Sexual Behaviors among Individuals Aged 20-49 in Japan: Initial Findings from a Quasi-Representative National Survey, 2022. Cyrus Ghaznavi et al. The Journal of Sex Research, Feb 26 2023. https://doi.org/10.1080/00224499.2023.2178614
Abstract: Nationally representative data on sexual health and behaviors in Japan are scarce. We conducted an online survey, including questions about a range of topics related to sexual behaviors and outcomes. The sample, including 8000 men and women aged 20–49 years in Japan, was stratified by sex and weighted with respect to age, marital status, and region of residence to reflect the population of Japan. Of the women, 82.9% and 10.0% reported that they were heterosexual and asexual, respectively; corresponding proportions for men were 87.4% and 6.9%. 15.3% of women and 19.8% of men reported never having had any partners with whom they engaged in vaginal, anal, or oral sex. 45.3% of women and 44.5% of men reported not having had any sexual partners during the past year; this proportion was highest among women aged 40–49 years (51.7%) and men aged 20–29 years (55.1%). The proportion of those reporting satisfaction with their sex life was 27.8% for women and 23.1% for men; 17.6% of women and 27.1% of men reported dissatisfaction. Pornography use of ≥3 times per week was most common among those aged 20–29 years (6.5% of women; 34.8% of men), and the frequency of pornography use decreased slightly with age. 4.0% of women and 48.3% of men reported ever having used commercial sex worker services in their lifetime. This survey-based study provides data on sexual behaviors and health outcomes in Japan. Compared to other high-income countries, levels of sexual inexperience and inactivity seem to be high in Japan.
Discussion
This quasi-representative national survey including women and men aged 20–49 years in Japan aimed to address the scarcity of data available on sexual health outcomes, behaviors, and wellbeing in the country. Below we describe our main findings.
Sexual Inexperience
We found that a large proportion of Japanese women and men report that they have never had sexual intercourse. The proportion reporting that they had zero lifetime sexual intercourse partners was around 30% for women and 43% for men aged 20–29 years, 14% for women and 17% for men aged 30–39 years, and 7% for both women and men aged 40–49 years. These proportions were higher than those previously reported using data from the National Fertility Survey in Japan conducted in 2015 (Ghaznavi et al., 2019), in which 12% of women and 13% of men aged 30–34 years and 9% of women and 10% of men aged 35–39 years reported no experience of heterosexual intercourse (data on non-heterosexual experience were not available). The findings of the two studies are compatible with the hypothesis that sexual inexperience has increased between 2015 and 2022, consistent with an increasing trend in sexual inexperience observed among women and men in their 30s in six rounds of the National Fertility Survey from 1992 to 2015 (Ghaznavi et al., 2019). Sexual inexperience across age groups may have been accelerated by the COVID-19 pandemic and associated social distancing measures. In fact, a decrease in the frequency of sexual intercourse during the pandemic in Japan has been previously reported (Kitamura et al., 2021). However, the differences between these studies could also be explained by how study participants were recruited: the National Fertility Survey was carried out by the Japanese Ministry of Health, Labor and Welfare and used a population-based sample of participants who were actively recruited by the investigators while we aimed to recruit a nationally representative sample from individuals who had volunteered to answer survey questions online. There may also have been differences in how participants reported their sexual experience, and the questions regarding sexual experience were differently phrased in the two surveys. Nonetheless, these findings lend further support to the notion that levels of sexual inexperience could be higher in Japan as compared to many Western countries (Jorgensen et al., 2015; Mercer et al., 2021; New Zealand Ministry of Health, 2019; Rissel et al., 2014). However, most studies on sexual inexperience in Western countries were conducted several years ago and it is possible that levels of sexual inexperience among adults in the US and Europe are catching up with those of Japan. For example, the nationally representative online survey Natsal-COVID, conducted in 2020, found indications of an increase in sexual inexperience in Britain as compared with the previous Natsal-3 study from 2010–2011: in Natsal-COVID, 27% of women and 28% of men aged 18–24, 10% of women and 7% of men aged 25–34, and 11% of women and 8% of men aged 35–44 years reported never having had partnered sex (Mercer et al., 2021), although it should be noted that some of these numbers are incompatible with the lower levels of sexual inexperience reported by the same birth cohorts when sampled 10 years earlier in the Natsal-3 study. Moreover, differences in sampling methods and response rates (the Japanese National Fertility Survey has a response rate of 70.0–92.5% as compared to 30–40% in many Western surveys; Mercer et al., 2013; Public Health Agency of Sweden, 2019; Ueda et al., 2020), how questions regarding sexual inexperience are phrased and perceived, and whether the data were gathered through interviews or questionnaires, may also partially explain the differences. Furthermore, sexual inexperience and inactivity is widely discussed in the public sphere and considered to be common in Japan (Ghaznavi et al., 2020; Kitamura, 2011). It is possible that social desirability bias is less pronounced among study participants without sexual experience in Japan.
