Tweens and teens are sending and receiving racy messages at increasing rates, a new meta-analysis in JAMA Pediatrics suggests.

Rehashing data from 39 high-quality studies, researchers estimate that around 27 percent of youths aged between 12 and 17 receive sext messages on their phones and—to a lesser extent—on their computers. About 15 percent reported sending sensitive videos, pics, and texts. The gap between senders and receivers could mean that some teens may not be fessing up to the spicy trend; some senders may dispatch their risqué communiqués to multiple people; or some receivers just don’t reciprocate. Perhaps the worst-case scenario is that receivers forward sext messages without consent. About 12 percent—one in eight youths—admitted to doing this, though only five studies touched on this scenario.

Sexting has “a unique ability to catalyze adult anxiety when children and adolescents engage in it,” psychologists Elizabeth Englander and Meghan McCoy from Bridgewater State University wrote in an accompanying editorial. “Yet there is not a great deal of research examining sexting, its prevalence, its causes, and its repercussions,” they note.

In fact, prior to the new analysis, published estimates of youth sexting ranged from 1.3 percent to 60 percent.

To clear things up, researchers, led by psychologist Sheri Madigan of the University of Calgary, sorted through the dozens of studies that have come out so far. They settled on 39 high-quality, comparable studies, which were largely completed between 2008 and 2016. Together, the studies involved 110,380 participants between the ages of 11.9 and 17, with a mean age of 15.2. Most studies were conducted in the US or Europe, but two were from Australia, and there was one study each from Canada, South Africa, and South Korea.

Analyzing the data collectively, researchers found that sexting prevalence increased over time. Prevalence also increased with age, and they found that mobile phones were the devices of choice for sexting.

Despite media attention focusing on females sending nudes or other sexualized content to males, the researchers found that the data didn’t support this. There were no significant gender differences in the rate of sending or receiving sexts.

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Overall, Madigan and colleagues concluded that, “contrary to some earlier findings, our results indicated that consensual sexting is becoming a more common practice among youth.” But they added that there’s still a lot to learn about sexting, such as “variables associated with nonconsensual sexting, as well as the evaluation of the effectiveness of educational campaigns and legal policies striving to mitigate nonconsensual sexting in youth.”

Englander and McCoy largely echoed the sentiment. Though there have been legal cases , sexting between minors is generally not prosecuted, they noted, “which has transformed the issue into a psychological and developmental concern rather than a legal risk.”

While calling the new analysis an “important step forward,” they note that there are many issues to clear up, including how studies even define what sexting is. For instance, many studies lump together nude videos and images with explicit text. Yet, “psychologically, it is likely that the significance of sending nude photos or videos is quite different from sending sexualized text,” they note.

Relationship status is also a likely important variable, Englander and McCoy note. Research has found that people who sext within an established relationship tend to feel positively about the experience. Negative experiences—such as feeling pressured, being the victim of sextortion or bullying, or having sexts posted online—have tended to be rarities in sexting studies. Most of these scenarios were reported by less than five percent of sexters.

Still, understanding those scenarios better can help prevent them, Englander and McCoy write. “Sexting is a new behavior that is evolving rapidly, as technology changes and awareness increases. The accuracy of our understanding about it defines our prevention and intervention efforts,” they conclude.

JAMA Pediatrics, 2018. DOI: 10.1001/jamapediatrics.2017.5314 (About DOIs).