When partners differ in their desire for sexual activity, conflict may ensue until one partner prevails. The partner who does not want sex may avoid the activity by using tactics ranging from gentle persuasion to firm refusal. Alternatively, the couple may engage in sexual activity because the partner who does not want to does not express that preference and instead complies with the other partner's desires, is pressured into consenting or is forced to have nonconsensual sex.

The concept of consensual versus nonconsensual sex should not be confused with that of wanted versus unwanted sex.¹ A person may want sex but may have reasons not to consent—for example, he or she may feel that it is too early in a relationship to have sex. Or a person may have unwanted but consensual sex for a variety of reasons, such as to maintain a sense of intimacy with his or her partner, satisfy his or her partner, or avoid interpersonal tension. Both men and women commonly report that they have consented to unwanted sex.^1,2

Voluntary participation in a sexual activity may entail a range of feelings about the activity, from extreme distaste to great desirability. For example, the 2002 National Survey of Family Growth asked 15–24-year-old women who described their first sexual intercourse as voluntary to also describe how they felt about that activity. Only 37% said they had really wanted that activity to happen, while most said they had had mixed feelings.³ For 7% of the women, their first voluntary sexual intercourse was unwanted altogether. Thus, some young adults participate in unwanted sexual activities that are not forced. These activities may be the result of pressure or more subtle coercion from the partner. Alternatively, individuals may freely consent to unwanted activity because of a desire to please their partner or because of their own beliefs about what is expected or is "supposed to happen" in a romantic relationship. This study focused on first sexual intercourse, but other sexual activities (e.g., nonvaginal activities and intercourse beyond the first time) are also likely to result in a range of subjective judgments by participants, such as whether the activity was liked or disliked. These activities should be included in studies of how desirable sexual activities are to those who participate in them.

Freely consenting to unwanted sex is associated with both positive and negative outcomes. It can provide satisfaction to the partner and avert relationship tension, but also lead to emotional and physical discomfort.² When the motivation for consenting to unwanted sexual activity is the hope of obtaining a positive outcome, such as partner happiness or increased intimacy, an individual's well-being and relationship quality are relatively high; however, when the motivation is the wish to avoid a negative outcome, such as conflict or the loss of the partner, well-being and relationship quality are relatively poor.⁴ In addition, consenting to unwanted sex is associated with a history of sexual victimization.⁵

When a person pressures or coerces a partner into consenting, avoidance motivations likely play a role in the partner's consent. The partner's resistance may be evident in anything from a subtle withdrawal and nonparticipation to verbalized refusal and physical struggle. While all of these situations involve some level of coercion, they clearly vary in intensity and may or may not ultimately involve the consent of both partners.

Both men and women experience sexual insistence (pressure or coercion) within established romantic relationships.^6–13 In a study conducted among college students, 58% of men and 78% of women said that their partners had employed some tactic to press for sex even after they had refused; 43% and 26%, respectively, reported having used such tactics themselves.¹³ Nonphysical pressure and coercion tactics have also been tied to a greater willingness to use force to obtain sex and to acceptance of myths about interpersonal violence and rape.^14,15

Although studies on sexual behavior often focus on characteristics of individuals, sexual activity usually takes place within couples, which provide a psychosocial context for such behavior and decision making. Interdependence theory assumes that if individuals remain in a relationship, they must consider even low-quality outcomes within the relationship at least marginally better than alternatives outside the relationship.¹⁶ However, the success of a person's behavior in influencing the quality of outcomes depends in part on his or her relative control within the couple, so each partner's desires or intentions might not have equal power over the outcomes. Strong feelings of love for a partner may make a person reluctant to risk disrupting the relationship, and perceptions that love is unequal in the relationship may change how much control each partner has. Thus, individuals with strong feelings of love may be more likely than others to report disliked sexual activities and may be less likely to terminate relationships after instances of partner insistence.

