxiety and Related Disorders. “Age 12 is going to be separation anxiety, social anxiety, and the specific phobia. Anxiety picks its own friends up first before it branches into the other disorders.” And the earlier it starts, the more likely depression is to follow.

All of which means we can no longer assume that childhood distress is a phase to be grown out of. “The group of kids whose problems don’t go away account for most adults who have problems,” says the National Institute of Mental Health’s Daniel Pine, a leading authority on how anxiety develops in children. “People go on to develop a whole host of other problems that aren’t anxiety.” Ronald C. Kessler, a professor of health-care policy at Harvard, once made this point especially vividly: “Fear of dogs at age 5 or 10 is important not because fear of dogs impairs the quality of your life,” he said. “Fear of dogs is important because it makes you four times more likely to end up a 25-year-old, depressed, high-school-dropout single mother who is drug-dependent.”

Compounding this, the young kids with mental-health problems today may have worse long-term prospects than did similar kids in decades past. That is the conclusion drawn by Ruth Sellers, a University of Sussex research psychologist who examined three longitudinal studies of British youth. Sellers found that youth with mental-health problems at age 7 are more likely to be socially isolated and victimized by peers later in childhood, and to have mental-health and academic difficulties at age 16. Concerningly, despite decreased stigma and increases in mental-health-care spending, these associations have been growing stronger over time.

Big societal shifts such as the ones we’ve undergone in recent years can hit people with particular traits particularly hard. A recent example comes from China, where shy, quiet children used to be well liked and tended to thrive. Following rapid social and economic change in urban areas, values have changed, and these children now tend to be rejected by their peers—and, surely no coincidence, are more prone to depressive symptoms. I thought of this when I met recently with the leaders of a support group for parents of struggling young adults in the Washington, D.C., area, most of whom still live at home. Some of these grown children have psychiatric diagnoses; all have had difficulty with the hurdles and humiliations of life in a deeply competitive culture, one with a narrowing definition of success and a rising cost of living.

The hope of early treatment is that by getting to a child when she’s 7, we may be able to stop or at least slow the distressing trajectory charted by Sellers and other researchers. And cognitive behavioral therapy, the most empirically supported therapy for anxiety, is often sufficient to do just that. In the case of anxiety, CBT typically involves a combination of what’s known as “cognitive restructuring”—learning to spot maladaptive beliefs and challenge them—and exposure to the very things that cause you anxiety. The goal of exposure is to desensitize you to these things and also to give you practice riding out your anxious feelings, rather than avoiding them.

Illustration: Oliver Munday; Marco Pasqualini / Getty

Most of the time, according to the largest and most authoritative study to date, CBT works: After a 12-week course, 60 percent of children with anxiety disorders were “very much improved” or “much improved.” But it isn’t a permanent cure—its results tend to fade over time, and people whose anxiety resurges may need follow-up courses.

A bigger problem is that cognitive behavioral therapy can only work if the patient is motivated, and many anxious children have approximately zero interest in battling their fears. And CBT focuses on the child’s role in his or her anxiety disorder, while neglecting the parents’ responses to that anxiety. (Even when a parent participates in the therapy, the emphasis typically remains on what the child, not the parent, is doing.)

A highly promising new treatment out of Yale University’s Child Study Center called SPACE (Supportive Parenting for Anxious Childhood Emotions) takes a different approach. SPACE treats kids without directly treating kids, and by instead treating their parents. It is as effective as CBT, according to a widely noted study published in the Journal of the American Academy of Child & Adolescent Psychiatry earlier this year, and reaches even those kids who refuse help. Not surprisingly, it has provoked a tremendous amount of excitement in the children’s-mental-health world—so much so that when I began reporting this piece, I quickly lost track of the number of people who asked whether I’d read about it yet, or talked with Eli Lebowitz, the psychology professor who created it.

In working directly with parents, Lebowitz’s approach aims to provide not a temporary solution, but a foundation for a lifetime of successful coping. SPACE is also, I have come to believe, much more than a way of treating childhood anxiety—it is an important keyhole to the broken way American adults now approach parenting.

When Lebowitz teaches other clinicians how to do SPACE, he starts by telling them, several times, that he’s not blaming parents for their kids’ pathologies.

“Because we represent a field with a very rich history of blaming parents for pretty much everything—autism, schizophrenia, eating disorders—this is a really important point,” he said one Sunday morning in January, as he and his collaborator Yaara Shimshoni kicked off a two-day training for therapists. A few dozen were in attendance, having traveled to Yale from across the country so that they might learn to help parents reduce what Lebowitz calls “accommodating” behaviors and what the rest of us may call “behaviors typical of a 21st-century parent.”

“There really isn’t evidence to demonstrate that parents cause children’s anxiety disorders in the vast majority of cases,” Lebowitz said. But—and this is a big but—there is research establishing a correlation between children’s anxiety and parents’ behavior. SPACE, he continued, is predicated on the simple idea that you can combat a kid’s anxiety disorder by reducing parental accommodation—basically, those things a parent does to alleviate a child’s anxious feelings. If a child is afraid of dogs, an accommodation might be walking her across the street so as to avoid one. If a child is scared of the dark, it might be letting him sleep in your bed.

Lebowitz borrowed the concept about a decade ago from the literature on how obsessive-compulsive disorder affects a patient’s family members and vice versa. (As he put it to me, family members end up living as though they, too, have OCD: “Everybody’s washing their hands. Everybody’s changing their clothes. Nobody’s saying this word or that word.”) In the years since, accommodation has become a focus of anxiety research. We now know that about 95 percent of parents of anxious children engage in accommodation. We also know that higher degrees of accommodation are associated with more severe anxiety symptoms, more severe impairment, and worse treatment outcomes. These findings have potential implications even for children who are not (yet) clinically anxious: The everyday efforts we make to prevent kids’ distress—minimizing things that worry them or scare them, assisting with difficult tasks rather than letting them struggle—may not help them manage it in the long term. When my daughter is in tears because she hasn’t finished a school project that’s due the next morning, I sometimes stop her crying by coaching her through the rest of it. But when I do, she doesn’t learn to handle deadline jitters. When she asks me whether anyone in our family will die of COVID-19, an unequivocal “No, don’t worry” may reassure her now, but a longer, harder conversation about life’s uncertainties might do more to help her in the future.

Parents know they aren’t helping their kids by accommodating their fears; they tell Lebowitz as much. But they also say they don’t know how to stop. They fear that day-to-day life will become unmanageable.

Here are some things that, over the course of the SPACE training, I heard of parents doing to avoid setting off their anxious children:

Going upstairs to get a child’s backpack before school because the child is scared to be alone in any area of the house and the parent doesn’t have time to argue about it. Driving a child to school because the child is frightened of the bus, with the result that the mother is late to work every single day.

Tying and retying a child’s shoes until they feel just right.

Spending 30 minutes a day, on average, checking and rechecking a child’s homework.

Announcing one’s presence as one moves around the house, so that a child will at all times know where to find a parent (“I’m going to the kitchen, Oliver”). Accompanying a 9-year-old child to the toilet because he is afraid to be alone. Allowing a 9-year-old to accompany a parent to the toilet because he is afraid to be alone. Peeing in a bucket—a mother, not a child—because the basement playroom has no bathroom, and the child is afraid to be alone.

Allowing a child to sleep in the parents’ bed. Sitting or lying with a child while he falls asleep.

Always carrying a plastic bag because a child is afraid she’ll vomit.

Cutting a 13-year-old’s food because she’s afraid of knives.

Ceasing to have visitors because a child is intensely shy. Speaking for a child in restaurants. Asking a child’s teacher not to call on her in class.

Installing the Find My Friends app on a child’s phone so that the child can track the parents’ whereabouts.

Preparing different foods for a child because she won’t eat what everyone else eats.

Buying a new burglar alarm. Buying a new car. Seriously contemplating buying a new house.

The list went on and on. The most disorienting thing about it was not its length, but the way it merged stories that seemed to me bizarre but turned out to be commonplace with stories that sounded familiar but upon further consideration seemed unhealthy. Many of us think nothing of preparing different meals for different family members. Bedtime has become such a protracted affair that parents may now do the work a stuffed animal once did.

I barely suppressed a laugh at the idea of a kid tracking his parents, rather than vice versa, but murmurs of recognition sounded around the room. “That’s common,” one therapist said. The idea of buying a new house must have made my eyebrows go up, because another woman leaned over and whispered: “I have a family that moved to a split-level because the daughter didn’t like to be out of earshot.”

Over the course of 12 sessions, SPACE helps parents figure out how to start reducing their accommodations, while also expressing empathy for their child’s suffering and confidence in her capabilities. If it works, and usually it does, it sets in motion a virtuous cycle: As parent behavior changes, kids will start coping for themselves. As they cope, they’ll come to feel more capable, and they will be treated as such by their parents, who will further reduce accommodation. In turn, the entire family’s well-being will improve.

AtlanticLIVE: Children in an Anxious Age

What can be done about overwhelmed children, and the parents struggling to care for them? The Atlantic’s editor in chief, Jeffrey Goldberg, discussed this mental health epidemic with Kate Julian, a senior editor who wrote the magazine’s May cover story.

II. The Anxious Parent

Most critiques of this century’s child-rearing practices have treated parents as rational actors, however extreme some of our actions might be. If we hover above our children (or lawn-mower or bulldoze or snowplow a path for them), we are said to do so in reaction to the surrounding conditions—media coverage of kidnappings, for example, or plummeting college-admission rates. In other words, modern parents, or at least the upper-middle-class ones who populate most articles about parenting trends, are widely perceived not as flailing but as the opposite: too hyper, too competent, too vigilant. And yet, despite more than a decade’s evidence that helicopter parenting is counterproductive—see, among other widely read takedowns, the Atlantic articles “How to Land Your Kid in Therapy,” by Lori Gottlieb, and “The Overprotected Kid,” by Hanna Rosin, and such books as Julie Lythcott-Haims’s How to Raise an Adult—kids today are perhaps more overprotected, more leery of adulthood, more in need of therapy.

Which raises a question: If modern parents are so unrelentingly on top of things, why have we not corrected course? Could it be that we are not at all on top of things? Might our children’s faltering mental health be related less to our hard-driving style than to our exhaustion and guilt and failure to put our foot down? We complain about kids being thin-skinned and susceptible to peer pressure, but maybe we’re the ones who are hypersensitive, to the judgment of our peers and, especially, of our children. And the harder we try to do the right thing—the more we nurture them, the more quickly we respond to their needs—the more we tie ourselves in knots.

Recently, several longtime commentators on the parenting scene have begun to sound similar notes. Take the evolution of Madeline Levine, the Bay Area psychologist whose 2006 best seller, The Price of Privilege, (reasonably) chastised parents for imposing their own ambitions on their children. Her new book, Ready or Not, offers a darker if also more sympathetic take on what it’s like to rear children in a world that appears to be unraveling, noting “the damage [that] unchecked anxiety does to parents’ decision-making.”

Illustration: Oliver Munday; DCDEBS / Getty

Consider, too, the 2018 book The Self-Driven Child, by William Stixrud, a clinical neuropsychologist, and Ned Johnson, who runs a successful Washington, D.C., tutoring business (as close as one gets to a ringside seat at the meritocratic circus). They argue that today’s parents deprive children of meaningful control over their own lives, putting them at heightened risk of anxiety and depression. And they devote a whole chapter to how parents’ mental health is harming that of their children. “Children don’t need perfect parents, but they do benefit greatly from parents who can serve as a non-anxious presence,” they write.

The book has struck such a chord among parents that, two years after its publication, Stixrud and Johnson are still on the national speaking circuit. In their hundreds of appearances and thousands of conversations with parents, they have come to believe that parents’ anxiety about their kids is even greater than they had realized, and more concerning. Watching them do a Q&A with private-school parents in December, I could see why. The audience was vibrating with self-doubt, asking fumbling questions about everything from academic pressure to sleep.

When I had coffee with Johnson the next day and later emailed with him, he told me that, since writing the book, he has concluded that parents’ overprotection of kids includes an under-recognized element of self-protection. When we shelter kids from difficulty or challenge, he says, we are not merely shielding them from distress; we are warding off the distress that their distress causes us. Moreover, when school and family systems both have a baseline level of stress—when adults are always on high alert—kids don’t get a chance to rebound, and so they resist taking on the sorts of natural and healthy risks that will help them grow. “Et voilà,” he said, “a generation of anxious kids, looking fearfully at the world around them, who become anxious adults.

“What happened to us adults that made us the helicopter parents we too often are?”

Anxiety travels in families. It travels in families partly because it has a hereditary component: Studies of twins suggest that about 30 to 40 percent of a person’s risk for an anxiety disorder is genetic (versus 60 percent or more for bipolar disorder, autism, and schizophrenia). To an even greater extent, anxiety travels in families because it is contagious—from spouse to spouse, from child to parent, and especially from parent to child. More than half of children who live with an anxious parent end up meeting the criteria for an anxiety disorder themselves.

Recognizing the relationship between parental and child anxiety suggests an important means of prevention and intervention: Because anxiety is only partially genetic, a change in parenting style may well help spare a child’s mental health.

In one famous study of how changes to parental health affect a child’s health, Myrna Weissman, a professor at Columbia University, established that treating a depressed mother with antidepressants quickly reduced depressive symptoms in her child; other researchers have since found that treating a mother with psychotherapy (such as CBT) has the same indirect benefit for her kids. In 2015, Golda S. Ginsburg of the University of Connecticut published the results of the first American study specifically focused on preventing anxiety disorders in children of anxious parents. The intervention, which involved giving anxious parents and their children eight weekly sessions with a therapist who taught them about anxiety, had dramatic effects: Within a year, only 5 percent of the children whose families had received the intervention met the criteria for an anxiety disorder, compared with 31 percent of children in a control group.

