Why anal sex ‘taboos’ put ‘generation of women’ at risk: doctors

Anal sex isn’t the taboo sex act it used to be — especially among heterosexual women.

Indeed, the most recent statistics provided by the Centers for Disease Control and the National Center for Health Statistics showed that more than a third — 35% — of women aged 15 to 49 have tried anal sex with a male partner.

Those numbers, taken from a survey of more than 5,500 women between 2015 and 2019, are rising — perhaps by a lot, depending on who you ask. A similar survey of 880 “sexually active adults,” conducted by doctor-led butt health brand Future Method, showed that 70% of women have tried anal sex at least once.

In the spirit of a new age of sexual exploration and health awareness, a duo of surgical researchers published an editorial in the BMJ this week, urging more clinicians to talk to women about the potential risks of engaging in anal sex — particularly for those who feel pressured by their partners to do so.

“Clinicians may shy away from these discussions, influenced by society’s taboos,” wrote Tabitha Gana and Lesley Hunt, colorectal and consultant surgeons, respectively, with the UK’s National Health System. “By avoiding these discussions, we may be failing a generation of young women, who are unaware of the risks.”

Physicians and healthcare workers, especially those in primary care and family medicine, “have a duty to acknowledge changes in society around anal sex in young women, and to meet these changes with open neutral and non-judgemental conversations to ensure that all women have the information they need to make informed choices about sex,” the colleagues wrote.

Silence on the albeit sensitive subject, they continued, “exposes women to missed diagnoses, futile treatments, and further harm arising from a lack of medical advice.”

Gana and Hunt referred to a national survey of British women that outlined the top reasons why they’ve tried anal sex, including curiosity and personal pleasure. Unfortunately, for approximately a quarter of women, pressure from their male partners has played a significant role. The US is meanwhile expected to reflect similar trends.

“The pain and bleeding women report after anal sex is indicative of trauma, and risks may be increased if anal sex is coerced,” they wrote.

Anal sex can be safe and enjoyable for many, but the authors warned there are anatomical features to women that bring a different set of risks, such as incontinence, due to their “less robust” sphincter and weaker anal canal muscles compared to men. That’s one reason why women who engage in the act show increased rates of fecal incontinence and anal injury.

The surgeons point out that a majority of medical literature for patients pertaining to anal sex focuses on sexually transmitted illnesses, such as HIV, herpes and HPV — which can lead to certain cancers — but misses the aforementioned physiological risks, as well as the emotional toll of coercion.

In the absence of clinical guidance, women are looking to a “plethora of non-medical or pseudomedical websites to fill the health information void,” some of which “may increase societal pressure to try anal sex,” rather than helping women “make informed decisions,” the authors said.

“Hit television shows such as ‘Sex and the City‘ and ‘Fleabag’ may unwittingly add to the pressure, as they seem to normalize anal sex in heterosexual relationships or make it appear racy and daring,” they added.

Beyond shame or stigma, the doctors urge clinicians to overcome the fear of coming off as “judgmental” or even “homophobic” by raising these concerns with patients — insisting there are resources for them to learn how to approach the subject in a conscientious way.

“With better information, women who want anal sex would be able to protect themselves more effectively from possible harm, and those who agree to anal sex reluctantly to meet society’s expectations or please partners, may feel better empowered to say no,” Gana and Hunt conclude.