Gender roles and expectations also may influence individuals' perceived level of control over different types of activities. Young people may develop sexual "scripts," or elaborate sets of ideas regarding sexuality and their sexual roles, which serve as guidelines for what types of sexual behaviors are appropriate for which people with which partners.^17,18 Despite cultural shifts, gender continues to play an important role in how young people interpret and approach sexual negotiations.^17–20 Traditionally, women are socialized to play the role of relationship caretaker and to put their partners' needs before their own. Gendered sexual scripts of passive female sexuality may make it difficult for women to communicate preferences or objections to partners.²¹ Scripts may also cause women to believe that men need more sexual activity and that to maintain monogamous relationships with men, they must provide that activity. Men are socialized to pursue sexual activity with women; they may feel that they are expected to want that activity at all times. Therefore, men may feel pressure to defend their masculinity by participating in sex even when they do not desire it. They may also feel that they must initiate sex frequently.⁵ For these reasons, women may be more likely than men to report partner insistence or disliked sexual activities and may be less likely than men to end relationships after these events.

The literature on sexual compliance, pressure and coercion focuses primarily on college students, rather than on more broadly representative samples.^{5,8–11,13–15,22} Also, many of the studies examine lifetime sexual experiences, rather than placing sexual behavior within the context of a specific relationship.^11–14 While participation in unwanted sexual activities has received some attention,^1–3 a related but understudied issue is whether people actually like the sexual activities in which they participate. This topic merits attention because the ability to derive pleasure from one's sexual activities is an important part of sexual health.

To address the gaps in the literature, this study used a nationally representative sample of young adults, examined the relevance of relationship characteristics as a context for sexual negotiations, and considered not only experiences with sexual pressure or insistence but also participation in disliked sexual activities. The specific aims were to determine the role of gender and of relationship characteristics in determining whether young adults used or experienced sexual insistence and engaged in disliked sexual activities with their current partners.

METHODS

Sample

Data for this study came from Wave 3 of the National Longitudinal Study of Adolescent Health (Add Health) contractual data set. For the first wave of Add Health, a computer-assisted in-home questionnaire was administered to more than 20,000 students enrolled in grades 7–12 in 1994–1995. These respondents included a core of about 12,000 adolescents who constituted a nationally representative sample. Supplementary samples from groups that typically may not be represented in large enough numbers for meaningful analysis—such as children with disabilities; black children from highly educated households; and children of Chinese, Cuban or Puerto Rican background—were also obtained. Weights based on the respondent's estimated probability of inclusion are used to produce unbiased estimates. In Wave 3, conducted in 2001–2002, some 15,197 of the original Wave 1 respondents were reinterviewed. Respondents ranged in age from 18 to 26 years old at Wave 3. The interviews included questions on respondents' romantic relationships, sexual experiences and other behaviors. Sensitive questions on sexual activity were asked using computer-assisted self-interviewing technology.

In this study, the analytic sample was restricted to young adults in a current sexual relationship with a partner of the opposite sex; the relationship had to be of at least three months' duration^* and had to qualify as one of the respondent's two most important relationships (as categorized by a scheme that gave priority to current relationships, marriages and relationships that resulted in pregnancy). Of the 14,322 Wave 3 respondents who were assigned weights by Add Health, 4,469 were in a qualifying relationship and had complete data on demographic characteristics; vaginal, oral and anal sex activity with the current partner; occurrence of sexual insistence in the relationship; how much they liked various sexual activities; and perceived levels of love between partners. This group made up the study sample.

Measures

•Sexual insistence. Sexual insistence was defined to include any method of making or insisting that a reluctant partner engage in unwanted sexual relations. Respondents were asked, "How often have you insisted on or made [partner] have sexual relations with you when [he/she] didn't want to?" and "How often has [partner] insisted on or made you have sexual relations with [him/her] when you didn't want to?" For each question, respondents could indicate never, once, twice, 3–5 times, 6–10 times, 11–20 times or more than 20 times. A response other than "never" was coded as a yes for insistence perpetration (first question) or insistence victimization (second question).