Another hint as to how parenting can affect childhood anxiety comes from the research on what’s known as behavioral inhibition—a shy, sensitive temperament that’s found in about 15 percent of 3-year-olds and that constitutes one of the strongest known risk factors for the development of anxiety disorders. Nathan Fox of the University of Maryland has spent the past few decades conducting longitudinal studies that explore how this temperament predicts experiences later in life. About 20 years ago, as Fox and his colleague Kenneth Rubin combed through the data from the first of these studies, trying to figure out what differentiated the kids who overcame their inhibition from the ones who didn’t, they came across an unexpected clue: Those who went to day care for their first two years were far more likely to be spared anxiety down the line than those who stayed home.

“On one level, it’s intuitive,” Fox says. “You put them into an environment with other kids; they’re desensitized to novelty or unfamiliarity; they get to interact at a very early age with other kids.” Fox and Rubin suspected that day care was also giving some behaviorally inhibited kids a much-needed break from their parents, who were likely to have an anxious parenting style—again, anxiety runs in families. Day care wasn’t the key factor; parenting was. Fox and Rubin found, and other researchers have since confirmed, that parenting style at age 2 predicts continuing behavioral inhibition at age 4—and, in turn, later risk of psychological problems. As Rubin put it to me: “The kids who maintain reticent behavior are the kids whose parents bubble-wrap them.”

III. Short-Term Gain, Long-Term Pain

We all have dreams, and Angela and Seth’s was to stop making turkey loaf.

By the time they sought help from the SPACE program’s Yaara Shimshoni last year, they had served it to their then-6-year-old son, Owen, some 3,000 times. (I have changed parents’ and children’s names.) Put another way, virtually every day for four years—two-thirds of his life—Owen had eaten turkey loaf for both lunch and dinner. For breakfast, he favored dry Cheerios.

Calling Owen a picky eater wouldn’t have captured the extent of the problem. He was terrified of most foods. On those rare occasions when he tasted something new, he would gag. Going out together as a family was a minor ordeal: Either they packed turkey loaf to take with them, or they hurried home before the next meal. Mostly, the family just stayed in. “If we ran out of it, Owen would have an absolute fit,” Seth said when he and Angela spoke with me in February. Once, after a supermarket strike disrupted the local turkey supply, he spent the night driving from store to store, searching for enough meat to get through the week.

Trying to understand how two down-to-earth-sounding people had found themselves in this predicament, I asked Angela and Seth whether they had been fans of turkey loaf to begin with. Was the recipe an old family favorite? “Oh God, no,” Seth said, horrified, explaining that they’d found it on a kids’-food blog when Owen was a toddler. “Disgusting,” Angela said with conviction. “It looks like prison food,” Seth added. They were very clear about another thing, too: They hadn’t simply found themselves in this predicament; over the course of their 12-week program with Shimshoni, they’d concluded that they’d helped create it. “Owen started off with eating issues”—he had been born prematurely and stayed in the NICU for a month because he refused to feed—“and we started getting our own anxieties” is how Seth put it. “I thought that I was doing the right thing by just keeping him happy and making him comfortable,” Angela said.

As ready as Owen’s parents were to take responsibility for his issues, I couldn’t help but notice the role played by something else: time, and the juggling acts parents develop to compensate for the lack of it. Owen wouldn’t have been fed turkey loaf 3,000 times had he and his parents been sharing meals; they wouldn’t have stood for it. But, like many parents, they staggered their work schedules. Seth picked Owen up at day care and fed him dinner. He and Angela ate later, after Owen was asleep. One of the first changes Shimshoni recommended was that they begin having dinner as a family. Owen didn’t have to eat everything his parents ate, but he could choose only from among the foods on the table—no substitutions. After dinner, the kitchen closed for the night. Shimshoni says her goal is not to turn a picky eater into an omnivore, but to get a kid like Owen to the point where he can find something to eat in most situations. When I spoke with Angela and Seth, Owen was several months into his post-SPACE life. He isn’t an adventurous eater, but he now gets by without bringing turkey loaf everywhere.

If the instinct to protect a child leads many of us into the trap of overparenting, I’ve come to believe that time pressures keep us there. In conversation after conversation with parents who were struggling to reduce a child’s dependency and fearfulness, rushed weekday mornings and evenings emerged as the crucible in which bad habits had formed. Eli Lebowitz makes much the same point. “One of the reasons parents accommodate is a child in distress, but another big reason is I want to get my child to school. That is a powerful driver too,” he said: “I have to get to work after I drop you at school.”

Ruthie Arbit, a therapist who specializes in maternal and pediatric mental health, observes that for mothers, especially, time pressure can be compounded by guilt. “When there’s all the guilt that, as a working parent, I missed X, Y, Z,” she told me, “it’s a lot harder to follow through with an unpleasant behavioral intervention.” And if you have only an hour with your child at night, you’d like it to be a pleasant one. A parent’s own underlying anxiety may also come to the fore. More than once in my interviews with SPACE parents and clinicians, I found myself thinking of the program as a form of exposure therapy not just for kids but for parents: If we learn to tolerate our children’s discomfort, we can stop getting in the way of their efforts to cope with it.

Therapists who treat anxiety like to talk about how short-term pain leads to long-term gain—how enduring discomfort now can make you more resilient later. In recent decades, however, the opposite principle has guided many American parents, and not only when it comes to the parenting of anxious children: On everything from toilet training to eating and sleeping habits, many of our parenting strategies trade short-term gain (a few minutes saved here, a conflict averted there) for long-term pain.

That we would cut corners in this way is maybe inevitable in a country that lacks adequate parental leave or quality, affordable child care; one in which school and employment schedules are misaligned, and in which our work culture expects employees to always be on. Add to the mix a permissive streak in American child-rearing, one that has simultaneously indulged children and encouraged their independence, and you have an extremely labor-intensive recipe for parental misery. “The accusation that American mothers coddle their children is not new,” writes the historian Paula S. Fass in her 2016 book, The End of American Childhood—but its recent combination with maternal employment has made for especially overburdened lives. By way of illustrating the point, she relates the contrast that Sara Harkness and Charles Super, two ethnographers, have drawn between American and Dutch parents:

American parents much more frequently emphasize individual attention, active interaction, and the developmental needs of the child … Dutch parents put their faith in regularity of habits (rest, quiet, and cleanliness) and family time together, especially around meals … One result of these different goals in households equally devoted to children’s welfare was that American parents were often tired and appeared frazzled. They tended to complain about their children’s sleeping habits and gave in to their demands because they were too exhausted to fight in the middle of the night.

The problem isn’t that American parents aren’t trying; if anything we’re trying too hard, but in ways that backfire, leaving us less time for the things that matter most. At a lab I visited at the University of Maryland, I learned about the Turtle Program, an intervention that, among other things, directs parents to set aside five minutes of “special time” each day with their behaviorally inhibited preschoolers, to be spent doing whatever the child chooses, with no directions or corrections given by parents. Parents told me how thirstily their children had drunk up this modest amount of time, so I tried it on my (non-anxious) 6-year-old. He was at first incredulous and then overjoyed. I realized, in dismay, just how divided my attention is most of the time, and how many of our interactions are dominated by my telling him to do this or not to do that, especially when I am rushing.

Changes in the way we’ve approached toilet training are a particularly dramatic example of how something that seems child-friendly can turn out to be parent-unfriendly and therefore everyone-unfriendly. As the early-childhood expert Erika Christakis notes in The Importance of Being Little, the age at which children are toilet trained has crept up over time. Several decades ago, 60 percent of 18-month-olds were fully trained. Studies earlier this century show only about half of American children being toilet trained by age 3, and today it’s not uncommon to see 4-year-olds wearing Pull-Ups. Some people have attributed this to a move away from harsh, old-school training methods, but I wonder whether an equal problem isn’t parents’ lack of time. Around my daughter’s second birthday, I saw a copy of Potty Training for Dummies by the register at Buy Buy Baby and impulsively bought it. I might not have, had I realized that it prescribed a festive three-day boot camp mortifyingly called “Potty Mambo Weekend.” In any case, the approach worked—but in conversations, I noticed how overwhelmed some friends seemed by the idea. Who had three days to spare? And yet, as Christakis notes, “time spent changing diapers is surely worth something, too.” (Delayed potty training makes for a strange contrast with the fact that many preschools have recently become more academic. The split screen between the two things—learning to read and write, still in diapers—foreshadows the situation later on, when high-school kids shoulder intense academic pressure even as many are behind in developing life skills.)

[From July/August 2018: Erika Christakis on the dangers of distracted parenting]

Or consider sleep. Whichever side one takes in the wars over infant sleep-training and bed-sharing, as children grow older, it can be easy to fall into the trap of privileging one night’s sleep over long-term sleep skills. Among parents I surveyed, certain refrains emerged. “I often let my 9 year old fall asleep w/us b/c she has anxiety at night,” one mother wrote me. “The sleeping in our bed is just us wanting to go to sleep as well.” Others mentioned how different their approach was from that of their parents. “As a kid, I was terrified of the dark. I had a night-light, and that was it,” another mother observed. “I don’t think it even occurred to me to ask my parents to stay with me while I fell asleep, nor can I imagine they would have entertained it if asked.”

Illustration: Oliver Munday; Khoa Vu / Getty

Of course, the more we parent this way day to day, the more time parenting consumes over the years. Understanding this cycle sheds light on a widely remarked-upon and baffling statistic: Time-use studies tell us that parents today spend significantly more hours caring for children than parents did 50 years ago, despite the fact that we work more hours outside the home. One explanation for this strange fact, as has been widely noted, is that kids today spend less time on their own. But a second, as we’ve just seen, is that parents really are doing more for their kids—and many kids are doing less for themselves.

IV. Failure to Launch

For one hint of just how much parenting style may influence a child’s anxiety level, consider the diverging paths of boys and girls.

“There is no greater risk factor for anxiety disorders than being born female,” Andrea Petersen writes in On Edge, her exploration of anxiety. “Women are about twice as likely as men to develop one, and women’s illnesses generally last longer, have more severe symptoms, and are more disabling.” Weirdly enough, females start off the less anxious sex; male newborns are the fussy, irritable ones. Various theories have been advanced as to why women end up more fearful and inhibited than men, but to my mind the most convincing is that, when we were kids, adults responded disparately to our fears. “When girls are anxious, adults are more likely to be protective and allow them to avoid scary situations. Boys are told to suck it up … It is as if boys are engaged in continual exposure therapy,” Petersen writes, going on to detail a damning body of research showing how parents have, through the decades, encouraged bravery and independence in boys while discouraging those traits in girls.

Maybe the way to think about recent parenting is this: All kids today are being overprotected the way only girls used to be. Except the changes in childhood are far broader than that. Even girls, after all, used to get themselves around the neighborhood and have summer jobs and chores. Today, only 10 percent of kids walk or bicycle to school, a steep decline from decades past. Forty years ago, 58 percent of teenagers got summer jobs; today, 35 percent do, and the after-school job is an even rarer species. When Braun Research surveyed more than 1,000 American adults, 82 percent said that as children they’d had regular chores—but only 28 percent said their own children did.

The problem with these declines is not that the activities in question are inherently virtuous, but that they provide children with two very important things, the first of which is experience tolerating discomfort. When I began interviewing clinicians, I was struck by how many of them talked about the importance of learning to endure emotional upset as well as physical distress and even pain. (Elisa Nebolsine, a child therapist who specializes in CBT, told me that when she meets parents, one of her first questions is: “How does your kid do being uncomfortable, being tired, being hot, being hungry?”) This message was so consistent, in fact, that some of the therapists started to sound like members of a cult with a sadistic bent. But I came to understand their concern. The more I thought about it, the more I saw myself shielding my kids from even the mild discomforts of my own childhood. Unless I had a high fever as a child, I was never given an analgesic. Why was I so ready to dole out liquid Tylenol, and in a choice of flavors? Speaking of flavors, why was I buying Crest Kid’s Sparkle Fun Toothpaste at a 50 percent markup over regular, I mean “spicy,” toothpaste (the only kind I knew as a child)? And why was I vetting my kids’ movie selections on Common Sense Media, a website that exhaustively catalogs frightening or otherwise objectionable content in children’s entertainment?

Doing chores and getting oneself where one needs to go also provide another, more obvious benefit: a sense of personal competence. This may be why doing chores from age 3 or 4 onward has been found to be a very strong predictor of academic, professional, and relational success in young adulthood. Obviously many people do just fine in life without ever having a summer job or walking themselves to school. But these developments combine with the recent changes in child-rearing and technology to create a particularly toxic combination: teenagers with a deficit of life skills, a lack of practice weathering the frustrations to which that deficit may lead, and the means to retreat and distract themselves from those frustrations.

Over the past five years, the age at which most kids get a smartphone has continued to tick downward. In 2015, according to a study by Common Sense Media, 32 percent of 11-year-olds had one; last year, 53 percent did. Several factors appear to be driving this and related trends. For kids of all ages, screens are cheap and reliable babysitters (see: time famine). Some parents embrace phones because they enable tracking of kids (see: parental anxiety). Others surrender to demands for technology because they can’t tolerate either their own kids’ anger or peer pressure from other kids’ parents. Finally, many parents have difficulty limiting their own device use, which may weaken their feeling of authority on the matter.

