Going Down is Coming Up: Oral Sex and its Confusions

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Considering it matches intercourse as common sexual fantasy, as an acceptable and prevalent sexual act, as a part of the normative American sexual script, as a popular Google search term (47 vs. 42 million hits, respectively), and as a method of facilitating presidential impeachments (leading 1-0 in this category), oral sex is still somewhat of a puzzlement—a slippery concept of ambiguous status. 

For example, despite periodic media frenzies bemoaning an epidemic of casual teenage oral sex, research suggests that most adolescents and young adults experience oral sex in the context of a romantic relationship and perceive it as an intimate sexual act. Moreover, having oral sex with someone who isn’t your partner is widely regarded as sexual cheating. 

At the same time, oral sex is commonly regarded as less intimate than intercourse, requiring a lesser level of commitment. 

For some, it is not sex at all. A 1998 Gallup poll showed that roughly 14 percent of people questioned agreed with then president Clinton’s famous contention that oral sex wasn’t sex. A study from 1999 with a sample of 599 Midwestern college students found that 59 percent did not think oral-genital contact constituted having sex. Only 20 percent of young participants in a more recent (2007) sample of college students thought oral sex constituted sex. Some even view oral sex as a form of abstinence, as many youngsters practice it as a substitute for sex, and consider themselves virgins. 

So if you’re having oral sex with someone other than your romantic partner, you may be sexually unfaithful without having had sex. Hmm.

Complications also abound when we consider oral sex in the context of sexual health and safety. As birth control, oral sex is safe and effective, insomuch as it facilitates sexual arousal, increases intimate bonding, and leads reliably to orgasm without the risk of pregnancy.

However, in the context of sexual health, oral sex is indeed risky. It may serve as transmission vehicle for multiple STIs including HIV, HPV (human papillomavirus), HSV (herpes simplex virus), hepatitis C, and a host of bacterial infections, such as syphilis and gonorrhea. 

Moreover, while transmission via oral sex is less likely than via intercourse for many STIs, notably HIV, oral sex is often practiced in lieu of intercourse, with more partners who are less likely to be exclusive. People are much less likely to use protection when engaging in oral sex. Dental dams—pleasantly colorful and scented as they may be—are still vastly less popular (and less well marketed) than condoms.

Thus, while safer in theory, oral sex might prove riskier than intercourse in practice when it comes to STIs.

The considerable prevalence and persistence of the practice throughout history and around the world, coupled with the fact that it serves no clear and direct reproductive function, have made it a topic of interest for evolutionary psychologists.

For example, Oakland University researchers Michael Pham, Todd Shackelford, and Yael Sela, have argued that the practice might serve an evolutionary function in the struggle for mate retention. They found that, “men at a greater recurrent risk of sperm competition expressed greater interest in, and spent more time performing, oral sex on their partner.” 

Also, “men who report performing more mate retention behaviors, in general, and more benefit-provisioning mate retention behaviors, in particular, also report greater interest in, and more time spent, performing oral sex on their female partner. Likewise, women who report performing more benefit-provisioning mate retention behaviors also report greater interest in, and more time spent, performing oral sex on their male partner.” 

In other words, in the competitive sexual hospitality business, servicing your partner orally constitutes that extra personal touch, as it were, that may keep them as repeat customers and prevent them from taking their business elsewhere.

Be that as it may, the non-reproductive aspect of the practice is one reason why oral sex is considered a B-lister in the hierarchy of what constitutes "having sex." This fact may also contribute to the practice’s glaring absence from sex education curricula in the U.S. This absence is emblematic of the fact that sex education in U.S. schools, to the extent that it exists, takes a defensive approach, emphasizing the hazards of sex while stridently sidestepping its positive pleasure and play aspects. In other words, our sex education avoids discussing the reasons most people actually have sex. Hmm.

Then there’s Sigmund Freud, who no doubt contributed to the practice’s inferior status by theorizing that a taste for oral pleasure constituted a neurotic fixation in an infantile stage of psychosexual development. In other words, a Libido Army that took too many early casualties conquering the provincial Oral Town may not have sufficient forces left to conquer the capital city of Intercourse. Robust evidence in support of this view is yet (and unlikely) to be produced.

Actually, a strong argument can be made that a taste for oral sex in fact reflects a refined and elevated sexual consciousness. The fact that oral sex is not reproductive aligns it with the higher realms of human experience, shaped primarily by social, psychological, or even spiritual motives. Notable in this context is the fact that the "giving" aspect is paramount in oral sex, and the focus is on the receiving partner’s pleasure.

Moreover, the traditional hegemony of intercourse can be viewed as having emerged in part from an increasingly passé consciousness that privileges heterosexuality. As gay and lesbian lovemaking attains normative status, non-reproductive bonding and pleasure acts such as oral sex stand to gain in stature as well.

Finally, oral sex is superior to intercourse in at least two additional ways:

1. For most women, it is a significantly more reliable method of achieving orgasm.
2. Oral sex can continue to be a source of sexual pleasure long after old age has taken away erection and adequate vaginal lubrication. 

The ambivalence surrounding oral sex stems in part from the imprecision of the term itself. In fact, "oral sex" packs together two separate and distinctive actions that are usually performed independently: oral stimulation of the penis (fellatio), and oral stimulation of the clitoris and vulva (cunnilingus).

As commonly deployed, the term "oral sex" connotes—and is often confused with—heterosexual fellatio alone. As the researchers Laina Bay-Cheng and Nichole Fava wryly note, “It is hard to imagine journalistic exposés such as the book and documentary of the same title, Oral Sex is the New Goodnight Kiss (Azam, 2009), being mistaken as warnings about rampant cunnilingus.”

Cunnilingus and fellatio are better regarded as unique and distinctive sexual practices underlined by different psychological processes, and carrying different social and personal implications.

For example, the relative absence of cunnilingus from casual hook ups, compared to the relative high prevalence of fellatio in such encounters, has been identified as one reason for the "orgasm gap:" the finding that women are less likely to orgasm in hookups than men. 

Further, recent work of Laina Bay-Cheng of the University of Buffalo School of Social Work and her colleagues found no associations between the age of initiation of cunnilingus and psychological functioning or sexual coercion in a sample of young women. Moreover, while engaging in fellatio at a younger age was associated with lower self esteem among the women in the sample, those who initiated cunnilingus at younger ages were more likely to report engaging in sexual intercourse for personal gratification and in order to feel assertive, agentic, and skillful.

“Cunnilingus,” the researchers conclude, “may involve young women’s advocacy on behalf of their own desires and the prioritization of their own sexual pleasure.”

Now, there’s a finding worth discussing in Sex Ed class.