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Sexual Health, 2014, 11, 451–460 http://dx.doi.org/10.1071/SH14117

Sexual identity, sexual attraction and sexual experience: the Second Australian Study of Health and Relationships Juliet Richters A,J, Dennis Altman B, Paul B. Badcock C,D, Anthony M. A. Smith C,I, Richard O. de Visser E, Andrew E. GrulichF, Chris RisselG and Judy M. SimpsonF A

School of Public Health and Community Medicine, UNSW Australia, Sydney, NSW 2052, Australia. Office of the Vice-Chancellor, La Trobe University, Bundoora, Vic. 3086, Australia. C Australian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia. D Centre for Youth Mental Health, University of Melbourne, Orygen Youth Health Research Centre, 35 Poplar Road, Parkville, Vic. 3052, Australia. E School of Psychology, Pevensey 1, University of Sussex, Falmer BN1 9QH, UK. F The Kirby Institute, Wallace Wurth Building, UNSW Australia, Sydney, NSW 2052, Australia. G Sydney School of Public Health, Charles Perkins Centre (D17), University of Sydney, Sydney, NSW 2006, Australia. H Sydney School of Public Health, Edward Ford Building (A27), University of Sydney, Sydney, NSW 2006, Australia. I Deceased. J Corresponding author. Email: [email protected] B

Abstract. Background: Behavioural and other aspects of sexuality are not always consistent. This study describes the prevalence and overlap of same-sex and other-sex attraction and experience and of different sexual identities in Australia. Methods: Computer-assisted telephone interviews were completed by a representative sample of 20 094 men and women aged 16–69 years recruited by landline and mobile phone random-digit dialling with a response rate (participation rate among eligible people) of 66.2%. Respondents were asked about their sexual identity (‘Do you think of yourself as’ heterosexual/straight, homosexual/gay, bisexual, etc.) and the sex of people with whom they had ever had sexual contact and to whom they had felt sexually attracted. Results: Men and women had different patterns of sexual identity. Although the majority of people identified as heterosexual (97% men, 96% women), women were more likely than men to identify as bisexual. Women were less likely than men to report exclusively other-sex or same-sex attraction and experience; 9% of men and 19% of women had some history of same-sex attraction and/or experience. Sexual attraction and experience did not necessarily correspond. Homosexual/gay identity was more common among men with tertiary education and living in cities and less common among men with blue-collar jobs. Many gay men (53%) and lesbians (76%) had some experience with an other-sex partner. More women identified as lesbian or bisexual than in 2001–02. Similarly, more women reported same-sex experience and same-sex attraction. Conclusion: In Australia, men are more likely than women to report exclusive same-sex attraction and experience, although women are more likely than men to report any non-heterosexual identity, experience and attraction. Whether this is a feature of the plasticity of female sexuality or due to lesser stigma than for men is unknown. Additional keywords: asexuality, bisexuality, heterosexuality, homosexuality, same-sex attraction, sexual behaviour, sexual orientation. Received 18 June 2014, accepted 23 August 2014, published online 7 November 2014

Introduction Categorising a person’s sexuality is not a simple matter of asking them a single question about their ‘orientation’. There are at least three aspects to consider: (1) how people describe or think of themselves; (2) whether they say they are or have been attracted Journal compilation  CSIRO 2014

to males and/or females; and (3) whom they have had sex with (in the widest definition of what counts as ‘sex’).1,2 Even these three aspects of sexuality omit how one is seen by others (a matter not readily accessible to survey research) and indeed wider questions of types of, or motives for, sexual www.publish.csiro.au/journals/sh

