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Book Review: Hooked: New Science on How Casual Sex is Affecting Our Children

November 28th, 2011 by

About the Authors

Joe McIlhaney, MD is an obstetrician-gynecologist.  He previously served on the Presidential Advisory Council on HIV/AIDS as well as on the Advisory Committee to the Director of the Centers for Disease Control and Prevention (CDC). He is also founder and chairman of The Medical Institute for Sexual Health.  He lives in Austin, Texas and has been married to his wife for 47 years.

Freda McKissic, MD has been a board certified ob-gyn for over 21 years.  She currently serves on the Presidential Advisory Council on HIV/AIDS. She is also on the clinical faculty at the University of Mississippi Medical Center in the Departments of ob-gyn and family practice.  She resides in Jackson, Mississippi and  is the mother of 4.


Recent advances in neuroscience have enabled professionals to better understand the brain’s role in sex, and to actually examine alterations/activity in the brain as a result of sexual behavior. Consequently,  documentation is acquired regarding a third, and often overlooked, risk of premarital sex: psychological consequences. Hooked is a non-religious book which utilizes this groundbreaking, ever-evolving, neuroscience to explain the potential psychological consequences of casual (as well as premarital) sex.

The Largest Sex Organ: The Brain

What is Sex?

When factoring in brain studies, Hooked defines sexual activity as “any intimate contact between two individuals that involves arousal, stimulation, and/or a response by at least one of two partners.”


The three primary neurochemicals involved during sexual activity are dopamine, oxytocin, and vasopressin.

Dopamine is present in both men and women and it can be thought of as the “reward chemical”.  It rewards an individual by saturating brain cells with a feeling of exhilaration and well being  when that individual engages in exciting behavior (i.e. sex).  Dopamine does not discriminate based on positive or negative behavior. Dopamine can reward the brain for a positive thing such as an academic accomplishment or something negative such as speeding. Dopamine plays a significant role in the addictive nature of sex.

Oxytocin is the female bonding chemical. It increases a woman’s desire for more touch and causes her to bond to the man with whom she has been in physical contact with. With sexual intercourse and orgasm, oxytocin floods the woman’s brain, causing her to desire more sex with the male to whom she has bonded. Similarly to dopamine, oxytocin is values neutral. A woman may become bonded to a man with whom she only intended to casually hookup with.

Vasopressin is the male bonding chemical. This chemical is responsible for a male’s bonding/attachment to a woman with whom he has had intimate physical contact with. Just like oxytocin, vasopressin is values neutral.

Poor Decisions and Psychological Consequences

This  neuroscientific research sheds light on the poor decisions and the psychological consequences which sometimes accompany premarital and/or casual sex:

1.) Couples remain in a relationship despite a relationship’s blatant toxicity

It’s the sex that keeps a couple together. The bonding effects of the neurochemicals create an attachment when the relationship has no foundation to begin with. Unfortunately, some of these couples end up marrying.

2.) Couples/Individuals jump into sex too quickly

When individuals engage in sexual behavior, brain synapses that regulate sexual decisions are molded in ways which makes it easier to say “yes” to sex. Brain synapses that govern sexual restraint are weakened and deteriorate. Additionally, that person craves the exhilaration provided by dopamine. Therefore, after a breakup, when an individual enters a new relationship, that relationship progresses to sexual contact quickly. Sex is no longer a big deal.

3.) Decreased ability to bond and corresponding decreased marital stability

The ability to bond is critical to sexual health, family development, and marital stability. When an individual engages in patterns of dating, having sex with that partner, breaking up, and having sex with a new partner, that individual jeopardizes his/her ability to bond. For a majority of people, this pattern interferes with neurological circuits crucial for long-term commitment. The brain is molded in a fashion where it becomes “hooked” on sex with little to no emotional investment.

The neurochemical imprints of sexual activity can last years, hampering a person’s ability to be  fully emotionally invested in future relationships. The individual only experiences the dopamine effects of sex. “Their inability to bond after multiple liaisons is almost like tape that loses its stickiness after being applied and removed multiple times “.


