Unhealthy culture around anal sex encouraging coercion and pain

Young men are not always concerned about getting consent from young women to have anal sex, and pain for women is considered normal, according to new research published in BMJ Open.

Researchers from the London School of Hygiene & Tropical Medicine say more open discussion is needed to challenge the culture and attitudes around anal sex – a subject that is often seen as unmentionable. In a new study looking at the expectations, attitudes and experiences of anal intercourse between opposite-sex partners and any implications these might have for health, researchers interviewed 130 men and women aged 16 to 18 from across England.

Young people talked to interviewers about an oppressive environment where some men compete with each other to have anal sex with women, even if they expect women to find it painful. Women also reported they were repeatedly asked for anal sex by their male partners. Their accounts also raise the real possibility of coercion for young women – who are sometimes put in situations where they are penetrated anally without their explicit consent.

Lead author Dr Cicely Marston, Senior Lecturer in Social Science at the London School of Hygiene & Tropical Medicine, said: "Our findings suggest an urgent need to act to reduce harms associated with anal sex, particularly to challenge views that normalise coercion. Teachers, parents and wider society must discuss anal sex with young people openly and, specifically, highlight the importance of "mutuality" – both partners listening and responding to each others' desires and concerns."

Previous research has shown that a significant minority of young people have had anal sex. The new study, published today in BMJ Open, suggests even those not having anal sex may nevertheless be talking about it with friends.

While the interviewees mentioned young men wanting to copy what they saw in porn as an explanation for anal sex, the interviews suggest other factors are more important, the researchers note. These include in some cases a lack of concern about young women's consent, or the levels of they might experience, and competition among to have anal sex with women.

However, the researchers note that not all men coerce their partners, that some may wish to have anal sex and that both partners may find it pleasurable.

Dr Marston added: "Current debates about young people's sex lives often seem to focus narrowly on the impact of porn. But our study suggests we need to think more widely about the lack of importance society places on women's rights, desires and concerns."

Study co-author Dr Ruth Lewis, Research Fellow at the London School of Hygiene & Tropical Medicine, said: "While anal sex might not be the easiest topic to raise, we cannot afford to ignore attitudes that help normalise coercion and negatively affect both and men. Anal sex is part of some young people's sexual lives, and we believe our study makes a powerful case for more open discussion."

The findings come from the sixteen18 project, a wider piece of research on the sex lives of 16 to 18 year olds. The authors note that study participants spanned diverse locations and social groups, and the findings are likely to be relevant to a wide range of across England.

More information: C Marston, R Lewis. Anal heterosex among young people and implications for health promotion: a qualitative study in the UK. BMJ Open. DOI: 10.1136/bmjopen-2014-004996

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