[From November 2018: Alexis Madrigal on the dangers of YouTube for young children]

Again, technology is not necessarily bad for mental health, especially as kids get older; for many teens, it can be a conduit for social support. But if you have an anxiety disorder and want to avoid things—other people, say, or the outside world—various aspects of digital life are ideally (meaning disastrously) suited to that goal. This appears to be especially true for two groups in particular. The first is young adults experiencing failure to launch—not working or attending school, and dependent on their parents. The second is those teenagers practicing “school refusal.” Lebowitz’s approach to both groups is multifaceted, as it must be—by the time young people get to this point, their problems tend to be pretty complicated. One key tactic is to strategically limit internet access when it seems to be making avoidance of something too comfortable—much the way he tries to limit parental accommodation. In school-refusal cases, for example, he counsels that if a kid is home during the school day, she shouldn’t have access to things she wouldn’t have if she were at school: TVs, phones, tablets, video games, parental attention, even recreational reading. “Books are highly entertaining, and boredom is our ally in this particular struggle,” Lebowitz explained during the SPACE training I attended.

This was the only moment in the two-day workshop when I heard participants express skepticism—our lives were too enmeshed with tech, they suggested, and kids were too tech savvy; removing internet access, even for a school day, was a lost cause. Lebowitz held firm. If you want to, you can. TV connected to the wall? Take the cord and the remote to work. Too many devices to keep track of? Get Circle, an access controller that attaches to your router. He is hair-on-fire about this point: For vulnerable kids, on-demand internet access makes hiding out much too comfortable. “It’s almost like the internet is devised to enable these problems, because you’re not naturally bored,” he said. “You can have social stimulation without the social stress of actual people.”

Lebowitz published a small study in 2012 on his work with parents of failure-to-launch young adults and has since treated a few dozen more families, with promising results. He says one of the most gratifying parts of his work is when, years later, he gets letters from parents with updates on a son or daughter who has finally gone to college or gotten married or otherwise picked up a life that was on hold. In February, I talked with the parents of one such young adult, Andy, who is in his early 20s. When Clive and Nora started working with Lebowitz, early last year, Andy hadn’t attended school regularly in several years, due to a stew of learning issues, depression, and anxiety. He was enrolled in a private high school, though he essentially never went. They had tried, with mixed success, different therapies, but eventually he refused help. Most of the time, he stayed in his room.

Lebowitz encouraged Clive and Nora to pick a single goal—Andy finishing high school—and to focus on how their accommodations (housing Andy, feeding him, giving him a car and a phone and Wi-Fi) were helping him avoid it. Jumping back into school overnight was unrealistic, so Lebowitz advised breaking the goal into achievable steps. The first, which lasted for a few weeks, was for Andy to get himself to school every day. He didn’t have to go to class, but he did need to send his parents a selfie proving that he’d been there; if he didn’t, they would withhold internet access for 24 hours.

When Clive and Nora announced this plan, Andy said it was really stupid. But within a day or two, he was complying, and he took more small steps in the months that followed. He started dating, and even had a girlfriend for several months; today, he’s almost finished with high school. Clive and Nora’s own thinking and behavior have also shifted radically. Nora says that if she had known sooner what she knows now, she would have reacted far less to Andy’s anxiety from the beginning. “Even when he was 4 or 5, he would ask me to stay home from school, and I often accommodated that,” she said. Clive now realizes that the more he helped Andy solve problems over the years, the worse Andy’s own problem-solving skills got.

This isn’t to say that the past year has been entirely smooth; along the way Nora and Clive have repeatedly been tempted to swoop in and help. One example of this has stuck with me. When Andy skipped school for a few days, they turned off the internet, so he began using his phone’s data and soon ran out. He wanted to go see his girlfriend, but he didn’t know how to get to her house without Waze, so he started sending his parents panicked texts, asking what they expected him to do. In turn they had a crisis of confidence. They wanted him out of the house and seeing people. Should they buy him more data? They called Lebowitz. “It’s not your problem,” he told them. “Just say, ‘We trust that you will find your way.’ ”

And he did.

V. “Draw the Earthquake”

Parenting style is not the only thing that can fortify our kids. Sleep, exercise, and friendship all confer tremendous psychological benefits, and are within our powers to promote, both individually and societally. A morally more urgent task is to reduce poverty, instability, and deep trauma (as opposed to ordinary stress) in children’s lives; research on these adverse childhood experiences demonstrates the overwhelming risk they pose to psychological functioning. The lack of children’s mental-health care is another pressing problem: Most children who need it don’t get it, and what they do get tends not to be evidence-based care (such as CBT). Finally, if we want to create the conditions for children’s mental health, we must first create the conditions for adult sanity, in the form of more support for families. It’s been said that a society that cares about children must also care about parents. That’s undoubtedly true. It’s also been said that a parent is only as happy as her unhappiest child. That’s true too, though, again, the relationship runs both ways. The more our unhappy children worry, the more we worry about them, and the more we worry about them, the more we do the very things that lead their worries to flourish.

[From March 2019: Erika Christakis on how active shooter drills are tragically misguided]

Of the many cutting portrayals of modern motherhood offered up by HBO’s Big Little Lies, the most evocative may be the episode in which Amabella, the second-grade daughter of Renata (played by Laura Dern), has a panic attack at school and passes out. A child therapist is dispatched, and reports that young Amabella is worried about the planet. “Her class is evidently talking about climate change,” the therapist explains. “She’s gotten the message that we’re doomed.” Renata is livid at the school for spilling the beans, as are other parents; a meeting is convened with the principal, who limply declares anxiety “an epidemic in our schools.” Because it is Big Little Lies, the particulars are over the top (Renata promises, or threatens, to “buy a fucking polar bear” for each kid), but the angst is recognizable.

Illustration: Oliver Munday; Nick David / Getty

When I spoke with Kathryn L. Humphreys, a psychology professor at Vanderbilt University who specializes in the effects of caregiving in early life, she observed a widespread hesitancy to talk about depressing concepts with kids. Parents seem to feel that doing so is “developmentally inappropriate,” she mused, though this strikes her as exactly backwards given what we know about the benefits of graduated exposure to things that frighten us. Humphreys listens to the news after work, and her 4-year-old daughter will often ask tough questions. She told me she understands why people are concerned about having difficult conversations with kids, and yet, she asked, “At what age is it that you think kids are capable of that?” Scary things are happening all the time, and avoiding them—“We’re just gonna turn off the news!” as she put it—won’t change that. “Sometimes it’s the avoidance that makes it harder for kids who are anxious,” she added.

In my experience, this cloistering extends to everything from the Holocaust to sex. I’m surprised by how many of my friends think their fourth and fifth graders don’t know how babies are made. Meanwhile, the efforts parents make to promote belief in, for example, Santa Claus seem more fervent than ever, via tools like Elf on the Shelf and apps that supposedly show Santa’s visit to your home. One of the more revealing mommy-board threads I’ve encountered began with an irate warning titled “Super Fudge book outs Santa as fake.” More than 100 people jumped into the outraged fray that followed, all over a revelation in a classic Judy Blume novel that’s aimed at third-to-sixth graders and that came out four decades ago. So we find ourselves with a bizarre mishmash: Some adults think their fourth graders believe in Santa Claus and don’t know how babies are made while other adults—or maybe some of the same adults—think fourth graders should have smartphones. In another era, the desire to keep kids in the dark might not be a problem, but it’s a strange combination with the easy access many of them now have to Pornhub and viral videos of real-life violence.

As I contemplate the likelihood that my kids’ lives will be more stressful than mine, my mind keeps wandering to two children’s drawings reproduced in the pediatrician W. Thomas Boyce’s book The Orchid and the Dandelion: Why Some Children Struggle and How All Can Thrive. Both depict California’s 1989 Loma Prieta earthquake, which killed dozens of people—and also, as chance would have it, occurred midway through a study Boyce was conducting of whether stress increased local children’s susceptibility to illness. Naturally, he and his team expanded the study to incorporate their reactions to the disaster, and they asked each child to “draw the earthquake.” The kids’ responses varied dramatically. Some produced cheerful pictures—“homes with minor damage, happy families, and smiling yellow suns”—while others generated scenes of destruction and injury, fear and sadness. To Boyce’s fascination, children who drew darker scenes tended to stay healthy in the weeks that followed, while those who drew sunny pictures were more likely to come down with infections and illnesses.

Boyce now believes it was protective for children to create “honest, even brutal depictions of a no-doubt-about-it disaster.” We talk about things that scare us, he ventures, “because it makes them gradually less scary; about sadness, because it makes the sadness diminish a little each time we do.” I am drawn to this story in part because in 1989 I was 11 years old, I lived in the Bay Area, and I was deeply, morbidly fascinated by the earthquake and its human toll. But I am also attracted to it because its moral is at odds with the way adults so often try to shield children from difficult topics. In fact, it sometimes seems that the more overwhelming the world gets, the more adults try to blindfold children.

In the end, one lesson we might derive from everything scientists and clinicians have learned about anxiety is this: If we want to prepare our kids for difficult times, we should let them fail at things now, and allow them to encounter obstacles and to talk candidly about worrisome topics. To be very clear, this is not a cure-all for mental illness. What we need to recognize, though, is that our current approach to childhood doesn’t reduce basic human vulnerabilities. It exacerbates them.

This article appears in the May 2020 print edition with the headline “Childhood in an Anxious Age.”

* This article originally stated that more than a quarter of doctor visits end with a prescription for an anti-anxiety medication. In fact, 7.4 percent do.

The Endangered Sex Scene

2019-08-06T08:00:00-04:00

John Cuneo

“This is my kit.” Alicia Rodis, who since early last year has been HBO’s lead intimacy coordinator, a new title that translates roughly to chief sex-scene coach, held up a clear vinyl case filled with what at first glance appeared to be toiletries and packages of pantyhose. On closer examination, though, the products and their names were mysterious. Shibue. Hibue. Stanga.

“Let’s say we’re coming in to do a sex scene,” she said. “They’re simulating sex and they’re excluding genitals—we are going to see someone fully naked, but not their genitals—and they’re in the bed, with sheets. So what do we need to make sure?” Here she picked up a Shibue (“she-boo”), which looks like a panty liner except that it’s meant to adhere to a person rather than to an undergarment. “We take a Shibue, open it up, and put a silicone guard underneath so everyone becomes like a Barbie doll.”

Rodis wants both to shield sensitive body parts and to make their contours undetectable. She explained that costume departments know all about the items in her kit, but she doesn’t like to leave anything to chance. If she’s new on a set, she will bring Shibues in a full range of human skin tones and some silicone guards, too. She waved a lavender package containing one (brand name: Silicone Valley), then continued riffling through her supplies. “Knee pads or elbow pads in case someone’s on a hard floor. Sticky tape, moleskin. Wet Ones, tissues, breath mints. Baby oil so they can take anything that’s adhesive off. Razors—though usually I’ll talk with actors beforehand and ask, ‘Could you shave your bikini line so we know that you’re not going to get a free spa treatment when we take off the Shibue?’ ” She held up a Hibue. “The same thing, but for someone who has a penis.”

Rodis, who in a previous life was an actor and a stuntwoman, still has headshot-ready blond ringlets and a performer’s lithe physicality. That day, a Wednesday, she was working from her home office in Astoria, Queens, preparing for shoots on various shows. Among them was The Deuce, the David Simon and George Pelecanos drama about sex work in 1970s Times Square and the birth of modern porn, which begins its third and final season this month. Rodis’s bookshelves were packed with volumes about theater, sex, and sword fighting; across from her desk hung a certificate from the Society of American Fight Directors identifying her as a stage-combat teacher and a bulletin board covered with photos, cartoons, and buttons with slogans like “No does not mean Convince me.”

[Read: ‘The Deuce’ is David Simon’s best work since ‘The Wire’]

We sat down on a couch and Rodis turned on an episode from The Deuce’s second season. She fast-forwarded to a scene that takes place on a porn set done up with a kitschy Arabian Nights look. Like many scenes in The Deuce, it is sexually graphic but deliberately unsexy, in this case comically so. As the movie-shoot-within-a-TV-episode unfolds, the porn director barks commands at an actor named Tyler (played by Justin Stiver), who appears to be naked save for a gold lamé turban. Tyler is having sex with a porn actor named Shana, and the director wants him to raise her hips six inches for a better camera angle; Shana resists indignantly, offering a vivid description of what the requested position will mean for her insides. “I don’t want to hurt her!” Tyler protests.

When I asked Rodis how she’d facilitated the scene, she explained that she’d briefed both actors on the planned nudity and physical interaction, and on what type of wardrobe assistance—or lack-of-wardrobe assistance—they should expect. The day of the shoot, the three met in person to discuss in more detail who would be touching whom, how, and where. A conversation like this, Rodis explained, can also involve choreographic elements, such as “setting the number of pumps.” Once she had established that everyone was comfortable with the plan and made sure both actors had robes to wear before and after the scene, it was finally time for filming.

Video: #MeToo Is Changing How Sex Is Simulated on Set

The growing demand for more ethical practices across the entertainment industry has paved the way for a new profession: intimacy directors.

However basic all of this might seem, Rodis’s work represents a major departure from how sex scenes have historically been planned—or, as has often been the case, improvised. Rodis, who is 38, began acting onstage in her teens and continued through her 20s, when she added some TV acting and also took up fight directing and stunt work. On TV sets, she found, actresses were sometimes expected to shed their shirt without advance notice. As for sex scenes, performers were often left to muddle their way through the action. Some directors had an attitude of, as she put it, “I want to discuss what your character does for everything until it gets to anything sexual, and then just go for it.” The message that sends to actors is: “ ‘You know how to kiss; kiss how you kiss.’ But no one should give a shit about how the actor kisses”—or comports himself sexually—“it should be about the character.” At best, this inattention produced lackluster sex scenes. At worst, it suggested an unserious attitude that could leave performers feeling confused if not traumatized.

