London School of Hygiene & Tropical Medicine

New results published in The Lancet as part of the third National Survey of Sexual Attitudes and Lifestyles (Natsal) reveal how sexual behaviour and attitudes in Britain have changed in recent decades. Data from three Natsal studies, carried out every ten years, demonstrate changes in age at first sex, number of sexual partners, and prevalence of sexual practices, as well as attitudes towards sex.

In this study, researchers led by Dr Cath Mercer from UCL in partnership with the London School of Hygiene & Tropical Medicine and NatCen Social Research, interviewed 15,162 people aged 16-74 resident in Britain during 2010-12. The survey was originally carried out in 1990-91 and then again in 1999-2001, but only amongst people 16-44 years. This time round for the first time, the survey has recorded behaviour patterns and attitudes in those up to age 74.

Over the last 60 years, age at first heterosexual intercourse has declined to an average [median] of 16 years among 16-24 year olds. Among this age group, the latest survey found that 31% of men and 29% of women now have first sex before age 16, which is not significantly different from the figures from the previous survey (1999-2001), and so is still a minority.

Study co-author Professor Kaye Wellings, of the London School of Hygiene & Tropical Medicine, said: "The change in women’s behaviour across the three surveys has been remarkable. In some areas of sexual behaviour we have seen a narrowing of the gender gap, but in others we have seen women overtaking men in the diversity of their behaviour. These trends need to be seen against the backdrop of the profound changes in the position of women in society, the norms governing their lifestyles, and media representations of female sexuality."

The latest survey interviewed people up to age 74 years, and showed that people continue to have sex into later life, with 42% of women and 60% of men aged 65-74 years reporting having had at least one opposite sex sexual partner in the previous year, although the range and frequency of sex reduced with age.

Frequency of sex has fallen over the past decade to just under five times a month for both sexes (an average [mean] of 4.9 for men and 4.8 for women) amongst those aged 16-44 years, from means of 6.2 and 6.3, respectively, in the previous survey. This is explained in part by demographic change with fewer people in the population married or cohabiting and so having less opportunity to have sex, although even among people who live with their partner sexual frequency has declined.

Overall, a similar proportion of men (95%) and women (96%) reported ever having had at least one opposite-sex partner. In the age group 16-44 years, the average number of partners over a woman’s lifetime has more than doubled since the first survey (in 1990-91), from an average [mean] of 3.7 in 1990-91 to 7.7 in the latest survey. In men, this figure has increased from 8.6 to 11.7, suggesting a narrowing of the gender gap.

Whilst the number of men reporting having same-sex partners has changed little from 3.6% in the first study to 4.8% this time around, for women the figure has increased four-fold, from 1.8% to 7.9%.

The number of people reporting heterosexual oral sex in the past year remained constant since the previous survey (1999-2001), at just over three-quarters of men and women aged 16-44 (77% and 75% respectively). However, there has been an increase in the minority of people reporting anal sex in the past year, up from 12% to 17% for men, and from 11% to 15% for women. Reporting two or more partners in the past year and no condom use during this time – a measure of unsafe sex – was less frequent among men in this survey than in the previous survey, down from 14% to 11%.

The survey has also illustrated changing attitudes in those aged 16-44 years over the past two decades. Whilst previously, fewer than one in four men thought same sex partnerships were ‘not wrong at all’ (22% for male same-sex partnerships and 24% for female), the figure is now approximately half (48% and 52% respectively); in women, the increase has been even greater, from less than one in three women in 1990-91 (28% for male same-sex partnerships and 28% for female) to two in three women today (66% and 66%, respectively).

By contrast, there is now greater disapproval of non-exclusivity in marriage amongst both men (increasing from 45% to 63%) and women (from 53% to 70%). One in five men (20%) now see nothing wrong in ‘one-night stands’, the same proportion as in 1990-91, but the number of women holding this view has increased from 5.4% to 13% over the same period.

The study was funded by the Medical Research Council and The Wellcome Trust, with additional funding from the Economic & Social Research Council and the Department of Health.

• Catherine H Mercer, Clare Tanton, Philip Prah, Bob Erens, Pam Sonnenberg, Soazig Clifton, Wendy Macdowall, Ruth Lewis, Nigel Field, Jessica Datta, Andrew J Copas, Andrew Phelps, Kaye Wellings, Anne M Johnson. Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (Natsal). The Lancet. DOI: 10.1016/S0140-6736(13)62035-8