Sexual behavior is difficult to define precisely, but it includes much more than coitus (penile-vaginal sexual intercourse). Any behavior that is accompanied by physiological signs of sexual arousal, or that is perceived as sexual by the participants, may be included.
Historically, attitudes toward masturbation or autoerotic behavior have been quite negative. These attitudes derive from moral teachings, from the notion that masturbation is unhealthy, and from a sense that people who masturbate are those who can’t find a sex partner. Even today, many people feel guilty about masturbating.
According to the NHSLS, about half of U.S. adults masturbate at least once per year. Factors associated with higher rates of masturbation include male sex, a younger age, and a higher educational level. Factors associated with lower rates of masturbation include being married, having religious beliefs, and being African-American. Gay people masturbate more than heterosexuals and derive more enjoyment from it. Masturbation does not seem to be simply a substitute for sex with partners.
Men tend to use a single technique for masturbation—direct manual stroking of the penis—whereas women use a greater variety of techniques, such as manual stimulation of the clitoris, labia, or vagina, or rubbing of the vulva against objects. Men experience orgasm during masturbation more frequently than do women.
Kissing is an important form of sexual expression in the United States, where it often has strong romantic significance, but it is not practiced in all human cultures.
Petting or fondling includes a variety of behaviors short of penetrative sex, including sensuous touching and kissing of the body. It may be a prelude to penetrative sexual interaction (foreplay), or it may form the entire sexual encounter, especially among adolescents.
Oral sex means contact between the mouth and the penis (fellatio), the vulva (cunnilingus), or the anus (anilingus). Oral sex has become increasingly popular among younger people in the United States and Britain, where 80% to 90% of young people have engaged in it. Like many noncoital sexual behaviors, it is more common among well-educated people.
About half of U.S. men, but fewer women, find fellatio very appealing. Cunnilingus is enjoyed about equally by men and women; about a third of the U.S. population finds it very appealing. Oral sex may be performed mutually in a head-to-genital arrangement; this behavior is called sixty-nining, or soixante-neuf.
Most adult heterosexual couples engage in coitus as the culmination of a sexual encounter. The most popular and traditional position for coitus in the United States is with the man above (“missionary position”), which requires the man to do most of the pelvic thrusting. The women’s movement of the 1970s encouraged the exploration of other positions, such as the woman-above position and rear-entry coitus. Each position may have particular advantages and disadvantages for certain couples or in certain situations.
Anal sex (penetration of the anus by the penis) is practiced in both male–male and female–male encounters. About 10% of Americans engage in heterosexual anal sex at least once a year. Anal sex can be performed in a variety of positions and does not damage the anus or rectum.
Some couples like to make coitus almost the entirety of a sexual encounter, while others include much foreplay and afterplay, or even dispense with coitus altogether. In general, women prefer more protracted lovemaking and do not place as much emphasis on coitus as do men. Thus sexual encounters between women tend to be considerably longer than heterosexual encounters. Women generally take longer to reach orgasm than do men, so men might have to learn to postpone their own orgasms in heterosexual encounters if the man and woman wish to experience orgasm at close to the same time.
Vibrators are electrically powered devices that deliver erotically arousing vibratory stimulation. They may be used by men or women, but they are particularly associated with use for masturbation by women and to help women reach orgasm in partnered sex. Dildos are unpowered, sometimes penis-shaped objects used for vaginal or anal penetration, in either partnered or solo sex.
Different cultures vary greatly in the openness with which they discuss sexual behavior. The classic how-to manual on sexual behavior is the Kama Sutra (India, fifth century or earlier). This book demonstrates that explicit discussion of sex is not the sole prerogative of modern Western society. Contemporary India, however, has less positive attitudes toward sex than those described in the Kama Sutra.
Some cultures are more sex-positive than others. In many Pacific Island cultures, such as that of Mangaia, children receive instruction and initiation into sexual practices at puberty. An important aim of this instruction is to encourage sexual pleasure and to ensure that men help their partners experience multiple orgasms.
Some disabilities interfere with sexual behavior by limiting movement or making movement painful. Arthritis is the leading culprit in this respect, with 15% of the U.S. population affected. Nevertheless, people with arthritis can usually engage in pleasurable and rewarding sex by advance preparation and by choosing positions for sex that put the least stress on affected joints.
Spinal cord injuries can cause a near-complete loss of movement and sensation in the body below the neck (quadriplegia) or in the lower half of the body (paraplegia). Although conscious sensations from the genitalia are often lost, reflex penile erection and vaginal lubrication and engorgement may be preserved, depending on the level and completeness of the injury. Most people with spinal cord injuries can engage in coitus if they desire it, and women with spinal cord injuries can sustain pregnancy and deliver a baby vaginally.
Most intellectually disabled people experience the same sexual feelings and desires as everyone else. They have a right to make informed choices about sexual behavior if they are capable of doing so. Facilitating the exercise of this right must be balanced against the need to protect intellectually disabled people from sexual exploitation. With appropriate education, many intellectually disabled people can enjoy active sex lives, and some become parents and raise children.
