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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We're racing towards another private debt crisis - so why did no one see it coming?

The Office for Budget Responsibility failed to foresee the rise in household debt. 

This is a call for a public inquiry on the current situation regarding private debt.

For almost a decade now, since 2007, we have been living a lie. And that lie is preparing to wreak havoc on our economy. If we do not create some kind of impartial forum to discuss what is actually happening, the results might well prove disastrous. 

The lie I am referring to is the idea that the financial crisis of 2008, and subsequent “Great Recession,” were caused by profligate government spending and subsequent public debt. The exact opposite is in fact the case. The crash happened because of dangerously high levels of private debt (a mortgage crisis specifically). And - this is the part we are not supposed to talk about—there is an inverse relation between public and private debt levels.

If the public sector reduces its debt, overall private sector debt goes up. That's what happened in the years leading up to 2008. Now austerity is making it happening again. And if we don't do something about it, the results will, inevitably, be another catastrophe.

The winners and losers of debt

These graphs show the relationship between public and private debt. They are both forecasts from the Office for Budget Responsibility, produced in 2015 and 2017. 

This is what the OBR was projecting what would happen around now back in 2015:

This year the OBR completely changed its forecast. This is how it now projects things are likely to turn out:

First, notice how both diagrams are symmetrical. What happens on top (that part of the economy that is in surplus) precisely mirrors what happens in the bottom (that part of the economy that is in deficit). This is called an “accounting identity.”

As in any ledger sheet, credits and debits have to match. The easiest way to understand this is to imagine there are just two actors, government, and the private sector. If the government borrows £100, and spends it, then the government has a debt of £100. But by spending, it has injected £100 more pounds into the private economy. In other words, -£100 for the government, +£100 for everyone else in the diagram. 

Similarly, if the government taxes someone for £100 , then the government is £100 richer but there’s £100 subtracted from the private economy (+£100 for government, -£100 for everybody else on the diagram).

So what implications does this kind of bookkeeping have for the overall economy? It means that if the government goes into surplus, then everyone else has to go into debt.

We tend to think of money as if it is a bunch of poker chips already lying around, but that’s not how it really works. Money has to be created. And money is created when banks make loans. Either the government borrows money and injects it into the economy, or private citizens borrow money from banks. Those banks don’t take the money from people’s savings or anywhere else, they just make it up. Anyone can write an IOU. But only banks are allowed to issue IOUs that the government will accept in payment for taxes. (In other words, there actually is a magic money tree. But only banks are allowed to use it.)

There are other factors. The UK has a huge trade deficit (blue), and that means the government (yellow) also has to run a deficit (print money, or more accurately, get banks to do it) to inject into the economy to pay for all those Chinese trainers, American iPads, and German cars. The total amount of money can also fluctuate. But the real point here is, the less the government is in debt, the more everyone else must be. Austerity measures will necessarily lead to rising levels of private debt. And this is exactly what has happened.

Now, if this seems to have very little to do with the way politicians talk about such matters, there's a simple reason: most politicians don’t actually know any of this. A recent survey showed 90 per cent of MPs don't even understand where money comes from (they think it's issued by the Royal Mint). In reality, debt is money. If no one owed anyone anything at all there would be no money and the economy would grind to a halt.

But of course debt has to be owed to someone. These charts show who owes what to whom.

The crisis in private debt

Bearing all this in mind, let's look at those diagrams again - keeping our eye particularly on the dark blue that represents household debt. In the first, 2015 version, the OBR duly noted that there was a substantial build-up of household debt in the years leading up to the crash of 2008. This is significant because it was the first time in British history that total household debts were higher than total household savings, and therefore the household sector itself was in deficit territory. (Corporations, at the same time, were raking in enormous profits.) But it also predicted this wouldn't happen again.

True, the OBR observed, austerity and the reduction of government deficits meant private debt levels would have to go up. However, the OBR economists insisted this wouldn't be a problem because the burden would fall not on households but on corporations. Business-friendly Tory policies would, they insisted, inspire a boom in corporate expansion, which would mean frenzied corporate borrowing (that huge red bulge below the line in the first diagram, which was supposed to eventually replace government deficits entirely). Ordinary households would have little or nothing to worry about.

This was total fantasy. No such frenzied boom took place.

In the second diagram, two years later, the OBR is forced to acknowledge this. Corporations are just raking in the profits and sitting on them. The household sector, on the other hand, is a rolling catastrophe. Austerity has meant falling wages, less government spending on social services (or anything else), and higher de facto taxes. This puts the squeeze on household budgets and people are forced to borrow. As a result, not only are households in overall deficit for the second time in British history, the situation is actually worse than it was in the years leading up to 2008.

And remember: it was a mortgage crisis that set off the 2008 crash, which almost destroyed the world economy and plunged millions into penury. Not a crisis in public debt. A crisis in private debt.

An inquiry

In 2015, around the time the original OBR predictions came out, I wrote an essay in the Guardian predicting that austerity and budget-balancing would create a disastrous crisis in private debt. Now it's so clearly, unmistakably, happening that even the OBR cannot deny it.

I believe the time has come for there be a public investigation - a formal public inquiry, in fact - into how this could be allowed to happen. After the 2008 crash, at least the economists in Treasury and the Bank of England could plausibly claim they hadn't completely understood the relation between private debt and financial instability. Now they simply have no excuse.

What on earth is an institution called the “Office for Budget Responsibility” credulously imagining corporate borrowing binges in order to suggest the government will balance the budget to no ill effects? How responsible is that? Even the second chart is extremely odd. Up to 2017, the top and bottom of the diagram are exact mirrors of one another, as they ought to be. However, in the projected future after 2017, the section below the line is much smaller than the section above, apparently seriously understating the amount both of future government, and future private, debt. In other words, the numbers don't add up.

The OBR told the New Statesman ​that it was not aware of any errors in its 2015 forecast for corporate sector net lending, and that the forecast was based on the available data. It said the forecast for business investment has been revised down because of the uncertainty created by Brexit. 

Still, if the “Office of Budget Responsibility” was true to its name, it should be sounding off the alarm bells right about now. So far all we've got is one mention of private debt and a mild warning about the rise of personal debt from the Bank of England, which did not however connect the problem to austerity, and one fairly strong statement from a maverick columnist in the Daily Mail. Otherwise, silence. 

The only plausible explanation is that institutions like the Treasury, OBR, and to a degree as well the Bank of England can't, by definition, warn against the dangers of austerity, however alarming the situation, because they have been set up the way they have in order to justify austerity. It's important to emphasise that most professional economists have never supported Conservative policies in this regard. The policy was adopted because it was convenient to politicians; institutions were set up in order to support it; economists were hired in order to come up with arguments for austerity, rather than to judge whether it would be a good idea. At present, this situation has led us to the brink of disaster.

The last time there was a financial crash, the Queen famously asked: why was no one able to foresee this? We now have the tools. Perhaps the most important task for a public inquiry will be to finally ask: what is the real purpose of the institutions that are supposed to foresee such matters, to what degree have they been politicised, and what would it take to turn them back into institutions that can at least inform us if we're staring into the lights of an oncoming train?