Sexual Pleasure Matters (Especially for Women) — Data from the German Sexuality and Health Survey (GeSiD). Verena Klein, Ellen Laan, Franziska Brunner & Peer Briken. Sexuality Research and Social Policy, Feb 19 2022. https://link.springer.com/article/10.1007/s13178-022-00694-y
Abstract
Introduction: Sexual pleasure has been a neglected issue in sexual health policies. Emerging trends in public health, however, emphasize the importance of sexual pleasure in preventing negative sexual health outcomes.
Methods: Using data from the German Sexuality and Health Survey (GeSiD), we tested the assumption that sexual pleasure is associated with sexual health, including a special focus on the role of gender. Participants were interviewed about their sexual experiences and health between October 2018 and September 2019. The analytical sample included 3472 partnered and single women and men who had been sexually active with a partner in the past 12 months. We examined if sexual pleasure was associated with various sexual health indicators (i.e., communication about sexually transmitted infections (STIs), condom use, and absence of sexual problems).
Results: Women reported less sexual pleasure than men. Results further indicate that sexual pleasure was associated with more sexual health indicators in women than in men.
Conclusions: Supporting emerging trends in public health our results emphasize the importance of sexual pleasure in preventing negative sexual health outcomes.
Policy Implications. To promote (especially women’s) sexual health, our results call for the implementation of comprehensive sexuality education programs that focus on more positive aspects of sex, such as sexual pleasure and agency.
Discussion
Research and sexual health policies have a long history of neglecting the role of sexual pleasure in preventing negative sexual outcomes (Ford et al., 2019). Our results point to the importance of sexual pleasure for sexual health — and even more pronounced for women. Aligning with the current public health discourse, sexual pleasure in our study was associated with making sexually healthy decisions (e.g., condom use, STI communication) and sexually satisfying experiences (e.g., oral sex engagement, absence of sexual problems, and orgasm frequency).
Although odds rations were overall small, sexual pleasure was associated with more sexual health indicators in women than in men. Ample evidence indicates that both women and men value men’s sexual pleasure more, and men are more likely to demand it during an encounter (McCabe et al., 2010; McClelland, 2011; Muehlenhard & Shippee, 2010). Globally speaking, men seem to have a better access to sexual pleasure and autonomy than women do (Hall, 2019; Higgins & Hirsch, 2007). Alingning with this assumption, in our study, men were more likely to report experiencing sexual pleasure than women. Based on those observed gender differences, it could be assumed that whereas men’s pleasure seems to be a “normal,” present condition, women’s sexual pleasure seems to be more often absent, an add-on, or at least less prioritized. That said, the results might not a function of pleasure being more important for women, but rather men’s scores lack variability (i.e., for men, sex is almost invariably pleasurable). This lower variability in scores might explain why sexual pleasure plays a more predictive role in women’s sexual health than in men’s.
Interestingly, pleasure had a greater influence on communication about STIs and condom use for partnered women than it did for single women. Public health research has emphasized that safer sex communication is interwoven with gendered power inequalities (Wingood & DiClemente, 2000). Women face more stigma when negotiating condom use (Peasant et al., 2015; Woolf & Maisto, 2008) as well as when expressing themselves in a sexually assertive manner (Klein et al., 2019). Women and men are especially likely to conform to traditional gender expectations surrounding sexual behavior (female submission vs. male dominance) in initial states of dating (Eaton & Rose, 2011). Sexual communication and safer sex negotiations, however, need some degree of assertiveness, which might undermine women’s conformity to gender norm expectations in the casual context. Nevertheless, the sample size of single women was small in the present study, what might explain the different role pleasure plays for single versus partnered women when it comes to communication about STIs and condom use.
Since our data are cross-sectional, all that is known is that sexual pleasure and the investigated sexual health indicators are associated. That said, it is possible that for instance being able to communicate about STI risk makes sex more pleasurable (by removing concerns about STIs etc.) or STI communication might be a good proxy for comfort with sexuality. There is also the possibility that sexual pleasure and safer sex practices may be linked via another third factor such as being comfortable with one’s sexuality. Moreover, we have focused on condom use as main safe-sex practice, which leaves out other safe-sex practices mostly practice by women who have sex with women such as dental dams and gloves. A closer examination of the interplay between sexual pleasure and sexual health among gender diverse samples would be an interesting venue for future research. Another limitation is that we have assessed some health behaviors such as condom use discussion retrospectively meaning that single and partnered people answered questions about different time periods. Consequently, we cannot exclude the possibility of recall biases. Although our cross-sectional, correlational study points to associations between sexual pleasure and sexual health behaviors, prospective studies that assess the influence of sexual pleasure on sexual risk and risk-reduction practices are warranted.
The present study included a large, representative sample with a balanced distribution of women and men; it is however important to keep in mind that our sample draws from Germany, a Western liberal country when it comes to sexual attitudes (i.e., acceptance of same-sex behavior, abortion, sex work; Klein & Brunner, 2018). Sexual pleasure has different meanings and varies in ascribed significance over different cultures (Hall & Graham, 2012), which limits the generalizability of our result to other cultural contexts. Societal and cultural judgements about sex, shame, and guilt have negative effects on both sexual pleasure and health (Hull, 2008).
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