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attraction that are independent of gender. Change over time is also omitted. Even asking these questions, let alone answering them, can be difficult for people from cultures where same-sex attraction or activity is taboo and hidden, and social roles that would enable the adoption of a non-heterosexual identity are absent. In these situations, there may be no word for the Western concept ‘heterosexual’, and indeed this concept may be unknown even to some people who have a word or concept for something like ‘queers’, ‘ladyboys’ or ‘deviants’. US researchers have encountered difficulties in finding non-pejorative terms in Spanish to describe homosexuality,1 which is possibly a reason for the high non-answer rate to sexual identity questions in the Spanish versions of questionnaires.3 In Australia, some of us have encountered a few Asian respondents to conveniencesample surveys who were unfamiliar with the term ‘heterosexual’, although they could apply a meaning to ‘homosexual’. There is considerable historical debate about when a specific homosexual identity emerged, but it is most clearly linked to the development of modern industrial societies, the growth of cities and the emergence of consumer culture.4–6 In Australia, it was probably not until the 20th century that there were people who identified as homosexual,7 and the term ‘gay’ came into the Australian language after the emergence of a gay movement in the 1970s, originally to include women as much as men. More recently, there have been ongoing international and local debates about whether to include bisexuals and trans (transgender, transsexual) people in some overall concept of sexual and gender difference, and ongoing, although largely academic, debates about the use of the term ‘queer’ to embrace all forms of sexual and gender non-conformity.8 The emergence of heterosexuality not only as a norm but as an identity in itself is more recent still.9 Data from representative surveys in other English-speaking countries suggest that approximately 90–98% of people regard themselves as heterosexual and approximately 2–5% identify as homosexual (i.e. gay or lesbian) or bisexual.3,10–12 In the first Australian Study of Health and Relationships (ASHR1), 97% of men and 98% of women identified as heterosexual in answer to the question ‘Do you think of yourself as . . .?’, given the three response options of heterosexual, homosexual (gay or lesbian) and bisexual. Men were more likely to identify as gay than bisexual and women were more likely to say they were bisexual than lesbian. More people had some lifetime same-sex experience or same-sex attraction (9% of men and 15% of women) than currently identified as homosexual or bisexual.13 The aim of this paper is to report current data on sexual identity, sexual attraction and sexual experience with same-sex partners, and describe changes between 2002 and 2013. Methods The methodology used in the Second Australian Study of Health Relationships (ASHR2) is described in detail elsewhere in this issue.14 Briefly, between October 2012 and November 2013, computer-assisted telephone interviews were completed by a representative sample of 20 094 Australian residents aged 16–69 years from all states and territories. Respondents were

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selected using dual-frame modified random-digit dialling (RDD), combining directory-assisted landline-based RDD with RDD of mobile telephones. The overall participation rate among eligible people was 66.2%. To maximise the number of interviews with people who had engaged in less common and/or more risky behaviours, all respondents who had had no sexual partners in the previous year, who had had more than one partner in the previous year and/or who reported homosexual experience completed a long form of the survey instrument, which collected detailed data on their sexual attitudes, relationships and behaviours. Of respondents who reported one partner in the previous year and no homosexual experience, 20% were randomly selected to complete the long-form interview and the other 80% completed a short-form interview. Answers to questions that occurred only in the long-form interview are reported after weighting to reflect the sample as a whole. Respondents were asked about their sexual identity, sexual attraction and sexual experience (Box 1). The words ‘males’ and ‘females’ were used in the questions rather than ‘men’ and ‘women’ so as not to exclude responses from young people who might think of their partners as boys and girls rather than adult men and women. The term ‘sexual identity’ is used in this article to mean self-identification as gay, lesbian, straight, bisexual, etc., rather than in the psychiatric sense of identification as male or female (gender identity). Throughout this paper, the terms ‘gay men’, ‘lesbians’ and ‘bisexuals’ are used only to refer to people who self-identify in this way (i.e. not to refer to people who are same-sex attracted or have same-sex experience). Correlates of the main outcomes examined in this paper included a range of demographic characteristics, recoded to facilitate analysis. Respondents’ ages were recoded into six groups: 16–19, 20–29, 30–39, 40–49, 50–59 and 60–69 years. Language spoken at home was recoded as English or a language other than English. Respondents’ reported highest completed level of education was recoded to distinguish between those who had not (yet) completed secondary school, those who had completed secondary school and those who had completed post-secondary education. Respondents’ postcodes were used with the Accessibility/Remoteness Index of Australia (ARIA)15 to determine whether respondents lived in a major city, a regional area, or a remote area (i.e. areas with relatively unrestricted, restricted, and very restricted access to goods, services and opportunities for social interaction respectively). To approximate the gross annual household income quintiles reported by the Australian Bureau of Statistics for 2009–10,16 respondents’ reported annual income was grouped into five categories: less than $28 000, $28 001–$52 000, $52 001–$83 000, $83 001–$125 000 and more than $125 000. Respondents’ reported occupation was coded into the nine major categories of the Australian Standard Classification of Occupations,17 and then recoded to distinguish between managerial/professional occupations, white-collar occupations and blue-collar occupations. Finally, the main outcome variables were compared with those of ASHR1 to identify significant changes over time. Data were weighted to adjust for the probability of each respondent being selected for a landline or mobile phone interview and (for landline participants), the number of in-

