Q&A on The National Survey of Sexual Attitudes and Lifestyles with the Wellcome Trust

We ran a Q&A with the Wellcome Trust about the National Survey of Sexual Attitudes and Lifestyles. The survey is carried out every 10 years and the latest results were published in November 2013.

Over 15,000 people were interviewed, a representative cross-section of the British public, and for the first time the researchers extended the age range beyond 16-44 years and interviewed people up to 74 years old. The study was co-founded by The Wellcome Trust, the UK's largest medical research charity, and it invited experts Cath Mercer and Wendy Macdowall to answer everything you wanted to know about its latest sex survey.


Expert panel

Dr Cath Mercer, senior lecturer at UCL

Dr Mercer is a senior lecturer for the Centre for Sexual Health and HIV Research at University College London. A statistician by training, Dr Mercer has worked on the National Surveys of Sexual Attitudes and Lifestyles (Natsal), Britain's national probability sample surveys of sexual behaviour, for the past 13 years.


Wendy Macdowall, lecturer at the London School of Hygiene & Tropical Medicine

Wendy Macdowall is a lecturer in the department of social and environmental health research at the London School of Hygiene & Tropical Medicine. Her interests are the determinants of sexual health, the development of interventions to improve and promote sexual health and the evaluation of public health interventions.



Generational differences

Q. gazzalw: Do you see a generational difference in attitudes towards sex and relationships? That sounds simplistic, but I'm sure there are interesting observations made twixt the 'War babies', 'Swinging Sixties babies' and those born since?

A. Cath Mercer: We do observe generational differences in the data collected by the Natsal surveys. The trend is that more recent birth cohorts, so younger people today, are more accepting of same-sex sexual partnerships and casual sex, specifically one-night stands. However, it's interesting to observe that younger people are less accepting than older people of non-exclusivity in marriage, so what many people would label as 'affairs'.

One reason might be that, given the increases in the divorce rate we've observed over recent decades for some younger people at least, they may have witnessed the impact of the breakdown of their parents' marriage perhaps as a result of one or both of their parents having an affair(s), and so, having experienced this hurt at first hand, may feel particularly strongly that non-exclusivity in marriage is wrong - but that's just my attempt at an explanation.

Q. Calypso2: It's interesting to read that people are having sex less frequently than 10 years ago. Why do you think that is?

A. Cath Mercer: The Natsal survey didn't ask people why they are having less sex these days than 10 years ago. There are likely to be many influences affecting how much sex people have, including economic worries. Those who have a job are working longer hours and so may be too tired to have sex, while those who are unemployed may be too worried to be interested in sex.

Another hypothesis that's been proposed to explain why we're having less sex nowadays is that it's the impact of the 'digital invasion'. Many people in Britain seem to be addicted to their smartphones, iPads and the like, and so find it difficult to disconnect from the internet and the outside world more generally. Of course, this isn't just a problem in the bedroom but throughout our waking hours including, for example, at meal times. We need to learn to switch off from the internet, so that we can also switch off.

Q. Charcoalbriquettes: What I really wanted to know is how our attitude to relationships and sexuality is changing. So, who is it OK to have sex with? How well do you need to know someone before you are ready to have sex? How much do you fancy someone to have sex with them? How are your expectations of what goes along with a sexual relationship changing as you move through the life stages of cohabiting, having children, separating, becoming menopausal etc?

Is any of this stuff in the whole report? I just looked at the infographics.

A. Cath Mercer: I'm pleased to hear that you've been looking at the Natsal study's infographics and I hope you found them interesting.

The questions you've asked are good ones. It seems that it's increasingly OK to have sex with people of the same gender, whether you're male or female, so people in Britain are increasingly accepting of more diverse sexual lifestyles.

However, what's less OK nowadays (at least in comparison to 10 years ago, and at least among people aged 16-44) is casual sex and specifically one-night stands as well as non-exclusivity in marriage, so the types of sexual partnerships that many people would consider as lacking trust and respect.

It seems that what's important regardless of your life stage, so whether you're 16 or 74 (the age range of the people who took part in the survey), and regardless of your life circumstances, eg whether you have kids or you're going through the menopause etc, is that you have sex that is informed, consensual, safe, respectful and pleasurable.


Non-volitional sex

Q. LineRunner: I have a series of linked questions about the statement: "The troubling statistic that one in 10 women (and one in 70 men) have been made to have sex against their will."

  • Why is the word rape not being used?
  • Is that a statistic that is predicated on people admitting that they have been raped? In other words, could the same statement be written as, "one in 10 women (and one in 70 men) have disclosed that they been made to have sex against their will"?
  • What's the gender break down of those stats so far, in terms of perpetrator-victim gender identifiers?

