Ah, remember the real-life childhood scene of a mom or dad taking their child to the doctor, and after a certain age the doc would pop the question. You know, the really embarrassing one: “Are you sexually active?”
Maybe this happened to you. Even though the doctor was just trying to do their job, it’s awkward to answer questions about sex when you’re young. Even as adults, we worry about confidentiality and being judged.
But the term “sexually active” is somewhat confusing. Some may hear the phrase and think exclusively of penis-in-vagina (aka, P-in-V sex) but there’s a little more to it than that. Essentially, your doctor is probably trying to understand how high the chances of certain situations, like STIs or pregnancy, are for you.
So, what does sexually active actually mean, and why is it important? Let’s talk!
What Does Being Sexually Active Mean?
Like we said, being sexually active is more than just P-in-V sex. According to Healthline, it involves other kinds of sexual activity, “like fingering or handjobs, dry humping or other genital-to-genital contact, rimming or other types of oral sex, and anal penetration.” Basically, it involves skin-to-skin contact with one or more partners.
Teen Vogue says sex can be really individual, and the meaning can differ for each person. Some may define sex as narrowly as when both or more partners have an orgasm, for example. “Especially in the LGBTQ community, one’s definition of ‘sex’ is highly individual and certainly isn’t confined to p-in-the-v intercourse.”
Their article gives a historical answer to the question, “What is sex?” and highlights the way terms like “virgin” and “sexually active” developed in a patriarchal, heteronormative society that only counted heterosexual vaginal penetration as sex. While it’s totally fine to have individual ideas about what constitutes sex and being sexually active, we think it’s safe to say anything with skin-to-skin contact that could put you at risk of STIs and pregnancy would fall under the category of sexually active when your doctor asks this question.
Does Masturbation Count As Sexual Activity?
In a medical context, masturbation alone doesn’t really count as being sexually active. While we can, of course, have extremely fulfilling lives and enjoy sexual wellness without any partners, what your doctor really wants to know is if you’re at risk for STIs or pregnancy. Masturbation is the safest sex out there, so you don’t have to worry about either.
Mutual masturbation, in which two or more partners enjoy self-pleasure at the same time, is only a risk if there’s skin-to-skin contact as well.
Can My Doctor Tell If I’m Sexually Active?
This answer is a little less black and white, but probably not. The myth about “breaking a hymen” is just that, a myth. Some people are born with a hymen, a piece of tissue around the vaginal opening, but some are born with a partial hymen. It’s not uncommon for a woman to have no hymen at all. And although the hymen can be torn during physical sexual activities, it can also happen during exercise or other physical activity, and it’s impossible to tell which one may have caused it.
However, there are some normal signs of sexual activity doctors may notice. A recent viral TikTok described light bruising that can occur while giving a blow job, which dentists may sometimes notice. They don’t say anything or show concern, however, unless the patient is underage or shows signs of abuse or trauma. Health.com interviewed the dentist who says he made the TikTok because he hoped to make appointments less scary and confusing.
Semen can live in the body for up to about five days after unprotected sex, so if you’ve recently had anal or vaginal sex and have a scheduled examination, your doctor may notice that. But again—sex is normal, and there’s no reason to be ashamed.
When Should I Tell My Doctor If I’m Sexually Active?
For the good of your sexual wellness, it’s important to be honest with your doctor or other healthcare provider about your sex life. If you’re engaging in sexual activity or having skin-to-skin contact with others, it does put you at a certain level of risk for STIs and pregnancy. You may also have other sexual activity concerns, like erectile dysfunction or pain during sex, that affect your sexual health and wellness. Your sexual activity will also be important when you ask for birth control, even if you’re seeking it for another reason, like acne. Your doctor can help you make decisions about all the important sexual health questions, but only if you tell them the truth.
“It’s important to let health care providers know about other forms of sex that may put people at risk for sexually transmitted infections, such as anal or oral sex,” Planned Parenthood says on their website.
Young people worried about confidentiality can call ahead to ask about policies at the doctor’s office, but local law and office policies can change when certain things about sexual intercourse or health need to be disclosed.
Teen Vogue puts it succinctly, saying, “There are sex acts that can cause pregnancy and STIs, and there are ones that don’t.”
If you’re engaging in sexual activity that could result in either of those things, your doctor needs to know! When in doubt, be honest.
We hope you now have a better understanding of what being sexually active means, and that you can use this knowledge to improve your sexual health and wellness. We’ve said it before but we’ll say it again: there’s no shame in whatever consensual sexual activities you and your sexual partners enjoy. Bringing your doctor into the conversation ensures you can keep enjoying them safely.