Rodis was struck by how much more care went into staging physical interactions that were violent or dangerous than into staging those that were sexual. For a fight scene, choreographers mapped out every beat, helping actors work through each movement in slow motion, over and over, until they were automatic. In stunt work, a focus on safety was considered “nonnegotiable.” Why weren’t sex scenes governed by the same approach?

When Rodis heard that a fellow fight choreographer, Tonia Sina, had begun offering what she called intimacy direction and choreography services, she reached out to her. In 2015, the two women joined forces with a third actor turned fight director, Siobhan Richardson, to found their own company, Intimacy Directors International. Initially most of their work was in the theater, where a series of scandals had focused attention on the question of how sex was performed onstage.

By late 2017, however, the nascent #MeToo and Time’s Up movements were drawing similar scrutiny to the TV and film industry, with allegations of on- and off-set wrongdoing leveled at actors including Kevin Spacey, Jeffrey Tambor, and Jeremy Piven. Then, in January 2018, the Los Angeles Times published an article in which several women accused the Deuce executive producer and lead actor James Franco of behavior on film sets that was “inappropriate or sexually exploitative.” One woman said he had removed protective guards from actresses’ genitals during an oral-sex scene. (Franco’s attorney disputed the women’s stories and told the paper, “The allegations about the protective guards are not accurate.”)

The next month, shortly before The Deuce was scheduled to begin taping its second season, Rodis got a message from a producer on the show. “He was like, ‘I’m looking at a website, and, um, it says that you do a service?’ ” She called him back, and two days later—after binge-watching the first season of the show—she went to Silvercup Studios in Queens to meet with David Simon and nine or 10 long-faced HBO producers and executives, each of whom had a copy of her résumé. “You could tell something was up,” she said dryly.

For the show’s first season, Nina K. Noble, an executive producer and a longtime collaborator of Simon’s, had taken various steps to ensure actors’ comfort, from personally reviewing scripts with them to improvising intimacy barriers out of yoga mats. But after #MeToo’s allegations and revelations, Noble told me, some of the cast members had asked the producers to do more, and she agreed that it was time for outside help. (I asked Noble whether the decision was related to the allegations against Franco; she denied that it was.) Rodis was asked to explain exactly what she might bring to the show, so she described the objectives of her theatrical work—including choreography, consent and safety, and cultivating a connection between actors so as to promote chemistry. Here, Simon jumped in. “We don’t want them to be connected,” Rodis remembered him saying. “This is transactional sex, and shame on us if we try to make that look glorified in any way.” She emphatically agreed. That night, she was offered the job.

In the opening season of The Deuce, Emily Meade’s character, Lori, has a lot of sex—all of it transactional, none of it glorified. Upon arriving in New York from Minnesota, she signs up with a pimp named C.C. and becomes a prostitute and later a porn actor. Both jobs are detailed graphically. Before The Deuce, Meade’s career had included several difficult sex scenes (the first, when she was 16, involved her character’s rape by an older man)—but she had powered through them with gritted teeth. Approaching Season 2, however, she felt ill: She now knew just how dense with difficult sex The Deuce could be, and #MeToo had brought back memories of sexual traumas she had suffered in her own life.

The first time Meade worked closely with Rodis was for a scene in which her character travels to Los Angeles for the Adult Film Association of America Awards. There she meets a talent scout named Greg, played by Ryan Farrell; they flirt, pile into the back of his limousine, snort some cocaine, and—fully clothed—make out. By any standard, let alone The Deuce’s, the scene is tame. Meade was nonetheless anxious. She didn’t know Farrell, and the atmosphere on TV and movie sets had recently grown tense. “This is right when we came back to work, right after Time’s Up. Everyone’s walking on eggshells,” she told me. “Obviously any decent man is going to feel uncomfortable just grabbing at my breast.” Farrell told me that he was, in fact, concerned about Meade’s well-being, but wasn’t sure how to effectively convey that concern. “If you keep telling somebody you’re not a creep, it’s kind of creepy,” he said.

Ahead of the shoot, the episode’s director, Steph Green, explained her vision of the scene to Rodis, who called the actors to run through a proposed plan. Afterward, Rodis made sure that each actor’s contract had a rider stipulating that Farrell would touch Meade’s clothed breasts, and Meade would grab Farrell’s crotch through his pants, under which he’d be wearing a prosthetic penis. The day of filming, Green, Rodis, and both actors met in private to prepare. (Green has long run trust- and chemistry-building exercises before intimacy scenes.) Before rehearsing the scene, she and Rodis asked the actors to hold each other’s gaze for a long interval. The actors also took turns inviting each other to touch agreed-upon body parts: hand, knee, thigh, and so on.

When it was time to shoot, the aforementioned prosthetic was produced. “It was an actual fake penis that they use in some of the scenes,” Farrell said. “I was like, ‘That’s pretty extreme!’ ” He put it in his pants. “Emily got to actually feel it when it was on top of me,” he said, “and when things like that start happening, it’s an icebreaker, and everybody loosens up a bit.”

Farrell and Meade got in the back of the limo, together with a cameraperson, while Rodis and Green watched the scene via monitor. (By long-standing tradition, TV and movie sex scenes are filmed on closed sets, without any unnecessary people milling around.) Early in the proceedings, they paused to fine-tune the way Farrell was touching Meade’s breast. “His hand was sort of flat,” Meade recalled. As a result, Rodis said, it looked as if Farrell’s character was pinning Lori down instead of caressing her. “If you give your hand just a little bit of a cup to it and bring it underneath,” she told Farrell, “it isn’t going to look like you’re forcing her down.” The small adjustment didn’t require added contact or pressure, Rodis said, but it made the scene into “an intimate moment and not something that he was pushing her into.” In the context of Lori’s story line, that was a crucial distinction. For all her sexual encounters up to this point in the series, this is the first one we see unfold entirely outside her pimp’s clutches—the first one she appears to actually want.

More graphic scenes call for different measures. In the new season, another actor performs oral sex on Meade’s character. “I’ve had to do that multiple times, and every time it’s been either someone inappropriately close or awkwardly far away,” she said. Rodis, by contrast, “was able to fully structure it—how he arched his back and where he put his hands; for him to put his mouth or his face toward my left leg in a certain way so it looked like he was doing that, without it being inappropriate.” The goal is to minimize, not eliminate, awkwardness. “It’s still awkward, no matter what,” Meade said. “You have somebody’s head in your crotch.”

Fundamental to Rodis’s approach is her comfort talking about human bodies and the things they can do together. “It is a skill just to speak freely and technically about sex scenes,” Green said, adding: “How can we figure out where this can all go wrong until we can talk about what it is in the first place?” When Rodis first arrived at HBO, such frankness wasn’t necessarily what people were expecting; to the contrary, she sensed that some veteran actors and directors suspected that intimacy coordinator was code for “censor”—that “the Millennials were coming to sanitize everything.” Rodis is sensitive and chooses her words carefully—she is capable of saying bloodless things like “rear backside nudity” with a straight face. But she is also, as Meade put it, “completely down for the raunchy silliness of it all.” This combination of candor and lightheartedness allows everyone around her to speak frankly, too. And that, far from sanitizing sex, enables richer and more realistic depictions of it.

In rethinking its approach to sex scenes, HBO is motivated by more than benevolence toward its actors. It is scrambling to salvage an essential element of its identity, not to mention its bottom line, in the face of new realities. Pay cable’s freedom to titillate no longer offers the same competitive advantage it once did, thanks to streaming porn. Last year, the network retired its late-night adult programming, including reality shows like Real Sex as well as soft-core erotic movies. At the same time, the revelations of #MeToo have made networks more tentative about shooting sex that could be interpreted as exploitative. Nina Noble told me that, in her view, The Deuce probably wouldn’t have been green-lit post #MeToo—even though the show’s objective is not to revel in exploitation but to shine a critical light on it.

Financial and cultural pressures have already had an unmistakable effect on how sex is depicted in film. In an essay this spring, The Guardian’s film editor, Catherine Shoard, described a new “age of cinematic abstinence.” In June, the Washington Post film critic Ann Hornaday declared that “the classic sex scene—once a staple of high-gloss, adult-oriented, mainstream movies—has been largely forgotten and ignored,” as studios now favor films that are either violent or kid-oriented.

For the moment, at least, HBO seems intent on finding a way to make sex safe for the small screen, and the small screen safe for sex. Rodis now advises about two dozen intimacy coordinators at the network, who work on shows across the network’s lineup, including High Maintenance, Succession, and Westworld. I asked her what she believes is at stake in her efforts. Suppressing such an essential aspect of the human experience would be negligent storytelling, she told me. Imagine if we treated sex like the ancient Greek playwrights treated violence, “where everyone just went offstage, and then someone came back and said, There was a killing!”

The costs of such an approach would not be merely artistic, she added. Depictions of sex on-screen have a powerful ability to shape our attitudes toward intimacy. “Sex scenes are not just a vehicle for someone to get off,” Rodis said. “Sex has so many narratives, and it’s so complex and it’s so important. People who are growing up with the internet and just seeing a certain type of pornography? I think we owe it to them to show forms of sexuality that are not the top 50 videos on Pornhub.” Put another way, the severing of sex from art would impoverish both.

This article appears in the September 2019 print edition with the headline “The Sex-Scene Coach.”

Why Are Young People Having So Little Sex?

2018-11-13T08:00:00-05:00

These should be boom times for sex.

The share of Americans who say sex between unmarried adults is “not wrong at all” is at an all-time high. New cases of HIV are at an all-time low. Most women can—at last—get birth control for free, and the morning-after pill without a prescription.

If hookups are your thing, Grindr and Tinder offer the prospect of casual sex within the hour. The phrase If something exists, there is porn of it used to be a clever internet meme; now it’s a truism. BDSM plays at the local multiplex—but why bother going? Sex is portrayed, often graphically and sometimes gorgeously, on prime-time cable. Sexting is, statistically speaking, normal.

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Polyamory is a household word. Shame-laden terms like perversion have given way to cheerful-sounding ones like kink. Anal sex has gone from final taboo to “fifth base”—Teen Vogue (yes, Teen Vogue) even ran a guide to it. With the exception of perhaps incest and bestiality—and of course nonconsensual sex more generally—our culture has never been more tolerant of sex in just about every permutation.

But despite all this, American teenagers and young adults are having less sex.

To the relief of many parents, educators, and clergy members who care about the health and well-being of young people, teens are launching their sex lives later. From 1991 to 2017, the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey finds, the percentage of high-school students who’d had intercourse dropped from 54 to 40 percent. In other words, in the space of a generation, sex has gone from something most high-school students have experienced to something most haven’t. (And no, they aren’t having oral sex instead—that rate hasn’t changed much.)

Meanwhile, the U.S. teen pregnancy rate has plummeted to a third of its modern high. When this decline started, in the 1990s, it was widely and rightly embraced. But now some observers are beginning to wonder whether an unambiguously good thing might have roots in less salubrious developments. Signs are gathering that the delay in teen sex may have been the first indication of a broader withdrawal from physical intimacy that extends well into adulthood.

Over the past few years, Jean M. Twenge, a psychology professor at San Diego State University, has published research exploring how and why Americans’ sex lives may be ebbing. In a series of journal articles and in her latest book, iGen, she notes that today’s young adults are on track to have fewer sex partners than members of the two preceding generations. People now in their early 20s are two and a half times as likely to be abstinent as Gen Xers were at that age; 15 percent report having had no sex since they reached adulthood.

Gen Xers and Baby Boomers may also be having less sex today than previous generations did at the same age. From the late 1990s to 2014, Twenge found, drawing on data from the General Social Survey, the average adult went from having sex 62 times a year to 54 times. A given person might not notice this decrease, but nationally, it adds up to a lot of missing sex. Twenge recently took a look at the latest General Social Survey data, from 2016, and told me that in the two years following her study, sexual frequency fell even further.

Some social scientists take issue with aspects of Twenge’s analysis; others say that her data source, although highly regarded, is not ideally suited to sex research. And yet none of the many experts I interviewed for this piece seriously challenged the idea that the average young adult circa 2018 is having less sex than his or her counterparts of decades past. Nor did anyone doubt that this reality is out of step with public perception—most of us still think that other people are having a lot more sex than they actually are.

When I called the anthropologist Helen Fisher, who studies love and sex and co-directs Match.com’s annual Singles in America survey of more than 5,000 unpartnered Americans, I could almost feel her nodding over the phone. “The data is that people are having less sex,” she said, with a hint of mischief. “I’m a Baby Boomer, and apparently in my day we were having a lot more sex than they are today!” She went on to explain that the survey has been probing the intimate details of people’s lives for eight years now. “Every year the whole Match company is rather staggered at how little sex Americans are having—including the Millennials.”

Fisher, like many other experts, attributes the sex decline to a decline in couplehood among young people. For a quarter century, fewer people have been marrying, and those who do have been marrying later. At first, many observers figured that the decline in marriage was explained by an increase in unmarried cohabitation—yet the share of people living together hasn’t risen enough to offset the decline in marriage: About 60 percent of adults under age 35 now live without a spouse or a partner. One in three adults in this age range live with their parents, making that the most common living arrangement for the cohort. People who live with a romantic partner tend to have sex more than those who don’t—and living with your parents is obviously bad for your sex life. But this doesn’t explain why young people are partnering up less to begin with.

