Archive for Sexology
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5th Congress of the
EUROPEAN FEDERATION OF SEXOLOGY
Berlin, 29 June - 2 July 2000
"For a Millennium of Sexual Health"
Friday 30th June 2000
Global Sex: Sexuality and sexual practices around the world
Dr Judith Mackay
Senior Policy Advisor, TFI, World Health Organization
Professor Erwin J. Haeberle, Director, Archive of Sexology at
the Robert Koch Institute, Berlin has, stated:
"Now that we have entered the age of economic
globalization, it is becoming increasingly important for
sexologists and other health professionals to take a
global view of sexual health as well." 
This paper is divided into two components - firstly, the
difficulties of global research on sex, and second, some of
I. GLOBAL SEX RESEARCH
Researching sex on a worldwide, comparable, basis -- as I have
been doing for the last 5 years -- is not easy:
1. Very few sexology institutes or specialists exist in most
countries, especially developing countries.
2. Only a handful of countries have comprehensive
3. There is no central depository for global sex data (in
contrast to World Health Organization's databank of health
statistics). For example, there are almost no archives of
quantitative research on sexual practices; international sex-
related legislation or regulations and enforcement; data on
economic aspects of sex; public opinion surveys; or trends.
There is not even a global coordinating organisation for sex
counselling, which has further implications for definition of
terms, ethical standards, and training.
4. Quantitative data seems particularly difficult to obtain;
qualitative data, while valid, is less suitable for
international comparative analyses.
5. Sex research, where it exists, is often
fertility-related, rather than sex-orientated. The only
almost-complete data-sets I could find were for pregnancy,
infertility, contraception and AIDS and, to a lesser extent,
legal minimum age of marriage, and divorce.
6. There has been a lack of standardisation of terms in many
areas of sex research. For example, in the tobacco field,
there are exact terms to define a smoker (daily smoker, aged
15 years and over), initially suggested by WHO and now used by
all countries in the world. This enables comparable analysis.
7. Even definitions vary, e.g.:
a) "sex counselling" can be used for in-depth specific
psycho-sexual counselling, while others use it when condoms
b) "obscenity" is particularly difficult to define, as the
concept varies from person to person, country to country, and
from different times to times. This is reflected in the
confusion of laws on obscenity, which in some countries are
complaint-driven, or widely disregarded in others.
c) "normal sex": My initial definition was "Sex that does no
harm" but that leaves some awkward questions, such as
necrophilia and bestiality. My final definition of "normal
sex" for the atlas was sex with "informed consent." This
therefore excludes paedophilia as a child cannot give informed
consent. It also exclude rape and other crimes of violence,
and bestiality and necrophilia, as neither beast nor dead body
d) "sex": Even the definition of "sex" causes confusion.
In the USA in 1999, two thirds of respondents in a survey
reported in the Journal of the American Medical Association
believed that oral-genital contact did not constitute "having
sex," and one in five thought the same about anal
8. Poor data are reported - although this is certainly not
confined to the discipline of sexology. Some surveys, eg those
on rarer problems, such as unconsummated marriages or uncommon
sex problems, are justified in reporting small sample size
surveys, but at the 14th World Congress of Sexology in 1999,
studies from some parts of the world were reported with 8%
response rates to surveys on 'the best sexual moment of my
life,' or a sample of 100 persons being asked their opinion on
9. Imprecise terms are used in data collection, for example,
I came across terms for "40 years and above" which on
questioning turned out to be 40-45 years. Studies conducted on
only the sexually active have been reported as national
10. Even where laws exist, they may be widely disregarded, eg
parental decisions can override the legal minimal age of
marriage in many countries.
11. Internet research: There is now an impressive array of
web sites with excellent information on sex. Many are linked
to Dr Haeberle's Robert Koch Institute site at: content:
Why are quantitative data so important?
It is not possible to plan interventions unless basic data are
available, for example, there is no point planning sex
education at the age of 15 if many young people are having sex
at 13 years of age. Health facilities for AIDS, pregnancy,
contraception and many other topics can also only be planned
on the basis of epidemiological information.