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Box 1. Ascertainment of sexual identity, attraction and experience among men

Corresponding questions were asked of women, with ‘gay’ replaced with ‘lesbian’, and responses 1–5 reversed for the latter two questions. Do you think of yourself as . . . (Interviewer reads out categories 1 to 3 with numbers. Interviewer codes ‘normal’ as 1.)

1. 2. 3. 4. 5. 6. 9.

Heterosexual or straight Homosexual (gay) Bisexual Queer Not sure; undecided Something else/other (Interviewer types in response as well as code.) Refused

Which of these six statements best describes you? I will read them out and ask you to please just give me the number.

1. 2. 3. 4. 5. 6. 9.

I have felt sexually attracted only to females, never to males. More often to females, and at least once to a male. About equally often to females and to males. More often to males, and at least once to a female. Only to males, never to females. I have never felt sexually attracted to anyone at all. Refused.

In the next question when we say ‘sexual experience’ we mean any kind of contact with another person that you felt was sexual. It could be kissing or touching, or intercourse, or any other form of sex. Which of these statements best describes you? Again I will read out the list and you tell me the number.

1. 2. 3. 4. 5. 6. 9.

I have had sexual experiences only with females, never with males. More often with females, and at least once with a male. About equally often with females and with males. More often with males, and at least once with a female. Only with males, never with females. I have never had any sexual experience with anyone at all. Refused.

scope adults in the household. Data were then weighted to match the Australian population on the basis of age, gender, area of residence (i.e. state by ARIA category) and telephone ownership (i.e. mobile telephone only vs other). The data were thus weighted to account for the specifics of our sample design and the fact that particular types of people were slightly overor under-represented. The data presented therefore describe the Australian population aged 16–69 years, subject to the biases noted elsewhere in this issue.14 Weighted data were analysed using the survey estimation commands in Stata version 11.2.18 Correlates of outcome variables were identified using univariate logistic regression (dichotomous outcome variables) and univariate linear regression analyses (continuous outcome variables). Percentages are presented in this article without standard errors or 95% confidence intervals. This decision was made to maximise both readability and brevity and is in keeping with the style of other studies of a similar scope and intent.12,19,20 Further information about the precision of estimates is found

elsewhere in this issue.14 Due to the large number of participants in ASHR2, the study has the statistical power to detect even small differences between groups as statistically significant, but these do not necessarily correspond to important differences in sociological terms. Results Table 1 displays data relating to sexual identity, sexual attraction and sexual experience with male and female partners. Men and women had different patterns of sexual identity. Men and women did not differ significantly with respect to those, the great majority, who identified as heterosexual (OR: 0.89; 95% CI: 0.74–1.08). However, significantly more men than women indicated that they were exclusively attracted to the other sex (OR: 0.43; 95% CI: 0.39–0.48) and had only had sexual experience with members of the other sex (OR: 0.50; 95% CI: 0.45–0.55). Women were significantly less likely than men to report a homosexual identity and significantly more

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Table 1. Prevalence of different forms of sexual identity, sexual attraction and sexual experience among men and women Unless indicated otherwise, data show the percentage of respondents in each category. Unadjusted odds ratios (OR) and 95% confidence intervals (CI) are given for women versus men, as determined by multinomial logistic regression Identity, attraction and experience

Men (n = 10 056)

Women (n = 10 037)

OR (95% CI)

Sexual identity Heterosexual Homosexual Bisexual Undecided/other Refused

96.7 1.9 1.3 0.1 0.0

96.3 1.2 2.2 0.2 0.0

1 0.65 (0.50–0.84) 1.78 (1.35–2.34) 1.53 (0.71–3.30) –A

Sexual attraction Exclusively to other sex Predominantly to other sex Equally often to both sexes Predominantly to same sex Exclusively to same sex No one Refused

