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This study considered whether school-based sexual double standards alter the association between sexual intercourse, gender, and adolescent mental health. Using two waves of Add Health data, I measured the sexual double standard across 75 schools by quantifying school-level gender differences in the perceived social consequences of sexual intercourse. Results indicate as school sexual double standards became stronger, girls who had intercourse with non-romantic partners had higher odds of depressed mood and low self-esteem, girls who only had sexual intercourse with romantic partners had higher risks of depressed mood, and girls who abstained from intercourse between waves had lower odds of low self-esteem. Conversely, boys who had sexual intercourse with one or more non-romantic partners had lower odds of both depressed mood and low self-esteem as the sexual double standard increased. Results demonstrate how sexual double standards and gender interact to influence how sexual activity impacts adolescent mental health.