Over the course of many conversations with sex researchers, psychologists, economists, sociologists, therapists, sex educators, and young adults, I heard many other theories about what I have come to think of as the sex recession. I was told it might be a consequence of the hookup culture, of crushing economic pressures, of surging anxiety rates, of psychological frailty, of widespread antidepressant use, of streaming television, of environmental estrogens leaked by plastics, of dropping testosterone levels, of digital porn, of the vibrator’s golden age, of dating apps, of option paralysis, of helicopter parents, of careerism, of smartphones, of the news cycle, of information overload generally, of sleep deprivation, of obesity. Name a modern blight, and someone, somewhere, is ready to blame it for messing with the modern libido.

Some experts I spoke with offered more hopeful explanations for the decline in sex. For example, rates of childhood sexual abuse have decreased in recent decades, and abuse can lead to both precocious and promiscuous sexual behavior. And some people today may feel less pressured into sex they don’t want to have, thanks to changing gender mores and growing awareness of diverse sexual orientations, including asexuality. Maybe more people are prioritizing school or work over love and sex, at least for a time, or maybe they’re simply being extra deliberate in choosing a life partner—and if so, good for them.

Many—or all—of these things may be true. In a famous 2007 study, people supplied researchers with 237 distinct reasons for having sex, ranging from mystical (“I wanted to feel closer to God”) to lame (“I wanted to change the topic of conversation”). The number of reasons not to have sex must be at least as high. Still, a handful of suspects came up again and again in my interviews and in the research I reviewed—and each has profound implications for our happiness.

1. Sex for One

The retreat from sex is not an exclusively American phenomenon. Most countries don’t track their citizens’ sex lives closely, but those that try (all of them wealthy) are reporting their own sex delays and declines. One of the most respected sex studies in the world, Britain’s National Survey of Sexual Attitudes and Lifestyles, reported in 2001 that people ages 16 to 44 were having sex more than six times a month on average. By 2012, the rate had dropped to fewer than five times. Over roughly the same period, Australians in relationships went from having sex about 1.8 times a week to 1.4 times. Finland’s “Finsex” study found declines in intercourse frequency, along with rising rates of masturbation.

In the Netherlands, the median age at which people first have intercourse rose from 17.1 in 2012 to 18.6 in 2017, and other types of physical contact also got pushed back, even kissing. This news was greeted not with universal relief, as in the United States, but with some concern. The Dutch pride themselves on having some of the world’s highest rates of adolescent and young-adult well-being. If people skip a crucial phase of development, one educator warned—a stage that includes not only flirting and kissing but dealing with heartbreak and disappointment—might they be unprepared for the challenges of adult life?

Meanwhile, Sweden, which hadn’t done a national sex study in 20 years, recently launched one, alarmed by polling suggesting that Swedes, too, were having less sex. The country, which has one of the highest birth rates in Europe, is apparently disinclined to risk its fecundity. “If the social conditions for a good sex life—for example through stress or other unhealthy factors—have deteriorated,” the Swedish health minister at the time wrote in an op-ed explaining the rationale for the study, it is “a political problem.”

This brings us to fertility-challenged Japan, which is in the midst of a demographic crisis and has become something of a case study in the dangers of sexlessness. In 2005, a third of Japanese single people ages 18 to 34 were virgins; by 2015, 43 percent of people in this age group were, and the share who said they did not intend to get married had risen too. (Not that marriage was any guarantee of sexual frequency: A related survey found that 47 percent of married people hadn’t had sex in at least a month.)

For nearly a decade, stories in the Western press have tied Japan’s sexual funk to a rising generation of soushoku danshi—literally, “grass-eating boys.” These “herbivore men,” as they are known in English, are said to be ambivalent about pursuing either women or conventional success. The new taxonomy of Japanese sexlessness also includes terms for groups such as hikikomori (“shut-ins”), parasaito shinguru (“parasite singles,” people who live with their parents beyond their 20s), and otaku (“obsessive fans,” especially of anime and manga)—all of whom are said to contribute to sekkusu shinai shokogun (“celibacy syndrome”).

Early on, most Western accounts of all this had a heavy subtext of “Isn’t Japan wacky?” This tone has slowly given way to a realization that the country’s experience might be less a curiosity than a cautionary tale. Dismal employment prospects played an initial role in driving many men to solitary pursuits—but the culture has since moved to accommodate and even encourage those pursuits. Roland Kelts, a Japanese American writer and longtime Tokyo resident, has described “a generation that found the imperfect or just unexpected demands of real-world relationships with women less enticing than the lure of the virtual libido.”

Let’s consider this lure for a moment. Japan is among the world’s top producers and consumers of porn, and the originator of whole new porn genres, such as bukkake (don’t ask). It is also a global leader in the design of high-end sex dolls. What may be more telling, though, is the extent to which Japan is inventing modes of genital stimulation that no longer bother to evoke old-fashioned sex, by which I mean sex involving more than one person. A recent article in The Economist, titled “Japan’s Sex Industry Is Becoming Less Sexual,” described onakura shops, where men pay to masturbate while female employees watch, and explained that because many younger people see the very idea of intercourse as mendokusai—tiresome—“services that make masturbation more enjoyable are booming.”

In their 2015 book, Modern Romance, the sociologist Eric Klinenberg and the comedian Aziz Ansari (who earlier this year became infamous for a hookup gone awry) describe Ansari’s visit to Japan seeking insights into the future of sex. He concluded that much of what he’d read about herbivore men missed the mark. Herbivores, he found, were “interested in sexual pleasure”—just not “through traditional routes.” Among Japan’s more popular recent innovations, he notes, is “a single-use silicone egg that men fill with lubricant and masturbate inside.” One night in Tokyo, Ansari picks one up at a convenience store, heads back to his hotel, and—sorry for the visual—gives it a go. He finds it cold and awkward, but understands its purpose. “It was a way,” he writes, “to avoid putting yourself out there and having an actual experience with another person.”

Justin Metz / Mendelsund / Munday

From 1992 to 2014, the share of American men who reported masturbating in a given week doubled, to 54 percent, and the share of women more than tripled, to 26 percent. Easy access to porn is part of the story, of course; in 2014, 43 percent of men said they’d watched porn in the past week. The vibrator figures in, too—a major study 10 years ago found that just over half of adult women had used one, and by all indications it has only grown in popularity. (Makes, models, and features have definitely proliferated. If you don’t know your Fun Factory Bi Stronic Fusion pulsator from your Power Toyfriend, you can find them on Amazon, which has these and some 10,000 other options.)

This shift is particularly striking when you consider that Western civilization has had a major hang-up about masturbation going back at least as far as Onan. As Robert T. Michael and his co-authors recount in Sex in America, J. H. Kellogg, the cereal maker, urged American parents of the late 19th century to take extreme measures to keep their children from indulging, including circumcision without anesthetic and application of carbolic acid to the clitoris. Thanks in part to his message, masturbation remained taboo well into the 20th century. By the 1990s, when Michael’s book came out, references to masturbation were still greeted with “nervous titters or with shock and disgust,” despite the fact that the behavior was commonplace.

Today, masturbation is even more common, and fears about its effects—now paired with concerns about digital porn’s ubiquity—are being raised anew by a strange assortment of people, including the psychologist Philip Zimbardo, the director of the famous Stanford Prison Experiment, who is enjoying an unlikely second act as an antiporn activist. In his book Man, Interrupted, Zimbardo warns that “procrasturbation”—his unfortunate portmanteau for procrastination via masturbation—may be leading young men to fail academically, socially, and sexually. Gary Wilson, an Oregon man who runs a website called Your Brain on Porn, makes a similar claim. In a popular tedx talk, which features animal copulation as well as many (human) brain scans, Wilson argues that masturbating to internet porn is addictive, causes structural changes in the brain, and is producing an epidemic of erectile dysfunction.

These messages are echoed and amplified by a Salt Lake City–based nonprofit called Fight the New Drug—the “drug” being porn—which has delivered hundreds of presentations to schools and other organizations around the country, including, this spring, the Kansas City Royals. The website NoFap, an offshoot of a popular Reddit message board founded by a now-retired Google contractor, provides community members (“fapstronauts”) a program to quit “fapping”—masturbating. Further outside the mainstream, the far-right Proud Boys group has a “no wanks” policy, which prohibits masturbating more than once a month. The group’s founder, Gavin McInnes, who also co-founded Vice Media, has said that pornography and masturbation are making Millennials “not even want to pursue relationships.”

The truth appears more complicated. There is scant evidence of an epidemic of erectile dysfunction among young men. And no researcher I spoke with had seen compelling evidence that porn is addictive. As the authors of a recent review of porn research note in The Archives of Sexual Behavior, “The notion of problematic pornography use remains contentious in both academic and popular literature,” while “the mental health community at large is divided as to the addictive versus non-addictive nature of Internet pornography.”

This isn’t to say there’s no correlation between porn use and desire for real-life sex. Ian Kerner, a well-known New York sex therapist and the author of several popular books about sex, told me that while he doesn’t see porn use as unhealthy (he recommends certain types of porn to some patients), he works with a lot of men who, inspired by porn, “are still masturbating like they’re 17,” to the detriment of their sex life. “It’s taking the edge off their desire,” he said. Kerner believes this is why more and more of the women coming to his office in recent years report that they want sex more than their partners do.

In reporting this story, I spoke and corresponded with dozens of 20- and early-30-somethings in hopes of better understanding the sex recession. I can’t know that they were representative, though I did seek out people with a range of experiences. I talked with some who had never had a romantic or sexual relationship, and others who were wildly in love or had busy sex lives or both. Sex may be declining, but most people are still having it—even during an economic recession, most people are employed.

The recession metaphor is imperfect, of course. Most people need jobs; that’s not the case with relationships and sex. I talked with plenty of people who were single and celibate by choice. Even so, I was amazed by how many 20-somethings were deeply unhappy with the sex-and-dating landscape; over and over, people asked me whether things had always been this hard. Despite the diversity of their stories, certain themes emerged.

One recurring theme, predictably enough, was porn. Less expected, perhaps, was the extent to which many people saw their porn life and their sex life as entirely separate things. The wall between the two was not absolute; for one thing, many straight women told me that learning about sex from porn seemed to have given some men dismaying sexual habits. (We’ll get to that later.) But by and large, the two things—partnered sex and solitary porn viewing—existed on separate planes. “My porn taste and partner taste are quite different,” one man in his early 30s told me, explaining that he watches porn about once a week and doesn’t think it has much effect on his sex life. “I watch it knowing it is fiction,” a 22-year-old woman said, adding that she didn’t “internalize” it.

I thought of these comments when Pornhub, the top pornography website, released its list of 2017’s most popular searches. In first place, for the third year running, was lesbian (a category beloved by men and women alike). The new runner-up, however, was hentai—anime, manga, and other animated porn. Porn has never been like real sex, of course, but hentai is not even of this world; unreality is the source of its appeal. In a New York–magazine cover story on porn preferences, Maureen O’Connor described the ways hentai transmogrifies body parts (“eyes bigger than feet, breasts the size of heads, penises thicker than waists”) and eroticizes the supernatural (“sexy human shapes” combine with “candy-colored fur and animal horns, ears, and tails”). In other words, the leading search category for porn involves sex that half the population doesn’t have the equipment to engage in, and the runner-up isn’t carnal so much as hallucinatory.

Many of the younger people I talked with see porn as just one more digital activity—a way of relieving stress, a diversion. It is related to their sex life (or lack thereof) in much the same way social media and binge-watching TV are. As one 24-year-old man emailed me:

The internet has made it so easy to gratify basic social and sexual needs that there’s far less incentive to go out into the “meatworld” and chase those things. This isn’t to say that the internet can give you more satisfaction than sex or relationships, because it doesn’t … [But it can] supply you with just enough satisfaction to placate those imperatives … I think it’s healthy to ask yourself: “If I didn’t have any of this, would I be going out more? Would I be having sex more?” For a lot of people my age, I think the answer is probably yes.

Even people in relationships told me that their digital life seemed to be vying with their sex life. “We’d probably have a lot more sex,” one woman noted, “if we didn’t get home and turn on the TV and start scrolling through our phones.” This seems to defy logic; our hunger for sex is supposed to be primal. Who would pick messing around online over actual messing around?

Teenagers, for one. An intriguing study published last year in the Journal of Population Economics examined the introduction of broadband internet access at the county-by-county level, and found that its arrival explained 7 to 13 percent of the teen-birth-rate decline from 1999 to 2007.

Maybe adolescents are not the hormone-crazed maniacs we sometimes make them out to be. Maybe the human sex drive is more fragile than we thought, and more easily stalled.

2. Hookup Culture and Helicopter Parents

I started high school in 1992, around the time the teen pregnancy and birth rates hit their highest levels in decades, and the median age at which teenagers began having sex was approaching its modern low of 16.9. Women born in 1978, the year I was born, have a dubious honor: We were younger when we started having sex than any group since.

But as the ’90s continued, the teen pregnancy rate began to decline. This development was welcomed—even if experts couldn’t agree on why it was happening. Birth-control advocates naturally pointed to birth control. And yes, teenagers were getting better about using contraceptives, but not sufficiently better to single-handedly explain the change. Christian pro-abstinence groups and backers of abstinence-only education, which received a big funding boost from the 1996 welfare-reform act, also tried to take credit. Yet the teen pregnancy rate was falling even in places that hadn’t adopted abstinence-only curricula, and research has since shown that virginity pledges and abstinence-only education don’t actually beget abstinence.

