Anal sex

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Anal sex or anal intercourse is a form of human sexual behavior. While there are many sexual acts involving the anus, anal cavity, sphincter valve and/or rectum, the term "anal sex" is often used to mean the insertion of the penis into the rectum. It is a form of sexual intercourse considered to be particularly risky, for a number of reasons related to the vulnerability of the tissues and the septic nature of the anus.

Such relations have been documented in a wide range of cultures, from earliest times. Where they involved two males, they have also been controversial and sometimes condemned since antiquity. Anal sex is encountered among people of all sexual identities and orientations. While it is reported more frequently among male couples, in absolute numbers more heterosexual couples have anal sex.

Penile-anal sex

Female receptive

In several cultures female receptive anal intercourse in a heterosexual context is widely accepted, especially as there is lower risk of unwanted pregnancy via unprotected anal intercourse (though this is not an absolute guarantee, since semen can leak from the anus, across the perineum, and enter the vagina). Anal sex is even sometimes seen as preserving female virginity, because it leaves the hymen intact. Another reason is that the anus is considered to be "tighter" than the vagina (especially right after a delivery), therefore yielding more tactile pleasure for the penis. The Renaissance poet Pietro Aretino strongly recommended the practice of anal sex in his Sonetti Lussuriosi (Lust Sonnets). Studies such as that done by Kinsey have suggested that approximately 35-40% of women who have experienced anal sex find it pleasurable, though this figure may vary depending on many factors.

Anal sex and technical virginity

Some historians and anthropologists note that many societies that place a high value on virginity before marriage, such as the United States before the sexual revolution, actually have a large amount of premarital sexual activity that does not involve vaginal penetration: e.g., oral sex, anal sex [Citation needed] and mutual masturbation. Some refer to this as "technical" virginity. In Norman Mailer's novel Harlot's Ghost, a character states that in Italy, an unmarried woman had to be "a maiden before and a martyr behind," which implied that such women often resorted to anal sex, and anal sex was consistently painful.


Edward O. Laumann's The Social Organization of Sexuality: Sexual Practices in the United States found that about 20% of heterosexuals have engaged in anal sex, and sex researcher Alfred Kinsey found that number to be closer to 40%. More recently, a researcher from the University of British Columbia (quoted in the May 5 2005 issue of The Georgia Straight) puts the number of heterosexuals who regularly practice anal sex at between 30% and 50%. A French survey of five hundred female respondents concluded that a total of 29% had practiced anal sex, though only one third of these claimed to have enjoyed the experience.Cite error: Closing </ref> missing for <ref> tag The Gay Urban Men's Study (P.I. Stall, UCSF) and the Young Men's Study (YMS, PI Osmond/Catania, UCSF), indicate that 50% of men surveyed engage in anal sex. The Laumann study claims that 80% of gay men practice it, while the remaining 20% never engage in it at all.

Anatomical homologies

Though women can enjoy receptive anal intercourse, or even insertive anal intercourse (through use of a strap-on dildo or other object), only men have fully developed prostates, also known as "male G-spots", "P-spots", or "A-spots". The prostate is located near mens' rectums and is the larger, more developed male homologue to the Skene's glands, also known as the "G-spot" or "female prostate", which are located near women's vaginas. Rectal stimulation of the prostate gland, either by a penis, or sex toy can result in very pleasurable sensations. Stimulation of the prostate gland can lead to a distinct type of orgasm in some cases.

Other types of anal sexuality

Anal sex can be achieved through penetration via penile insertion, but this does not have to be the case. When the active partner is a female or a male who does not wish to use his penis, he or she might utilize other appendages, including but not limited to fingering and fisting. Rimming (the manipulation of the anus by the mouth and tongue) is also common, either by itself or in tandem with other acts intended to produce physical arousal and climax.

Such individuals might also choose to employ an artificial apparatus, primarily phallic reproductions (strap-on dildos), of which a diverse selection of style and manufacturer exists. Other accoutrements of a similar design are also often employed: these are generally engineered specifically for anal penetration (butt plugs). When the female is the penetrator and the receiver is a male, it is referred to as pegging.


The rectum can contain a disruptive amount of fecal matter when anal sex is performed, but it isn't necessarily so. Nina Hartley, in Nina Hartley's Guide to Anal Sex, points out that anal sex is not necessarily messy because the rectum is usually empty: it only contains a significant amount of feces at the point when it needs to be emptied. Once the rectum is emptied normally, it contains only trace amounts of feces. Enemas can also be used to empty the rectum.

Risks and protective measures

Anal sex exposes the participants to hazards of two kinds: infections, due to the high number of infectious microorganisms not found elsewhere on the body, and physical damage to the anus and the rectum due to their vulnerability. An insufficient amount of lubricant can make it especially painful or injurious.

