As Bill Clinton so memorably made clear when he insisted he "did not have sex with that woman", there is no uniform consensus for what it means when people say they "had sex".
Health24's Great South African Sex Survey 2010 found that 30% of people don't consider oral sex to be sex; half say the old cigar trick isn't sex (i.e. only penile penetration counts); a third of women and slightly fewer men consider anal sex to fall outside the definition of sex; and only about 60% of us think mutual masturbation counts.
Now a new study from the Kinsey Institute at Indiana University, which polled a representative sample of 18- to 96-year-olds, confirms that Americans are no more clear than South Africans: though some statistics might differ, the definition of what constitutes sex is anything but consistent.
Perceptions of sex
Brandon Hill, research associate at the Kinsey Institute, points out that these findings are more than idle gossip: this kind of information about perceptions of sex can inform – or misinform – research, medical advice and health education efforts.
"Researchers, doctors, parents, sex educators should all be very careful and not assume that their own definition of sex is shared by the person they're talking to, be it a patient, a student, a child or study participant," he said.
The Kinsey study, conducted in conjunction with the Rural Centre for Aids/STD Prevention in Indiana University's School of Health, Physical Education and Recreation, delves deeper into a question first examined in 1999, in the midst of the Clinton sex scandal which centred on the definition of sex. Researchers from the Kinsey Institute asked college students that what "had sex" meant to them. No consensus was found then, either.
The new study, published in the international health journal Sexual Health in February 2010, examined whether more information helped clarify matters. Study participants were asked about specific sexual behaviours, and such qualifiers as whether orgasm was reached. Researchers also wanted to involve a more representative audience, not just college students.
"Throwing the net wider, with a more representative sample, only made it more confusing and complicated," Hill said. "People were even less consistent across the board."
Responses did not differ significantly overall for men and women in either survey. However, the Great South African Sex Survey found that the greatest gap was in the area of penile-anus penetration (there was a 7% difference, with men more inclined to say yes), and mutual masturbation (5%, with women more inclined to say yes).
The Kinsey study found that 95% of respondents would consider penile-vaginal intercourse (PVI) to constitute sex, but this rate drops to 89% if there is no ejaculation.
Also in the Kinsey study, significantly fewer men in the oldest age group answered "yes" for PVI (77%).
Hill said it is common for a doctor, when seeing a patient with symptoms of sexually transmitted infections, to ask how many sexual partners the patient has or has had. The patients' definitions of sex, therefore, is key information.
William L. Yarber, co-author of the study, said the findings reaffirm the need to be specific about behaviours when talking about sex. "There's a vagueness of what sex is in our culture and media," Yarber said. "If people don't consider certain behaviours sex, they might not think sexual health messages about risk pertain to them.
"The Aids epidemic has forced us to be much more specific about behaviours, as far as identifying specific behaviours that put people at risk instead of just sex in general. But there's still room for improvement." - (EurekAlert! / Heather Parker, Health24, 4 March, 2010)