A. Wendy Macdowall: We asked women and men about their experience of sex against their will which, in the most literal interpretation of the question, we report as non-volitional sex. We have not used the word rape as rape has a precise legal definition and whether a man has committed the crime would be decided by a court. Only a man can be charged with rape, as it involves the penetration by a penis of the vagina, anus or mouth of another person. The law on rape is set out in the Sexual Offences Act of 2003, which is available here.

In reference to your second point, yes, this is the reported prevalence of non-volitional sex. Given the sensitive nature of the topic, participants may have chosen not to disclose the experience. However of the 8,409 women and 5,874 men who were asked whether they had experienced sex against their will, only 2.6% of women and 2.9% of men did not answer the question.

We compared those who responded to the question with those that didn't and found a higher proportion of the non-responders were of lower educational level, were in the highest quintile of deprivation and were of older age (over 55 for men and over 65 for women). It is worth noting, though, that we consider the non-response to this question to be low. Interestingly, the question which had the highest non-response in the survey was the one that asked participants about their income.

In reference to your third point, we did not ask the gender of the perpetrator, though we do know from other sources that the majority of sexual violence is committed by men on women.

Q. BOF: By saying "sex against their will" and "sexual coercion" isn't this just sanitising rape? Why can't we call a spade a spade here?

While women and men are still framing rape in a way which brushes it under the carpet and turns it into a misunderstanding or a failure in communication, we are never going to see convictions rise and hold men that rape accountable. I can understand why victims don't always want to define their experience in this way, but I am disappointed that the academic discourse appears to fudge the issue in this way.

A. Wendy Macdowall: We should be under no doubt that sex without consent is rape but, as noted above, we have not used the word rape when reporting the survey findings as the issue of consent in individual cases would be one decided by a court.

We asked women and men if anyone had made them have sex against their will, rather than asking if they had been raped, as there is wide agreement in the academic literature that the term rape should be avoided as it is highly subjective and likely to result in under-reporting (we know from research in America that many women who have experienced what would legally defined as rape do not acknowledge their experience as such).

Q. TottWriter: What are the chances going forward of using these survey results to put legitimate and sustained pressure on the government to make comprehensive and appropriate sex and relationship education into schools of a quality which can educate children about how to grow into their sexualities and respect that of others? For that matter, given the numbers of people who reported having sex against their will, is this not a huge marker that something needs to change?

Additionally, are there any regrets about the survey's choice to report rates of sex against the person's will without additionally recording the number of people willing to admit they had been raped? At the moment, this statistic could be confused and diluted.

Although it's a little early to be asking this perhaps, will the next survey expand further into this area of questioning?

A. Wendy Macdowall: I very much hope that the findings will be used to lobby for more comprehensive and more consistent sex and relationship education in schools and I would like to be active in that process.

One of the challenges is that the relationship aspect of sex and relationship education is not statutory and provision is patchy. We have yet to analyse the findings from the survey on participants' experience of learning about sex, but we know from the last survey in 2000 that young people wanted to know more about the psychosocial aspects of sex and that they wanted this information from an authoritative source (most commonly schools or a parent).

In relation to your second point, it would have been interesting to ask participants who reported experiencing sex against their will whether they defined the experience as rape. It would also have been interesting to use exactly the same question wording as the Crime Survey for England and Wales to see how much difference the context of the survey (sexual health versus crime) makes to reporting.

I would indeed like to see an expanded set of questions in Natsal 4. These could include more detailed questions about experience of non-volitional sex (nature of coercion and/or force, involvement of drugs or alcohol, number and gender of perpetrators) and also questions on other forms of sexual violence.

Q. misty75: I agree that "sex against their will" is always rape and should be named as rape in this survey. Can I ask why there is an upper age limit on this survey, why stop at 74?

A. Wendy Macdowall: As noted above, we should be under no doubt that sex without consent is rape, but we have not used the word rape when reporting the survey findings as the issue of consent in individual cases would be one decided by a court.

In relation to the upper age limit, the last survey (in 2000) stopped at 44 years so we were delighted to have gone up to 74 years this time round. We may be able to go even further next time.


Safe sex

Q. LineRunner: Why is non-PIV sex portrayed as safe sex as opposed to safe and enjoyable and real sex?

A. Cath Mercer: We created a measure of unsafe sex, which we defined as reporting at least two partners - of either gender - with whom no condom was used in the past year, to identify those people who will have been at risk of acquiring and possibly transmitting STI (sexually transmitted infections).

However, we recognise that STIs are just one element of sexual health and well-being, and our measure is just one measure of unsafe sex. We also recognise that sex is more than just penetrative intercourse, and so the survey considered sex as vaginal, oral, anal sex, and/or other genital contact not necessarily leading to intercourse eg mutual masturbation.

Despite what's seen on screen, for example in porn, we found that mutual masturbation was commonly reported and a big part of many people's sexual repertoire. As such, it shouldn't be overlooked as a satisfying sexual experience for both men and women - after all, sex isn't all about penetration.

Last updated: 9 months ago