•Repeated disliked sexual activities. Individuals may freely consent without pressure to sexual activities that they dislike or may consent because of subtle pressure that may not be captured by the sexual insistence question. Therefore, in addition to the direct question on sexual insistence, analyses include measures of disliked experiences. Respondents were asked if they had ever engaged in vaginal sex, fellatio, cunnilingus or anal sex with their partner. If they indicated they had engaged in a specific sexual activity, they were asked if they had done so once or more than once, as well as how much they liked participating in that activity with their partner. For the latter question, response options were "like very much,""like somewhat,""neither like nor dislike,""dislike somewhat" and "dislike very much." Respondents were then asked if they expect to engage in that activity with that partner again. Those who indicated that they disliked the activity very much and either had engaged in it more than once or expected to engage in it again were coded positive for repeating disliked sexual activities. By excluding people who disliked an activity but had engaged in it only once and did not expect to again, the measure does not count those who experimented with an activity once and then dropped it when they found it unappealing.

•Relationship characteristics. Type of relationship was categorized as dating, cohabiting or married. Love for partner and perceived love from partner were assessed by two questions: how much respondents loved their partner and how much they thought their partner loved them. Answer choices were "a lot,""somewhat,""a little" and "not at all." On the basis of these answers, the relationship was characterized as one in which the partners loved each other a lot, neither partner loved the other a lot, the respondent loved his or her partner a lot (not reciprocated), or the partner loved the respondent a lot (not reciprocated).

•Demographic characteristics. The analyses include respondents' current age (measured as a continuous variable), biological sex (male or female), and race or ethnicity (non-Latino white, Latino, black, Asian or other).

Analyses

Stata 7.0 was used to incorporate weights and adjust for Add Health's sampling design in all analyses, and to provide estimates that are standardized to the U.S. Census Bureau estimates of the demographic profile of the U.S. adolescent population.^23,24 Pearson design-based F tests were used to determine whether respondents experienced sexual insistence (perpetration or victimization) with their current partner and whether they repeatedly engaged in disliked sexual activities. Multiple logistic regression models were used to determine predictors of these outcomes. Because of significant interaction terms between gender and relationship characteristics, men and women were modeled separately to facilitate interpretation. Dummy variables were used to represent categorical concepts.

RESULTS

The sample comprised 1,788 males and 2,681 females, who were, on average, 22 years old. Forty percent were in dating relationships, and 30% each were cohabiting and married (Table 1). Eighty-five percent of respondents reported that they and their partners loved each other "a lot."

Bivariate Findings

Almost one out of 10 respondents reported experience with sexual insistence, and the proportions were similar for men and women; 4% of each reported perpetration, and 7–8% reported victimization. Of those who reported any insistence, 30% reported both victimization and perpetration, 52% reported victimization only and 18% reported perpetration only (not shown). Thus, sexual insistence often was mutual, and the majority of those who reported perpetration also reported victimization. Most respondents who reported sexual insistence behavior indicated that it occurred just once or twice. Victimization and perpetration were associated among both men and women (p<.05).

A significantly greater proportion of women than of men (12% vs. 3%) had engaged repeatedly in sexual activities they disliked, primarily fellatio and anal sex. Similar proportions of males and females who reported disliking an activity—61% and 66%, respectively—said that they had participated in it more than once (not shown). However, 81% of those who had engaged even once in a disliked activity were female, so females were at greater risk than males of being in the position to repeat a disliked activity.

The extent to which respondents liked sexual activities they had engaged in varied significantly by gender (Table 2). The large majority of both sexes (92% of men and 87% of women) liked having vaginal sex very much. While men who had received oral sex overwhelmingly liked it very much (84%), only 40% of women who had performed it liked it very much. However, only 8% of women who had engaged in fellatio disliked it somewhat or very much. The majority of men and women who had experienced cunnilingus reported liking it very much (62% and 75%, respectively). In contrast, only 51% of men and 14% of women who had had anal sex with their partner liked it very much; 41% of women reported disliking it somewhat or very much.