While nationally representative data are not available, it is possible that other East Asian countries have rates of sexual inexperience comparable to those of Japan. For example, in a survey of undergraduates aged 15–24 years (mean 20 years) conducted in China in 2019, 86% of women and 73% of men reported having no experience of sexual intercourse (Lyu et al., 2020), and the median age of sexual debut in our Japanese sample (20 years) was similar to values reported by limited surveys from South Korea and China (Park et al., 2021; Zhang, 2020). Furthermore, in a national survey in India from 2019–2021, 3% of women and 11% of men aged 30–34 and 1% of women and 4% of men aged 35–39 reported having no experience of sexual intercourse (Ministry of Health and Family Welfare, 2021).
Sexual Inactivity
We found that 42% of women and 55% of men aged 20–29 years reported having had no sexual partners during the past year. These proportions are higher than those reported in comparable studies from other countries before the pandemic. For example, in nationally representative US data from 2016–2018, the proportion reporting no partnered sexual activity in the past year was around 20% for women and 30% for men aged 18–24 years and 14% for men and 13% for women aged 25–34 years (Ueda et al., 2020). In a national survey in Germany from 2016, around 20% of both men and women aged 18–30 years reported no sexual activity in the past year (Beutel et al., 2018; Burghardt et al., 2020). A Danish study from 2012 found that among those aged 15–29, around 4% of women and 8% of men reported zero sexual partners in the past year (Jorgensen et al., 2015), and in a British study from the same year, around 10% of men and women aged 20–29 years were sexually inactive (Ueda & Mercer, 2019). However, comparisons with our findings should be done with caution due to differences between surveys in sampling methods, response rates, the phrasing of questions, and potential cultural differences affecting self-reported sexual activity. Importantly, the data from these previous studies were collected before the COVID-19 pandemic. In the British Natsal-COVID study, over 40% of women and men aged 18–24 and around 25% of women and men aged 25–34 reported no partnered sexual activity during the up to 4 months that had passed between society going into “lockdown” and study participation (Mercer et al., 2021).
Sexual Orientation, Including Asexuality, Importance of Sex and Sexual Satisfaction
A substantial proportion of women (15%) and men (11%) aged 20–29 years responded that they were asexual. While this proportion decreased slightly with age, it is manyfold higher than the prevalence of asexuality (<1%) reported in countries such as Britain (Aicken et al., 2013) and Sweden (Public Health Agency of Sweden, 2019). Moreover, 37% of women and 54% of men in our study responded that they considered sex to be important; these proportions are lower than those reported in countries such as Sweden (Public Health Agency of Sweden, 2019), Britain (Field et al., 2013), and France (Bajos et al., 2010). In a previous study using data from a national survey in 2015, around half of Japanese singles (21% of the women and 25% of men in the total population aged 18–39 years) reported that they had no interest in heterosexual romantic relationships (Ghaznavi et al., 2020). The proportion reporting no interest in heterosexual relationships was largest among those aged 18–24 years and decreased with higher age. Questions regarding sexual orientation, the perceived importance of sex, and interest in sexual relationships address different aspects of sexual interest/desire; findings from the current and previous studies indicate that sexual relationships might play a less prominent role in Japan at the individual, cultural, and societal level as compared with many Western countries, although potential differences across study populations in how the survey questions were perceived and interpreted warrant caution when making cross-cultural comparisons.
While 28% of women and 23% of men indicated that they were satisfied with their sex life, 18% of women and 27% of men indicated that they were dissatisfied. In addition, 26% of women and 46% of men indicated that they wanted to increase their sexual frequency. While the higher levels of sexual dissatisfaction and desire to increase sexual frequency among men than women have been observed across many cultures and countries (Hakim, 2015; Mitchell et al., 2013), our findings indicate that a large proportion of women and men in Japan are dissatisfied with their sex lives and wish to increase their level of sexual activity.
Pornography Use
We found that approximately 36% of women and 84% of men used pornography. Among those aged 20–29 years, 17% of women and 59% of men reported a frequency of pornography use of weekly or more and 2% of women and 15% of men reported daily or almost daily use. While detailed data on the frequency of pornography use in national populations are scarce (Miller et al., 2020; Regnerus et al., 2016; Rissel et al., 2017), the values reported in this study were similar to those observed in analyses of nationally representative survey data collected in Sweden where 13% of women and 66% of men aged 16–24 years reported at least weekly pornography use and 1% of women and 17% men reported daily or almost daily use (Malki et al., 2021). In accordance with findings from Australia and Sweden, reporting negative effects of pornography use on one’s sex life was rare and less common than reporting positive effects (Malki et al., 2021; Rissel et al., 2017).
