Talking about sex

26 August 2015

Earlier this year, we held some in-gallery discussions in the Institute of Sexology exploring the definitions and terms used in Britain’s Natsal survey for different aspects of sexual behaviour, and how these map onto visitors’ own ideas about sex. Soazig and her team look at how you describe something as fluid as sex.

In the late 1980s, amid growing fear and uncertainty about the spread of HIV and AIDS in Britain, the idea for a large-scale representative national sex survey was born. The aim was to use the best available sampling methods to collect robust, reliable, data for a National Survey of Sexual Attitudes and Lifestyles; the first time something like this had been attempted anywhere in the world.

But once you’ve got your representative sample, how do you actually go about asking those difficult questions? What kind of language do you use to make sure that people of all ages, and from all backgrounds, can understand – and will answer – the questions? Are some questions too offensive or personal to ask?

 The front page from the 1990 Natsal survey, showing the definitions of activities.

The front page from the 1990 Natsal self-completion booklet, showing the definitions of activities.

In May, we held a series of in-gallery discussions in the Institute of Sexology exploring the definitions and terms we used in Britain’s National Survey of Sexual Attitudes and Lifestyles (Natsal) for different aspects of sexual behaviour, and how these map onto visitors’ own ideas about sex.

First things first, what do we mean by “sex”? We asked visitors to think of all the different sexual things people might do and write them on sticky notes. This, they obediently did. Some even drew pictures. We then asked them to stick the notes under the headings “sexual intercourse or having sex” or “any other type of experience of a sexual kind”. This was trickier.

For many people, the idea of grouping sexual activities like this didn’t make sense and they questioned our need to label and define. For others there were clear distinctions: people generally agreed that sexual intercourse had to involve more than one person, and had to involve penetration, whereas other sexual experiences could include things like kissing, massage, masturbation, fantasy and phone sex.

 The post-it notes generated during the discussions about what

The post-it notes generated during the discussions about what “sex” is.

Although no group came up with a clear consensus about what counted as sex, most people understood the need for researchers to settle on some kind of definition so that participants are all thinking of the same thing when they answer the questions. For our findings to be useful for public health, we need information on the specific physical acts that people have engaged in. However, in real life sex is rarely a purely physical “act” and over time the survey has evolved to include more questions about the emotional and social aspects of sex and relationships.

The Natsal questionnaire covers topics ranging from how people first learned about sex when they were growing up to the wide range of experiences they may have had since, and their current views on different types of sexual relationships.

How do the questions stand up to scrutiny from members of the public? We borrowed techniques from cognitive interviewing (a method of testing questionnaires for comprehension, acceptability and ease of recall) to probe visitors’ understanding of the questions we use on Natsal. What did they think the question was getting at? Would they be able to answer accurately? How would they feel about being asked these questions?

 Soazig leading the discussion in our Sexology exhibition.

Soazig leading the discussion in our Sexology exhibition.

On the whole, people said our questions were clear and easy to understand and felt that they’d be happy to answer them, quite a relief given the work we put into designing and testing them. However, there were some criticisms: some found our questions implied certain norms when it comes to sex or identity and that there was an underlying assumption in some questions that a particular sexual experience was consensual.

Others laughed about the old-fashioned wording; perhaps our questions haven’t quite caught up with the way technology has changed people’s sexual and romantic lives.

 “The internet? That’s a bit 1990’s isn’t it? I can almost hear the modem clunking in the background!”

“The internet? That’s a bit 1990’s isn’t it? I can almost hear the modem clunking in the background!”

It won’t be long before we start thinking about doing another Natsal survey, which would be the fourth in a series carried out every 10 years since 1990. When we do, we’ll be faced again with the challenge of balancing the need to keep the wording consistent so that we can look at change over time, while at the same time making sure that our questions are inclusive, relevant and reflect the diversity of people’s sex lives.

For more about how the original Natsal definitions were devised, based on interviews with members of the public in the late 1980s, the original “Talking about sex” report can be downloaded here.

Soazig Clifton is an NIHR Research Methods Fellow at University College London, and a Senior Researcher at NatCen Social Research. She is part of the core research team for the National Survey of Sexual Attitudes and Lifestyles (Natsal).

Oxana Metiuk is an Interviewer at NatCen Social Research, and has worked both on the development of the Natsal questionnaire, and also conducting Interviews for the main study. She was the North-West of England Project Manager for the study fieldwork.

Hayley Lepps is a Researcher at NatCen Social Research, specialising in health research and cognitive testing of questionnaires.