Most respondents who reported disliked activities did not report partner insistence, but for women, having a partner who had insisted on sex was associated with repeated disliked sexual activities (p&;.05—not shown). In addition, women whose partners had insisted on sexual activity were significantly more likely than others to report repeated disliked vaginal intercourse (4% vs. 0.5%), repeated disliked cunnilingus (4% vs. 1%), repeated disliked fellatio (15% vs. 5%) and repeated disliked anal sex (14% vs. 4%).

Multivariate Findings

•Insistence perpetration. Initial analyses of the overall sample, controlling for demographic and relationship characteristics, revealed no significant gender differences in the odds of insistence perpetration resulting in sexual relations. Analyses stratified by gender showed associations between relationship characteristics and insistence perpetration for both men and women (Table 3). Cohabiting and married men had higher odds than dating men of having insisted that their partner have sex (odds ratios, 2.9 and 2.7, respectively). Women who loved their partner "a lot" but felt that their level of love was not reciprocated had higher odds of perpetration than those in relationships with high levels of mutual love (3.9).

•Insistence victimization. In preliminary analyses, women had marginally higher odds of insistence victimization than men (odds ratio, 1.3; p=.06—not shown). Stratified analyses demonstrated that insistence victimization resulting in sexual relations was predicted by relationship characteristics for men and women (Table 3). Men in relationships with unreciprocated levels of love had higher odds of experiencing insistence victimization than those in relationships in which high levels of love were mutual (odds ratios, 3.3–3.7). Cohabiting women had higher odds of experiencing victimization than dating women (1.9). Women who reported that neither partner loved the other a lot or that one partner felt unreciprocated love also had elevated odds of experiencing victimization (2.7–4.2).

•Disliked activities. Women were significantly more likely than men to report having repeatedly engaged in sexual activities they disliked (odds ratio, 3.7—not shown). In addition, married women had higher odds of repeatedly participating in disliked sexual activities than dating women (1.8—Table 3).

DISCUSSION

Health professionals and relational therapists who provide services and guidance to young adults should be aware that a substantial proportion of relationships include sexual insistence and disliked sexual acts, particularly fellatio and anal intercourse. Both men and women may need education on the importance of accepting initial refusals and being sensitive to both a partner's unwillingness to engage in an activity and the true extent of a partner's dislike of certain activities. They may also need guidance on how to voice their own preferences and dislikes. Some individuals may need assistance to leave relationships if insistence is physical or highly coercive, causing them distress.

Consistent with results of previous research on coercion,^12,13 findings from this study suggest that rates of sexual insistence victimization are higher than rates of perpetration. While the differences likely reflect differences in the social desirability of reporting such acts, they may also reflect a failure of perpetrators to fully recognize that their partners are unwilling or that their own behaviors may be perceived as pressure or insistence.¹³ Differences in reports of sexual insistence stemming from misunderstandings or differing perceptions would highlight the need for better educational efforts to help men and women understand each others' perspectives. However, the reports of insistence perpetration by 4% of both men and women in this sample indicate that individuals often do understand their partners' initial unwillingness to have intercourse, but insist or employ coercive tactics anyway.

Sexual insistence was reciprocated in many relationships, and reports of perpetration and victimization were associated. These findings may imply that for some relationships, sexual insistence has become integrated as a component of sexual interactions, or that individuals who use coercive tactics tend to find partners who also incorporate coercion in their behavioral strategies. Mutual sexual insistence may have disturbing implications for maintaining open lines of communication within these couples regarding sexual desires and expression.

Multivariate analyses revealed some unexpected results. The factors predicting repeated disliked activities and experiences with sexual insistence were very different, indicating that even though these outcomes are associated with each other, they capture different phenomena. Gender was the primary predictor of repeated participation in disliked sexual acts, but was not associated with reports of sexual insistence, for which relationship characteristics were significant predictors.

The finding that women were more likely than men to have repeatedly engaged in disliked activities supports the role of gender as a critical factor in sexual scripts and sexual decision making. Combined with the finding that the majority of those who reported disliked activities did not report partner insistence, this finding indicates that many women freely comply with disliked sexual activities. These results are consistent with findings from studies indicating greater sexual compliance among women than among men.^2,5 Sexual scripts that emphasize male pleasure and portray men as insatiable aggressors and women as passive relationship caretakers increase the likelihood that women will experience all of these reasons to be compliant to a greater extent than men.

