Study examines: What anal behaviors count as having had sex?

New research published in The Journal of Sex Research investigated whether heterosexual men and women considered certain anal behaviors as “having had sex.”

The study of 3,218 adults from the United States found that people labelled a variety of behaviors as having had sex. About 90 percent of the participants considered penile-anal intercourse as having sex, but there was less agreement about whether oral-anal contact or manual-anal contact counted as having sex. Men were more likely than women to count these two latter behaviors as having had sex.

PsyPost interviewed the study’s corresponding author, Kimberly R. McBride of the University of Toledo. Read her responses below:

PsyPost: Why were you interested in this topic?

McBride: Existing research examining the labeling of behaviors as having “had sex” among heterosexual samples has focused on penile-vaginal behaviors and penile-anal intercourse. Those studies have consistently demonstrated that heterosexuals are less likely to categorize penile-anal intercourse as having “had sex” when compared to penile-vaginal intercourse and they are less likely to label oral-penile (fellatio), oral-vaginal (cunnilingus), and manual (e.g. vaginal fingering) behaviors as “sex” when compared to either type of intercourse. Evidence also indicates that people are more likely to label a behavior “sex” when they have behavioral experience.

Our team was interested in determining whether the same pattern of differences would be observed when focusing, specifically, on anal behaviors in a sample that all have some form of behavioral experience (anal intercourse, manual-anal, oral-anal). From our perspective, understanding how people categorize anal behaviors is important because it has implications for clinical assessment, research measurement, and sexual health education. It also provides some insight into factors that influence individual conceptualizations of having “had sex.”

What should the average person take away from your study?

The same patterns of labeling observed in previous research were noted in the current study. The majority of heterosexuals in our sample, 89% of women and 92% of men, categorized penile-anal intercourse as having “had sex.” However, there was significant variation in the labeling of non-intercourse anal behaviors and no consensus on which specific behaviors “counted.” Respondents that had experience with a particular behavior were more likely to categorize it as having “had sex” than those without. Our data also indicated differences in labeling by age and gender, with older respondents and men being more likely to “count” behaviors as having “had sex” when compared to younger respondents and women.

Are there any major caveats? What questions still need to be addressed?

The most significant questions that remain are why variability in labeling exists and how individual characteristics such as behavioral experience, age, and gender contribute to variation. While a number of hypotheses have been developed to explain differences, additional research is needed. Further, studies that explore the reasons why people do not categorize specific behaviors as “sex” would help improve our understanding of the underlying cognitive processes that influence categorization.

The primary caveat is that our cross-sectional approach did not allow us to examine changes in labeling and the participation in anal sexual behaviors over time. It should also be noted that the data was collected in 2007 and it is possible that attitudes have shifted.

Is there anything else you would like to add?

To the best of our knowledge, this is the first study to examine the labeling of both penile-anal intercourse and non-intercourse anal behaviors in a sample of heterosexuals with some form of anal sex experience. We view this as an important first step to understanding how heterosexuals are thinking about anal sex, which may have implications for sexual health outcomes. For example, unprotected receptive anal intercourse is a well-established risk factor for the acquisition of HIV and other sexually transmitted infections (STI), yet roughly 10% of our sample did not count it as having “had sex.” It is possible that people are less likely to take protective measures, such as using a male latex condom, when they do not perceive a behavior to be “sex.”

Improved understanding of behavioral categorization may allow healthcare providers and sexual health educators to more accurately assess risk as well as address gaps in the knowledge of their patients and clients who may be a greater risk for adverse sexual health outcomes based on their behavioral practices.

The study, “Heterosexual Women’s and Men’s Labeling of Anal Behaviors as Having ‘Had Sex’“, was also co-authored by Stephanie A. Sanders, Brandon J. Hill and June M. Reinisch.