Still, the trend continued: Each wave of teenagers had sex a little later, and the pregnancy rate kept inching down. You wouldn’t have known either of these things, though, from all the hyperventilating about hookup culture that started in the late ’90s. The New York Times, for example, announced in 1997 that on college campuses, casual sex “seems to be near an all-time high.” It didn’t offer much data to support this, but it did introduce the paper’s readers to the term hooking up, which it defined as “anything from 20 minutes of strenuous kissing to spending the night together fully clothed to sexual intercourse.”

Pretty much ever since, people have been overestimating how much casual sex high-school and college students are having (even, surveys show, students themselves). In the past several years, however, a number of studies and books on hookup culture have begun to correct the record. One of the most thoughtful of these is American Hookup: The New Culture of Sex on Campus, by Lisa Wade, a sociology professor at Occidental College. The book draws on detailed journals kept by students at two liberal-arts colleges from 2010 to 2015, as well as on Wade’s conversations with students at 24 other colleges and universities.

Wade sorts the students she followed into three groups. Roughly one-third were what she calls “abstainers”—they opted out of hookup culture entirely. A little more than a third were “dabblers”—they hooked up sometimes, but ambivalently. Less than a quarter were “enthusiasts,” who delighted in hooking up. The remainder were in long-term relationships.

This portrait is compatible with a 2014 study finding that Millennial college students weren’t having more sex or sexual partners than their Gen X predecessors. It also tracks with data from the Online College Social Life Survey, a survey of more than 20,000 college students that was conducted from 2005 to 2011, which found the median number of hookups over a four-year college career to be five—a third of which involved only kissing and touching. The majority of students surveyed said they wished they had more opportunities to find a long-term boyfriend or girlfriend.

When I spoke with Wade recently, she told me that she found the sex decline among teens and 20-somethings completely unsurprising—young people, she said, have always been most likely to have sex in the context of a relationship. “Go back to the point in history where premarital sex became more of a thing, and the conditions that led to it,” she said, referring to how post–World War II anxiety about a man shortage led teen girls in the late 1940s and ’50s to pursue more serious romantic relationships than had been customary before the war. “Young women, at that point, innovate ‘going steady,’ ” Wade said, adding that parents were not entirely happy about the shift away from prewar courtship, which had favored casual, nonexclusive dating. “If you [go out with someone for] one night you might get up to a little bit of necking and petting, but what happens when you spend months with them? It turns out 1957 has the highest rate of teen births in American history.”

In more recent decades, by contrast, teen romantic relationships appear to have grown less common. In 1995, the large longitudinal study known as “Add Health” found that 66 percent of 17-year-old men and 74 percent of 17-year-old women had experienced “a special romantic relationship” in the past 18 months. In 2014, when the Pew Research Center asked 17-year-olds whether they had “ever dated, hooked up with or otherwise had a romantic relationship with another person”—seemingly a broader category than the earlier one—only 46 percent said yes.

So what thwarted teen romance? Adolescence has changed so much in the past 25 years that it’s hard to know where to start. As Jean Twenge wrote in The Atlantic last year, the percentage of teens who report going on dates has decreased alongside the percentage who report other activities associated with entering adulthood, like drinking alcohol, working for pay, going out without one’s parents, and getting a driver’s license.

These shifts coincide with another major change: parents’ increased anxiety about their children’s educational and economic prospects. Among the affluent and educated, especially, this anxiety has led to big changes in what’s expected of teens. “It’s hard to work in sex when the baseball team practices at 6:30, school starts at 8:15, drama club meets at 4:15, the soup kitchen starts serving at 6, and, oh yeah, your screenplay needs completion,” said a man who was a couple of years out of college, thinking back on his high-school years. He added: “There’s immense pressure” from parents and other authority figures “to focus on the self, at the expense of relationships”—pressure, quite a few 20-somethings told me, that extends right on through college.

Malcolm Harris strikes a similar note in his book, Kids These Days: Human Capital and the Making of Millennials. Addressing the desexing of the American teenager, he writes:

A decline in unsupervised free time probably contributes a lot. At a basic level, sex at its best is unstructured play with friends, a category of experience that … time diaries … tell us has been decreasing for American adolescents. It takes idle hands to get past first base, and today’s kids have a lot to do.

Marriage 101, one of the most popular undergraduate classes at Northwestern University, was launched in 2001 by William M. Pinsof, a founding father of couples therapy, and Arthur Nielsen, a psychiatry professor. What if you could teach about love, sex, and marriage before people chose a partner, Pinsof and Nielsen wondered—before they developed bad habits? The class was meant to be a sort of preemptive strike against unhappy marriages. Under Alexandra Solomon, the psychology professor who took over the course six years ago, it has become, secondarily, a strike against what she sees as the romantic and sexual stunting of a generation. She assigns students to ask someone else out on a date, for example, something many have never done.

This hasn’t hurt the class’s appeal; during registration, it fills within minutes. (It may or may not have helped that a course with overlapping appeal, Human Sexuality, was discontinued some years back after its professor presided over a demonstration of something called a fucksaw.) Each week during office hours, students wait in line to talk with Solomon, who is also a practicing therapist at the university’s Family Institute, not only about the class but about their love woes and everything they don’t know about healthy and pleasurable sex—which, in many cases, is a lot.

Over the course of numerous conversations, Solomon has come to various conclusions about hookup culture, or what might more accurately be described as lack-of-relationship culture. For one thing, she believes it is both a cause and an effect of social stunting. Or, as one of her students put it to her: “We hook up because we have no social skills. We have no social skills because we hook up.” For another, insofar as her students find themselves choosing between casual sex and no sex, they are doing so because an obvious third option—relationship sex—strikes many of them as not only unattainable but potentially irresponsible. Most Marriage 101 students have had at least one romantic relationship over the course of their college career; the class naturally attracts relationship-oriented students, she points out. Nonetheless, she believes that many students have absorbed the idea that love is secondary to academic and professional success—or, at any rate, is best delayed until those other things have been secured. “Over and over,” she has written, “my undergraduates tell me they try hard not to fall in love during college, imagining that would mess up their plans.”

One Friday afternoon in March, I sat in on a discussion Solomon was hosting for a group of predominantly female graduate students in the Family Institute’s counseling programs, on the challenges of love and sex circa 2018. Over rosé and brownies, students shared thoughts on topics ranging from Aziz Ansari’s notorious date (which had recently been detailed on the website Babe) to the ambiguities of current relationship terminology. “People will be like, ‘We’re dating, we’re exclusive, but we’re not boyfriend and girlfriend.’ What does that mean?” one young woman asked, exasperated. A classmate nodded emphatically. “What does that mean? We’re in a monogamous relationship, but …” She trailed off. Solomon jumped in with a sort of relationship litmus test: “If I get the flu, are you bringing me soup?” Around the conference table, heads shook; not many people were getting (or giving) soup.

The conversation proceeded to why soup-bringing relationships weren’t more common. “You’re supposed to have so much before you can get into a relationship,” one woman offered. Another said that when she was in high school, her parents, who are both professionals with advanced degrees, had discouraged relationships on the grounds that they might diminish her focus. Even today, in graduate school, she was finding the attitude hard to shake. “Now I need to finish school, I need to get a practice going, I need to do this and this, and then I’ll think about love. But by 30, you’re like, What is love? What’s it like to be in love?”

In early May, I returned to Northwestern to sit in on a Marriage 101 discussion section. I had picked that particular week because the designated topic, “Sex in Intimate Relationships,” seemed relevant. As it happened, though, there wasn’t much talk of sex; the session was mostly consumed by a rapturous conversation about the students’ experiences with something called the “mentor couple” assignment, which had involved interviewing a couple in the community and chronicling their relationship.

“To see a relationship where two people are utterly content and committed,” one woman said, with real conviction, “it’s kind of an aha moment for me.” Another student spoke disbelievingly of her couple’s pre-smartphone courtship. “I couldn’t necessarily relate to it,” she said. “They met, they got each other’s email addresses, they emailed one another, they went on a first date, they knew that they were going to be together. They never had a ‘define the relationship’ moment, because both were on the same page. I was just like, Damn, is that what it’s supposed to be like?” About two-thirds of the way through the allotted discussion time, one of the teaching assistants finally interrupted. “Should we transition?” she asked, tentatively. “I wanted to transition to talk about sex. Which is the topic of this week.”

3. The Tinder Mirage

Simon, a 32-year-old grad student who describes himself as short and balding (“If I wasn’t funny,” he says, “I’d be doomed”), didn’t lack for sex in college. (The names of people who talked with me about their personal lives have been changed.) “I’m outgoing and like to talk, but I am at heart a significant nerd,” he told me when we spoke recently. “I was so happy that college had nerdy women. That was a delight.” Shortly before graduation, he started a relationship that lasted for seven years. When he and his girlfriend broke up, in 2014, he felt like he’d stepped out of a time machine.

Before the relationship, Tinder didn’t exist; nor did iPhones. Simon wasn’t particularly eager to get into another serious relationship right away, but he wanted to have sex. “My first instinct was go to bars,” he said. But each time he went to one, he struck out. He couldn’t escape the sense that hitting on someone in person had, in a short period of time, gone from normal behavior to borderline creepy. His friends set up a Tinder account for him; later, he signed up for Bumble, Match, OkCupid, and Coffee Meets Bagel.

He had better luck with Tinder than the other apps, but it was hardly efficient. He figures he swiped right—indicating that he was interested—up to 30 times for every woman who also swiped right on him, thereby triggering a match. But matching was only the beginning; then it was time to start messaging. “I was up to over 10 messages sent for a single message received,” he said. In other words: Nine out of 10 women who matched with Simon after swiping right on him didn’t go on to exchange messages with him. This means that for every 300 women he swiped right on, he had a conversation with just one.

At least among people who don’t use dating apps, the perception exists that they facilitate casual sex with unprecedented efficiency. In reality, unless you are exceptionally good-looking, the thing online dating may be best at is sucking up large amounts of time. As of 2014, when Tinder last released such data, the average user logged in 11 times a day. Men spent 7.2 minutes per session and women spent 8.5 minutes, for a total of about an hour and a half a day. Yet they didn’t get much in return. Today, the company says it logs 1.6 billion swipes a day, and just 26 million matches. And, if Simon’s experience is any indication, the overwhelming majority of matches don’t lead to so much as a two-way text exchange, much less a date, much less sex.

When I talked with Simon, he was seven months into a relationship with a new girlfriend, whom he’d met through another online-dating service. He liked her, and was happy to be on hiatus from Tinder. “It’s like howling into the void for most guys,” he explained, “and like searching for a diamond in a sea of dick pics for most girls.”

So why do people continue to use dating apps? Why not boycott them all? Simon said meeting someone offline seemed like less and less of an option. His parents had met in a chorus a few years after college, but he couldn’t see himself pulling off something similar. “I play volleyball,” he added. “I had somebody on the volleyball team two years ago who I thought was cute, and we’d been playing together for a while.” Simon wanted to ask her out, but ultimately concluded that this would be “incredibly awkward,” even “boorish.”

At first, I wondered whether Simon was being overly genteel, or a little paranoid. But the more people I talked with, the more I came to believe that he was simply describing an emerging cultural reality. “No one approaches anyone in public anymore,” said a teacher in Northern Virginia. “The dating landscape has changed. People are less likely to ask you out in real life now, or even talk to begin with,” said a 28-year-old woman in Los Angeles who volunteered that she had been single for three years.

This shift seems to be accelerating amid the national reckoning with sexual assault and harassment, and a concomitant shifting of boundaries. According to a November 2017 Economist/YouGov poll, 17 percent of Americans ages 18 to 29 now believe that a man inviting a woman out for a drink “always” or “usually” constitutes sexual harassment. (Among older groups, much smaller percentages believe this.)

Laurie Mintz, who teaches a popular undergraduate class on the psychology of sexuality at the University of Florida, told me that the #MeToo movement has made her students much more aware of issues surrounding consent. She has heard from many young men who are productively reexamining their past actions and working diligently to learn from the experiences of friends and partners. But others have described less healthy reactions, like avoiding romantic overtures for fear that they might be unwelcome. In my own conversations, men and women alike spoke of a new tentativeness and hesitancy. One woman who described herself as a passionate feminist said she felt empathy for the pressure that heterosexual dating puts on men. “I think I owe it to them, in this current cultural moment particularly, to try to treat them like they’re human beings taking a risk talking to a stranger,” she wrote me. “There are a lot of lonely, confused people out there, who have no idea what to do or how to date.”

I mentioned to several of the people I interviewed for this piece that I’d met my husband in an elevator, in 2001. (We worked on different floors of the same institution, and over the months that followed struck up many more conversations—in the elevator, in the break room, on the walk to the subway.) I was fascinated by the extent to which this prompted other women to sigh and say that they’d just love to meet someone that way. And yet quite a few of them suggested that if a random guy started talking to them in an elevator, they would be weirded out. “Creeper! Get away from me,” one woman imagined thinking. “Anytime we’re in silence, we look at our phones,” explained her friend, nodding. Another woman fantasized to me about what it would be like to have a man hit on her in a bookstore. (She’d be holding a copy of her favorite book. “What’s that book?” he’d say.) But then she seemed to snap out of her reverie, and changed the subject to Sex and the City reruns and how hopelessly dated they seem. “Miranda meets Steve at a bar,” she said, in a tone suggesting that the scenario might as well be out of a Jane Austen novel, for all the relevance it had to her life.

Video: The Sex Drought

How could various dating apps be so inefficient at their ostensible purpose—hooking people up—and still be so popular? For one thing, lots of people appear to be using them as a diversion, with limited expectations of meeting up in person. As Iris, who’s 33, told me bitterly, “They’ve gamified interaction. The majority of men on Tinder just swipe right on everybody. They say yes, yes, yes to every woman.”