Hooked also contains much quantitative data, pulled from various sources:

The Heritage Foundation (a conservative think tank) released the following findings in its study “Sexually Active Teenagers are More Likely To Be Depressed and Report Suicide”:

The National Campaign to Prevent Teen Pregnancy (a nonprofit, nonpartisan organization) performed a nationally representative survey of 1,000 young people aged 12-19.  54% were girls and 46% were boys. The findings indicate:

In the study “Emotional and Physical Satisfaction in Married, Cohabiting and Dating Sexual Unions: Do Men and Women Differ?”:
  • Cohabitors are 4x more likely than married individuals to report having been involved in infidelity
  • Married couples, when compared to cohabiting couples, have sex more and enjoy it better, both physically and emotionally


Throughout the book are revealing quotes obtained by Lynne Lutz, a clinical psychologist. While each quote is memorable, below are some of the most powerful ones:

The hardest breakup I ever had was with the first person I had sex with. Fifteen years later, I still don’t think I’m over him. I still dream about him and think about him and compare every guy since then to him. I’m married now and I feel like it’s a threesome in my heart. He is still here. It is like he is part of me and I still can’t get over him.

-Jordi, 33

I don’t want my kids to do what I did. I had no idea how my sexual past would affect the rest of my life. I worry my kids won’t listen to my advice since they know I made very different choices, and in their eyes I seem fine.

-Tory, 36

What is love? I don’t think I ever really knew, although I thought I did. Now I wonder if I have ever really loved or been loved. It all got so tangled with sex. I think it is going to take me a long time to get it all sorted out.

-Tim, 25

The hardest thing about encouraging my kids to be abstinent is looking in the mirror and knowing that I wasn’t. They wonder why it is such a big deal to me. If they ever found out everything I’ve been through, they would understand.

-Richard, 41

I had no idea how having sex as a teenager could affect the rest of my life. I didn’t really know what love was. By the time I got married, sex was so confusing for me. It has been a huge issue in our marriage and I don’t know how to fix it.

          -Christie, 29

I see what sex has done to some of my friends and their relationships. I know although I am tempted now, that my choice to say no will protect my heart and my body for the future. I try to remember that as I try to make good choices.

 -Laura, 16

We’re proud of it. We set a goal to be pure for each other on our wedding day and we did it. It wasn’t easy, but it taught us a lot about each other. I’m glad we did it.

-David, 30

After I accepted the challenge to model abstinent behavior for my teenage daughter, I expected to feel different. But I had no idea I would feel so clean.

-Jennifer, 37

It was the hardest thing we ever did, but we are so glad we waited. We had to talk through our disagreements. We couldn’t just feel close by having sex- we had to really work things out.

-Charles, 28

Brief Evaluation

Hooked is a must read for educators, medical professionals, parents, sexually active and unmarried individuals, as well as those practicing abstinence. Hooked possesses a wealth of quantitative and qualitative information while presenting quite possibly the most effective non-religious case for abstinence (even more fascinating is that this research is only the beginning and that the book provides advice for those struggling with these psychological consequences).

Though Hooked suffers from occasional redundancy, the exciting research is delivered in a practical, non judgmental, and strictly scientific fashion. The third risk of premarital and/or casual sex is established in a convincing manner, proving that not all sex outside of marriage can truly be “safe sex”.


National Campaign to Prevent Teen Pregnancy 2003 Study/Survey

Sexually Active Teenagers are More Likely To Be Depressed and Report Suicide




Author: Olivier

Olivier writes many of the site's articles, some articles requiring many hours of research; he also helps with site strategy/focus. He has a Bachelors in Accounting, Masters in Theology, and is currently an accounting manager for a teleconferencing solutions company. In his spare time he enjoys reading, writing, NFL, and movies.

21 Responses to “Book Review: Hooked: New Science on How Casual Sex is Affecting Our Children”

  1. Sally says:

    Wow TG! Great article!! I’m just curious about the statistics though…although obvi I agree with waiting/being abstinent, how many teens did they do the study with? How did they come to those conclusions? They seem kind of broad to me. I’m not saying that personally, I’ve just been taught in college to be critical of sources, whether you agree with them or not.

  2. Aditya says:

    You nailed it once more TG!

    Dunno how… but you manage it every single time & in a way, compel me to come out of my ‘woodwork’ & congratulate you! LOL

    I would also like to mention that the deeper analysis & the CONFESSIONS from the non-waiters, really makes this one your best article till date!

    Great job TG! I am sorta looking forward to see you come up with another article that supersedes this one! Yeah… TG Vs TG, lets see whoz the best! LOL.

  3. ThatGuy says:

    Aditya — Thanks so much! I’ve thought about PM’ing you to check in with you but I don’t wanna disrupt your studies. I’m so happy you liked the article…it was very draining but worth it.

