The Social Construction of Sexual Practice: Setting Sexual Culture and the Body in Casual Sex Between Men

Human sexual behaviour is highly variable and not tightly linked to biological reproduction. However, it has not been studied as social behaviour until the last 40 years and until recently it is largely deviant behaviour that has gained the attention of sociologists. Sociology has adopted an unnecessarily antibiologistic position and consequently neglected the body. In reviewing sociological approaches to sex I draw on social constructionism, particularly the work of Gagnon and Simon (1974) and their notion of scripts; these can be interpreted as discursive structures defining sexual acts and sexual actors at both the individual and societal level. I outline a range of social constructionist positions in relation to sexuality and adopt a moderately radical but realist one that concedes some place for the physiology of arousal linking the elements of the discursive realm of the sexual in social life. Finding the basic assumptions of symbolic interactionism a fruitful base from which to approach sexual conduct I reject the concept of 'desire' as too complex and obscure to serve as a starting point in understanding the social organisation of sex. A review of the ethnographic observational studies of settings in which men have casual sex shows that beats (public places such as parks and toilets) operate in a similar manner in many countries. Commercial sex venues are more varied. They are safer and more comfortable than beats and may offer private rooms and facilities for esoteric sex such as bondage. Sex in such settings is impersonal and anonymous, costs little effort, time or money, and offers a variety of partners. Interaction is largely nonverbal. Interview studies of men who have casual sex with other men tend to undersample men who are not gay-identified, but they offer insights into men's motivations and understandings. Both kinds of research are necessary. The empirical component of the thesis is a thematic analysis of transcripts from three interview studies of gay men in Sydney done between 1993 and 1997: Negotiating Sex (n = 9), the Sites study (n = 21) and the Seroconversion study (n = 70). All involved detailed narratives of sexual encounters. The analysis takes a situational interactionist approach with a specific focus on practice. Central questions asked are: how does the setting (beat, sex venue, home) affect what happens? What does sex mean to the men, and how does this affect what they do? How do men's sexual skills, tastes and experience relate to their practice? How do men's bodies and their understandings of the body affect their practice? What do different sexual practices mean and how are they organised and negotiated within the encounter? How (if at all) do men integrate considerations of safe sex into their practice? Physical surroundings were found to have a profound effect on practice. Sex venues as cultural institutions enable patterns of practice that do not occur elsewhere. Physical arrangements within beats and venues encourage or enable particular practices, such as oral sex or group sex. Motivations for and meanings of sex to the participants varied widely; these were related to practice within the men's own accounts but not in any clear predictive way. Men's sexual skills, tastes and preferences, which were also very varied, related to their practice. Men made trade-offs between risk and pleasure. Men looked for a range of features in casual partners. Suppression of social cues restricted the range of criteria on which partners were selected, enabling wider choice. Men's bodies affected their practice most strikingly in the issue of erection or the lack of it. Understandings of the body and physiological processes affected men's interpretations of information about HIV risk. These men have a vocabulary of sexual practices within which some common practices are less salient. These practices are socially patterned in ways that benefit men with certain tastes and abilities and frustrate those with others. Safe sex considerations are routinely integrated into sexual practice but in a way that leaves room for considerable risk of HIV transmission. In conclusion I argue that conceptualising sex between men exclusively in terms of gay identity and culture is inappropriate. The outcome of the empirical work confirms the theoretical analysis that found it necessary to incorporate some physiological notions, such as 'libido', into a social constructionist view of sex. The findings and their interpretations have important implications for framing effective HIV prevention programs. Some specific suggestions are made for how this might be done

The Social Construction of Sexual Practice: Setting Sexual Culture and the Body in Casual Sex Between Men