Use of Commercial Sex Worker Services
We found that 4% of women and 48% of men reported ever having used commercial sex worker services in their lifetime. These proportions are higher than those reported in surveys from other countries. For example, in a national survey from Sweden, around 10% of men and less than 1% of women aged 16–84 years reported that they had given money or other types of compensation for sex in their lifetime (Public Health Agency of Sweden, 2019). In the British Natsal-3 survey, the proportion of men who reported having paid for sex during the past 5 years ranged between 3 and 5% across age groups, while this proportion was close to zero for women (Mercer et al., 2013). In a Danish survey among those aged 15–29 years, around 10% of men had paid for sex during their lifetime, while this proportion was nearly zero for women (Jorgensen et al., 2015). In Germany, 27% of men participating in a national survey reported having paid for sex in their lifetime (Doring et al., 2022). It could be hypothesized that the rate of commercial sex service use is high in Japan due to easy accessibility and visibility of such services in metropolitan areas (e.g., the famous red light district in Kabukicho, Tokyo), many types of sexual services being legal in Japan (although services including vaginal intercourse are not technically legal, these laws are not strictly enforced), the diversity in the types of services offered (including many services that do not include penetrative sex), and the relatively low stigma concerning the use of commercial sex services, among men but also women, as compared with Western nations (Fu, 2011; Koch, 2021; Takeyama, 2021).
Implications for Future Research
The findings presented here engender additional opportunities for future research. First, given the increasing socioeconomic disparities in Japan, which may also correlate with sexual inactivity and prospects for finding sexual partners (Ghaznavi, Sakamoto et al., 2022; Ghaznavi et al., 2019), it would be informative to assess the sociodemographic characteristics of those who have responded that they are sexually inexperienced, sexually inactive, and asexual. Assessment of the association of sexual inexperience, sexual inactivity, and asexuality with variables related to sexual health and wellbeing may shed light on potential reasons for and experiences of sexual inexperience and inactivity. For example, whether individuals who have responded that they are asexual are sexually inactive and whether sexually inactive individuals tend to report satisfaction with their sex lives or consider sex as unimportant would be of interest to explore (Andresen et al., 2022; Ueda & Mercer, 2019). Another venue for future research is to assess the association of frequent pornography use with sexual health outcomes and with self-reported positive or negative effects of pornography use on individuals’ sex lives (Hald & Malamuth, 2008; Malki et al., 2021; McKee, 2007; Miller et al., 2020; Rissel et al., 2017). Moreover, sociodemographic characterization of individuals who use commercial sex work services and assessment of the association between use of commercial sex work services and sexual health outcomes and sexual behaviors, including other risk behaviors, are warranted (Doring et al., 2022).
Limitations
Our study had limitations. First, the survey used in the current analysis was conducted via an online platform. Similar to other quasi-representative national surveys (Herbenick et al., 2017; Mercer et al., 2021), it is uncertain to what extent the study participants are representative of the national population (Ross et al., 2005). Although we weighted the sample based on age, region, and marital status to ensure that the survey was nationally representative with respect to these variables, the weighted NInJaS sample was more educated and had slightly higher income across all age and sex groups, as compared to the National Fertility Survey; the slight overrepresentation of highly educated and higher income individuals has been reported in previous literature using the same survey platform (Nomura et al., 2021). Second, questions pertaining to sexual health are sensitive and thus susceptible to response bias, especially social desirability bias. However, the anonymous nature of the self-administered online survey may have mitigated the risk of response bias (Gribble et al., 1999). Third, our survey was conducted in July 2022, during the late stages of the COVID-19 pandemic in Japan. During the course of the pandemic, between one and four state of emergency declarations (SoEs) were implemented in each of Japan’s 47 prefectures, with the final SoE ending after the Tokyo Olympic Games in late 2021. During SoEs, residents of Japan were encouraged to minimize social interactions outside the home by limiting nonessential outings, restaurants and bars instituted shortened business hours or halted services entirely, and many businesses switched to remote work. Notably, SoE compliance was voluntary, but even still considerable declines in mobility were recorded, especially during earlier SoEs (Ghaznavi, Yoneoka et al., 2022). Previous research has found that the frequency of sexual activity decreased in Japan during the pandemic (Kitamura et al., 2021), possibly due to the nationwide social distancing policies and SoEs. Thus, future iterations of this survey will be needed to assess sexual behavior during non-pandemic periods. Fourth, we were limited in the number of items we could include in our questionnaire, and thus the first iteration of NInJaS was not as comprehensive as many other, long-established sexual health surveys from Western nations. As we expected few participants to identify as transsexual, we did not include questions that encompass trans experiences. Finally, the self-administered nature of the survey precluded respondents from asking clarifying questions and may have led to misunderstandings regarding the intent of specific questions. For example, terms such as sexual orientation are not yet widely used in Japanese. In these instances, we added explanations next to terms that may be unfamiliar to the average Japanese resident in order to minimize any misunderstandings.
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