Shades of Bill Clinton — Just What DOES ‘Had Sex’ Mean?

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 percent 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 percent of us think mutual masturbation counts.

Now, a new study from the famous 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.

It may sound like a simple question: Have you had sex? But results from the Kinsey Institute study reveal that there is no consensus among adults of any age about what the phrase “had sex” means to them.

About 30 percent of the people said that oral sex isn't sex. Twenty percent said the same about anal sex. However, the study did not find large differences between what men and women consider sex.

According to the study, 95 percent of people agree that vaginal sex is sex. But some older men don't even count that, and 89 percent said it doesn't count if the man does not ejaculate.

The topic of anal sex had some variation. Overall, 81 percent said it is sex. But the rate was 77 percent for men 18 to 29, 50 percent for men older than 65 and 67 percent for women over 65.

The study was published in the international health journal Sexual Health.

Few people will likely forget when President Bill Clinton said he did not “have sex” with Monica, but perhaps one thing people will most take away from hearing that phrase is a question: What does “have sex” or “had sex” mean?

This is not a frivolous question, as Clinton’s dilemma illustrated but also for parents, doctors, researchers, and sex educators, who should have an accurate idea of what that phrase means to the people with whom they are interacting.

In fact, Brandon Hill, research associate at the Kinsey Institute, notes that people asking that question “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.” This became clear when researchers at Kinsey Institute queried 486 residents of Indiana ranging in age from 18 to 96.

Back when the president was grappling with the question, researchers at the Kinsey Institute had asked college students what “had sex” meant to them, and no consensus was found.

Researchers from the Kinsey Institute had asked college students in 1999 what "had sex" meant to them, taking the approach, which was unique at the time, of polling the students on specific behaviors. No consensus was found then, either.

Now, about a decade later, the same question was posed again, but with some changes. The new study was conducted in conjunction with the Rural Center for AIDS/STD Prevention (RCAP), which is part of Indiana University’s School of Health, Physical Education and Recreation.

The new study examined whether more information helped clarify matters – study participants were asked about specific sexual behaviors and such qualifiers as whether orgasm was reached-and 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. People were even less consistent across the board," said Hill.

In the new study, a telephone survey that consisted primarily of heterosexuals (204 men and 282 women), participants were asked, “Would you say you ‘had sex’ with someone if the most intimate behavior you engaged in was ...” and then they were offered 14 specific choices. Here are some of the results:

About 30 percent of adults did not consider oral sex to be sex, and 20 percent said anal sex was not sex, although these figures changed depending upon the age and sex of the respondent. For example, 23 percent of men ages 18 to 29 said anal sex was not sex; while 50 percent of men and 67 percent of women age 65 and older said it was not sex.

While the substantial 95 percent did agree that penile-vaginal intercourse (called ‘PVI’ in the study) fit their definition of “had sex,” this figure dropped to 89 percent if there was no ejaculation.

A surprising number of older men did not consider penile-vaginal intercourse to be sex, the study found. Among men age 65 and older, 23 percent did not consider PVI to fit their definition of “had sex.”

Medical researchers sometimes need to know how a person's sex life affects their health. And it can affect how a doctor relates to a patient. Gathering accurate information about a person’s sexual activities can be critical, especially when health care providers are dealing with possible cases of sexually transmitted diseases, including HIV and AIDS. Individuals who are asked how many sexual partners they have had as part of their visit may provide inaccurate answers depending on their “personal” definition of sexual activity.

Such situations emphasize the importance of clearly defining and understanding what an individual’s definition of “had sex” is. William L. Yarber, RCAP’s senior director and a co-author of the study notes, “If people don’t consider certain behaviors sex, they might not think sexual health messages about risk pertain to them.” Therefore a seemingly casual question, “had sex?” can mean a lot, even a matter of life and death.

I find this study truly fascinating: the most basic of all sex questions has no clear definition in our society, and at least in one other. No wonder kids are so confused. If there is no consensus as to what having sex is, is it any wonder that there are questions about how to cope with it and its ramifications? Egads.

— The Curator