Debunking the myths: what is sex really like for ordinary people?

"Few people enjoy a perfect sexual relationship - we need to encourage those people to access the services and support they need."

As a nation we’re fascinated by sex and we all want to know whether our own sex lives are ’normal’. It’s surprisingly difficult to find out, because media stories tend to focus on the sensational and many people hesitate before sharing their personal experiences with others. We are vulnerable to the myth that we can, and should, have the perfect sex life. This myth shapes our expectations of our own sex life and can leave us feeling dissatisfied. Unbiased, reliable data is so important in getting the facts straight.

The three National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been documenting trends in sexual behaviour in Britain from 1990 through 2000 to 2010. Over that time they have collected data on over 46,000 individuals and provide the most reliable information on sexual behaviour and sexual health in Britain. The results of the most recent survey - Natsal-3 - led by the London School of Hygiene & Tropical Medicine, UCL and NatCen Social Research, have just been published. In Natsal-3, we extended the age range to 74 (in Natsal-2 it was 44) and we broadened our focus to look at health and well-being in relation to sexuality. This enabled us to explore how health and relationships affect our sex lives.

The Natsal data show that on average over the past two decades there has been a decrease in how often people have sex, from a median of five times a month in 1990, to three times in 2010.This is partly because fewer people are in relationships, but even those in relationships are having sex less often. This trend is best explained by changes in lifestyle, and the increased stress and busyness of modern life seem likely culprits.

Our health can also affect our sex lives. The Natsal-3 survey shows that one in six people have a health condition that affects their sex life. Those in poorer health are less likely to have had sex recently and are less likely to be sexually satisfied, even after taking into account their age and whether or not they have a partner. Poor health does not necessarily spell the end of an active and satisfying sex life, but what is striking is that only a quarter of men and a fifth of women who say they have a health condition that has affected their sex life have sought help or advice from a professional. That suggests that there are a lot of people with unmet need.

Sexual problems are a common feature of ordinary sexual relationships. Around half of women and four out of ten men report a recent sexual problem, with lack of interest being the most common. Young people are not exempt from experiencing sexual problems either. One in ten women aged 16-24 say they lack enjoyment in sex and one in ten young men say they lack interest. Some things get easier with age - as they get older, women tend to experience less anxiety and men are less likely to climax too quickly. But some things get more difficult - older women increasingly report vaginal dryness and men increasingly experience difficulty getting and keeping an erection. Although sexual problems are common, only one in ten people report distress about their sex life, so it’s important to take account of the personal significance of problems to each individual.

Few of us enjoy a perfect sexual relationship. Around a quarter of men and women say they don’t share the same interest in sex as their partner and almost one in ten do not share the same sexual likes and dislikes. Just under one in five of us has a partner who has experienced difficulties in the last year, and this proportion increases with age, particularly for women.

Natsal-3 used a new measure to come up with a composite score of sexual function – the extent to which an individual is able to participate in and enjoy a sexual relationship. The measure takes account not only of sexual problems, but also of the relationship in which they occur and the degree of personal distress and dissatisfaction. Using this composite score, we found that individuals with depression and poor general health are more likely to have low sexual function. We also found a strong connection between low sexual function and experiencing relationship breakdown and not being happy in a relationship.

It seems that few of us have the perfect sex life and that it would be healthier to aim for a good-enough one instead. On the other hand, there are a large number of people who are not seeking help even though they would benefit from doing so. We need to encourage those people to access the services and support they need, and when they do, we must ensure that we have the resources to provide them with good quality advice and treatment. We also need to spend more time educating young people so that they start out with realistic expectations, and so that they learn that sex is about relationships and relationships are about respect.

Dr Kirstin Mitchell is Lecturer in Sexual and Reproductive Health at the London School of Hygiene & Tropical Medicine and co-author of the Natsal study, which was conducted in partnership with UCL and NatCen Social Research.

A 2002 artwork by Max Whatley and Meg Zakreta. (Photo: Getty)
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The government has admitted it can curb drugs without criminalising users

Under the Psychoactive Substances Act it will not be a criminal offence for someone to possess for their own consumption recreational drugs too dangerous to be legally sold to the public.

From Thursday, it may be illegal for churches to use incense. They should be safe from prosecution though, because, as the policing minister was forced to clarify, the mind-altering effects of holy smells aren’t the intended target of the Psychoactive Substances Act, which comes into force this week.

Incense-wafters aren’t the only ones wondering whether they will be criminalised by the Act. Its loose definition of psychoactive substances has been ridiculed for apparently banning, among other things, flowers, perfume and vaping.

Anyone writing about drugs can save time by creating a shortcut to insert the words “the government has ignored its advisors” and this Act was no exception. The advisory council repeatedly warned the government that its definition would both ban things that it didn’t mean to prohibit and could, at the same time, be unenforcable. You can guess how much difference these interventions made.

But, bad though the definition is – not a small problem when the entire law rests on it – the Act is actually much better than is usually admitted.

Under the law, it will not be a criminal offence for someone to possess, for their own consumption, recreational drugs that are considered too dangerous to be legally sold to the public.

That sounds like a mess, and it is. But it’s a mess that many reformers have long advocated for other drugs. Portugal decriminalised drug possession in 2001 while keeping supply illegal, and its approach is well-regarded by reformers, including the Liberal Democrats, who pledged to adopt this model in their last manifesto.

This fudge is the best option out of what was politically possible for dealing with what, until this week, were called legal highs.

Before the Act, high-street shops were free to display new drugs in their windows. With 335 head shops in the UK, the drugs were visible in everyday places – giving the impression that they couldn’t be that dangerous. As far as the data can be trusted, it’s likely that dozens of people are now dying each year after taking the drugs.

Since legal highs were being openly sold and people were thought to be dying from them, it was obvious that the government would have to act. Until it did, every death would be blamed on its inaction, even if the death rate for users of some newly banned drugs may be lower than it is for those who take part in still-legal activities like football. The only question was what the government would do.

The most exciting option would have been for it to incentivise manufacturers to come up with mind-altering drugs that are safe to take. New Zealand is allowing drug makers to run trials of psychoactive drugs, which could eventually – if proved safe enough – be sold legally. One day, this might change the world of drug-taking, but this kind of excitement was never going to appeal to Theresa May’s Home Office.

What was far more plausible was that the government would decide to treat new drugs like old ones. Just as anyone caught with cocaine or ecstasy faces a criminal record, so users of new drugs could have been hit with the same. This was how legal highs have been treated up until now when one was considered serious enough to require a ban.

But instead, the government has recognised that its aim – getting new drugs out of high-street shop windows so they don’t seem so normal – didn’t depend on criminalising users. A similar law in Ireland achieved precisely this. To its credit, the government realised it would be disproportionate to make it a criminal offence to possess the now-illegal highs.

The reality of the law will look chaotic. Users will still be able to buy new drugs online – which could open them to prosecution for import – and the law will do nothing to make drugs any safer. Some users might now be exposed to dealers who also want to sell them more dangerous other drugs. There will be few prosecutions and some head shop owners might try to pick holes in the law: the government seems to have recognised that it needed a better definition to have any chance of making the law stick.

But, most importantly for those of us who think the UK’s drug laws should be better at reducing the damage drugs cause, the government, for the first time, has decided that a class of recreational drugs are too dangerous to be sold but that it shouldn’t be a crime to possess them. The pressure on the government to act on legal highs has been relieved, without ordinary users being criminalised. For all the problems with the new law, it’s a step in the right direction.

Leo Barasi is a former Head of Communications at the UK Drug Policy Commission. He writes in a personal capacity