Considering sexual and reproductive health as an essential part of Human Health and well-being, the World Health Organization (WHO) has created, in 2023, the Sexual Health Assessment of Practices and Experiences (SHAPE) Questionnaire.
This questionnaire was translated into several languages. Its first implementation worldwide happened with a representative sample of the Portuguese population and was carried out by the Research Group on Sexuality and Gender of the Psychology Center at the University of Porto (CPUP), one of the Research centers based at the Faculty of Psychology and Education Sciences of the University of Porto, in Portugal.
This includes innovative and comprehensive data on the Sexual Health and sexual behaviors of the Portuguese population, including: sexual biography, sexual practices, sexual violence, discrimination, sexual identity and rights, sexual difficulties, among others.
Results point out that the majority of people (74%) started their sexual activity with another person between the ages of 15 and 21 years (average of 18.9 years). Regarding sexual practices, 2.7% of people reported that they never had any sexual experience with another person, 16.6% of people never performed oral sex, 14% never received oral sex and 13.7% never masturbated. Women reported significantly less involvement in these sexual practices compared to men, and hetero-cisgender also reported less involvement compared to LGBT+ people. 9% of respondents stated that they had at least one sexual experience with more than one gender.
Regarding frequency of sexual activity, results indicate that in the four weeks prior to the study, 34.9% of the respondents had no sexual activity and 60.8% had a sexual activity with just one person. Among the people who had sexual activity in the previous four weeks, the average was 5.3, that is, slightly more than once a week (the most frequent response is just once a month).
Around half of the people who participated in the study were dissatisfied with their sex life, with 20% reporting having sexual difficulties that cause significant distress. The most reported sexual problems were difficulties with ejaculation in men (11.7%) as well as orgasm in women (11.3%), followed by sexual pain in women (10.7%), low sexual desire (10. 6%) and erectile dysfunction (10.4%). Less frequent, but still relevant, are difficulties with arousal in women (8.7%) and premature ejaculation in men (7.1%).
Data on sexual violence estimates that 9% of the population has been forced or threatened by another person to do something sexual, with 1.8% being forced into having sex for their first sexual experience with another person. Women were three times more victimized than men, while LGBT+ people were 6 times more victimized than the hetero-cisgender population. Moreover, the results indicate that 9% of the population feels little or not at all safe from sexual coercion outside the house and 1.5% inside the house, particularly women.
In terms of sexual orientation and gender identity, the results showed that 93.4% of people identify as heterosexual, 6.6% as Lesbian, Gay, Bisexual (LGB)+ and 0.5% as non-cisgender / transgender. 37.7% of LGBT+ people say they were discriminated against based on their sexual orientation (of these, 40% were discriminated against in the previous year, despite the existing legal protections) and 3.2% were discriminated against based on their gender identity. Sexual orientation was also the cause of discrimination in access to employment or in the job itself for 27% of the respondents. 31% of people say they have been discriminated against by healthcare professionals.
The assessment of the link between sexual health and the different dimensions of global health and well-being shows that the satisfaction with sexual life is positively associated with the perception of physical and mental health, as well as with quality of life, and well-being, that is, the greater the satisfaction with sexual life, the greater the perception of physical and mental health, quality of life, and well-being.
Overall, these results capture an important snapshot of the state of sexual health in Portugal and draw attention to a set of problems related to sexual violence, discrimination based on sexual and gender identity and sexual difficulties, which demand the urgent development of evidence-based public policies.
The goal of the Research Group on Sexuality and Gender is to create a Sexual Health Observatory that systematically and regularly uses global questionnaires such as SHAPE, allowing the assessment of the evolution of sexual health indicators and sexual behaviors in the Portuguese population. Those indicators would be the basis of the development and implementation of public policies that promote the health and sexual rights of all people.