Human sexual behaviour is highly variable and not tightly linked to biological reproduction. However, it has not been studied as social behaviour until the last 40 years and until recently it is largely deviant behaviour that has gained the attention of sociologists. Sociology has adopted an unnecessarily antibiologistic position and consequently neglected the body. In reviewing sociological approaches to sex I draw on social constructionism, particularly the work of Gagnon and Simon (1974) and their notion of scripts; these can be interpreted as discursive structures defining sexual acts and sexual actors at both the individual and societal level. I outline a range of social constructionist positions in relation to sexuality and adopt a moderately radical but realist one that concedes some place for the physiology of arousal linking the elements of the discursive realm of the sexual in social life. Finding the basic assumptions of symbolic interactionism a fruitful base from which to approach sexual conduct I reject the concept of 'desire' as too complex and obscure to serve as a starting point in understanding the social organisation of sex. A review of the ethnographic observational studies of settings in which men have casual sex shows that beats (public places such as parks and toilets) operate in a similar manner in many countries. Commercial sex venues are more varied. They are safer and more comfortable than beats and may offer private rooms and facilities for esoteric sex such as bondage. Sex in such settings is impersonal and anonymous, costs little effort, time or money, and offers a variety of partners. Interaction is largely nonverbal. Interview studies of men who have casual sex with other men tend to undersample men who are not gay-identified, but they offer insights into men's motivations and understandings. Both kinds of research are necessary. The empirical component of the thesis is a thematic analysis of transcripts from three interview studies of gay men in Sydney done between 1993 and 1997: Negotiating Sex (n = 9), the Sites study (n = 21) and the Seroconversion study (n = 70). All involved detailed narratives of sexual encounters. The analysis takes a situational interactionist approach with a specific focus on practice. Central questions asked are: how does the setting (beat, sex venue, home) affect what happens? What does sex mean to the men, and how does this affect what they do? How do men's sexual skills, tastes and experience relate to their practice? How do men's bodies and their understandings of the body affect their practice? What do different sexual practices mean and how are they organised and negotiated within the encounter? How (if at all) do men integrate considerations of safe sex into their practice? Physical surroundings were found to have a profound effect on practice. Sex venues as cultural institutions enable patterns of practice that do not occur elsewhere. Physical arrangements within beats and venues encourage or enable particular practices, such as oral sex or group sex. Motivations for and meanings of sex to the participants varied widely; these were related to practice within the men's own accounts but not in any clear predictive way. Men's sexual skills, tastes and preferences, which were also very varied, related to their practice. Men made trade-offs between risk and pleasure. Men looked for a range of features in casual partners. Suppression of social cues restricted the range of criteria on which partners were selected, enabling wider choice. Men's bodies affected their practice most strikingly in the issue of erection or the lack of it. Understandings of the body and physiological processes affected men's interpretations of information about HIV risk. These men have a vocabulary of sexual practices within which some common practices are less salient. These practices are socially patterned in ways that benefit men with certain tastes and abilities and frustrate those with others. Safe sex considerations are routinely integrated into sexual practice but in a way that leaves room for considerable risk of HIV transmission. In conclusion I argue that conceptualising sex between men exclusively in terms of gay identity and culture is inappropriate. The outcome of the empirical work confirms the theoretical analysis that found it necessary to incorporate some physiological notions, such as 'libido', into a social constructionist view of sex. The findings and their interpretations have important implications for framing effective HIV prevention programs. Some specific suggestions are made for how this might be done

Associations between religiosity and sexuality in a representative sample of Australian adults

Many studies have examined the influence on sexual attitudes and behavior of religious belief (i.e., religious denomination) or religiosity (e.g., attendance at services, subjective importance of religion). However, few studies have examined the combined effects of religion and religiosity on sexual attitudes and behavior. This study examined such effects in a representative sample of 19,307 Australians aged 16–59 years (response rate, 73.1%). The study compared members of four religious groups (Protestant, Catholic, Buddhist, Muslim) and two levels of frequency of attendance at religious service (less than monthly, at least monthly). Religious participants were compared to their non-religious peers in analyses adjusted for potential confounding by demographic variables. The outcomes were five sexual behaviors and five corresponding measures of sexual attitudes. The study revealed inconsistent patterns of association between religion/religiosity and a range of sexual behaviors and attitudes. In general, greater attendance at religious services was associated with more conservative patterns of behavior and attitudes. However, religious people who attended services infrequently were more similar to their non-religious peers than their more religious peers. The results of this study highlight the importance of considering not only religion or religiosity, but the intersection between these two variables