II. GLOBAL SEX RESEARCH FINDINGS
"After people are clothed and fed, then they think about sex."
-- K'ung Fu-Tzu (Confucius) 551-479 BC
Sex: this most universal experience comes complete with an
array of international similarities and some surprising
differences, from country to country; between different ages,
genders and cultures; and from the intensely personal to the
economic and political. This essentially private activity
often raises public and legal issues, even invoking the death
SELECTED FINDINGS 
- 60% of marriages are still arranged, in part or in whole.
- In the US, 30% of men and 28% of women are celibate or
have sex only a few times each year.
- 40% of sexually active 16-45 year old Germans admit to
having been sexually unfaithful, compared with 50% of
Americans, 42% of British, 40% of Mexicans, 36% of the
French, and 22% of the Spanish.
- The highest divorce rate is in Hungary, followed by the
USA and the Central African Republic. The divorce rates
in the US are about double those in the UK.
- SEX NOT SAFE ENOUGH
- The percent of 16-45 year olds who always use a condom
with a casual partner is 69% of the French, 56% of
Americans, 48% of Italians, 40% of British, 36% of
Spanish, 32% of Germans, albeit ahead of Canada and
Poland at less than 25%. Thailand tops the charts at 82%
- LAWS AND CONDEMNATION
- Repressive laws exist for many aspects of sex.
There are 8 countries with the death penalty for
homosexuality: Afghanistan, Iran, Mauritania, Pakistan,
Saudi Arabia, Sudan, United Arab Emirates, Yemen.
There are 4 countries with the death penalty for
adultery: Iran, Pakistan, Saudi Arabia, and Yemen.
Religion has a profound impact on many aspects of sex,
from masturbation, adultery and homosexuality to birth
control and divorce. In the UK in 1995 the Church of
England denied a homosexual the right to be godfather to
his sister's son. In Brazil in 1996 a Catholic Bishop
refused to marry a paraplegic man, because he would not
be able to have sex and father children.
- SEXUALLY TRANSMITTED INFECTIONS
- Half the world's STIs are in Asia. The shadow of AIDS
will also fall most heavily across Asia, in part because
of large population numbers.
- WHERE IS THE FUN?
- It was surprisingly difficult to find cheerful aspects of
sex. Most of what is measured is negative - teenage
abortions, diseases, child prostitutes, harsh laws, sex
crimes such as rape, harassment and stalking. Even the
success of sex education is usually measured by the
avoidance of unwanted pregnancies and STIs, not by
whether children grow up to have a fulfilling sex life.
- The USA is the world's leading producer and consumer of
Internet pornography (73%).
Studies on pornography fail to consider all the
variables. For example, the liberalization of pornography
laws in the USA, UK, Australia, and the Scandinavian
countries has been accompanied by a rise in the rates of
reported rapes. But the rates of all violent crimes have
increased and more women come forward to report rape,
making it difficult to draw any firm conclusions.
Few studies differentiate between erotica, soft and hard
porn, or take into account baseline norms. It is one
thing to say that x percent of rapists read pornography
before committing a rape, but that statistic is
meaningless unless it is known how many non-rapists read
the same kind of porn. Further studies are needed to
assess the effect of the various types of pornography.
- THE FUTURE OF SEX
- Sex is increasingly separated from reproduction, by test
tube babies, surrogate mothers, and cloning. New
technology will introduce undreamt of possibilities in
the sexual arena. Thus, quite new areas of sex research
will arise in the future, ideally with globally
standardised research tools and protocols.
1. Haeberle E. Foreword, The Penguin Atlas of Human Sexual
Behavior, by Dr Judith Mackay, Penguin, 2000.
2. Stephanie A. Sanders, June Machover Reinisch, "Would You
Say You "Had Sex" If...?" January 20, 1999. Journal of the
American Medical Association 1999;281. p 275-277.
3. See ref 1, also www.myriadeditions.com
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