Young people might expect that their having unwanted sex will be reciprocated with benefits in some other area of the relationship. However, this is not necessarily true. For instance, if women are less likely than men to hold substantial power in a relationship or if their sexual sacrifices and favors are made quietly and go unrecognized, their compromises may not be reciprocated. In such cases, one partner may be consistently sacrificing in multiple areas of the relationship. We need more research on how sacrifices or compliance in sexual matters may be reciprocated in other areas of the relationship and how these dynamics may relate to gender and gender scripts.

Interdependence theory supports the hypothesis that individuals who feel they love their partner more than their partner loves them may be more likely than others to engage in disliked sexual activity. However, in the current study, love and the reciprocity of love did not predict disliked sexual activities.

Perceived patterns of love within a relationship were, however, associated with sexual insistence. These results support the idea that people who feel they are in nonequitable relationships may become distressed and try to restore equity.²⁵ Sexual insistence victimization was positively associated with respondents' feeling that they loved their partner more than their partner loved them, as expected. Respondents' increased level of investment in these relationships might make them less likely to dissolve a relationship, despite sexual pressure and insistence from their partner. However, sexual insistence victimization was also positively associated with respondents' feeling that their partner loved them more than they loved their partner. Perhaps individuals interpret a partner's insistence as a symbol of interest or love. Alternatively, individuals who do not think their partners reciprocate their feelings may insist on sexual activities as a way of relieving distress, increasing a sensation of control or restoring perceived equity to a relationship.²⁵

Although research on sexual coercion perpetration often focuses on male behavior,^15,26 the substantial level of male victimization reported here indicates that researchers should not assume that men always want sexual activity and should not exclude women from studies examining the use of sexual pressure, insistence and coercion. The findings suggests that relationship factors are more important than gender as predictors of sexual insistence.

Strengths and Limitations

This study contributes to the literature by examining sexual activities within the context of relationship characteristics and by using a nationally representative sample, rather than a college convenience sample, as is common in research on sexual compliance or sexual coercion.^5,27 In addition, the analyses examined both female and male insistence perpetration and victimization and participation in disliked activities. However, a number of study limitations must be kept in mind. The most substantial limitation is that these analyses do not distinguish between physical and nonphysical methods of sexual insistence or determine respondents' level of distress. Future research with representative populations would benefit from the use of more detailed measures of sexual activity and motivation.^22,26,28 In addition, the findings reported here are based on cross-sectional data, and causality cannot be assessed.

Reports of sexual insistence and disliked sexual acts in this study are conservative estimates. Because the sample was restricted to respondents in current relationships, these findings apply only to relationships that were at least three months old and had not dissolved as a result of sexual insistence or disliked sexual experiences. In addition, sexual insistence is a particularly sensitive area for self-reports, making underreporting likely. However, to minimize underreporting, Add Health uses computer-assisted self-interviewing, which can help provide privacy and improve reporting of potentially stigmatizing behaviors.^29,30

Conclusion

The occurrence of insistence and disliked activities in young adults' sexual relationships has critical implications for sexual health and development. Healthy sexual relationships are marked by expression and communication, but participating in unwanted or strongly disliked sexual behavior may involve dishonesty or feigning of desire or pleasure. In particular, experiencing insistence may make negative emotional outcomes more likely than freely agreeing to unwanted or disliked sex. Compliance motivated by avoidance—for example, to prevent partner anger—is associated with feelings such as fear and shame, and sexual passivity has been tied to reduced sexual satisfaction.^21,31 Ambivalent feelings about sexual activities and compliance resulting from insistence or from avoidance motivations may also increase the chances that individuals will not protect themselves against STDs.^5,32 Future research is needed to elucidate the subtle differences and interconnections between disliked sexual activities and the use of sexual insistence to pressure partners to engage in unwanted sex and how these dynamics influence sexual health outcomes.