Perceptions and attitudes toward sexual norms: key insights from the International Society of Sexual Medicine Young Researchers Committee survey.

Background: Sexuality is a complex aspect of human life, and the perception of sexual normality may vary across genders, religious beliefs, and other aspects.

Aim: To report preliminary findings of a pilot survey on sexual attitudes, behaviors, and individual perception of sexual normality in a contemporary cross-cultural scenario.

Methods: A 48-item survey was developed by the Young Researchers Committee (YRC) on behalf of the International Society for Sexual Medicine (ISSM) to collect data on cross-cultural perceptions and attitudes toward sexual norms. The survey consisted of questions related to sexual attraction, behavior, identity, orientation, and subjective perception of sexual normality. Data were collected via five translated versions across five countries (Italy, United States, Brazil, Spain, and Japan) and analyzed to investigate how cultural norms, personal experiences, and social expectations shape individuals' views on sexual normality.

Outcomes: The primary outcome was to assess gender-based differences in sexual behaviors, satisfaction, religious beliefs' impact, pornography use, and anatomical perceptions.

Results: This pilot study included 3423 respondents [63.5% female, 36.2% male; median (IQR) age 39 (30.00, 50.00) years]. Of all, active sexual life was reported by 83.3% participants, with 58.8% expressing satisfaction with their sex life. Heterosexual orientation was predominant (90%), with significant differences in distribution between genders in terms of sexual orientation (P < .001). Religious influence on sexual activity was reported by 18.6% of respondents, more commonly among females (20.2% vs 15.8%, P < .001). Median ages of first sexual intercourse and pornography exposure were 18 (16.00, 19.00) and 14 (12.00, 16.00) years, respectively, with females reporting older ages for both experiences (P < .001). Regarding perceptions of normality, most respondents (55.6%) believed first sexual intercourse typically occurs between 16 and 19 years. The perception of normal erect penile length differed between genders, with men more likely to report greater values (>16.1 cm: 13.1% vs 6.2%, P < .01). Gender differences were also observed in orgasm frequency, with fewer females reporting orgasm during >80% of sexual encounters (38.2% vs 66.5%, P < .001).

Clinical implications: Our findings shape the development of sexual education, fostering inclusivity, equity, and sexual health for overall satisfaction.

Strengths and limitations: Possible biases associated with different modalities throughout data collections and with different linguistic and cultural weights given the cross-sectional nature of the pilot survey.

Conclusion: Current preliminary findings from the pilot survey developed by the ISSM YRC start shedding lights on perceptions and attitudes toward sexual norms, and gender differences in sexual behaviors and satisfaction.