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014

The Sydney Women and Sexual Health (SWASH) survey is run by a collaboration of ACON and researchers at the University of Sydney (prior to 2009, researchers were based at the University of New South Wales). It was first carried out in 1996, initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. The survey is regularly revised to reflect the needs of the community and knowledge deficits identified through research literature. Over its lifetime, SWASH has become a comprehensive survey of sexual health and wellbeing, violence, mental health and levels of psychological distress, and a number of other important health issues relevant to lesbian, bisexual and queer (LBQ) women, such as tobacco use, illicit drug use, alcohol consumption, and cancer screening behaviours. Where possible, questions have been used from established national surveys such as the Australian Health Survey, National Drug Strategy Household Survey, Australian Study of Health and Relationships, and Australian Longitudinal Survey of Women’s Health. While research on LBQ women’s health and wellbeing has increased since the birth of the survey, epidemiological data on sexual health, mental health, experiences of abuse and violence and behaviours such as screening, illicit drug use, alcohol and smoking that can leave women vulnerable to adverse health outcomes, is still inconsistent. Moreover, as long as the inclusion of sexuality questions in large epidemiological surveys remains patchy or data is reported only by sexuality and not by sexuality and gender, SWASH provides a unique and important source of health-related information about Australian LBQ women. This report presents results from surveys conducted at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008, 2010, 2012 and 2014.SWASH owes a deep debt of gratitude to ACON, particularly the staff in the Policy, Planning and Research and the Lesbian Health Project, for continued practical and financial support. This research could not have happened without their commitment, enthusiasm and contact

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008, 2010, 2012, 2014, 2016

The Sydney Women and Sexual Health (SWASH) survey is a comprehensive survey of important health issues relevant to lesbian, bisexual and queer (LBQ) women including sexual health and wellbeing, violence, mental health, tobacco use, illicit drug use, alcohol consumption, and cancer screening behaviours. SWASH is run by a collaboration of ACON and researchers at the University of Sydney (since 2009; prior to this researchers were based at the University of New South Wales). It was first carried out in 1996, initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. The survey is regularly revised to reflect the needs of the community and knowledge deficits identified through research literature. Where possible, questions are used from established national surveys such as the Australian Health Survey, National Drug Strategy Household Survey, Australian Study of Health and Relationships, and Australian Longitudinal Survey of Women’s Health. Australian epidemiological data on sexual health, mental health, experiences of abuse and violence, preventive health practices, and behaviours such as illicit drug use, alcohol use and smoking remains inconsistent. The inclusion of sexuality questions in large epidemiological surveys remains patchy, and data is often reported only by sexuality and not by sexuality and gender. In this context, SWASH provides a unique and important source of health-related information on Australian LBQ women. This report presents results from surveys conducted at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008, 2010, 2012, 2014, and 2016. It highlights several areas of particular concern – many of which have persisted over time – where mainstream preventive health interventions that are inclusive of this group or targeted to LBQ women, are needed.ACON Healt

Tobacco smoking and sexual difficulties among Australian adults: a cross-sectional study

Background: Few studies have examined smoking and female sexual difficulties. The aim of this study was to investigate the association between current tobacco smoking and sexual difficulties in Australian men and women. Methods: Data for this study came from the Second Australian Study of Health and Relationships (2012–13), which includes a representative sample of 18 427 sexually active Australian adults (aged 16–69 years). The main study and outcome measures were tobacco smoking and sexual difficulties. A multiple logistic regression analysis was conducted to adjust for potential confounders. Results: Male heavy smokers (>20 cigarettes per day) were significantly more likely than non-smokers to have trouble keeping an erection [adjusted odds ratio (AOR) 4.14, 95% confidence interval (CI) 1.87 – 9.20; P < 0.0001], lack interest in having sex (AOR 2.18, 95% CI 1.20 – 3.97; P = 0.011), have anxiety about performance (AOR 2.46, 95% CI 1.24 – 4.86; P = 0.010) and be unable to come to orgasm (AOR = 2.81, 95% CI 1.23–6.42; P = 0.015). Female smokers were also significantly more likely than non-smokers to not find sex pleasurable (AOR 1.48, 95% CI 1.05 – 2.07; P = 0.025); and light female smokers were significantly more likely than non-smokers to be unable to come to orgasm (AOR = 1.44, 95% CI 1.05–1.98; P = 0.025). Conclusions: Current tobacco smoking was associated with sexual difficulties in both men and women. For women, even light smoking was associated with not finding sex pleasurable and being unable to come to orgasm

Enhancing use of emergency contraceptive pills: A systematic review of women’s attitudes, beliefs, knowledge and experiences in Australia

