What Constitutes 'Sexually Active'?
Tabby Kibugi of Get Me Giddy asks me about what it means to be sexually active. There’s not as much consensus as you might think.
Read the full article here or an excerpt below:
If you've ever been to the gynecologist, you've probably been asked whether you are sexually active. It's a common question but one that could prove confusing.
Perhaps you've wondered what the term "sexually active" even means in medical circles.
As a matter of fact, many adults and some physicians get conflicted about what activities constitute sex. In a 2015 study published in the Journal of Sexuality Education, which examined how men and women defined having sex, most (but not all) respondents agreed that penile-vaginal intercourse was "definitely sex."
However, a quarter of them didn't consider anal sex as "definitely sex." The respondents were even more divided over whether activities such as oral and manual stimulation counted, with only 24 percent of them considering oral sex as "definitely sex."
Another study carried out a year later aimed to determine what behaviors medical students considered to be sex. Its findings suggested that more than 25 percent of the participants did not consider genital-to-genital contact without penetration, oral-genital contact and foreign object in the rectum as sex.
As this research indicated, people have their own varied definitions of what sex actually is. A general consensus does exist that PIV (penis-in-vagina) sex is primarily what is considered when we talk about sexual activity.
However, strictly from a medical perspective, this term encompasses other activities, too.
"Any activity that involves potential fluid exchange and requires barriers to protect from sexually transmitted infections (STIs) is often considered as sex from a medical risk assessment perspective. That is when you're answering a doctor's questionnaire," said Indigo Stray Conger, L.M.F.T., a Denver-based sex therapist for Mile High Psychotherapy who is certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). "This includes any activity involving direct oral or genital contact with genitals or anus."
Masturbation is generally not considered when talking about sexual activity from a medical perspective because there is no exchange of body fluids. If you aren't having any physical sexual contact with another person, there is no risk of contracting a sexually transmitted disease (STD) or STI unless you're sharing sex toys with someone who has an infection.
Can a doctor tell if you're sexually active?
A doctor's pelvic or physical exam is not enough to determine whether you are sexually active.
Sperm can be tested for in the vagina and anus, as with a forensic rape exam (rape kit) but beyond that, there is no physical evidence of being sexually active or not a "virgin" as part of an OB-GYN exam.
Contrary to popular belief, Conger said it's impossible for a doctor to establish sexual activity based on a hymen.
"The hymen is different for every person with a vulva," she added. "Some female bodies have one, some don't. They are of different sizes and thicknesses and may or may not cover the entire vaginal vestibule. The hymen may be broken during sexual activity or not. But it can also be impacted by tampon use or friction in the area from riding a bike or horse."
Basically, the only way for your doctor to tell if you are sexually active is if you tell them.