Infectious diseases

Among the diseases with which anal sex is associated are HIV, anal cancer, typhoid fever[1] and various diseases associated with the infectious nature of fecal matter or sexual intercourse in general. Among these are: Amoebiasis; Chlamydia; Cryptosporidiosis; Giardiasis; Gonorrhea; Hepatitis A; Hepatitis B; Hepatitis C; Herpes simplex; Human papillomavirus; Lymphogranuloma venereum; Pubic lice; Salmonellosis; Shigella; Syphilis; Tuberculosis.


The high concentration of white blood cells around the rectum, together with the risk of cuts to the rectum and that one of the functions of the rectum is to absorb fluid, increases the risk of HIV transmission because the HIV retrovirus reproduces within the immune system's T-cells/CD4 cells. Use of condoms and other precautions are a medically recommended way to lessen risk of infections. Unprotected receptive anal sex is the most risky sexual behavior in terms of HIV transmission.

Physical damage

Physical damage to the rectum and anus can manifest as generalized ano-rectal trauma, hemorrhoids, anal fissures,[2] anal fistula and rectal prolapse. Damage is more likely if anal sex is done without consent, if alcohol or other drugs have dulled sensitivity, if communication is poor, or if technique is clumsy.


Incontinence has also been reported; the result of the anal sphincter losing its tonus. A 1993 study published in the Journal of the Royal Society of Medicine found that out of a sample of forty individuals receiving anal intercourse, fourteen experienced episodes of frequent anal incontinence. Tristan Taormino argues in her book The Ultimate Guide to Anal Sex for Women that proper technique, clear communication, and mutual consent can reduce the risk of incontinence.

Protective measures

As the rectum has no natural lubrication, artificial lubrication is most often required or preferred when penetrating the anus, either with natural appendages or artificial devices.

Because the vaginal opening is located so closely to the anus, without proper precautions it is not uncommon for sexual partners to spread bacteria from the anus into the vagina, as well as the urethra, the repercussions of which can include urinary tract infection (UTI), which can lead to infection of the kidneys. Latex gloves or condoms are used to reduce the risk. It is also possible to take acceptable measures separate from such protection, which include (but are not limited to) hand washing and being conscious and wary of where one's hands and devices are placed.

Condoms are alleged to be less effective and more prone to burst or slip during anal sex than vaginal sex. While one study estimates that condoms fail anywhere from 10% - 32% of the time during anal sex, SIECUS indicates a much lower failure rate of 0.5 to 12%.>

Some manufacturers offer "extra strong" condoms designed specifically for anal intercourse. These condoms, while stronger, are usually not coated with spermicide and so offer less protection against pregnancy should semen enter a woman's vagina, but will lessen the chance of irritation to the sensitive anus area.

In a 1998 joint conference of the Society for the Scientific Study of Sexuality and the American Association of Sex Educators, Counselors, and Therapists, Jack Morin recommended Kegel exercises for people interested in anal sex to eliminate the possibility of loss of muscle tone, though he claimed he'd never observed muscle loosening himself and the comment was primarily concerned with insertion of fists and large objects.

The danger of cancer may be partially alleviated through the use of a new vaccine. According to Dr Anne Szarewski, "Men who have sex with men are at a much higher risk than average of anal cancer and genital warts, particularly if they are HIV-positive," and this population may also benefit from the human papillomavirus vaccine, presently licensed for use in children.

Legal issues


The legal status of anal sex varies greatly between jurisdictions. From being completely open and legal, to being illegal for male to male participation, to only being legal in marriage or even totally outlawed. In some areas where anal sex may otherwise be legal and the participants are above the general age of consent there exists a higher age of consent for anal sex.

United States

Until 2003, the status of whether anal sex was a crime varied from state to state. In some states, the practice was illegal. New York,[3] Montana,[4] Kentucky,[5] Pennsylvania,[6] and Georgia[7] had their anti-sodomy laws challenged and struck down by state supreme court decisions, but other states, including Texas,[8] upheld their state's laws criminalizing such conduct.

The United States Supreme Court, in 1986, decided the case of Bowers v. Hardwick, 478 U.S. 186. It decided there was no constitutional right to privacy with respect to acts of anal sex performed in the privacy of one's home. A Georgia law criminalizing consensual sodomy in the privacy of one's home was therefore found not to be unconstitutional. The Supreme Court of Georgia, in the case of Powell v. Georgia 270 Ga. 327, 510 S.E. 2d 18 (1998), however, later found that statute inconsistent with the Georgia state constitution.

In 2003, the Supreme Court revisited Bowers in the case of Lawrence v. Texas, 539 U.S. 558, and found the Texas law against consensual sodomy to be unconstitutional. This invalidated all statutes in the United States that would make consensual sodomy illegal. The principle has also been held applicable in other cases; the Supreme Court of Virginia decided in Martin v. Ziherl, 607 S.E.2d 367 (Va. 2005), that the generally unenforced law against fornication was unconstitutional based on Lawrence.