Stories from other app users bear out the idea of apps as diversions rather than matchmakers. “Getting right-swiped is a good ego boost even if I have no intention of meeting someone,” one man told me. A 28-year-old woman said that she persisted in using dating apps even though she had been abstinent for three years, a fact she attributed to depression and low libido: “I don’t have much inclination to date someone.”

“After a while it just feels exactly the same as getting good at a bubble-popping game. I’m happy to be good at it, but what am I really achieving?” said an app user who described herself as abstinent by choice. Another woman wrote that she was “too lazy” to meet people, adding: “I usually download dating apps on a Tuesday when I’m bored, watching TV … I don’t try very hard.” Yet another woman said that she used an app, but only “after two glasses of white wine—then I promptly delete it after two hours of fruitless swiping.”

Many critiques of online dating, including a 2013 article by Dan Slater in The Atlantic, adapted from his book A Million First Dates, have focused on the idea that too many options can lead to “choice overload,” which in turn leads to dissatisfaction. Online daters, he argued, might be tempted to keep going back for experiences with new people; commitment and marriage might suffer. Michael Rosenfeld, a sociologist who runs a longitudinal study out of Stanford called “How Couples Meet and Stay Together,” questions this hypothesis; his research finds that couples who meet online tend to marry more quickly than other couples, a fact that hardly suggests indecision.

Maybe choice overload applies a little differently than Slater imagined. Maybe the problem is not the people who date and date some more—they might even get married, if Rosenfeld is right—but those who are so daunted that they don’t make it off the couch. This idea came up many times in my conversations with people who described sex and dating lives that had gone into a deep freeze. Some used the term paradox of choice; others referred to option paralysis (a term popularized by Black Mirror); still others invoked fobo (“fear of a better option”).

And yet online dating continues to attract users, in part because many people consider apps less stressful than the alternatives. Lisa Wade suspects that graduates of high-school or college hookup culture may welcome the fact that online dating takes some of the ambiguity out of pairing up (We’ve each opted in; I’m at least a little bit interested in you). The first time my husband and I met up outside work, neither of us was sure whether it was a date. When you find someone via an app, there’s less uncertainty.

As a 27-year-old woman in Philadelphia put it: “I have insecurities that make fun bar flirtation very stressful. I don’t like the Is he into me? moment. I use dating apps because I want it to be clear that this is a date and we are sexually interested in one another. If it doesn’t work out, fine, but there’s never a Is he asking me to hang as a friend or as a date? feeling.” Other people said they liked the fact that on an app, their first exchanges with a prospective date could play out via text rather than in a face-to-face or phone conversation, which had more potential to be awkward.

Anna, who graduated from college three years ago, told me that in school, she struggled to “read” people. Dating apps have been a helpful crutch. “There’s just no ambiguity,” she explained. “This person is interested in me to some extent.” The problem is that the more Anna uses apps, the less she can imagine getting along without them. “I never really learned how to meet people in real life,” she said. She then proceeded to tell me about a guy she knew slightly from college, whom she’d recently bumped into a few times. She found him attractive and wanted to register her interest, but wasn’t sure how to do that outside the context of a college party. Then she remembered that she’d seen his profile on Tinder. “Maybe next time I sign in,” she said, musing aloud, “I’ll just swipe right so I don’t have to do this awkward thing and get rejected.”

Apart from helping people avoid the potential embarrassments (if also, maybe, the exhilaration) of old-fashioned flirting, apps are quite useful to those who are in what economists call “thin markets”—markets with a relatively low number of participants. Sexual minorities, for example, tend to use online dating services at much higher rates than do straight people. (Michael Rosenfeld—whose survey deliberately oversampled gays and lesbians in an effort to compensate for the dearth of research on their dating experiences—finds that “unpartnered gay men and unpartnered lesbians seem to have substantially more active dating lives than do heterosexuals,” a fact he attributes partly to their successful use of apps. This disparity raises the possibility that the sex recession may be a mostly heterosexual phenomenon.)

Justin Metz / Pablo Delcan

In all dating markets, apps appear to be most helpful to the highly photogenic. As Emma, a 26-year-old virgin who sporadically tries her luck with online dating, glumly told me, “Dating apps make it easy for hot people—who already have the easiest time.” Christian Rudder, a co-founder of OkCupid (one of the less appearance-centric dating services, in that it encourages detailed written profiles), reported in 2009 that the male users who were rated most physically attractive by female users got 11 times as many messages as the lowest-rated men did; medium-rated men received about four times as many messages. The disparity was starker for women: About two-thirds of messages went to the one-third of women who were rated most physically attractive. A more recent study by researchers at the University of Michigan and the Santa Fe Institute found that online daters of both genders tend to pursue prospective mates who are on average 25 percent more desirable than they are—presumably not a winning strategy.

So where does this leave us? Many online daters spend large amounts of time pursuing people who are out of their league. Few of their messages are returned, and even fewer lead to in-person contact. At best, the experience is apt to be bewildering (Why are all these people swiping right on me, then failing to follow through?). But it can also be undermining, even painful. Emma is, by her own description, fat. She is not ashamed of her appearance, and purposefully includes several full-body photos in her dating profiles. Nevertheless, men persist in swiping right on her profile only to taunt her—when I spoke with her, one guy had recently ended a text exchange by sending her a gif of an overweight woman on a treadmill.

An even bigger problem may be the extent to which romantic pursuit is now being cordoned off into a predictable, prearranged online venue, the very existence of which makes it harder for anyone, even those not using the apps, to extend an overture in person without seeming inappropriate. What a miserable impasse.

4. Bad Sex (Painfully Bad)

One especially springlike morning in May, as Debby Herbenick and I walked her baby through a park in Bloomington, Indiana, she shared a bit of advice she sometimes offers students at Indiana University, where she is a leading sex researcher. “If you’re with somebody for the first time,” she said evenly, “don’t choke them, don’t ejaculate on their face, don’t try to have anal sex with them. These are all things that are just unlikely to go over well.”

I’d sought out Herbenick in part because I was intrigued by an article she’d written for The Washington Post proposing that the sex decline might have a silver lining. Herbenick had asked whether we might be seeing, among other things, a retreat from coercive or otherwise unwanted sex. Just a few decades ago, after all, marital rape was still legal in many states. As she pushed her daughter’s stroller, she elaborated on the idea that some of the sex recession’s causes could be a healthy reaction to bad sex—a subset of people “not having sex that they don’t want to have anymore. People feeling more empowered to say ‘No thanks.’ ”

Bloomington is the unofficial capital of American sex research, a status that dates back to the 1940s, when the Indiana University biologist Alfred Kinsey’s pioneering sex surveys inaugurated the field. It retains its standing thanks partly to the productivity of its scientists, and partly to the paucity of sex research at other institutions. In 2009, Herbenick and her colleagues launched the ongoing National Survey of Sexual Health and Behavior, which is only the second nationally representative survey to examine Americans’ sex lives in detail—and the first to try to chart them over time. (The previous national survey, out of the University of Chicago, was conducted just once, in 1992. Most other sex research, including Kinsey’s, has used what are known as convenience samples, which don’t represent the population at large. The long-running General Social Survey, which much of Jean Twenge’s research is based upon, is nationally representative, but poses only a few questions about sex.)

I asked Herbenick whether the NSSHB’s findings gave her any hunches about what might have changed since the 1990s. She mentioned the new popularity of sex toys, and a surge in heterosexual anal sex. Back in 1992, the big University of Chicago survey reported that 20 percent of women in their late 20s had tried anal sex; in 2012, the NSSHB found a rate twice that. She also told me about new data suggesting that, compared with previous generations, young people today are more likely to engage in sexual behaviors prevalent in porn, like the ones she warns her students against springing on a partner. All of this might be scaring some people off, she thought, and contributing to the sex decline.

“If you are a young woman,” she added, glancing down at her daughter, “and you’re having sex and somebody tries to choke you, I just don’t know if you’d want to go back for more right away.”

Justin Metz / Pablo Delcan

Some of Herbenick’s most sobering research concerns the prevalence of painful sex. In 2012, 30 percent of women said they’d experienced pain the last time they’d had vaginal intercourse; during anal intercourse, 72 percent had. Whether or not these rates represent an increase (we have no basis for comparison), they are troublingly high. Moreover, most women don’t tell their partners about their pain. J. Dennis Fortenberry, the chief of adolescent medicine at Indiana University’s medical school and a co-leader of the NSSHB, believes that many girls and women have internalized the idea that physical discomfort goes with being female.

A particularly vivid illustration of this comes from Lucia O’Sullivan, a University of New Brunswick psychology professor who has published research documenting high rates of sexual dysfunction among adolescents and young adults. That work grew out of a lunch several years ago with a physician from the university’s student-health center, who told O’Sullivan that she was deeply concerned by all the vulvar fissures she and her colleagues were seeing in their student patients. These women weren’t reporting rape, but the condition of their genitals showed that they were enduring intercourse that was, literally, undesired. “They were having sex they didn’t want, weren’t aroused by,” O’Sullivan says. The physician told her that the standard of care was to hand the women K‑Y Jelly and send them on their way.

Painful sex is not new, but there’s reason to think that porn may be contributing to some particularly unpleasant early sexual experiences. Studies show that, in the absence of high-quality sex education, teen boys look to porn for help understanding sex—anal sex and other acts women can find painful are ubiquitous in mainstream porn. (This isn’t to say that anal sex has to be painful, but rather that the version most women are experiencing is.) In a series of in-depth interviews, Cicely Marston of the London School of Hygiene and Tropical Medicine found that teenage boys experimenting with anal sex—perhaps influenced by what they’ve seen in porn—may find that sudden, unlubricated penetration is more difficult than it looks, and more agonizing for the recipient. Some of her subjects appear to have pressured their partner; others seem to have resorted to what another researcher described to me, clinically, as “nonconsensual substitution of anal for vaginal sex.”

In my interviews with young women, I heard too many iterations to count of “he did something I didn’t like that I later learned is a staple in porn,” choking being one widely cited example. Outside of porn, some people do enjoy what’s known as erotic asphyxiation—they say restricting oxygen to the brain can make for more intense orgasms—but it is dangerous and ranks high on the list of things you shouldn’t do to someone unless asked to. Tess, a 31-year-old woman in San Francisco, mentioned that her past few sexual experiences had been with slightly younger men. “I’ve noticed that they tend to go for choking without prior discussion,” she said. Anna, the woman who described how dating apps could avert awkwardness, told me she’d been choked so many times that at first, she figured it was normal. “A lot of people don’t realize you have to ask,” she said.

As Marina Adshade, a professor at the University of British Columbia who studies the economics of sex and love, said to me, “Men have bad sex and good sex. But when sex is bad for women, it’s really, really bad. If women are avoiding sex, are they trying to avoid the really bad sex?”

Sex takes time to learn under the best of circumstances, and these are not the best of circumstances. Modeling your behavior after what you’ve seen on-screen can lead to what’s known as “spectatoring”—that is, worrying about how you look and sound while you’re having sex, a behavior the sex researchers William H. Masters and Virginia E. Johnson long ago posited was bad for sexual functioning. Some young women told me they felt pressured to emulate porn actresses—and to achieve orgasm from penetration alone, which most women can’t do. “It took me a while to be comfortable with the fact that I don’t have to be as vocal during sex as the girls seem to be in porn,” a 24-year-old woman in Boston said. A 31-year-old in Phoenix explained that in her experience, porn has made men “expect that they can make any woman orgasm by just pounding away.”

Learning sex in the context of one-off hookups isn’t helping either. Research suggests that, for most people, casual sex tends to be less physically pleasurable than sex with a regular partner. Paula England, a sociologist at NYU who has studied hookup culture extensively, attributes this partly to the importance of “partner-specific sexual skills”—that is, knowing what your partner likes. For women, especially, this varies greatly. One study found that while hooking up with a new partner, only 31 percent of men and 11 percent of women reached orgasm. (By contrast, when people were asked about their most recent sexual encounter in the context of a relationship, 84 percent of men and 67 percent of women said they’d had an orgasm.) Other studies have returned similar results. Of course, many people enjoy encounters that don’t involve orgasms—a third of hookups don’t include acts that could reasonably be expected to lead to one—but the difference between the two contexts is striking. If young people are delaying serious relationships until later in adulthood, more and more of them may be left without any knowledge of what good sex really feels like.

As I was reporting this piece, quite a few people told me that they were taking a break from sex and dating. This tracks with research by Lucia O’Sullivan, who finds that even after young adults’ sex lives start up, they are often paused for long periods of time. Some people told me of sexual and romantic dormancy triggered by assault or depression; others talked about the decision to abstain as if they were taking a sabbatical from an unfulfilling job.

Late one afternoon in February, I met up with Iris, the woman who remarked to me that Tinder had been “gamified,” at the Lemon Collective, a design studio and workshop space in the Petworth neighborhood of Washington, D.C. The collective hosts DIY and design classes as well as courses geared toward the wellness of Millennial women; Valentine’s Day had been celebrated with a wildly oversubscribed real-estate workshop called “House Before Spouse.” (“We don’t need partners to be financially savvy and create personal wealth,” the event’s description said. “Wine and cheese will be served, obviously.”)

As we chatted (over, obviously, wine), Iris despaired at the quality of her recent sexual interactions. “I had such bad sex yesterday, my God, it was so bad,” she said wearily. “He basically got it in and—” She banged a fist against her palm at a furious tempo. It was the first time she’d slept with this man, whom she had met on Tinder, and she wondered aloud whether she could coach him. She was doubtful, though; he was in his 30s—old enough, she thought, to know better.

