Having sex doesn’t necessarily mean what you think.
In fact, having sex means different things to different people, the most comprehensive study of sexual health-related behaviors in recent years concludes.
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The national survey, conducted by a team of Indiana University researchers, found that the phrase “having sex” can encompass a variety of acts beyond intercourse, including masturbation and oral sex.
Study participants reported engaging in more than 40 combinations of acts during their most recent sexual encounters. And that did not include kissing.
“Sex isn’t a one-size-fits-all definition,” said Logan Levkoff, a New York-based sexologist who weighed in during a conference call detailing the study’s findings.
The National Survey of Sexual Health and Behavior, which appears Monday in the Journal of Sexual Medicine, paints one of the most complete pictures of Americans’ behavior in the bedroom in recent years.
Details include how frequently people engage in sexual activity, what they do, and whether they take precautions when they do it.
Study authors say the most surprising finding reveals how complex Americans’ sexual activity has become.
“Our main point is that sex is more than just vaginal intercourse. While it does appear to be the most common behavior,. .. many people are being diverse in their sexual lives,” said Michael Reece, director of Indiana University’s Center for Sexual Health Promotion and a study author.
Such findings show that health-care providers can no longer simply ask patients if they are sexually active, said John DeLamater, a professor of sociology at the University of Wisconsin in Madison.
They must delve into what it means when a patient answers yes or no.
“You always hope that will galvanize some health-care professionals to be more aware,” said DeLamater, who was not involved with the study.
Carmel, Ind., gynecologist Dr. Lynda Smirz knows it’s not enough to ask her teen patients if they’re having sex.
Many say no. But they are having oral sex, potentially exposing themselves to diseases such as herpes.
“You really have to be very careful in how you word it, and you also have to be somewhat of a detective to read whether or not they’re really not sexually active,” said Smirz, chief medical officer at Clarian North Medical Center.
Shifting definitions of sex have positive implications, too.
In presenting such a broad range of sexual behavior, the study may help people accept that their desires fall within the range of what’s normal, said Lara M.W. Powell, an Indiana therapist who specializes in sexual issues.
“Everybody is kind of curious to know if what they’re doing is normal,” Powell said. “There’s not a revolution but an evolution. Values and mores and practices are changing all the time.”
Another sign of the evolution is the use of condoms. Of the 5,865 Americans between ages 14 94 who participated in the study, condoms were used in one in four acts of vaginal intercourse in the United States. One in three single people uses them.
Between 60% and 80% of teens used condoms during their most recent sexual encounter, according to the study, which was financed by Church & Dwight, the maker of Trojans.
By age 17, 40% of boys and 36% of girls had sexual interaction with a partner.
Study authors hailed the adolescent condom use as a victory for public health officials who have been pushing a safe-sex message for years.
“This indicates that we have had a public health success that we need to acknowledge,” said Dr. Dennis Fortenberry, a professor of pediatrics at the Indiana University School of Medicine. He led the adolescent side of the study.
But that message has not reached parents and grandparents. About two-thirds of those older than 50 do not take precautions against sexually transmitted diseases, the study found.
Newly divorced or widowed seniors back on the dating scene may have missed the campaigns to encourage condom use.
Younger people are also more likely to engage in oral sex than their seniors. While 21.1% of women in their 40s say that they have received oral sex in the past month, 38% of those in their 20s have had oral sex in the past 30 days.
Such findings may reassure people about their own sexual desires and offer alternatives for couples having difficulty with intercourse, Reece said. The study found about one in three women compared with 5% of men reported experiencing pain the last time they had sex.
“It’s nice to have this validation of just how much the sexual repertoire is changing,” he said. “We do know how many people struggle with the conceptualization of what a normal sex life looks like.”