Over a decade after emergency contraceptive pills (ECPs) became available without a prescription, the rate of unintended pregnancies remains high in many settings. Understanding women’s experiences and perceptions of ECPs may provide insights into this underutilisation. We systematically searched databases to identify qualitative and quantitative primary studies about women’s beliefs, knowledge and experiences of ECPs in Australia. Findings demonstrate persistent misunderstandings around access, how ECPs work, and a moral discourse around acceptable versus unacceptable use. Addressing knowledge and the stigma around ECPs use is fundamental to increasing the use of this medically safe and effective strategy

Women in contact with the Sydney gay and lesbian community: Report of the Sydney Women and Sexual Health (SWASH) Survey 2006, 2008 and 2010

The Sydney Women and Sexual Health (SWASH) survey was first carried out in 1996. It was initiated by workers from two ACON projects, Women Partners of Gay and Bisexual Men and the Gay and Lesbian Injecting Drug Use Project, who were faced with a lack of empirical evidence on which to base their intervention work. While research on same-sex-attracted women’s health and wellbeing has increased since then, epidemiological data on sexual health, mental health, experiences of abuse and violence and behaviours such as screening, illicit drug use, alcohol and smoking that can leave women vulnerable to adverse health outcomes, is still scarce. Moreover, as long as the inclusion of sexuality questions in large epidemiological surveys remains patchy or data is reported only by sexuality and not by sexuality and gender, SWASH provides a unique and important source of health-related information in Australian lesbian, bisexual and queer (LBQ) women. SWASH has been run biennially since 1996 by a collaboration of ACON and researchers at the University of New South Wales (until 2009), and now the University of Sydney (since 2010). The survey is regularly revised to reflect the needs of the community and research needs identified through research literature. Over its lifetime, SWASH has become a comprehensive survey of sexual health and wellbeing, violence, mental health and levels of psychological distress, and a number of other important health issues relevant to LBQ women, such as illicit drug use, alcohol consumption, and cancer screening behaviours. Where possible, questions have been used from established national surveys such as the National Drug Strategy Household Survey (NDSHS), the Australian Study of Health and Relationships (ASHR), and the Australian Longitudinal Survey of Women’s Health (ALSWH). This report presents results from surveys collected at the Sydney Gay and Lesbian Mardi Gras Fair Day and other community events and venues during the Sydney Gay and Lesbian Mardi Gras seasons in 2006, 2008 and 2010

Romantic jealousy: a test of social cognitive and evolutionary models in a population-representative sample of adults

Whereas sexually dimorphic evolutionary models argue for clear sex differences in responses to jealousy-evoking scenarios, social cognitive models emphasize the importance of other factors. This paper explores variables associated with responses to a commonly-used jealousy-evoking scenario in a population-representative sample. Data from 8,386 Australian men and women aged 16-69 were weighted to match the population. The results provided some support for evolutionary models among heterosexual respondents, but findings contrary to evolutionary models were found among non-heterosexual respondents. Support for social cognitive models was provided by the identification of six variables that had significant independent multivariate associations with jealousy: sex, age, education, lifetime number of partners, relationship status, and attitudes toward infidelity. The results suggest that although men and women may tend to respond differently to sexual or emotional infidelity scenarios, the anticipated experience of jealousy in each context is strongly influenced by biographical and cultural factors

Reproductive experiences and outcomes among a representative sample of women: the second Australian study of health and relationships

Objective: To enumerate pregnancy outcomes for a representative sample of women in Australia surveyed in 2012–2013 (primary aim) and compare these with women surveyed in 2001–2002 (secondary aim). Methods: Computer-assisted telephone interviews with over 10,000 women aged 16–69 years (participation rate 68.4%). Results are weighted for chance of selection and to reflect the population as a whole. Results: Of women with experience of vaginal intercourse, 75.1% had ever been pregnant, 18.4% reported difficulties getting pregnant and 10.0% had had fertility treatment. Of those who had been pregnant, 91.3% had ever had a live birth, 34.3% a miscarriage, 22.8% an abortion and 2.3% a stillbirth; 0.9% had relinquished a child for adoption. The proportion first pregnant in their 30s was 11% among women aged 60–69 and 26% among those aged 40–49. Fewer older women reported difficulties getting pregnant. Of the 21,882 pregnancies reported, 70% led to live births and 10% were terminated. Compared with our 2001–2002 survey, fewer women reported ever having been pregnant. Giving up newborns for adoption has become very rare. Conclusions: Falling fertility since the 1960s reflects greater access to contraception and abortion and higher opportunity costs of childbearing. Implications for public health: These findings on women's lifetime reproductive experiences complement routine annual data collections