Iris observed that her female friends, who were mostly single, were finding more and more value in their friendships. “I’m 33, I’ve been dating forever, and, you know, women are better,” she said. “They’re just better.” She hastened to add that men weren’t bad; in fact, she hated how anti-male the conversations around her had grown. Still, she and various platonic female friends—most of whom identified as straight—were starting to play roles in one another’s lives that they might not be playing if they had fulfilling romantic or sexual relationships. For instance, they’d started trading lesbian-porn recommendations, and were getting to know one another’s preferences pretty well. Several women also had a text chain going in which they exchanged nude photos of themselves. “It’s nothing but positivity,” she said, describing the complimentary texts they’d send one another in reply to a photo (“Damn, girl, your tits!”). She wasn’t ready to swear off men entirely. But, she said, “I want good sex.” Or at least, she added, “pretty good sex.”

5. Inhibition

“Millennials don’t like to get naked—if you go to the gym now, everyone under 30 will put their underwear on under the towel, which is a massive cultural shift,” Jonah Disend, the founder of the branding consultancy Redscout, told Bloomberg last year. He said that designs for master-bedroom suites were evolving for much the same reason: “They want their own changing rooms and bathrooms, even in a couple.” The article concluded that however “digitally nonchalant” Millennials might seem—an allusion, maybe, to sexting—“they’re prudish in person.” Fitness facilities across the country are said to be renovating locker rooms in response to the demands of younger clients. “Old-timers, guys that are 60-plus, have no problem with a gang shower,” one gym designer told The New York Times, adding that Millennials require privacy.

Some observers have suggested that a new discomfort with nudity might stem from the fact that, by the mid-1990s, most high schools had stopped requiring students to shower after gym class. Which makes sense—the less time you spend naked, the less comfortable you are being naked. But people may also be newly worried about what they look like naked. A large and growing body of research reports that for both men and women, social-media use is correlated with body dissatisfaction. And a major Dutch study found that among men, frequency of pornography viewing was associated with concern about penis size. I heard much the same from quite a few men (“too hairy, not fit enough, not big enough in terms of penis size,” went one morose litany). According to research by Debby Herbenick, how people feel about their genitals predicts sexual functioning—and somewhere between 20 and 25 percent of people, perhaps influenced by porn or plastic-surgery marketing, feel negatively. The business of labiaplasty has become so lucrative, she told me in an email, “that you will actually see billboards (yes, billboards!) in some cities advertising it.”

As one might imagine, feeling comfortable in your body is good for your sex life. A review of 57 studies examining the relationship between women’s body image and sexual behavior suggests that positive body image is linked to having better sex. Conversely, not feeling comfortable in your own skin complicates sex. If you don’t want your partner to see you getting out of the shower, how is oral sex going to work?

Maybe, for some people, it isn’t. The 2017 iteration of Match.com’s Singles in America survey (co-led by Helen Fisher and the Kinsey Institute’s Justin Garcia) found that single Millennials were 66 percent less likely than members of older generations to enjoy receiving oral sex. Which doesn’t bode particularly well for female pleasure: Among partnered sex acts, cunnilingus is one of the surest ways for women to have orgasms.

Ian Kerner, the New York sex therapist, told me that he works with a lot of men who would like to perform oral sex but are rebuffed by their partner. “I know the stereotype is often that men are the ones who don’t want to perform it, but I find the reverse,” he said. “A lot of women will say when I’m talking to them privately, ‘I just can’t believe that a guy wants to be down there, likes to do that. It’s the ugliest part of my body.’ ” When I asked 20-somethings about oral sex, a pretty sizable minority of women sounded a similar note. “Receiving makes me nervous. It feels more intimate than penetration,” wrote one woman. “I become so self-conscious and find it difficult to enjoy,” wrote another.

Mendelsund / Munday

Over the past 20 years, the way sex researchers think about desire and arousal has broadened from an initially narrow focus on stimulus to one that sees inhibition as equally, if not more, important. (The term inhibition, for these purposes, means anything that interferes with or prevents arousal, ranging from poor self-image to distractedness.) In her book Come as You Are, Emily Nagoski, who trained at the Kinsey Institute, compares the brain’s excitement system to the gas pedal in a car, and its inhibition system to the brakes. The first turns you on; the second turns you off. For many people, research suggests, the brakes are more sensitive than the accelerator.

That turn-offs matter more than turn-ons may sound commonsensical, but in fact, this insight is at odds with most popular views of sexual problems. When people talk about addressing a lack of desire, they tend to focus on fuel, or stimulation—erotica, Viagra, the K‑Y Jelly they were handing out at the New Brunswick student-health center. These things are helpful to many people in many cases, but they won’t make you want to have sex if your brakes are fully engaged.

In my interviews, inhibition seemed a constant companion to many people who’d been abstinent for a long time. Most of them described abstinence not as something they had embraced (due to religious belief, say) so much as something they’d found themselves backed into as a result of trauma, anxiety, or depression. Dispiritingly but unsurprisingly, sexual assault was invoked by many of the women who said they’d opted out of sex. The other two factors come as no great shock either: Rates of anxiety and depression have been rising among Americans for decades now, and by some accounts have risen quite sharply of late among people in their teens and 20s. Anxiety suppresses desire for most people. And, in a particularly unfortunate catch‑22, both depression and the antidepressants used to treat it can also reduce desire.

“I have a therapist and this is one of the main things we’re working on,” a 28-year-old woman I’ll call April wrote to me, by way of explaining that, owing to intense anxiety, she’d never slept with anyone or been in a relationship. “I’ve had a few kisses & gone to second base (as the kids say) and it really has never been good for me.” When we later spoke by phone, she told me that in adolescence, she’d been shy, overweight, and “very, very afraid of boys.” April isn’t asexual (she gives thanks for her Magic Bullet vibrator). She’s just terrified of intimacy. From time to time she goes on dates with men she meets through her job in the book industry or on an app, but when things get physical, she panics. “I jumped out of someone’s car once to avoid him kissing me,” she said miserably. As we were ending the conversation, she mentioned to me a story by the British writer Helen Oyeyemi, which describes an author of romance novels who is secretly a virgin. “She doesn’t have anyone, and she’s just stuck. It’s kind of a fairy tale—she lives in the garret of a large, old house, writing these romantic stories over and over, but nothing ever happens for her. I think about her all the time.”

In exchanges like these, I was struck by what a paralyzing and vicious cycle unhappiness and abstinence can be. The data show that having sex makes people happier (up to a point, at least; for those in relationships, more than once a week doesn’t seem to bring an additional happiness bump). Yet unhappiness inhibits desire, in the process denying people who are starved of joy one of its potential sources. Are rising rates of unhappiness contributing to the sex recession? Almost certainly. But mightn’t a decline in sex and intimacy also be leading to unhappiness?

Moreover, what research we have on sexually inactive adults suggests that, for those who desire a sex life, there may be such a thing as waiting too long. Among people who are sexually inexperienced at age 18, about 80 percent will become sexually active by the time they are 25. But those who haven’t gained sexual experience by their mid-20s are much less likely to ever do so. The authors of a 2009 study in The Journal of Sexual Medicine speculated that “if a man or woman has not had intercourse by age 25, there is a reasonable chance [he or she] will remain a virgin at least until age 45.” Research by Stanford’s Michael Rosenfeld confirms that, in adulthood, true singledom is a far more stable category than most of us have imagined. Over the course of a year, he reports, only 50 percent of heterosexual single women in their 20s go on any dates—and older women are even less likely to do so.

Other sources of sexual inhibition speak distinctly to the way we live today. For example, sleep deprivation strongly suppresses desire—and sleep quality is imperiled by now-common practices like checking one’s phone overnight. (For women, getting an extra hour of sleep predicts a 14 percent greater likelihood of having sex the next day.) In her new book, Better Sex Through Mindfulness, Lori Brotto, an obstetrics-and-gynecology professor at the University of British Columbia, reviews lab research showing that background distraction of the sort we’re all swimming in now likewise dampens arousal, in both men and women.

How can such little things—a bad night’s sleep, low-grade distraction—defeat something as fundamental as sex? One answer, which I heard from a few quarters, is that our sexual appetites are meant to be easily extinguished. The human race needs sex, but individual humans don’t.

Among the contradictions of our time is this: We live in unprecedented physical safety, and yet something about modern life, very recent modern life, has triggered in many of us autonomic responses associated with danger—anxiety, constant scanning of our surroundings, fitful sleep. Under these circumstances, survival trumps desire. As Emily Nagoski likes to point out, nobody ever died of sexlessness: “We can starve to death, die of dehydration, even die of sleep deprivation. But nobody ever died of not being able to get laid.”

When Toys “R” Us announced this spring—after saying it had been struggling because of falling birth rates—that it would be shutting down, some observers mordantly remarked that it could be added to the list of things that Millennials had destroyed.

Societal changes have a way of inspiring generational pessimism. Other writers, examining the same data I’ve looked at, have produced fretful articles about the future; critics have accused them of stoking panic. And yet there are real causes for concern. One can quibble—if one cares to—about exactly why a particular toy retailer failed. But there’s no escaping that the American birth rate has been falling for a decade.

At first, the drop was attributed to the Great Recession, and then to the possibility that Millennial women were delaying motherhood rather than forgoing it. But a more fundamental change may be under way. In 2017, the U.S. birth rate hit a record low for a second year running. Birth rates are declining among women in their 30s—the age at which everyone supposed more Millennials would start families. As a result, some 500,000 fewer American babies were born in 2017 than in 2007, even though more women were of prime childbearing age. Over the same period, the number of children the average American woman is expected to have fell from 2.1 (the so-called replacement rate, or fertility level required to sustain population levels without immigration) to 1.76. If this trend does not reverse, the long-term demographic and fiscal implications will be significant.

A more immediate concern involves the political consequences of loneliness and alienation. Take for example the online hate and real-life violence waged by the so-called incels—men who claim to be “involuntarily celibate.” Their grievances, which are illegitimate and vile, offer a timely reminder that isolated young people are vulnerable to extremism of every sort. See also the populist discontent roiling Europe, driven in part by adults who have so far failed to achieve the milestones of adulthood: In Italy, half of 25-to-34-year-olds now live with their parents.

When I began working on this story, I expected that these big-picture issues might figure prominently within it. I was pretty sure I’d hear lots of worry about economic insecurity and other contributors to a generally precarious future. I also imagined, more hopefully, a fairly lengthy inquiry into the benefits of loosening social conventions, and of less couple-centric pathways to a happy life. But these expectations have mostly fallen to the side, and my concerns have become more basic.

Humans’ sexual behavior is one of the things that distinguish us from other species: Unlike most apes, and indeed most animals, humans have sex at times and in configurations that make conception not just unlikely but impossible (during pregnancy, menopause, and other infertile periods; with same-sex partners; using body parts that have never issued babies and never will). As a species, we are “bizarre in our nearly continuous practice of sex,” writes the UCLA professor Jared Diamond, who has studied the evolution of human sexuality. “Along with posture and brain size, sexuality completes the trinity of the decisive aspects in which the ancestors of humans and great apes diverged.” True, nobody ever died of not getting laid, but getting laid has proved adaptive over millions of years: We do it because it is fun, because it bonds us to one another, because it makes us happy.

A fulfilling sex life is not necessary for a good life, of course, but lots of research confirms that it contributes to one. Having sex is associated not only with happiness, but with a slew of other health benefits. The relationship between sex and wellness, perhaps unsurprisingly, goes both ways: The better off you are, the better off your sex life is, and vice versa. Unfortunately, the converse is true as well. Not having a partner—sexual or romantic—can be both a cause and an effect of discontent. Moreover, as American social institutions have withered, having a life partner has become a stronger predictor than ever of well-being.

Like economic recessions, the sex recession will probably play out in ways that are uneven and unfair. Those who have many things going for them already—looks, money, psychological resilience, strong social networks—continue to be well positioned to find love and have good sex and, if they so desire, become parents. But intimacy may grow more elusive to those who are on less steady footing.

When, over the course of my reporting, people in their 20s shared with me their hopes and fears and inhibitions, I sometimes felt pangs of recognition. Just as often, though, I was taken aback by what seemed like heartbreaking changes in the way many people were relating—or not relating—to one another. I am not so very much older than the people I talked with for this story, and yet I frequently had the sense of being from a different time.

Sex seems more fraught now. This problem has no single source; the world has changed in so many ways, so quickly. In time, maybe, we will rethink some things: The abysmal state of sex education, which was once a joke but is now, in the age of porn, a disgrace. The dysfunctional relationships so many of us have with our phones and social media, to the detriment of our relationships with humans. Efforts to “protect” teenagers from most everything, including romance, leaving them ill-equipped for both the miseries and the joys of adulthood.

In October, as I was finishing this article, I spoke once more with April, the woman who took comfort in the short story about the romance novelist who was secretly a virgin. She told me that, since we’d last talked, she’d met a man on Tinder whom she really liked. They’d gone on several dates over the summer, and fooled around quite a bit. As terrified as she had been about getting physically and emotionally intimate with another person, she found, to her surprise, that she loved it: “I never thought I would feel that comfortable with someone. It was so much better than I thought it was going to be.”

As things progressed, April figured that, in the name of real intimacy, she should explain to the man that she hadn’t yet had sex. The revelation didn’t go over well. “I told him I was a virgin. And he broke up with me. Beforehand, I figured that was the worst thing that could happen. And then it happened. The worst thing happened.” She paused, and when she spoke again her voice was steadier and more assured. “But I’m still here.”

This article appears in the December 2018 print edition with the headline “The Sex Recession.”