    My next couple of articles will be pretty standard- there’s an STD and Pregnancy Rates article (Mike will roll it out when he sees fit), and there’s another one about harmful effects of early sexual activity. BUT after that I’m doing another one on hormonal contraception… that should be good… and then another one that I’m keeping on the hush hush 😉

    Sally — Good call on the statistics! While the authors were responsible for the brain studies, the authors got the information in the “statistics” section from different sources (maybe that’s why it seems so “broad”?).

    I’ll update the article to reveal the sources. With the exception of the National Campaign to Prevent Teen Pregnancy study, I won’t be able to go into much detail about the methodologies (since these sources are separate journals, books, that I’d have to read and analyze). However, I think the transparency should be good enough. What do you think? Please review my changes and lemme know if you want me to change anything else?

  4. Jegsy Scarr says:

    Great article, TG! The book sounds really good: I may buy it. I’m interested in psychology, so this is the kind of book I think I’d enjoy. It’s also a great set of non-religious arguments for waiting till marriage, so I think some of my not-quite-as religious-friends might find it interesting…


  5. Lizard says:

    Awesome article! Other than the fact that I really like neuro, I’ve always enjoyed reading about the scientific reasons for WTM because it even further backs up my beliefs in a more concrete way. Great choice of such powerful and eye-opening quotes as well.

    Looking forward to your piece on contraception!

  6. ThatGuy says:

    Jegs — Thnx for commenting! Glad you liked it. You should definitely buy the book. There’s a decent amount that I didn’t even get to touch on here!! Like how the prefrontal cortex, the center largely respnsible for decision making, doesn’t fully develop until mid twenties

    Lizard — (Lizardbath??) Thnx for the feedback! Yeah, the quotes made me go “wow” too.

    Hopefully the hormonal contraception article is a good one!

  7. dodgedude says:

    Awesome article TG!! That’s something thats honestly never crossed my mind..that there could be scientific evidence for this kind of thing. VERY enlightening! I’m usually not much for this “genre” of literature (psychological, etc.) but you really have me considering buying it!!

  8. Tempest Desh says:

    Nice article! I like it when scientific facts are presented that back up our position on this issue. Definitely makes it clear that those who choose this lifestyle choice not religious fanatics out of touch with reality or a bunch of wishy-washy naive romantics. Hopefully this kind of stuff will at least get people to think for they take the plunge and perhaps stop them from making a regretful decision that they can’t take back. Incidently, as some going into bio-engineering, with hopes of pursuing a specialization in neural engineering, the reference to the effects of various neurotransmitters related to sexual activity is quite interesting for my nerdy self, lol.

  9. ThatGuy says:

    DD – thnx for the feedback! This isn’t my “genre” of literature but I did find it to be a fascinating read.

    TD — thnx for taking the time to post. The fact that this is a non-religious book that examines scientific data made me even more excited to do this article. I had no idea you were into bio-engineering. I think Hooked is a “must read” for you ;-P.

  10. Sally says:

    TD totally agree abt having scientific facts to back up our argument. That makes it more credible in the eyes of people who don’t agree. Always helps 🙂

  11. bluedove says:

    Thanks for this, this is why the bible tells us to keep our hearts and minds pure till and in marriage, he created us this way for a reason!

  12. Olivier says:

    Thanks, bluedove. (I am “ThatGuy”)I agree 100%.

  13. DAnonitedSolider says:


  14. just my opinion says:

    Love article!!!

    It is hard to wait sometimes but marriage will not be a walk in the park. So with the waiting you lurn the quality to stand thru your hard decisions and to work thru the problems your marriage might face.

  15. Monique says:

    It is hard to get someone out of your heart even when just kissing them emotionally.

  16. […] addition to these discussions, a friend of mine referred me to a book called Hooked:New Science on How Casual Sex is Affecting Our Children. Written by two physicians who have done the research as to what actually happens to the human […]

  17. […] addition to these discussions, a friend of mine referred me to a book called Hooked:New Science on How Casual Sex is Affecting Our Children. Written by two physicians who have done the research as to what actually happens to the human […]

  18. Google@MissChristiLuv says:


  19. Chantel says:

    How does one regain his/her ability to bond? I am still a virgin, but I am just curious how one can recover from unwise sexual behavior.

  20. John says:

    Hi Chantel,

    Jesus can break the power of emotional and neurological ties with people if anyone comes to Him, repent of their sins and ask Him to set them free. Being in a church that believes in the Bible and the power of the Holy Spirit helps too

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