92.8 4.4 0.4 1.0 1.1 0.3 0.1

84.8 11.9 1.4 0.9 0.5 0.4 0.1

2.95 3.71 1.01 0.45 1.57

1 (2.57–3.37) (2.47–5.55) (0.72–1.42) (0.30–0.67) (0.82–3.01) –A

Sexual experience Exclusively with other sex Predominantly with other sex Equally often with both sexes Predominantly with same sex Exclusively with same sex No one Refused

91.2 4.2 0.3 1.1 0.9 2.3 0.1

83.7 11.6 0.8 0.8 0.3 2.6 0.2

3.02 3.26 0.83 0.35 1.25

1 (2.64–3.44) (1.92–5.52) (0.60–1.15) (0.22–0.57) (0.98–1.61) –A

A

Too few people to compute.

Table 2. Relationship between lifetime sexual attraction and lifetime sexual experience among men and women Data exclude the people (2.8%) who said they had no sexual experience and/or no sexual attraction. Data show the percentage of respondents in each category with confidence intervals in parentheses Sexual attraction Exclusively with other sex

Sexual experience At least some with same sex

Total

Men (n = 9797) Exclusively to other sex At least some to same sex Total

91.1 (90.4–91.7) 2.4 (2.0–2.7) 93.4 (92.8–94.0)

2.0 (1.7–2.3) 4.6 (4.1–5.1) 6.6 (6.0–7.2)

93.1 (92.5–93.6) 6.9 (6.4–7.5) 100.0

Women (n = 9731) Exclusively to other sex At least some to same sex Total

80.8 (79.9–81.7) 5.3 (4.8–5.8) 86.2 (85.3–87.0)

4.2 (3.7–4.7) 9.6 (8.9–10.3) 13.8 (13.0–14.7)

85.2 (84.4–86.0) 14.8 (14.0–15.6) 100.0

likely to identify as bisexual. Similarly, women were less likely than men to report exclusively other-sex or exclusively same-sex attraction and experience and were more likely to report a mixture of same-sex and other-sex attraction and experience. Although ‘queer’ was available for coding as a response option (although not read out to respondents), only three people identified as queer; they have been omitted from the analyses that follow. Table 2 shows the relationship between history of sexual attraction to and sexual experience with male and female people, among respondents who were sexually experienced. The data reveal that 91.1% of men and 80.8% of women

have exclusively other-sex experience and attraction. In other words, 8.9% of men and 19.2% of women have some history of same-sex attraction and/or experience. Table 2 also shows that for 4.4% of men and 9.5% of women, sexual attraction does not match sexual experience. Women were significantly more likely than men to report a disjunction between attraction and experience, both in terms of having been attracted to one or more other females but not acted upon it and having had sexual contact with one or more females without feeling same-sex attraction. Overall, the great majority of respondents had had some form of sexual experience with an other-sex partner (men 96.7%,

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Table 3. Sociodemographic and behavioural correlates of current sexual identity among men Unless indicated otherwise, data show the percentage of respondents in each category. Note, n varies because of missing data for correlates Correlate Heterosexual (n = 9725)

Sexual identity Homosexual (n = 189)

P-value Bisexual (n = 126) $125 000

13.5 14.2 21.1 21.6 29.7

15.6 19.4 21.0 18.6 25.4

17.1 28.1 16.4 15.1 23.3

Occupational category Blue collar White collar Manager/professional

36.5 23.0 40.5

10.8 42.3 46.9

27.4 37.0 35.7

Sexual experience Only with females With both males and females Only with males

96.3 3.7 0.0

3.0 48.1 48.9

17.4 81.4 1.3

Sexual attraction Only to females To both males to females Only to males

96.0 4.0 0.0

1.8 42.0 56.3

7.9 90.3 1.9

0.26

0.001

0.05

0.02

Sexual identity, sexual attraction and sexual experience: the Second Australian Study of Health and Relationships.

Background Behavioural and other aspects of sexuality are not always consistent. This study describes the prevalence and overlap of same-sex and other...
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