What makes sex, sex?

What is sex? How would you define sex? When does it “count”? Sex varies largely between individuals and there is not one definition of sex.


On the NHS Choices website, there are 14 methods of contraception. These all assume that sex is always between men and women, and is penis-in-vagina (PIV) sex. A large body of research has found that definitions and ideas on what sex is can differ hugely from individual to individual*. Even in sex between people with male and female genitals, where contraception is of most concern for those who want to avoid getting pregnant, penis-in-vagina sex may not be an accurate assumption


A Canadian study found that while under 25% of university students considered oral sex to be ‘having sex’, more than 60% thought that the giver or receiver of oral sex was a sexual partner, and more than 97% considered a partner who had oral sex with someone else to be have been unfaithful (Randall et al, 2003). Perhaps oral sex was not regarded as sex by the participants as it is not PIV sex, but it is interesting how oral sex is seen as an act with a sexual partner, as well as being an unfaithful act when a partner does it with someone else. This highlights how people’s opinions and definitions of sex are often not clear cut. Interestingly, this brings in a larger debate about what makes sex, sex. Are there any further repercussions of only seeing penetrative sex as sex in a contraception context?

“There is still a risk of pregnancy if there is genital contact without penetration”

Another study highlighted the prevalence of non-penetrative sex with partners.  In the National Survey of Sexual Attitudes and Lifestyles (NATSAL), 60% of 16-24 year old women reported vaginal sex in the last 4 weeks, but 72.6% reported genital contact without intercourse with a male partner.  Of the women in this study who were slightly older (25-34 year olds), 76% reported vaginal intercourse with a male partner in the previous 4 weeks and 77% reported genital contact without intercourse. These statistics show how non penetrative sex is just as prevalent as penetrative sex, however non-penetrative sex is often left out of the conversation.  Of course, there is still a risk of pregnancy if there is genital contact without penetration and sperm enters the vagina – but discussion of this risk may never happen if we do not discuss non-penetrative sex during conversations about contraception.


Changing the conversation

Our discussion on contraception is evidently focused around penetrative sex between men and women and this can reflect or influence our societal views. Should we be having more discussions in contraceptive consultations on the risks of non-penetrative sex, or does this need to be taken into school sex education and further? Is society’s idea of sex excluding LGBTQ+ relationships? Drop us a comment and share your thoughts!

Check out our blog posts on ‘Why are lesbians missing from sexual health discussions?’, ‘Safe sex for women who have sex with women’ , ‘10 top tips for safe sex’  as well as our forum on for more information on sex and contraception.


Mercer C., Tanton C., Prah P.,  et al. Changes in sexual attitudes and lifestyles through the life course and over time:  Findings for the National Survey of Sexual Attitudes and Lifestyles.  The Lancet, 2013; 382: 1781-1794

Randall H., Byers S.  What is sex? Student definitions of having sex, sexual partner and unfaithful sexual behaviour.  Canadian Journal of Human Sexuality, 2003; 12: 87-96