Mental health articles

Oral, Anal, and Penile–Vaginal Intercourse Among 18- to 21-year-olds, approximately 75% report having received or given oral sex (Mosher, Chandra, & Jones, 2005). Oft en treated casually, oral sex is increasingly embraced as a substitute for penile–vaginal intercourse that satisfi es (mostly) male sexual demands while maintaining virginity. Unfortunately, the potential for contracting an STI is also frequently underestimated. Heterosexual anal sex is less common, averaging 22% (Mosher et al., 2005), but may be underreported because of stigma. Although anal stimulation oft en produces sexual arousal in males, heterosexual men who desire or enjoy receptive anal intercourse may experience emotional upheaval and identity crisis if they believe that these desires imply they are gay. As with other sexual matters, a therapist’s ability to convey acceptance allows clients to share these embarrassing desires. Following exploration of possible homoerotic fantasies, a therapist can off er relief by explaining about the proximity of the prostate to the anus and its contribution to arousal.

Heterosexual penile–vaginal intercourse is acknowledged by approximately
90% of 18- to 24-year-olds and occurs at increasingly younger ages, especially
among females (Laumann, Gagnon, Michael, & Michaels, 1994). Various sex
and race diff erences have been found. For example, young women most frequently
report fi rst engaging in intercourse to evoke their partner’s love; black
youth report fi rst intercourse at an earlier age than white and Hispanic youth
(Blum et al., 2000). Compared with young women, young men are more likely
to achieve orgasm and highly rate activities other than intercourse, such as
viewing their partner undress and giving/receiving oral sex (Laumann et al.,
1994). Th ese sex diff erences may be the consequence of females being socialized
to focus on romance, love, and marriage rather than sexuality, which
they’re taught may be dangerous and lead to pregnancy or rape. It is thus not
surprising that following sexual activity young women report greater feelings
of regret, shame, and guilt, though less so when sex occurs within an intimate,
committed relationship. Age of fi rst intercourse also is important. Early onset
of sexual behavior correlates with problematic behaviors—such as substance
abuse, delinquent activities, academic misconduct, increased STI, and female
depression—and may constitute the primary focus of therapy (Crockett, Bingham,
Chopak, & Vicary, 1996).
Inexperienced college students engaging in sexual intimacy for the fi rst
time may be unprepared for disappointment and negative emotions, especially
if the media is their primary instructor. Confl icting motives and expectations
are particularly likely to hurt females, who may benefi t from counseling to
reclaim sexual agency, demystify and normalize sexual libido, and learn to
articulate future needs and establish limits with prospective partners. Among
emotionally or socially unfulfi lled males, a therapist can downplay the physical
pleasures of sex while emphasizing ways in which sexual and romantic
intimacy fulfi lls emotional needs and bolsters psychological resilience.