Cultural issues

Historically, a number of cultures have recorded the practice of male-male anal intercourse. The males who participated in such homosexual relationships often did not do so exclusively, as participation in these male-male relationships did not preclude sex with women. Such relations have also been documented as taking place in houses of prostitution, which provided youths or young men.

Ancient cultures

The term "Greek love" has long been used to refer to the practice, and in modern times, "Doing it the Greek way" is sometimes used as slang for anal sex. However, the view that homosexual anal sex was a universally accepted practice in Ancient Greece may be misleading. In Ancient Greece the practice was the butt of jokes in surviving comedies. Aristophanes mockingly alludes to the practice, claiming that "Most citizens are europroktoi (wide-arsed) now."[9] While pedagogic pederasty was an important part of society, these relationships were not necessarily sexual. There are very few works of pottery and other art that display anal sex between older men and boys, or even adult men. There are many more such works depicting intercrural sex, which was not condemned for feminizing the boys. Other sources make it clear that the practice was criticized as shameful.[10]

Anal sex was considered permissible only with youths who had attained the proper age, but had not yet become adults. Seducing children into the practice was considered very shameful for the adult, and having such relations with a male who was no longer adolescent was considered more shameful for the male than for the one mounting him. Greek courtesans, or hetaerae, are said to have frequently practiced heterosexual anal intercourse as a means of preventing pregnancy, a matter in dispute.[Citation needed] How acceptable anal sex was may also have varied with the time-period and the location, as Ancient Greece spanned a long time and stretched over three continents and two major seas.

For a male citizen to take the passive role in anal intercourse was (traditionally) frowned upon in Rome, while playing the active role with a young slave was more likely to be ignored. In fact the Romans thought of anal sex as something particularly "Greek".[11]

File:Suzuki Harunobu Shunga.jpg
Japanese shunga-style print

In Japan, records (including detailed shunga) leave no question that at least some male-male couples did engage in penetrative anal intercourse.

Evidence suggestive of widespread heterosexual anal intercourse in a pre-modern culture can be found in the erotic vases, or stirrup-spout pots, made by the Moche people of Peru; in a survey[12] of a collection of these pots, it was found that 31 percent of them depicted heterosexual anal intercourse, more by far than any other sex act.

The 19th century anthropologist Richard Francis Burton has theorized that there is a geographical Sotadic zone wherein male/male penetrative intercourse is particularly prevalent and accepted; moreover he was one of the first writers to advance the premise that such an orientation is biologically determined.[13]

Western cultures

In many Western countries, anal sex has generally been thought taboo since the Middle Ages when heretical movements were sometimes slandered by rumours that their members practiced anal sex among themselves. At that time the mainstream Christian clergy was not celibate, but the highest orders of some heretical sects were, leading to rumours that their celibacy was a sign of their attraction to members of the same sex. The term buggery originated in medieval Europe as an insult used to describe the rumoured same-sex sexual practices of the heretics from the Buggre sect. This sect originated in medieval Bulgaria, where its followers were called bogomils, but when they spread out of the country they were called buggres (from the ethnonym Bulgars). Another term for the practice, more archaic, is "pedicate" from the [[Latin language|Lati

See also

  1. "In August 2000, the Ohio Department of Health reported a cluster of men with typhoid fever who denied having traveled abroad. To determine the cause and the extent of the outbreak, an epidemiological investigation was initiated in which 7 persons in Ohio, Kentucky, and Indiana with culture-confirmed Salmonella enterica serotype Typhi infection and 2 persons with probable typhoid fever were evaluated; all were men, and all but one reported having had sex with 1 asymptomatic male S. Typhi carrier." [1]
  2. [2]
  3. New York: People v. Onofre, 415 N.E.2d 936 (N.Y. 1980)
  4. Montana: Gryczan v. Montana, 942 P.2d 112 (1997)
  5. Kentucky: Commonwealth v. Wasson, 842 S.W.2d 487 (1992)
  6. Pennsylvania: Commonwealth v. Bonadio, 490 Pa. 91, 415 A.2d 47 (Pa. 1980)
  7. Georgia: Powell v. Georgia, 270 Ga. 327, 510 S.E. 2d 18 (1998)
  8. Texas' appeals court upholds its anti-sodomy statute: Baker v. Wade, 553 F. Supp. 1121 (N.D.Tex. 1982)
  9. [3]
  10. Aesop, "Zeus and Shame" (Perry 109, Chambry 118, Gibbs 528), in Fables
  11. Quignard, Pascal (1996) Le Sexe et l'effroi
  12. Rafael Larco Hoyle and Dr. Francisco Guerra, quoted in Tannahill, Reay (1992) Sex in History, p. 297-298
  13. Burton, Sir Richard Francis (1885). "Section D: Pederasty". "Terminal Essay", from his translation of The Arabian Nights. Retrieved 2006-04-03.